Objective To investigate the disgnostic value of thoracic CT and X-ray plain film in giant bulla and its differential diagnosis with pneumothorax.Methods 6 patients with surgical proved giant pulmonary bulla were analyzed retrospectively,all patient underwent chest radiography and CT scan.Results The lesions occupied 30%~80% of thoracic cavity,4 cases lied left thoracic cavity and 2 cases lied right thoracic cavity.3 cases were misdiagnosed as pneumothorax by X-ray plain film.CT could show the wall and internal condition of bulla as well as compression of the normal pulmonary tissue.Conclusion Giant pulmonary bulla is easily misdiagnosed,thoracic CT is of significant value in diagnosis of giant bulla.

Objective To assess the relationship of ankle brachial index (ABI) with the other traditional risk factors for cardiovascular disease (CVD). Methods A total of 2005 participants with a full data were selected from the survey of risk factors for CVD, carried out in Wuming, Guangxi province, 2004. The relationship of ABI with the other risk factors of CVD was analyzed by multivariate Logistic regression (backward stepwise; probability for stepwise, entry:0.05, removal:0.10). T test used in participants having risk factors vs the normal participants. The risk factors of CVD include age, sex, hypertension, high total cholesterol (HTC), high fasting plasma glucose (high FPG), low high-density lipoprotein cholesterol (low HDL-C), overweight or obesity, cigarette smoking, etc. Results The mean ABI values were significant in the groups having risk factors of overweight or obesity (P=0.02), low HDL-C (P= 0.04) and cigarette smoking (P

Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.

Objective To discuss whether Omega-3 fish oil fat emulsion has the potential protective mechanism for 7-day-old rats with hypoxic-ischemic brain damage (HIBD).Methods One hundred and sixty-eight 7-day-old SD rats were randomly divided into 4 groups:group A (sham group),group B (Omega-3 fish oil fat emulsion group),group C (normal fat emulsion group),group D (model group),and there were 42 cases in each group.Neonatal HIBD was induced by the method of Rice.Rats were sacrificed at 1 d,3 d and 7 d after the surgery.Hippocampus was removed for Real-time PCR and Western blot test to detect Toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) mRNA and protein expression.TUNEL staining comparison was done among different groups to observe the number of cellular apoptosis.Results HE staining of hippocampus CA1 area in 3 d showed that brain tissues in group A maintained normal structures;those in group D had much more brain cells with severe edema than other groups;TLR4 and NF-κB mRNA and protein expression levels in group D were higher than those in group A in 1 d (all P ＜0.05);TLR4 and NF-κB expression levels of mRNA and protein in group B (4.89 ± 0.51,9.30 ± 1.53;1.15 ±0.10,1.44 ± 0.14) were lower than those in group C (17.58 ± 2.50,20.13 ± 1.00;2.56 ± 0.10,2.82 ± 0.09) and group D (15.94-± 2.52,26.21 ± 3.00;2.34 ± 0.11,4.51 ± 0.36) in 3 d (all P ＜ 0.05),and compared with group A (6.30 ± 1.52,5.32 ± 1.06;1.32 ± 0.10,2.42 ± 0.14),there was significant difference (all P ＞ 0.05);TLR4 and NF-κB mRNA and protein expression levels in group B were lower than those in group C and group D in 7 d(all P ＜0.05),and compared with group A there was no significant difference (all P ＞ 0.05).The apoptotic cell number of brain tissues in 3 d:group B (13.67 ±2.52) were lower than those in group C (27.67 ±2.52) and group D (41.00 ±3.61) (all P ＜0.05),and compared with the group A (6.00 ±2.00),the difference was not statistically significant (P ＞ 0.05).Conclusions Omega-3 fish oil fat emulsion plays an important role in protecting neonatal rats with HIBD.The mechanisms were likely to reduce TLR4,NF-κB and cell apoptosis levels.

To study the effect of soybean isoflavone on liver oxidative stress resulting from 60Co-gamma rays. Methods: Totally 80 normal female Kunming mice were evenly randomized into 5 groups according to body weight: 3 intervention groups, single irradiation group and normal control group. The normal group and single irradiation groups were given 0.5% CMC-Na, and the 3 intervention groups were given different doses of soybean isoflavone (50 mg/kg, 100 mg/kg, 400 mg/kg) respectively for 14 d. The whole body of single irradiation group and intervention groups were subjected to 4.56 Gy 60Co-γ radiation once on the 7th day, and then the mice were killed on the 2nd day and the 7th day after radiation. Results: The CAT activity of liver tissue of 100,400 mg/kg intervention groups and 3 SI groups were significantly increased on the 2nd day and 7th day after irradiation(P<0.05), respectively; the GSH-Px activity of 100 mg/kg SI group was significantly increased(P<0.05) on the 7th day after irradiation; the T-SOD activity of 50 mg/kg SI group was significantly decreased (P<0.05) on the 2nd day after irradiation,while no difference was observed among remaining groups. The MDA content of 100 mg/kg group was significantly decreased on the 7th day after radiation compared with control group, and MDA content of each group subjected to irradiation were increased on the 2nd day after irradiation,but 3 SI groups nearly decreased to normal level on the 7th day after irradiation. Conclusion: The soybean isoflavone can enhance the antioxidant capability of mice, but it does not show a dose-effect relationship.

BACKGROUND: Endothelium-dependent vasodilatation (EDD) has been assessed by intracoronary acetylcholine infusion and digital subtraction angiography. However, its applications in continuous observing on early onset, progression and outcomes of clinical interventions of the disease are limited due to the potential trauma of the method. OBJECTIVE: This study was designed to assess the changes in brachial EDD in patients with hyperlipidemia using high-resolution ultrasound and to compare the outcomes of the patients to those of the healthy individuals. DESIGN: Case-control study SETTING: This study was carried out at the Cardiology Department and the Ultrasound Department of Xinyang CentralHospital PARTICIPANTS: Sixty patients with hyperlipidemia, 37 males and 23females, with an age ranging from 36 to 75 years old, were selected at the Cardiology Department of Xinyang Central Hospital from May 2001 to March 2002. They were divided into 3 groups according to abnormalities in blood lipid, as hypercholesterolemia group (HC, 20 cases),hypertriacylglycerolemia group (HTG, 20 cases) and mixed hyperlipidemia group (HLP,20 cases). Twenty voluntary individuals with normal physical examination findings were allocated into control group, 12 males and 8 females. Informed consents were obtained from all the eligible. METHODS: The brachial artery inner diameter and the changes in blood flow of the brachial artery were assessed using high-resolution ultrasound.After the patients having a rest for more than 10 minutes, the inner diameter (D0) and the baseline blood flow of their brachial artery were measured. The blood pressure cuff was placed under the elbow with a pressure at 300 mm Hg, lasting for 4 to 5 minutes and followed with a sudden deflation. 15 s after deflation, the reactive brachial artery inner diameter (D1) and the blood flow of the brachial artery were detected. The patients took another rest for more than 15 minutes and after the artery restored to a normal condition,the patients took nitroglycerol sublingually at a dose of 400 μg. Three to four minutes later, the brachial artery inner diameter (D2) and the blood flow of the brachial artery were detected. The increasing rate of the inner diameter of brachial artery were calculated, the increasing rate of reactive brachial artery inner diameter (%)= (D1-D0)/D0×100% and the increasing rate of post-treatment brachial artery inner diameter (%)=(D2-D0)/D0 ×100%.Meanwhile, the increasing rate of reactive blood flow (%)=(reactive blood flow-baseline blood flow)/ baseline blood flow (100% and the increasing rate of post-treatment blood flow (%)=(the post-treatment blood flow-baseline blood flow)/baseline blood flow×100%. MAIN OUTCOME MEASURES:In three hyperlipidemia groups and the control group, the inner diameter of the brachial artery were measured under resting conditions, in reactive congestion status and after sublingual nitroglycerol treatment respectively using high-resolution ultrasound. RESULTS: All the 60 patients with hyperlipidemia and 20 healthy controls entered the analysis procedure. In HC group, HTG group and HLP group, the increasing rate of reactive brachial-artery inner diameter were significantly lower than that in control group [(5.7±3.2)%, (5.4±3.0)%,(3.8±2.4)%, (11.3±3.1)%,P ＜ 0.05], which was most significant in HLP group. The increasing rate of both the reactive and the post-treatment blood flow in three experimental groups and the increasing rate of the post-treatment brachial-artery inner diameter were not significant (P ＞ 0.05). CONCLUSION:EDD were impaired significantly in patients with hyperlipidemia. High-resolution ultrasound is capable of assessing EDD accurately and reliably.

Objective:To systematically evaluate the effect of glucagon-like peptide 1 receptor agonists(GLP-1RA)on the brain structure of rat or mouse Alzheimer’s disease(AD)models.Methods:Data of randomized controlled trials from January 2000 to January 2018 for the effect of GLP-1RA on the brain structure of AD rats or mice were searched from all databases, including the Cochrane Library, EMbase, PubMed, Chinese Journal Full-text Database, the Chinese biomedical literature database, Chinese PSTP VIP and Wanfang database.Literature was selected based on inclusion and exclusion criteria defined in advance, and the quality was evaluated using the SYRCLE as animal experimental bias risk assessment tools.Valid data were retrieved and a meta-analysis was performed using the RevMan 5.3software.Results:A total of 9 articles with 207 rats and mice were included.Among the 207 cases, 123cases were in the experimental group and 84 cases in the control group.After treatment with GLP-1RA, there were significant differences in the amyloid plaque load[Low dose group: mean difference(MD)=-5.55, 95% CI: -6.92 to-4.17, P<0.01, High dose group: MD=-4.81, 95% CI: -6.63to-2.98, P<0.01], the amount of p-tau protein(MD=-3.16, 95% CI: -4.29 to-2.02, P<0.01), and the activation of microglia in rat or mouse brain(liraglutide treatment group: MD=-7.85, 95% CI: -12.66 to-3.04, P<0.01, lixisenatide treatment group: MD=-7.60, 95% CI: -9.56 to-5.65, P<0.01)between the treatment group and the control group. Conclusions:GLP-1RA can reduce the amyloid plaque load, decrease the number of neurofibrillary tangles and inhibit the activation of microglia in the rat or mouse brain.

The phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a common oncogene located in the 10q23.3 region on the long arm of human chromosome l0, which regulates a variety of biological processes such as proliferation, survival, cell structure, motility, energy metabolism and genomic stability. Inactivation of PTEN is prevalent in almost all malignancies and correlates with tumor progression. Thyroid malignancies are among the most common endocrine malignancies, and PTEN has been shown to be critically associated with their development. The aim of this review is to describe the structural function of PTEN, as well as to summarize and discuss the recent findings of PTEN in thyroid malignancies.

Objective: To study the role of rs 12145833 polymorphism of SDCCAG 8 gene in the intervention of childhood obesity, so as to provide scientific basis for formulating personalized intervention measures based on genetic background in children with obesity. Methods: From September 2018 to June 2019, a total of 393 children aged 8-10 years in Beijing were enrolled in a cluster randomized controlled trial. Eight schools were randomly allocated into intervention group and control group at a ratio of 1∶1. Saliva DNA samples were collected to detect rs 12145833 polymorphism of SDCCAG 8 gene. The intervention group received a comprehensive intervention, while the control group received usual practice. Intervention measures included diet improvement, sports, school amd family sport. The obesity related indicators were measured at baseline and after the end of intervention 1 academic year. Multiple linear regression and Logistic regression were used to analyze the interaction between genes and intervention on obesity indicators. Results: In the intervention group, children with TT genotype of rs 12145833 of the SDCCAG 8 gene had less increase in systolic( β=4.56, 95%CI=1.84-7.28, P <0.01) and diastolic blood pressure( β=2.59, 95%CI=0.45-4.73, P <0.05) than those with GT and GG genotypes. In the control group, the systolic blood pressure of children with TT genotype increased more than those with GT and GG genotype( β=-2.86, 95%CI=-5.63--0.83, P <0.05). There was an interaction between rs 12145833 polymorphism of SDCCAG 8 gene and intervention on systolic blood pressure, diastolic blood pressure and body fat percentage in children( P <0.05). Conclusion Children with TT genotype of rs 12145833 in the SDCCAG 8 gene are more sensitive to obesity intervention than those with GG and GT genotypes, especially in the improvement of systolic blood pressure, diastolic blood pressure and body fat percentage. Further trials to study the role of rs 12145833 polymorphism of SDCCAG 8 gene in the intervention of childhood obesity among different ethnic populations are needed.

Objective:To explore the predictive value of the serum C-reactive protein (CRP)/albumin (ALB) ratio (CAR) for organ damage in tsutsugamushi disease.Methods:The clinical data of 166 patients with tsutsugamushi disease admitted to the First Affiliated Hospital of Wenzhou Medical University from January 1, 2010 to December 31, 2020 were retrospectively analyzed. The patients were divided into the organ damage group (72 cases) and non-organ damage group (94 cases) according to the organ damage criteria. The general data and laboratory test results of the two groups of patients were compared. The significant indicators of univariate analysis were analyzed by multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive value of CAR for organ damage in patients with tsutsugamushi disease.Results:There were no significant differences in age, sex, days of fever, and admission body temperature between the organ damage group and non-organ damage group ( P>0.05). However, the body mass index, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), length of hospital stay, hospitalization expense, percentage of neutrophils (NEUT), lymphocyte count, procalcitonin, CRP, and CAR in the organ damage group were significantly higher than those in the non-organ damage group ( P<0.05), and ALB was significantly lower than that in the non-organ damage group ( P<0.05). Multivariate logistic regression analysis showed that APACHEⅡ( P=0.039), NEUT ( P=0.003), and CAR ( P=0.011) were independent risk factors for tsutsugamushi disease complicated by organ damage. The ROC curve showed that the AUCs of APACHEⅡ, NEUT, and CAR were 0.655, 0.716, and 0.727, respectively. When the cut-off value of CAR was 2.86, the sensitivity was 55.6%, and the specificity was 79.8%. Conclusions:Elevated CAR is an independent risk factor for tsutsugamushi disease complicated with organ damage and can be used as an important indicator to evaluate the presence or absence of organ damage in patients with tsutsugamushi disease.