Objective To establish an auxiliary method for diagnosis of mild traumatic brain injury based on serum GFAP rapid detection test strips using immunochromatographic technology labeled with quantum dot microspheres.Methods The quantum dot microspheres were coupled with GFAP antibodies.The detection conditions were optimized to obtain the fluorescence probe in order to prepare the immunochromatographic test strips.An auxiliary diagnostic method was established after optimization of detection conditions.Finally,the auxiliary diagnostic effect of the test strips was evaluated using clinical samples.Results The serum concentration of GFAP could be detected by the optimized test strips within 13 mins with a detection limit of 0.15 ng/mL,and no more than 70μL of the serum sample was required.In addition,good reproducibility was achieved by different batches of test strips(CV=10.7%).The detection sensitivity and specificity of the strips to mild traumatic brain injury using 51 clinical samples were 95.24%and 96.67%respectively,indicating good effects of detection.Conclusion The developed test strips are user-friendly with reliable results,which can facilitate field rapid diagnosis of mild traumatic brain injury in complicated wartime environments.

Objective:To explore the application value of optical surface monitoring system (OSMS) volume rendering technique (VRT) body surface imaging in intensity-modulated radiotherapy for thoracic tumors.Methods:A retrospective case series study was performed. The clinical data of 65 patients with thoracic tumors treated with intensity-modulated radiotherapy at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from September 2021 to October 2022 were retrospectively analyzed. In the first treatment,after cone-beam computed tomography (CBCT) scan and correction, VRT body surface images were obtained by using OSMS. In subsequent treatment, the VRT image was used as the benchmark and the 6-dimensional bed was automatically positioned to record the 6-dimensional bed positioning value. The CBCT scan was performed to record the translation and rotation errors of left-right direction (X-axis), head-foot direction (Y-axis) and front-rear direction (Z-axis). After the calibration of the 6-dimensional automatic bed shifting, the new real-time deltas (RTD) value of digital imaging and communications in medicine (DICOM) body surface image was recorded, and the new VRT image was obtained. CBCT registration error value was defined as VRT image-guided setup error. The sum of CBCT registration error value and moving bed movement value was defined as the body surface marker line-guided setup error. The sum of CBCT registration error value and the recorded DICOM image RTD value was defined as the theoretical error of DICOM image-guided setup. The advantages and disadvantages of VRT image, body surface marker line and DICOM image-guided setup were compared and analyzed.Results:There were 42 males and 23 females in 65 patients with thoracic tumors, and the age [ M ( Q1, Q3)] was 58 years (51 years, 64 years). The linear errors [ M ( Q1, Q3)] of VRT image-guided setup in X, Y and Z axes were 0.6 mm (0.3 mm, 1.2 mm), 1.2 mm (0.5 mm, 2.4 mm) and 1.1 mm (0.5 mm, 1.9 mm); and the rotational errors were 0.4° (0.1°, 0.7°), 0.4° (0.1°, 0.6°) and 0.4° (0.2°, 0.6°). The linear errors of the marker line-guided setup were 1.6 mm (0.9 mm, 2.6 mm), 2.2 mm (1.1 mm, 3.8 mm) and 1.0 mm (0.4 mm, 1.8 mm); and the rotational errors were 0.7° (0.3°, 1.2°), 0.5° (0.2°, 0.8°) and 0.5° (0.2°, 0.8°). The linear errors of the DICOM image-guided positioning were 1.1 mm (0.6 mm, 1.9 mm), 2.1 mm (1.0 mm, 3.4 mm) and 1.3 mm (0.6 mm, 3.1 mm), and the rotational errors were 0.6° (0.2°, 1.1°), 0.7° (0.3°, 1.1°), 0.7° (0.2°, 1.1°). Compared with the marker line-guided setup, except for Z-axis linear error ( P = 0.218), the VRT-guided setup errors were low (all P < 0.001). Compared with the DICOM imaging-guided setup, the VRT image-guided setup linear error and rotational error in X-, Y- and Z-axis were low (all P < 0.01). Conclusions:VRT image-guided setup is superior to traditional body surface marker setup and DICOM imaging setup; OSMS VRT body surface imaging can effectively improve the setup accuracy and stability of intensity-modulated radiotherapy for thoracic tumors, and reduce the setup errors.

AIM:To explore the protective effect of Xiaoxuming decoction(XXMD)on synaptic plasticity in the context of cerebral ischemia-reperfusion injury following ischemic stroke.METHODS:An oxygen-glucose depriva-tion/reoxygenation(OGD/R)model was employed in vitro using mouse hippocampal neurons(HT22 cells)to simulate ischemia-reperfusion injury.Cell viability was assessed using a CCK-8 assay to determine the optimal XXMD concentra-tion.The HT22 cells were divided into two groups:control and model(OGD/R).Cellular morphological changes were ob-served using an inverted microscope.The levels of IL-1β,IL-6 and TNF-α in the supernatant were quantified by ELISA.Ultrastructural changes were examined by transmission electron microscopy.Immunofluorescence staining was used to de-tect neuron markers NeuN and synaptic proteins NF200 and MAP2.The protein levels of NF200 and MAP2 were analyzed by Western blot.RESULTS:The highest cell survival rate occurred at an XXMD concentration of 100 mg/L(P<0.05).Compared with control group,the cells in model group exhibited round shape and shrinkage,mitochondrial swelling or vacuolization,and a marked decrease in survival rate.There were significant increases in IL-1β,IL-6 and TNF-α levels(P<0.05).Immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2 were notably reduced(P<0.05).Treatment with XXMD improved cell morphology,ultrastructure and survival rate(P<0.05),and decreased in-flammatory factor levels(P<0.05).Compared with model group,the cells in OGD/R+XXMD group showed significantly increased immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2(P<0.05).CONCLUSION:Xiaoxuming decoction may mitigate OGD/R-induced injury,potentially by inhibiting inflammatory responses and enhanc-ing synaptic plasticity.

Objective To study the influence of rosemary essential oil inhalation on the memory of mice experiencing sleep deprivation and to delineate the possible mechanisms involved.Methods C57BL/6J mice were randomly divided into four experimental groups in this study:a control group(Con),a control group with rosemary essential oil inhalation(Con+REO),a sleep deprivation group(SD)and a sleep deprivation group with rosemary essential oil inhalation(SD+REO).A 72-hour sleep deprivation model was induced using the multiple platform water environment method,with the Con+REO and SD+REO groups exposed to rosemary essential oil inhalation.Cognitive function was evaluated through Y-maze and novel object recognition tests.The hippocampal tissue was analyzed for superoxide dismutase(SOD)activity and the concentrations of malondialdehyde(MDA)and glutathione(GSH).ELISA was used to determine the levels of norepinephrine(NE),dopamine(DA),and serotonin 5-hydroxytryptamine(5-HT)in the hippocampus.The expression levels of postsynaptic density 95(PSD95)and brain-derived neurotrophic factor(BDNF)in the hippocampus were determined using immunoblotting techniques.Results Compared with the Con and Con+REO groups,the SD group demonstrated a significant reduction in the spontaneous alternation percentage in the Y-maze as well as the novel object recognition index.Additionally,there was a pronounced decrease in hippocampal SOD activity and GSH content,a substantial elevation in MDA levels,and a decrease in the levels of DA,NE,and 5-HT.The expressions of PSD95 and BDNF proteins also decreased.In comparison with the SD group,the SD+REO group exhibited a significant increase in the spontaneous alternation percentage in the Y-maze and the novel object recognition index.There was also a marked increase in hippocampal SOD activity and GSH content,a reduction in MDA levels and elevated levels of NE and DA.Moreover,the expressions of PSD95 and BDNF proteins were upregulated.Conclusion The inhalation of rosemary essential oil enhances the memory of sleep-deprived mice,and the underlying mechanism may involve the mitigation of oxidative stress within the hippocampal tissue,the modulation of neurotransmitter levels,and the facilitation of synaptic plasticity.

Objective: To investigate the relationship between tropomodulin 3(TMOD3) and the malignant biological characteristics of hepatocellular carcinoma, and the predictive potential of TMOD3 as a biomarker for the recurrence and metastasis of hepatocellular carcinoma. Methods: Firstly, the structure of TMOD3 and its subcellular localization in cells and tissues were analyzed using database of Human Protein Atlas. Then explored the differential expression of TMOD3 in hepatocellular carcinoma tissues and normal liver tissues and its impact on clinical pathological characteristics and prognosis using TCGA and GEO datasets. Subsequently, the STRING database was utilized to explore the interacting proteins of TMOD3, followed by enrichment analysis conducted using the Metascape database. Finally, Logistic regression was used to analyze the independent risk factors for metastasis of hepatocellular carcinoma and evaluated the importance of predictive variables using ROC curves and Wald tests. Survival analysis was conducted using the Kaplan-Meier curve and the Log-rank test. Results: TMOD3 was localized to actin filaments in cells, and compared with normal tissues, the expression level of TMOD3 in liver cancer tissues is higher(P<0.05), and high expression of TMOD3 was closely related to lymph node metastasis and distant metastasis of hepatocellular carcinoma patients(P<0.05). Enrichment analysis results revealed that TMOD3 and its interacting proteins mainly function and signaling pathways related to tumor invasion and migration. Logistic regression found that TMOD3 was an independent risk factor for recurrence and metastasis of hepatocellular carcinoma(OR: 4.359, 95%CI: 1.235-15.384,P=0.022). Survival analysis revealed that high expression of TMOD3 was associated with poor OS, DFS, and RFS of hepatocellular carcinoma patients(P<0.05). Both ROC analysis and Wald test indicated that TMOD3 has good predictive characteristics for recurrence and metastasis of hepatocellular carcinoma. Conclusion TMOD3 is closely associated with the invasion and metastasis of hepatocellular carcinoma and is an independent risk factor for the recurrence and metastasis of liver cancer. TMOD3 performs well in predicting the recurrence and metastasis of hepatocellular carcinoma and has the potential to become a biomarker for predicting the recurrence and metastasis of hepatocellular carcinoma.

OBJECTIVE To evaluate the innovation and sustainable development ability of traditional Chinese medicine(TCM) preparation in medical institutions, and to provide reference for the decision-making of administrative departments and the sustainable development of TCM preparation in hospitals. METHODS Based on the information data of 133 medical institutions in Zhejiang Province, analytic hierarchy process was used to construct the evaluation system of innovation and sustainable development ability of TCM preparation of medical institutions, and the prediction model of evaluation system of TCM preparation room/center was built by back propagation neural network. RESULTS The evaluation index system for innovation and sustainable development of TCM preparations in medical institutions included 4 second-level indexes and 19 third-level indexes. Among them, the number of varieties developed, the number of over one million varieties, the number of registered varieties, the way of research and development, and the area of preparation room had higher weight values, which were 0.15758, 0.12928,0.09343, 0.07879 and 0.07458, respectively. The entropy weight method and analytic hierarchy process index weights were used to construct the back propagation neural network. The overall correlation coefficients of the training models of the Levenberg-Marquardt algorithm and the Scaled Conjugate Gradient algorithm were 0.98983 and 0.93480, respectively. CONCLUSION This study establishes a scientific and effective comprehensive evaluation system for the innovation and sustainable development ability of TCM preparations in medical institutions, which can realize the prediction and evaluation of the comprehensive ability of TCM preparations in medical institutions.

BACKGROUND:Epidemiologic studies have shown a correlation between type 2 diabetes mellitus and bone mineral density,but the causal association between the two and whether it is age-related remains unknown. OBJECTIVE:To study the correlation between type 2 diabetes mellitus and whole body bone mineral density at unspecified age and at all ages based on the Mendelian randomization technique. METHODS:The genome-wide association study(GWAS)data of type 2 diabetes mellitus and bone mineral density at all ages were selected from the IEU GWAS database of the University of Bristol.The exposure data were single nucleotide polymorphisms with significant correlation with type 2 diabetes mellitus as instrumental variables,and bone mineral density at all ages was selected as the outcome variable.Two-sample Mendelian randomization analysis of type 2 diabetes mellitus and bone mineral density was performed using inverse variance weighted method,weighted median estimator,and MR-Egger regression.The βvalue was used to evaluate the causal relationship between type 2 diabetes mellitus and bone mineral density at all ages. RESULTS AND CONCLUSION:A total of 118 single nucleotide polymorphisms were extracted from the GWAS summary data as instrumental variables.The MR-Egger regression results showed that there was no horizontal pleiotropy,but there was heterogeneity.Therefore,this study was based on the inverse variance weighted results.Inverse variance weighted results showed that type 2 diabetes mellitus may be a potential protective factor for bone mineral density and is associated with age:age-unspecified bone mineral density[β=0.038,95%confidence interval(CI):1.01-1.07,P=0.002],bone mineral density over 60 years old(β=0.052,95%CI:1.01-1.09,P=0.027),bone mineral density between 45-60 years old(β=0.049,95%CI:1.01-1.09,P=0.009),bone mineral density between 30-45 years old(β=0.033,95%CI:0.99-1.07,P=0.127).bone mineral density of 15-30 years old(β=0.025,95%CI:0.95-1.10,P=0.506),bone mineral density of 0-15 years old(β=0.006,95%CI:0.96-1.04,P=0.716).Similar results were obtained from the MR-Egger regression and weighted median estimator analyses.These findings indicate that type 2 diabetes mellitus may be one of the protective factors of bone mineral density,and there is a correlation with age.

Objective:To evaluate the diagnostic value of thromboelastogram (TEG) parameters for cognitive impairment in patients with recurrent ischemic stroke (RIS), and construct a nomograph model.Methods:The clinical data of 75 patients with RIS and treated in the Yiwu Central Hospital from June 2020 to June 2022 were retrospectively summarized. Multivariate Logistic regression model was used to screen the risk factors of cognitive impairment in RIS patients. R software was used to establish a nomogram model, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of TEG index and nomogram on cognitive impairment in RIS patients.Results:The results of multivariate Logistic regression analysis showed that National Institutes of Health Stroke Scale (NIHSS) score on admission, stroke interval, change in clotting time 48 h after admission and 48 h before discharge (ΔR) and change in maximum clot intensity (ΔMA) were the risk factors for cognitive impairment 3 months after RIS ( P<0.05). Age, ΔR and ΔMA were the risk factors for cognitive impairment 12 months after the onset of RIS ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) predicted by the nomogram for cognitive impairment 3 and 12 months after the onset of RIS was higher than that of the patients with ΔR and ΔMA ( P<0.01). Conclusions:Detection of TEG parameters, especially ΔR and ΔMA, establishment of nomogram model have good practical value for guiding clinical rapid identification of high-risk patients with cognitive impairment.

Objective To compare the efficacy of thoracoscopic surgery and closed thoracic drainage in the treatment of stage Ⅰand Ⅱ empyema.Methods A retrospective analysis was performed for 62 patients with stage Ⅰ and Ⅱ empyema who were admitted to the Department of Thoracic Surgery of the First Affiliated Hospital of Bengbu Medical University from January 2018 to January 2023,and the patients were divided into drainage group(32 cases)and clearance group(30 cases)according to different types of surgery.The basic perioperative data and lung volume before and after surgery were compared between two groups.Results Both groups of patients successfully completed the operation.The duration of drain use,antibiotic use,fever,leukocyte recovery,albumin recovery and hospital stay in drainage group were significantly longer than those in clearance group(P＜0.05).The total complication rates of new atelectasis,air leakage,hypotension and arrhythmia in clearance group were significantly higher than those in drainage group,and the total complication rates of loculated effusion and persistent pulmonary infection were significantly lower than those in drainage group(P＜0.05).The overall prognosis of patients in clearance group was significantly better than that in drainage group(x2=7.398,P=0.007).One week after operation,the lung volume and the difference between before and after operation in clearance group were significantly higher than those in drainage group(P＜0.05).Conclusion Compared with closed thoracic drainage,thoracoscopic surgery can significantly increase lung volume,improve recruitment,and achieve better recovery and prognosis.

Objective:To analyze the causal relationship between SARS-CoV-2 infection and retinal vascular obstruction by mendelian randomization (MR).Methods:A two-sample MR analysis utilizing summary statistics from genome-wide association studies (GWAS) in European populations was conducted. The GWAS data for SARS-CoV-2 infection comprised cases of common infection (2 597 856), hospitalized infection (2 095 324), and severe infection (1 086 211). Data on retinal vascular obstruction were obtained from the FinnGen database, which included 203 269 cases of retinal artery obstruction and 182 945 cases of retinal vein obstruction (RVO). Inverse variance weighting (IVW), random effects models, weighted median (WM), MR-Egger regression, simple models, and weighted models were used to analyze the bidirectional causal relationship between different SARS-CoV-2 infection phenotypes and retinal obstruction. The Q statistic was used to assess heterogeneity among single nucleotide polymorphisms (SNP), while MR-Presso was utilized to detect SNP outliers, and MR-Egger intercept tests were performed to evaluate horizontal pleiotropy.Results:The MR analysis, using IVW, random effects models, MR-Egger, WM, and weighted models, indicated no significant association between common SARS-CoV-2 infection, hospitalized infection, severe infection, and retinal vascular obstruction ( P>0.05). Additionally, retinal vascular obstruction did not show a significant association with the various SARS-CoV-2 infection phenotypes ( P>0.05). In the simple model, a significant association was found between severe SARS-CoV-2 infection and RVO ( P<0.05), as well as between RVO and common SARS-CoV-2 infection ( P<0.05). No heterogeneity was observed in the IVW and MR-Egger analyses ( P>0.05). The MR-Egger test provided no evidence of horizontal pleiotropy ( P>0.05), and MR-Presso detected no outlier SNP. Conclusion:The findings of this study do not support a causal relationship between SARS-CoV-2 infection and the occurrence of retinal vascular obstruction.