ObjectiveTo employ Helicobacter hepaticus (H.hepaticus, H.h) to induce intestinal fibrosis in vitamin D receptor deletion (VDR^-/-) mice, thereby establishing a model of inflammatory bowel disease to investigate its pathological characteristics and underlying mechanisms. MethodsFive male WT and five male VDR^-/- mice were orally administered a suspension containing 2×10⁸ CFU of H.hepaticus (referred to as the WT+H.h group and the VDR^-/-+H.h group, respectively), with treatments occurring every other day for three administrations. Concurrently, two uninfected control groups were established, consisting of five WT and five VDR^-/- mice, which were administered an equivalent volume of PBS. Seven days after the final administration, the infection status of the mice was assessed, and their body weight was recorded weekly. At the 16^th week post-infection, the mice were dissected, and the length of the colon tissue was measured, with fecal moisture content analyzed. The colon tissue was partitioned into four parts: one for paraffin embedding for HE, alcian blue-periodic acid Schiff (AB-PAS), Masson's trichrome staining, and immunohistochemical analysis; one for DNA extraction to evaluate the colonization levels of H.hepaticus through real-time fluorescent quantitative polymerase chain reaction (RFQ-PCR), thereby assessing the impact of the infection; one for RNA extraction to analyze cytokine expression via reverse transcription-PCR (RT-PCR); and one for protein extraction to measure the expression levels of alpha smooth muscle actin (α-SMA) and interleukin (IL)-33 using Western blotting. Results All mice in the infected groups successfully were infected with H. hepaticus after three oral gavages. Compared to VDR^-/- control group, VDR^-/- mice exhibited significant weight loss (P<0.05), intestinal hemorrhage, and higher fecal water content after 16 weeks of H. hepaticus infection than the uninfected control group and the WT+H.h group (P<0.05). Compared to the WT+H.h group, HE staining of the VDR^-/-+H.h group showed inflammatory cell infiltration, AB-PAS staining revealed irregular atrophy of intestinal glands and reduced acini, and Masson staining showed increased collagen area. RT-PCR demonstrated that the transcription levels of inflammation and fibrosis-related genes, including IL-6, IL-33, tumor necrosis factor-α (TNF-α), and α-SMA (P < 0.000 1), were significantly upregulated in the colon tissues of VDR^-/-+H.h group. Additionally, immunohistochemical analysis and Western blotting showed that the protein expression levels of IL-33 and α-SMA were markedly increased (P<0.001) in the VDR^-/-+H.h group. ConclusionVDR^-/- mice infected with H.hepaticus exhibit more severe inflammatory responses, including mucosal inflammatory infiltration, impaired mucosal tissue function, and collagen deposition, indicating successful construction of the inflammatory bowel disease model. Further research suggests that VDR deficiency may exacerbate the intestinal fibrosis process associated with inflammatory bowel disease by affecting IL-33 expression.

Soil cadmium pollution can adversely affect the cultivation of the ornamental plant, Coleus scutellarioides. Upon cadmium contamination of the soil, the growth of C. scutellarioides is impeded, and it may even succumb to the toxic accumulation of cadmium. In this study, we investigated the effects of arbuscular mycorrhizal fungi (AMF) on the adaptation of C. scutellarioides to cadmium stress, by measuring the physiological metabolism and the degree of root damage of C. scutellarioides, with Aspergillus oryzae as the test fungi. The results indicated that cadmium stress increased the activity of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT), and the content of malondialdehyde (MDA) and proline (Pro) within the cells of C. scutellarioides, but inhibited mycorrhizal infestation rate, root vigour and growth rate to a great degree. With the same cadmium concentration, the inoculation of AMF significantly improved the physiological indexes of C. scutellarioides. The maximum decrease of MDA content was 42.16%, and the content of secondary metabolites rosemarinic acid and anthocyanosides could be increased by up to 27.43% and 25.72%, respectively. Meanwhile, the increase of root vigour was as high as 35.35%, and the DNA damage of the root system was obviously repaired. In conclusion, the inoculation of AMF can promote the accumulation of secondary metabolites, alleviate root damage, and enhance the tolerance to cadmium stress in C. scutellarioides.
Cadmium/toxicity* ; Mycorrhizae/physiology* ; Plant Roots/drug effects* ; Soil Pollutants/toxicity* ; Stress, Physiological ; Superoxide Dismutase/metabolism*

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective To determine the radiation dose of sensitive organs under different protective methods in lung CT scanning environment, and to explore the best protective scheme of corresponding organs. Methods Annealed thermoluminescence dose elements were placed in the stomach, liver, colon, and thyroid gland of a simulated human body model. The dose effect experiment of protective methods included non-protective group, half lead apron group, and full lead apron group. The dose effect experiment of protective thickness included 0.50 mmpb full lead apron group and 0.35 mmpb full lead apron group. The same exposure conditions of lung CT scan were used in the above experiments. Results Compared with the non-protective group, the exposure dose of the stomach, liver, colon, and thyroid gland increased significantly in the half lead apron group (P < 0.05), and the exposure dose of the thyroid gland and colon decreased significantly in the full lead apron group (P < 0.05). There were no significant differences in the exposure dose of the liver, stomach, and colon in the simulated human body model between the 0.35 mmpb full lead apron group and the 0.50 mmpb full lead apron group. Conclusion For lung CT scan, the protective measure of lead apron may not reduce the exposure dose of subjects. The protective thickness of lead apron does not necessarily have a substantial influence on the exposure dose of human body.

Objective:To study the effect mechanism of Guilu Erxian gum on Alzheimer's disease （AD） from the perspective of regulating perivascular space （PVS），and to explore the scientific connotation of "essence generating marrow". Method:The 80 patients with AD diagnosed by western medicine and kidney deficiency and marrow empty syndrome diagnosed by traditional Chinese medicine were randomly divided into two groups，with 40 cases in each group. Both groups of patients were orally administered with cholinesterase inhibitor Alison，one tablet （5 mg） each time before sleep at night. On this basis，the control group additionally received placebo，while the treatment group was additionally treated with Guilu Erxian gum for 60 days. The Mini-Mental State Examination scale （MMSE）， Wechsler Memory Scale and Activity of Daily Living Scale （ADL） were used before treatment （0 d），as well as 31 d and 61 d after treatment. The number and diameter of PVS in midbrain，basal ganglia，deep insular white matter and semiovale center were counted and their diameters were measured with use of nuclear magnetic resonance imaging （MRI） for head. In addition，the curative effect was evaluated according to MMSE scores on 61 d. Result:There was no significant difference between the two groups 31 d. On 61 d，MMSE and WMS scores increased，while ADL scores decreased as compared with the conditions on 0 d（P<0.01），and there were significant differences in the three indexes and clinical effective rate between two groups （P<0.05，P<0.01） . In addition，there was no significant difference in the number of PVS as compared with the number before treatment and in the comparison between the two groups after treatment，but there was a significant difference in the diameter of PVS（P<0.01）. Conclusion:Guilu Erxian gum is effective in the treatment of AD，and it can improve the PVS diameter in patients，which may be related to the mechanism of "essence generating marrow ".

Objective: To investigate the correlation of 18F-FDG PET/CT imaging metabolic indexes and clinicopathological factors of primary colorectal adenocarcinoma. Methods: Clinical data of 52 patients with colorectal adenocarcinoma confirmed by operation and pathology were retrospectively analyzed. All patients underwent 18F-FDG PET/CT imaging, and the maximum diameter, maximum standard uptake value (SUVmax), mean standard uptake value(SUVmean) and metabolic volume (MTV) of the primary tumors were recorded, and the total lesion glycolysis (TLG) was calculated. The patients were grouped according to the largest diameter, T stage, N stage and cell differentiation degree of the primary tumor respectively, and the differences of the above parameters were compared, and the correlations of the above parameters and clinicopathological features were analyzed. Results: SUVmax, SUVmean, MTV and TLG of 52 patients with colorectal adenocarcinoma were 13.38±7.34, 7.75±3.94, (15.83±11.18)cm3 and 103.15(45.28,140.23)g, respectively. There were significant differences in metabolic indexes of the maximum diameter groups (all P<0.05). There was no significant difference in SUVmax and SUVmean among different T-stage groups (both P>0.05), while there were significant differences in MTV and TLG among different T-stage groups (both P<0.05). There was no significant difference in the metabolic indexes of colorectal adenocarcinoma among different N stages and cell differentiation groups (all P>0.05). There were positive correlations of SUVmax, SUVmean with the maximum diameter of the primary tumor (both P<0.05), while there was no obvious correlation with T stage, N stage and cell differentiation degrees (all P>0.05). MTV and TLG were positively correlated with the maximum diameter and T stage of the primary tumor (all P<0.05), but not correlated with N stage nor cell differentiation degrees (all P>0.05). Conclusion: MTV and TLG can reflect the pathological factors of colorectal adenocarcinoma in some degree, and have higher evaluation value than SUVmax and SUVmean.

Objective To investigate the correlation of metabolic parameters of 18F-FDG PET/CT and clinicopathological factors of gastric cancer. Methods 18F-FDG PET/CT characteristics and clinical data of histopathologically proved gastric cancer in 44 patients were reviewed retrospectively. The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) and metabolic tumor volume (MTV) of primary lesions were measured, and total lesion glycolysis (TLG) was calculated. The differences of the above metabolic parameters among different T-stage, N-stage, pathological stage and cell differentiated degree of tumors were compared, and the correlation of metabolic parameters and clinicopathological factors was analyzed. Results SUVmax, SUVmean, MTV and TLG of 44 primary lesions was 5.81 (3.45, 7.77), 3.42 (1.87, 4.37), 14.80 (9.02, 25.19)cm3 and 42.03 (18.89, 107.87) g, respectively. There was no statistical difference of SUVmax, SUVmean, MTV nor TLG between different T-stage of primary lesions (all P>0.05). There were statistical differences of MTV and TLG of different N-stage and pathological stage groups (all P<0.05). There was no statistical difference of SUVmax and SUVmean of different N-stage and pathological stage groups (all P>0.05). There were statistical differences of SUVmax and SUVmean among different cell differentiated degrees (both P<0.05). There was no statistical difference of MTV and TLG among different cell differentiated degrees (both P>0.05). SUVmax and SUVmean were positively correlated with T-stage and cell differentiated degree of tumors (all P<0.05), respectively. There was no significant correlation of SUVmax, SUVmean with N-stage nor pathological stage of tumors (all P>0.05). MTV and TLG were positively correlated with T-stage, N-stage with pathological stage of tumors (all P<0.05), respectively. There was no significant correlation of MTV, TLG with pathological stage of tumors (all P>0.05). Conclusion 18F-FDG PET/CT metabolic parameters of primary gastric cancer could reflect partial clinicopathological characteristics, therefore being helpful to individual treatment planning.

BACKGROUND AND PURPOSE: This study investigated the contribution of white-matter hyperintensities (WMH) and lacunar infarcts (LI) to the risk of Alzheimer's disease (AD) in an elderly cohort in China. METHODS: Older adults who were initially cognitively normal were examined with MRI at baseline, and followed for 5 years. WMH were classified as mild, moderate, or severe, and LI were classified into a few LI (1 to 3) or many LI (≥4). Cognitive function was assessed using the Mini Mental State Examination and the Activities of Daily Living scale. RESULTS: Among the 2,626 subjects, 357 developed AD by the end of the 5-year follow-up period. After adjusting for age and other potential confounders, having only WMH, having only LI, and having both WMH and LI were associated with an increased risk of developing AD compared with having neither WMH nor LI. Moderate and severe WMH were associated with an increased risk of developing AD compared with no WMH. Furthermore, patients with many LI had an increased risk of developing AD compared with no LI. CONCLUSIONS: Having moderate or severe WMH and many LI were associated with an increased risk of developing AD, with this being particularly striking when both WMH and LI were present.
Activities of Daily Living ; Adult ; Aged* ; Alzheimer Disease* ; China* ; Cognition ; Cohort Studies ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Strikes, Employee ; Stroke, Lacunar*

Objective: To investigate the prognostic value of metabolic parameters calculated from pretreatment ¹⁸F-fluorodeoxyglucose (FDG) PET/CT images in patients with extranodal natural killer/T cell lymphoma (ENKTL) of stage Ⅰ-Ⅱ. Methods: From August 2010 to April 2018, 67 patients with ENKTL of stage Ⅰ-Ⅱ disease (47 males, 20 females; median age 57 years) in the First Affiliated Hospital of Nanjing Medical University were enrolled, and the clinic data and pretreatment ¹⁸F-FDG PET/CT imaging data were retrospectively analyzed. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of tumor tissue were calculated from PET/CT images with the threshold value of 40% of maximum standardized uptake value (SUV_max). The optimal cut-off values of progression-free survival (PFS) and overall survival (OS) of SUV_max, MTV and TLG were investigated by using receiver operating characteristic (ROC) curve analysis. Kaplan-Meier method, log-rank test and Cox proportional hazards model were used for data analysis. Results: SUV_max, MTV and TLG of 67 patients were 12.32(8.65, 16.96), 13.13(7.37, 22.74) ml, 92.17(46.54, 198.46), respectively. ROC curve analysis showed that the cut-off values of SUV_max, MTV and TLG were 13.09, 18.05 ml and 152.81, respectively. Univariate analysis showed that B symptoms, lactate dehydrogenase (LDH) level, β₂-microglobulin, Eastern Cooperative Oncology Group (ECOG) score, Korean prognostic index (KPI), SUV_max, MTV, TLG and treatment mode (chemotherapy or chemoradiotherapy) were relative factors affecting PFS (χ²: 5.466-27.163, all P<0.05). B symptoms, LDH level, β₂-microglobulin, EB virus (EBV)-DNA, extra-cavitary extension, ECOG score, KPI, MTV, TLG and treatment mode were relative factors affecting OS (χ²: 4.022-34.774, all P<0.05). SUV_max was not the influencing factor of OS(χ²=2.766, P>0.05). Multivariate analysis showed that ECOG score, MTV and TLG were independent prognostic predictors of PFS (relative ratio (RR): 5.107-6.802, all P<0.05), and ECOG score, MTV, TLG and treatment mode were independent prognostic predictors of OS (RR: 0.221-9.106, all P<0.05). Conclusions MTV and TLG from pretreatment ¹⁸F-FDG PET/CT images are independent prognostic factors for PFS and OS in patients with ENKTL of stage Ⅰ-Ⅱ. MTV and TLG may be more useful than SUV_max for prognosis.

Objective To study the effect of hypertension on motor function in Parkinson's disease (PD) patients with white matter lesion (WML).Methods Two hundred and nineteen PD patients with WML were divided into hypokinesia group (n=137) and non hypokinesia group (n=82).The patients were followed up for 1 year.The relationship of vascular risk factors with hypertension and hypokinesia was analyzed.Results The age was older,the incidence of hypertension,DM and lipidemia was higher,the SBP and DBP were higher in hypokinesia group than in non hypokinesia group (P＜0.01,P＜0.05).Logistics regression analysis showed that age,hypertension and DM were the risk factors for hypokinesia in PD patients with WML (OR =1.78,95 ％CI:1.43-2.14,OR =1.97,95 ％0 CI:1.49-2.52,OR =1.63,95 ％ CI:1.31-1.94).Further analysis showed that grade 2 and 3 hypertension were closely related the risk of hypokinesia in PD patients with WML(OR=1.62,95％CI:1.29-1.95;OR=2.19,95％CI:1.49-2.91).Conclusion Hypertension,especially grade 2 and 3 hypertension,can aggravate hypokinesia in PD patients with WML.