ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.

Purpose To explore the effect of compressed sensing(CS)technique with different acceleration factors on the quality of cardiac magnetic resonance cine sequences and feasibility of clinical application.Materials and Methods From January to July 2021,40 healthy volunteers were prospectively recruited for cardiac magnetic resonance cine imaging in Hefei First People's Hospital.Four scan protocols of volunteers were designed:SENSE 2 and CS-cine sequences with acceleration factors of 3,4 and 8.The imaging slices include four chamber heart,short axis heart,left ventricular two chamber heart and three chamber heart.Subjective score of image quality,left ventricular cardiac function and 16-segment myocardial thickness of SENSE 2 and CS3,CS4 and CS8 were compared and analyzed.Results Taking SENSE 2 image as the standard score of 5,the scores of CS3 and CS4 were above 3,and the scores of CS8 were below 3.There was no significant difference between the scores of four chamber heart and short axis heart images of CS3 and SENSE 2 sequence(all P>0.05).There were statistically significant differences in the subjective scores of image quality between the left ventricular two chamber heart and three chamber heart groups of each sequence(all P<0.05).There was no statistically significant difference in left ventricular function(left ventricular ejection fraction,left ventricular end systolic volume,left ventricular end diastolic volume,left ventricular stroke volume,left ventricular end-diastolic mass)(F=0.027,0.182,0.057,0.140,0.545)and myocardial thickness(F=0.052-7.366)among the four imaging schemes(all P>0.05).Conclusion Cardiac cine based on compressed sensing technology have good application prospects.With the increase of acceleration factors,the scanning time gradually decreases,and the corresponding image quality will also decrease.When the acceleration factor is 4,that is,the scanning time of the conventional cine sequence is reduced by 50%,the left ventricular function and myocardial thickness can still be accurately measured,and the image quality basically meets the diagnostic requirements.

Objective:To investigate the effect of posterior nasal neurectomy（PNN） with pharyngeal neurectomy （PN） on chronic sinusitis with nasal polyps （CRSwNP）complicated with perennial allergic rhinitis （PAR）. Methods:83 patients with perennial allergic rhinitis combined with chronic group-wide sinusitis with nasal polyps who attended our hospital from July 2020 to July 2021 were selected. All patients underwent conventional functional endoscopic sinusitis surgery（FESS）+ nasal polypectomy. Patients were divided according to whether they underwent PNN+PN. 38 cases in the experimental group underwent FESS combined with PNN+PN; 44 cases in the control group underwent conventional FESS alone. All patients underwent the VAS, RQLQ, and MLK before treatment, and at 6 months and 1 year after surgery. Meanwhile, other relevant data were collected and the preoperative and postoperative follow-up data were collected and analyzed to assess the differences between the two groups. Results:The total postoperative follow-up period was 1 year. The recurrence rate of nasal polyps at 1 year postoperatively and the nasal congestion VAS score at 6 months postoperatively were not statistically significant in the two groups（P>0.05）. However, the patients in the experimental group had statistically significantly lower effusion and sneezing VAS scores, MLK endoscopy scores and RQLQ scores at 6 months and 1 year postoperatively, and nasal congestion VAS scores at 1 year postoperatively compared to the control group（P<0.05）. Conclusion:For patients with perennial AR complicated with CRSwNP, the combination of the PNN+PN in FESS can significantly improve the short-term curative effect, and PNN+PN is a safe and effective surgical treatment.
Humans ; Nasal Polyps/surgery* ; Rhinitis, Allergic/surgery* ; Sinusitis/surgery* ; Rhinitis, Allergic, Perennial ; Endoscopy ; Denervation ; Chronic Disease ; Rhinitis/complications*

Purpose To investigate the clinical value of artificial intelligence(AI)quantitative parameters in predicting the invasion degree of lung adenocarcinoma with diameter≤2 cm of ground-glass density.Materials and Methods A total of 80 patients with lung adenocarcinoma with diameter≤2 cm ground-glass density confirmed by pathology from March 2019 to April 2022 were retrospectively analyzed.A total of 90 nodules were rerolled,including 8 adenocarcinomas in situ(AIS),34 minimally invasive adenocarcinomas(MIA)and 48 invasive adenocarcinomas(IAC).They were divided into the experimental group(IAC)and the control group(AIS and MIA).The differences of the AI quantitative parameters such as volume,three-dimensional length diameter,maximum area,maximum CT value,minimum CT value and average CT value were compared between two groups,and the predictive values of AI quantitative parameters for the invasion degree of lung adenocarcinoma was evaluated.Results There were statistically significant differences with age,volume,three-dimensional length diameter,maximum area,maximum CT value and average CT value between the two groups(all P<0.05),but no statistically significant differences in gender and minimum CT value(both P>0.05).Binary Logistic regression analysis showed that the three-dimensional length diameter(odd ratio=2.020,P=0.034)and the maximum CT value(odd ratio=1.008,P=0.013)were independent predictors for lung adenocarcinoma with diameter≤2 cm of ground-glass density.The regression model based on the three-dimensional length diameter and the maximum CT value had the best predictive performance,and its AUC was 0.901.When the critical value was 2.432,its sensitivity and specificity were 93.75%and 71.43%,respectively.Conclusion AI quantitative parameters have a high value in predicting the degree of invasion of lung adenocarcinoma with diameter≤2 cm of ground-glass density,and the combined model with three dimensional long diameter and maximum CT value has the highest diagnostic efficiency.

Objective:To explore whether left ventricular interstitial fibrosis is associated with left atrial enlargement and left atrial dysfunction in patients of hypertrophic cardiomyopathy(HCM) with preserved ejection fraction.Methods:From October 2018 to September 2021, 59 HCM including 30 with enlarged maximal left artrial volume index (LAVI max), 29 with normal LAVI max and 28 age-and gender-matched controls were retrospectively enrolled. Imaging protocol included cine sequence, late gadolinium enhancement and T 1 mapping.The relationships between left ventricular mass index (LVMI), quantitative myocardial fibrosis and left atrial-related indexes were analyzed. One-way analysis of variance with Bonferroni post hoc correction or Kruskal-Wallis was performed for continuous variables. Categorical variables were assessed using the Chi-square test or Fisher′s exact test. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:The left ventricular end-diastolic volume index, left ventricular end-systolic volume index, left ventricular cardiac output and LVMI of HCM with enlarged LAVI max group were higher than HCM with normal LAVI max group and control group( P<0.05).Correlation analysis showed that LVMI correlated positively with LAVI max( r=0.780, P<0.001) and minimal left artrial volume index (LAVI min) ( r=0.816, P<0.001), extracellular volume correlated positively with LAVI max( r=0.462, P<0.001) and LAVI min( r=0.483, P<0.001),%LGE was correlated positively with LAVI max( r=0.311, P<0.05) and LAVI min( r=0.327, P<0.05),left ventricular index interstitial volume was correlated negatively with left atrial ejection fraction of reservoir ( r=-0.669, P<0.001),left atrial ejection fraction of conduit ( r=-0.472, P<0.001),left atrial ejection fraction of pump ( r=-0.518, P<0.001)and left atrial expansion index( r=-0.626, P<0.001). Conclusion:There is association between LVMI and fibrosis and left atrial enlargement and phases dysfunction in HCM with preserved ejection fraction.

[Abstract] Objective: To investigate whether AP1903, a small-molecule chemical inducer, can terminate the cytotoxicity of CD19CAR-T cells over-expressing iCasp9 suicide gene in vivo and in vitro. Methods: CD19CAR-T cells over-expressing iCasp9 (iCasp9-CD19CAR-T) were constructed and co-incubated with AP1903. Then, the cell phenotype and apoptosis were detected by Flow cytometry, and the iCasp9/CID suicide gene system was verified on K562 and T cells, respectively. The cytotoxicity of iCasp9-CD19CAR-T cells was detected in vivo (survival rate of NCG mice bearing Raji cell transplanted xenograft) and in vitro (cell killing function was detected by Flow cytometry) under the administration of AP1903. Results: Compared with CD19CAR-T cells, iCasp9-CD19CAR-T cells showed in significant difference in proliferation, phenotype and cytotoxicity both in vitro and in vivo (all P>0.05). At 2 h after AP1903 administration, the apoptosis rates of K562 and T cells co-expressing iCasp9 and CD19CAR were (33.8±0.9)% and (27.95±0.35)%, respectively; and at 24 h after AP1903 administration, the apoptosis rates reached 100% in both cell lines. The in vitro cytotoxicity of iCasp9-CD19CAR-T cells induced by AP1903 was significantly lower than that without AP1903 treatment (P<0.01); the 60-day survival rate of mice bearing Raji cell transplanted tumor treated with AP1903-induced iCasp9-CD19CAR-T cells was also significantly lower than those treated with iCasp9-CD19CAR-T cells alone (P<0.01). Conclusion: AP1903 can effectively terminate the cytotoxicity of CD19CAR-T cells over-expressing iCasp9 suicide gene in vitro and in vivo.

OBJECTIVE：To establish a method for the determination of aloesin in plasma of rats ，and to investigate pharmacokinetic characteristics of aloesin. METHODS ：The plasma samples were precipitated with methanol. Using aloeresin D as internal standard ，the plasma concentration of aloesin was determined by LC-MS/MS. The determination was performed on Synergi Hydro-RP column with mobile phase consisted of 0.1‰ formic acid-methanol （gradient elution ）at the flow rate of 0.50 mL/min. The column temperature was 30 ℃，and sample size was 5 µL. The electrospray ionization source was applied to carry out negative ion detection with multiple reaction monitoring mode . The ion transitions for quantitative analysis were m/z 393.1→272.9（aloesin） and m/z 555.3→144.9（internal standard ），respectively. The concentration of aloesin in venous blood was determined by above method at 0.083，0.167，0.333，0.667，1，1.5，2.5，4，6，8，10 h after intravenous injection （3.35 mg/kg）and intragastric administration（16.75 mg/kg）of aloesin. DAS 3.0 software was used to calculate pharmacokinetic parameters. RESULTS ：The linear range of aloesin were 1-600 ng/mL（r＝0.994 5）. The lower limit of quantification was 1 ng/mL，and RSDs of within and between batches were less than 15％；accuracies within and between batches were within ±15％. The matrix factors were （92.74± 4.33）％-（94.84±2.57）％，and extraction recoveries were （69.04±2.13）％-（75.03±2.84）％；the deviation between the measured results of the stability test and the theoretical values were within ±15％. After intravenous injection and intragastric administration of aloesin ，main pharmacokinetic parameters were as follows ：cmax were（10 693.3±2 745.3）and（223.3±36.2）ng/mL；t1/2 were （2.45±1.45）and（3.33±1.91）h；AUC0－24h were（4 190.6±883.6）and（1 210.1±93.9）ng·h/mL（n＝3）. Absolute bioavailabi- lity was 11.13％. CONCLUSIONS ：The established method is rapid and sensitive for plasma determination of aloesin ，and suitable for its pharmacokinetic study.

Objective:Metabolic syndrome (MS) patients and determine factors related to platelet hyperactivation.Methods:A total of 999 participants (822 males and 177 females) were enrolled. Participants were divided into two groups according to the metabolic index: MS group (501) and normal control (NC) group (498). Platelet function was tested with PFA100 (Siemens USA, Deerfield, Illinois) which measures the time it takes for blood to occlude an aperture (closure time, CT) following stimulation with collagen and adenosine diphosphate. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA).Results:MS group had significantly shorter CT values compared with NC group (106.6±27.8s) vs (113.7±27.9s). Higher BMI, WC, BP, TC, TG, LDL-C, UA, and PRL were correlated with shorter CT values (all P<0.05). Conclusion:Our results indicated platelet hyperactivation exists in MS which was related to obesity and elevated blood pressure, blood lipids, uric acid, and PLR.

Alpinia officinarum Hance of the Chinese traditional herb for the treatment of emesis,abdominal pain and diarrhea has been used to counteract gastric disease induced by indomethacin in rats without obvious side effects.However,the role of herb-drug interaction between indomethacin and A.officinarum based on pharmacokinetic,tissue distribution and excretion still remains unknown.In this study,an ultra-fast liquid-tandem mass spectrometry(UFLC-MS/MS)method was developed for simultaneous determina-tion of indomethacin and its three metabolites,O-desmethylindomethacin(ODI),deschlor-obenzoylindomethacin(NDI)and indomethacin acyl-β-D-glucuronide(IDAβG)by oral administration of indomethacin solution with and without the ethanolic extract of A.officinarum and applied to comparative pharmacokinetic,tissue distribution and excretion studies.Our results clarified that oral administration of A.officinarum produced significant alterations in the pharmacokinetic parameters of indomethacin.And the pharmacokinetic interaction between indomethacin and A.officinarum reduced the systemic exposure of indomethacin and increased its elimination.Tissue distribution results demonstrated that co-administration of A.Officinarum could not reduce the accumulation of indo-methacin in the target tissue of the stomach,but could accelerate the excretions of indomethacin and its three metabolites including ODI,NDI and IDAβG in the bile and feces of rats in the excretion study.Therefore,A.Officinarum might have a gastrointestinal protective effect through the interaction role with indomethacin based on the pharmacokinetics and excretion in rats.

The aim of this study is to evaluate the efficacy of endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma. Forty-three patients with olfactory neuroblastoma undergoing surgery combined with radiotherapy were retrospectively analyzed. The patients were divided into endoscopic surgery and conventional surgery. All patients received postoperative radiotherapy at a dose of 60-70 Gy, the 5-year survival rate and local recurrence time of the two groups were compared, and the therapeutic effects of endoscopic surgery and traditional surgery were compared. Through survival analysis, the 5-year overall survival rates of the traditional surgery group and the endoscopic surgery group were 50% and 58% （=0.560）, the local recurrence rates were 44% and 48% （=0.288）, and the mean recurrence time was 5.6 months and 12.5 months （=0.032）. There was no difference between endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma, and the time of local recurrence was significantly prolonged. In early Neuroblastoma, endoscopic sinus surgery may be superior to open surgery in terms of efficacy and patient survival.