Objective:Glioblastoma(GBM)and brain metastases(BMs)are the two most common malignant brain tumors in adults.Magnetic resonance imaging(MRI)is a commonly used method for screening and evaluating the prognosis of brain tumors,but the specificity and sensitivity of conventional MRI sequences in differential diagnosis of GBM and BMs are limited.In recent years,deep neural network has shown great potential in the realization of diagnostic classification and the establishment of clinical decision support system.This study aims to apply the radiomics features extracted by deep learning techniques to explore the feasibility of accurate preoperative classification for newly diagnosed GBM and solitary brain metastases(SBMs),and to further explore the impact of multimodality data fusion on classification tasks. Methods:Standard protocol cranial MRI sequence data from 135 newly diagnosed GBM patients and 73 patients with SBMs confirmed by histopathologic or clinical diagnosis were retrospectively analyzed.First,structural T1-weight,T1C-weight,and T2-weight were selected as 3 inputs to the entire model,regions of interest(ROIs)were manually delineated on the registered three modal MR images,and multimodality radiomics features were obtained,dimensions were reduced using a random forest(RF)-based feature selection method,and the importance of each feature was further analyzed.Secondly,we used the method of contrast disentangled to find the shared features and complementary features between different modal features.Finally,the response of each sample to GBM and SBMs was predicted by fusing 2 features from different modalities. Results:The radiomics features using machine learning and the multi-modal fusion method had a good discriminatory ability for GBM and SBMs.Furthermore,compared with single-modal data,the multimodal fusion models using machine learning algorithms such as support vector machine(SVM),Logistic regression,RF,adaptive boosting(AdaBoost),and gradient boosting decision tree(GBDT)achieved significant improvements,with area under the curve(AUC)values of 0.974,0.978,0.943,0.938,and 0.947,respectively;our comparative disentangled multi-modal MR fusion method performs well,and the results of AUC,accuracy(ACC),sensitivity(SEN)and specificity(SPE)in the test set were 0.985,0.984,0.900,and 0.990,respectively.Compared with other multi-modal fusion methods,AUC,ACC,and SEN in this study all achieved the best performance.In the ablation experiment to verify the effects of each module component in this study,AUC,ACC,and SEN increased by 1.6%,10.9%and 15.0%,respectively after 3 loss functions were used simultaneously. Conclusion:A deep learning-based contrast disentangled multi-modal MR radiomics feature fusion technique helps to improve GBM and SBMs classification accuracy.

Objective:To explore the effects of a structured exercise intervention on the healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation.Methods:It was a randomized controlled trial, conducted from August 2022 to October 2023 at the Department of Hematology of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital). Fifty leukemia patients undergoing umbilical cord blood transplantation were recruited and were randomly assigned to either the control group (24 cases) or the intervention group (26 cases) using a random number table method. The control group received routine nursing care, health education, and exercise guidance during hospitalization. The intervention group were given moderate-intensity structured exercise intervention, including aerobic, resistance exercises, and flexibility training, three times per week for 30 to 40 minutes per session, over a period of 6 to 8 weeks. During the study, 2 patients withdrew due to disease reasons, and finally, 22 patients in the control group and 26 patients in the intervention group were obtained. The paired t-test, Wilcoxon test, and covariance analysis were used to compare the indices of healthy physical fitness before and after the intervention between the two groups, aiming to explore the effects of a structured exercise intervention on the healthy physical fitness of leukemia patients undergoing umbilical cord blood transplantation. Results:Before the intervention, there was no significant differences in baseline characteristics, such as age, gender and disease status between the two groups (all P>0.05). During the hospitalization phase, the rate of exercise participation in the intervention group was 73.4%, the frequency of exercise was (2.20±0.41) sessions per week and the duration of each exercise session was (34.34±5.05) minutes, and the Borg′s rating of perceived exertion was (13.04±0.82) points. After intervention, the indicators including cardiovascular endurance, muscle fitness, and functional activity status in the two groups were all decreased, and the reduction degree of the indicators were all significantly lower in the intervention group when compared with those in the control group [6-minute walk distance (48.81±30.39) m vs (143.05±77.26) m, grip strength of left hand (2.57±1.30) kg vs (6.72±4.88) kg, grip strength of right hand (2.47±1.97) kg vs (6.34±5.70) kg, muscle strength of left upper limb (4.12±2.07) times vs (8.18±5.26) times, muscle strength of right upper limb (3.96±2.29) times vs (7.91±5.16) times, 30 second chair standing test (3.65±1.98) times vs (7.86±4.34) times, and timed-up-and-go test (0.65±0.53) s vs (2.35±1.79) s] (all P<0.05). The flexibility fitness was improved in the intervention group after the intervention [sit-and-reach 2.00(-4.75, 8.18) cm vs 0(-9.75, 6.43) cm] ( P=0.011), but no significant differences was found in the control group ( P>0.05). Conclusions:The structured exercise intervention has advantages in reducing the decline of healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation, and exerts a protective effect on healthy physical fitness.

Necroptosis is a regulated process of programmed cell death independent of aspartic acid-specific cysteine protease,which can induce inflammation.Studies have shown that necroptosis is closely related to the progression and prognosis of pancreatic disease and plays an important two-way regulatory role in its progression.Related necroptosis inhibitors and inducers are expected to be used in the treatment of pancreatic disease.We herein review the mechanism of necroptosis and its role in the progression of pancreatic disease to provide a new understanding of the pathogenesis and treatment of pancreatic diseases and offer a theoretical basis for the research and development of targeted drugs.

Prostate cancer is a prevalent malignant tumor in the male genitourinary system,characterized by a high propensity for bone metastasis.It is a leading cause of mortality,with approximately 70％of deaths attributed to this form of metastasis.Mouse models provide a crucial tool in the investigation of prostate cancer bone metastasis,and play a pivotal role in elucidating the underlying pathophysiological mechanisms and in the development and assessment of therapeutic agents.In this review,we summarize research progress in the construction method and evaluation strategies used in establishing prostate cancer bone metastasis mouse models.Notably,this review focuses on the exploration of the mechanisms responsible for prostate cancer bone metastasis,using mouse models,with the aim of offering insights and serving as a valuable reference for prostate cancer bone metastasis.

OBJECTIVE To study the metabolites derived from the ethanol extract from the leaves of Dimocarpus longan preliminarily in rats in vivo ，and to provide reference for elucidating the possible metabolic mechanism of the leaves of D. longan in lowering blood glucose . METHODS Ultra high performance liquid chromatography quadrupole time -of-flight mass spectrometry （UPLC-Q-TOF-MS/MS） was adopted by taking ethanol extract of D. longan leaves，the feces and urine of rats at 0-72 h and 0-48 h after intragastric administration of 33.8 g/kg ethanol extract of D. longan leaves（by extract ），the feces and urine of rats at the corresponding time after intragastric administration of normal saline （blank control ） as samples . The accurate relative molecular weight ，formula and fragment information of the compounds were collected ， and the compounds were speculated and i dentified by matching with the database and spectrum library of the instrument ，and comparing with the reference substance and relevant literature . RESULTS A total of eight compounds were identified in urine and feces of rats ，including 2 prototype components and 6 metabolites. Three compounds （including two prototype components as quercetin ，luteolin and one metabolite as luteolin or kaempferol） in feces of rats were identified ；five compounds （all metabolites ） in urine of rats were identified ，involving metabolites of quercetin ，luteolin or kaempferol . Metabolites mainly included the products of methylation ，glucuronidation and oxidation. CONCLUSIONS After intragastric administration ，the ethanol extract from the leaves of D. longan is mainly metabolized in rats through methylation ，glucuronidation and other pathways . The identified compounds are mostly metabolites of quercetin and luteolin .

Objective:To investigate the clinical outcome of arthroscopic suture-button Bristow procedure using suture-button fixation for treatment of recurrent anterior shoulder instability.Methods:A retrospective case series study was conducted to analyze 28 patients with recurrent anterior shoulder instability admitted to Shanghai Sixth People’s Hospital from March 2015 to September 2018，including 26 males and 2 females，aged 18-36 years ［（24.1 ± 3.2）years］. Preoperative MRI showed Bankart injury and three-dimensional CT showed glenoid bone defect > 15%. The Hill-Sachs injury was found in 27 patients. Arthroscopic Bristow procedure was used to fix coracoid process graft with the suture-button plate and glenoid labial complex was repaired with the suture anchor to treat anterior instability of the shoulder joint. The visual analogue scale （VAS），American shoulder and elbow surgeon （ASES） scale，Constant score and Rowe score were used to evaluate the shoulder joint function preoperatively，at postoperative 3，6，12 months and at the last follow-up. The postoperative infection，neurovascular injury，redislocation and other complications were recorded，and the incidence rate was calculated. The bone resorption and bone healing of coracoid process graft were analyzed by CT.Results:All patients were followed up for 22 - 36 months ［（24.5 ± 6.3） months］. Three months after operation，the VAS，ASES scale and Constant score were not significantly different from those before operation （ P > 0.05）. In comparison，the Rowe score was significantly higher than that before operation （ P < 0.05）. Six and twelve months after operation，the VAS，ASES scale，Constant score and Rowe score were significantly improved from those before operation （ P < 0.05）. At the last follow-up，the VAS decreased from （2.7 ± 1.5）points preoperatively to （0.8 ± 0.3）points，the ASES scale increased from （78.6 ± 12.7）points preoperatively to （92.4 ± 8.4）points，the Constant score increased from （43.4 ± 5.2） points preoperatively to （81.6 ± 6.7） points，the Rowe score increased from （52.3 ± 7.1）preoperatively to （92.7 ± 5.4） points （ P < 0.05）. During the follow-up，there was no infection，neurovascular injury，re-dislocation and other complications. In addition，24 （86%） out of the 28 patient showed healing of coracoid process grafts，and the overall bone resorption rate was （18.4 ± 6.1）%. No patients had glenohumeral joint osteoarthritis. Conclusion:Arthroscopic Bristow procedure using suture-button fixation for treatment of recurrent anterior shoulder instability has advantages of a low rate of postoperative complications and a high union rate，indicating an effective and safe surgical procedure.

Objective To explore the effects of improvements on setup error ( SE ) and clinical target ( CTV ) margin of supraclavicular field ( SCF ) by using moisture-cured resin cushion and breast bracket for lower neck fixation in breast cancer patients who underwent post-mastectomy radiotherapy. Methods Totally 13 patients with breast cancer who underwent post-mastectomy radiotherapy were enrolled. All patients were immobilized by breast bracket and moisture-cured resin cushion. Firstly, each patient′s lower neck and head was fixed well by moisture-cured resin cushion, filling the gap between the neck and breast bracket. Secondly,each patient underwent the cone-beam CT ( CBCT) at the first, tenth and twentieth treatment after positioning. Then these CBCT images were registered to the planning CT to determine setup errors in translational and rotational directions, and SCF CTV margins by the systematic and random errors were evaluated. Results The setup errors in x (left-right), y (superior-inferior), z (anterior-posterior) translational directions were (2. 16 ± 1. 25), (1. 50 ± 1. 28), (1. 94 ± 1. 12) mm and (1. 76 ±1. 87)°, (1. 82 ±1. 12)°, (0. 99 ±0. 58)°, respectively in θ (pitch degree),Ф(roll degree),ψ( yaw degree) rotational directions. Non-parametric rank test ( Mann-Whitney U test) was performed with previous data, the differences of the setup error in y, z,θ directions were statistically significant ( Z =4. 152, 3. 415, 2. 053, P<0. 05). The margins from CTV were 4. 07, 4. 03 and 3. 73 mm in x, y and z directions, respectively. Compared with the previous study on SCF, CTV margin required 8, 8 and 6 mm in x, y and z axis directions, the volume of CTV to PTV were decreased by 32. 73% on average. Conclusions Compared with plastic circular pillow alone, moisture-cured resin cushion with breast bracket locating method could reduce setup errors in SCF target region. The margins from CTV to PTV weredecreased to 4. 07, 4. 03 and 3. 73 mm in x, y and z axis directions at least.

Objective: To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use.Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI.Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels.Logistic models were applied in multiple analysis adjusting for possible confounders.Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years.Among them, 78.3% were on hypoglycemic therapy.The cutoff points of quartiles of VAI were calculated for the males and females, respectively.According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e.Q1, Q2, Q3, and Q4.The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χ2=12.20, P<0.001).After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM.Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003).With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282).Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI.High level of VAI is an indicator of poor glycemic control.

Objective To evaluate the efficacy and safety of dezocine versus sufentanil for postoperative patient-controlled epidural analgesia (PCEA).Methods PubMed,EMBASE,Cochrane Library,ISI Web of knowledge,Chinese Biomedical Database,Chinese Science-Technology Journal Database,China Journal Full-text Database and Wanfang Database were searched for randomized controlled trials involving the efficacy and safety of dezocine and sufentanil for PCEA from the date of database establishment up to April 2014.Randomized controlled trials met the inclusion criteria were included,and the data were extracted.The quality of the trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.1 software.Results Seven studies involving 760 patients were included in this meta-analysis.The results of meta-analyses showed that there was no significant difference between dezocine group and sufentanil group in VAS scores at 4,8,12,16,24 and 48 h after surgery and in Ramsay sedation scores at 4,12,24 and 48 h after surgery,and the incidence of adverse reactions (postoperative nausea and vomiting,pruritus,urinary retention and somnolence) was significantly lower in dezocine group than in sufentanil group,and there was no significant difference in the incidence of respiratory depression and dizziness between dezocine group and sufentanil group.Conclusion Dezocine provides better efficacy and safety for postoperative PCEA than sufentanil.

Objective To investigate the clinical efficacy of fluoroscopy-guided intestinal adhesion lysis, as a new non-surgical method, in treating incomplete adhesive small intestinal obstruction in order to improve the therapeutic results of adhesive intestinal obstruction. Methods A total of 93 patients with incomplete adhesive small intestinal obstruction were enrolled in this study. The patients were divided into study group (n=49) and control group (n=44). Fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele was carried out for the patients of the study group , while traditional conservative surgical therapy was employed for the patients of the control group. The study group was comparable with the control group in patients’ age, gender, medical history, disease course, X-ray findings, etc. Results Of the 49 cases in the study group, complete cure was obtained in 40 with a cure rate of 81.6%. The mean hospitalization day was 0.3 day, and the average operation time was 3.25 hours. Among the 44 patients in the control group, complete cure was obtained in 37 with a cure rate of 84.1%. The mean hospitalization day was 7.6 days, and the average therapeutic time was 183.26 hours. Conclusion For the treatment of incomplete adhesive small intestinal obstruction , the therapeutic efficacy of fluoroscopy-guided intestinal adhesion lysis together with restoration of inter-intestinal loop enterocele is better than that of traditional conservative surgical therapy.