Optimization of energy window of yttrium-90 bremsstrahlung SPECT imaging:In vitro experimental study / 中国介入影像与治疗学

Objective To observe the influence of different energy windows of the medium-energy general-purpose(MEGP)collimator on image quality,so as to optimize the energy window of yttrium-90(90Y)bremsstrahlung SPECT imaging.Methods 90Y bremsstrahlung spectrum was acquired,and the sensitivity,percentage of the source counts in useful field of view(S/FOV%)and signal-to-background ratio(S/B)of 90Y bremsstrahlung SPECT imaging at MEGP under different energy windows were compared.Results The energy spectrum of 90Y bremsstrahlung was a continuous curve,with the peak of 76.2 keV with MEGP collimator.The images obtained with MEGP collimator were clear,and no significant differences of S/FOV%nor S/B was found between 10%and 20%window width groups(both P＞0.05),but the sensitivities of the latter was higher than the former(P＜0.05).The sensitivity of 70-90 keV images was relatively high,while the S/FOV%and S/B had decreased.The S/FOV%and S/B of images ranging from 40-60 keV were high,but the sensitivity was low.Images acquired with 100 keV±20%showed fairly high sensitivity,S/FOV%and S/B,which was 69.73%,0.62 and 1.64,respectively.Conclusion When performing 90Y bremsstrahlung SPECT with MEGP collimator,the image quality at 20%window width was better than at 10%window width,and 100 keV±20%showed fairly high sensitivity and not significantly decreased S/FOV%and S/B.

Relationship between left ventricular hypertrophy diagnosed by Peguero-Lo-Presti index and recurrence after radiofrequency catheter ablation of paroxysmal atrial fibrillation / 天津医药

Objective To investigate the relationship between left ventricular hypertrophy(LVH)diagnosed by Peguero-Lo-Presti index and recurrence of paroxysmal atrial fibrillation(AF)after radiofrequency ablation.Methods A total of 652 patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation were selected.According to Peguero-Lo-Presti index,patients were divided into the LVH group(167 cases)and the normal left ventricle group(485 cases).Baseline data were collected,and regular follow-up was performed at 3,6 and 12 months after radiofrequency catheter ablation.The recurrence of AF was assessed.Kaplan-Meier survival curve was used to analyze the recurrence rate of AF in the two groups.Cox proportional hazard model was used to assess risk factors for recurrent atrial fibrillation.Results The median follow-up time was 20.5(15.0,26.0)months.A total of 155 patients(23.8%)developed recurrence of AF,including 95 patients in the LVH group and 60 patients in the LVN group.The recurrence rate without AF was significantly lower in the LVH group than that in the LVN group(64.1%vs.80.4%,Log-rank χ2=26.361,P＜0.01).After adjusting for age,sex,body mass index,hypertension,diabetes,coronary heart disease,cardiac dysfunction,left anteroposterior and posterior atrial diameter,left ventricular end-diastolic diameter,and left ventricular ejection fraction,LVH diagnosed by Peguero-Lo-Presti index was still a risk factor for recurrent AF[HR(95%CI):2.359(1.663-3.345),P＜0.01].Conclusion In patients with paroxysmal AF,LVH diagnosed by Peguero-Lo-Presti index is a risk factor of AF recurrence after radiofrequency catheter ablation.

Clinical prospective study of Gallium 68 (68Ga)-labeled fibroblast-activation protein inhibitor PET/CT in the diagnosis of biliary tract carcinoma.

PURPOSE: This study is to investigate the [68Ga]Ga-DOTA-FAPI PET/CT diagnosis performance in biliary tract carcinoma (BTC) and analyze the association between [68Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. METHODS: A prospective study (NCT05264688) was performed between January 2022 and July 2022. Fifty participants were scanned using [68Ga]Ga-DOTA-FAPI and [18F]FDG PET/CT and acquired pathological tissue. We employed the Wilcoxon signed-rank test to compare the uptake of [68Ga]Ga-DOTA-FAPI and [18F]FDG, and the McNemar test was used to compare the diagnostic efficacy between the two tracers. Spearman or Pearson correlation was used to assess the association between [68 Ga]Ga-DOTA-FAPI PET/CT and clinical indexes. RESULTS: In total, 47 participants (mean age 59.09 ± 10.98 [range 33-80 years]) were evaluated. The [68Ga]Ga-DOTA-FAPI detection rate was greater than [18F]FDG in primary tumors (97.62% vs. 85.71%), nodal metastases (90.05% vs. 87.06%), and distant metastases (100% vs. 83.67%). The uptake of [68Ga]Ga-DOTA-FAPI was higher than [18F]FDG in primary lesions (intrahepatic cholangiocarcinoma, 18.95 ± 7.47 vs. 11.86 ± 0.70, p = 0.001; extrahepatic cholangiocarcinoma, 14.57 ± 6.16 vs. 8.80 ± 4.74, p = 0.004), abdomen and pelvic cavity nodal metastases (6.91 ± 6.56 vs. 3.94 ± 2.83, p < 0.001), and distant metastases (pleural, peritoneum, omentum, and mesentery, 6.37 ± 4.21 vs. 4.50 ± 1.96, p = 0.01; bone, 12.15 ± 6.43 vs. 7.51 ± 4.54, p = 0.008). There was a significant correlation between [68Ga]Ga-DOTA-FAPI uptake and fibroblast-activation protein (FAP) expression (Spearman r = 0.432, p = 0.009), carcinoembryonic antigen (CEA) (Pearson r = 0.364, p = 0.012), and platelet (PLT) (Pearson r = 0.35, p = 0.016). Meanwhile, a significant relationship between [68Ga]Ga-DOTA-FAPI metabolic tumor volume and carbohydrate antigen199 (CA199) (Pearson r = 0.436, p = 0.002) was confirmed. CONCLUSION: [68Ga]Ga-DOTA-FAPI had a higher uptake and sensitivity than [18F]FDG in the diagnosis of BTC primary and metastatic lesions. The correlation between [68Ga]Ga-DOTA-FAPI PET/CT indexes and FAP expression, CEA, PLT, and CA199 were confirmed. TRIAL REGISTRATION: clinicaltrials.gov: NCT 05,264,688.

Comparison of clinical effects of endoscopic thyroidectomy using the modified gasless transsubclavian approach and traditional open surgery for cN0 unilateral papillary thyroid carcinoma / 中华外科杂志

Objective: To compare the clinical effects of endoscopic thyroidectomy using a modified gasless transsubclavian approach and the traditional neck approach for unilateral papillary thyroid carcinoma (cN0). Methods: The clinical data of 135 patients with cN0 papillary thyroid carcinoma who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from October 2020 to November 2022 were retrospectively analyzed. There were 37 males and 98 females, aging (43.2±8.8) years (range: 21 to 59 years). There were 51 cases using the modified gasless transsubclavian approach (TS group) and 84 cases using the traditional neck approach (TN group). Comparative analyses were performed between the operative results of the 2 groups by t-test, Wilcoxon rank sum test, and χ2 test. Results: All endoscopic operations were successfully completed without conversion to the traditional neck approach. Compared to the TN group, the TS group had a longer operation time (M(IQR)) (73.5 (22.5) minutes vs. 90.0 (30.0) minutes, Z=-5.831, P<0.01), more postoperative drainage (60 (25) ml vs. 95 (45) ml, Z=-6.275, P<0.01), higher hospitalization costs (22 687 (3 488) yuan vs. 26 652 (2 431) yuan, Z=-6.944, P<0.01), and a higher rate of parathyroid autotransplantation (15.5% (13/84) vs. 60.8% (31/51), χ2=29.651, P<0.01). There was no significant difference in the total exposure rate of the central compartment, postoperative hospitalization time, the number of dissected lymph nodes, the number of metastatic lymph nodes, C-reactive protein ratio before and after operation, and preoperative and postoperative parathyroid hormone (all P>0.05). Conclusions: Endoscopic thyroidectomy using the modified gasless transsubclavian approach is safe for cN0 papillary thyroid carcinoma, with longer operating time, more postoperative drainage, higher hospitalization costs, and moredifficulty in preserving the inferior parathyroid gland in situ compared to traditional open surgery.

Role of the ferroptosis pathway mediated by GSH/GPx4 in preventing hepatocyte peroxidative injury following aerobic exercise in an elderly mouse model / 中国实验动物学报

Objective To elucidate the role of the glutathione(GSH)/glutathione peroxidase 4(GPx4)-mediated ferroptosis pathway in preventing age-related hepatocyte peroxidation injury following aerobic exercise in mice,and to provide a new target for improving liver aging and metabolism disorders.Methods Twenty specific-pathogen-free C57BL/6 male mice aged 52 weeks were divided randomly into an elderly control group(EC group)and elderly exercise group(EE group)(n = 10 per group).The mice performed moderate-intensity exercise with incremental loads(1～2 weeks 14 m/min,3～4 weeks 15 m/min,5～10 weeks 16 m/min,11～16 weeks 17 m/min,60 min/day,slope 0°)for 16 weeks.After perfusion of the ascending aorta,the lateral liver lobes were harvested and sectioned for hematoxylin and eosin staining and ultrathin sections were used for transmission electron microscopy.Levels of 8-hydroxy-2 deoxyguanosine(8-OHdG)and 4-hydroxynonenal(4-HNE)in the liver and serum interleukin-6(IL-6)were detected by enzyme-linked immunosorbent assay.Hepatic glycogen,triglycerides(TG),malondialdehyde(MDA),nicotinamide adenine dinucleotide phosphate(NADPH),and GSH were determined by colorimetry.Hepatic GPx4,glucose transporter(GLUT2),NAD(P)H:quinone oxidoreductase 1(NQO1),and solute carrier protein 7 family member 11(SLC7A11)were detected by Western Blot.Results(1)Oxidative damage to hepatocytes was effectively delayed,normal mitochondrial structure and glycogen storage in hepatocytes were maintained.(2)Hepatic GSH and NADPH contents were significantly increased in EE mice compared with EC mice(P<0.01).(3)In addition,liver levels of 8-OHdG,4-HNE,MDA,and non-heme iron were significantly decreased in the EE group compared with the EC group(P<0.01).(4)Expression levels of GPx4,NQO1,and SLC7A11 in the liver were increased(P<0.01)while NOX2 expression was decreased(P<0.01)in the EE group compared with the EC group.Conclusions GSH synthesis was increased in aged mice following aerobic exercise,providing reaction substrates for GPx4 and activating the GSH/GPx4 pathway.Ferroptosis was inhibited,thus improving hepatocyte peroxidation damage caused by aging,and maintaining the normal structure and physiological function of hepatocytes.

Comparison of therapeutic effects of internal fixation with percutaneous minimally invasive hollow nail assisted by electromagnetic navigation robot and guided by C-arm in the treatment of Tile type C pelvic fracture / 中华创伤杂志

Objective:To compare the early therapeutic effects of internal fixation with percutaneous minimally invasive hollow nail assisted by electromagnetic navigation robot and guided by C-arm in the treatment of Tile type C pelvic fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 32 patients with Tile type C pelvic fracture admitted to Weihai Central Hospital from January 2020 to March 2022, including 18 males and 14 females; aged 36-60 years [(44.1±3.9)years]. Among them, 17 patients were treated with internal fixation with percutaneous minimally invasive hollow nail assisted by electromagnetic navigation robot (electromagnetic navigation group), and 15 with internal fixation with percutaneous minimally invasive hollow nail guided by C-arm (C-arm guidance group). Operative time, intraoperative blood loss, sacroiliac screw placement time, pubic branch screw placement time, ambulation time and fracture healing time were compared between the two groups. Visual analog scale (VAS), Majeed function score and complication rate at 1 day, 6 months, 12 months after surgery and at the last follow-up were compared between the two groups.Results:All the patients were followed up for 12-24 months [(15.4±0.5)months]. The operative time and intraoperative blood loss in the electromagnetic navigation group were (42.0±2.5)minutes and (10.9±2.6)ml, shorter or less than (50.0±3.5)minutes and (14.9±3.1)ml in the C-arm guidance group (all P<0.01). The placement time of sacroiliac screw and pubic branch screw in the electromagnetic navigation group was (12.4±0.2)minutes and (10.1±0.3)minutes, shorter than (15.3±0.3)minutes and (13.2±0.3)minutes in the C-arm guidance group (all P<0.01). The ambulation time was (3.2±0.4)weeks in the electromagnetic navigation group, earlier than (3.5±0.4)weeks in the C-arm guidance group ( P<0.05). There was no significant difference in fracture healing time between the two groups ( P>0.05). VAS scores of the electromagnetic navigation group were (4.4±0.3)points and (1.1±0.1)points at 1 day and 6 months after surgery respectively, lower than those of the C-arm guidance group [(4.8±0.4)points and (1.2±0.3)points] ( P<0.05 or 0.01). Majeed function scores of the electromagnetic navigation group were (37.3±1.1)points and (88.5±1.4)points at 1 day and 6 months after surgery respectively, higher than those of the C-arm guidance group [(30.7±4.2)points and (82.6±1.8)points] (all P<0.01). There were no significant differences in VAS and Majeed scores at 12 months after surgery and at the last follow-up between the two groups (all P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusion:Compared with C-arm guidance, electromagnetic navigation robot-assisted internal fixation with percutaneous minimally invasive hollow nail for Tile type C pelvic fracture can reduce operative time and intraoperative blood loss, shorten screw placement time and ambulation time, relieve pain and improve functional recovery at early stage.

Effect of single nucleotide variation of PFN1 gene on osteoporosis and bone metabolism after stroke / 中华内分泌外科杂志

Objective:To explore the correlation between the single nucleotide variation of profibrin-1 (PFN1) gene and secondary osteoporosis (OP) after stroke and its influence on bone metabolism indexes.Methods:120 patients with post-stroke hemiplegia who were treated in our hospital from Jan. 2019 to Jun. 2023 were selected as study objects and divided into OP group and non-OP group. Levels of vitamin D[25- (OH) D], tartrate-resistant acid phosphatase (TRAP) , osteocalcin (BGP) , serum type I procollagen amino terminal prolongation brain (P1NP) and type I collagen basal terminal β special sequence (β-CTX) were detected in all patients. Two SNPS (rs6559 and rs78224458) in PFN1 gene were genotyped.Results:There were significant differences in serum 25- (OH) D, TRAP, P1NP and β-CTX levels between OP group and non-OP group ( P<0.05) . The GG, GA and AA genotypes at rs6559 of PFN1 gene were significantly different between OP and non-OP patients ( P<0.05) . The combined model showed that compared with GG genotype carriers, the risk of secondary OP in GA and AA genotype carriers was 3.250 and 5.417 times higher, respectively. The results of the dominant model showed that the risk of secondary OP was 3.792 times higher in patients with mutant genes (GA or AA) than in patients with GG genotype. Recessive model results showed that patients with AA genotype had a 3.810-fold increased risk of secondary OP compared with GG and GA carriers. There was no significant difference in TT, TC, CC genotype distribution, genetic model and allele frequency at rs78224458 of PFN1 gene between OP patients and non-OP patients ( P>0.05) . There were no significant differences in 25- (OH) D, TRAP or BGP among the rs6559 GG, GA and AA genotypes of PFN1 gene ( P>0.05) , while there were significant differences in P1NP andβ-CTX levels among the three groups ( P<0.05) . Conclusion:The rs78224458 variation of PFN1 gene is associated with secondary OP in patients with hemiplegia after stroke, and may affect the bone metabolism indexes of patients.

Inhibition of phosphodiesterase 4 attenuates aquapo-rin 4 expression and astrocyte swelling following cerebral ischemia/reperfusion injury / 中国药理学与毒理学杂志

OBJECTIVE To investigate the role of PDE4 inhibition in astrocyte swelling caused by cerebral ischemic/reperfusion(I/R)injury and the molecular mech-anisms.METHODS SD rats were subjected to 2 h of focal cerebral ischemia induced by middle cerebral artery occlusion/reperfusion(MCAO/R).Roflumilast(Roflu)was intraperitoneally injected 2 h after MCAO.At 24 h after reperfusion,a high-resolution MRI was performed and using the wet-dry weighting method to measure the water content.The oxygen-glucose deprivation/reoxygenation(OGD/R)model was established in primary astrocytes for 2 h.After 24 h of reoxygenation,CellMask? plasma membrane stain was used to label the plasma membrane to calculate cell volume.The protein expressions insides astrocytes and penumbra were detected by Western blot-ting.To investigate the role of Akt/FoxO3a in mediating the effect of Roflu on the expression of AQP4.The astro-cytes were treated with an Akt inhibitor MK2206 before treatment with Roflu and the activation of Akt,the expres-sion of AQP4 and cell volume were determined as described above.In addition,an IL-1β-stimulated cell model was established in astrocytes,the expression of AQP4 and the activation of Akt/FoxO3a were detected by Western blotting.The change of AQP4 expression inside astrocytes and penumbra were visualized by immunofluo-rescence staining.RESULTS Roflu reduced MCAO/R-induced water contents,the expression of AQP4 and the phsophorylation of Akt and FoxO3a in the brains of MCAO/R rats.Inhibition of PDE4 decreased the cell volume and the expression of AQP4 in primary astro-cytes subjected to OGD/R.PDE4 inhibition activated Akt/FoxO3a,and inhibition of Akt by MK2206 blocked the protective effect of Roflu against OGD/R induced astro-cyte swelling.PDE4B knocking down reduced the expres-sion of AQP4,while PDE4B overexpression reversed the effect of PDE4B siRNA in astrocytes.Roflu exert-ed similar protective effect in IL-1β-cultured astrocytes,and importantly overexpression of FoxO3a remarkably increased the expression of AQP4 in IL-1β-stimulated astrocytes.CONCLUSION Our findings indicate that PDE4 inhibition limits I/R-induced brain edema and astro-cyte swelling via the Akt/FoxO3a/AQP4 pathway.PDE4 inhibition is a promising strategy for the treatment of brain edema after I/R injury.

PDE4 inhibition protects against rotenone-induced neurotoxicity through activation of the AMPK/Sirt1 pathway / 中国药理学与毒理学杂志

OBJECTIVE We have previously shown that inhibition of phosphodiesterase-4(PDE4)protects against neuronal damage in models of Parkinson's dis-ease(PD).However,the mechanisms have not yet been completely revealed.Here we aimed to elucidate the pharmacological effects and mechanisms of action of rof-lupram(ROF),an novel PDE4 inhibitor,in experimen-tal models of PD.METHODS The survival rate,apopto-sis rate and toxicity level of SH-SY5Y cells were deter-mined by MTT,flow cytometry and lactate dehydroge-nase detection kit.At the same time,LYT staining was used to detect the changes of lysosome fluorescence intensity:Western blotting was used to detect the changes of lysosome associated proteins,Sirtuin1 and α-Syn;NAD/NADH assay kit was used to determine the change of NAD content.To explore whether SIRT1 inhibitor(EX527)and lysosomal inhibitor could block the effect of ROF.In addition,ROT was used to stimulate C57BL/6J mice to construct a mouse model of PD to verify the effect and mechanism of ROF.The changes of motor function were evaluated by behavioral experiments(pole climb-ing,bar rotating and balance beam experiments).Super-oxide dismutase kit and Western blotting were used to detect the changes of SOD activity and expression of related proteins in substantia nigra.RESULTS We showed that pretreatment with ROF significantly attenu-ated cell apoptosis in ROT-treated SH-SY5Y cells.Fur-thermore,ROF significantly enhanced the lysosomal function,as evidenced by the increased levels of mature cathepsin D(CTSD)and lysosomal-associated mem-brane protein 1(LAMP1)through increasing NAD+/NADH and the expression of sirtuin 1(SIRT1).Pretreatment with an SIRT1 inhibitor selisistat(SELI,10 μ mol·L-1)attenuated the neuroprotection of ROF,and ROF-increased expression levels of LAMP1 and mature CTSD.Moreover,inhibition of CTSD by pepstatin A(20 μmol·L-1)attenuated the protective effects of ROF.In vivo study was conducted in mice exposed to ROT(10 mg·kg-1·d-1,ig)for six weeks;then,ROT-treated mice received ROF(0.5,1 and 2 mg·kg-1·d-1,ig)for four weeks.ROF significantly ameliorated motor deficits,which was accompanied by increased expression levels of tyro-sine hydroxylase,SIRT1,mature CTSD,and LAMP1 in the substantia nigra pars compacta.CONCLUSION Taken together,these results demonstrate that ROF exerts a neuroprotective action in PD models.The mech-anisms underlying ROF neuroprotective effects appear to be associated with NAD+/SIRT1-dependent activation of lysosomal function.

Comparative study of endoscopic spine surgery with and without assistance of an electromagnetic navigation surgical robot in the treatment of lumbar disc herniation / 中华显微外科杂志

Objective:To compair the clinical effect of endoscopic spine surgery with and without assistance of an electromagnetic navigation surgical robot(ENSR) system in the treatment of lumbar disc herniations(LDH).Methods:From March 2021 to December 2021, 73 patients with LDH underwent endoscopic minimally invasive treatment in the Department of Spine Surgery, Limin Hospital of Weihai High District. Thirty-eight patients were treated with endoscopic spine surgery assisted by domestic ENSR system(ENSR group), and 35 patients were treated with endoscopic spine surgery alone(endoscopic group). The patients received follow up regularly by telephone or Wechat. The intraoperative fluoroscopy times, puncture times, upper facet arthroplasty times, operation time, preoperative and postoperative Visual Analogue Scale(VAS), Japanese Orthopaedic Association Scores(JOA), and the MOS item short from health survey(SF-36)were compared between the 2 groups. The early postoperative efficacy was evaluated by modified MacNab criteria at 1 week after surgery. SPSS 26.0 was used to analyse the data. P<0.05 was considered that the difference was statistically significant. Results:The age, gender, body mass index(BMI) and other general data of the 2 groups were basically the same, and there was no statistically significant difference( P>0.05). There was no significant difference in the excellent and good rate of postoperative treatment between ENSR group(97.37%) and endoscopic group(94.29%)( Z=0.90, P>0.05). In terms of operation time, intraoperative fluoroscopy times, puncture times, and plasty times, ENSR group[(67.00±17.00) min, (4±2) times, 1 time, 1 time, respectively] was compared with the endoscopic group[(82.00±16.00] min, (17±6) times, (9±5) times, (5±2) times], and the difference was statistically significant( t=3.87,12.62, 9.87, respectively, P<0.05). There were significant differences in VAS, JOA and SF-36 scores between the 2 groups between before and after surgery( F=106.42, 112.14, 26.88, respectively, P<0.05). There was no significant difference in VAS, JOA and SF-36 scores before and after surgery between the 2 groups( F=0.95, 3.54, 0.97, respectively, P>0.05). Conclusion:The endoscopic spine surgery assisted by the ENSR can achieve satisfactory clinical results and is a safe and effective surgical assistance system. For the endoscopic surgery, assisted by the ENSR has obvious advantages in reducing the times of fluoroscopy, puncture, and facet arthroplasty, and shortening the operation time.

Analysis of risk factors for bleeding after CT-guided percutaneous lung puncture biopsy and construction of a line graph model / 中国医师进修杂志

Objective:To analyze the risk factors of postoperative bleeding after CT-guided percutaneous fly biopsy, and to construct a nomogram model for predicting postoperative bleeding.Methods:A total of 328 patients with CT-guided percutaneous fly biopsy who were admitted to the Affiliated Hospital of Ningbo University School of Medicine from June 2019 to March 2021 were selected, and the general clinical data of the patients were retrospectively analyzed. The patients were divided into observation group and control group according to postoperative bleeding. Statistical analysis was performed on clinical data of patients with statistical significance, receiver operating characteristic (ROC) curve analysis on continuous variables with statistical significance, and Logistic multiple regression analysis on all variables with statistical significance. The risk factors of bleeding complications in CT-guided percutaneous lung biopsy were obtained, and a Nomogram model for predicting bleeding after percutaneous lung biopsy was constructed using the R language software 4.0 "rms" package.Results:The results of the study showed that the size of the mass , the depth of the mass, the number of punctures, the number of cases with inflammation around the lesion , and the number of cases with chronic lung lesions in the observation group were greater than those in the control group: (5.20 ± 1.20) cm vs. (4.30 ± 0.90) cm, (4.30 ± 0.60) cm vs. (2.90 ± 0.30) cm, (2.70 ± 0.60) times vs. (2.30 ± 0.50) times, 38(14, 70) cases vs. 17(24, 60) cases, 102(39, 40) cases vs. 41(59, 40) cases; while the number of normal preoperative prothrombin time (PT) in the observation group was less than that in the control group: 4(5, 80) cases vs. 151(58, 30) cases ( P<0.05). ROC curve analysis was performed on the continuous variables with statistical significance in the control table of patients′general clinical data. The results showed that the area under the curve for swelling size, swelling depth, number of punctures, and number of tissue blocks cut were 0.563, 0.714, 0.680, and 0.559, respectively; the optimal cut-off values were 53.00 cm, 5.56 cm, 2.00 times, and 1.00 blocks ( P<0.05). The univariate indicators were included in the Logistic multiple regression model, and the results showed that tumor depth, puncture times, inflammation around the lesion, and abnormal preoperative PT were the risk factors for complications of percutaneous lung biopsy under CT ( P<0.05). The internal validation results showed that the Nomogram model predicted the risk of bleeding complicated by percutaneous lung biopsy under CT, with a C index of 0.687 (95% CI 0.241 - 1.988). The calibration curve showed good agreement between the observed and predicted values. The Nomogram model predicted percutaneous lung biopsy under CT with a bleeding risk threshold of >0.16, and the Nomogram model provided a clinical net benefit; in addition, the Nomogram model had a higher clinical net benefit than independent indicators. Conclusions:In conclusion, patients with poor coagulation function, inflammation around tumor lesions, deeper lesions, and more puncture times are more prone to bleeding. The Nomogram model constructed in this study has a high clinical application value for predicting the bleeding complications of CT-guided percutaneous lung biopsy.

Mechanism of LncRNA-ANCR expression and cellular malignant proliferation in human glioma tissues and cells / 中华内分泌外科杂志

Objective:To investigate the expression of LncRNA ANCR in human glioma tissues and its relationship with malignant proliferation of cells.Methods:The samples of 10 normal brain tissue,13 low-grade and 45 high-grade gliomas were regarded as normal group, low-grade group and high-grade group, which were collected from neurosurgery department in Linyi Central Hospital, and the expression of ANCR and potential interaction molecule eIF4B was detected by reverse transcription polymerase chain reaction (RT-PCR) in vitro. Lentivirus transfection in vitro was used to construct the U251 shRNA ANCR and control cell line in human high-grade gliomas as control, test 1 and test 2 group cells in the study. QPCR detect the expression level ANCR, eIF4B and Myc mRNA in cells. Western blot was used to detect the expression of eIF4B and c-Myc protein, CCK-8 assay was used to detect the relative proliferation ability of cells, and the colony formation assay was used to observe the change of cell clone formation. SPSS 21.0 was used for statistical analysis, analysis of variance was used for inter group comparison, and SNK-q pairwise comparison method was used for intra group comparison.Results:The expressions of ANCR mRNA in high-grade glioma tissues, low-grade gliomas and normal brain tissues were 0.710±0.125, 2.033±0.312 and 3.408±0.296. The expressions of eIF4B mRNA in high-grade glioma tissues, low-grade gliomas and normal brain tissues were 0.176±0.019, 0.268±0.022 and 0.426±0.028. The expression of ANCR and eIF4B in high-grade glioma tissues was higher than that in low-grade gliomas and normal brain tissues ( P<0.001). The expression of ANCR in low-grade glioma tissues was higher than that in normal brain tissues ( P=0.013). There was a significant positive correlation between the expression of ANCR and eIF4B in glioma tissues ( P<0.001) ; The expressions of ANCR mRNA in Control, test1 and test2 were 1.000±0.021, 0.202±0.057 and 0.300±0.016. The expressions of eIF4B mRNA were 1.000±0.078, 0.452±0.012 and 0.526±0.037, and the expressions of c-Myc mRNA were 1.000±0.053, 0.688±0.067 and 0.564±0.089. the expressions of ANCR, eIF4B and c-Myc mRNA and protein in test1 and test2 cells were significantly lower than those in the control group ( P<0.01) ; the proliferation of test1 and test2 groups were significantly decreased at 72h and 96h, and the ability of colony formation was significantly decreased ( P<0.001) . Conclusion:The expression of ANCR was significantly up-regulated in high-grade glioma tissues and positively correlated with the expression of eIF4B. Interference with ANCR in vitro could mediate the decrease of the expression of eIF4B and c-Myc mRNA and protein molecules, thereby inhibiting the proliferation of glioma cells.

Efficacy and safety of modified Atkins diet in children with global developmental delay: a multicenter clinical study / 中华实用儿科临床杂志

Objective:To evaluate the efficacy and safety of modified Atkins diet (MAD) in treating global growth retardation (GDD).Methods:A prospective multicenter clinical controlled study was conducted.The children were included from 8 departments of children′s rehabilitation in Henan Province from July 2017 to October 2017.A total of 154 children who met the inclusion criteria were randomly assigned into the routine treatment group (88 cases) and MAD therapy group (66 cases). A total of 62 children in MAD therapy group and 59 children in routine treatment group completed the study for 15 months.The routine treatment group was provided comprehensive rehabilitation training, and the MAD therapy group was given MAD treatment on the basis of rehabilitation training.Two-way repeated-measures ANOVA was used to compare the differences among datas at different time points. Results:After 3 months, there were significant differences in the scores of the Chinese Version of Urban Infant-Toddler Social and Emotional Assessment (CITSEA)/Achenbach Children′s Behavior Scale (CBCL) between the 2 groups (all P<0.05). Significant improvement was seen in the MAD group.After 6 months, the MAD therapy group had significantly higher scores on the Gesell Developmental Scale for language and social behavior than the routine treatment group (all P<0.05). After 9 months, the scores of the children in the MAD therapy group were better than those in the routine treatment group in the Gesell Developmental Scale adaptive energy area and the infant-junior high school student social life scale (S-M scale), and the differences were statistically significant (all P<0.05). After 15 months, the fine motor in the MAD therapy group was better than that in the routine treatment group ( P<0.05). At the early stage of MAD therapy, 28 patients showed mild adverse reactions that were reversed after symptomatic treatment.No severe adverse reactions were observed. Conclusions:MAD therapy can improve the neuro-development, emotional and social behaviors, and adaptive behaviors with no severe adverse effects.

Effect of different courses of Bifidobacterium tetravaccine tablets (live) in the treatment of Helicobacter pylori positive gastric ulcer / 中国综合临床

Objective:To explore the effects of different courses of Bifidobacterium combined with bismuth on the eradication rate, ulcer healing rate and adverse reactions in the initial eradication treatment of Helicobacter pylori positive gastric ulcer patients.Methods:From September 2018 to September 2021, 219 patients with gastric ulcer were selected from the outpatient department of gastroenterology department of Kailuan General Hospital Affiliated,all of whom were positive for 13C or 14C-urea breath test and were not treated with Helicobacter pylori eradication. Group A, B and C were randomly divided by Excel, Group A was the control group (73 patients): 14-day bismuth quadruple therapy (Eprazole + colloidal bismuth pectin + amoxicillin + furazolidone); group B (73 patients): 7 days Bifidobacterium tetravaccine tablets (live) was given in the second week of treatment in group A; group C (73 patients): Bifidobacterium tetravaccine tablets (live) was given 14 days on the basis of treatment in group A. 13C or 14C-urea breath test and gastroscope were reexamined after all treatments, to compare the eradication rate, ulcer healing rate and the incidence of adverse reactions.Results:The eradication rates in three groups were 90.8%(59/65), 91.2% (62/68)and 91.0%(61/67) respectively, there was no significant difference among the three groups (χ 2=0.01, P=0.997). The ulcer healing rate in three groups were 93.8%(61/65), 94.1%(64/68) and 95.5%(64/67) respectively, group B and group C were compared with group A, and the difference was not statistically significant(group B: group A P=1.000, group C: group A P=0.716).The incidence of adverse reactions in three groups was 21.4%(15/70), 7.1%(5/70) and 7.0%(5/71) respectively, the difference was statistically significant (χ 2=9.21, P=0.010). The incidence of adverse reactions in group B and C was significantly lower than that in group A (group B: group A χ 2=5.83, P=0.016; group C: groups A χ 2=5.99, P=0.014). Compare means of measurement data among the three groups use analysis of variance. Chi square test, Fisher exact probability method and split chi square test were used to compare the three groups of counting data. Conclusion:14-day Bifidobacterium tetravaccine tablets (live) and the second half of the treatment lasted for 7-day Bifidobacterium Bifidobacterium tetravaccine tablets (live), they are combined separately with bismuth quadruple therapy in the first eradication of Helicobacter pylori positive gastric ulcer patients can significantly reduce adverse reactions, but Bifidobacterium tetravaccine tablets (live) could not significantly improve the eradication rate, and had no promoting effect on the healing of gastric ulcer.

Human Umbilical Cord Mesenchymal Stem Cells Improve the Necrosis and Osteocyte Apoptosis in Glucocorticoid-Induced Osteonecrosis of the Femoral Head Model through Reducing the Macrophage Polarization

Background and Objectives@#Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. @*Methods@#and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. @*Conclusions@#Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.

Over-expression of kinesin family member 23 (KIF23) is associated with the development and prognosis of triple-negative breast cancer / 国际生物医学工程杂志

Objective:To investigate the expression and clinical significance of kinesin family member 23 (KIF23) in human triple-negative breast cancer (TNBC).Methods:The clinicopathological characteristics of 74 cases of TNBC patients were retrospectively analyzed. The expression of KIF23 in tumor tissues and adjacent normal tissues was detected by immunohistochemical method, and the expression of KIF23 in TNBC patients and its relationship with clinicopathological characteristics were analyzed. The mRNA level of KIF23 in TNBC tissues and normal tissues adjacent to cancer was analyzed by bioinformatics methods, and the relationship between its expression and the survival rate of patients was also analyzed.Results:The results of bioinformatics analysis showed that the high expression of KIF23 in TNBC tissue was significantly related to the overall survival and disease-free survival of patients (all P<0.05). In TNBC tissues, the positive high expression rate of KIF23 was 64.9%, while it was mainly low or no expression in adjacent tissues. The high expression of KIF23 was significantly correlated with the tumor size and pTNM stage of TNBC patients (all P<0.05). Conclusions:KIF23 plays a regulatory role in the progression of TNBC, and it can be used as a new diagnostic and therapeutic target for TNBC.

Investigation and analysis of radiation diagnosis and radiotherapy in Southeaster Chongqing area / 中国辐射卫生

Objective To understand the status of radiological diagnosis and radiotherapy in southeaster Chongqing area, and to provide evidence for health authorities to carry out radiological diagnosis and radiotherapy management. Methods The questionnaire survey was carried out in radiological diagnosis and radiotherapy institutions. Results In 2020 there are 224 radiological diagnosis and radiotherapy institutions, including 3 tertiary hospitals and 16 secondary hospitals. Three hospitals carried out radiotherapy, two hospitals carried out nuclear medicine, and seven hospitals carried out interventional radiology. There were 376 sets of radiological diagnosis and radiotherapy equipment, and the number of DR and CT machine was large (58.8% and 14.9% respectively). There were 786 radiological workers (66.9% male), and most of them were X-ray diagnostic workers (85.8%). There were 977, 043 cases of routine X-ray diagnosis(application frequency of 357.7 per 1000 population), mainly in the first level and below hospitals (accounting for 45.3%). There were 391, 067 cases of CT diagnosis (application frequency 143.8 per 1000 population), mainly in secondary hospitals (66.0%). 4860 patients received interventional therapy (application frequency 1.78 per 1000 population) and 781 patients received radiotherapy (application frequency 0.003 per 1000 population), mainly in tertiary hospitals (55.3% and 69.8% respectively). Conclusion Radiological diagnosis and radiotherapy resources in southeast Chongqing area backward and unevenly developed, and there are few hospitals carrying out radiotherapy, nuclear medicine and interventional radiology. Except for Qianjiang district, the level of radiological diagnosis and radiotherapy in the other five districts and counties (autonomous counties) is weak, it is necessary to further improve the level of radiological diagnosis and radiotherapy.

Study on the problems of the public health emergency system and countermeasures to complement the shortcomings in Suzhou / 公共卫生与预防医学

Objective To meet the needs of public health emergency management in the new era, to improve the problems exposed in the public health emergency system after the outbreak of COVID-19, and to provide the government with a list of the gaps in the construction of the public health emergency system. Methods Several methods, including literature review, observation (discussion and questionnaire survey), and comparative and descriptive research, were used to conduct comprehensive analysis through the combination of induction and deduction. The evaluation questions were graded and were translated into some recognition indexes (averages). The golden section method was used for the recognition standard of evaluation problems, and U test method was used for statistical test. Results Five aspects of problem evaluation and suggestions were determined, including early warning, emergency plan, emergency management department, linkage between systems and epidemic situation judgment. The recognition indexes were 0.916, 0.905, 0.571, 1.000 and 1.190, respectively, all of which met the recognition standard, and there was no significant difference between them(P=0.357). The corresponding measures and suggestions were as follows: early warning trigger mechanism, modular emergency plan, government public health emergency agencies, collaborative emergency drill system of various industries, and expert epidemic situation judgment mechanism. Conclusion It is determined that the proposed measures to complement the weaknesses of public health emergency system in Suzhou are suitable for the locality and objectivity after the three steps of literature review, management staff discussion and professional questionnaire survey. The present study provides an objective basis for the health administrative department to propose the public health emergency system construction project to the government.

Application value of cardiovascular MR T 1 mapping in patients recovered from COVID-19 / 中华放射学杂志

Objective:To explore the value of cardiovascular MR (CMR) T 1 mapping in evaluating myocardial injury in patients recovered from COVID-19. Methods:The clinical and image data of 15 patients with COVID-19 (9 with moderate clinical manifestation, 6 with severe clinical manifestation) who underwent CMR screening at 3 months after being discharged from the Second People′s Hospital of Fuyang City during May 2020 to June 2020 were prospective collected. Fifteen COVID-19 patients were selected as case group, and another 11 healthy volunteers were selected as control group. A standardized CMR protocol included cine, native and enhanced T 1 mapping, late gadolinium enhancement (LGE). Cardiac functional parameters, native T 1 value of left ventricular and extracellular volume fraction (ECV) were measured. One way ANOVA was used to assess the difference between CMR parameters among moderate and severe manifestation groups and control group, and LSD- t was used to assess the difference between the three groups. Results:LGE value was negative in all subjects. ECV values were higher in recovered COVID-19 patients with either moderate (27.9%±2.7%) or severe manifestation (30.0%±3.7%) than control group (23.2±1.9%) ( P<0.05); there was no significant difference of ECV values between recovered COVID-19 patients with moderate and severe manifestation ( P=0.100). There was no difference of native T 1 values and other functional and morphologic parameters of left ventricular and right ventricular among recovered COVID-19 patients with moderate and severe manifestation and control group ( P>0.05). Conclusion:CMR myocardial tissue ECV increase in patients who recovered from COVID-19, suggesting subclinical myocardial injury.