BACKGROUND:Cistanoside A has the effects of anti-inflammation,antioxidation,antioxidation,reducing renal damage and anti-osteoporosis,but its effect on osteoclast differentiation,function and its underlying molecular mechanisms remain unclear. OBJECTIVE:To investigate the effect of Cistanoside A on osteoclast differentiation and bone resorption induced by receptor activator of nuclear factor kappa-B ligand(RANKL)in vitro and its mechanism. METHODS:Bone marrow macrophages were obtained from the femur and tibia of 4-6-week-old C57BL/6 mice.The cytotoxic effect of Cistanoside A(5,10,20,40,80,and 160 μmol/L)on bone marrow macrophage viability was examined using the cell counting kit-8 assay kit.Tartrate-resistant acid phosphatase staining was performed to observe the effect of different concentrations of Cistanoside A on osteoblast differentiation and its effective intervention concentration was determined.There was positive control group,Cistanoside A low,medium,and high dose groups(40,80,and 160 μmol/L).After cell attachment,50 ng/mL RANKL was added to induce osteoblast differentiation,and the corresponding dose of Cistanoside A was added to the Cistanoside A low,medium,and high dose groups,respectively.F-actin ring and 2-(4-Amidinophenyl)-6-indolecarbamidine dihydrochloride staining were performed to detect the effects of Cistanoside A on the formation of osteoclasts.Toluidine blue staining of bone abrasion slices was used to observe the effects of Cistanoside A on bone resorption function of osteoclasts.The expression of upstream and downstream proteins of the JNK/MAPK pathway was detected by Western blot.The expression of genes related to osteoclast differentiation and bone resorption function such as tartrate-resistant acid phosphatase,DC-STAMP,Nfatc-1,Ctsk and c-Fos was detected by RT-qPCR. RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase staining,F-actin ring staining and resorption pit assay showed that Cistanoside A significantly inhibited RANKL-induced osteoclast differentiation and bone resorption in a dose-dependent manner compared with the positive control group.The results of RT-qPCR showed that compared with the positive control group,both high and low dose groups of Cistanoside A could significantly downregulate the mRNA expression of tartrate-resistant acid phosphatase,DC-STAMP,Nfatc-1,Ctsk and c-Fos in a dose-dependent manner.The results of western blot assay showed that the high dose group of Cistanoside A significantly inhibited the expression of p-JNK protein at 10,20,30 and 60 minutes of intervention;compared with the positive control group,Cistanoside A significantly inhibited the expression of Nfatc1 and c-Fos proteins in a dose-dependent manner.To conclude,Cistanoside A could inhibit the formation and bone resorption of osteoclasts by reducing the level of p-JNK protein,inhibiting the activation of MAPK pathway and the expression of key genes in osteoclasts.

Objective:To analyze the correlation between the expressions of human epidermal growth factor receptor 2(HER2)and carbohydrate antigen 153(CA153)and the technical parameter of acoustic palpation tissue imaging quantification(VTIQ)in patients with breast cancer.Methods:A total of 80 female patients with breast cancer admitted to The Third People's Hospital of Hefei from May 2018 to May 2020 were selected,including 14 cases at WHO stage Ⅰ,22 cases at WHO stage Ⅱ,31 cases at WHO stage Ⅲ and 13 cases at WHO stage Ⅳ.Another 53 female patients with benign breast diseases who were treated during the same period were selected as controls.At first,all patients underwent routine ultrasound examination,and then they entered the ultrasound VTIQ imaging mode to obtain the mean value of shear wave velocity(SWV).An immunohistochemistry was used to detect HER2 expressions in breast tissues,and Roche E411 electrochemiluminescence immunoassay analyzer was used to detect serum CA153 levels of them.Pearson method was used to analyze the correlation between serum CA153 levels and SWV mean values in patients with breast cancer.Results:Compared with benign patients,the SWV mean value of VTIQ technical parameter,serum CA153 level and HRR2 positive expression rate in patients with breast cancer were significantly higher,and the difference was statistically significant(F=39.107,78.353,P<0.05),respectively.Compared with patients at stages Ⅰ + Ⅱ of breast cancer,the SWV mean value of VTIQ technical parameter,serum CA153 level and HRR2 positive expression rate of patients at stages Ⅲ and Ⅳ of breast cancer significantly increased(t=2.685,3.556,8.326,10.455,P<0.05),respectively.Compared with patients at stage Ⅲ of breast cancer,the SWV mean value of VTIQ technical parameters,serum CA153 level and HRR2 positive expression rate of patients at Ⅳ stage of breast cancer were significantly higher(t=4.632,8.659,P<0.05),respectively.Compared with the SWV mean value of patients with HER2 negative expression of breast cancer,that of patients with HER2 positive expression of breast cancer was significantly higher(x2=59.751,P<0.05).There was a positive correlation between serum CA153 levels and SWV mean values in patients with breast cancer(r=0.501,P<0.05).Conclusion:The SWV mean value of VTIQ parameters is closely related to the expression levels of biomarkers HER2 and CA153 in patients with breast cancer.

Objective:To investigate the prevalence and potential classification of symptoms after total knee arthroplasty (TKA) in patients with knee osteoarthritis (KOA), and to analyze the differences in demographic characteristics and surgical data, compare the different potential subgroups, in order to provide a basis for clinical symptom management plans.Methods:This study was a multicenter cross-sectional survey. Through convenience sampling, patients with KOA undergoing TKA in the orthopaedic wards of four tertiary hospitals in Urumqi were selected as the study from November 2023 to February 2024. The study subjects were surveyed using a general information questionnaire, the Visual Analogue Scale (VAS) for pain, the Hospital Anxiety and Depression Scale (HADS), and the Pitts Burgh Sleep Quality Index (PSQI), and the degree of postoperative joint swelling and size of ecchymosis were measured. Latent class analysis was performed using Mplus 8.3 software, and Logistic regression analysis was conducted using SPSS 26.0 software to explore the influencing factors of the latent classes.Results:Totally 337 effective questionnaires were collected, and the recovery rate was 94.7% (337/356), and the age distribution ranged from 47 to 85 (65.19 ± 6.99) years old, with 90 (26.7%) males and 247 (73.3%) females. There were 92.3% (311/337) of TKA patients with postoperative symptom cluster. The symptom cluster of patients with TKA were identified as 3 classes. They were named as "high level pain-psychological disorder group"(12.5%, 39/311), "high bruises-moderate psychological disorders group"(25.4%, 79/311) and "low symptom burden group" (62.1%, 193/311). The results of the unordered multi-class logistic regression analysis showed that age 45-59 years ( OR = 2.367), body mass index 24.0-27.9 kg/m 2 ( OR = 0.207), living with children/parents ( OR = 6.473), and this being the second joint surgery ( OR = 0.040) were the factors influencing the "high level pain-psychological disorders group" (all P<0.05). The factors influencing the "high bruises-moderate psychological disorders group" were living with children/parents ( OR = 4.023), comorbid chronic diseases ( OR = 1.979, 3.842), and intraoperative blood loss ≤100 ml ( OR = 2.342) (all P<0.05). Conclusions:The postoperative symptom cluster of TKA patients have a relatively high incidence, and there is heterogeneity within the symptom cluster, so nurses need to identify at-risk patients early according to the characteristics of different categories and give interventions.

Objective To analyze the epidemiological characteristics,clinical manifestations and treatment of hallucinogenic boletus poisoning patients,and to provide reference for clinical diagnosis and treatment.Methods We retrospectively analyzed the epidemiological data,clinical manifestations,laboratory tests,treatment and outcomes of 36 patients with hallucinogenic boletus poisoning in our hospital from 2015 to 2022,and identified the species of mushrooms responsible for poisoning the patients.Results Of the 36 cases,32 cases were poisoned from June to September,24 cases were poisoned in towns and 12 cases in the countryside.Twenty-three patients were poisoned after eating multiple meals.Thirty-five patients ate Boletus lanmao identified by using genetic fingerprint and 7 ate Lanmaoa asiatica by using genetic sequence comparison.The incubation period of poisoning ranged from 1 to 48 h,with a median(quartile)of 19.0(12.0,24.8)h.All 36 cases had hallucinatory symptoms.Other symptoms were agitation and irritability in 21 cases,consciousness disorders in 29 cases,motor disorders in 21 cases,speech disorders in 19 cases and gastrointestinal symptoms in 18 cases.Laboratory tests showed that 16 patients had increased white blood cells(WBC)and percentage of neutrophils(NEUT%)and decreased percentage of lymphocyte(LY%).After fluid resuscitation combined with sedation and antipsychotic medication,all patients were cured and discharged from the hospital,of which 33 cases were discharged within 7 days.Conclusion Hallucinogenic boletus mushroom poisoning mainly occurs in summer and fall,the poisoned mushrooms are mainly Lanmaoa asiatica mushrooms,the incidence of poisoning is high in patients eating multiple meals,and the typical symptom is hallucination,and the patients can be cured through active symptomatic supportive treatment.

Objective:To study the clinical effect of sacrospinous ligament fixation (SSLF) and traditional vaginal hysterectomy on pelvic organ prolapse (POP) .Methods:A retrospective analysis was performed on 68 patients with POP of degree II-IV admittedl from Jan. 2017 to Dec. 2019. Among them, 33 patients were treated with SSLF (observation group) and 35 patients were treated with vaginal total hysterectomy (control group). Intraoperative blood loss, operative time, postoperative indwelling catheter and average length of hospital stay were compared between the two groups. The patients were followed up for 6 months, and the scores of pelvic floor dysfunction questionnaire-20 (PFDI-20) and sexual quality questionnaire -12 (PISQ-12) were used to evaluate the subjective satisfaction degree of postoperative recovery.Results:In the observation group, the intraoperative blood loss (173.94±52.14) ml, postoperative indurating catheter time (2.72±0.45) d and average length of hospital stay (7.09±0.63) d were observed. There were statistically significant differences in intraoperative blood loss (228.86±53.40) ml, postoperative induration time (4.54±0.61) d and mean hospital stay (9.22±0.81) d in the control group ( P<0.05). There was no significant difference in the operation time between the observation group (99.57±9.50) min and the control group (101.06±8.64) min, ( P>0.05). The improvement of PFDI-20 and PISQ-12 in both groups was significant before and after treatment. The PISQ-12 score of the observation group was higher than that of the control group 6 months after surgery, and the difference was statistically significant ( P <0. 05). There was no significant difference in PFDI-20 score between the two groups ( P>0.05). There was statistical significance in the positions of pop-Q indicators in the two surgical methods ( P < 0.05) . Conclusions:SSLF with uterus preservation and total vaginal hysterectomy are both effective in treatment of moderate and severe POP. However, SSLF with uterus preservation has less intraoperative blood loss, and the postoperative recovery is significantly better than that with total vaginal hysterectomy. In addition, it satisfies patients’ desire to preserve uterus, improves the postoperative sexual life quality, which is worthy of promotion.

ObjectiveTo explore the effect of mindfulness-based childbirth on pregnant women's anxiety and depression， and to provide references for related psychological intervention. MethodsA total of 80 pregnant women who attended the obstetrics department of the Third People's Hospital of Mianyang from October 2018 to March 2019 and met the diagnostic criteria of mild to moderate anxiety and depression in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were selected， and they were divided into two groups by random number table method， each with 40 cases. Both groups received regular mental health education. On this basis， experimental group received mindfulness-based childbirth training for 8 times， once a week. Meantime， all pregnant women were assessed using Patient Health Questionnaire-9 item （PHQ-9） and Generalized Anxiety Disorder Scale （GAD-7） at the baseline and after intervention. ResultsAt the baseline and after intervention， the scores of PHQ-9 ［（6.95±1.40） vs. （2.10±1.34）， P<0.05］ and GAD-7 ［（7.23±1.29） vs. （2.08±1.51）， P<0.05］ in the experimental group had statistical significance， and the scores of PHQ-9 ［（7.00±1.43） vs. （3.65±1.35）， P<0.05］ and GAD-7 ［（7.18±1.57） vs. （3.38±1.66）， P<0.05］ in the control group had statistical significance. Moreover， the post-intervention scores of PHQ-9 and GAD-7 were significantly lower in experimental group than in control group （t=5.161， 3.666， P<0.01）. ConclusionCompared with mental health education alone， its combination with mindfulness-based childbirth achieves better effect in alleviating the anxiety and depression status of pregnant women.

Objective: To investigate the clinical value of endoscopic ultrasonography (EUS) and Multi-slice Spiral CT (MSCT) in the preoperativestaging of tumor(T) and lymph node (N) metastasis in patients with SiewertⅡand Ⅲ typeadenocarcinoma of esophagogastric junction(AEG). Methods: Clinical data of 145 Siewert Ⅱ and Ⅲ type AEG patientswithout preoperative chemoradiotherapy were retrospectively reviewed. Theyall received preoperative EUS and MSCT examination and underwent surgical resection, and the results of EUS and MSCT were compared with their postoperative pathologic staging. Results: The sensitivity, specificity, and accuracy of EUS for T stage in Siewert Ⅱ and Ⅲ type AEG were higher than those of MSCT. The total accuracy of EUS and MSCT were 90.3% and 63.5%, respectively, and the difference was statistically significant (χ²=29.52, P<0.01). The sensitivity of EUS for T1, T2 and T3 were 89.5%, 91.1% and 85.2%, respectively, which were significantly higher than 42.1%, 66.7% and 29.6% of MSCT (χ²=9.47, P<0.01 for T1; χ²=8.07, P<0.01 for T2; χ²=17.40, P<0.01 for T3). In addition, the total accuracy of EUS and MSCT for lymph node metastasis status of Siewert Ⅱ and Ⅲ type AEG were 75.9% and 64.8%, respectively, showing a statistically significant difference(χ²=4.23, P=0.04). The sensitivity of EUS for N1 and N2 were 82.1% and 79.2%, respectively, which were significantly higher than 53.6% and 60.4% of MSCT (χ²=5.24, P=0.02; χ²=4.48, P=0.03). There was no statistical significance for sensitivity of EUS and MSCT in N0 and N3 (P>0.05). Conclusion EUS diagnosis of T and N staging in Siewert Ⅱ/Ⅲ type AEG showed significantly greater performance than MSCT.

We presented a new method for vessel segmentation and vascular structure recognition for coronary angiographic images. During vessel segmentation, a new vessel function was proposed to attain vessel feature map. Then the region growing algorithm was implemented with an automatic selection of seed point, extraction of main vessel branch, and vessel detail repairing. In the algorithm of vascular structure recognition, a fuzzy operator was used, which can detect the structures of vascular segments, bifurcations, crosses, and tips. The experimental results indicated that there was about 5 percent larger vessel region which was extracted by the proposed segmentation method than that by the simple region growing algorithm, and several thinner vessels were resumed from the lower gray region. The results also indicated that the fuzzy operator could correctly infer the simulative and real vessel structure with 100% and 90.59% correctness rate on the average, respectively.
Algorithms ; Coronary Angiography ; Humans ; Radiographic Image Enhancement ; methods ; X-Rays

Objective To investigate the gene polymorphism of inhibitory killer cell immunoglobulin- like receptor (iKIR) in patients with inflammatory bowel disease (IBD) and whether the iKIR gene polymorphisms were associated with IBD.Methods Peripheral blood DNA samples were isolated from 100 patients with ulcerative colitis (UC),52 patients with Crohn's disease (CD) and 106 randomly ethnically matched healthy controls.The iKIR gene polymorphisms were analyzed by sequence specific primer polymerase chain reproduction (PCR-SSP).Phenotypic frequency and gene frequency of iKIR gene were calculated,and differences were compared between IBD patients and healthy controls.Results iKIR genes (including KIR2DL1,KIR2DL2,KIR2DL3,KIR2DL4,KIR2DL5,KIR3DL1,KIR3DL2, KIR3DL3) were found to be present in all subjects at different levels.Interestingly,phenotypic frequencies of KIR2DL1 and KIR2DL3 were significantly lower in UC patients than those in healthy controls (P = 0.001),while phenotypic frequencies of KIR2DL2,KIR2DL4,KIR2DL5,KIR3DL1, KIR3DL2 and KIR3DL3 were no difference between UC patients and healthy controls (P>0.05).The phenotype frequency of KIR2DL1 was significantly decreased in CD patients compared with healthy controls (P = 0.007),while phenotypic frequencies of other iKIR were observed to be no significant change between CD patients and healthy controls (P>0.05 ).Conclusions The KIR2DL1 and KIR2DL3 gene phenotype frequencies are decreased in UC patients,which suggests that these gene polymorphisms are associated with the susceptibility of UC,and the polymorphism of KIR2DL1 gene is involved in the susceptibility of CD.

A new proposed data mining technique, support vector machine (SVM), is used to predict the degree of malignancy in brain glioma. Based on statistical learning theory, SVM realizes the principle of data dependent structure risk minimization, so it can depress the overfitting with better generalization performance, since the prediction in medical diagnosis often deals with a small sample. SVM based rule induction algorithm is implemented in comparison with other data mining techniques such as artificial neural networks, rule induction algorithm and fuzzy rule extraction algorithm based on fuzzy max-min neural networks (FRE-FMMNN) proposed recently. Computation results by 10 fold cross validation method show that SVM can get higher prediction accuracy than artificial neural networks and FRE-FMMNN, which implies SVM can get higher accuracy and more reliability. On the whole data sets, SVM gets one rule with the classification accuracy of 89.29%, while FRE-FMMNN gets two rules of 84. 64%, in which the rule got by SVM is of quantity relation and contains more information than the two rules by FRE-FMMNN. All the above show SVM is a potential algorithm for the medical diagnosis such as the prediction of the degree of malignancy in brain glioma.
Algorithms ; Artificial Intelligence ; Brain Neoplasms ; pathology ; Diagnosis, Computer-Assisted ; methods ; Female ; Glioma ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Models, Statistical ; Neural Networks (Computer) ; Predictive Value of Tests