The glymphatic system (GS) is an essential waste clearance pathway in the central nervous system, playing a crucial role in the occurrence and progression of cerebrovascular diseases. In recent years, advancements in imaging techniques have provided important tools for assessing the structure and dynamics of the GS, further advancing its research in patients with cerebrovascular disease. This article reviews various imaging evaluation methods and clinical significance of GS in patients with cerebrovascular disease, aiming to provide a new perspective for a deeper understanding of the pathophysiological mechanisms and clinical practice of cerebrovascular disease.

Objective To investigate the preoperative prediction of the expression level of programmed cell death ligand 1(PD-L1)in non-small cell lung cancer(NSCLC)by a nomogram model constructed with clinical data,conventional CT signs and spectral CT parameters.Methods A retrospective analysis was conducted on 52 patients with pathologically confirmed NSCLC and undergoing preoperative spectral CT examination.The patients were categorized into positive and negative groups according to PD-L1 expression level,and their clinical data,conventional CT signs and spectral CT parameters were collected.Specifically,clinical data included gender,age,Ki-67 and tumor markers;conventional CT signs included tumor density,margins,calcification,spiculation,lobulation,pleural indentation and cavitation;and spectral CT parameters measured in the arterial and venous phases included effective atomic number(Eff-Z),iodine concentration(IC),water concentration(WC)and normalized iodine concentration(NIC).Intergroup differences were analyzed,and multivariate Logistic regression was used to identify independent predictors and establish the prediction model which was evaluated for prediction performance and accuracy using receiver operating characteristic(ROC)curves,calibration curve and decision curve analyses.Results For clinical data,only the difference in gender between two groups had statistical significance(P<0.05).The spectral CT parameters(IC,NIC and Eff-Z)in the arterial and venous phases of PD-L1 positive group were all greater than those of PD-L1 negative group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis identified gender(P=0.024),venous-phase Eff-Z(P=0.002),and venous-phase IC(P=0.003)as independent predictive factors for PD-L1 expression.The nomogram prediction model constructed with these independent predictors had an area under curve of 0.80,a sensitivity of 88.00%,and a specificity of 59.00%.The calibration curve showed that the predicted values had a high consistency with the actual values.The decision curve revealed that when the high-risk threshold was between 0.10 and 0.83,the model could achieve the maximum net benefit.Conclusion The nomogram model constructed with spectral CT parameters and clinical data has certain value in predicting the expression level of PD-L1 in NSCLC.

Objective To investigate the preoperative prediction of the expression level of programmed cell death ligand 1(PD-L1)in non-small cell lung cancer(NSCLC)by a nomogram model constructed with clinical data,conventional CT signs and spectral CT parameters.Methods A retrospective analysis was conducted on 52 patients with pathologically confirmed NSCLC and undergoing preoperative spectral CT examination.The patients were categorized into positive and negative groups according to PD-L1 expression level,and their clinical data,conventional CT signs and spectral CT parameters were collected.Specifically,clinical data included gender,age,Ki-67 and tumor markers;conventional CT signs included tumor density,margins,calcification,spiculation,lobulation,pleural indentation and cavitation;and spectral CT parameters measured in the arterial and venous phases included effective atomic number(Eff-Z),iodine concentration(IC),water concentration(WC)and normalized iodine concentration(NIC).Intergroup differences were analyzed,and multivariate Logistic regression was used to identify independent predictors and establish the prediction model which was evaluated for prediction performance and accuracy using receiver operating characteristic(ROC)curves,calibration curve and decision curve analyses.Results For clinical data,only the difference in gender between two groups had statistical significance(P<0.05).The spectral CT parameters(IC,NIC and Eff-Z)in the arterial and venous phases of PD-L1 positive group were all greater than those of PD-L1 negative group,with statistically significant differences(P<0.05).Multivariate Logistic regression analysis identified gender(P=0.024),venous-phase Eff-Z(P=0.002),and venous-phase IC(P=0.003)as independent predictive factors for PD-L1 expression.The nomogram prediction model constructed with these independent predictors had an area under curve of 0.80,a sensitivity of 88.00%,and a specificity of 59.00%.The calibration curve showed that the predicted values had a high consistency with the actual values.The decision curve revealed that when the high-risk threshold was between 0.10 and 0.83,the model could achieve the maximum net benefit.Conclusion The nomogram model constructed with spectral CT parameters and clinical data has certain value in predicting the expression level of PD-L1 in NSCLC.

Objective To design a mobile personnel radiation protection equipment for operation in environments with high radiation such as spent fuel reprocessing plants, to achieve simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol, to reduce the internal and external exposure dose of radioactive workers, and to meet the requirement of operation for two hours. Methods The core parts of the mobile personnel radiation protection equipment included a shielding chamber and a respiratory maintenance system. An automated chassis was used for the movement and lifting of the shielding chamber. MCNP software was used to simulate and calculate the protective effects of shielding chamber made of different materials and material thicknesses. Experimental verification of the shielding chamber design was conducted. Mathematical models were established to describe the variations in the content of various gases in the chamber with personnel operation time. A respiratory maintenance system, a harmful gas absorption device, and an automated mobile chassis were designed. Results The shielding chamber made of polyethylene with a thickness of 80 mm achieved an 80% neutron shielding rate. The respiratory maintenance system could support workers for 2 hours of operation inside the equipment. The mobile chassis allowed operation of the equipment with one person. Conclusion This mobile personnel radiation protection equipment can solve the problem in simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol. The equipment can provide radiation protection for radioactive workers, reduce exposure dose, and reduce personnel burden. This system provides technical means for the operation and maintenance of equipment in high-radiation sites such as spent fuel reprocessing plants.

Objective:To investigate the effects and the mechanism of Shendansanjie capsules on angiogenesis of colitis associated cancer(CAC) mice.Methods:Azoxymethane and dextran sulfact sodium were used to construct a mice model with CAC. Ten mice were divided into the normal group, model group, Shendan Sanjie capsule group, MK-2206 group, and Shendan Sanjie capsule + IGF-1 group, respectively. Immunohistochemistry was used to detect the microvessel density (MVD) in the colon tissue of each group of mice. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the mRNA levels of basic fibroblast growth factor (bFGF) and angiopoietin 2 (Ang2) in colon tissue. Western blot was used to detect the expressions of Akt, p-Akt, vascular endothelial growth factor A (VEGFA), hypoxia-inducible factor-1α (HIF-1α).Results:The number of MVD in the colon tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group, Shendan Sanjie capsule + IGF-1 group were 63.3±3.3, 36.6±2.3, 36.6±2.2, 50.3±2.5, significantly higher than 2.0±0.1 in the normal group ( P<0.05). The number of MVD in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group are lower than that in model group ( P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie Capsule group ( P<0.05). The relative expressions of bFGF mRNA in the colon cancer tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were 4.55±0.31, 2.46±0.37, 2.49±0.33, 3.34±0.21, respectively, and the relative mRNA expressions of Ang2 were 5.78±0.19, 2.21±0.14, 2.26±0.17 and 3.67±0.32, respectively, which were significantly higher than 1.01±0.05 and 0.99±0.07 in the normal group ( P<0.05). The mRNA levels of bFGF and Ang2 in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were lower than those in the model group ( P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie capsule group ( P<0.05). The relative expression levels of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues of the model group were 4.75±0.18, 4.64±0.22 and 4.84±0.12, respectively, which were significantly higher than 1.01±0.07, 0.95± 0.08 and 0.98±0.05 in the normal group ( P<0.05). The relative expressions of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues in the Shendan Sanjie capsule group were 2.24±0.22, 3.15±0.26 and 2.07±0.18, respectively, which were significantly lower than those in the model group ( P<0.05). However, compared with the MK-2206 group, the difference was not statistically significant ( P>0.05). The relative expression levels p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissue of the Shendan Sanjie capsule+ IGF-1 group were 3.37±0.15, 4.02±0.11, 3.52±0.24, respectively, which were significantly higher than those in the Shendan Sanjie capsule group ( P<0.05). Conclusion:Shendan Sanjie capsules may inhibit Akt/HIF-1α/VEGFA signaling pathway, and then reduce the expression of microvascular growth factors bFGF and Ang2, thereby inhibit the tumor angiogenesis of CAC.

Objective:To investigate the effects and the mechanism of Shendansanjie capsules on angiogenesis of colitis associated cancer(CAC) mice.Methods:Azoxymethane and dextran sulfact sodium were used to construct a mice model with CAC. Ten mice were divided into the normal group, model group, Shendan Sanjie capsule group, MK-2206 group, and Shendan Sanjie capsule + IGF-1 group, respectively. Immunohistochemistry was used to detect the microvessel density (MVD) in the colon tissue of each group of mice. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the mRNA levels of basic fibroblast growth factor (bFGF) and angiopoietin 2 (Ang2) in colon tissue. Western blot was used to detect the expressions of Akt, p-Akt, vascular endothelial growth factor A (VEGFA), hypoxia-inducible factor-1α (HIF-1α).Results:The number of MVD in the colon tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group, Shendan Sanjie capsule + IGF-1 group were 63.3±3.3, 36.6±2.3, 36.6±2.2, 50.3±2.5, significantly higher than 2.0±0.1 in the normal group ( P<0.05). The number of MVD in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group are lower than that in model group ( P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie Capsule group ( P<0.05). The relative expressions of bFGF mRNA in the colon cancer tissue of mice in the model group, Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were 4.55±0.31, 2.46±0.37, 2.49±0.33, 3.34±0.21, respectively, and the relative mRNA expressions of Ang2 were 5.78±0.19, 2.21±0.14, 2.26±0.17 and 3.67±0.32, respectively, which were significantly higher than 1.01±0.05 and 0.99±0.07 in the normal group ( P<0.05). The mRNA levels of bFGF and Ang2 in Shendan Sanjie capsule group, MK-2206 group and Shendan Sanjie capsule+ IGF-1 group were lower than those in the model group ( P<0.05), while Shendan Sanjie capsule+ IGF-1 group is higher than Shendan Sanjie capsule group ( P<0.05). The relative expression levels of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues of the model group were 4.75±0.18, 4.64±0.22 and 4.84±0.12, respectively, which were significantly higher than 1.01±0.07, 0.95± 0.08 and 0.98±0.05 in the normal group ( P<0.05). The relative expressions of p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissues in the Shendan Sanjie capsule group were 2.24±0.22, 3.15±0.26 and 2.07±0.18, respectively, which were significantly lower than those in the model group ( P<0.05). However, compared with the MK-2206 group, the difference was not statistically significant ( P>0.05). The relative expression levels p-Akt/Akt, VEGFA and HIF-1α in colon cancer tissue of the Shendan Sanjie capsule+ IGF-1 group were 3.37±0.15, 4.02±0.11, 3.52±0.24, respectively, which were significantly higher than those in the Shendan Sanjie capsule group ( P<0.05). Conclusion:Shendan Sanjie capsules may inhibit Akt/HIF-1α/VEGFA signaling pathway, and then reduce the expression of microvascular growth factors bFGF and Ang2, thereby inhibit the tumor angiogenesis of CAC.

Objective: To explore the correlation between microdamage in white matter and radiotherapy dose at early stage after radiotherapy (RT) in patients with nasopharyngeal carcinoma (NPC). Methods: Thirty-three patients who were initially diagnosed with NPC were recruited and received diffusion tensor imaging (DTI) scan and neuro-cognitive scale test within 1 week before RT and the first day after RT. DTI-related characteristic parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ_‖), and radial diffusivity (λ_⊥) were calculated based on whole-brain voxel analysis method. Paired t-test was conducted to evaluate statistical significance between pre-RT and post-RT groups. In the subgroup analysis, all the subjects were divided into 3 groups according to the average dose of temporal lobe, and each group was set with an equal dose interval range. The DTI-related parameters of whole brain pre-RT and post-RT in each group were statistically compared. All the statistical results were corrected by FDR with a threshold of P<0.05 and clusters>100. Results: FA, MD, λ_‖ and λ_⊥in the post-RT group significantly differed compared with those in the pre-RT group (P<0.05). The values of FA, MD, λ_‖ and λ_⊥were 0.455±0.016, (9.893±0.403)×10^-4, (13.441±0.412)×10^-4 and (8.231±0.429)×10^-4, respectively. Subgroup analysis showed that the extent and degree of λ_‖ and λ_⊥ changes were exacerbated with the increase of the average dose of temporal lobe after RT. Particularly in high-dose group, the average dose range was 25-35 Gy and the extent of regions with significant changes was significantly larger than those in the medium-dose (15-25 Gy) and low-dose groups (5-15 Gy)(P<0.05). Conclusions DTI can be utilized to detect" normal" brain tissue microdamage in NPC patients at early stage after RT. The average radiation dose of temporal lobe may be one of the reasons for the severity of cerebral microdamage. In the future, DTI technique may be useful for guiding exposure dose of organs at risk during RT planning and to evaluate the cohort with a high risk of cerebral microdamage at early stage after RT, thereby protecting normal cerebral tissues to the maximum extent.

Objective To explore the state of cardiac autonomic nerve function in schizophrenia patients with metabolic syndrome and analyze its influence factors and to reduce the occurrence of sudden cardiac death of the patients. Methods A total of 168 cases of patients according with the ICD-10 schizophrenia diagnostic criteria were divided into group A(78 cases of schizophrenia with metabolic syndrome),group B(90 cases of schizophre-nia without metabolic syndrome)and another 92 normal cases were included as control group(group C). Twenty-four hours dynamic electrocardiogram was conducted respectively and the heart rate variability (HRV) was ana-lyzed. Results Values of LF,HF,SDNN,SDANN,RMSSD and PNN50 in group A and group B were much low-er than those in group C and they were statistically significant(P < 0.05). Values of LF,HF,SDNN,SDANN, RMSSD and PNN50 in group B were much higher than those in group A and they were statistically significant(P<0.05). Excluding the influence of schizophrenia ,logistic regression analysis showed that the influence factors of HRV values were course of the disease(OR = 1.864,95%CI 1.110~3.128),age(OR = 1.170,95%CI 1.018~2.491),types of antipsychotic drugs(OR=2.419,95%CI 0.976~1.835),abdominal obesity(OR=2.425,95%CI 1.347~4.366),blood pressure value(OR=1.263,95%CI 1.575~3.937),blood glucose value(OR=3.376, 95%CI 1.359~2.923)and blood lipid value(OR = 2.178,95%CI 1.492~6.756). Conclusions Schizophrenia patients with metabolic syndrome have obvious cardiac autonomic nerve dysfunction. Excluding the influence of schizophrenia itself,the other possible risk factors include course of the disease,age,types of antipsychotic drugs,abdominal obesity,blood pressure value,blood glucose value and blood lipid value.

Objective To probe into possibilities and sensitivity of CCD video camera system in the assessment of balance function.Methods The system is composed of a CCD video camera,a video image capture board and analysis software.Three indexes:Trunks,ayAngle (TSS Trunk Sway Speed(TSS) and fall index (FI).the normal group:FI≥I; mild group:0.7≤FI＜I; moderate group:0.4≤FI＜0.7; severe group:FI ＜0.4.Disorder of balance function group:42 patients with cerebrovascular accident,mean age of (67.4±8.0) years.Control group:42 healthy subjects,mean age of (65.3±6.5) years.All cases were measured by Berg balance scale and determinated three times by CCD video camera system with eye opening (eo) and eye closing(ec),and averaged.Results There were very significant differences in TSAeo,TSAec,TSSeo,TSSec,FIeo,FIec between disorder of balance function group and control group (P＜0.01).as well as Berg balance scale (P＜0.05).In disorder of balance function group,the differences among three groups were significant in TSAeo,TSAec,TSSeo,TSSec (P＜0.05).There were significant differences in TSAeo,TSAec,TSSeo,TSSec between severe group and mild group (P＜0.01) as well as in Berg balance scale (P＜0.05).Conclusions CCD video camera system has a higher sensitivity in assessment of body,balance than Berg balance sca land great value in clinical application.

BACKGROUND: Chinese medicine Gukang prescription has a clear effect on clinical treatment of osteoporosis, but the therapeutic pathway is stil unclear.
OBJECTIVE:To investigate the effects of Chinese medicine Gukang on the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin by regulating core binding factor alpha 1 expression to control the growth and development of osteoblasts.
METHODS:Sprague-Dawley neonatal rats within 24 hours after delivery were used for the separation and culture of osteoblasts. Adult Sprague-Dawley rats were used to prepare drug-containing serum, and then divided into two groups randomly:normal control group and Gukang group. Rats in the normal control and Gukang groups were intragastrical y administrated with extract of Gukang prescription and normal saline based on rat’s body surface area, for 1 consecutive week. Two hours after the last administration, blood samples were taken from the heart. Then the serum was col ected. Osteoblasts at passage 3 were confirmed with alkaline phosphatase assay and digested. After counting and planting, al osteoblasts were divided into two groups and treated with col ected
serum for 72 hours. Proliferative rate of osteoblasts was detected by using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide test. Secretion of alkaline phosphatase was detected by using enzyme linked immunosorbent assay and corrected with the corresponding absorbance value. mRNA expression of core binding factor alpha 1, receptor activator of nuclear factor kappa B ligand and osteoprotegerin were detected by using reverse
transcription-PCR in al groups.
RESULTS AND CONCLUSION:mRNA expression of osteoprotegerin and core binding factor alpha 1 in the Gukang group was significantly higher than that in the normal control group, but protein and mRNA expression of receptor
activator of nuclear factor kappa B ligand were dramatical y lower in the Gukang group compared with the normal control group (P<0.01). These findings indicate that Chinese medicine Gukang prescription can modulate the expression of
core binding factor alpha 1, thereby adjusting the expression of receptor activator of nuclear factor kappa B ligand and osteoprotegerin, which may be one of the mechanisms underlying Gukang treatment for osteoporosis.