Objective·To analyze the clinicopathologic characteristics,gene mutation profile,and prognostic factors of thyroid diffuse large B-cell lymphoma(DLBCL).Methods·From November 2003 to December 2021,a total of 66 patients with thyroid DLBCL[23 cases(34.8%)with primary thyroid DLBCL,and 43 cases(65.2%)with secondary thyroid DLBCL]admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed for their clinicopathological data,survival and prognostic factors.Gene mutation profiles were evaluated by targeted sequencing(55 lymphoma-related genes)in 40 patients.Results·Compared to primary thyroid DLBCL,secondary thyroid DLBCL had advanced ratio of Ann Arbor stage Ⅲ?Ⅳ(P=0.000),elevated serum lactate dehydrogenase(LDH)(P=0.043),number of affected extranodal involvement≥2(P=0.000),non-germinal center B cell(non-GCB)(P=0.030),BCL-2/MYC double expression(DE)(P=0.026),and international prognostic index(IPI)3?5-scores(P=0.000).The proportion of patients who underwent thyroid surgery(P=0.012)was lower than that of patients with primary thyroid DLBCL.The complete remission(CR)rate in primary thyroid DLBCL patients was higher than that in secondary thyroid DLBCL patients(P=0.039).Fifty-five patients(83%)received rituximab combined with cyclophosphamide,doxorubicin,vincristine,and prednisone(R-CHOP)-based first-line regimen.The estimated 5-year progression free survival(PFS)rate of primary thyroid DLBCL patients was 95.0%,higher than the 49.7%of the secondary patients(P=0.010).Univariate analysis showed that Ann Arbor Ⅲ?Ⅳ(HR=4.411,95%CI 1.373?14.170),elevated LDH(HR=5.500,95%CI 1.519?19.911),non-GCB(HR= 5.291,95%CI 1.667?16.788),and DE(HR=6.178,95%CI 1.813?21.058)were adverse prognostic factors of PFS in patients with thyroid DLBCL.Ann Arbor Ⅲ?Ⅳ(HR=7.088,95%CI 0.827?60.717),elevated LDH(HR=6.982,95%CI 0.809?60.266),and DE(HR=18.079,95%CI 1.837?177.923)were adverse prognostic factors of overall survival(OS).Multivariate analysis showed that Ann Arbor Ⅲ?Ⅳ(HR=4.693,95%CI 1.218?18.081)and elevated LDH(HR=5.058,95%CI 1.166?21.941)were independent adverse prognostic factors of PFS in patients with thyroid DLBCL.Targeted sequencing data showed mutation frequency>20%in TET2(n=14,35%),KMT2D(n=13,32%),TP53(n=11,28%),GNA13(n=10,25%),KMT2C(n=9,22%),and TP53 were adverse prognostic factors of PFS in patients with thyroid DLBCL(P=0.000).Conclusion·Patients with primary thyroid DLBCL have better PFS and OS than those with secondary thyroid DLBCL.Ann Arbor Ⅲ?Ⅳ,elevated LDH,non-GCB,and DE(MYC and BCL2)are adverse prognostic factors in thyroid DLBCL.TET2,KMT2D,TP53,GNA13,and KMT2C are commonly highly mutated genes in thyroid DLBCL,and the prognosis of patients with TP53 mutations is poor.

BackgroundBariatric surgery has emerged as an important tool in the management of obesity. Some patients undergoing bariatric surgery are prone to develop emotional abnormalities and have abnormally elevated concentrations of inflammatory factors level in peripheral blood， whereas current domestic research focusing on the impact of preoperative emotional states and peripheral blood inflammatory factors level on weight loss effect remains limited. ObjectiveTo explore the correlation of preoperative emotional abnormalities with the effectiveness of bariatric surgery in obese patients， and to provide theoretical basis for improving the clinical efficacy of bariatric surgery. MethodsEighty-one obese patients scheduled for bariatric surgery at gastrointestinal surgery Department of West China Hospital， Sichuan University from December 30， 2022 to June 30， 2023 were enrolled and assessed using Hamilton Depression Scale-17 item （HAMD-17） and Hamilton Anxiety Scale （HAMA）. Patients who scored 7 or above on HAMD-17 or HAMA or had a history of previous depression or anxiety diagnoses were classified into emotional abnormality group （n=34）， and samples who scored less than 7 on HAMD-17 and HAMA and were free of history of previous depression and anxiety diagnoses were set as non-emotional abnormality group （n=47）. The data were collected by the self made questionnaire. Patients were subjected to complete the assessment of Beck Scale for Suicide Ideation-Chinese Version （BSI-CV）， Eating Disorder Inventory （EDI） and Pittsburgh Sleep Quality Index （PSQI）. Laboratory tests including peripheral blood C-reactive protein （CRP） and interleukin-6 （IL-6）. Body weight and height assessed in the early morning after an overnight fasting period were recorded in all participants at 1- and 6-month after surgery through outpatient clinic visits or telephone follow-up. Pearson correlation coefficient was used to examine relationship among body mass index （BMI）， preoperative emotional states and peripheral blood inflammation mediators. ResultsAmong 81 obese patients， 62 completed the study， including 27 cases in emotional abnormality group and 35 cases in non-emotional abnormality group. Emotional abnormality group scored higher on BSI-CV （current）， BSI-CV （worst）， EDI and PSQI， and detected higher levels of CRP and IL-6 compared with non-emotional abnormality group （Z=2.677， 2.975， t=3.573， 4.035， 1.990， 2.799， P<0.05 or 0.01）. For BMI， there was no significant group effect and time×group interaction effect （P>0.05）， but a significant time effect （F=227.740， P<0.01）. Within emotional abnormality group， BMI at the baseline， 1- and 6-month after surgery showed a positive correlation with IL-6 level （r=0.419， 0.510， 0.559， P<0.05 or 0.01）， BMI at 6-month after surgery was positively correlated with HAMD-17 total score （r=0.390， P<0.05）， and ΔBMI% at 6-month after surgery was negatively correlated with HAMD-17 total score （r=-0.421， P<0.05）. Within non-emotional abnormality group， baseline BMI was positively correlated with IL-6 level （r=0.338， P<0.01）. ConclusionThe short-term effect of bariatric surgery may be comparable in obese patients with or without emotional abnormalities， while it cannot be ruled out whether the outcome of bariatric surgery is related to the severity of preoperative depression.

ObjectiveExisting artificial vision devices can be divided into two types: implanted devices and extracorporeal devices, both of which have some disadvantages. The former requires surgical implantation, which may lead to irreversible trauma, while the latter has some defects such as relatively simple instructions, limited application scenarios and relying too much on the judgment of artificial intelligence (AI) to provide enough security. Here we propose a system that has voice interaction and can convert surrounding environment information into tactile commands on head and neck. Compared with existing extracorporeal devices, our device can provide a larger capacity of information and has advantages such as lower cost, lower risk, suitable for a variety of life and work scenarios. MethodsWith the latest remote wireless communication and chip technologies, microelectronic devices, cameras and sensors worn by the user, as well as the huge database and computing power in the cloud, the backend staff can get a full insight into the scenario, environmental parameters and status of the user remotely (for example, across the city) in real time. In the meanwhile, by comparing the cloud database and in-memory database and with the help of AI-assisted recognition and manual analysis, they can quickly develop the most reasonable action plan and send instructions to the user. In addition, the backend staff can provide humanistic care and emotional sustenance through voice dialogs. ResultsThis study originally proposes the concept of “remote virtual companion” and demonstrates the related hardware and software as well as test results. The system can not only achieve basic guide functions, for example, helping a person with visual impairment to shop in supermarkets, find seats at cafes, walk on the streets, construct complex puzzles, and play cards, but also can meet the demand for fast-paced daily tasks such as cycling. ConclusionExperimental results show that this “remote virtual companion” is applicable for various scenarios and demands. It can help blind people with their travels, shopping and entertainment, or accompany the elderlies with their trips, wilderness explorations, and travels.

AIM To study the extraction process,enzymatic properties and practical application of glucuronic hydrolase in Scutellaria baicalensis stems and leaves(sbsl GUS).METHODS With granularity,water consumption,extraction time and extraction frequency as influencing factors,enzymatic activity as an evaluation index,the extraction process was optimized by orthogonal test on the basis of single factor test.The relationship between substrate(baicalin)concentration and enzymolysis rate,after which Vmax and Km were calculated,the effects of pH value,temperature and metal ion on enzymatic activity were investigated,pH stability and heat stability were evaluated.sbsl GUS was adotped in the enzymolysis of baicalin to prepare baicalein,then the effects of pH value,temperature,reaction time,initial substrate concentration and enzyme addition on transfer rate were investigated.RESULTS The optimal extraction process was determined to be 40 mesh for granularity,10 times for water consumption,15 min for extraction time,and 3 times for extraction frequency.The enzymolysis accorded with the kinetics of enzymatic reaction,Km was 0.006 3 mol/L,Vmax was 70.42 μmol/h,the strongest enzymatic activity was found at the pH value of 6.0,temperature of 45℃and metal ion of 100 mmol/L Cu2+,sbsl GUS demonstrated good stability at the ranges of 4.0-7.0 for pH value and 4-30℃for temperature.The optimal preparation process was determined to be 6.0 for pH value,45℃for temperature,more than 12 h for reaction time,67.2 mmol/L for initial substrate concentration,and 1 mL/0.269 mmol baicalin for enzyme addition,the transfer rate was 97.83%.CONCLUSION sbsl GUS enzymolysis exhibits high efficiency and mild condition,which can provide a simple preparation method for obtaining baicalein,and expand the application path of Scutellaria baicalensis stems and leaves.

AIM To investigate the variation rules of main secondary metabolites in Hedysari Radix before and after rubbing strip.METHODS UPLC-MS/MS was adopted in the content determination of formononetin,ononin,calycosin,calycosin-7-glucoside,medicarpin,genistein,luteolin,liquiritigenin,isoliquiritigenin,vanillic acid,ferulic acid,γ-aminobutyric acid,adenosine and betaine,after which cluster analysis,principal component analysis and orthogonal partial least squares discriminant analysis were used for chemical pattern recognition to explore differential components.RESULTS After rubbing strip,formononetin,calycosin,liquiritigenin and γ-aminobutynic acid demonstrated increased contents,along with decreased contents of ononin,calycosin-7-glucoside and vanillic acid.The samples with and without rubbing strip were clustered into two types,calycosin-7-glucoside,formononetin,γ-aminobutynic acid,vanillic acid,calycosin-7-glucoside and formononetin were differential components.CONCLUSION This experiment clarifies the differences of chemical constituents in Hedysari Radix before and after rubbing strip,which can provide a reference for the research on rubbing strip mechanism of other medicinal materials.

Objective:To evaluate the self-assessed and proxy-assessed quality of life among disabled elderly individuals aged 60 and above in Chengdu,analyze the factors influencing these assessments,and assess the consistency between these two types of outcomes and the feasibility of proxy assessments.Methods:The quality of life for disabled elderly individuals is measured using the EQ-5D-5L for both self-assessments and proxy assessments.Consistency testing is conducted using weighted Kappa and Intraclass Correlation Coefficient(ICC).Univariate and differential analyses are performed with the Mann-Whitney/Wilcoxon and Kruskal-Wallis tests,respectively.The analysis of influencing factors employs generalized linear model regression.Results:The results of proxy assessments are slightly higher than those of self-assessments.The consistency between self-assessed and proxy-assessed health utility values and EQ-VAS scores is good(with ICC values exceeding 0.7),while the consistency across various dimensions is fair to moderate(with weighted Kappa values approximately between 0.4 and 0.5).The degree of disability,economic status,outdoor activities and sleep,the relationship between caregivers and the elderly,and whether caregivers possess relevant caregiving knowledge,all have a statistically significant impact on the quality of life of disabled elderly individuals and the differences between self-assessed and proxy-assessed outcomes(P＜0.05).Conclusion:The quality of life of disabled elderly individuals is significantly lower than that of the general population.It is essential to consider various related factors to enhance the quality of life for these individuals.The EQ-5D-5L proxy assessment results from their primary caregivers can serve as a supplement to the self-assessment results of disabled elderly individuals.However,individual dimensions should be applied with caution,taking into account the characteristics and individual differences of the evaluated population,types of proxies,and measurement tools used.

Objective:To evaluate the self-assessed and proxy-assessed quality of life among disabled elderly individuals aged 60 and above in Chengdu,analyze the factors influencing these assessments,and assess the consistency between these two types of outcomes and the feasibility of proxy assessments.Methods:The quality of life for disabled elderly individuals is measured using the EQ-5D-5L for both self-assessments and proxy assessments.Consistency testing is conducted using weighted Kappa and Intraclass Correlation Coefficient(ICC).Univariate and differential analyses are performed with the Mann-Whitney/Wilcoxon and Kruskal-Wallis tests,respectively.The analysis of influencing factors employs generalized linear model regression.Results:The results of proxy assessments are slightly higher than those of self-assessments.The consistency between self-assessed and proxy-assessed health utility values and EQ-VAS scores is good(with ICC values exceeding 0.7),while the consistency across various dimensions is fair to moderate(with weighted Kappa values approximately between 0.4 and 0.5).The degree of disability,economic status,outdoor activities and sleep,the relationship between caregivers and the elderly,and whether caregivers possess relevant caregiving knowledge,all have a statistically significant impact on the quality of life of disabled elderly individuals and the differences between self-assessed and proxy-assessed outcomes(P＜0.05).Conclusion:The quality of life of disabled elderly individuals is significantly lower than that of the general population.It is essential to consider various related factors to enhance the quality of life for these individuals.The EQ-5D-5L proxy assessment results from their primary caregivers can serve as a supplement to the self-assessment results of disabled elderly individuals.However,individual dimensions should be applied with caution,taking into account the characteristics and individual differences of the evaluated population,types of proxies,and measurement tools used.

Objective:To evaluate the self-assessed and proxy-assessed quality of life among disabled elderly individuals aged 60 and above in Chengdu,analyze the factors influencing these assessments,and assess the consistency between these two types of outcomes and the feasibility of proxy assessments.Methods:The quality of life for disabled elderly individuals is measured using the EQ-5D-5L for both self-assessments and proxy assessments.Consistency testing is conducted using weighted Kappa and Intraclass Correlation Coefficient(ICC).Univariate and differential analyses are performed with the Mann-Whitney/Wilcoxon and Kruskal-Wallis tests,respectively.The analysis of influencing factors employs generalized linear model regression.Results:The results of proxy assessments are slightly higher than those of self-assessments.The consistency between self-assessed and proxy-assessed health utility values and EQ-VAS scores is good(with ICC values exceeding 0.7),while the consistency across various dimensions is fair to moderate(with weighted Kappa values approximately between 0.4 and 0.5).The degree of disability,economic status,outdoor activities and sleep,the relationship between caregivers and the elderly,and whether caregivers possess relevant caregiving knowledge,all have a statistically significant impact on the quality of life of disabled elderly individuals and the differences between self-assessed and proxy-assessed outcomes(P＜0.05).Conclusion:The quality of life of disabled elderly individuals is significantly lower than that of the general population.It is essential to consider various related factors to enhance the quality of life for these individuals.The EQ-5D-5L proxy assessment results from their primary caregivers can serve as a supplement to the self-assessment results of disabled elderly individuals.However,individual dimensions should be applied with caution,taking into account the characteristics and individual differences of the evaluated population,types of proxies,and measurement tools used.

Objective:To evaluate the self-assessed and proxy-assessed quality of life among disabled elderly individuals aged 60 and above in Chengdu,analyze the factors influencing these assessments,and assess the consistency between these two types of outcomes and the feasibility of proxy assessments.Methods:The quality of life for disabled elderly individuals is measured using the EQ-5D-5L for both self-assessments and proxy assessments.Consistency testing is conducted using weighted Kappa and Intraclass Correlation Coefficient(ICC).Univariate and differential analyses are performed with the Mann-Whitney/Wilcoxon and Kruskal-Wallis tests,respectively.The analysis of influencing factors employs generalized linear model regression.Results:The results of proxy assessments are slightly higher than those of self-assessments.The consistency between self-assessed and proxy-assessed health utility values and EQ-VAS scores is good(with ICC values exceeding 0.7),while the consistency across various dimensions is fair to moderate(with weighted Kappa values approximately between 0.4 and 0.5).The degree of disability,economic status,outdoor activities and sleep,the relationship between caregivers and the elderly,and whether caregivers possess relevant caregiving knowledge,all have a statistically significant impact on the quality of life of disabled elderly individuals and the differences between self-assessed and proxy-assessed outcomes(P＜0.05).Conclusion:The quality of life of disabled elderly individuals is significantly lower than that of the general population.It is essential to consider various related factors to enhance the quality of life for these individuals.The EQ-5D-5L proxy assessment results from their primary caregivers can serve as a supplement to the self-assessment results of disabled elderly individuals.However,individual dimensions should be applied with caution,taking into account the characteristics and individual differences of the evaluated population,types of proxies,and measurement tools used.

Urodynamics is a critical field that studies the physiological and biomechanical parameters involved in urine production, storage, and voiding.This paper first reviews the development process of urodynamics, expounds the development and progress of urodynamic testing instruments from early basic research to modern advanced equipment and the history of their introduction into China, and then introduces in detail the principle of action, system composition and clinical application status of major urodynamic instruments, and further points out the technical shortcomings of current instruments, and then proposes improvement directions, including the core load sensor technology, comfort and privacy of urodynamic testing instruments, work data transfer and close integration with artificial intelligence, in order to provide a valuable reference for clinical understanding of the development of this field.