Objective To evaluate the digital tomosynthesis in the diagnosis of occult bone fracture. Methods Both DR and DTS were performed in 135 cases with traumatic-induced pain. All the cases were suspected of bone fractures but with no abnormal findings in DR images. Two radiologists reviewed all the images and diagnosed in consensus. All cases were followed up and the imaging diagnoses were reviewed. Results Bone fractures or joint dislocations of 61 cases were shown in DTS images but not in DR images, including atlanto-axial fracture and subluxation in 7 cases, articular fracture of limbs in 20 cases, bone fractures of wrist, hand and foot in 11 cases, fractures of cervical, thoracic and lumbar vertebra in 7 cases, fracture of sacrococcyx in 8 cases, fracture of nasal bone in 4 cases, fractures of Sternum ,rib ,orbit and mandible in 1 case. Thirty-four cases with bone fractures were determined by using DTS in suspected cases and 17 cases were denied. Both DR and DTS images showed normal findings in 23 cases. Imaging diagnoses of all cases were consistent with the results of follow up. Conclusion DTS can depict bone fractures especially in the deep and complex bony structures, which may improve the diagnostic accuracy of bone fracture.

Objective To evaluate the feasibility of chest digital tomosynthesis(DTS)for lung lesion screening by comparing the effective dose of chest DTS with chest digital radiography(DR),low-dose MSCT and MSCT examinations.Methods The Fluke lung/chest phantom underwent posterior-anterior (PA),left lateral(LAT)chest DR and DTS with automatic exposure control technique.Using RTI DoseGuard and WinODS,the dose area product(DAP)and effective dose of PA,LAT and total DTS were calculated.CareDose technique was used for MSCT and low-dose MSCT scans,the dose length products (DLP)was acquired.According to the DLP to E(k)conversion coefficient in ICRP 103,the effective dose of low-dose MSCT and MSCT were calculated.Paired t test was used for comparison of the mean effective dose of DTS,DR and low-dose MSCT.Results The mean effective dose was 0.1 3 mSv for chest DR and 0.11 mSv for DTS examination.The mean effective dose of low-dose MSCT and MSCT scans were 1.13 mSv and 6.38 mSv.The effective dose of chest DTS was comparable to that of chest DR,and was approximately 1/10 and 1/60 times lower than that of low-dose MSCT and MSCT scans.There was no statistical difference between chest DTS and DR(t =3.514,P ＞0.01),and there was a significant difference between chest DTS and low-dose MSCT(t =178.769,P ＜0.01).Conclusion DTS is a new X-ray tomography which has the advantage of low radiation dosage in chest examination for lung lesion screening comparing with low-dose MSCT.

Objective:To study the correlation between zinc finger protein A20 (A20) and basic fibroblast growth factor (BFGF) and liver fibrosis in chronic hepatitis B.Methods:A retrospective study was conducted to select 120 patients with chronic hepatitis B diagnosed and treated in the Fifth Hospital of Shijiazhuang City from January 2019 to December 2020, all of whom underwent liver tissue biopsy, and 25 cases of liver pathological specimens who underwent liver hemangioma resection were selected. The correlation between the expression of A20 and BFGF in liver tissue and the stage of hepatic fibrosis and inflammation were analyzed.Results:The expression of A20 in the S1 - S4 phase was higher than that in the S0 phase: (6.12 ± 1.22)%, (10.18 ± 2.43)%, (16.94 ± 5.06)%, (25.99 ± 7.57)% vs. (0.81 ± 0.29)%; the expression of BFGF in the S1 - S4 phase was higher than that in the S0 phase: (6.12 ± 1.22)%, (10.18 ± 2.43)%, (16.94 ± 5.06)%, (25.99 ± 7.57)% vs. (0.81 ± 0.29)%, there were statistical differences ( P<0.05). The expression of A20 in the G1 - G4 phase was higher than that in the G0 phase: (6.56 ± 1.87)%, (10.01 ± 3.29)%, (15.54 ± 5.01)%, (25.86 ± 8.02)% vs. (0.85 ± 0.71)%; the expression of BFGF in the G1 - G4 phase was higher than that in the G0 phase: (5.91 ± 1.52)%, (9.65 ± 2.48)%, (15.03 ± 4.86)%, (24.62 ± 7.22)% vs. (0.79 ± 0.41)%, there were statistical differences ( P<0.05). The results of Pearson test showed that there was a positive correlation between liver A20 and BFGF ( r = 0.824, P<0.05). Conclusions:The expressions of A20 and BFGF in liver tissue increase with the aggravation of liver pathological fibrosis and inflammation, which can be used as important indicators to evaluate the severity of liver fibrosis.

Objective: To investigate the curative effect of local application of CpG-oligodeoxynucleotide (CpG-ODN) combined with 4-1BB monoclonal antibody in hepatoma-bearing mice, and to evaluate the effect of 4-1BB monoclonal antibody on CpG-ODN immunotherapy. Methods: H22 single cell suspension was injected subcutaneously into the axilla and four limbs of the BALB/c male mice to establish a tumor-bearing mice model. After 7 days, 30 mice with corresponding tumor-bearing volume were screened and randomly divided into model control group, CpG group and CpG+4-1BB group, and the drug was injected into the tumors of left lower extremity. The same batch of normal mice was selected as normal control group. Survival of mice was recorded. Tumor-bearing volume and organ index were calculated. Serum levels of interleukin (IL) - 12 and interferon (IFN) gamma and spleen CD8⁺T lymphocyte ratio were measured. The measurement data were analyzed by analysis of variance. The survival rate of each group of mice was analyzed by log-rank test. Results: Mice in the model control group with tumor-bearing volume had a sustained growth before the execution. CpG group and the CpG+4-1BB group [(976.08 ± 29.55) mm³, (47.25 ± 0.93) mm³)] tumor-bearing volume was decreased than model group [(1 336.52 ± 39.40) mm3] (F = 5 329.273, P < 0.05). CpG+4-1BB group distant tumor-bearing volume [(611.83 ± 113.02) mm3] was decreased than model group and CpG group [(1 406.62 ± 51.09) mm³, (1 380.01 ± 51.44) mm3] (F = 247.160, P < 0.05), but there was no significant difference between the CpG group and the model group (P > 0.05). Serum IL-12 concentration (23.90 ± 2.33 pg/ml), IFN-γ concentration (103.02 ± 6.10 pg/ml) and spleen CD8⁺T cell ratio (4.54 ± 0.62%) in the model group were lower than those in the normal group (P < 0.05). Serum IL-12 concentration in CpG group and CpG+4-1BB group (29.21 ± 2.23 pg/ml, 37.04 ± 1.49 pg/ml), IFN-γ concentration (116.12 ± 4.08 pg/ml, 138.65 ± 1.72 pg/ml), CD8⁺T cell ratio (6.65 ± 0.64%, 12.73 ± 0.88%) were higher than the model group, while CpG+4-1BB group was higher than the CpG group (P < 0.05). The survival rate of CpG+4-1BB group was higher than that of model group and CpG group (χ² = 25.544, P < 0.05), but there was no significant difference between CpG group and model group (P > 0.05). There was no significant difference in organ index between the four groups (P > 0.05). Conclusion 4-1BB monoclonal antibody combined with CpG-ODN therapy can shrink hepatoma-bearing capacity, inhibit the growth of distant tumors and significantly prolong the survival time of mice.

Objective Studies on the expression and location of zinc finger protein A20 (A20) and connective tissue growth factor (CTGF) in liver tissues of patients with chronic hepatitis B were conducted, and the relationship between them and liver fibrosis was determined by FibroScan. Methods Studies on A20 and CTGF in liver tissues of 160 patients with chronic hepatitis B were conducted in accordance with the stage of pathological fibrosis and inflammation of the liver, and quantitative immunohistochemistry test was conducted, and statistical analysis was conducted by FibroScan. Results The expressions of A20 and CTGF in liver tissues increased with the aggravation of liver pathological fibrosis and inflammation, and there were significant differences between each stage and the control group (P<0.05), and there were significant differences between adjacent groups (P<0.05). Studies have shown that FibroScan increases along with pathological fibrosis and inflammation in the liver. There are significant differences between the stage and the control group (P<0.05), and no significant differences between the adjacent groups (P>0.05). There was positive correlation between liver A20 and CTGF, r=0.796 (P<0.05). Conclusions In patients with chronic hepatitis B, A20, CTGF and FibroScan are positively correlated with the degree of liver fibrosis, and A20 and CTGF are also positively correlated with the degree of liver inflammation, which can be used as indicators to evaluate the degree of liver inflammation and fibrosis, and further guide the anti-inflammatory and anti-fibrosis treatment of patients.