Objective To investigate the value of low kilovoltage (100 kVp)in combination with sinogram affirmed iterative re-construction (SAFIRE)of flash dual source CT in pelvic scan in comparison with routine kilovoltage (120 kVp)and filtered back projection (FBP).Methods 88 patients with suspected pelvic lesions underwent CT scan,and the range of BMI was 1 9 kg/m2

Objective To establish a finite element model of rotator cuff which can be used to simulate the rotator cuff injury and to evaluate the biomechanical effects of rotator cuff surgery.Methods The Dicom CT images of the right shoulder of a Chinese healthy volunteer were used to establish models of the scapula,humerus and clavicle.The rotator cuff structures were separated and modeled based on the MRI images and anatomical knowledge.After the rotator cuff model was introduced into the finite element analysis software Abaqus 6.12,the anatomical positions were simulated when the shoulder was at 30° internal rotation,30° external rotation,30° abduction,30° adduction,30° flexion and 30° extension.Results When the shoulder was in 30° flexion,the average stress was 52.2 kPa on the supraspinatus,223.0 kPa on the inffaspinatus and the teres minor,and 90.4 kPa on the subscapularis.When the shoulder was in 30° extension,the average stress was 105.0 kPa on the supraspinatus,78.2 kPa on the infraspinatus and the teres minor,and 55.7 kPa on the subscapularis,indicating that the muscle and tendon of the supraspinatus was subjected to greater stress and the humerus and the scapula produced less stress compared with the shoulder in 30° flexion.Conclusion Since our finite element model of the rotator cuff can simulate common activities of the shoulder joint and obtain stress values of the corresponding rotator cuff muscles,it can be used in simulation of rotator cuff injury and its surgery.

Objective:To explore a new method of the cultivation of adoptive immunotherapy cells.Methods: Mononuclear cells was isoplated by density gradient centrifugation and then proliferated by using CD 40-agonist monoclonal antibody 5C11、cytokine of IFN-αand IL-7(CD40 group)in vitro.During the culturing procedure ,the cell morphology was obersved by optical microscope.The percentage of T-lymphocytes, NK-T cells, Treg cells and the cell proliferation, which were compared with CIK group CD3mAb activated,was detected on the 9th day.Results:There was no significant difference of CD 4+/CD8+T cells percentage between the two groups.But the Treg cells percentage of CIK group was far higher than that of CD 40 group,while the percentage of CD3+CD56+NK-T cells was lower than that of CD 40 group.And a group of Mo-NK-DC cells were observed in the CD 40 group.Conclusion: The new method of adoptive immunity therapy has been established in this study could increase the percentage of NK -T cells which had the ability to kill tumor cells.Simultaneously ,it is reduced the amount of Treg cells significantly.

Objective To investigate the clinical effect of distal radioulnar ligament reconstruction by autologous tendon pal‐maris longus transplantation under arthroscopic assistance in treating chronic instability of the distal radioulnar joint .Methods Seven patients with chronic instability of the distal radioulnar joint after failure of conservation therapy were definitely diagnosed by the wrist joint exploration .Then the autologous tendon palmaris longus was taken for conducting the anatomical reconstruction of distal radioulnar ligament ;the average follow up was 12 months .The preoperative and postoperative grip strength and the motion of wrist joint were recorded ;the pain status of the wrist joint was evaluated by using the visual analogue scale (VAS) ,and the wrist function status was evaluated by using the Disabilities of the Arm ,Shoulder and Hand(DASH) and the Modified Mayo Wrist Score (MMWS) .Results The average VAS score of the rist joint motion was recovered from (7 ± 2) points before operation to (3 ± 3) points after operation ,the MMWS score was improved from preoperative (50 ± 9) points to postoperative (83 ± 11) points ,the DASH score was decreased significantly from preoperative (37 ± 15) points to postoperative (16 ± 10) points ,the grip strength was improved from preoperative 84 .5 ± 16 .0 to postoperative 93 .4 ± 11 .0 ,the differences were statistically significant .The mean range of motion(ROM ) in flexion/extension of the wrist was increased from preoperative 93 .5% ± 6 .0% to postoperative 96 .4% ± 3 .0% ,the ROM in pronation/supination of the forearm was increased from preoperative 92 .6% ± 7 .0% to postoperative 97 .2% ± 5 .0% ,but the differences were not statistically significant .Conclusion Under arthroscopic assistance ,the anatomical reconstruc‐tion of the distal radioulnar ligaments is an effective treatment method for treating chronic distal radioulnar joint instability ,its short term follow up has satisfactory effect .

Objective To assess the curative effect of percutem transilluminated with negative pressured on the potaried technique on the treatment of venous ulcer in lower extremity.Methods The clinical date of 300 cases involving 300 legs with venous ulcer in lower extremity,who underwent the percutum transilluminated negative pressured potaried technique using TRIVEXTM Ⅱ potaried system or the percutum transfixion surgical treatment from October 2005 to June 2009,were analyzed.Three hundred cases were randomly divided into potaried group and transfixion group.In potaried group,there were 190 cases involving 190 legs treated with TRIVEXTM Ⅱ potaried system.In transfixion group,110 cases involving 110 legs treated with percutum transfixion.The clinical indexes of skin infection rate and skin necrosis rate,shrinkage rate of wound area and skin depigmentation rate,ulcer healing rate and ulcer recurrence rate were calculated to assess the clinical curative effect on day 5,day 20,day 120 and day 360 after operation respectively.Results The rates of skin infection and skin necrosis were significantly decreased in potaried group compared with transfixion group on day 5 after operation (P0.05).Ulcer recurrence rate was remarkably lower in potaried group than that in transfixion group on day 360 (P

Epidemiological and animal studies indicate that pre-existing diabetes increases the risk of Parkinson's disease(PD).However,the mechanisms underlying this association remain unclear.In the present study,we found that high glucose(HG)levels in the cerebrospinal fluid(CSF)of diabetic rats might enhance the effect of a subthreshold dose of the neurotoxin 6-hydroxydopamine(6-OHDA)on the development of motor disorders,and the damage to the nigrostriatal dopaminergic neuronal pathway.In vitro,HG promoted the 6-OHDA-induced apoptosis in PC12 cells differentiated to neurons with nerve growth factor(NGF)(NGF-PC12).Metabolomics showed that HG promoted hyperglycolysis in neurons and impaired tricarboxylic acid cycle(TCA cycle)activity,which was closely related to abnormal mito-chondrial fusion,thus resulting in mitochondrial loss.Interestingly,HG-induced upregulation of pyruvate kinase M2(PKM2)combined with 6-OHDA exposure not only mediated glycolysis but also promoted abnormal mitochondrial fusion by upregulating the expression of MFN2 in NGF-PC12 cells.In addition,we found that PKM2 knockdown rescued the abnormal mitochondrial fusion and cell apoptosis induced by HG+6-OHDA.Furthermore,we found that shikonin(SK),an inhibitor of PKM2,restored the mito-chondrial number,promoted TCA cycle activity,reversed hyperglycolysis,enhanced the tolerance of cultured neurons to 6-OHDA,and reduced the risk of PD in diabetic rats.Overall,our results indicate that diabetes promotes hyperglycolysis and abnormal mitochondrial fusion in neurons through the upre-gulation of PKM2,leading to an increase in the vulnerability of dopaminergic neurons to 6-OHDA.Thus,the inhibition of PKM2 and restoration of mitochondrial metabolic homeostasis/pathways may prevent the occurrence and development of diabetic PD.

Objective To investigate the histone acetylation status of forkhead box P3(Foxp3)gene and its roles in immunological pathogenesis of Kawasaki disease(KD). Methods Forty - two children with KD and 32 age -matched healthy children consented to participate in this study as a control group. Co - immunoprecipitation and real -time PCR were performed to determine acetylation levels of histone H4 associated with Foxp3 gene and binding abilities of Kruppel like factor 10(KLF10)and p300 / CBP - associated factor (PCAF)with Foxp3 gene in CD4 + T cells. The proportion of CD4 + CD25 high Foxp3 + cells (Treg)and protein levels of Foxp3,KLF10,PCAF,phosphated SMAD family member 2 / 3(pSmad2 / 3)and itchy E3 ubiquitin protein ligase(Itch)were analyzed by flow cytometry. Quantitative real - time PCR was used to evaluate the levels of Foxp3,transforming growth factor - β1 receptor Ⅱ (TGF - βRⅡ), transforming growth factor - β1 receptor Ⅰ(TGF - βR Ⅰ),tyrosine kinase 2 (Tyk2),SH2 domain - containing protein - tyrosine phosphatase - 2(SHP2)and cytotoxic T - lymphocyte - associated protein 4 (CTLA4)mRNA in Treg. Plasma concentrations of TGF - β and interleukin - 6(IL - 6)were measured by enzyme - linked immunosorbent assay. Results (1)Compared with the control group,the proportion of Treg,expression levels of Foxp3 and TGF - β, and histone acetylation levels of Foxp3 promoter decreased remarkably during acute KD,and the differences were all statistically significant(all P < 0. 05),and restored after IVIG therapy(all P < 0. 05). Meanwhile,the 5 indexes afore-mentioned in KD patients with coronary artery lesions (KD - CAL +)were lower than those without coronary artery le-sions(KD - CAL -),and the differences were all statistically significant (all P < 0. 05). (2)Compared with the control group,protein levels of KLF10 and PCAF in Treg cells,and their binding abilities with Foxp3 gene were significantly down - regulated during acute KD,and the differences were all statistically significant(all P < 0. 05),and restored to some extent after IVIG treatment(all P < 0. 05). Positive correlations between protein levels of KLF10 and PCAF,and mRNA level of Foxp3 were detected in acute KD patients (r = 0. 47,0. 59,all P < 0. 05). Furthermore,protein levels of KLF10 and PCAF and their binding abilities with Foxp3 gene in KD - CAL + group were lower than those in KD -CAL - group,and the differences were all statistically significant(all P < 0. 05). (3)Compared with the control group, the plasma concentration of TGF - β and expressions of TGF - βRⅡ/ Ⅰ,pSmad2 / 3,Itch,CTLA4 and SHP2 in Treg were down - regulated during the acute phase of KD,and the differences were all statistically significant(all P < 0. 05), as well as plasma concentration of IL - 6 and expression its downstream molecule Tyk2 increased remarkably in patients with acute KD(all P < 0. 05). All the indexes mentioned before restored significantly after IVIG treatment (all P <0. 05). Simultaneously,the 7 former indexes in KD - CAL + group were found to be lower than those in KD - CAL -group,while 2 indexes of the latter in KD - CAL + group were higher than those in KD - CAL - group,and the differ-ences were all statistically significant(all P < 0. 05). Conclusion Histone hypoacetylation of Foxp3 promoter might be one of the important factors contributing to insufficiency and dysfunction of regulatory T cells during acute Kawasaki dis-ease.

Objective To investigate the effects of leptin on Treg cells and the possible mecha-nism. Methods Leptin-deficient ( ob/ob) mice and homologous wild-type mice were used in this study. The percentages of Treg cells in spleen tissues and peripheral blood samples were measured by flow cytometry ( FCM) . Differences in Treg cell functionality were compared between the two groups. Splenic CD4+T cells, separated from the ob/ob mice and the wild-type mice by magnetic beads, were respectively cultured with leptin and anti-leptin neutralization antibody to evaluate the effects of leptin on Treg cells. Quantitative real-time PCR was performed to analyze the expression of Treg cell-related cytokines at transcriptional level. The levels of IL-10 and TGF-β in the supernatants of CD4+T cell culture were measured with Luminex technolo-gy. Results Compared with the wild-type mice, the ob/ob mice showed higher percentages of Treg cells in both peripheral blood samples and spleen tissues [(11. 56 ± 0. 72)％ vs (5. 47 ± 0. 81)％, (10. 16 ± 0.93)％ vs (6.29±0. 69)％]. Treg cells isolated from the ob/ob mice had stronger immunosuppressive effects on the proliferation of effector T ( Teff) cells and the secretion of TNF-α and IFN-γ than those from the wild-type mice [TNF-α:(1. 6±0. 2)％ vs (2. 4±0. 5)％, IFN-γ:(4. 3±0. 3)％ vs (7. 2±1. 2)％]. The percentages of Treg cells were decreased from (12. 2±1. 8)％ to (7. 6±0. 9)％ upon the in vitro treat-ment of CD4+ T cells from the ob/ob mice with leptin and the immunosuppressive effects of Treg cells were also weakened. However, the percentages of Treg cells were increased from (7. 8±0. 85)％ to (13. 1± 1. 5)％ upon the in vitro treatment of CD4+T cells from the wild-type mice with anti-leptin antibody and the immunosuppressive effects of Treg cells were improved as well. Moreover, the expression of Foxp3, IL-10 and TGF-β at transcriptional level and the levels of IL-10 and TGF-β in the ob/ob group were higher than those in the wild-type group. Conclusions Leptin deficiency significantly promoted the generation of Treg cells in mice and resulted in an increased expression of Foxp3, IL-10 and TGF-βat mRNA level and elevat-ed levels of IL-10 and TGF-β. The treatment of CD4+T cells with leptin might inhibit the generation of Treg cells through down-regulating the transcription of Foxp3, IL-10 and TGF-β.

Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of malignant endometrial lesions.Methods:A total of 142 patients with endometrial lesions who underwent contrast-enhanced ultrasound examination in Beijing Tiantan Hospital, Capital Medical University from January 2019 to September 2021 were selected. The endometrial lesions were divided into benign group (including endometrial hyperplasia and endometrial polyps) and malignant group (endometrial cancer) according to the pathological results of surgery, and the differences of contrast enhancement patterns between benign group and malignant group were compared. The sensitivity, specificity of CEUS in the diagnosis of endometrial cancer were calculated, and the Kappa value was calculated with the initial enhancement time earlier than or equal to the muscularity or the peak time earlier than the muscularity as the diagnostic index for the diagnosis of endometrial malignant lesions. The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer and endometrial cancer with thickness ≥10 mm were calculated.Results:A total of 108 patients underwent surgery with clear pathological results, including 66 patients in the benign lesion group and 42 patients in the malignant lesion group. The thickness of malignant lesions was significantly larger than that of benign lesions, and the difference was statistically significant( t=4.039, P<0.05), but there was no significant difference of hemodynamic parameters between the two groups ( P>0.05). The initial enhancement time, peak time and peak intensity of benign lesions were significantly different from those of malignant lesions(all P<0.05). The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer were 64.3%, 100% and 0.668, respectively. The sensitivity, specificity and Kappa value of CEUS in the diagnosis of endometrial carcinoma with lesion thickness ≥10 mm were 75.0%, 100% and 0.795, respectively. Conclusions:For the diagnosis of endometrial lesions, especially the malignant endometrial lesions with thickness and diameter greater than or equal to 10mm, there is a high diagnostic coincidence rate between CEUS and pathological diagnosis, and endometrial malignant lesions have more specific CEUS manifestations.

Cutaneous T-cell lymphomas are a relatively rare group of mature T-cell lymphomas mainly manifesting in the skin, and its common subtype is mycosis fungoides. Total skin electron irradiation is one of the important conventional treatment methods, but there are many disadvantages, such as uneven dose distribution, poor position repetition, and long treatment time, which affect the clinical efficacy and patient prognosis. With the emergence and gradual popularization of helical tomotherapy in recent years, more and more medical institutions are gradually expanding their applications in total skin irradiation due to their ability to treat ultra-long targets and achieve dose-sculpted distribution, aiming to further explore its good or bad, and confirm whether it can replace the traditional total skin electron irradiation. In this article, research progress on total skin irradiation using helical tomotherapy was reviewed, the development of treatment technology, clinical efficacy and current concerns and controversies were illustrated.