Objective: To explore the clinical value of adenosine triphosphate (ATP) stress99mTc-methoxyisobutylisonitrile (99mTc-MIBI) gated myocardial perfusion imaging (G-MPI) for evaluating the severity and region of myocardial ischemia and left ventricular function in patients with myocardial bridge. Methods: A total of 58 patients with CAG or CTA confirmed diagnosis of myocardial bridge received ATP stress99mTc-MIBI G-MPI examination in our hospital. The short and vertical long-axis image of left ventricular myocardium were divided into 13 segments and the radionuclide distribution was semi-quantitatively evaluated into 4 classes by 0-3 scores visually (0: normal, 1: mild reduction, 2: moderate reduction, 3: severe reduction). The summed stress score (SSS) of left ventricular myocardium was calculated, the severity and region of myocardial ischemia were judged and compared with the severity of myocardial bridge. The LVEF obtained by ATP stress 99mTc-MIBI G-MPI was compared with LVEF obtained by cardiac color ultrasound (UCG).Results: The detection rate of myocardial ischemia by ATP Stress 99mTc-MIBI G-MPI and by 24h dynamic ECGwere 82.76% vs 56.10%, P <0.05. ATP Stress 99mTc-MIBI G-MPI presented abnormal radionuclide distribution in258 segments (63.55%) of LAD supplied territory, 82 (47.13%) of LCX supplied territory and 74 (42.53%) of RCAsupplied territory; the ischemic segments in LAD supplied territory were more than those in LCX and RCA suppliedterritories, P <0.0125. The resting LVEF obtained by ATP Stress 99mTc-MIBI G-MPI and by UCG were (69.59 ± 4.13)% vs (63.22 ± 4.12) %, P >0.05 and they had positive correlation (r =0.555, P <0.05).Conclusion: ATP stress 99mTc-MIBI G-MPI could accurately and intuitively evaluate the severity and region ofmyocardial ischemia and left ventricular function in patients with myocardial bridge, it has certain guiding value inclinical practice.

Objective To investigate differences between Han and Uyghur children in dyslexia prevalence and potential environmental risk factors as well as to provide diagnosis and treatment evidence for dyslexia children . Methods We used cluster sampling to recruit 2 854 students in grades 3~6 from five Uyghur -Chinese bilingual primary schools in Xinjiang province .The children with dyslexia were selected step by step according to the defini‐tion of ICD-10 and DSM -IV .The children with DD and children without DD were selected and compared by 1∶1 of the same class ,ages and genders .Then single factor analysis and logistic regression analysis were used to as‐sess children'environmental risk factors .Results In total ,2 438 effective quostionnaires have been got .The difference between Han (3 .89% ) and Uyghur (7 .05% ) dyslexia prevalence was statistically significant .The factor analysis revealed that educational grades ,family income ,father's and mother's occupations ,and their education levels as well as some home literacy environmental factors were significantly different for the two groups of children with dyslexia (P<0 .05) .Conclusion The prevalence of dyslexia was high in both groups ,and especially for Uyghur children . Some environmental factors may be responsible for the differences noted ,especially for the occupation of mother .

Objective To investigate whether the Serum Ig is help to choose the optimal treatment in patients with immune thrombocytopenia(ITP) .Methods 128 ITP patients were collected for 3 years .All of ITP patients were treated with the step-style protocol including glucocorticoid(CsA)lombied IVIG ,Ciclosporin A and TPO receptor agonist lombied rituximab .The treatment re-sponse were evaluated according the comparison between the two groups namely ≤IgG ,IGM ,IgA median and > median groups . Results There was no relationship between the bleeding and IgA 、IgM、IgG level .Low IgM level was associated with first line treatment resistance and showed the response to CsA and TPO receptor agonist lombied rituximab .High IgA level was associated with the resistance of first line and CsA treatment ,but showed no response to TPO receptor agonist lombied rituximab .Conclusion Serum Ig level is helpful for the choice of optimal treatment strategies in adult IT P patients .

Objective To investigate the relationship of HSP27 expression with treatment response ,remission rate ,prognosis in multiple myeloma(MM) patients .Methods Eighty‐six patients with MM first diagnosis and 27 relapse cases were collected re‐spectively .Control was defined as non‐hematological malignance .The MM patients divided into first diagnosis ,relapse conventional chemotherapy group and bortezomib group .HSP27 expression and protein level were measured on pre‐and post 1 ,2 and 3 treatment circles .Results The tendency of HSP expression and protein level:relapse‐MM patients> first‐diagnosis MM patients> control . HSP27 expression and level in Ⅲ phase was higher than those in Ⅱ phase for first‐diagnosis MM patients .Bortizomib‐containing chemotherapy protocol showed more effectively decrease on HSP27 than chemotherapy treatment only .At post‐1 treatment circle , HSP27<1 showed higher survival rate than HSP27>1 and delayed the relapse time .Conclusion BMMNC‐HSP27 expression and protein level is associated with staging ,treatment response and prognosis in MM patients .

Objective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.

Objective To investigate the value of cytokines in bile combined with clinical indices in predicting the degree of liver injury after liver transplantation. MethodsA total of 16 patients undergoing liver transplantation who were hospitalized in Center of Organ Transplantation, The Affiliated Hospital of Qingdao University, from January to December 2018 were enrolled, and according to the level of alanine aminotransferase (ALT) on day 1 after surgery, the patients were divided into mild liver injury (ALT ＜500 U/L) group with 10 patients and severe liver injury (ALT ＞500 U/L) group with 6 patients. Bile samples were collected on days 1, 3, 5, and 7 after surgery, and MILLIPLEX assay was used to measure the levels of 17 cytokines. R software was used to perform principal component analysis (PCA) of bile cytokines and clinical indices and gene ontology (GO) enrichment analysis of bile cytokines. The two-independent-samples t-test was used for comparison of normally distributed continuous data between two groups; The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. A Spearman correlation analysis was performed to evaluate the correlation between clinical indices and bile cytokines. ROC curve analysis was used to evaluate the predictive value of cytokines in bile and clinical indices for liver injury after liver transplantation. ResultsCompared with the mild liver injury group, the severe liver injury group had significantly higher expression levels of bile Fractalkine (Z=-2.828, P=0.003), soluble CD40 ligand (sCD40L) (Z=-2.850, P=0.008), interleukin-4 (Z=-2.398, P=0.017), CXCL10 (Z=-2.475, P=0.023), and macrophage inflammatory protein-1α (Z=-1844, P=0.043). The correlation analysis showed that on day 1 after liver transplantation, aspartate aminotransferase, ALT, and lactate dehydrogenase were positively correlated with the levels of several cytokines in bile (all P＜0.05). The area under the ROC curve of Fractalkine, sCD40L and AST were 0.933 (0.812-1.000), 0.833 (0.589-1.000) and 0.917 (0.779-1.000), respectively, suggesting that AST and Fractalkine and sCD40L in bile on the first day after liver transplantation have significant predictive value for liver injury. The results of PCA showed that bile cytokines combined with clinical indices on day 1 after liver transplantation could better distinguish the patients with mild liver injury from those with severe liver injury. GO analysis showed that bile cytokines were associated with positive feedback regulation of external stimulus, cell chemotaxis, receptor ligand activity, cytokine activity, and cytokine-cytokine receptor interaction. ConclusionFractalkine and sCD40L in bile can predict the degree of liver injury after liver transplantation.

Objective To investigate the relationship between plasma tau protein, phosphorylated tau protein (p-tau) protein and cognitive function in subjects with generalized brain atrophy. Methods A total of 100 subjects with moderate and severe brain atrophy were divided into two groups according to cognitive function: normal group (n=50 cases) and dementia group (n=50 cases). And their gender, age, educational level, etc. are recorded. The tau protein and p-tau protein content in plasma were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The differences between plasm tau and p-tau protein expression and their relationship with cognitive function were analyzed. Results Plasma tau protein and p-tau protein levels were significantly higher (P<0.05) in the dementia group [(210.92±43.79)pg/mL、(81.15±16.85)pg/mL] than in the normal group[(210.92±43.79)pg/mL、(81.15±16.85)pg/mL]. Plasma tau protein and p-tau protein levels were negatively correlated with the MMSE score (P<0.05) and had no significant correlation with the degree of brain atrophy (P>0.05). Conclusion Cognitive impairment may be associated with elevated tau protein levels in patients with extensive brain atrophy.

Objective:To summarize the technical points of laparoscopic pancreaticoduodenectomy (LPD) carried out in a single center.Methods:The clinical data of 102 patients who underwent laparoscopic pancreaticoduodenectomy in 2018 at the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University were retrospectively analyzed, and the general conditions, operation time, intraoperative blood loss, and surgical operation were analyzed. Post-operative complications, hospital stay and other indicators were studied.Results:Of the 102 patients who were included, there were 57 males and 45 females, aged 15.0 to 79.0 (59.9±11.8) years old, with a body mass index (23.6±3.6) kg/m 2. For the 102 patients who underwent LPD, 6 were total pancreatic resection. Three were combined with vascular resection in the form of portal vein-superior mesentery vein segmental resection. The operation time was (376.6±87.2) min, the intraoperative blood loss was 350 (100, 800) ml, and the postoperative hospital stay was (17.0±5.9) days. Postoperative complications occurred in 26 of the 102 patients (25.5%), and more than two complications occurred in 17 patients. B/C grade pancreatic fistula occurred in 9 patients (9.4%), abdominal bleeding in 8 patients (7.8%), gastrointestinal bleeding in 2 patients (2.0%), biliary fistula in 4 patients (3.9%), and gastric emptying disorder in 5 patients (4.9%), 8 patients had pulmonary infection (7.8%). Five patients (4.9%) died during the perioperative period. Conclusion:The main technical points of LPD included en bloc resection, pancreaticojejunostomy, and vascular reconstruction. The basis of LPD is en bloc resection. Combined resection and reconstruction of vascular segments is a sign of maturity of LPD technology and a prerequisite for further development as a routine procedure.

Boron neutron capture therapy(BNCT), a promising radiotherapy, belongs to precision treatment for cancers. BNCT can accurately kill cancer cells and protect normal cells at the same time relying on 10B compounds with high efficacy. The research about developing new 10B compounds is in progress, and novel and efficient 10B compounds are emerging, which greatly facilitate broadening the advantages and efficacy of BNCT. Considering the mixed rays generated from the BNCT process, its biological effects on tumor cells are relatively complex, and related studies are still lacking. The molecular mechanisms underlying BNCT need to be elucidated further. BNCT has been applied in the treatment of malignant brain tumors, head and neck cancers, and malignant melanoma with favorable curative effects. This review mainly focuses on the development of 10B compounds, biological mechanisms, potential advantages, and clinical applications.

OBJECTIVE To mine the signals of adverse dr ug events （ADE）for tolvaptan based on FAERS database ，and to provide reference for safe use of drugs in clinic. METHODS The data of tolvaptan-induced ADE were collected from FAERS database during the first quarter of 2004 to the third quarter of 2020；the reporting odds ratio （ROR）method and the proportional reporting ratio （PRR）method of disproportional method were used for data mining. RESULTS A total of 4 744 ADE reports of the target drug tolvaptan were extracted ，involving 1 279 ADEs. The reporting countries were mainly the United States and Japan ，etc. A total of 199 ADE signals were obtained ，involving 21 system organ classes （SOCs），which mainly focused on various examinations（n＝56），hepatobiliary disorders （n＝17），renal and urinary disorders （n＝14），etc. Among them ，80 signals were not mentioned in existing instructions for tolvaptan in China ，such as decreased glomerular filtration rate ，positional vertigo ， rupture of renal cyst ，renal cyst infection ，pulmonary malignant tumor. CONCLUSIONS Before using tolvaptan ，drug evaluation should be performed well ，especially the patients with basic diseases such as heart failure ，liver insufficiency and renal insufficiency. During treatment ，the indexes of liver function and renal function should be closely monitored ；timely intervention measures should be taken to avoid related injury and disease deterioration caused by ADE when ADE or disease progression occurs.