To summarize Notch, basic hel ix-loop-hel ix (bHLH) and Wnt gene signal transduction pathways in the process of differentiation and development of neural stem cells. Methods The l iterature on the gene signal transduction pathway in the process of differentiation and development of neural stem cells was searched and then summarized and analyzed. Results The formation of Nervous System resulted from common actions of multi-signal transduction pathways. There may exist a fixed threshold in the compl icated selective system among Notch, bHLH and Wnt gene signal transduction pathways. Conclusion At present, the specific gene signal transduction pathway of multi pl ication and differentiation of neural stem cells is still unclear.
Objective To analyze the distribution differences of lipid-related metabolic indicators between interstitial lung abnormality (ILA) and non-ILA, as well as between ILA subtypes, and to evaluate their associations with ILA and subpleural fibrotic ILA subtype which carries a high risk of progression. Methods A cross-sectional study was conducted based on a health screening cohort from West China Hospital of Sichuan University and four physical examination centers between January 2013 and January 2023. Propensity score matching was employed to balance baseline characteristics between ILA and non-ILA populations. Multivariate logistic regression, restricted cubic spline, and stratified interaction analyses were performed to assess the associations of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TG/HDL-C ratio, and the triglyceride-glucose (TyG) index with ILA and subpleural fibrotic ILA. Results Compared with the non-ILA group (n=6690), the ILA group (n=6690) exhibited higher levels of TG, LDL-C, TG/HDL-C ratio, and TyG index (P<0.05), and lower levels of TC and HDL-C (P<0.05). Compared with the non-fibrotic ILA group (n=5603), the fibrotic ILA group (n=1087) had lower levels of TG, TC, LDL-C, TG/HDL-C ratio, and TyG index (P<0.05). Elevated levels of TG [odds ratio (OR)=1.050, 95% confidence interval (CI) (1.023, 1.078), P<0.001], LDL-C [OR=1.067, 95%CI (1.021, 1.115), P=0.004], TG/HDL-C [OR=1.047, 95%CI (1.025, 1.069), P<0.001], and TyG [OR=1.106, 95%CI (1.039, 1.176), P=0.002] were independently associated with an increased odds of ILA, whereas higher TC [OR=0.954, 95%CI (0.919, 0.990), P=0.015] and HDL-C [OR=0.491, 95%CI (0.438, 0.549), P<0.001] were independent related to lower odds of ILA. Elevated HDL-C [OR=0.731, 95%CI (0.584, 0.909), P=0.005] showed an independent linear correlation with reduced odds of fibrotic ILA. Stratified analysis indicated that age (P-interaction=0.002) exerted a modulatory effect on HDL-C and fibrotic ILA. A risk prediction model of fibrotic ILA constructed using 8 indicators including age, HDL-C, and albumin yielded an area under the curve of 0.659 [95%CI (0.642, 0.677)]. Conclusions blood lipid profile and metabolic index exhibited heterogeneous distribution patterns across different subtypes of ILA. While elevated TG, LDL-C, TG/HDL-C, and TyG index, along with decreased TC and HDL-C, are independently associated with an increased risk of ILA, only HDL-C maintained a linear independent correlation with a reduced risk of fibrotic ILA. The predictive model integrating HDL-C, age and other indicators demonstrated moderate value for identifying fibrotic ILA. These findings highlighted the complex interplay between lipid metabolism and ILA and provide hematological evidence for the early identification of high-risk ILA subtypes.
Objective To explore the clinical diagnostic value of transbronchial cryobiopsy (TBCB) for lung diseases. Methods All patients who underwent TBCB in the bronchoscopy room of West China Hospital, Sichuan University from November 5, 2020 to August 7, 2024 were consecutively included. Clinical information of the patients was collected, and the distribution of pathological diagnosis, clinical diagnosis, and the consistency between the two were statistically analyzed. The distribution of diagnosis and the consistency with pathological diagnosis of interstitial lung disease (ILD) were analyzed. The distribution of diagnosis of patients who underwent more than two lung biopsies was summarized. Results A total of 351 TBCB patients were included. The concordance rate between the overall pathological diagnosis and the clinical diagnosis was 68.66%. Among 351 patients who underwent TBCB, 199 cases were diagnosed as ILD by pathological diagnosis, and the consistency rate with the clinical diagnosis was 90.45%. 22 cases were pathologically suggested or suspected of tumor by pathology, and the final consistency rate with clinical diagnosis was 95.45%. Descriptive pathological conclusions were found in 74 cases. The clinical diagnosis of ILD was 255 cases, and the diagnostic rate of TBCB was 71.76%. 83 cases of immune-related ILD (diagnostic rate 83.13%); 75 cases of idiopathic interstitial pneumonia (diagnostic rate 44.00%). There were 59 cases of ILD with cysts and/or air spaces (diagnostic rate 83.05%). 33 cases of exposion-associated ILD (diagnostic rate 81.82%); 5 cases of pulmonary sarcoidosis (diagnostic rate 100.00%). Among them, 28 patients underwent lung biopsy more than twice, and the disease distribution was mainly ILD. ConclusionTBCB has significant value in the auxiliary clinical diagnosis of lung diseases, especially interstitial lung diseases, with the greatest advantages in the auxiliary diagnosis of pulmonary alveolar proteinosis, tumors, and idiopathicinterstitial pneumonia.
