ObjectiveThe aim of this meta-analysis and systematic review is to assess the effectiveness of microRNAs as a diagnostic tool for individuals with epilepsy. MethodsA systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science databases was performed to collect literature on miRNA diagnosis of epilepsy up to January 1, 2024. Two researchers independently screened and extracted the literature and resolved discrepancies by negotiation. The QUADAS-2 evaluation tool was used to assess the quality of the included studies. Statistical analysis was performed using Review Manager 5.4, Meta-Disc 1.4, and Stata 17.0. Results A total of 17 papers were included, including 942 patients with epilepsy and 932 healthy controls. miRNA in the diagnosis of epilepsy had a combined sensitivity of 0.76 [95%CI (0.71, 0.79)], combined specificity of 0.78 [95%CI (0.74, 0.82)], and area under the SROC curve of 0.84 [95%CI (0.80, 0.87)]. Subgroup analysis showed that miRNA had higher diagnostic value for temporal lobe epilepsy, especially medial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). ConclusionThe study suggests that miRNA may be a promising tool for the diagnosis of epilepsy, especially temporal lobe epilepsy, but more high-quality studies are needed to support it.
ObjectiveTo investigate the role of myeloid-derived suppressor cell (MDSC) in bleomycin (BLM)-induced pulmonary fibrosis and the possible mechanism of bone marrow mesenchymal stem cell (MSC) in therapy of BLM-induced pulmonary fibrosis.MethodsBone marrow mesenchymal stem cells (MSC) were harvested from 6-week old male BALB/c mice. One hundred and four female BALB/c mice were randomly divided into 3 groups. Mice in control (n=32) and BLM group were instilled with normal saline (NS) or BLM via trachea and NS were injected via tail vein on the 1st, 2nd and 3rd day after NS administration. Mice in MSC group (n=40) were instilled with BLM via trachea and MSC (total cell number=1.5×106) were injected via tail vein. On the 1st, 3rd, 5th, 8th, 11th, 14th, 18th, 21st, 25th and 32nd day after BLM administration, the percentage of Gr-1+CD11b+ cells in peripheral blood mononuclear cell (PBMC) was detected by flow cytometry. Eight mice from each group were killed on the 3rd, 8th, 18th and 32nd day after BLM administration, the percentage of Gr-1+CD11b+ cells in the lung tissue was detected by flow cytometry. Meanwhile, the lung tissue specimens were stained with Masson. The sry gene of Y chromosome was detected by polymerase chain reaction (PCR).ResultsCompared with BLM group, MSC transplantation significantly reduced pulmonary inflammation in MSC group [(1.32±0.25) vs. (2.53±0.56); and (1.06±0.42) vs. (2.27±0.82), respectively, P<0.01)]. Likewise, MSC transplantation significantly reduced pulmonary fibrosis and deposition of collagen as compared with BLM group [(1.02±0.44) vs. (1.81±0.74), and (1.51±0.73) vs. (2.72±0.54), respectively, P<0.05)]. The percentage of Gr-1+CD11b+ cells in the BLM group was significantly increased as compared with control group. Compared with BLM group, MSC transplantation significantly reduced Gr-1+CD11b+ cells in MSC group (P<0.05). The sry gene (201 bp) was detected in the lungs of female mice within 96 hours after MSC administration.ConclusionsMDSC participates in the procedure of BLM-induced pulmonary fibrosis. Syngeneic MSC inhibits the generation of MDSC and further suppresses BLM-induced pulmonary fibrosis.
ObjectiveTo evaluate the quality differences in recommendations generated by large language models (LLMs) and clinical practitioners for sarcopenia-related questions. MethodsA sarcopenia knowledge base was constructed based on the latest domestic and international research and consensus guidelines. Using the Python environment, a locally deployed and sarcopenia-focused hybrid vertical LLM (referred to as LC) was implemented via LangChain-LLM. Eight fixed questions covering etiology, diagnosis, and prevention were selected, along with eight virtual patient cases. The evaluation team assessed the quality of answers generated by LC and written by clinical practitioners. Quantitative analysis was performed on the precision, recall, and F1 scores (harmonic mean of precision and recall) of treatment recommendations. ResultsThe responses were generally perceived as "possibly written by humans or AI", with a stronger inclination toward being AI-generated, although the accuracy of such judgments was low. Regarding answer quality attributes, LC's responses were superior to those of clinical practitioners in guideline consistency (P<0.01), exhibited similar acceptability (P>0.05), showed better practicality (P<0.05), and had a lower proportion of "1–2 errors" (P<0.05). Quantitative analysis of treatment recommendations indicated that LC and GPT-4.0 outperformed clinical practitioners in recall and F1 scores (P<0.05), with minimal differences between LC and GPT-4.0. ConclusionThe locally deployed sarcopenia-focused hybrid vertical LLM demonstrates high accuracy and applicability in addressing sarcopenia-related issues, outperforming clinical practitioners and exhibiting strong clinical decision-support capabilities.
