Objective To investigate the total examinations of conventional X-ray diagnosis and CT diagnosis of radiation diagnosis and treatment institutions,in order to explore the distribution characteristic of radiological diagnosis frequency and diagnostic patients,and to estimate the application frequency of medical X-ray diagnosis in Heilongjiang province.Methods The questionnaire was sent to all radiation diagnosis and treatment institutions in forms of public document issued by the administrative department of health and family planning of Heilongjiang province.Basic situations and patient numbers of conventional X-ray diagnosis (interventional diagnosis not included) and CT diagnosis in 2016 were collected and summarized combined with sampled on-site verification.The application frequency of medical X-ray diagnosis was obtained using permanent resident population in Heilongjiang province in 2016.Results Totally 1 645 medical radiation institutions were investigated,including 81 tertiary hospitals,359 secondary hospitals,808 primary hospitals or unrated medical institutions,and 397 private dental clinics.The examinations of conventional X-ray diagnosis and CT diagnosis were 7 706 050 and 7 063 734,respectively.The application frequency of conventional X-ray diagnosis and CT diagnosis was 200.9 and 184.1 examinations per 1 000 population,respectively,and varied from 98.0 to 274.7 in different areas.The ratio of examinations in public medical institutions to that in private medical institutions was 7.47 ∶ 1.Conclusions 50％ of the total radiological diagnosis were made in tertiary hospitals,and only 13％ were made in medical institutions below primary in Heilongjiang.Meanwhile,although the number of public and private medical institutions was at the same scale,the total examination of radiological diagnosis in public medical institutions was 7 times of that in private medical institutions.The application frequency of conventional X-ray diagnosis and CT diagnosis in Heilongjiang province in 2016 was similar to that of Jiangsu province in 2015.

Objective To observe the clinical effect of "palace bone-setting" Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi fixation in the treatment of acute ankle sprain.Methods A total of 60 patients with acute ankle sprain were collected and randomly divided into observation group and control group according to the random number table method,with 30 cases in each group.The observation group was treated with "Palace Bone-setting" Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi for fixation.The control group was treated with external application of diclofenac diethylamine emulsion and fixation of elastic bandage.Two groups were treated for 14 days.The patients pain disappeared time and the swelling subsided,the VAS scale for assessment of ankle pain observed.The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-after scoring system was used to assess the Ankle function,evaluation of clinical curative effect.Results The pain disappear time (9.7 ± 1.6 d vs.13.4 ± 3.5 d,t=5.638),regression and time (3.5 ± 1.3 d vs.6.7 ± 1.1 d,t=10.292) in the observation group were significantly earlier than those in the control group (P＜0.01).After treatment,VAS score (1.9 ± 1.1 vs.3.3 ± 1.3,t=4.503) of the observation group significantly lower than that of the control group (P＜0.01);AOFAS score (93.6 ± 3.9 vs.84.2 ± 5.1,t=8.019) significantly higher than the control group (P＜0.01).Total effective rate in the observation group was 96.7％ (29/30),and the control group was 80.0％ (24/30),which the difference was statistically significant (x2=4.043,P=0.044).Conclusions The "Palace Bone-setting" Dieda-Wanying cream combined with Yuan Shu Zhi Pai Zi fixation has definite curative effect on acute ankle sprain,relieve pain,swelling and promote the ankle function.

Objective To observe the value of clinical and CT radiomics features for predicting microsatellite instability-high(MSI-H)status of gastric cancer.Methods Totally 150 gastric cancer patients including 30 cases of MSI-H positive and 120 cases of MSI-H negative were enrolled and divided into training set(n=105)or validation set(n=45)at the ratio of 7∶3.Based on abdominal vein phase enhanced CT images,lesions radiomics features were extracted and screened,and radiomics scores(Radscore)was calculated.Clinical data and Radscores were compared between MSI-H positive and negative patients in training set and validation set.Based on clinical factors and Radscores being significant different between MSI-H positive and negative ones,clinical model,CT radiomics model and clinical-CT radiomics combination model were constructed,and their predictive value for MSI-H status of gastric cancer were observed.Results Significant differences of tumor location and Radscore were found between MSI-H positive and negative patients in both training and validation sets(all P＜0.05).The area under the curve(AUC)of clinical model,CT radiomics model and combination model for evaluating MSI-H status of gastric cancer in training set was 0.760,0.799 and 0.864,respectively,of that in validation set was 0.735,0.812 and 0.849,respectively.AUC of clinical-CT radiomics combination model was greater than that of the other 2 single models(all P＜0.05).Conclusion Clinical-CT radiomics combination model based on tumor location and Radscore could effectively predict MSI-H status of gastric cancer.

Objective To explore the effect and potential mechanisms of melatonin combined with gemcitabine on the chemosensitivity of human pancreatic cancer cell line PANC-1.Methods Human pancreatic cancer cell line PANC-1 was trea-ted with gemcitabine alone or in combination with melatonin.Cell viability was assessed using CCK-8.Effect of melatonin and gem-citabine alone or in combination on the clonogenic capacity of PANC-1 cells were observed through colony formation experiments.Scratch assays and transwell experiments were conducted to evaluate cell migration ability.Reactive oxygen species(ROS)and mitochondrial membrane point JC-1 assay kit were used to determine reactive oxygen species synthesis and membrane potential levels.Intracellular Fe2+level was measured using ferrous ion fluorescent probe.The protein expression levels of LC3,P62,GPX4 and SLC7A11 in different treatment groups were detected by immunofluorescence and Western blotting.Results CCK-8 results showed that the viability of PANC-1 cells was inhibited by gemcitabine alone after 48 h and 72 h of treatment in a time-and dose-dependent manner.The cell viability of gemcitabine combined with melatonin group was significantly lower than that of gemcitabine group,and the cell viability decreased with the increase of melatonin concentration.Scratch assays,transwell experiments,and plate colony formation assay results demonstrated that the proliferation and migration of cells in the gemcitabine combined with the me-latonin group were significantly inhibited compared with the gemcitabine group.The levels of reactive oxygen species and Fe2+in PANC-1 in gemcitabine combined with the melatonin group were higher than those in the gemcitabine group,and the mitochondri-al membrane potential was significantly decreased(P＜0.01).Western blotting and immunofluorescence results showed that the ra-tio of autophagy-related protein LC3-Ⅱ/LC3-Ⅰ in gemcitabine combined with the melatonin group was lower than that in the gem-citabine group,and the expression of P62 was up-regulated,and the expression of anti-iron death-related protein GPX4 and SLC7A11 was significantly inhibited(P＜0.05),suggesting that melatonin combined with gemcitabine can inhibit autophagy and promote ferroptosis in PANC-1 cells.Conclusion Melatonin enhances the chemosensitivity of pancreatic cancer cell PANC-1 to gemcitabine by inhibiting autophagy and promoting ferroptosis of tumor cells.

Helicobacter pylori (H. pylori), creating a global infection rate over 50%, presents great challenges in clinical therapies due to its complex pathological microenvironment in vivo. To improve the eradication efficacy, herein we fabricated a pharmaceutical vesicle RHL/Cl-Ch-cal where cholesterol-PEG, calcitriol and first-line antibiotic clarithromycin were co-loaded in the rhamnolipid-composed outer lipid layer. RHL/Cl-Ch-cal could quickly penetrate through gastric mucus layer to reach H. pylori infection sites, and then effectively destroyed the architecture of H. pylori biofilms, killed dispersed H. pylori and inhibited the re-adhesion of residual bacteria (called biofilms eradication tetralogy). Moreover, RHL/Cl-Ch-cal activated the host immune response to H. pylori by replenishing cholesterol to repair lipid raft on the cell membrane of host epithelial cells. Finally, RHL/Cl-Ch-cal killed the intracellular H. pylori through recovering the lysosomal acidification and assisting degradation. In experiments, RHL/Cl-Ch-cal demonstrated prominent anti-H. pylori efficacy in the classical H. pylori-infected mice model. Therefore, the study provides a "comprehensive attack" strategy for anti-H. pylori therapies including biofilms eradication tetralogy, immune activation and intracellular bacteria killing.