Nucleotide metabolism (NM) is a fundamental process that enables the rapid growth of tumors. Glioblastoma (GBM) primarily relies on NM for its invasion, leading to severe clinical outcomes. This study focuses on NM to identify potential biomarkers associated with GBM. Publicly available databases were used as the primary data source for this study, excluding biological tissue samples. We identified and evaluated key genes involved in NM, followed by developing and validating a prognostic model. Patients were classified into high- and low-risk groups based on this model, and the two groups were compared with respect to cellular immunity and mutation profiles. The biomarkers were confirmed using real-time reverse-transcriptase polymerase chain reaction. Our study identified UPP1, CDA, NUDT1, and ADSL as significant biomarkers associated with prognosis, all of which were upregulated in patients with GBM. The risk score and clinical factors such as age, sex, GBM stage, MGMT promoter status, and IDH mutation status were found to be independent prognostic factors. Patients with glioblastoma showed a higher overall mutation burden. Using bioinformatics, this study identifies key factors associated with NM in GBM that may influence patient prognosis. This study enhances our understanding of GBM, provides valuable insights for further research, and serves as a reference for evaluating patient outcomes.

Abstract Background: Glioblastoma (GBM) is one of the deadliest of all cancers. And nucleotide metabolism (NM) is the most critical link in malignant tumor cell replication. Therefore, we mined NM-related biomarkers to provide new direction for GBM treatment. Methods: In TCGA-GBM, differences of gene expression between tumor and normal samples were compared to obtain DEGs. And differentially expressed NM-related genes (DE-NMRGs) were screened by intersecting DEGs and NMRGs. Then, biomarkers were screened by Cox regression analysis and proportional hazards (PH) assumption to construct the prognostic model, and the prognostic model was validated by plotting ROC, survival analysis and PCA. Next, to assess the ability of the prognostic model to serve as independent prognostic factor, independent prognostic analyses were performed across numerous clinical characteristics. Finally, the regulatory mechanism of GBM by biomarkers was further explored by single-gene GSEA, immune-related analysis, gene mutation analysis and protein expression validation. Results: The NUDT1, CDA, UPP1 and ADSL were treated as the biomarkers to construct prognostic model, which indicated that the above biomarkers had good prognostic impact on GBM. The IDH mutation status, MGMT promoter status and riskScore were screened as independent prognostic factors. In TCGA-GBM samples, the expression of four biomarkers was significantly higher in GBM. Immune-related analysis showed that the cell abundance of activated memory CD4+ T cell, activated NK cell, M1 macrophage and neutrophil were significantly different between high- /low-risk groups. Tumor mutation load analysis revealed that the overall tumor mutation load was higher in the high-risk group. Conclusion: The four biomarkers were obtained by bioinformatic analysis to construct new prognostic assessment model, providing theoretical reference value to guide the treatment of GBM.

目的 测定动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CV)患者与脑血管未痉挛患者脑脊液中miRNA-3177-3p的表达情况,探讨其与CV的发病关系及临床意义.方法 将29例aSAH患者分成脑血管痉挛组(CV组)与脑血管未痉挛组(non-CV组).比较两组患者的一般临床资料;通过生物信息数据分析确定miRNA-3177-3p作为研究对象,测定两组患者脑脊液中miRNA-3177-3p实际表达情况并比较差异;预测miRNA-3177-3p下游靶基因ATP1B3,构建ATP1B3质粒,双萤光素酶报告实验验证miRNA-3177-3p与ATP1B3靶向关系;最后,ELISA法测定两组患者脑脊液中ATP1B3转录产物ATP1β3含量并比较差异.结果 CV组患者Hunt评级高于non-CV组(P＜0.05);CV组脑脊液中miRNA-3177-3p表达丰度为(0.873±0.044),与non-CV组(0.908±0.034)比较,差异有统计学意义(t=2.157,P=0.040);双萤光素酶报告实验结果显示,与miRNA-3177-3p作用后,ATP1B3-3'UTR区相较对照组活性降低15％(P＜0.05);将ATP1B3-3'UTR区进行突变,ATP1B3-3'UTR区相较突变前活性上升14％(P＜0.05);ELISA 法证实表达产物 ATP1β3 在 CV 组脑脊液中(1.776±0.013)ng/mL 高于 non-CV 组(1.722±0.016)ng/mL(t=7.778,P=0.000).结论 CV患者脑脊液中miRNA-3177-3p表达下调,ATP1B3高表达可能参与了 CV的发病过程,该机制可能在预测与治疗CV上具有一定临床意义.

BackgroundGeometrical factors associated with the surrounding vasculature can affect the risk of aneurysm formation. The aim of this study was to determine the association between carotid siphon curvature and the formation and development of paraclinoid aneurysms of the internal carotid artery.MethodsDigital subtraction angiography (DSA) data from 42 patients with paraclinoid aneurysms (31 with non-aneurysmal contralateral sides) and 42 age- and gender-matched healthy controls were analyzed, retrospectively. Morphological characteristics of the carotid siphon [the posterior angle (α), anterior angle (β), and Clinoid@Ophthalmic angle (γ)] were explored via three-dimensional rotational angiography (3D RA) multiplanar reconstruction. The association between carotid siphon morphology and the formation of paraclinoid aneurysms was assessed through univariate analysis. After this, logistic regression analysis was performed to identify independent risk factors for aneurysms.ResultsSignificantly smaller α, β, and γ angles were reported in the aneurysmal carotid siphon group when compared with the non-aneurysmal contralateral healthy controls. The β angle was best for discriminating between aneurysmal and non-aneurysmal carotid siphons, with an optimal threshold of 18.25°. By adjusting for hypertension, smoking habit, hyperlipidemia, and diabetes mellitus, logistic regression analysis demonstrated an independent association between the carotid siphons angles α [odds ratio (OR) 0.953; P < 0.05], β (OR 0.690; P < 0.001), and γ (OR 0.958; P < 0.01) with the risk of paraclinoid aneurysms.ConclusionsThe present findings provide evidence for the importance of morphological carotid siphon variations and the likelihood of paraclinoid aneurysms. These practical morphological parameters specific to paraclinoid aneurysms are easy to assess and may aid in risk assessment in these patients.

目的:调查分析医护在线医学教育现状,为医学继续教育模式探讨对策建议.方法:采用定性定量结合的问卷调查法随机对医护进行问卷调查.问卷主要由三部分14个问题组成,采用单选、多选及梯度评价等多种方式.结果:137名医护完成了有效调查问卷;疫情导致在线教育所占比例较传统线下教育明显增加(P<0.01);最常选用的直播软件平台主要是zoom(59.12％)、腾讯会议(15.33％)、skype(7.30％)等;在线上课程评价中,对教师质量和教学内容的满意度比较高,参与度表现的最差.结论:COVID-19的流行导致在线教育所占比例明显提升,弥补了线下教育的缺失,但在线教学存在不足.因此,在线医学继续教育需要进一步改进.

AbstractIntroductionThe neural mechanism underlying decision‐making, which is an important component of executive function, is complex and not fully understood. Few studies have directly investigated the two types of decision‐making functions – under ambiguity and under risk – in patients with brain tumors in different brain regions.MethodsParticipants were classified into the ventral prefrontal cortex tumor group (VPFC, n = 27), the dorsolateral prefrontal cortex tumor group (DLPFC, n = 29), and matched healthy controls (HCs, n = 32). All participants were given a battery of neuropsychological tests, and they then performed the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT) to assess their decision‐making under ambiguity and under risk, respectively.ResultsThe two patient groups performed significantly worse on attention, memory, information processing, and executive function. Additionally, patients in the DLPFC group performed significantly worse on the memory and information processing tests compared with the VPFC and HC groups.ConclusionThis study found that the decision‐making functions of participants in the VPFC and DLPFC tumor groups were impaired to varying degrees. Among them, there was decision‐making impairment under ambiguity and under risk in the VPFC group, and there was decision‐making impairment under risk in the DLPFC group.

Objective To investigate the difference of the decision-making ability in prefrontal lobe tumor patients. Methods With the Iowa gambling task ( IGT) and game of dice task( GDT) , the experiment compared 38 cases of dorsolateral frontal lobe tumor patients ( tumor group) with 30 cases of healthy controls ( healthy control group) to investigate the decision-making ability. Results The tumor group had no statistically significant difference with the healthy controls in IGT’s five block projects. In the GDT task,the frequency of the number “2” project and the safety option was high, while the frequency of the number“3” project and the risky option was low. The difference was statistically significant. Conclusion Experiments showed that the decision-making of the prefrontal lobe tumor patients was significantly impaired , and the separation existed in the decision cognitive processing.

Objective To explore the clinical efficacy and influencing factors of surgical clipping and endovascular embolization in the treatment of posterior communicating artery aneurysm induced oculomotor nerve palsy ( ONP) .Methods The clinical and follow-up data of communicating artery aneurysm induced oculomotor nerve palsy in 48 patients from July 2010 to July 2013 were analyzed retrospectively. Among the 48 patients, 13 patients were treated with surgical clipping and 35 patients with endovascular embolization.The different treatment modalities that might affect ONP prognostic factors were compared, including the age, whether having preoperative subarachnoid hemorrhage ( SAH) , size of aneurysm, seriousness of oculomotor nerve palsy and therapeutic duration.Results Of the 48 patients with PcomAA, 41 (85.4%) patients with ONP recovered completely and 7 (14.6%) recovered partially.Of the 35 patients treated with endovascular emboli-zation, 31 patients with ONP recovered completely and 4 patients recovered partially.Of the 13 patients in the surgical clipping group, 10 pa-tients with ONP recovered completely and 3 patients recovered partially.Compared to the patients with unruptured intracranial aneurysm, with preoperative complete ONP or accepted treatment after 14 days since the onset of symptoms, the symptoms of oculomotor nerve palsy recov-ered significantly in the patients accompanying subarachnoid hemorrhage( SAH) , with preoperative partial ONP or accepted treatment in 14 days since the onset of symptoms( P<0.05) .Conclusion There is no significant difference in the clinical efficacy between surgical clip-ping and endovascular embolization as treatment for posterior communicating artery aneurysm patients with ONP.