Objective To invcstigate the effects of Maixiansan on insulin-like growth factor binding protein 7 (IGFBP7) and apoptosis in rats with ulcerative colitis related colorectal cancer.Methods The rat model of ulcerative colitis-related coloreetal cancer was induced by dextran sulfate sodium (DSS) and azoxymethane(AOM). 40 male SD rats [weight (160 ± 10) g] were randomly divided into 4 groups: model, Maixiansan and Meisalazine treatment as well as normal group peritoneally irjected with saline.The expression of IGFBP7 and apoptosis in coloreetal tissue were detected by real-time PCR and TUNEL after 16 weeks. Results The numbers of colorectal cancer in model group( 1.2 ± 0.4 ),in Maixiansan group ( 0.70 ± 0.15 ),in Meisalazine group ( 0.60 ± 0.16 )were higher than in normal control (P ＜ 0.05), but no differences were found among model,Maixiansan and Meisalazine groups(P＞0.05).The apoptosis in colonic mucosa for Meixiansan(8.70±3.47) group and Mesalazine group were enhanced as compared with that in model group( 1.20 ±0.26 vs.0.38±0.11,P＜0.05).The mRNA expression of IGFBP7 in colon for Meixiansan group were higher than those in model group,Meisalazine group,and normal control(50.5 ± 14.0 vs.18.0 ±3.9 and 39.3±11.4,46.4±6.0,P＜0.05). Conclusions Maixiansan may resist the occurrence and development of ulcerative colitis-related colorectal cancer through upregulating IGFBP7 expression of colorectal tissue and promoting apoptosis of tumor cell.

Objective To analyze the radiologic features of intestinal duplications in children and improve the diagnostic rate of this disease presurgical resection.Methods The clinical presentation and imaging data of eight cases confirmed surgically and patho-logically with intestinal duplications were retrospectively analyzed,as well as reviewed based on literature review.Results 8 cases were given ultrasonography,7 of them had positive performance.7 csaes were given CT scan and 6 of them had positive performance. 6 cases had ECT examination and 4 of them were positive.Their positive rates were 87.5%,85.7%,66.7% respectively.The posi-tive rates were all 100% combining ultrasonography with CT or CT with ECT.Conclusion Ultrasonography,CT and ECT is helpful to diagnose of intestinal duplications in children,their results are the no-specificity.Choosing a suitable imaging examination is useful to offer a pre-operative diagnosis.

Objective To observe the value of iterative model reconstruction(IMR)technique in CT pulmonary angiography (CTPA)with lower radiation dose and lower contrast medium.Methods 60 patients with clinical suspicion of pulmonary embolism underwent 256-slice CTPA were prospectively enrolled.The raw data of test group(n=30)were reconstructed by filtered back projection (FBP)(group A)and IMR technique (group B).And the raw data of control group(n=30)were reconstructed by FBP(group C).The values of volume CT dose index(CTDIvol),effective radiation dose (ED)were recorded and calculated.The image quality parameters:CT value,image noise,signal-to-noise (SNR),contrast-to-noise ratio (CNR)and subjective image score(from one to five)were measured and compared between group A and B,B and C.Results The BMI was no statistically significant difierenee between two groups(P=0.001).The CTDIvol, ED on test group were respectively lower than that on control(P<0.001).The CT value was no statistically significant difierenee between group A and B(P=0.999).The CT valueon group B was higher than that on group C(P=0.005).The image noise on group B was lower than that on group A(P<0.001),but which was higher than that on group C(P<0.096).The SNR,CNR on group B were higher than that on group A(P<0.001).The SNR,CNR did not differ significantly between B and C(P=0.831,P=0.958).The diagnosable rate and good quality rate on group B were higher than that on group A(P<0.001),and there were no significantly diferent between B and C(P=1.000).Conclusion The application of optimized IMR technique can improve image quality at lower radiation dose and lower contrast medium for CTPA.

Objective To explore the efficacy and safety of percutaneous transhepatic portal vein or transjugular intrahepatic portosystemie shunt (TIPS)to implant the portal vein metallic stent in treatment of cavernous transformation of portal vein (CTPV).Methods Clinical and imaging data of 8 patients with CTPV were retrospectively analyzed who were treated in our hospital.All patients were treated with metallic stent implantation in portal vein including 3 patients by TIPS and 5 by percutaneous transhepatic portal vein.Results All patients were successful in the stent implantation without any occurrence of serious complications such as intra-abdominal hemorrhage and so on.Intraoperative angiography showed blood circulated freely in these stents.1 day-2 weeks later,the patients symptoms of abdominal pain and gastrointestinal bleeding were obviously relieved or disappeared.Follow up 1 month-3 years,1 patient with stent occlusion after one year of operation,the blood flow recovery after stent reimplantation,and the remaining patients,color doppler ultrasound reflected patency of blood flows in their stents.No one suffered from gastrointestinal bleeding or abdominal pain again.Conclusion Implantation of portal vein metallic stent via percutaneous transhepatic portal vein or via TIPS in treatment of cavernous transformation of portal vein is safe and effective.

Objective To explore the feasibility of high-pitch CT pulmonary angiography (CTPA)with low dose contrast medium optimization in dual-source CT.Methods Eighty patients with high risk of pulmonary embolism who underwent CTPA on a dual-source CT were divided into two groups randomly:Group A,40 patients,50 mL contrast medium per patient,with conventional bolus tracing scanning;Group B,40 patients,contrast medium=body weight×0.3 mL/kg,with test bolus of small dose contrast agent. Pulmonary artery CT value,the differences of CT values in the paired PA and PV,SNR,CNR,radiation dose of two Groups were compared by two sample t-test.The positive rate of pulmonary embolism and the subjective indexes for assessing CT image quality were compared byχ2 test.Results There were no difference of the positive rate of PE between two Groups (P =0.655),and no sta-tistical difference for image quality scores between two Groups(P =0.1 74).The MPA CT value and the differences of CT values in the paired PA and PV in L-SⅢ of Group B were higher than those in Group A (P =0.001).However,no significant differences in CNR and SNR in MPA were observed between the two Groups(P =0.250,0.203,respectively).The ED of Group B was lower than that of Group A (P =0.001).Conclusion High-pitch CTPA in dual-source CT with lower dose contrast medium optimization can minimize the amount of contrast agent while meeting the clinical requirements.

Objective To investigate the correlation between Young′s elastic modulus (EI) using shear wave elastography (SWE) and liver pathology .Methods Liver biopsy was performed on 231 patients with chronic hepatitis B (CHB) under supersonic guidance ,and SWE with EI of liver was obtained concurrently .The correlation between measured liver stiffness and pathology was analyzed by using the liver pathology as golden standards .One‐way analysis of variance and Spearman rank correlation analysis were performed for the comparison between groups and correlation between two variables , respectively .Receiver operating characteristic (ROC) curve was used to explore the predictive value of shear modulus for the liver inflammation grades and fibrosis stages .Results The EI medians of different liver inflammation grades were 6 .78 kPa (G1) ,7 .30 kPa (G2) ,9 .93 kPa (G3) and 14 .93 kPa (G4) , respectively ,which were statistically different (H=55 .19 ,P<0 .01) .And EI medians of various fibrosis stages were 6 .62 kPa (S0 -S1) ,7 .15 kPa (S2) ,9 .78 kPa (S3) and 14 .62 kPa (S4) ,respectively , which were also significantly different (H=62 .14 ,P<0 .01) .EI was positively correlated with both liver inflammation grades (r=0 .454 6 ,P<0 .01) and liver fibrosis stages (r=0 .505 6 ,P<0 .01) .The areas under the ROC for G≥2 ,G≥3 and G=4 were 0 .68 (95% CI:0 .61 -0 .75) ,0 .77 (95% CI:0 .70 -0 .84) and 0 .85 (95% CI:0 .77-0 .92) ,respectively .The areas under the ROC for S≥2 ,S≥3 and S=4 w ere 0 .73 (95% C I:0 .66 -0 .79 ) ,0 .78 (95% C I:0 .72 -0 .85 ) and 0 .83 (95% C I:0 .75 -0 .91 ) , respectively .Conclusion The EI measured by SWE is correlated with liver pathology of CHB patients , which may be used to dynamically monitor the progress of liver fibrosis .

Objective: To investigate the coping styles and subjective well-being of nurses in the emergency treatment room of grade A tertiary hospitals in a province of China, and to explore the relationship between coping styles and subjective well-being. Methods: In January 2016, 189 nurses in the emergency treatment room were selected from 9 grade A tertiary hospitals in a province of China by random sampling. The general data, coping styles, and subjective well-being of these nurses were analyzed using the general questionnaire, coping style questionnaire, and Campbell index of well-being scale, respectively. Results: The total score of subjective well-being of nurses in the emergency treatment room was 7.54, and the subjective well-being was significantly different between the nurses with different professional titles and between those with different education levels (F=3.46 and 3.47, both P<0.05). The score of illusion coping style differed significantly across the nurses of different ages (F=5.17, P<0.05) , the scores of self-reproach, illusion, and withdrawal coping styles differed significantly across the nurses with different nursing years (F=3.99, 5.30, and 4.97, all P<0.05) , and the score of illusion coping style differed significantly across the nurses with different education levels (F=5.09, P<0.05). Most (71.9%) of the nurses in the emergency treatment room adopted the mature coping style. Subjective well-being was positively correlated with problem-solving, help-seeking, and rationalization (r=0.232, 0.018, and 0.167, all P<0.05) and negatively correlated with withdrawal (r=-0.146, P<0.05) . Conclusion Most nurses in the emergency treatment room adopt the mature coping style. Their subjective well-being and coping style vary with different ages, nursing years, professional titles, and education levels, and the subjective well-being is relatively low.

Objective:To compare the diagnostic values of C-TIRADS, ACR-TIRADS and EU-TIRADS.Methods:According to the classification methods of the 3 guidelines, the ultrasonographic features of 283 thyroid nodules from 266 patients in Sir Run Run Shaw Hospital from January 2019 to June 2020 were analyzed retrospectively. The pathological results were taken as the gold standard, the malignant percentage of different classification was calculated, the ROC curve was plotted, the area under the ROC curve (AUC) and the best diagnostic cut-off value were calculated, and the diagnostic values of the three guidelines were compared. According to the FNA recommendations of the guidelines, the recommended number of thyroid nodules and the detection rate of malignant nodules in different guidelines were analyzed.Results:The AUCs of C-TIRADS, ACR-TIRADS and EU-TIRADS were 0.80, 0.66, 0.61, respectively. The AUC of C-TIRADS was higher than those of ACR-TIRADS and EU-TIRADS ( P<0.001, P<0.001). The best diagnostic cutoff values of C-TIRADS, ACR-TIRADS and EU-TIRADS were 4C, 5 and 5, respectively. Under the critical points, the sensitivities of the 3 guidelines were 95.27%, 98.10%, 99.53%, the specificities were 54.17%, 33.33%, 20.83%, respectively. There was no significant difference in the number of FNA recommendations among the 3 guidelines(all P>0.05), their FNA recommendations were highly consistent (Kappa>0.9). Conclusions:The diagnostic value of C-TIRADS in the classification of benign and malignant thyroid nodules is higher than those of ACR-TIRADS and EU-TIRADS. The best critical value for diagnosis of thyroid nodules is C-TIRADS 4C. The three guidelines are similar in the number of FNA recommendations and the detection rate of malignancy.

Objective To explore the effect of age factor on the degree of pulmonary fibrosis and on the change in telomerase reverse transcriptase(TERT) activity in mice.Methods A total of 80 healthy male C57BL/6 mice aged 20-weeks were randomized into 4 groups:a young pulmonary fibrosis model group(n=20),a young control group(n=20),a senile pulmonary fibrosis model group(n=20),and an elderly control group (n =20).Two model groups were induced by an intratracheally injected bleomycin in 5 mg/kg,and two control groups by an intratracheally injected normal saline.The elderly were defined as 26 weeks old mice.Five mouse pulmonary fibrosis models and five mouse controls in four groups were randomly selected and killed at 7,14,21,28 days.Lung tissue specimens were stained with hematoxylin eosin (HE)and Masson trichrome (Masson)method,and then pathological changes were observed.In addition,immunohisto-chemical staining was used to observe the expression levels of epithelial cell marker protein E-cadherin(E-cad),stromal cell marker protein Vimentin,and alpha smooth muscle actin(α-SMA).Finally,the expression level of telomerase reverse transcriptase(TERT)protein was detected by Western blotting.Results A bleomycin-induced pulmonary fibrosis mice model was successfully prepared.The degree of pulmonary fibrosis was more severe in old mice than in young mice.Compared with the young pulmonary fibrosis model group,the expression level of E-Cad was decreased in the senile pulmonary fibrosis model group(P ＜0.05).Compared with the young control group and the elderly control group,the expression levels of E-Cad in the young pulmonary fibrosis model group and the senile pulmonary fibrosis model group were decreased (P ＜ 0.05),and decreased along with the prolongation of the modeling time.Compared with the young pulmonary fibrosis model group,the expression levels of alpha-SMA and vimentin were increased in the senile pulmonary fibrosis model group(P ＜ 0.05).The expression levels of alpha-SMA and vimentin were increased in the young pulmonary fibrosis model group and the senile pulmonary fibrosis model group,as compared to the young control group and the elderly control group(P＜0.05),and increased along with the prolongation of the modeling time.The activity of TERT in lung tissue of mice was increased at first and then decreased.Compared with the young pulmonary fibrosis model group,the activity of TERT in the senile pulmonary fibrosis model group significantly fluctuated(P＜0.05).Conclusions Age factor can affect the severity of pulmonary fibrosis by affecting the activity of telomerase reverse transcriptase in mouse models of pulmonary fibrosis.

Objective:To construct a biospecimen bank of patient derived organoids (PDOs) from pancreatic cancer tissues and to explore the feasibility of PDOs drug sensitivity assay technology to guide chemotherapy drug selection for pancreatic cancer.Methods:Pancreatic cancer tissue specimens obtained after surgical resection and puncture biopsy from Mar 2020 to Dec 2022 at Drum Tower Hospital, Nanjing University School of Medicine were collected. Pancreatic cancer PDOs were cultured in vitro and histologically identified; PDOs were treated with gemcitabine, Nab-paclitaxel, fluorouracil, Oxaliplatin, and Irinotecan and cell viability was measured to analyze the correlation between PDOs drug sensitivity and the actual clinical treatment response.Results:The PDOs can reproduce the pathological features of corresponding tumor tissues; the sensitivity of different PDOs to the same chemotherapeutic drug is significantly different; The sensitivity of PDOs was highly consistent with the actual treatment effect of the corresponding patients 75.76% (25/33); organoid organ-based susceptibility testing had predictive value for the treatment response of patients (AUC=0.733, 95% CI: 0.546-0.919, P<0.05). Conclusion:A biobank of pancreatic cancer PDOs was successfully constructed, and the drug susceptibility test results were significantly correlated with the actual medication response of patients, suggesting that the drug susceptibility test technology based on PDOs has the potential to guide individualized chemotherapy for pancreatic cancer.