BACKGROUND:Indolepropionic acid has been shown to reduce diabetes-induced central nervous system inflammation.However,there is a lack of research on whether to inhibit microglia M1 polarization for the treatment of spinal cord injury. OBJECTIVE:To investigate the mechanism of indolepropionic acid inhibition of microglial cell M1 polarization for the treatment of spinal cord injury through cell and animal experiments. METHODS:(1)In vitro experiments:BV2 cell viability was assessed using the CCK-8 assay to determine optimal concentrations of indolepropionic acid.Subsequently,BV2 cells were categorized into control group,administration group(50 μmol/L indolepropionic acid),lipopolysaccharide group(100 ng/mL lipopolysaccharide),and treatment group(100 ng/mL lipopolysaccharide + 50 μmol/L indolepropionic acid).Nitric oxide content was quantified using the Griess method.Real-time quantitative PCR and western blot assay were employed to measure mRNA and protein levels of pro-inflammatory factors.Cell immunofluorescence staining was conducted to assess inducible nitric oxide synthase expression.The Seahorse assay was employed to assess glycolytic stress levels in BV2 cells.(2)In vivo experiments:30 SD rats were randomly divided into three groups:sham surgery group,spinal cord injury group,and indolepropionic acid group.Motor function recovery in rats after spinal cord injury was assessed using BBB scoring and the inclined plane test.Immunofluorescence staining of spinal cord tissue was conducted to evaluate the expression of inducible nitric oxide synthase in microglial cells.ELISA was employed to measure protein expression levels of the pro-inflammatory cytokines interleukin-1β and tumor necrosis factor-α in spinal cord tissue. RESULTS AND CONCLUSION:(1)In vitro experiments:Indolepropionic acid exhibited significant suppression of BV2 cell viability when its concentration exceeded 50 μmol/L.Indolepropionic acid achieved this by inhibiting the activation of the nuclear factor κB signaling pathway,thereby suppressing the mRNA and protein expression levels of pro-inflammatory cytokines(interleukin-1β and tumor necrosis factor-α),as well as the M1 polarization marker,inducible nitric oxide synthase,in BV2 cells.Additionally,indolepropionic acid notably reduced the glycolytic level in BV2 cells induced by lipopolysaccharides.(2)In vivo experiments:Following indolepropionic acid intervention in spinal cord injury rats,there was a noticeable increase in BBB scores and the inclined plane test angle.There was also a significant decrease in the number of M1-polarized microglial cells in spinal cord tissue,accompanied by a marked reduction in the protein expression levels of pro-inflammatory cytokines(interleukin-1β and tumor necrosis factor-α).(3)These results conclude that indolepropionic acid promotes functional recovery after spinal cord injury by improving the inflammatory microenvironment through inhibition of microglia M1 polarization.

Objective:To predict the 3-year cancer-specific survival(CSS)of patients with non-meta-static T3a renal cell carcinoma after surgery.Methods:A total of 336 patients with pathologically con-firmed T3a N0-1M0 renal cell carcinoma(RCC)who underwent surgical treatment at the Department of Urology,Peking University Third Hospital from March 2013 to February 2021 were retrospectively collect-ed.The patients were randomly divided into a training cohort of 268 cases and an internal validation co-hort of 68 cases at an 4∶1 ratio.Using two-way Lasso regression,variables were selected to construct a nomogram for predicting the 3-year cancer-specific survival(CSS)of the patients with T3aN0-1M0 RCC.Performance assessment of the nomogram included evaluation of discrimination and calibration ability,as well as clinical utility using measures such as the concordance index(C-index),time-dependent area un-der the receiver operating characteristic curve[time-dependent area under the curve(AUC)],calibra-tion curve,and decision curve analysis(DCA).Risk stratification was determined based on the nomo-gram scores,and Kaplan-Meier survival analysis and Log-rank tests were employed to compare progres-sion-free survival(PFS)and cancer-specific survival(CSS)among the patients in the different risk groups.Results:Based on the Lasso regression screening results,the nomogram was constructed with five variables:tumor maximum diameter,histological grading,sarcomatoid differentiation,T3a feature,and lymph node metastasis.The baseline data of the training and validation sets showed no statistical differences(P＞0.05).The consistency indices of the column diagram were found to be 0.808(0.708-0.907)and 0.903(0.838-0.969)for the training and internal validation sets,respectively.The AUC values for 3-year cancer-specific survival were 0.843(0.725-0.961)and 0.923(0.844-1.002)for the two sets.Calibration curves of both sets demonstrated a high level of consistency between the actual CSS and predicted probability.The decision curve analysis(DCA)curves indicated that the column dia-gram had a favorable net benefit in clinical practice.A total of 336 patients were included in the study,with 35 cancer-specific deaths and 69 postoperative recurrences.According to the line chart,the patients were divided into low-risk group(scoring 0-117)and high-risk group(scoring 119-284).Within the low-risk group,there were 16 tumor-specific deaths out of 282 cases and 36 postoperative recurrences out of 282 cases.In the high-risk group,there were 19 tumor-specific deaths out of 54 cases and 33 post-operative recurrences out of 54 cases.There were significant differences in progression-free survival(PFS)and cancer-specific survival(CSS)between the low-risk and high-risk groups(P＜0.000 1).Conclusion:A nomogram model predicting the 3-year CSS of non-metastatic T3a renal cell carcinoma patients was successfully constructed and validated in this study.This nomogram can assist clinicians in accurately assessing the long-term prognosis of such patients.

Humans ; Vaccines, Inactivated ; COVID-19/prevention & control* ; Vaccination ; Viral Vaccines ; Immunity ; Antibodies, Viral

Objective To explore the utility of CT for the evaluation of abdominal aortic calcification(AAC)in chronic kidney disease(CKD).Methods Laboratory examination indexes and abdominal plain CT imaging of 132 CKD stage 3-5 patients were analyzed retrospectively.The ACC score was evaluated according to quantitative method,the risk factors related to AAC were analyzed.Results In correlation analyses,AAC score was positively correlated with creatinine(Cr)level,CO2 combining power(P＜0.05),and negatively corrected with albumin(ALB).Logistic regression analysis showed that Cr level were risk factors for AAC,and ALB were protective factors.Conclusion Based on abdominal plain CT images,Cr level,CO2 combining power and ALB level are related to AAC.Quantitative method based on CT has a high application value in evaluating AAC.

Objective:To establish a model C-GALAD for detecting hepatocellular carcinoma (HCC) from the chronic liver disease and healthy people based on the serum markers.Methods:A clinical cohort including 229 hepatocellular carcinoma patients, 2 317 patients with chronic liver disease and 982 healthy people, was retrospectively collected from eight hospitals or physical examination institutions from April 2018 to October 2020. The data were divided into a training set and a testing set by stratified sampling with a 6∶4 ratio. A predictive model was established on the training set using a logistic backward regression method and validated on the testing set. In addition, clinical data from March to July 2021 in Beijing You′ an Hospital affiliated to Capital Medical University, including 84 patients with liver cancer and 204 patients with chronic liver disease collected were used for external independent validation of the model. The receiver operating characteristic curve (ROC) area under curve (AUC), the sensitivity and the specificity were used to evaluate the effectiveness of the model.Results:Through the logistic backward regression method, the seven signatures including age, gender, alpha-fetoprotein (AFP), alpha-fetoprotein alloplasm-3 ratio (AFP-L3%), des-gamma-carboxyprothrombin(DCP), platelet (PLT) and total bilirubin (TBIL) were selected as risk factors in the detection model. The area under the ROC curve (AUC) of the model on the testing set was 0.954, with an 88.04% sensitivity and a 94.85% specificity, and the AUC of model on the external independent validation set was 0.943, with an 89.29% sensitivity and a 90.2% specificity, which were better than other published models.Conclusion:The C-GALAD Ⅱ model can accurately predict the risk of hepatocellular carcinoma occurrence, and thus provide a trustworthy diagnosis method of hepatocellular carcinoma.

Objective:To analyze the prognostic factors of primary and metastatic tumor resection for metastatic renal carcinoma.Methods:Clinical data of 12 cases of renal carcinoma with distant metastasis admitted to the Peking University Third Hospital from June 2011 to December 2019 were analyzed retrospectively, including 10 males and 2 females. Age was from 36 to 67 years old, with average of 53.7 years old. BMI was 20.9-30.8 kg/m 2, with average of 25.8 kg/m 2.There were 6 cases of right kidney tumor and 6 cases of left kidney tumor. The diameter of the primary tumor was 2.7-16.0 cm, with an average of 7.1 cm. There were 2 cases of lung metastasis, 1 case of liver metastasis and 9 cases of bone metastasis. All the 12 patients underwent primary and metastatic tumorectomy. Postoperative pathological results showed 10 cases of clear cell carcinoma, 1 case of papillary type 2 tumor and 1 case of collecting duct carcinoma. The pathological results of the metastases were the same as those of the original lesions. Results:All the 12 patients underwent primary and metastatic renal carcinoma resection, among which 3 received postoperative chemotherapy and 6 received radiotherapy .Two patients were treated with targeted drugs. The interval between primary resection and metastatic resection was 1-84 months, and the median time was 2.5 months. In this study, 12 patients were followed up for 2-96 months, with the median survival time of 34 months, and mortality rate of 25%.There was no significant correlation between age( P=0.265), gender( P=0.183), BMI( P=0.152), primary tumor size ( P=0.082), radiotherapy, chemotherapy or targeted therapy ( P=0.915) and overall survival, and the interval between primary resection and metastatic resection ( P=0.046) was significantly correlated with overall survival. Conclusion:The interval between primary and metastatic tumor resection was a risk factor for the prognosis of patients.

Objective To evaluate the effects of problem-based learning (PBL) teaching model in medical imaging education in China. Methods Such databases as PubMed, Medline, CNKI, WanFang, VIP Data were electronically searched for literature on PBL versus lecture-based learning (LBL) applied in medical imaging education in China up to April, 2015. According to the strict quality evaluation of the in-cluded studies, meta-analysis was performed using RevMan 5.2 software. Results Fourteen studies were included totally. Studies included 1 233 students, of whom the PBL group had 608 cases, while LBL group had 625 cases. Compared with LBL, PBL was superior in medical imaging theoretical scores [WMD=5.22, 95%CI(3.06, 7.37), P=0.000], and the case analysis scores [WMD=6.45, 95%CI(4.77, 8.12), P=0.000]. PBL was also superior in the autonomous learning ability [RR=1.78, 95%CI (1.47, 2.16), P=0.000], the unity cooperation ability [RR=1.42,95%CI (1.25, 1.61), P=0.000] and analysis ability [RR=1.73,95%CI (1.42, 2.11), P=0.000]. There were significant differences between PBL group and LBL group. Conclusion PBL can improve teaching results in medical imaging education.

ObjectiveTo investigate the value of perfusion CT imaging in thyroid nodule. Methods Of the 40 cases of post-surgical thyroid nodule identified by pathology, nodular goiter was verified in 22 cases, thyroid adenoma in 6 cases,and thyroid carcinoma in 12 cases. All cases underwent CT perfusion scan at preoperative. The perfusion parameters including the blood flow ( BF), blood volume ( BV ), mean transit time ( MTT), and permeability of surface (PS) of region of interest (ROI) were calculated. The Mann-whitney test was used to comparing the differences of the different perfusion parameters. The ones with statistical significance would be introduced into the discriminatory analysis to distinguish the benign and malignant thyroid nodule. ResultsThe median MTT in 28 cases with benign thyroid nodule were 4. 33 s (Min 1.42 s,Max 10. 93 s), and that in 12 cases with malignant nodules were 2. 18 s( Min 1. 95 s, Max 2. 87 s). The difference had statistical significance ( P ＝ 0. 00 ) . The median BF in cases with thyroid carcinoma was 560. 23( Min 330. 66, Max 1000.00) ml ·100 g-1 ·min-1, and that in cases with the benign nodular were 374.79(Min 117.47,Max 1000.00) ml · 100 g-1 · min-1. There was a significant statistical difference ( P ＝0. 01 ). Through the discriminatory analysis, the difference of MTT between benign and malignant nodules were statistically significant (P ＝ 0. 00 ).After establing the Bayes discriminatory function, the overall diagnostic accuracy was 87.5％ (35/40).Conclusions MTT and BF are useful parameters in CT perfusion imaging to distinguish the benign and malignant thyroid nodules and the MTT is more accuracy.

OBJECTIVE: To preliminary discuss the questions of deep and superficial layer under intranasal endoscope operation for nasal septum malignant tumour. METHOD: The patients of 19 cases with nasal septum malignant tumour who adapt to the operation under intranasal endoscope were divided into 3 groups and were treated separately according to the range, position, infiltrative degree of tumour and exploring conditions in operative process. The treatments of first group had executed with first layer operation. The second group had executed with second layer operation in addition partial patients radiotherapy. The third group had executed with third layer operation in addition total patients radiotherapy. RESULT: The tumour-free survivals have 4 cases and local recurrences have 2 cases in 6 cases of first group. The tumour-free survivals have 5 cases, local recurrence has 2 cases, local metastasis has 1 cases and death has 1 case in 9 cases of second group. The tumour-free survivals have 2 cases, local recurrence has 1 case and local metastasis has 1 case in 4 cases of third group. The treated effects have not statistical differences in 3 groups (P > 0.05). Five-year survival rate was 84.2% and five-year tumour-free survival rate was 57.9% for all patients. CONCLUSION The operations under intranasal endoscope for nasal septum malignant tumour have certainly indication. The selection of operative deep and superficial layer and control of operative safety margin have the same important clinical signification.
Adolescent ; Adult ; Aged ; Disease-Free Survival ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; Nose Neoplasms ; surgery ; Young Adult

Objective To explore the relationship between EEG feature and TCD with secondary epileply in cerebrul infarction.Methods EEG and TCD were done and analyzed in 40 patients with secondary epileply in cerebrul infarction.Results The EEG abnormality rate was 95%,TCD abnormaity rate was 87.5%,abnormal EEG mainly showed increase of slow waves with low to middle amplitude,with diffuse or local distribution,epileptiform discharges were foumd only in 9 of the 38 ones,cerebral blood flow(CBF) was increased,decreased or bilateral dissymmetry,abnormal spectral frequency(higher force).Conclusion The abnormality rate of EEG is higher,but the detection rate of epileptiform discharges is lower;Unilateral increased of CBF might predict the side of epileptogenic focus.