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Objective Methods Results Conclusion Supported by remote signal processing techniques and wireless communication technology, remote electronic fetal monitoring (REFM) has emerged as a promising alternative to traditional electronic fetal monitoring (TEFM) in clinical practice. The aim of this study was to evaluate the comparability, accessibility, and clinical utility of REFM in contrast to TEFM.This was a multicenter prospective cohort study. A cohort of 2900 pregnant women were enrolled from three medical centers between June 1, 2021 and June 31, 2022. Among them, 800 utilized REFM, with 760 of them completing the self‐rating anxiety scale (SAS) and self‐rating depression scale (SDS) assessments using the devices for 1 month. The control group comprised 2100 pregnant women who did not use REFM. Additionally, 80 pregnant women concurrently employed both REFM and TEFM, and their respective curve coincidence rates were determined through curve fitting. Primary outcomes encompassed pregnancy outcomes in both groups, average curve coincidence rates between REFM and TEFM, as well as SDS and SAS scores.Among the 760 pregnant women who completed SAS and SDS assessments, their average SAS scores before and after 1 month of REFM usage were 43.09 ± 8.04 and 41.58 ± 6.59, respectively. Concurrently, the average SDS scores before and after 1 month of REFM usage were 45.45 ± 9.60 and 44.80 ± 9.17, respectively. A statistically significant decrease was observed in SAS scores (P = 0.005), whereas no significant difference was noted in SDS scores (P = 0.340). Furthermore, a statistically significant difference in the rate of adverse pregnancy outcomes (neonatal asphyxia) emerged between the two groups, those who employed REFM and those who did not (P = 0.021). In the subset of 80 pregnant women employing both REFM and TEFM, all 80 results showed precise congruence between the two methods. The average coincidence rate was determined to be 79.45% ± 12.64%.REFM contributes to improved pregnancy outcomes and exhibits a high level of concordance with TEFM, thereby accurately reflecting the quality of fetal heart monitoring. Additionally, REFM effectively mitigates pregnant women's anxiety. Thus, REFM demonstrates comparability, accessibility, and clinical utility. [ABSTRACT FROM AUTHOR]

Background: In recent years, research on the apolipoprotein E (APOE) gene has gradually proven that many diseases, including atherosclerosis, coronary heart disease, and neurological diseases, are closely related to ApoE gene diversity. However, the relationship between the APOE gene and the prediction and prognosis evaluation of ischemic stroke has not been determined or unified so far. The purpose of this study was to investigate the application value of APOE allele-4 combined with high-resolution vascular wall imaging in predicting the occurrence and prognosis of acute ischemic stroke. Methods: A total of 511 patients with acute ischemic stroke (AIS), who were admitted from January 2022 to December 2023, were included in the study, including 317 patients with intracranial artery stenosis. Blood lipids, lipoproteins, apolipoprotein E (including allelic typing), and lipoproteins (a) were measured in all cases, and highresolution magnetic resonance imaging of the vascular walls was performed. At 6 months, the functional outcomes of the AIS patients were followed up, assessed by using the modified Rankin Scale (mRS) (a score of 2 - 6 was rated as poor prognosis), and the high-definition vascular wall imaging results were followed up as well. High-definition vascular wall imaging ensures the accurate location of vascular stenosis and the accurate diagnosis of acute stroke. Results: There were no significant differences in the total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, or lipoprotein (a) in patients with and without intracranial artery stenosis, but the plasma apolipoprotein E (APOE) levels were significantly reduced in patients with intracranial artery stenosis (ICAS). At the 6-month follow-up, 230 patients with the APOE-ε4 gene were enrolled, out of which 104 had a poor prognosis (mRS score ≥ 2), accounting for 45.22%. Among 281 patients without the APOE-ε4 gene, 45 had a poor prognosis (mRS score ≥ 2), accounting for 16.01%. Patients with the APOE-ε4 gene had a worse functional prognosis after 6 months. Conclusions: It is suggested that low plasma APOE levels may be a high risk factor for ICAS in patients with acute ischemic stroke, and carrying the APOE-ε4 gene may be a high risk factor for a poor functional prognosis in AIS patients. The APOE-ε4 genotype, combined with high-resolution vascular wall imaging, has certain clinical application value in predicting the occurrence of acute ischemic death and evaluating the functional outcome. [ABSTRACT FROM AUTHOR]

Yongru Chen,1 Chongyue Chen,1 Wei Chen,2,3 Wei Gai,4 Yafeng Zheng,4 Yuxin Guo,4 Zhaoning Wang,1 Yongsong Chen,1 Zhiming Cai1,5,6 1The First Affiliated Hospital of Shantou University, Shantou, Guangdong, People’s Republic of China; 2Department of Urology, Shenzhen Institute of Translational Medicine, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, International Cancer Center, Shenzhen University School of Medicine, Shenzhen, People’s Republic of China; 3Guangdong Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Shenzhen, People’s Republic of China; 4WillingMed Technology (Beijing) Co., Ltd, Beijing, People’s Republic of China; 5BGI Genomics, BGI Shenzhen, Shenzhen, People’s Republic of China; 6Carson International Cancer Center, Shenzhen University, Shenzhen, People’s Republic of ChinaCorrespondence: Zhiming Cai, Carson International Cancer Center of Shenzhen University, No. 1066, Xueyuan Road, Shenzhen, Guangdong Province, People’s Republic of China, Tel +86 136 0253 0322, Email caizhiming2000@163.com Yongsong Chen, The First Affiliated Hospital of Shantou University, No. 57, Changping Road, Shantou, Guangdong Province, People’s Republic of China, Tel +86 0754-88905000, Email yongsongchen@126.comPurpose: This study aimed to evaluate the clinical utility of metagenomic next-generation sequencing (mNGS) in sepsis patients who received early empirical antibiotic treatment.Patients and Methods: A retrospective analysis was conducted on clinical data from sepsis patients diagnosed in the Emergency Intensive Care Unit (EICU) between April 2019 and May 2023. All patients underwent standard conventional microbiological testing. Patients were categorized into either the mNGS group or the control group based on whether they underwent mNGS tests. Baseline variables were matched using propensity scores.Results: Out of 461 sepsis patients screened, 130 were included after propensity matching, with 65 patients in each group. Despite prior antibiotic treatment, 57 cases (87.69%) in the mNGS group had positive mNGS results, exceeding the culture detection rate (52.31%). Besides, a higher proportion of patients in the mNGS group experienced antibiotic adjustments compared to the control group (72.31% vs 53.85%). Mortality rates were also compared based on the duration of antibiotic exposure before mNGS sampling. Patients exposed to antibiotics for less than 24 hours had a lower mortality rate compared to those exposed for over 8 days (22.22% vs 42.86%). COX multivariate analysis identified mNGS testing, underlying diseases, lymphocyte percentage, infection site (respiratory and bloodstream) as independent risk factors for mortality in sepsis patients.Conclusion: With increased antibiotic exposure time, the positive rate of culture testing significantly decreased (44.44% vs 59.52% vs 35.71%, P = 0.031), whereas the positive rate of mNGS remained stable (77.78% vs 88.10% vs 92.86%, P = 0.557). mNGS demonstrated less susceptibility to antibiotic exposure. Early mNGS detection positively impacted the prognosis of sepsis patients.Keywords: metagenomic next-generation sequencing, sepsis, antibiotic management, clinical value, prognosis

N6-methyladenosine (m6A) is widely recognized as the predominant form of RNA modification in higher organisms, with the capability to finely regulate RNA metabolism, thereby influencing a series of crucial physiological and pathological processes. These processes include regulation of gene expression, cell proliferation, invasion and metastasis, cell cycle control, programmed cell death, interactions within the tumour microenvironment, energy metabolism, and immune regulation. With advancing research into the mechanisms of RNA methylation, the pivotal role of m6A modification in the pathophysiology of reproductive system tumours, particularly cervical cancer, has been progressively unveiled. This discovery has opened new research avenues and presented significant potential for the diagnosis, prognostic evaluation, and treatment of diseases. This review delves deeply into the biological functions of m6A modification and its mechanisms of action in the onset and progression of cervical cancer. Furthermore, it explores the prospects of m6A modification in the precision diagnosis and treatment of cervical cancer, aiming to provide new perspectives and a theoretical basis for innovative and advanced treatment strategies for cervical cancer.

Abstract Background The aim of this study is to explore the clinical value of computed tomography angiography (CTA) in the diagnosis of aortic aneurysm. Methods The imaging data of 60 patients suspected of having aortic aneurysms who were examined in the Radiology Department of the First Affiliated Hospital of Nanjing Medical University from April 2017 to April 2020 were analyzed retrospectively. CTA and digital subtraction angiography (DSA) were used to examine the patients, and CTA image findings were collected and compared with DSA findings. Results There was no significant difference in the accuracy of diagnosing aortic aneurysms (P > 0.05) between DSA [98.33% (59/60)] and CTA [95.00% (57/60)]. There was no significant difference in the diagnosis of image features (e.g., typing, site, form) of aortic aneurysms (P > 0.05). Conclusion CTA can be used to successfully confirm if patients suffer from an aortic aneurysm; it produces quality images with high specificity, sensitivity, and accuracy and can be promoted in clinical practice.

Background: The aim of this study is to explore the clinical value of computed tomography angiography (CTA) in the diagnosis of aortic aneurysm. Methods: The imaging data of 60 patients suspected of having aortic aneurysms who were examined in the Radiology Department of the First Affiliated Hospital of Nanjing Medical University from April 2017 to April 2020 were analyzed retrospectively. CTA and digital subtraction angiography (DSA) were used to examine the patients, and CTA image findings were collected and compared with DSA findings. Results: There was no significant difference in the accuracy of diagnosing aortic aneurysms (P > 0.05) between DSA [98.33% (59/60)] and CTA [95.00% (57/60)]. There was no significant difference in the diagnosis of image features (e.g., typing, site, form) of aortic aneurysms (P > 0.05). Conclusion: CTA can be used to successfully confirm if patients suffer from an aortic aneurysm; it produces quality images with high specificity, sensitivity, and accuracy and can be promoted in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To study the clinical value of serum fibroblast growth factor-21 (FGF-21) and fibroblast growth factor-23 (FGF-23) detection in patients with sepsis combined with acute kidney injury (AKI). Methods: 202 patients with sepsis admitted to Baiyun Hospital Affiliated to Guizhou Medical University and the Affiliated Hospital of Guizhou Medical University from May 2020 to August 2023 were selected, and patients were divided into non-AKI group (n=109) and AKI group (n=93) according to whether they were combine with AKI, 70 healthy volunteers who underwent physical examinations in our hospital were selected as health group during the same period. Patients were divided into death group and survival group according to the 28-day clinical outcome of patients with sepsis combine with AKI. Serum FGF-21 and FGF-23 levels were detected. The influencing factors of 28-day death in patients with sepsis combine with AKI were analyzed by multivariate Logistic regression model, the predictive value of serum FGF-21 and FGF-23 for 28-day death in patients with sepsis combined with AKI were analyzed by receiver operating characteristic (ROC) curve. Results: Compared with healthy group, the levels of serum FGF-21 and FGF-23 in non-AKI group and the AKI group were significantly increased (P<0.05). Compared with non-AKI group, the serum levels of FGF-21 and FGF-23 in AKI group were significantly increased (P<0.05). Among 93 patients with sepsis combined with AKI, 26 died within 28 days, with a mortality rate of 27.96%. Compared with survival group, the serum FGF-21 and serum FGF-23 in death group were significantly increased (P<0.05). Multivariate Logistic regression analysis showed that AKI stage Ⅱ～Ⅲ, increased APACHE II score, increased SOFA score, increased serum FGF-21 and increased serum FGF-23 were risk factors for 28-day death in patients with sepsis combine with AKI (P<0.05). ROC curve results showed that, the AUC, sensitivity and specificity of FGF-21 combine with FGF-23 in predicting 28-day death in patients with sepsis combine with AKI were 0.798, 0.769 and 0.791 respectively, which were significantly better than those of single detection. Conclusion: Serum FGF-21 and FGF-23 are highly express in patients with sepsis combined with AKI, which are relate to 28 deaths in patients with sepsis combined with AKI. The combined detection of serum FGF-21 and FGF-23 has a high predictive value for 28-day death in patients with sepsis combined with AKI. [ABSTRACT FROM AUTHOR]

Simple Summary: Numerous genetic mutations have been documented in HCC, and associated with clinical characters. Herein, we demonstrated that XIRP2 mutation is one of the high-frequency mutations in HCC, and is associated with poor prognosis and drug resistance. The presence of the XIRP2 mutation leads to enhanced stability of the XIRP2 protein, whereas its depletion significantly heightens sensitivity to oxaliplatin by inducing an excessive influx of zinc and calcium ions. XIRP2 mutation holds potential as a prognostic biomarker and that targeting the XIRP2 protein may offer therapeutic benefits in the management of HCC. Hepatocellular carcinoma (HCC) is a prevalent malignant digestive tumor. Numerous genetic mutations have been documented in HCC, yet the clinical significance of these mutations remains largely unexplored. The objective of this study is to ascertain the clinical value and biological effects of xin actin binding repeat containing 2 (XIRP2) mutation in HCC. The gene mutation landscape of HCC was examined using data from the Cancer Genome Atlas and the International Cancer Genome Consortium databases. The prognostic significance of the XIRP2 mutation was assessed through KM plot analysis. The association between drug sensitivity and the XIRP2 mutation was investigated using the TIDE algorithm and CCK-8 experiments. The biological effects of the XIRP2 mutation were evaluated through qRT-PCR, protein stability experiments, and relevant biological experiments. The XIRP2 mutation is one of the high-frequency mutations in HCC, and is associated with poor prognosis. A total of 72 differentially expressed genes (DEGs) were observed in HCC tissues with the XIRP2 mutation as compared to those with the XIRP2 wildtype, and these DEGs were closely related to ion metabolic processes. The XIRP2 mutation was linked to alterations in the sensitivity of fludarabine, oxaliplatin, WEHI-539, and LCL-161. CCK-8 assays demonstrated that HCC cells carrying the XIRP2 mutation exhibited increased resistance to fludarabine and oxaliplatin, but enhanced sensitivity to WEHI-539 and LCL-161 as compared with those HCC cells with the XIRP2 wildtype. The XIRP2 mutation was found to have no impact on the mRNA levels of XIRP2 in tissues and cells, but it did enhance the stability of the XIRP2 protein. Mechanically, the inhibition of XIRP2 resulted in a significant increase in sensitivity to oxaliplatin through an elevation in zinc ions and a calcium ion overload. In conclusion, the XIRP2 mutation holds potential as a biomarker for predicting the prognosis and drug sensitivity of HCC and serves as a therapeutic target to enhance the efficacy of oxaliplatin. [ABSTRACT FROM AUTHOR]

Background: Through preoperative localization, surgeons can easily locate ground glass nodules (GGNs) and effectively control the extent of resection. Therefore, it is necessary to choose an appropriate puncture positioning method. The purpose of this study was to evaluate the effectiveness and safety of medical glue and positioning hooks in the preoperative positioning of GGNs and to provide a reference for clinical selection. Methods: From March 30, 2020 to June 13, 2022, a total of 859 patients with a CT diagnosis of GGNs requiring surgical resection were included in our study at the hospital. Among them, 21 patients who either opted out or could not undergo preoperative localization for various reasons were excluded. Additionally, 475 patients who underwent preoperative localization using medical glue and 363 patients who underwent preoperative localization through positioning hooks were also excluded. We conducted statistical analyses on the baseline data, success rates, complications, and pathological results of the remaining patients. The success rates, complication rates, and pathological results were compared between the two groups--those who received medical glue localization and those who received positioning hook localization. Results: There was no statistically significant difference between the two groups of patients in terms of age, body mass index, smoking history, location of the nodule, distance of the nodule from the pleura, or postoperative pathological results (P > 0.05). The success rate of medical glue and positioning hooks was 100%. The complication rates of medical glue and positioning hooks during single nodule positioning were 39.18% and 23.18%, respectively, which were significantly different (p < 0.001); the complication rates during multiple nodule positioning were 49.15% and 49.18%, respectively, with no statistically significant differences (p > 0.05). In addition, the method of positioning and the clinical characteristics of the patients were not found to be independent risk factors for the occurrence of complications. The detection rate of pulmonary nodules also showed some positive correlation with the spread of COVID-19 during the 2020-2022 period when COVID-19 was prevalent. Conclusion: When positioning a single node, the safety of positioning hooks is greater than when positioning multiple nodes, the safety of medical glue and positioning hooks is comparable, and the appropriate positioning method should be chosen according to the individual situation of the patient. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical value of angiopoietin-like protein 3(ANGPTL3) in predicting heart failure (HF) after percutaneous coronary intervention (PCI) in coronary heart disease. Methods A total of 128 patients with coronary heart disease treated with PCI from January 2020 to January 2022 were included in the study. According to whether the patients were complicated by HF during the one-year follow-up period after surgery, they were divided into the HF group(41 cases) and the HF-free group (87 cases), and 30 healthy patients were selected for the control group. Serum samples were collected from each group, and the serum ANGPTL3 levels of each group were detected and compared by enzyme-linked immuno sorbent assay. Cardiac function related indicators [left ventricular end-diastolic diameter (LVESD), left atrial diameter (LAD), left ventricular posterior wall thickness(LVPW),and left ventricular ejection fraction (LVEF)] were measured by echocardiography. Pearson correlation analysis was used to analyze the correlation between AN- GPTL3 and cardiac function-related indexes, and the ROC curve was used to analyze the clinical value of serum ANGPTL3 in predicting HF complicated after PCI in coronary heart disease. Results There was significant difference in serum ANGPTL3 levels among the three groups (P<0.001). Compared with the control group, the serum levels of ANGPTL3 in the patients with HF and without HF were higher, with statistical significance (P<0.001). Compared with the HF-free group, the serum level of ANGPTL3 in the patients with HF was higher, and the measured values of LVESD, LAD and LVPW were higher, while the measured values of LVEF were lower, and the differences were statistically significant (P<0.001). Pearson correlation analysis showed that the expression level of serum ANGPTL3 was positively correlated with New York Heart Association cardiac function classification, LVESD, LAD and LVPW (P<0.001), but negatively correlated with LVEF(P<0.001). The ROC curve analysis showed that the area under the curve of serum ANGPTL3 for predicting HF after PCI was 0. 803(95% confidence interval 0.684-0.935,P<0.001), the diagnostic cutoff value was 41.27 g/L, the sensitivity was 91, 32%, the specificity was 73. 29%, and the Youden index was 0. 647. Conclusion ANGPTL3 expression in serum of patients with coronary heart disease complicated with HF is increased. Its expression level is related to the patient's cardiac function. It will become an evaluation index for HF complicated by PCI after coronary heart disease surgery. [ABSTRACT FROM AUTHOR]

Background: The diagnostic and prognostic clinical value of circulating tumor DNA (ctDNA) and cell-free DNA (cfDNA) in pancreatic malignancies are unclear. Herein, we aimed to perform a meta-analysis to evaluate ctDNA and cfDNA as potential diagnostic and prognostic biomarkers. Methods: PRISMA reporting guidelines were followed closely for conducting the current meta-analysis. The PubMed/Medline, Scopus, and Web of Science (WoS) databases were scanned in detail to identify eligible papers for the study. A quality assessment was performed in accordance with the REMARK criteria. The risk ratios (RRs) of the diagnostic accuracy of ctDNA compared to that of carbohydrate antigen 19.9 (CA 19.9) in all disease stages and the hazard ratios (HRs) of the prognostic role of ctDNA in overall survival (OS) were calculated with 95% confidence intervals (CIs). Results: A total of 18 papers were evaluated to assess the diagnostic accuracy and prognostic value of biomarkers related to pancreatic malignancies. The pooled analysis indicated that CA19.9 provides greater diagnostic accuracy across all disease stages than ctDNA or cfDNA (RR = 0.64, 95% CI: 0.50-0.82, p < 0.001). Additionally, in a secondary analysis focusing on prognosis, patients who were ctDNA-positive were found to have significantly worse OS (HR = 2.00, 95% CI: 1.51-2.66, p < 0.001). Conclusion: The findings of this meta-analysis demonstrated that CA19-9 still has greater diagnostic accuracy across all disease stages than KRAS mutations in ctDNA or cfDNA. Nonetheless, the presence of detectable levels of ctDNA was associated with worse patient outcomes regarding OS. There is a growing need for further research on this topic. [ABSTRACT FROM AUTHOR]

Diagnostic tests have intrinsic characteristics such as sensitivity, specificity, overall accuracy and likelihood ratios which define their operational performance. It is not uncommon to find in the literature that test value and clinical utility are defined based exclusively on those characteristics. This paper introduces several arguments aimed at prompting a reflection regarding the characteristics that define the true value of diagnostic tests in clinical practice. It concludes with the view that the value of each diagnostic test needs to be established in accordance with the circumstances in which it is used, taking into account extrinsic characteristics such as in whom it is used, when, where and by who. [ABSTRACT FROM AUTHOR]

Aims: Hypertensive disorders of pregnancy (HDP) is a unique disease during gestational period, which is detrimental to pregnancy outcome. This study examined the clinical significance of long non-coding RNA GAS5 in gestational hypertension (GH) and preeclampsia (PE), aiming to explore potential biomarkers for the disease detection. Methods: 180 pregnant women with HPD including 90 cases with GH and 90 cases with PE, and another 100 healthy pregnant women were enrolled. Serum GAS5 levels were measured by RT-qPCR method. The diagnostic performance of GAS5 was assessed in GH and PE through plotting receiver operating characteristic (ROC) curve. Logistic regression was applied for the identification of independent factors. Results: Elevated serum GAS5 was identified in GH patients, and its diagnostic performance in discriminating GH cases from healthy people was determined by ROC curve. Serum GAS5 was positively associated with SBP, DBP, LDL-C and CRP values. Cases with PE had an increased serum GAS5 level relative to those with GH. Serum GAS5 was identified to be an independent predictor for PE, and can differentiate PE cases from GH ones. with a good diagnositc performance. Cases with high levels of serum GAS5 had a high risk of poor pregnancy outcomes. Conclusion: Elevated serum GAS5 could serve as an effective diagnostic biomarker in discriminating GH patients from healthy people by first trimester screening. Detection of serum GAS5 level has a certain predictive value for PE. [ABSTRACT FROM AUTHOR]

Abstract Background Breast cancer is the most common cause of cancer-related deaths among women globally and the most deadly illness for them. New advances in nanotechnology have led to the development of strategies intended to target breast cancer cells more precisely while causing the least amount of damage to healthy cells. We retrieved articles about nanomaterials for the diagnosis and treatment of breast cancer from the Web of Science Core Collection (WoSCC) database between 2008 and 2023. Our research aims to assess publications on the use of nanomaterials for breast cancer treatment and diagnosis to predict future research directions. Results A total of 457 papers on nanomaterials in breast cancer were discovered from various nations, with China being the primary source and the United States having the highest H index. The number of papers in this discipline is increasing on an annual basis. The Egyptian Knowledge Bank is an important research center in this sector. The International Journal of Nanomedicine has the most papers, and Kesharwani P is the most frequently referenced author. The most quoted article was written by Miele, Evelina of India in 2009. Topics such as drug delivery may be emerging areas of research. Conclusion Our findings predict that the use of nanomaterials in medication delivery will become a significant research area in the future, and provide valuable references for scholars investigating the role of nanotechnology in breast cancer.

Background: Breast cancer is the most common cause of cancer-related deaths among women globally and the most deadly illness for them. New advances in nanotechnology have led to the development of strategies intended to target breast cancer cells more precisely while causing the least amount of damage to healthy cells. We retrieved articles about nanomaterials for the diagnosis and treatment of breast cancer from the Web of Science Core Collection (WoSCC) database between 2008 and 2023. Our research aims to assess publications on the use of nanomaterials for breast cancer treatment and diagnosis to predict future research directions. Results: A total of 457 papers on nanomaterials in breast cancer were discovered from various nations, with China being the primary source and the United States having the highest H index. The number of papers in this discipline is increasing on an annual basis. The Egyptian Knowledge Bank is an important research center in this sector. The International Journal of Nanomedicine has the most papers, and Kesharwani P is the most frequently referenced author. The most quoted article was written by Miele, Evelina of India in 2009. Topics such as drug delivery may be emerging areas of research. Conclusion: Our findings predict that the use of nanomaterials in medication delivery will become a significant research area in the future, and provide valuable references for scholars investigating the role of nanotechnology in breast cancer. [ABSTRACT FROM AUTHOR]

Objective To explore the clinical value of methylation at promoter sites of urine protein kinase Y-linked (PRKY) gene in the early diagnosis of prostate cancer(PCa). Methods Urine samples were collected from 50 suspected PCa patients. After extracting DNA, the methylation levels of the PRKY gene promoter sites cg05163709, cg08045599, and cg05618150 were detected using quantitative methylation-specific PCR (qMSP). Simultaneously, the patients were divided into the benign prostatic hyperplasia (BPH) group and the PCa group. The differences in clinical indicators between the two groups were analyzed, as well as the methylation status of the PRKY gene promoter sites in the urine of the two groups of patients. The receiver operating characteristic (ROC) curve of PRKY promoter sites methylation was established, and the area under the curve (AUC) was calculated to analyze the diagnostic value of PRKY promoter sites methylation in PCa, and to perform combined diagnosis with clinical indicators. Results The methylation rates of cg05163709 and cg05618150 in urine specimens of PCa patients were significantly higher than those of BPH patients. The AUC for cg05163709 methylation in diagnosing PCa was 0.762, with a sensitivity of 86.70%. It showed better performance in early screening for PCa compared to total prostate specific antigen (tPSA), percentage free prostate specific antigen(f/tPSA)and prostate specific antigen density (PSAD)index. We found that the AUC for cg05618150 methylation in conjunction with PSAD in diagnosing PCa was 0.787, with a sensitivity of 86.70%. The AUC of cg05163709 methylation and PSAD in the joint diagnosis of PCa was 0.855, and the specificity could reach 95.00%. Conclusion The methylation of urine PRKY gene promoter sites cg05163709 and cg05618150 shows high sensitivity and specificity in diagnosing PCa, making them promising biomarkers for early detection of PCa. [ABSTRACT FROM AUTHOR]

Objective To investigate the optimal display orientation of rotator cuff space (RI) structures on magnetic resonance (MR) scanning and arthrography. Methods A total of 80 patients who underwent MR scanning and arthrography in our hospital from January 2021 to March 2023 were selected and all of them were confirmed to have normal RI by shoulder arthroscopy. The RI and the superior glenohumeral ligament (SGHL), the long head of biceps tendon (LHBT), and the coracohumeral ligament (CHL) in the transverse axial, oblique sagittal, and oblique coronal positions were counted in the transverse axial, oblique sagittal, and oblique coronal positions on MR scanning and arthrography. Results The display rate of RI structure by oblique sagittal scan was 17.50% higher than that by horizontal scan, 0.00% and oblique coronal scan, 5.00% (4/80) (χ² = 18.739, P < 0.001). The display of SGHL, LHBT and CHL in RI by MR Oblique sagittal scan was better than that in transverse axis and oblique coronal scan ( χ² = 26.036, P<0.001). MR oblique sagittal arthrography showed a higher rate of RI structures 57.50% than transverse axial 5.00% and oblique coronal 17.50% (χ² = 61.534, P<0.001); MR oblique sagittal arthrography showed better display of SGHL, LHBT, and CHL structures in RI than transverse axial and oblique coronal (χ² = 64.569, P < 0.001); MR oblique sagittal arthrography had a significantly higher rate of complete visualization of RI structures in 57.50% than MR oblique sagittal plain scanning in 17.50% (χ² = 27.307, P<0.05). Conclusion Oblique sagittal position is the optimal display orientation for MR scanning and arthrography to show RI structures. [ABSTRACT FROM AUTHOR]

Objective: In clinical practice, there are few effective biomarkers for identifying non-alcoholic fatty liver disease (NAFLD). The aim of this study is to investigate the diagnostic value of γ-glutamyl transpeptidase to platelet ratio (GPR) combined with triglyceride (TG) in NAFLD. Methods: A total of 14,415 individuals participated in the annual physical examination. Multivariate logistic regression analysis was conducted to investigate the exposure factors associated with NAFLD. Spearman's analysis was performed to assess the correlation among the exposure factors of NAFLD. Furthermore, the diagnostic efficacy of the combination of GPR and TG in NAFLD was analyzed using the receiver operating characteristic curve (ROC). Results: The results of the multivariate logistic regression analysis showed that BMI (OR = 1.619), Systolic Blood Pressure (SBP) (OR = 1.014), Diastolic Blood Pressure (DBP) (OR = 1.028), GPR (OR = 12.809), and TG (OR = 2.936) were all risk factors for NAFLD, while HDL-C (OR = 0.215) was a protective factor. Spearman correlation analysis revealed significant positive correlations between GPR and SBP, DBP, BMI, TG (p

BackgroundThe diagnostic and prognostic clinical value of circulating tumor DNA (ctDNA) and cell-free DNA (cfDNA) in pancreatic malignancies are unclear. Herein, we aimed to perform a meta-analysis to evaluate ctDNA and cfDNA as potential diagnostic and prognostic biomarkers.MethodsPRISMA reporting guidelines were followed closely for conducting the current meta-analysis. The PubMed/Medline, Scopus, and Web of Science (WoS) databases were scanned in detail to identify eligible papers for the study. A quality assessment was performed in accordance with the REMARK criteria. The risk ratios (RRs) of the diagnostic accuracy of ctDNA compared to that of carbohydrate antigen 19.9 (CA 19.9) in all disease stages and the hazard ratios (HRs) of the prognostic role of ctDNA in overall survival (OS) were calculated with 95% confidence intervals (CIs).ResultsA total of 18 papers were evaluated to assess the diagnostic accuracy and prognostic value of biomarkers related to pancreatic malignancies. The pooled analysis indicated that CA19.9 provides greater diagnostic accuracy across all disease stages than ctDNA or cfDNA (RR = 0.64, 95% CI: 0.50–0.82, p < 0.001). Additionally, in a secondary analysis focusing on prognosis, patients who were ctDNA-positive were found to have significantly worse OS (HR = 2.00, 95% CI: 1.51–2.66, p < 0.001).ConclusionThe findings of this meta-analysis demonstrated that CA19-9 still has greater diagnostic accuracy across all disease stages than KRAS mutations in ctDNA or cfDNA. Nonetheless, the presence of detectable levels of ctDNA was associated with worse patient outcomes regarding OS. There is a growing need for further research on this topic.Systematic review registrationhttps://doi.org/10.37766/inplasy2023.12.0092, identifier INPLASY2023120092.

Summary: Background: High prices of anticancer drugs have raised concerns due to their financial impact on patients and healthcare systems. This study aimed to assess the initial and latest list prices and clinical value of reimbursed anticancer drugs in China, Japan, and South Korea. Methods: We identified anticancer drugs newly approved by the National Medical Products Administration of China from January 2012 to June 2022, and by the Pharmaceuticals and Medical Devices Agency of Japan and the Ministry of Food and Drug Safety of South Korea up until June 2022. We compared initial and latest treatment prices between countries and assessed clinical value using patients’ survival, quality of life (QoL), and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). We calculated Spearman rank correlation coefficients of treatment prices with clinical value for individual countries and employed regression analyses to investigate whether the relationship between prices and clinical value was modified by the country setting. Findings: Our cohort included 91 anticancer drug indications, with 60 listed for reimbursement in China, 91 in Japan, and 87 in South Korea. Median treatment prices were highest in Japan, followed by South Korea, and lowest in China, both for initial prices (US$64082 vs. US$45529 vs. US$19144, p

Abstract Background Deep venous thrombosis (DVT) is the common clinical cardiovascular disease, and easily develops into post-thrombotic syndrome (PTS). The study aimed to examine the clinical value of long non-coding RNA NORAD gene in the development of DVT and PTS. In vitro, the underlying mechanism was explored. Methods Serum levels of lncRNA NORAD gene in 85 DVT cases and 85 healthy individuals were tested. The role of lncRNA NORAD gene in human umbilical vein endothelial cells (HUVECs) proliferation, migration and inflammation was examined. The candidate downstream target gene was predicted via bioinformatic analysis. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were done for the function annotation and pathway enrichment. Results LncRNA NORAD gene was at high expression in the serum of DVT patients, it can distinguish DVT patients from healthy controls with the area under the curve of 0.919. Elevated expression of lncRNA NORAD gene in PTS patients was detected, DVT cases with high expression of lncRNA NORAD gene were more susceptible to PTS. LncRNA NORAD gene knockdown promoted HUVECs’ proliferation, migration while suppressing cell apoptosis and inflammation. MiR-93-5p served as a target of lncRNA NORAD gene, and its overexpression reversed the role of lncRNA NORAD gene in the biological function of HUVECs. The target genes of miR-93-5p were enriched in HIF-1 signaling, TGF-beta signaling and PI3K-Akt signaling, protein-protein interaction (PPI) network indicated STAT3, MAPK1 to be the key targets. Conclusions Upregulation of expression of lncRNA NORAD gene was a potential diagnostic biomarker for DVT and related to the development of PTS. LncRNA NORAD/miR-93-5p axis was involved in the progress of DVT through regulating endothelial cell function.

Meng-Qi Huang,&ast; Ting-Ting Zheng,&ast; Xiao-Rong Wang, Fei Xiang Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fei Xiang, Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province, 430022, People’s Republic of China, Tel +86-18971550171, Fax +86-27-85726114, Email 2006xh0855@hust.edu.cn; 93135729@qq.comBackground: The incidence of Pneumocystis jirovecii pneumonia (PJP) is increasing.Methods: 108 patients were analysed retrospectively at the Wuhan Union Hospital. The patients were classified into the PJP group or the P. jirovecii colonisation (PJC) group based on clinical diagnosis. Clinical data included demographics, laboratory examinations, treatment, and outcomes.Results: A notable difference in the fungal load was seen between two groups, with median reads of 3215.79 vs. 5.61 in two groups, respectively (P< 0.001). The optimal threshold value for discriminating P. jirovecii infection between colonisation for mNGS was six, and serum (1,3)-β-D-glucan (BDG) was 47.6 pg/mL. Besides, the positive detection rate of mNGS for co-pathogens in PJP patients was significantly higher than that of culture (88.16% vs. 22.37%, P< 0.0001). Epstein-Barr virus and cytomegalovirus were the most common pathogens of co-infection in PJP patients. The antibiotic therapy in PJP patients was adjusted according to the mNGS results, of which seventeen (22.37%) were downgraded, 38 (50.0%) patients were upgraded, and 21 (27.63%) were unchanged. And almost all patients showed significant improvement in C-reactive protein.Conclusion: mNGS is a promising and valuable technique with good performance for differentiating P. jirovecii infection and colonisation, the detection of pathogens, and antibiotic treatment.Keywords: Pneumocystis jirovecii pneumonia, Pneumocystis jirovecii, clinical value, metagenomic next-generation sequencing, non-HIV

AIM: To investigate the clinical value of serum vitamin A(Vit A)and basic fibroblast growth factor(bFGF)levels predicting retinopathy of prematurity(ROP).METHODS: Prospective cohort studies. A total of 411 premature or low birth weight infants with gestational age less than 37 wk or birth weight less than 2 500 g who were delivered in Hainan Branch, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine from January 2020 to December 2022 were selected as subjects. The Vit A and bFGF levels in peripheral blood were detected at 7 d and 35 d after birth, respectively.RESULTS: A total of 392 premature infants or low birth weight infants completed clinical study, including 51 cases in stage 1-2 ROP group, 23 cases in stage 3-5 ROP group and 318 cases in the group without ROP. At 7 d postnatal, the serum Vit A(0.44±0.17 μmol/L)and bFGF(0.53±0.16 ng/L)levels in stage 1-2 ROP group were lower than those in the group without ROP(0.50±0.12 μmol/L and 0.63±0.15 ng/L; all P

Abstract Background Many controversies still exist concerning the optimal extent of lymphadenectomy during esophagectomy in esophageal squamous cell carcinoma (ESCC). The objective of this study was to explore the characteristics of 4R metastasis and evaluate the clinical value of 4R node dissection in ESCC. Methods A total of 736 ESCC patients who underwent radical esophagectomy between 2005 and 2013 were retrospectively collected, among which 393 ones underwent 4R dissection. Propensity score matching (PSM) method was applied to reduce the effects of confounding variables between the 4R dissection and non-dissection groups to analyze overall survival. Results Patients showed a low 4R metastasis rate of 5.1% (20/393) (5.2%, 5.8%, and 1.8% for upper, middle, and lower tumors, respectively). Correlation analyses identified that 4R metastasis was significantly associated with station 2R metastasis (p

Background: Endometrial cancer is one of the common cancers in gynecology, which seriously endangers women’s reproductive health. Therefore, it is urgent to search for new diagnostic and prognostic monitoring markers for endometrial cancer. This study aimed to explore the clinical significance and biological role of spindle and kinetochore-associated complex subunit 3 (SKA3) in endometrial cancer. Methods: Weighted gene co-expression network analysis (WGCNA) and identification of differentially expressed genes (DEGs) were conducted to identify the key gene in endometrial cancer. The clinical significance of SKA3 within endometrial cancer was assessed through receiver operating characteristic (ROC) and Kaplan-Meier (KM) curves. Spearman correlation analysis, the STRING database, Cytoscape software, and the molecular complex detection (MCODE) algorithm were employed to investigate genes associated with SKA3. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were carried out for elucidating the functional role and pathways involving SKA3. The cBioPortal online platform was utilized to explore mutations in SKA3. The biological effects of SKA3 were further investigated through Cell Counting Kit-8 (CCK8) and cell scratch experiments. Results: SKA3 emerges as a pivotal gene in endometrial cancer, exhibiting a statistically significant high expression level. Its area under the curve (AUC) for diagnosing endometrial cancer stands at 0.943. Patients displaying elevated SKA3 expression demonstrated a notably poorer prognosis. In the context of endometrial cancer, 9 genes directly interact with SKA3. The functional pathway of SKA3 in endometrial cancer likely involves the mitotic pathway. The alterations observed in SKA3 in endometrial cancer primarily manifest as “mutations”. Specifically, SKA3 exhibits 26 mutation sites in endometrial cancer, distributed across 7 distinct regions and involving 4 mutation types. Furthermore, SKA3 is implicated in promoting the proliferation and migration of HEC-1A cells. Conclusion: SKA3, a key gene in endometrial cancer, holds significant diagnostic and prognostic value and may influence the progression in endometrial cancer.

Objective: To investigate the changes and clinical value of silent information regulator-1 (Sirtuin-1) and Sirtuin-6 in gingival crevicular fluid of chronic periodontitis (CP) patients with type 2 diabetes mellitus (T2DM). Methods: 147 CP patients with T2DM (T2DM group), 128 patients with simple CP (CP group) and 121 healthy subjects (control group) who were admitted to The 970 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from March 2020 to March 2023 were selected. Patients in T2DM group were divided into mild group (n=49), moderate group (n=67) and severe group (n=31) according to the results of periodontal examination. The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid and the expression of nucleotide-binding oligomerization domain-like receptor hot protein domain subfamily member 3 (NLRP3) messenger ribonucleic acid (mRNA), programmed cell death-associated speck-like protein (ASC) mRNA and cysteine protease 1 (Caspase-1) mRNA in peripheral blood mononuclear cells were detected, and the periodontal clinical indexes were evaluated. The correlation between the levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid and periodontal clinical indicators, the expression of NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA in peripheral blood mononuclear cells in CP patients with T2DM were analyzed by Pearson correlation analysis. The value of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid in the diagnosis of CP combined with T2DM were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid in T2DM group were lower than those in CP group and control group (P<0.05), the bleeding index (SBI), probing depth (PD), gingival index (GI), plaque index (PLI), attachment loss (AL), NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA expression in peripheral blood mononuclear cells in T2DM group were higher than those in CP group and control group (P<0.05). The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid in CP group were lower than those in control group (P<0.05), the expressions of GI, SBI, PLI, PD, AL, NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA in peripheral blood mononuclear cells in CP group were higher than those in control group (P<0.05). The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid in severe group were lower than those in moderate group and mild group (P<0.05). The expression of GI, PLI, SBI, AL, PD, NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA in peripheral blood mononuclear cells in severe group were higher than those in moderate group and mild group (P<0.05). The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid in moderate group were lower than those in mild group (P<0.05), and the expressions of GI, PLI, SBI, AL, PD, NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA in peripheral blood mononuclear cells were higher than those in mild group (P<0.05). The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid of CP patients with T2DM were negatively correlated with GI, PLI, SBI, AL, PD, NLRP3 mRNA, ASC mRNA and Caspase-1 mRNA expression in peripheral blood mononuclear cells (P<0.05). The area under the curve (AUC) of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid for the diagnosis of CP combined with T2DM was 0.787 and 0.806 respectively, and the AUC of combined diagnosis was 0.912, which was higher than that of single diagnosis. Conclusion: The levels of Sirtuin-1 and Sirtuin-6 in gingival crevicular fluid of CP patients with T2DM are decrease, which are relate to the aggravation of periodontal tissue damage and the activation of NLRP3 inflammasome. Sirtuin-1 combine with Sirtuin-6 in gingival crevicular fluid has high value in the diagnosis of CP combine with T2DM. [ABSTRACT FROM AUTHOR]

Background: Deep venous thrombosis (DVT) is the common clinical cardiovascular disease, and easily develops into post-thrombotic syndrome (PTS). The study aimed to examine the clinical value of long non-coding RNA NORAD gene in the development of DVT and PTS. In vitro, the underlying mechanism was explored. Methods: Serum levels of lncRNA NORAD gene in 85 DVT cases and 85 healthy individuals were tested. The role of lncRNA NORAD gene in human umbilical vein endothelial cells (HUVECs) proliferation, migration and inflammation was examined. The candidate downstream target gene was predicted via bioinformatic analysis. Gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were done for the function annotation and pathway enrichment. Results: LncRNA NORAD gene was at high expression in the serum of DVT patients, it can distinguish DVT patients from healthy controls with the area under the curve of 0.919. Elevated expression of lncRNA NORAD gene in PTS patients was detected, DVT cases with high expression of lncRNA NORAD gene were more susceptible to PTS. LncRNA NORAD gene knockdown promoted HUVECs' proliferation, migration while suppressing cell apoptosis and inflammation. MiR-93-5p served as a target of lncRNA NORAD gene, and its overexpression reversed the role of lncRNA NORAD gene in the biological function of HUVECs. The target genes of miR-93-5p were enriched in HIF-1 signaling, TGF-beta signaling and PI3K-Akt signaling, protein-protein interaction (PPI) network indicated STAT3, MAPK1 to be the key targets. Conclusions: Upregulation of expression of lncRNA NORAD gene was a potential diagnostic biomarker for DVT and related to the development of PTS. LncRNA NORAD/miR-93-5p axis was involved in the progress of DVT through regulating endothelial cell function. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by excess androgen hormone and symptoms like obesity, irregular cycles, acne, hirsutism, and abnormal ovarian follicle development. Treatment targets anovulation, hyper androgenism, and menstrual dysfunction. This study developed machine learning models using clinical data to predict PCOS presence. The dataset included FSH/LH values and observed symptoms. Random Forest, Decision, SVM, Naïve Bayesian, Gradient Boosting, and KNN classifiers were evaluated. Random Forest achieved 90% accuracy. Additionally, a doctor model based on CNN deep learning will provide a secondary diagnostic opinion to professionals. This model will enhance the accuracy of PCOS diagnosis and support healthcare providers in decision-making. An assistive platform is proposed to detect PCOS, provide prevention measures, and offer education on menstrual health and well-being. It aims to benefit rural communities and address specific PCOS needs in a concise manner. [ABSTRACT FROM AUTHOR]

Background: Many controversies still exist concerning the optimal extent of lymphadenectomy during esophagectomy in esophageal squamous cell carcinoma (ESCC). The objective of this study was to explore the characteristics of 4R metastasis and evaluate the clinical value of 4R node dissection in ESCC. Methods: A total of 736 ESCC patients who underwent radical esophagectomy between 2005 and 2013 were retrospectively collected, among which 393 ones underwent 4R dissection. Propensity score matching (PSM) method was applied to reduce the effects of confounding variables between the 4R dissection and non-dissection groups to analyze overall survival. Results: Patients showed a low 4R metastasis rate of 5.1% (20/393) (5.2%, 5.8%, and 1.8% for upper, middle, and lower tumors, respectively). Correlation analyses identified that 4R metastasis was significantly associated with station 2R metastasis (p < 0.001) and pathologic tumor-node-metastasis (pTNM) stage (p < 0.001). All 4R metastases were observed in stages IIIB and IVA. Moreover, patients with station 4R dissection failed to achieve significantly improved overall survival compared with those without 4R dissection, regardless of tumor stage (overall: p = 0.696; stage 0-IIIA: p = 0.317; stage IIIB-IVA: p = 0.619). Conclusion: 4R metastasis is likely to be associated with more aggressive disease, and routine 4R node dissection might not be necessary for ESCC patients. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a prevalent malignant digestive tumor. Numerous genetic mutations have been documented in HCC, yet the clinical significance of these mutations remains largely unexplored. The objective of this study is to ascertain the clinical value and biological effects of xin actin binding repeat containing 2 (XIRP2) mutation in HCC. The gene mutation landscape of HCC was examined using data from the Cancer Genome Atlas and the International Cancer Genome Consortium databases. The prognostic significance of the XIRP2 mutation was assessed through KM plot analysis. The association between drug sensitivity and the XIRP2 mutation was investigated using the TIDE algorithm and CCK-8 experiments. The biological effects of the XIRP2 mutation were evaluated through qRT-PCR, protein stability experiments, and relevant biological experiments. The XIRP2 mutation is one of the high-frequency mutations in HCC, and is associated with poor prognosis. A total of 72 differentially expressed genes (DEGs) were observed in HCC tissues with the XIRP2 mutation as compared to those with the XIRP2 wildtype, and these DEGs were closely related to ion metabolic processes. The XIRP2 mutation was linked to alterations in the sensitivity of fludarabine, oxaliplatin, WEHI-539, and LCL-161. CCK-8 assays demonstrated that HCC cells carrying the XIRP2 mutation exhibited increased resistance to fludarabine and oxaliplatin, but enhanced sensitivity to WEHI-539 and LCL-161 as compared with those HCC cells with the XIRP2 wildtype. The XIRP2 mutation was found to have no impact on the mRNA levels of XIRP2 in tissues and cells, but it did enhance the stability of the XIRP2 protein. Mechanically, the inhibition of XIRP2 resulted in a significant increase in sensitivity to oxaliplatin through an elevation in zinc ions and a calcium ion overload. In conclusion, the XIRP2 mutation holds potential as a biomarker for predicting the prognosis and drug sensitivity of HCC and serves as a therapeutic target to enhance the efficacy of oxaliplatin.

Introduction: Breast cancer is the most common malignancy diagnosed in women, and despite advancements in diagnosis and treatment, it still leads to significant morbidity and mortality. Distinguishing between benign and malignant breast disease is clinically challenging, and there is currently no serum biomarker available for early breast cancer detection. As part of the preoperative work-up for breast lesions, a Complete Blood Count (CBC) analysis is typically performed. Aim: This study aimed to evaluate the utility of CBC parameters in diagnosing malignant breast lesions and to analyse the diagnostic role of haematological parameters within benign and malignant breast lesions, as well as different histological breast cancer stages. Materials and Methods: This retrospective observational study was conducted for one year, from January to December 2021, at the Department of Pathology of PSG Institute of Medical Sciences and Research in Coimbatore, Tamil Nadu, India. The study included 60 female patients with both benign and malignant breast lesions. Histopathological examination confirmed the diagnoses of these lesions. CBC parameters, including haemoglobin, Total White Cell Count (TWBC), neutrophil count, lymphocyte count, monocyte count, platelet count, and Mean Platelet Volume (MPV), were collected from a total of 120 cases. Additionally, the Neutrophil-Lymphocyte Ratio (NLR), MonocyteLymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR) were calculated from the obtained CBC parameters for all cases. The values were expressed as mean and standard deviation, and an independent t-test was used to compare the two groups. A p-value less than 0.05 was considered significant. Results: Malignant breast lesions showed a significant increase in neutrophils (64.1±8.4%) and a significant decrease in lymphocytes (25.9±8%) and MPV (7.6±0.76 pg) compared to benign breast cases. The calculated ratios, such as NLR (2.9±1.7), MLR (0.32±0.2), and PLR (14.4±8), were also found to be increased in malignant cases. However, there were no significant variations in CBC parameters across the various stages of breast malignancy. Conclusion: Among the CBC parameters evaluated, neutrophil count, lymphocyte count, MPV, NLR, MLR, and PLR were significantly altered in breast malignancy compared to benign breast masses. Measuring CBC parameters and their derived ratios are fast, simple, inexpensive, and readily available method that can assist physicians in predicting breast malignancy.

Objective DJ-1 is an oncoprotein secreted by cancer cells. However, the physiological and pathological significance of DJ-1 secretion is not clearly understood. This study investigated the clinical value of serum DJ-1 in lung adenocarcinoma (LUAD). Methods The study involved 224 LUAD patients, 110 patients with benign pulmonary disease and 100 healthy controls from the First Affiliated Hospital of Nanjing Medical University. We detected the expression of DJ-1 in lung cell lines in vitro. Meanwhile, serum concentrations of DJ-1, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragment (CYFRA21-1) were measured. The diagnostic performance of LUAD was obtained using receiver operating characteristic (ROC) curves. Kaplan–Meier, univariate and multivariate Cox regression analyses were performed for progression-free survival (PFS). Results DJ-1 was highly expressed in LUAD cell lines. Serum DJ-1 levels were significantly higher in the LUAD group compared to the benign pulmonary disease group (5.04 vs. 3.66 ng/mL, P

Objective To investigate the clinical value of serum N-terminal pro B type natriuretic peptide (NT-proBNP) and P-selectin combined with ischemia-modified albumin (IMA) in predicting poor electrocardiographic ST-segment regression (STR) after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Methods 100 patients with ASTEMI who were admitted to the emergency Department of the Second Affiliated Hospital of Nanjing Medical University from January 2020 to July 2022 were selected, and they were divided into STR poor group and STR good group according to electrocardiographic STR after PCI, and 50 healthy volunteers during the same period were selected as control group. Serum NT-proBNP, P-selectin and IMA levels were detected by enzyme-linked immunosorbent assay. Multivariate Logistic regression was used to analyze the influencing factors of poor electrocardiographic STR in patients with ASTEMI after PCI, and the predictive value of serum NT-proBNP, P-selectin and IMA levels in patients with ASTEMI after PCI was analyzed by receiver operating characteristic (ROC) curve. Results Compared with the control group, the serum NT-proBNP, P-selectin and IMA levels in the ASTEMI group before PCI were increased (P＜0.05). According to electrocardiographic STR, patients with ASTEMI were divided into STR poor group of 35 cases and STR good group of 65 cases. The serum NT-proBNP, P-selectin and IMA levels in the STR poor group and STR good group after PCI were lower than those before PCI (P＜0.05). The serum NT-proBNP, P-selectin and IMA levels before PCI and after PCI in the STR poor group were higher than those in the STR good group (P＜0.05). The proportion of Killip grade≥2 grade and troponin I in the STR poor group were higher than those in the STR good group, and the total deviation of ST segment was lower than that in the STR good group (P＜0.05). Multivariate Logistic regression analysis showed that Killip grade≥2 grade and elevated NT-proBNP, P-selectin and IMA were independent risk factors for poor electrocardiographic STR after PCI in patients with ASTEMI (P＜0.05). ROC curve analysis showed that the area under curve (AUC) of serum NT-proBNP, P-selectin combined with IMA in predicting poor electrocardiographic STR after PCI in patients with ASTEMI was greater than that predicted by NT-proBNP, P-selectin and IMA alone. Conclusion Elevated serum NT-proBNP, P-selectin and IMA levels are independently correlated with poor electrocardiographic STR after PCI in patients with ASTEMI, and the combined value of the three is high in predicting poor electrocardiographic STR in patients with ASTEMI after PCI. [ABSTRACT FROM AUTHOR]

Background: Immunity and ferroptosis often play a synergistic role in the progression and treatment of hepatocellular carcinoma (HCC). However, few studies have focused on identifying immune-related ferroptosis gene biomarkers. Methods: We performed weighted gene co-expression network analysis (WGCNA) and random forest to identify prognostic differentially expressed immune-related genes (PR-DE-IRGs) highly related to HCC and characteristic prognostic differentially expressed ferroptosis-related genes (PR-DE-FRGs) respectively to run co-expression analysis for prognostic differentially expressed immune-related ferroptosis characteristic genes (PR-DE-IRFeCGs). Lasso regression finally identified 3 PR-DE-IRFeCGs for us to construct a prognostic predictive model. Differential expression and prognostic analysis based on shared data from multiple sources and experimental means were performed to further verify the 3 modeled genes' biological value in HCC. We ran various performance testing methods to test the model's performance and compare it with other similar signatures. Finally, we integrated composite factors to construct a comprehensive quantitative nomogram for accurate prognostic prediction and evaluated its performance. Results: 17 PR-DE-IRFeCGs were identified based on co-expression analysis between the screened 17 PR-DE-FRGs and 34 PR-DE-IRGs. Multi-source sequencing data, QRT-PCR, immunohistochemical staining and testing methods fully confirmed the upregulation and significant prognostic influence of the three PR-DE-IRFeCGs in HCC. The model performed well in the performance tests of multiple methods based on the 5 cohorts. Furthermore, our model outperformed other related models in various performance tests. The immunotherapy and chemotherapy guiding value of our signature and the comprehensive nomogram's excellent performance have also stood the test. Conclusion: We identified a novel PR-DE-IRFeCGs signature with excellent prognostic prediction and clinical guidance value in HCC. [ABSTRACT FROM AUTHOR]

Background: The traditional postoperative visit consists of an in-person hospital visit at a predetermined date which requires the investment of time and resources. This implies a need to prioritize visits rather than mandating them, which can be assessed by the requirement of clinical intervention at the time of follow-up. The purpose of this study is to determine the clinical value of routine postoperative physical follow-up in common pediatric surgery conditions, to identify factors determining follow--up, and to estimate the cost of routine follow-up. Materials and Methods: Surgical data of 226 patients admitted for routine pediatric surgical procedures were collected. The postoperative period was documented in detail and interventions done either physically or telephonically at the time of follow-up were used as a proxy measure of clinical value. Results: There were 226 patients enrolled, of which 64.60% followed up physically in outpatient department and 35.40% followed up telephonically. Maximum percentage of patients with postoperative complications belonged to the group of laparotomy at 22.22%, followed by complicated appendicitis at 15.62%. 13.27% of patients required clinical intervention at the time of follow-up. Conclusion: Patients undergoing simpler procedures such as inguinal hernia, hydrocele, and orchidopexy have lesser rate of complications which translates to requirement of fewer clinic visits, whereas those undergoing procedures such as appendectomy and laparotomy require a physical visit after discharge since they are more susceptible to develop complications requiring interventions. By selecting patients for physical visit, we can potentially eliminate unnecessary visits in patients who have low chance of developing complications. [ABSTRACT FROM AUTHOR]

Introduction: Circulating microRNAs (miRNAs) are widely identified as promising and novel biomarkers for the diagnosis of human diseases. This study investigated the clinical value of miR-532-5p for asymptomatic carotid artery stenosis (CAS) patients and detected its predictive value for the occurrence of future cerebral ischaemic events (CIE). Material and methods: Serum expression of miR-532-5p was measured using qRT-PCR. A receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic value of miR-532-5p in asymptomatic CAS patients, and the area under the curve (AUC) was calculated. The predictive value of miR-532-5p for the occurrence of CIE was evaluated by using Kaplan- Meier methods and Cox regression analysis. Results: Serum expression of miR-532-5p was identified to be significantly decreased in CAS patients compared with healthy controls. The ROC curve with an AUC of 0.903 indicated high diagnostic accuracy of serum miR-532-5p expression in asymptomatic CAS patients. As Kaplan-Meier analysis results suggested, more CIE events were observed in cases with low miR-532-5p expression. Low miR-532-5p and high degree of carotid stenosis were independent factors for the occurrence of CIE in asymptomatic CAS patients. Conclusions: The study suggests the potential clinical value of miR-532-5p for the early diagnosis of asymptomatic CAS patients. MiR-532-5p might have predictive value for the risk of future CIE in asymptomatic CAS patients. [ABSTRACT FROM AUTHOR]

Objective: To study the clinical importance of hemoglobin, albumin, lymphocyte, and platelet (HALP) indexes in predicting lymph node metastasis and recurrence of endometrial cancer. Methods: From July 2016 to July 2020, 158 patients suffering from endometrial cancer who visited the gynecology department of General Hospital of Ningxia Medical University from were collected. Employing the X-Tiles program, the ideal HALP cut-off value was established, and the patients were separated into low and high HALP groups. Univariate and multivariate analysis were used to determine the relationship between HALP score and lymph node metastasis and recurrence of endometrial cancer. Results: The optimal cut-off value of HALP score was established to be 22.2 using X-Tiles software, and the patients were separated into high HALP group (HALP score > 22.2, with 43 cases) and low HALP group (HALP score = 22.2, 115 cases). Endometrial cancer patients' HALP scores were strongly connected with differentiation, the degree of myometrial invasion, and lymph node metastasis (P < 0.05), although not with age, menopausal status, or stage (P > 0.05). Multivariate logistic regression analysis revealed that the HALP score (OR = 2.087) was the influencing factor for lymph node metastasis (P < 0.05). The ROC curve suggested that the AUC of HALP score in predicting lymph node metastasis was 0.871, which had high diagnostic value. When compared to patients without recurrence, HALP scores of patients with recurrence were considerably lower (P < 0.05). Multivariate logistic regression analysis showed that HALP score (OR = 2.216) was the influencing factor for the occurrence of lymph node metastasis (P < 0.05). The ROC curve suggested that the AUC of HALP score in predicting relapse was 0.855, with high diagnostic value. Conclusion: The HALP score shows good predictive performance in predicting lymph node metastasis and recurrence of endometrial cancer, and has high clinical value, which helps in improving the accuracy and effectiveness of clinical diagnosis and prognosis research. [ABSTRACT FROM AUTHOR]

Background. Worldwide, lung squamous cell carcinoma (LUSC) has wreaked havoc on humanity. Matrix metallopeptidase 12 (MMP12) plays an essential role in a variety of cancers. This study aimed to reveal the expression, clinical significance, and potential molecular mechanisms of MMP12 in LUSC. Methods. There were 2,738 messenger RNA (mRNA) samples from several multicenter databases used to detect MMP12 expression in LUSC, and 125 tissue samples were validated by immunohistochemistry (IHC) experiments. Receiver operator charac- teristic (ROC) curves, Kaplan-Meier curves, and univariate and multivariate Cox regression analyses were used to assess the clinical value of MMP12 in LUSC. The potential molecular mechanisms of MMP12 were explored by gene enrichment analysis and immune correlation analysis. Furthermore, single-cell sequencing was used to determine the distribution of MMP12 in multiple tumor microenvironment cells. Results. MMP12 was significantly overexpressed at the mRNA level (p<0:05, SMD D 3.13, 95% CI [2.51 -3.75]), which was verified at the protein level (p<0:001) by internal IHC experiments. MMP12 expression could be used to differentiate LUSC samples from normal samples, and overexpression of MMP12 itself implied a worse clinical prognosis and higher levels of immune cell infiltration in LUSC patients. MMP12 was involved in cancer development and progression through two immune-related signaling pathways. The high expression of MMP12 in LUSC might act as an antigen- presenting cell-associated tumor neoantigen and activate the body's immune response. Conclusions. MMP12 expression is upregulated in LUSC and high expression of MMP12 serves as a risk factor for LUSC patients. MMP12 may be involved in cancer development by participating in immune-related signaling pathways and elevating the level of immune cell infiltration. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common malignancy diagnosed in women, and despite advancements in diagnosis and treatment, it still leads to significant morbidity and mortality. Distinguishing between benign and malignant breast disease is clinically challenging, and there is currently no serum biomarker available for early breast cancer detection. As part of the preoperative work-up for breast lesions, a Complete Blood Count (CBC) analysis is typically performed. Aim: This study aimed to evaluate the utility of CBC parameters in diagnosing malignant breast lesions and to analyse the diagnostic role of haematological parameters within benign and malignant breast lesions, as well as different histological breast cancer stages. Materials and Methods: This retrospective observational study was conducted for one year, from January to December 2021, at the Department of Pathology of PSG Institute of Medical Sciences and Research in Coimbatore, Tamil Nadu, India. The study included 60 female patients with both benign and malignant breast lesions. Histopathological examination confirmed the diagnoses of these lesions. CBC parameters, including haemoglobin, Total White Cell Count (TWBC), neutrophil count, lymphocyte count, monocyte count, platelet count, and Mean Platelet Volume (MPV), were collected from a total of 120 cases. Additionally, the Neutrophil-Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR) were calculated from the obtained CBC parameters for all cases. The values were expressed as mean and standard deviation, and an independent t-test was used to compare the two groups. A p-value less than 0.05 was considered significant. Results: Malignant breast lesions showed a significant increase in neutrophils (64.1±8.4%) and a significant decrease in lymphocytes (25.9±8%) and MPV (7.6±0.76 pg) compared to benign breast cases. The calculated ratios, such as NLR (2.9±1.7), MLR (0.32±0.2), and PLR (14.4±8), were also found to be increased in malignant cases. However, there were no significant variations in CBC parameters across the various stages of breast malignancy. Conclusion: Among the CBC parameters evaluated, neutrophil count, lymphocyte count, MPV, NLR, MLR, and PLR were significantly altered in breast malignancy compared to benign breast masses. Measuring CBC parameters and their derived ratios are fast, simple, inexpensive, and readily available method that can assist physicians in predicting breast malignancy. [ABSTRACT FROM AUTHOR]

Objective: To analyze the value of serum lactate dehydrogenase in evaluating severe pneumonia in patients undergoing craniocerebral surgery. Methods: 268 patients undergoing selective craniocerebral surgery in our hospital from July 2020 to June 2022 were selected. They were divided into non infection group (n=185) and pneumonia group (n=83) according to whether they were complicated with postoperative pneumonia. The pneumonia group was divided into severe pneumonia 31 cases and common pneumonia 52 cases according to the severity of pneumonia. Serum PCT and CRP levels were measured by ELISA; The serum LDH level was detected by enzyme colorimetry, and the correlation between the serum LDH, PCT, CRP levels and the severity of the disease in patients with pneumonia was analyzed by Pearson correlation test. ROC curve was used to analyze the clinical diagnostic value of serum LDH, PCT, CRP levels in patients with severe pneumonia after craniocerebral surgery, and the prognostic value of serum LDH, PCT, CRP levels in patients with severe pneumonia after craniocerebral surgery. Results: The levels of serum LDH, PCT and CRP in patients with common pneumonia were significantly higher than those in the uninfected group on the 1st, 3rd and 7th day after operation (P<0.05); Compared with the common pneumonia group, the serum LDH, PCT and CRP levels in the severe pneumonia group were significantly higher (P<0.05). Pearson correlation test showed that serum LDH, PCT, CRP levels were positively correlated with PSI scores in patients with craniocerebral surgery complicated with pneumonia (P<0.05). The ROC curve was established based on the serum LDH, PCT and CRP levels on the first day after operation. The results showed that the areas under the curve of serum LDH, PCT and CRP were 0.840, 0.825 and 0.746 respectively. The ROC curve was established based on the serum LDH, PCT and CRP levels 7 days after operation. The results showed that the areas under the curve of serum LDH, PCT and CRP were 0.819, 0.725 and 0.684 respectively. Conclusion: LDH is highly expressed in patients with craniocerebral operation complicated with pneumonia, which is positively related to the severity of pneumonia. LDH has good value in distinguishing non severe pneumonia patients from severe pneumonia patients and predicting the 28 day mortality of severe pneumonia patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical value of fecal calprotectin (FC) for evaluating disease activity in patients with Crohn’s disease (CD) and its relationship with disease location. Methods: Patients with CD were enrolled retrospectively, and clinical data, including FC levels, were collected. Clinical activity was assessed using the Crohn’s disease activity index (CDAI). Endoscopic activity was assessed using a simple endoscopic score for Crohn’s disease (SES-CD). The partial SES-CD (pSESCD) was scored for the size of ulcers in each segment as defined by the SES-CD and was calculated as the sum of segmental ulcer scores. Results: This study included 273 CD patients. The FC level was significantly positively correlated with the CDAI and SES-CD, with correlation coefficients of 0.666 and 0.674, respectively. The median FC levels in patients with clinical remission and mildly active and moderately–severely active disease were 41.01, 164.20, and 444.45 μg/g. These values were 26.94, 66.77, and 327.22 μg/g during endoscopic remission and mildly and moderately–severely active stages, respectively. Compared with c-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and other biomarker parameters, FC was better at predicting disease activity for CD patients. For an FC <74.52 μg/g, the area under the curve (AUC) for predicting clinical remission was 0.86, with a sensitivity of 89.47% and a specificity of 71.70%. Moreover, endoscopic remission was predicted with a sensitivity of 68.02% and a specificity of 85.53%. The AUC was 0.83, and the cutoff value was 80.84 μg/ g. In patients with ileal and (ileo) colonic CD, FC was significantly correlated with the CDAI, SES-CD, and pSES-CD. The correlation coefficients were 0.711 (CDAI), 0.473 (SES-CD), and 0.369 (pSES-CD) in patients with ileal CD and 0.687, 0.745, and 0.714 in patients with (ileo) colonic CD, respectively. For patients in remission, those in the active stage, and those with large or very large ulcers, differences in FC levels were not significant between patients with ileal and (ileo) colonic CD. Conclusion: FC is a reliable predictor of disease activity in patients with CD, including those with ileal CD. FC is thus recommended for the routine follow-up of patients with CD [ABSTRACT FROM AUTHOR]

Videolaryngostroboscopy (VLS) is considered gold standard method for assessing voice disorders. But patients with irregular waveform of vocal folds cannot benefit from the VLS. Videokymography [VKG] is a single line real time, high speed imaging technique. It detects voice disorders based on vocal fold vibration characteristics whether the vibrations are regular or irregular. There is no standard clinical protocol or evidence on the clinical relevance of VKG for functional assessment of voice disorders. Since mechanism of voice production depends on vibration characteristics, VKG imaging leads to new possibilities for diagnosis, objective documentation and monitoring of vocal fold behavior in clinical practice in case of voice disorders. This study aims to evaluate clinical value of VKG in addition to VLS as a complementary tool for the assessment of voice disorder. [ABSTRACT FROM AUTHOR]

With the introduction of various subjects, such as clinical epidemiology and evidence-based medicine, the qualities and levels of Traditional Chinese Herbal Medicine (TCHM) in China improved substantially, and the processes of internationalization of Traditional Chinese Medicine (TCM) are further accelerated. Since, a variety of drug products in China have been approved for marketing in other countries, and approximately 10 products have submitted the IND application to FDA of United States, of which various Chinese herbal preparations such as compound Danshen dripping pills, Xingling granules, and HMPL-004 have been approved to be investigated in phase III clinical trials. In general, multi-center studies of TCHM are increasing with years, but most of the studies are performed in some certain country, and the actual international multicenter clinical trials are very rare. Number of SCI literatures on multi-center clinical trials of TCHM that published in the recent decade also showed increasing tendency with years, despite the evident reduction in the past 2 years due to the influence of COVID-19 pandemic. Of the multi-center clinical trials of TCHM that performed by mainland China and other oversees regions, except for Taiwan, China, nearly 70% were focused on classic Chinese medicinal formulae and Chinese patent medicine, while the other 30% were on dietary supplements and plant extracts. Facing the future, the "human experience" has attracted close attentions from researchers throughout the world. Effectively utilizing the historic "human experience" is an important method to vitalize potential of original scientific and technological resources of TCHM. Performing multi-center clinical trials with high qualities is still an essential method for TCHM in accessing the mainstream medicine market. In addition, it is also required to further improve the evaluation techniques and methods that not only meet the international standards but also meet the characteristics of TCHM. Furthermore, we should also focus on the TCHM specific clinical values and scientific reports. [ABSTRACT FROM AUTHOR]

Background: The traditional postoperative visit consists of an in-person hospital visit at a predetermined date which requires the investment of time and resources. This implies a need to prioritize visits rather than mandating them, which can be assessed by the requirement of clinical intervention at the time of follow-up. The purpose of this study is to determine the clinical value of routine postoperative physical follow-up in common pediatric surgery conditions, to identify factors determining follow–up, and to estimate the cost of routine follow-up. Materials and Methods: Surgical data of 226 patients admitted for routine pediatric surgical procedures were collected. The postoperative period was documented in detail and interventions done either physically or telephonically at the time of follow-up were used as a proxy measure of clinical value. Results: There were 226 patients enrolled, of which 64.60% followed up physically in outpatient department and 35.40% followed up telephonically. Maximum percentage of patients with postoperative complications belonged to the group of laparotomy at 22.22%, followed by complicated appendicitis at 15.62%. 13.27% of patients required clinical intervention at the time of follow-up. Conclusion: Patients undergoing simpler procedures such as inguinal hernia, hydrocele, and orchidopexy have lesser rate of complications which translates to requirement of fewer clinic visits, whereas those undergoing procedures such as appendectomy and laparotomy require a physical visit after discharge since they are more susceptible to develop complications requiring interventions. By selecting patients for physical visit, we can potentially eliminate unnecessary visits in patients who have low chance of developing complications.

Fang Ding,1 Wenjing Liu,2 Huiqing Wang,3 Weiwei Wang,1 Caixia Yang1 1Department of Geriatrics, Hengshui People’s Hospital, Hengshui City, Hebei Province, People’s Republic of China; 2Department of Respiratory Medicine, Hengshui People’s Hospital, Hengshui City, Hebei Province, People’s Republic of China; 3Department of Intensive Care Medicine, Hengshui People’s Hospital, Hengshui City, Hebei Province, People’s Republic of ChinaCorrespondence: Fang Ding, Department of Geriatrics, Hengshui People’s Hospital, No. 180, Renmin East Road, TaoCheng District, Hengshui City, Hebei Province, 053000, People’s Republic of China, Tel +86 0318-2187239, Email dingfan99g@126.comObjective: To analyse the guiding value of procalcitonin (PCT) for the selection of ventilation switching points in sequential mechanical ventilation for patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and respiratory failure, and to provide a reference for the optimisation of mechanical ventilation for patients with COPD and respiratory failure.Methods: The study included 160 patients with an acute exacerbation of COPD complicated by respiratory failure who received sequential mechanical ventilation treatment. They were divided into two groups of 80 participants. The critical point of the pulmonary infection observation window (PIC) was used as the switching point for sequential mechanical ventilation treatment in the control group, and PCT clinical node was used as the switching point for sequential mechanical ventilation treatment in the observation group. The invasive ventilation time, non-invasive mechanical ventilation time, total mechanical ventilation time, intensive care unit (ICU) treatment time, complication rate and prognosis were compared for the two groups.Results: (1) There was no significant difference in the respiratory rate, heart rate, arterial systolic pressure, arterial oxygen partial pressure, arterial carbon dioxide partial pressure or pH value between the two groups after 1 day of treatment, and (2) invasive mechanical ventilation time, non-invasive mechanical ventilation time, total mechanical ventilation time, ICU treatment time and the incidence of complications were significantly different in the two groups (P = 0.0001).Conclusion: Detecting PCT can guide the selection of ventilation switching points in sequential mechanical ventilation therapy for patients with COPD with respiratory failure in the acute exacerbation stage, effectively reduce the misevaluation of PIC switching points so that patients can obtain stable criteria for judgement and effectively improve the efficiency and safety of mechanical ventilation treatment for patients in the acute exacerbation stage.Keywords: acute exacerbation of chronic obstructive pulmonary disease, respiratory failure, sequential mechanical ventilation, selection of ventilation mode switching point, procalcitonin, observation window of pulmonary infection, clinical value

Objectives: This study aimed to evaluate the clinical value of metagenomic next-generation sequencing (mNGS) in patients with suspected lower respiratory tract infections. Methods: This retrospective study reviewed patients with suspected lower respiratory tract infections at the Wuhan Union Hospital. Data including demographic, laboratory, and radiological profiles; treatment; and outcomes were recorded and analyzed. Results: mNGS identified pathogenic microbes in 100/140 (71.4%) patients, although 135 (96.4%) had received empiric antibiotic treatment before the mNGS tests. Single bacterial infection (35/100, 35%) was the most common type of infection in patients with positive mNGS results, followed by single fungal infection (14/100, 14%), bacterial-viral coinfection (14/100, 14%), single viral infection (12/100, 12%), bacterial-fungal coinfection (9/100, 9%), fungal-viral coinfection (9/100, 9%), and bacterial-fungal-viral coinfection (7/100, 7%). Moreover, compared with culture test, mNGS showed higher sensitivity (63/85, 74.1% vs 22/85, 25.9% P = 0.001) and lower processing time (24 hours vs 48 hours). Antibiotic treatment was adjusted or confirmed based on the mNGS results in 123 (87.9%) patients, including five (3.6%), 33 (23.6%), and 85 (60.7%) patients, in whom treatment was downgraded, upgraded, and unchanged, respectively. Almost all patients, regardless of escalation, de-escalation, or no change in treatment, showed significant improvement in clinical symptoms and inflammatory indicators. In addition, 17 (12.1%) patients were referred to Wuhan Pulmonary Hospital for further treatment because of confirmed or suspected tuberculosis. Conclusion: mNGS could be a promising technique for microbiological diagnosis and antibiotic management, potentially improving outcomes for patients.

Objective: This study aims to investigate the clinical application of fecal recombinant human adhesin syndecan 2 (SDC2) gene methylation test in the early screening of colorectal tumors. Methods: Eightyseven subjects admitted to the hospital from March 2021 to October 2022 were selected as the study subjects, including 41 cases with normal colorectum, 21 with colorectal adenoma and 25 with colorectal cancer. In this study, the fecal DNA of the subjects was extracted for the fecal SDC2 gene methylation test, and the negative and positive results of the tested specimens were determined according to the Cutoff value set by the kit. The effects of the SDC2 gene methylation test were compared with the results of colonoscopy diagnosis. The analysis of variance on SDC2 gene methylation cycle thresholds (Ct) was performed to assess the expression of SDC2 methylation in colorectal tumors. The subject operating characteristic curve (ROC) was used to calculate the area under the curve (AUC) to evaluate the diagnostic value of SDC2 gene methylation in colorectal tumors and to analyze the sensitivity and specificity of SDC2 gene methylation in colorectal tumor diagnosis. Results: Among the 87 enrolled cases, 35 were positive for SDC2 gene methylation and 52 were negative. The positive rate in the stool of colorectal adenoma patients and colorectal cancer patients was 57.14% (12/21) and 84.00% (21/25), respectively and there were statistically significant differences (P = 0.044). The results of the analysis under the ROC curve showed that the area of SDC2 gene methylation under the curve (AUC) of the test for the diagnosis of colorectal adenoma and colorectal cancer was 0.715 and 0.918, respectively, with a sensitivity of 57.14% and 88.00% and a specificity of 95.12% and 92.68%, respectively and there were statistically significant differences (P = 0.010 7, P < 0.000 1) . Conclusion: Fecal SDC2 gene methylation has a high specificity for detecting colorectal cancer and its precancerous lesions, and the sensitivity of detection increases as the cancer progresses, so it is of great clinical value in early screening of colorectal cancer. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to investigate the clinical value of the Global Registry of Arterial Events in Acute Coronary Syndromes (GRACE) score combined with the D-dimer/fibrinogen ratio (DFR) in predicting the short-term prognosis of patients undergoing percutaneous coronary intervention (PCI) early after thrombolysis for acute myocardial infarction (AMI). PATIENTS AND METHODS: A total of 102 patients who underwent PCI early after thrombolysis for AMI during April 2020 to January 2022 in our hospital were picked as study subjects. These subjects were assigned as the good prognosis group (without adverse cardiovascular events) and poor prognosis group (with adverse cardiovascular events) according to whether adverse cardiovascular events occurred during hospitalization and follow-up. Changes in GRACE scores and DFR levels in patients with different prognoses were analyzed. The GRACE score and DFR level of patients with different prognosis were analyzed. The clinic pathological characteristics were collected, and the risk factors for poor prognosis of AMI patients were analyzed by logistic risk regression; ROC curve was used to analyze the prognostic value of GRACE score combined with DFR in early PCI patients after AMI thrombolysis. RESULTS: Compared with the good prognosis group, the GRACE score and DFR level in the poor prognosis group were much higher (p<0.001). Significant differences existed in blood pressure, ejection fraction, number of diseased branches, and Killip grading between the patients with good prognosis and those with poor prognosis (p<0.05). There existed no significant difference in clinical medication between the patients with good prognosis and those with poor prognosis (p>0.05). Logistic multivariate analysis indicated that GRACE score, DFR, ejection fraction, number of lesion branches, and Killip grade were all risk factors influencing the prognosis of patients undergoing early PCI after thrombolysis in AMI (p<0.05). The ROC curve was established and the area under the curve (AUC) of GRACE score, DFR, and combined detection were 0.815, 0.783, and 0.894, respectively, and the sensitivity and specificity were 80.24%, 60.42%, 83.71%, 66.78%, 91.42% and 77.83%, respectively. The AUC, sensitivity, and specificity of combined detection were higher than those of the two alone and had a higher predictive value for the short-term prognosis of patients. CONCLUSIONS: The GRACE score combined with DFR was of great value in diagnosing the short-term prognosis of patients undergoing PCI early after thrombolysis for AMI. Furthermore, the GRACE score, DFR, ejection fraction, number of lesion branches, and Killip classification were all important factors influencing the short-term prognosis of patients, which were of great significance in determining the prognosis of patients. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is the most malignant form of glioma and is difficult to diagnose, leading to high mortality rates. Circular RNAs (circRNAs) are noncoding RNAs with a covalently closed loop structure. CircRNAs are involved in various pathological processes and have been revealed to be important regulators of GBM pathogenesis. CircRNAs exert their biological effects by 4 different mechanisms: serving as sponges of microRNAs (miRNAs), serving as sponges of RNA binding proteins (RBPs), modulating parental gene transcription, and encoding functional proteins. Among the 4 mechanisms, sponging miRNAs is predominant. Their good stability, broad distribution and high specificity make circRNAs promising biomarkers for GBM diagnosis. In this paper, we summarized the current understanding of the characteristics and action mechanisms of circRNAs, illustrated the underlying regulatory mechanisms of circRNAs in GBM progression and explored the possible diagnostic role of circRNAs in GBM. [ABSTRACT FROM AUTHOR]

Abstract Background At present, surgery is the primary clinical treatment for SCIWORA patients, but conservative treatment still plays an important role in patients with incomplete spinal cord injury. As an important index of cervical spine degeneration, cervical curvature has an impact on the prognosis of spinal cord injury patients. This paper studied the prognosis of conservatively treated patients with SCIWORA and the correlation between cervical curvature and neurological prognosis. Methods A retrospective study was conducted in all the patients with SCI admitted to the Third Affiliated Hospital of Hebei Medical University between January 2017 and June 2020. Data were recorded in 106 eligible patients, including sex, age, injury factors, Cobb angle, CCI, CSA, and ASIA motor and sensory scores. The Wilcoxon sign rank sum test was used to analyze the data postinjury and at the 1-year follow-up. Pearson correlation analysis was performed for the Cobb angle, CCI and CSA. Simple linear regression analysis and multiple linear regression analysis were performed for each group of variables. Results The Wilcoxon signed rank sum test confirmed that the Cobb angle, the CCI and the CSA of the patients were not significantly different at the 1-year follow-up when compared with the postinjury values, and the ASIA motor and sensory scores were significantly improved. The Pearson correlation analysis showed correlations among the Cobb angle, the CCI and the CSA. Simple linear regression analysis and multiple linear regression analysis showed that the nerve recovery rate was negatively correlated with age and was positively correlated with the Cobb angle. Conclusion Conservative treatment of incomplete SCIWORA can achieve a good prognosis. There is a clear correlation between the Cobb angle, CCI and CSA, and the Cobb angle, as an important influencing factor, needs to be considered. For SCIWORA patients undergoing nonsurgical treatment, improving cervical curvature is beneficial to the prognosis of patients. Age negatively affects the neurological prognosis.