Objective To investigate the relationship between serum Th1/Th2 cytokine expres-sion levels and the degree of bone destruction in patients with skeletal tuberculosis.Methods A to-tal of 75 patients with skeletal tuberculosis admitted from August 2022 to August 2024 were enrolled as the study subjects.Based on varied degree of bone destruction assessed by imaging,the patients were divided into mild bone destruction group(n=51)and severe bone destruction group(n=24).Clinical data of the two groups were compared.Fasting venous blood samples were collected from the patients in the early morning.The levels of Th1 cytokines[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-2(IL-2)]and Th2 cytokines[transforming growth factor-β(TGF-β),inter-leukin-4(IL-4),interleukin-10(IL-10)]in the serum were measured using the enzyme-linkedim-munosorbent assay(ELISA).Meanwhile,imaging data such as plain X-rays and magnetic reso-nance imaging(MRI)were collected to assess the degree of bone destruction.Spearman correlation analysis was used to evaluate the correlation between serum Th1/Th2 cytokine expression and the degree of bone destruction.Multivariate Logistic regression analysis was conducted to identify the in-fluencing factors of the degree of bone destruction in patients with skeletal tuberculosis.The receiver operating characteristic(ROC)curve was employed to analyze the diagnostic efficacy of serum Th1/Th2 cytokines for the degree of bone destruction in patients with skeletal tuberculosis.Results There were no significant differences in age,gender,body mass index(BMI),and the proportions of patients with a history of hypertension,diabetes mellitus,or hyperlipidemia between the two groups(P＞0.05).Compared with the mild bone destruction group,the severe bone de-struction group showed significantly elevated serum levels of Th1 cytokines(TNF-α,IFN-γ,IL-2)and significantly decreased serum levels of Th2 cytokines(TGF-β,IL-10)(P＜0.05).Spearman correlation analysis revealed that serum TNF-α(r=0.363,P=0.001),IFN-γ(r=0.383,P＜0.001),and IL-2(r=0.347,P=0.002)levels were positively correlated with the degree of bone destruction,while serum TGF-β(r=-0.380,P＜0.001)and IL-10(r=-0.365,P=0.001)levels were negatively correlated with the degree of bone destruction.Logistic regression analysis in-dicated that TNF-α,IFN-γ,TGF-β,and IL-10 were independent influencing factors for the degree of bone destruction in patients with skeletal tuberculosis(P＜0.05).ROC curve analysis demon-strated that the areas under the curve(AUCs)for TNF-α,IFN-γ,TGF-β,and IL-10 in predicting the degree of bone destruction in patients with skeletal tuberculosis were 0.725,0.737,0.735,and 0.726,respectively.The corresponding sensitivities were 62.50％,75.00％,62.50％,and 83.33％,and the specificities were 84.31％,62.75％,86.27％,and 62.75％,respectively.The combined AUC of these indicators was 0.887,which was superior to that of individual predic-tions.Conclusion In patients with skeletal tuberculosis,as the degree of bone destruction increa-ses,the serum levels of TNF-α,IFN-γ,and IL-2 rise,the serum levels of TGF-β and IL-10 gradu-ally decrease.TNF-α,IFN-γ,TGF-β,and IL-10 are independent influencing factors for the degree of bone destruction.Moreover,the combined application of Th1/Th2 cytokines has a certain predic-tive value for the degree of bone destruction.

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland–Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

Objective To evaluate the efficacy and safety of laparoscopic technique in the treatment of refractory adhesive intestinal obstruction. Methods In a retrospective matched?pair analysis, 68 patients of re?fractory adhesive intestinal obstruction whose relapsed more than 3 times were included in the research. All patients were treated with laparoscopic operation or continued follow?up observation after conservative treatment from Janu?ary 2011 to January 2016. The patients were divided into 2 groups, laparoscopic surgery (32 cases) and observation group (36 cases), to contrast the recurrence rate and safety of the two types of treatment. Results The recurrence rate of laparoscopic surgery group was significantly lower in the observation group (18.8%vs. 77.8%, P<0.05). Re?fractory adhesive intestinal obstruction is further divided into Mixed type, Patchy adhesion type and Cable Belt Com?pression type, in the laparoscopic surgery subgroup analysis, hybrid recurrence rate (66.7%, 4/6 cases) was signifi?cantly higher than that of patchy adhesion type (10.0%, 1/10 cases) and cord compression type (6.3%, 1/16 cases). Conclusion Laparoscopic operation is safe and feasible in the treatment of refractory adhesive intestinal obstruc?tion, and then it can effectively reduce the recurrence rate of refractory adhesive intestinal obstruction;the curative effect is closely related to the type of adhesion.

Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.