Circ_0004592:An auxiliary diagnostic biomarker for gastric cancer

BACKGROUND Gastric cancer(GC)has a high mortality rate,and robust diagnostic biomarkers are currently lacking.However,the clinical relevance of circular RNAs(circRNAs)as GC biomarkers remains largely unexplored.AIM To evaluate the potential of novel circRNA circ_0004592 in the early screening and prognosis of GC.METHODS High-throughput sequencing of circRNAs was performed to screen for potential target molecules.Circ_0004592 expression was examined in GC tissues,cells,and plasma.Plasma samples were collected from healthy subjects’patients,as well as from patients with benign lesions,precancerous lesions,and GC,whereafter the diagnostic accuracy of circ_0004592 was evaluated.The correlation between circ_0004592 levels in plasma and clinicopathological data of patients with GC was further analyzed.RESULTS Circ_0004592 was upregulated in both the tissue and plasma of patients with GC.Further,circ_0004592 expression was higher in patients with precancerous lesions than in healthy controls while being highest in patients with GC.In the same patient,the postoperative plasma level of circ_0004592 was lower than that in the preoperative period.Moreover,circ_0004592 level was significantly correlated with tumor differentiation,tumor depth,and lymph node metastasis.The area under the curve(AUC)of plasma circ_0004592 exhibited high sensitivity and specificity for differentiating patients with GC from healthy donors.Diagnosis based on circ_0004592,carcinoembryonic antigen,and cancer antigen 199 achieved a superior AUC and was highly sensitive.CONCLUSION Plasma circ_0004592 may represent a potential non-invasive auxiliary diagnostic biomarker for patients with GC.

Deep learning models semi-automatic training system for quality control of transthoracic echocardiography

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAX GV).The videos were divided into development set(245 A4C,155 PLAX,225 PSAX GV),semi-automated training set(98 A4C,62 PLAX,90 PSAX GV)and test set(147 A4C,93 PLAX,135 PSAX GV)at the ratio of 5∶2∶3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33%,97.26%,97.26%and 97.26%to 99.73%,99.65%,99.77%and 99.71%,respectively,while the overall accuracy for assessing A4C,PLAX and PSAX GV TTE as standard views in test set improved from 89.12%,83.87%and 90.37%to 93.20%,90.32%and 93.33%,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.

BRAF^(V600E) vs. TIRADS in predicting papillary thyroid cancers in Bethesda system Ⅰ, Ⅲ, and Ⅴ nodules

Objective: Bethesda System for Reporting Thyroid Cytopathology(BSRTC) categories Ⅰ, Ⅲ, and Ⅴaccount for a significant proportion of fine needle aspiration cytology(FNAC) diagnoses. This study aimed to compare the diagnostic efficacy of BRAF^(V600E) mutation and the Thyroid Imaging Reporting and Data System(TIRADS) classification in differentiating papillary thyroid cancers(PTCs) from benign lesions among BSRTC I, III, and V nodules.Methods: A total of 472 patients with 479 nodules were enrolled in this prospective study. Ultrasound, BRAF^(V600E) mutation testing, and FNAC were performed in each nodule, followed by surgery or regular ultrasound examination.Results: In the BSRTC I category, BRAF^(V600E) showed similar sensitivity, higher specificity, and lower accuracy when compared with TIRADS. In the BSRTC III/V category, the sensitivity, specificity, and accuracy of BRAF^(V600E) were similar to those of TIRADS. In comparison to BRAF^(V600E) alone, the combination of the two methods significantly improved sensitivity(BSRTC Ⅰ:93.6% vs. 67.7%, P < 0.01; BSRTC Ⅲ: 93.8% vs. 75.0%, P < 0.01; BSRTC V: 96.0% vs. 85.3%, P < 0.001). When compared with TIRADS alone, the combination improved sensitivity in BSRTC Ⅰ nodules(93.6% vs. 74.2%, P < 0.05), increased sensitivity and decreased accuracy in BSRTC III nodules(93.8% vs. 75.0%, P < 0.01, 91.0% vs. 93.6%, P < 0.01), and improved both sensitivity and accuracy in BSRTC V nodules(96.0% vs. 82.0%, P < 0.001; 94.2% vs. 81.3%, P < 0.001).Conclusions: BRAF^(V600E) exhibited higher specificity and lower accuracy compared with TIRADS in BSRTC Ⅰ nodules, while the two methods showed similar diagnostic value in BSRTC Ⅲ/Ⅴ nodules. The combination of the two methods distinctly improved sensitivity in the diagnosis of PTCs in BSRTC Ⅰ, Ⅲ, and Ⅴ nodules.

Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint:a pilot study

The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management.The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism,compared with occlusal splint.Twenty-four volunteers with sleep bruxism were divided into two groups：the GTB group that were treated with biofeedback therapy（n 512） and the GTO group that were treated with occlusal splint（n 512）.A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated.To foster the relaxation of the masticatory muscles and the nervous system,the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded.Total episodes and average duration of bruxism events during8 hours of sleep were analyzed with the monitoring program（TRMY1.0）.After 6 and 12 weeks,the episodes（P 50.001） and duration（P,0.05） in the GTB group declined dramatically.In contrast,there were no significant differences in the GTO group after the treatment（P.0.05）.Furthermore,the episodes had significant differences between the GTB group and the GTO group after the same period of treatment（P 5 0.000）.The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers,when compared with occlusal splint therapy.The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future.

维持性血液透析患者姑息照护需求和症状负担的调查研究

目的调查行维持性血液透析的终末期肾病患者姑息照护需求和症状负担的现况,并比较老年与非老年患者姑息照护需求和症状负担的差异。方法采用横断面调查法,选取2021年11月至2022年6月南京市2所三级医院血透中心的患者作为研究对象,采用一般资料调查表、姑息照护结局量表(Palliative Care Outcome Scale,POS)、透析症状指数(Dialysis Symptom Index,DSI)、欧洲五维健康量表(The European Quality of Life 5-Dimensions 3-Levels questionnaire,EQ-5D-3L)进行资料收集。采用描述性统计方法、组间比较和相关分析等进行资料分析。结果本研究共纳入236例患者,其中非老年和老年患者各118例。结果显示维持性血液透析患者POS中位数得分为16.0(12.0,23.0),老年患者得分更高(P<0.01)。患者平均症状数目为15.04±5.06,症状严重程度的中位数得分为59.0(52.0,71.0),老年患者得分更高(P<0.01)。患者最常见的症状是口干(91.5%),其次是瘙痒(83.1%)和皮肤干燥(82.2%)。此外,姑息照护需求与症状负担和生活质量之间存在显著相关性(P<0.01)。结论行维持性血液透析的终末期肾病患者症状负担严重并有中等程度的姑息照护需求,且在老年患者中尤为明显。未来需组建跨学科的姑息照护团队,除了积极管理患者的症状外,还需满足与姑息照护相关的生理、心理、社会和精神需求,以改善患者的生活质量。

Chronic intermittent hypoxia induces cardiac inflammation and dysfunction in a rat obstructive sleep apnea model

Chronic intermittent hypoxia is considered to play an important role in cardiovascular pathogenesis during the development of obstructive sleep apnea（OSA）.We used a well-described OSA rat model induced with simultaneous intermittent hypoxia.Male Sprague Dawley rats were individually placed into plexiglass chambers with air pressure and components were electronically controlled.The rats were exposed to intermittent hypoxia 8 hours daily for 5weeks.The changes of cardiac structure and function were examined by ultrasound.The cardiac pathology,apoptosis,and fibrosis were analyzed by H＆E staining,TUNNEL assay,and picosirius staining,respectively.The expression of inflammation and fibrosis marker genes was analyzed by quantitative real-time PCR and Western blot.Chronic intermittent hypoxia/low pressure resulted in significant increase of left ventricular internal diameters（LVIDs）,endsystolic volume（ESV）,end-diastolic volume（EDV）,and blood lactate level and marked reduction in ejection fraction and fractional shortening.Chronic intermittent hypoxia increased TUNNEL-positive myocytes,disrupted normal arrangement of cardiac fibers,and increased Sirius stained collagen fibers.The expression levels of hypoxia induced factor（HIF）-l α,NF-κB,IL-6,and matrix metallopeptidase 2（MMP-2） were significantly increased in the heart of rats exposed to chronic intermittent hypoxia.In conclusion,the left ventricular function was adversely affected by chronic intermittent hypoxia,which is associated with increased expression of HIF-lα and NF-κB signaling molecules and development of cardiac inflammation,apoptosis and fibrosis.

Clinical significance of peripheral blood UL16 and DR-70 for the early diagnosis and prognostic evaluation of colorectal cancer

BACKGROUND Early diagnosis of colorectal cancer(CRC)is of great significance to improve the survival rate and quality of life of patients,but early diagnosis of CRC requires more sensitive techniques.Peripheral blood UL16-binding protein 2(ULBP2)and human fibrinogen degradation products(DR-70)are the main indicators for the diagnosis of malignant tumors.AIM To assess ULBP2 and DR-70 potential for the early diagnosis and prognostic evaluation of CRC to provide a reference.METHODS This study involved 60 patients with early-stage CRC(CRC group),50 patients with benign colorectal tumors(benign group),and 50 healthy patients(control group)enrolled at the Affiliated Hospital of Jiangnan University and Jiangsu Province Official Hospital between January,2020 and January,2022.ULBP2 and DR-70 levels in the blood were determined and differences among the three groups and early diagnostic values for CRC were determined.Patients with CRC were divided into the good prognosis and poor prognosis groups,and ULBP2 and DR-70 levels in the blood and diagnostic values were compared.RESULTS ULBP2 and DR-70 serum levels were significantly higher in the CRC group than in the control and benign groups(P<0.05);however,no significant differences were observed between the benign and control groups(P>0.05).Among the 60 patients with CRC followed up for two years,two died(3.33%)and 15 exhibited tumor metastasis,progression,or recurrence(25.00%).ULBP2 and DR-70 serum levels were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).A receiver operating characteristic curve was plotted.Area under the curve,sensitivity,and specificity of serum ULBP2 with DR-70 for the early diagnosis of CRC were higher than those of the single serum indices(P<0.05)in both the good and poor prognosis groups.CONCLUSION ULBP2 and DR-70 serum levels were significantly high in patients with early-stage CRC.They improved the diagnostic rate of early-stage CRC and predicted patient prognosis,thereby showing clinical application potential.