[Recognition of abnormal changes in echocardiographic videos by an artificial intelligence assisted diagnosis model based on 3D CNN].

Objective: To investigate the diagnostic efficiency and clinical application value of an artificial intelligence-assisted diagnosis model based on a three-dimensional convolutional neural network (3D CNN) on echocardiographic videos of patients with hypertensive heart disease, chronic renal failure (CRF) and hypothyroidism with cardiac involvement. Methods: This study is a retrospective study. The patients with hypertensive heart disease, CRF and hypothyroidism with cardiac involvement, who admitted in Henan Provincial People's Hospital from April 2019 to October 2021, were enrolled. Patients were divided into hypertension group, CRF group, and hypothyroidism group. Additionally, a simple random sampling method was used to select control healthy individuals, who underwent physical examination at the same period. The echocardiographic video data of enrolled participants were analyzed. The video data in each group was divided into a training set and an independent testing set in a ratio of 5 to 1. The temporal and spatial characteristics of videos were extracted using an inflated 3D convolutional network (I3D). The artificial intelligence assisted diagnosis model was trained and tested. There was no case overlapped between the training and validation sets. A model was established according to cases or videos based on video data from 3 different views (single apical four chamber (A4C) view, single parasternal left ventricular long-axis (PLAX) view and all views). The statistical analysis of diagnostic performance was completed to calculate sensitivity, specificity and area under the ROC curve (AUC). The time required for the artificial intelligence and ultrasound physicians to process cases was compared. Results: A total of 730 subjects aged (41.9±12.7) years were enrolled, including 362 males (49.6%), and 17 703 videos were collected. There were 212 cases in the hypertensive group, 210 cases in the CRF group, 105 cases in the hypothyroidism group, and 203 cases in the normal control group. The diagnostic performance of the model predicted by cases based on single PLAX view and all views data was excellent: (1) in the hypertensive group, the sensitivity, specificity and AUC of models based on all views data were 97%, 89% and 0.93, respectively, while those of models based on a single PLAX view were 94%, 95%, and 0.94, respectively; (2) in the CRF group, the sensitivity, specificity and AUC of models based on all views data were 97%, 95% and 0.96, respectively, while those of models based on a single PLAX view were 97%, 89%, and 0.93, respectively; (3) in the hypothyroidism group, the sensitivity, specificity and AUC of models based on all views data were 64%, 100% and 0.82, respectively, while those of models based on a single PLAX view were 82%, 89%, and 0.86, respectively. The time required for the 3D CNN model to measure and analyze the echocardiographic videos of each subject was significantly shorter than that for the ultrasound physicians ((23.96±6.65)s vs. (958.25±266.17)s, P<0.001). Conclusions: The artificial intelligence assisted diagnosis model based on 3D CNN can extract the dynamic temporal and spatial characteristics of echocardiographic videos jointly, and quickly and efficiently identify hypertensive heart disease and cardiac changes caused by CRF and hypothyroidism.

[Application of multiplex PCR capillary electrophoresis and analysis of distribution characteristics of HPV infection subtypes].

Objective: To analyze the characteristics of human papillomavirus (HPV) infection and the distribution of HPV subtypes in Shijiazhuang, Hebei Province, and to explore the application evaluation of multiple PCR capillary electrophoresis fragment analysis for HPV typing test. Methods: A population-based cross-sectional study was conducted among 434 women (age range 17 to 74 years old, 260 patients and 174 physical examinations) included from May to August 2022 in Hebei General Hospital. HPV typing was detected by multiple PCR-capillary electrophoresis fragment analysis. Using the multiple fluorescence quantitative PCR kit as a reference, Chi-square test was used to analyze the diagnostic effect of multiple PCR-capillary electrophoresis fragment analysis, and the consistency was analyzed by Kappa value. Results: The total HPV infection rate was 45.85%(199/434), including 35.48% (154/434) of high-risk HPV (HR-HPV), 3.92% (17/434) of low-risk HPV (LR-HPV), 6.45% (28/434) of HR-HPV and LR-HPV mixed infection, 27.88% (121/434) of single type HPV and 17.97% (78/434) of multi type HPV. HPV52 (9.68%, 42/434), HPV16 (6.91%, 30/434), and HPV58 (6.91%, 30/434) are common HPV subtypes. The positive rate of physical examination was 45.40% (79/174), which was slightly lower than that of patients 46.15% (120/260), there was no significant difference (χ2=0.024,P>0.05). The highest infection rate in the 17-30 age group was 54.76% (46/84), and there was no statistical difference among the age groups(χ2=4.123,P>0.05). The sensitivity and specificity of multiplex PCR capillary electrophoresis fragment analysis were 92.96% and 94.04%, respectively, and Kappa value was 0.870, with the multiplex fluorescent quantitative PCR as the reference. Conclusion: HPV infection may appear younger, and the positive rate of HR-HPV infection is the highest, with HPV52, 16, 58 as the main infection subtypes. The detection results of multiplex PCR capillary electrophoresis fragment analysis method are highly consistent with those of multiplex fluorescent quantitative PCR method, which is suitable for HPV DNA typing.

[Epidemiological characteristics of human adenovirus 2, 3 and 7 genetypes in hospitalized children with respiratory infection in a hospital of pediatric in Hebei Province from 2018 to 2020].

Objective: To investigate the epidemiological characteristics of human adenovirus (HADV) 2, 3 and 7 in hospitalized children with respiratory infection. Methods: A total of 25 686 children with respiratory infection hospitalized at Children's Hospital of Hebei Province from January 2018 to December 2020 were retrospectively included.Deep sputum or nasopharyngeal aspirates of those children were collected. Then thirteen common respiratory pathogens were detected by multiplex PCR. 510 HADV positive specimens were randomly selected via random number and classified for type 2, 3 and 7 using a multiplex real-time quantitative PCR. SPSS 21.0 software was used to perform all of the statistical analyses. Enumeration data were expressed by frequency and percentage. χ2 test was used for comparison between groups. Results: The HADV-positive rate was 7.99% (2 052/25 686). Children at age 3-<6 years had the highest HADV-positive rate (11.44%). The HADV-positive rate in 2019 was highest (10.64%). Among the 510 HADV-positive specimens, the proportion of type 3 was the highest (31.16%), followed by type 7 (21.37%) and type 2 (11.18%). The rate of type 2 in 2019 was significantly lower than that in 2018 and 2020 (χ2=8.954 and 16.354; P=0.003 and <0.01), while the rate of type 3 was significantly higher than that in 2018 and 2020 (χ2=5.248 and 4.811; P=0.022 and 0.028). The rate of type 2, type 3 and type 7 were lowest in winter, spring and autumn, respectively. The rate of type 2 increased significantly in autumn and the rate of type 3 and type 7 increased significantly in winter.The co-detection rate of HADV with other respiratory pathogens was 43.33%(221/510). Among, the co-detection rate of type 3 was highest (47.32%), and the co-detection rate of type 2, 3 and 7 was significantly higher than the alone detection rate (χ2=20.438, P<0.01; χ2=42.105, P<0.01; χ2=27.573, P<0.01).The proportion of severe pneumonia in children with type 7 positive (15.89%) was higher than that in children with non-type 7 positive (8.23%) (χ2=5.260, P=0.022). Conclusion: HADV is one of the important pathogens of children with respiratory infection in Children's Hospital of Hebei Province. The susceptible population of HADV is preschool children aged 3 to 6 years. HADV often co-detects with other respiratory pathogens. Type 3 and 7 is likely to be the dominant genotypes in this region, and type 7 may be one of the risk factors of severe pneumonia in children.

[Analysis of epidemiological characteristics of human coronavirus in hospitalized children with respiratory tract infection in Hebei region].

Objective: To investigate the epidemiological characteristics of human coronavirus (HCoV) in hospitalized children with respiratory tract infection in Hebei region, providing evidence for the diagnosis and prevention of children with respiratory tract infection. Methods: A retrospective study was conducted on 1 062 HCoV positive children hospitalized for respiratory tract infection in Children's Hospital of Hebei Province from January 2015 to December 2020, aged from 33 days to 14 years, with a median age of 2 years. 27 932 (60.9%) were males and 17 944(39.1%) were females. And the gender, ages, seasonal distribution, HCoV-positive rates, co-detection distribution and clinical diagnosis of HCoV positive cases were analyzed by SPSS 25.0. Enumeration data were expressed by frequency and percentage; categorical variable were compared by the Pearson χ2test. Results: The overall HCoV-positive rate was 2.31% (1 062/45 876), which was 2.37% (662/27 932) in male children and 2.23% (400/17 944) in female children. There was no statistically significant difference between genders (χ²=0.916, P=0.339). Children at age groups<1 years (2.44%) and 1-<3 years (2.63%) had higher HCoV-positive rates than those at age groups 3-<5 years (1.97%) and ≥5 years (1.38%) (χ²=27.332,P<0.01). The HCoV-positive rates from 2015 to 2018 were 2.13%, 2.45%, 2.28% and 2.23%. The HCoV-positive rate of 2019 (1.71%) was significantly lower than in 2016 (χ²=12.05, P<0.01), 2017 (χ²=7.34, P=0.01) and 2018 (χ²=6.78, P=0.01), but there was no significant difference compared with 2015 (χ²=2.84, P=0.09). The HCoV-positive rate of 2020 (3.37%) was significantly higher than in 2015 (χ²=13.636, P<0.01), 2016 (χ²=11.099, P<0.01), 2017 (χ²=15.482, P<0.01), 2018(χ²=18.601, P<0.01) and 2019(χ²=45.580, P<0.01). The positive rate was highest in spring (March to May) in 2015 and 2017 to 2018. February to April and July to September of 2016 were the peak periods of positive detection. No obvious seasonal change was observed in 2019 and the HCoV-positive rate of 2020 was extremely low from January to July, following significantly increased from August to December. 26.37% (280/1 062) of HCoV were co-detected with other respiratory pathogens and the most frequently identified mixed detection was RSV. Three or more pathogens were detected in 7.34% (78/1 062) of the HCoV-positive samples. Bronchopneumonia and bronchiolitis were more frequently observed in the single HCoV positive (61.89% and 16.75%) children compared to co-detected children(34.29% and 9.64%)(χ²=63.394 and 8.228, P<0.01). However, compared to those with HCoV mono-detection, co-detected children were more likely to have severe pneumonia (4.6% and 47.14%) (χ²=280.171, P<0.01). Conclusions: HCoV is one of the respiratory pathogens in children in Hebei region and more prevalent in spring. The susceptible population of HCoV is mainly children under the age of 3 years old. HCoV often co-detects with other respiratory pathogens, and the co-infection is one of the risk factors of severe pneumonia in children with respiratory infection.

[An investigation of insulin injection-related needlestick injuries among clinical nurses in Hunan, China].

Objective: To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China. Methods: From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) . Results: Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process. Conclusion: The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.

MiR-566 protects the malignant progression of breast cancer by negatively regulating WNT6.

OBJECTIVE: To elucidate the relationship between microRNA-566 (miR-566) and prognosis in breast cancer (BC) and to clarify the influences of miR-566 and WNT6 in its locus region on BC progression. PATIENTS AND METHODS: MiR-566 and WNT6 levels in 44 pairs of BC samples were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The influences of miR-566 on clinical features and prognosis in BC patients were analyzed. According to the differential expressions of miR-566 in the tested BC cell lines, MDA-MB-231 and MCF-7 cells were selected for generating miR-566 knockdown and overexpression models, respectively. Cell counting kit-8 (CCK-8), 5-Ethynyl-2'-deoxyuridine (EdU) and transwell assays were conducted to explore the role of miR-566 in BC cell functions. Besides, the regulatory interaction between miR-566 and its downstream gene WNT6 was assessed by performing Dual-Luciferase reporter assay. Finally, the co-regulation of miR-566 and WNT6 in BC cell functions was examined. RESULTS: MiR-566 was downregulated in BC tissues. BC patients with a low expression level of miR-566 were prone to suffering a large tumor size, advanced tumor grade, high incidence of lymphatic metastasis and poor prognosis. Overexpression of miR-566 weakened proliferative and migratory abilities in MCF-7 cells, whereas knockdown of miR-566 produced the opposite results in MDA-MB-231 cells. WNT6 was the target gene binding to miR-566, and they displayed a negative expression correlation in BC tissues. Regulatory effects of miR-566 on BC progression could be reversed by WNT6. CONCLUSIONS: MiR-566 is closely related to tumor size, tumor grade, lymphatic metastasis and prognosis in BC. It protects the malignant progression of BC by negatively regulating WNT6.

Proteomic analysis of susceptibility in intestinal stromal tumors.

We analyzed the susceptibility of intestinal stromal tumors using cell culture and proteomics. Human SGC7901 gastric cells were selected and divided into a blank control group (untransfected SGC7901 cells), a negative control group [SGC7901 cells transfected with negative interference control-small interfering RNA (siRNA)], and a COOH-terminus tensin-like molecule (CTEN)-siRNA-1 group (SGC7901 cells transfected with CTEN-siRNA-1). The cells were successfully transfected and subjected to analyses of cell proliferation, cell cycle, cell invasion, CTEN expression, and proteomics. The percentages of cells in the G0/G1, S, and G2/M phases were similar in the three groups (P > 0.05), and the OD values were also similar at 24, 48, and 72 h (P > 0.05). Compared with the levels in the blank and negative control groups, CTEN protein in the CTEN-siRNA-1 group decreased by 66 and 65%, respectively, and significantly fewer cells in the CTEN-siRNA-1 group were capable of invasion (P < 0.05). Proteomic analysis showed that in the CTEN-siRNA-1 group, 283 proteins were upregulated and 242 were downregulated; from these, the expression levels of E-cadherin and ERK proteins changed significantly. Silencing the expression of CTEN in intestinal stromal tumor cells reduces their invasion capability. Moreover, silencing CTEN at different stages can also regulate the expression levels of E-cadherin and ERK proteins.

The prognostic value of PD-L1 expression for non-small cell lung cancer patients: a meta-analysis.

BACKGROUND: A meta-analysis was conducted to investigate the much-debated relationship between the gene expression of programmed cell death-ligand 1 (PD-L1) and cancer patient prognosis. The prognostic value of measuring PD-L1 expression in non-small cell lung cancer (NSCLC) patients was analyzed. METHODS: We searched PubMed for studies about the relationship between PD-L1 expression and NSCLC patient prognosis. Only studies with patient survival data related to PD-L1 expression in NSCLC patients with different characteristics were included. The effect size (ES) for this analysis was the hazard ratio (HR) with 95% confidence intervals (CI) for overall survival (OS). RESULTS: Six studies with 1157 patients were included with the defined including and excluding criteria. There is no significant heterogeneity among the studies (I(2) = 0%, p = 0.683). PD-L1 expression was significantly associated with the differentiation of tumor (poor vs. well: OR = 1.91, 95% CI: 1.33-2.75, p = 0.001). High PD-L1 expression was also correlated with poor prognosis in terms of the OS of patients with NSCLC (pooled HR = 1.75, 95% CI: 140-2.20, p < 0.001; heterogeneity test: I(2) = 0%, p = 0.643). CONCLUSIONS: NSCLC patients with positive PD-L1 expression exhibited poor OS. The PD-L1 expression was higher in tumors with poor differentiation.

Differences in differential gene expression between young and mature Arabidopsis C58 tumours.

Tumorigenesis of plants triggered by Agrobacterium tumefaciens has been investigated for over a century, but a global study on changes in gene expression in plant tumours during growth and development has received little attention so far due to technical difficulties. Recently a great advance in 'omic' technologies, e.g. microarray, proteome and transcriptome analyses, has allowed differential expression profiling of genes for metabolic regulation during plant tumour growth and development. Deeken et al.(The Plant Cell Online, 18, 3617) and Lee C.-W. et al.(The Plant Cell Online, 21, 2948) used a fold change approach to profile genes differentially expressed (DE) between Arabidopsis inflorescence stalks infected with Agrobacterium strains C58 (carrying T-DNA) or GV3101 (without T-DNA) and control stalks at 3 hours, 6 days and 35 days after inoculation. We utilised ranking analysis of microarray data, a modified t-test approach, to further analyse these microarray data and compared DE gene functioning in photosynthesis, energy, nucleotide, RNA, DNA, protein and lipid metabolism, biological defence, cell wall and signalling pathways in young (6-day-old) and mature (35-day-old) tumours. There were large differences in differential expression of genes for these basic metabolic pathways between young and mature tumours. In young tumours, more genes were up-regulated in most metabolic functional categories than down-regulated, whereas in mature tumours, genes involved in basic and major metabolic pathways were more down-regulated than up-regulated, strongly indicating that relative to the control stalk, many metabolic pathways were enhance in young tumours but decayed or tended to be decayed in mature tumours.

X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures / Estudio cefalométrico con rayos X de diferentes partes del espacio de las vías respiratorias superiores y cambios en la posición hioidea tras fracturas mandibulares

OBJECTIVE: This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. METHODS: Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. RESULTS: The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function ofpatients. CONCLUSIONS: Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

OBJETIVO: Este estudio analiza las diferentes partes del espacio de las vías respiratorias superiores y los cambios de posición hioidea. Los resultados proporcionan una referencia clínica para desarrollar programas de tratamiento oportuno y eficaz para los pacientes con fracturas de la mandíbula, causadas por trauma maxilofacial. MÉTODOS: Se hicieron mediciones X-cefalométricas estándares del cráneo lateral a 210 sujetos. Los sujetos fueron divididos en cuatro grupos de fractura: ángulo mandibular, condilar, cuerpo mandibular y parasinfisaria. RESULTADOS: Las radiografías de los grupos de fractura mandibular fueron comparadas con el grupo de oclusión normal para analizar el espacio de las vías respiratorias superiores y los cambios de posición hioidea. Diferentes tipos de fracturas tienen diferentes efectos sobre el espacio de las vías respiratorias superiores. La fractura de cuerpo mandibular bilateral y la fractura de parasinfisaria tienen una influencia significativa en los espacios de las vías respiratorias orofaríngea y laringofaríngea inferiores, con serios obstáculos restringiendo severamente la función respiratoria de los pacientes. CONCLUSIONES: Las fracturas en diferentes partes de la estructura mandibular se hallan estrechamente vinculadas a las vías respiratorias superiores y a la posición hioidea.

X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures.

OBJECTIVE: This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. METHODS: Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. RESULTS: The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function of patients. CONCLUSIONS: Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

Changes in the expression of telomere maintenance genes might play a role in the pathogenesis of systemic lupus erythematosus.

Previous studies demonstrated that telomerase activity increased while telomere length shortened in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE). This study aimed to examine the changes of telomere maintenance genes and their clinical significance in SLE. The mRNA level of telomeric proteins in PBMCs, including shelterin complex (TRF1, TRF2, POT1, TPP1, TIN2 and hRAP1), a set of multifunctional proteins involved in telomere maintenance (MRE11, KU80 and RPA1), and Ki67, was measured using real-time quantitative PCR in 56 SLE patients (36 treated and 20 untreated; 32 with renal involvement and 24 without renal involvement) and 46 healthy subjects (controls). The expression of TPP1, TIN2, POT1 and KU80 was significantly reduced while that of TRF2 and MRE11 increased in SLE patients (p < 0.05, respectively); significant difference was not found in the expression of TRF1, hRAP1, RPA1 and Ki67 (p > 0.05, respectively). The expression of TRF2, MRE11 and Ki67 was much higher in untreated SLE patients than in controls or treated SLE patients (p < 0.05, respectively); the expression of hRAP1 was much higher in SLE patients with renal involvement than in controls or SLE patients without renal involvement (p < 0.05, respectively). Significant positive correlation was found between level of KU80 and C3, TPP1 and TIN2, TPP1 and POT1, while significant negative correlation was found between KU80 and serum total globulins, TIN2 and RF, TPP1 and SLEDAI score (p < 0.05, respectively). In conclusion, altered expression of telomere maintenance genes might be involved in the pathogenesis of SLE. Further study in expression and functions of telomeric proteins would be needed.