Objective To explore the diagnostic values of dual energy lung perfusion in the diagnosis of pulmonary embolism by using dual-source CT (DSCT). Methods Thirty patients with clinically suspected pulmonary embolism underwent dual-energy scanning with dual-source CT. The scanned data were integrated into three groups including 140, 80 kV and coefficient of 0.3. According to the CT pulmonary angiography (CTPA) of the fusion data, the patients were divided into pulmonary embolism group and normal group. The thin-slice reconstruction of data was analyzed using dual-energy perfusion imaging analysis software. The lung field was divided into upper, middle and lower part to make quantitative analysis of lung tissue perfusion. Paired t-tests were used in the normal patients to compare bilateral lungs, and independent samples t-tests were applied to compare the embolism group and normal group, while minimum intensity projection images (MinIP) were utilized in the assessment of lung ventilation. Results Dual energy CT showed symmetrical homogeneous perfusion in 16 normal cases, without significant perfusion defects. Quantitative analysis showed that left and right lung perfusion were (27 ± 7) and (28 ± 8 ) HU respectively, and no significant difference was found between the two sides ( t=-1.73, P ＞0.05 ).Perfusion of the left upper, middle and lower lung was ( 23 ± 6), (24 ± 6), and (28 ± 8) HU respectively, while the perfusion of right upper, middle and lower lung was (26 ±8), (27 ±8), and (28 ±9) HU respectively, showing no statistical significant difference between the two sides (t=-1.91, -1.96,-1.73 ,P＞0.05 ). Angiography of pulmonary embolism group(14 cases)showed filling defects in the pulmonary trunk, segments and sub-segments. Pulmonary perfusion imaging showed low perfusion or defectsin lung field that dominated by embolic vessels. Quantitative analysis showed that the perfusion of the whole lung and the middle and lower lung were (22 ±5), (22 ±8), and (21 ±8) HU in the embolism group,which were significantly different from the normal group (t=-2. 10, -2.32, -2.63, P＜0.05).Minimum intensity projection images showed a good consistency of abnormal ventilation zone area and perfusion abnormalities. Conclusions Pulmonary perfusion status, especially pulmonary embolism, can be analyzed by dual energy CT scanning. It helps to early discover and precisely locate the embolism.

ObjectiveTo investigate the role of Notch1 gene in xenografted human cutaneous squamous cell (SCL-1) carcinoma. MethodsFifteen nude mice were divided into three groups, including untreated group(inoculated with SCL-1 cells treated with phosphate buffered saline), empty vector group (inoculated with SCL-1 cells transfected with empty vector) and Notch1 group(inoculated with SCL-1 cells transfected with Notch1 expression vector). All the mice were inoculated with SCL-1 cells(1 x 108/ml) of0.2 ml. Then, the growth of xenografted tumor was observed every other day. Fifteen days later, the mice were sacrificed, tumor tissue was dissected and subjected to terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay for the detection of cell apoptosis, reverse-transcription(RT)-PCR and Western blot for the examination of mRNA and protein expressions of Notch1, bcl-2 and bax, respectively. ResultsThe proliferation of xenografted tumor in Notch1 group was obviously inhibited compared with the untreated group. The weight of xenografted tumor in Notch1 group was significantly lower than that in the untreated group and empty vector group (0.574 ± 0.219 g vs. 2.642 ± 0.404 g and 2.606 ± 0.512 g, F= 26.642, P＜ 0.01). TUNEL assay demonstrated that the number of apoptotic cells per 500 cells in tumor tissue specimens was(87 ± 9) in Notch1 group, evidently higher than that in the untreated group(8 ± 2) and empty vector group(10 ± 3) (F = 194.266, P ＜ 0.05 ). Further, RT-PCR and Western blot revealed that the mRNA and protein expressions of Notch1 and bax were significantly upregulated, but those of bcl-2 were markedly downregulated in the Notch 1 group, with significant difference among the three groups(all P ＜ 0.05). ConclusionsNotch 1 gene can inhibit the growth of xenogra ffted human cutaneous squamous cell(SCL-1) carcinoma and induce SCL-1 cell apoptosis likely by upregulating bax expression and downregulating bcl-2 expression.

ObjectiveTo investigate the role and clinical pathological significance of PTTG and bFGF in cutaneous squamous cell carcinoma(CSCC).MethodsTissue specimens were collected from the lesions of 42 patients with CSCC and normal skin of 42 normal human controls.The protein and mRNA expressions of PTTG and bFGF were detected by immunohistochemistry and in situ hybridization in these specimens respectively.ResultsA significant increase was observed in the positive expression rates of PTTG and bFGF proteins[64.3％(27/42) vs.11.9％(5/42),73.8％(31/42) vs.21.4％(9/42),both P＜ 0.05] and mRNA [59.5％(25/42) vs.7.1％(3/42),75.0％(29/42) vs.16.7％(7/42),both P＜ 0.05] in the CSCC tissue specimens than in the control specimens.The protein and mRNA expressions of PTTG were positively correlated with those of bFGF(both P ＜ 0.05),and closely correlated with histological grade of CSCC (both P ＜0.05).ConclusionThe high expression of PTTG and bFGF may be associated with the initiation of CSCC.

Objective To investigate the effect of pituitary tumor-transforming gene (PTTG)siRNA on the growth,invasion of,and expression of metastasis-related cytokines including matrix metalloproteinase-2 (MMP-2)and MMP-9 in xenografted human cutaneous squamous cell carcinoma in nude mice.Methods SCL-1 cells were subcutaneouslv inoculated into Balb/c nude mice to establish a xenograft model of human cutaneous squamous cell carcinoma.Then,15 mice bearing xenografted carcinoma were equally divided into 3 groups to be inoculated with phosphate buffer saline (PBS),control siRNA,and PTTG siRNA of 50 nmoI/L,respectively,ever),other day for 2 weeks.The size of xenograted carcinoma in these mice was measured every other day.At the end of 2-week treatment.the mice were killed followed by the evaluation of tumor weight,as well as the quantification of mRNA and protein expression of PTTG,MMP-2 and MMP-9 by reverse transcription (RT)-PCR and Western-blot,respectively.Results The xenograft model of human cutaneous squamous cell carcinoma was successfully established.The treatment with PTTG siRNA obviously inhibited the growth of the xenografted tumom and the expression of PTTG mRNA and protein compared with PBS and control siRNA (all P<0.05).In addition,the expression of MMP-2 and MMP-9 in xenografted tumors in PTTG siRNAtreated mice were significantly lower than those in PBS and control siRNA-treated mice.suggesting that PTTG siRNA evoked the decrease in invasive and metastatic ability of xenografted tumors.Conclusions PTTG siRNA can inhibit the growth of human cutaneous squamous cell carcinoma xenografts in nude mice,and downregulate the expression of invasion-and metastasis-related cytokines,including MMP-2 and MMP-9.

Objective: To investigate the forecasting value of serum fibroblast growth factor 23(FGF23) for major adverse cardiovascular adverse events (MACE) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). Methods: One hundred and five patients with ACS who underwent PCI in the First People′s Hospital of Tianmen City from June 2017 to June 2019 were enrolled. According to the happening of a MACE event occurs, the patients were divided into the MACE group (32 cases) and the non-MACE group (32 cases). The differences of general data, ultrasound indicators and biochemical indicators of patients between the two groups were compared. Logistic regression analysis was used to analyze independent risk factors for MACE after PCI in patients with ACS. Receiver operating characteristic (ROC) curve analysis was used to predict the predictive value of postoperative MACE in patients with ACS. Results: There were no significant difference in the comparison of general data such as age and gender between the two groups (P>0.05). The Global Registered Risk of Acute Coronary Events (GRACE) score in the MACE group was significantly higher than that in the non-MACE group [(119.18 ± 11.49) scores vs. (111.57 ± 9.31) scores, P<0.05]. Compared with the non-MACE group, the left ventricular end diastolic diameter (LVEDD), brain natriuretic peptide (BNP), C-reactive (CRP), and FGF23 in the MACE group were significantly increased, and the left ventricular ejection fraction (LVEF) was significantly decreased [(52.04 ± 3.43) mm vs. (48.57 ± 3.69) mm, (509.48 ± 52.08) ng/L vs. (474.68 ± 89.27) ng/L, (9.61 ± 2.06) mg/L vs. (7.85 ± 0.83) mg/L, (504.73 ± 82.27) ng/L vs. (331.99 ± 81.68) ng/L, (34.77 ± 2.93)% vs. (37.80 ± 3.62)%] (P<0.05). Logistic multivariate regression analysis showed that LVEF, CRP, and FGF23 were independent risk factors for MACE after PCI in patients with ACS (P<0.05). ROC curve analysis showed that AUC of LVEF that predicted for MACE after PCI in patients with ACS was 0.747,and AUC of CRP and FGF23 were 0.772 and 0.944. The AUC of FGF23 was significantly higher than that of LVEF and CRP (Z = 3.867, 2.698, P<0.05). Conclusions Abnormal elevation of serum FGF23 is associated with cardiovascular adverse events after PCI in patients with ACS, which can be used as a serum indicator for early assessment of poor cardiovascular outcomes in patients.

OBJECTIVE: To explore the current situation of work stress,mental resilience and mental health in the local policemen,and to explore the association among these three variables. METHODS: A total of 260 local policemen in 3 districts of a city in Hebei Province were selected as the study subjects using cluster sampling method. The Chinese version of Perceived Stress Scale,Connor-Davidson Resilience Scale and General Health Questionnaire were used to evaluate their work stress,mental resilience and mental health. RESULTS: There was a negative correlation between work stress and mental resilience( P < 0. 01). Positive correlation was found between work stress and mental health( P < 0. 01). The mental resilience was negatively correlated with mental health( P < 0. 01). The mental resilience could negatively predict mental health( β =-0. 31,P < 0. 01). Work stress could positively predict mental health( β = 0. 56,P < 0. 01). Work stress had a negative prediction on mental resilience( β =-0. 47,P < 0. 01). Mental resilience played a partial mediating role between work stress and mental health( β = 0. 41,P < 0. 01). The mediating effect accounted for 26. 0% of the total effect. CONCLUSION: Mental resilience plays a partial mediating role in influencing work stress on mental health. Reducing work stress and increasing resilience play an important protective role in mental health of local policemen.

Objective To investigate the selective targeting ability of a novel folate-modified nanobubbles with two-fold amount of folate [(FOL)2-NBs] . Methods DSPE-PEG2000-AD-(FOL)2with two-fold of folate per DSPE-PEG2000 chain was synthesized and then tested by 1 H nuclear magnetic resonance (1H NMR) . The novel (FOL)2-NBs was prepared using the mechanical shaking method based on lipid-stabilized perfluoropropane . The bubble size was measured by Malvern laser particle size analyzer and the contrast enhancement ability was also detected with imaging machine using a self-made agarose mold . The experiment of selective targeting ability was also carried out in human breast cancer MCF-7 cell with over-expression of folate receptor ( FR) using fluorescence activated cell sorting ( FACS) . Results The result of 1H NMR proved that DSPE-PEG2000-AD-( FOL )2was successfully synthesized ,and the purity reached up to 90% . The novel prepared ( FOL) 2-NBs showed superior contrast enhancement ability with a particle size of ( 286 .87 ± 22 .96) nm . Compared with the conventional NBs ,the novel ( FOL) 2-NBs exhibited improved selective cellular targeting ability proven by FACS . Conclusions A novel nanobubble with improved selective targeting ability is successfully prepared and shows great potential in extravascular imaging and curation in FR overexpressed tumors .

Objective:To investigate the correlation between the plasma trimethylamine oxide (TMAO) level and the disease severity in patients with acute coronary syndrome (ACS).Methods:The clinical data of 200 patients with ACS (ACS group) and 90 chest discomfort patients without obvious coronary artery disease (control group) in Department of Cardiology Medicine, the First People′s Hospital of Tianmen City, Hubei Province, from June 2018 to June 2019 were retrospectively analyzed. The plasma TMAO level were detected by high performance liquid chromatography tandem spectroscopy with stable isotope dilution. Left ventricular ejection fraction (LVEF), left ventricle diameter (LAD), left ventricular posterior wall end-systolic thickness (PWS) and left ventricular posterior wall end-diastolic thickness (LVPWT) were examined by color ultrasound. The diagnostic value of plasma TMAO for ACS was analyzed by receiver operating characteristic (ROC) curve. Correlation was analyzed by Pearson correlation analysis.Results:The TMAO, LAD, PWS and LVPWT in ACS group were significantly higher than those in control group: (6.33 ± 1.31) μmol/L vs. (3.75 ± 1.11) μmol/L, (39.63 ± 8.89) mm vs. (31.90 ± 8.79) mm, (12.88 ± 1.76) mm vs. (7.00 ± 1.27) mm and (13.45 ± 2.51) mm vs. (8.97 ± 2.00) mm, the LVEF was significantly lower than that in control group: (44.63 ± 10.00)% vs. (59.71 ± 11.58)%, and there were statistical differences ( P<0.01). ROC curve analysis result showed that when the optimal cutoff value of plasma TMAO was 4.83 μmol/L, the area under curve (AUC) was 0.942, and its sensitivity and specificity for diagnosing ACS were 87.50% and 88.89%; when the optimal cutoff value of plasma TMAO was 4.66 μmol/L, the AUC was 0.908, and its sensitivity and specificity of early diagnosis of ACS were 88.00% and 83.33%. The correlation analysis result showed that the plasma TMAO had negative correlation with LVEF in patients with ACS ( r=-0.715, P<0.01), and positive correlation with LAD, PWS and LVPWT ( r=0.715, 0.746 and 0.729; P<0.01). Conclusions:The plasma TMAO level in patients with ACS is significantly increased, which is related to the level of heart function. Plasma TMAO can be used as an indicator of early diagnosis and severity assessment of ACS.

Objective:To study the application of flipped classroom teaching mode in nursing teaching of Gastroenterology Department and its influence on the mastery of nursing theory and professional skills of nursing students.Methods:Using the convenient sampling method, a total of 136 nursing students who took internship Gastroenterology Department of Shanxi Provincial People's Hospital from July 2018 to January 2020 were selected. From July 2019 to January 2020, 69 nursing students were selected as the experimental group, and they were given flipped classroom teaching mode. From July 2018 to January 2019, 67 nursing students were set as the control group, and they were given the traditional teaching mode. The nursing theory, professional skills and comprehensive ability of nursing students and their evaluation of the teaching quality and satisfaction were observed and compared between the two groups.Results:The scores of after-department nursing theory and professional skills of nursing students in the experimental group were respectively (88.45±7.12) and (92.78±3.03) , which were higher than (80.32±8.56) and (88.15±3.62) of the control group, and the differences were statistically significant ( t=5.921, 7.952; P<0.05) . Scores of nursing consultation, physical examination, diagnosis, measures, health education, humanistic care, organizational efficiency and overall evaluation of the experimental group were respectively (6.21±1.25) , (6.45±1.03) , (6.53±1.21) , (6.59±1.28) , (6.98±1.12) , (6.59±1.21) , (6.30±1.18) and (7.01±1.16) , higher than (5.37±1.59) , (5.58±1.32) , (5.29±1.64) , (5.62±1.71) , (6.03±1.57) , (5.70±1.42) , (5.21±1.72) and (6.08±1.65) of the control group ( t=3.370, 4.216, 4.940, 3.686, 4.001, 3.867 , 4.246, 3.746; P<0.05) . The scores of teaching effect, teaching content and teaching method in experimental group were respectively (21.65±1.19) , (20.27±1.80) and (21.43±1.25) , which were higher than (19.13±1.28) , (18.81±2.79) and (19.47±1.21) in control group, and the differences were statistically significant ( t=11.676, 3.575, 9.112; P<0.05) . The satisfaction of the nursing students in the experimental group on theoretical knowledge, learning interest, practical skills, self-study ability and actual problem-solving ability were respectively 94.03%, 97.01%, 95.52%, 91.04% and 92.54%, which were higher than 81.25%, 85.94%, 84.38%, 78.13%, 79.69% in the control group, and the differences were statistically significant (χ 2=4.986, 5.222, 4.550, 4.224, 4.560; P<0.05) . Conclusions:The application of the flipped classroom teaching mode in the nursing teaching of Gastroenterology Department helps nursing students to master nursing theory and professional skills and improve the quality of teaching.

Objective:To analyze the dimensional structure and the item characteristics of the Chinese version of the cerebral palsy quality of life questionnaire for children (CPQOL-child).Methods:Multi-dimensional and single-dimensional item response models were used. Ninety children aged 4 to 12 with cerebral palsy were evaluated using the CPQOL-child. The internal consistency was determined by analyzing the correlations among the different dimensions using a multi-dimensional response model. Dimensions were merged or split based on a one-dimensional Rasch analysis of the primary and secondary dimensions to revise the main and additional questionnaires.Results:The multi-dimensional item response model analysis found greater than 0.90 correlation among the four dimensions of social well-being and tolerance, function, participation ability and physical health, and emotional health and self-esteem, showing that they have good internal consistency and could be analyzed as the primary dimension. The correlation coefficients relating the other three dimensions were relatively low and could be analyzed as secondary dimensions. A single-dimension Rasch analysis was used to form a revised CPQOL main questionnaire consisting of 40 items, with three additional questionnaires for pain and disability impact consisting of 8 items, for access to services consisting of 6 items, and for family health consisting of 3 items. Compared with the original 65 items, the 8 items deleted were mainly about relationships between children and with siblings, providing respite services, as well as community and school services.Conclusions:Applying the Chinese version of the CPQOL-Child in Shanghai requires appropriate adjustments based on the children′s cultural background.