Objective: To elucidate the potential mechanisms by which mesothelin (MSLN) contributes to chemotherapy resistance in high-grade serous ovarian cancer (HGSOC). Methods: A Meta-analysis utilizing public ovarian cancer databases was performed to evaluate the correlation between MSLN expression levels and overall survival (OS) in ovarian cancer patients. Pathway enrichment analysis was employed to identify key signaling pathways regulated by MSLN and their roles in chemotherapy resistance. Additionally, the TCGA-HGSOC database was analyzed to examine genomic features associated with MSLN-mediated chemotherapy resistance. To validate the biological function of MSLN in chemotherapy resistance, an intraperitoneal metastasis model was established using MSLN-knockdown ID8 ovarian cancer cells in mice. Results: Elevated MSLN expression was significantly associated with poor patient prognosis (HR: 1.42, 95%CI: 1.16-1.74). Differential gene expression and pathway enrichment analyses revealed that high MSLN expression upregulates resistance-associated genes and pathways involved in drug metabolism and DNA-binding signaling. Genomic association analysis showed a negative correlation between high MSLN expression and chromosomal instability features, specifically CX3, CX11, and CX13 scores. In vivo studies demonstrated that MSLN knockdown enhanced the tumor-suppressive effects of cisplatin. Conclusion: High MSLN expression represents a potential biomarker for poor prognosis and chemotherapy resistance in HGSOC patients, suggesting MSLN as a promising target for therapeutic intervention.
Objective: To investigate the associations of reproductive health indicators with lung function and chronic obstructive pulmonary disease (COPD) among women aged 40 years and above. Methods: From Jul to Sep, 2021, female subjects aged 40 years and above were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for COPD screening. A questionnaire was used to obtain information on demographic characteristics and reproductive health indicators. Linear regression was used to analyze the effects of reproductive health indicators on forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1). Logistic regression was also used to analyze the effects of reproductive health factors on FVC as a percentage of the predicted value (FVC%Pred) and FEV1%Pred as well as on COPD. Results: A total of 1 876 women aged 40 years and above were enrolled with mean age of (62.1±8.2) years old, among them, 78.1% were menopausal, and 40.9% had been pregnant ≥3 times. Multivariate analysis showed that FVC and FEV1 decreased in postmenopausal women, but menopause was not associated with a decrease in their percentage of predicted values. Pregnancies ≥3 times was a risk factor for COPD (for 3 times, OR=4.92, 95%CI: 1.48-19.95, P < 0.05;for≥4 times, OR=9.06, 95%CI: 2.32-41.57, P < 0.01), while pregnancies of 2 times did not increase the risk of COPD. Conclusion: In women aged 40 years and above, menopause is associated with poorer FVC and FEV1, and excessive pregnancy (≥3 times) is a risk factor for COPD.
Objective: To develop an MRI-based habitat radiomics model for the preoperative prediction of endometrial cancer (EC) molecular subtypes. Methods: Patients with pathologically proven EC from two hospitals were included in the training (n=270) and testing (n=70) cohorts. All patients had preoperative MRI and histological and molecular diagnoses. First, the tumor was divided into habitat subregions based on diffusion-weighted imaging (DWI) and contrast-enhanced (CE) images. Subsequently, habitat radiomic features were extracted from different subregions of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), DWI, and CE images. Three machine learning classifiers, including logistic regression, support vector machines, and random forests, were applied to develop predictive models for p53-abnormal endometrial cancer, with model performance validated. The model demonstrating the best overall predictive performance was selected as the habitat radiomics model. Using the same procedure, a whole-region radiomics model based on T1WI, T2WI, DWI, and CE sequences and a clinical model were constructed. The performance of the models was evaluated using receiver operating characteristic curves, and DeLong's test was employed to compare differences between the models. Decision curve analysis was used to assess the clinical benefits of the models' application. Results: After feature selection, eight habitat radiomic features were retained to construct the habitat radiomics model, ten features for the whole-region radiomics model, and three clinical features for the clinical model. The habitat radiomics model achieved the highest area under the curve (AUC), with 0.855 (0.788-0.922) in the training cohort and 0.769 (0.631-0.907) in the testing cohort. DeLong's test showed that the habitat radiomics model outperformed the whole-region radiomics model in the training cohort (P=0.001), but there was no significant difference in the testing cohort (P=0.543). In both cohorts, the habitat radiomics model outperformed the clinical model (P=0.007, training cohort; P=0.038, testing cohort). Decision curve analysis (DCA) demonstrated that this model provided clinical benefit for diagnosis within a threshold probability range of approximately 0.2-0.8. Conclusion: The MRI-based habitat radiomics model can accurately predict p53-abnormal EC, outperforming both the whole-region radiomics model and the clinical model, and is useful for the non-invasive molecular subtyping of endometrial cancer before surgery.
Objective: To establish a mouse model of human Escherichia coli (E. coli) colonization in early mammalian intestines, and to explore the trend and influencing factors of E. coli colonization in mouse intestines. Methods: A wild-type E. coli strain LFYP5, derived from an infant, was inoculated into the SPF mice via gavage. The abundance change curves of E. coli were plotted by collecting intestinal contents or fecal samples from the mice and utilizing plate counting colony forming unit (CFU) methods. This study investigated the effects of different intestinal locations, inoculation ages, weaning time, and cage-changing time on the colonization abundance of E. coli. Additionally, 16S rRNA sequencing was used to explore the changes in the microbial composition of the mouse gut after inoculation with E. coli. Results: E. coli LFYP5 was able to colonize the intestinal tract of mice before the weaning age. Its abundance decreased rapidly at the weaning stage, independent of the inoculation age, and whether to change the cages. When weaning occurred too early, the abundance of E. coli declined correspondingly earlier. Mice inoculated with E. coli LFYP5 had a lower alpha diversity of the gut microbiota composition and higher relative abundance of the lactobacillus genus compared to mice without E. coli LFYP5 inoculation. Conclusion: A mouse model of human E. coli colonization in the early mammalian gut has been successfully established. This model may be used to study the colonization mechanisms of human E. coli in the mammalian gut in the future.
Objective: To investigate the latent classes of mental workload and related factors among cardiovascular nurses. Methods: A convenience sample of 664 cardiovascular nurses were surveyed from Jun to Jul 2023. General information questionnaire, the Nurse Workload Index Scale and the Nursing Interruption Event Scale were conducted in the investigation. Latent class analysis and multiple Logistic regression analysis were employed to analyze the latent classes of nurses' mental workload and its related factors. Results: Two latent classes were identified, named low mental workload group (25.90%) and a high mental workload group (74.10%). Multiple Logistic regression analysis revealed that educational qualifications (OR=1.641, 95%CI: 1.036-2.598), nursing interruption event scores (OR=1.060, 95%CI: 1.044-1.076), and the region of nurses (OR=0.688, 95%CI: 0.542-0.874) were the influencing factors for cardiovascular nurses' mental workload. Conclusion: There are obvious categorical characteristics of cardiovascular nurses' mental workload, nurses with higher education, frequent interruption events, and from the eastern region have higher mental workload. Nursing managers need to focus on human resource allocation and optimize processes to reduce the occurrence of nursing interruptions.
Objective: To study the trend of stroke mortality in Minhang District, Shanghai from 2012 to 2022 and to predict stroke mortality from 2023 to 2027. Methods: Annual percentage change (APC) of stroke deaths in Minhang District, Shanghai from 2012 to 2022 was calculated, and then Joinpoint linear regression model was used to analyze the time trend of stroke deaths. A grey GM(1, 1) model was constructed based on the stroke mortality rate in Minhang District, Shanghai from 2012 to 2022. The model was used to predict and analyze the stroke mortality rate in Minhang District, Shanghai from 2023 to 2027. The fitting effect of the model was evaluated using relative error and grade deviation. Results: From 2012 to 2022, the overall mortality rate of stroke in Minhang District, Shanghai was on the rise for both males and females (total population: APC=2.50%, P < 0.001; male: APC=3.41%, P < 0.001; female: APC=1.46%, P=0.008). The grey GM (1, 1) model was used to predict the increasing trend of stroke mortality rate in Minhang District from 2023 to 2027. The crude mortality rate of stroke in the entire population in 2027 would be 97.55/100 000, with 112.31/100 000 for males and 83.33/100 000 for females. The fitting effect of the model was tested and evaluated to meet high requirements. Conclusion: In the past decade, the mortality rate of stroke in Minhang District, Shanghai has shown a significant upward trend. The 5-year prediction results showed that the mortality rate will still on the rise year by year.
Objective: To establish a renal cell co-culture system to simulate the renal barrier system, and to test its responsiveness to different glucose concentrations, and to investigate the regulatory effect of miR-29b-3p on osteopontin (OPN)/transforming growth factor β (TGF-β) pathway and the changes of this pathway under high glucose condition. Methods: The three-cell co-culture system consisting of human renal podocytes, human glomerular mesangial cells and human renal tubular epithelial cells was established to test the cell viability and glucose consumption value at glucose concentrations of 5, 8, 12 and 16 mmol/L. The content of TGF-β and OPN in cell supernatant was measured. The recombinant plasmid and siRNA of OPN were transfected, and the expressions of TGF-β and OPN were detected by Q-PCR and Western blot. Results: The mRNA expressions of OPN, TGF-β and miR-29b were significantly increased at 12 mmol/L glucose conditions. Western blot results showed that the protein expression of OPN increased in high glucose conditions, while the protein expression of TGF-β did not change significantly. After adding miR-29b-3p activator, the mRNA levels of OPN and TGF-β in the cell supernatant were significantly increased. After adding miR-29b-3p inhibitor, the mRNA levels of OPN and TGF-β in the cell supernatant were significantly decreased. Western blot results showed that compared with 5 mmol/L glucose, the protein expressions of OPN and TGF-β were increased by miR-29b-3p activator, and the protein expressions of OPN and TGF-β were decreased by miR-29b-3p inhibitor. After transfection with OPN recombinant plasmid, the content of TGF-β in the cell supernatant was significantly increased, and the mRNA expressions of OPN and TGF-β in the cells were significantly increased. After transfection with OPN siRNA, the content of TGF-β in the cell supernatant was decreased, and the expression of OPN mRNA in the cells was significantly decreased, but the expression of TGF-β mRNA was not significantly increased. Conclusion: The renal cell co-culture system can mimic the complex renal environment in vivo. When induced by high glucose, cell proliferation is inhibited, glucose consumption is increased, and the content of TGF-β in the cell supernatant is increased, and miR-29b-3p has a regulatory effect on OPN/TGF-β signaling pathway in the co-culture system.
Objective: To analyze the correlation of eyeball diameters of normal fetuses with fetal gender and gestational age (GA) in the second and third trimesters, as well as the MRI morphological features of fetal eyeball, for providing reference for prenatal MRI diagnosis. Methods: MRI data of fetuses who underwent prenatal MRI in Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University from Mar 2014 to Jun 2020 were retrospectively analyzed. All fetuses had no abnormal findings in MRI and the subsequent ultrasound follow-up before birth. The left and right maximum transverse diameter of the eyeball (TDE), the upper-lower diameter of the eyeball (ULDE), and the anterior-posterior diameter of the eyeball (APDE) were measured in the transverse and sagittal T2-HASTE images (the maximum distance between the outer edges of the eye-rings), respectively. The correlation between the diameters and fetal gender was analyzed, as well as between the diameters and GA. Regression analyses were performed on the diameters and fetal age. MRI morphological features of fetal eyeballs in different GA in the second and third trimesters were observed, and the changing trends in TDE/APDE, TDE/ULDE and APDE/ULDE with the increasing GA were quantitatively analyzed. Results: There were no significant differences between the left and right TDE, APDE and ULDE in normal fetuses in the second and third trimesters (t=0.198, -0.963, 0.774, respectively), and none of them was related to fetal gender (r=-0.047, -0.040, -0.030, -0.022, -0.026 and -0.026, respectively). The left and right TDE, APDE and ULDE showed a highly linear increase with GA in the second and third trimesters (r=0.964, 0.962, 0.966, 0.966, 0.972, 0.972, 0.972, respectively, all P < 0.001). The linear regression equations were as follows: left TDE (cm)=0.044×GA (wk)+0.368 (R2=0.930), right TDE (cm)=0.045×GA (wk)+0.359 (R2=0.926), left APDE (cm)=0.049×GA (wk)+0.078 (R2=0.934), right APDE (cm)=0.049×GA (wk)+0.0073 (R2=0.933), left ULDE (cm)=0.044×GA (wk)+0.242 (R2=0.946), right ULDE (cm)=0.045×GA (wk)+0.237 (R2=0.945). The fetal eyeballs transitioned from a conoidal shape in about the 20th week towards a more spherical geometry in about the 38th week. The TDE/APDE and TDE/ULDE decreased while APDE/ULDE increased with increasing GA. All of them gradually approached 1.0 in the third trimester, but the TDE was always the largest throughout the second and third trimesters. Conclusion: The normal fetal eyeball development in the second and third trimesters demonstrates a symmetrical pattern and is gender-neutral. The TDE, APDE and ULDE linearly increased with GA and morphologically transitioned from a conoidal shape towards a more spherical geometry.
Objective: To investigate the prevalence of post-traumatic stress disorder (PTSD) in patients during the postoperative period following cardiac surgery and to identify its influencing factors. Methods: Post-cardiac surgery patients hospitalized during Sep to Nov, 2023 were surveyed using questionnaires consisting of a general information questionnaire, PTSD checklist, resilience scale, social support rating scale, anxiety and depression self-rating scale, and simple coping style questionnaire. Then we analyzed the factors influencing PTSD symptoms after cardiac surgery. Results: A total of 267 cases were enrolled.The mean PTSD score of the post-cardiac surgery patients was 16.51±12.31, with 29 patients at high risk for developing PTSD. Stepwise regression analysis revealed that low educational level, use of cardiopulmonary bypass, long stay in ICU, high pain scores, low levels of psychological resilience and social support, as well as high depression score were associated with higher PTSD scores in post-cardiac surgery patients (P < 0.05). Conclusion: The occurrence of PTSD symptoms in patients after cardiac surgery is common and varies in severity. The influencing factors include the patient's educational level, use of extracorporeal circulation during surgery, length of ICU stay, duration of ventilator use, pain, patient's depression score, psychological resilience, and social support. Medical staff should pay more attention to the mental health level of high-risk patients and take targeted intervention measures in a timely manner.
Objective: To investigate the effect of early postoperative abnormal blood glucose on the short-term prognosis of non-small cell lung cancer (NSCLC), and to analyze the clinical characteristics and risk factors related to poor early prognosis. Methods: A total of 897 patients with NSCLC who underwent thoracoscopic surgery in Huadong Hospital, Fudan University from Jan 2020 to Aug 2021 were divided into hyperglycemia (HG) group (> 7.8 mmol/L) and normal blood glucose (NG) group (≤7.8 mmol/L and ≥3.9 mmol/L) according to the early postoperative blood glucose values. Additionally, the patients were divided into higher blood glucose fluctuation group(≥4 mmol/L)and the group with lower blood glucose fluctuation (< 4 mmol/L) basing on the fasting blood glucose. Using Logistic regression models, column line charts, ROC curves and other methods, we aimed to clarify the impact of early postoperative blood glucose abnormalities on short-term prognosis, explore clinical characteristics associated with poor short-term outcomes, identify other high-risk factors, and establish relevant risk prediction models. Results: Compared with the NG group, the incidence of postoperative pneumonia, thromboembolism, ICU admission rate, total length of hospital stay and hospital cost were significantly higher in the HG group (P < 0.05). Higher blood glucose fluctuation group had a greater risk of ICU admission (P=0.003). Logistic regression analysis showed that age, preoperative fasting glucose, white blood cell count and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) were risk factors for postoperative hyperglycemia (P < 0.05). Contrary to the effect of BMI, diabetes, male patients, higher blood glucose fluctuation, white blood cell count and age were the risk factors for postoperative adverse events (P < 0.05). The AUC of the column line chart model was 0.661 (95%CI: 0.624-0.698), indicating good discriminative ability for predicting poor short-term prognosis postoperatively. Calibration curves also demonstrated good consistency between predicted and actual probabilities. Conclusion: Early postoperative blood glucose fluctuations independently impact the short-term prognosis of thoracoscopic NSCLC patients. Blood glucose combined with gender, BMI, white blood cell count, age and diabetes history can serve as predictive factors for poor short-term prognosis postoperatively. Additionally, a column line chart constructed based on these factors may aid clinicians in early intervention for NSCLC patients with indications.
Objective: To compare the early effects on pelvic floor function of three modes of labor: natural delivery, cesarean section and forceps-assisted delivery. Methods: Fifty-eight cases of women who underwent transperineal three-dimensional pelvic floor ultrasonography at 6 weeks postpartum at Obstetrics and Gynecology Hospital, Fudan University from Jan 2019 to Jan 2020 were collected and divided into three groups: the natural birth group (n=22), cesarean section group (n=9), and forceps group (n=27). General data such as age, parity, birth order, neonatal weight, and pelvic floor ultrasonography findings were collected. Results: The differences in age, gestational week at delivery, newborn weight and number of pregnancies among the three groups were not statistically significant. In pelvic floor ultrasonography, it was found that in the resting state, the cervix had a smaller vertical distance from the inferior border of the pubic symphysis and a smaller posterior vesicourethral angle in the forceps group compared with the cesarean section group. In the forceps group, the angle of urethral inclination was greater, and the area of the anorectal hiatus was smaller in the resting state compared with the natural birth group and cesarean section group. In the Valsalva state, the vertical distance of the bladder neck and the cervix from the lower edge of the pubic symphysis were smaller in the forceps group compared with the natural birth group and cesarean section group. In the transition from resting to Valsalva state, the angle of rotation of the urethra was greater in the natural birth group and the forceps group than in the cesarean section group. Cervical mobility and recto-pubic abdominal mobility were greater in the forceps group compared to the natural birth group and the cesarean section group. All these differences were statistically significant (P < 0.05). Conclusion: In the early stage of labor, forceps-assisted delivery had a greater effect on the displacement of pelvic floor organs than natural labour and cesarean section.
Objective: To identify the latent profile of physical and psychological symptoms in postpartum women and examine the associations of the latent class membership with individual characteristics, based on a latent profile analysis. Methods: A cross-sectional survey study was conducted. With convenience sampling, 157 postpartum women who had delivered at the Obstetrics and Gynecology Hospital, Fudan University from Dec 2023 to Mar 2024 were selected. The participants were surveyed with patient-reported outcomes measurement information system (PROMIS) Anxiety, Depression, Fatigue, Sleep Disturbance, and Pain interference short forms. LPA and multinomial Logistic regression model were performed to identify subgroups based on physical and psychological symptoms in postpartum women and population heterogeneity. Results: LPA results suggested that there existed three distinct classes of postpartum physical and psychological symptoms: severe symptoms distress class (10.2%), moderate symptoms distress class (50.3%), and mild symptoms distress class (39.5%). Postpartum women's age, living arrangements, newborn's birthweight, newborn's feeding method, newborn's medical background, prenatal pregnancy risk assessment, mode of delivery, and postpartum complications had significant associations with the latent class membership (P < 0.05). Conclusion: There are 3 latent profiles of postpartum physical and psychological symptoms. Healthcare providers could provide targeted intervention to postpartum women according to the characteristics of different subgroup population characteristics, so as to improve the postpartum experience of women.
Objective: To establish a genetic counseling and follow-up model for hereditary gynecologic tumor variant gene carriers in medical and nursing cooperation, and to evaluate its practical effect. Methods: A total of 70 hereditary gynecologic tumor carriers who were admitted to the Gynecologic Cancer Genetic Counseling Clinic, Obstetrics and Gynecology Hospital, Fudan University from Jan 2021 to Jun 2023 were randomly divided into control group and observation group, with 35 cases in each group. The control group underwent routine outpatient management of tumor genetic counseling, and the observation group underwent the genetic counseling and follow-up mode of medical and nursing cooperation. Before and 6 months after intervention, the degree of psychological anxiety-depression, psychological crisis, quality of life and related clinical indicators of the two groups of mutant gene carriers were evaluated. Results: In terms of the degree of psychological anxiety and depression, the observation group was significantly lower than the control group after 6 months of intervention (P < 0.05). In terms of psychological crisis, the scores of all dimensions in the observation group were lower than those in the control group after 6 months of intervention (P < 0.05). In terms of quality of life. After 6 months of intervention, the scores of the observation group in all seven dimensions were higher than those in the control group (P < 0.05). After 6 months of intervention, 8 patients in the observation group underwent prophylactic salpingo-oophorectomy, 4 patients in the childbearing age carrier successfully underwent preimplantation genetic testing, and the number of cases in the control group was 0. Conclusion: The genetic counseling and follow-up mode of hereditary gynecologic tumor variant gene carriers can provide a full-cycle, standardized and intelligent management for mutant gene carriers, reduce the degree of psychological anxiety-depression, psychological crisis, improve their quality of life, and guide them to adopt scientific methods to prevent the occurrence of hereditary tumors, which provides a practical basis for the management of hereditary gynecologic tumor variant gene carriers.
Objective: To summarize the clinical experience of pulmonary lobectomy by uniportal video-assisted thoracoscope in parallel position. Methods: The clinical data of 90 patients who underwent uniportal video-assisted thoracoscopic lobectomy in Zhongshan Hospital (Xiamen Branch), Fudan University were retrospectively analyzed. Among them, 41 patients underwent lobectomy by uniportal thoracoscope in parallel position, and 49 patients underwent lobectomy by uniportal thoracoscope in non-parallel position. The perioperative related indicators of the two groups were compared. Results: There was no significant statistical difference between the parallel uniportal thoracoscopic group and the non-parallel uniportal thoracoscopic group in terms of operation time [(135.2±18.1) min vs. (132.7±25.6) min], intraoperative blood loss[(100.1±27.2) mL vs. (117.3±33.5) mL], postperative extubation time[(3.0±0.7) d vs. (3.1±0.9) d], hospitalization time after operation[(4.3±1.3) d vs. (4.8±1.5) d] and relapse rate after surgery in 3 year(7.32% vs. 10.20%). Conclusion: Lobectomy by uniportal thoracoscope in parallel position was safe and feasible in technique.
Objective: To construct trajectory models of care-seeking patterns for type 2 diabetes mellitus (T2DM) patients, analyze the influencing factors of different trajectories, and explore the fasting blood glucose control levels of T2DM patients with different trajectories. Methods: A retrospective cohort study was carried out on 18 088 T2DM patients who had health records and been involved in the diabetic management in Community Health Service Center of Minhang District, Shanghai from 2006 to 2009. Starting from Jan 1, 2010, participants were followed up until Dec 31, 2019, with complete follow-up information. Group-based trajectory modelling (GBTM) was employed to identify and construct the fluctuation trajectory of fasting blood glucose in the patients. Bayesian information criterion (BIC), average posterior probability (AvePP) and other evaluation indicators were used to select the optimum subgroup number model. Then the differences in demographic characteristics, health status, family history, fasting blood glucose, BMI, etc were compared among different categories. Multinational logistic regression model was constructed to explore the influencing factors of different fluctuation trajectories. Cox regression analysis was used to examine the relationship between the long-term trajectories of care-seeking patterns and fasting blood glucose control level. Results: Using GBTM analysis, we constructed the optimal Model 4 to categorize 18 088 T2DM patients with community health records into five distinct trajectory subgroups: continuous non-attendance group (22.29%), low-level increasing group (15.09%), high-level slowly decreasing group (14.18%), high-level rapidly decreasing group (14.90%), and continuous regular attendance group (33.54%). With the continuous regular attendance group serving as the reference, gender, age, place of residence, baseline comorbidity of hypertension, baseline fasting plasma glucose level, and BMI were found to influence the community attendance trajectories of T2DM patients (P < 0.05). After adjusting for confounding factors, Cox regression analysis revealed that compared to the continuous non-attendance group, the low-level increasing group, high-level slowly decreasing group, and continuous regular attendance group had better glycemic control, with HRs of 0.37 (95%CI: 0.34-0.39), 0.72 (95%CI: 0.67-0.78), and 0.78 (95%CI: 0.73-0.84), respectively. The glycemic control level in the high-level rapidly decreasing group was comparable, with an HR of 1.06 (95%CI: 0.99-1.12). Conclusion: Based on the optimal model, the community medical treatment trajectories of T2DM patients showed different dynamic characteristics. Factors such as gender, residence, hypertension, and weight loss may influence these varying trajectories. Regular community visits and follow-up may help control blood glucose levels.
Objective: To investigate whether the combination of conventional respiratory training and articulatory visual feedback training can improve respiratory function and diaphragmatic function in stroke patients. Methods: This single-blind randomized controlled trial recruited a total of 30 stroke patients who were admitted to Department of Rehabilitation Medicine, Zhongshan Hospital, Fudan University, from Nov 2022 to Aug 2023, and divided them into two groups: a experimental group (n=15) and a control group (n=15). The experimental group received conventional respiratory training combined with articulatory visual feedback training, and the control group received conventional respiratory training. The training in the 2 groups was conducted 5 times per week for 4 weeks. Results: Both groups significantly improved in maximum inspiratory pressure (MIP), peak inspiratory flow (PIF), maximum phonation time (MPT), maximum counting ability (MCA), and peak expiratory flow (PEF) in each of the two groups improved significantly after training (P < 0.05). After training, compared with the control group, the experimental group showed significant differences in MIP [(46.04±13.58)cmH2O vs.(63.46±16.96)cmH2O; P=0.004; 95%CI: -28.91, -5.93;effect size(ES)=1.13], PIF [(144.00±43.81) L/min vs. (190.20±75.01) L/min; P=0.049; 95%CI: -1.54, 0; ES=0.75], MCA [(7.06±3.25)s vs. (10.30±4.89) s; P=0.041; 95%CI: -6.34, -0.13; ES=0.77], forced vital capacity (FVC)[(1.74±0.76) L vs. (2.26±0.57) L; P=0.04;95%CI: -1.03, -0.03;ES=0.77], forced expiratory volume in one second (FEV1)[(1.10±0.40)L vs. (1.60±0.50)L; P=0.004; 95%CI: -0.85, -0.18; ES=1.1], and PEF [(83.40 (55.80) L/min vs. 171.12 (94.80) L/min; P=0.012)]. However, there were no statistically significant differences after training between the two groups in the maximum phonation time (MPT), vital capacity(VC), maximum voluntary ventilation (MVV), diaphragm mobility of the nonparetic side and paretic side, thickening fraction of the nonparetic side and paretic side. Conclusion: Compared with conventional respiratory training alone, the combination of articulatory visual feedback training with conventional respiratory training is more effective in enhancing respiratory and lung function in stroke.
Objective: To explore the feasibility and clinical effects of a novel hysteroscopic levonorgestrel-releasing intrauterine system (LNG-IUS) fixation at the fundus of uterus. Methods: From Aug 2023 to Jan 2024, a prospective and novel hysteroscopic LNG-IUS fixation at the fundus of uterus surgery was performed at Obstetrics and Gynecology Hospital, Fudan University. The patient's clinical symptoms, surgical time, surgical complications, postoperative LNG-IUS expulsion, and other follow-up information were recorded. Results: A total of 21 patients were included in this study, with an average age of (37.8±6.8) years old. The average uterine depth was (9.06±0.74) cm. Among them, 8 cases had a history of LNG-IUS expulsion (uterine depth > 8.5 cm in 5 cases, uterine depth≤8.5 cm in 3 cases, but the cervical canal was relatively loose), and other 13 cases had no history of LNG-IUS expulsion, but the uterine depth was all deeper than 8.5 cm. The average surgical time was (14.0±4.3) minutes, and the average intraoperative blood loss was (4.5±3.3) mL. All patients did not experience complications such as uterine perforation, massive bleeding, fluid overload, or postoperative infection. The average follow-up time after surgery was (3.2±0.8) months, and there was no LNG-IUS expulsion occured. The pain assessment and mean menstrual flow after operation were less than those before operation, and the endometrial thickness and mean uterine volume after operation were lower than those before operation, with statistically significant differences. For patients with dysmenorrhea, the postoperative relief rate was 95.0% (19/20), and for those with excessive menstruation, the postoperative effective rate reached 94.4% (17/18). The main adverse reaction was irregular vaginal bleeding, with an incidence rate of 57.1% (12/21). Conclusion: Hysteroscopic LNG-IUS fixation at the fundus of uterus is safe and effective. The procedure is simple, minimally invasive, has a short surgical time, minimal bleeding, and fast recovery. It is suitable for patients with dysmenorrhea, excessive menstruation, or large uterine cavity who have previously experienced LNG-IUS expulsion.
Helicobacter pylori (HP), a well-established carcinogenic factor, is implicated in the pathogenesis of gastric ulcer, gastric cancer, and other related diseases. Recent studies have unveiled a significant association between HP infection and an increased prevalence of non-alcoholic fatty liver disease (NAFLD). Furthermore, it has been observed that eradication of HP can ameliorate metabolic disorders and relieve NAFLD. Some studies have explored the possible mechanism, which may be related to energy metabolism disorder and gut microbiota imbalance caused by HP. This review outlined the current research status regarding the association between HP and NAFLD, as well as elucidated the potential mechanisms through which HP promoted the onset and progression of NAFLD.
Gallbladder adenoma, a benign tumor of mucosal epithelial origin, is considered to be a pre-cancer to gallbladder cancer (GBC), and its malignant transformation may occur in a relatively short time. The pathological process and molecular mechanism of gallbladder adenoma carcinogenesis are still controversial; ultrasound and CT are widely used to examine gallbladder diseases, and the application of contrast-enhanced ultrasound (CEUS) and high-frame-rate contrast-enhanced ultrasound (H-CEUS) has improved the diagnostic accuracy. In this paper, we summarize the literature on the clinicopathological features, imaging manifestations, gene expression, treatment, and clinical prognosis of gallbladder adenoma carcinogenesis.
This paper introduces a transfer learning approach based on regression models and demonstrates its application in the medical field through an example. Using data from the 2013-2014 U.S. National Health and Nutrition Examination Survey, the study investigates the association of sleep duration with depression levels and depressive disorder. It employs demographic characteristics and lifestyle factors as predictor variables to predict depression levels and depressive disorder across different racial groups. Compared to models built solely on target racial groups, transfer learning enhances the accuracy of estimating the effect of sleep duration in the target group and improves the prediction accuracy for depression levels and depressive disorder. The results illustrate that transfer learning effectively integrates source data to significantly improve estimation and prediction capabilities of target models, especially in situations with limited target data and heterogeneous data sources.
