Objective     To explore the correlation between the imaging features of peripheral ground-glass pulmonary nodules and the invasion degree of lung adenocarcinoma, and the high risk factors for infiltrating lung adenocarcinoma under thin-slice CT, which provides some reference for clinicians to plan the surgical methods of pulmonary nodules before operation and to better communicate with patients, and assists in building a clinical predictive model for invasive adenocarcinoma. Methods    Clinical data of the patients with peripheral ground-glass pulmonary nodules (diameter≤3 cm) in thin-slice chest CT in the First Affiliated Hospital of Soochow University from January 2019 to January 2020 were continuously collected. All patients underwent thin-slice CT scan and thoracoscopic surgery in our center. According to the pathological examination results, they were divided into two groups: an adenocarcinoma lesions before infiltration group, and an invasive lung adenocarcinoma group. The thin-slice CT imaging parameters of pulmonary nodules were collected. The nodular diameter, mean CT value, consolidation tumor ratio (CTR), nodular shape, vacuolar sign, bronchial air sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign and other clinical data were collected. Univariate and multivariate analyses were conducted to analyze the independent risk factors for the infiltrating lung adenocarcinoma, and to analyze the threshold value and efficacy of each factor for the identification of infiltrating lung adenocarcinoma. Results     Finally 190 patients were enrolled. There were 110 patients in the adenocarcinoma lesions before infiltration group, including 21 males and 89 females with a mean age of 53.57±10.90 years, and 80 patients in the invasive lung adenocarcinoma group, including 31 males and 49 females with a mean age of 56.45±11.30 years. There was a statistical difference in the mean CT value, nodular diameter, CTR, gender, smoking, nodular type, nodular shape, vacuolar sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign between the two groups (P<0.05). However, there was no statistical difference between the two groups in age (P=0.081), lesion site (P=0.675), and bronchial air sign (P=0.051). Multiple logistic regression analysis showed that nodular diameter, mean CT value, CTR and lobulation sign were independent risk factors for differentiating preinvasive adenocarcinoma from invasive adenocarcinoma. At the same time, the threshold value was calculated by Youden index, indicating that the CTR was 0.45, the nodal diameter was 10.5 mm and the mean CT value was –452 Hu. Conclusion     In the peripheral ground-glass pulmonary nodules, according to the patient's CT imaging features, such as mixed ground-glass nodules, irregular shapes, vacuoles, short burrs, clear boundaries, pleural indentations, and vascular clusters, have a certain reference value in the discrimination of the invasion degree of ground-glass pulmonary nodules. At the same time, it is found in this research that peripheral ground-glass pulmonary nodules with diameter greater than 10.5 mm, CT value greater than –452 Hu, CTR greater than 0.45 and lobulation sign are more likely to be infiltrating lung adenocarcinoma.

Uncovering the risk factors of pulmonary hypertension and its mechanisms is crucial for the prevention and treatment of the disease.In the current study,we showed that experimental periodontitis,which was established by ligation of molars followed by orally smearing subgingival plaques from patients with periodontitis,exacerbated hypoxia-induced pulmonary hypertension in mice.Mechanistically,periodontitis dysregulated the pulmonary microbiota by promoting ectopic colonization and enrichment of oral bacteria in the lungs,contributing to pulmonary infiltration of interferon gamma positive(IFNγ+)T cells and aggravating the progression of pulmonary hypertension.In addition,we identified Prevotella zoogleoformans as the critical periodontitis-associated bacterium driving the exacerbation of pulmonary hypertension by periodontitis,and the exacerbation was potently ameliorated by both cervical lymph node excision and IFNγ neutralizing antibodies.Our study suggests a proof of concept that the combined prevention and treatment of periodontitis and pulmonary hypertension are necessary.

Objective To explore the effects of two methods of video laryngoscope insertion on the success rate of tracheal intubation and postoperative pharyngeal complications.Methods We selected 80 elective surgerypatients with American Society of Anesthesiologists(ASA)classification Ⅰ to Ⅱ who had no difficult airway in preoperative assessment under general anesthesia with orotracheal intubation.They were aged 18 to 65 years old and there were no restrictions on height and weight.The patients were randomly divided into a group with laryngoscope inserted through the middle of the mouth(group M)and a group with laryngoscope inserted through the right corner of the mouth(group C),with 40 cases in each group.Observe the laryngoscope exposure grading,oropharyngeal mucosal bleeding,first-time intubation success rate,and occurrence of pharyngeal pain and hoarseness within 48 hours after surgery in both groups;record the patients'systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)among admission to the room(T0),after giving anesthesia drugs(T1),immediately after intubation(T2),1 min after intubation(T3),and 3 min after intubation(T4).Results The SBP of group M was lower than that of group C at T3(P＜0.05);There was no statistically significant difference in laryngoscope exposure grading between the two groups(P＞0.05).The intubation time,oropharynx mucosal bleeding and the cases of sore throat within 48 hours of group M were less than those in group C(P＜0.05).The success rate of primary intubation in group M was higher than that in group C(P＜0.05).Conclusion Inserting a video laryngoscope through the middle of the mouth can reduce oropharyngeal mucosal bleeding,improve the success rate of intubation,and reduce the incidence of postoperative pharyngeal complications.

Objective To explore the improvement effect of myricitrin on bone defect in rats with bacterial osteomyelitis(OM)through vascular endothelial growth factor A(VEGFA)/stromal cell-derived factor(SDF-1)/C-X-C chemokine receptor 4(CXCR4)pathway.Methods Rats were randomly divided into the sham operation group,the OM group,the myricitrin group[50 mg/(kg·d)],PX-478 group[25 mg/(kg·d)VEGFA/SDF-1/CXCR4 signaling pathway inhibitor PX-478],and the myricitrin+PX-478 group[50 mg/(kg·d)myricitrin and 25 mg/(kg·d)PX-478],18 mice per group.Bilateral proximal tibia bone defects were used to construct bacterial OM rat model.After 12 weeks of continuous treatment,the wound healing degree of rats was observed,and anal temperature of rats was measured.The serum inflammatory factors interleukin(IL)-6,IL-1β,IL-17 and bone metabolism indexes bone alkaline phosphatase(BALP),osteocalcin(BGP)and C-terminal telopeptide of type Ⅰ collagen(CTX-Ⅰ)were measured by enzyma-linked immunosorbent assay(ELISA).The bacterial load of tissue around the lesion was detected.HE staining was used to detect the pathological changes of the tissue around lesions.The expression of CD31 was detected by immunofluorescence staining.Western blot assay was used to detect the expression of VEGFA/SDF-1/CXCR4 signal pathway related proteins.Results Compared with the sham operation group,the number of rats with grade A wound healing,BALP and BGP levels,CD31 positive area,VEGFA,SDF-1 and CXCR4 protein levels were decreased in the OM group(P＜0.005 or P＜0.05),and the anal temperature,bacterial load,IL-6,IL-1β,IL-17 and CTX-Ⅰlevels were increased(P＜0.05).Compared with the OM group,the BALP and BGP levels,CD31 positive area,VEGFA,SDF-1 and CXCR4 protein levels were increased,and the anal temperature,bacterial load,IL-6,IL-1β,IL-17 and CTX-Ⅰlevels were decreased in the myricitrin group(P＜0.05).Results of PX-478 group showed the opposite trend.PX-478 reversed the effect of myricitrin on the improvement of bone defects in bacterial OM rats.Conclusion Myricitrin may improve bone defect of OM rats by activating the VEGFA/SDF-1/CXCR4 signal pathway.

Objective:The aim of this study was to explore the associations of muscle size and density with handgrip strength(HGS)and the Timed Up and Go(TUG)test.Methods:Totally 301 participants living in the Xinjiekou community near Beijing Jishuitan Hospital were recruited for CT imaging of the hip and a 1-cm slice of the mid-thigh.The cross-sectional area and density of the gluteus maximus and the mid-thigh muscles were estimated by the Osirix viewer based on CT images.HGS and TUG were also performed in these subjects.Logistic regression analysis was used to evaluate the correlations of muscle density and size with TUG and grip strength.Results:In women, after adjustment for age and BMI, the density of the gluteus maximus was negatively correlated with TUG( P trend=0.0366), while the size of the gluteus maximus and the mid-thigh muscles was not correlated with TUG.In men, the density or size of these muscles was not correlated with TUG.After adjustment for age and BMI, the density of the gluteus maximus was positively correlated with grip strength( P trend=0.0334)and the size of the mid-thigh muscles was also positively correlated with grip strength( P trend=0.0155)in men, but they were not correlated with grip strength in women. Conclusions:There were sex differences in the relationship between muscle size or density and grip strength or timed up and go.The density of the gluteus maximus is associated with muscle strength and physical performance while the size of the mid-thigh muscles is correlated with muscle strength.

Objective: To evaluate the curative effects of zinc medicine in the treatment of recurrent aphthous ulcers(RAU). Methods: The randomized controlled trials (RCTs) about the zinc medicine in the treatment of RAU were retrieved from PubMed, CENTRAL, EMbase, CNKI and WANFANG from January 1, 1980 to June 1, 2016, the references included in the study were manually selected. After quality evaluation and material extraction by the reviewer, Meta analysis was done according to the documents and materials by software Stata. Results: 4 RCTs involving 156 patients were included in the study, with 74 cases in the zinc medicine treatment group and 82 cases in the placebo control group. Meta analysis showed that zinc medicine was effective in the treatment of RAU(P＜ 0. 05). Conclusion: Zinc medicine is safe and effective in the treatment of RAU. Zinc deficiency is a risk factor of RAU.

Objective To establish a mouse model of bacterial vaginosis ( BV) by infecting estro-gen-treated mice with Prevotella bivia ( P. bivia) . Methods The mice were intraperitoneally injected with beta-estradiol 17 valerate which was suspended in sesame oil and then inoculated with different doses of P. bivia strains at the logarithmic phase. Samples of vaginal flushing fluid were collected at different time points after inoculation and used for the isolation of P. bivia strains and the detection of sialidase activities. Altogether 30 mice treated with estrogen and high dose of P. bivia were killed on days 2, 7 and 21 (n=10). Samples of cornua uteri, bladder and kidney were collected from those mice for P. bivia strains isolation. Re-sults Injection the estrogen-treated mice with P. bivia via vagina could cause the P. bivia infection for more than 14 days. The numbers of P. bivia strains isolated on day 21 decreased significantly. Enhanced sialidase activities and clue cells were observed in vaginal secretions of mice with P. bivia infection. Injection of mice with the high dose of P. bivia could spread the infection to cornua uteri. Conclusion Estrogen-treated mice could be used as an animal model for researches on BV.

Objective To analyze the rules for acupoint selection of warming acupuncture and moxibustion in clinical treatment of knee osteoarthritis based on data mining technology. Methods CNKI, Wanfang Data, CBM, VIP, PubMed and Cochrane Library were searched for relevant literature about warming acupuncture and moxibustion in treatment of knee osteoarthritis. Database was built according to the search results. Association rules were used to analyze the rules for acupoint selection. Results Totally 189 papers were included, involving 189 prescriptions of acupuncture and moxibustion, 46 acupoints, 1270 times of acupoint selection. There were 1119 times of neighboring acupoint selection (88.1%), 151 times of distant acupoint selection (11.9%), 654 times of acupoint selection in yang meridian (51.5%) and 283 times of acupoint selection in yin meridian (22.3%). Conclusion Warming acupuncture and moxibustion in clinical treatment of knee osteoarthritis focuses on acupoints in Stomach Meridian of Foot-Yangming, Spleen Meridian of Foot-Taiyin; the neighboring acupoint selection is the main method, combined with evidence-based distant acupoint selection; acupoint selection from yang meridian was emphasized.

Ribavirin is a broad-spectrum antiviral agent and glycyrrhizin has activities of anti-inflammation, immunoregulation and anti-viral infections. To enhance antiviral efficacy and weaken side-effects of ribavirin, antiviral effects of the combination of glycyrrhizin and ribavirin were studied in the present study. Firstly, a mouse model of viral pneumonia was established by inoculation of influenza H1N1 virus. Protective effects of glycyrrhizin and ribavirin used alone or in combination against H1N1 virus infection in mice were evaluated based on the survival rate, lung index and virus titer in lungs of mice. Results showed that the combination of glycyrrhizin and ribavirin significantly inhibited the lung consolidation with a 36% inhibition ratio on the lung swell of infected mice. The combination of the two drugs exhibited synergetic effects on survival of infected mice. The combination of 50 mg · kg(-1) · d(-1) glycyrrhizin and 40 mg · kg(-1) · d(-1) ribavirin resulted a 100% protection for infected mice with a synergetic value of 36, which was significantly higher than the control group and each drug alone. This combination also resulted a significant drop of lung virus titer (P < 0.01), as well as inhibition on the production of proinflammatory cytokines IL-6 (P < 0.01), TNF-α (P < 0.01) and IL-1β (P < 0.05) induced by virus infection compared to the control. The treatment of ribavirin plus glycyrrhizin was more effective in influenza A infection in mice than either compound used alone, which suggested a potential clinical value of the combination of the two agents.

Objective To explore the effects of diethylenetriamine/nitric oxide (DETA/NO)on capillary spasm and early brain injury (EBI)after subarachnoid hemorrhage (SAH)in rats.Methods Sixty-nine male Sprague-dawley rats were randomized into three groups:sham group,SAH group and DETA/NO group.SAH model was established by wearing out the willis ring with thread and then Garcia neurological score was observed in the general animals.The expressions of alpha smooth muscle actin (αSMA)and PDGFRβwere detected by dual immunofluorescence staining;nitric oxide kit was used for detecting brain tissue NO concentration.Changes in the hemoglobin-stimulated capillaries were observed in rat slices.Results Three days after surgery,neurological deficit score was remarkably improved in DETA/NO group compared with that in SAH group (P<0 .0 5 ). Immunofluorescence results showed that the expressions of peri-capillaryαSMA and PDGFRβwere significantly increased after SAH (P<0.05 ),and that DETA/NO could down-regulate the expressions (P<0.05 ).NO concentration was greatly reduced about 3 hours after SAH and then gradually increased;DETA/NO could maintain the concentration of NO at an early stage (P<0 .0 5 ).The capillary contraction was observed in slices perfused with hemoglobin;DETA/NO could alleviate capillary spasm.Conclusion DETA/NO can alleviate the severity of capillary spasm and EBI after SAH in rats.