Genetic susceptibility of lung cancer plays an important role in genesis of lung cancer.Studies find that tumor necrosis factor α(TNF-α)is significantly up-regulated in lung cancer patients.It may be correlated with the TNF-α polymorphism in its promoter region which affects its transcription and expression.TNF-α polymorphisms may be an important genetic marker for susceptibility of lung cancer.

Objective To investigate the feasibility, image quality, and safety of low?tube?voltage, low iodine load iso?osmolar contrast comprehensive cardiac and aortoiliac CT angiography (CTA) for transcatheter aortic valve replacement (TAVR) planning. Methods Ninety?eight consecutive TAVR candidates prospectively underwent combined contrast?enhanced CTA of the aortic root complex and vascular access route. Patients were assigned to group A (2nd generation dual?source CT, 100 kV, contrast 270 mgI/ml iodixanol) or group B (2nd generation dual?source CT, 120 kV, contrast 370 mgI/ml). Mean vascular attenuation, noise, signal?to?noise ratio (SNR), and contrast?to?noise ratio (CNR) of aorta including aortic root, aortic arch, descending aorta at level of diaphragm, abdominal aorta at level of renal artery and femoral artery were compared. Patient creatinine levels before the examination of CTA and during follow?up (24—48 h) were measured. Results The image quality score of aortic root and whole aorta was (4.2±0.7) and (4.3±0.4) respectively in experimental group, (4.3±0.6) and (4.3±0.3) in control group. No significant difference in subjective image quality score between two groups including aortic root image and whole aorta image (t=-0.130,-0.155,P=0.694, 0.822). The image noise of aortic root and femoral artery were higher in experimental group than that in control group (P<0.05). Radiation dose in experimental group was higher than that in control group [(6.1 ± 0.4) vs. (8.0 ± 0.4) mSv, t=-9.253, P=0.001]. There were no significant changes in creatinine levels among groups during the follow?up. Conclusion TAVR candidates can be safely and effectively evaluated by a comprehensive CTA protocol with low iodine load iso?osmolar contrast using low?tube?voltage acquisition.

Objective: To compare the characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different bicuspid aortic valve (BAV) morphology. Methods: A total of 197 patients who underwent aortic valve replacement between April 2014 and March 2015 and were diagnosed with BAV by pathology were included, and their clinical data were retrospectively analyzed. Patients were divided into raphe⁺ group(109 cases) and raphe^- group(88 cases) according to the presence or absence of raphe, and L-R group(fusion of left and right cusp, 125 cases) and L/R-N group(fusion of left or right and noncoronary cusp, 72 cases) according to fusion type of the cusps. The characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different BAV morphology were compared. Results: (1) Aortic stenosis incidence was lower in raphe⁺ group than in raphe^- group(22.9%(25/109) vs. 69.3%(61/88), P<0.001). Aortic regurgitation incidence was higher in raphe⁺ group than in raphe^- group (61.5%(67/109) vs. 22.7%(20/88), P<0.001). Incidence of type 1 of aortic root dilation was higher in raphe⁺ group than in raphe^- group (23.9%(26/109)vs.10.2%(9/88), P=0.024). (2) Aortic stenosis incidence was lower in L-R group than in L/R-N group(29.6%(37/125) vs. 68.1%(49/72), P<0.001). Aortic regurgitation incidence was higher in L-R group than in L/R-N group (59.2%(74/125) vs. 18.1%(13/72), P<0.001). Incidence of type 3 of aortic root dilation was lower in L-R group than in L/R-N group(10.4%(13/125) vs. 37.5%(27/72), P=0.006). (3) Aortic stenosis incidence was lower in L-R patients than in L/R-N patients(15.1%(13/86)vs. 52.2%(12/23), P=0.001), and aortic regurgitation incidence was higher in L-R patients than in L/R-N patients in raphe⁺ group(73.3%(63/86)vs. 17.4%(4/23), P<0.001). Conclusion There is significant difference in the type of valvular dysfunction and ascending aorta dilatation in patients with different morphological characteristics of BAV.

Objective:To investigate the classification and prevalence of simple congenital coronary artery anomalies (CCAA) in Chinese in a large samples of coronary CT angiography (CCTA), and briefly summarize the CT characteristics of "malignant" anomalies.Methods:The data of patients who had undergone CCTA from July 2009 to January 2017 and were diagnosed as simple CCAA were analyzed retrospectively. CCAA were classified according to the origination, number of orifices and termination, and the prevalence of various CCAA was statistically analyzed. Anomalous origin of coronary artery included the origin of coronary artery from the opposite coronary sinus, the non-coronary sinus, the aorta or around the primary sinus, the pulmonary artery, and left circumflex artery originated from the diagonal branch. Abnormal number of orifices included single coronary artery (SCA), right coronary artery and conus branch arising separately, and left anterior descending branch and circumflex branch arising separately. Abnormal termination was coronary artery fistula (CAF). Anomalous origin of coronary artery from the opposite sinus, anomalous origin of the coronary artery from the pulmonary artery, SCA, and multiple or large CAFs were defined as"malignant"anomalies.Results:Among 165 133 patients, 2 148(1.301%) had coronary anomalies, including 1 302 (0.789%) of origin anomalies, 298 (0.181%) of abnormal number of orifices and 548 (0.332%) of abnormal termination. There were 700 cases (0.424%) with coronary artery rising from the opposite sinus, 179 of which had opening or proximal lumen stenosis due to compression, 7 of which had subendocardial myocardial ischemia or infarction on CCTA without coronary artery disease (CAD). The coronary arteries originated from posterior sinus, the aorta or around the primary sinus were found in 48 cases (0.029%), 531 cases(0.322%), respectively. Coronary artery originating from pulmonary artery was detected in 20 cases (0.012%), all of which were left main trunk originating from pulmonary artery, showed tortuous dilation of coronary arteries. Five cases showed obvious subendocardial myocardial ischemia or infarction without CAD. SCA, right coronary artery and conus branch arising separately, left anterior descending branch and circumflex artery arising separately were detected in 102 (0.062%), 53 (0.032%) and 143 (0.087%) cases respectively. Only 1 of 102 cases with SCA showed myocardial ischemia without CAD. A total of 548 cases (0.332%) were diagnosed as CAF, of which the coronary-pulmonary fistula was most common with a highest prevalence of 0.277% (458 cases). Coronary artery-atrial fistula and coronary artery-ventricular fistula were detected in 22 (0.013%) and 60 (0.036%) cases. There were 6 cases (0.004%) of coronary artery-coronary venous fistula and 2 cases (0.001%) of coronary artery-superior vena cava fistula.Conclusions:The occurrence of CCAA is not uncommon, among which anomalous origin of coronary artery is the most common, and special attention should be paid to "malignant"anomalies.

Objective:To investigate the reproducibility of left ventricular strain assessed by CT feature tracking(CT-FT) and its correlation and agreement with speckle tracking echocardiography (STE).Methods:Thirty outpatients with suspected coronary heart disease who underwent whole cardiac cycle coronary CTA and transthoracic echocardiography within one week were prospectively enrolled in November 2019. Left ventricular volume and strain parameters were measured by CT-FT and STE, including left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), global longitudinal strain(GLS), global radial strain (GRS),and global circumferential strain(GCS). GLS included endocardial global longitudinal strain (EndoGLS) and myocardial global longitudinal strain (MyoGLS), GCS included endocardial global circumferential strain (EndoGCS) and myocardial global circumferential strain (MyoGCS). ICC was used to evaluate intra-and inter-observer differences in strain measured by CT-FT. The differences of measurements between CT-FT and STE were compared by paired-samples t test. Pearson correlation coefficient was used to analyze the correlation between CT-FT and STE measurements. Agreement between measurements of two modalities was assessed by Bland-Altman analysis. Results:There was a good consistency in EDV, ESV, EF, EndoGLS, MyoGLS, GRS, EndoGCS and MyoGCS measured by CT-FT between intra-and inter-observer (ICC was 0.775-0.964, P<0.001). There was no significant difference in EF measured by CT-FT and STE [(60.27±8.70) % and (61.22±5.64) %, P=0.443]. EndoGLS, MyoGLS, GRS and MyoGCS measured by CT-FT were (-20.47±4.01)%, (-18.06±3.75)%, (73.90±20.58) % and (-18.48±3.65)%, respectively, while the strain measured by STE were (-18.97±3.33)%, (-16.49±2.60)%, (18.56±3.06)% and (-20.26±4.45)%, respectively. The differences were statistically significant between CT-FT and STE ( t=-2.367, -2.945, 12.161, 2.459, P<0.05). The EndoGCS measured by CT-FT and STE were (-27.78±6.66)% and (-29.18±7.24)%, respectively, with no statistical significance ( P=0.223).The correlation coefficients of EndoGLS, MyoGLS, GRS, EndoGCS and MyoGCS measured by CT-FT and STE were 0.566, 0.629, 0.509, 0.606 and 0.539, respectively ( P<0.05). The average difference of EndoGLS, MyoGLS, GRS, EndoGCS and MyoGCS measured by CT-FT and STE was -1.5%, -1.6%, 55.3%, 1.4% and 1.8%, respectively, with 95% limits of agreement was -8.3%-5.3%, -7.3%-4.2%, 18.1%-92.5%, -10.7%-13.6% and -6.0%-9.5%, respectively. Conclusions:The left ventricular global strain evaluated by CT-FT was feasible, and the agreement of global strain between CT-FT and STE was good but not interchangeable. CT can be an alternative method for "one-stop" evaluation of cardiac anatomy and function in patients with poor echogenic windows and contraindications for MRI.

To investigate the clinical efficacy of consolidation chemotherapy with docetaxel and cisplatin (DP) in elderly patients of esophageal cancer.
 Methods: Seventy-nine elderly patients of esophageal cancer were randomly divided into the treatment group (38 patients) and the control group (41 patients). Intensity modulated radiation therapy (IMRT) was applied in both groups and prescribed dose was set to 56 to 59.4 Gy in 28 to 33 fractions. The concurrent chemotherapy regime for both groups was as follow: docetaxel 25 mg/m2 plus cisplatin 25 mg/m2, per week. After concurrent chemoradiotherapy, consolidated chemotherapy was applied to the treatment group with docetaxel 60 mg/m2 and cisplatin 75 mg/m2 
for 3 weeks in one cycle. There was no subsequent treatment for the control group.
 Results: The clinical efficacy was assessed in 76 patients. For the treatment group, 31 patients (response rate, 89.2%) obtained effective response, including 10 cases with complete response (CR) and 21 cases with partial response (PR), both of which were significantly more than that in the control group (response rate, 61.5%), with 9 cases of CR and 15 cases of PR. The median progression-free survival was 19.7 months in the treatment group, clearly longer than that in the control group (10.8 months, P=0.04). The overall survival for 1-year, 2-year and 3-year were 78.5%, 57.9% and 37.8% in the treatment group versus 61.2%, 42.3% and 22.7% in the control group (P>0.05), respectively. Grade 1 and 2 adverse effects were commonly observed in both groups, such as hematologic toxicity and radiation-induced esophagitis, but there was no significant difference between the two groups. 
 Conclusion: For elderly patients with esophageal carcinoma, the overall response rate can be significantly improved by concurrent chemoradiotherapy with subsequently consolidated chemotherapy based on docetaxel and cisplatin..
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; Chemoradiotherapy ; adverse effects ; Cisplatin ; adverse effects ; Consolidation Chemotherapy ; adverse effects ; Disease-Free Survival ; Docetaxel ; Esophageal Neoplasms ; mortality ; Esophagitis ; epidemiology ; Female ; Hematologic Diseases ; epidemiology ; Humans ; Male ; Radiotherapy, Intensity-Modulated ; adverse effects ; Remission Induction ; Taxoids ; adverse effects