Objectives:Primary cardiac involvement (SSc-PHI) in systemic sclerosis is an important prognostic factor. We aimed to characterize and identify subclinical SSc-PHI using cardiovascular MRI to determine whether disease severity and serum biomarkers are associated with subclinical SSc-PHI.Methods:A total of 26 patients with SSc who had no history of cardiovascular disease or pulmonary hypertension underwent 3 T-enhanced cardiovascular MRI. Measurements included native T 1, extracellular volume, advanced gadolinium enhancement, T 2 mapping, and left ventricular volume function. Troponin T and N telencephalic natriuretic peptide precursors were also determined. Results:LGE was observed in 13 of 26 patients (50.0%), suggesting focal fibrosis, and T 2 mapping was significantly higher in the dcSSc group than in the lcSSc group ( P=0.009). Left ventricular volume and function were within the normal range in all patients, but final systolic left ventricular volume was significantly higher in dcSSc than in lcSSc ( P=0.021). The modified Rodnan skin score (mRSS) was significantly higher in patients with LGE focal fibrosis ( P=0.019). Logistic regression analysis confirmed the association between mRSS and LGE ( OR=1.224, P=0.037). In multivariate analysis, T 2 mapping was negatively correlated with disease course, and was correlated with dcSSc and fingertip ulcer ( R2=0.711, P=0.018, P=0.013, P=0.030). Troponin T was correlated with T 2 mapping ( r=0.555, P=0.049). Conclusions:Subclinical SSc-PHI is characterized by diffuse and focal myocardial fibrosis, but preserves myocardial systolic function. Subclinical SSC-Phi is associated with TNT, SSc disease severity, and complex peripheral vascular disease. These data provide information for identifying individuals at risk of SSc-PHI.

We retrospectively analyzed therapy efficacy and the adverse reactions of 10 patients suffering from systemic lupus erythematosus (SLE) with intestinal involvement treated with rituximab (RTX). Patients were hospitalized in the Department of Rheumatology and Immunology of the First Medical Center of PLA General Hospital from January 2015 to January 2023. Among the 10 patients, two were men and eight were women. The age of the cohort was (41.9±8.8) years. The age at disease onset was (28.8±9.2) years. The total course of the SLE diagnosis was(109.6±59.9) months. The course of the diagnosis of SLE with intestinal involvement was (89.3±50.2) months. The time from the appearance of intestinal symptoms to the diagnosis of SLE with intestinal involvement was 1.5 (1.0,8.0) months. The time from the diagnosis of SLE with intestinal involvement to RTX use was 13.0 (1.0,46.3) months. Follow-up duration after application of RTX treatment was (55.3±28.4) months. There were five cases of abdominal pain, four cases of abdominal distension, nine cases of diarrhea, three cases of nervous-system involvement, nine cases of lupus nephritis, and seven cases of serositis. All 10 patients underwent computed tomography and radiology of the abdomen. Eight patients had intestinal-wall edema, seven suffered intestinal dilation, four had target signs, three suffered congestion of mesenteric blood vessels, eight had increased mesenteric-fat density, and six had false intestinal obstruction. All 10 patients showed a low level of complement C3 (250-750 mg/L). Nine cases showed a low level of complement C4 (10-90 mg/L). The SLE disease activity index 2000 (SLEDAI-2K) at baseline in 10 patients was 20.5 (17.8, 30.0). After receiving RTX (0.5 g: day 1, day 14, or 375 mg/m 2: day 1, day 14) induction treatment, the intestinal symptoms of 10 cases were relieved completely. Four patients had adverse reactions, of which three received a high-dose glucocorticoid combined with RTX treatment simultaneously. Adverse reactions manifested mainly as a reduced level of IgG and infection with herpes simplex virus in one case, reduced level of IgG and lung infection in one patient, lung infection in one case, and reduced IgG level in one patient. RTX may an efficacious treatment strategy for patients suffering from refractory SLE with intestinal involvement.

The protection effect of flash-radiotherapy(Flash-RT)with super-high dose on normal tissue has obtained wide attention in therapeutic radiology since it was found in 2014 year.The increasing research demand of Flash-RT with super-high dose-rate proposed new challenge for the existing radiotherapy equipment.Based on the demands of FLASH-RT research and clinical application,this review analyzed the proposed new requirement of Flash-RT for equipment,and introduce current scientific facilities with the experimental ability of X-ray FLASH-RT,as well as the situation of the specialized FLASH-RT equipment which were developing.The research of Flash-RT mechanism need the existing equipment with high-energy X-ray source develop toward high power,while the clinical application of Flash-RT demand these transient high-power devices should possess a series of radiotherapy techniques such as multi angle irradiation,conformal radiotherapy and others.Currently,China's X-ray FLASH-RT research is at the forefront of the world,which is expected to achieve the first breakthrough of high-end medical equipment in the X-ray Flash RT field.

The study aimed to analyze the efficacy and safety of rituximab in the treatment of 23 cases of lupus nephritis and explore the prospect of half-dose rituximab in lupus nephritis treatment. Twenty-three patients with lupus nephritis hospitalized in the Department of Rheumatology and Immunology at the First Medical Center of the PLA General Hospital from May 2013 to December 2021 were selected. Eighteen patients received rituximab 375 mg/m 2 on the first and 14th days, 5 patients received 500 mg of rituximab on the first and 14th days, and rituximab was used as needed 6 months later. Methylprednisolone (80-120 mg) was given together with rituximab. Afterward, 1 mg/kg prednisone was used for 4 weeks, which was progressively tapered to maintenance doses or discontinued. B lymphocyte level, renal function, 24-h urine protein level, and systemic lupus erythematosus (SLE) disease activity index 2000 (SLEDAI2K) score before and after treatment were recorded. The efficacy and adverse reactions were analyzed. The results showed that 11 patients suffered from renal insufficiency [creatinine (162.7±58.6) μmol/L ] at baseline, while the creatinine level of 9 patients returned to normal 12 months after the treatment [ (66.3±10.1)μmol/L ]. Normal renal function of the other 12 patients was maintained during treatment. After 12 months, the 24-h urine protein level decreased from 4.00 (2.00,6.80) g in the baseline period to 0.10 (0.08,0.40) g. SLEDAI2K score decreased from 22 (18,26) in the baseline period to 3 (0,6) 12 months after the treatment. The B lymphocyte level reached 0.00 (0.00,0.01)% at 3 months. Of 23 patients, 13 patients achieved complete remission, and 7 patients achieved partial remission after 6 months of rituximab treatment. Five patients experienced adverse reactions related to rituximab, including 1 case of transfusion reaction, 1 case of perioral herpes with pulmonary infection, and 3 cases of decreased IgG levels. Therefore, rituximab regimen used in this study can be an effective treatment strategy for lupus nephritis.

Irradiation based on accelerator is the main method of radionuclide production. In recent years, with the development of theranostics of nuclear medicine, there is a new demand for the preparation of accelerator radionuclides. In this paper, the nuclides and nuclide pairs of theranostics prepared by accelerators are divided into the three categories: nuclides of theranostics, nuclide pairs of theranostics of same element and different elements. The physical properties and current applications of some nuclides and nuclide pairs are introduced. The problems in the application of accelerator radionuclides preparation in China are analyzed, and the application prospect of the integration of accelerator radionuclides diagnosis and treatment is prospected.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Alphapapillomavirus ; Humans ; Lupus Erythematosus, Systemic ; Papillomavirus Infections/prevention & control* ; Vaccination

Objective: To investigate and analyze the clinical features, epidemiologic information and pathogenic characteristics of a rabies patient. Methods: Clinical data of the patient(boy) was collected and epidemiological survey was conducted, fluorescence quantitative reverse transcription-polymerase chain reaction (FQRT-PCR) and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the samples of saliva, cerebrospinal fluid (CSF), skin tissue with hair follicle at the back of the neck for rabies laboratory diagnosis. Results: Early symptoms of the boy were vomiting, diarrhea, fever and irritability, followed by coma and death. The boy had nasal trauma one month ago and the domestic dog died of illness during the same period. He did not accept the rabies post-exposure prophylaxis (PEP). The result of the saliva sample was positive by FQRT-PCR. The predicted segments of the glycoprotein(G), nucleoprotein (N) genes of rabies virus were amplified from the positive saliva sample of the patient by RT-PCR. Compared with rabies virus strains in Henan province, the nucleotide homology and amino acid homology in G gene segment were 96.5%-98.8% and 96.5%-99.2% respectively. Conclusions The case was diagnosed in laboratory as rabies case. The pathogenic rabies virus strain was endemic in Henan province. The nasal trauma, the dead domestic dog were probably related to the infection of the boy.

Objective To investigate the efficacy of arthroscopic synovectomy on refractory knee arthritis complicated with popliteal cyst.Methods Patients diagnosed as rheumatoid arthritis (RA) or spondyloarthritis (SPA) with refractory knee arthritis who underwent knee arthroscopic synovectomy in our hospital from 2010 to 2017 were enrolled,including 20 patients (16 RA,4 SpA) with popliteal cyst.Clinical data,RA disease activity score (DAS28),SpA back pain score,etc,were collected to evaluate the efficacy of knee surgery.Results Erythrocyte sedimentation rate (ESR) [58(17,79)mm / 1h vs.19(9,30)mm/1h,P＜ 0.001],C reactive protein (CRP) [3.72(0.92,8.14) mg/L vs.0.85(0.10,3.08) mg/L,P＜0.001],rheumatoid factor [64.6(20.2,193.3) vs.20.5(10.0,58.4),P＜0.001],DAS28 score(4.67±1.25 vs.2.81±1.23,P＜0.001),knee joint discomfort score [5(4,6) vs.2(1,3),P＜0.001] and the volume of knee joint effusion by ultrasound (P＜0.05) in 95 RA patients were significantly decreased compared to those before operation.ESR [27(12,54)mm/1h vs.20 (16,28) mm/1 h,P＜0.001],CRP [3.27(1.06,6.95) mg/L vs.1.41(0.34,3.03)mg/L,P＜0.001],knee discomfort score [2(0,5) vs.1(0,3),P＜0.05],back pain visual analogue score (VAS) [5(4,5) vs.2(1,3),P＜0.001],and the volume of knee joint effusion by ultrasound (P＜0.001) in 58 SpA patients were significantly lower than those before the operation.The rate [16.84％(16/95) vs.6.32％(6/95),P=0.023] and grading (P=0.007) of popliteal cyst in RA were decreased after the operation.No statistically difference was observed in the rate [6.90％ (4/58) vs.5.17％(3/58),P=0.697] of popliteal cyst in patients with SpA,yet with a trend of decrease in 4 patients.Conclusion This study provide evidence that knee arthroscopic synovectomy has a good effect for refractory knee arthritis,which can reduce disease activity,improve joint symptoms and decrease the grading of popliteal cyst.

Objective · To investigate the effects of simo decoction combined with mannitol on the intestinal preparation of magnetically guided capsule endoscopy (MGCE). Methods · A total of 120 patients were enrolled in this randomized controlled trial and randomly divided into two groups according to the random number table. The observation group (n=60) was pretreated with simo decoction 20 mL each time, 3 times a day combined with mannitol 500 mL for oral administration before MGCE examination, while control group (n=60) only was done with mannitol 500 mL for oral administration. Then the intestinal cleanliness and occurrence of adverse reaction were observed. Results · The intestine bubbles in observation group were less than that of control group based on evaluation criteria (Z=-1.976, P=0.048), and the intestine juices in observation group were also less than control group (Z=-2.489,P=0.013) suggesting that the intestinal cleanliness in observation group was superior to control group. Simultaneously, the score of nausea and vomiting in observation group was lower than control group according to the evaluation criteria (Z=-2.215, P=0.027), and abdominal pain, distension and anal stenosis in observation group were less than control group (Z=-2.158, P=0.031), meanwhile, the overall incidences of adverse reaction were 8.33% and 36.67%, respectively (χ2=13.811, P=0.000) , all of which implied that the occurrence of adverse reaction was lower in observation group compared to control group. Conclusion · Simo decoction combined with mannitol could enhance intestinal cleanliness and reduce the occurrence of adverse reaction so as to improve the effect of intestinal preparation.