Objective To investigate the CT imaging manifestations of tumor-like proliferation of extramedullary hematopoiesis(EMH)in thalassemia(TM).Methods A retrospective analysis was conducted on the clinical data of 41 patients with tumor-like proliferation of EMH in TM.The CT imaging features of the patients were analyzed,including the location,lesion morphology,density,and degree of enhancement of the lesions.Results Lesions of varying sizes were identified on both sides of the thoracic vertebrae in all 41 cases,including 20 cases with lesions in the inner edge of the ribs and 1 case within the spinal epidural space.A total of 23 abdominal scans and 2 lumbar scans,lesions were found in the sacral region in 18 cases,primarily in the presacral area and sacral wings.Lesions adjacent to the thoracic paravertebral and in the sacral region were quasi-circular,while those on the ribs were quasi-circular or flat and mound-shaped,closely adhering to the inner edge of the ribs.Intraspinal epidural lesions were characterized by a longitudinal orientation,positioned adjacent to the posterior part of the thoracic spinal canal.Most lesions showed homogeneous moderate density.Bone erosion was observed in 14 rib lesions and 7 sacral region lesions,resulting in heterogeneous slightly high density shadow of the lesions.Small nodular high density shadow were identified in 4 cases,and small amounts of fatty density shadow were observed in 4 cases.20 cases showed mild-to-moderate enhancement on enhanced scan,and 11 cases showed"vascular traversal sign"in thoracic paravertebral lesions.Conclusion The CT manifestations of tumor-like proliferation of EMH in TM are characteristic.The combination of typical CT manifestations and medical history facilitates an accurate diagnosis.Indicators such as fat replacement,iron deposition nodules,bone erosion,and"vascular traversal sign"are valuable in the diagnosis of tumor-like proliferation of EMH.

Background: The function of CD69 expressed on T cells in chronic hepatitis B (CHB) remains unclear. We aimed to elucidate the roles of CD69 on T cells in the disease process and in antiviral therapy for CHB. Methods: We enrolled 335 treatment-naive patients with CHB and 93 patients with CHB on antiviral therapy. CD69, antiviral cytokine production by T cells, T-helper (Th) cells, and inhibitory molecules of T cells were measured using flow cytometry, and clinical-virological characteristics were examined dynamically during antiviral therapy. Results: CD69 expression on CD3+, CD4+, and CD8+ T cells was the lowest in the immune-active phase and was negatively correlated with liver transaminase activity, fibrosis features, inflammatory cytokine production by T cells, and Th-cell frequencies but positively with inhibitory molecules on T cells. CD69 expression on CD3+, CD4+, and CD8+ T cells decreased after 48 weeks of antiviral therapy, and patients with hepatitis B e antigen (HBeAg) seroconversion in week 48 showed lower CD69 expression on T cells at baseline and week 48. The area under the ROC curve of CD69 expression on T cells at baseline for predicting HBeAg seroconversion in week 48 was 0.870, the sensitivity was 0.909, and the specificity was 0.714 (P = 0.002). Conclusions CD69 negatively regulates T-cell immunity during CHB, and its expression decreases with antiviral therapy. CD69 expression predicts HBeAg seroconversion in week 48. CD69 may play an important negative role in regulating T cells and affect the efficacy of antiviral therapy.

Objective To investigate the CT imaging manifestations of tumor-like proliferation of extramedullary hematopoiesis(EMH)in thalassemia(TM).Methods A retrospective analysis was conducted on the clinical data of 41 patients with tumor-like proliferation of EMH in TM.The CT imaging features of the patients were analyzed,including the location,lesion morphology,density,and degree of enhancement of the lesions.Results Lesions of varying sizes were identified on both sides of the thoracic vertebrae in all 41 cases,including 20 cases with lesions in the inner edge of the ribs and 1 case within the spinal epidural space.A total of 23 abdominal scans and 2 lumbar scans,lesions were found in the sacral region in 18 cases,primarily in the presacral area and sacral wings.Lesions adjacent to the thoracic paravertebral and in the sacral region were quasi-circular,while those on the ribs were quasi-circular or flat and mound-shaped,closely adhering to the inner edge of the ribs.Intraspinal epidural lesions were characterized by a longitudinal orientation,positioned adjacent to the posterior part of the thoracic spinal canal.Most lesions showed homogeneous moderate density.Bone erosion was observed in 14 rib lesions and 7 sacral region lesions,resulting in heterogeneous slightly high density shadow of the lesions.Small nodular high density shadow were identified in 4 cases,and small amounts of fatty density shadow were observed in 4 cases.20 cases showed mild-to-moderate enhancement on enhanced scan,and 11 cases showed"vascular traversal sign"in thoracic paravertebral lesions.Conclusion The CT manifestations of tumor-like proliferation of EMH in TM are characteristic.The combination of typical CT manifestations and medical history facilitates an accurate diagnosis.Indicators such as fat replacement,iron deposition nodules,bone erosion,and"vascular traversal sign"are valuable in the diagnosis of tumor-like proliferation of EMH.

The SNP loci of ACOX1 gene in 83 China Holstein cows were detected by PCR amplifica-tion and direct sequencing,and the association between the genetic polymorphism loci of ACOX 1 gene and milk quality traits of China Holstein cows was analyzed by SPSS 25.0 software.The re-sults showed that a SNP locus I3-2 267 G→C was found in the third intron of ACOX1 gene,it was moderately polymorphic and in Hardy Weinberg equilibrium in the population.By correlation anal-ysis,it was found that the SNP locus was significantly related to the somatic cell content and cor-rected milk quantity of dairy cows.The I3-2 267 G→C locus of ACOX1 gene can be used as a mo-lecular marker of quality traits of Holstein cows in China,and provide reference for the study of quality traits of Holstein cows in China.

Objective:To assess the validity and applicability of the questionnaires through the survey of patient-perceived service quality at the sample Internet hospital, gain the information of service quality of the Internet hospital and put forward suggestions for its improvement.Methods:Random cluster sampling method was used to conduct an online questionnaire survey on the perceived service quality of an Internet hospital in Beijing from September 15 to October 30, 2022. Altogether 450 valid questionnaires were collected. The questionnaire included 23 questions in 3 categories: environment quality, interaction quality and outcome quality; and it also investigated the patient′s demographic characteristics and chronic disease status. Cronbach′s alpha, Kendall′s W, and Bollen-Stine models were employed to analyze the reliability and validity of the questionnaire, Spearman correlation coefficient and Wilcoxon test were used to analyze the correlation and comparison of quality results, and expectation-performance gap and importance performance analysis methods were applied to analyze quality management issues and improvement priorities. Results:The Cronbach′s alpha of the questionnaire was 0.97, Kendall′s W was 0.36. The Bollen-Stine analysis showed that all the evaluation indicators met the consistency requirements. Taken 7 as the highest score, the overall perception score of the service quality of the Internet hospital was 5.22, the expected score was 5.41, and the difference was -0.19. Among the 23 indicators, 6 indicators had perceived scores exceeding the expected score, and 17 indicators had perceived scores below the expected score. The patient′s satisfaction score of the Internet hospital was 5.29, which was significantly correlated with the perceived score of service quality. The results of expectation-performance gap analysis and importance performance analysis suggested that emergency handling, risk notification, privacy protection, online and offline close combination, etc. should be the focus in the improvement of the Internet hospital′s service quality. Conclusions:The questionnaire of Internet hospital service quality is scientific and applicable, which can serve as references for future related research. The construction and operation of Internet hospitals need to focus on the aging needs, and improve the service quality and satisfaction level by strengthening medical security and information security management, coordinating online and offline medical resources, and improving the number and medical level of physicians.

Objective:To assess the validity and applicability of the questionnaires through the survey of patient-perceived service quality at the sample Internet hospital, gain the information of service quality of the Internet hospital and put forward suggestions for its improvement.Methods:Random cluster sampling method was used to conduct an online questionnaire survey on the perceived service quality of an Internet hospital in Beijing from September 15 to October 30, 2022. Altogether 450 valid questionnaires were collected. The questionnaire included 23 questions in 3 categories: environment quality, interaction quality and outcome quality; and it also investigated the patient′s demographic characteristics and chronic disease status. Cronbach′s alpha, Kendall′s W, and Bollen-Stine models were employed to analyze the reliability and validity of the questionnaire, Spearman correlation coefficient and Wilcoxon test were used to analyze the correlation and comparison of quality results, and expectation-performance gap and importance performance analysis methods were applied to analyze quality management issues and improvement priorities. Results:The Cronbach′s alpha of the questionnaire was 0.97, Kendall′s W was 0.36. The Bollen-Stine analysis showed that all the evaluation indicators met the consistency requirements. Taken 7 as the highest score, the overall perception score of the service quality of the Internet hospital was 5.22, the expected score was 5.41, and the difference was -0.19. Among the 23 indicators, 6 indicators had perceived scores exceeding the expected score, and 17 indicators had perceived scores below the expected score. The patient′s satisfaction score of the Internet hospital was 5.29, which was significantly correlated with the perceived score of service quality. The results of expectation-performance gap analysis and importance performance analysis suggested that emergency handling, risk notification, privacy protection, online and offline close combination, etc. should be the focus in the improvement of the Internet hospital′s service quality. Conclusions:The questionnaire of Internet hospital service quality is scientific and applicable, which can serve as references for future related research. The construction and operation of Internet hospitals need to focus on the aging needs, and improve the service quality and satisfaction level by strengthening medical security and information security management, coordinating online and offline medical resources, and improving the number and medical level of physicians.

Blood deficiency syndrome (BDS) refers to a pathological state with blood dysfunction and organ dystrophy in traditional Chinese medicine. Danggui Wuji granules (DWG) was developed from a formula containing Angelicae Sinensis Radix and Musculus et Os Galli Domestici. Herein, we investigated the mechanism of DWG in treating BDS by modulating gut microbiota. We found that DWG protected mice from BDS by elevating the levels of red blood cell count, hemoglobin, and hematocrit in peripheral blood and increasing the erythrocyte membrane Na⁺-K⁺-ATPase activity. Danggui Wuji granules changed the composition and metabolites of colonic flora. Notably, Lactobacillus, Muribaculaceae, and Alistipes were the main genera showing changes after DWG treatment. Our findings revealed that DWG presented a positive therapeutic effect on BDS in mice by regulating the gut microbiota and metabolites. The protective mechanism of DWG was associated with pathways such as metabolic pathways, biosynthesis of secondary metabolites, ABC transporters, ribosome, thyroid hormone synthesis, lysine degradation, galactose metabolism, tyrosine metabolism, etc.

ObjectiveTo clarify the therapeutic effect of Huashi Baidu prescription on pneumonia in mice caused by influenza A （H1N1） virus and explore its mechanism based on the transcriptome. MethodA mouse influenza viral pneumonia model was built by intranasal infection with influenza A virus， and mice were continuously administered the drug for five days， so as to investigate the general condition， lung index， viral load， pathological morphology of lung tissue， survival time， and prolongation rate of survival time of mice and clarify the therapeutic effect of Huashi Baidu prescription on influenza viral pneumonia. Transcriptome technology was used to detect the differentially expressed genes in the lung tissue of mice in the model group and the normal group， as well as the Huashi Baidu prescription group and the model group， and the potential core target of the Huashi Baidu prescription for the treatment of influenza viral pneumonia was screened. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to verify the effect of Huashi Baidu prescription on the mRNA expression level of core target genes. ResultCompared with the normal group， the lung index and viral load in the lung tissue of the model group were significantly increased （P<0.05， P<0.01）. Compared with the model group， the high-dose group of Huashi Baidu prescription significantly prolonged the survival time of mice infected with influenza A virus （P<0.05） and significantly reduced the lung index value of mice （P<0.05） and the viral load of lung tissue. The high-dose， medium-dose， and low-dose groups of Huashi Baidu prescription could significantly reduce lung tissue inflammation， blood stasis， swelling， and other pathological changes in mice （P<0.05， P<0.01）. Transcriptome analysis of lung tissue showed that core genes were mainly enriched in the nuclear transcription factor-κB （NF-κB） signaling pathway， interleukin-17 （IL-17） signaling pathway， cytokine-cytokine receptor interaction， and other pathways after the intervention of Huashi Baidu prescription. TRAF6， NFKBIA， CCL2， CCL7， and CXCL2 were the top five node genes with combined score values. Real-time PCR validation showed that Huashi Baidu prescription significantly downregulated the mRNA expression of key genes TRAF6 and NFKBIA in the NF-κB signaling pathway， as well as chemokines CCL2， CCL7， and CXCL2 （P<0.05， P<0.01）. ConclusionHuashi Baidu prescription has a therapeutic effect on influenza viral pneumonia， possibly by inhibiting the expression of key nodes TRAF6 and NFKBIA in the NF-κB signaling pathway and that of chemokines CCL2， CCL7， and CXCL2， reducing the recruitment of inflammatory cells and viral load， and exerting anti-influenza viral pneumonia effects.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.

Objective To explore and analyze the effects of ω-3 polyunsaturated fatty acid(PUFA)on oxidative stress and Toll like receptor-4(TLR4)and tumor necrosis factor alpha(TNF-α)in rats with acute lung injury(ALI)induced by lipopolysaccharide (LPS).Methods 120 healthy adult Wistar rats(clean grade;weight,180-240 g)were randomly divided into control group and ob-servation group,60 rats in each group,rats in the control group were randomly divided into untreated group,6 h group(LPS injec-tion),and 24 h group(LPS injection),20 rats in each group.The rats in the observation group were randomly divided into untreated group,6h group(PUFA+LPS injection),and 24 h group(PUFA+LPS injection),20 rats in each group.The relative expression of Superoxide Dismutase(SOD)before treatment,6 h after treatment and 24 h after treatment,Malondialdehyde(MDA),intercellular cell adhesion molecule-1(ICAM-1),TNF-α,and TLR4 in two groups were observed.Results The difference of SOD levels before and after treatment in the two groups of rats was statistically significant(P<0.05),the difference of SOD levels before treatment in the two groups of rats was not statistically significant(P> 0.05).As the processing time went on,the level of SOD in the two groups of rats decreased,but the decrease of the rats in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05),the difference of MDA level before and after treatment in two groups of rats was statistically significant(P<0.05).As the processing time went on,The level of MDA in the two groups of rats increased,but the increase of the rats in the observation group was significantly lower than that of the control group,and the difference was statistical-ly significant(P<0.05).The difference of ICAM-1 level before and after treatment in the two groups of rats was statistically signif-icant(P<0.05).As the processing time went on,the levels of ICAM-1 and TNF-alpha in the two groups increased,but the increase of the rats in the observation group was significantly lower than that in the control group,the difference was statistically significant (P<0.05).The relative expression of TLR4 in the lung tissue of the observation group was significantly lower than that of the control group(P<0.05).Conclusion PUFA could effectively reduce the oxidative stress and inflammation in ALI rats induced by LPS,which may contribute to the treatment of ALI.