Objective To develop an innovative recognition algorithm that aids physicians in the identification of pulmonary nodules. Methods Patients with pulmonary nodules who underwent thoracoscopic surgery at the Department of Thoracic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School in December 2023, were enrolled in the study. Chest surface exploration data were collected at a rate of 60 frames per second and a resolution of 1 920×1 080. Frame images were saved at regular intervals for subsequent block processing. An algorithm database for lung nodule recognition was developed using the collected data. Results A total of 16 patients were enrolled, including 9 males and 7 females, with an average age of (54.9±14.9) years. In the optimized multi-topology convolutional network model, the test results demonstrated an accuracy rate of 94.39% for recognition tasks. Furthermore, the integration of micro-variation amplification technology into the convolutional network model enhanced the accuracy of lung nodule identification to 96.90%. A comprehensive evaluation of the performance of these two models yielded an overall recognition accuracy of 95.59%. Based on these findings, we conclude that the proposed network model is well-suited for the task of lung nodule recognition, with the convolutional network incorporating micro-variation amplification technology exhibiting superior accuracy. Conclusion Compared to traditional methods, our proposed technique significantly enhances the accuracy of lung nodule identification and localization, aiding surgeons in locating lung nodules during thoracoscopic surgery.

Objective: To investigate the comorbidity of abnormal spinal curvature and screening myopia among primary and middle school students in Taizhou City, Zhejiang Province, so as to provide the reference for the prevention and control of abnormal spinal curvature and myopia among children and adolescents. Methods: Students from nine counties (cities, districts) in Taizhou City were selected using a stratified cluster random sampling method. Basic information, sleep, physical activity, diet, electronic device usage, frequency of seat changes, after class study, reading and writing posture, and eye-use habits were collected through questionnaire surveys. Abnormal spinal curvature was screened according to the Technical Guidelines for the Prevention and Control of Abnormal Spinal Curvature in Children and Adolescents. Myopia was screened based on Specification for Screening of Refractive Error in Primary and Middle School Students (WS/T 663—2020). The influencing factors for the comorbidity of abnormal spinal curvature and screening myopia were analyzed using a multivariable logistic regression model. Results: A total of 13 596 students were surveyed, including 7 423 males (54.60%) and 6 173 females (45.40%). The average age was (13.45±2.59) years. The prevanlece of the comorbidity of abnormal spinal curvature and screening myopia, was 2.90% (394 cases). Multivariable logistic regression analysis showed that students who used computers for <1 hour in the past 7 days (not use as the reference, OR=1.312, 95%CI: 1.023-1.684), after class study for ≥3 hours in the past 7 days (OR=1.513, 95%CI: 1.068-2.143), and frequently/always read books or watched screens under direct sunlight (OR=1.604, 95%CI: 1.018-2.526) had a higher risk of the comorbidity of abnormal spinal curvature and screening myopia. In contrast, the students who slept for >9 h/d (OR=0.638, 95%CI: 0.411-0.991), engaged in outdoor activities for ≥3 h/d in the past 7 days (OR=0.645, 95%CI: 0.427-0.975), and changed seats once per month or more (OR=0.740, 95%CI: 0.573-0.955) had a lower risk of the comorbidity of abnormal spinal curvature and screening myopia. Conclusion The comorbidity of abnormal spinal curvature and screening myopia among primary and middle school students is mainly influenced by sleep, physical activity, electronic device use, frequency of seat changes, after class study and eye-use habits.

Background::Although some well-established oncogenes are involved in cancer initiation and progression such as prostate cancer (PCa), the long tail of cancer genes remains to be defined. Goosecoid ( GSC) has been implicated in cancer development. However, the comprehensive biological role of GSC in pan-cancer, specifically in PCa, remains unexplored. The aim of this study was to investigate the role of GSC in PCa development. Methods::We performed a systematic bioinformatics exploration of GSC using datasets from The Cancer Genome Atlas, Genotype-Tissue Expression, Gene Expression Omnibus, German Cancer Research Center, and our in-house cohorts. First, we evaluated the expression of GSC and its association with patient prognosis, and identified GSC-relevant genetic alterations in cancers. Further, we focused on the clinical characterization and prognostic analysis of GSC in PCa. To understand the transcriptional regulation of GSC by E2F transcription factor 1 ( E2F1), we performed chromatin immunoprecipitation quantitative polymerase chain reaction (qPCR). Functional experiments were conducted to validate the effect of GSC on the tumor cellular phenotype and sensitivity to trametinib. Results::GSC expression was elevated in various tumors and significantly correlated with patient prognosis. The alterations of GSC contribute to the progression of various tumors especially in PCa. Patients with PCa and high GSC expression exhibited worse progression-free survival and biochemical recurrence outcomes. Further, GSC upregulation in patients with PCa was mostly accompanied with higher Gleason score, advanced tumor stage, lymph node metastasis, and elevated prostate-specific antigen (PSA) levels. Mechanistically, the transcription factor, E2F1, stimulates GSC by binding to its promoter region. Detailed experiments further demonstrated that GSC acted as an oncogene and influenced the response of PCa cells to trametinib treatment. Conclusions::GSC was highly overexpressed and strongly correlated with patient prognosis in PCa. We found that GSC, regulated by E2F1, acted as an oncogene and impeded the therapeutic efficacy of trametinib in PCa.

Oral bacteria are associated with a variety of oral diseases such as caries,periodontal disease and oral cancer.Some patho-genic bacteria also play an important role in the occurrence and development of systemic diseases.The rapid identification of bacterial pathogens helps the diagnosis and precise treatment of oral diseases.Raman spectroscopy is a simple,rapid and non-invasive novel de-tection technique that can provide abundant and detailed bacterial information and can rapidly identify bacteria,but the application of this technique in oral clinical settings is still relatively rare and needs further exploration.This paper summarizes the research progress of Raman spectroscopy in the identification of oral bacteria and discusses the prospects and challenges of its clinical application.

Objective·To explore the correlation between the quantitative results of autofluorescence imaging under computer assistance and the grade of epithelial dysplasia in oral leukoplakia.Methods·From April 2016 to January 2024,357 patients with oral leukoplakia who visited the Department of Oral Mucosal Diseases at Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,were included.Autofluorescence images of the lesions were obtained using a handheld autofluorescence device.These images were converted to grayscale images to obtain quantitative metrics.An ordered multinomial Logistic regression model was fitted in Python,and cumulative probability plots were generated.The dataset was divided into training and testing sets,and a decision tree was generated.Different hyperparameters were adjusted to achieve optimal model performance.Accuracy,precision,and F1 scores were calculated.The model performance was visualized using a confusion matrix.Results·As the degree of epithelial dysplasia increased,the relative mean color level showed a declining trend.In the binary classification of epithelial dysplasia,there was no overlap between the cumulative probability curves of different categories.In the four-category classification,only severe epithelial dysplasia overlapped with other category curves,indicating good discriminative ability of the model.In binary pathological grading,when the training and testing set ratio was 4∶1 and the maximum depth was 2,the accuracy,precision,and F1 scores were 0.792,0.801,and 0.795,respectively.In the four-category pathological grading,when the training and testing set ratio was 9∶1 and the maximum depth was 4,the accuracy,precision,and F1 scores were 0.611,0.537,and 0.569,respectively.Conclusion·Computer-assisted quantitative analysis of autofluorescence images can be used by oral mucosal specialists as a reference to predict the degree of epithelial dysplasia in patients with oral leukoplakia and to monitor their risk of cancer.

Arrhythmogenic cardiomyopathy (ACM), a fatal heart disease characterized by fibroadipocytic replacement of cardiac myocytes, accounts for 20% of sudden cardiac death and lacks effective treatment. It is often caused by mutations in desmosome proteins, with Desmoglein-2 (DSG2) mutations as a common etiology. However, the mechanism underlying the accumulation of fibrofatty in ACM remains unknown, which impedes the development of curative treatment. Here we investigated the fat accumulation and the underlying mechanism in a mouse model of ACM induced by cardiac-specific knockout of Dsg2 (CS-Dsg2 ^-/-). Heart failure and cardiac lipid accumulation were observed in CS-Dsg2 ^-/- mice. We demonstrated that these phenotypes were caused by decline of fatty acid (FA) β-oxidation resulted from impaired mammalian target of rapamycin (mTOR) signaling. Rapamycin worsened while overexpression of mTOR and 4EBP1 rescued the FA β-oxidation pathway in CS-Dsg2 ^-/- mice. Reactivation of PPARα by fenofibrate or AAV9-Pparα significantly alleviated the lipid accumulation and restored cardiac function. Our results suggest that impaired mTOR-4EBP1-PPARα-dependent FA β-oxidation contributes to myocardial lipid accumulation in ACM and PPARα may be a potential target for curative treatment of ACM.

Objective    To investigate the expression of α7 nicotinic acetylcholine receptor (α7 nAChR) in thymocytes of patients with myasthenia gravis (MG) and its effect on cytokine secretion and T cell proliferation. Methods    Patients with MG who underwent expanded thoracoscopic thymectomy in the Comprehensive Diagnosis and Treatment Center of the Henan Provincial People’s Hospital from June 2021 to June 2022 were selected and allocated to a MG group. Patients who underwent partial thymectomy to expose the surgical field during the cardiac disease surgery from June 2021 to September 2022 in the Department of Adult Cardiac Surgery of Fuwai Huazhong Cardiovascular Hospital were selected as the control group. Thymic single cell suspensions were prepared from MG and control groups, and the expression of α7 nAChR in thymocytes of the two groups was detected by real-time polymerase chain reaction and Western blotting. Then CD3/CD28 monoclonal antibody coupled with magnetic beads was used to induce T cell activation, and the levels of cytokines interferon-gamma (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), IL-6, IL-10, IL-17, and IL-21 in thymocytes of the two groups were detected by enzyme-linked immunosorbent assay (ELISA). The activated T cells of the MG group were divided into a blank control group, an α7 nAChR antagonist group, and an α7 nAChR agonist group according to different treatment methods. After 72 hours of culture, IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17, and IL-21 expression levels in the culture supernatant were measured by ELISA. Afterwards, CD4-PE and CD8-APC antibodies were added, and the proliferation of T cell subsets was detected by flow cytometry. Results    A total of 10 MG patients were collected, including 3 males and 7 females with an average age of 19.25±6.28 years; and 15 control patients were collected, including 6 males and 9 females with an average age of 26.18±6.77 years. Compared with the control group, the mRNA and protein levels of α7 nAChR in the thymocytes of MG group were decreased, and the expression levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-21 in the supernatant were increased (P<0.05), but there was no statistical difference in the expression of IL-10 and IL-17 (P>0.05). The cell-culture experiment showed that compared with the blank control group, the levels of IFN-γ, TNF-α, IL-6 and IL-21 secreted by T cells in the α7 nAChR antagonist group were increased (P<0.05), while they were decreased in the α7 nAChR agonist group (P<0.05). There was no statistical difference in the secretion levels of IL-4, IL-10 or IL-17 among the three groups (P>0.05). CD4+ T and CD8+ T cells in the α7 nAChR agonist group were significantly less than those in the blank control group and α7 nAChR antagonist group (P<0.001), while they were significantly more in the α7 nAChR antagonist group than those in the blank control group (P<0.001). Conclusion    The expression of α7 nAChR in thymocytes of MG patients is decreased, and α7 nAChR may be involved in the inflammatory response in thymocytes and thus in thymic function.

Objective:To investigate the mediating effect of inflammatory factors in the association between low density lipoprotein-cholesterol(LDL-C) and thyroid associated ophthalmopathy(TAO).Methods:This study was a prospective study, which icluded a total of 86 patients with Graves′ disease who attended the Department of Endocrinology of the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2022. Among them, there were 56 patients with Graves′ disease accompanied by TAO, including 30 cases in the inactive group and 26 in the active group. Additionally, there were 30 cases having Graves′ disease alone. The relationship between LDL-C, inflammatory factors, and the onset and activity of TAO were analyzed using binary logistic regression. Mediation analysis was used to explore the mediating effect of inflammatory factors in the association between LDL-C and TAO onset and activity.Results:Interleukin(IL) -6 was a potential mediator that linking the association between LDL-C and TAO onset: LDL-C had a direct effect on TAO(Total effect value=0.274, 95% CI 0.161-0.386), while IL-6(mediated effect=0.067, 95% CI 0.011-0.123) and IL-17(mediated effect=0.042, 95% CI 0.007-0.077) partially mediated the effect of LDL-C on TAO, accounting for 24.45% and 15.33% of the total effect, respectively. IL-6 was a potential mediator of the association between LDL-C and TAO activity: LDL-C had a direct effect on TAO activity(Total effect value=0.320, 95% CI 0.204-0.435), and IL-6(mediated effect=0.103, 95% CI 0.021-0.185) partially mediated the effect of LDL-C on TAO activity, with a mediation effect of 32.19%. Conclusion:IL-6 plays a partiall mediating role in the association of LDL-C with TAO onset and activity.

Objective: To analysis the epidemiological characteristics of overweight and obesity among middle school students in Taizhou from 2013 to 2020, to provide support for prevention and control efforts. Methods: Through stratified sampling, one primary school, one junior middle school and one senior high school were randomly selected from nine counties (cities and districts) in Taizhou, and continuous monitoring was conducted in all participants Height, weight and other variables were assessed and body mass index was calculated. The epidemic characteristics were analyzed according to the detection rate, fixed base ratio, sequential growth ratio and average growth rate. Results: From 2013 to 2020, the overall overweight rate among primary and middle school students in Taizhou was 14.5%(36 592/252 583), and the obesity rate was 11.2%(28 256/252 583). The rates of overweight and obesity increased, with average annual growth rates of 1.9% and 5.5%, respectively; thus, the rate of obesity increased more rapidly. The obesity rate was higher among boys (13.2%) than girls (9.0%)( χ 2=1 119.57, P <0.01), and the average annual growth rate was higher among girls than boys (6.1%, 5.2%, respectively). The rate of overweight among boys (17.6%) was higher than that among girls (10.9%)( χ 2=2 307.35, P <0.01). The average annual growth rate of overweight in girls was 2.3% and 1.7%, respectively. The obesity rate among primary school students (17.5%) was higher than that among middle school (9.7%) and high school (4.9%) students( χ 2=7 291.33, P <0.01). The average annual growth rate in students in middle school was fastest, followed by those in high and primary schools (6.5%, 3.9% and 2.6%, respectively). The rate of overweight in primary school students ( 15.8 %) was higher than that in middle school students (15.3%), and both were higher than that in high school students(12.2%)( χ 2=521.06, P <0.01). The average annual growth rate was also fastest in students in middle school, followed by high and primary schools (2.4%, 2.2% and 0.6%, respectively). Conclusion The detection rate of overweight and obesity among primary and middle school students in Taizhou is high and increasing rapidly, indicating high pressure on prevention and control. Boys and primary school students are the key target groups for prevention and control. Comprehensive prevention and control strategies should be adopted specifically.

Objective:To investigate the CT features of primary hepatic lymphoma in order to improve the accuracy of diagnosis.Methods:The clinical data, CT and pathological findings of 11 patients with primary hepatic lymphoma confirmed by surgery and pathology in Wenzhou Medical University Affiliated Yueqing Hospital, Wenzhou People′s Hospital of Zhejiang Province and the First Affiliated Hospital of Wenzhou Medical College from September 2008 to September 2018 were retrospectively analyzed.Results:Among the 11 patients, the tumors were located in the right liver in 7 cases, in the left liver in 2 cases, and in the left and right lobe of the liver in 2 cases; there were 27 tumors with the largest diameter of 1.7 to 12.6 cm; the tumors were round in 3 cases, oval in 5 cases and irregular in 3 cases; the tumor boundary was clear in 8 cases and unclear in 3 cases. CT scan showed low density in 6 cases, slightly low density in 3 cases and equal density in 2 cases; the density was uniform in 7 cases and inhomogeneous in 4 cases; CT value was 26 to 47 (38 ± 5) HU; there were 2 cases of splenic metastasis, 1 case of rib metastasis and 1 case of abdominal and retroperitoneal lymph node enlargement. CT enhanced scan showed no obvious enhancement in 1 case; in arterial phase, mild to moderate enhancement was seen in 10 cases, including 8 cases of continuous circular enhancement at the edge of the lesions in portal venous phase and delayed phase, and 2 cases with nodular enhancement; the CT value of arterial phase was 30 to 68 (53.8 ± 11.6) HU, that of portal venous phase was 52 to 69 (64.3 ± 9.3) HU, and that of delayed phase was 43 to 64 (56.4 ± 6.0) HU. Eight cases were completely resected, and 6 cases recurred after operation. Five cases survived for 3 years and 2 cases survived for 5 years; 3 cases were not completely resected, and all of them recurred after operation. One case survived for 3 years and no patient survived for 5 years. Among them,. Pathological diagnosis was diffuse large B-cell lymphoma in 10 cases and T-cell lymphoma in 1 case.Conclusions:CT examination of primary hepatic lymphoma has important value in the localization, qualitative and auxiliary clinical diagnosis of the tumor.