Objective To observe the concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy (PDR) after intravitreal ranibizumab injection (IVR).Methods A total of 80 PDR patients (80 eyes) were enrolled in this study.The patients were randomly divided into vitrectomy group (group A) and IVR combined with vitrectomy group (group B),40 eyes in each group.The differences of sex(x2=0.05),age (t=0.59),duration of diabetes (t=0.36),HbA1c (t=0.13) and intraocular pressure (F=0.81) between two groups were not significant (P＞0.05).The eyes in group B received 0.5 mg (0.05 ml) ranibizumab injection at 7 days before operation.The vitreous samples (0.4 ml)were obtained before operation.The concentration of vascular endothelial growth factor (VEGF),interleukin (IL)-6,IL-8,intercellular adhesion molecule-1 (ICAM-1) and connective tissue growth factor (CTGF) were measured by enzyme-linked immunosorbent assays.Results The concentration of VEGF and ICAM-1 were (10.70±3.60),(224.64±90.32) pg/L in group B and (72.38±23.59),(665.61±203.34)pg/L in group A.The differences of VEGF and ICAM-1 concentration between two groups was significant (t=16.34,12.53 ; P＜ 0.001).The concentration of IL-6 and IL-8 were (210.64 ± 80.27),(156.00±57.74) pg/L in group B and (45.78±33.82),(41.07±13.82) pg/L in group A.The differences of IL-6 and IL-8 concentration between two groups was significant (t=11.97,12.24; P＜0.001).There was no difference of CTGF concentration between two groups (t=1.39,P=0.17).The CTGF/VEGF in group B was higher than that in group A (t=14.75,P＜0.001).Conclusions One week after IVR,the concentration of VEGF and ICAM-1 are decreased,while IL-6 and IL-8 increased.There is no obvious change in CTGF,but CTGF/VEGF is increased.

No abstract available.
Claudin-1 ; Immunohistochemistry

Objective To determine the real time radiation dose rate displayed on DSA equipment in interventional management for patients with coronary heart disease in order to provide medical staff with useful basis to reasonably control the radiation dose. Methods A total of 30 patients with coronary heart disease, who received interventional treatment at authors’ hospital in September 2014 with a GE DSA unit, were randomly selected. Intraoperative radiation dose rates when fluoroscopy was converted to movies , which were displayed on DSA at respective sequence, were determined, and the results were analyzed and compared. Results The fluoroscopy radiation dose rate ranged from 18.5 to 212.0 mGy/min, the mean value was (114.7±42.1) mGy/min;while the radiation dose rate of movies varied from 216 to 1 691 mGy/min, with a mean value of(970.1±298.4) mGy/min. The overall mean fluoroscopy-to-movies radiation dose ratio was 1 ∶8.5. The larger the digital flat panel detector area was , the bigger the mean radiation dose rate would be and the more obvious increase in the mean radiation dose rate of movies than that of the fluoroscopy would be observed; the mean radiation dose rate of fluoroscopy was lower than that of movies , and the difference was significantly. Conclusion During the performance of coronary intervention , the medical staff should make reasonable choice of the equipment and closely observe the dynamic real-time display of the radiation dose rate, promptly adjust the inspection mode and the controllable parameters when it is needed , make immediate evaluation of dose level that might cause radiation injury to the patient , and reasonably control the radiation dose to reduce the effects of ionizing radiation on human health.

Objective:To investigate the safety and protection level of radiological treatment in the CT modules in the makeshift hosptials in Wuhan during the prevention and treatment of COVID-19 cases.Methods:The layout of the CT modules in makeshift hospitals, radiological protection facilities and personal protective equipment were investigated. Based on the national standards, the CT dose index was estimated and the radiological protection level at the CT modules were measured.Results:The layout of the CT modules in makeshift hospitals is reasonable, with well-equipped radiological protection facilities. Of 23 CT modules, 20 were up to standards with acceptability of 87.0%. The other three were unqualified each with 1 detection points having values in excess of the national standards. Which, after being modified immediately reached the national standards. In addition, CT dose index for 7 CT modules were estimated, with CTDI W within ±7.5%. Conclusions:The CT modules in Wuhan meet the requirements of radiological safety and protection during the prevention and treatment of COVID-19 cases.

Objective:To explore the effect of postoperative coping style on marital quality and spouse post-traumatic growth in breast cancer patients.Methods:A total of 80 breast cancer patients who underwent radical mastectomy and chemotherapy in Department of Breast Surgery in Tongling Maternal and Child Health Hospital from January 2016 to June 2021 were selected and they were followed up for 0.5 to 1.0 year. Medical Coping Modes Questionnaire (MCMQ) , Olson Marital Quality Questionnaire (ENRICH) and Posttraumatic Growth Inventory (PTGI) were used to investigate patients and their spouses. A total of 80 questionnaires were distributed and 80 valid questionnaires were recovered, with an effective recovery rate of 100%. The correlations among medical coping, marital quality and spouse's post-traumatic growth in 80 breast cancer patients were analyzed.Results:ENRICH score and PTGI score of spouse in 80 breast cancer patients were positively correlated with the face dimension score of MCMQ ( r=0.549-0.693, P<0.05) , and negatively correlated with the avoidance and yield dimension score ( r=-0.256--0.391, P<0.05) . In the mediating effect model, the regression coefficients of multiple linear regression analysis were all significant ( P<0.05) . The indirect effects of facing, avoiding and yielding coping styles on spouse's post-traumatic growth and marital quality were 0.382, 0.183 and 0.079 (95% CI did not include 0) , and the relative effects were 47.04%, 22.54%, and 9.73%, respectively. Conclusions:Face is the main coping style of breast cancer patients after surgery. The face coping style is not only positively correlated with the quality of marriage and the level of post-traumatic growth of spouse, but also plays a mediating effect between them. For spouses of patients with poor post-traumatic growth level, the quality of marriage can be improved by improving the level of post-traumatic growth of patients' spouses and the coping ability of patients.

Objective To investigate the impact of acacetin(Aca)on angiogenesis in diabetes retinopathy(DR)rats by regulating Hippo signaling pathway.Methods Sixty SD rats were grouped into the control group,the DR group,the Aca low dose group(10 mg/kg),the Aca medium dose group(20 mg/kg),the Aca high dose group(30 mg/kg)and Hippo-YAP signaling pathway inhibitor Verteporfin group(Aca high dose 30 mg/kg+Verteporfin 0.8 pmol/kg),with 10 rats in each group.Except the control group,streptozotocin and high-fat feed were used to construct the DR model.Body weight and fasting blood glucose(FBG)levels of rats were measured.Fluorescein angiography(FFA)was applied to observe retinal angiogenesis and fluorescein leakage.Enzyme linked immunosorbent assay was applied to detect serum levels of vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2).Pathological changes of retinal tissue were observed by hematoxylin-eosin staining.Western blot assay was applied to detect expression levels of VEGF,hypoxia-inducible factor 1 alpha(HIF-1α),vascular cell adhesion molecule-1(VCAM-1)and Hippo signaling pathway proteins.Results Compared with the control group,retinal cells of rats in the DR group were arranged in a disordered and loose manner,with neovascularization and a large amount of fluorescein leakage,and body weight,the expression of large tumor suppressor homolog 2(LATS2),p-Yes-associated protein(YAP)were reduced.FBG and expression levels of VEGF,Ang-2,HIF-1α,VCAM-1,YAP,transcription activator with PDZ binding motif(TAZ),TEA domain family member 1(TEAD1)were increased(P＜0.05).Compared with the DR group,retina cells of rats in the Aca low,medium and high-dose groups and the Verteporfin group were arranged neatly,with reduced neovascularization and fluorescence leakage,body weight and the expression levels of LATS2 and p-YAP were increased,and FBG,expression levels of VEGF,Ang-2,HIF-1α,VCAM-1,YAP,TAZ and TEAD1 were reduced(P＜0.05).The effect was more obvious in the Aca high dose group.However,there was no significant difference in each indicator between the Verteporfin group and the Aca high dose group.Conclusion Aca can inhibit angiogenesis and improve retinal pathological damage in DR rats,and its mechanism of action may be related to regulating the Hippo signaling pathway.

Objective: To analyze the association of cytogenetic abnormalities with the prognosis of chronic myeloid leukemia (CML) patients in tyrosine kinase inhibitors (TKI) era. Methods: Karyotype analysis of chromosome G-banding was carried out in 387 newly diagnosed CML patients by short-term culture of bone marrow cells. The correlation of cytogenetic abnormalities and CML progression was explored in combination with ABL tyrosine point mutations. Result: Of 387 patients with positive BCR-ABL fusion gene assayed by fluorescence in situ hybridization (FISH) technique, 94.1% (364/387) patients were Ph positive and 5.9% (23/387) Ph negative; 320 patients (87.9%) had a translocation t (9;22) (q34;q11) and 5 (1.4%) a variant translocation t (v;22) . Additional cytogenetic aberrations (ACA) at diagnosis were found in 10.7% (39/387) Ph⁺ patients, major route ACA in 22 (56.4%) cases and minor route ACA in 15 (38.5%) cases and 2 patients (5.1%) lacked the Y chromosome (−Y) ; 23.4% (71/303) patients occurred ACA during TKI treatment and the most frequent abnormalities were abnormal chromosome numbersd, which were likely associated with high proportion of disease progression (χ²=168.21, P<0.001) and ABL tyrosine point mutations (χ²=29.04, P<0.001) . Newly diagnosed CML-CP patients with t (9;22) (q34;q11) had a longer event-free survival (EFS) and disease-free survival (DFS) rates than that of patients with ACA (P=0.037; P=0.003) , while the overall survival (OS) had no significant differences (P=0.209) . As for CML-CP patients that occurred ACA during TKI therapy would have a marked low OS, EFS and DFS (all P<0.001) compared with no ACA occurred patients. Survival of advanced patients that occurred ACA were dramatically reduced. Conclusion ACA often emerged during the disease progress in CML patients, regular and timely detection of chromosomes karyotype and ABL tyrosine point mutations during TKI treatment was important for therapeutic evaluation, progress and prognosis of CML.

Objective: To investigate the clinical implications of p16 gene deletion in adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL) . Methods: Retrospective analysis of clinical, immunophenotypic, cytogenetics, molecular characteristics and prognosis of 80 newly diagnosed Ph⁺ ALL patients with p16 deletion. Results: Of 80 adult Ph⁺ ALL, the prevalence of p16 gene deletion was 31.3%. p16 gene deletion carriers frequently accompanied with high WBC counts (WBC≥30×10⁹/L) and CD20 expression. The incidence of complex chromosome abnormality in p16 gene deletion group was higher than that in non-deletion group, with alternations in chromosome 7, 8, 19 and der (22) more frequently observed. There was no difference occurred between patients with or without p16 gene deletion in complete remission (CR) rate following induction chemotherapy combined with tyrosine kinase inhibitors (TKIs) . However, after three cycles of chemotherapy, the MMR and CMR rate in the p16 gene deletion group was lower than patients with wild-type p16 gene (P=0.034, P=0.036) . The p16 gene deletion patients showed no significant differences in MMR, CMR and relapse rate between Imatinib or Dasatinib plus chemotherapy (P>0.05) . Deletion of p16 gene was significantly associated with poor outcomes including worse overall survival (OS) (37.1% vs 54.1%, P=0.037) , lower disease free-survival (DFS) (12.4% vs 45.9%, P=0.026) , and increased cumulative incidence of relapse (P=0.033) . Among the 25 patients with p16 deletion, 14 underwent allo-HSCT and the median survival was 21 months, better than that of patients received chemotherapy alone (12 months) (P=0.030) . Conclusion This study indicated that deletion of p16 was associated with poor prognosis in adult Ph⁺ ALL, and the utility of second-generation TKI (Dasatinib) does not necessarily have an edge on efficacy over Imatinib, but allo-HSCT has the potential of elongating life expectancy. It is an important significance to define the status of p16 in Ph⁺ ALL for predicting prognosis and guiding therapy decision-making.

Objective To explore the effects of dexmedetomidine combined with desflurane anesthesia on cerebral oxygen metabolism,sedation depth and cerebral function in liver cancer patients undergoing partial hepatic lobectomy.Methods A total of 30 liver cancer patients undergoing partial hepatic lobectomy at the Affiliated Cancer Hospital of Zhengzhou University from March to September 2022 were selected as the research subjects,they were divided into control group(n=15)and observation group(n=15)according to different anesthesia methods.Patients in both groups underwent partial open hepatectomy,and they were given the same anesthesia induction method.The patients in the control group received desflurane for anesthesia mainte-nance,while patients in the observation group received dexmedetomidine combined with desflurane for anesthesia maintenance.The anesthesia recovery indexes including the postoperative recovery time,recovery time of spontaneous breathing,eye-opening time of patients between the two groups were compared.The arterial oxygen saturation(SaO2),cervical vein oxygen saturation(SjvO2),arterial partial pressure of oxygen(PaO2)and partial pressure of venous oxygen of patients were detected by blood gas analyzer before anesthesia induction(T0),at the completion of anesthesia induction(T,),at 10 minutes after hepatic portal occlusion(T2),after hepatic lobectomy(T3)and after surgery(T4),and arterio-venous oxygen content difference(AVDO2)and cerebral oxygen extraction rate(CEO2)were calculated.The sedation depth of patients was evaluated by bispectral index(BIS)and patient state index(PSI)at T0,T1,T2,T3 and T4.The cerebral function of patients was evaluated by the Glasgow-Pittsburgh cerebral performance category scale at 3 months after surgery.The incidence of postoperative adverse reactions of patients between the two groups was compared.Results The postoperative recovery time,recovery time of sponta-neous breathing and eye-opening time of patients in the observation group were significantly shorter than those in the control group(P＜0.05).There was no significant difference in SaO2 of patients between the two groups at different time points(P＞0.05).At T2 and T3,SjvO2,AVDO2 and CEO2 of patients in the observation group were significantly lower than those in the control group(P＜0.05),but there was no significant difference in SjvO2,AVDO2 and CEO2 of patients between the two groups at the other time points(P＞0.05).At T2,T3 and T4,BIS and PSI of patients in the observation group were significantly lower than those in the control group(P＜0.05),but there was no significant difference in BIS and PSI of patients between the two groups at T0 and T1(P＞0.05).In the control group,there were 11 patients with postoperative brain function in grade 1,3 patients in grade Ⅱ and 1 patient in grade Ⅲ;in the observation group,there were 12 patients in grade Ⅰ and 3 patients in gradeⅡ.There was no significant difference in postoperative grading of brain function between the two groups(x2=1.044,P＞0.05).There was no significant difference in the total incidence of postoperative adverse reactions between the control group and observation group[20.00％(3/15)vs 26.67％(4/15),x2=0.186,P＞0.05].Conclusion Dexmedetomidine combined with desflurane anesthesia can shorten anesthesia recovery time,improve anesthesia depth and reduce cerebral oxygen metabolism in patients undergoing liver cancer surgery,which has no effect on cerebral function,showing good safety.

Objective:To attain comprehensive insight into the diagnostic X-ray equipment and examination frequency in radiological diagnosis and treatment institutions in Wuhan, with the purpose of assisting the health administration department in formulating medical exposure protection strategies and efficiently allocating radiological diagnosis and treatment resources.Methods:Using the census method, questionnaires on the basic information on diagnostic X-ray equipment and the annual number of examinations filled out in 2022 by the 1 030 radiological diagnosis and treatment institutions (excluding military and armed police hospitals) were collected through the Wuhan Prevention and Treatment Information Management Platform for Occupational Diseases. To obtain the data on number and frequency of diagnostic X-ray examinations, the different types of diagnostic X-ray examinations were divided by the total number of permanent residents by the end of 2021 in Wuhan.Results:In Wuhan, 1 030 radiological diagnosis and treatment institutions had 7 062 radiation workers and 2 540 diagnostic X-ray units of various types. 37.76% of units and 75.01% of radiation workers were concentrated in tertiary hospitals. The number of diagnostic X-ray units per million population was 186.10, with the top two being 48.65 DR machines per million population and 31.21 intraoral dental machines per million population. The total number of diagnostic X-ray examinations was 11 884 582, with plain radiographs and computed tomography (CT) examinations accounting for 43.61% and 43.59% of the total, respectively. The annual frequency of examinations was 379.75 and 379.52 per 1 000 population, respectively. Radiodiagnosis and treatment resources were higher in central urban areas than that in remote urban areas.Conclusions:The development of diagnostic X-ray equipment in Wuhan was experiencing rapid growth, with potential for further expansion, and the frequency has not yet recovered to the level before the COVID-19 pandemic. The allocation of radiodiagnosis and treatment resources between central urban areas and remote urban areas needs to be coordinated and the management of medical radiation protection should be continuously strengthened, so as to promote the sustainable development of inter-regional radiodiagnosis and treatment, and ensure the health and safety of examinaed patients and indivuduals.