Objective·To establish a multifactorial discriminative model for predicting the degree of infiltration in patients with non-small cell lung adenocarcinoma based on clinically accessible laboratory indicators,such as tumor markers,coagulation function indicators,routine blood count indicators,and biochemical indicators.Methods·A retrospective study was conducted on 202 patients with lung adenocarcinoma admitted to Shanghai Chest Hospital in 2022.Multifactorial Logistic regression analysis was applied to screen independent factors that influenced the predictive infiltration degree of lung adenocarcinoma and to establish a regression model.In addition,machine learning was used to construct a discriminative model,and the area under the receiver operating characteristic curve(AUC)was used to evaluate the discriminative ability of the model to discriminate the degree of infiltration in lung adenocarcinoma patients.Results·A total of 202 patients with lung adenocarcinoma were included in the study,and divided into pre-invasive lesion group(n=59)and invasive lesion group(n=143).Multifactorial Logistic regression analysis revealed that urea,percentage of basophilic granulocytes,and albumin were independent factors for predicting the degree of infiltration of lung adenocarcinoma(all P<0.05).The predictive model expression was P = eX/(1 + eX),where X =(0.534×urea)+(1.527×percentage of basophilic granulocytes)-(1.916×albumin)+ 6.373.Machine learning results showed that the model performed best when urea,fibrinogen,albumin,percentage of basophilic granulocytes,prealbumin and carcino embryonic antigen(CEA)were included.After comparing the performance of 8 machine learning algorithms(based on ridge regression,least absolute shrinkage and selection operator,neural network,random forest,k-nearest neighbors,support vector machine,decision tree,and adaptive boosting algorithms)using the DeLong test,the ridge regression algorithm with the highest AUC was selected.The AUC of the predictive model was calculated to be 0.744(95%CI 0.656-0.832),with a sensitivity of 70.8%and a specificity of 70.2%.Conclusion·A comprehensive differentiation model constructed by urea,fibrinogen,albumin,percentage of basophilic granulocytes,prealbumin and CEA can effectively predict the infiltration degree of the enrolled lung adenocarcinoma patients,holding the potential to provide more precise guidance for the clinical grading and adjunctive treatment of lung adenocarcinoma.

A 11-year old female patient with severe thalassemia, receipt a lentivirus-based cell and gene therapy (CGT) therapy in Shenzhen Children′s Hosptial on July 27th, 2021. At the two follow-up visits after discharge, patient were continuously tested positive for HIV screening through HIV Ag/Ab Combo assay (chemiluminescence Immunoassay), and the viral load results of HIV-1 nucleic acid testing (NAT) were both>5 000 copies/ml. The patient can be diagnosed with HIV infection according to the National Guideline for Detection of HIV/AIDS(2020 Revised Edition). The thorough investigation findings and supplementary experiment results indicated that the false-positive HIV-1 NAT results was caused by cross-reactivity between the target sites detected by conventional HIV-1 NAT reagents and the lentiviral vectors fragments integrated into the genome of patient′s hematopoietic stem/progenitor cells. In conclusion, it is important for laboratories to select appropriate HIV-1 NAT testing platforms which won′t cause cross-reactivity for the testing of samples from patients who have been treated with HIV-derived vectors. It is also recommended to design and develop NAT testing platforms with multiple target regions labeled by different fluorescents for HIV NAT supplementation experiment to reduce the risk of false-positive diagnoses of HIV infection.

Ferroptosis is a kind of programmed cell death, involves multi-molecular and multi-signaling pathways, and the core processes is iron overload and lipid peroxidation. It affects cancer, neurological disease, cardiovascular disease, digestive system disease, and many other diseases. While, ischemia-reperfusion injury is an extremely complex pathological process, including ischemia-reperfusion injury of the heart, brain, liver and kidney, etc., which often occurs in shock, organ surgery and organ transplantation, seriously affecting human health, and there is no effective radical treatment. However, ferroptosis is closely related to ischemia-reperfusion injury so that it is possible to find the prevention and treatment measures of ischemia-reperfusion injury by exploring the internal relationship between them. Therefore, the author tries to summarize the signaling pathways of ferroptosis, and explores the relationship between ferroptosis and ischemia-reperfusion injury of heart, brain, liver and kidney by moderating the ferroptosis targets properly to find the effective ways to treat cancer, improve inflammation and relieve other diseases.

Objective To investigate the effect of bone marrow mesenchymal stem cells(BMSCs)on the inflamma-tory response of lipopolysaccharide(LPS)induced acute lung injury(ALI)in mice.Methods 32 SPF KM mice,aged 4 weeks were randomly divided into four groups,control group,LPS group,dexamethasone treatment group(LPS+DEX)and BMSCs treatment group(LPS+BMSCs).The latter three groups were injected with LPS by tra-cheal puncture to establish mouse ALI model 24 h after modeling,BMSCs isolated from the femur of mice were in-jected into the caudal vein,and DEX were injected into caudal vein at the same time in LPS+DEX group for 3 consecutive days.On the 4th day after cell transplantation or 24 h after DEX injection,the survival quantity of mice was recorded,lung function was detected,and the wet/dry weight ratio(W/D)of lung was measured.Then in-flammatory cells in bronchoalveolar lavage fluid(BALF),lung pathological changes and serum inflammatory cyto-kines were collected.Green fluorescent protein(GFP)staining was used to observe the homing of BMSCs in lung tissues.The mRNA and protein expression of TLR4,MyD88 and NF-κB in lung tissues were detected by RT-PCR and Western blot assay respectively.Results Compared with the control group,LPS model group showed de-creased lung function,significantly increase in the W/D weight ratio of lung,inflammatory cytokines in serum and inflammatory cells in BALF,and severe damage in lung tissue.Compared with LPS group,LPS+DEX group and LPS+BMSCs group showed improved lung function,reduced lung tissue damage,significantly decrease in the W/D weight ratio of lung,inflammatory cytokines in serum and inflammatory cells in BALF.And the expression of TLR4-MyD88-NF-κB signaling pathway-related genes and proteins decreased,the survival quantity increased.Conclusion Homologous BMSCs transplantation can effectively treat LPS-induced acute lung injury,and the mechanism may be related to the regulation of TLR4-MyD88-NF-κB signaling pathway and the reduction of inflam-matory response.These findings provide the experimental basis for BMSCs homologous transplantation for ALI.

Objective:To explore the value of stress hyperglycemia ratio (SHR) in predicting the prognosis of patients with acute heart failure (AHF).Methods:AHF patients admitted to the Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2016 to January 2019 were retrospectively included. Clinical data were recorded and SHR was calculated. According to the survival of the patients within 1 year, they were divided into the death group ( n=89) and the survival group ( n=218). Logistic regression analysis was used to analyze the risk factors of mortality. Kaplan-Meier analysis was used to evaluate the correlation between SHR and the prognosis of AHF patients. Results:A total of 307 patients aged 83 ( range 74-87) years old who met the inclusion criteria were included in this study, including 153 males and 104 females. The age, SHR and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the death group were higher than those in the survival group [84 (78, 88) vs 82 (72, 86), 1.11 (0.91, 1.51) vs 1.02 (0.86, 1.27), 5 351 (2 098, 14 039)μg/L vs 4 243 (2 294, 7 565)μg/L ]. The left ventricular ejection fraction (LVEF) in the death group was significantly lower than that of the survival group [53 (45, 57) % vs 58 (44, 64) %, P< 0.05]. Logistic regression analysis showed that SHR was an independent risk factor for death in AHF patients ( OR=2.397, 95% CI: 1.285-4.471, P< 0.05). Median SHR was used to draw the survival curve. Patients with high SHR had a lower cumulative survival rate, and the difference was statistically significant ( P<0.05). Conclusion:SHR can identify critically ill patients and is an independent risk factor for death in AHF patients.

Objective To investigate the relationships between serum osteocalcin (OC) levels and glycometabolism markers in nondiabetic post-traumatic male patients.Methods Populaitons were selected at the Department of Emergency Medicine of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from October 2017 to February 2019.The age,injury severity score (ISS),and characteristic indicators were recorded.The inclusion criteria were age ≥ 18 years and blood collection time ＜ 24 h after the injury.The exclusion criteria were emergency surgery,acute brain trauma,and hemoglobin A1c (HbA1c) ≥ 6.0％.The patients were divided into two groups by fasting plasma glucose (FPG):stress hyperglycemia (SH) (FPG＞7.8 mmol/L) and nonstress hyperglycemia (NO-SH) (FPG ≤ 7.8 mmol/L) groups.The fasting venous blood samples were collected and examined.The characteristics and biochemical indicators in the two groups were compared statistically by LSD-t test,rank sum test and ANOVA,and the relationships between serum OC levels and glycometabolism markers were analyzed by partial correlation analysis.Results A total of 395 traumatic patients were enrolled and divided into the SH group (n=182) and NO-SH group (n=213).There were no differences in ISS,fasting insulin (FINS),and C-peptide (C-P) levels between groups.Age,HbAlc and FPG were higher (P=0.041,P=0.037,P＜0.01),while the OC level was lower (P=0.023),in the SH group than those in the NO-SH group.The serum OC level did not correlate with HbAlc,FPG,and FINS,but negatively correlated with C-P by partial correlation analysis (r=-0.262,P=0.008).The multivariate linear regression analysis showed that C-P was an independent factor affecting serum OC levels after trauma (β=-0.655,P=0.043).Conclusion A correlation existed between the serum OC level and glycometabolism markers in nondiabetic post-traumatic male patients.

Objective:To observe the size and density of adrenal gland, and the dynamic changes in patients with COVID-19.Methods:Study sample consisted of 67 patients diagnosed as COVID-19 (COVID-19 group) and 70 normal controls. COVID-19 group were divided into two groups: ordinary cases and severe cases. The CT value and thickness of adrenal gland in the control group (uni-temporal) and the COVID-19 group (multi-temporal) were measured, the CT value of adreal/erector spinae were calculated.Results:Compared with the control group, the COVID-19 group had bigger body, medial and lateral branches of bilateral adrenal gland ( P<0.05) . There was no significant difference between the CT value of adrenal/erector spinae for the two groups. Receiver operating characteristic curve analysis showed the thickness of right medial adrenal limb in detecting diffuse adrenal hyperplasia was the best (0.881) . And there was no significant difference in the CT value of adrenal/erector spinae, thickness of bilateral adrenal body, medial and lateral branches in COVID-19 group at different times. Conclusion:The bilateral adrenal glands of COVID-19 patients were slightly swollen, adrenal body, medial and lateral branches were slightly bigger than the normal adrenal glands, but the density was normal, and there were no dynamic changes during the course of the disease.

Objective:To explore the value of thyroid radioactive iodine uptake (RAIU) on predicting the residual activity in patients with differentiated thyroid carcinoma (DTC) after administration of 131I. Methods:A total of 178 patients (63 males, 115 females, age: (39.8±11.4) years) with DTC who underwent initial treatment of 131I in Suzhou Science & Technology Town Hospital between August 2018 and April 2019 were enrolled in this retrospective study. RAIU test and thyroid imaging were performed before 131I treatment. Patients were divided into 3 groups according to the thyroid remnant showed by thyroid imaging: no remnant group, a little remnant group, and obvious remnant group. Radiation dose equivalent rates at different time points (immediately/24 h/48 h/72 h after injection of 131I) were measured to estimate the residual activity of 131I after administration. RAIU and residual activity at 72 h among different thyroid remnant groups were compared by one-way analysis of variance. Relationship between RAIU/ 131I therapeutic dose and residual activity at 72 h was analyzed by Pearson correlation analysis. The linear regression equation between RAIU and residual activity at 72 h after treatment was established. Results:The 3 h RAIU in no remnant group ( n=45), a little remnant group ( n=101), and obvious remnant group ( n=32) were (4.77±1.46)%, (5.53±1.70)% and (8.92±3.75)%, respectively ( F=39.35, P<0.01), and the 24 h RAIU was also significantly different among those 3 groups ((1.54±0.88)%, (3.41±2.55)%, (13.52±8.59)%; F=91.52, P<0.01). The residual activity at 72 h in no remnant group, a little remnant group, and obvious remnant group were (81.70±25.61), (108.24±51.58) and (283.07±133.72) MBq, respectively ( F=92.84, P<0.01). There was a significant positive correlation between RAIU and the residual activity at 72 h (3 h: r=0.753, 24 h: r=0.817, both P<0.01). The linear regression equations between RAIU at 3 h and 24 h and the residual activity at 72 h were y=28.88 x-38.42 and y=13.87 x+ 67.01, respectively. When RAIU was higher than 24.01% at 3 h or 15.18% at 24 h, the residual activity at 72 h after treatment was likely to exceed 400 MBq. There was little correlation between 131I therapeutic dose and the residual activity at 72 h after treatment ( r=0.119, P>0.05). Conclusion:RAIU can be used to predict the residual activity at 72 h after treatment in DTC patients who underwent initial 131I treatment.

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to The Sixth People′s Hospital of Shanghai and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells (WBC) were analyzed. Patients in COVID-19 group showed relatively lower absolute WBC count 4.95(3.90,6.03)×10 9/L, lymphocyte absolute count 1.20(0.98,1.50)×10 9/L and eosinophil absolute count 0.01(0.01,0.01)×10 9/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20(6.78,9.03)×10 9/L ( P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10 9/L( P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10 9/L( P=0.005). Lymphocytopenia occurred in 16.7% patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non-COVID-19 patients.