Background and purpose:Owing to the reliance on computed tomography(CT)for evaluating skull-base bone invasion in nasopharyngeal carcinoma and the potential harm of ionizing radiation from CT,zero echo time magnetic resonance imaging(ZTE-MRI)offers high-resolution bone delineation without radiation exposure.Therefore,this study aimed to systematically assess the diagnostic performance of ZTE-MRI for detecting skull-base bone invasion and to explore its clinical feasibility as an alternative to CT.Methods:This prospective study collected 95 nasopharyngeal carcinoma patients treated in Fujian Provincial Cancer Hospital from April 2020 to December 2022 as the research subjects.The patients who do not meet the inclusion standards would be excluded.Using the GE Discovery 750W 3.0T MR scanner to obtain unenhanced scan and enhanced scan,using ZTE-MRI technology to obtain ZTE-MRI and CT image.The results of the imaging scans were used to independently assess skull base bone invasion by two radiologists.This study was approved by the Ethics Committee of Fujian Cancer Hospital(K2025-314-01),and informed consent from the patients were obtained.Results:A total of 80 nasopharyngeal carcinoma patients were included in the final analysis.There was a high degree of consistency between CT diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards,and the difference was statistically significant(κ=0.645,P＜0.001).There was a high degree of consistency between ZTE-MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards,and the difference was statistically significant(κ=0.774,P＜0.001).There was a high degree of consistency between ZTE-MRI combined with conventional MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and gold standards,and the difference was statistically significant(κ=0.912,P＜0.001).Conclusion:ZTE-MRI technology provides"like CT"images for the skull base bone invasion in nasopharyngeal carcinoma,and ZTE-MRI technology can replace CT examination in clinical practice.

Background and purpose:Owing to the reliance on computed tomography(CT)for evaluating skull-base bone invasion in nasopharyngeal carcinoma and the potential harm of ionizing radiation from CT,zero echo time magnetic resonance imaging(ZTE-MRI)offers high-resolution bone delineation without radiation exposure.Therefore,this study aimed to systematically assess the diagnostic performance of ZTE-MRI for detecting skull-base bone invasion and to explore its clinical feasibility as an alternative to CT.Methods:This prospective study collected 95 nasopharyngeal carcinoma patients treated in Fujian Provincial Cancer Hospital from April 2020 to December 2022 as the research subjects.The patients who do not meet the inclusion standards would be excluded.Using the GE Discovery 750W 3.0T MR scanner to obtain unenhanced scan and enhanced scan,using ZTE-MRI technology to obtain ZTE-MRI and CT image.The results of the imaging scans were used to independently assess skull base bone invasion by two radiologists.This study was approved by the Ethics Committee of Fujian Cancer Hospital(K2025-314-01),and informed consent from the patients were obtained.Results:A total of 80 nasopharyngeal carcinoma patients were included in the final analysis.There was a high degree of consistency between CT diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards,and the difference was statistically significant(κ=0.645,P＜0.001).There was a high degree of consistency between ZTE-MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and of gold standards,and the difference was statistically significant(κ=0.774,P＜0.001).There was a high degree of consistency between ZTE-MRI combined with conventional MRI diagnosis of nasopharyngeal carcinoma skull base bone invasion and gold standards,and the difference was statistically significant(κ=0.912,P＜0.001).Conclusion:ZTE-MRI technology provides"like CT"images for the skull base bone invasion in nasopharyngeal carcinoma,and ZTE-MRI technology can replace CT examination in clinical practice.

The 6-min walk test(6MWT)is an effective tool to assess the cardiopulmonary function and exercise tolerance,and is widely used in clinical practice to assess the exercise capacity in the patients with car-diopulmonary disease.Pulmonary hypertension(PH)is a serious cardiovascular disease manifested by a con-tinuous increase in pulmonary circulatory pressure,which limits the right heart function and eventually devel-ops into the right heart failure,moreover its clinical manifestations lack specificity,making diagnosis difficult.With the development of PH diagnosis and treatment technology,the medical staffs have paid more and more attention to the application of 6MWT in the diagnosis,treatment and prognosis of the patients with PH.This article reviews the characteristics of 6MWT,its application in PH,and its limitations and future prospects in order to help clinic to better understand the role of 6MWT in the whole disease course of the patients with PH,and encourage the medical care staffs to broadly apply and improve 6MWT to make it to be more reliable clinical evidence.

Objective:To develop corresponding aviation otitis media intervention measures by investigating and analyzing the related factors in civil aviation aircrews.Methods:A total of 4 789 civil aviation aircrews were selected as the subjects of observation. The incidence of aviation otitis media among civil aviation aircrew was evaluated by 7-items Eustachian Tube Dysfunction Questionnaire, and the possible influencing factors were investigated and statistically analyzed.Results:All 4 789 survey questionnaires were validate. In this survey, the total flying hours was mainly 1 000-5 000 h, and the main aircraft was A320. There were 613 out of 4 789 civil aviation aircrews had suffered from aviation otitis media/secretory otitis media, accounting for 12.80%. In which 91.96% had no ear discharge or watery discharge, 70.81% had not experienced rhinitis/sinusitis, and more than 90% had no tonsil hypertrophy, no thin or calcified tympanic membrane, no history of surgery for the eustachian tube or middle ear cavity, and no ear tightness or occasional ear tightness that resolves spontaneously. The severity of ear tightness was mainly distributed in 0-3 points range, accounting for 88.70%. In which 43.62% were with no ear tightness and 45.10% were with mild ear tightness. Among the 4 789 civil aviation aircrews, the severity of ear tightness of left and right ears had the highest incidence rate of 1 point, followed by 2 points, and the incidence rate of 3-7 points was relatively low. The incidence rate of 1-2 points was significantly higher than that of 3-7 points, and the difference was significant (( χ2=2 135.68-7 623.25, P=0.001-0.004). Conclusions:Most of the Chinese civil aviation aircrews have good eustachian tube function, but there are still a few cases of aviation otitis media. Regular inspections and timely and effective interventions are crucial for protecting the eustachian tube function and reducing the incidence of aviation otitis media in civil aviation aircrews.

Objective:To develop corresponding aviation otitis media intervention measures by investigating and analyzing the related factors in civil aviation aircrews.Methods:A total of 4 789 civil aviation aircrews were selected as the subjects of observation. The incidence of aviation otitis media among civil aviation aircrew was evaluated by 7-items Eustachian Tube Dysfunction Questionnaire, and the possible influencing factors were investigated and statistically analyzed.Results:All 4 789 survey questionnaires were validate. In this survey, the total flying hours was mainly 1 000-5 000 h, and the main aircraft was A320. There were 613 out of 4 789 civil aviation aircrews had suffered from aviation otitis media/secretory otitis media, accounting for 12.80%. In which 91.96% had no ear discharge or watery discharge, 70.81% had not experienced rhinitis/sinusitis, and more than 90% had no tonsil hypertrophy, no thin or calcified tympanic membrane, no history of surgery for the eustachian tube or middle ear cavity, and no ear tightness or occasional ear tightness that resolves spontaneously. The severity of ear tightness was mainly distributed in 0-3 points range, accounting for 88.70%. In which 43.62% were with no ear tightness and 45.10% were with mild ear tightness. Among the 4 789 civil aviation aircrews, the severity of ear tightness of left and right ears had the highest incidence rate of 1 point, followed by 2 points, and the incidence rate of 3-7 points was relatively low. The incidence rate of 1-2 points was significantly higher than that of 3-7 points, and the difference was significant (( χ2=2 135.68-7 623.25, P=0.001-0.004). Conclusions:Most of the Chinese civil aviation aircrews have good eustachian tube function, but there are still a few cases of aviation otitis media. Regular inspections and timely and effective interventions are crucial for protecting the eustachian tube function and reducing the incidence of aviation otitis media in civil aviation aircrews.

Objective:To determine lysophosphatidic acid receptor 6 (LPAR6) expression in patients with mycosis fungoides (MF) , a variant of cutaneous T-cell lymphoma (CTCL) , and to investigate its role and mechanism of action in the development and prognosis of CTCL.Methods:A total of 110 patients with confirmed MF were collected from Department of Dermatology, Peking University First Hospital from 2011 to 2020, including 24 with large-cell transformation (LCT) and 25 with non-large cell transformation (NLCT) in the discovery cohort, and 24 with LCT and 37 with NLCT in the validation cohort. RNA sequencing and RT-PCR were conducted to determine the LPAR6 expression in patients in the discovery cohort and validation cohort respectively. LPAR6 expression was compared between patients with LCT and those with NLCT, and its effect on the prognosis of patients was evaluated. Two LPAR6-overexpressing CTCL cell lines MyLa and Sz4 were constructed to evaluate the effect of LPAR6 overexpression on proliferative activity of MyLa and Sz4 cells, with the cells normally expressing LPAR6 as the control group; after the treatment with LPAR6-related ligand lysophosphatidic acid (LPA) , 2S-OMPT, adenosine triphosphate (ATP) or adenosine (ADO) , the effects of LPAR6 activation on the proliferative activity and apoptosis of LPAR6-overexpressing MyLa and Sz4 cells were evaluated by the MTS method and flow cytometry respectively. Log-rank test was used for prognostic analysis, and t test or Mann-Whitney U test was used for comparisons between two groups. Results:As RNA sequencing showed, LPAR6 was one of the significantly underexpressed genes in the LCT group in the discovery cohort; in the validation cohort, LPAR6 expression (median[ Q1, Q3]) was significantly lower in the LCT group (204.90[81.90, 512.70]) than in the NLCT group (809.40[417.50, 1 829.20], U= 242.00, P= 0.002) ; in the two cohorts, the underexpression of LPAR6 was significantly associated with increased risk of poor prognosis (both P < 0.01) . Cell proliferation assay showed no significant difference in the proliferative activity of MyLa or Sz4 cells between the LPAR6 overexpression group and control group at 0, 24, 48 and 72 hours during the experiment (all P > 0.05) ; 48 hours after activation of LPAR6 by LPA, 2S-OMPT, ATP and ADO in MyLa cells, the LPAR6 overexpression group showed significantly decreased cellular proliferative activity (1.38 ± 0.01, 1.04 ± 0.01, 1.09 ± 0.03, 1.23 ± 0.01, respectively) compared the control group (1.73 ± 0.04, 1.23 ± 0.01, 1.24 ± 0.01, 1.42 ± 0.03, t= 30.33, 18.38, 4.78, 5.75, respectively, all P < 0.05) , but significantly increased cell apoptosis rate (17.93% ± 0.88%, 17.75% ± 0.35%, 23.97% ± 0.57%, 31.44% ± 0.34%, respectively) compared the control group (3.98% ± 0.03%, 7.81% ± 0.59%, 11.95% ± 0.85%, 12.02% ± 0.48%, t= 15.93, 14.49, 11.74, 33.01, respectively, all P < 0.05) ; 48 hours after activation of LPAR6 by 2S-OMPT and ADO in Sz4 cells, compared with the control group, the LPAR6 overexpression group also showed significantly decreased cellular proliferative activity (2S-OMPT: 1.29 ± 0.04 vs. 1.48 ± 0.01; ADO: 1.27 ± 0.01 vs. 1.51 ± 0.02; both P < 0.05) , but significantly increased cell apoptosis rate (2S-OMPT: 41.70% ± 0.70% vs. 29.35% ± 0.55%; ADO: 37.05% ± 0.15% vs. 24.60% ± 1.00%; both P < 0.05) . Conclusions:LPAR6 was underexpressed in the patients with LCT, and its underexpression was significantly associated with increased risk of poor prognosis. In vitro activation of LPAR6 could inhibit the proliferation of CTCL cells and promote their apoptosis, suggesting that the decrease of LPAR6 expression may be one of the important mechanisms underlying disease progression in patients with LCT.

Background and purpose:Currently, subjective questionaire is the most frequently used methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, while lacking of effective objective examinations. This study aimed to explore effective methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, and gain knowledge of the incidence and severity of swallowing dysfunctions. Methods: From Oct. 2013 to Dec. 2013, 128 consecutive outpatients with previously treated nasopharyngeal carcinoma received esophageal barium lfuoroscopy examination at there regularly follow-ups to evaluate swallowing function. Among these patients, 89 were primary treated with intensity modulated radiation therapy (IMRT) and 39 with conventional radiotherapy (CRT). In this study, each patient received esophageal barium lfuoroscopy examination for 3 times with thin, thick and pasty barium and were dynamically observed using X-ray fluoroscopy from front and lateral direction. Swallowing dysfunctions were defined as follows:①The bolus could not be swallowed and blocked in the mouth;②The dilute barium diverted to the glottis or trachea;③Residual barium delayed in the pyriform sinus and vallecula;④The movement of the hyoid bone or epiglottis were restricted;⑤Bolus prolong through the pharynx;⑥Barium slowed down when went though the esophageal entrance. Results:Of the 128 patients, incidence of dysphagia was 60.2%for the entire cohort, 52.8%for IMRT group and 76.9%for CRT group. Incidence of dysphagia for IMRT group was signiifcantly lower than CRT group (P=0.018). Dysphagia incidence within 1 year, 1 to 2 years and more than 2 years after RT were 63.1%, 33.3%and 69.0%, respectively (P=0.019). Conclusion:There was a high incidence of swallowing dysfunction for the nasopharyngeal carcinoma patients treated with radiotherapy and dysphagia incidence decreased when treated with IMRT. Esophageal barium lfuoroscopy examination is objective method to evaluate the incidence and severity of the swallowing dysfunction.

BACKGROUNDSerine threonine kinase 15 (STK15) is a kind of mitotic kinase. The overexpression of STK15 is significantly associated with carcinogenesis in many tumors, however, its expression and significance in human lung cancer are still unclear. The aim of this study is to investigate the expression of STK15 in squamous cell carcinoma and adenocarcinoma of the lung and to analyze the correlation between STK15 expression and clinicopathological factors.

METHODSThe pattern of STK15 protein expression was detected in 44 squamous cell carcinomas, 36 adenocarcinomas and 20 paracancerous lung tissue samples by immunohistochemistry method using anti-STK15 antibody. The relative quantity of STK15 protein expression was detected by Western blot, and STK15 mRNA expression was detected by RT-PCR in 40 fresh lung cancer samples and corresponding paracancerous lung tissues.

RESULTSPositive expression rate of STK15 protein was 68.75% (55/80) in lung cancer tissues and 0% in paracancerous controls (P < 0.001). STK15 expression was significantly related to differentiation grade of lung cancer (P=0.011), but not to histological classification, TNM stages or lymphatic metastasis (P > 0.05). The relative expression levels of STK15 protein (P < 0.001 ) and STK15 mRNA (P < 0.001) in lung cancer tissues were both significantly higher than those of corresponding paracancerous lung tissues.

CONCLUSIONSThe expression of STK15 protein and STK15 mRNA is significantly higher in lung cancer tissues than that in paracancerous lung tissues. The expression of STK15 correlates with differentiation of lung cancer.