Objective To investigate the application of ~(18)F-fluorodeoxyglucose hybrid PET/CT (~(18)F-FDG hPET/CT) imaging in clinical staging of non-small cell lung cancer (NSCLC). Methods Seventy two consecutive patients with NSCLC undergoing ~(18)F-FDG hPET/CT before radiotherapy were analyzed. The results were compared with previous CT scan and conventional clinical staging. The patients were followed-up for at least 6 months. Results Among the 72 patients, the staging grade was changed in 27 patients due to the result of ~(18)F-FDG hPET/CT in whom with 20 patients having their grade raised and 7 lowered. Radical treatment was changed to palliative treatment in view of a raise of staging grade. Because of distant metastasis was detected by ~(18)F-FDG hPET/CT imaging, 14 patients received palliative treatment. Compared with CT, 47 more lymph nodes and 26 distant metastases were found with ~(18)F-FDG hPET/CT imaging, and the patients in question received radiotherapy and palliative treatment accordingly. Conclusion ~(18)F-FDG hPET/CT imaging, by changing the clinical staging in 37.5% (27/72) NSCLC patients, has impact on treatment strategy and treatment planning of radiotherapy in NSCLC patients. Patients were frequently spared unnecessary treatment, and management was more appropriately targeted.

ObjectiveTo compare the values of serum citrulline, intestinal fatty acid binding protein (IFABP) and intes-tinal trefoil factor (ITF) in diagnosis of acute gastrointestinal injury in critically ill children.MethodsA total of 84 critically ill children were enrolled. The serum citrullin, IFABP, and ITF were measured by high performance liquid chromatography and enzyme-linked immunosorbent assay. The testing results and clinical data were analyzed.ResultsCompared with non gastroin-testinal injury group, the serum citrulline level was signiifcantly lower and IFABP and ITF levels were signiifcantly higher in gas-trointestinal injury group (allP<0.05). In critically ill children, the serum citrulline level was negatively correlated with C-reactive protein, procalcitonin and hospitalization time (r=-0.36 to -0.31,P<0.01).ConclusionsThe levels of citrulline, IFABP and ITF have diagnostic values for acute gastrointestinal injury in critically ill children. The level of citrulline may relfect the degree of acute gastrointestinal injury in critically ill children.

Objective:To test the hypothesis that Pertussis toxin (PTX) can promote the occurrence of interstitial lung disease (ILD) in experimental autoimmune myositis (EAM) model and clarify the potential pathogenic mechanism.Methods:EAM mice model were induced by Skeletal muscle thomogenate with or without PTX, and the relationship between ILD phenotypes and neutrophil extracellular traps (NETs) infiltration was analyzed by histopathological and serological studies in EAM with PTX group and EAM without PTX group. Healthy mice were given PTX alone intraperitoneally to clarify whether NETs formation could be induced in vivo, and neutrophils separated from healthy human blood were intervened with PTX to induce NETs formation in vitro. The data was tested for normality using Shapiro-Wilk. Statistical methods and were analyzed using t-test or ANOVA, and multiple comparisons between different groups were tested using Tukey test. Results:Compared with EAM without PTX group, lung tissues in EAM with PTX group had multiple pathological changes similar to polymyositis/dermatomyositis-related ILD. Nonspecific interstitial pneumonia and usual interstitial pneumonia were the main pathological types. The pulmonary interstitial lesions were accompanied by significant infiltration of NETs; and serum NETs markers levels were obviously elevated in EAM with PTX group, compared with the control group [ n=5, (87±10) ng/ml], cfDNA levels were statistically significantly elevated in both the EAM without PTX group [ n=4, (115±27) ng/ml] and the EAM with PTX group [ n=7, (150±50) ng/ml] ( F=4.24, P=0.038); Cit-H3-DNA levels were elevated in the EAM without PTX group ( n=4, 0.24±0.09), and in the EAM EAM with PTX group ( n=6, 0.33±0.11) compared with the control group ( n=4, 0.13±0.02) ( F=6.21, P=0.016). After PTX intervention, serum cfDNA levels were higher in the PTX group [ n=3, (100±40) ng/ml] than in the control group [ n=3, (45±12) ng/ml, t=2.27, P=0.086]; PTX also induced neutrophils to form NETs in vitro. Conclusion:PTX may promote the development of ILD in EAM mice model by inducing the formation of NETs, indicating that EAM mice can serve as a model for targeting NETs to study the pathogenesis ILD.

Objective:To compare the clinical effect of combined anterior and posterior approach and posterior median approach to treat O'Driscoll type III b fracture of ulnar coronoid process.Methods:A retrospective case control study was made on 67 patients with O'Driscoll type III b fracture of ulnar coronoid process treated in Honghui Hospital, Xi'an Jiaotong University from January 2015 to January 2019, including 35 males and 32 females, aged from 21 to 61 years [(38.0±9.4)years]. Among them, 31 patients were treated with combined anterior and posterior approach for reduction and internal fixation (combined approach group), and 36 patients with median posterior elbow approach group for reduction and internal fixation (posterior elbow approach group). The operation time, amount of intraoperative blood loss and fracture healing time were compared between groups. The visual analogue score (VAS), elbow joint range of motion and Mayo elbow performance score (MEPS) were assessed for pain and function evaluation at postoperative 1, 3, 6 months and at the last follow-up. The occurrence of complications were observed as well.Results:All patients were followed up for 12 to 28 months [(20.1±4.2)months]. There was no significant difference in operation time and VAS between the two groups ( P>0.05). The intraoperative blood loss [(133.6±20.3)ml] and fracture healing time [(12.3±1.7)months] in combined approach group were less or shorter than those in posterior elbow approach group [(144.4±22.1)ml, (13.2±2.0)months] ( P<0.05). The range of flexion and extension of elbow joint in combined approach group [(88.7±10.8)°, (111.1±13.9)°, (121.3±14.1)°, (127.1±13.3)°] was higher than that in posterior elbow approach group [(74.5±11.8)°, (97.6±12.6)°, (111.3±13.0)°, (115.2±12.7)°] at postoperative 1, 3, 6 months and at the last follow-up ( P<0.05). The MEPS in combined approach group [(31.7±8.6)points, (55.6±9.3)points, (84.6±10.5)points, (85.0±10.3)points] was higher than that in posterior elbow approach group [(27.2±8.2)points, (50.7±8.7)points, (77.4±11.2)points, (80.1±9.4)points] at postoperative 1, 3, 6 months and last follow-up ( P<0.05). The incidence of complications in combined approach group [10%(3/31)] was lower than that in posterior elbow approach group [31%(11/36)]( P<0.05). Conclusion:Compared with the simple posterior elbow median approach, the combined anterior and posterior elbow approach for treatment of O'Driscoll type IIIb fracture of ulnar coronoid process has lower intraoperative blood loss, faster fracture healing, lower incidence of complications and better elbow function.

Objective:To investigate the risk factors of deep venous thrombosis in patients before hip arthroplasty, and to explore the possible causes of postoperative thrombosis.Methods:The clinical data of 361 patients with hip arthroplasty treated in the Department of Orthopaedic Trauma of Xi′an Honghui Hospital from September 2015 to December 2019 were studied retrospectively, including 102 males and 259 females, aged 65 to 94 years, and the average age was 72.25 years old. All fracture patients were given subcutaneous injection of low molecular weight heparin calcium to prevent lower extremity thrombosis. The deep veins of both lower extremities were examined before and after operation. The general data of the two groups of patients were collected and recorded, including age, sex, whether complicated with medical diseases (essential hypertension, type 2 diabetes, coronary heart disease), serological indexes, time from injury to admission, and time from admission to operation. The software of SPSS 19.0 was used for statistical analysis.Results:The incidence of lower limb DVT, before operation was 29.92%, including 26 males (24.07%) and 82 females (75.93%). The results of multivariate logistic regression analysis showed that diabetes mellitus ( OR=2.127, 95% CI: 1.134-3.989, P=0.019), coronary heart disease ( OR=1.692, 95% CI: 1.056-2.713, P=0.029) and the time from injury to admission ( OR=1.677, 95% CI: 1.037-2.712, P=0.035) were independent risk factors for DVT in elderly patients undergoing hip arthroplasty. The incidence of lower limb DVT, after operation was 46.54%. After operation, proximal thrombus were occurred in 2 cases (1.19%), distal thrombus in 143 cases (85.12%), and mixed thrombus in 23 cases (13.69%). Postoperative thrombus was ipsilateral to the fracture limb in 84 cases (50.00%), thrombus was located in the healthy side of the fracture in 19 cases (11.31%), and DVT occurred in 65 cases (38.69%) in both lower limbs. Conclusions:Delayed admission longed than 48 hours, coronary heart disease and diabetes mellitus are the risk factors for the formation of DVT. The thrombus that existed before operation and did not disappear after operation accounted for 48.81% of the total incidence of postoperative thrombosis, and the new thrombus accounted for 51.19% of the total incidence of postoperative thrombosis. For the elderly patients with femoral neck fracture undergoing hip arthroplasty, ultrasonic examination of both lower limbs should be performed before and after operation to find the changes of thrombus in time and do a good job of prevention and treatment.

Objective To investigate the causal association of liver function and lipid metabolism levels with sleep disorders based on the Mendelian randomization analysis.Methods The analysis was conducted using the data from genome-wide association studies,with the exposure factors of liver function and lipid metabolism levels(alanine aminotransferase[ALT],aspartate aminotransferase[AST],gamma-glutamyl transpeptidase[GGT],albumin[Alb],serum total protein[TP],total bilirubin[TBil],alkaline phosphatase[ALP],triglyceride[TG],triglyceride-to-glycerol-3-phosphate[TG/G3P]ratio,total cholesterol[TC],high-density lipoprotein cholesterol[HDL-C],low-density lipoprotein cholesterol[LDL-C],poly-unsaturated fatty acids[PUFA],total fatty acids[TFA],PUFA/TFA ratio)and the outcome factor of sleep disorders(nonorganic).The regression models including inverse variance weighted,MR-Egger,Simple mode,weighted median,and Weighted mode were used to perform the Mendelian randomization analysis.Results Serum Alb(odds ratio[OR]=0.728,95%confidence interval[CI]:0.535-0.989,P＜0.05),HDL-C(OR=0.879,95%CI:0.784-0.986,P＜0.05),and PUFA/TFA ratio(OR=0.800,95%CI:0.642-0.998,P＜0.05)were negatively associated with sleep disorders,while TG/G3P ratio(OR=1.222,95%CI:1.044-1.431,P＜0.05)was positively associated with sleep disorders.The results of Mendelian randomization did not show a causal association of ALT,AST,GGT,TP,TBil,ALP,TG,TC,LDL-C,PUFA,and TFA with sleep disorders(all P＞0.05).The results of the MR-Egger intercept test showed no pleiotropy(P＞0.05),and Mendelian randomization was a valid method for causal inference in this study.Conclusion According to the results of the Mendelian randomization analysis,liver function and lipid metabolism show significant association with sleep disorders.Liver function and lipid metabolism can be used as indicators for predicting the risk of sleep disorders and performing intervention.

Objective To explore the key of post-processing techniques for continuous and symmetrical display of cervical verte-bral bony structures using curve planar reformation(CPR).Methods Data from 150 patients who underwent cervical spine CT scans were collected and divided into three groups based on cervical curvature:normal,straightened,and kyphotic.A multi-slice CPR post-processing method was designed,using the display rate of structures such as C2/C3 to C6/C7 intervertebral foramina,uncovertebral joints,facet joints,and pedicles of vertebral arch as the measurement index to find the optimal site and angle for CPR baseline selection.Additionally,the consistency of the intervertebral foramen diameter and area measurements on both sides of the CPR baseline level,as well as the normal appearance of the cervical vertebral bony structures during baseline translation were observed.Results The optimal site for the CPR baseline was C4/C5 with a best angle of 100° for normal or straightened cervical curvature,and C5/C6 with a best angle of 100° for kyphotic curvature.At these baseline levels,the measurements of the longitudinal and transverse diameters,as well as the area,of the intervertebral foramina on both sides were similar,providing a valuable comparison.When translating the baseline forwards and backwards,CPR could continuously and symmetrically display the cervical vertebral bony structures clearly.Conclusion Performing multi-slice CPR image post-processing based on the aforementioned baseline sites and angles aids in the comparison of the left and right sides,facili-tating the convenient and intuitive detection of subtle abnormalities in cervical vertebral bony structures.

Post-stroke urinary incontinence (PSUI) is a common complication in patients with stroke, affecting at least one-third of patients with stroke and seriously affecting their quality of life and rehabilitation process. This article reviews the pathogenesis, risk factors, and treatment of PSUI.

Background: The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis. Methods: We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved. Results: Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects. Conclusions This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.

Background: The immune system plays a critical role in the development and progression of osteoporosis and fractures. However, the causal relationships between antibody immune responses, immune cells, and these bone conditions remain unclear. This study aimed to explore these relationships using Mendelian randomization (MR) analysis. Methods: We collected complete blood count data from patients with fractures and healthy individuals and analyzed their differences. Then, we conducted a 2-sample, 2-step MR analysis to investigate the causal effects of antibody immune responses on osteoporosis and fractures, using inverse-variance weighted (IVW) as the primary method. We also explored whether immune cells mediate the pathway between antibodies and osteoporosis or fractures. Finally, we analyzed the functions and expression levels of key genes involved. Results: Overall, the fracture group exhibited increased white blood cell count, absolute neutrophil count, absolute monocyte count, platelet count, and their respective proportions, while absolute lymphocyte count, absolute eosinophil count, absolute basophil count, red blood cell count, and their proportions were decreased. We identified 44 causal relationships between antibodies and osteoporosis or fractures, with 7 supported by multiple MR methods, and 5 showing odds ratios significantly deviating from 1 in the IVW analysis. Epstein-Barr virus-related antibodies had a notable impact on osteoporosis and fractures. The human leukocyte antigen (HLA) gene family, particularly HLA-DPB1, emerged as a significant risk factor. However, immune cells were not found to mediate these effects. Conclusions This study elucidated the causal relationships between antibody immune responses, immune cells, and osteoporosis or fractures. The HLA gene family plays a crucial role in the interaction between antibodies and these bone conditions, with HLA-DPB1 identified as a key risk gene. Immune cells do not serve as mediators in this process. These findings provide valuable insights for future research.