Objective To investigate the clinical diagnostic value of anti-cyclic citrullinated peptide(CCP)antibody,anti-mutated citrullinated vimentin(MCV)antibody and 25-hydroxyvitamin D[25-(OH)D]in rheumatoid arthritis(RA)patients.Methods A total of 466 patients with RA who were admitted the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from August 2016 to November 2021 were included in RA group,100 patients with other autoimmune diseases and metabolic diseases without RA were included in non-RA group,100 healthy subjects were included in control group.Serum anti-CCP antibody,anti-MCV antibody and 25(OH)D were detected in three groups.Receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of anti-CCP antibody,anti-MCV antibody and 25(OH)D in RA.The correlation between anti-MCV antibody and clinical indexes in RA patients was analyzed.Results Serum anti-MCV antibody and anti-CCP antibody in RA group were significantly higher than those in non-RA group and control group(P<0.05).The serum 25(OH)D level in RA group was significantly lower than that in control group(P<0.05).The area under the curve(AUC)of anti-CCP antibody,anti-MCV antibody and 25(OH)D for the diagnosis of RA were 0.74,0.81 and 0.75,respectively.The AUC for the combined diagnosis of RA was 0.90,the sensitivity was 83.70%,and the specificity was 82.40%.Anti-MCV antibody was positively correlated with erythrocyte sedimentation rate and C-reactive proten(r=0.66,0.64,P<0.05),and negatively correlated with complement C3 and C4(r=-0.69,-0.62,P<0.05).Conclusion Anti-CCP antibody,anti-MCV antibody and 25(OH)D have good sensitivity and specificity for the diagnosis of RA,and anti-MCV antibody was helpful for the diagnosis of the disease activity.

Objective:To explore the diagnostic value of contrast-enhanced mammography (CEM) and MRI in differentiating benign and malignant breast lesions based on the 2013 breast imaging reporting and data system (BI-RADS) lexicon and the supplement on CEM.Methods:The clinical and imaging data of 83 patients with breast lesions from March 2019 to April 2022 in the Third Affiliated Hospital of Soochow University were retrospectively analyzed. Totally 100 breast lesions from 83 female patients aged 28 to 78 (49±14) years, were divided into benign lesions (50 lesions) and malignant lesions (50 lesions) according to the pathological results. The t-test, χ 2 test and Fisher′s exact test were used to compare the differences of clinical and imaging features between benign and malignant lesions, and these imaging features which had statistical differences were established CEM and MRI models by multivariate logistic regression analysis respectively. The receiver operating characteristic curves and the area under the curve (AUC) were used to assess the diagnostic efficacy of two models in differentiating benign and malignant breast lesions. Using the DeLong test compared the AUC. Results:Multivariate logistic regression analysis showed that associated features (OR=9.075,95%CI 1.430-57.570, P=0.019), lesion conspicuity (OR=6.180,95%CI 2.608-14.646, P<0.001), mass margin (OR=2.193,95%CI 1.405-3.422, P=0.001) and calcification distribution (OR=2.147,95%CI 1.157-3.986, P=0.015) were independent predictors of differentiating benign and malignant breast lesions in CEM, and then the predictive model of CEM was constructed. Time-signal intensity curve (OR=9.230, 95%CI 3.178-26.805, P<0.001), associated features (OR=5.289,95%CI 1.343-20.831, P=0.017) and mass margin (OR=2.192,95%CI 1.336-3.597, P=0.002) were independent predictors of differentiating benign and malignant breast lesions in MRI, and the predictive model of MRI was constructed. The AUC of CEM and MRI models for differentiating benign and malignant breast lesions were 0.947 and 0.930 respectively, and two models were no significant difference ( Z=0.68, P=0.494). Conclusion:The diagnostic efficacy of CEM and MRI in differentiating benign and malignant breast lesions is comparable based on the 2013 BI-RADS lexicon and the supplement on CEM.

【Objective】 To evaluate the efficacy and safety of percutaneous nephrolithotomy in Galdakao-modified supine Valdivia (GMSV) position and prone position in the treatment of renal calculi. 【Methods】 PubMed, Embase and Cochrane Library databases were searched systematically to identify all eligible studies. Literature collected were screened and data were extracted by three authors independently. RevMan5.4 software was used for Meta-analysis. 【Results】 A total of 9 articles were enrolled, including 7 randomized controlled studies and 2 case-control studies, with a total of 1 690 patients. The results of Meta-analysis showed that compared with the prone position group, the GMSV group had shorter hospital stay (WMD:-9.04, 95%CI:-16.85--1.22, P=0.02), shorter intraoperative radiation exposure (WMD:-1.23, 95%CI:-1.98--0.48, P=0.001), lower rate of complications (RR:0.72, 95%CI:0.59-0.88, P=0.001), but there were no significant differences in operation time, primary stone clearance rate, postoperative hemoglobin loss, blood transfusion rate, fever rate and non-tubulization rate. 【Conclusion】 Compared with percutaneous nephrolithotomy in prone position, percutaneous nephrolithotomy in GMSV position has the comparable stone clearance rate, but has significant advantages in hospital stay, intraoperative radiation time, and overall complications. It is safe for the treatment of renal stones and upper ureteral stones.

OBJECTIVE To establish the fingerprint and multi-component content determination method of Crataegus pinnatifida leaves from different producing areas， and to evaluate the quality of C. pinnatifida leaves and screen the differential markers. METHODS Seventy-eight batches of C. pinnatifida leaves were collected from Chengde of Hebei Province， Huludao of Liaoning Province， Yuncheng of Shanxi Province and Linyi of Shandong Province. High-performance liquid chromatography （HPLC） and Similarity Evaluation System for Traditional Chinese Medicine Chromatographic Fingerprints （2012 edition） were used to draw the fingerprints and conduct similarity evaluation. Grey correlation analysis， cluster analysis （CA）， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed by using SPSS 19.0， MetaboAnalyst 5.0 and SIMCA 14.1 software. The differential markers affecting the quality of C. pinnatifida leaves were screened with variable importance in the projection （VIP） value greater than 1 and the error line not exceeding the origin as the criterion. Using vitexin rhamnoside as an internal reference， the contents of chlorogenic acid， glucosylvitexin， hypericin and isoquercetin in 78 batches of C. pinnatifida leaves were determined by the same HPLC combined with quantitative analysis of multi- components by single-marker （QAMS）， and the results were compared with external standard method. RESULTS Eight common peaks were calibrated in the fingerprints for 78 batches of C. pinnatifida leaves from 4 producing areas. Five known components were identified， including chlorogenic acid （peak 1）， glucosylvitexin （peak 3）， vitexin rhamnoside （peak 4）， hypericin （peak 7） and isoquercetin （peak 8）； their similarities ranged from 0.871 to 0.998. Average relative correlations of samples from Chengde of Hebei Province， Huludao of Liaoning Province， Yuncheng of Shanxi Province and Linyi of Shandong Province were 0.538， 0.528， 0.462 and 0.435， respectively. CA and PCA showed that the samples from Chengde of Hebei Province and Huludao of Liaoning Province were roughly classified into one category， while the samples from Linyi of Shandong Province and Yuncheng of Shanxi Province were roughly classified into one category； VIP values of peak 1， 2， 3 and 5 were all greater than 1. By QAMS， the relative correction factors of chlorogenic acid， glucosylvitexin， hypericin and isoquercetin were 0.401， 0.993， 1.670 and 1.615 （RSD＜2%）. Compared with external standard method， except for isoquercetin in the two batches of samples （S39 and S41）， there was no significant difference in the content of each component in other batches of samples （the relative deviations≤ 5%）. CONCLUSIONS The established fingerprint and QAMS method are simple to operate and can be used to evaluate the quality of C. pinnatifida leaves. The sample from Chengde of Hebei Province is relatively good in quality. Chlorogenic acid （peak 1）， glucosylvitexin （peak 3）， and the corresponding components of peaks 2 and 5 may be differential markers affecting the quality of C. pinnatifida leaves.

OBJE CTIVE To establish a method for quality evaluation of Xin ’an capsule by combining fingerprint ， multi-component quantitative analysis and chemical pattern recognition analysis. METHODS High performance liquid chromatography（HPLC）combined with Similarity Evaluation System of TCM Chromatogram Fingerprint （2012 edition）were used to establish the fingerprints of 24 batches of Xin ’an capsules and evaluate the similarity. The common peaks were determined. The contents of glucosylvitexin ，rhamnosylvitexin，vitexin，hyperoside and isoquercetin in Xin ’an capsules were determined by the same HPLC method. Taking the common peak area of fingerprint as the variable ，MetaboAnalyst 5.0 tool was used to draw the cluster analysis （CA）heat map. SIMCA 14.1 software was used to perform principle component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）. RESULTS Twelve common peaks were identified with the similarity greater than 0.97. Six common peaks were identified as chlorogenic acid ，glucosylvitexin，rhamnosylvitexin，vitexin，hyperoside and isoquercetin.The linear range of glucosylvitexin ，rhamnosylvitexin，vitexin， hyperoside and isoquercetin were 2.36-151.35，9.15-585.20， 1.20-76.50， 0.68-43.20， 0.44-27.90 µg/mL（all r＞0.999）.RSDs of precision ，repeatability and stability （24 h）tests were 163.com all less than 2.00％ . The average recoveries were 95.80％（RSD＝0.96％ ，n＝6），102.10％ （RSD＝0.93％ ，n＝6）， 103.26％（RSD＝1.28％，n＝6），103.89％（RSD＝0.73％，n＝6） and 102.09％（RSD＝1.79％，n＝6），respectively. The contents of the five components were 0.988 8-1.559 1，4.336 6-11.220 1， 0.065 1-0.830 5，0.043 8-0.692 5 and 0.023 2-0.427 2 mg/grain，respectively. The results of CA and PCA showed that 24 batches of samples could be divided into three categories ，i.e. S 1-S15，S16-S18 and S 19-S24. PLS-DA showed that variable importance in projection values of the corresponding component of peak 6 and glucosylvitexin （peak 7），rhamnosylvitexin（peak 8），hyperoside （peak 10） and isoquercetin （peak 11） were greater than 1. CONCLUSIONS The established HPLC fingerprint and multi-component quantitative method are simple and feasible. Combined with chemical pattern recognition analysis ，it can be used for the quality control of Xin ’an capsules. Glucosylvitexin ，rhamnosylvitexin and other components may be differentital markers affecting the quality of each batch of samples.

Objective:To investigate the value of multimodal MRI radiomics in the preoperative prediction of Fuhrman nuclear grade of clear cell renal cell carcinoma (ccRCC).Methods:A total of 129 patients with ccRCC confirmed by pathology from April 2011 to April 2021 in Third Affiliated Hospital of Soochow University were collected, and the imaging and clinicopathological data were retrospectively analyzed. All patients were divided into training set ( n=90) and validation set ( n=39) at the ratio of 7∶3 using random indicator method. According to the postoperative pathological results, Fuhrman grades Ⅰ and Ⅱ were included in the low grade group (96 cases, 65 cases in the training set and 31 cases in the validation set), and Fuhrman grades Ⅲ and Ⅳ were included in the high grade group (33 cases, 25 cases in the training set and 8 cases in the validation set). Two radiologists manually delineated regions of interest (ROI) on T 1WI, T 2WI, Dixon-water, Dixon-fat, susceptibility weighted imaging (SWI), blood oxygen level dependent (BOLD) images, and 396 texture features were extracted from each ROI. In the training set, intra-class correlation coefficient, Mann-Whitney U test, minimum redundancy maximum relevance and least absolute shrinkage and selection operator method were used to reduce the dimension of features to obtain the best texture features. The logistic regression was used to develop the multimodal radiomics model, and the receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of the model in identifying high and low-grade ccRCC in training set and validation set. Results:Four SWI, one T 2WI and one BOLD texture features were selected for modeling. The areas under the ROC curve (95%CI) of the multimodal radiomics model for identifying high and low grade ccRCC in the training and validation sets were 0.859 (0.770-0.923) and 0.883 (0.740-0.964), with the specificity at 95.4% and 87.1%, the sensitivity at 68.0% and 87.5%, the accuracy at 87.8% and 87.2%, respectively. Conclusion:The multimodal MRI radiomics model based on T 2WI, SWI and BOLD images has high effectiveness in preoperative predicting Fuhrman nuclear grade of ccRCC.

Objective:To explore artificial intelligence technology and propose an algorithm for automatic identification of dicentric chromosomes to realize fast and high-throughput biodosimetry. In order to solve the time-consuming and laborious problem of manual analysis of dicentric chromosomes.Methods:Combining artificial intelligence technology and image processing technology, based on MATLAB software, algorithms like image preprocessing, threshold segmentation algorithm, binarization processing, area identification algorithm, convolutional neural network algorithm and double centripetal recognition algorithm were applied. A fuzzy membership function was defined to describe the degree of each chromosome belonging to a dicentric chromosome, and the discrimination threshold was set to realize the automatic identification of dicentric chromosomes.Results:Through the test on 1 471 chromosome images, compared with manual recognition, the detection rate of dicentric chromosomes cells of this algorithm reached 70.7%.Conclusions:This algorithm method carries out a preliminary study on the automatic identification of dicentric chromosomes with good result.

Objective: To investigate the protective effect of cordycepin( Cor) on cardiac function in aged rats and its mechanism． Methods : The aged rats were divided into Model group，Cor administration group ( Cor 5，10，20g / kg) ，and young rats were used as Control group ( Control) ．The levels of heart rate (HR) ，left ventricular e- jection fraction (LVEF) and fractional shortening (FS) were detected by echocardiography．The levels of creatine kinase MB ( CK-MB) ，myohemoglobin (Mb) ，cardiac troponin Ⅰ (cTnI) ，superoxide dismutase (SOD) ，malon- dialdehyde (MDA) and lactate dehydrogenase ( LDH) were detected by ELISA．The pathological morphology of heart tissue was observed by HE staining． The apoptosis of myocardial cells was observed by TUNEL staining. Western blot detected the protein expression of cysteine aspartic protease 9 ( Caspase 9) ，cleaved cysteine aspartic protease 9 (cleaved Caspase 9) ，cysteine aspartic protease 3 ( Caspase 3 ) ，cleaved cysteine aspartic protease 3 ( cleaved Caspase 3) ，nuclear factor E2 related factor 2 (Nrf2) ，phosphorylation nuclear factor E2 related factor 2 (p-Nrf2) ，quinone oxidoreductase 1 (NQO1) ，heme oxygenase 1 ( HO-1) . Results : Compared with the elderly model group，HR , LVEF ，FS increased ，CK-MB ，Mb ，cTnI levels decreased ，MDA ，LDH content decreased， SOD activity increased，cleaved Caspase 9 / Caspase 9，cleaved Caspase 3 / Caspase 3 expression decreased，The ex- pressions of Nrf2，NQO1 and HO-1 were increased，and the pathological morphology of cardiac tissue and myocar- dial apoptosis were improved in Cor groups． Conclusion Cor can improve cardiac function of elderly rats，relieve oxidative stress response，inhibit myocardial cell apoptosis and have a certain protective effect on cardiac tissue in- jury in rats，and the mechanism may be related to the promotion of Nrf2 / HO-1 pathway related protein expression.

Objective To design and build a set of experimental equipment for neutron radiation irradiation by using the ²⁴¹Am-Be neutron source. Methods In the preliminary work, the spatial distribution data of the neutron energy spectrum and the gamma energy spectrum inside and outside the device were simulated by Monte Carlo method, and the changes of radiation fluence rate with spatial distribution was studied. The model of the ²⁴¹Am-Be neutron device was established, and the neutron transport process in the irradiation field was studied using the method of shadow cone, inverse square law and other data analysis methods. Results Based on the simulation results, the normalized effective does of fast neutron fluence at the measurement point is about 72.9 pSv/n, and the one of photon fluence is about 3.04 pSv/γ. The ratio of effective dose of photon fluence to neuteon is about 4.17%. Conclusion Using Monte Carlo method, a standard model of ²⁴¹Am-Be neutron source was constructed, the shadow cone design was optimized, and the feasibility of using the shadow cone conversion method to establish a standard neutron source radiation device was discussed.

Objective:To explore the time series characteristics of 5 types of viral hepatitis in China and predict their incidence through effective models.Methods:The monthly incidence data of 5 types of viral hepatitis (A, B, C, D and unspecified) in China from 2009 to 2018 were collected for descriptive and time series analyses, decomposition methods were used to explore the seasonality in the form of seasonal indices and the long-term trend in the form of a linear regression model. Autoregressive integrated moving average (ARIMA) models were established for each type of viral hepatitis.Results:From 2009 to 2018, a total of 14 856 990 cases of viral hepatitis were reported, the seasonal index range of 5 types of viral hepatitis were all lower than 1, the seasonality of hepatitis E was significant, and its incidence was unimodal, but no obvious seasonality characteristics were observed for other four types of viral hepatitis. The incidences of hepatitis A, hepatitis E and unspecified hepatitis remained at lower levels, showing slow declines. Although the cases of hepatitis B accounted for the highest proportion (79.59%, 11 824 262/14 856 990) among 5 types of viral hepatitis, the decline was fastest (-0.01/100 000). The incidence of hepatitis C was on rise, and the rate of increase remained stable (0.005/100 000). The predicted incidences of 5 types of viral hepatitis in China from January 2009 to December 2018 fitted by ARIMA model were consistent with the actual incidences, and the mean absolute error percentage (MAPE) ranged from 3.756 8 to 8.068 3.Conclusions:Time series analysis on surveillance data is useful for better understanding the incidence of the viral hepatitis. The ARIMA model has good application value in the short-term prediction of viral hepatitis incidence in China.