Objective To evaluate the relationship between hypertension and recurrence of stroke,and to search for the risk factors.Methods The study was done from Dec.2000 to Jun.2002 at Tongji Hospital.The study consisted of 300 hospitalised patients,of which computerized tomography scan proved 100 cases of haemorrhagic stroke and 200 cases of ischemic stroke,and an age and sex matched control per case.The controls were selected from healthy people.We observed difference between stroke and control people in the results of one-year follow-up.Results The recurrence rate of stroke was 10.34% in stroke patients,which was significantly higher than the rate in controls(0.34%)(P

Objective To study the efficacy of chemotherapy combined with immunotherapy in treatment of middle and advanced stage non-small cell lung cancer and improvement of patients'life quality.Methods 140 patients with middle and advanced stage non-small cell lung cancer treated from Mar .2012 to Mar.2014 were in-cluded and they were randomly divided into two groups:the observation group(70 cases)and the control group(70 cases).The observation group took chemotherapy combined with immunotherapy , while the control group took chemotherapy treatment alone .Patients'life quality , treatment effects and changes in immune indexes were co-mared between the two groups .Results The improvement rate of life quality of the observation group (90.0%) was significantly higher than that of the control group (58.6%), and the difference had satistical significance (P<0.05).The response rate of the observation group (88.6%) was significantly higher than that of the control group(70.0%), and the difference had statistical significance (P<0.05).The increasement rate of CD3 +, CD4 +, CD8 +cells, as well as CD4 +/CD8 +cells was significantly higher in the observation group than in the control group, and the difference had statistical significance (P<0.05).Conclusion Chemotherapy combined with immunotherapy in teatment of patients with middle and advanced non-small cell lung cancer has obvious effect, high safety, and high clinical value .

S100 A7 is a small calcium-binding protein that has an important role to play in the differentiation of human kerati -nocytes.It also helps build the chemical defense system of the skin and responds to oxidative stress and inflammation .The expression of S100 A7 can be induced by physical , chemical and biological stimulations .S100 A7 has many ligands and is related to the reactive oxygen species (ROS) via specific signaling pathways.As an important antimicrobial peptide, S100A7 helps the skin fight against main pathogens .S100 A7 is also a key indicator for the state of inflammation and cell differentiation;and its up-regulation has been cor-roborated in various skin diseases .In the brain of patients with Alzheimer′s disease, the up-regulation of S100A7 in primary cortico-hippocampal neurons can inhibit the generation of β-amyloid peptides .Moreover , S100 A7 is also up-regulated in different types of cancer and closely related to tumor malignancy and progression .In this review, we introduce biological properties of S 100A7 and high-light its expression characteristic in related diseases .This should have implication for the discovery of potential biomarkers and targets for the treatment of S100A7-related diseases.

BACKGROUND: Recently, a few studies have reported the correlation between transforming growth factor-α (TGF-α) and graft-versus-host disease (GVHD); however, the combination of TGF-α with other cytokines in patients with chronic or acute GVHD requires further study.OBJECTIVE: To analyze the changes of serum tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and transforming growth factor-α (TGF-α) in leukemic patients after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and investigate the effects of these cytokines on different grades of GVHD.DESIGN: Case control study.SETTING: Department of Hematology, Organ Transplantation Center, the Second Affiliated Hospital, General Hospital of Chinese PLA; Department of Nuclear Medicine, the Second Affiliated Hospital, General Hospital of Chinese PLA.PARTICIPANTS: Forty-two leukemic patients (23 males and 19 females, 16-68 years old, mean age of 35 years) who underwent Allo-HSCT for the first time were selected from the Department of Hematology, Organ Transplantation Center, the Second Affiliated Hospital, General Hospital of Chinese PLA and Department of Transplantation, the 307 Hospital of Chinese PLA from June 2005 to June 2007. Twelve patients had acute granulocytic leukemia (AGL), fifteen patients had acute lymphocytic leukemia (ALL), and fifteen patients had chronic granulocytic leukemia (CGL). Among the 42 patients, 37 underwent peripheral blood transplantation and five received bone marrow transplantation. Twenty-one patients had acute GVHD (18 cases in grades Ⅰ-Ⅱ and three cases in grades Ⅲ-Ⅳ) after Allo-HSCT, but the other 21 patients did not. Fourteen patients had chronic GVHD (five cases of limited type and nine cases of extensive type), but the other 28 patients did not. An additional 30 healthy subjects (18 males and 12 females, 20-70 years old, mean age of 44 years) were collected as a normal control group. All patients provided confirmed consent, and the study was approved by the local ethics committee.METHODS: Levels of serum TNF-α, IL-4, and TGF-α in leukemic patients with Allo-HSCT and normal subjects were measured by radio-immuno-assay, the cytokines levels of the patients with/without acute GVHD, of those with/without chronic GVHD and of different grades of GVHD were compared.MAIN OUTCOME MEASURES: Comparisons of serum TNF-α, IL-4, and TGF-α among the groups.RESULTS: All 42 leukemic patients and 30 healthy subjects were included in the final analysis. Levels of TNF-α, IL-4, and TGF-α in patients with acute or chronic GVHD were significantly higher than those in the normal subjects (P<0.05-0.01). Levels of TNF-α and IL-4 in patients without acute GVHD were significantly higher than those in the normal subjects (P<0.01,0.05). Levels of TNF-α, IL-4, and TGF-α in patients with acute GVHD were significantly higher than those in patients without acute GVHD (P<0.05). Levels of TNF-α, IL-4, and TGF-α in patients with chronic GVHD were significantly higher than those in patients without chronic GVHD (P<0.05). Levels of serum TNF-α and TGF-α in patients with acute GVHD of grades Ⅲ-Ⅳ or chronic GVHD of extensive type were significantly higher than those in patients with acute GVHD of grades Ⅰ-Ⅱ or chronic GVHD of limited type (P<0.05-0.01).CONCLUSION: After Allo-HSCT, dynamically monitoring changes of levels of TNF-α, IL-4, and TGF-α may serve as a possible means of predicting the onset of acute or chronic GVHD and may contribute considerably to deciding clinical severity of GVHD.

Objective To evaluate the value of magnetic resonance black-blood thrombus imaging (BTI) of the stage of disease in intracranial venous and sinus thrombosis(CVT).Methods From June 2015 to October 2016,37 patients with CVT diagnosed with routine imaging examinations in Beijing Xuanwu Hospital,Capital Medical University were enrolled prospectively,and they also underwent BTI examination.The patients were randomly divided into either a acute group (≤14 d,n=23) or a chronic group (>15 d,n=14) according to the time from the onset of symptoms to BTI.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) difference between acute and chronic CVT groups were compared.The magnetic resonance venography (MRV) examination was used as a reference to calculate the accuracy of BTI on per-segment level.Results (1) The SNR and CNR of thrombosis in the acute group and chronic group were 206±97 and 94±41,201±96 and 86±40,respectively.There was significant difference between two groups (t=4.9 and 5.0 respectively;all P<0.01).(2) In 37 patients with CVT,the thrombi in 159 cerebral veins and venous sinus segments were detected with MRV.BTI identified the thrombi accurately in 152 vascular segments,and the thrombi in 352 vascular segments were eliminated.The diagnostic sensitivity and specificity were 95.6% (152/159) and 98.0% (352/359) respectively.Conclusion Achieving direct angiography of cerebral venous thrombosis,BTI technique can accurately differentiate acute or chronic thrombus.It has higher accuracy.

Objective:To evaluate the pathological features of a heart failure with preserved ejection fraction(HFpEF) model, which is established by spontaneously hypertensive rats (SHR) through high-fat diet and diabetic factors.Methods:Twenty specific pathogen-free grade(SPF grade) and 14-week-old SHR rats were randomly divided into SHR group (normal diet) and HFpEF group [high-fat diet combined with intraperitoneal injection of streptozotocin (STZ, 25 mg/kg) were used to create a diabetic complex model] with 10 rats in each group. Ten SPF and 14-week-old WKY rats with the same genetic background were set as blank control group (WKY group). All rats were fed for 8 weeks. Echocardiography was performed to measure cardiac parameters: peak velocity of early diastolic mitral inflow(E), peak velocity of late diastolic mitral inflow(A), and the early diastolic mitral annulus e′ in the same cardiac cycle, left atrial ejection fraction (LAEF), left ventricular ejection fraction (LVEF), left atrial diameter, right atrial diameter and interventricular septal thickness(IVST). Serological testing included glucose (GLU) and glycosylated serum protein (GSP); Enzyme-linked immunoassay (ELISA) testing included insulin (INS), glucagon (PG), C-peptide (CP), leptin (LEP), atrial natriuretic peptide (ANP) and B-type brain natriuretic peptide (BNP). The rat heart tissue was stained with HE, and the morphological changes of atrial/ventricular tissue were observed under an optical microscope.Results:The pathological characteristics of HFpEF was established in SHR rats fed with high fat and diabetes. Echocardiography showed that compared with the WKY group, the values of E, E/A and E/e′ in the HFpEF group were significantly increased (all P<0.01), and e′and LAEF were significantly reduced (all P<0.01). In the HFpEF group, the anteroposterior and tranverse dimensions of the left atrium and the long-axis dimension of the right atrium increased to varying degrees (all P<0.05), and the IVST was also significantly increased ( P<0.01). At the same time, atrial wall was thickened obviously, myocardial cells were disordered, and myocardial fibers were broken. Compared with the WKY group, the levels of serum markers ANP and BNP in HFpEF group were significantly increased (all P<0.01), and the levels of serum insulin-related indicators INS, PG, CP, LEP, GSP, and GLU increased to varying degrees (all P<0.01). Conclusions:The composite model established by SHR rats through high-fat diet and diabetic factors can simulate the Doppler echocardiographic changes and pathological features of HFpEF, as well as abnormal changes in serum related markers and insulin indicators.

Objective:To investigate the value of mammography and MRI parameters combined with red cell distribution width to lymphocyte ratio (RLR) in predicting recurrence and metastasis of breast cancer after modified radical surgery.Methods:104 female breast cancer patients who received improved radical surgery in Jiande First People’s Hospital from Jun. 2021 to Dec. 2023 were included as the study objects. The Japanese MGU-1000D MAMMOREX Pe.ru.ru DIGITAL mammography machine was used to examine each subject before surgery, and the X-ray signs of the primary tumor lesion were recorded, including maximum diameter, breast density, calcification, mass morphology, vascular signs and tumor margin. The primary tumor was evaluated by MRI using a MAGNETOM Verio magnetic resonance imaging machine and a dedicated breast examination coil, the apparent diffusion coefficient (ADC) value was measured and automatically calculated, and the RLR was recorded.Results:There were 31 patients with recurrence and metastasis and 73 patients without recurrence or metastasis. The proportion of patients with clinical stage III and Ki67 level > 14% in postoperative recurrence and metastasis group was significantly higher than that in patients without recurrence and metastasis. The proportion of patients with calcification, vascular thickening, increase and burr at the edge of mass in the recurrence and metastasis group was significantly higher than that in the patients without recurrence or metastasis. The ADC value of patients with recurrence and metastasis after breast cancer surgery was 0.93±0.12, and that of patients without recurrence and metastasis was 1.08±0.15, the former was significantly lower than the latter, and the difference was statistically significant ( t=5.64, P<0.001). The RLR of peripheral blood in patients with recurrence and metastasis after breast cancer surgery was 21.36±2.39, and that of patients without recurrence and metastasis was 19.93±2.14, the former was significantly higher than the latter, and the difference was statistically significant ( t=4.37, P<0.001). Multivariate Logistic regression analysis showed that axillary lymph node metastasis, vascularization, thickening, burr on tumor edge, small ADC value and large peripheral blood RLR were independent risk factors for recurrence and metastasis after breast cancer surgery ( P<0.05). ROC curve results showed that the area under the curve of the logistic regression model based on the above factors was 0.860 (0.798-0.921), the sensitivity was 80.4%, and the specificity was 81.8%. Conclusion:Mammogram and MRI parameters combined with peripheral blood RLR level have certain value in predicting recurrence and metastasis after modified radical breast cancer surgery.

Objective To propose a classification method for ultrasound images of pedicle screw canals based on radiomics analysis,and to evaluate the integrity of the screw canal.Methods With thoracolumbar spine specimens from 4 fresh cadavers,50 pedicle screw canals were pre-established and ultrasound images of the canals were acquired.A total of 2 000 images(1 000 intact and 1 000 damaged canal samples)were selected.The dataset was randomly divided in a 4∶1 ratio using 5-fold cross-validation to form training and testing sets(consisting of 1 600 and 400 samples,respectively).Firstly,the optimal radius of the region of interest was identified using the Otsu's thresholding method,followed by feature extraction using pyradiomics.Principal component analysis and the least absolute shrinkage and selection operator algorithm were employed for dimensionality reduction and feature selection,respectively.Subsequently,3 machine learning models(support vector machine[SVM],logistic regression,and random forest)and 3 deep learning models(visual geometry group[VGG],ResNet,and Transformer)were used to classify the ultrasound images.The performance of each model was evaluated using accuracy.Results With a region of interest radius of 230 pixels,the SVM model achieved the highest classification accuracy of 96.25%.The accuracy of the VGG model was only 51.29%,while the accuracies of the logistic regression,random forest,ResNet,and Transformer models were 85.50%,80.75%,80.17%,and 75.18%,respectively.Conclusion For ultrasound images of pedicle screw canals,the machine learning model performs better than the deep learning model as a whole,and the SVM model has the best classification performance,which can be used to assist physicians in diagnosis.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.

To explore the safety and efficacy for radiofrequency ablation of paroxysmal supraventricular tachycardia (PSVT) guided by Carto Univu three-dimensional mapping system.
 Methods: A total of 99 patients with PSVT underwent radiofrequency catheter ablation (RFCA) were assigned to a Carto Univu group (51 patients) and a two-dimensional X-ray group (48 patients) according to the mapping method. The operation time, X-ray exposure time, X-ray exposure dose, dose area product (DAP), operation success rate and complication rate were compared between the two groups.
 Results: The Carto Univu group and the two-dimensional X-ray group were not significant difference in the operation time, the X-ray exposure time of placing catheter, the X-ray DAP of placing catheter, the number of discharge, the discharge power, and the total discharge time (P>0.05). The mapping and ablation time, total exposure time, mapping and ablation DAP and total DAP in the Carto Univu group were significantly lower than those in the two-dimensional X-ray group (P<0.01). In the right accessory pathway cases, the mapping and ablation DAP and the total DAP in the Carto Univu group decreased compared with X-ray group (P<0.05), but it decreased more profound (P<0.01) in the left accessory pathway cases and the dual atrioventricular nodal pathways cases. Seven cases in the Carto Univu group achieved "zero X-ray", including 5 cases of the dual atrioventricular nodal pathways and 2 cases of the left accessory pathway. The immediate success rate for the two groups was 100%. After 3-12 months of follow-up, there was no recurrence in the Carto Univu group but 3 suspected recurrences in the two-dimensional X-ray group. In addition, no complications occurred in the two groups. 
 Conclusion: Carto Univu electroanatomic mapping system can guide PSVT safely and effectively during radiofrequency ablation and reduce radiation exposure to both doctors and patients. It is especially suitable for dual atrioventricular nodal pathways, which may even achieve "zero X-ray". Perhaps Carto Univu will be the first choice for RFCA of dual atrioventricular nodal pathways.
Catheter Ablation ; instrumentation ; methods ; Humans ; Imaging, Three-Dimensional ; instrumentation ; methods ; Operative Time ; Radiation Exposure ; prevention & control ; statistics & numerical data ; Radiography ; statistics & numerical data ; Recurrence ; Tachycardia, Supraventricular ; diagnostic imaging ; surgery ; Treatment Outcome