Research progress of artificial intelligence technology in early diagnosis of sepsis / 中华危重病急救医学

Sepsis is caused by infection, which can ultimately lead to multiple organ dysfunction and even life-threatening. Early recognition and early treatment can significantly improve the prognosis of sepsis patients. However, the effect of using a single biomarker for early diagnosis of sepsis is still not ideal. In recent years, researchers have turned their attention to artificial intelligence technology for early diagnosis of sepsis. This paper briefly introduces the advantages and disadvantages of sepsis related inflammatory indicators, biomarkers, and scoring systems of disease severity for early identification of sepsis, and focuses on the research progress and limitations of artificial intelligence technology for early diagnosis of sepsis, aiming to seek new methods and ideas for early diagnosis of sepsis.

Cancer-associated fibroblast-derived exosome microRNA-21 promotes angiogenesis in multiple myeloma.

Multiple myeloma (MM) is the second most common hematological malignancy, and angiogenesis determines its progression. In the tumor microenvironment, normal fibroblasts (NFs) are transformed into cancer-associated fibroblasts (CAFs), which can promote angiogenesis. Microribonucleic acid-21 (miR-21) is highly expressed in various tumors. However, research on the relationship between tumor angiogenesis and miR-21 is rare. We analyzed the relationship between miR-21, CAFs, and angiogenesis in MM. NFs and CAFs were isolated from the bone marrow fluids of patients with dystrophic anemia and newly-diagnosed MM. Co-culturing of CAF exosomes with multiple myeloma endothelial cells (MMECs) showed that CAF exosomes were able to enter MMECs in a time-dependent manner and initiate angiogenesis by promoting proliferation, migration, and tubulogenesis. We found that miR-21 was abundant in CAF exosomes, entering MMECs and regulating angiogenesis in MM. By transfecting NFs with mimic NC, miR-21 mimic, inhibitor NC, and miR-21 inhibitor, we found that miR-21 significantly increased the expression of alpha-smooth muscle actin and fibroblast activation protein in NFs. Our results showed that miR-21 can transform NFs into CAFs, and that CAF exosomes promote angiogenesis by carrying miR-21 into MMECs. Therefore, CAF-derived exosomal miR-21 may serve as a novel diagnostic biomarker and therapeutic target for MM.

Value of morphological characteristics and number of myelogenous lymphoma cells in prognostic evaluation of diffuse large B-cell lymphoma / 中华检验医学杂志

Objective:To summarize the morphological characteristics of diffuse large B-cell lymphoma (DLBCL) cells and investigate the prognosis value of the characteristics and the number of DLBCL cells in bone marrow.Methods:Retrospective study. We collected 79 cases newly diagnosed with DLBCL in the First Affiliated Hospital of Zhengzhou University from January 2020 to August 2022. 30 cases newly diagnosed without bone marrow involvement were selected as controls, whose mean age 58 years (30-82 years). The DLBCL cells were evaluated by the bone marrow smear, biopsy and flow cytometry separetely.The detection rate of DLBCL cells in the bone marrow was compared, to analyse the relationship between the morphological characteristics of DLBCL in the smear, clinical characteristics and flow cytometry parameters, and the prognostic value of DLBCL detected in the bone marrow smear and its quantity was analyzed. Logistic regression was used to analyze the correlation between the detection of DLBCL cells in bone marrow smears and the age, clinical stage, and the number of extraderules involved organs. Multivariate Cox regression was used to analyze the influence of DLBCL cells detection and its number on the prognosis of patients.Results:(1) The positive rates of DLBCL cells in bone marrow biopsy, bone marrow smear and flow cytometry were 4.86%, 5.14% and 9.27% respectively. (2) The morphological characteristics of 79 cases in bone marrow smears were described: more than 2 times the volume of the cell body of the lymphocyte, the shape was different, round or quasi-round or irregular shape, can be seen pseudopodia or protrusion; The volume of cytoplasm was moderate, vacuoles were visible, and a few perinuclear areas were visible. The nucleus were different in shape, round or quasi-round or irregularly shaped, with a majority of them having multiple nuclei and a few of them having delicate and loose chromatin. Most nucleoli were medium or large obviously, with a majority of them having 1-2 nucleoli and a few having more than 3.Sergiosomes and hemophagocytosis were observed in some DLBCL cases, tumor cell aggregation phenomenon was observed in a few DLBCL cases, occasionally pathological mitosis.(3) DLBCL cells in bone marrow smear was positively related to the age of patients, clinical stage and the number of extranodal organs involved(regression coefficient were 2.012, 2.754, 2.028, P<0.05);The volume of DLBCL cells in bone marrow smear was positively correlated with the ratio of CD4 and CD8(regression coefficient is 2.545, P<0.05);The vacuoles in cytoplasm and the pseudopod of tumor were both negative relationship with the quantity of CD38 expressed on DLBCL cells(regression coefficient was -2.465, -3.045, P<0.05); (4) DLBCL cells in bone marrow smear was an independent risk factor for PFS and OS( RR=7.059, P<0.05); RR=5.409, P<0.05). Conclusion:The appearace of DLBCL cells in bone marrow smear with prognosis, and could be used for clinical staging.

Progress on T cell subsets and pathogenesis of asthma / 国际儿科学杂志

Asthma is a common chronic airway inflammatory disease, which is characterized by airway stenosis, airway wall thickening and increased mucus secretion followed by reversible airflow restriction.At present, asthma is considered to be a complex and heterogeneous disease, and its pathogenesis remains elusive.There are diverse immune cells involved in the formation of asthma, including T lymphocytes, eosinophils, neutrophils, etc.Due to the continuous renewal of classification and function of T lymphocytes subsets, their role in asthma has attracted more attention.Here, this review aims to summarize the immunological characteristics and roles of different T cell subsets in asthma, and highlight the new findings of T cell subsets in the pathogenesis of severe asthma, leading to provide inspiration and help for the study of the immunology pathogenesis, clinical diagnosis, treatment and prognosis in asthma.

DEAD-box Helicase 27 Promotes Hepatocellular Carcinoma Progression Through ERK Signaling.

Introduction: DEAD-box helicase 27 (DDX27) belongs to DEAD-Box nucleic acid helicase family. The function of DDX27 in hepatocellular carcinoma (HCC) remain enigmatic. In light of this, we tried to investigate the regulatory role and underlying mechanism of DDX27 in HCC. Materials and methods: DDX27 expression levels were detected by qRT-PCR, Western blot and immunohistochemistry assays in HCC tissues and cells. Colony formation, CCK-8, growth curve, wound healing and transwell assays were conducted to investigate the effect of DDX27 on the proliferation and metastasis of HCC cells. RNA-sequencing was performed to detect the effect of DDX27 on downstream signaling pathway. The effect of DDX27 on HCC progression was evaluated using in vivo murine xenograft model. Results: we found an increased expression of DDX27 in HCC tissues with comparison to its para-tumor tissues. The high expression levels of DDX27 were associated with poor prognosis in HCC patients. DDX27 upregulation promoted cell metastasis. Mechanistic studies suggested that DDX27 overexpression induces the major vault protein (MVP) expression and enhances the phosphorylation levels of ERK1/2. Inhibition of ERK pathway impaired the cellular metastastic abilities induced by DDX27. The induction of DDX27 in HCC progression was further confirmed from tumors in mouse model. Conclusion: our results disclose a novel mechanism by which DDX27 enhances ERK signaling during HCC progression. DDX27 might be used in targeted therapy for HCC patients.

Management and Prognosis of Interstitial Lung Disease With Lung Cancer (ILD-LC): A Real-World Cohort From Three Medical Centers in China.

BACKGROUND AND OBJECTIVE: Interstitial lung disease with lung cancer (ILD-LC) is rare and its management has not been fully described. This study aimed to investigate the management and prognosis of ILD-LC patients in China. METHODS: The present analysis is a retrospective real-world cohort study. Clinical data of ILD-LC patients were obtained from 3 hospitals in China. The overall survival (OS) of patients was analyzed. Univariate and multivariate regression analyses were performed. RESULTS: One hundred eighty-four ILD-LC patients included were biased toward male (85.3%), smokers (75.5%), idiopathic pulmonary fibrosis (IPF) (58.2%) patients with comorbidities (67.9%) and ECOG-PS score of 1 (65.2%). Most patients were advanced peripheral non-small cell lung cancer. The initial anti-cancer regimen for ILD-LC is mainly chemotherapy, and patients with early-stage LC prefer surgery. In the anti-cancer cohort, the number of ILD-LC patients who underwent the 2nd and 3rd or more anti-cancer regimens were 78 (55.7%) and 32 (22.8%), respectively. In the non-anticancer cohort, the median OS was 3.5 months. In the early-stage cohort, the median OS was 14.2 months in the systematic therapy group; however, the median OS was not reached in the surgery group. In the advanced-stage cohort with systematic therapy, the median OS was 7.2 months. Interstitial pneumonia (IIP) and anti-angiogenesis were associated with OS in the univariate analysis, whereas anti-angiogenesis was an independent protective factor for advanced LC with ILD. CONCLUSION: Patients with ILD-LC have very poor prognosis. Appropriate anti-tumor treatment can prolong the survival time of patients who can tolerate it. Targeted therapy and immunotherapy are alternative treatments for LC patients with mild ILD. For ILD patients with advanced LC, antiangiogenic regimens significantly improve the prognosis of the disease.

Clinical study of gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer / 中国基层医药

Objective To evaluate the recent efficacy and safety of gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer. Methods From August 2014 to May 2017,27 patients with advanced biliary tract cancer confirmed by pathology in the First People＇s Hospital of Zhengzhou received gemcitabine (1 000mg/m2 ,day 1 and 8) and S-1(80mg/m2,day 1-14) every three weeks.The recent efficacy and toxicities were observed after two cycles of chemotherapy.Results All of the 27 patients were evaluated,1 patient(3.7%) achieved CR,6 patients(22.2%) with PR,12 patients(44.4%) with SD,8 patients(29.6%) with PD.The total response rate was 25.9%(7/27),the disease control rate was 70.4%(19/27).The main toxicities were gastrointestinal reactions and myelosuppression,no chemotherapy-related death was observed.Conclusion Gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer is safe and effect.

Clinical study of gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer / 中国基层医药

Objective@#To evaluate the recent efficacy and safety of gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer.@*Methods@#From August 2014 to May 2017, 27 patients with advanced biliary tract cancer confirmed by pathology in the First People's Hospital of Zhengzhou received gemcitabine(1 000mg/m2, day 1 and 8) and S-1(80mg/m2, day 1-14) every three weeks.The recent efficacy and toxicities were observed after two cycles of chemotherapy.@*Results@#All of the 27 patients were evaluated, 1 patient(3.7%) achieved CR, 6 patients(22.2%) with PR, 12 patients(44.4%) with SD, 8 patients(29.6%) with PD.The total response rate was 25.9%(7/27), the disease control rate was 70.4%(19/27). The main toxicities were gastrointestinal reactions and myelosuppression, no chemotherapy-related death was observed.@*Conclusion@#Gemcitabine combined with S-1 in the treatment of advanced biliary tract cancer is safe and effect.

Association between plasma selenium and the risk of impaired glucose regulation / 中华预防医学杂志

Objective@#To investigate the association between plasma selenium exposure and the risk of impaired glucose regulation (IGR).@*Methods@#A case-control study was conducted to select IGR patients who were admitted to the outpatient clinic of the Department of Endocrinology to perform oral glucose tolerance test(OGTT) at the Tongji Hospital affiliated to the Tongji Medical College from September 2004 to 2016 as a case group. Participants with normal glucose tolerance recruited from an unselected group of population undergoing routine health examinations in the same hospital were selected as a control group. The control group was matched according to the age (±5 years old) and sex of the case group. The inclusion criteria for subjects recruited were as follows: age ≥30 years, body mass index (BMI) <40 kg/m2, no history of a diagnosis of IGR or type 2 diabetes, and no history of receiving pharmacological treatment for hyperlipidemia or hypertension. Patients with any clinically systemic disease such as neurological or endocrine disease, acute illness, chronic inflammatory disease or infectious disease were excluded from the study. A total of 1 957 subjects, 897 in the case group and 1 060 in the control group, were included. Questionnaires were used to collect information of all subjects, and peripheral venous blood was collected after fasting and OGTT, respectively. Plasma selenium, fasting blood glucose, blood lipid (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol) and 2 h OGTT plasma glucose concentration were detected, respectively. The subjects were divided into low, medium and high concentration groups according to the tertiles of plasma selenium concentration in the control group. The multivariate unconditional logistic regression analysis was performed to analyze the association between plasma selenium exposure and IGR.@*Results@#The age (mean±SD) of the case and control group was (53.71±11.38) and (53.95±12.17) years old. The plasma selenium concentration [M (P25, P75)] in the case group was 92.81(77.07, 107.05) μg/L, which was significantly higher than the control group [88.73 (77.13, 100.88) μg/L] (P<0.05). The results of multivariate unconditional logistic regression analysis showed that after adjusting for age, sex, BMI, family history of diabetes and hypertension, the risk of IGR was higher in the high-concentration group and the low-concentration group compared with the middle-concentration group, the values of OR (95%CI) were 1.22 (95%CI: 0.94-1.59) and 1.81 (95%CI: 1.42-2.30), respectively.@*Conclusion@#The study suggested a U-shaped association between plasma selenium and IGR.

Validation of the Chinese version of the uterine fibroid symptom and health-related quality of life / 中华妇产科杂志

Objective To evaluate the reliability and validity of the Chinese version of the uterine fibroid symptom and health-related quality of life (UFS-QOL) in patients with uterine fibroid. Methods The original English UFS-QOL was translated into Chinese and linguistically validated following the cross-cultural adaptation of health-related quality of life measures. Patients recruited randomly from Peking Union Medical College Hospital from June 2013 to December 2016 were scheduled for two visits with 2 weeks apart, and they were surveyed through the Chinese version of UFS-QOL and short-form 12-item health survey (SF-12). The reliability and validity of the Chinese version of UFS-QOL were evaluated. Results A total of 190 uterine fibroid patients who met the criteria participated this study. The Chinese version of UFS-QOL had a high internal consistency (Cronbach′s α, uterine fibroid symptom severity scale:0.912, health-related quality of life scale: 0.976) and high test-retest reliability (intraclass correlation coefficient, 0.572 - 0.951, P<0.01). The symptom severity scores and SF-12 scores were negatively correlated (r=-0.813, P<0.01); the health-related quality of life scores and SF-12 scores were positively correlated (r=0.620, P<0.01). The factor analysis showed good construct validity. Conclusion Psychometric testing supports the reliability and validity of the Chinese version of UFS-QOL as an disease-specific measure of health-related quality of life.

The synergistic mechanism of hospital scientific research management and ethical review / 中华医学科研管理杂志

Objective To explore the cooperative mechanism of hospital research management and ethics review.Methods Through the analysis of current ethical conditions,as well as the relationship between hospital research management and ethical review,study on how to integrate them during the management of scientific research project.Results Research management and ethical review have different emphasis from different perspectives,however,both of them serve for research projects which makes inseparable connections.Conclusions Hospital research management and ethical review can be synergistic,according to which the management of scientific research projects will be more reasonable and scientific.

Effect of two kinds of drainage operation on the short-term curative effect, mortality and complications risk in patients with single giant bacterial liver abscess / 中国医师进修杂志

Objective To investigate the effect of two kinds of drainage operation including incision and drainage of abdominal operation and percutaneous puncture and drainage operation under ultrasound guidance on the short-term curative effect, mortality and complications risk in patients with single giant bacterial liver abscess. Methods Eighty patients with single giant bacterial liver abscess were selected, and all patients were treated with conventional therapy. Among them, 40 patients underwent incision and drainage of abdominal operation (control group), and 40 patients underwent percutaneous puncture and drainage operation under ultrasound guidance (observation group). The short-term curative effect, operation time, time of returning to normal body temperature, time of returning to normal white blood cell, hospitalization time, mortality and incidence of postoperative complication were compared between 2 groups. Results There were no statistical differences in total effective rate and mortality between control group and observation group: 92.5%(37/40) vs. 97.5%(39/40) and 5.0%(2/40) vs. 7.5%(3/40), P>0.05. The operation time, time of returning to normal body temperature, time of returning to normal white blood cell and hospitalization time in observation group were significantly lower than those in control group:(44.52 ± 5.68) min vs. (98.59 ± 12.70) min, (3.25 ± 0.74) d vs. (4.86 ± 1.32) d, (5.20 ± 1.35) d vs. (7.42 ± 1.79) d, (16.94 ± 3.61) d vs. (25.52 ± 5.28) d. The incidence of postoperative complication was significantly lower than that in control group:10.0%(4/40) vs. 27.5%(11/40), and there were statistical differences (P<0.05). Conclusions Two kinds of drainage operation in the treatment in patients with single giant bacterial liver abscess possesses the same clinical efficacy for short-and long-term curative effect; but percutaneous puncture and drainage operation under ultrasound guidance application can efficiently alleviate the clinical symptoms and signs, accelerate the recovery process of disease and be helpful to reduce the risk of postoperative complications.

Analyses of chronic otitis media with intact tympanic membrane concurrent with intracranial complication / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.</p><p><b>METHOD</b>Ten patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.</p><p><b>RESULTS</b>All the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).</p><p><b>CONCLUSIONS</b>In chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.</p>

The correlations between varying tinnitus severity and anxiety and depression in non-acute tinnitus patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression.@*METHOD@#Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS).@*RESULT@#THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38.@*CONCLUSION@#Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.

Effect of Jinfeng particles on MMP-1/TIMP-1 expression in articular cartilage of gouty arthritis in rabbits / 中国免疫学杂志

Objective:To explore the effect of Jinfeng particles on the expression of MMP-1/TIMP-1 in cartilage of gout arthritis rabbit′s articular,to explicit treatment mechanism of gouty arthritis. Methods:Perfusion of ethambutol and adenine,inject MSU into joint cavity of rabbits to copy the model of gouty arthritis. After successful mode,were randomly divided into model group,Jinfeng granules in high,medium and low dose group(19. 6,9. 8,4. 9 g/kg),allopurinol group(0. 028 g/kg),Tongfengding group(0. 448 g/kg) ,another blank group. Administered for 7 days. 2 h after the last administration,were taken and painted articular cartilage tissue,to observe the changes of the pathological morphology;and the use of immune cell detection of the expression of TIMP-1,MMP-1,MMP-1/TIMP-1 ratio calculation. Results: Jinfeng granule could obviously reduce the articular cartilage of rats with inflammatory cells infiltration,hyperemia, swelling and necrosis, could significantly inhibit the expression of MMP-1 ( P< 0. 05 ) , stimulate TIMP-1 activation(P< 0. 01),and significantly reduce the ratio of MMP-1/TIMP-1(P< 0. 05). Conclusion: Jinfeng particles can effectively inhibit the pathological damage of gouty arthritis,upside the expression of TIMP-1 and its mechanism may be related to the inhibition of MMP-1,regulated the balance of MMP-1/TIMP-1,and then exert anti-inflammatory effects.

Role of IL-12 family in autoimmune diseases / 军事医学

The interleukin-12 (IL-12) family, including IL-12, IL-23, IL-27,and IL-35, is characterized by unique structures and molecular partners.This is the only family of heterodimeric cytokines, which endows them with a unique set of connections and functional interactions.They not only play an important role in the regulation of inflammation, but are closely related to various autoimmune diseases.Here we discuss the structural aspects of these cytokines and their effect on some autoimmune diseases.

Programmed death ligand 1 negatively regulates inflammatory response of chronic periodontitis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate whether programmed death ligand 1 (PD-L1) expressed in the periodontal tissue of chronic periodontitis and the correlativity of PD-L1 and different degrees of chronic periodontitis, provide experience for immunoregulation mechanism, clinical treatment and prognosis of chronic periodontitis.</p><p><b>METHODS</b>Gingiva and periodontal tissue of healthy people and chronic periodontitis patients were collected. Based on clinical probing, periodontal tissue were classified into three groups: periodontal tissues of healthy people, periodontal tissue of mild chronic periodontitis, periodontal tissue of severe chronic periodontitis. Fluorescent quantitation polymerase chain reaction was applied to explore the expression of PD-L1 mRNA in the periodontal tissue of the different groups. Western blot and immunohistochemistry method were utilized to test the expression of PD-L1 protein in the periodontal tissue of the different groups. Combining with clinical image data, the relationship between differentially expressions of PD-L1 and different degrees of chronic periodontitis was analyzed.</p><p><b>RESULTS</b>The relative expression quantity of PD-L1 in the periodontal tissue of the mild chronic periodontitis was significantly higher that of the severe chronic periodontitis (P<0.01). The relative expression quantity of PD-L1 in the periodontal tissue of healthy subjects and severe chronic periodontitis had no statistical significance (P>0.05).</p><p><b>CONCLUSION</b>The expression of PD-L1 in the periodontal tissue negativelv regulates inflammatory periodontal tissue damage.</p>

The additional 180° roll test in the determination of affected side of horizontal semicircular canal benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the significance of additional 180-degree roll test (RT) in the determination of affected side in patients with horizontal semicircular canal benign paroxysmal vertigo (HSC-BPPV).@*METHOD@#One hundred and six patients with HSC-BPPV were performed the 90 degree RT. patients whose affected side cannot be determined by 90 degree RT were performed 180 degree roll test.@*RESULT@#The affected side was deter- mined by the 180 degree RT in 10 cases in which the lesion side cannot be determined by the 90-degree RT.@*CONCLUSION@#The affected side of HSC BPPV was able to be determined by 180 degree RT when it not possible to be determined by 90 degree RT. 180 degree RT is an effective and simple additional method.

Clinical characteristics of solitary plasmacytoma of temporal bone / 临床耳鼻咽喉头颈外科杂志

Patient of plasmacytoma of temporal bone often suffered from evident symptom in unilateral ear and obvious damage of bone. Clinical characteristics, imaging examination and histopathology can established an accurate diagnose. The therapy will be surgery and followed radiotherapy.