Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by high rates of prevalence and recurrence. Repetitive transcranial magnetic stimulation (rTMS) has been widely utilized in the acute phase treatment of MDD and has shown potential in maintenance therapy. However, the factors influencing the efficacy of rTMS during the acute phase and the sustainability of its long-term therapeutic effects remain incompletely understood. Additionally, a consensus on the optimal maintenance treatment protocol has yet to be established. This article reviews recent evidence on the application of rTMS in both acute and maintenance treatment of MDD, aiming to summarize current research progress and provide insights for the further promotion and application of rTMS in clinical practice.

Objective To observe the efficacy of percutaneous mechanical thrombectomy(PMT)for treating different traditional Chinese medicine(TCM)syndrome type lower extremity arterial thromboses.Methods Forty patients with lower extremity arterial thromboses who underwent PMT were retrospectively enrolled and divided into dampness-heat syndrome group(n=18)and blood stasis syndrome group(n=22)according to TCM syndrome types.The technical success rate,ankle-brachial index(ABI),Rutherford grade and vascular patency rate 12 months after PMT were compared between groups.Perioperative complications and adverse events during follow-up were recorded.Results The technical success rate of PMT in dampness-heat syndrome group and blood stasis syndrome group was 94.44%(17/18)and 100%(22/22),respectively.Twelve months after PMT,ABI was 0.45±0.11 and 0.52±0.14,and vascular patency rate was 94.44%(17/18)and 81.82%(18/22)in dampness-heat syndrome group and blood stasis syndrome group,respectively,both not significantly different between groups(all P＞0.05).No significant difference of Rutherford grade before treatment was found between groups(P＞0.05),while 12 months after PMT,Rutherford grade in dampness-heat syndrome group was higher than in blood stasis syndrome group(P＜0.05).During perioperative period,false aneurysm of brachial artery occurred in 1 case in dampness-heat syndrome group,while osteofascial compartment syndrome and atrial fibrillation occurred each in 1 case in blood stasis syndrome group,both relieved after treatments.No serious adverse event such as amputation nor death occurred during follow-up.Conclusion PMT was effective and safe for treating different TCM syndrome type lower extremity arterial thromboses.The prognosis of patients with blood stasis syndrome type lower extremity arterial thromboses was better than that of those with dampness-heat syndrome.

Osteochondral lesions of the talus (OLT) frequently manifest following ankle joint trauma, causing ankle pain, swelling and impaired mobility, thereby significantly impeding daily activities of the patients. Presently, clinical treatment approaches encompass both conservative management and surgical intervention. Conservative management endeavors to alleviate symptoms, while patients experiencing persistent symptoms resort to surgical intervention. Commonly employed surgical treatments encompass bone marrow stimulation, autologous osteochondral transplantation, and allogeneic osteochondral transplantation. Bone marrow stimulation is employed as a therapeutic approach for the management of smaller OLT, demonstrating favorable short-term effectiveness; however, the long-term prognosis remains uncertain. Autologous osteochondral transplantation is a viable option for larger OLT lesions, albeit it carries the potential of complications at the donor site. Conversely, allogenic osteochondral transplantation exhibits a diminished success rate. In recent times, the utilization of cell transplantation techniques has garnered escalating interest in the treatment of OLT due to their capacity to regenerate cartilage resembling hyaline and their diverse range of cellular origins. The authors reviewed the progress of cell transplantation in the treatment of OLT, providing a reference for the clinical treatment.

Objective:To investigate the value of a deep learning method based on MobileNet in classification of bedside chest radiograph and improvement of the work efficiency.Methods:A total of 6, 320 bedside chest radiographs from January 2017 to December 2022 in the Second Peoples′ Hospital of Changzhou were retrospectively collected. The included cases were divided into normal group (885 images), pneumonia group (1 927 images), pleural effusion group (373 images), and pneumonia with pleural effusion group (3 135 images). Three hundred and fifty images were selected as a validation set, while the remaining images were divided into a train set (4 775 images) and a test set (1 195 images) using simple randomization, by 8∶2 ratio. Two lightweight convolutional neural network models (MobileNetV1 and MobileNetV2) were used to construct a bedside chest radiograph classification model, based on which two fine-tuning strategies were designed. Four models were generated namely MobileNetV1_False (V1_False), MobileNetV1_True (V1_True), MobileNetV2_False (V2_False) and MobileNetV2_True (V2_True). In the first stage, a binary classification model was established to divide the images into normal and lesion groups; then a four-class classification model was established in the second stage, with which the images were divided into four groups: normal, pneumonia, pleural effusion and pneumonia with pleural effusion. Metrics for model performance evaluation including accuracy (Ac), precision (Pr), recall rate (Rc), F1 score (F1) and area under the receiver operating characteristic curve (AUC) were calculated.Results:In both the first and second stages, V1_True and V2_True had higher Ac, Pr, Rc, and F1 than V1_False and V2_False in both the training set and validation set; and the V1_True model outperformed the other three models in classification. The classification Ac of the V1_True model in the validation set was higher than that of radiologists in the first stage [95.71% (335/350) vs. 90.29% (316/350)] and in the second stage [93.43% (327/350) vs. 87.14% (305/350)]. The recognition time of V1_True model′s in the validation set of 350 bedside chest radiographs was significantly less than that of the radiologists (mean: 17 s vs. 300 min).Conclusions:V1_True is an optimal MobileNet model for classifying bedside chest radiographs. The application of this model in clinical practice may help to accurately identify the information of lung lesions from bedside chest radiographs in time, and may improve the work efficiency in the radiology department.

OBJECTIVE: To carry out preimplantation genetic testing (PGT) for a couple where the husband was affected by osteogenesis imperfecta combined with balanced translocation using the karyomapping technique. METHODS: Blastocysts were detected using karyomapping, the carrier status of COL1A1 c.760G>A (p.Gly254Arg) variant and the carrier status of the translocated chromosome were analyzed simultaneously. RESULTS: For a total of 10 blastocysts, two euploid blastocysts were found to not carry the COL1A1 c.760G>A (p.Gly254Arg) variant but a balanced translocation. After transplanting one of the blastocysts, clinical pregnancy was achieved. Amniocentesis at 18th gestational week and prenatal genetic testing was in keeping with the result of PGT.A healthy female was born at 40+4 weeks gestation. CONCLUSION For patients simultaneously carrying genetic variant and balanced chromosomal translocation, PGT can be performed with efficiency by the use of karyomapping method.
Blastocyst ; Female ; Fertilization in Vitro ; Genetic Testing ; Humans ; Osteogenesis Imperfecta/genetics* ; Pregnancy ; Preimplantation Diagnosis ; Spouses ; Translocation, Genetic

Toxoplasma gondii, an intracellular protozoan parasite that infects one-third of the world’s population, has been reported to hijack host cell apoptotic machinery and promote either an anti- or proapoptotic program depending on the parasite virulence and load and the host cell type. However, little is known about the regulation of human FHs 74 small intestinal epithelial cell viability in response to T. gondii infection. Here we show that T. gondii RH strain tachyzoite infection or ESP treatment of FHs 74 Int cells induced apoptosis, mitochondrial dysfunction and ER stress in host cells. Pretreatment with 4-PBA inhibited the expression or activation of key molecules involved in ER stress. In addition, both T. gondii and ESP challenge-induced mitochondrial dysfunction and cell death were dramatically suppressed in 4-PBA pretreated cells. Our study indicates that T. gondii infection induced ER stress in FHs 74 Int cells, which induced mitochondrial dysfunction followed by apoptosis. This may constitute a potential molecular mechanism responsible for the foodborne parasitic disease caused by T. gondii.

OBJECTIVE: To explore the genetic etiology for a fetus with congenital orofacial cleft. METHODS: Single nucleotide polymorphism microarray (SNP array) was carried out on skin tissues sampled from the fetus following induced abortion for the detection of copy number variation (CNVs). Pathogenicity of the candidate gene was validated through experiment. RESULTS: SNP array revealed that the fetus has carried a hemizygous 9.23Mb deletion at Xq21.31-q22.1(91 063 807-100 293 555), which was inherited from its mother. The region contained 13 OMIM genes and 1 ncRNA coding gene(MIR548M). Inhibiting of the expression of the MIR548M gene in oral epithelial celllines has resulted in up-regulation of the expression of SUMO1 gene which was known to involve in the pathogenesis of orofacial cleft. CONCLUSION Dosage insufficiency of the MIR548M gene may underlie the etiology of orofacial cleft in this fetus.
Cleft Lip/genetics* ; Cleft Palate/genetics* ; DNA Copy Number Variations/genetics* ; Female ; Fetus ; Humans ; MicroRNAs/genetics* ; Polymorphism, Single Nucleotide ; Pregnancy ; SUMO-1 Protein

Objective: To investigate the effects of cancer susceptibility candidate gene 19 (CASC19) regulating the expression of microRNA-449b-5p (miR-449b-5p) on the proliferation, apoptosis and radiation sensitivity of cervical cancer cells. Methods: (1) HeLa cells of cervical cancer cell line were cultured. HeLa cells were irradiated with X-ray at different doses (0, 2, 4, 6, 8 Gy, respectively), then the expression level of CASC19 mRNA and miR-449b-5p were detected by real-time quantitative PCR. (2) HeLa cell proliferation, apoptosis, radiation sensitivity (expressed as a survival fraction) and its related protein expression included cyclin D1, cleaved-caspase-3, and histone variant H2AX (γ-H2AX) were examined after different treatment including silencing CASC19 expression, over-expressing miR-449b-5p, down-regulating miR-449b-5p and silencing CASC19 expression. (3) The dual luciferase reporter gene experiment and real-time quantitative PCR technology were used to verify the targeting relationship between CASC19 and miR-449b-5p. Results: (1) With the increase of X-ray irradiation different dose (0, 2, 4, 6, 8 Gy), the expression level of CASC19 mRNA in HeLa cells gradually increased (F=502.681, P=0.000), and the expression level of miR-449b-5p gradually decreased (F=202.936, P=0.000).(2) After silencing CASC19 expression or over-expressing miR-449b-5p, the survival rate of HeLa cells was significantly reduced (P<0.05), the apoptosis rate was significantly increased (P<0.05), the survival fraction was significantly reduced (P<0.05), the expression level of cyclin D1 protein was significantly reduced (P<0.05), and the expression levels of cleaved-caspase-3 and γ-H2AX protein were significantly increased (P<0.05). After down-regulating miR-449b-5p and silencing CASC19 expression, the survival rate of HeLa cells was significantly reduced (P<0.05), the apoptosis rate was significantly increased (P<0.05), the survival fraction was significantly reduced (P<0.05), the expression levels of cyclin D1 and γ-H2AX protein were significantly increased (P<0.05), and the expression level of cleaved-caspase-3 was significantly decreased (P<0.05). (3) Over expression of miR-449b-5p could significantly reduce the luciferase activity of CASC19 wild type (1.00±0.09 versus 0.37±0.05, P<0.01), but there were no significant effect on the luciferase activity of CASC19 mutant type (0.92±0.07 versus 0.94±0.05, P>0.05). After the expression of CASC19 was silenced, the expression level of miR-449b-5p in HeLa cells increased significantly (1.00±0.12 versus 4.84±0.49, P<0.05). After overexpression of CASC19, the expression level of miR-449b-5p in HeLa cells was significantly reduced (1.00±0.09 versus 0.38±0.04, P<0.05). Conclusion CASC19 in HeLa cells negatively regulates the expression of miR-449b-5p, and down-regulating the expression of miR-449b-5p could partially reverse the effects of silencing CASC19 on HeLa cell proliferation, apoptosis and radiation sensitivity.

Objective The aim of this study was to investigate FFDM differential diagnosis between breast mastitis,benign hyperplasia and breast cancer. Methods Fifty-nine cases of non-puerperal breast mastitis,sixty-eight cases of benign hyperpla-sia and two hundred and forty cases with non-mass type breast cancer were analyzed retrospectively,which were verified by surgery and pathology by contrast with FFDM signs,pathological types,grouped and statistics processed. The observation indexes of lamellar shadow included shape,density and edge. The observation indexes of linear shadow included direction,form and diameter. Results The FFDM signs in three groups of breast diseases were statistically significant(P<0. 05):the form of linear shadow,accompanied by calcifications,the shape of lamellar shadow,the direction of linear shadow,the distribution of lesion,the sharp angle of shadow edge. χ2 segmentation show that there were significant differences between three groups(P<0. 0125):the shape of lamellar shadow,the direc-tion of linear shadow. Conclusion There have some values for the diagnosis of breast cancer by rigid form and radial distribution of linear shadow,rigid shape and segmental distribution of lamellar shadow,the polymorphic calcifications and the sharp angle sign.

Objective To investigate the effect of evodiamine on the proliferation and sensitivity of endometrial cancer cells to irradiation.Methods After administration of evodiamine,cell proliferations of human endometrial carcinoma cell lines of Ishikawa,HEC-1A,AN3CA were detected by MTT and the half maximal inhibitory concentration (IC50) of drug was calculated.The cell lines most sensitive to drug were screened for further experiment and administered with evodiamine (IC50) and 8 Gy irradiation.Then,cell apoptosis was detected by flow cytometry,the levels of Cleaved Caspase-3,p38 and p-p38 were measured by Western blot,and the level of intracellular ROS was detected by a ROS kit.Cell clone survival was also detected to evaluate cell radiosensitivity.Results 1,2,4,6 and 8 μmol/L evodiamine could inhibit the proliferation of the cell line of Ishikawa,HEC-1A,and AN3CA with IC50 of(8.32 ± 0.95),(3.98 ± 0.84) and (4.78 ± 0.64) μmol/L,respectively.Compared with radiation alone,after radiation in combination with 4 μmol/L evodiamine,the apoptosis rate of HEC-1A cells was increased from (45.54 ±4.25)％ to (65.87 ±2.93)％ (t =11.010,P ＜0.05) and cell viability decreased from (41.84±4.18)％ to (33.27 ± 3.52)％ (t =7.484,P ＜0.05),and the levels of ROS,Cleaved Caspase-3 and p-p38 were also enhanced.In addition,the sensitivity ratio of evodiamine for HEC-1A cells was calculated to be 1.628.Conclusions Evodiamine could inhibit the proliferation,promote apoptosis and enhance the radiosensitivity of endometrial carcinoma cells,in which the intracellular ROS and p38 signaling pathway may be involved.