0.05).②Gabexate mesilate significantly reduced the frequency of contraction (P0.05).③High dose gabexate mesilate could markedly reduce the motility index ( P

Objective To investigate the correlation between vitamin D receptor gene and bone mass and obesity phenotypes in patients with type 2 diabetes mellitus.Methods 318 patients with type 2 diabetes were chosen as diabetes group,and 50 healthy people were selected as healthy control group.Vitamin D receptor gene Apa Ⅰ type was detected in the two groups.Height,weight and body mass index(BMI)biochemical index,fat content(FM),lean tissue content(LM)and bone mineral density were detected in patients with type 2 diabetes mellitus.The relationship between vitamin D receptor gene(Apa Ⅰ)polymorphism and BMD and obesity phenotypes in type 2 diabetes was analyzed.Results The VDR gene distribution between the diabetes group and healthy control group showed no signif-icant difference(Z =0.561,P >0.05).The vitamin D receptor genotype in the diabetes group included AA 31 cases (9.7%),Aa type 108 cases(34.0%),aa type 179 cases(56.3%),while the vitamin D receptor genotype in the healthy control group comprised AA 7 cases(9.3%),Aa type 29 cases(38.7%),aa type 39 cases(52.0%).The percentage of AA in both groups was significantly less than that of Aa and aa(χ2 diabetic group =4.127,3.976,all P <0.05;χ2 healthy control group =5.129,4.213,all P <0.05).Proportion of normal bone mass and average bone density in AA,Aa,aa type decreased(χ2 =15.552,P <0.05;F =5.127,P <0.05),the genotype AA was not detec-ted in osteoporosis group.BMI and FM were the highest in AA,which were significantly higher than those of Aa,aa (F =4.319,4.263,all P <0.05).Conclusion Vitamin D receptor gene Apa Ⅰ type polymorphism is related with BMD and obesity in type 2 diabetes mellitus,and it has predictive value on bone mass changes.The increase of BMI and FMmay be beneficial to bone mineral density.

Objective To investigate the mechanism and effect of thalidomide on gastrointestinal bleeding of angiodysplasia. Methods The endothelial cells of human umbilical vein were cultured in vitro to exponential phase of growth, then were divided into blank control, solvent control and different concentrations (10- 100 μg/ml) of thalidomide incubated with or without basic fibroblast growth factor (bFGF). The cell proliferation was measured by MTT assay 72 h after stimulation. The expressions of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) were detected by ELISA and real-time PCR, respectively. Results The proliferation of endothelial cells of human umbilical vein was inhibited by thalidomide (≥40 μg/ml) both in presence or absence of bFGF. The expression of VEGF could be inhibited by 20 μg/ml of thalidomide in the absence of bFGF and 10 μg/ml in the presence of hFGF. No expression of TNF-α was detected. Conclusions The in vitro study reveals that thalidomide can inhibit the proliferation and the expression of VEGF, which may treat gastrointestinal bleeding of angiodysplasia by suppressing the angiogenesis.

Objective To investigate the inhibitory effect of thalidomide on angiodysplasia.Methods Excisional intestinal specimens were collected and immunohistochemical examination was carried out.The human umbilical vein endothelial cells were cultured in vitro to exponential phase of growth,divided into six groups and synchronized for 24 hours.They were then stimulated with thalidomide (40-100 μg/ml) for 72 hours.MTT assay was used to assess cellular proliferation.ELISA,real-time quantitative PCB and western blot were applied to detect the expression of VEGF/HIF-1α of human umbilical vein endothelial cells (HUVEC).Results Immunohistochemical analysis of intestinal pathological specimens demonstrated higher expression of VEGF.ELISA showed that the expression of VEGF under hypoxia was obviously higher than that under normoxia [ ( 1199.3 ± 61.4) ng/L vs ( 864.7 ± 41.2 ) ng/L,P < 0.05 ].Real-time quantitative PCR and Western blot discovered that thalidomide inhibited the expression of VEGF/ HIF-1α of HUVEC (P < 0.05).The effect of thalidomide was dose-dependent.Conclusions Thalidomide can suppress the expression of HIF-1α and VEGF in HUVEC in vitro and then inhibit angiodysplasia,which may play a significant role in stopping the rebleeding in patients with recurrent gastrointestinal bleeding.

Objective To observe and investigate the therapeutic effect of thalidomide on gastrointestinal bleeding of angiodysplasia.Methods Eighteen patients with recurrent gastrointestinal bleeding of angiodysplasia were treated with thalidomide 100 mg daily for 4 months.Median follow-up time was 16.7 months.The changes of clinical setting and serum.vascular endothelial growth factor(VEGF)and tumor necrosis faetor-α(TNF-α)level between pre-therapy and post-therapy were compared.Results The clinical setting of patients in post therapy was significantly better than that in pre-therapy.The overall symptom score,the median bleeding frequency and median transfusion volume of patients after therapy was significantly lower than those before the therapy[(15.000±3.630)vs(5.330±3.325),(11.220±6.404)vs(1.000±1.237),(1422.22±1556.601)ml vs(100.00±240.098)ml,respectively,all P＜0.01],while median hemoglobin was obviously higher than that before the therapy[(5.950±1.656)g/ml vs(9.533±2.278)g/ml,P＜0.01].Serum VEGF and TNF-α levels decreased obviously after the therapy(118 pg/ml vs 58 pg/ml,116 pg/ml vs 34 pg/ml,P＜0.01).Conclusions Thalidomide can suppress the serum VEGF and TNF-α levels of the patients with recurrent gastrointestinal bleeding of angiodysplasia,then play a significantly role in preventing the rebleeding in patients with recurrent gastrointestinal bleeding of angiodysplasia.

Objective To investigate protective activity against Aβ25-35-induced cytotoxicity in PC12 cells of different extracts and ursolic acid, which were isolated from pyrola decorata. Methods Aβ25-35-induced cytotoxicity in PC12 cells was established as the model in vitro. The cultured PC12 cells were divided into blank control group, DMSO control group, model control group, different extract groups of pyrola decorate and ursolic acid(UA) group. The different extract groups included ether extract (PE), acetidin extract (AE), n-butanol extract (BE), the water extract (WE), 50% ethanol extract (HEE). MTT assay was used to test the optimum concentration, and the number of viable cells in culture medium was measured by ELISA at 490 nm wavelength. Results The cell viabilities in different extracts groups(PE, AE, BE, WE, HEE) were respectively 89.3%, 77.2%, 79. 2%, 75. 1% ,74. 0% at the concentration of 5. 0 mg ? mL-1 . Moreover, ursolic acid showed the best neuroprotective activity (88.9%) at the concentration of 500 μg?L-1 . Compared with model control group, the survival rate of each group was remarkably increased, and the protective activities of PE and UA were more significant among them. Conclusion Different polar extracts of pyrola decorata and isolated ursolic acid have neuroprotective effects on Aβ25-35-induced cytotoxicity in PC12 cells in certain degrees.

Objective:To investigate the feasibility and clinical diagnostic value of rapid arterial spin labeling (ASL) imaging in brain glioma.Methods:Patients with glioma admitted to Beijing Tiantan Hospital, Capital Medical University from May 2021 to December 2022 were prospectively enrolled. All patients received MR rapid ASL (scan time: 1 min) and conventional ASL (scan time: 4 min 30 s), where the cerebral blood flow (CBF) perfusion maps were obtained. The qualitative analysis of CBF signal intensity and quantitative analysis of average CBF values from both tumor solid and edema regions were conducted by two radiologists independently. Kappa test and intraclass correlation coefficient ( ICC) were used to analyze the consistency of qualitative and quantitative results, respectively. Results:A total of 30 patients with brain glioma were included. The 2 physicians used rapid ASL to determine low perfusion, isoperfusion, and hyperperfusion in the tumor area in 1, 6, 23 cases and 0, 5, and 25 cases, respectively; and used conventional ASL to determine low perfusion, isoperfusion, and hyperperfusion in the tumor area in 0, 9, and 21 cases, respectively. The results of qualitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups ( Kappa was 0.830 and 0.850 respectively). The results of quantitative analysis of rapid ASL and conventional ASL were highly consistent within and between groups ( ICC 0.940—0.994). Conclusion:Rapid ASL with shorter scanning time could be applied in assessing tissue perfusion in brain glioma and contribute to the clinical diagnosis of gliomas.

Background::Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods::This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram.Results::Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. Conclusion::A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration::Chictr.org.cn, ChiCTR2100049131.

Objective:To construct a spatial radiomics model based on the spatial distribution characteristics of supratentorial pilocytic astrocytoma (PA) and ganglioglioma (GG) and to evaluate its differential diagnosis efficiency.Methods:The study was a cross-sectional study. A retrospective collection of 244 patients with episodic PA and GG who attended Beijing Tiantan Hospital of Capital Medical University (Center 1) from June 2016 to June 2022 and 116 patients with episodic PA and GG who attended General Hospital of Eastern Theater Command (Center 2) from March 2019 to October 2022 was performed. The patients in Center 1 were divided into a training set (171 patients) and a validation set (73 patients) in a 7∶3 ratio according to the random number table method, and the patients in Center 2 as a whole were regarded as test sets. All patients underwent MRI. Segmentation of tumor based on enhanced T 1WI and T 2WI images, alignment to standard space to generate a statistical parametric mapping of tumor locations and intergroup comparison was conducted. The Johns Hopkins University template was used to extract 189 tumor location features to construct a spatial model of tumor location; PyRadiomic 3.0.1 software was used to extract tumor radiomics features to construct a radiomics model; and the two models were fused to construct a spatial radiomics model. The efficacy of spatial radiomics model, spatial model, and radiomics model to discriminate PA from GG was analyzed using receiver operating characteristic curves and area under the curve (AUC). The generalization ability of the model was assessed by the difference in accuracy between the test sets and the validation sets (ΔACC). The clinical utility of the model was compared using clinical decision curves and calibration curves. Results:The statistical parametric mapping of lesions showed that supratentorial PA was vulnerable to medial structure areas such as suprasellar region, thalamus, basal ganglia and frontal lobe, temporal lobe, parietal lobe. GG was mainly distributed in bilateral temporal lobes, as well as frontal lobe, occipital lobe and parietal lobe. The AUCs of spatial radiomics model, radiomics model and spatial model to identify PA and GG in the test set were 0.876, 0.785, and 0.819, with accuracies of 77.59%, 72.41%, and 77.14%, respectively, and ΔACCs in the test set and validation set were 11.6%, 15.43%, and 6.94%, respectively. The clinical decision curves showed an overall greater clinical benefit of the spatial radiomics model compared with the conventional radiomics model and spatial model.Conclusion:Spatial radiomics model containing spatial information on lesion location can improve the diagnostic efficacy of supratentorial PA and GG, and enhance the generalization of the prediction model.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.