Objective:To explore the value of spectral CT parameters combined with dynamic contrast enhanced magnetic resonance imaging（DCE-MRI） parameters in the short-term efficacy of concurrent chemoradiotherapy for nasopharyngeal carcinoma. Methods: A total of 110 cases with nasopharyngeal carcinoma Ⅲ-Ⅳ staging who received synchronous radiotherapy and chemotherapy at our Hospital from October 2022 to October 2024 were regarded as the study subjects. Complying with the evaluation results after radiotherapy and chemotherapy, they were divided into a complete remission（CR） group of 53 cases and a non CR group of 57 cases. All patients underwent DCE-MRI and energy dispersive CT scans to obtain parameters, such as iodine concentration（IC）, volume transfer constant（Ktrans）, slope of spectral HU curve（λHU）, rate constant（Kep）, and normalized iodine concentration（NIC）. Logistic regression analysis was used to screen for influencing factors. ROC curve was used to analyze the evaluation value of various parameters. In addition, Z-test was used to compare area under the curve（AUC）. Results:The proportion of retropharyngeal lymph node metastasis and λHUvalue in the non CR group were higher than those in the CR group, while Ktrans, Kep, IC value, and NIC value were lower than those in the CR group（P<0.05）. Retropharyngeal lymph node metastasis, Ktrans, Kep, IC value, λHUvalue, and NIC value were all influencing factors（P<0.05）. The AUC of individual prediction of Ktrans, Kep, IC value, λHUvalue, and NIC value was 0.817, 0.800, 0.785, 0.783, and 0.835, respectively. The AUC of the combination of DCE-MRI parameters, the combination of spectral CT parameters, and the combination of the five parameters were 0.874, 0.900, and 0.980, respectively, the AUC of the combination of the five parameters was significantly higher than the AUC of each indicator alone, the AUC of the combination of DCE-MRI parameters, and the AUC of the combination of spectral CT parameters（P<0.05）. Conclusion:The DCE-MRI, and spectral CT parameters （Ktrans, Kep, IC value, λHUvalue, and NIC value）can be used to evaluate concurrent radiotherapy and chemotherapy short-term efficacy for nasopharyngeal carcinoma. And the combination of various parameters can greatly improve the predictive value of efficacy, which has important clinical application value.
Humans ; Chemoradiotherapy ; Nasopharyngeal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging ; Nasopharyngeal Carcinoma ; Tomography, X-Ray Computed ; Male ; Female ; Contrast Media ; Middle Aged ; Adult ; Lymphatic Metastasis ; Dynamic Contrast Enhanced Magnetic Resonance Imaging

Objective:To investigate the value of radiomics nomogram based on standardized pre-treatment chest enhanced CT in predicting the mutation status of epidermal growth factor receptor (EGFR) for patients with lung adenocarcinoma.Methods:A retrospective analysis was conducted on pre-treatment chest enhanced CT images and clinical data of 262 patients from the affiliated hospital of Jining Medical University with pathologically proven primary lung adenocarcinoma who received EGFR gene testing, including EGFR wild type ( n=122) and mutant type ( n=140). The patients were divided into training group ( n=183) and testing group ( n=79) according to a ratio of 7∶3 by stratified sampling method. Standardized pre-processed the images, delineated the ROI and extracted the radiomics features. Least absolute shrinkage and selection operator (LASSO) algorithm was used to reduce the dimension and select key features. The standardized radiomics model, clinical model and the combined model were established by Logistic Regression (LR) machine learning method. Calculated the Rad-score and drew the nomogram. ROC curve and Delong were used to evaluate and compare the predictive performance of different models. Results:23 standardized enhanced CT radiomics features and 4 clinical features were selected. The predictive performance of standardized radiomics model was better than that of non-standardized radiomics model [area under curve (AUC): 0.863 vs. 0.805, t=2.19, P<0.05]. The AUCs of the combined model and standardized radiomics model were higher than that of the clinical model (training group: 0.885, 0.863 vs. 0.774, t=3.57, 2.17, P<0.05; testing group: 0.873, 0.829 vs. 0.763, t=2.19, 2.02, P<0.05). The radiomics nomogram was built based on Rad-score, age, sex, smoking history and BMI. Conclusions:The combined model and standardized radiomics model could effectively predict the mutation status of EGFR gene in lung adenocarcinoma patients before treatment, providing valuable clinical insights.

Objective:To investigate the incidence and treatment of gastric cancer in 16 medical centers in Tianjin from 2020 to 2021.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 122 gastric cancer patients who underwent surgery in 16 medical centers, including Tianjin Medical University Cancer Institute & Hospital, et al, in Tianjin from 2020 to 2021 were collected. There were 2 112 males and 1 010 females, aged (64±11)years. Observation indicators: (1) general data of patients; (2) treatment situations; (3) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted by the chi-square test. Results:(1) General data of patients. From 2020 to 2021, a total of 3 122 gastric cancer patients received surgeries in 16 medical centers in Tianjin, including 2 112 males and 1 010 females. There were 1 443 cases in 2020, including 976 males and 467 females, aged (63±11) years. There were 1 679 cases in 2021, including 1 136 males and 543 females, aged (65±11) years. Of the 3 122 pati-ents, cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 696, 667, 1 466, 293, accounting for 22.293%(696/3 122), 21.365%(667/3 122), 46.957%(1 466/3 122), 9.385%(293/3 122), respectively. Cases with early gastric cancer, locally advanced gastric cancer, advanced gastric cancer account for 17.265%(539/3 122), 73.350%(2 290/3 122), 9.385%(293/3 122). There were 2 829 patients without distant metastasis and 293 patients with distant metastasis. For the 2 829 patients without distant metas-tasis, cases in stage T1, T2, T3, T4a, T4b accounted for 19.053%(539/2 829), 12.089%(342/2 829), 20.148%(570/2 829), 41.499%(1 174/2 829), 7.211%(204/2 829)respectively, cases in stage N0, N1, N2, N3 account for 37.328%(1 056/2 829), 16.331%(462/2 829), 15.836%(448/2 829), 30.505%(863/2 829). For the 293 advanced gastric cancer patients with distant metastasis, 190 cases had peri-toneal metastasis, 47 cases had lymph node metastasis, 27 cases had ovarian metastasis, 37 cases had liver metastasis, 14 cases had other metastasis (some patients had ≥2 distant metastases). (2) Treatment situations. ① For the 539 with early gastric cancer, cases undergoing endoscopic submu-cosal dissection, laparoscopic surgery, open surgery were 22, 150, 86 in 2020, versus 19, 212, 50 in 2021, showing a significant difference between them ( χ2=19.42, P<0.05). For the 498 patients with early gastric cancer who underwent laparoscopic or open surgery, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 25, 81, 30, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrec-tomy were 18, 309, 35, respectively, showing a significant difference between them ( χ2=40.62, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery and laparoscopic surgery were 446 and 617 in 2020, versus 410 and 817 in 2021, showing a significant difference between them ( χ2=17.75, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proxi-mal gastrectomy were 336, 377, 143, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 377, 920, 137, respectively, showing a significant difference between them ( χ2=89.64, P<0.05). Of the 293 patients with advanced gastric cancer, 175 cases underwent surgeries due to hemorrhage, stenosis, perforation, 76 cases under-went surgery after chemotherapy, 42 cases underwent surgery directly. ② For 756 cases of 3 122 pati-ents undergoing total gastrectomy, 357 and 4 cases received open digestive tract reconstruction including Roux-en-Y and other anastomosis, versus 380 and 15 cases with laparoscopic digestive tract reconstruction including Roux-en-Y and other anastomosis, showing a significant difference between them ( χ2=5.57, P<0.05). For 1 687 cases undergoing distal gastrectomy, 84, 160, 158, 55 cases received open digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, versus 154, 489, 417, 170 cases with laparoscopic digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, showing a significant difference between them ( χ2=10.90, P<0.05) . Of the 539 patients with early gastric cancer, 65 cases had lymph node metastasis, in which 18 of 306 stage T1a cases had lymph node metastasis and 47 of 233 stage T1b cases had lymph node metastasis. The number of detected lymph nodes for the 2 290 patients with advanced gastric cancer was 31±15, including ≥16 for 2 059 cases and ≥30 for 1 276 cases. Of the 3 122 patients, cases with neoadjuvant therapy, complete response and incomplete response was 128, 13 and 115 in 2020, versus 250, 49 and 201 in 2021, showing a significant difference between them ( χ2=5.51, P<0.05). (3) Postoperative complications. Of the 3 122 patients, 746 cases had postoperative complications, with an incidence of 23.895%(746/3 122). There were 62 patients with grade 3 or more complications. Reoperation was conducted in 34 patients. There were 14 cases of postoperative death. The duration of postoperative hospital stay and hospital expense were (11±5)days and (98 114±46 598)yuan for the 3 122 patients, (26±14)days and (122 066±68 317)yuan for cases with complications, (40±21)days and (196 926±12 747)yuan for cases with grade 3 or more complications. Conclusion:Compared with 2020, cases undergoing laparoscopic surgery and distal gastrectomy for gastric cancer in Tianjin increases in 2021, and the digestive tract reconstruction also differs. The number of patients with neoadjuvant chemotherapy and complete response rate for advanced gastric cancer increases.

Objective:To investigate the application value of magnetic resonance imaging (MRI) intravoxel incoherent motion (IVIM)-diffusion-weighted imaging (DWI) metrics and texture analysis in the differential diagnosis and staging of nasopharyngeal carcinoma.Methods:The clinical data of 125 nasopharyngeal carcinoma patients (the research group) in Tangshan People's Hospital from October 2019 to October 2021 and 76 patients with nasopharyngeal hyperplasia during the same period (the control group) were retrospectively analyzed. All patients underwent MRI T2WI and IVIM-DWI sequence scanning, and then the plain T2WI images, DWI, and IVIM-DWI quantitative parameter pseudo-color maps including pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were obtained. The texture analysis metrics like apparent diffusion coefficient (ADC), D, D* and f were recorded. IVIM-DWI and texture analysis metrics were compared among patients in both groups and patients in different clinical stages; and the receiver operating characteristic (ROC) curve was plotted to evaluate the efficacy of IVIM sequence parameters and texture analysis metrics in the differential diagnosis and staging of nasopharyngeal carcinoma.Results:Compared with the control group, a marked reduction in D value [(0.80±0.13)×10 -3 mm 2/s vs. (1.19±0.27)×10 -3 mm 2/s], f value [(11.3±2.2)% vs. (15.6±3.3)%], mean ADC value [(0.92±0.17)×10 -3 mm 2/s vs. (1.16±0.19)×10 -3 mm 2/s] and variance (2 189±862 vs. 3 563±925) (all P < 0.05); a notable increase in skewness (0.50±0.17 vs. 0.31±0.12), kurtosis (0.56±0.13 vs. -0.21±0.06) and entropy (10.5±2.3 vs. 7.1±2.1) (all P < 0.05). The area under the curve (AUC) of IVIM sequence parameters and texture analysis metrics in the differential diagnosis of nasopharyngeal carcinoma was 0.763 and 0.803, respectively; the AUC, sensitivity and specificity of the combination of IVIM sequence parameters and texture analysis metrics for the differential diagnosis of nasopharyngeal carcinoma was 0.868, 89.6% and 86.8%, respectively. Compared with patients in stage Ⅰ-Ⅱ nasopharyngeal carcinoma, patients in stage Ⅲ-Ⅳ reported the lower D value [(0.75±0.13)×10 -3 mm 2/s vs. (0.89±0.16)×10 -3 mm 2/s], f value [(10.8±2.8)% vs. (12.1±3.0)%] (all P < 0.05), and the lower mean ADC value [(0.90±0.14)×10 -3 mm 2/s vs. (0.96±0.16)×10 -3 mm 2/s], and variance (2 063±831 vs. 2 431±846) (all P < 0.05), skewness (0.56±0.15 vs. 0.39±0.16), kurtosis (0.62±0.15 vs. 0.44±0.13) and entropy (11.0±2.1 vs. 9.1±2.4) (all P < 0.05). The AUC of IVIM sequence parameters and texture analysis metrics in differentiating nasopharyngeal carcinoma with different stages was 0.863 and 0.796, respectively; the AUC, sensitivity and specificity of the combination of IVIM sequence parameters and texture analysis metrics in differentiating nasopharyngeal carcinoma with different stages was 0.894, 85.4% and 90.7%, respectively. Conclusions:MRI texture analysis and IVIM quantitative analysis are of high value in the differential diagnosis and staging of nasopharyngeal carcinoma; and the texture analysis achieves higher sensitivity and specificity in the differential diagnosis and staging of nasopharyngeal carcinoma compared with IVIM quantitative analysis; the combined application of both has the highest overall efficacy.

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.

Bioactive peptides play important roles in promoting human health, such as lowering blood pressure, blood sugar and blood lipid, anti-obesity, and anti-cancer. Thus, exploring functional bioactive peptides and developing efficient production technologies are of crucial importance. Herein, we review the development of function discovery and production technology for natural bioactive peptides. Presently, the top-down and bottom-up approaches are mainly used for the function discovery and production of natural active peptides. The top-down approach includes the direct extraction and identification for functional discovery, and the direct extraction, enzymatic hydrolysis and microbial fermentation for production. The bottom-up approach includes the polypeptide modification and database mining for functional discovery, and the chemical synthesis, enzyme synthesis, recombinant expression and cell-free synthesis for production. The top-down approach is usually associated with complicated process, lower efficiency, higher cost, harder quality control, and uncertain functionality, while the bottom-up approach is more suitable for the development of peptide drugs but difficult to be used for functional foods. With the technology development of sequencing and mass spectrometry, it is easier to obtain the proteomic information of various organisms at the molecular level. Based on the proteomic information, the top-down and bottom-up approaches can be combined to overcome the disadvantages of using these two approaches alone, thus providing a new strategy for the rapid development and production of natural active peptides.
Fermentation ; Humans ; Mass Spectrometry ; Peptides/metabolism* ; Proteomics ; Technology

Objective:To investigate the clinical effect of deep brain stimulation (DBS) in the treatment of Parkinson′s disease (PD).Methods:32 PD patients treated in Hunan Brain Hospital from January 2016 to December 2018 were selected for the study. Guided by MRI and supplemented by electrophysiological stimulation to correct the target, PD patients were treated with DBS for the nucleus accumbens. Based on Webster and Unified Parkinsons Disease Rating Scale (UPDRS) scores before and after DBS treatment, the clinical treatment effects were evaluated. And the content of Aβ1-42, interleukin (IL)-1β, IL-6, uric acid (UA), malondialdehyde (MDA), homocysteine (Hcy), S-nitrosylated dynamin-relatedprotein 1 (SNO-Drp1) and Drp1 was measured before and after DBS treatment. The ratio of SNO-Drp1/Drp1 was also measured.Results:The Webster score and UPDRS score of PD patients after DBS treatment were lower than those before DBS treatment ( P<0.05). The Aβ1-42 and Drp1content of PD patients after DBS treatment was higher than that before DBS treatment ( P<0.05), while the content of IL-1β, UA, MDA, Hcy and the ratio of SNO-Drp1/Drp1 were lower than before treatment ( P<0.05). Conclusions:DBS has confirmed a good clinical effect in the treatment of PD patients and significantly improved the quality of life of patients.

Objective · To investigate the clinical effects of photo-activated disinfection (PAD)-assisted non-surgical therapy on the treatment of chronic periodontitis. Methods · Eleven patients with chronic periodontitis (totally 118 selected sites) were randomly enrolled. A split-mouth self-control method was adopted. Selected sites with the probing depth (PD) of bilateral homonymous teeth ≥ 5 mm were randomly assigned to the group A (receiving scaling and root planning, SRP) and the group B (receiving SRP+ PAD). Periodontal clinical indexes, inflammation indexes, and periodontal pathogens at selected sites were examined at baseline and 6 and 12 weeks after treatment. Results · Both SRP alone and SRP+PAD improved the periodontal inflammation significantly. The positive rate of bleeding on probing (BOP) 12 weeks after treatment was remarkably lower in the group B than in the group A (37.3% vs 57.6%, P=0.042). Both SRP and SRP+PAD effectively decreased matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) levels in gingival crevicular fluid. The IL-1β levels 6 and 12 weeks after treatment were significantly lower in the group B than in the group A [(17.99±14.26) pg/mL vs (32.64±30.69) pg/mL, P=0.007; (11.37±10.25) pg/mL vs (23.85±15.55) pg/mL, P=0.000]. Both treatments decreased the ratio of P. gingivalis and F.nucleatum in total bacteria. Conclusion · PAD can serve as a potential adjunctive therapy to conventional SRP in the treatment of chronic periodontitis with better improvement of bleeding gums and control of periodontal inflammation.

Objective To analysis the occurrence status of breast disease in married women in Tangshan area,and to provide basis for early prevention of breast cancer in this region.Methods 773 married women in Tangshan area were given mammography examination.The tissue biopsy or surgical treatment was recommended for patients with above grade 3 of breast imaging reporting and data system (BI-RADS) classification to obtain pathological diagnosis.Results In 773 women,482 cases (62.35 ％) were diagnosed as BI-RADS grade 2 or below,256 cases (33.12 ％) were BI-RADS grade 3,33 cases (4.27 ％) were BI-RADS grade 4,2 cases (0.26 ％) were BI-RADS grade 5.The distribution of each BI-RADS grade among different age group was statistically significant (x2 =17.90,P ＜ 0.001),35 cases got pathological diagnosis by biopsy or surgical treatment,including 30 cases of mammary gland hyperplasia,3 cases of breast fibroadenoma,and 2 cases of breast cancer.Conclusion Women's mammography screening is important for the prevention and early detection of mammary gland diseases.

Objective: To investigate the correlation between admission blood glucose (ABG) level and long-term prognosis in patients with acute coronary syndrome (ACS) without diabetes mellitus (DM). Methods: A total of 585 ACS patients received percutaneous coronary intervention (PCI) in our hospital from 2014-01 to 2015-10 were consecutively enrolled and no one combined with DM. Based on ABG levels, the patients were divided into 2 groups:ABG≥7.0 mmol/L group,n=133 and ABG<7.0 mmol/L group,n=452. Demographic, clinical data and treatment conditions were collected to conduct follow-up study and to assess the prognosis. Results: The median follow-up time was 350 days and all cause death in ABG≥7.0 mmol/L group and ABG<7.0 mmol/L group was 2.4% vs 0.9%,P>0.05. Compared with ABG<7.0 mmol/L group, the patients in ABG≥7.0 mmol/L group had the higher incidences of MACE, PCI complication, recurrence of angina and more re-admissions for cardiac event, all P<0.05.Cox regression mode lanalysis in dicated that in addition to acute STEMI (HR=2.016), malignant arrhythmia (HR=3.028) and previous MI history (HR=2.293), blood glucose≥7.0mmol/L was also an independent risk factor for poor long-term prognosis in relevant patients. Conclusion: ABG≥7.0 mmol/L implies poor long-term prognosis in ACS patients and special attention is necessary in secondary prevention.