Objective To observe the value of B1 corrected T1 mapping for distinguishing pathological types and differentiation degrees of lung cancers.Methods A total of 74 lesions in 65 patients with lung cancers were prospectively enrolled,including 49 poorly differentiated lesions and 25 moderately or well differentiated ones,i.e.42 adenocarcinomas,14 squamous cell carcinomas and 18 small cell lung cancers(all poorly differentiated).B1 corrected T1 mapping was performed,ROI(ROI1 and ROI2)were delineated using 2 methods,and T1 values of different pathological types and differentiation degrees lung cancers were compared.The receiver operating characteristic(ROC)curves were drawn,and the areas under the curve(AUC)were calculated.Results Significant differences of T1 values were found among different pathological types of lung cancer(all P＜0.05),as well as between small cell lung cancer and the rest 2 types of lung cancer(both P＜0.05).There were significant differences of T1 values between poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)(both P＜0.05).Taken ROI1 T1 value=1 524.21 ms as the cut-off value,the AUC of T1 value for distinguishing poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)was 0.698,with sensitivity of 64.50％and specificity of 76.00％.Taken ROI2 T1 value=1 630.68 ms as the cut-off value,the AUC of T1 value was 0.676,with sensitivity of 54.80％and specificity of 80.00％.Conclusion B1 corrected T1 mapping was helpful for distinguishing pathological types and differentiation degrees of lung cancers.

Objective To compare the value of stack-of-stars-volumetric interpolated breath-hold examination(Star-VIBE)and T1-volumetric interpolated breath-hold examination(T1-VIBE)MRI for displaying peripheral lung cancer.Methods Fifty-two patients with 56 peripheral lung cancer were prospectively enrolled,and chest Star-VIBE and T1-VIBE MRI were acquired.The morphological features were observed,and the subjective scores were recorded.The maximum diameter,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of lesions were measured based on Star-VIBE and T1-VIBE MRI,respectively.Taken CT as the references,the value of Star-VIBE and T1-VIBE MRI for displaying peripheral lung cancer were compared.Results Star-VIBE MRI had higher scores for displaying spiculation sign,lobulation sign,pleural depression sign and halo sign than T1-VIBE(both P＜0.05).CNR and SNR of Star-VIBE MRI were significantly higher than those of T1-VIBE(both P＜0.001).No significant difference of the maximum diameter of lesions measured based on Star-VIBE and T1-VIBE MRI compared with CT was found,nor between Star-VIBE and T1-VIBE MRI(all P＞0.05).Conclusion Star-VIBE MRI had better value for displaying peripheral lung cancer than T1-VIBE.

Objective:To evaluate the relationship between hippocampal miR-3065-5p and insulin-like growth factor-1/phosphatidylinositol 3-kinase/protein kinase B(IGF-1/PI3K/Akt)signaling pathway in a mouse model of perioperative neurocognitive disorder (PND).Methods:Eighty clean-grade healthy male C75BL/6 mice, aged 12-14 weeks, weighing 20-30 g, were divided them into 4 groups ( n=20 each) using the random number table method: control group (C group), PND group, miR-3065-5p agonist group (Ag group) and miR-3065-5p agonist negative control group (Ag-NC group). PND model was prepared by internal fixation of tibial fracture under anesthesia with 1.5% isoflurane. Two days before developing the model, miR-3065-5p agomir 2 μl was injected into the lateral ventricle in Ag group, miR-3065-5p agomir negative control 2 μl was injected into the lateral ventricle in Ag-NC group. Morris water maze test and open field test were performed at 7 days after surgery. The mice were sacrificed after the end of test, and hippocampal tissues were obtained for determination of the expression of miR-3065-5p, IGF-1 mRNA and Bcl-2 mRNA (by quantitative real-time polymerase chain reaction) and expression of IGF-1, phosphorylated Akt (p-Akt), phosphorylated glycogen synthase kinase-3β (p-GSK3β) and Bcl-2 (by Western blot). Results:There was no significant difference in each parameter in the open field test among the four groups ( P>0.05). Compared with group C, the postoperative escape latency was significantly prolonged, the percentage of time of stay at the target quadrant was decreased, the number of crossing the original platform was reduced, the expression of miR-3065-5p was up-regulated, and the expression of IGF-1 mRNA, Bcl-2 mRNA, IGF-1, p-Akt, p-GSK3β and Bcl-2 was down-regulated in the other three groups ( P<0.05). Compared with PND group and Ag-NC group, the postoperative escape latency was significantly prolonged, the percentage of time of stay at the target quadrant was decreased, the number of crossing the original platform was reduced, the expression of miR-3065-5p was up-regulated, and the expression of IGF-1 mRNA, Bcl-2 mRNA, IGF-1, p-Akt, p-GSK3β and Bcl-2 was down-regulated in Ag group ( P<0.05). Conclusions:Up-regulation of miR-3065-5p can inhibit the activation of IGF-1/PI3K/Akt signaling pathway, which might be one of the mechanisms of PND developed in mice.

Objective:To evaluate the role of miR-124-3p in reduction of oxygen-glucose deprivation and restoration (OGD/R) injury by electrostimulation preconditioning in microglia and its relationship with microglial polarization.Methods:The well-growing BV2 cells were divided into 4 groups ( n=30 each) by the random number table method: control group (group C), OGD/R group, electrostimulation preconditioning group (group E) and miR-124-3p inhibitor group (group I). Group C was cultured under normal conditions, and group OGD/R was deprived of oxygen and glucose for 2 h followed by restoration of oxygen and glucose supply for 24 h to develop the OGD/R injury model. In group E, cells were stimulated with 100 mV/mm direct current for 4 h before oxygen-glucose deprivation, and the other treatments were similar to those previously described in group OGD/R. Group I was transfected with micrOFF? mmu-miR-124-3p inhibitor at 48 h before oxygen-glucose deprivation, and the other treatments were similar to those previously described in group E. The cell survival rate was determined by CCK-8 assay, the concentrations of tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β) and IL-10 in the cell supernatant were measured by enzyme-linked immunosorbent assay. The expression of a surface marker of M1 microglia inducible nitric oxide synthase (iNOS) and a surface marker of M2 microglia arginase 1 (Arg-1) was detected by immunofluorescence and Western blot, respectively. The expression of iNOS and Arg-1 mRNA and miR-124-3p was detected by quantitative polymerase chain reaction. Results:Compared with group C, the cell survival rate was significantly decreased, the concentrations of TNF-α, IL-1β and IL-10 in the supernatant were increased, and the expression of iNOS and Arg-1 protein and mRNA and miR-124-3p was up-regulated in the remaining three groups ( P<0.05). Compared with group OGD/R, the cell survival rate was significantly increased, the concentrations of TNF-α and IL-1β in the supernatant were decreased, the IL-10 concentration was increased, the expression of iNOS protein and mRNA was down-regulated, and the expression of Arg-1 protein and mRNA and miR-124-3p was up-regulated in E and I groups ( P<0.05). Compared with group E, the cell survival rate was significantly decreased, the concentrations of TNF-α and IL-1β in the supernatant were increased, the IL-10 concentration was decreased, the expression of iNOS protein and mRNA was up-regulated, and the expression of Arg-1 protein and mRNA and miR-124-3p was down-regulated in group I ( P<0.05). Conclusions:The mechanism by which electrostimulation preconditioning reduces OGD/R injury in microglia is related to up-regulation of the expression of miR-124-3p, promotion of M2 microglia polarization, inhibition of M1 microglia polarization, and thus inhibiting the inflammatory responses.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To compare the efficacy of volume therapy guided by inferior vena cava ultrasound and lung ultrasound at different sites in patients undergoing grade four hysteroscopic surgery.Methods:A total of 90 patients, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classificationⅠ or Ⅱ, undergoing elective grade four hysteroscopic surgery under general anesthesia, were divided into 3 groups ( n=30 each) using a random number table method: conventional group (C group), ultrasound at the subcostal area group (S group) and ultrasound at right mid-axillary line group (R group). When the inferior vena cava distensibility index<15% or pulmonary ultrasound B-line score>8.5 or arterial blood gas Na + concentrations <125 mmol/L, surgeons were advised to speed up the process of surgery and decrease the pressure of uterine distention, furosemide 10-20 mg was intravenously injected, and the speed of infusion was adjusted at the same time.On admission to the operating room (T 0), at 20 min after induction (T 1), 40 min after induction (T 2), and at the end of operation (T 3), the B-line score of lung ultrasound, concentrations of Lac and Na + and PaO 2/FiO 2 were recorded, and the postoperative complications, amount of uterine distention fluid, volume of fluid infused and time of laryngeal mask airway removal were recorded. Results:Compared with group C, the pulmonary ultrasound B-line score was significantly decreased, the concentrations of Na + and PaO 2/FiO 2 were increased, the time of laryngeal mask airway removal was shortened, and the amount of uterine distention fluid was decreased in S and R groups, and the total incidence of complications was significantly decreased in group R ( P<0.05). Compared with group S, the lung ultrasound B-line score was significantly decreased, PaO 2/FiO 2 was increased, and the amount of uterine distention fluid was decreased in group R ( P<0.05). Conclusions:Compared with subxiphoid process, the volume therapy guided by inferior vena cava ultrasound on the right mid-axillary line and lung ultrasound has more advantages in the patients undergoing grade four hysteroscopic surgery.

ObjectiveTo investigate current status of hospital infection management in psychiatric hospitals in the Ningxia Hui Autonomous Region， so as to provide references for improving the level of hospital infection management of psychiatric hospitals. MethodsIn December 2020， on-site supervision was conducted on hospital infection management in all 9 psychiatric hospitals in the Ningxia Hui Autonomous Region， meantime， the self-compiled questionnaire on hospital infection management status was used for investigation. ResultsAmong the selected hospitals， nine （100.00%） psychiatric hospitals had the main hospital leaders in charge of hospital infection management， five （55.56%） hospitals had established a hospital infection management committee， six （66.67%） hospitals had established an independent hospital infection management department， and one （11.11%） hospital had developed all 13 systems mentioned in the questionnaire related to hospital infection management and job responsibilities. In terms of hospital infection management staff， there were 23 staff members in the nine psychiatric hospitals， including 3 in the specialty （13.04%） and 20 in the part-time setting （86.96%）. The score of the implementation of the basic system of hospital infection management in nine hospitals was （3.28±2.22）. ConclusionThe system specification related to hospital infection management in the Ningxia Hui Autonomous Region psychiatric hospitals needs to be improved and further strengthened， the professionalism of hospital infection management personnel needs to be improved.

With the outbreak of COVID-19 around the globe, the epidemic prevention and control in China will take a long-term trend. As the main treatment of gynecological malignant tumor, rational application of radiotherapy bring patients with both "epidemic prevention" and "anti-tumor" benefits. This recommendation combined the domestic epidemic prevention guidelines, foreign literature related to epidemic prevention and gynecological tumor treatment, and the experiences of Peking Union Medical College Hospital during the prophase of epidemic period, aiming to provide guidance for the clinical work for radiotherapy and gynecological departments during COVID-19 crisis from the perspectives of gynecological radiotherapy principles, clinical trials, MDT and academic activities.

非经典信号通路IKKε和TBK1与恶性肿瘤密切相关，多种因素激活IKKε和TBK1通路，可引起NF-κB途径的激活， 导致肿瘤细胞的凋亡减少、细胞周期加快，促进肿瘤发生和发展。抑制IKKε和TBK1信号通路，可增加多种细胞凋亡因子的表 达，抑制肿瘤细胞增殖，促进肿瘤细胞凋亡，同时提高化疗和放疗的敏感性。因此，阻断IKKε和TBK1信号通路可有效治疗恶性 肿瘤，已有的实验证实有多种阻断IKKε和TBK1通路的药物均具有良好的抗肿瘤作用。

Objective To evaluate the clinical value of magnetic resonance imaging T2WI texture analysis in the diagnosis of prostate cancer.Methods A total of 78 patients with pathological-confirmed prostate cancer and prostatic hyperplasia from Jan.2016 to Dec.2018 in our hospital were retrospectively collected.MaZda software was used to analyze 300 texture feature parameters of each lesion on T2WI images,and Weka software was used to select the most discriminative texture feature parameters.The differences of texture features between the two groups and diagnostic efficacy were compared by independent sample t test,Mann-Whitney U test and ROC.Results There were 7 texture feature parameters of the most discriminative significance between the two groups:AngScMom,Contrast,Entropy,Horzl_GLevNonU,45dgr_RLNonUni,WavEnLL_s-1 and WavEnHL_s-3,respectively.There were significant differences in 7 texture feature parameters between prostate cancer group and prostate hyperplasia group (P＜0.05).The AUC of each texture feature was between 0.78 and 0.91,the accuracy was between 79.6％ and 92.1％,the sensitivity was between 70.8％ and 91.9％,and the specificity was between 72.2％ and 92.5％,respectively.Conclusions The texture features parameters of T2WI images are different in the diagnosis of prostate cancer and prostatic hyperplasia.As an objective and quantitative analysis method,texture features analysis can be used in the differential diagnosis of prostate cancer and prostatic hyperplasia.