Objective:To study the relationship between urinary arsenic methylation metabolism patterns and skin keratinization and pigmentation abnormalities in population exposed to arsenic through drinking water.Methods:Using a cross-sectional study method, a survey on endemic arsenic poisoning was conducted among permanent residents of drinking water endemic arsenic poisoning areas in Bayannur City, Inner Mongolia Autonomous Region in 2004 (before water improvement). In 2017 (after water improvement), 71 arsenic exposed individuals were followed up as survey subjects. According to the "Diagnosis of Endemic Arsenism" (WS/T 211-2015), the clinical grading of skin injuries (skin keratinization, pigmentation abnormalities) in the survey subjects was evaluated. Urine samples were collected for detection of arsenic methylation metabolite levels by high-performance liquid chromatography inductively coupled plasma mass spectrometry and calibrated with urinary creatinine. The changes and amplitudes of urinary arsenic methylation indicators before and after water improvement were calculated and analyzed according to the outcome of skin keratinization and pigmentation abnormalities which were divided into reduced, unchanged, and added groups.Results:(1) The changes in urinary total arsenic (TAs), inorganic arsenic (iAs), monomethyl arsenic (MMA), and dimethyl arsenic (DMA) levels in different outcome groups of skin keratinization were compared, and the differences were statistically significant ( H = 9.08, 8.77, 9.28, 8.57, P < 0.05). The changes in urinary TAs, iAs, MMA, DMA levels, iAs percentage (iAs%), DMA percentage (DMA%), and primary methylation index (PMI) in different outcome groups of skin pigmentation abnormalities were compared, and the differences were statistically significant ( H = 8.04, 10.67, 8.29, 9.14, 6.30, 9.10, 7.20, P < 0.05). (2) The comparison of amplitudes in urinary TAs, iAs, MMA, and DMA levels in different outcome groups of skin keratinization showed statistically significant differences ( H = 6.92, 7.34, 6.66, 6.16, P < 0.05). The amplitudes in urinary iAs level, iAs%, DMA%, and PMI in different outcome groups of skin pigmentation abnormalities were compared, and the differences were statistically significant ( H = 7.94, 7.61, 9.95, 7.22, P < 0.05). Conclusion:The changes pattern of urinary TAs, iAs, MMA, DMA, iAs%, DMA%, and PMI in population exposed to arsenic through drinking water is related to the transformation of skin keratinization and pigmentation abnormalities.

Purpose To explore the application value of auto-prescription technique in CT portal venography and liver volume measurement.Materials and Methods A total of 180 patients who underwent contrast-enhanced abdominal CT in the First Affiliated Hospital of Dalian Medical University from April to November 2022 were prospectively collected and randomly divided into two groups,with 90 cases in each group.Group A(experimental group)was scanned with auto-prescription technique.Group B(conventional group)was scanned with 120 kVp,and the other imaging parameters kept the same as group A.In group A,the correlation between body mass index and tube voltage(kVp)recommended by auto-prescription technique was analyzed.The following values were compared between group A and group B,including the volume CT dose index,dose length product,CT value of portal vein and liver,standard deviation,contrast-to-noise ratio(CNR),image quality and subjective score of automatic segmentation.The liver volumes of group A and B were measured by Liver Segmentation software.The volumes measured by automatic segmentation software(Vsoft)were recorded,and then were compared with those segmented manually(gold standard)(Vstnd).Results Compared with group B,the volume CT dose index and dose length product in group A decreased by 22%and 25%(t=-4.654,-5.403,both P<0.05),respectively.The CT value and CNR of portal vein and liver in group A were higher than those in group B(t=4.857-6.011,all P<0.05).There was no significant difference in standard deviation,Vstnd and Vsoft between group A and group B(P>0.05).The consistency of subjective scores between the two observers was good(ICC=0.773-0.856,all P<0.05).The subjective scores of two-dimensional and three-dimensional images,as well as the automatic software segmentation scores in group A were higher than those in group B(Z=897.500,1 287.500,912.721,all P<0.05).The recommended kVp value in group A was positively correlated with body mass index(r=0.674,P<0.001).Conclusion The application of auto-prescription technique in CT portal venography can ensure the image quality,measure the liver volume accurately,and reduce the patient's radiation dose individually.

Objective To explore the feasibility of spectral CT material decomposition technique Ca(Iodine)for opportunistic osteoporo-sis screening in enhanced scanning.Methods A total of 314 patients who underwent abdominal enhancement were selected.They were divided into group A and group B according to gender,and the groups were divided into three subgroups according to age(18-45 years,46-60 years,>60 years).The bone mineral density(BMD)values of L1-L3 vertebral were measured in the unenhanced images using quan-titative computed tomography(QCT)software,and Ca(Iodine)values were measured on three enhancement phases Ca(Iodine)based substance images.Pearson correlation analysis was performed between iodine intake and Ca(Iodine)values in three enhancement phases,Ca(Iodine)values and quantitative computed tomography bone mineral density(BMDQCT),and the diagnostic efficacy was analyzed.Results There was no significant difference in the Ca(Iodine)values of L1-L3 vertebral in three enhancement phases(F=0.001-0.018,P>0.05);there was no correlation between the Ca(Iodine)values of L1-L3 vertebral in three enhancement phases and iodine intake(r=0.073-0.105,P>0.05).Six groups of measured Ca(Iodine)values and BMDQCT both had a strong positive correlation(r=0.901-0.954,P<0.05).The Ca(Iodine)cutoff values for the diagnosis of osteoporosis and osteopenia were 830.41(2 mg/cm3)and 849.32(2 mg/cm3)respectively,with corresponding area under the curve(AUC)of 0.969[95%confidence interval(CI)0.943-0.985]and 0.973(95%CI 0.944-0.989),respectively.There were statistically significant differences in Ca(Iodine)values and BMDQCT in the>60 years age group between different genders(t=3.081-3.091,P<0.05).Conclusion Spectral CT material decomposition technique can be used for oppor-tunistic osteoporosis screening in enhanced scanning,with good diagnostic performance,which provides a new perspective for the clin-ical diagnosis of osteoporosis.

Objective To develop an automated bone mineral density(BMD)assessment model based on proximal femur images from abdomen-pelvic CT scans and to analyze its application value in opportunistic osteoporosis(OP)screening.Methods A retrospective selection was conducted on 351 patients who underwent abdomen-pelvic plain CT examination.The patients were randomly divided into training set(n=245)and test set(n=106)in a ratio of 7∶3.All images were transferred to a quantitative computed tomography(QCT)post-processing workstation to measure the BMD of the left proximal femur.According to the QCT BMD T-score,the patients were divided into osteoporosis(T-score-2.5),osteopenia(-2.5＜T-score＜-1)and normal bone density(T-score≥-1).The left proximal femur was dissected using an automatic segmentation model,and two three-class BMD assessment radiomics models were constructed using random forest(RF)and logistic regression(LR)classifiers,respectively.The receiver operating characteristic(ROC)curves were generated,and the area under the curve(AUC),sensitivity,specificity and other metrics were calculated to evaluate the diagnostic performance of the two models.The DeLong test was used to compare differences between the models.Results In the test set,the AUC of the RF and LR models for identifying osteoporosis were 0.953 and 0.954,respectively.The AUC for identifying osteopenia were 0.894 and 0.870,and the AUC for identifying normal bone density were 0.975 and 0.982,respectively.The comparison of model performance showed no statistically significant differences between the RF and LR models in identifying the three bone states in both the training and test sets(P＞0.05).Conclusion Both the RF and LR radiomics models,constructed based on abdomen-pelvic plain CT scans,can be used for opportunistic BMD screening with high diagnostic efficiency.

Objective To investigate the relationship between serum levels of tumor necrosis factor-related protein 5(CTRP5),fibronectin-3(Ficolin-3),and CXC chemokine ligand 12(CXCL12)and microvascular lesions in patients with type 2 diabetes mellitus(T2DM).Methods A total of 75 patients with T2DM microangiopathy admitted to the Seventh People's Hos-pital of Zhengzhou from January 2023 to June 2024 were selected as the observation group.At the same time,150 T2DM pa-tients without microangiopathy were included as the control group according to the principle of 1∶2 matching of age,gender and body mass index(BMI).The general information,blood glucose indicators,Homa-insulin resistance(HOMA-IR),and serum CTRP5,Ficolin-3,and CXCL12 levels of the two groups were statistically analyzed by hospital medical staff.The Logistic re-gression equation was used to analyze the influencing factors of the onset of microvascular lesions in T2DM.The relationship be-tween the levels of serum CTRP5,Ficolin-3,and CXCL12 and microvascular lesions in T2DM was analyzed using smooth curve fitting method.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the pre-dictive value of serum CTRP5,Ficolin-3,and CXCL12 for T2DM microvascular lesions.Results There were no significant differences in gender,age,BMI,duration of T2DM,abdominal circumference,DBP,SBP,TC,HDL-C,TG,LDL-C,smoking his-tory and drinking history between the two groups(all P＞0.05).FPG,2hPG,HbA1c and HOMA-IR in the observation group were significantly higher than in the control group(all P＜0.05).The serum levels of CTRP5,Ficolin-3 and CXCL12 in the ob-servation group were significantly higher than in the control group(all P＜0.05).Logistic regression analysis showed that FPG,2hPG,HbA1c,HOMA-IR,CTRP5,Ficolin-3 and CXCL12 were the influencing factors of T2DM microangiopathy(all P＜0.05).After adjusting for FPG,2hPG,HbA1c,HOMA-IR and other confounding factors,the relationship between serum Fico-lin-3,CTRP5,CXCL12 and T2DM microangiopathy was analyzed by curve fitting,the results showed that serum Ficolin-3,CTRP5,CXCL12 were linearly positively correlated with T2DM microangiopathy,with the increase of their levels,the risk of T2DM microangiopathy increased.The ROC curve showed that the AUC of serum Ficolin-3,CTRP5 and CXCL12 levels in pre-dicting T2DM microvascular lesions was 0.756,0.761 and 0.791,respectively.The AUC of combined prediction was 0.931,and the sensitivity and specificity were 90.67％and 80.00％,respectively.Delong test showed that the AUC of combined prediction was significantly greater than that of single prediction(Z=32.123,P＜0.01).Conclusion The changes in serum levels of CTRP5,Ficolin-3,and CXCL12 are closely related to microvascular lesions in patients with T2DM,providing a reference for ear-ly clinical prediction and evaluation of microvascular lesions in patients with T2DM,as well as for the development of corre-sponding intervention strategies.

Purpose To explore the application value of auto-prescription technique in CT portal venography and liver volume measurement.Materials and Methods A total of 180 patients who underwent contrast-enhanced abdominal CT in the First Affiliated Hospital of Dalian Medical University from April to November 2022 were prospectively collected and randomly divided into two groups,with 90 cases in each group.Group A(experimental group)was scanned with auto-prescription technique.Group B(conventional group)was scanned with 120 kVp,and the other imaging parameters kept the same as group A.In group A,the correlation between body mass index and tube voltage(kVp)recommended by auto-prescription technique was analyzed.The following values were compared between group A and group B,including the volume CT dose index,dose length product,CT value of portal vein and liver,standard deviation,contrast-to-noise ratio(CNR),image quality and subjective score of automatic segmentation.The liver volumes of group A and B were measured by Liver Segmentation software.The volumes measured by automatic segmentation software(Vsoft)were recorded,and then were compared with those segmented manually(gold standard)(Vstnd).Results Compared with group B,the volume CT dose index and dose length product in group A decreased by 22%and 25%(t=-4.654,-5.403,both P<0.05),respectively.The CT value and CNR of portal vein and liver in group A were higher than those in group B(t=4.857-6.011,all P<0.05).There was no significant difference in standard deviation,Vstnd and Vsoft between group A and group B(P>0.05).The consistency of subjective scores between the two observers was good(ICC=0.773-0.856,all P<0.05).The subjective scores of two-dimensional and three-dimensional images,as well as the automatic software segmentation scores in group A were higher than those in group B(Z=897.500,1 287.500,912.721,all P<0.05).The recommended kVp value in group A was positively correlated with body mass index(r=0.674,P<0.001).Conclusion The application of auto-prescription technique in CT portal venography can ensure the image quality,measure the liver volume accurately,and reduce the patient's radiation dose individually.

Objective To investigate the relationship between serum levels of tumor necrosis factor-related protein 5(CTRP5),fibronectin-3(Ficolin-3),and CXC chemokine ligand 12(CXCL12)and microvascular lesions in patients with type 2 diabetes mellitus(T2DM).Methods A total of 75 patients with T2DM microangiopathy admitted to the Seventh People's Hos-pital of Zhengzhou from January 2023 to June 2024 were selected as the observation group.At the same time,150 T2DM pa-tients without microangiopathy were included as the control group according to the principle of 1∶2 matching of age,gender and body mass index(BMI).The general information,blood glucose indicators,Homa-insulin resistance(HOMA-IR),and serum CTRP5,Ficolin-3,and CXCL12 levels of the two groups were statistically analyzed by hospital medical staff.The Logistic re-gression equation was used to analyze the influencing factors of the onset of microvascular lesions in T2DM.The relationship be-tween the levels of serum CTRP5,Ficolin-3,and CXCL12 and microvascular lesions in T2DM was analyzed using smooth curve fitting method.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the pre-dictive value of serum CTRP5,Ficolin-3,and CXCL12 for T2DM microvascular lesions.Results There were no significant differences in gender,age,BMI,duration of T2DM,abdominal circumference,DBP,SBP,TC,HDL-C,TG,LDL-C,smoking his-tory and drinking history between the two groups(all P＞0.05).FPG,2hPG,HbA1c and HOMA-IR in the observation group were significantly higher than in the control group(all P＜0.05).The serum levels of CTRP5,Ficolin-3 and CXCL12 in the ob-servation group were significantly higher than in the control group(all P＜0.05).Logistic regression analysis showed that FPG,2hPG,HbA1c,HOMA-IR,CTRP5,Ficolin-3 and CXCL12 were the influencing factors of T2DM microangiopathy(all P＜0.05).After adjusting for FPG,2hPG,HbA1c,HOMA-IR and other confounding factors,the relationship between serum Fico-lin-3,CTRP5,CXCL12 and T2DM microangiopathy was analyzed by curve fitting,the results showed that serum Ficolin-3,CTRP5,CXCL12 were linearly positively correlated with T2DM microangiopathy,with the increase of their levels,the risk of T2DM microangiopathy increased.The ROC curve showed that the AUC of serum Ficolin-3,CTRP5 and CXCL12 levels in pre-dicting T2DM microvascular lesions was 0.756,0.761 and 0.791,respectively.The AUC of combined prediction was 0.931,and the sensitivity and specificity were 90.67％and 80.00％,respectively.Delong test showed that the AUC of combined prediction was significantly greater than that of single prediction(Z=32.123,P＜0.01).Conclusion The changes in serum levels of CTRP5,Ficolin-3,and CXCL12 are closely related to microvascular lesions in patients with T2DM,providing a reference for ear-ly clinical prediction and evaluation of microvascular lesions in patients with T2DM,as well as for the development of corre-sponding intervention strategies.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.

Background: Nasopharyngeal carcinoma (NPC) is characterized by high programmed death-ligand 1 (PD-L1) expression and abundant infiltration of non-malignant lymphocytes, which renders patients potentially suitable candidates for immune checkpoint blockade therapies. Palate, lung, and nasal epithelium clone (PLUNC) inhibit the growth of NPC cells and enhance cellular apoptosis and differentiation. Currently, the relationship between PLUNC (as a tumor-suppressor) and PD-L1 in NPC is unclear. Methods: We collected clinical samples of NPC to verify the relationship between PLUNC and PD-L1. PLUNC plasmid was transfected into NPC cells, and the variation of PD-L1 was verified by western blot and immunofluorescence. In NPC cells, we verified the relationship of PD-L1, activating transcription factor 3 (ATF3), and β-catenin by western blot and immunofluorescence. Later, we further verified that PLUNC regulates PD-L1 through β-catenin. Finally, the effect of PLUNC on β-catenin was verified by co-immunoprecipitation (Co-IP). Results: We found that PLUNC expression was lower in NPC tissues than in paracancer tissues. PD-L1 expression was opposite to that of PLUNC. Western blot and immunofluorescence showed that β-catenin could upregulate ATF3 and PD-L1, while PLUNC could downregulate ATF3/PD-L1 by inhibiting the expression of β-catenin. PLUNC inhibits the entry of β-catenin into the nucleus. Co-IP experiments demonstrated that PLUNC inhibited the interaction of DEAD-box helicase 17 (DDX17) and β-catenin. Conclusions PLUNC downregulates the expression of PD-L1 by inhibiting the interaction of DDX17/β-catenin in NPC.