Objective:To investigate the value of diameter of pulmonary nodules,radiological indicators,serum tumor markers(CEA,CYFRA21-1,and SCC),and methylation of HOXA7 and SOX17 in circulating tumor DNA(ctDNA)in the early diagnosis of lung can-cer.Methods:A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admit-ted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group,respectively,and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group.The three groups were compared in terms of the diameter of nodules,spiculation sign,levels of serum tumor markers,and meth-ylation rates of HOXA7 and SOX17 in plasma ctDNA,and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of the model.Results:Compared with the benign nodule group and the control group,the lung cancer group had significantly higher diameter of pulmonary nodules,proportion of patients with spiculation sign,CEA,ProGRP,CYFRA21-1,and methylation rates of serum HOXA7,and SOX17,and the lung can-cer group had a significantly higher level of SCC than the control group(all P<0.05).The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules(P<0.05),and a predictive model was established as Y=ex/(1+ex),where x=-7.233+(0.108×nodule diameter)+(3.860×spiculation sign)+(0.021×HOXA7 methylation rate)+(0.043×SOX17 methylation rate).The predictive model had an area under the ROC curve(AUC)of 0.981,with a significantly larger AUC than each indicator alone and the Mayo and LCBP models(P<0.05).Conclusion:The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer,and the predictive model based on these indicators can significantly improve diagnostic performance.

Objective:To compare the efficacy of amide proton transfer-weighted (APTw) imaging with time-dependent diffusion MRI (td-dMRI) in the diagnosis of malignant breast lesions.Methods:This study was a cross-sectional study. The clinical, pathological and imaging data of patients with breast lesions admitted to the First Affiliated Hospital of Zhengzhou University from March to August 2023 were prospectively analyzed. All patients firstly underwent T 2WI, diffusion-weighted imaging, followed by dynamic contrast-enhanced MRI (DCE-MRI), and finally APTw imaging and td-dMRI were performed for breast lesions using DCE-MRI as reference. Reconstructed images from APTw imaging measured lesions with a frequency shift of 3.5 ppm asymmetric magnetic susceptibility MTR asym(+3.5 ppm). The apparent diffusion coefficient (ADC) values at different oscillating frequency gradients (ADC PGSE, ADC 17 Hz, ADC 33 Hz values) were measured using reconstructed td-dMRI images. Independent sample t-test was used to compare APTw imaging, td-dMRI parameter differences between benign and malignant breast tumors, breast malignant tumors with different molecular types [estrogen receptor (ER) negative and positive, progesterone receptor (PR) negative and positive, human epidermal growth factor receptor (HER-2) negative and positive, proliferation index (Ki-67) low and high expression] and different histological grades (grade Ⅱ and Ⅲ). Receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the efficacy of APTw imaging and td-dMRI parameters in differentiating benign and malignant breast tumors, molecular classification and histological grading of malignant breast lesions. Results:There were 171 lesions in 171 patients, including 103 malignant lesions and 68 benign lesions. Histological grades were grade Ⅱ in 51 cases and grade Ⅲ in 38 cases of 89 cases of invasive carcinoma. Totally 98 cases of malignant lesions were included in molecular typing analysis, 36 cases were ER negative and 62 cases were ER positive. PR was negative in 51 cases and positive in 47 cases. There were 33 negative HER-2 patients, 65 positive HER-2 patients. There were 50 cases of low Ki-67 expression and 48 cases of high Ki-67 expression. The MTR asym(+3.5 ppm) value of malignant breast lesions was higher than that of benign lesions ( t=5.76, P<0.001), and the ADC PGSE, ADC 17 Hz and ADC 33 Hz values were lower than those of benign breast lesions ( t was 4.84, 4.62, 4.01, respectively, all P<0.001). MTR asym(+3.5 ppm) had the highest AUC value (0.83) and the highest specificity (90.38%), and ADC PGSE had the highest sensitivity (85.86%). There were no significant differences in MTR asym(+3.5 ppm), ADC PGSE, ADC 17 Hz and ADC 33 Hz between grade Ⅱ and grade Ⅲ histological grades of malignant breast lesions (all P>0.05). The ADC PGSE value of ER negative was higher than that of ER positive ( t=2.34, P=0.018), and the AUC for distinguishing ER positive from negative was 0.64. The ADC PGSE and ADC 17 Hz values of PR negative were higher than those of PR positive ( t=2.87, 2.81, P=0.004, 0.006, respectively), and their AUCs for identifying PR positive versus negative breast malignant lesions were 0.68 and 0.67, respectively. The ADC 33 Hz value of negative HER-2 was lower than that of positive HER-2 ( t=3.00, P=0.003), and the AUC for distinguishing positive and negative HER-2 was 0.67. There were no significant differences in other parameters among different subtypes of breast malignant lesions (all P>0.05). Conclusion:Compared with td-dMRI, APTw imaging is more effective in differentiating benign and malignant lesions of breast tumors, and ADC values at different gradient oscillation frequencies obtained by td-dMRI show better diagnostic efficacy in differentiating different molecular types of breast malignant lesions.

Extensive intracranial calcification is rare in patients with systemic lupus erythematosus. This article reported a patient with antiphospholipid antibody syndrome secondary to systemic lupus erythematosus, complicated with bilateral symmetrical extensive intracranial calcification. By reviewing literature, the results suggested that the flare of neuropsychiatric systemic lupus erythematosus and the presence of antiphospholipid antibodies may be risk factors for intracranial calcification. Therefore, in order to prevent the formation of intracranial calcification, it is necessary to maintain continuous disease remission and anticoagulant therapy.

Objective To explore the deployment of sidewalks and the possible relationship with local GDP,population density and prosperity of streets in 12 cities selected in China.Methods For all the streets in 333 blocks of 12 cities surveyed (Beijing,Tianjin,Shanghai,Qingdao,Hangzhou,Shaoxing,Suzhou,Nantong,Zhenjiang,Chengdu,Xining and Harbin),the deployment and management of sidewalks were observed.And we collected the GDP data of the 12 cities,the population data of 333 blocks,and the numbers of stores and restaurants along the streets.Results A total of 4 255 streets were included in the study.In the 12 cities,71.1％ of the streets had sidewalks.The deployment rates of sidewalks was high in Qingdao (91.9％) and Harbin (90.6％),and low in Suzhou (48.6％) and Shaoxing (52.6％),the differences were significant.The higher GDP of city was,the more sidewalks were deployed.But on the other hand there were more parking cars and obstacles on the sidewalks.The higher the population density was,the worse the condition of sidewalks was.Conclusions The survey of sidewalks in the 12 cities indicated that efforts could be made to improve the condition of sidewalks.Attention should be paid not only to the deployment of sidewalks,but also the management of sidewalks.Reasonable deployment of sidewalks should be considered according to the local population density and traffic flow.

Objective To explore the condition on bike lanes and the relationship with GDP of the related cities,residential of regions and prosperity of streets in 12 selected cities in China.Methods Eexistence and maintenance of bike lanes were examinedin in all the streets under survey in 333 blocks of 12 cities (Beijing,Tianjin,Shanghai,Qingdao,Hangzhou,Shaoxing,Suzhou,Nantong,Zhenjiang,Chengdu,Xining and Harbin).Data were collected on GDP of the related cities,together with the sizes of population and proportion of the 333 blocksand the numbers of stores and restaurants in those streets.Results A total of 4 202 streets were included in the study.In the 12 cities,32.6％ of the streets were equipped with bike lanes.Bike-lane-equipmentsseemed better in Nantong (46.5％),Tianjin (39.6％) and Shanghai (39.4％),but the scores were lower in Xining (2.0％),Qingdao (5.4％),and Harbin (27.1％).The higher GDP was,the better bike lanes were equipped.In the meantime,the isolation of bike lanes were worse and the streets more crowded.Density of the residential area was negatively correlated with the score on bike lane-equipments.Conclusion Differences of the condition of bike lanes in the 12 cities indicated that improvement should be made on bike lanes.More attention should be paid to those cities with high GDPs and crowded residential regions on setting up the isolated bike lanes and reasonable equipments.

AIM: To investigate the regulatory function of bone marrow-derived mesenchymal stem cells (MSCs) on T helper 17 cells (Th17) and regulatory T cells (Treg) in peripheral blood of severe asthmatic children . METHODS:MSCs were isolated , cultured and identified in vitro.MSCs digested with mitomycin were cocultured with T lymphocytes (TLC) at different ratios (1∶1, 1∶2, 1∶10 and 1∶20) from severe asthmatic children for 72 h.The prolifera-tion of TLC was measured by CCK-8 method.In the coculture system of the 1∶2 ratio and the single TLC system , the super-natant levels of interleukin-17 (IL-17) and transforming growth factor-β(TGF-β) were measured by ELISA.The mRNA expression of retinoic acid-related orphan nuclear receptor C (RORC) and forkhead box protein 3 (Foxp3) in TLC was de-tected by qRT-PCR.RESULTS:After cocultured with MSCs , the proliferation of TLC decreased significantly in a dose-dependent manner (P<0.05).It also showed decreases in IL-17 (3 799 ±441 vs 4 890 ±373, P<0.05) and RORC mRNA level (1.21 ±0.14 vs 3.85 ±0.48, P<0.05), while an increase in TGF-βlevel (209 ±32 vs 117 ±26, P<0.05) was observed.No influence on the mRNA expression of Foxp3 was found (P>0.05).CONCLUSION: MSCs suppresses Th17 polarization of naive peripheral blood CD 4 +T cells and matures Th17 cells secreting IL-17, which may ef-fectively revise Th17/Treg imbalance of asthma .

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.

[Objective] To investigate the changes of CD4~+ CD25~+ regulatory T cells (Tr) in peripheral blood and their relation with their body mass index (BMI) of children with acute attack asthma. [Methods] Peripheral blood was obtained from 70 children with acute attack asthma, 30 remission children, and 50 normal control children. Then 70 children with acute attack asthma, were divided by normal weight group (40 cases) and overweight group (30 cases). The levels of CD4~+CD25~+Tr of the patients were tested by flow cytometry (FCM), and their BMI were calculated. [ Results] The levels of CD4~+ CD25~+ Tr [(6.17± 1.72)%] in acute attack group were lower than that in remission group [(7.56±1.48)%] or that in the control group [(7.13± 1.48)%] (P<0.05), but no difference between that in the remission and that in the control (P>0.05). The CD4~+CD25~+Tr of asthmatic children with normal weight [(6.34±1.71)%] was higher than that of asthmatic children with overweight [(4.74±1.20)%] (P<0.05). There was a remarkably negative correlation between the level of CD4~+ CD25~+ Tr of asthmatic children [(6.17±1.72)%] and the BMI (16.00±2.14) (r_p=-0.814, P<0.05). [Conclusion] The levels of CD4~+ CD25~+Tr are remarkable decrease in attack asthmatic children, and more decrease in overweight patients. There is remarkably negative correlation between the levels of CD4~+CD25~+ Tr in peripheral blood of attack asthmatic children and their BMI.

[Objective] This study was designed to determine Th1, Th2 cell numbers and investigate T-bet mRNA, GATA-3 mRNA expression of spleen MNC in a mufine asthmatic model which intended to understand effect of airway T-bet plasmid gene transfer on Th differentiation. [ Methods] A mouse asthmatic model was established by sensitization with ovalbumin (OVA). Thirty-two C57BL/6 mice were divided into four groups (8 mice in each group): the normal control group (group A ), the asthmatic model group (group B), the pcDNA3 plasmid group (group C), the pcDNA3-T-bet group (group D). All animals were sensitized and challenged with OVA, except group A normal saline was applied. The group C was intranasally administered 50 μg pcDNA3 plasmid at 24 h before intranasal challenges, and the 50 μg pcDNA3-T-bet plasmid for the mice of group D. We investigated Th1 and Th2 cell numbers by FACS and T-bet, GATA-3mRNA expression of spleen mononuclear cells (MNC) by semi-quantitative PCR in the four groups. [Result] Th1 percent in spleen MNC of pcDNA3-T-bet treated mice was significantly increased ([2.29±1.551% vs. [1.93±1.141%, P<0.05), while Th2 percent was significantly decreased ([0.93±0.64]% vs. [1.63±0.59]%), compared with that of the asthmatic control group mice by FACS. Spleen MNC was detected a high level of T-bet mRNA expression (0.53±0.027 vs. 0.28±0.035, P<0.05) and a low level of GATA-3 mRNA expression (0.24±0.022 vs. 0.58±0.038, P<0.05) after pcDNA3-T-bet treatment by RT-PCR. There was no significant change between the pcDNA3 plasmid group and the asthmatic model group. [Conclusion] The intranasal transfer of pcDNA3-T-bet plasmid was effective in modulating the imbalance of Th1/Th2 in mice asthma model, which provides a novel therapeutic strategy for transferring transcriptional factor in allergic asthma.

AIM: To investigate the effect of T-bet plasmid gene transfer to airway on allergen induced airway inflammation in a murine asthmatic model. METHODS: A mouse asthma model was established by sensitization with ovalbumin (OVA). Forty C57BL/6 mice were divided into 4 groups (10 mice in each group): the normal control group (group A), the asthmatic model group (group B), the pcDNA3 plasmid group (group C), and the pcDNA3-T-bet group (group D). The animals in group B, C and D were sensitized and challenged with OVA. The animals in group A were applied with normal saline. pcDNA3 plasmid at dose of 50 μg was intranasally administered at 24 h before intranasal challenges to the mice in group C, and the 50 μg pcDNA3-T-bet plasmid for the mice in group D. Bronchial alveolar lavage fluid (BALF) was collected and lung tissues were resected at 48 h after OVA challenge for later assay. RESULTS: After administration with pcDNA3-T-bet plasmid, high level of T-bet expression at 48 h was detected in the lung tissue by Western blotting. In pcDNA3-T-bet treated asthmatic models, histological evaluation revealed the significant suppression of eosinophil peribronchial and perivascular infiltration, and reduction of epithelial damage. The numbers of eosinophils, neutrophils and lymphocytes in BALF from pcDNA3-T-bet treated mice were significantly reduced compared to those in asthmatic control group (P<0.05). The level of IL-4 in BALF was significantly decreased in pcDNA3-T-bet group compared to that in asthmatic control group (P<0.05), while the level of IFN-γ in BALF was significantly increased in pcDNA3-T-bet group. No significant change of inflammation cells and cytokines in pcDNA3 plasmid group and asthmatic control group was observed (P>0.05). CONCLUSION: Intranasal pcDNA3-T-bet plasmid transfer inhibits asthmatic airway inflammation in the murine asthmatic model, suggesting a new therapeutic strategy for allergic asthma.