Objective To observe the value of shear wave viscoelastography(SWV)for differentiating lung peripheral inflammatory masses and malignant tumors.Methods Conventional gray-scale ultrasound and SWV were prospectively performed in 70 patients with lung peripheral inflammatory mass or malignant tumor.The patients were divided into malignant group(n=42)and inflammatory group(n=28)according to pathological results.Clinical and ultrasonic data,including the maximum diameter of lesions,the mean Young's modulus(Emean),mean viscosity(Vmean),and mean dispersion slope(Dmean)were compared between groups.Receiver operating characteristic curves of ultrasonic parameters being significantly different between groups were drawn,and area under the curves(AUCs)were calculated to evaluate the efficacy of each parameter for differentiating lung peripheral inflammatory mass or malignant tumor.Results In malignant group,the maximum diameter and Emean of lesions were both higher,while Vmean and Dmean of lesions were both lower than those in inflammatory group(all P＜0.05).Vmean and Dmean of lesions had moderately/good efficacy for differentiating lung peripheral inflammatory mass or malignant tumor(AUC=0.843,0.866),both better than that of conventional ultrasound and Emean(AUC=0.673,0.685)(all P＜0.05).The combination of Emean,Vmean and Dmean had good efficacy for differentiating lung peripheral inflammatory masses and malignant tumors,with AUC of 0.874.Conclusion The viscous parameters of SWV could effectively differentiating lung peripheral inflammatory masses and malignant tumors.

Objective To investigate how the immune status,inflammatory factors,and nervous function of coma patients with severe traumatic brain injury(sTBI)were impacted by early personalized enteral nutrition support in combination with An'gong Niuhuang pill.Methods A total of 80 patients with sTBI admitted to the First Central Hospital of Baoding from July 2020 to June 2023 were selected as the study objects.The patients were divided into control group and observation group according to different treatment methods,with 40 cases in each group.The control group received early individualized nutritional support treatment,and the observation group was supplemented with one An'gong Niuhuang pill daily(3 g per pill)based on the above nutritional support.Each group underwent a 7-day treatment regimen.Serum immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM)and lymphocyte subsets were collected at 1,3 and 7 days after treatment,as well as serum levels of interleukin-6(IL-6),neutrophil count(NEUT)and lymphocyte count(LYM)before and 7 days after treatment,neutrophil/lmphocyte ratio(NLR)was calculated,and the change of nerve function was observed.Results ①Complement and immunoglobulin:the level of complement C4 in the observation group was significantly lower than that in the control group 3 days after treatment(g/L:0.2±0.1 vs.0.3±0.1,P<0.05),and the level of complement C3,IgA,IgG and IgM were significantly higher than that in the control group 7 days after treatment[C3(g/L):1.2±0.2 vs.0.9±0.2,IgA(g/L):2.7±0.8 vs.2.0±0.6,IgG(g/L):9.3±1.2 vs.8.0±1.0,IgM(g/L):1.2±0.4 vs.0.7±0.3,all P<0.05].②Lymphocyte subsets:the levels of CD8+T and natural killer cell(NK cell)in the observation group were significantly lower than those in the control group at 3 days after treatment(CD8+T:0.20±0.05 vs.0.25±0.06,NK cell:0.16±0.10 vs.0.22±0.03,both P<0.05),the levels of CD3+T and CD4+T in the observation group were significantly higher than those in the control group 7 days after treatment(CD3+T:0.76±0.07 vs.0.71±0.01,CD4+T:0.48±0.05 vs.0.41±0.07,both P<0.05),NK cell levels continued to decrease compared with control group(0.12±0.05 vs.0.17±0.02,P<0.05).③Inflammation index and blood routine index:after 7 days of treatment,IL-6 and NLR levels in both groups were significantly decreased compared with those before treatment,and the decrease was more significant in the observation group[IL-6(ng/L):26.4(15.3,38.4)vs.42.9(30.7,58.8),NLR:5.7±2.5 vs.9.1±5.0,both P<0.01],the level of LYM in both groups after treatment was significantly lower than that before treatment,but the level of LYM in the observation group was significantly higher than that in the control group after treatment(×109/L:1.6±0.4 vs.1.1±0.5,P<0.05).④GCS score:7 days after treatment,the GCS score of both groups was significantly higher than before treatment,but the GCS score of the observation group was significantly higher than that of the control group(6.8±2.7 vs.5.6±2.1,P<0.05).Conclusion Treatment with An'gong Niuhuang pill based on early individualized enteral nutrition support can effectively reduce the inflammatory response of patients with sTBI,enhance the body fluid and cellular immune function,and help to improve the neurological function.

Aural vertigo frequently encountered in the otolaryngology department of traditional Chinese medicine （TCM） mainly involves peripheral vestibular diseases of Western medicine， such as Meniere's disease， benign paroxysmal positional vertigo， vestibular neuritis， and vestibular migraine， being a hot research topic in both TCM and Western medicine. Western medical therapies alone have unsatisfactory effects on recurrent aural vertigo， aural vertigo affecting the quality of life， aural vertigo not relieved after surgery， aural vertigo with complex causes， and children's aural vertigo. The literature records and clinical practice have proven that TCM demonstrates unique advantages in the treatment of aural vertigo. The China Association of Chinese medicine sponsored the "17th youth salon on the diseases responding specifically to TCM： Aural vertigo" and invited vertigo experts of TCM and Western medicine to discuss the difficulties and advantages of TCM diagnosis and treatment of aural vertigo. The experts deeply discussed the achievements and contributions of TCM and Western medicine in the diagnosis and treatment of aural vertigo， the control and mitigation of the symptoms， and the solutions to disease recurrence. The discussion clarified the positioning and advantages of TCM treatment and provided guidance for clinical and basic research on aural vertigo.

Interleukins (ILs) and associated cytokines serve as the means of communication for immune cells and non-immune cells. The use of ILs in harnessing the immune system to cancer treatment has been a promising approach. ILs not only nurture an environment enabling cancer growth but also simultaneously trigger a productive tumor-directed immune response. These properties of ILs are increasingly being explored as a strategy to improve the outcomes of cancer. Here, we describe recently innovative technological approaches that have been developed to improve the pharmacokinetics, safety, and efficacies of IL-2, 15, 10, and 18 in the treatment of melanoma. Furthermore, the combination of ILs and immune checkpoint inhibition may synergize to reshape the tumor environment, thus yielding better clinical benefits in the future.
Cytokines ; Humans ; Interleukins ; Melanoma/drug therapy*

【Objective】 To compare the enhancement effects of lean body weight （LBW） and total body weight （TBW） as indexes to calculate the contrast agent dosage under the condition of energy spectrum CT scanning. 【Methods】 A total of 218 patients who received liver enhancement CT from November 2018 to January 2019 were enrolled in this study. There were 101 patients in LBW group and 117 patients in TBW group. Both groups were scanned by energy spectrum CT， and the parameters of scanning and reconstruction were identical. The contrast agent dose was 500 mgI/kg （LBW） in LBW group and 450 mgI/kg （TBW） in TBW group， and the injection rate was 2.8 mL/s. Images were transferred to a GE AW4.7 workstation and the 50 keV monochromatic images were analyzed. We compared the dosage of contrast medium， CT value of aorta in arterial phase （HU-aorta）， hepatic enhancement CT value in venous phase （-liver）， the rate of reaching the enhancement standard and variability in the two groups. 【Results】 Compared with TBW group， LBW group had lower contrast agent dosage， HU-aorta and ∆-liver （P<0.05）， LBW and TBW group had no statistically different enhanced rate of HU-aorta as （91.09% vs. 90.60%） or ∆-liver （92.08% vs. 88.89%） （P>0.05）. The variation rate of HU-aorta and ∆-liver in LBW group was lower than that in TBW group. Using LBW as an index to calculate the dosage of liver enhanced CT also made the enhancement of liver parenchyma more consistent in different patients. 【Conclusion】 Even on the premise of energy spectrum CT scanning， using LBW-based contrast injection in liver enhanced CT can not only reduce contrast dose， but also make the enhancement in liver parenchyma more consistent among different patients.

Objective:To find out the optimal ratio of tip projection to nasal length for Chinese in order to help doctors to reduce the dissatisfactory rate of rhinoplasty.Methods:The authors retrospectively reviewed the records of patients with rhinoplasty from June 2015 to June 2018. The patients were classified into satisfactory, underprojected and overprojected groups. The average, maximum, minimum of tip projection (TP), nasal length (NL) and TP/NL, median of TP/NL of each group were measured. The results were used in later patients to assess their efficacy by comparing the dissatisfactory rates of patients before and after June 2018.Results:In satisfactory group, the mean of TP/NL was 0.63 with minimum 0.56, maximum 0.69, and median 0.64 in primary cases, while the mean of TP/NL was 0.63 with minimum 0.52, maximum 0.75, and median 0.64 in secondary cases. In underprojected group, the mean of TP/NL was 0.60 with median 0.58. In overprojected group, the mean of TP/NL was 0.64 with median 0.65. The dissatisfactory rates of patients before and after June 2018 were 8% and 2.2%, respectively ( P>0.05). Conclusions:The optimal ratio of tip projection to nasal length for Chinese is near 0.63-0.64. Combined with the desire of patient, it is possible for doctors to satisfy the patients by controlling tip projections between 2.5 cm to 2.8 cm.

Objective:To assess the possibility of allogenic decalcified bone matrix used as material to rebuild the midline structure in rhinoplasty.Methods:From January 2018 to June 2018, allogenic decalcified bone matrix was used as material to rebuild the midline structure in rhinoplasty in six carefully selected patients, who did not have enough septum and conchal cartilage to be harvested and refused to have costal cartilage harvested. Nasal length and tip projection were measured preoperatively, 2 weeks and 18 months postoperatively.Results:All patients were satisfied with the appearance of the nose two weeks after operation. However, four patients experienced the reduction of tip projection in 18 months postoperatively and needed revised rhinoplasty. In the revised operation, the implanted allogenic decalcified bone matrix could not be removed integrally. Matrix residues were harvested and observed under the microscope, which showed fragment of the matrix and fibers surrounded by inflammatory cells and foreign-body giant cells. No osteocyte was found in the ground substances of bone.Conclusion:The commercial allogenic decalcified bone matrix applied in this study is not recommended to use as the material for rebuilding the midline structure in rhinoplasty.

Objective To explore the CRP harmonization by calibration using commutable trueness verification materials. Methods High and low level of CRP concentrations trueness verification materials(H and L) were prepared by Beijing center for clinical laboratories. Thesetrueness verification materials were diluted to 5 calibration points(5L, 4L+1H, 3L+2H, 1L+4H, 5H) by weighing method, respectively. These 5 points were used to calibrate four different brands of CRP detection system (Diasys, Leadman, Siemens and Roche) instead of the original procedure. Sera from 21 patients and the international standard ERM DA-474/IFCC were used to compare harmonization and trueness after calibration. Each sample above was measured twice. Results After calibration, the median of CV was reduced from 19.33％ to 2.92％ among 21 patient samples, less than the optimal CV based on biological variability (CV=10.6％). Compared with Desai, the slopes were closer to 1 from 0.90-1.09 to 0.93-0.96 after calibration. Meanwhile, if ERM-DA474/IFCC was used as the trueness verification materials, the absolute bias wasreduced from 3.08-11.07 mg/L to 0.52-2.97 mg/L which was close to theuncertainty of itself (2.5 mg/L). Conclusions Afterthe calibration which contained five linear concentration points of CRP trueness verification materials by weighing method, both harmonization and trueness of CRP were improved.

Objective To prepare the trueness verification materials of C-reactive protein (CRP) and evaluate its homogeneity, stability and commutability. Methods The high and low CRP concentrations trueness verification materials were from patient leftover sera which were pooled, mixed thoroughly, filtered and aliquoted. The homogeneity, stability and commutability of these materials were evaluated according to CNAS(China National Accreditation Service for Conformity Assessment, CNAS)-GL29:2010 "Reference materials-General and statistical principles for certification (ISO Guide35:2006)"and the Clinical and Laboratory Standards Institute (CLSI) EP30A. The trueness verification materials were used to evaluate the commutability in 10 clinical CRP detection systems, using forty-five patients' leftover sera with different CRP concentration evaluated by Deming regression in EP30A of CLSI. Meanwhile, the commutability of dilution series of ERM DA-474/IFCC were evaluated using the same method. Results A total of two CRP concentration level trueness verification materials were prepared, with high and low concentration levels of 754 and 743 vials, 1 ml each, respectively. The preparation showed good homogeneity (F

Objective To value C-reactive protein ( CRP ) trueness verification materials and to perform the CRP trueness verification program in Beijing .Methods The CRP value of trueness verification materials were assigned by the international reference material ERM DA-474/IFCC, using 10 clinical routine detection systems at departments of clinical laboratory of Beijing Chaoyang and Luhe Hospital Affiliated to Capital Medical University .The calibration curves with 4 ERM DA-474/IFCC dilutions were established and used for value transfer for trueness verification materials of two levels .The uncertainty was also assessed during the process.Then, the trueness verification was performed in the EQA at Beijing Center for Clinical Laboratories ( BCCL ) among 42 clinical laboratories.The samples were distributed according to BCCL standard operating procedure .The Microsoft Excel 2007 and SPSS 17.0 were used to process the results and the function of efficiency ( En) was calculated to verify the difference between the value and the overall mean of all participating laboratories .Results The values and uncertainties of two trueness verification materials of CRP were (109.9 ±9.4) mg/L and (27.1 ±2.4) mg/L respectively.The results of trial application of two level trueness verification materials in the EQA at Beijing Center for Clinical Laboratories (BCCL) were satisfied.There were no significant difference between the transfer values from our study and the values from means of all laboratories in Beijing .The function of efficiency ( En ) was less than 1.Conclusions The valueswhich were established by using multiple detection platforms for CRP trueness verification materialswere accurate and the uncertainties were small .This method is a preferably method for CRP value assignment because there was no suitable reference method for CRP measurement till now .Thematerialswere suitable for the trueness verification program for clinical laboratories in Beijing .