【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

Objective To investigate the value of HALP score in evaluating the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy and whether the nomogram based on HALP score could effectively predict the postoperative survival of patients. Methods A retrospective study was performed for the clinical data of 253 HCC patients who underwent surgical treatment in Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, from July 2013 to March 2020. The receiver operating characteristic (ROC) curve was plotted to calculate the optimal cut-off values of HALP score and other related indicators; the chi-square test was used to investigate the association between HALP score and clinicopathological features; the Kaplan-Meier method was used to plot survival curves, and the Log-rank test method was used for comparison. The univariate and multivariate Cox regression analyses were used to investigate the association of HALP score and other clinical parameters with the prognosis of patients. R3.6 was used to establish a nomogram; C-index and calibration curve were used to evaluate the predictive ability of the nomogram, and net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to compare predictive ability between the nomogram model and the conventional model. Results The Kaplan-Meier analysis showed that the high HALP group had significantly better overall survival (OS) and recurrence-free survival (RFS) than the low HALP group ( P < 0.001). The univariate Cox regression analysis showed that white blood cell count, gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), alpha-fetoprotein (AFP), surgical approach, microvascular invasion, TNM stage, degree of tumor differentiation, HALP, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) were significantly associated with OS (all P < 0.05). The variables with statistical significance in the univariate Cox regression analysis were included in the multivariate Cox regression analysis, and the results showed that ALP, AST/ALT ratio, ALP, AFP, degree of tumor differentiation, and TNM stage were independent influencing factors for OS after surgery in HCC patients (all P < 0.05). The univariate Cox regression analysis showed that GGT, ALP, AFP, microvascular invasion, TNM stage, degree of tumor differentiation, HALP, AST/ALT ratio, NLR, and MLR were significantly associated with RFS (all P < 0.05), and the multivariate Cox regression analysis showed that HALP, AST/ALT ratio, NLR, ALP, AFP, and TNM stage were independent influencing factors for RFS after surgery in HCC patients (all P < 0.05). The nomograms for OS and RFS of HCC patients were established based on the multivariate analysis. The nomogram for OS had a C-index of 0.732 (95% confidence interval [ CI ]: 0.691-0.774) and an area under the ROC curve of 0.795, 0.791, and 0.775, respectively, in predicting 1-, 3-, and 5-year survival rates, and the nomogram for RFS had a C-index of 0.677 (95% CI : 0.637-0.717) and an area under the ROC curve of 0.742, 0.733, and 0.716, respectively, in predicting 1-, 3-, and 5-year survival rates. The calibration curves of 1-, 3-, and 5-year OS were well fitted to those of 1-, 3-, and 5-year RFS. Conclusion A low level of HALP before surgery is a predictive factor for poor long-term prognosis in HCC patients undergoing surgical treatment, and the nomogram model based on HALP score is superior to the BCLC staging model and can better predict the prognosis of HCC.

Total knee arthroplasty， as a common treatment option for advanced knee osteoarthritis， can alleviate the clinical symptoms of patients. Deep vein thrombosis of the lower extremity is the most common complication of total knee arthroplasty. Previous studies have shown that the occurrence of deep vein thrombosis after total knee arthroplasty is mostly related to the overexpression of inflammatory factors in vivo. Nuclear transcription factor-κB， Toll-like receptor 4， phosphatidylinositol 3-kinase/protein kinase B， tumor necrosis factor， and nuclear transcription factor E₂-related factor 2 are typical signaling pathways related to inflammation. Regulating the expression of the signaling pathways can intervene the formation of inflammatory factors. Inhibiting the formation of inflammatory factors can help suppress the activation of platelets， thereby blocking thrombosis. According to previous research， Chinese medicine monomers， Chinese medicine extract， and compound Chinese medicine prescriptions all directly or indirectly inhibit the expression of inflammatory factors by regulating the above signaling pathways， thereby suppressing the occurrence of deep vein thrombosis after total knee arthroplasty. Therefore， Chinese medicine can reduce postoperative complications and promote postoperative recovery of patients at low cost with small side effects. This article summarizes the research on Chinese medicine intervention on deep vein thrombosis-related signaling pathways after total knee arthroplasty， which is expected to lay a basis for the in-depth study and clinical application of Chinese medicine in deep vein thrombosis.

Bivalves are species-rich mollusks with prominent protective roles in coastal ecosystems.Across these ancient lineages,colony-founding larvae anchor themselves either by byssus produc-tion or by cemented attachment.The latter mode of sessile life is strongly molded by left-right shell asymmetry during larval development of Ostreoida oysters such as Crassostrea hongkongensis.Here,we sequenced the genome of C.hongkongensis in high resolution and compared it to reference bivalve genomes to unveil genomic determinants driving cemented attachment and shell asymmetry.Importantly,loss of the homeobox gene Antennapedia(Antp)and broad expansion of lineage-specific extracellular gene families are implicated in a shift from byssal to cemented attachment in bivalves.Comparative transcriptomic analysis shows a conspicuous divergence between left-right asymmetrical C.hongkongensis and symmetrical Pinctada fucata in their expression profiles.Especially,a couple of orthologous transcription factor genes and lineage-specific shell-related gene families including that encoding tyrosinases are elevated,and may cooperatively govern asymmet-rical shell formation in Ostreoida oysters.

Objective:To investigate the correlations of dynamic iodine nutrition status and thyroid function in pregnant women and newborns in Lingang of Shanghai, so as to provide an evidence for whether urine iodine testing and iodine supplementation should be carried out.Methods:A prospective study was conducted by randomly selecting pregnant women from October 2017 to October 2018 in Shanghai Sixth People’s Hospital East Affiliated to Shanghai University of Medicine & Health Sciences. The pregnant women were divided into early (5-12 weeks), middle (22-24 weeks), late pregnancy (36-37 weeks). Samples of serum and 24 hours urine were collected to test on thyrotropin (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), anti-thyroid peroxidase (TPOAb), anti-thyroglobulin (TgAb) and urinary iodine. TSH in neonatal heel blood was analyzed 72 h after birth (newborns from pregnant women in the late pregnancy). The differences of thyroid function of pregnant women with different pregnant periods and different urinary iodine levels were analyzed, as well as the neonatal TSH levels of pregnant women with different urinary iodine levels. Results:A total of 109, 90 and 54 cases of pregnant women in early, middle and late pregnancy were investigated and the medians of urinary iodine were 120.95, 136.30 and 116.80 μg/L, respectively. There was no significant difference in urinary iodine content among different pregnant periods( P > 0.05). The proportions of urinary iodine level less than 150 μg/L in early, middle and late pregnancy were 75.2% (82/109), 61.1% (55/90) and 59.3% (32/54), respectively. The median values of serum TSH in early, middle and late pregnancy were 1.81, 1.95 and 2.29 mU/L, mean values of FT 3 were (5.21 ± 0.84), (4.79 ± 0.72) and (4.13 ± 0.56)pmol/L, and means of FT 4 were (16.48 ± 2.58), (15.02 ± 2.78) and (13.31 ± 1.87) pmol/L, respectively. The FT 3 and FT 4 levels in the late pregnancy were lower than those in the early and middle pregnancy, while the TSH levels in the late pregnancy were higher than those in the early and middle pregnancy. There were no significant difference in serum FT 3, FT 4 and TSH levels among early, middle and late pregnancy under different urinary iodine levels. The median TSH of newborn heel blood was 1.48 mU/L. There was no statistically significant difference between the neonatal heel blood TSH level of pregnant women with urinary iodine < 150 μg/L [1.45(1.09, 2.23)mU/L] in late pregnancy and those with urinary iodine ≥150 μg/L [1.42 (1.14, 2.61) mU/L, Z=- 0.354, P > 0.05]. Conclusions:There is mild iodine deficiency in pregnant women in Lingang of Shanghai. However, due to the compensatory regulation, it has no significant effect on the thyroid function of mother and newborn. Monitoring of iodine nutrition of pregnant women should be carried out and iodine supplementation should be done scientifically and reasonably.

To address the increasing need for detecting and validating protein biomarkers in clinical specimens, mass spectrometry (MS)-based targeted proteomic techniques, including the selected reaction monitoring (SRM), parallel reaction monitoring (PRM), and massively parallel data-independent acquisition (DIA), have been developed. For optimal performance, they require the fragment ion spectra of targeted peptides as prior knowledge. In this report, we describe a MS pipe-line and spectral resource to support targeted proteomics studies for human tissue samples. To build the spectral resource, we integrated common open-source MS computational tools to assemble a freely accessible computational workflow based on Docker. We then applied the workflow to gen-erate DPHL, a comprehensive DIA pan-human library, from 1096 data-dependent acquisition (DDA) MS raw files for 16 types of cancer samples. This extensive spectral resource was then applied to a proteomic study of 17 prostate cancer (PCa) patients. Thereafter, PRM validation was applied to a larger study of 57 PCa patients and the differential expression of three proteins in prostate tumor was validated. As a second application, the DPHL spectral resource was applied to a study consisting of plasma samples from 19 diffuse large B cell lymphoma (DLBCL) patients and 18 healthy control subjects. Differentially expressed proteins between DLBCL patients and healthy control subjects were detected by DIA-MS and confirmed by PRM. These data demonstrate that the DPHL supports DIA and PRM MS pipelines for robust protein biomarker discovery. DPHL is freely accessible at https://www.iprox.org/page/project.html?id=IPX0001400000.

Objective To investigate the changes of hemodynamics and cardiac function in pediatric living donor liver transplantation (LDLT).Methods 50 cases of pediatric living donor liver transplantation in our hospital from January 2016 to January 2017 were collected.The hemodynamics was monitored by Mostcare with the radial artery.Acquisition of heart rate (HR),mean arterial pressure (MAP),peripheral vascular resistance index (SVR/SVRI),stroke volume / stroke index (SV/SVI),cardiac output (CO/CI),cardiac index / stroke volume variability (SVV),dp/dtmax (cardiac contractility),cardiac cycle efficiency (CCE) at the moment of the start of operation(T0),before occlusion of the inferior vena cava (T1),immediately after occlusion of the inferior vena cava (T2),anhepatic phase 30 min (T3),immediately after reperfusion(T4),neohepatic phase 5 min (T5),30 min (T6) and 60 min (T7).Results There were no significantly hemodynamic fluctuations before occlusion of the portal vein.At T3,the increased of MAP,CI,SVRI (T3 vs T0,P＜0.05),while CCE decreased significantly (T3 vs T0,P＜0.05);MAP,SVRI,lower HR,CI and dp/dtmax have different degrees of liver T4,but the change was not significant.SVV fluctuated in the anhepatic phase at 11％ ～ 15％,maintained in the new liver stage at 12％ ～ 15％,but fluctuated slightly.Conclusion Mostcare can be used to monitor the hemodynamic and cardiac function changes in pediatric living donor liver transplantation,but the reasons for the change of the monitoring indicators and the significance of guiding the perioperative treatment need to be further studied.

Objective To compare the diagnostic value of CT and MRI in the diagnosis of far lateral lumbar disc herniation (FLLDH). Methods The CT and MRI imagine data of 34 patients with FLLDH were retrospectively analyzed and compared. Results The positive rate of CT in diagnosis FLLDH was 88.24%(30/34), and the positive rate of MRI was 94.12%(32/34). There was no statistical difference (P>0.05). There were no statistical differences in the diagnosis of disease region and image representation between CT and MRI (P>0.05). Conclusions There is higher coincidence rate of CT and MRI in the diagnosis of FLLDH, but the two imaging methods have their own advantages and disadvantages. In clinical practice, the two imaging methods can be used to improve the clinical diagnosis rate, and provide a reliable basis for determining the surgical treatment options.

Objective To observe the peroxidase body growth activated receptor γ (PPARγ) agonist rosiglitazone on acute pancreatitis in mice with hepatic injury and to investigate the mechanism of hepatic injury .Methods Seventy‐two male Kunming mice were randomly allocated into three groups(24 cases for each group):acute pancreatitis group(AP group) ,rosiglitazone group (AP‐ROS group) ,saline group(NS group) .Mice were killed at 6 ,12 and 24 h after induction of acute pancreatitis .Serum amylase , ALT and AST activities were measured .The expressions of NF‐κB and PPARγmRNA were assessed by RT‐PCR .The expressions of NF‐κB and PPARγ protein were assessed by Western blot .Results Compared with NS group ,serum amylase ,ALT and AST levels at each time point significantly increased in AP group(P< 0 .01);serum amylase ,ALT and AST levels in AP‐ROS group were significantly lower than those in AP group(P<0 .01) .Compared with NS group ,the expressions of liver PPARγ mRNA and protein in AP group were markedly lower at 6 h and 12 h(P<0 .05) ,and the expressions of PPARγmRNA and protein in AP‐ROS group were significantly higher than those in NS group and AP group(P<0 .01) .The expressions of liver NF‐κB mRNA and NF‐κB p65 protein in AP group were significantly higher than those in NS group and AP‐ROS group at all time points(P<0 .01) .Con‐clusion There are clear relationships between NF‐κB and hepatic injury in acute pancreatitis .The expressions of PPARγin injuried hepatic decreased .Rosiglitazone can increase the expressions of PPARγand prevent the expressions of NF‐κB in hepatic during the early phase of acute pancreatitis .

Objective To investigate the value of perfusion CT in the evaluation of neoadjuvant chemotherapy in locally advanced squamous cell carcinoma.Methods Sixty-seven patients with Ib2-IIb squamous cell carcinoma of the cervix underwent CT perfusion imaging before neoadjuvant chemotherapy to measure blood flow (BF),blood volume (BV),peak time (MTT),permeability sur-face (PMB),perfusion time to peak (TTP)and MIP(HU);and underwent routine enhancement CT after the two course of neoadju-vant chemotherapy treatment to measure tumor size,and evaluate the therapeutic effect.Results Among 67 patients,48 patents were effective (2 completely remission and 46 partial remission),and 1 9 patients were ineffective (1 5 stable and 4 progressed),with the overall response rate of 71.6%.The differences of PMB and BV value between effective and ineffective group were statistically significant before neoadjuvant chemotherapy (P <0.001).The BF,MTT,TTP value were no significant difference between effec-tive and ineffective group before neoadjuvant chemotherapy (P >0.05).The BV and PMB value were relatively higher in the patients with effective chemotherapy.Conclusion CT perfusion imaging could measure the BV and PMB value of the tumor before neoadju-vant chemotherapy to provide the basis for treatment selection.