Objective: To explore the distribution of traditional Chinese medicine (TCM) syndromes in patients with interstitial lung disease (ILD) and its influencing factors. Methods: This cross-sectional study included 385 patients with ILD admitted to the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine) from January 2018 to June 2022. Data on sex, age, body mass index, smoking history, respiratory rate, hospitalization time, treatment cost, whether velcro rales can be heard, comorbidities with rheumatic immune diseases, TCM four examination information, and clinical examination results, including CT imaging, D-dimer level, and lung function-related indicators, were collected. The distribution pattern of TCM syndromes in patients with ILD and the association between TCM syndromes and clinical indicators were analyzed using the cluster analysis and binary Logistic regression analysis. Results: Among the 385 patients with ILD, sticky phlegm (59.74%) and shortness of breath (56.10%) were common symptoms, while greasy tongue coating (55.32%), red tongue (52.73%), and slippery and rapid pulse (25.71%) were common tongue and pulse manifestations. The patients were divided into five syndromes using cluster analysis: syndrome of phlegm-heat stagnation in the lung (36.62%), syndrome of turbid phlegm obstructing lung (29.35%), syndrome of deficiency of both qi and yin (12.99%), syndrome of qi deficiency of lung and kidney (11.95%), and syndrome of phlegm and blood stasis obstructing lung (9.09%). The D-dimer level was lower in patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of qi deficiency of lung and kidney than in those with syndrome of phlegm and blood stasis obstructing lung (P<0.05). The percentage of predicted forced vital capacity (FVC%pred) of patients with syndrome of phlegm-heat stagnation in the lung, syndrome of turbid phlegm obstructing lung, syndrome of deficiency of both qi and yin, and syndrome of phlegm and blood stasis obstructing lung was higher than in those with syndrome of qi deficiency of lung and kidney (P<0.05). Among patients aged 60 and above, those with syndrome of phlegm-heat stagnation in the lung, syndrome of phlegm and blood stasis obstructing lung, and syndrome of deficiency of both qi and yin containing dual pathogenic syndrome elements were more likely to experience moderate to severe pulmonary diffusion impairment than those with syndrome of turbid phlegm obstructing lung and syndrome of qi deficiency of lung and kidney containing single pathogenic syndrome elements (P<0.05). The Logistic regression showed that the FVC%pred was an influential factor for syndrome of qi deficiency of lung and kidney, and the area under the receiver operating characteristic (ROC) curve (AUC) between FVC%pred and the formation of syndrome of qi deficiency of lung and kidney was 0.676 (95%CI: 0.598-0.755), P=0.002. The sensitivity was 0.431, the specificity was 0.966, and the best threshold on the ROC curve of 0.397 was 79.1%. The D-dimer level was an influential factor in the formation of syndrome of phlegm and blood stasis obstructing lung. The AUC between D-dimer level and the formation of syndrome of phlegm and blood stasis obstructing lung was 0.729 (95%CI: 0.655-0.802), P<0.001. The sensitivity was 0.914, the specificity was 0.523, and the best threshold on the ROC curve of 0.437 was 0.675 mg/L. Conclusion syndrome of phlegm-heat stagnation in the lung and syndrome of turbid phlegm obstructing lung are common among patients with ILD. Complex pathological syndromes are more likely to exacerbate pulmonary diffusion dysfunction. The FVC%pred can assist in differentiating syndrome of qi deficiency of lung and kidney, whereas the D-dimer level can assist in differentiating syndrome of phlegm and blood stasis obstructing lung.

Objective:To construct a machine-learning model for predicting the progression of pancreatic cystic lesions (PCLs) based on clinical and CT features, and to evaluate its predictive performance in internal/external testing cohorts.Methods:Baseline clinical and radiological data of 200 PCLs in 177 patients undergoing abdominal thin slice enhanced CT examination at Peking Union Medical College Hospital from July 2014 to December 2022 were retrospectively collected. PCLs were divided into progressive and non-progressive groups according to whether the signs indicated for surgery by the guidelines of the European study group on PCLs were present during three-year follow-up. 200 PCLs were randomly divided into training (150 PCLs) and internal testing cohorts (50 PCLs) at the ratio of 1∶3. 15 PCLs in 14 patients at Jinling Affiliated Hospital of Medical School of Nanjing University from October 2011 to May 2020 were enrolled as external testing cohort. The clinical and CT radiological features were recorded. Multiple feature selection methods and machine-learning models were implemented and combined to identify the optimal machine-learning model based on the 10-fold cross-validation method. Receiver operating characteristics (ROC) curve was drawn and area under curve (AUC) was calculated. The model with the highest AUC was determined as the optimal model. The optimal model's predictive performance was evaluated on testing cohort by calculating AUC, sensitivity, specificity and accuracy. Permutation importance was used to assess the importance of optimal model features. Calibration curves of the optimal model were established to evaluate the model's clinical applicability by Hosmer-Lemeshow test.Results:In training and internal testing cohorts, the progressive and non-progressive groups were significantly different on history of pancreatitis, lesions size, main pancreatic duct diameter and dilation, thick cyst wall, presence of septation and thick septation (all P value <0.05) In internal testing cohort, the two groups were significantly different on gender, lesion calcification and pancreatic atrophy (all P value <0.05). In external testing cohort, the two groups were significantly different on lesions size and pancreatic duct dilation (both P<0.05). The support vector machine (SVM) model based on five features selected by F test (lesion size, thick cyst wall, history of pancreatitis, main pancreatic duct diameter and dilation) achieved the highest AUC of 0.899 during cross-validation. SVM model for predicting the progression of PCLs demonstrated an AUC of 0.909, sensitivity of 82.4%, specificity of 72.7%, and accuracy of 76.0% in the internal testing cohort, and 0.944, 100%, 77.8%, and 86.7% in the external testing cohort. Calibration curved showed that the predicted probability by the model was comparable to the real progression of PCLs. Hosmer-Lemeshow goodness-of-fit test affirmed the model's consistency with actual PCLs progression in testing cohorts. Conclusions:The SVM model based on clinical and CT features can help doctors predict the PCLs progression within three-year follow-up, thus achieving efficient patient management and rational allocation of medical resource.

Active exploratory behaviors have often been associated with theta oscillations in rodents, while theta oscillations during active exploration in non-human primates are still not well understood. We recorded neural activities in the frontal eye field (FEF) and V4 simultaneously when monkeys performed a free-gaze visual search task. Saccades were strongly phase-locked to theta oscillations of V4 and FEF local field potentials, and the phase-locking was dependent on saccade direction. The spiking probability of V4 and FEF units was significantly modulated by the theta phase in addition to the time-locked modulation associated with the evoked response. V4 and FEF units showed significantly stronger responses following saccades initiated at their preferred phases. Granger causality and ridge regression analysis showed modulatory effects of theta oscillations on saccade timing. Together, our study suggests phase-locking of saccades to the theta modulation of neural activity in visual and oculomotor cortical areas, in addition to the theta phase locking caused by saccade-triggered responses.
Animals ; Frontal Lobe/physiology* ; Macaca mulatta ; Neurons/physiology* ; Saccades ; Theta Rhythm ; Visual Fields

Objective To evaluate the feasibility of peripheral artery CT angiography (CTA)under 70 kV with 50 ml contrast medium on the third-generation dual-source CT. Methods Totally 82 patients who were equally randomized into two groups:70 kV group:the scan was performed under 70 kV tube voltage+50 ml iopromide on the third-generation dual-source CT;and 100 kV group:the scan was performed under 100 kV tube voltage+90 ml iopromide on the second-generation dual-source CT. The CT number of abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were measured and contrast to noise ratio(CNR),signal to noise ratio(SNR)were calculated. The image quality was compared between these two groups. Results The dose-length product was (195.8±46.9)mGy·cm in 70 kV group,which was significantly lower than that in 100 kV group (461.6±57.9)mGy·cm,and was decreased by 57% (t=-22.848,P=0.000). Compared with the 100 kV group,the CT number of the proximal abdominal aorta in 70 kV group was significantly lower(t=-2.502,P=0.014),while the CT number of superficial femoral arteries (t=3.053,P=0.003)and popliteal arteries (t=4.013,P=0.000)was much higher in 70 kV group. SNR and CNR of proximal abdominal aorta,distal abdominal aorta,bilateral common iliac arteries,common femoral arteries,superficial femoral arteries,popliteal arteries and arteries of the calf were significantly lower in 70 kV group than those in 100 kV group (all P<0.05). The artifacts in abdominal aorta (t=2.893,P=0.000)and feet arteries (t=3.776,P=0.000)were higher in 70 kV group than those in 100 kV group,the enhancement of abdominal aorta (t=-1.000,P=0.002)and feet arteries (t=2.893,P=0.010)were lower in 70 kV group,the enhancement of femoral-popliteal arteries (t=-1.000,P=0.000)and arteries of calf (t=4.261,P=0.000)were higher in 70 kV group. Compared with the 100 kV group,the image noise in aorta (t=2.048,P=0.044),femoral-popliteal arteries (t=8.370,P=0.000),arteries of the calf (t=8.315,P=0.000)and feet arteries (t=7.202,P=0.000)were higher in 70 kV group. Conclusion Compared to conventional scan protocol,using 70 kV tube voltage with 50 ml contrast medium to perform peripheral artery CTA can assure the image quality and meanwhile remarkably reduce the radiation dose and the use of contrast medium.
Aorta, Abdominal ; diagnostic imaging ; Arteries ; diagnostic imaging ; Artifacts ; Computed Tomography Angiography ; Contrast Media ; Humans ; Iohexol ; analogs & derivatives ; Leg ; blood supply ; Radiation Dosage ; Signal-To-Noise Ratio ; Tomography, X-Ray Computed

Objective To observe the degradation time and the intimal hyperplasia of biodegradable magnesium alloy stent (MPM) implanted in the abdominal aorta of experimental rabbits.Methods A total of 24 New Zealand white rabbits were randomly divided into four groups (30 d,60 d,90 d and 180 d) with 6 rabbits in each group.In cach rabbit one MPM stent was implanted in the abdominal aorta at the level of one cm below the left renal artery.Reexamination of abdominal aortography with DSA was separately performed at 30,60,90 and 180 d after stent implantation to check the stent condition.The rabbits of each group were sacrificed at the corresponding scheduled day,the stenting segment of aorta of each rabbit was removed and the specimen was sent for microscopic examination.The experimental results were analyzed with SPSS20.0 software.Results All the 24 experimental rabbits survived.During the follow-up period the stent showed gradual degradation changes,and basically complete degradation was not observed until to 180 days.Meanwhile,the intimal hyperplasia reached its peak at 90 days after implantation.The abdominal aorta remained unobstructed during the whole process of degradation.Conclusion The time of complete degradation for MPM stent is 182 days,which is long enough to meet the needs of vascular positive remodeling.

Objective To discuss the application of different types of bronchial arteriography catheter in performing bronchial artery embolization (BAE) for the treatment of hemoptysis.Methods The clinical data of a total of 97 patients with hemoptysis,who received BAE during the period from January 2013 to May 2016,were collected.According to angiographic findings in aspect of the opening and running direction of the arteries causing bleeding,the responsible arteries were divided into 4 types:upward opening,horizontal opening and running upwards,horizontal opening and running downwards,and downward opening.For each responsible artery,appropriate angiography catheter was selected from the following catheters:MIK catheter,left gastric artery catheter,Cobra catheter,Simmon-1 catheter and Simmon-2 catheter.With super-selective catheterization technique the selected suitable catheter was inserted into the responsible artery and angiography was subsequently performed.The effect of the selection of bronchial arteriography catheter in performing BAE for hemoptysis was analyzed.Results A total of 180 responsible arteries were detected in 97 patients.Of the 180 responsible arteries,artery with upward opening was seen in 42,artery with horizontal opening and running upwards was found in 54,artery with horizontal opening and running downwards was observed in 46,and artery with downward opening was detected in 38.The success rates of super-selective catheterization for MIK catheter,left gastric artery catheter,Cobra catheter and Simmon catheter were 83.3％ (35/42),92.6％ (50/54),87.0％ (40/46) and 89.5％ (34/38,including 30 Simmon-1 catheters and 4 Simmon-2 catheters) respectively.After BAE,the responsible arteries were occluded in all patients,and hemoptysis stopped immediately.The recurrence rate at 6 months after BAE was 7.2％ (7/97).Conclusion For the treatment of hemoptysis,BAE is safe and effective.The key point to ensure a successful BAE is that the selection of appropriate catheter should be based on the opening and running direction of the artery causing bleeding.

Objective To analyze the causes for the failures after posterior pedicle screw instrumentation for thoracolumbar fractures.Methods From June 2003 to December 2014,182 patients with thoracolumbar fracture were treated by fixation through the posterior approach using pedicle screws and fully followed up in our institute.We analyzed the cases of postoperative infection,recovery of neural symptoms,breakage and loosening of pedicle screws and connecting rod,non-union of the fractured vertebra,and correction loss of kyphosis in associations with the AO classification and Loading Sharing Classification of Spine Fracture (LSCSF) system,osteoporosis,intervertebral disc injury and methods of internal fixation.Results In this series,altogether 27 cases failed(14.8％).The rate of postoperative infection was 1.1％ (2/182).The rate of breakage of pedicle screw or connecting rod was 7.7％ (14/182).The implant breakage rates for fractures of AO types A1,A2 and A3.1 were significantly lower than for other types (P ＜ 0.05).The implant breakage rate for the patients with ≤6 LSCSF points was significantly lower than for those with ≥7 LSCSF points (P ＜ 0.05).The implant breakage occurred in 3 cases of those who underwent fixation of one normal vertebra respectively below and above the two contiguous segments but not in those who underwent additional fixation of the injured vertebrae.The rate of screw loosening was 2.2％ (4/182).The non-union rate of the injured vertebra was 2.7％ (5/182).The rate of kyphosis recurrence was 1.1％ (2/182).Conclusions To prevent the failure of posterior pedicle screw fixation,surgeons should pay more attention to the following key points before operation:the type and evaluation of spinal fractures,a proper approach and method of internal fixation,and the weight bearing capability of the anterior column.

Objective To evaluate the inhibitory effect of butyric acid (BA) as a histone deacetylase (HDAC) inhibitor on lipopolysaccharide (LPS)-induced pulmonary fibrosis and its mechanism. Methods Thirty C57/BL6 mice were randomly divided into three groups according to the random number method, namely control group (physiological saline was given intraperitoneally and by gavage), LPS challenge group (LPS-induced murine model of pulmonary fibrosis was reproduced with intraperitoneal injection of 10 mg/kg LPS), and BA preconditioning + LPS challenge group (10 mg/kg BA was given followed by intraperitoneal injection of 10 mg/kg LPS), with 10 mice in each group. Mice were sacrificed painlessly, and lung tissue samples were harvested at 2 weeks and 4 weeks respectively (five samples every group each time). HDAC activity was evaluated with fluorescence analysis kit. Protein expression of acetylated-histone H3 (Ace-H3), acetylated-histone H4 (Ace-H4) and thymocyte differentiation antigen 1 (Thy-1) were determined by Western Blot. The mRNA expression of Thy-1 was assessed by real-time reverse transcription- polymerase chain reaction (real-time RT-PCR). The degree of lung inflammation and fibrosis were microscopic detected after hematoxylin-eosin (HE) staining and Masson collagen staining. The deposition of lung collagen was detected by hydroxyproline content measurement kit. Results Compared to control group, the degree of lung inflammation and fibrosis was aggravated after LPS challenge, as manifested by increased hydroxyproline content (μg/mg, 2 weeks: 8.384±0.632 vs. 4.388±0.334, 4 weeks: 8.308±0.244 vs. 4.370±0.342, both P < 0.01), increased HDAC activity (μmol/L, 2 weeks: 7.243±0.384 vs. 3.628±0.641, 4 weeks: 6.479±0.202 vs. 3.238±0.524, both P < 0.01), increased deacetylation degree of histone H3 and H4 [relative expression of Ace-H3 (gray value): 0.516±0.115 vs. 1.005±0.359 at 2 weeks, 0.633±0.143 vs. 1.092±0.193 at 4 weeks, both P < 0.05; relative expression of Ace-H4 (gray value): 0.402±0.164 vs. 0.759±0.187 at 2 weeks, P > 0.05; 0.426±0.098 vs. 0.858±0.177 at 4 weeks, P < 0.01], and lowered Thy-1 mRNA and protein expression [Thy-1 mRNA (2-ΔΔCt): 0.606±0.066 vs. 1.005±0.109 at 2 weeks, P < 0.01; 0.824±0.101 vs. 1.210±0.400 at 4 weeks, P > 0.05; relative expression of Thy-1 protein (gray value): 0.725±0.284 vs. 1.249±0.297 at 2 weeks, 0.589±0.139 vs. 1.372±0.343 at 4 weeks, both P < 0.05]. Compared with LPS group, BA precondition could inhibit above processes, as manifested by decreased hydroxyproline content (μg/mg: 5.943±0.726 vs. 8.384±0.632 at 2 weeks, 4.938±0.209 vs. 8.308±0.244 at 4 weeks, both P < 0.01), decreased HDAC activity (μmol/L: 4.386±0.117 vs. 7.243±0.384 at 2 weeks, 4.863±0.096 vs. 6.479±0.202 at 4 weeks, both P < 0.01), increased Thy-1 mRNA expression at 2 weeks (2-ΔΔCt: 0.884±0.216 vs. 0.606±0.066, P < 0.05), increased acetylation degree of histone H4 and Thy-1 protein expression at 4 weeks [relative expression of Ace-H4 (gray value): 0.715±0.145 vs. 0.426±0.098, P < 0.05; relative protein expression of Thy-1 (gray value): 0.939±0.098 vs. 0.589±0.139, P < 0.01]. Conclusions LPS-induced pulmonary fibrosis was related with activation of HDAC, deacetylation of histone H3 and H4 and Thy-1 gene silencing. HDAC inhibitor BA could inhibit LPS-induced pulmonary fibrosis and Thy-1 gene silencing through inhibiting activation of HDAC and deacetylation of histone H4.

Objective To investigate the clinical therapeutic effect of thymosin combined with antibiotics on acute exacerbation of chronic obstructive pulmonary disease in eldly patients ,and its influence on cellular immune function.Methods 60 elderly patients with acute exacerbation of chronic obstructive pulmonary disease were select-ed,by using the method of random number table,they were divided into the treatment group (n =30)and control group (n =30).The control group was given antibiotics and conventional treatment,the treatment group was given thymosin on the basis of treatment of the control group.The clinical curative effect and the influence of the cellular immune function were compared in the two groups.Results The after treatment 1s forced expiratory volume (FEV1 ),FEV1 /FVC(%)and FEV1 /expected value (%)of the treatment group were (1.59 ±0.15)L,(58.83 ± 13.14),(76.13 ±3.21),and those of the control group were (1.31 ±0.11)L,(54.62 ±12.41),(68.74 ±3.01), the differences were statistically significant (t =7.261,6.923,8.793,all P <0.05).After treatment,the clinical symptom score and quality of life score of the treatment group were (3.71 ±0.83),(6.48 ±1.12),which were sig-nificantly lower than those of the control group [(4.71 ±0.79),(7.41 ±0.97)],the differences were statistically significant (t =4.983,4.214,all P <0.05).The total effective rate of the treatment group was 96.7%,which was significantly higher than 70.0% in the control group,the difference was statistically significant (χ2 =7.271,P <0.05).After treatment,the CD +4 ,CD +4 /CD +8 of the treatment group were (41.7 ±5.9),(1.35 ±0.49)respectively, which of the control group were (33.2 ±4.8),(1.89 ±0.65),the differences were statistically significant (t =5.107,3.142,all P <0.05).In terms of incidence of adverse reactions,the difference between the two groups was not statistically significant (P >0.05).Conclusion The clinical effect of thymosin combined with antibiotic therapy in the treatment of acute exacerbation of chronic obstructive pulmonary disease in elderly patients is remarkable,safe and reliable,and can improve the cellular immune function in patients,it is worthy of further clinical application.

This study aimed to investigate infiltration related microRNAs (miRNAs) in bladder urothelial carcinoma (BUC). Twenty patients with BUC were enrolled and divided into 2 groups according to infiltration or not: infiltrating BUC group (n=12) and non-infiltrating BUC group (n=8). Gene chip was used to detect infiltration related miRNAs in the BUC samples. In other recruited 17 patients with BUC who were divided into infiltrating BUC samples (n=14) and non-infiltrating BUC samples (n=3), and in 4 BUC cell lines (EJ, 5637, T24 and BIU-87), the expression of miRNAs was assayed by using reverse transcription-polymerase chain reaction (RT-PCR). In infiltrating BUC group, as compared with non-infiltrating BUC group, there were 7 differentially expressed miRNAs: hsa-miR-29c, hsa-miR-200a, hsa-miR-378, hsa-miR-429, hsa-miR-200c and hsa-miR-141 were up-regulated, while hsa-miR-451 was down-regulated. In the BUC samples, the results of RT-PCR were consistent with those by the miRNA array. In the cancer cell lines, RT-PCR in T24 only revealed the similar expression pattern of miRNAs to that by the miRNA array. It is suggested that infiltration of BUC is related with different expression of miRNAs, which may provide a novel platform for further study on function and action mechanism of miRNAs.
Carcinoma ; genetics ; Cell Line, Tumor ; Humans ; MicroRNAs ; genetics ; Urinary Bladder ; metabolism ; Urinary Bladder Neoplasms ; genetics