Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

Objective:To analyze the relationship between CT characteristics and related quantitative parameters of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in patients.Methods:This retrospective analysis included 198 patients with thyroid nodules who visited Shangqiu First People’s Hospital between Jun. 2019 and Dec. 2024. The patients included 53 males and 145 females, aged (50.96 ± 5.36) years. A total of 105 patients were classified as benign nodules and 93 patients as malignant nodules (45 with metastasis and 48 without metastasis). All patients underwent spectral CT scans to analyze the efficacy of spectral CT in diagnosing the nature of thyroid nodules and lymph node metastasis in malignant nodules. Continuous data were expressed as ±s, and intergroup comparisons were performed using independent sample t-tests. Enumeration data were expressed as [n (%) ] and tested using the chi-squared test. Receiver-operating characteristic (ROC) curves were constructed to determine the diagnostic efficacy of various CT features and related quantitative parameters in diagnosing thyroid nodules and cervical lymph node metastasis. Results:The AUCs of capsule, edge and shape for diagnosing malignant nodules were 0.706, 0.701 and 0.735, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase for diagnosing malignant thyroid nodules were 0.967, 0.992, 0.966, 0.819, 0.991 and 0.986, respectively. The AUCs of nodule number, capsule, edge, shape and long diameter of nodule for diagnosing cervical lymph node metastasis in patients with malignant thyroid nodules were 0.642, 0.617, 0.643, 0.619 and 0.651, respectively. The AUCs of IC, NIC and slope of energy spectrum curve in arterial phase and IC, NIC and slope of energy spectrum curve in venous phase were 0.941, 0.941, 0.955, 0.786, 0.881 and 0.824, respectively. Multivariate analysis showed that multiple nodules, absence of capsule, blurred margins, irregular shape, nodule long diameter >10 mm, IC, NIC in the arterial and venous phases, and increased slope of the energy spectrum curve were independent risk factors for cervical lymph node metastasis in patients with malignant thyroid nodules ( OR=2.631, 1.854, 2.694, 1.936, 2.657, 2.064, 2.314, 2.525, 2.342, 2.712, 2.986, P<0.05) . Conclusions:In spectral CT examinations of patients with thyroid nodules, malignant nodules often show characteristics such as no capsule and blurred edges, accompanied by changes in relevant quantitative parameters. These CT characteristics and quantitative parameters have good diagnostic efficacy for the nature of thyroid nodules and cervical lymph node metastasis in patients with malignant nodules, and have high clinical application value.

OBJECTIVES: To estimate postmortem interval (PMI) by analyzing the protein changes in skeletal muscle tissues with the protein chip technology combined with multivariate analysis methods. METHODS: Rats were sacrificed for cervical dislocation and placed at 16 ℃. Water-soluble proteins in skeletal muscles were extracted at 10 time points (0 d, 1 d, 2 d, 3 d, 4 d, 5 d, 6 d, 7 d, 8 d and 9 d) after death. Protein expression profile data with relative molecular mass of 14 000-230 000 were obtained. Principal component analysis (PCA) and orthogonal partial least squares (OPLS) were used for data analysis. Fisher discriminant model and back propagation (BP) neural network model were constructed to classify and preliminarily estimate the PMI. In addition, the protein expression profiles data of human skeletal muscles at different time points after death were collected, and the relationship between them and PMI was analyzed by heat map and cluster analysis. RESULTS: The protein peak of rat skeletal muscle changed with PMI. The result of PCA combined with OPLS discriminant analysis showed statistical significance in groups with different time points (P<0.05) except 6 d, 7 d and 8 d after death. By Fisher discriminant analysis, the accuracy of internal cross-validation was 71.4% and the accuracy of external validation was 66.7%. The BP neural network model classification and preliminary estimation results showed the accuracy of internal cross-validation was 98.2%, and the accuracy of external validation was 95.8%. There was a significant difference in protein expression between 4 d and 25 h after death by the cluster analysis of the human skeletal muscle samples. CONCLUSIONS The protein chip technology can quickly, accurately and repeatedly obtain water-soluble protein expression profiles in rats' and human skeletal muscles with the relative molecular mass of 14 000-230 000 at different time points postmortem. The establishment of multiple PMI estimation models based on multivariate analysis can provide a new idea and method for PMI estimation.
Animals ; Humans ; Rats ; Multivariate Analysis ; Postmortem Changes ; Protein Array Analysis ; Technology

This article reports a case of small cell lung cancer with chronic intestinal pseudo-obstruction as the initial manifestation in the Changzhou No.2 People′s Hospital, and reviews relevant literature reports in order to improve clinicians′ understanding of paraneoplastic syndrome associated with small bowel obstruction and reduce missed diagnosis and misdiagnosis.

This article reports a case of small cell lung cancer with chronic intestinal pseudo-obstruction as the initial manifestation in the Changzhou No.2 People′s Hospital, and reviews relevant literature reports in order to improve clinicians′ understanding of paraneoplastic syndrome associated with small bowel obstruction and reduce missed diagnosis and misdiagnosis.

Objective:To investigate the role of Bruton's tyrosine kinase (BTK) in pyroptosis of intestinal cells caused by endotoxin/lipopolysaccharide (LPS) in scalded mice.Methods:The experimental research method was applied. One hundred and twenty-eight male C57BL/6 mice aged 6-8 weeks were divided into sham injury group, scald alone group, scald+LPS group, scald+LPS+3 mg/kg LFM-A13 group, scald+LPS+10 mg/kg LFM-A13 group, and scald+LPS+30 mg/kg LFM-A13 group. There were 8 mice in sham injury group, and there were 24 mice in the other 5 groups, respectively. Mice in 5 scald groups were inflicted with 10% total body surface area full-thickness scald on the back, and mice in sham injury group were sham injured on the back. At post injury hour (PIH) 0 (immediately), mice in sham injury group and scald alone group were intraperitoneally injected with normal saline, mice in scald+LPS group were intraperitoneally injected with LPS, and mice in scald+LPS+3 mg/kg LFM-A13 group, scald+LPS+10 mg/kg LFM-A13 group, and scald+LPS+30 mg/kg LFM-A13 group were intraperitoneally injected with LPS and LFM-A13 in corresponding doses. Mice in sham injury group were sacrificed at PIH 0 to collect serum and intestinal tissue, and 8 mice in each group of 5 scald groups were sacrificed at PIH 0, 12, and 24 to collect intestinal tissue and serum at PIH 12. Immunohistochemistry was used to detect phosphorylation of BTK in intestinal tissue of mice. Western blotting was used to detect the protein expressions of phosphorylated BTK (p-BTK), cleaved cysteine aspartic acid specific protease 1 (caspase-1), and cleaved caspase-11 in intestinal tissue of mice. Enzyme-linked immunosorbent assay method was used to detect interleukin-1β (IL-1β) in serum and intestinal tissue of mice. Data were statistically analyzed with one-way analysis of variance and least significant difference test.Results:There was no obvious phosphorylation of BTK in intestinal tissue of mice in 6 groups at PIH 0 and scald alone group at PIH 12 and 24. Phosphorylation of BTK in intestinal tissue of mice in scald+LPS group at PIH 12 and 24 were obviously increased compared with those in scald alone group. Phosphorylation of BTK in intestinal tissue of mice in scald+LPS+3 mg/kg LFM-A13 group, scald+LPS+10 mg/kg LFM-A13 group, and scald+LPS+30 mg/kg LFM-A13 group were obviously decreased compared with those in scald+LPS group, and the degrees of decline gradually increased with increase of dose in LFM-A13. Compared with (0.130±0.010) of sham injury group and (0.120±0.040 and 0.110±0.040) of scald alone group, protein expressions of p-BTK in intestinal tissue of mice in scald+LPS group at PIH 12 and 24 were obviously increased (0.470±0.090 and 0.430±0.080, P<0.01). Compared with those in scald+LPS group, protein expressions of p-BTK in intestinal tissue of mice in scald+LPS+3 mg/kg LFM-A13 group at PIH 24, and scald+LPS+10 mg/kg LFM-A13 group and scald+LPS+30 mg/kg LFM-A13 group at PIH 12 and 24 were obviously decreased (0.280±0.060, 0.300±0.120, 0.150±0.050, 0.280±0.090, 0.140±0.040, P<0.05 or P<0.01). Compared with those in scald+LPS+3 mg/kg LFM-A13 group, protein expressions of p-BTK in intestinal tissue of mice in scald+LPS+10 mg/kg LFM-A13 group and scald+LPS+30 mg/kg LFM-A13 group at PIH 24 were obviously decreased ( P<0.01). Compared with those in sham injury group and scald alone group, protein expressions of cleaved caspase-1 and caspase-11 in intestinal tissue of mice in scald+LPS group were obviously increased at PIH 12 and 24 ( P<0.01). Compared with those in scald+LPS group, protein expressions of cleaved caspase-1 at PIH 12 and cleaved caspase-11 at PIH 12 and 24 in intestinal tissue of mice in scald+LPS+3 mg/kg LFM-A13 group and protein expressions of cleaved caspase-1 and caspase-11 in intestinal tissue of mice in scald+LPS+10 mg/kg LFM-A13 group and scald+LPS+30 mg/kg LFM-A13 group at PIH 12 and 24 were obviously decreased ( P<0.01). Compared with those in scald+LPS+3 mg/kg LFM-A13 group, protein expressions of cleaved caspase-1 and caspase-11 in intestinal tissue of mice in scald+LPS+10 mg/kg LFM-A13 group and scald+LPS+30 mg/kg LFM-A13 group at PIH 12 and 24 were obviously decreased ( P<0.05 or P<0.01). At PIH 12, content of IL-1β in intestinal tissue and serum of mice in scald+LPS group were obviously higher than those in sham injury group and scald alone group ( P<0.01), and content of IL-1β in intestinal tissue and serum of mice in scald+LPS+30 mg/kg LFM-A13 group were obviously lower than those in scald+LPS group ( P<0.01). Conclusions:Phosphorylation of BTK is related to increases of cleaved caspase-1 and caspase-11 in intestinal tissue, and IL-1β content in intestinal tissue and serum of scalded septic mice caused by LPS. Phosphorylation of BTK mediates intestinal cell pyroptosis of scalded mice caused by LPS. Inhibiting phosphorylation of BTK can alleviate intestinal cell pyroptosis of scalded mice, with protective effect on intestinal injury intestine.

Objective:To evaluate a new nano-carbon lymphatic tracing method to increase the number of lymph nodes acquired in patients with neoadjuvant chemotherapy for gastric cancer.Method:From Jan 2015 to Mar 2016, 159 patients with gastric cancer were recruited including 66 cases in study group receiving nano carbon injection under the mucosa layer one day before the operation, and 93 cases with intraoperative subserosal layer injection as control.Results:The average number of lymph nodes obtained in the study group was 47.0±14.7, while that in control was 38.0±14.5, P<0.05. The number of fibrotic lymph nodes obtained in the study group was 3.1 ± 1.9, compared with 3.0±1.8 in control, P>0.05. The number of black-stained lymph nodes in the former was 22.3±4.4, and the later was 14.7±4.8, P<0.05. The lymph nodes harvested in the first station in study group was 26.6±8.5, while that in the control group was 24.1±9.9, P>0.05. The lymph nodes obtained in the second station was 20.4±6.9 in study group, while in control was 13.8±5.7, P<0.05. Conclusions:The submucosal injection of nanocarbon one day before surgery increase the number of lymph nodes obtained in gastric cancer patients with neoadjuvant chemotherapy.

Objective To investigate the clinical effect of microsurgical repair after ring avulsion injuries. Methods From March, 2009 to December, 2014, 6 cases (6 fingers) of ring avulsion injury were repaired. There were 4 males and 2 females with an age range of 18-30 (mean, 22) years, which were 4 cases of ring finger and 2 cas-es of middle finger. The plane of injury was metacarpophalangeal band. Fracture and dislocation was reduced and fixed if damage fingers following with fracture and dislocation of interphalangeae.The damage ligament and volar plate and extensor tendon was repaired. The digital arteries and veins were repaired, and the digital nerves were sutured. System rehabilitation exercise carried out postoperatively. Results All fingers survived, and were followed-up for 8 to 30 months. The appearance of the fingers was excellent. The avarege range of motion of the proximal interpha-langeal was 80°(ranged from 70°to 100°).The distal interphalangeal was 50°(ranged from 40°to 60°).The sensory re-covery of finger pulp ranged from S3to S3+.The two-point discrimination was 5 mm to 12 mm. According to the Eval-uation Criteria for Finger Replantation and Reconstruction Issued by Chinese Hand Surgery of Chinese Mdical Associ-ation, 4 fingers had excellent while 2 had fairly good function. Conclusion Microsurgical repair of ring avulsion injury can achieve satisfactory clinical results by rehabilitation exercises postoperatively.

[Objective]To observe the effects of qing-nao-ding-tong decoction on the levels of IL-6 and TNF-? in subarachnoid hemorrhage.[Methods]Cases were randomly divided into integrated traditional Chinese and western medicine (TCW) groups,western medicine group and control group.After 2w treatment,the levels of IL-6 and TNF-? were contrasted.[Results]The levels of IL-6 and TNF-? were both raised.Combined with western medicine,qing-nao-ding-tong decoction could effectively reduce the levels of IL-6 and TNF-?.[Conclusion]Combined with western medicine,qing-nao-ding-tong decoction can effectively reduce the levels of IL-6 and TNF-? in patients with subarachnoid hemorrhage,and there is synergistic reaction between TCM and WM.