0.05).There were significant difference but 50mA image quality betweer the rest of the three groups(P

Objective To investigate the feasibility of diffusion-weighted imaging (DWI) for differentia-tion of small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) at 3.0 T MRI. This study also aims to optimize b values. Methods Thirty-six patients with lung cancer proved by pathology were examined by T2WI and DWI (b = 400, 600 and 800 s/mm2) and apparent diffusion coefficient (ADC) values of each lesion were calculated among different b values. The receiver operating characteristic (ROC) curves were used to calcu-late the difference between the ADC of SCLC and NSCLC and to evaluate the diagnostic capability. Analysis of variance was used to determine difference in ADC of NSCLC histological types at the optimal b values. Results The ADC values of SCLC and NSCLC decreased with increasing b values , and the differences were statistically significant (P = 0.002, P < 0.001). ROC analysis showed that the area under curve (AUC) values were 0.775、0.892、0.804 (b = 400, 600, 800 s/mm2, respectively). The AUC with a b value of 600 s/mm2 was the largest. When an ADC of 1.296 × 10-3 mm2/s was considered as a threshold, the sensitivity, and specificity were 76.9%, and 90.0%, respectively. Conclusion DWI reflects the diffusion motion of water protons in lung carcinoma and it has moderate diagnosis potency in differentiating SCLC and NSCLC. The optimal b value is 600 s/mm 2.

Objective To probe into the variation of CT values of surface enhanced layers of nasopharynx wall,intensified regularity and choosing the best scanning time.Methods 138 patients received conventional plus enhanced CT scan and 58 cases of them received delayed and repeated scans.Results 83% of the cases were correspondent to the surface of nasopharynx and had manifest linear enhancement.After giving contrast injection,it reached 97% at the 74 second.All CT values of the cases were enhanced in the phase of 92～344 second.Conclusion The ratio of linear enhancement is manifestly high,which is very helpful to the CT diangosis of NPC restricted to or under the mucosa.The best acquisition time should be just before or after the 74 second,correspondent to the surface of nasopharynx.The enhancement lasted long.

Objective To analyze mutations in the ATP2A2 gene in a Kazakh family with Darier's disease.Methods Clinical data were collected from 49 members from a family with Darier's disease,and peripheral blood samples were obtained from 44 family members and 100 unrelated healthy people.Genomic DNA was extracted from these blood samples.PCR and DNA sequencing were performed to detect mutations in the ATP2A2 gene.Results Darier's disease was inherited in an autosomal dominant manner in this family.A G→A heterozygous mutation (1288-1G→A) was identified at position 1288-1 at the splice site in exon 12 of the ATP2A2 gene in 11 patients in this family,but not in 33 healthy members or 100 healthy controls.Conclusion Darier's disease in this family may be caused by the heterozygous mutation (1288-1G→A)at the splice site in exon 12 of the ATP2A2 gene.

Objective To detect the level of 5-hydroxymethyl-cytosine (5-hmc)in melanoma tissues,and to analyze the correlation between 5-hmc and the invasion,metastasis and prognosis of melanoma.Methods A streptavidin-peroxidase immunohistochemical method was used to detect the level of 5-hmc in 67 melanoma tissues and 20 pigmented nevi tissues.Univariate and multivariate analyses were performed with the Cox's proportional hazards regression model to analyze the correlation between the expression of 5-hmc and the prognosis of melanoma.Results The expression rate of 5-hmc was significantly lower in melanoma tissues than in pigmented nevus tissues (40.30％ [27/67] vs.75％ [15/20],22 =7.428,P =0.006).According to American Joint Committee on Cancer (AJCC) TNM staging system,the expression level of 5-hmc was significantly lower in the stage Ⅳ melanoma tissues than in the stage Ⅱ and stage Ⅲ melanoma tissues (x2 =4.416,P =0.036).Patients with lymph node metastasis showed significantly lower expression of 5-hmc compared with those without lymph node metastasis (x2 =5.902,P =0.015),and the level of 5-hmc expression significantly decreased along with the increase of Clark grade (x2 =4.828,P =0.028).There were no significant differences in the level of 5-hmc expression between patients of different ages,genders or nationalities (P ＞ 0.05).Multivariate Cox regression analysis showed that distant lymph node metastasis (HR:2.67,95％ CI:1.22-5.84),not receiving surgical resection (HR:0.41,95％ CI:0.18-0.95),and low expression of 5-hmc (HR:3.54,95％ CI:1.09-11.43)were independent risk factors for poor prognosis of melanoma.Conclusion 5-Hmc may participate in the invasion and metastasis of melanoma,and be associated with the prognosis of melanoma.

Objective To study the role of leucine rich repeat neuronal 3 (LRRN3) in the prolif-eration of non-small cell lung cancer and its possible mechanism of expression regulation. Methods The expression of LRRN3 in non-small cell lung cancer was detected by real-time quantitative polymerase chain reaction ( qPCR) , immunohistochemistry and bioinformatics retrieval;A lung cancer cell line A549-LRRN3 with stable over-expression of LRRN3 was established by lentivirus over-expression technology;The effect of LRRN3 on the proliferation of non-small cell lung cancer was detected by methyl thiazolyl tetrazolium ( MTT) assay;Bioinformatics search for changes in methylation of LRRN3 promoter region and treatment of lung cancer cells by methyltransferase inhibitors to detect the effect of methylation on the regulation of LR-RN3 expression; Finally, bioinformatics search analyzes the correlation between LRRN3 and lung cancer prognosis. Results The mRNA expression of LRRN3 in clinical tissues of non-small cell lung cancer (n=12) was significantly lower than that of adjacent normal tissues (n=12) (P=0. 0014). The results of immunohistochemistry showed that the protein expression level of LRRN3 in non-small cell lung adenocar-cinoma was lower than that in normal tissues (P=0. 001), and the expression in non-small cell lung squa-mous cell carcinoma was also lower than that in normal tissues (P=0. 003). Overexpression of LRRN3 in-hibited the proliferation of tumor cells (P<0. 01), and the hypermethylation of LRRN3 in the promoter re-gion inhibited its transcriptional expression. LRRN3 was positively correlated with the survival prognosis of lung adenocarcinoma (P=5. 2e-09;HR=0. 48). Conclusions Hypermethylation in the promoter region of LRRN3 inhibits its transcriptional expression, thereby promoting the proliferation of lung cancer cells.

Objective:To investigate the epidemiological characteristics of lower extremity deep vein thrombosis (DVT) in patients with femoral fracture.Methods:Retrospectively analyzed were the data of 2,571 patients with femoral fracture who had been treated at the Third Hospital of Hebei Medical University from January 2019 to December 2019. There were 1,079 males and 1,492 females, aged from 14 to 96 years (average, 67.1 years). There were 1,158 femoral neck fractures, 951 femoral intertrochanteric fractures, 309 femoral shaft fractures, and 153 femoral condylar fractures. 2,414 patients were treated surgically while 157 patients non-surgically. Color Doppler ultrasonography of both lower extremities was performed to determine the occurrence of DVT before operation and every week after operation for patients undergoing surgical treatment, and within 48 hours after admission and every week during hospitalization for those undergoing non-surgical treatment. The incidence and location of DVT were recorded for different femoral fractures.Results:The incidence of DVT in this cohort was 35.5%(913/2,517), that of proximal DVT 5.3%(135/2,571), and that of distal DVT 30.3% (778/2,571). In patients with femoral neck fracture, femoral intertrochanteric fracture, femoral shaft fracture and femoral condylar fracture, the incidence of DVT was respectively 28.8% (334/1,158), 44.7% (425/951), 30.7% (95/309) and 38.6% (59/153), the incidence of proximal DVT was respectively 2.7% (31/1,158), 5.6%(53/951), 9.7% (30/309) and 13.7% (21/153), and the incidence of distal DVT was respectively 26.2% (303/1,158), 39.1% (372/951), 21.0% (65/309) and 24.8%(38/153). The incidence of DVT in the femoral vein and above, popliteal vein, tibiofibular vein and intermuscular vein in this cohort was respectively 2.3%(60/2,571), 2.9%(75/2,571), 6.4%(165/2,571) and 23.8%(613/2,571).Conclusions:The incidence of DVT may be high in patients with femoral fracture, and the proximal DVT with a high risk of pulmonary embolism may occur more in patients with femoral condylar fracture.

Objective : To explore the differences in the effects of psoriatic serum and a mixture of five proinflam⁃ matory cytokines on keratinocyte inflammation and proliferation . Methods : he human immortalized keratinocyte cell line (HaCaT cells) was used to cultivate with serum of healthy human serum , psoriasis patients and M5 factors , and the cell proliferation was monitored by CCK⁃8 . RT⁃qPCR was used to detect the mRNA expression levels of inflammatory factors interleukin 1β/8/21 /23 (IL⁃1β/8/21 /23) , proliferation markers keratin 6/16 (K6/K16) and nucleus related antigen 67 (Ki67) in HaCaT cells in each group . Results : Healthy human serum , psoriasis serum and M5 factors could effectively promote the growth of HaCaT cells , and psoriasis serum and M5 factors could promote cell growth more than healthy human serum . Similar to M5 factors , serum from patients with psoriasis significantly promoted the mRNA levels of inflammatory factors IL⁃1β , IL⁃8 , IL⁃23 and proliferation markers K6 and Ki67 in cells . Different from M5 factors , the serum of psoriasis patients had enhanced the mRNA level of inflammatory factor IL⁃21 , but weakened the promotion of proliferation marker K16 . Conclusion The serum micro environment of patients with psoriasis can promote the proliferation and inflammatory response of keratinocytes higher than that of healthy people , and is similar to M5 factors , which can be used to build a keratinocyte model of psoriasis .

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.