Objective To evaluate the effect of deep learning reconstruction algorithm combined with smart metal artifact reduction(DLMAR)on the quality of abdominal CT images in critically ill patients who are unable to raise their arms and require electrocardiographic(ECG)monitoring.Methods A total of 102 patients were retrospectively enrolled.All subjects were critically ill patients who were unable to raise their arms and required ECG monitoring.Images were reconstructed using 6 algorithms,including filtered back projection(FBP),iterative reconstruction(IR),deep learning(DL),FBP combined with smart metal artifact reduction(FBPMAR),adaptive statistical iterative reconstruction-V combined with smart metal artifact reduction(IRMAR),and DLMAR.A quantitative analysis of CT values,noise,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)was conducted in regions without metal artifacts and regions with metal artifacts in the liver,as well as the tissues,including those from the liver,spleen,pancreas,and aorta,between the two arms.Qualitative analysis of electrode metal artifacts,the visualization of the structures between the two arms,and image noise was performed with a 5-point scoring system(l=worst and 5=best).Results In the regions of the liver with metal artifacts,there was a significant difference between the CT values of the DLMAR group([98.5±9.8]Hounsfield units[H[J])and those of the FBP group([73.7±5.6]HU),the IR group([75.3±7.5]HU),and the DL group([66.3±11.4]HU)(P＜0.01).There was no significant difference between the CT values of the DLMAR group and those of the FBPMAR group([99.8±4.8]HU)and the IRMAR group([99.6±3.4]HU)(P＞0.05).The noise of the DLMAR group was found to be significantly lower than that of the other groups(P＜0.01).Furthermore,the SNR and CNR of the DLMAR group were also found to be higher than those of the other groups(P＜0.01).In the tissue region between the two arms,the differences in CT values among the six groups were not statistically significant(P＞0.05).The noise of the DLMAR group was lower than those of the other groups(P＜0.01),and the SNR and CNR of the DLMAR group were higher than those of the other groups(P＜0.01).In terms of the removal of metal artifacts,the scores of the FBPMAR,IRMAR,and DLMAR groups(4.27±0.32,4.44±0.34,and 4.61±0.28,respectively)were higher than those of the FBP,IR,and DL groups(1.36±0.54,1.32±0.45,and 1.24±0.46,respectively)(P＜0.01).The DLMAR group also had a higher score of 4.62±0.37 in the visualization of structures between the two arms and 4.53±0.39 in the noise reduction of images,both of which were higher than those of the other groups(P＜0.01).Conclusion DLMAR reduces artifacts,decreases noise,and improves the quality of abdominal CT imaging in critically ill patients who are unable to raise their arms and require ECG monitoring.

Humans ; Cardiologists ; Neoplasms/drug therapy* ; Medical Oncology ; Heart ; Oncologists

Hypertension has a high global prevalence rate,which is the main preventable risk factor for cardiovascular disease.Home blood pressure monitoring plays an important role in diagnosis,adjustment of treatment strategies and long-term follow-up of hypertension.However,there are still enormous challenges for the popularization and standardized application of home blood pressure monitoring.Therefore,this review article describes indication,standardized implementation protocol,current status and influencing factors of implementation and management forms of home blood pressure monitoring.It can provide a reference for promoting the implementation of practical guidelines for home blood pressure monitoring and optimizing the application of home blood pressure monitoring.

[摘 要] 目的：探讨PD-1抗体联合化疗对比抗血管生成药物联合化疗在晚期驱动基因阴性肺腺癌一线治疗中的疗效和安全性。方法：收集2018年3月至2021年8月河北医科大学第四医院收治的141例不可手术切除的ⅢB/ⅢC和Ⅳ期驱动基因阴性肺腺癌患者，回顾性分析PD-1抗体联合化疗对比抗血管生成药物联合化疗在一线治疗中的疗效与安全性。主要研究终点为无进展生存期（PFS），次要终点为客观缓解率（ORR）、疾病控制率（DCR）和不良反应。结果：141例患者均纳入生存分析，中位随访时间为13.0个月（95% CI：12.0～14.0）。PD-1抗体联合化疗组（A组）和抗血管生成药物联合化疗组（B组）的ORR分别为33.33%和27.38%，DCR分别为98.25%和89.29%，差异均无统计学意义。A组和B组的中位PFS分别为8.4个月（95% CI: 7.3～9.9）和6.9个月（95% CI: 6.1～7.7），差异无统计学意义。亚组分析结果显示，ⅢB/ⅢC期、肝或脑转移患者中，A组中位PFS较B组均延长（均P<0.01）。A组和B组不良反应发生率分别为26.32%和14.29%，多数为1~2级。结论：PD-1抗体联合化疗对比抗血管生成药物联合化疗一线治疗晚期驱动基因阴性肺腺癌疗效相当，不良反应可耐受，可成为晚期驱动基因阴性肺腺癌标准一线治疗。

Psychogenic non-epilepsy seizures (PNES) are defined as paroxysms with clinical symptoms similar to epilepsy without epileptiform discharges. It is often misdiagnosed as epilepsy. Misdiagnosis not only delays the time for patients with PNES to get correct diagnoses and treatments, but also may increase the risk of adverse effects from improper use of antiseizure medications. The diagnostic method of PNES is video electroencephalogram monitoring, but there is no consensus on the optimal duration of monitoring. At the same time, the use of diverse physiological signals, brain imaging, laboratory examination, and the application of machine learning provide new perceptions for the precise identification of PNES and epilepsy. This article reviewed the progress of precise differential diagnosis between PNES and epilepsy.

【Objective】 To investigate the changes of platelet microRNA (miRNA) expression profiles on d1 and d5 during storage with riboflavin and ultraviolet-B (UVB) light (VB2-PRT) treatment, and to explore the molecular mechanism of miRNAs involved in the regulation of platelet storage lesion (PSL) under VB2-PRT treatment. 【Methods】 20 apheresis platelet concentrates (5mL / sample) were collected from voluntary blood donors. After mixing and shaking, the samples was treated with riboflavin (final concentration 50 μmol/L) and 6.24J/mL UVB light for 8min, then split into two aliquots and agitated stored at (22±2) ℃. The concentrates were sampled (5mL) on d1 and d5, respectively, and sequenced by DNA nanoball (DNB) sequencing technology. The differentially expressed miRNAs between the two groups (at different storage periods) were screened by DEGseq and MA-plot analysis software. The miRNAs, reached more than 2 times different expression between groups, were considered significant different(P<0.01). The miRanda and TargetScan softwares were used to predict the target genes. Gene Ontology (GO) function enrichment analysis and Kyoto Encyclopedia of genes and genomes (KEGG) pathway enrichment analysis were performed on the target genes of significant differentially expressed miRNAs. The expression of miRNAs was verified by real-time fluorescence quantitative PCR (qRT-PCR). 【Results】 miRNA expression profile: compared with d1 platelets, there were 590 miRNAs with significantly different expression (P< 0.01) in d5 group, including 255 up-regulated miRNAs (such as miR-99b, miR-7) and 335 down regulated miRNAs (such as miR-451a, miR-19b). Among the 272 known miRNAs, 112 were up-regulated and 160 were down regulated. There were 318 new miRNAs sequences. The enriched GO terms of target genes of differentially expressed miRNAs in d5 and d1 groups included cell components, organelles, cell membranes and other cellular structures, molecular functions such as adhesion, catalysis, molecular conversion, transportation, transcription factor and receptor activity, and biological processes such as cell processing, metabolism, biological regulation and stress. The corresponding pathways in the top 10 of KEGG enrichment were mainly secretion, glucose metabolism, signal transduction, membrane transport, translation, environmental adaptation and other signal pathways. The six randomly selected differentially expressed miRNAs verified by qRT-PCR was consistent with those of DNB sequencing. 【Conclusion】 The expression profiles of platelets miRNAs has changed significantly between d1- and d5-storage under VB2-PRT treatment. Functional prediction suggests that these miRNAs might be involved in the regulation of platelet PSL underVB2-PRT treatment.

【Objective】 To investigate the changes of platelet microRNA (miRNA) expression profiles of storage in vitro, and to explore the molecular mechanism of miRNAs involved in the regulation of platelet storage lesion (PSL). 【Methods】 20 platelet samples (5 mL / sample) were collected from apheresis platelet donors, fully mixed and stored in a shaker with (22±2) ℃ horizontal agitation, sampled on day 1 and day 5, and sequenced by DNA nanoball (DNB) sequencing technology. The miRNAs with more than 2 times expressions (P<0.01) were considered as significantly differences between d5 and d1 groups. The miRanda and TargetScan softwares were used to predict the target genes. Gene Ontology (GO) function enrichment analysis and Kyoto Encyclopedia of genes and genomes (KEGG) pathway enrichment analysis were performed on the target genes of significant differentially expressed miRNAs. The expression of miRNAs was verified by real-time fluorescence quantitative PCR (qRT-PCR). 【Results】 Compared with d1 group, 315 miRNAs with significantly different expression (P<0.01) were screened in d5 group, including 146 up-regulated miRNAs (such as miR-146a, let-7b), and 169 down-regulated miRNAs (such as mir-30d, mir-142). Among 126 known miRNAs, 43 were up-regulated and 83 were down-regulated. There are 189 new miRNA sequences. The enriched GO terms of target genes of differentially expressed miRNAs in d5 and d1 groups included cell components, organelles, cell membrane and other cell structures, molecular functions such as adhesion, catalysis and activity, and biological processes such as cell processing, metabolism, biological regulation and stress. The corresponding pathways in the top 10 of KEGG enrichment were mainly signal transduction, secretion, membrane transport, amino acid metabolism, polysaccharide metabolism, protein synthesis and environmental adaptation. The 6 randomly selected differentially expressed miRNAs verified by qRT-PCR were consistent with those of DNB sequencing. 【Conclusion】 The expression profiles of platelets miRNAs have changed significantly between the d1 and d5 of storage in vitro. Functional prediction suggested that these miRNAs might be involved in the regulation of platelet PSL.

【Objective】 To analyze the changes of microRNA (miRNA) expression profiles on day 1 and day 5 after storage with or without riboflavin and ultraviolet-B (UVB) light (VB2-PRT) treatment, and to explore the molecular mechanism of miRNAs involved in the regulation of platelet storage lesion (PSL) under VB2-PRT treatment. 【Methods】 20 apheresis platelet concentrates (5mL / sample), collected from voluntary donors, were split into two group after mixing and agitation. One was treated with riboflavin (final concentration 50 μmol/L) plus 6.24 J/mL UVB light(E group), and the other worked as a control group (C group) without any treatment. Both groups were subjected to agitated storage at (22±2) ℃ horizontally. The platelet concentrates were sampled on d1 and d5 (5mL) during storage, named as E1, E5, C1 and C5 groups, respectively, and sequenced by DNA nanoball (DNB) sequencing technology. The differentially expressed miRNAs between E and C groups were screened by using DEGseq and MA-plot analysis software, and GO function enrichment analysis and KEGG pathway enrichment analysis were further performed when the different expression between groups reached twofold and above. 【Results】 Compared with C1 group, 487 miRNAs with significantly different expression (P<0.01) were screened in E1 group, including 220 up-regulated miRNAs, such as miR-146a and let-7b, and 267 down regulated miRNAs, such as miR-7 and miR-1260. Compared with C5 group, 229 miRNAs with significantly different expression (P<0.01) were screened in E5, including 80 miRNAs with up-regulated expression, such as miR-423 and miR-378, and 149 down regulated miRNAs, such as miR-451 and miR-30.The target genes with differentially expressed miRNAs in E1 vs C1 groups and E5 vs C5 groups were similar in the numbers of enriched GO terms, including cell components, organelles, cell membrane and other cell structures, molecular functions such as adhesion, catalysis, molecular transformation, transportation, transcription factors and receptor activity, cell processing, metabolism, biological regulation, stress and other biological processes etc. Compared with E1 and C1 groups, E5 and C5 groups lacked of signal pathways related to environmental adaptation, translation and mucin synthesis, however, it increased inositol phosphate metabolism, phosphatidylinositol signaling system and chemokine signaling pathway. 【Conclusion】 The expression profiles of platelets miRNAs treated with VB2-PRT has changed significantly after storage for a period of time. Functional prediction suggests that these miRNAs might be involved in the regulation of platelet PSL induced by VB2-PRT.

Detection of serum biomarkers is an important strategy for the diagnosis of cardiovascular diseases. The roles of serum biomarker detection have become increasingly valuable in the baseline risk stratification among cancer patients in recent years. The Cardio-oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology newly proposed the “role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies”. By evaluating the characteristics of cardiac biomarkers in cancer patients receiving cardiotoxic cancer therapy, this statement discussed the mechanism, clinical application, value on monitoring and prognosis of the two main biomarkers,cardiac troponin and natriuretic peptide on chemotherapy induced cardiac toxic responses. The purpose of this statement is to help establish the multidisciplinary collaborative diagnosis and treatment strategies and provide a clinical framework, and guide clinicians to select appropriate serum biomarker monitoring programs based on risk stratification to prevent cardiovascular disease in cancer patients.

Atrial fibrillation (AF) is one of the most common arrhythmias, associated with high morbidity, mortality, and healthcare costs, and it places a significant burden on both individuals and society. Anti-arrhythmic drugs are the most commonly used strategy for treating AF. However, drug therapy faces challenges because of its limited efficacy and potential side effects. Catheter ablation is widely used as an alternative treatment for AF. Nevertheless, because the mechanism of AF is not fully understood, the recurrence rate after ablation remains high. In addition, the outcomes of ablation can vary significantly between medical institutions and patients, especially for persistent AF. Therefore, the issue of which ablation strategy is optimal is still far from settled. Computational modeling has the advantages of repeatable operation, low cost, freedom from risk, and complete control, and is a useful tool for not only predicting the results of different ablation strategies on the same model but also finding optimal personalized ablation targets for clinical reference and even guidance. This review summarizes three-dimensional computational modeling simulations of catheter ablation for AF, from the early-stage attempts such as Maze III or circumferential pulmonary vein isolation to the latest advances based on personalized substrate-guided ablation. Finally, we summarize current developments and challenges and provide our perspectives and suggestions for future directions.