Objective To investigate the expression of AIF, CYT C, PAF-1, caspase-3, and XIAP in Sprague-Dawley rats with spontaneous mammary neoplasms.Methods One-hundred and thirty 3-4-week old SPF Spargue-Dawley rats (♀∶♂=1∶1) were fed in a specific pathogen free (SPF) breeding barrier for 60 weeks.The occurrence of spontane-ous breast tumors was recorded and histopathology was performed to identify the types of tumors.The rats were divided into 3 groups:rats with normal breast tissue ( group I) , with benign tumors ( group II) and with malignant tumors ( group III) . The expression of AIF, CYT C, APAF-1, caspase-3 and XIAP proteins and mRNAs were detected by immunhistochemistry ( IHC) and RT-PCR assay.Results Among these 130 SD rats, 14 rats were observed having spontaneous mammary neo-plasms with the incidence rate of 10.77%(14/130).In these neoplasm cases, 7 cases were mammary fibroadenomas, 7 cases of breast carcinoma, both with an incidence rate of 5.38%.Immunohistochemistry showed that, compared with the group I, the positive expressions of AIF, APAF-1, caspase-3 were decreased significantly (P<0.01), and the CYT C and XIAP expressions were significantly increased in the group II.The positive expression of all genes except XIAP was de-creased in the group III(P<0.01).Compared with the group II, APAF-1 and XIAP were significantly higher in the group III (P<0.01), and the positive expression of AIF, Cyt C, and caspases-3 were significantly decreased (P<0.01).In the results of RT-PCR assay, except APAF-1 which showed significant correlation with the results of immunohistochemistry ( P<0.05 ) , all the others showed an extremely significant correlation with immunohistochemical results ( P <0.01 ) . Conclusions Mammary tumors are most common spontaneous neoplasms in SD rats.Abnormal expression of mitochondrial apoptotic pathway-related factors AIF, CytC, APAF-1, caspase-3, and XIAP are correlated with the carcinogenesis and de-velopment of breast tumors.

Objective:To investigate the effect of etocoxib combined with colchicine on acute gouty arthritis and its influence on serum uric acid, renal function and inflammatory factors.Methods:From January 2018 to June 2019, 60 patients with acute gouty arthritis in the Third People's Hospital of Hangzhou were divided into treatment group (30 cases) and control group (30 cases) according to the random number table method.The patients in the control group were treated with colchicine, while the patients in the treatment group were treated with etocoxib on the basis of the control group.The course of treatment in both two groups was 7 days.The changes of joint swelling, joint tenderness score, blood uric acid, renal function and inflammatory factors were compared before and after treatment.Results:The total effective rate of the treatment group (90.00%) was higher than that of the control group (63.33%) (χ 2=5.963, P<0.05). The scores of joint swelling[(0.49±0.10)points] and joint tenderness[(0.38±0.09)points] in the treatment group were lower than those in the control group[(0.87±0.15)points and (0.91±0.18)points] ( t=11.545, 14.425, all P<0.05). There was no statistically significant difference in serum uric acid level between the two groups ( t=0.777, P>0.05). There were no statistically significant differences in SCR and BUN between the two groups ( t=0.248, 0.150, all P>0.05). The ESR [(15.21±3.04)mm/h], CRP [(7.06±1.04)mg/L] and IL-1β [(4.17±0.76)pg/mL] in the treatment group were lower than those in the control group [(21.98±3.64)mm/h, (10.94±1.26)mg/L and (6.28±1.08)pg/mL] ( t=7.819, 13.008 and 8.751, all P<0.05). Conclusion:The therapeutic effect of etocoxib combined with colchicine on acute gouty arthritis is obvious, but it has no significant effect on the blood uric acid and renal function, and it can reduce the inflammatory reaction.

Objective To learn the endocardial strain patterns of the left ventricles on the short-axis views in normal youth volunteers using feature tracking techniques on cine cardiac MR imaging,and to build up the reference ranges of strain peak and time to peak (TTP) for endocardial strain analysis.Methods Twenty-nine normal youth volunteers aged from 24-34 years old were enrolled in the study in march 2015.The Cine MR imaging were acquired using balance FFE sequence with 24 phases for each cardiac cycle.The standard short-axis imaging planes were basal,mid-cavity and apical levels and divided into 16 segments.The peaks and TTPs of myocardial displacement and its velocity,radial and circumferential strain and strain rate and its velocity in each segment were calculated using feature tracking techniques.The data with normal distribution were analyzed by ANOVA and Student-Newman-Keuls (SNK) method,and Kruskal-Wallis and Wilcoxon rank sum test were used for the data without normal distribution.Results The peaks and TTPs of radial strain and strain rate differed in 16-segmental levels and basal,middle and apical plane levels and had no concordant reference ranges.The circumferential strain and strain rate were homogeneous at basal and middle plane levels [(-27.09 ±9.51)％,(1.94 ±0.98)/s,respectively].Their TTPs were homogenous [0.38 (0.08)RR,0.54 (0.08)RR,respectively],and there were no significant differences in planar-segments or inter-segment level.Except for middle level,the peaks of radial displacement and velocity differed in basal and apical levels and had no concordant reference ranges.But radial velocity TTPs were homogeneous in all 16 segments [0.21 (0.04)RR].Except for the radial strain rate,TTPs showed no significant difference between basal level and middle level.The measurements at apical level revealed high variance.No regular pattern could be found on individual peak and TTP curves of velocity and strain rate.Conclusion The peaks and TTPs of radial strain are different in segmental and planar levels without a concordant reference range.The peaks and TFPs of circumferential strain and the radial velocity rTTPs are homogeneous in middle and apical plane level and have homogeneous reference range.

Purpose To measure the longitudinal and transverse strain and displacement parameters of each segment of long axis myocardium on cardiac MRI film images of normal young volunteers using feature tracking technique (FT), and to analyze the regularity of left ventricular long axis strain and establish peak and time to peak (TTP) reference range concerning the longitudinal and transverse strain and displacement. Materials and Methods Cardiac film images of 29 healthy volunteers aged 24 to 34 were collected using Philips Multiva 1.5T MRI scanner, including three typical long axis planes of the left ventricular long axis, left ventricular outflow tract, and four-chamber view. The MRI film images were analyzed drawing on myocardial feature tracking software TOMTEC, and the peak value and TTP of longitudinal and transverse strain and displacement of the 16 AHA segments excluding apex cordis were obtained thereby. The regularity of each parameter concerning the plane, layer, and segment was summarized and analyzed. Results The TTP of longitudinal strain, longitudinal displacement and transverse strain were consistent among each myocardial segment, which was a constant indicator in (41.24±12.51) ％ RR interphase. The peak value of longitudinal displacement was represented by apex cordis (2.56±0.89) mm < middle (6.09±2.03) mm < cardiac base (8.07±2.05) mm, and the peak value of transverse displacement was manifested as apex cordis (4.57±1.18) mm < middle (5.65±0.84) mm < cardiac base (8.48 ±1.18) mm, which was consistent with cardiac geometric deformation visually observed. The longitudinal strain showed consistency on 2CH-3CH-4CH plane, whose peak reference value was (-22.46±13.19)％; while the peak value of transverse strain displayed no consistency on different planes. Conclusion The longitudinal strain of the left ventricular on different planes has consistent peak value and TTP, suggesting good reference value.

Objective:To investigate the therapeutic effect of nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on systemic lupus erythematosus (SLE) patients and its immune function.Methods:Sixty-two patients with systemic lupus erythematosus admitted to Third People′s Hospital of Hangzhou from March 2017 to March 2019 were randomly divided into observation group (31 cases) and control group (31 cases) by random number table. The patients in the control group were treated with prednisone and methotrexate, while the patients in the observation group were treated with nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on the basis of the control group. Both groups were treated for 3 months. The therapeutic effects of the two groups were compared, and the changes of complement C3 and C4, immune function before and after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group [96.77%(30/31) vs.74.19%(23/31)], and there was significant difference ( χ2=6.369, P<0.05). The levels of complement C3 and C4 in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of complement C3 and C4 in two groups were significantly increased ( P<0.05), and the levels of complement C3 and C4 in observation group were significantly higher than those in control group [(1.08 ± 0.15) g/L vs. (0.81 ± 0.13) g/L, (0.24 ± 0.05)g/L vs. (0.18 ± 0.03) g/L], and there were significant differences ( t=7.574, 5.729, P<0.05). The levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups were significantly increased ( P<0.05), and the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in observation group were significantly higher than those in control group [(65.72 ± 5.62)% vs. (58.93 ± 4.25)%, (41.03 ± 1.75)% vs.(38.21 ± 1.43)%, 1.65 ± 0.09 vs.1.41 ± 0.12], and there were significant differences ( t=5.365, 6.948, 8.908, P<0.05). The levels of IgA, IgG and IgM in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of IgA, IgG in two groups were increased, the level of IgM in two groups was decreased, and there were significant differences ( P<0.05). The levels of IgA, IgG in observation group were significantly higher than those in control group [(1.85 ± 0.38) g/L vs. (2.54 ± 0.42) g/L, (12.19 ± 1.63) g/L vs. (14.53 ± 1.37) g/L], and there were significant differences ( t=6.783, 6.119, P<0.05). Conclusions:Nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate in treating SLE is effective, which can effectively improve the levels of complement C3 and C4 and immune function.

Objective To analyze the risk factors for iatrogenic pseudoaneurysm(PSA)occurring after cardiovascular interventional procedures.Methods The clinical data of 48 patients,who developed PSA after receiving cardiovascular interventional procedure at the Yantai Yuhuangding Hospital of China between January 2018 and December 2022,were retrospectively analyzed.The control group included 192 patients who had no PSA.At a case-control ratio of 1∶4,the PSA patients and non-PSA patients were paired,and the paired indicators included age,and puncture site.Univariate and multivariate logistic regression analyses were used to analyze the patients'basic data,hematological examination,and situation of the interventional procedure,and the independent risk factors were screened out.Results Multivariate logistic regression analysis showed that the high body mass index(BMI,OR=1.324,95％CI=1.097-1.598,P=0.003),smoking history(OR=4.477,95％CI=1.599-12.536,P=0.004),use of antiplatelet agents(OR=4.861,95％CI=1.018-23.214,P=0.047),combination use of antiplatelet and anticoagulant(OR=26.994,95％CI=2.353-309.686,P=0.008),the operator of the interventional procedure being an attending physician(OR=5.817,95％CI=1.139-29.717,P=0.034),low haemoglobin level(OR=0.946,95％CI=0.922-0.971,P＜0.01),elevated D-dimer level(OR=2.407,95％CI=1.367-4.239,P=0.002),long-time interventional operation(OR=1.019,95％CI=1.005-1.033,P=0.009),and sheath size＞6 F(OR=4.368,95％CI=1.196-15.947,P=0.026)were the independent risk factors for PSA occurring after cardiovascular interventional surgery.Conclusion High BMI,smoking history,use of antiplatelet agents,combination use of antiplatelet and anticoagulant,the operator of the interventional procedure being an attending physician,low haemoglobin level,elevated D-dimer level,long-time interventional operation,and sheath size＞6 F are the independent risk factors for PSA occurring after cardiovascular interventional procedure,which can provide a basis for the early prevention of PSA.(J Intervent Radiol,2024,33:646-650)

Objectives:To compare the efficacy of cyclosporin A (CsA) alone and CsA combined with recombined human thrombopoietin (rhTPO) in patients with non-severe aplastic anemia (NSAA) .Methods:Data from 83 patients with NSAA between August 2014 and February 2019 were collected retrospectively. The study population included 35 men and 48 women, with a median age of 45 years (14-85 years) . Among them, 57 had been treated with CsA + rhTPO, TPO was administered at 15 000 U QD for 7 days, once a month for 3 months, and the other 26 patients with compatible baseline characters were treated with CsA alone. All the enrolled patients had been treated with CsA for at least 6 months and were followed up for at least 1 year. The efficacy and outcome were compared between the two groups.Results:Total 23 men and 34 women, with a median age of 46 years (14-85 years) were treated with CsA + rhTPO. The median duration of CsA treatment was 17 (8-28) months, and the patients were followed up for a median of 27 (12-45) months. Total 12 men and 14 women, with a median age of 40 years (20-64) were treated with CsA alone. The median duration of CsA treatment was 19 months (9-30 months) , and the median follow-up duration was 29 months (16-66 months) . There was no significant difference in the baseline characteristics of the two groups ( P>0.05) . There was no significant difference in the CR and OR rates of the two groups at 1, 3, 6, 12, and 24 months of treatment ( P>0.05) . The change in the platelet level for the CsA + rhTPO treated group after 1 month[8 (-12-86) ×10 9/L vs. 3 (16-57) ×10 9/L, P=0.029) , 3 months[24 (-6-102) ×10 9/L vs. 7 (-9-76) ×10 9/L, P=0.006], and 6 months[33.5 (-4-123) ×10 9/L vs. 12.5 (-14-109) ×10 9/L, P=0.048] of treatment was higher than that in the CsA alone group, while no significant difference was found between the two groups at other time points. There was no significant difference in the change in the megakaryocyte level between the two groups[3 (0-4) vs. 2 (0-5) , z=-0.868, P=0.385] after 6 months of treatment. Apart from 10.5% (6/57) of the patients in the CsA + rhTPO treated group who reported soreness at the injection site, there was no other significant difference between the two groups in terms of adverse effects. During the follow-up period, there were two cases of increasing paroxysmal nocturnal hemoglobinuria clone to over 10%, one in the CsA + rhTPO treated group, the other in the CsA alone group; and there was one case of progression to SAA in the CsA + rhTPO treated group; while no case of death or thromboembolic event (TEE) , fibrosis or reticulin proliferation, progression to myelodysplastic syndrome (MDS) , or acute myeloid leukemia was observed in either group. There was one case of progression to SAA in the CsA + rhTPO treated group but none in the CsA alone group. Conclusion:Compared to CsA alone, CsA + rhTPO treatment can accelerate the recovery of the platelet level with acceptable adverse effects.

Objective to explore the use of performance management as a lever in public hospitals to achieve quality improvement,efficiency enhancement,and high-quality development under the dual influences of na-tional civil service examination and Diagnosis-Related Groups(DRGs)payment policy reform.Methods A questionnaire survey was conducted to summarize the current situation and problems of performance assessment in public hospitals in China.Based on the identified problems,an upgraded performance management system was proposed,and key indicators were selected through a case study in a specific hospital.Results An empirical study in a specific hospital demonstrated the positive effects of the upgraded performance management system on hospital management improvement.Conclusion Public hospitals should establish a long-term mechanism for performance management,focusing on organizational positioning,indicator design,management levers,and talent development,to continuously support high-quality development.

The human brain undergoes rapid development during childhood, with significant improvement in a wide spectrum of cognitive and affective functions. Mapping domain- and age-specific brain activity patterns has important implications for characterizing the development of children’s cognitive and affective functions. The current mainstay of brain templates is primarily derived from structural magnetic resonance imaging (MRI), and thus is not ideal for mapping children’s cognitive and affective brain development. By integrating task-dependent functional MRI data from a large sample of 250 children (aged 7 to 12) across multiple domains and the latest easy-to-use and transparent preprocessing workflow, we here created a set of age-specific brain functional activity maps across four domains: attention, executive function, emotion, and risky decision-making. Moreover, we developed a toolbox named Developmental Brain Functional Activity maps across multiple domains that enables researchers to visualize and download domain- and age-specific brain activity maps for various needs. This toolbox and maps have been released on the Neuroimaging Informatics Tools and Resources Clearinghouse website (http://www.nitrc.org/projects/dbfa). Our study provides domain- and age-specific brain activity maps for future developmental neuroimaging studies in both healthy and clinical populations.

As people's living standards improve， the development trend of diabetes has gradually become severe. Diabetes is a chronic inflammatory disease associated with abnormal expression of nuclear factor-kappa B （NF-κB） in patients. NF-κB exists in various tissue cells and participates in the regulation of a variety of genes related to immune function and inflammation. Varieties of factors can activate NF-κB when the body is stimulated by external factors， so as to produce inflammation and other reactions. Previous studies on NF-κB mainly focus on cancer， and the pathological mechanism of the treatment of diabetes by related signaling pathways and the progress of traditional Chinese medicine （TCM） treatment have not been systematically elaborated on. By referring to the relevant literature in China and abroad， it was found that NF-κB is not isolated in the development and progression of diabetes but is associated with signal molecules related to inflammation， oxidative stress， and energy metabolism， and it is involved in mediating inflammation， pancreatic β cell apoptosis， insulin signal transduction， and other physiological functions. Therefore， blocking the transmission of NF-κB signaling pathway is beneficial to the treatment of diabetes. At present， Western medicine for the treatment of diabetes mainly includes oral hypoglycemic drugs and insulin injections， but the adverse reactions are obvious. TCM has been characterized by multi-target， extensive action， and excellent curative effects in the treatment of diabetes. TCM and its compounds with functions of tonifying Qi and promoting blood circulation， regulating qi and eliminating phlegm， clearing heat and detoxifying， and nourishing Yin and moistening dryness can effectively intervene in the abnormal expression of NF-κB signaling pathway in vivo through anti-inflammatory effects. In this paper， the association between NF-κB signaling pathway and diabetes was summarized， and the modern research progress of TCM intervention of NF-κB signaling pathway in the treatment of diabetes in the past five years was reviewed， so as to lay a laboratory foundation for the study of a new pathological mechanism of diabetes based on NF-κB signaling pathway and provide new targets and research direction for the prevention and treatment of diabetes and development of related TCM.