Abstract:Objective：To get DNA aptamers binding to different subtypes of breast cancer cells. Methods：A random double - stranded DNA（dsDNA）pool was established by PCR，and single-stranded DNA（ssDNA）library was separated from the dsDNA pool by coated sepharose. Based on subtractive cell - systematic evolution of ligands by exponential enrichment（SELEX），the in vitro cultured breast cancer cells，MCF -7 and MDA -MB -231，were alternately used as positive screening targets while normal mammary gland cell MCF - 10A as negative. The effect of PCR amplification and the recovery of aptamer were confirmed by agarose electrophoresis. The PCR conditions were optimized through temperature gradient experiment，while the affinity of aptamers for target cells was monitored by using flow cytometry（FCM）. Cloning and sequencing of aptamers were carried out by conventional molecular biology techniques. The aptamers were preliminarily screened by sequence analysis，and DNA aptamers were selected by FCM，laser confocal and immunofluorescence staining. Results：A random ssDNA library was successfully established，and the screening conditions of SELEX were optimized. Specific DNA aptamers for MCF-7 and MDA-MB-231 cells were obtained after 20 runs’tandem crossed cell-SELEX. Of 100 positive sequenced clones，72 aptamers were identified. Accurate alignment of Blastn implied no similar sequence to the 72 submitted aptamers. Five aptamers were preliminarily screened by sequence analysis，and two aptamers which could bind to breast cancer subtype tissue cells were obtained by optimization experiment. Conclusion：By using the tandem crossed cell -SELEX，DNA aptamers of broad -spectrum combing with clinical breast cancer subtypes can be obtained in a short time，which may be helpful for the targeted drug delivery system of breast cancer.

Abstract:Objective：To explore the correlation between the expression of annexin A5（ANXA5）and ferroptosis in melanoma. Methods：The expression of ANXA5 in melanoma was analyzed using The Human Protein Atlas data and further validated by immunohistochemistry on a human melanoma tissue microarray. The B16F10 melanoma cell line was used as the research model， where ANXA5 knockout cell lines were generated using CRISPR -Cas9 technology. The effect of ANXA5 knockout on ferroptosis in B16F10 cells was assessed using CCK - 8 and lactate dehydrogenase（LDH）assays. RNA - seq was further performed to identify the possible target molecules of ANXA5 related to ferroptosis，followed by validation. Additionally，the endogenous expression of ANXA5 in different melanoma cell lines was measured to confirm its regulatory role in ferroptosis sensitivity. Results：ANXA5 was aberrantly overexpressed in melanoma tissues，and knockingdown or knockingout ANXA5 promoted the sensitivity to ferroptosis in melanoma cells. Acyl - CoA synthetase long - chain family member 4（ACSL4）as a key regulator of ferroptosis，was negatively correlated with ANXA5 expression. Overexpression of ANXA5 reduced the level of ACSL4 and showed resistance to ferroptosis. Conclusion：In melanoma cells，downregulation of ANXA5 enhanced the sensitivity to ferroptosis via upregulating ACSL4，suggesting that ANXA5 may be a potential target of ferroptosis-based therapy in melanoma.

Abstract:Objective：To prepare a soothing liposome emulsion using madecassoside（MC）and ectoin（EC）as the primary ingredients and to evaluate its transdermal absorption. Methods：The optimal ratio of MC and EC that produced anti-inflammatory and barrier repair activities was determined through cellular assays；MC -EC liposomes were prepared using the thin film hydration. The particle size，dispersibility coefficient，and Zeta potential were measured using a Malvern particle size analyzer. The morphology was observed under transmission electron microscope. The contents of MC and EC in the solution were determined by high - performance liquid chromatography. The encapsulation rate and drug loading capacity were determined by the dialysis method. The transdermal characteristics of the liposome emulsion were evaluated via the Franz diffusion cell method. Results：The cell experiments determined that the best anti-inflammatory and barrier-repairing activities were achieved with a MC to EC mass ratio of 1∶9. Under these parameters， the liposome preparation conditions were optimized with a phosphorus - bile ratio of 5∶1 and a drug - to - lipid ratio of 1∶10. The encapsulation rate of MC in the liposomes was 51.33%，and the drug loading capacity of MC was 0.35%，the encapsulation rate of EC was 26.39%，and the drug loading capacity of EC was 1.20%. The liposomes had a particle size of 166.53 nm，the Zeta potential of-29.63 mV，and the PDI of 0.20. Over a 24 h period，the solution demonstrated a lower cumulative permeability compared with the aqueous control，without exhibiting an abrupt release；instead，a sustained release effect was observed. Conclusion：The MC and EC liposome emulsion prepared in this experiment has a high drug load and stable internal particle distribution，and may achieve slow - release effect on the skin surface and prolong the action time of the effective substance.

Abstract:Objective：To analyze the value of continuous finger pulse oxygen saturation（SpO₂）monitoring in guiding oxygen therapy in pneumonia patients with hypoxemia. Methods：A total of 101 viral pneumonia patients with hypoxemia were enrolled，56 with continuous finger pulse oximetry monitoring and 45 with routine monitoring. Two groups were compared about hospital days， arterial blood gas（ABG）counts，course of oxygen therapy，as well as the differences in blood oxygenation and inflammatory factors [interleukin-6（IL-6）and C-reactive protein（CRP）]on day（7±1）. The continuous finger pulse oximetry monitoring group was divided into an escalation group and a no-escalation group according to whether or not an oxygen therapy escalation event occurred within 48 h of admission and the monitoring data of the two groups were analyzed. Correlations of finger pulse oximetry and pulse rate - related parameters with inflammatory and immune factors were analyzed. Finger pulse oximetry monitoring data were also analyzed in the case of a further oxygen therapy escalation event within 48 h after escalation to bilevel positive airway pressure（BiPAP）oxygen therapy. The value of finger pulse oximetry in diagnosing early oxygen escalation events was explored using receiver operating characteristic （ROC）curve. Results：①The ABG counts，the day of oxygen therapy initiation escalation and reaching the maximum parameters in the continuous finger pulse oximetry monitoring group were less than those in the routine finger pulse oximetry monitoring group（P ＜ 0.05）. Compared with the routine finger pulse oximetry monitoring group, the continuous finger pulse oximetry monitoring group had higher PaO₂/FiO₂ and lower levels of IL-6 and CRP on day（7±1）of admission（P ＜ 0.05）. ②The differences in monitoring parameters in the continuous finger pulse oximetry monitoring group in terms of lowest SpO₂（ SpO_2L），mean SpO₂（ mSpO₂），the percentage of time with daily SpO₂ below 86%，88%，90%，92% and 94%（T₈₆，T₈₈，T₉₀，T₉₂，and T₉₄），and standard deviation of SpO₂ in 24 h between the escalation group and no - escalation group were statistically significant（all P ＜ 0.05）. IL - 6，CRP and immunoglobulin G were significantly correlated with SpO₂ parameters. ③ Continuous monitoring parameters on BiPAP days in the continuous finger pulse oximetry monitoring group showed events of sudden oxygen desaturation accompanied by increasing pulse rate. Such hypoxic events were found to be associated with BiPAP offline. The difference in descending area（DA）of SpO₂ desaturation was statistically significant between the escalation and no-escalation groups. The ROC for DA diagnosis of escalation events of early oxygen therapy on BiPAP respiratory support was 0.852（P ＜ 0.05），suggesting that DA can be used as a predictor of oxygen therapy escalation events. Conclusion：Continuous finger pulse oximetry monitoring parameter T₉₂ can identify the risk of progressive exacerbation of hypoxic events at an early stage，which assist in the timely adjustment of oxygen therapy regimen. The DA of SpO₂ desaturation under BiPAP daily offline can be used as a predictor of escalation events of oxygen therapy. Continuous finger pulse oximetry monitoring help guide decisions about oxygen therapy regimens in pneumonia patients with hypoxemia.

Abstract:Objective：To develop and validate a radiomics nomogram based on intratumoral and peritumoral multiparametric magnetic resonance imaging（MRI）for preoperative prediction of N2 - 3 stage axillary lymph node（ALN）in invasive breast cancer. Methods：We retrospectively analyzed 320 invasive breast cancer patients（224 in the training set and 96 in the validation set）who underwent preoperative standardized breast MRI from January 2018 to December 2019. Based on the number of axillary metastatic lymph nodes in the pathological reports，patients were divided into N0-1 group（fewer than 4 metastatic nodes）and N2-3 group（4 or more metastatic nodes）. Radiomics features associated with ALN stage were selected from three regions of interest（ROI）across five MRI sequences：intratumor，peritumor，and intratumor + peritumor. Three radiomics models（intratumoral model，peritumoral model， and intratumoral + peritumoral model）were constructed using a random forest（RF）classifier，and radiomics scores for each model were calculated. Univariate and multivariate logistic regression were performed to identify clinical parameters and then constructed a clinical model. Features from the optimal radiomics model and clinical model were integrated to build a combined model and visualized as a nomogram. The predictive performance and clinical utility of each model were evaluated and compared using receiver operating characteristic（ROC）curves，calibration curves，and decision curve analysis（DCA）. Results：The intratumoral + peritumoral model performed best among the three radiomics models，with an area under the curve（AUC）of 0.911 and 0.858 in the training and validation sets，respectively. The nomogram integrating the intratumoral + peritumoral radiomics features and clinical features （peritumoral edema and lesion enhancement pattern）had the best predictive efficacy of N2-3 stage ALN among all models，with an AUC of 0.923 and 0.892 in the training and validation datasets，respectively. Calibration curves showed that the predicted values of the nomogram were in good agreement with the actual observed values. DCA demonstrated that the nomogram had high clinical utility. Conclusion：A nomogram constructed by multiregion multiparametric MRI radiomics features and clinical features has high value for personalized prediction of N2-3 stage ALN in invasive breast cancer.

Abstract:Objective：To evaluate the predictive value of the neutrophil - to - lymphocyte ratio（NLR）and the systemic immune - inflammation index（SII）in predicting patients with anti - melanoma differentiation - associated gene 5 - positive（anti - MDA5 ⁺ ） dermatomyositis（DM）develop into the rapidly progressive interstitial lung disease（RPILD）. Methods：We retrospectively analyzed the clinical and laboratory data of 124 anti - MDA5 ⁺ DM patients from the First Affiliated Hospital of Nanjing Medical University between March 2019 and September 2023. We identified independent risk factors associated with the development and mortality of RPILD with the Cox regression analysis，and determined the optimal cut-off values for predicting adverse outcomes with the receiver operating characteristic（ROC）curve analysis. Results：Among the 124 patients，36 patients（29.03%）developed RPILD，and 39 patients（31.45%）died during the follow-up period. The results of multivariate Cox regression analysis showed that the elevated NLR was an independent risk factor for RPILD development，while the elevated SII expression was independently associated with the increased mortality of RPILD. Based on the ROC curve analysis，NLR＞6.12 was a predictor for RPILD，and SII ＞875.79 was associated with increased mortality risk of RPILD. Conclusion：Both NLR and SII are accessible，cost-effective，and reliable prognostic indicators for the prognosis of patients with anti-MDA5⁺ DM，providing a valuable guidance for clinical management and risk stratification of the disease.

Abstract:Objective：To investigate the correlation between MRI phenotypes and various clinical and histopathological characteristics in patients with early - stage cervical cancer（CC）. Methods：The MRI radiomics features，along with clinical and histopathological characteristics of 164 patients with CC were collected retrospectively from July 2019 to December 2023. Tumors and pelvic lymph nodes of all patients were divided into two clusters using raidomics-based consensus clustering. Differences in clinical and histopathological characteristics between the two groups were compared. Results：Tumor - based clustering analysis showed no significant differences between the two groups in terms of average age，histological type，tumor differentiation，lymphovascular space invasion，or parametrial invasion. Clustering analysis based on tumors showed that compared with the cluster 1，patients in the cluster 2 had a more advanced postoperative International Federation of Gynecology and Obstetrics（FIGO）stage[ⅡA and above：22/72（30.6%） vs. 56/92（60.9%），P=0.001]，a higher probability of lymph node metastasis[9/72（12.5%）vs. 30/92（32.6%），P=0.002]，larger tumor size[short diameter：（16.67 ± 6.32）mm vs.（28.38 ± 9.73）mm，long diameter：（21.02 ± 7.39）mm vs.（34.34 ± 9.72）mm，height：（18.93 ± 8.01）mm vs.（29.92 ± 10.61）mm，all P ＜ 0.001]，and deeper stromal invasion[＞2/3：26/72（36.1%）vs. 62/92（67.4%），P ＜ 0.001]. Clustering analysis based on lymph nodes showed that no significant differences between the two clusters in short axis，long axis，short - to - long axis ratio，signal，border，or lymph node metastasis. Conclusion：Associations between radiomics features and clinical and histopathological characteristics of patients with CC could be identified by consensus clustering based on multiparametric MRI-based radiomics，suggesting possibilities for preoperative risk stratification.

Abstract:Objective：To investigate the correlation between angiotensin[including angiotensin（Ang）Ⅰ，Ang Ⅱ and Ang 1-7]with its converting enzyme[including angiotensin converting enzyme（ACE）and ACE2]and cognitive and motor impairments in Parkinson’s disease（PD）. Methods：Two hurdred patients diagnosed with PD at Jiangyin People’s Hospital between september 1，2023 and June 1， 2024 were included. We evaluated cognitive and motor functions of patients by collecting medical history，assessed cognitive function by using Montreal cognitive assessment（MoCA），mini - mental state examination（MMSE）and other scales，and assessed motor symptoms by using the International Movement Disorders Association Parkinson’s Disease Score scale. Serum samples were collected. ACE，ACE2，AngⅠ，AngⅡ，Ang1 - 7 and other indicators were detected by enzyme linked immunosorbent assay method，and PD cognitive and motor disorders were predicted by a random forest model. Results：The predictive model of PD cognitive impairment was constructed based on ACE，AngⅠ，AngⅡ，Ang1-7 and age，and the accuracy of the validation set was 0.847，the area under receiver operating characteristic curve（AUC）was 0.909. Based on the ACE，AngⅠ and Ang1-7，the prediction model of PD dyskinesia was built，and the AUC value of validation set was 0.618. Patients with early versus late dyskinesia showed statistically significant differences in ACE，AngⅠ，AngⅡ，and Ang1-7 levels regardless of the presence or absence of cognitive impairment. Conclusion：The differences of ACE and Ang Ⅰlevels in PD cognitive and motor disorders suggest that those indicators may play key roles in the progression of PD disease. The random forest model performed well in predicting PD cognitive impairment and was helpful in early identification of PD patients with cognitive dysfunction.

Abstract:Objective：To investigate the imaging features of limited intimal tear（LIT）of ascending aorta in patients with acute aortic syndrome（AAS），and compare the imaging differences between LIT and other types of AAS. Methods：CT angiography（CTA） data of 212 patients with AAS and 212 normal controls were retrospectively enrolled. There were 120 cases of aortic dissection（AD）， 52 cases of intramural hematoma（IMH）and 40 cases of LIT. The imaging parameters included maximal diameter，minimal diameter and area of the ascending aorta at the lesion，adjacent normal ascending aorta and descending aorta at corresponding level respectively. Aortic remodeling index was calculated as maximal diameter/minimal diameter. Results：The maximal diameter of involved ascending aorta in LIT group were larger than those in AD group and IMH group（P ＜ 0.05），the remodeling index was also higher than that in the AD group and IMH group（P ＜ 0.05）. Binary logistic regression analysis suggested that the maximal diameter of ascending aorta was an independent predictor of LIT occurrence（OR：1.533，P ＜ 0.001）. Conclusion：The imaging parameters of LIT are different from those of other types of AAS lesions. When the maximal diameter of the ascending aorta was greater than 40.5 mm in patients with suspected AAS，LIT should be considered clinically.

Abstract:Objective：To establish a microbiological qualitative detection method for three antibiotics（chloramphenicol，ofloxacin， and cefixime）in cosmetics. Method：A cosmetic standard solution containing antibiotics was prepared to simulate the background matrix of actual cosmetic samples. Modified Letheen broth（MLEB）was used to neutralize preservatives in the samples. The volume ratio of the sample，MLEB and bacterial solution（concentration was approximately 1×10¹¹ cfu/mL）was 1∶9∶2. After cultured at 37 ℃ for 45 and 90 minutes，the bacterial recovery rate was analyzed and compared with the standard recovery rate in order to make qualitative judgments. Results：The detection limit of this method for chloramphenicol，ofloxacin and cefixime were 5 μg/g，1 μg/g，and 1 μg/g，respectively. Conclusion：This method is convenient，cheap，accurate，and suitble for the rapid detection of 3 common antibiotics in cosmetics.

Abstract:Objective：The aim of this study was using multimodality echocardiographic parameters to evaluate early changes in systolic and diastolic functions of left ventricle in patients with hypertrophic cardiomyopathy（HCM）. Methods：A total of 54 HCM patients were selected，including 34 with non - obstructive HCM patients and 20 with obstructive HCM patients，who visited the outpatient department of the First Affiliated Hospital of Nanjing Medical University from October 2019 to June 2021. Additionally，30 healthy individuals were chosen as a control group. Multimodality echocardiographic parameters were used to compare the changes in left ventricular systolic and diastolic functions among three groups. Results：HCM patients exhibited reduced left ventricular systolic and diastolic function. Obstructive HCM patients showed more significant reduction in global longitudinal strain（GLS），global work index（GWI），global constructive work（GCW），and global work efficiency（GWE）. The difference in global waste work（GWW）among the three groups was not statistically significant. Conclusion：Multimodality echocardiographic parameters can comprehensively evaluate the early impairment of left ventricular systolic and diastolic functions in HCM patients，providing important basis for clinical diagnosis，treatment，and prognosis as early as possible.

Abstract:Objective：To investigate the expression of structural maintenance of chromosome 1A（SMC1A）in breast cancer，analyze its correlation with clinical pathologic features，and explore its influence on apoptosis of breast cancer cells. Methods：The study first analyzed the expression differences of SMC1A mRNA in breast cancer and healthy breast tissues and their prognostic significance using The Cancer Genome Atlas（TCGA）database. It then involved collecting tumor and adjacent non-tumor tissue samples from 48 breast cancer patients who underwent surgical resection at the First Affiliated Hospital of Nanjing Medical University from January to December 2023. Real -time quantitative polymerase chain reaction（RT - qPCR）and immunohistochemistry（IHC）were performed to analyze SMC1A expression and evaluate its correlation with clinical pathologic traits. Additionally，by downregulating SMC1A expression in the MCF - 7 breast cancer cell line，apoptosis - related protein changes were recorded. Results：Analysis of TCGA transcriptomic sequencing data revealed that SMC1A mRNA expression was significantly higher in breast cancer tissues compared to normal breast tissues，and was closely orrelated with poorer cancer prognosis. Clinical sample validation confirmed that SMC1A expression levels were significantly elevated in breast cancer tissues compared to adjacent tissues and were correlated with TNM stage， lymph node metastasis，and pathological differentiation. Downregulation of SMC1A via siRNA1 in MCF - 7 cells notably increased Cleaved - caspase - 3，Cleaved - caspase - 9，and Bax levels，while decreased Bcl2 levels. Conclusion：SMC1A is highly expressed in breast cancer tissues，correlating with disease progression and pathological differentiation. Early mechanistic investigations indicate that reducing SMC1A expression may promote apoptosis in breast cancer cells，suggesting its regulatory role could be critical in mitigating breast cancer progression.

Abstract:Papillary thyroid carcinoma is the most common histological type of malignant thyroid tumor. The central cervical lymph nodes，particularly Delphian lymph nodes，are the first areas affected by metastasis in papillary thyroid carcinoma. Early diagnosis of Delphian lymph node metastasis is crucial for determining the treatment approach and improving survival prognosis of patients. Ultrasound is the preferred method for diagnosing lymph node metastasis in papillary thyroid carcinoma. This review focuses on the research progress and applications of high - frequency ultrasound and its advanced technologies in detecting Delphian lymph node metastasis in papillary thyroid carcinoma.

Abstract:Chronic kidney disease（CKD）is a common chronic disease，which is characterized by structural defects and dysfunction in the kidney. The incidence of cognitive dysfunction in CKD patients is significantly higher than that in the general population. Cognitive dysfunction seriously affects the quality of life and therapeutic treatment of CKD patients. In recent years，significant progress has been made in research on the mechanisms and treatments of cognitive impairment induced by CKD. The risk factors of CKD induced cognitive dysfunction include vascular damage，uremic toxins，metabolic acidosis，hemodialysis，and these factors are interwoven with complex mechanisms of renal -brain crosstalk. The current treatments for CKD induced cognitive dysfunction mainly rely on drug therapy，combined with other non-drug therapeutic approaches，such as cognitive rehabilitation training and non-invasive brain electrophysiological stimulation，aiming to achieve optimal therapeutic effects. This review focused on the research progress of the mechanisms and treatments of cognitive impairment induced by CKD，providing a basis for the early identification，prevention，and treatment of cognitive dysfunction. In the future，studies will continue to explore the pathogenesis of CKD induced cognitive impairment，aiming to provide more effective treatment strategies for clinical practice and improve the quality of life and prognosis of patients.

Abstract:Cesarean scar diverticulum（CSD）is one of the long-term complications of cesarean section，which can cause symptoms such as abnormal menstrual patterns and chronic pelvic pain，significantly affecting the quality of life of patients. Currently，there is no unified standard of diagnosis and treatment for CSD. Surgical treatment was considered to be the primary option for patients with fertility requirements，but the specific selection criteria of surgical procedures and the impact of different surgical procedures on subsequent fertility remain controversial. Here，we summarize recent research fingdings on CSD from scholars around the world over the past 5 years，reviewing the factors contributing to the CSD formation，diagnostic methods，treatment options，and their effects on the future fertility，in order to provide a references for optimizing clinical strategies.

Abstract:Heart failure is a detrimental consequence of various cardiac diseases，and one of its pathological bases is the structural and functional changes caused by progressive interstitial fibrosis. Fibroblasts mediate and activate fibrosis to generate extracellular matrix，and excessive activation leads to the accumulation of matrix proteins，ultimately resulting in pathological fibrosis and organ damage. Thyroid hormone plays a crucial role in regulating the cardiovascular system，while subclinical and overt thyroid disorders impact cardiac fibrosis through a series of pathological mechanisms. Thyroid hormone replacement therapy is also considered for safeguarding cardiac function. This review is to provide an overview of current research on thyroid hormones and cardiac fibrosis.

Abstract:Gastric cancer is closely related to the reprogramming of the tumor microenvironment，but the complexity and heterogeneity of the tumor microenvironment presents a significant challenge to the development of individualized and precise diagnose and treatment strategies for gastric cancer. Focusing on the reprogramming process of tumor microenvironment，single-cell sequencing technology can depict the“landscape”of the gastric cancer tumor microenvironment at the single - cell level，explore the interactions between cell subtypes and their components，reveal the novel immune mechanisms by which the tumor microenvironment regulates the progression and metastasis of gastric cancer，explore the molecular mechanism of chemo-resistance in the tumor microenvironment of gastric cancer，identify the potential immunotherapy targets for gastric cancer within the tumor microenvironment，and provide a new prediction method for the prognosis of gastric cancer. The technology will provide more comprehensive and precise evidence for the study of origin，pathogenesis，progression，and immune tolerance in gastric cancer. The following paper reviews the application of single-cell RNA sequencing technology in the reprogramming of the tumor microenvironment in gastric cancer and attempts to provide new ideas for the precise diagnosis and treatment of gastric cancer.

Abstract: