[Artificial intelligence research advances in discrimination and diagnosis of pulmonary ground-glass nodules].

Lung cancer, which accounts for about 18% of all cancer-related deaths worldwide, has a dismal 5-year survival rate of less than 20%. Survival rates for early-stage lung cancers (stages IA1, IA2, IA3, and IB, according to the TNM staging system) are significantly higher, underscoring the critical importance of early detection, diagnosis, and treatment. Ground-glass nodules (GGNs), which are commonly seen on lung imaging, can be indicative of both benign and malignant lesions. For clinicians, accurately characterizing GGNs and choosing the right management strategies present significant challenges. Artificial intelligence (AI), specifically deep learning algorithms, has shown promise in the evaluation of GGNs by analyzing complex imaging data and predicting the nature of GGNs, including their benign or malignant status, pathological subtypes, and genetic mutations such as epidermal growth factor receptor (EGFR) mutations. By integrating imaging features and clinical data, AI models have demonstrated high accuracy in distinguishing between benign and malignant GGNs and in predicting specific pathological subtypes. In addition, AI has shown promise in predicting genetic mutations such as EGFR mutations, which are critical for personalized treatment decisions in lung cancer. While AI offers significant potential to improve the accuracy and efficiency of GGN assessment, challenges remain, such as the need for extensive validation studies, standardization of imaging protocols, and improving the interpretability of AI algorithms. In summary, AI has the potential to revolutionise the management of GGNs by providing clinicians with more accurate and timely information for diagnosis and treatment decisions. However, further research and validation are needed to fully realize the benefits of AI in clinical practice.

[Effects of comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome].

Objective: To investigate the characteristics and comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome. Methods: A retrospective observational study was conducted. From May 2012 to December 2021, the data of 19 patients with iatrogenic Cushing's syndrome discharged from the Department of Burns and Plastic Surgery of the First Affiliated Hospital of Guangxi Medical University were collected, including 8 males and 11 females, aged 28-71 (56±11) years, with 12 cases of infected acute wounds and 7 cases of infected chronic wounds. The lesions were located in the limbs, perianal, and sacrococcygeal regions, with original infection ranging from 9 cm×5 cm to 85 cm×45 cm. After admission, the patients were performed with multidisciplinary assisted diagnosis and treatment, and the wounds were treated with debridement and vacuum sealing drainage, according to the size, severity of infection, suture tension, and bone and tendon tissue exposure of wounds, direct suture or autologous skin and/or artificial dermis and/or autologous tissue flap transplantation was selected for wound repair. The levels of cortisol and adrenocorticotropic hormone (ACTH) of patients at 8:00, 16:00, and 24:00 within 24 h after admission were counted. After admission, the number of operations, wound repair methods, and wound and skin/flap donor site healing of patients were recorded. During follow-up, the wounds were observed for recurrent infection. Results: The cortisol levels of 16 patients at 8:00, 16:00, and 24:00 within 24 h after admission were (130±54), (80±16), and (109±39) nmol/L, respectively, and ACTH levels were (7.2±2.8), (4.1±1.8), and (6.0±3.0) pg/mL, respectively; and the other 3 patients had no such statistical results. After admission, the number of surgical operation for patients was 3.4±0.9. The following methods were used for wound repair, including direct suturing in 4 cases and autologous skin and/or artificial dermis grafting in 9 cases, of which 2 cases underwent stage Ⅱ autologous skin grafting after artificial dermis grafting in stage Ⅰ, and 6 cases had pedicled retrograde island flap+autologous skin grafting. The wound healing was observed, showing that all directly sutured wounds healed well; the wounds in 6 cases of autologous skin and/or artificial dermis grafting healed well, and the wounds in 3 cases also healed well after the secondary skin grafting; the flaps in 4 cases survived well with the wounds in 2 cases with distal perforators flap arteries circumfluence obstacle of posterior leg healed after stage Ⅱ debridement and autologous skin grafting. The healing status of skin/flap donor sites was followed showing that the donor sites of medium-thickness skin grafts in the thigh of 4 cases were well healed after transplanted with autologous split-thickness grafts from scalp; the donor sites of medium-thickness skin grafts in 3 cases did not undergo split-thickness skin grafting, of which 2 cases had poor healing but healed well after secondary skin grafting 2 weeks after surgery; the donor sites of split-thickness skin grafts in the head of 2 patients healed well; and all donor sites of flaps healed well after autologous skin grafting. During follow-up of more than half a year, 3 gout patients were hospitalized again for surgical treatment due to gout stone rupture, 4 patients were hospitalized again for surgical treatment due to infection, and no recurrent infection was found in the rest of patients. Conclusions: The infected wounds in patients with iatrogenic Cushing's syndrome have poor ability to regenerate and are prone to repeated infection. Local wound treatment together with multidisciplinary comprehensive treatment should be performed to control infection and close wounds in a timely manner, so as to maximize the benefits of patients.

[Clinical outcome of allogeneic hematopoietic stem cell transplantation with FLAG sequential busulfan/cyclophosphamide conditioning regimen for refractory/relapsed acute myeloid leukemia].

Objective: To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia. Methods: From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed. Results: After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred. 76.2% (16/21) patients had fever with 4 septicemia. One patient died of septic shock before engraftment. Twenty patients achieved neutrophil engraftment with a median time of 13 days (range, 10 to 21 days). Seventeen patients achieved platelet engraftment with a median time of 18 days (range, 9 to 25 days). The cumulative incidence of acute graft-versus-host disease (aGVHD) was 39.5%, and 3 patients developed grade Ⅲ-Ⅳ aGVHD. Of 19 patients who survived more than 100 days after transplantation, 4 had local chronic graft-versus-host disease (cGVHD). Of 21 patients, the median survival time was 15 months (range, 0.5 to 67 months) post-transplantation. Transplantation-related mortality rate was 28.7%. Leukemia relapse occurred in 4 patients with a median time of 4 months (range, 3 to 8 months) after transplantation. The cumulative relapse rate at 1 year was 21.4%. The 1-year and 3-year overall survival (OS) rates were 60.7% and 54.9% respectively. Log-rank analysis revealed that bone marrow blasts ≥ 20% or extramedullary leukemia before transplantation, poor platelet engraftment and grade Ⅲ-Ⅳ aGVHD were significantly related to shortened OS (P<0.05). Conclusions: Allo-HSCT with FLAG sequential Bu/Cy conditioning regimen in patients with refractory/relapsed myeloid leukemia has acceptable transplantation-related risk and relapse rate. The 1-year and 3-year OS rates are comparable with those in remission patients.

Correlation analysis of ADAMTS-4, VCAM-1, and TAK1 expression in cartilage tissue from spine tuberculosis.

A disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4) can effectively degrade articular cartilage matrix proteoglycan and damage the intervertebral disc of spinal tuberculosis patients, resulting in deterioration of the physical properties of articular cartilage. Transforming growth factor ß activated kinase 1 (TAK1) is similar to vascular cell adhesion molecule 1 (VCAM-1) and closely related to a variety of pathophysiological processes. This study intended to explore the expression of ADAMTS-4, VCAM-1, and TAK1 in cartilage tissue obtained from spinal tuberculosis patients and their inter-relationships, aiming to provide new treatment approaches for spinal tuberculosis. Patients with spinal tuberculosis (N = 60) from the department of orthopedics and patients with traumatic spinal fracture (N = 60, controls) were recruited for the study. ADAMTS-4, VCAM-1, and TAK1 expression was detected by immunohistochemistry. SPSS 19.0 software was used for data processing and analysis. The score values of ADAMTS-4, TAK1, and VCAM-1 were 1.45 ± 0.10, 1.33 ± 0.09, and 1.54 ± 0.11, respectively, which were significantly higher than those in normal controls (P < 0.05). ADAMTS-4 showed positive correlation with VCAM-1 and TAK1. ADAMTS-4, TAK1, and VCAM-1 expressions increased in spinal tuberculosis patients. They could provide clinical reference for spinal tuberculosis diagnosis and new treatment strategies can be devised by focusing on their positive correlation.

Seasonal dynamics of the tick Haemaphysalis tibetensis in the Tibetan Plateau, China.

The tick Haemaphysalis tibetensis (Acari: Ixodidae) Hoogstraal is an important arthropod vector widespread in the Qinghai-Tibet Plateau, and knowledge of its seasonal dynamics is still poor. The current study investigated the seasonal dynamics of the parasitic and non-parasitic H. tibetensis over a 2-year period from March 2014 to February 2016 in the Tibetan Plateau, China. During this timeframe, non-parasitic ticks were collected weekly by flag-dragging in grassland and shrubland areas, and parasitic ticks were removed weekly from selected sheep. Plateau pikas were captured using traps and examined for immature ticks between May to September 2014. Results suggest that non-parasitic H. tibetensis were mainly distributed in the grassland, and the parasitic adults and nymphs were found mostly on sheep. Larvae were usually found on Plateau pikas and the prevalence of infestation and mean parasitic intensity were 72.1 and 1.81%, respectively. Adults were observed from March to July with the major peak occurring in mid-April. Nymphs were found from March to August and reached a peak in late June. Larvae were collected from April to September, and their numbers peaked in late May. In the parasitic and non-parasitic period, the overall sex ratio of males to females was 1.62 and 1.30, respectively. Results show that H. tibetensis can complete one generation per year, with a population overlap between stages over the spring-summer months. These findings provide additional information on the biology and ecology of H. tibetensis as well as insights on its control in the environment and on sheep.

[Effect of dibutyl phthalate on demodicidosis].

OBJECTIVE: To evaluate the curative effect and safety of dibutyl phthalate on demodicidosis. METHODS: A single blinded and controlled study of human demodicidosis treated with dibutyl phthalate was conducted. One hundred and forty three patients with demodicidosis, including 81 acne and 62 rosacea, randomly divided into trial and control groups. The trial group was treated with dibutyl phthalate and control group with "new fumanling" cream twice a day in the early morning and evening respectively for six weeks consecutively. RESULTS: The rates of excellent, good, and fair efficacy and total effective rate in the trial group with acne were 53.7%, 41.5%, 4.9% and 100% respectively, with a significant difference to the control group (P < 0.05). The rates in the trial group with rosacea were 40.6%, 40.6%, 18.8% and 100% respectively, with no statistical difference to the control group (P > 0.05). No complaint of side effects in the trial group was recorded. CONCLUSION: Dibutyl phthalate is highly effective to demodicidosis without prominent adverse reactions.

[CD5+B cells and autoimmune diseases].

By using two colour flow cytometric analysis, we examined the proportion of B lymphocytes bearing CD5 surface antigen (CD5+B cell). The level of CD5+B cells was markedly increased in active chronic ITP and active hyperthyroid patients with Graves' disease. There was an inverse correlation between the percentage of circulating CD5+B cells and platelet counts, and a positive correlation between the level of CD5+B cells in peripheral blood and serum T3 level. These results suggested that the level of CD5+B cells might play a role in producing autoantibodies in some autoimmune diseases.

[Observation on imprints of the tongue caused by recurrent oropharyngeal ulcers and its clinical significance].

In this article 36 cases of recurrent oropharyngeal ulcers were differentiated according to the local condition of the oropharyngeal ulcerations, tongue pictures, pulse feeling and other signs and symptoms. The authors considered this disease as the deficiency syndrome accompanied with the excess syndrome. The three steps for treatment were: Treating the Biao (secondary) aspect for emergency, then simultaneous treatment of Biao and Ben (primary), and lastly reinforcing the body resistance. The course of treatment lasted three months. The whole effective rate was 86.21%. The patients were divided into A and B groups according to the situation, the area, the amount and the deep degree of oropharyngeal ulcerations. The result of observation on exfoliated cells by imprints of tongue of two groups, The positive rates of six indices in the imprints of tongue of B group were higher than those of A group obviously (P less than 0.05-0.005). It conformed to the serious condition of the patients of B group, in which the number and area and deep degree of ulcers were more and larger and deeper, and their distributions were often involved in pharynx and larynx. Therefore the observation of the imprints of tongue may pre-indicate the conditions of the illness which will get better or worse. A comparison of before- and after-treatment showed that positive rates of all indices were reduced markedly (P less than 0.05-0.005). It proved that the observation of tongue picture by the imprint was more sensitive and exact than by the naked eye. It was proved beneficial to evaluating the therapeutic effect and prognosis.