Objective Paraquat(PQ) is an effective herbicide which is widely used in agricultural production .PQ poisoning is frequently seen in humans with the lung as the target organ ,but the poisoning mechanisms is not very clear .Studies show that endoplasmic reticulum stress(ERS) is closely associated with poisoning , but there are few reports on the relationship between ER stress and PQ poi-soning.This article was to investigate the effects of ERS-induced apoptosis and total flavonoids from astragalus complanatus (FAC) in a-cute lung injury(ALI) following paraquat poisoning in rats . Methods A total of 30 adult healthy Sprague-Dawley (SD) rats were ran-domly divided into 3 groups:control group, ALI group, ALI+FAC group and ALI+saline group.Biochemical method was applied to de-tect superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) in lung tisssue,TdT-mediated dUTP nick end labeling (TUNEL) assay in observing lung apoptosis, Western blotting and real-time PCR(RT-PCR) in detecting the changes in expressions of C/EBP homologous peotein (CHOP), activating transcription factor 4 (ATF4) and X-box binding protein 1 (XBP) following ALI, and HE staining in observing the pathological changes of lung tissue . Results Compared with control group , the expression of MDA content was enhanced in ALI group ([3.26 ±0.24] vs [5.04 ±0.36],P<0.01), along with significantly decreased activity of SOD and CAT ([300.26 ±35.69] vs [187.21 ±25.66]), ([5.78 ±1.28] vs [2.15 ±1.12],P<0.01), increased cell apoptosis , upregulated pro-tain level of CHOP ([0.74 ±0.20] vs [0.23 ±0.07],P<0.01) and mRNA expression of ATF4, XBP1 and CHOP.However, FAC sig-nificantly attenuated ALI following PQ , as showed by reduced MDA content , enhanced activity of SOD and CAT , decreased cell apopto-sis, inhibited protain level of CHOP and mRNA expression of ATF 4, XBP1 and CHOP ([5.04 ±0.36] vs [3.99 ±0.27],P<0.01). Furthermore, the activity of SOD and CAT were higher in FAC pretreatment group than those in ALI group ([ 0.74 ±0.20 ] vs [0.42 ±0.11],P<0.01). Conclusion From the research, ERS-induced cell apoptosis is involved in ALI following PQ , and the protec-tive role of FAC in lung tissue following PQ is due to its effect in atten-uating ERS-induced apoptosis .

Objective To evaluate the value of SUVmax/ADCmin obtained by 11 C?choline PET/MR imaging in the differential diagnosis of benign and malignant prostate disease. Methods Suspicious prostate cancer patients who underwent PET/MR before transperineal prostate biopsy in People′s Liberation Army General Hospital from April 2014 to January 2015 were observed. Prostate gland was divided into five dis?tricts. A ROI with the diameter of 1 cm was drawn at the highest radioactivity concentration and/or lowest ADC signal area in each district, and SUVmax , ADCmin and SUVmax/ADCmin were then calculated. Taking the pathological results as the gold standard, malignant and benign prostate disease districts were separated. Pearson correlation analysis and two?sample t test were used for statistical analysis. Results Biopsy pathol?ogy showed 9 cases were malignant ( 25 prostate cancer districts, and 20 benign prostate disease districts) , and 6 cases were benign (30 benign prostate disease districts). The SUVmax had a negative correlation with ADCmin( r=-0.521, P<0?05) . The SUVmax/ADCmin of benign and malignant districts was significantly dif?ferent(5.67±3.03 and 13?76±7.13; t=6.9, P<0.01). The ROC AUC for ADCmin, SUVmax and SUVmax/ADCmin were 0?880, 0?809 and 0.898. Using SUVmax/ADCmin of 7.78 as a cutoff, the sensitivity, specificity and accuracy of 11 C?choline PET/MR imaging for differentiating the benign and malignant prostate lesions were 84.0%(21/25), 86.0%(43/50) and 85.3%(64/75), respectively. Conclusions Simultaneous 11C?choline PET/MR could be used for detecting prostate cancer. SUVmax/ADCmin may serve as an effective diag?nostic indicator for differentiating benign and malignant prostate lesions.

Objective To evaluate the diagnostic efficiency of the parameters obtained from PET/MR in brain tumors.Methods In this prospective study,28 patients (21 males,7 females,age range: 6-82 years) with clinical suspicion of brain tumor from November 2012 to September 2015 underwent PET/MR multi-modality imaging.The examination of PET/MR included 11C-MET PET and multiple MR sequences.The qualities of images were estimated firstly.The ROC curve and the accuracy of SUVmax,ADCmean,rCBF and NAA/(Cho+Cre) ratio were calculated.The pathology or final clinical diagnosis was taken as the standard.The diagnostic efficiency of the multi-modality imaging was determined based on the cutoff values of the four parameters.Two-sample t test was used to analyze the differences of parameters between glioma group and inflammatory group.Results SUVmax,ADCmean,rCBF and NAA/(Cho+Cre) ratio were validated to be effective parameters in diagnosing brain tumors with the diagnostic accuracy of 89.3％(25/28),82.1％(23/28),78.6％(22/28) and 75.0％(21/28),respectively.The SUVmax exhibited the highest diagnostic accuracy,while the diagnostic efficiency of the combination of four parameters was superior to the separate parameter.The values of SUVmax,rCBF and NAA/(Cho+Cre) ratio were significantly different between glioma group(n=10) and inflammatory group(n=11;t values:-2.31,-3.11,-2.77,all P<0.05).Conclusions PET/MR can provide a one-stop examination with multi-modality imaging of brain.The obtained parameters SUVmax,ADCmean,rCBF and NAA/(Cho+Cre) ratio,especially their combination,have effective diagnostic values on brain tumor.

OBJECTIVETo investigate the prognostic significance of metastatic lymph node ratio in patients with colorectal cancer.

METHODSThe clinicopathological data of 303 surgically treated patients with colorectal cancer were retrospectively analyzed. Spearman correlation analysis was used to determine the correlation coefficient. The survival was analyzed using Kaplan-Meier method, and the survival difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Receiver working characteristic curve was used to compare the accuracy of the metastatic lymph nodes ratio in predicting the death of patients at 5 years postoperatively with that of the number of metastatic lymph nodes.

RESULTSThe MLR was not correlated with the total number of dissected lymph nodes (Spearman correlation coefficient: -0.099, P > 0.05), but the positive rate of metastatic lymph nodes did (correlation coefficient: 0.107, P < 0.05). Kaplan-Meier survival analysis revealed that the MLR significantly influenced the postoperative survival time (Log-rank chi(2) = 42.878, P < 0.01), even in the patients with less than 12 resected lymph nodes. The 5-year survival rates for rN0, rN1, rN2 and rN3 were 90.9%, 68.9%, 54.7% and 39.4%, respectively. There was a significant difference between the different stages (P < 0.01). Cox proportional hazard regression model analysis showed that the metastatic lymph node ratio was an independent prognostic factor. (EXP(B) = 7.809, P < 0.01). There was no significant difference between metastatic lymph node ratio and the number of metastatic lymph nodes in predicting the death of patients at 5 years postoperatively based on the area under the receiver working characteristic curve.

CONCLUSIONThe metastatic lymph node ratio in colorectal cancer patients is not correlated with the total number of dissected lymph nodes. The metastatic lymph node ratio is a major independent prognostic factor for patients with colorectal cancer. The ability of metastatic lymph node ratio in predicting the death of colorectal cancer patients at 5 years postoperatively is the same as that of the number of metastatic lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonic Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Proportional Hazards Models ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Tumor Burden ; Young Adult

OBJECTIVEThe purpose of the present study was to compare the plaque composition between patients with acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) by intravascular ultrasound virtual histological analysis.

METHODSTwo hundred and ten patients were divided into ACS group (n = 131, 188 diseased vessels) and SCAD group (n = 79, 158 diseased vessels). A total of 346 de novo lesions with > 50% stenosis in native coronary arteries with diameters > 2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software.

RESULTSThere were no significant differences in overall lesions for fibrous (51.2% +/- 12.5% vs. 52.6% +/- 9.6%), fibrolipidic (11.3% +/- 10.6% vs. 12.9% +/- 9.4%), calcium (15.1% +/- 8.9% vs. 20.5% +/- 12.5%) or necrotic core (23.1% +/- 9.8% vs. 20.4% +/- 6.8%, all P > 0.05) components between ACS and SCAD patients. Culprit lesions for fibrous (49.1% +/- 11.2% vs. 50.3% +/- 9.7%), fibrolipidic (10.2% +/- 9.5% vs. 12.7% +/- 9.5%), calcium (15.4% +/- 8.9% vs. 17.4% +/- 24.8%), or necrotic core (24.0% +/- 11.5% vs. 19.7% +/- 5.3%, all P > 0.05) components were also similar between ACS and SCAD patients. High density lipoprotein-cholesterol (HDL) levels > 1.04 mmol/L was associated with more fibrolipidic (15.6% +/- 9.6% vs. 7.4% +/- 5.9%) and less necrotic core (19.4% +/- 8.6% vs. 28.6% +/- 11.2%, all P < 0.05 vs. patients with HDL < or = 1.04 mmol/L) components in ACS patients.

CONCLUSIONCoronary plaque composition was similar between ACS and SCAD patients.

Acute Coronary Syndrome ; diagnostic imaging ; pathology ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional

Objective To explore the efficacy and safety of ticagrelor de-escalation and nicorandil therapy in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 300 elderly patients with ACS were selected from the Sixth and Seventh Medical Center of Chinese PLA General Hospital and Beijing Chaoyang Integrative Medicine Emergency Rescue and First Aid Hospital from November 2016 to June 2019,including 153 males and 147 females,aged>65 years old.All the patients received PCI,and all had double antiplatelet therapy(DAPT)scores≥2 and a new DAPT(PRECISE-DAPT)score of≥25.All patients were divided into two groups by random number table method before operation:ticagrelor group(n=146,ticagrelor 180 mg load dose followed by PCI,and ticagrelor 90 mg bid after surgery)and ticagrelor de-escalation + nicorandil group(n=154,ticagrelor 180 mg load dose followed by PCI,ticagrelor 90 mg bid+nicorandil 5 mg tid after surgery,changed to ticagrelor 60 mg bid+ nicorandil 5 mg tid 6 months later).Follow-up was 12 months.The composite end points of cardiovascular death,myocardial infarction and stroke,the composite end points of mild hemorrhage,minor hemorrhage,other major hemorrhage and major fatal/life-threatening hemorrhage as defined by the PLATO study,and the composite end points of cardiovascular death,myocardial infarction,stroke and bleeding within 12 months in the two groups were observed.Results The comparison of general baseline data between the two groups showed no statistically significant difference(P>0.05).There was also no significant difference in the composite end points of cardiovascular death,myocardial infarction and stroke between the two groups(P>0.05).The cumulative incidence of bleeding events in ticagrelor de-escalation + nicorandil group was significantly lower than that in ticagrelor group(P<0.05),while the composite end points of cardiovascular death,myocardial infarction,stroke and bleeding were also significantly lower than those in tecagrelor group(P<0.05).Conclusion In elderly patients with ACS,the treatment of ticagrelor de-escalation + nicorandil after PCI may not increase the incidence of ischemic events such as cardiovascular death,myocardial infarction or stroke,and it may reduce the incidence of hemorrhagic events.

Objective Endometrial cancer (EMC) is a most common malignancy in the female reproductive system. The purpose of this study was to investigate the relationship of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with the prognosis of EMC. Methods We retrospectively analyzed the clinical and follow-up data about 153 EMC patients surgically treated in the Second Affiliated Hospital of Zhengzhou University. Based on the cutoff values of NLR and PLR, we divided the patients into a high and a low value group,and analyzed the relationships of NLR and PLR with clinical pathological features and prognosis of the patients. Results There were statistically significant differences between the high value group(NLR>3.40) and the low value group (NLR≤3.40) in the FIGO stage,pathological grade,invasion depth,and lymph node metastasis(P<0.05). No sig-nificant correlation was found between the PLR and the prognosis EMC (P>0.05). COX regression analysis showed that FIGO stageⅢ-Ⅳ (P<0.001),pathological grade G3(P=0.022) and NLR>3.4(P=0.004) were independent risk factors for the overall surviv-al and disease-free survival of the EMC patients. Conclusion High preoperative NLR was closely related with the FIGO stage, pathological grade,invasion depth,and lymph node metastasis in pa-tients with endometrial cancer.

Objective To observe the influence of spinal cord injury on lower limbs weight support capacity,and the changes with time. Methods Six adult female rhesus monkeys with thoracic(T7-9)right spinal cord hemi-section were measured the plantar pressure ratio of both lower limbs with Foot-Scan system before,and six and twelve weeks after operation. Results There was no statistical difference between both sides of limbs before operation(Z=-1.330,P>0.05),while the plantar pressure ratio was more on the left limbs six and twelve weeks after operation(Z>4.783,P<0.001).The plantar pressure ratio of right lower limb became less and less during observation(Z=3.191,P<0.001). Conclusion The weight support capacity of affected limbs is injured after spinal cord hemi-section in monkeys, and would become worse without intervention.

OBJECTIVETo investigate the role of platelet-derived growth factor-BB (PDGF-BB) in the degeneration of the hypertrophied ligamentum flavum (LF) in the lumbar spine.

METHODSSurgical specimens of degenerative hypertrophied LF were obtained from 11 patients with lumbar spinal stenosis (LSS, mean age 57.8 years), with those from 10 age-matched patients with lumbar disc herniation (LDH, mean age 53.5 years) as the normal controls. The thickness of the LF was measured preoperatively by axial T1-weighted magnetic resonance imaging (MRI) at the facet joint level. Immunohistochemistry was employed to determine the expression of PDGF β and PDGF-BB in the LF. The mRNA and protein expressions of PDGF-BB in the LF were detected using real-time PCR and Western blotting, respectively.

RESULTSThe thickness of the LF was 5.30±1.12 mm in the degenerative group and 2.80±1.53 mm in the control group, showing a significant difference between the two groups (P<0.001). PDGF-β and PDGF-BB were positive in the fibroblasts in hypertrophied LF. The mRNA and protein expressions of PDGF-BB were significantly higher in the degenerative group than in the control group (P=0.013 and 0.023, respectively).

CONCLUSIONThe high expression of PDGF-BB in the hypertrophied LF suggests its important role in the development of hypertrophy of LF in lumbar spinal canal stenosis.

Adult ; Aged ; Female ; Humans ; Hypertrophy ; metabolism ; Intervertebral Disc Degeneration ; metabolism ; pathology ; Ligamentum Flavum ; metabolism ; pathology ; Lumbar Vertebrae ; Male ; Middle Aged ; Proto-Oncogene Proteins c-sis ; metabolism ; Spinal Stenosis ; metabolism ; pathology

OBJECTIVETo evaluate the effectiveness of dynamic SPECT (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy on the assessment of reserve function of cirrhosis liver.

METHODSFrom January 2010 to December 2011, 55 patients with cirrhosis liver were enrolled in this study. The case numbers of male and female were 43 and 12 respectively and the age was (51 ± 9) years (ranging from 35 to 69 years). After routine biochemistry test, CT scan and (99m)Tc-GSA dynamic SPECT scan were performed in turn using a juxtaposed SPECT/CT system. Then the morphologic volume of liver parenchyma (MLV), functional liver volume (FLV) and the hepatic cell absorption rate constant (GSA-K) were calculated. The correlations between GSA-K and routine biochemistry test, Child-Pugh score, indocyanine green clearance rate (ICG-K) were analyzed. The patients were further divided into 3 groups according to whether there was occlusion or stenosis in the main branch of left portal vein (group 1, n = 5), right portal vein (group 2, n = 13) or not (group 3, n = 37) and the regional hepatic functions index of the 3 groups were compared.

RESULTSThe value of FLV of the whole, left and right liver was (594 ± 152) ml, (244 ± 119) ml and (356 ± 171) ml, respectively. There were correlations between GSA-K and total bilirubin, prothrombintime, Child-Pugh score and ICG-K (r = -0.730--0.298, P < 0.05). The FLV and MLV ratios of involved hemiliver to uninvolved hemiliver were 0.09 ± 0.06 and 0.30 ± 0.14 in group 1, 0.57 ± 0.43 and 1.08 ± 0.63 in group 2, 0.71 ± 0.30 and 0.71 ± 0.48 in group 3. The difference in MLV-FLV ratio was signifcant between group 1 and group 3, between group 2 and group 3 (P = 0.000).

CONCLUSIONSThe dynamic SPCECT (99m)Tc-GSA scintigraphy can not only assess the whole liver function of cirrhosis liver effectively, but also evaluate the variation of regional liver function accurately.

Adult ; Aged ; Female ; Humans ; Liver ; physiopathology ; Liver Cirrhosis ; physiopathology ; Liver Function Tests ; Male ; Middle Aged ; Technetium Tc 99m Aggregated Albumin ; metabolism ; Technetium Tc 99m Pentetate ; metabolism ; Tomography, Emission-Computed, Single-Photon