ObjectiveTo analyze the expression level of triggering receptor expressed on myeloid cells-1 （TREM-1） in serum and ascites of patients with cirrhotic ascites， and to investigate its correlation with clinical features and inflammatory markers and its role in the diagnosis of infection and prognostic evaluation. MethodsA total of 110 patients with cirrhotic ascites who were hospitalized in The Fifth Hospital of Shijiazhuang from January 2019 to December 2020 were enrolled， and according to the presence or absence of intra-abdominal infection， they were divided into infection group with 72 patients and non-infection group with 38 patients. The patients with infection were further divided into improvement group with 38 patients and non-improvement group with 34 patients. Clinical data and laboratory markers were collected from all patients. Serum and ascites samples were collected， and ELISA was used to measure the level of TREM-1. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate the correlation between indicators. A multivariate Logistic regression analysis was used to identify the influencing factors for the prognosis of patients with cirrhotic ascites and infection. The receiver operating characteristic （ROC） curve was used to evaluate the diagnostic and prognostic efficacy of each indicator， and the Delong test was used for comparison of the area under the ROC curve （AUC）. ResultsThe level of TREM-1 in ascites was significantly positively correlated with that in serum （r=0.50， P<0.001）. Compared with the improvement group， the non-improvement group had a significantly higher level of TREM-1 in ascites （Z=-2.391， P=0.017） and serum （Z=-2.544， P=0.011）， and compared with the non-infection group， the infection group had a significantly higher level of TREM-1 in ascites （Z=-3.420， P<0.001）， while there was no significant difference in the level of TREM-1 in serum between the two groups （P>0.05）. The level of TREM-1 in serum and ascites were significantly positively correlated with C-reactive protein （CRP）， procalcitonin （PCT）， white blood cell count， and neutrophil-lymphocyte ratio （r=0.288， 0.344， 0.530， 0.510， 0.534， 0.454， 0.330， and 0.404， all P<0.05）. The ROC curve analysis showed that when PCT， CRP， and serum or ascitic TREM-1 were used in combination for the diagnosis of cirrhotic ascites with infection， the AUCs were 0.715 and 0.740， respectively. The multivariate Logistic regression analysis showed that CRP （odds ratio ［OR］=1.019， 95% confidence interval ［CI］： 1.001‍ ‍—‍ ‍1.038， P=0.043） and serum TREM-1 （OR=1.002， 95%CI： 1.000‍ ‍—‍ ‍1.003， P=0.016） were independent risk factors for the prognosis of patients with cirrhotic ascites and infection， and the combination of these two indicators had an AUC of 0.728 in predicting poor prognosis. ConclusionThe level of TREM-1 is closely associated with the severity of infection and prognosis in patients with cirrhotic ascites， and combined measurement of TREM-1 and CRP/PCT can improve the diagnostic accuracy of infection and provide support for prognostic evaluation.

Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.

OBJECTIVE To observe the changes of static functional connectivity(sFC) and dynamic functional connectivity(dFC) of amygdala subregions in patients with bilateral idiopathic tinnitus and hearing loss(TINHL). METHODS The resting-state functional magnetic resonance imaging(fMRI) data of 30 patients with bilateral tinnitus and hearing loss and 37 normal controls(NCs) were collected to analyze the intensity changes of sFC and dFC in 8 subregions of amygdala and the whole brain in TINHL patients. RESULTS There were no significant differences in age,sex and education between the two groups. Compared with the NCs group,the sFC intensity of the right basolateral subregion and right cerebellar peduncle 1 region,the left basolateral subregion and left orbital medial frontal gyrus and left angular gyrus in TINHL group was significantly decreased. The dFC intensity of left amygdalostriatal subregion and left precuneus in TINHL group was increased,but the dFC intensity was reduced in the left basolateral subregion and right angular gyrus as well as between the right superficial subregion and right medial orbital of superior frontal gyrus. CONCLUSION Among the 8 subregions of amygdala,the bilateral basolateral subregions,the left amygdalostriatal subregion and the right superficial region shown abnormal functional connectivity with other regions of the brain,which are the important parts of emotional abnormalities in TINHL.

Objective:To investigate the biocompatibility of coral-like barium titanate nano-piezoelectric coatings and the influence of ultrasound-excited piezoelectric effect on the early osteogenic differentiation.Methods:The barium titanate nano-piezoelectric coating (the coating group) was prepared on the surface of titanium metal by anodic oxidation, hydrothermal reaction and high-temperature annealing, and polished titanium specimens were used as control group. The surface morphology, composition, and crystal phase and hydrophilicity of the two groups of titanium specimens were characterized using scanning electron microscopy, X-ray photoelectron spectroscopy, Raman spectroscopy and contact angle meter. The piezoelectric properties of the materials were characterized by piezoresponse force microscopy. Rat bone marrow mesenchymal stem cells (BMSC) were cultured and identified and seeded the surface of titanium specimens in two groups. The cells seeded on blank culture plates were used as blank group. After low intensity pulsed ultrasound intervention, cell proliferation and live/dead staining were detected to evaluate cytocompatibility of the coatings. Alkaline phosphatase (ALP) activity of each group was detected by ALP staining kit, and the expression of osteogenesis-related genes [integrin, bone morphogenetic protein 2 (BMP-2), Runt-related transcription factor 2 (RUNX2)] was detected by real-time fluorescent quantitative PCR (RT-qPCR) to evaluate the effect of the coating on promoting the early osteogenic differentiation of BMSC.Results:The surface of titanium specimens in the coating group showed a uniform coral-like morphology, and the diameter of the coral tentacles was 70-100 nm. The main component was tetragonal barium titanate. The surface hydrophilicity of the coating group (water contact angle 10.12°± 0.93°) was significantly better than that of the control group (water contact angle 78.32°±0.71°) ( F= 10 165.91, P<0.001). The coating has a stable piezoelectric property with a piezoelectric constant of about 5 pC/N. Cell experiments showed that, with or without ultrasound, the cell proliferation activity of the coating group was significantly lower than that of the blank group and the control group on the third day ( P<0.05). On the fifth day, with or without ultrasound, there was no significant difference in cell proliferation activity between the three groups ( P>0.05). After 7 days of culture, the ALP activity of the coating group was significantly higher than that of the blank group and the control group ( P<0.05). The results of RT-qPCR showed that the mRNA expression of integrin and BMP-2 in the coating group with ultrasound was significantly higher than that in the other groups with ultrasound, and was higher than that of the coating group without ultrasound ( P<0.05). The expression of integrin mRNA in the control group with ultrasound was significantly higher than that in the control group without ultrasound ( P<0.05). The expression of RUNX2 mRNA in the coating group with ultrasound was significantly higher than that in the coating group without ultrasound ( P<0.05). Conclusions:The coral-like barium titanate nano-piezoelectric coating exhibits favorable biocompatibility and stable piezoelectric property, and facilitates the early osteogenic differentiation of BMSC under the excitation of low-intensity pulsed ultrasound.

Objective:To explore the cutoff value for assessing small airway dysfunction in children with asthma.Methods:A total of 364 asthmatic children aged 5 to 14 years, with normal ventilatory function, followed up at the Asthma Clinic of the Children′s Hospital of Capital Institute of Pediatrics from January 2017 to January 2018, were selected as the case group. Concurrently, 403 healthy children of the same age range and without any symptoms in the community were chosen as the control group, and pulmonary function tests were conducted. The values of forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC), forced expiratory flow at 50% of FVC (FEF 50), forced expiratory flow at 75% of FVC (FEF 75) and maximum mid-expiratory flow (MMEF) were compared between case group and control group. Statistical tests such as t-test, χ2 test, or Mann-Whitney U test were used to analyze the differences between the groups. Receiver operating characteristic (ROC) curves were constructed, and the maximum Youden Index was utilized to determine the optimal cutoff values and thresholds for identifying small airway dysfunction in asthmatic children. Results:This study comprised 364 children in the case group (220 boys and 144 girls) and 403 children in the control group (198 boys and 205 girls). The small airway parameters (FEF 50%pred, FEF 75%pred, MMEF%pred) in the asthmatic group were significantly lower than in the control group (77% (69%, 91%) vs. 95% (83%, 109%), 67% (54%, 82%) vs. 84% (70%, 102%), 76% (66%, 90%) vs. 97% (86%, 113%), Z=12.03, 11.35, 13.66, all P<0.001). The ROC curve area under the curve for FEF 50%pred, FEF 75%pred, MMEF%pred was 0.75, 0.74, and 0.79, respectively. Using a cutoff value of 80% for FEF 50%pred achieved a sensitivity of 56.9% and specificity of 81.4%. A cutoff value of 74% for FEF 75%pred resulted in a sensitivity of 67.3% and specificity of 69.2%. Finally, using a cutoff value of 84% for MMEF%pred achieved a sensitivity of 67.9% and specificity of 77.2%. Conclusion:In the presence of normal ventilatory function, utilizing FEF 50<80% predicted or MMEF<84% predicted can accurately serve as criteria for identifying small airway dysfunction in children with controlled asthma.

Objective To investigate the protective effect of hyperoside(Hyp)on transverse aortic constriction-in-duced cardiac hypertrophy and its possible mechanism.Methods Forty 8-week-old male C57BL/6J mice were randomly divided into four groups:Sham group,TAC group,Hyp+TAC group and Hyp+ML385+TAC group.Four weeks after operation,cardiac function including left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS)and left ventricular end-diastolic posterior wall thickness(LVPWd)were measured with echocardiography.HE staining was used to evaluate the myocyte cross-sectional area.Masson staining was used to determine myocardial fibrosis.The ratio of heart weight/body weight was calculated.DHE staining was used to assess reactive oxygen species(ROS)production.The mRNA levels of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP)and β-myosin heavy chain(β-MHC)were detected by qRT-PCR.The protein levels of NF-E2-related factor 2(Nrf2),heme oxygenase-1(HO-1),superoxide dismutase2(SOD2)and NAD-PH-Oxidase 2(gp91phox)were detected by Western blot.Differences among groups were compared by one-way a-nalysis of variance,and LSD-t test was used for comparison between the two groups.Results Compared with the Sham group,the values of LVEF and LVFS in the TAC group decreased(P＜0.01).The value of LVPWd,the cross-sectional area,fibrosis and the ratio of HW/BW increased(P＜0.01).The mRNA levels of ANP,BNP andβ-MHC were upregulated(P＜0.01).The ROS production and gp91phox protein level were elevated in the TAC group(P＜0.01),while the protein levels of Nrf2,HO-1 and SOD2 decreased(P＜0.01).Compared with the TAC group,the values of LVEF and LVFS in the Hyp+TAC group increased(P＜0.01).The value of LVPWd,the cross-sectional area,fibrosis and the ratio of HW/BW decreased(P＜0.01).The mRNA levels of ANP,BNP and β-MHC were downregulated(P＜0.01).The ROS production and gp91 phox protein levels were reduced in the Hyp+TAC group(P＜0.01),while the protein levels of Nrf2,HO-1 and SOD2 increased(P＜0.01).However,ML385 could partially reverse the protective effects of Hyp on TAC-induced cardiac hypertrophy.Conclusion Hyp alleviates pressure overload-induced cardiac hypertrophy by inhibiting oxidative stress and fibrosis,and its mechanism may be related to Nrf2/HO-1 signaling.

Objective:To evaluate the efficacy and safety of limited pars plana vitrectomy(LPPV), pressure-controlled phacoemulsification(PCP), intraocular lens implantation(IOL), and posterior capsulotomy (PC) in treatment of nanophthalmic glaucoma eyes which intraocular pressure(IOP) were still out of control after peripheral iridectomy.Methods:All 24 patients(29 eyes) with nanophthalmic glaucoma whose IOP failed to be reduced after peripheral iridectomy and needed LPPV plus PCP plus IOL plus PC were recruited from July 2017 to April 2021. The age of these patients was(44.6±11.0) years old. Preoperative and postoperative IOP, best corrected visual acuity(BCVA), anterior chamber depth(ACD) and number of glaucoma medications were recorded by chart review and compared by using paired t-test or Wilcoxon signed rank-sum test. P<0.05 was considered as statistical significant. IOP could be controlled in normal range(≥5 mmHg and≤21 mmHg), without both of disease progression and serious complications were regarded as the success criteria of the operation. Surgical success rate was evaluated. Surgery-associated complications were recorded. Results:The average follow-up time was(11.52±12.44) months. After the microsurgery, IOP decreased from(33.12±9.25) mmHg to(14.23±3.44) mmHg( P<0.01); The ACD increased from(1.23±0.46) mm to(2.86±0.62) mm, and the median number of glaucoma medications dropped from 3(3,4) to 3(0,3) at final follow-up visit( P<0.05). There were no significant differences in BCVA( P=0.196) and the degrees of angle closure(AC) ( P=0.478) before and after operation. The total surgical success rate was 86.2%(25/29) at the final follow-up visit. Two eyes suffered from local choroidal detachment which recovered within 2 weeks with medical treatment. Conclusion:LPPV plus PCP plus IOL plus PC is a safe and effective novel surgical procedure in the treatment of nanophthalmic glaucoma patients with uncontrolled IOP after peripheral iridectomy. It could significantly decrease IOP, increase the depth of ACD, reduce the number of glaucoma medications and maintain BCVA. It can be considered as a first choice for the surgical management for patients with a such condition.

Objective:To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy.Methods:From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups: 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS).Results:After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ 2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ 2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ 2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS ( HR(95% CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS ( HR(95% CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant ( P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant( P= 0.026). Conclusion:The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected by many clinicopathological factors.

Objective:To investigate the effect of organ dose modulation (ODM) technique on reducing the breast radiation dose in chest CT scanning.Methods:In the phantom test, the PBU-2 adult chest module was used. The clinical chest scan protocol was used and three sets of scans performed on the chest module： (1) ODM off group, ODM was not used; (2) ODM part group, ODM was applied only in the breast region； (3) ODM all group, ODM was applied in the whole scan scope. Other scan parameters were same for the three groups, with smart mA applied. The volume CT dose index (CTDI vol) was recorded for all three groups. A long rod ionization chamber was placed in a fixed position in front of the right breast area to measure the breast skin dose (D). The contrast noise ratio (CNR) and the figure of merit (FOM) were measured respectively. In clinical research, 72 female patients who underwent chest CT scanning in Beijing Tongren Hospital Capital Medical University from August to November 2018 were retrospectively recruited. According to the application of ODM, the patients were divided into ODM off group (without ODM, 36 cases) and ODM part group (ODM applied in the breast region, 36 cases). The CTDI vol and the dose length product (DLP) were recorded. CNR, noise of images were measured and calculated, respectively. The image quality was evaluated by subjective evaluation scores. The one way ANOVA analysis was used in comparing the difference of CNR among the 3 groups in module test. As for clinical cases, the independent samples t test was used to compare the difference in CTDI vol, DLP, CNR and the noise between two groups; and the rank-sum test was used for comparison in image quality subjective evaluation. Results:In module test, the radiation dose was highest in ODM off group, and lowest in ODM all group. The CTDI vol were (6.90±0.02), (6.26±0.02) and (5.99±0.02) mGy, and the D values were (9.17±1.01), (8.01±0.92) and (7.58±0.87) mGy for ODM off group, ODM part group and ODM all group respectively. The CNR values of images with soft tissue algorithm reconstruction were highest in ODM off group and lowest in ODM all group, while no statistically significant difference was displayed ( P>0.05). The CNR values of the images with lung algorithm reconstruction showed the same trend, with statistically significant difference among the three groups ( F=154.732, P=0.006). The FOM of the lung and soft tissue algorithm images was maximized when the ODM was partially applied. As for clinical cases, compared with ODM off group, the dose of ODM part group showed significantly decreased, with CTDI vol decreased by 16.12% ( t=2.604, P=0.011), and the DLP decreased by 16.85% ( t=3.293, P=0.002). No significant difference was found in CNR, noise and subjective score by two doctors between two groups ( P>0.05). Conclusion:The application of ODM in chest CT imaging can reduce the radiation dose of breast with simultaneously maintaining the image quality.

Objective:To investigate the ultrastructural and biomechanical properties of the internal limiting membrane (ILM) in high myopic macular hole (HM-MH) eyes.Methods:ILM specimens were peeled from 14 eyes with HM-MH from August to December in 2017, and 16 eyes with idiopathic macular hole (IMH) in the same period were served as a control.Specimens were detected by immunefluorescence, transmission electron microscopy (TEM) and atomic force microscopy (AFM). This study followed the Declaration of Helsinki, and was approved by the Ethics Committee of Zhongshan Ophthalmic Center.Results:The immunofluorescence staining results showed that collagen Ⅳ was mainly distributed on the vitreal side and laminin on the retinal side of ILM in both groups.TEM findings revealed that the thickness of ILMs in the HM-MH group was (1.01±0.17)μm, which was significantly decreased compared with (1.92±0.21)μm in the IMH group ( t=12.880, P<0.001). The stiffness of the ILMs in the HM-MH group was (2.86±0.33)MPa, which was significantly higher than (0.88±0.23)MPa in the IMH group ( t=-12.650, P<0.001). The stiffness of the ILMs in the HM-MH group was positively correlated with the axial length ( r=0.832, P<0.001). Conclusions:Compared with IMH, the thickness of ILMs from HM-MH patients is thinner and the stiffness is higher, which contribute to a deep understanding of the pathogenesis of HM-MH.