Based on the theory of collateral disease， the treatment of late-stage sequela of cerebrovascular disease is considered to be primarily associated with deficiency and obstruction of cerebral collaterals and dysfunction of the spirit mechanism. Therefore， the fundamental therapeutic principle is to unblock and supplement the brain collaterals. Clinically， the late-stage sequelae of cerebrovascular disease are classified into four patterns， which are malnourishment， deficiency-heat， stasis obstruction， and phlegm clouding of brain collaterals. These are treated respectively with Tiansui Tongqiao Decoction （填髓通窍汤） to supplement essence and nourish the brain through moistening， unblocking and supplementing， Qingnao Touluo Decoction （清脑透络汤） to enrich yin， regulate spirit， and unblock collaterals through clearing and penetrating， Yiqi Tongluo Decoction （益气通络汤） to tonify qi and resolve stasis while softening tendons and unblocking collaterals， and Xinrun Touqiao Beverage （辛润透窍饮） to unblock and tonify yin and yang while unblocking the collaterals through acrid-moistening medicinals. Flexible modification of prescriptions according to individual symptoms was applied， resulting in favorable therapeutic outcomes.

Objective To investigate the value of flexible subtraction CE-Boost technique combined with low dosage contrast agents for CT pulmonary angiography(CTPA).Methods A total of 68 patients who would undergo CTPA examination due to suspected pulmonary embolism(PE)were prospectively enrolled and randomly divided into study group(n=34)and control group(n=34)using block randomization method.After injecting 25 ml contrast agents at a flow rate of 2.5 ml/s in study group or 50 ml contrast agents at a flow rate of 3.5 ml/s in control group,CTPA scanning were performed with identical parameters.For images in study group,hybrid iterative reconstruction was performed,followed by flexible subtraction CE-Boost post-processing to obtain CE-Boost CTPA.For images in control group,conventional CTPA was obtained with hybrid iterative reconstruction.Subjective and objective evaluations of image quality were compared between groups.Taken the final clinical diagnosis as standard,the accuracy rate of diagnosing PE were compared between groups.Results There were 7 cases of pulmonary artery main trunk PE and 15 cases of pulmonary lobe-level PE in study group,while in control group there were 8 cases and 17 cases.No statistical difference of subjective scores of CTPA was found between groups(P＞0.05).CT values of the main pulmonary artery,bilateral pulmonary artery trunks and lower lobes of both lungs,signal-to-noise ratio or contrast-to-noise ratio in CTPA were not significantly different between groups(all P＞0.05),while no significant difference of the accuracy rate of CTPA for diagnosing PE of pulmonary artery main trunk(100％[7/7]vs.100％[8/8])nor pulmonary lobe-level PE(86.67％[13/15]vs.88.24％[15/17])was detected between groups(all P＞0.05).Conclusion Flexible subtraction CE-Boost technique combined with low dosage contrast agents for CTPA could reduce contrast agent dosage without affecting image quality.

Objective To investigate the value of flexible subtraction CE-Boost technique combined with low dosage contrast agents for CT pulmonary angiography(CTPA).Methods A total of 68 patients who would undergo CTPA examination due to suspected pulmonary embolism(PE)were prospectively enrolled and randomly divided into study group(n=34)and control group(n=34)using block randomization method.After injecting 25 ml contrast agents at a flow rate of 2.5 ml/s in study group or 50 ml contrast agents at a flow rate of 3.5 ml/s in control group,CTPA scanning were performed with identical parameters.For images in study group,hybrid iterative reconstruction was performed,followed by flexible subtraction CE-Boost post-processing to obtain CE-Boost CTPA.For images in control group,conventional CTPA was obtained with hybrid iterative reconstruction.Subjective and objective evaluations of image quality were compared between groups.Taken the final clinical diagnosis as standard,the accuracy rate of diagnosing PE were compared between groups.Results There were 7 cases of pulmonary artery main trunk PE and 15 cases of pulmonary lobe-level PE in study group,while in control group there were 8 cases and 17 cases.No statistical difference of subjective scores of CTPA was found between groups(P＞0.05).CT values of the main pulmonary artery,bilateral pulmonary artery trunks and lower lobes of both lungs,signal-to-noise ratio or contrast-to-noise ratio in CTPA were not significantly different between groups(all P＞0.05),while no significant difference of the accuracy rate of CTPA for diagnosing PE of pulmonary artery main trunk(100％[7/7]vs.100％[8/8])nor pulmonary lobe-level PE(86.67％[13/15]vs.88.24％[15/17])was detected between groups(all P＞0.05).Conclusion Flexible subtraction CE-Boost technique combined with low dosage contrast agents for CTPA could reduce contrast agent dosage without affecting image quality.

To address the issue that the existing weakly supervised segmentation methods have difficulties in obtaining fine-grained glandular features from colorectal pathological images,leading to the inability to generate high-quality pseudo-labels and compromising the gland segmentation performance,a dual-branch network based on weakly supervised learning is proposed for gland segmentation in colorectal pathological image.The patch-level colorectal pathological images are input into the first branch network,where the interaction and fusion of local and global features of patch-level images are achieved through the feature interaction module and affinity attention fusion module,and fine-grained glandular features are obtained.Subsequently,image-level colorectal pathological images are input into the second branch network,where the gland locations are located using the partial class activation attention module,and coarse-grained class activation maps are obtained.Finally,high-quality pseudo-labels are derived from the fine-grained glandular features and coarse-grained class activation maps,and gland segmentation is realized in the segmentation network through the cross-scale connected spatial perception module.The tests on two colorectal pathological image datasets(GlaS and CRAG)reveal that the proposed method is superior to other segmentation methods in segmentation performance,confirming its effectiveness.

Objective:To investigate the levels and diagnostic value of topoisomerase Ⅱα (TOP2A) and human epidermal growth factor receptor 2 (ERBB2) in early colorectal cancer (CRC) .Methods:Ninty-three early CRC patients (CRC group) admitted to Shijiazhuang Hospital of Traditional Chinese Medicine were selected for the study from January 2019 to April 2022, and 93 healthy subjects during the same period were selected as the healthy group, and 93 colorectal polyps patients diagnosed and treated in the same period were selected as the colorectal polyp group. TOP2A and ERBB2 mRNA levels in peripheral blood mononuclear cell (PBMC) and serum carcinoembryonic antigen (CEA) level were detected and compared in each group. The value of TOP2A, ERBB2 mRNA and serum CEA level in the diagnosis of early CRC were evaluated by using receiver operating characteristic (ROC) curve. The relationship between TOP2A and ERBB2 levels and clinicopathological features of early CRC patients was analyzed.Results:There were statistically significant differences in the PBMC TOP2A (1.04±0.35 vs. 1.72±0.57 vs. 2.83±0.71, F=246.73, P<0.001), ERBB2 mRNA (1.01±0.34 vs. 1.64±0.55 vs. 2.75±0.71, F=234.80, P<0.001) levels and serum CEA levels (1.29±0.52 vs. 1.93±0.64 vs. 3.17±0.81, F=190.78, P<0.001) in healthy group, colorectal polyp group and CRC group. Compared with the healthy group and colorectal polyp group, the levels of TOP2A and ERBB2 mRNA in PBMC and serum CEA level in CRC group were significantly increased (all P<0.05) ; Compared with the healthy group, the levels of TOP2A and ERBB2 mRNA in PBMC and serum CEA level in the colorectal polyp group were increased (all P<0.05). The ROC curve showed that the area under curve (AUC) of TOP2A and ERBB2 mRNA levels in PBMC and serum CEA level for the diagnosis of early CRC were 0.85, 0.85 and 0.84, respectively, and the AUC for the combined diagnosis of early CRC was 0.96, which was higher than that of TOP2A, ERBB2 and CEA alone ( Z=2.92, P=0.004; Z=3.16, P=0.002; Z=2.86, P=0.005). The combination of the three diagnosed early CRC with a sensitivity of 94.64% and a specificity of 85.96%. There were statistically significant differences in PBMC TOP2A and ERBB2 mRNA levels in early CRC patients with different differentiation degrees ( χ2=6.21, P=0.013; χ2=10.49, P=0.001) . Conclusion:The expression levels of TOP2A, ERBB2 mRNA in PBMC in CRC patients are higher. The combination of TOP2A, ERBB2 mRNA levels in PBMC and serum CEA level may be more helpful for clinical diagnosis of early CRC.

Objective: To investigate the effects CXCL1 derived from TAMs on the progression of HCC by CXCL1 in tumor microenvironment (TME) ． Methods : PMA induced human monocyte (THP-1) to obtain undifferentiated macrophages (M0) and then co-cultured with Huh 7 HCC cells．The biomarkers of macrophage phenotype and mRNA level of HCC were analysed by qRT-PCR. Colony formation assay，cell viability assay and transwell assay were performed to evaluate the biological alteration of HCC cells in TME．Epithelial-mesenchymal transition (EMT) molecular genetics were detected using western blot．The levels of CXCL1 in TME were measured by ELISA assay. Results : High CXCL1 expression in HCC patients predicted poor prognosis．Abundant macrophages were found in CXCL1 high expression HCC tissues．In macrophages and HCC co-cultured model，significantly increasing CXCL1 expression was detected in both two cells and the biomarkers of M2 macrophages，CD163 and CD206 were elevated．The growth and migration of HCC cells were promoted． Conclusion Co-culture of macrophages with HCC cells induces macrophages pro-tumor phenotype and CXCL1 secretion which promotes the progression of HCC.

OBJECTIVE:To investigate clinical efficacy and safety of meglumine adenosine cyclophosphate in the treatment of acute myocardium infarction. METHODS:A total of 80 patients with acute myocardium infarction in our hospital during May 2015-Jan. 2016 were selected and divided into control group and observation group according to random number table,40 cases in each group. Control group was given conventional treatment. Observation group was additionally given Meglumine adenosine cyclo-phosphate injection 120 mg added into 5% Glucose injection 250 mL,ivgtt,qd,on the basis of control group. Both groups re-ceived treatment for 7 d. Clinical efficacies as well as the levels of serum hs-CRP and NT-proBNP before and after treatment were observed in 2 groups,and the occurrence of ADR was compared between 2 groups. RESULTS:Total response rate of observation group(92.50%)was significantly higher than that of control group(75.00%),with statistical significance(P<0.05). Before treat-ment,there was no statistical significance in the serum levels of hs-CRP or NT-proBNP between 2 groups(P>0.05). After treat-ment,the serum levels of hs-CRP and NT-proBNP in 2 groups were decreased significantly,and the observation group was signifi-cantly lower than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Meglumine adenosine cyclophosphate shows significant therapeutic efficacy for acute myocardium infarction,reduces serum levels of hs-CRP and NT-proBNP significantly with good safety.

AIM:To investigate the effect of atorvastatin on myocardial apoptosis , ventricular remodeling and cardiac function after acute myocardial infarction (AMI) in diabetic rats, and to explore whether the effect is mediated by hepatocyte growth factor ( HGF)/c-Met signaling pathway .METHODS:Diabetes in 70 male SD rats was induced by in-traperitoneal injection of streptozotocin (STZ, 65 mg/kg).After 8 weeks, AMI was induced by the ligation of the left ante-rior descending coronary artery in the diabetic rats , and 32 surviving rats were divided into AMI group (n=16) and AMI+atorvastatin group ( n=16, 20 mg· kg -1 · d-1 ) at random.The similar surgical procedure was completed in sham group (n=11) without coronary ligation.Atorvastatin was given daily by gavage from the first day after AMI .Two weeks later, the cardiac function , pathological changes of myocardial tissues , myocardial apoptosis , and the expression of HGF and c-Met were compared among groups .RESULTS: AMI significantly reduced cardiac function , increased collagen volume fraction ( CVF) and myocardial apoptotic index , and up-regulated the expression of HGF and c-Met at mRNA and protein levels in AMI control group (P<0.05).The cardiac function was improved , and CVF and myocardial apoptotic index were reduced by the treatment with atorvastatin , which also up-regulated the expression of HGF and c-Met (P<0.05).CON-CLUSION:Atorvastatin significantly attenuates myocardial apoptosis and cardiac remodeling , and improves cardiac func-tion after AMI in diabetic rats by further enhancing the activation of HGF /c-Met pathway .