Objective: To investigate the protective effects and underlying mechanisms of sodium pyruvate (SP) on RBC storage lesions using an oxidative damage model. Methods: Six units of leukocyte-depleted suspended RBCs (discarded for non-infectious reasons within three days post-collection) were randomly assigned to four groups: negative control (NS), positive control (PS), experimental group 1 (SP1), and experimental group 2 (SP2). Oxidative stress was induced in the PS group by the addition of hydrogen peroxide (H O ), while SP1 and SP2 received SP supplementation at different concentrations (25 mM and 50 mM, respectively) in the presence of H O . After 1 hour of incubation, RBC morphology was assessed microscopically, and biochemical indicators including glutathione (GSH), malondialdehyde (MDA), methemoglobin (MetHb), adenosine triphosphate (ATP), and Na /K -ATPase activity were measured. Results: RBCs in the PS group exhibited pronounced morphological damage, including cell shrinkage and echinocyte formation, whereas both SP-treated groups showed significantly reduced structural injury. SP treatment led to elevated GSH levels and decreased concentrations of MDA and MetHb, suggesting attenuation of oxidative stress. Additionally, SP enhanced intracellular ATP levels and Na /K -ATPase activity, thereby contributing to membrane stability. Notably, the SP2 group (50 mM) demonstrated superior protective effects compared to SP1 (25 mM). Conclusion: Sodium pyruvate effectively attenuates oxidative storage lesions in RBCs, primarily through its antioxidant properties, energy metabolism supporting ability, and celluar membrane stabilizing function. These findings suggest SP as a promising additive for enhancing the quality and safety of stored RBCs.

Objective:To analyze the correlations between the ultrasound contrast features and the expression of human epidermal growth factor receptor 2(HER-2)of molecular biological indicators of breast cancer,and between ultrasound elastography features and that.Methods:A total of 63 patients with invasive breast cancer who admitted to The Affiliated Suzhou Hospital of Nanjing Medical University and The First Affiliated Hospital of Jiamusi University from February 2019 to June 2022 were selected as the study subjects.The HER-2 positive expression of molecular biological indicator of breast cancer was measured by immunohistochemistry.According to the immunohistochemical results,the patients were divided into positive group(22 cases)and negative group(41 cases).All patients underwent examinations of ultrasound contrast and ultrasound elastography.The differences of the features of ultrasound contrast and ultrasound elastography between the two groups were analyzed and compared.The influencing factors of HER-2 positive expression were analyzed by binary logistic regression,and the receiver operating curve(ROC)was established to assess respectively the values of single ultrasound contrast,single ultrasound elastography and the combination of them in predicting HER-2 positive expression.Results:There was significant differences in the features of ultrasound elastography between the two groups.The ratios of the irregular shape and burr at the edge of the imaging features of the patients with HER-2 positive expression were significantly higher than those of the patients with HER-2 negative expression[(86.4%vs.58.5%)and(77.3%vs.51.2%)],and the differences were statistically significant(x2=5.117,4.060,P<0.05),respectively.The difference of the features of ultrasound contrast between two groups was significant.The ratios of nourishing vessels,and the lesion enlargement≥3 cm after angiography in patients with HER-2 positive expression were significantly higher than those in the patients with HER-2 negative expression[(77.3%vs.41.5%)and(81.8%vs.39.0%)],the differences were statistically significant(x2=7.390,10.554,P<0.05),respectively.The features(shape,edge,nourishing vessels and lesion enlargement after contrast)of ultrasound contrast and ultrasound elastography were used respectively as independent variables,and the HER-2 positive expression was used as dependent variables.The logistic regression analysis showed that regular shape,smooth edge,without nourishing vessels and enlarged lesion<3 cm after angiography were protective factors for HER-2 positive expression of patients with breast cancer(OR=0.185,0.199,0.070,0.186,P<0.05),respectively.The areas under curve(AUC)values of the ROC curve of imaging features(shape,edge,nourishing vessels,and lesion enlargement after angiography)of ultrasound contrast and ultrasound elastography were respectively 0.630,0.639,0.679 and 0.714 in single predicting HER-2 positive expression of patients with breast cancer,and that of the combination of them was 0.874 in prediction.Conclusion:In features of ultrasound contrast and ultrasound elastography,the shape,edge,nourishing vessels and the enlargement lesion after contrast were the influencing factors of HER-2 positive expression in patients with breast cancer.The combined assessment of ultrasound contrast and ultrasound elastography before surgery has certain clinical reference value in predicting HER-2 expression.

Objective:To analyze the preferences of outpatients in a tertiary public specialized hospital, for references for optimizing the allocation of outpatient medical resources, and enhancing the medical experience.Methods:This study used convenience sampling method to select outpatients from a tertiary public stomatological hospital from January to September 2022 as the survey subjects, and conducted a questionnaire survey. The questionnaire mainly included gender, age, place of residence, education level, and medical needs, etc. Logistic regression model and Boruta algorithm were used to analyze the factors influencing patients′ preferred tertiary public specialized hospitals for treatment.Results:A total of 19 255 patients were included in this study. 13 558 patients (70.41%) preferred tertiary public specialized hospital for treatment, including 9 715 patients (71.65%) aged 21 to 45, 1 015 local patients (73.87%), 8 278 patients (61.05%) who chose treatment options, and 6 442 patients (47.51%) who came to the hospital for medical insurance reimbursement. By logistic regression analysis, age, residence, education level, medical needs, oral health habits, access to oral health knowledge, pre interview experience of Internet hospitals, monthly income, number of family members and reasons for seeking medical treatment were the influencing factors of patients′ preference for tertiary public specialized hospitals. According to the Boruta algorithm analysis, the top 6 important factors were the reasons for seeking medical treatment (Z=126.66), oral health habits (Z=96.44), access to oral health knowledge (Z=66.91), medical needs (Z=62.21), age (Z=57.54), and residence (Z=55.21).Conclusions:Local patients and young and middle-aged patients tended to choose tertiary public specialized hospitals for treatment, and treatment projects were the main business types that attract patients to visit tertiary public specialized hospitals. There were many important influencing factors for patients choosing tertiary public specialized hospitals for treatment, including the reasons for seeking medical treatment, oral health habits, access to oral health knowledge, and medical needs.

Marsdenia tenacissima injection, a standard Marsdenia tenacissima extract (MTE), has been approved as an adjuvant therapeutic agent for various cancers. Our previous study showed that MTE inhibited the proliferation and metastasis of prostate cancer (PCa) cells. However, the underlying mechanisms and active ingredients of MTE against PCa were not completely understood. This study revealed that MTE induced significant decreases in cell viability and clonal growth in PCa cells. In addition, MTE induced the apoptosis of DU145 cells by reducing the mitochondrial membrane potential and increasing the expression of Cleaved Caspase 3/7, Cyt c, and Bax. In vivo, DU145 xenografted NOD-SCID mice treated with MTE showed significantly decreased tumor size. TUNEL staining and Western blot confirmed the pro-apoptotic effects of MTE. Network pharmacology analysis collected 196 ingredients of MTE linked to 655 potential targets, and 709 PCa-associated targets were retrieved, from which 149 overlapped targets were screened out. Pathway enrichment analysis showed that the HIF-1, PI3K-AKT, and ErbB signaling pathways were closely related to tumor apoptosis. Western blot results confirmed that MTE increased the expression of p-AKT^Ser473 and p-GSK3β^Ser9, and decreased the expression of p-STAT3^Tyr705in vitro and in vivo. A total of 13 compounds in MTE were identified by HPLC-CAD-QTOF-MS/MS and UPLC-QTOF-MS/MS. Molecular docking analysis indicated that six compounds may interact with AKT, GSK3β, and STAT3. In conclusion, MTE induces the endogenous mitochondrial apoptosis of PCa by regulating the AKT/GSK3β/STAT3 signaling axis, resulting in inhibition of PCa growth in vitro and in vivo.
Mice ; Animals ; Male ; Humans ; Mice, Inbred NOD ; Mice, SCID ; Marsdenia ; Proto-Oncogene Proteins c-akt ; Glycogen Synthase Kinase 3 beta ; Molecular Docking Simulation ; Phosphatidylinositol 3-Kinases ; Tandem Mass Spectrometry ; Prostatic Neoplasms ; Apoptosis ; STAT3 Transcription Factor

OBJECTIVE: To propose a non-contrast CT-based algorithm for automated and accurate detection of pancreatic lesions at a low cost. METHODS: With Faster RCNN as the benchmark model, an advanced Faster RCNN (aFaster RCNN) model for pancreatic lesions detection based on plain CT was constructed. The model uses the residual connection network Resnet50 as the feature extraction module to extract the deep image features of pancreatic lesions. According to the morphology of pancreatic lesions, 9 anchor frame sizes were redesigned to construct the RPN module. A new Bounding Box regression loss function was proposed to constrain the training process of RPN module regression subnetwork by comprehensively considering the constraints of the lesion shape and anatomical structure. Finally, a detection frame was generated using the detector in the second stage. The data from a total of 728 cases of pancreatic diseases from 4 clinical centers in China were used for training (518 cases, 71.15%) and testing (210 cases, 28.85%) of the model. The performance of aFaster RCNN was verified through ablation experiments and comparison experiments with 3 classical target detection models SSD, YOLO and CenterNet. RESULTS: The aFaster RCNN model for pancreatic lesion detection achieved recall rates of 73.64% at the image level and 92.38% at the patient level, with an average precision of 45.29% and 53.80% at the image and patient levels, respectively, which were higher than those of the 3 models for comparison. CONCLUSION The proposed method can effectively extract the imaging features of pancreatic lesions from non-contrast CT images to detect the pancreatic lesions.
Humans ; Pancreas/diagnostic imaging* ; Algorithms ; China ; Pancreatic Neoplasms/diagnostic imaging* ; Tomography, X-Ray Computed

Objective:To compare the clinical and imaging outcomes of fascia lata autograft bridging repair reinforecd with an artificial ligament as the internal brace with the autograft bridging repair for the treatment of irreparable massive rotator cuff tears (IMRCTs).Methods:The data of 26 patients with IMRCT who underwent fascia lata autograft bridging repair augmented with artificial ligament as the internal brace (internal brace group) and of 24 patients with IMRCT who underwent bridging autograft repair alone (control group) were retrospectively evaluated preoperatively and at 2-year follow-up. Clinical outcomes were assessed using shoulder activity, the American Shoulder and Elbow Surgeons (ASES) Score, University of California Los Angeles (UCLA) Score, and visual analogue scale (VAS) for pain. Imaging outcomes were evaluated using acromiohumeral distance (AHD), Goutallier grade, and status of fascia lata grafts according to radiographs or magnetic resonance imaging results.Results:All 50 cases were followed up for 34.2±7.2 months (range 24-45 months). Compared to the control group, the internal brace group showed better ASES score (93.5±5.3 vs. 89.5±5.7, P<0.05), UCLA score (31.7±3.8 vs. 28.5±5.6, P<0.05), improvement in UCLA score (19.6±4.2 vs. 15.9±5.7, P<0.05), active elevation (167.3°±8.4° vs. 159.4°±13.6°, P<0.05), abduction strength (8.9±1.2 vs. 8.2±1.2, P<0.05), improvement in abduction strength (4.1±1.2 vs. 3.3± 1.0, P<0.05), AHD (7.0±1.4 mm vs. 5.9±1.0 mm, P<0.05), improvement in AHD (3.3±1.5 mm vs. 2.0±0.6 mm, P<0.05), and healing rate of fascia lata autografts (92% vs. 54%, P<0.05) at 2-year follow-up. Conclusion:Fascia lata autograft bridging repair reinforced with an artificial ligament as the internal brace improves healing rate of bridging graft and postoperatively short-term clinical outcomes of patients with IMRCT.

OBJECTIVE: To summarize the application and recent development of orthognathic surgery in treating syndromic craniosynostosis. METHODS: The related literature at home and abroad in recent years was extensively reviewed, and the indications, routine procedures, and protocols of orthognathic surgery in the treatment of syndromic craniosynostosis were summarized and analyzed. RESULTS: Craniosynostosis is a common congenital craniofacial malformation. Syndromic craniosynostosis usually involves premature fusion of multiple cranial sutures and is associated with other deformities. Orthognathic surgery is the necessary and effective means to improve the midfacial hypoplasia and malocclusion. Le Fort I osteotomy combined with sagittal split ramus osteotomy are the common surgical options. Orthognathic surgery should combine with craniofacial surgery and neurosurgery, and a comprehensive long-term evaluation should be conducted to determine the best treatment plan. CONCLUSION Orthognathic surgery plays an important role in the comprehensive diagnosis and treatment of syndromic craniosynostosis. The development of digital technology will further promote the application and development of orthognathic surgery in the treatment of syndromic craniosynostosis.
Humans ; Orthognathic Surgery ; Craniosynostoses/surgery* ; Osteotomy ; Osteotomy, Sagittal Split Ramus

OBJECTIVES: To explore the physicochemical characteristics and biocompatibility of calcium peroxide (CPO)-loaded polycaprolactone (PCL) microparticle. METHODS: The CPO/PCL particles were prepared. The morphology and elemental distribution of CPO, PCL and CPO/PCL particles were observed with scanning electron microscopy and energy dispersive spectroscopy, respectively. Rat adipose mesenchymal stem cells were isolated and treated with different concentrations (0.10%, 0.25%, 0.50%, 1.00%) of CPO or CPO/PCL particles. The mesenchymal stem cells were cultured in normal media or osteogenic differentiation media under the hypoxia/normoxia conditions, and the amount of released O₂ and H₂O₂ after CPO/PCL treatment were detected. The gene expressions of alkaline phosphatase (ALP), Runt-associated transcription factor 2 (RUNX2), osteopontin (OPN) and osteocalcin (OCN) were detected by realtime RT-PCR. SD rats were subcutaneously injected with 1.00% CPO/PCL particles and the pathological changes and infiltration of immune cells were observed with HE staining and immunohistochemistry at day 7 and day 14 after injection. RESULTS: Scanning electron microscope showed that CPO particles had a polygonal structure, PCL particles were in a small spherical plastic particle state, and CPO/PCL particles had a block-like crystal structure. Energy dispersive spectroscopy revealed that PCL particles showed no calcium mapping, while CPO/PCL particles showed obvious and uniform calcium mapping. The concentrations of O₂ and H₂O₂ released by CPO/PCL particles were lower than those of CPO group, and the oxygen release time was longer. The expressions of Alp, Runx2, Ocn and Opn increased with the higher content of CPO/PCL particles under hypoxia in osteogenic differentiation culture and normal culture, and the induction was more obvious under osteogenic differentiation conditions (all P<0.05). HE staining results showed that the muscle tissue fibers around the injection site were scattered and disorderly distributed, with varying sizes and thicknesses at day 7 after particle injection. Significant vascular congestion, widened gaps, mild interstitial congestion, local edema, inflammatory cell infiltration, and large area vacuolization were observed in some tissues of rats. At day 14 after microparticle injection, the muscle tissue around the injection site and the tissue fibers at the microparticle implantation site were arranged neatly, and the gap size was not thickened, the vascular congestion, local inflammatory cell infiltration, and vacuolization were significantly improved compared with those at day 7. The immunohistochemical staining results showed that the expressions of CD3 and CD68 positive cells significantly increased in the surrounding muscle tissue, and were densely distributed in a large area at day 7 after particle injection. At day 14 of microparticle injection, the numbers of CD3 and CD68 positive cells in peripheral muscle tissue and tissue at the site of particle implantation were lower than those at day 7 (all P<0.01). CONCLUSIONS CPO/PCL particles have good oxygen release activity, low damage to tissue, and excellent biocompatibility.
Rats ; Animals ; Osteogenesis ; Core Binding Factor Alpha 1 Subunit ; Rats, Sprague-Dawley ; Hydrogen Peroxide/pharmacology* ; Cell Differentiation ; Oxygen ; Hypoxia ; Cells, Cultured

Objective:To compare the incidence of postoperative complications of single- and multiple-perforator flaps, to provide reference for future clinical decision.Methods:Literatures on the comparison of postoperative complications of single- and multiple-perforator flaps at home and abroad from January 1995 to December 2020 were searched in PubMed, Cochrane Library, Embase, Wanfang, CNKI, VIP database. The literatures were screened and extracted according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software.Results:8 studies were included, including 1 008 flaps. There were 535(53%) single-perforator flaps, 473(47%) multiple-perforator flaps. Compared with multiple-perforator flaps, single-perforator flaps had a higher rate of venous crisis ( OR=2.29, 95% CI: 1.25-4.21, Z=2.67, P=0.008) and a higher rate of fat necrosis ( OR=2.04, 95% CI: 1.02-4.10, Z=2.10, P=0.040), the total necrosis rate of flaps was higher ( OR=2.71, 95% CI: 1.26-5.86, Z=2.54, P=0.010), and the differences were statistically significant. There were no significant differences in the incidence of arterial crisis ( OR=1.18, 95% CI: 0.48-2.90, Z=0.37, P=0.710) and partial necrosis of flaps ( OR=1.20, 95% CI: 0.61-2.36, Z=0.52, P=0.600). Conclusion:Compared with multiple-perforator flap, single-perforator flap may have higher incidence of venous crisis, fat necrosis and complete necrosis.

Objective:To compare the incidence of postoperative complications of single- and multiple-perforator flaps, to provide reference for future clinical decision.Methods:Literatures on the comparison of postoperative complications of single- and multiple-perforator flaps at home and abroad from January 1995 to December 2020 were searched in PubMed, Cochrane Library, Embase, Wanfang, CNKI, VIP database. The literatures were screened and extracted according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software.Results:8 studies were included, including 1 008 flaps. There were 535(53%) single-perforator flaps, 473(47%) multiple-perforator flaps. Compared with multiple-perforator flaps, single-perforator flaps had a higher rate of venous crisis ( OR=2.29, 95% CI: 1.25-4.21, Z=2.67, P=0.008) and a higher rate of fat necrosis ( OR=2.04, 95% CI: 1.02-4.10, Z=2.10, P=0.040), the total necrosis rate of flaps was higher ( OR=2.71, 95% CI: 1.26-5.86, Z=2.54, P=0.010), and the differences were statistically significant. There were no significant differences in the incidence of arterial crisis ( OR=1.18, 95% CI: 0.48-2.90, Z=0.37, P=0.710) and partial necrosis of flaps ( OR=1.20, 95% CI: 0.61-2.36, Z=0.52, P=0.600). Conclusion:Compared with multiple-perforator flap, single-perforator flap may have higher incidence of venous crisis, fat necrosis and complete necrosis.