Objective To explore the application value of triggered angiography non-contrast enhanced (TRANCE) technology in diagnosing lower limb arterial occlusive disease.Methods Totally 22 lower limb arterial occlusive disease patients were randomly selected,and then underwent TRANCE and DSA examinations.The arteries from the abdomen to the lower limb were divided into abdominal aorta,common iliac artery,external iliac artery,internal iliac artery,superficial femoral artery,deep femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery and peroneal artery.Totally 337 sections displayed clearly were chosen to go through examinations by TRANCE and DSA.Results Of the 337 sections there were 312 ones with the same stenoses found by TRANCE and DSA,TRANCE found 16 sections with worse stenoses and 9 milder ones than by DSA.There were 153 sections with the same moderate stenoses (≥50％) displayed by TRANCE and DSA;Of the 153 sections,there were 15 ones with worse stenoses and 6 ones with milder stenoses found by TRANCE than by DSA.Kappa value of the two methods was 0.905.Conclusion TRANCE technology is a non-invasive,safe and nonradiative diagnosing method for the lower limb arterial occlusive disease.

Epilepsy occurs as a result of episodic abnormal synchronous discharges in cerebral neuronal networks.It is characterized by an imbalance between excitatory and inhibitory neurotransmission.Although various non-conventional mechanisms are implicated in epileptic synchronization, glutamate excitatory neurons play an essential role.AMPA receptors mediate fast synaptic excitation within and between brain regions relevant to epilepsy, and play a role in epileptogenesis and in seizure-induced brain damage.However, direct modulation of AMPA receptors may have undesirable consequences, given its wide expression within the central nervous system and critical roles on brain circuitry development.Hippocampal CA1 region, as the main site of epilepsy, selectively regulates the high expression of AMPA receptor GluA2 subunit and transmembrane AMPA receptor regulatory protein family(TARPs)γ-8 subtype and its complex GluA2/TARPγ-8, whether it can produce anti-epileptic and avoid adverse reactions.

Objective : To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19. Methods : All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. Results : By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts. Conclusions The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Objective:To investigate the protective effect of interfering peptide TAT-GluA2CT on hippocampal neurons in the Lithium chlorine-Pilocarpine status epilepticus model and the optimal time of administration.Methods:Male SD rats (72 cases) were induced to status epilepticus by using Lithium chlorine-Pilocarpine, while a control group ( n=12) was established.The 72 rats were divided into epilepsy group ( n=12), TAT-sham peptide group ( n=12), TAT-GluA2CT peptide group ( n=48) according to the random number table method, and the TAT-GluA2CT peptide group were further divided into the pre-1 h group ( n=12), the post-2 h group ( n=12), the post-4 h group( n=12), and the post-6 h group ( n=12) according to the administration time of the TAT-GluA2CT peptide.Nissl staining and terminal dUTP nick end labeling (TUNEL) assay were performed on 6 rats each from control group, epilepsy group, TAT-shampeptide group, pre-1 h group, post-2 h group, post-4 h group, and post-6 h group to observe the morphological changes and apoptosis of neurons in the CA1 region of the rat hippocampus.Western blot and co-immunopercipitation test were used to detect the expression of GluA2[second subunit of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) recepter] and the coupling of GluA2/transmembrane AMPA receptor regulatory protein (TARP γ-8) complex in control group, epilepsy group, pre-1 h group, post-2 h group, post-4 h group and post-6 h group.The t-test was used to compare the data differences between 2 groups, and one-way ANOVA was adopted to compare the differences between the groups. Results:Compared with the epilepsy group, the number of neurons in each TAT-GluA2CT peptide group increased significantly, and the difference was statistically significant( epilepsy group 20.07±3.51, pre-1 h group 39.40±2.39, post-2 h group 38.43±2.42, post-4 h group 30.30±2.55, and post-6 h group 27.93±3.20, F=235.28, P<0.05). Compared with the epilepsy group, the number of apoptotic cells in each TAT-GluA2CT peptide group was significantly reduced, and the difference was statistically significant(epilepsy group 31.47±3.19, pre-1 h group 7.30±3.45, post-2 h group 9.27±3.81, post-4 h group 12.86±3.08, and post-6 h group 14.43±3.13, F=248.60, P<0.05). Compared with the control group, the expression of hippocampal GluA2 decreased after epilepsy induction, and the difference was statistically significant(control group 21 626.53±2 700.58, epilepsy group 14 578.16±2 917.02, pre-1 h group 13 375.47±3 180.54, post-2 h group 15 244.10±1 390.41, post-4 h group 15 799.16±4 559.49, post-6 h group 15 722.95±1 756.01, F=3.83, P<0.05). No statistical difference was observed in the expression of GluA2 between the TAT-GluA2CT peptide group and the epilepsy group( F=0.45, P=0.77). Compared with the epilepsy group, GluA2/TARPγ-8 complex coupling was decreased in each TAT-GluA2CT peptide group, and the difference was statistically significant(epilepsy group 24 509.80±3 718.54, pre-1 h group 12 055.18±5 847.11, post-2 h group 9 630.51±5 805.17, post-4 h group 12 749.35±7 108.45, post-6 h group 11 092.98±7 330.08, F=10.68, P<0.05). Compared with the epilepsy group, the incubation period of seizures in the pre-1 h group was prolonged and the seizure rating was decreased, with statistically significant differences[epilepsy group (18.58±3.99) min, pre-1 h group (103.25±9.21) min, t=29.23, P<0.05]. Conclusions:TAT-GluA2CT peptide can attenuate the neuronal damage in hippocampus of epileptic rats.The neuroprotective effect of TAT-GluA2CT peptide was most obvious at 1 h before or 2 h after administration of Pilocarpine.

Objective:To compare the efficacies of MRI, X-ray mammography (XMG) and Ultrasound (US) in detecting and diagnosing breast ductal carcinoma in situ (DCIS).Methods:Two hundred and forty one consecutive patients with pathology-confirmed DCIS were retrospectively recruited from January 2011 to December 2017 in PLA General Hospital. The imaging examination modalities included MRI and/or XMG and/or US.The breast imaging reporting and data system (BI-RADS) categorizations by MRI, XMG and US were compared and their sensitivities of detecting DCIS were calculated. The causes of underestimation on MRI were interpreted with the information of XMG and US. Chi-square test was used to compare the differences.Results:The diagnostic sensitivity of XMG, US and MRI was 65.9% (29/44), 71.6% (101/141) and 91.2% (145/159), respectively, with statistical significant differences (χ2 =24.034, P<0.001). Breast density and lesion type would influence the sensitivity of XMG. And the sensitivity of US was decreased because of non-mass lesion. Of the 14 cases under-evaluated as BI-RADS category 1 to 3 on MRI, 5 were corrected by XMG and/or US to BI-RADS category 4. The cause of underestimation on MRI was the coexistence of DCIS with adenoma or other benign lesion. Conclusion:The retrospective comparison of MRI, XMG and US in this study showed that MRI had significant higher sensitivity in detecting breast DCIS, while the false negative rates of XMG and US were un-negligible.

Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.

Objective To observe the value of intratumoral and peritumoral radiomics based on diffusion weighted imaging(DWI)for predicting histological grade of breast cancer.Methods Preoperative DWI data of 700 patients with single breast cancer diagnosed by pathology were retrospectively analyzed.The patients were divided into training set(n= 560,including 381 of grade Ⅰ+Ⅱ and 179 of grade Ⅲ)and test set(n=140,including 95 of grade Ⅰ+Ⅱ and 45 of grade Ⅲ)at the ratio of 8∶2.Intratumoral ROI(ROIintra)was manually delineated on DWI,which was automatically expanded by 3 mm and 5 mm to decline peritumoral ROI(ROIperi,including ROI3 mm and ROI5 mm),then intratumoral-peritumoral ROI(ROIintra+3 mm,ROIintra+5 mm)were obtained.The optimal radiomics features were extracted and screened,and the radiomics model(RM)for predicting the histological grade of breast cancer were constructed.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the predictive efficacy of each model.Calibration curve method was used to evaluate the calibration degree,while decision curve analysis(DCA)was performed to explore the clinical practicability of each model.Results AUC of RMintra,RM+3 mm,RM+5mm,RMintra+3 mm and RMintra+5 mm was 0.750,0.724,0.749,0.833 and 0.807 in training set,while was 0.723,0.718,0.736,0.759 and 0.782 in test set,respectively.In training set,significant differences of AUC was found(all P＜0.01),while in test set,no significant difference of AUC was found among models(all P＞0.05).The calibrations of models were all high.DCA showed that taken 0.02-0.88 as the threshold,the clinical net benefit of RMintra+per were greater in training set,while taken 0.40-0.72 as the threshold,the clinical net benefit of RMintra+per was greater in test set.Conclusion Both DWI intratumoral and peritumoral radiomics could effectively predict histological grade of breast cancer.Combination of intratumoral and peritumoral radiomics was more effective.

Objective:To investigate the value of intratumoral and peritumoral radiomics features of multi-parameter MRI in evaluation of the status of human epithelial growth factor receptor 2 in breast cancer.Methods:The clinical, pathological and imaging data of 340 patients with pathologically confirmed breast cancer in Henan Provincial People′s Hospital from September 2019 to December 2020 were retrospectively collected. All patients were female, 48 (42, 55) years old. All patients underwent multi-parameter breast MRI before surgery, including dynamic contrast-enhanced T 1WI (DCE-T 1WI), fat-suppressed T 2WI (T 2WI) and diffusion-weighted imaging (DWI). The region of interest (ROI) for lesions were manually delineated and the segmented ROIs were zoomed in ring shape by 4 mm to acquire ROI intra and ROI prei, respectively. Then six sets of radiomics features were extracted from ROI intra and ROI prei of DCE-T 1WI, T 2WI and DWI. The cases were divided into a training set (272 cases) and a test set (68 cases) by stratified sampling at a ratio of 4∶1. The Mann-Whitney U test, Select K Best and minimum absolute contraction and selection operator were used for feature selection of the 6 sets of radiomics features. The feature subsets after reduction were used to construct independent and combined radiomics signatures with support vector machine algorithm to predict the HER2 status of breast cancer. Receiver operating characteristic curve was generated and area under curve (AUC) was calculated to compare the prediction performance of different models. Results:Of the 340 patients, 80 were HER2-positive and 260 were HER2-negative. Among the radiomics signatures based on single sequence, the DWI peri showed the best performance in predicting HER2 status of breast cancer, with an AUC of 0.678 for the test set. Among the combination of intratumoral and peritumoral radiomics signatures based on same sequence, the DWI intra+DWI peri had the highest prediction value, achieving an AUC of 0.774 for the testing set. Among the intratumoral or peritumoral radiomics signatures derived from two different sequences, the DCE-T 1WI intra+DWI intra and T 2WI peri+DWI peri showed the best predictive performance, yielding AUC of 0.766 and 0.769 in the testing set, respectively. Among the combination of intratumoral or peritumoral radiomics signatures derived from all 3 sequences or combinations of all features, the DCE-T 1WI intra+T 2WI intra+DWI intra+DCE-T 1WI peri+T 2WI peri+DWI peri obtained the highest prediction efficiency, with an AUC of 0.913 for the testing set. Conclusion:The radiomics features of intratumoral and peritumoral regions based on multi-parameter MRI have a certain value in non-invasive evaluation of HER2 status of breast cancer, which can help clinicians to provide scientific basis for decision-making of targeted therapy in patients with breast cancer.

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.

ObjectiveTo observe the effect of water extract of Mori Folium （MLE） on oxidative stress in adipose tissue of type 2 diabetes mellitus （T2DM） mice and explore its mechanism. MethodTwenty-four male db/db mice were randomly divided into model group， metformin group， low-dose MLE （MLE-L） group， and high-dose MLE （MLE-H） group according to their body weight and blood glucose， with six mice in each group， and other six C57BLKS/JGpt wild littermate mice were selected as normal group. The mice in the metformin group were given 200 mg·kg^-1 metformin suspension， and the mice in the MLE-L and MLE-H groups were respectively given 2 g·kg^-1 and 4 g·kg^-1 MLE， while the mice in the normal group and model group were given the same dose of deionized water by daily gavage for eight weeks. Body weight， subcutaneous fat index， fasting blood glucose （FBG）， and oral glucose tolerance level （OGTT） of the mice were detected， and serum superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， and malondialdehyde （MDA） were measured. The expression levels of silent information regulator 1 （SIRT1） and NADPH oxidase type 4 （NOX4） protein in subcutaneous adipose tissue of the mice were detected by Western blot. ResultThe FBG level， OGTT， and subcutaneous fat index of T2DM mice were significantly decreased （P<0.05， P<0.01） after administration of MLE compared with the blank group. The contents of serum SOD and GSH were significantly increased， while the level of oxidative stress damage marker MDA was significantly decreased （P<0.05， P<0.01）. The expression of SIRT1 protein in adipose tissue was significantly increased， while the expression of NOX4 protein was significantly decreased （P<0.05， P<0.01）. ConclusionMLE can ameliorate T2DM by alleviating oxidative stress in adipose tissue of T2DM mice and reducing blood glucose.