OBJECTIVE Taking Professor Zhou Zhongying's clinical cases of treating hyperthyroidism as the research object,this article explored the use of the TabNet model based on neural networks to discover the diagnosis and treatment rules of hyperthyroid-ism,providing a method reference for inheriting the academic thoughts of famous veteran traditional Chinese medicine practitioners and assisting clinical diagnosis and treatment.METHODS Based on the clinical diagnosis and treatment cases of hyperthyroidism of Pro-fessor Zhou Zhongying and his team,standardized and structured training data were constructed;algorithms based on attention mecha-nism and sparse feature selection mechanism were studied;a pathogenesis prediction model was constructed by inputting standardized clinical manifestations,standardized tongue and pulse conditions;core symptoms,pathogenesis and medication were analyzed,as well as the relationship between the three.RESULTS The trained prediction model was used to predict the 6 pathogenesis of liver stagna-tion,liver fire,phlegm fluid,kidney deficiency,yin deficiency,and blood stasis.Compared with multi-label classification models constructed by classic algorithms such as decision trees and random forests,this model had better classification and prediction indica-tors.Mining was carried out through the decision tree algorithm,and 6 core pathogenesis corresponding Chinese medicine groups were summarized:vinegar-baked Bupleurum chinense,prunella vulgaris,oyster,processed Carapax trionycis,Scrophularia ningpoensis,Asparagus cochinchinensis,Ophiopogon japonicus,etc.CONCLUSION Using the TabNet algorithm on clinical medical record data to build a pathogenesis prediction model based on clinical manifestations,tongue and pulse conditions can effectively predict the core pathogenesis,and then discover the connection between symptoms,pathogenesis and medication,providing methodological references for the inheritance of academic ideas of famous veteran traditional Chinese medicine practitioners and clinical auxiliary diagnosis and treatment decision-making.

AIM: To compare the effect of small-incision lenticule extraction(SMILE)with different corneal cap thicknesses on postoperative astigmatism and short-term visual quality of patients with myopic astigmatism.METHODS: A total of 54 patients(108 eyes)with myopic astigmatism who underwent SMILE from June 2020 to June 2022 in our hospital were selected for the prospective controlled study, and patients were randomly assigned into two groups, with 27 cases(54 eyes)each. The corneal cap thickness design was 110 μm for the group A and 120 μm for the group B, while other operation parameters were consistent. Additionally, the uncorrected visual acuity(UCVA), spherical equivalent(SE), stiffness parameter A1(SP-A1), visual quality and vector parameters at baseline, 1 d,1 wk and 1 mo after surgery were compared between two groups.RESULTS: There was a statistically significant difference in UCVA, SE, and SP-A1 between the two groups at various time points before and after surgery(all P<0.05), and UCVA in the group A was better than that in the group B at 1 d after surgery(P<0.05). There was no statistically significant difference in the results of astigmatism vector analysis between the two groups of patients(both P>0.05). The objective scattering index(OSI)of the group A was lower than that of the group B, while Strehl ratio(SR)of the group A was higher than that of the group B at 1 d after surgery(both P<0.05). There was no significant difference in modulation transfer function cutoff frequency(MTF cut off), contrast vision, visual symptoms and overall satisfaction, postoperative complications between the two groups(all P>0.05).CONCLUSION: SMILE procedures with both 110 μm and 120 μm corneal cap thicknesses are safe and effective in correcting myopic astigmatism without affecting postoperative SE, astigmatism, SP-A1 or contrast visual acuity. Whereas 110 μm corneal cap thickness results in faster early postoperative visual recovery and better early visual quality than 120 μm.

Objective To investigate the effects of microRNA-602(miR-602)on the growth and invasion of SH-SY5Y cell lines in neuroblastoma(NB)and its possible mechanism.Methods Real-time quantitative polymerase chain reaction(qPCR)was used to detect the expression of miR-602 in SH-SY5Y cell lines of NB and HEK-293 cells of normal human embryonic kidney.MTT asssy was used to detect the effect of miR-602 on the growth of SH-SY5Y cell lines.Transwell invasion assay was used to detect the effect of miR-602 on the invasion of SH-SY5Y cell lines of NB.The possible target genes of miR-602 were screened,and the regulatory effects of miR-602 on target genes were verified by the luciferase reporter gene system combined with qPCR technology.Results The expression level of HEK-293 cells in healthy people embryonic kidney was normal-ized as 1,the relative expression level of miR-602 in SH-SY5Y cell lines of NB was 3.83±0.85 and the differ-ence was statistically significant(P＜0.01).The results of MTT assay showed that the cell relative activity of miR-602 mimics group(1.20±0.05)was higher than that of NC mimics group(1.00±0.01),while the cell relative activity of miR-602 inhibitor group(0.76±0.04)was lower than that of NC inhibitor group(1.00±0.01),and the differences were statistically significant(P＜0.05).The results of Transwell invasion experi-ment showed that the number of transmembrane cells in miR-602 mimics group(193.33±8.02)was higher than that in NC mimics group(97.33±20.03).The number of transmembrane cells of miR-602 inhibitor group(62.01±11.79)was lower than that of NC inhibitor group(132.33±11.24),and the differences were statistically significant(P＜0.05).qPCR results showed that the expression level of recombinant human Sprouty-related EVH1 domain(SPRED1)mRNA in miR-602 mimics group was 0.56±0.08 compared with the control NC mimics group.The relative change factor of SPRED1 mRNA expression level in miR-602 in-hibitor group was 4.16±0.91 compared with NC inhibitor group,and the differences were statistically signif-icant(P＜0.01).Conclusion miR-602 is highly expressed in SH-SY5Y cell lines,and it may promote the growth and invasion in SH-SY5Y cells by targeting the regulation of expression of SPRED1.

Objective:Hepatic fibrosis is a common pathological basis for many chronic liver diseases and can progress to cirrhosis,a leading cause of mortality in liver diseases.Early identification and reversal of hepatic fibrosis are key in the treatment of chronic liver disease.This study aims to compare the expression levels of serum core fucosylated low molecular weight kininogen(LMWK-Fc)and alpha-galactosylated(α-Gal)antibodies in patients with hepatic fibrosis at different stages,and to evaluate their diagnostic efficacy for hepatic fibrosis. Methods:A retrospective analysis was conducted on 275 patients with chronic liver disease who visited the Department of Infectious Diseases at the Second Xiangya Hospital of Central South University between June 2022 and March 2023.Among these,115 patients underwent liver biopsy.Based on the extent of collagen deposition and its impact on liver structure and microcirculation,patients were staged from 0 to 4:S0(no significant collagen deposition in liver tissues;liver structure and microcirculation are normal),S1(mild collagen deposition in liver tissues,with partial disruption of lobule structure,but microcirculation remains largely normal),S2(moderate collagen deposition in liver tissues,with partial disruption of lobule structure and microcirculation),S3(extensive collagen deposition in liver tissues,with substantial disruption of lobule structure and microcirculation),and S4(development of cirrhosis,with heavy collagen deposition,complete disruption of lobule structure,and severe impairment of microcirculation).Patients were grouped as no fibrosis(S0),fibrosis(S1-S2),and significant fibrosis(S3-S4).For the 160 patients without liver biopsy,they were categorized based on liver stiffness measurement(LSM)value:no fibrosis(F0:LSM＜7.3 kPa),fibrosis(F1-F2:LSM 7.3-12.4 kPa),and significant fibrosis(F3-F4:LSM＞12.4 kPa).Demographic data(age,gender)and laboratory indicators(alanine transaminase,aspartate transaminase,gamma-glutamyl transferase,alkaline phosphatase,alpha-fetoprotein,platelet count)were collected to calculate the fibrosis-4 index(FIB-4)and aspartate aminotransferase-to-platelet ratio index(APRI).Serum LMWK-Fc and α-Gal antibodies were measured and compared across the groups,and their correlation with fibrosis severity was analyzed.The receiver operating characteristic(ROC)curve was used to assess the predictive value of serum LMWK-Fc and α-Gal antibody levels for hepatic fibrosis. Results:Among the 160 patients without complete liver biopsy,serum α-Gal antibody and LMWK-Fc levels increased progressively from the no fibrosis group to the significant fibrosis group,with statistically significant differences(P＜0.05).Among the 115 patients with liver biopsy,serum LMWK-Fc levels were significantly higher in the fibrosis group and the significant fibrosis groups compared with the no fibrosis group,and α-Gal antibody levels were significantly higher in the significant fibrosis group compared with the no fibrosis group and the fibrosis group(P＜0.001,P=0.032,respectively).Univariate and multivariate linear regression analyses showed that hepatic fibrosis was correlated with gender and LMWK-Fc levels(both P＜0.05),but not with age,α-Gal antibody levels,FIB-4,or APRI(all P＞0.05). Conclusion:The expression levels of serum LMWK-Fc and α-Gal antibodies vary across different stages of hepatic fibrosis,suggesting a potential association with fibrosis progression.LMWK-Fc levels have a certain predictive value for the diagnosis of hepatic fibrosis.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Grid management plays an important role in improving the efficiency of social service management. The authors explored the establishment of a nosocomial infection grid management model and implemented it at a tertiary general hospital in Shanghai. χ2 test results showed that since the hospital fully implemented the grid management model in early 2016, the number of hospital infections, surgical site infections, type I surgical incision infections, and ventilator-related pneumonia had shown a downward trend year by year. The number of inspections before the use of antibacterial drugs, the number of blood cultures submitted for fever patients, and the timing of hand hygiene compliance showed an increasing trend year by year( P<0.05), and the management of nosocomial infection was more effective than the previous period. The application of grid management model required establishment of grid organization structure, control of key links, implementation of the special personnel responsibility, formulation of a performance evaluation system, and implementation of incentive measures. The grid management model can significantly reduce the risk of hospital infection, improve the efficiency of hospital infection management, and was valuable to be applicated and promoted in medical institutions.

Objective:To investigate the asymmetric geometry of middle cerebral artery (MCA) bifurcations and aneurysm formation.Methods:From January 2017 to April 2020, 65 patients with MCA aneurysm underwent 3D-digital subtraction angiography (DSA) in our hospital were recruited in this study; 170 patients without arterial stenosis or cerebral aneurysm at the same time period were selected as normal control group; their corresponding morphological parameters of MCA bifurcations in the imaging data were analyzed. Bifurcation angle was termed as φ1, while small and large lateral angles were termed as φ2 and φ3, respectively. D2, S2, C2, T2 and E2 represented diameter, sectional area, circumference, tortuosity and ellipticity of the branch forming angle φ2 with parent vessel, respectively; whereas D3, S3, C3, T3 and E3 represented diameter, sectional area, circumference, tortuosity and ellipticity of the branch forming angle φ2 with parent vessel on the contralateral branch, respectively. The independent factors affecting the formation of MCA aneurysm were screened by binary Logistic regression, and the predictive value of independent factors affecting the formation of MCA aneurysm was evaluated by receiver operating characteristic (ROC) curve.Results:(1) The aneurysmal group had significantly larger φ1, significantly smaller φ2 and φ3 than the normal control group ( P<0.05); D3, S3, C3, T2, T3 and E2 in the aneurysmal group were significantly higher/larger than those in the normal control group ( P<0.05). In terms of the symmetry of bilateral branches of blood vessels, the difference of φ3/φ2 ratio between the normal control group and aneurysm group was statistically significant ( P<0.05). (2) Binary Logistic regression results showed that φ2 was the protective factor for aneurysm formation ( OR=0.880, 9 5%CI: 0.844-0.918, P=0.000), while D3 and φ3/φ2 ratio were the risk factors for aneurysm formation ( OR=4.493, 9 5%CI: 1.414-14.278, P=0.011; OR=30.676, 95%CI: 9.884-95.202, P=0.000). (3) The ROC curve showed that the area under the curve of φ2 was the largest, reaching 0.93, and the optimal cut-off point was 104.59°, enjoying sensitivity and specificity of 87.7% and 85.9%, respectively. Conclusion:Normal MCA bifurcations almost show symmetrical morphology, whereas aneurysmal MCA bifurcations show asymmetrical morphology in both lateral angles and daughter branches; φ2 is the best morphological parameter to predict the aneurysm formation of MCA bifurcations.

Objective To explore the CT dominant phase and optimal classification model in differenting clear cell renal cell carcinoma (ccRCC) from fat‐poor angiomyolipoma (fpAML) through quantitative multiple‐phase CT radiomic features analysis. Methods Clinical and imaging data of 195 cases pathologically confirmed ccRCC (n=131) and fpAML (n=64) were retrospectively studied. All the patients underwent non‐contrast enhanced CT scans and dynamic multi‐phase (corticomedullary phase, medullary phase and excretion phase) contrast‐enhanced CT scans. Regions of interest (ROIs) were manually delineated based on the selected image slices with the maximal diameter of the lesion using ITK‐SNAP software, followed by the acquisition of candidate CT radiomic feature sets from each phase with statistically significant differences by using Mann‐Whitney U test. Then, using the synthetic minority oversampling technique (SMOTE), 232 classification models which are composed of 29 different feature selection algorithms (top 10 features were chosen by the backward elimination method) and 8 different classifiers were constructed. Employing the 5‐fold cross‐validation method, the performance of each classification models for each phase was evaluated using accuracy (ACC), sensitivity (SEN), specificity (SPE) and area under receiver operating characteristic curve (AUC), to acquire dominant CT phases and the optimal classification models for distingushing ccRCC and fpAML, along with the key imaging radiomic features. Results In this study, the mean maximal diameter of ccRCC and fpAML lesions were (3.9±1.4) cm, and (3.5±1.7) cm, respectively, and there was no statistically significant difference in the size of the tumor between two groups (P>0.05). From 102 initial imaging feature sets, the total number of candidate imaging feature sets (P<0.05) were:non‐enhanced phase (n=26), corticomedullary phase (n=71), medullary phase (n=68), excretion phase (n=62). Among the 232 classification models through different combination of classifiers and feature selectors, the amount of classification models which achieved the maximum of AUC value (AUCmax) from different CT phases were: non‐enhanced phase (n=106, 45.7%), corticomedullary phase (n=94, 40.5%), medullary phase (n=23, 9.9%), excretion phase (n=9, 3.9%). Imaging features from non‐enhanced phase and corticomedullary phase yielded higher performance compared with medullary phase and excretion phase, with the corresponding optimal prediction models were SVM‐fisher_score (AUC: 0.897, ACC: 83%, SEN: 84%, SPE:80%) and Logistic Regression‐RFS (AUC: 0.891, ACC: 83%, SEN: 81%, SPE: 89%), respectively. Conclusions The quantitative imaging features from non‐enhanced and corticomedullary phase have better performance among proposed classification models than that from medullary phase and excretion phase. Furthermore, it is feasible to acquire proper combination of feature selection and classifiers to achieve high performance in identifying ccRCC and fpAML.

OBJECTIVE: To explore the effects of psychological capital on occupational stress of employees in labor-intensive electronic enterprises. METHODS: A total of 1 723 employees in 5 labor-intensive electronic enterprises were selected as study subjects by cluster sampling method. The Psychological Capital Questionnaire and Simple Job Stress Questionnaire were used to investigate their psychological capital and job demand-control( JDC) occupational stress. The effect of psychological capital on occupational stress was analyzed. RESULTS: Total average score of psychological capital of the study subjects was( 4. 4 ± 0. 7). The average scores of self-efficacy,hope,resilience,optimism dimensions were( 4. 3 ± 0. 9),( 4. 5 ± 0. 8),( 4. 5 ± 0. 8) and( 4. 4 ± 0. 7),respectively. The proportions of active,relaxed,nervous and passive occupational stress accounted for 24. 2%,24. 7%,23. 5% and 27. 6% respectively. The detection rate of JDC mode high occupational stress was 68. 7%( 1 184/1 723). The proportion of active occupational stress of the low-psychologicalcapital group was lower( 28. 3% vs 20. 2%,P < 0. 001),the proportion of passive occupational stress was higher( 23. 4% vs 31. 7%,P < 0. 001),the positive rate of JDC high occupational stress was higher( 63. 3% vs 74. 1%,P <0. 01),compared with the high-psychological-capital group. The multivariate logistic analysis showed that the risk of JDC high occupational stress in the low-psychological-capital group was higher than that in the high-psychological-capital group( P < 0. 01),after eliminating the confounding factors such as length of service,education level and personal monthly income. CONCLUSION: The psychological capital of employees in labor-intensive electronics enterprises was associated with the occupational stress of the JDC model. The occupational stress can be reduced by improving the psychological capital of workers.

Objective:To prepare nanobody-based immunotoxin BI7D12-PE38KDEL targeting EGFR and to examine its cytotoxicity against EGFR positive tumor cells.Methods:By using molecular cloning strategy,prokaryotic expression construct of pET28a-BI7D12-PE38KDEL was generated which consisted of nanobody 7D12 targeting EGFR in the form of a divalent fused with PE38KDEL,a truncated form of pseudomonas exotoxin A via a flexible peptide(G4S)4,and then transformed into E.coli BL21(DE3).Protein expression was induced by adding IPTG,purified by Ni-affinity column chromatography,and verified by Western blot.The binding capacity of the resulted immunotoxin to EGFR-positive cells A549,HT29,MCF-7 and EGFR-negative cells CEM,Jurkat were determined by flow cytometry assay,and its cytotoxicity against the target cells was examined.Briefly,tumor cells were treated with different dosage of the immunotoxin,and the killing efficacy of BI7D12-PE38KDEL on these cells were assessed by WST-1 assay after 72 hours.Results:The SDS-PAGE and Western blot results showed the recombinant immunotoxin BI7D12-PE38KDEL was successfully prepared,and majority of them was expressed in soluble form.BI7D12-PE38KDEL could selectively bind to EGFR-positive cells of A549,HT29,and MCF-7.More importantly,the immunotoxin exhibited much more significant killing effect on these EGFR positive cells compared to the negative control group of CEM and Jurkat cells(P<0.01).Conclusion:In the current study,the nanobody-based immunotoxin BI7D12-PE38KDEL targeting EGFR was successfully prepared and exhibited a superior inhibition effect for the growth of EGFR-positive cells.