Human myostatin negatively regulates human myoblast growth and differentiation.

Myostatin, a member of the transforming growth factor-ß superfamily, has been implicated in the potent negative regulation of myogenesis in murine models. However, little is known about the mechanism(s) through which human myostatin negatively regulates human skeletal muscle growth. Using human primary myoblasts and recombinant human myostatin protein, we show here that myostatin blocks human myoblast proliferation by regulating cell cycle progression through targeted upregulation of p21. We further show that myostatin regulates myogenic differentiation through the inhibition of key myogenic regulatory factors including MyoD, via canonical Smad signaling. In addition, we have for the first time demonstrated the capability of myostatin to regulate the Notch signaling pathway during inhibition of human myoblast differentiation. Treatment with myostatin results in the upregulation of Hes1, Hes5, and Hey1 expression during differentiation; moreover, when we interfere with Notch signaling, through treatment with the γ-secretase inhibitor L-685,458, we find enhanced myotube formation despite the presence of excess myostatin. Therefore, blockade of the Notch pathway relieves myostatin repression of differentiation, and myostatin upregulates Notch downstream target genes. Immunoprecipitation studies demonstrate that myostatin treatment of myoblasts results in enhanced association of Notch1-intracellular domain with Smad3, providing an additional mechanism through which myostatin targets and represses the activity of the myogenic regulatory factor MyoD. On the basis of these results, we suggest that myostatin function and mechanism of action are very well conserved between species, and that myostatin regulation of postnatal myogenesis involves interactions with numerous downstream signaling mediators, including the Notch pathway.

Comparison of whole-body 18F-FDG SPECT and posttherapeutic 131I scintigraphy in the detection of metastatic thyroid cancer.

PURPOSE: The usefulness of fluorine 18 fluorodeoxyglucose ((18)F-FDG) imaging in differentiated thyroid cancer (DTC) has been demonstrated by investigators. The aim of this study is to compare the ability of fluorodeoxyglucose (FDG)-single photon emission computed tomography (SPECT) to detect metastatic DTC with posttherapeutic iodine131 ((131)I) scintigraphy. METHODS: 239 patients (78 men, 161 women; age range, 23-76 years, mean 45 years); All patients underwent FDG-SPECT and (131)I whole-body scan. RESULTS: The sensitivity of (18)F-FDG and (131)I imaging in the patients with high hTg levels is 48.7% (114/234) and 50.4% (118/234) respectively. However, the combined sensitivity of both protocols is 89.7% (210/234). In the patients with (131)I Imaging negative, the sensitivity of (18)F-FDG is 79.3%,but in the patients with (131)I imaging positive, the sensitivity of (18)F-FDG is only 18.6%. CONCLUSION: This study with (131)I and (18)F-FDG in FDG-SPECT further demonstrates the single study of (131)I whole body scan or (18)F-FDG imaging can not provide a high enough sensitivity for the detection of metastatic thyroid cancer. But, the combined protocols can get better results for the staging of thyroid carcinoma with the alternating uptake of (131)I and (18)F-FDG.

Assessing Abdominal Aortic Aneurysm Progression by Using Perivascular Adipose Tissue Attenuation on Computed Tomography Angiography

Objective@#Recent studies have highlighted the active and potential role of perivascular adipose tissue (PVAT) in atherosclerosis and aneurysm progression, respectively. This study explored the link between PVAT attenuation and abdominal aortic aneurysm (AAA) progression using computed tomography angiography (CTA). @*Materials and Methods@#This multicenter retrospective study analyzed patients with AAA who underwent CTA at baseline and follow-up between March 2015 and July 2022. The following parameters were obtained: maximum diameter and total volume of the AAA, presence or absence of intraluminal thrombus (ILT), maximum diameter and volume of the ILT, and PVAT attenuation of the aortic aneurysm at baseline CTA. PVAT attenuation was divided into high (> -73.4 Hounsfield units [HU]) and low (≤ -73.4 HU). Patients who had or did not have AAA progression during the follow-up, defined as an increase in the aneurysm volume > 10 mL from baseline, were identified. Kaplan–Meier and multivariable Cox regression analyses were used to investigate the association between PVAT attenuation and AAA progression. @*Results@#Our study included 167 participants (148 males; median age: 70.0 years; interquartile range: 63.0–76.0 years), of which 145 (86.8%) were diagnosed with AAA accompanied by ILT. Over a median period of 11.3 months (range: 6.0–85.0 months), AAA progression was observed in 67 patients (40.1%). Multivariable Cox regression analysis indicated that high baseline PVAT attenuation (adjusted hazard ratio [aHR] = 2.23; 95% confidence interval [CI], 1.16–4.32; P = 0.017) was independently associated with AAA progression. This association was demonstrated within the patients of AAA with ILT subcohort, where a high baseline PVAT attenuation (aHR = 2.23; 95% CI, 1.08–4.60; P = 0.030) was consistently independently associated with AAA progression. @*Conclusion@#Elevated PVAT attenuation is independently associated with AAA progression, including patients of AAA with ILT, suggesting the potential of PVAT attenuation as a predictive imaging marker for AAA expansion.

Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly / 中华心血管病杂志

Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.

Clinical value of arterial stiffness assessment on risk prediction of vascular stiffness in the octogenarian elderly / 中华心血管病杂志

Objective: This study aimed to analyze clinical factors related to arterial stiffening and establish a risk prediction nomogram of arterial stiffening in the octogenarian(≥80 years). Methods: This study was a retrospective cross-sectional study, which enrolled the octogenarian elderly who underwent physical examination and secondary prevention intervention in the outpatient department of Chinese People's Liberation Army General Hospital from April 2022 to August 2022. Clinical data including demographics, biochemical indicators and medical history were collected. Brachial-ankle pulse wave velocity (baPWV) was detected during the clinical visit. Participants were divided into the control group (baPWV≤1 800 cm/s) and vascular sclerosis group (baPWV>1 800 cm/s). The risk factors of arterial stiffness were analyzed by univariate and logistic regression analysis, and the nomogram model was constructed by R programming language. The predictive effect of the nomogram model was evaluated by the receiver operating characteristic curve (ROC). Results: The median age of the 525 participants was 87.0 (82.0, 92.0) years, 504 (96.0%) were male, 82 in the control group, 443 in the vascular sclerosis group. The baPWV, age, systolic blood pressure, mean arterial pressure and diastolic blood pressure were significantly lower in the control group than those in the vascular sclerosis group (all P<0.05). Logistic regression analysis showed that high-density lipoprotein cholesterol, alanine aminotransferase and amylase were protective factors, and alkaline phosphatase and creatinine were risk factors of arterial stiffening (all P<0.05). The combined nomogram model scores including age, mean arterial pressure and the above five laboratory indicators indicated that mean arterial pressure and serum creatinine levels were strongly correlated with vascular sclerosis. The ROC curve suggested that the nomogram model had good prediction ability. Conclusions: Age, mean arterial pressure, high-density lipoprotein cholesterol, alanine aminotransferase, alkaline phosphatase, amylase and creatinine are independently determinants for increased vascular stiffness. The combined prediction model in this study can provide reference for individualized clinical risk prediction of vascular sclerosis in the octogenarian elderly.

Efficacy and safety of modified four-point fixed IOL suspension implantation in aphakic eyes / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the efficacy and safety of modified four-point fixed intraocular lens suspension implantation in aphakic eyes.METHODS:A prospective study. A total of 32 aphakic patients(32 eyes)with an average age of(44.56±8.48)years who underwent modified four-point fixed intraocular lens suspension implantation in our hospital from October 2020 to May 2021 were selected. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), corneal astigmatism, intraoperative and postoperative complications were observed before and after operation.RESULTS:The mean follow-up of all patients was(4.84±0.64)mo. The preoperative UCVA(LogMAR)was 1.25±0.42 and the last follow-up was 0.5±0.25(P&#x003C;0.001). The preoperative BCVA(LogMAR)was 0.41±0.19 and the last follow-up was 0.42±0.19,(P &#x003E;0.05). The preoperative corneal astigmatism was(1.17±0.64)D and the last follow-up was(1.20±0.59)D(P&#x003E;0.05). There were no intraoperative complications, but 2 eyes had low intraocular pressure, 1 eye had high intraocular pressure and 2 eyes had corneal edema occurred after operation. There were no complications of hyphema, vitreous hemorrhage, macular cystoid edema, corneal endothelial decompensation, inclination or eccentricity of intraocular lens and exposure of suture.CONCLUSION:The modified four-point fixed intraocular lens suspension implantation can significantly improve the postoperative visual acuity of aphakic patients without additional corneal astigmatism,and with fewer complications.

Effect of psychological capital and social support on job satisfaction among workers in a natural gas field / 中国职业医学

@#To explore the effects of psychological capital social support and their interaction on job satisfaction in Methods natural gas field workers. A total of 1 473 workers from a natural gas field were selected as the research subjects ， using convenient sampling method. Job Satisfaction Questionnaire Psychological Capital Questionnaire and Social Support ， Results Scale were used to investigate the scores of job satisfaction psychological capital and social support level. The ， ， detection rates of job satisfaction psychological capital and social support in the high level group were 55.9% 52.5% and ， 48.1% respectively. The detection rates of job satisfaction of workers in the high level psychological capital group and high level （ social support group were higher than those in the low level psychological capital group and low level social support group 67.4% vs ， vs ， P ） 43.3% 71.9% 41.2% all <0.01 . The results of multivariate logistic regression analysis showed that psychological capital ［ （CI） （ - ） and social support had positive effects on job satisfaction odds ratio and 95% confidence interval were 1.58 1.17 2.41 （ - ）， ， P ］ ， and 2.53 1.82 3.52 respectively all <0.01 . Moreover the psychological capital and social support had additive effect on ［ CI （ - ）， CI job satisfaction relative excess risk of interaction and 95% was 3.07 1.02 5.12 attributable proportion and 95% was （ - ）， CI （ - ）］， 0.48 0.35 0.61 synergy index and 95% was 2.34 1.72 3.16 but there was no multiplication interaction between （P ）Conclusion psychological capital and social support >0.05 . Psychological capital and social support can positively affect job satisfaction of natural gas workers. There is an additive interaction between psychological capital and social support on job ， satisfaction but no multiplicative interaction is found. Keywords: ； ； ； ； ； Psychological capital Social support Job satisfaction Interaction Natural gas Worker

The value of CT features in predicting the invasion and invasive degree of lung pure ground-glass nodules based on the new classification of lung tumor in 2021 / 中华放射学杂志

Objective:To investigate the value of CT features in predicting the invasion and degree of invasiveness of lung pure ground-glass nodules (pGGN) in the new histological classification in 2021.Methods:A total of 281 patients (304 lesions) with pGGN confirmed by surgical pathology from December 2018 to January 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University were retrospectively analyzed. According to the pathological types, the patients were divided into prodromal lesion group [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS), 129 cases], minimally invasive group [minimally invasive adenocarcinoma (MIA), 116 cases] and invasive group [invasive adenocarcinoma (IAC), 59 cases]. Clinical data (age, gender, smoking history, family history of cancer), and CT parameters [shape, boundary, lobulation, burr, vacuolar sign, bronchial abnormality sign, internal vessel sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT values in venous phase, the degree of enhancement (ΔCT A-N, ΔCT V-N)] were recorded and measured. The ANOVA, Kruskal-Wallis H and χ 2 test were used to compare the differences among the three groups. Binary logistic regression analysis was used to evaluate the independent risk factors of nodular invasion [prodromal lesion and invasive lesion (MIA and IAC)] and the degree of nodular invasion (MIA and IAC), and receiver operating characteristic (ROC) curve analysis was performed for each parameter. Results:There were statistically significant differences in age, pGGN morphology, lobulation, vacuolar sign, bronchial abnormality sign, internal vascular sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT value in venous phase among the precursor lesion group, minimally invasive group and invasive group ( P<0.05). Binary logistic regression analysis showed that vacuole sign (OR=2.832, 95%CI 1.363-5.887, P=0.005), internal vascular sign (OR=3.021, 95%CI 1.909-4.779, P<0.001) and unenhanced CT value (OR=1.003, 95%CI 1.001-1.006, P=0.019) were independent risk factors for invasion. Lobulation (OR=5.739, 95%CI 2.735-12.042, P<0.001), internal vascular sign (OR=1.968, 95%CI 1.128-3.433, P=0.017) and unenhanced CT value (OR=1.004, 95%CI 1.001-1.008, P=0.012) were independent risk factors for the degree of invasiveness. ROC curve analysis showed that the efficiency of internal vascular sign was the highest in distinguishing precursor lesion and the invasive, the area under the curve (AUC) was 0.757, the sensitivity was 50.3%, the specificity was 89.8%. The efficiency of lobulation was the highest in distinguishing MIA and IAC (AUC=0.702), with a sensitivity of 61.0% and specificity of 79.3%. Conclusions:CT features are of certain value in predicting the invasion and degree of invasiveness of lung pGGN in the new histological classification in 2021, and internal vascular sign is more effective in predicting the invasion of lung pGGN. Lobulation can predict the degree of invasiveness of pGGN better.

Correlation study of triglyceride-glucose index and plaque burden and characteristics of vulnerable plaque based on coronary CT angiography plaque quantitative analysis / 中华放射学杂志

Objective:To explore the relationship between triglyceride-glucose (TyG) index with plaque components, plaque burden and characteristics of vulnerable plaque using coronary plaque analysis based on coronary artery computed tomography (CCTA).Methods:A total of 498 patients(male 296, female 202), the age ranged from 33 to 87 (63±9) years who underwent CCTA from January 2020 to September in Shandong Provincial Hospital Affiliated to Shandong First Medical University were included. The enrolled patients were divided into three groups according to the tertiles of TyG index: T 1 group (the lowest one-third), T 2 group (middle one-third) and T 3 group (the highest one-third). The plaque burden, volume and ratio of calcified, lipid and fibrous components of plaques as well as the incidence of vulnerable plaques were measured based on CCTA images. Chi-square test, ANOVA and Kruskal-Wallis test were used to compare whether the differences of indexes among the three groups were statistically significant. Multiple stepwise regression was used to analyze the influencing factors of coronary atherosclerotic plaque burden and multiple logistic regression was used to analyze the risk factors of CT high-risk plaque. Finally, ROC curve was used to evaluate the value of TyG index in the diagnosis of CT high-risk plaque, and the best diagnostic threshold of TyG index was determined. Results:The plaque burden, non-calcified plaque volume and ratio had positive relationship with TyG index ( P<0.001).TyG index was significantly correlated with plaque burden according to multiple stepwise regression analysis (regression coefficient 7.267, P<0.001). The results of CT vulnerable characteristics of plaques showed that positive remodeling, low-attenuation plaque sign and the incidence of vulnerable plaque increased with TyG index ( P<0.05). Multivariate Logistic regression analysis showed that TyG index was an independent risk factor for CT vulnerable plaque(OR=2.324,95 %CI 1.533-3.523, P<0.001). The cut-off value of TyG index that can predict vulnerable plaque was 8.43(sensitivity 77.24%, specificity 45.60%, AUC 0.645, P<0.001). Conclusions:With the increase of TyG index, the burden of coronary atherosclerosis plaque and the incidence of CT vulnerable plaque increased. TyG index is expected to be a simple and effective predictor of cardiovascular disease and adverse cardiovascular events.

Effect of acupuncture on neurological function, cerebral infarction volume, thrombolysis time window and cerebral cell apoptosis signaling pathway in cerebral infarction rats / 针刺研究

OBJECTIVE: To observe the effect of acupuncture (Acupunct) on cerebral infarction volume and expression of poly ADP ribose polymerase 1 (PARP1), apoptosis-inducing factor (AIF) and endonuclease G (Endo-G) in the cerebral cortex tissue at different time-points after cerebral ischemia (CI) in acute cerebral infarction rats, so as to explore its underlying mechanisms in prolonging time window of thrombolysis. METHODS: Forty-eight SD rats were randomly divided into sham operation, model, intravenous thrombolysis (IVT)-4.5 h, IVT-6 h, IVT-9 h, Acupunct＋IVT-4.5 h, Acupunct ＋IVT-6 h, Acupunct＋IVT-9 h groups (n＝6 in each group). The CI model was established by using modified autologous thromboembolism via the right common carotid artery. Two hours after modeling, rats of the Acupunct groups received Acupunct stimulation of "Shuigou" (GV26) and bilateral "Neiguan" (PC6) for 30 min. Thrombolysis was conducted by injection of recombinant human tissue-type plasminogen activator (rt-PA, 10 mg/kg) via caudal vein. The neurological deficit was assessed with reference to Bederson's methods. 2，3，5-triphenyltetrazolium chloride (TTC) staining was used to assess the cerebral infarction volume, and the expression of cerebral PARP1, AIF and Endo-G proteins detected by Western blot. RESULTS: Compared with the sham operation group, the neurological score and percentage of cerebral infarction volume, expression levels of PARP1, AIF and Endo-G proteins were significantly increased in the model group (P0.05). The levels of neurological score, percentage of cerebral infarction volume, and AIF expression were significantly lower in both the Acupunct＋IVT 4.5 h and Acupunct＋IVT-6 h groups than in the simple IVT-4.5 h and simple IVT-6 h groups, respectively (P<0.05), and the expression levels of PARP1 and Endo-G proteins were obviously lower in the Acupunct＋IVT-4.5 h group than in the IVT-4.5 h group (P<0.05). Endo-G proteins were obviously lower in the Acupunct＋IVT-9 h group than in the IVT-9 h group (P<0.05). CONCLUSION: Acupuncture may improve neurological function, reduce cerebral infarction volume and prolong the time window of thrombolysis in CI rats, which may be associated with its effect in suppressing AIF/PARP1/ Endo-G signaling.

Evaluation on the effect of Clinical Medicine PBL Comprehensive Course / 中华医学教育探索杂志

Objective:To evaluate the effect of web-based problem-based learning software on the Clinical Medicine PBL Comprehensive Course. Methods:Thirty-eight students from the pilot class of undergraduate excellent doctors in clinical medicine were selected as the research objects. Based on the test scores of web-based problem-based learning software before the start of the course, the improvement of scores after passing the training of the Clinical Medicine PBL Comprehensive Course were compared, and the students' clinical thinking were quantitatively evaluated. Results:After all students completed the course, their abilities of expression and communication, teamwork and cooperation, problem analysis and clinical reasoning, and knowledge information management of the students increased steadily with the increase in the number of cases, but it was statistically significant after two PBL case trainings ( P<0.05). Learning intentions and attitudes scored the highest in the second PBL case (acute myocardial infarction), with statistical differences ( P<0.05). After training through the PBL course, diagnostic performance, clinical thinking, treatment scores, and overall performance scores of the students were significantly increased than before, with statistical significance ( P<0.05). The scores of case report writing and knowledge acquisition were not obviously improved. Conclusion:The combination of formative evaluation and web-based problem-based learning software can better evaluate the teaching effect and help students to understand their own shortcomings.

Correlation study of coronary plaque quantitative analysis and myocardial ischemic injury based on coronary CT angiography / 中华放射学杂志

Objective@#To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease.@*Methods@#Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury (n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined.@*Results@#For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant (Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm3, LPV 32.18 (18.93,54.55) mm3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm3, 16.64 (13.26, 24.73) mm3, 18.44%±7.09% respectively with statistically significant (Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR=1.55,P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant (P<0.05).@*Conclusions@#In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury.

Correlation study of coronary plaque quantitative analysis and myocardial ischemic injury based on coronary CT angiography / 中华放射学杂志

Objective:To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease.Methods:Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury ( n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined. Results:For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant ( Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm 3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm 3, LPV 32.18 (18.93,54.55) mm 3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm 3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm 3, 16.64 (13.26, 24.73) mm 3, 18.44%±7.09% respectively with statistically significant ( Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR =1.55, P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant ( P<0.05). Conclusions:In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury.

Clinical application of dual-source CT in coronary angiography with contrast medium injection based on automatic tube voltage technique / 中华放射学杂志

Objective:To explore the clinical value of auto-tube voltage controlled contrast medium injection based on 3rd generation dual source CT coronary angiography.Methods:Patients with suspected coronary heart disease were prospectively enrolled from March to December, 2019 at Shandong Provincial Hospital and coronary CT angiography (CCTA) images were acquired from 220 patients, including 107 male, 113 female, aged from 34 to 82 years. Patients were divided into experimental and control groups with the random number table. In experimental group (113 patients), automatic tube voltage selection technology was used, the contrast agent dosage was set according to tube voltage. The injection time was 10 s; In control group (107 patients), tube voltage and contrast agent dosage were set according to weights. The injection time was 12 s. Images were acquired by ECG gating using the 3rd generation dual source CT (DSCT) with intravenous injection of 350 mg/L contrast medium, followed up with saline of the same dose. Interclass correlation coefficient (ICC) was used to evaluate the individual bias of raters. The rank sum test was used to evaluate the group-level differences of subjective image quality and contrast agent dosage. The t-test was used to evaluate the group-level differences of objective image quality and effective radiation dose (ED). Results:The noise of aortic root in the two groups were (27±4), (26±5) HU, respectively, with no statistical difference ( t=1.017, P=0.284). All ICC values were more than 0.5 indicating good correlation batween 2 raters. The objective image quality score was no significant differences( P>0.05). The subjective image quality scores of the two groups were 1.15±0.10 and 1.18±0.12, respectively, with no statistical difference (Z=-0.231, P=0.818). The ED value (2.2±0.6) mSv of experimental group was statistically lower than that of control group (4.6±1.8) mSv ( t=-13.107, P<0.001); the contrast dosage (35±7) ml of experimental group was statistically lower than that of control group（46±6）ml ( t=-8.699, P<0.001). Conclusions:The novel scanning protocol with auto-tube voltage based contrast agent setting is more convenient and practical with reduced radiation dose and contrast dose, while maintaining image quality.

A preliminary study on the dynamic imaging of chest high resolution CT in patients with mild COVID-19 / 中华放射学杂志

Objective:To explore the evolution of imaging findings on dynamic chest high resolution CT（HRCT） in patients with mild COVID-19.Methods:The data of epidemiology, clinical data and continuous dynamic chest high-resolution CT images of the patients with mild COVID-19 were analyzed retrospectively. Twenty-five patients (including 24 common type and 1 mild) were enrolled in the group, including 14 males and 11 females, with age of （42±12） years and hospital stay of （19±5） days. The basic images and dynamic images of HRCT were analyzed and compared by the radiologists.Results:The clinical manifestations were fever (22 cases), cough (18 cases), expectoration (8 cases), pharyngeal pain (6 cases). Most laboratory tests lacked specificity. There were no significant abnormalities on chest CT of one mild patient. HRCT findings of the common type were as follows: (1) the distribution of the lesions: most of the multiple lesions involved both lungs (19 cases), with average of 3 (3±1) lobes, located in the peripheral pulmonary zone near the pleura (22 cases); (2) the morphology and density of the lesions: most of the lesions were ground glass density foci (22 cases), which were patchy and massive (18 cases), nodular (10 cases) and arc broadband (7 cases); with the development of the disease, the density of some lesions increased with localized pulmonary consolidation (10 cases), accompanied by air bronchus sign (5 cases) and halo sign (5 cases). Dynamic changes of HRCT images in the chest: the positive manifestations were found on the 5th (5, 6) day after the onset of the disease, the progressive time of CT lesions was 5 (5, 7) days, the peak time of CT lesions was 11 (10, 13) days, and the turning time of CT lesions was 9 (8, 11) days.Conclusions:Dynamic chest HRCT can monitor the basic evolution process of the disease in patients with mild COVID-19, and provide a more intuitive basis for clinical early diagnosis and treatment.

Pathogenesis of Metabolic Syndrome from "Qi of five Internal Organs" / 中国实验方剂学杂志

Metabolic syndrome (MS) is a group of syndromes caused by the disorder of metabolism of various substances in the body. The main clinical manifestations are dyslipidemia, central obesity, hypertension, abnormal glucose tolerance and insulin resistance. With the changes of diet structure and habits, the incidence rate of MS is increasing, and the patients are younger. It is an important factor in many diseases, such as diabetes, atherosclerosis, coronary heart disease, hyperlipidemia, cirrhosis and some cancers. MS has seriously affected people's lives and health. Central obesity and insulin resistance are recognized as important pathogenic factors. At present, the pathogenesis of MS and its components has not been fully understood. The clinical manifestations of metabolic syndrome are complex and diverse. Traditional Chinese medicine (TCM) believes that the occurrence of metabolic syndrome is related to such factors as proper diet, emotional disorders, excessive escape and little movement, old age and physical deficiency. TCM scholars have studied the pathogenesis of MS in such pathological factors as phlegm and blood stasis, such visceral functions as liver, spleen and kidney, roles of Qi and blood, and emotional factors. As the basic substance of organism, Qi is closely related to the process of metabolism. The occurrence of MS is closely related to the rise and fall of Qi moving to and from the body as well as the abnormal gasification function of the transformation of Qi. Qi is derived from the five internal organs, which are respectively called Heart Qi, liver Qi, spleen Qi, lung Qi and kidney Qi. The "Qi of the five internal organs" is involved in the whole process of the generation, transportation and excretion of the essence of the body. Based on the "Qi of five internal organs", this paper discusses the pathogenesis of MS with phlegm, blood stasis and water drink as pathological factors.

Effect of two kinds of materials on the prevention of early erosive enamel wear / 中华口腔医学杂志

Objective@#To investigate the preventive effect of resin infiltration and adhesive on early erosive enamel wear.@*Methods@#Orthodontic reduction premolars collected from Central Laboratory of Nanjing Stomatological Hospital, Medical School of Nanjing University were used to prepare 70 specimens. Forty samples were divided into eight groups (n=5) and treated with different conditions (pH=1.6, 2.4, 3.2 or 4.0 hydrochloric acid solution, etching time was 30 or 60 s), and the conditions for obtaining early erosive enamel samples were selected. Based on this procedure, thirty early erosive enamel samples were made and divided into three groups: control group, resin infiltration group, and adhesive group. And the treatment of 30 days acid abrasion cycle was carried out. Confocal microscopy was used to measure the thickness changes of enamel or material before and after cycle.@*Results@#Early erosive enamel samples was obtained when pH was 4.0 and etching time was 60 s. After 30 days cycle, the wear of enamel was (29.71±6.72) μm in control group, (5.60±2.24) μm in resin infiltration group and (2.89±1.03) μm in adhesive group. In infiltration group and adhesive group, lower enamel was not affected by the cycle, and the material loss ratios of the infiltration resin group and adhesive group were 0.41±0.14 and 0.29±0.13, respectively. The ratio of material loss was not significantly different (P>0.05). But infiltration group lost (12.95±2.22) μm of enamel during the application of the material.@*Conclusions@#Resin infiltration and adhesive have the same short-term protective effect against early erosive enamel wear. Adhesive has less damage to enamel and better effect.

Influencing factors of epileptic seizure in patients with chronic renal failure / 中华神经医学杂志

Objective To investigate the influencing factors of epileptic seizure in chronic renal failure (CRF) patients.Methods CRF patients,admitted to our hospital from March 2014 to October 2018,were chosen in our study,and divided into epilepsy group (n=40) and non-epilepsy group (n=3653) according to whether the patients were with or without epilepsy.Clinical data,as length of hospital stays,dialysis methods,presences of infection,sites of infection,and use of antibiotics,and laboratory variables,as blood routine examination,straw aminotransferase (AST),and alanine aminotransferase (ALT),were collected and retrospectively analyzed.Logistic regression analysis was used to determine the independent factors affecting seizures in patients with CRF.Results The patients in the epilepsy group had significantly longer duration of dialysis and length of hospital stays,statistically higher incidence of infection and proportion of dialysis,and significantly worse prognosis than the patients from non-epilepsy group (P＜0.05).The leukocyte count of the epilepsy group was significantly higher than that of the non-epilepsy group,the contents of hemoglobin,ALT and albumin were significantly lower than those of the non-epilepsy group,and the contents of urea nitrogen,creatinine and serum potassium were significantly higher than those of the non-epilepsy group (P＜0.05).Logistic regression analysis showed that epilepsy was associated with serum potassium,creatinine,urea nitrogen and dialysis.Conclusion The etiology of epilepsy is complex,which is related to dialysis,toxin levels,and electrolyte imbalance;the mortality rate of those patients is high and the prognosis is not good.

Clinical characterization of testicular yolk sac tumor in children and adults / 中华男科学杂志

Objective@#To compare the clinical characteristics of simple testicular yolk sac tumor (YST) in children with those in adults so as to improve the diagnosis and treatment of the malignance.@*METHODS@#This study included 75 cases of simple testicular YST pathologically confirmed between May 2008 and July 2018, which were divided into groups A (aged <18 years, n = 64) and B (aged ≥18 years, n = 11). We analyzed the clinical data on all the cases and compared the clinical manifestations, laboratory results, pathological findings, clinical stages, treatment methods and prognostic outcomes between the two groups of patients.@*RESULTS@#The patients of group A ranged in age from 6 months to 5 years (［1.38 ± 0.89］ yr), with the tumor diameter of 0.9－6.0 (2.48 ± 1.12) cm, while those of group B from 25 to 49 years (median 34 years), with the tumor diameter of 3.5－6.3 (5.16 ± 1.32) cm, most presenting with a painless scrotal mass, 4 (6.2%) in group A and 5 (45.5%) in group B with testis pain. There were statistically significant differences between the two groups in the tumor diameter and initial manifestations (P < 0.05). All the patients were treated by radical high-level spermatectomy and orchiectomy and, in addition, 1 in group A and 3 in group B by retroperitoneal lymph node dissection (RPLND), 24 in the former and 5 in the latter group followed by chemotherapy. Elevated levels of serum alpha-fetoprotein (AFP) were observed in all the cases. Sixty-five of the patients were followed up for 10－78 (52.00 ± 23.78) months, during which 2 cases of simple metastasis, 3 cases of simple relapse, 3 cases of relapse with metastasis and 5 cases of death were found in group A, and 5 cases of simple metastasis, 1 case of simple relapse, 1 case of relapse with metastasis and 4 cases of death in group B.@*CONCLUSIONS@#There are significant differences in the clinical manifestation, biological behavior, treatment and prognosis of testicular YST between children and adults. In children, most of the testicular YST cases are at clinical stage I and preferably treated by radical high-level spermatectomy and orchiectomy with favorable prognosis. In adults, however, the tumor is highly malignant, with high incidences of recurrence and metastasis and poor prognosis, for the treatment of which the first choice is radical high-level spermatectomy and orchiectomy combined with RPLND and chemotherapy.

Effects of dendritic cell-based adoptive immunotherapy with over-expressed SOCS1 on Th17- and Treg-related cytokines in the BALF of COPD mice / 医学研究生学报

Objective　Dendritic cells (DCs), helper T cells 17 (Th17) and regulatory T cells (Treg) are closely related to the pathogenesis of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the changes of Th17- and Treg-related cytokines in the bronchoalveolar lavage fluid (BALF) of COPD mice after DC-based adoptive immunotherapy with over-expressed suppressor of cytokine signaling protein 1 (SOCS1) and provide some new ideas for the treatment of COPD.　Methods　A total of 48 male C57BL/6 mice were randomly divided into 5 groups: healthy control, COPD model control, immature DC (imDC), DC-SOCS1 1×106, and DC-SOCS1 2×106. The healthy controls were exposed to air and fed normally, the COPD model controls injected with normal saline at 0.5 mL/ on the first day of modeling by fumigation, the mice of the imDC group injected via the tail vein with 1 ×106 imDCs, and those of the DC-SOCS1 groups injected with 1 ×106 or 2 ×106 DCs with over expressed SOCS1, all via the tail vein on the 1st and 7th day of modeling. Then the lung tissues were collected from the mice for preparation of paraffin sections and HE staining, and ELISA was employed for determination of the levels of Th17-related IL-17 and IL-23 and Treg-related IL-10 and TGF-β in the BALF of the model mice.　Results　Compared with the COPD model controls, the mice in the imDC, DC-SOCS1 1×106 and DC-SOCS1 2×106 groups showed significantly decreased levels of IL-17 on the 1st day ([78.87 ± 1.08] vs [46.46 ± 0.77], [34.09 ± 3.98] and [24.12 ± 0.57] pg/mL, P < 0.05) and 7th day after modeling ([78.87 ± 1.08] vs [55.69 ±0.35], [35.65 ± 0.54] and [27.00 ± 0.58] pg/mL, P < 0.05), and IL-23 on the 1st day ([200.62 ± 0.65] vs [150.19 ± 0.53], [121.09 ± 0. 53] and [70.21 ± 0.91] pg/mL, P < 0.05) and 7th day ([200.62 ± 0.65] vs [167.70 ± 1.73], [136.34 ± 0.90] and [99.35 ± 1.83] pg/mL, P < 0.05), but remarkably increased levels of IL-10 on the 1st day ([39.46 ± 3.88] vs [50.74 ± 1.77], [58.71 ± 3.84] and [70.12 ± 2.62] pg/mL, P < 0.05) and 7th day ([39.46 ± 3.88] vs [44.56 ± 2.63], [54.78 ± 1.43] and [63.00 ± 2.57] pg/mL, P < 0.05), TGF-β on the 1st day ([24.98 ± 0.43] vs [36.46 ± 0.98], [42.40 ± 0.62] and [50.55 ± 0.53] pg/mL, P < 0.05) and 7th day ([24.98 ± 0.43] vs [33.27 ± 0.92], [40.12 ± 0.83] and [44.98 ± 0.52] pg/mL, P < 0.05). The contents of IL-17 and IL-23 were markedly lower while those of IL-10 and TGF-β higher in the DC-SOCS1 1×106 than in the imDC group (P < 0.05), and the levels of the former two significantly higher and those of the latter two lower in the DC-SOCS1 2×106 than in the DC-SOCS1 1×106 group (P < 0.05).　Conclusion　Transfusion of DCs with over-expressed SOCS1 can inhibit the secretion of Th17-related cytokines in COPD, and the effect is better than that of imDCs alone and related to the concentration and time.