Objective To assess whether aortic valve calcification (AVC) and mitral annual calcification (MAC) is independent predictors for coronary artery disease (CAD).Methods Coronary CT angiography(CCTA) data in a total of 263 patients were included in this study,including 30 patients with MAC, 82 patients with AVC and 31 patients with MAC+AVC;meanwhile other 120 patients without valvular calcification were regarded as a control group.Five indicators were used to evaluate the extent and severity of CAD, namely, the prevalence of coronary plaque, multi-coronary vessels lesions, degrees of coronary artery narrowing, incidence of moderate to severe coronary artery calcification score and mean number of affected coronary artery segments.The correlations of MAC,AVC,MAC+AVC with CAD were analyzed by Logistic regression analysis.Results The presence and severity of CAD were significantly greater in patients with MAC, AVC and MAC+AVC than those in control group.After adjustment for CAD conventional risk factors,Logistic regression analysis revealed that AVC,MAC and MAC+AVC were independently associated with the presence and severity of CAD.Conclusion AVC and MAC are independent predictors for CAD and often predict the more presence and greater severity of CAD.

Objective:To observe the effect of triptolide on asthmatic mice IL-23, Th17 cells and their cytokine IL-17 expression,and to explore its effect on Th17 cell-mediated airway inflammation,and its mechanism of action,which provides targets for triptolide in treatment of asthma.Methods: 32 SPF level BALB/c mice were randomly divided into normal control group ( NC ) , asthmatic group ( A ) , triptolide group ( TA group ) and dexamethasone group ( DA group ) , n=8.Asthmatic group with ovalbumin sensitization and aluminum hydroxide;ovalbumin intranasal inhalation challernge.Mice of triptolide group and dexamethasone group were sensitized and challenged as asthmatic group, and the two groups were respectively given triptolide and dexamethasone by intraperitoneal injection 30 minutes before challenged.Mice of control group was sensitized and challenged by saline.The total number of white blood cells and the number of eosinophils of BALF were calculated by cell counter.IL-23 and IL-17 levels in BALF were measured by ELISA.Lung tissue were stained with hematoxyin and eosin(HE).IL-17 protein expression levels were detected by immu-nohistochemistry in lung tissue,and the mRNA expression levels of right lung tissue were detected by qRT-PCR.Th17 percentage of CD4+T lymphocytes were analyzed by flow cytometry.Results:Numbers of white blood cells( WBC) and eosinophils( Eos) of BALF, IL-23 and IL-17 levels of BALF,IL-17 protein and IL-17 mRNA expression in lung tissue,and Th17 cell frequencies in peripheral blood were all significantly increased in the asthmatic group compared to the control group(P<0.05),but reduced significantly in triptolide group and dexamethasone group compared to asthmatic group;there was no significant difference in the above mentioned indicators between in triptolide group and dexamethasone group ( P>0.05 ) .Conclusion: Triptolide can inhibit airway inflammation, which mechanism is possible by inhibiting IL-23/Th17(IL-17) inflammatory axis.

Prompt gamma rays are a kind of secondary radiation produced in particle therapy, and prompt gamma information largely reflects the incidence of particles. Consequently, use of prompt gamma information to verify the range of particles is a promising verification method. In this article, the concept of prompt gamma ray in vivo range verification and the advantages of prompt gamma verification over existing methods were introduced. Secondly, the progress in developing a method for range verification using prompt gamma in recent years was reviewed, and the advantages and disadvantages of three methods including prompt gamma imaging (PGI), prompt gamma timing (PGT) and prompt gamma spectroscopy (PGS) were discussed. Finally, these three methods were summarized, and the development trend of prompt gamma rays for in vivo range monitoring was prospected.

Objective To identify Chinese character writing related cortex (WRC) and its relationship with hand motor cortical areas. Methods Ten native Chinese-speaking, right-hand volunteers were recruited in the study. NTMS mapping was conducted during picture naming task. The WRC were mapped based on nTMS-induced impairment of Chinese character writing. The extent and area of WRC was calculated. The right-hand motor representations were mapped while motor-evoked potentials were produced under nTMS stimulation. EMG data and coordinates of positive stimulus were recorded. The relationship between WRC and hand motor cortex (HMC) was analyzed on the basis of area comparison and distance calculation. Results The cortical areas related to Chinese character writing were mapped successfully in all subjects by nTMS. WRC was primarily centered in left posterior middle frontal gyrus (pMFG) (86%,55/64). The mean WRC area (161.03 mm2 ±62.58mm2) was significantly smaller than the mean HMC area (589.50 mm2±227.34mm2) (P<0.001). The WRC and HMC were not conjoined or overlapped in the dominant hemisphere. The distance between those two was 12.58mm±2.71mm. Conclusions NTMS can provide reliable assistance in mapping WRC areas. The WRC is relatively fixed and centralized in pMFG but is not overlapped with the HMC.

Objective: Aimed to construct an immune-related risk signature and nomogram predicting endometrial cancer (EC) prognosis. Methods: An immune-related risk signature in EC was constructed using the least absolute shrinkage and selection operator regression analysis based on The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A nomogram integrating the immune-related genes and the clinicopathological characteristics was established and validated using the Kaplan-Meier survival curve and receiver operating characteristic (ROC) curve to predict the overall survival (OS) of EC patients. The Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) R tool was used to explore the immune and stromal scores. Results: CCL17, CTLA4, GPI, HDGF, HFE2, ICOS, IFNG, IL21R, KAL1, NR3C1, S100A2, and S100A9 were used in developing an immune-related risk signature evaluation model. The Kaplan-Meier curve indicated that patients in the low-risk group had better OS (p<0.001).The area under the ROC curve (AUC) values of this model were 0.737, 0.764, and 0.782 for the 3-, 5-, and 7-year OS, respectively. A nomogram integrating the immune-related risk model and clinical features could accurately predict the OS (AUC=0.772, 0.786, and 0.817 at 3-, 5-, and 7-year OS, respectively). The 4 immune cell scores were lower in the high-risk group. Forkhead box P3 (FOXP3) and basic leucine zipper ATF-like transcription factor (BATF) showed a potential significant role in the immune-related risk signature. Conclusion Twelve immune-related genes signature and nomogram for assessing the OS of patients with EC had a good practical value.

Objective: This study aims to analyze factors associated with lymphovascular space invasion (LVSI) and evaluate the prognostic significance of LVSI in Chinese endometrioid endometrial cancer (EEC) patients. Methods: Five-hundred eighty-four EEC patients undergoing surgery in our center from 2006 to 2016 were selected for analysis. Univariate analysis and multivariate logistic regression were used to examine relevant factors of LVSI. To evaluate the prognostic role of LVSI, survival analyses were conducted. In survival analyses, both multivariate Cox regression and propensity score matching were used to control the confounders. Results: The incidence of LVSI was 12.16% (71/584). Diabetes history (p=0.021), lymph node metastasis (p=0.005), deep myometrial invasion (p<0.001) and negative PR expression (p=0.007) were independently associated with LVSI. Both Kaplan-Meier method and univariate Cox regressions showed LVSI negative and positive cases had similar tumor-specific survival (TSS) and disease-free survival (DFS). After adjusting for the influence of adjuvant therapy and other clinicopathological factors with multivariate Cox regressions, LVSI still could not bring additional survival risk to the patients (p=0.280 and p=0.650 for TSS and DFS, respectively). This result was verified by Kaplan-Meier survival analyses after propensity score matching (p=0.234 and p=0.765 for TSS and DFS, respectively). Conclusion LVSI does not significantly compromise the survival outcome of Chinese EEC patients.

Objective To make bibliometrics analysis on case management literature in China so as to understand the research hotspots of case management and provide a basis for development of case management. Methods Journal articles related to case management were retrieved based on the theme "Case Management"in Chinese National Knowledge Infrastructure (CNKI) from 1st January 2009 to 31st December 2018 and the bibliography was collected. Excel and self-design computer program were used to frequency statistics and to construct co-word analysis and co-occurrence matrix of high-frequency keywords. SPSS 22.0 was used to hierarchical cluster analysis. Results A total of 1 102 articles were included and 53 high-frequency keywords were extracted. From 2009 to 2018, case management applied research showed growth trend in China. A total of 988 authors published 1 102 articles in 531 journals. Hierarchical cluster analysis showed that research hotspots of case management in China focused on 8 aspects including community-based rehabilitation, Aids, chronic heart failure, diabetes, peritoneal dialysis, chronic obstructive pulmonary disease, human resources and social work. Conclusions Nearly 10 years, case management is widely used in nursing field and social work, but research depth and width is insufficient. Achievable case management scheme should be built and informative case management system should be constructed to improve prognosis and quality of life of patients. There is still large room for development in the future.

Objective To investigate the effects of Naoxintong Capsule treatment on the carotid artery intima media thickness(IMT),plasma beta thromboglobulin(beta TG),P-selectin(CD62p)and plasminogen activator inhibitor 1 (PAI 1)in elderly patients with type 2 diabetes mellitus and subclinical atherosclerotic vascular disease.Methods In retrospective study,110 cases of elderly patients with type 2 diabetic vascular diseases were selected and admitted as study subjects from June 2014 to May 2015.They were randomized into observation group and control group(n=55,each).All patients were given routine treatment.The patients in the observation group were treated with Naoxintong Capsule.The levels of plasma β-TG,CD62p and PAI 1 were measured and compared between two groups.Results Before treatment,there were no significant differences in IMT,PAI 1,β-TG and CD62p levels between the two groups(P＞0.05).After treatment,the observation group versus control group showed an improved four parameters of carotid artery IMT(1.31 ±0.26)mm vs.(1.44±0.26)mm,PAI 1(2.23 ±0.48)μg/L vs.(2.56 ±0.61)μg/L,β-TG(29.76 ± 10.24)μg/L vs.(35.98 ± 10.35)tμg/L,CD62p(162.3 ± 21.5)ng/L vs.(176.96 ± 20.3)ng/L(t=4.058,3.965,11.293,14.624 respectively,all P ＜ 0.05) with statistically significant differences.Conclusions Naoxintong Capsule treatment of type 2 diabetic patients with subclinical atherosclerotic vascular disease can reduce carotid intima-media thickness,decrease platelet releasing activity and lower the oxidative stress reaction.Thereby,it protects the vascular endothelium,and alleviates subclinical atherosclerotic vascular disease in the elderly type 2 diabetic patients.

Objective:To compare the clinical efficacy of femoral neck system (FNS) and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 76 young and middle-aged patients with femoral neck fracture admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2018 to September 2020, including 45 males and 31 females, aged 23-63 years [(49.5±8.2)years]. Garden classification of the fracture was 25 patients with type II, 34 with type III and 17 with type IV. Pauwels classification of the fracture was 16 patients with type I, 31 with type II and 29 with type III. A total of 40 patients were treated with cannulated screw fixation (cannulated screw group) and 36 patients with FNS fixation (FNS group). Operation time, frequency of fluoroscopy, length of hospital stay, weight-bearing time and bone union time were compared between the two groups. Hip function was assessed by Harris hip score at 6, 12 months after operation. The incidence of postoperative complications was observed.Results:All patients were followed up for 12-20 months [(15.2±1.7)months]. The frequency of fluoroscopy [(13.4±1.9)times], weight-bearing time [(11.1±1.9)weeks] and bone union time [(13.8±1.6)weeks] in FNS group were lower or shorter than those in cannulated screw group [(18.2±2.6)times, (15.7±1.6)weeks, (14.6±1.6)weeks] (all P<0.05 or 0.01). There were no significant differences in operation time, length of hospital stay and Harris hip score at 6, 12 months after operation between the two groups (all P>0.05). No postoperative infection occurred in both groups. In cannulated screw group, there were 4 patients with femoral neck shortening, 3 with deep venous thrombosis, 2 with internal fixation loosening, 2 with nail withdrawal and 1 with fracture non-union, showing the incidence of complications of 30% (12/40). In FNS group, there was 2 patients with femoral neck shortening, 1 with deep vein thrombosis and 1 with internal fixation loosening, showing the incidence of complications of 11% (4/36) ( P<0.05). Conclusion:For femoral neck fracture in the young and middle-aged patients, both FNS and cannulated screw fixation can obtain satisfactory efficacy, but FNS has the advantages of decreased frequency of intraoperative fluoroscopy, early weight bearing, reduced time to bone union and low incidence of complications.

Objective:To investigate the clinicopathological features, treatment and short-term prognosis of diffuse endocapillary proliferative Henoch-Schonlein purpura nephritis (DEP-HSPN) in children.Methods:Clinicopathological data of children with DEP-HSPN diagnosed by renal biopsy in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2019 were retrospectively analyzed.Children with HSPN with segmental endocapillary proliferation (non DEP-HSPN) and matched with the gender, age and pathological grade at the ratio of 1∶2 in the same period were recruited as controls.Results:(1) A total of 42 cases of DEP-HSPN were pathologically confirmed, accounting for 5.9% of the 712 children with HSPN during the same period.Thirty-nine newly treated cases were included, with the mean age of (8.9±3.2) years old, and the gender ratio was 1.79∶1.00.There were 21 cases of nephrotic syndrome, 14 cases of hematuria and albuminuria, 2 cases of acute glomerulonephritis, 1 case of rapid progressive nephritis and 1 case of isolated proteinuria.Pathological findings were accompanied by diffuse prolife-ration of mesangial and endocapillary.There were 13, 22 and 4 cases with pathological gradeⅡb, Ⅲb and Ⅳb, respectively.(2) Compared with non DEP-HSPN subjects, DEP-HSPN patients had a shorter course from renal symptoms to renal biopsy, and a higher incidence of nephrotic albuminuria, hypoalbuminemia, hypocomplementemia, hypertension and anemia.The main clinical type was nephrotic syndrome.The levels of D-dimer, 24-hour urinary protein (24 h UP) and urea nitrogen were significantly higher in DEP-HSPN group ( Z=-2.416, -2.595, -2.019, all P<0.05), while the red blood cells, hemoglobin, serum albumin, C 3 and glomerular filtration rate (eGFR) were significantly lower ( t=-2.499, -3.746, 2.836, -3.410, 3.236, all P<0.05). Besides, the glomerular C 3 deposition was higher than those in non DEP-HSPN subjects ( Z=-1.977, P<0.05). (3)The urinary protein remission rate in DEP-HSPN group was significantly reduced at 1 month follow-up [37.0%(10/27 cases) vs.62.5%(40/64 cases), P<0.05]. There was no significant difference between the 2 groups at 3 months, and the urinary protein remission was relieved at 6 months in both groups.There was no significant difference in hematuria remission between the 2 groups at the end of follow-up. Conclusions:Clinical manifestation of DEP-HSPN is severe, which is easy to be complicated with hypertension, anemia, hypocomplementemia C 3 and so on, and the hypercoagulable state is obvious.The degree of glomerular complement C 3 deposition was high in DEP-HSPN group.Urinary protein can be relieved slowly within 1 month after active treatment, but can be relieved at 6 months.