Objective To investigate the influence of TRF on high-intensity cerebrospinal fluid artifacts in T2-FLAIR MR imaging.Methods In a GE Signa Twinspeed 1.5T system,50 cases were examined with T2-FLAIR sequences including 2 different optional imaging parameters according to the augmentation of TRF.Results TRF pulses significantly improved image quality(P

Objective To investigate the value of the adaptive statistical iterative reconstruction (ASIR) algorithm for reducing the radiation dose and optimizing the image quality in the low-dose spectral CT scanning in GSl (Gemstone spectral imaging) of the liver.Methods A total of 60 patients who underwent hepatic spectral CT scanning in GSI were enrolled in this study.The patients were randomly divided into two groups according to priority with 30 cases per group.Low-dose spectral CT scanning was used for group A, and images were reconstructed by ASIR 0 and 50％ , marked as A1 and A2.Group B was scanned with conventional dose of spectral CT, and images were reconstructed by Filtered back projection (FBP).Effective doses (E) for each group were calculated.Image quality was assessed by two radiologists, and the radiation doses were compared between groups A and B.Results All image quality of each group were good enough for clinical diagnosis.E for group A and B were (3.2 ±0.2) and (5.8 ± 0.2) mSv, respectively.There was statistical difference with image noise between group A and B(Z =-6.784,P ＜ 0.05).The image noise, SNR and CNR had statistical differences between group A and B (F =24.013, 15.646, 8.285, P ＜0.05).Compared with group A1, the image noise was lower, and the SNR and CNR were higher in groups A2 and B(P ＜ 0.05).There were no statistical differences of image noise, SNR and CNR between groups A2 and B (P ＞ 0.05).There were no statistical differences of the image quality score between groups A1, A2 and B (F =102.38,105.768, P ＜ 0.05).Conclusions ASIR combined with low-dose spectral CT scanning was helpful to reduce radiation dose and could obtain better image quality in hepatic CT examination.

Although guidelines and expert consensuses have been published on the diagnosis and treatment of cholestatic liver disease recently in China and the rest of the world, many problems still exist in the biochemical standard for the diagnosis of cholestasis; for example, there are substantially different diagnostic criteria for cholestasis of various causes. This brings confusion to clinical doctors and is not good for research. This article analyzes common parameters in cholestasis and points out the problems in diagnosis. It is recommended to organize in-depth discussions and set standard for the diagnosis of cholestasis, in order to provide a more reliable basis for clinical research on cholestasis.

Objective:To investigate levels of autophagy in T cells and B cell of patients with systemic lupus erythematosus ( SLE) and its clinical significance.Methods: 68 SLE patients without treatment within 4 weeks were enrolled in this study.We accessed the levels of autophagy in T cells and B cells of 23 healthy controls and 68 patients before and after treatment by flow cytometry,and analyzed their correlations with serum levels of C3 and anti-dsDNA antibodies,SLEDAI score,et al.Results: Before treatment,a significantly increased levels of LC3-Ⅱ was observed in SLE patients than healthy controls, the active group ( SLEDAI score≥10) was significantly higher than the stable group(SLEDAI score<10),and the newly diagnosed group was significantly higher than the recurrent group(all P<0.05).While the levels of LC3-Ⅱ was decreased in B lymphocytes in SLE patients,the active group was significantly lower than stable group,and the active group was significantly lower than the newly diagnosed group(all P<0.05). Correlation analysis found that,a positively correlation was observed for the levels of LC3-Ⅱwith SLEDAI score in T lymphocyte( rs=0.289,P<0.05),and the levels of C3 were positively correlated the levels of LC3-Ⅱ in B lymphocyte(rs=0.371,P<0.01).After treatment for five days, levels of autophagy in T lymphocytes of SLE patients with good prognosis ( SLEDAI score decreased ≥4 ) significantly decreased(P<0.05).Also,three days after treatment,levels of autophagy in B lymphocytes of SLE patients with good prognosis were increased significantly ( P<0.05 ) .However, SLE patients with poor prognosis had no such difference ( P>0.05 ) . Conclusion:Levels of autophagy in T and B lymphocytes of SLE patients are abnormal compared to healthy controls,and these changes are associated with disease activity.Also,these changes are expected to be the indicators of disease activity and potential therapeutic targets in SLE.

BACKGROUND: Mild cognitive impairment (MCI) in elderly people is becoming increasingly a new hot spot for the clinical study of Alzheimer disease at present, and it is still unknown how many cases of MCI will convert into Alzheimer disease. OBJECTIVE: To analyze the incidence rate of mild cognitive impairment and the conversion rates into dementia and Alzheimer disease among elderly people.DESIGN: A prospective cohort study based on diagnosis. SETTING: Second Department of Cadre's Ward, Bethune International Peace Hospital of Chinese PLA.PARTICIPANTS: The subjects were 216 MCI patients and 2 302 subjects with normal cognition selected in the baseline investigation to the retired cadres aged 60 years and above, in 26 military cadres' sanatoriums of Shijiazhuang city between August and September 2001.METHODS: The MCI diagnosis was according to the MCI diagnostic standard in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-Ⅳ), and the diagnosis of dementia was according to the standard in DSM-Ⅳ revised by American Psychiatric Association. Alzheimer disease was diagnosed according to the standards of National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA). All the 216 MCIpatients and 2 302 subjects with normal cognition were enrolled in the 3-year cohort study. MAIN OUTCOME MEASURES: The incidences of MCI among subjects with normal cognition; the annual conversion rates into Alzheimer disease in MCI patients and subjects with normal cognition; the relative risks (RR) and 95% confidence interval (95% CI) of MCI and normal cognition developing into Alzheimer disease. RESULTS: The MCI group and normal cognition group were followed up once every year for 3 years. Of the 216 MCI patients, 7 died, and 209 were followed up actually, and the follow-up rate was 96.8%. Of the 2 302 subjects with normal cognition, 36 died, and 2 266 were followed up actually,and the follow-up rate was 98.4%. ① In the elderly subjects with normal cognition, the annual incidence of MCI was 4.8%, and those of dementia and Alzheimer disease were 1.3% and 0.8 respectively. ② The annual in cidence rates of dementia and Alzheimer disease in MCI patients were 8.1% and 5.6% respectively, which were insignificantly different between males and females (P ＞ 0.05). ③ The incidence rates of dementia and Alzheimer disease showed a descending trend with the elevation of educational level in both the MCI patients (trend x2 =5.57, P=0.02; trend x2 =4.92, P=0.03) and the subjects with normal cognition (trend x2 =23.1, P＜ 0.001; trend x2 =18.0, P ＜ 0.001). ④ The annual incidence rates of dementia and Alzheimer disease showed an ascending trend with aging in both the MCI patients (trend x2 =14.6, P ＜ 0.01; trend x2 =13.9, P ＜ 0.01) and the subjects with normal cognition (trend x2 =32.3, P ＜ 0.01; trend x2=23.8, P ＜ 0.01). ⑤ The relative risks of the conversion into dementia and Alz heimer disease in MCI patients were 6.4 and 7.4 times as many as those in the subjects with normal cognition.CONCLUSION: The risks of conversion into dementia and Alzheimer disease in elderly MCI patients are far higher than those in elderly people with normal cognition. It should be reinforced to monitor elderly MCI patients, who are the of high risk group of dementia.

Objective To explore the state of cardiac autonomic nerve function in schizophrenia patients with metabolic syndrome and analyze its influence factors and to reduce the occurrence of sudden cardiac death of the patients. Methods A total of 168 cases of patients according with the ICD-10 schizophrenia diagnostic criteria were divided into group A(78 cases of schizophrenia with metabolic syndrome),group B(90 cases of schizophre-nia without metabolic syndrome)and another 92 normal cases were included as control group(group C). Twenty-four hours dynamic electrocardiogram was conducted respectively and the heart rate variability (HRV) was ana-lyzed. Results Values of LF,HF,SDNN,SDANN,RMSSD and PNN50 in group A and group B were much low-er than those in group C and they were statistically significant(P < 0.05). Values of LF,HF,SDNN,SDANN, RMSSD and PNN50 in group B were much higher than those in group A and they were statistically significant(P<0.05). Excluding the influence of schizophrenia ,logistic regression analysis showed that the influence factors of HRV values were course of the disease(OR = 1.864,95%CI 1.110~3.128),age(OR = 1.170,95%CI 1.018~2.491),types of antipsychotic drugs(OR=2.419,95%CI 0.976~1.835),abdominal obesity(OR=2.425,95%CI 1.347~4.366),blood pressure value(OR=1.263,95%CI 1.575~3.937),blood glucose value(OR=3.376, 95%CI 1.359~2.923)and blood lipid value(OR = 2.178,95%CI 1.492~6.756). Conclusions Schizophrenia patients with metabolic syndrome have obvious cardiac autonomic nerve dysfunction. Excluding the influence of schizophrenia itself,the other possible risk factors include course of the disease,age,types of antipsychotic drugs,abdominal obesity,blood pressure value,blood glucose value and blood lipid value.

Objective To explore the prevalence of mild cognitive impairment (MCI) among elderly veterans. Methods 2 674 veterans ( aged 60 years and over) from 26 military sanatorium in Shijiazhuang city were studied. The Mini-Mental State Examination, Global Deterioration Scale, Activity of Daily Living, Hachinski Ischemic Scale and Hamilton Depression Scale were served as screening tools. Results The prevalence of total MCI was 8 08% in elderly people. The standardized prevalence of MCI was 6 87% in male and 10 38% in female (P

OBJECTIVETo elucidate the prognostic influence of preoperative weight loss for gastric cancer.

METHODSA total of 672 gastric cancer patients who underwent gastrectomy between January 2003 and December 2007 were enrolled. The patients were categorized into three groups according to the percentage of weight loss before surgery: no weight loss group (0%), limited group ( < 10%), and severe group ( ≥ 10%). Compared the clinicopathologic characteristics and analyzed the prognostic influence of preoperative weight loss. The survival was analyzed by Kaplan-Meier survival cure and the prognostic factors were analyzed univariately and multivariately by Cox comparative hazard modal.

RESULTSAmong the 672 cases gastric cancer, no weight loss group had 275 cases, limited group 294 cases, severe group 103 cases. Tumor size (F = 4.386) , tumor location (χ² = 15.864), depth of invasion (χ² = 22.245) , the number of lymph node metastasis (χ² = 23.803), Surgical approach (χ² = 18.423) , extent of lymphadenectomy (χ² = 8.172) , curability (χ² = 15.650) were discrepant among the three groups (all P < 0.05) . The 5-year survival rate of the patients with severe group was 28.0%, limited group was 37.7%, while the no weight loss group was 40.3% (χ² = 20.148, P < 0.05). Age (95% CI: 0.480 - 0.744, P = 0.000), weight loss before surgery (95% CI: 0.371 - 0.687, P = 0.000), depth invasion (95% CI: 0.289 - 0.564, P = 0.000), lymph node metastasis (95% CI: 0.451 - 0.783, P = 0.000), extent of lymphadenectomy (95% CI: 0.647 - 0.990, P = 0.000), curability (95% CI: 0.291 - 0.486, P = 0.000), postoperative adjuvant chemotherapy (95% CI: 0.511 - 0.846, P = 0.000) were associated with survival of this group. In multivariate analysis, age (HR = 1.618, 95% CI: 1.298 - 2.016, P = 0.000), weight loss before surgery (HR = 1.258, 95%CI: 1.077 - 1.469, P = 0.004), depth of invasion (HR = 1.810, 95% CI: 1.287 - 2.545, P = 0.000), N stage (HR = 1.555, 95% CI: 1.413 - 1.172, P = 0.000) were independent prognostic factors for survival.

CONCLUSIONSPatients with weight loss above 10% have poor prognosis. Weight loss before surgery may be an important independent prognostic factor for gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Preoperative Period ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; surgery ; Survival Analysis ; Weight Loss ; Young Adult

Receptor-interacting serine/threonine-protein kinase 1 (RIPK1) functions as a key regulator in inflammation and cell death and is involved in mediating a variety of inflammatory or degenerative diseases. A number of allosteric RIPK1 inhibitors (RIPK1i) have been developed, and some of them have already advanced into clinical evaluation. Recently, selective RIPK1i that interact with both the allosteric pocket and the ATP-binding site of RIPK1 have started to emerge. Here, we report the rational development of a new series of type-II RIPK1i based on the rediscovery of a reported but mechanistically atypical RIPK3i. We also describe the structure-guided lead optimization of a potent, selective, and orally bioavailable RIPK1i, 62, which exhibits extraordinary efficacies in mouse models of acute or chronic inflammatory diseases. Collectively, 62 provides a useful tool for evaluating RIPK1 in animal disease models and a promising lead for further drug development.