Objective: To examine the effect of SiO2 exposure on the airway surface microenvironment and NIMA-related kinase 7 (NEK7)/nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) inflammasome in rats. Methods: Twenty-four specific pathogen-free male rats of the SD strain were randomly divided into the control group and the model group, of 12 rats in each group. Rats in the model group were given SiO2 suspensions through disposable tracheal intubation perfusion to model silicosis in rats, while rats in the control group was perfused with the same amount of physiological saline. The pH value and glucose level were measured in the rat bronchoalveolar lavage fluid (BALF) 14 and 28 days after modeling. Lung tissues were stained with HE and Masson and the distribution of inflammatory cells and the deposition of pulmonary interstitial collagens were observed in lung tissues under a light microscope. The expression of transforming growth factor β1 (TGF-β1), collagen type Ⅰ(ColⅠ), collagen type Ⅲ (Col Ⅲ), interleukin-1β (IL-1β), NLRP3, N-terminal domain of Gasdermin D (GSDMD-NT), caspase-1, and NEK7 was quantified in lung specimens using immunohistochemistry. Results: Lower pH values were measured in rat BALF in the model group than in the control group 14 [(6.38±0.05) vs. (6.68±0.08), P<0.05] and 28 days after modeling [(6.63±0.14) vs. (6.86±0.05), P<0.05], while higher glucose levels were seen in the model group than in the control group 14 [(0.39±0.06) vs. (0.31±0.04) mg/dL, P<0.05] and 28 days after modeling [(0.39±0.08) vs. (0.31±0.06) mg/dL, P<0.05]. HE and Masson staining showed mild to moderate alveolitis and pulmonary fibrosis in rats 14 days post-exposure to SiO2, and showed moderate to severe alveolitis and pulmonary fibrosis 28 days post-exposure. Immunohistochemistry detected higher TGF-β1, ColⅠ, Col Ⅲ, IL-1β, NLRP3, GSDMD-NT, caspase-1 and NEK7 expression in rat lung tissues in the model group than in the control group (all P<0.05). Conclusions SiO2 exposure may cause changes in rat airway surface microenvironment, including BALF acidification and elevated glucose. Pyroptosis induced by activation of NEK7-associated NLRP3 inflammasome may be an important mechanism of pulmonary fibrosis caused by silicosis.

Objective To detect the ascites CD64 index of patients with decompensated cirrhosis ,and explore the value in the di-agnosis of spontaneous bacterial peritonitis (SBP) .Methods Decompensated cirrhosis with ascites patients were divided into non-SBP group ,SBP suspected group and SBP diagnosed group .Two control groups were composed of patients with ascites culture pos-itive and non-SPB group .SBP suspected group were further grouped according to abdominal pain and the percentage of peripheral blood neutrophils .The CD64 index was detected by flow cytometry .Compared the difference of ascites CD64 index after treatment , and analyzed diagnosis performance of procalcitonin in human peripheral blood and ascites white blood cell count of SBP .Results The level of the ascites CD64 index was significantly higher in SBP diagnosed group (179 .39 ± 65 .56)and SBP suspected group (115 .49 ± 58 .42)than that of non-SBP group(26 .88 ± 26 .05)(P<0 .01) .The differences of the ascites CD64 index between SBP suspected associated with abdominal pain group and SBP suspected associated with painless group was not statistically significant (P>0 .05) .The level of the ascites CD64 index in SBP suspected with percentage of peripheral blood neutrophils elevated group was increased significantly than non-elevated group(P<0 .05) .CD64 index level in effective treatment group was significantly lower than the ineffective treatment group(P<0 .01) .The area of the ascites CD64 index under the curve was greater than procalcitonin in human peripheral blood and ascites WBC count ,and had a higher sensitivity and specificity .Conclusion The detection process of the ascites CD64 index is fast and with less influential factors ,which provides a new choice for the clinical diagnosis of SBP .

Objective To investigate the imaging features of sarcomatoid carcinoma(SC)of lung on chest radiography and CT and to improve knowledge of SC.Methods The chest plain films,CT images and clinical data of all 7 cases of pathologically proved lung SC were retrospectively analyzed.Results All cases presented with a spheroid solid lung mass ranged from 3 to 11 cm in diameter(average 7 cm).All the lesions were located in middle and lower fields of the lung:3 lesions in right lower lobe,2 in right middle lobe,and the other 2 in left lower lobe.Among the 7 cases:6 cases were of peripheral type and 1 case was of central type.The peripheral-typed lesions of 5 cases had clear margin and 3 of them were lobulated.Three massess were homogenous in density,and the other 4 were inhomogeneous in density with formation of central cavity or calcification.After intravenous contrast administration.Three lesions showed homogeneous enhancement,and the other 4 lesions had inhomogeneous enhancement.The lesions with diameter larger than 6 cm showed marginal or patch-like enhancement.Five cases had pleural or chest walls invasion.Two cases had mediastinal lymph nodes metastases.One case had multiple remote metastasis.Conclusion There are some relatively specific features of lung SC on chest radiography and CT,which may be helpful for diagnosis.

OBJECTIVE: To explore the characteristics and return of cases without psychosis in forensic psychiatry. METHODS: Seventy four cases without psychosis were follow up researched,and statistics relevant data. RESULTS: Five point seven percent cases were diagnosed without psychosis. They had explicit motive and purpose, protect by one's own was good, "the psychotic symptom" disappears after authenticate. CONCLUSION Analysis of many factor contribute to authenticate cases without psychosis. That schizophrenia symptom in early days should be identified to prevent from the misdiagnosis.
Adolescent ; Adult ; Crime ; Expert Testimony ; Female ; Follow-Up Studies ; Forensic Psychiatry ; Humans ; Male ; Middle Aged ; Psychotic Disorders/psychology* ; Schizophrenic Psychology ; Young Adult

Objective To recognize the CT manifestations of benign metastasizing leiomyoma (BML).Methods Four cases of BML proved by pathology were retrospectively analysed.Among these, 2 cases were pulmonary BML,1 ease was leiomyomatosis peritonealis diseminata(LPD),and 1 case was combined with pulmonary BML and LPD.All of them were female,and had a history of hysterectomy,the average age were 45.The CT findings of them were analyzed.Results The CT of pulmonary BML in three cases showed multiple rounded,well-defined discrete nodules,0.2—2.0cm in diameter,random distribution,and no calcification in the nodules.No hilum or mediastinum lymphadenopathy,and no pleural effusion.There were no enhancement after intravenous contrast examination.The CT findings of LPD in two cases were many masses around the vena cava,abdominal aorta and/or iliac artery.The masses were 4— 5cm in diameter with smooth margin and homogeneous density.No lymph node or ascites were found.One case who got intravenous contrast enhanced CT scan showed significant enhancement of the lesions;another case who got PET CT study showed no significant tracer concentration.Conclusion When multiple metastasizing nodular lesions with sharp margin and homogeneous density were found in the lungs or abdomen,they should be considered the possibility of BML in women with hysterectomy history.

ObjectiveTo explore the characteristics multi-detector-row computed tomography (MDCT)findings of ACTH-independent macronodular adrenal hyperplasia ( AIMAH ).Methods The un-enhanced and contrast-enhanced MDCT features in 24 patients ( 14 males and 10 females) with clinically confirmed AIMAH were retrospectively assessed for the morphology and enhancement patterns.ResultsThe adrenal glands were involved bilaterally in all of the 24 cases( 100％ ).24 patients had massively enlarged multinodular adrenal glands.Nodules were( 1.79 ± 1.02) cm (0.50 ～ 3.85 cm),which usually distorted and completely obscured the normal adrenal glands.The enlarged adrenal glands were still retained the adreniform contour,showed characteristic ginger-like.22 of the 24 ( 91.7 ％ ) hyperplastic nodular glands demonstrated mild homogeneous enhancement.Calcification was revealed in 1 adrenals ( 1/24,4.2％ ).Conclusion MDCT reveals the characteristic morphology and CT attenuation in AIMAH.Combined with its clinical presentation and biochemical findings,AIMAH is able to be diagnosed with high specificity and accuracy on MDCT.

Objective To analyze the diagnostic value of apolipoprotein E and lipid levels in patients for early diagnosis of cerebral infarction.Methods A total of 80 patients with cerebral infarction were enrolled in this study as the study group from June 2015 to October 2016.Meanwhile,80 healthy subjects were selected as the control group.The serum apolipoprotein E and blood lipid were compared between the two groups.Results The difference of apolipoprotein E levels between the two groups was statistically significant (P ＜ 0.05).Apolipoprotein E combined with serum total cholesterol and low density lipoprotein cholesterol for the diagnosis of cerebral infarction had a sensitivity of 37.5 ％,specificity accuracy of 100％,and diagnostic efficiency of 60％.Conclusion Early cerebral infarction patients diagnosed with apolipoprotein E combined with lipid levels had a good clinical value.

Objective To evaluate the CT findings of lymphofollicular thymic hyperplasia in adult myasthenia gravis (MG).Methods The CT findings of thymus area of 134 adult patients with lymphofolficular thymic hyperplasia in MG were reviewed,all of them with surgically and histologically proven diagnosis,and compared with the CT findings of 165 normal subjects.Results In the group of patient,CT showed enlargement of thymus in 31 patients,5 patients had nodule or mass(＜3 cm);thus 36 cases(26.9%)can confirmed diagnose by CT with thymic hyperplasia.CT showed 2 masses(＞3 em) and 9 patients(6.7%)had normal size thymus with soft-tissue density,it can considered with thymic hyperplasia.The spotty or streak shadow showed in other patients,though it could not be certain diagnosed as thymic hyperplasia,but could not be except it.The thymus area tissue complete replacement by fatty density were not found in patient group.The CT findings of patients had marked difference when compared with group of normal subjects(P＜0.01),except the spotty or streak shadows.Conclusion CT scan is an important method in diagnosing thymic lymphofollicular hyperplasia of MG in adult.

Objective To explore the influence of Buqi Qingchang Decoction(composed of Buzhong Yiqi Decoction plus Baitouweng Decoction with Curcumae Radix and Curcumae Longae Rhizoma added)combined with XELOX chemotherapy and Bevacizumab targeted therapy on the clinical efficacy,quality of life and survival period of patients with metastatic colorectal cancer of qi deficiency and damp-heat syndrome.Methods A retrospective study was conducted in 70 patients with metastatic colorectal cancer of qi deficiency and damp-heat syndrome who were admitted to the Department of Oncology,Chongqing Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine(Chongqing Beibei District Hospital of Traditional Chinese Medicine)from December 2020 to December 2023.The patients were divided into an observation group and a control group according to the therapy,with 35 cases in each group.The control group was treated with XELOX chemotherapy combined with Bevacizumab targeted therapy,while the observation group was given oral administration of Buqi Qingchang Decoction together with chemotherapy and targeted therapy.The changes in the serum levels of tumor markers such as carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199),and Karnofsky Performance Status(KPS)scores for quality of life in the two groups were observed before and after treatment.Moreover,the clinical efficacy,progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results(1)After treatment,the objective response rate(ORR)and disease control rate(DCR)in the observation group were 51.42％(18/35)and 85.71％(30/35),respectively,which were significantly higher than those in the control group[25.71％(9/35)and 54.29％(19/35),respectively],and the differences between the two groups were statistically significant(P＜0.05 or P＜0.01).(2)The PFS of the observation group was 16.7 months and that of the control group was 12.9 months,and the OS of the observation group was 23.3 months and that of the control group was 17.7 months.The PFS and OS of the observation group were significantly longer than those of the control group,and the differences were statistically significant(P＜0.05 or P＜0.01).(3)After treatment,the levels of serum CEA and CA199 in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the KPS scores were significantly increased compared with those before treatment(P＜0.05).The decrease of serum CEA and CA1 99 levels and the increase of KPS scores in the observation group were superior to those in the control group,and the differences were statistically significant(P＜0.05).Conclusion XELOX chemotherapy and Bevacizumab regimen combined with Buqi Qingchang Decoction exerts certain effect in treating metastatic colorectal cancer.The combined therapy is effective on enhancing the efficacy to a certain extent,prolonging the survival period of patients,reducing the risk of disease progression,decreasing the levels of serum tumor markers,and improving the quality of life of patients.

Objective To evaluate the effect of the water conservancy schistosomiasis control projects combined with mollus-cicide to control Oncomelania hupensis snails in the rivers connecting with the Yangtze River. Methods The water conservancy schistosomiasis control projects of Zhujiashan River,Qili River and Gaowang River were chosen as the study objects in Pukou District,Nanjing City. The data review method and field investigation were used to evaluate the effect of the water conservancy schistosomiasis control projects combined with molluscicide to control O. hupensis snails. Results After the projects of the wa-ter level control and concrete slope protection and mollusciciding were implemented,the snails in the project river sections were completely eliminated. The snail diffusion did not happen in the inland irrigation area too. In the outside of the river beach , though the snails still existed,the snail densities plunged below 1.0 snail per 1.0 m2. Conclusion The comprehensive mea-sures of the combination of water level control,concrete slope protection and mollusciciding can effectively control and eliminate the snails,and prevent the snails from spreading.