Objective To evaluate the value of an optimized three-dimensional inversion-recovery with real reconstruction (3D-real IR) sequence with a longer repetition time (TR, 16 000 ms) based on modulated flip angle technique in refocused imaging with extended echo train (MATRIX) in the endolymphatic hydrops (EH) imaging after intratympanic gadolinium (Gd) administration, and to compare it with a conventional 3D-real IR based on the turbo spin echo (TSE) sequence. Methods From July 2021 to November 2022, twenty-seven patients received both the conventional and optimized 3D-real IR sequences after bilateral intratympanic Gd administration. Images of the two sequences were qualitativly evaluated and compared. Contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and area ratio of endolymph against the total lymphatic space from the two sequences were measured and compared. Results 14(25.9%) ears with insufficient contrast for the EH diagnosis on the conventional sequence were clearly displayed on the optimized sequence. Image score, CNR and SNR of the optimized sequence were significantly higher than those of the conventional sequence (P ＜ 0.001). The scanning time of two sequences was similar. The area ratio of endolymph against the total lymphatic space in the cochlear was significantly higher on the conventional 3D-real IR than that on the optimized 3D-real IR (P ＜ 0.001); there was no statistical difference in the vestibule between the two sequences. Conclusions Compared with conventional sequence, optimized 3D-real IR sequence with a longer TR may be better for evaluation of EH after intratympanic Gd administration.

Objective To investigate the value of artificial intelligence-assisted compressed sensing (ACS) technology for intravenous gadolinium contrast-enhanced magnetic resonance imaging of the inner ear using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence. Methods The patients received gadolinium contrast-enhanced magnetic resonance imaging using ACS and united compressed sensing (uCS) 3D-FLAIR at Zhongshan Hospital, Fudan University from January to November 2024 were prospectively enrolled. The repetition time was 16 000 ms, and acquisition time was 6 min 40 s and 10 min 24 s in ACS 3D-FLAIR and uCS 3D-FLAIR, respectively. The images on the two sequences were evaluated independently by two radiologists. The image quality of the two sequences was subjectively evaluated and compared. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between the two sequences. The grading consistencies using two sequences and between the two doctors were analyzed. Results There was no statistically difference in subjective score of image quality between the two sequences. SNR and CNR of the ACS 3D-FLAIR sequence were significantly higher than those of the uCS 3D-FLAIR sequence (P＜0.001). The kappa values of grades of cochlear and vestibular endolymphatic hydrops were 0.942 and 0.888 using two sequences (P＜0.001). The kappa values of grades of cochlear and vestibular endolymphatic hydrops using the ACS 3D-FLAIR sequence between the two doctors were 0.784 and 0.831, respectively (P＜0.001); the kappa values of grades of cochlear and vestibular endolymphatic hydrops using uCS 3D-FLAIR sequence between the two doctors were 0.725 and 0.756, respectively (P＜0.001). Conclusions ACS 3D-FLAIR could provide higher SNR and CNR than uCS 3D-FLAIR, and is more suitable for intravenous gadolinium contrast-enhanced magnetic resonance imaging of the inner ear; the endolymphatic hydrops grades using ACS 3D-FLAIR is similar to use uCS 3D-FLAIR.

Objective: To investigate the effects of different storage temperatures and durations on the activities of coagulation factor Ⅷ (Factor Ⅷ, FⅧ) and coagulation factor Ⅸ (Factor Ⅸ, FⅨ) after whole blood collection, so as to provide data support for the optimal storage conditions. Methods: A total of 16 mL of whole blood was collected from each of the 20 healthy volunteers at our blood center and aliquoted into 8 sodium citrate anticoagulant tubes. Two tubes were immediately centrifuged for the measurement of FⅧ and FⅨ activity levels. The remaining 6 tubes of whole blood were respectively stored under room temperature and low-temperature conditions. At 2, 4, and 6 h, the whole blood samples were centrifuged and analyzed for FⅧ and FⅨ activity levels. The mean values of the two immediately tested tubes were used as the control group, while other tubes were designated as the experimental groups for comparison. Statistical analysis was performed using SPSS 26.0. Results: The activity of FⅧ in whole blood remained stable after 4 hours of storage at both room temperature and low temperature (116.53±25.95 vs 125.22±27.33, 109.77±23.23 vs 125.22±27.33) (P>0.05 for both). However, by 6 hours, FⅧ activity showed a statistically significant decline compared to the control group (108.65±22.92 vs 125.22±27.33, 100.46±20.19 vs 125.22±27.33) (P<0.05 for both), though the room temperature group results were closer to the control values. The activity of FⅨ in whole blood remained stable after 6 hours of storage under both conditions (97.14±19.48 vs 96.76±19.67, 97.10±17.45 vs 96.76±19.6) (P>0.05 for all comparisons). Conclusion: For whole blood samples after collection, storage at either room temperature or low temperature for up to 4 hours does not compromise the accuracy of test results. When stored for 6 hours, FⅨ activity remains stable, whereas FⅧ activity decreases significantly. Notably, FⅧ activity demonstrates better stability at room temperature than under low-temperature conditions within the 6-hour storage.

Objective To explore the mediating role of sleep quality on the impact of occupational stress on depressive symptom among secondary industry occupational population. Methods A total of 895 secondary industry workers in Wuxi City were selected as the study subjects using the stratified random sampling method. The Core Occupational Stress Scale (COSS), Patient Health Questionnaire-9 items (PHQ-9) and Self-Filled Sleep Questionnaire (SSQ) were used to investigate their occupational stress, depressive symptom and sleep quality. Depressive symptom, occupational stress and sleep quality were respectively regarded as dependent variable, independent variable and mediating variable. Process program was used to construct a mediation model, and Bootstrap method was used to test its mediating effect. Results The median score and 25th, 75th percentile for occupational stress, depressive symptom and sleep quality was 43.0 (43.0, 48.0), 6.0 (3.0, 8.0) and 3.0 (1.0, 3.0) points. The detection rates of occupational stress, depressive symptom, sleep disorder were 28.7%, 63.0% and 38.8%, respectively. Spearman correlation analysis result showed that occupational stress was positively correlated with both depressive symptom and sleep quality (Spearman correlation coefficients of 0.46 and 0.49, all P<0.01). Bootstrap test result showed that occupational stress had positive effect on both depressive symptom and sleep quality (partial regression coefficients of 0.25 and 0.09, all P<0.01). Sleep quality partially mediated the impact of occupational stress on depressive symptom with the mediation effect value of 0.05 (95% confidence interval of 0.03-0.06), accounting for 20.0% of the total effect. Conclusion Both depression symptom and sleep quality are positively correlated with occupational stress in secondary industry occupational population. Sleep quality of this population partially mediate the impact of occupational stress on depressive symptom.

Objective:To retrieve, evaluate and summarize the best evidence for the assessment and non-pharmacological management of chemotherapy-induced peripheral neuropathy.Methods:The literature related to the assessment and non-pharmacological management of chemotherapy-induced peripheral neuropathy was systematically searched from January 1, 2018 to December 4, 2023 in clinical decision support systems, guideline networks, databases and related society websites at home and abroad, including clinical decision-making, guidelines, expert consensus, evidence summary, systematic review, and randomized controlled studies. Four reviewers evaluated the quality of the included studies and extracted evidence.Results:A total of 18 articles were included, including 1 clinical decision, 2 guidelines, 3 expert consensuses, 5 evidence summaries, 4 systematic reviews, and 3 randomized controlled studies. A total of 21 pieces of evidence were summarized from 7 items: assessment, exercise therapy, acupuncture therapy, cryotherapy, compression therapy, health education, and multidisciplinary diagnosis and treatment.Conclusions:Non-pharmacological intervention is an effective means to improve chemotherapy-induced peripheral neuropathy. Medical personnel should combine professional judgment with patient′s will, prudently, wisely and clearly use the best evidence to prevent or reduce chemotherapy-induced peripheral neuropathy and improve patients′ quality of life.

Objective To study the predictive factors for a poor prognosis of hemorrhagic stroke,build a prediction model,and improve the current evaluation system.Methods A cross-sectional survey was conducted from the perspective of pre-hospi-tal and intra-hospital integration.After single factor comparison,indicators with significant differences were sequentially includ-ed in univariant and multivariant Poisson regression analysis.The selected independent risk factors were constructed as predic-tive models.The prediction model was converted into a visual optimization rating scale in the form of a column chart to obtain the corresponding prediction probability for the corresponding rating.The ROC curve was used to test the effectiveness of opti-mizing scores and ICH-CT scores in predicting poor prognosis.Relevant data of patients in the validation group were extracted based on the two scoring information,and the final score of each validation group patient was obtained.The scoring and prog-nostic results were substituted into the ROC curve to evaluate the predictive ability of different prediction models,and the pre-diction models were converted into visual optimization scoring scales to quantify the probability of adverse prognosis outcomes.The ICH-CT model was used as a reference to explore the effectiveness of optimizing scoring in evaluating poor prognosis out-comes in patients with hemorrhagic stroke.Results After sample size calculation,273 patients were ultimately selected as the model group for this cross-sectional study:a total of 110 hemorrhagic stroke patients had poor prognosis,163 patients had a good prognosis,and the time span was from January 2021 to September 2021.Another 81 patients with acute hemorrhagic stroke between September 2021 and January 2022 were collected as the validation group:21 patients with poor prognosis and 60 patients with acceptable prognosis were included in the hemorrhagic stroke group.The demographic characteristics of the valida-tion group were compared,and significant statistical differences were observed in the proportion of men,age,and history of dia-betes(P＜0.05),Comparison of other clinical data between groups showed significant statistical differences(P＜0.05)in GCS score,visit time,amount of bleeding and hematoma,mixed sign,cerebral hernia,and intraventricular hemorrhage.The cut-off values for the optimization score and ICH-CT score were 186 and 128,respectively.The AUC and Youden indices of the optimi-zation score were both higher than those of the ICH-CT score.The evaluation efficiency of the optimization score for adverse prognosis was better than that of the ICH-CT score(Z=2.369,P＜0.05).Conclusion A predictive model for poor prognosis in patients with hemorrhagic stroke was constructed in this study,and it was converted it into an optimized score that has strong feasibility in clinical practice.

Objective To investigate the mechanism of hearing loss caused by tympanic membrane(TM)per-foration.Methods We constructed a full ear finite element model,and the personalized finite element model of TM perforation was constructed to simulate hearing loss caused by TM perforation.The difference between the displace-ment response of the basement membrane and the baseline was applied to simulate hearing loss,and the contribution of various components of the middle ear to hearing loss was analyzed to study the mechanism of hearing loss caused by TM perforation.Results If the coupling of the round window membrane and the middle ear air was removed,the hearing loss at the low frequency was about 40 dB,while the high-frequency was the same as the baseline.Re-moval of the coupling between the inner side of the eardrum and the middle ear cavity resulted in a reduction in par-tial low-frequency hearing and an increase in high-frequency hearing loss.The continuous disconnection between the air in the external auditory canal and the air in the middle ear cavity increased the low-frequency hearing loss.How-ever,after the removal of the coupling between the round window membrane and the middle ear air and the connec-tion between the middle ear air and the lateral side of the TM,the original hearing loss of 40 dB at low-frequency dropped to 10 dB.While the removal of the coupling between the middle ear cavity air and the ossicular chain had no significant impact on hearing loss.Conclusion TM perforation may cause hearing loss by both the reduction of sound transmission and the reduction of sound pressure difference between the two sides of TM.The round window membrane can counteract the influence of the hearing loss caused by TM perforation.

Objective:To explore the application value of preoperative serum vitamin A level in the prediction of benign or malignant pulmonary nodules.Methods:It was a retrospective cohort study. A total of 1 224 patients who underwent surgery for pulmonary nodules at the General Hospital of the People′s Liberation Army from January 2016 to December 2018 were consecutively included. The demographic information, postoperative pathological results, pulmonary CT findings and preoperative serum vitamin A test results were collected. The preoperative serum vitamin A levels of patients with lung cancer and benign pulmonary nodules were compared pairwise using the χ2 test. Logistic regression analysis was used to analyze the relevant factors for the occurrence of lung cancer and a stratified analysis was performed too. Prediction models for the benignity or malignancy of pulmonary nodules were constructed based on the results of multivariate logistic regression analysis. The efficacy of the models was evaluated, and the optimal preoperative prediction model was determined. The application value of preoperative serum vitamin A levels in predicting the benignity or malignancy of pulmonary nodules was then analyzed. Results:Of the 1 224 patients, postoperative pathology confirmed 1 044 cases with lung cancer and 180 cases with benign pulmonary nodules. The mean preoperative serum vitamin A level of patients with lung cancer was significantly lower than that in patients with benign pulmonary nodules (0.90 vs 1.06 μmol/L) ( Z=-3.493; P<0.001). Preoperative serum vitamin A level was a negative related factor for the occurrence of lung cancer ( OR=0.663, 95% CI: 0.484-0.914) ( P=0.011). In patients aged<60 years ( OR=0.623, 95% CI: 0.428-0.912), male ( OR=0.649, 95% CI: 0.438-0.976), with a body mass index≥24 kg/m 2 ( OR=0.634, 95% CI: 0.420-0.974), no family history of tumors ( OR=0.634, 95% CI: 0.440-0.923), no smoking history ( OR=0.619, 95% CI: 0.412-0.941), no drinking history ( OR=0.625, 95% CI: 0.424-0.933), with pulmonary nodules measuring 1-3 cm in diameter ( OR=0.643, 95% CI: 0.455-0.920), and with solid pulmonary nodules ( OR=0.681, 95% CI: 0.466-1.001), the preoperative serum vitamin A levels were significantly negatively correlated with the occurrence of lung cancer (all P<0.05). The prediction model incorporating preoperative serum vitamin A, CT characteristics of pulmonary nodules (nodule diameter, density), and clinical characteristics (age, gender) showed the best predictive efficacy for the benignity or malignancy of pulmonary nodules (the area under the curve was 0.792). Conclusions:Among patients receiving surgical treatment for pulmonary nodules, the preoperative serum vitamin A level of patients with lung cancer is lower than that of patients with benign pulmonary nodules. The preoperative serum vitamin A level is a negative associated factor for the occurrence of lung cancer. A combined model incorporating the preoperative serum vitamin A level provides a good prediction of benign or malignant pulmonary nodules.

Feces and intestinal contents of pigs suspected with porcine epidemic diarrhea virus were collected from a farm in Minqin County,Gansu Province,China.After the suspected positive sam-ples were detected by RT-PCR,Vero cells were used to isolate and culture them in vitro.The suc-cessfully isolated virus was identified in the laboratory,and its whole genome sequence was ana-lyzed for genetic evolution.The pathogenicity was evaluated by animal regression test.The results showed that typical syncytial lesions could be observed when the PEDV-positive treatment solu-tion was inoculated with Vero cells in the 4th generation,and the virus titer in the 6th generation reached 10-4 75TCID50/mL.PEDV-like virions with a diameter of about 100 nm and a round shape with obvious capsular membranes and spikes were observed by electron microscopy.Whole genome sequencing analysis showed that the total length of this strain was 28 085 bp,which was far from the G1 subtype represented by the classical strain CV777(96.6％),and had a high homology with the G2b strains BC-2011-1,IA1,USA/Colorado/2013 and WELL(98.6％).This indicated that the strain belonged to the G2b epidemic strain.The animal regression test showed that the 5-day-old piglets developed vomiting,acute watery diarrhea,emaciation and mental depression within 12 h after the attack,and the symptoms worsened and died within 24 h.After autopsy,the infected piglets could be observed with stomach swelling,high intestinal heave,thin and transparent intesti-nal wall,and undigested milk clots inside.In summary,a PEDV G2b epidemic strain was success-fully isolated and identified in this study,and its whole genome sequence and pathogenicity were analyzed,providing research materials for future studies on PEDV gene function,pathogenic mech-anism and vaccine development.

Six new ent-abietane diterpenoids, abientaphlogatones A-F (1-6), along with two undescribed ent-abietane diterpenoid glucosides, abientaphlogasides A-B (7-8) and four known analogs were isolated from the aerial parts ofPhlogacanthus curviflorus (P. curviflorus). The structures of these compounds were determined using high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), one-dimensional and two-dimensional nuclear magnetic resonance (NMR) spectroscopy, electronic circular dichroism (ECD) spectra, and quantum chemical calculations. Notably, compounds 5 and 6 represented the first reported instances of ent-norabietane diterpenoids from the genus Phlogacanthus. In the β-hematin formation inhibition assay, compounds 2, 4, 7-10, and 12 displayed antimalarial activity, with IC₅₀ values of 12.97-65.01 μmol·L^-1. Furthermore, compounds 4, 5, 8, and 10 demonstrated neuroprotective activity in PC12 cell injury models induced by H₂O₂ and MPP⁺.
Abietanes/pharmacology* ; Antimalarials ; Hydrogen Peroxide ; Biological Assay ; Plant Components, Aerial