Objective:To compare the imaging quality and metabolic quantitative parameters of pulmonary nodules between Q. Flex whole information five-dimensional (5D) and conventional three-dimensional (3D) PET/CT imaging for clinical evaluation.Methods:Fifty-four patients (30 males, 24 females, age: 60(42, 75) years; 78 solid pulmonary nodules (maximum diameter≤3 cm) with abnormal uptake of 18F-FDG) from Tianjin Cancer Hospital Airport Hospital between June 2022 and August 2022 were enrolled in this retrospective study. All patients underwent 5D scanning and 3D, 5D reconstruction. Image quality scores, signal-to-noise ratio (SNR), SUV max, SUV mean and metabolic tumor volume (MTV) of pulmonary nodules of 5D group and 3D group were evaluated and compared with χ2 test and Wilcoxon signed rank test. Correlation of quantitative parameters between 2 groups were analyzed by using Spearman rank correlation analysis. Results:Thirty-five of 78(45%) pulmonary nodules with image quality score≥4 were found in 5D group, which were more than those in 3D group (22/78(28%); χ2=4.67, P=0.031). Meanwhile, SNR, SUV max, SUV mean, and MTV were significantly positively correlated between the 2 groups ( rs values: 0.86, 0.86, 0.85, and 0.95, all P<0.001). SNR, SUV max and SUV mean of pulmonary nodules in 5D group were significantly higher than those in 3D group, which were 37.46(18.42, 62.00) vs 32.72(16.97, 54.76) ( z=-4.07, P<0.001), 9.71(5.48, 13.82) vs 8.96(4.82, 12.63) ( z=-3.05, P<0.001) and 6.30(3.39, 8.94) vs 5.61(2.99, 7.63)( z=-4.07, P<0.001) respectively. MTV of pulmonary nodules in 5D group was significantly lower than that in 3D group, which was 1.72(0.66, 2.74) cm 3vs 1.98(1.06, 4.63) cm 3 ( z=-7.13, P<0.001). Quantitative parameters of lower lung field and nodules with maximum diameters of >10 mm and ≤20 mm based on 5D scanning changed most significantly compared with those based on 3D scanning ( z values: from -5.23 to -2.48, all P<0.05). Conclusion:Q. Flex 5D PET significantly improves the quantitative accuracy of SUV and MTV of pulmonary nodules, and the improvement of image quality is substantial without increasing the radiation dose, which has clinical practical value.

ObjectiveTo investigate the possible mechanism of Shenqi Jianxin Formula （参芪健心方） in the treatment of chronic heart failure （CHF） from the perspective of pyroptosis. MethodsFifty-two rats were randomly divided into sham operation group （n=8） and modeling group （n=44）. In the modeling group， the anterior descending branch of the left coronary artery was ligated to construct CHF rat model. Forty successfully-modelled rats were randomly divided into model group， Entresto group， Shenqi Jianxin Formula group， MCC950 group and the combination group （Shenqi Jianxin Formula plus MCC950）， with 8 rats in each group. In Shenqi Jianxin Formula group， 7.4 g/（kg·d） of Shenqi Jianxin Formula was given by gavage， while in Entresto group， 68 mg/（kg·d） of Entresto suspension was given by gavage； in MCC950 group， MCC950 was injected intraperitoneally with 10 mg/kg once every other day， and in the combination group， 7.4 g/（kg·d） of Shenqi Jianxin Formula was given by gavage， and MCC950 was injected intraperitoneally with 10 mg/kg once every other day； 10 ml/（kg·d） of saline was given by gavage in the sham operation group and the model group. After 3 weeks of continuous intervention， serum brain B-type natriuretic peptide （BNP）， creatine kinase isoenzyme MB （CK-MB）， interleukin 1β （IL-1β）， and interleukin 18 （IL-18） levels were detected by ELISA； HE staining and MASSON staining were used to observe pathological changes in rat myocardium. Except for the Entresto group， western blot technique was used to detect the expression of NOD-like receptor protein 3 （NLRP3）， caspase-1， and apoptosis-associated speck-like protein possessing a caspase-recruiting domain （ASC）； RT-PCR was used to detect the expression of NLRP3 and caspase-1 mRNA. ResultsCompared with the sham operation group， HE staining of rats in the model group showed obvious myocardial injury， while MASSON staining showed increased area of collagen fibrosis， and serum BNP， CK-MB， IL-1β， IL-18， myocardial tissue NLRP3， caspase-1， ASC protein expression and NLRP3， caspase-1 mRNA expression were all elevated （P＜0.05）. Compared with those in the model group， cardiomyocyte injury of rats and collagen fibrosis area were reduced， and serum BNP， CK-MB， IL-1β， and IL-18 contents were all reduced in Shenqi Jianxin Formula group， Entresto group， MCC950 group， and the combination group； except for Entresto group， myocardial tissue NLRP3， caspase-1， ASC protein expression and NLRP3， caspase-1 mRNA expression were reduced in the remaining three medication group （P＜0.05）. Compared with Shenqi Jianxin Formula group， the MCC950 group and the combination group showed decreased serum IL-1β and IL-18 content， collagen fibrosis area， myocardial tissue NLPR3， caspase-1 protein expression， and caspase-1 mRNA expression， and decreased ASC and NLRP3 mRNA expression was shown in the combination group （P＜0.05）. Compared with MCC950 group， collagen fibrosis area was reduced， and serum IL-18 content， NLRP3， caspase-1 mRNA expression were reduced in the combination group （P＜0.05）. ConclusionShenqi Jianxin Formula can effectively improve the myocardial injury and heart failure in rats with CHF， and its mechanism may be related to the inhibition of cardiomyocyte pyroptosis through NLPR3/Caspase-1 pathway to reduce the level of intramyocardial inflammation. The combined use of MCC950 with Shenqi Jianxin Formula could more effectively inhibite myocardial pyroptosis， with better therapeutic result than single use of each part.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the association of HbA 1C level and variability with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. Methods:A total of 527 elderly type 2 diabetic patients with baseline estimated glomerular filtration rate(eGFR)≥60 mL·min -1·(1.73 m 2) -1 at the diabetes center of a tertiary hospital in Jiangsu province were included and followed up. The mean value and the variability of HbA 1C, including standard deviation(HbA 1C-SD), variation coefficient(HbA 1C-CV), and adjusted standard deviation(Adj-HbA 1C-SD) were calculated. According to the annual decreased rate of eGFR, the patients were divided into △eGFR>5% group and △eGFR≤5% group. Cox proportional risk regression model was used to evaluate the relationship between HbA 1C variability and the risk of decreased glomerular filtration rate. Results:With a mean follow-up time of 19 months, there were 176 patients whose △eGFR>5%. Compared with △eGFR≤5% group, the HbA 1C-mean and HbA 1C variability were significantly higher in △eGFR>5% group( P<0.05). Cox regression analysis showed that HbA 1C-mean, HbA 1C-SD, HbA 1C-CV, and Adj-HbA 1C-SD were significantly correlated with decreased glomerular filtration rate. After adjustment for age, gender, HbA 1C-mean, and other factors, only Adj-HbA 1C-SD was correlated with renal insufficiency [ HR=3.32(1.68-6.57)]. Conclusions:HbA 1C variability is independently associated with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. The Adj-HbA 1C-SD is the most sensitive indicator in predicting decreased glomerular filtration rate.

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

Objective To observe the effect of external application of monascus on ecchymosis caused by ablative treatment.Methods Totally 60 patients with ecchymosis caused by ablative treatment were randomly divided into the experimental group and the control group,with 30 cases in each group. All patients received cold and dry compress on the first day. On the second day,patients in the experimental group was treated with external application of monascus,while patients in the control group received hot and dry compress, and a course of treatment included 3 days. The curative effect of two groups were compared.Results The total effective rate of experimental group(100.00%)was higher than that of control group(6.67%)(χ2=24.78, P<0.01).ConclusionsThe curative effect of external application of monascus on ecchymosis caused by ablative treatment is significant in clinical treatment. Besides,this treatment is cheap and simple,and it can be widely used in clinical practice.

OBJECTIVETo explore the effect of microRNA-30a-5p (miRNA-30a-5p) on the biological behavior of human hepatoma cells.

METHODSThe liver cancer cell line SMCC-7721 cells and the normal liver cell line L02 cells (control) were transiently transfected with miRNA-30a-5p mimics and an miRNA-30a-5p inhibitor by Lipofectamine 2000 (Life Technologies). miR-30a-5p mRNA expression was detected by quantitative real-time (q)PCR. Cell proliferation was evaluated using the Cell Counting Kit-8 (CCK-8) assay and apoptosis was assessed by flow cytometry.Invasion and migration were measured by transwell chamber assays. The SMCC-7721 cells was injected subcutaneously into nude mice to establish a tumor animal model.

RESULTSThe SMCC-7721 cells transfected with miRNA-30a-5p mimics showed significantly higher miRNA-30a-5p mRNA expression than the non-transfected SMCC-7721 cells and the transfected control L02 cells (P<0.01). The miRNA-30a-5p mRNA expression was significantly lower in the SMCC-7721 cells transfected with the miRNA-30a-5p inhibitor than the non-transfected SMCC-7721 cells the control L02 cells (P<0.01). The overexpression of miRNA-30a-5p inhibited the viability, colony formation rate, and invasion and migration abilities, as shown in the cells transfected with the miRNA-30a-5p mimics (P<0.05); in addition, the miRNA-30a-5p promoted proliferation of cells (P<0.05), as shown by more S phase cells detected by flow cytometry. SMCC-7122 cells transfected with miRNA-30a-5p mimics produced tumors with significantly higher average weight than tumors produced by SMCC-7122 cells that were untransfected or transfected with empty vector (both P<0.01).

CONCLUSIONOverexpression ofmiR-30a-5p had an inhibitory effect on cell proliferation, induced apoptosis, increased the number of cells in S phase, and markedly inhibited invasion and migration of SMCC-7721 HCC cells in vitro and in vivo.

Animals ; Apoptosis ; Carcinoma, Hepatocellular ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Neoplasms ; Mice ; Mice, Nude ; MicroRNAs ; Neoplasm Invasiveness ; Transfection

ObjectiveTo evaluate regional and global systolic function of left ventricle (LV) after mitral valve replacement(MVR) of different methods by 2-dimensional strain (2DS).MethodsAccording to the operational method whether preserve the posterior leaflet and its subvalvular apparatus,48 patients who underwent MVR were divided into two groups,the preservation group (group A) and the resection group (group B).Echocardiography was examinated before and after MVR and the apical four-chamber view,two-chamber view and long-axis view of LV were acquired.Regional peak strain (Sp) and global strain (GS) of LV longitudinal movement were analysed by 2DS software.Results①Compared to preoperation,the Sp in basal segment of posterior septum and inferior wall and middle segment of lateral wall in group A increased significantly ( P ＜0.01 or P ＜0.05).The Sp of group B were improved in both basal and middle segments of posterior septum ( P ＜0.05),while declined in middle segment of lateral wall and anterior wall,basal segment of lateral wall and apical segment of anterior wall significantly (P ＜0.01 or P ＜0.05).②Compared with group A,subtractions between preoperative and postoperative Sp of group B decreased in middle segment and apical segment of anterior wall,middle segment of lateral wall and middle segment of inferior wall significantly ( P ＜0.01 or P ＜0.05).③The GS of group A increased significantly ( P ＜0.05),while that in group B tended to reduce with no statistical significance ( P ＞0.05).Compared with group A,subtractions between preoperative and postoperative GS of group B droped significantly (P ＜ 0.05).ConclusionsAppropriate preservation of the posterior leaflet and its subvalvular apparatus has morebeneficial effect in improving the early regional and global function of LV after surgery,which would be recommended in MVR.Early regional and global systolic function of LV after MVR could be accurately evaluated by 2DS relatively,which has the application value of guiding clinical treatment and estimating prognosis.

Objective To establish the fingerprints for characterization of the chemical components of maidong(root of Ophiopogon japonicus) in two main cultivate regions of China,Sichuan(Chuanmaidong) and Zhejiang(Hangmaidong).Methods An HPLC-UV analytical methods was applied to detect 70% ethanol extracts of 20 samples from Sichuan and Zhejiang province,a "Fingerprint similarity evaluating system for TCM" issued by Pharmacopoeia Committee of P.R.China was used to evaluate the similarities all of the samples.Results The fingerprints revealed that the similarities were higher than 0.95 between samples from the same cultivate region,and were lower than 0.80 between samples from different regions of above two.Conclusion The fingerprints of Chuanmaidong and Hangmaidong were provided with high difference,and the difference can be taken as a most important proof for distinguishing the material medica of Chuanmaidong and Hangmaidong,but also in patent medicine of TCM.

OBJECTIVESTo observe the synthesis of Toll-like receptor (TLR) 4 protein and its mRNA expression in Kupffer cells (KCs) and evaluate the role of TLR 4 in liver injury to rats through alcohol-induced liver disease.

METHODSTwenty-eight Wistar rats were divided into two groups: ethanol-fed (group E) and control (group C). Group E rats were given ethanol at a dose of 5 - 12 g x kg(-1) x d(-1), while group C received dextrose. Animals from both groups were killed at 4 and 8 weeks. The KCs were isolated and synthesis of TLR 4 protein was determined by laser scanning confocal microscopy. TLR 4 mRNA expression in KCs was determined by reverse transcription polymerase chain reaction (RT-PCR) analysis. The levels of endotoxin, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in plasma were determined. Changes in liver pathology were observed.

RESULTSLaser scanning confocal microscopy showed that the intensity of fluorescence of TLR 4 protein in group E was stronger than group C. Ethanol administration led to a significant increase in TLR 4 mRNA expression in group E compared with group C (P < 0.05). The concentrations of plasma endotoxin, TNF-alpha and IL-6 were higher in group E than in group C (P < 0.05). Liver sections from rats in group E demonstrated marked pathological changes.

CONCLUSIONEthanol administration can lead to the synthesis of TLR 4 protein and its gene expression in KCs, indicating that TLR 4 may play a major role in the development of alcohol-induced liver injury.

Animals ; Drosophila Proteins ; Female ; Interleukin-6 ; blood ; Kupffer Cells ; physiology ; Lipopolysaccharide Receptors ; physiology ; Liver Diseases, Alcoholic ; etiology ; pathology ; Membrane Glycoproteins ; genetics ; physiology ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Receptors, Cell Surface ; genetics ; physiology ; Toll-Like Receptor 4 ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha ; analysis