Ojective To investigate the clinical application value of low dose contrast agent in computerized tomography pulmonary angiography (CTPA) with spectral CT imaging.Methods Totally 52 patients suspected with pulmonary embolism underwent multi-slice spiral CT pulmonary angiography,and were randomly divided into a control group (n =27) and a research group (n=25).The research group used spectral CT with 35 ml of contrast medium and the control group used 64-slice CT with conventional 80 to 90 ml of contrast medium.The CT values of the pulmonary trunk,left pulmonary artery (LPA),right pulmonary artery (RPA),pulmonary vein and ascending aorta were measured.The contrast to noise ratio (CNR) of the pulmonary artery was also calculated.In addition,the image quality of CTPA was evaluated independently by two experienced radiologists.Results The CT values (HU) of the pulmonary trunk,left pulmonary artery(LPA),right pulmonary artery (RPA) in the research group were (432.2±63.4),(373.5±48.8),(381.4±53.6) and (62.5-±6.4),respectively,and significantly higher than those in the control group,showing statistical differences (P＜0.05).The evaluation results of the CTPA images by two radiologists showed that the image quality in the research group was better than that in the control group (P＜0.05).Conclusion The image quality of pulmonary angiography with spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.

Objective To evaluate the diagnostic value of 64-row VCT coronary angiography(CTA) in diagnosing coronary artery disease.Methods 64-row VCT coronary angiography(CTA) and cathter coronary angiography(CAG) were performed in 173 patients with suspected coronary artery disease.All images were analysed at GE AW4.3 workstation,the constructed images included maximum intensity projection(MIP),mlti-planar reconstruction(MPR) and volume rendering(VR).The results were compared with that of CAG.Results 746 segments of coronary artery with diameter ＞1.5 mm were showed by CTA in 173 patients.The sensitivity,specificity,positive predictive value and negative predictive value of the CTA in detecting coronary arterial stenosis were 94.15%(193/203),95.90% and 89.77% and 97.90% respectively.Statistical analysis using a 2-related χ~2 test showed that there were no obvious differences in diagnosing coronary arterial stenosis between CTA and CAG(χ~2=1.58,P＞0.05) and in evaluating the stenosis degree of coronary artery(Kappa=0.890,P＜0.001).Conclusion 64-row VCT has important clinical value in screening coronary arterial disease and in following-up post operational effectiveness of coronary stent implantation and vascular bypass.

Objective To optimize the formulation of the sunscreen used in military training.Methods The different formulations of sunscreen were prepared according to the orthogonal design,and then applied on 3M adhesive tape posted on the color dish with a certain amount;the absorbance in 280 nm-320 nm and 320 nm-400 nm of them were measured and the arithmetic mean (A) was concluded.By comparing A,the protective effect and the main factors affecting preventive bask were determined.The preventive bask test of the optimum formula was carried out in human trials using the method of multi point increasing ultraviolet irradiation.Results OMC,TinosorbTM M,rutin,pearl powder and baicalin all had significant effects in preventing UVA.OMC had a significant effect in preventing UVB.The formula 1 (containing the five materials mentioned above) had the best effects in preventing both UVA (SPF 18) and UVB (PA+).Conclusions The formula 1 has the best effects in preventing both UVA and UVB.

Purpose To investigate the role of SOCS3 on diabetic renal injury. Methods Male CD-1 mice were randomly divided into four groups:control group, diabetic group, empty plasmid vector transfection group and SOCS3 plasmid transfection group. The diabet-ic mice were induced by intraperitoneal injection of STZ at a dose of 150 mg/kg body weight. The mice of transfection group were re-ceived an injection of SOCS3 plasmid or empty vector at every 7 days thereafter. Specimens were collected at 12 week after STZ injec-tion. The morphological changes of tubular epithelial cells were observed by transmission electron microscope. RT-PCR and immuno-histochemistry were used to determine the mRNA and protein expression of CK18 and α-SMA. Western blotting analysis was used to determine the protein expression of SOCS3, p-STAT3, CK18 and α-SMA. Results SOCS3 overexpression in kidney down-regulated the levels of p-STAT3 andα-SMA but up-regulated the expression of CK18. Conclusion Overexpression of SOCS3 can ameliorate the tubular epithelial-mesenchymal transdifferentiation of diabetic mice via inhibiting the phosphorylation of STAT3.

Monoclonal antibody drugs that inhibit programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) have been widely used in esophageal cancer (EC) and yielded significant therapeutic responses. However, only a few patients obtain lasting clinical benefits due to primary or acquired drug resistance, and new treatment schemes are urgently needed. The tumor immune microenvironment is the main factor that affects patients' response to immunosuppressive agents. This article will discuss the role of immunosuppressive cells and non-cellular components in the immune process to provide ideas for the next research direction of EC.

Objective:To investigate the development of MLL-AF4 fusion gene-positive in newly-treated acute lymphoblastic leukemia (ALL) and to analyze the clinical characteristics and prognosis of patients with MLL-AF4 fusion gene-positive ALL.Methods:The clinical data of 455 patients with primary newly-treated ALL from February 2010 to February 2021 in Zhumadian Central Hospital were retrospectively analyzed. Fluorescence in situ hybridization was used to detect the presence of MLL gene rearrangement, and multiplexed nested reverse transcription polymerase chain reaction was used to detect the development of MLL-AF4 fusion gene-positive, and to compare the clinical characteristics and prognosis of patients with positive and negative MLL-AF4 fusion gene.Results:Among 455 patients with primary newly-treated ALL, 30 cases (6.6%) were positive for MLL gene rearrangement, including 21 positive for MLL-AF4 fusion gene (MLL-AF4 positive group), 6 cases positive for MLL-ENL fusion gene, 2 cases positive for MLL-AF9 fusion gene, and 1 case positive for MLL-AF10 fusion gene. A total of 60 ALL patients without any detection of fusion gene during the same period were randomly selected as the MLL-AF4-negative group. The proportion of those with hepatomegaly or splenomegaly, central nervous system (CNS) invasion, and the median peripheral blood leukocyte count and median peripheral blood na?ve cells absolute value in the MLL-AF4-positive group were higher than those in the MLL-AF4-negative group (all P < 0.05). The complete remission rates on day 15 of chemotherapy were 81.0% (17/21) and 90.0% (54/60), respectively in the MLL-AF4-positive group and MLL-AF4-negative group ( χ2 = 0.49, P = 0.484), and the cumulative relapse rates of 3 months were 38.1% (8/21) and 13.3% (8/60), respectively in the MLL-AF4-positive group and MLL-AF4-negative group ( χ2 = 4.56, P = 0.033). The overall survival in the MLL-AF4-positive group was worse than that in the MLL-AF4-negative group ( χ2 = 5.93, P = 0.015). Conclusions:Patients with MLL-AF4 fusion gene-positive ALL have a higher tumor load, a higher recurrence rate, a lower overall survival rate, and a poorer prognosis compared with negative patients at the initial diagnosis.

Objective:To observe any therapeutic effect of combining botulinum toxin type A (BTX-A) with rehabilitation training in treating Parkinson′s disease (PD) patients with striatal foot deformity (SFD).Methods:A total of 68 PD patients with SFD were randomly divided into a control group and a treatment group. Both groups were given routine medication with pramipexole and dopamine receptor agonists and received lower limb rehabilitation training, including passive activity training, strength training and walking training. The treatment group was additionally injected with BTX-A. Sciatic pain was quantified using a visual analogue scale. The Unified Parkinson′s Disease Rating Scale-lower limb motor lower limb motor function (UPDRS-LLM) scale, the Berg balance scale and the modified Barthel index were applied to test all of the participants before the experiment and on the 7th, 14th and 30th day of the treatment.Results:The average scores of the control group on all of measures at were significantly better than those of the control group at the same time points, and by the 14th and 30th day had improved significantly compared with those before treatment.Conclusion:Supplementing rehabilitation training with BTX-A can significantly improve foot deformity and relieve the muscle tension and spastic pain of PD patients with SFD, promoting the motor functioning of their lower limbs, their balance and their performance in the activities of daily living.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by the highest mortality among carcinomas. The pathogenesis of PDAC requires elevated autophagy, inhibition of which using hydroxychloroquine has shown promise. However, current realization is impeded by its suboptimal use and unpredictable toxicity. Attempts to identify novel autophagy-modulating agents from already approved drugs offer a rapid and accessible approach. Here, using a patient-derived organoid model, we performed a comparative analysis of therapeutic responses among various antimalarial/fungal/parasitic/viral agents, through which econazole (ECON), an antifungal compound, emerged as the top candidate. Further testing in cell-line and xenograft models of PDAC validated this activity, which occurred as a direct consequence of dysfunctional autophagy. More specifically, ECON boosted autophagy initiation but blocked lysosome biogenesis. RNA sequencing analysis revealed that this autophagic induction was largely attributed to the altered expression of activation transcription factor 3 (ATF3). Increased nuclear import of ATF3 and its transcriptional repression of inhibitor of differentiation-1 (ID-1) led to inactivation of the AKT/mammalian target of rapamycin (mTOR) pathway, thus giving rise to autophagosome accumulation in PDAC cells. The magnitude of the increase in autophagosomes was sufficient to elicit ER stress-mediated apoptosis. Furthermore, ECON, as an autophagy inhibitor, exhibited synergistic effects with trametinib on PDAC. This study provides direct preclinical and experimental evidence for the therapeutic efficacy of ECON in PDAC treatment and reveals a mechanism whereby ECON inhibits PDAC growth.