ObjectiveTo investigate the effect of Gegen Qinliantang on glucose and lipid metabolism in the rat model of catch-up growth （CUG） induced by a high-fat diet and the underlying mechanism. MethodA total of 60 SD rats were randomized into a normal control group （n=18） and a modeling group （n=42）. The rat model of CUG was established with a restricted diet followed by a high-fat diet， and the changes of general status and body weight were observed. The levels of fasting blood glucose （FBG）， fasting insulin （FINS）， triglyceride （TG）， and total cholesterol （TC） were measured in 6 rats in each group at the end of the 4^th and 8^th week， respectively. The homeostasis model assessment of insulin resistance index （HOMA-IR） was calculated， and the insulin sensitivity and body composition changes of CUG rats were evaluated. The successfully modeled rats were assigned into 6 groups： normal control， model， high-， medium-， and low-dose Gegen Qinliantang （2.5， 5， 10 g·kg^-1）， and pioglitazone （3.125 mg·kg^-1）. The rats were administrated with corresponding drugs by gavage for 6 weeks， and the normal control group and model group were administrated with the same amount of normal saline. During the experiment period， the changes of body weight were recorded， and the FBG， FINS， HOMA-IR， TG， and TC were determined at the end of the experiment. Hematoxylin-eosin （HE） staining was employed to observe the pathological changes of skeletal muscle in rats. The levels of reactive oxygen species （ROS） and malondialdehyde （MDA） in the skeletal muscle were measured strictly according to the manuals of the reagent kits. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was performed to measure the mRNA levels of silencing information regulator 1 （SIRT1）， peroxisome proliferator-activated receptor-gamma coactivator1α （PGC1α）， and nuclear respiratory factor 1 （Nrf1） in the skeletal muscle. Western blot and immunohistochemistry were employed to assess the expression of SIRT1， PGC1α， and Nrf1 in the skeletal muscle. ResultCompared with the normal control group， the model group presented elevated levels of FBG， FINS， TG， and TC （P<0.05， P<0.01）， increased HOMA-IR （P<0.01）， increased diameter of muscle fibers and adipocytes between muscle cells in the skeletal muscle， rising levels of ROS and MDA in the skeletal muscle （P<0.01）， and down-regulated mRNA and protein levels of SIRT1， PGC1α， and Nrf1 （P<0.05， P<0.01）. Compared with the model group， Gegen Qinliantang （especially the medium and high doses） and pioglitazone decreased the body weight， FINS， HOMA-IR， and TG （P<0.05， P<0.01） and reduced interstitial components such as intermuscular fat in the skeletal muscles and the diameter of muscle fibers. Furthermore， the drugs lowerd the levels of ROS and MDA （P<0.05， P<0.01） and up-regulated the mRNA and protein levels of SIRT1， PGC1α， and Nrf1 （P<0.05， P<0.01） in the skeletal muscle. ConclusionGegen Qinliantang can ameliorate the glucose and lipid metabolism disorders and insulin resistance in CUG rats by regulating the SIRT1/PGC1α/Nrf1 signaling pathway.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

Hepatocellular carcinoma is one of the common malignant tumors, and most patients with hepatocellular carcinoma are already in the middle stage at the time of clinical detection, transarterial chemoembolization is the treatment of choice for mid-stage hepatocellular carcinoma.Due to the high degree of tumor heterogeneity, accurately predicting the outcome of patients with hepatocellular carcinoma after transarterial chemoembolization remains one of the difficulties in clinical practice.As an emerging technology, radiomics can not only reflect tumor heterogeneity non-invasively, but also monitor, evaluate and predict tumor progression by analyzing changes in the tumor microenvironment to guide patients′ personalized treatment and prolong their survival time.This article reviews the progress of the application of radiomics in predicting the efficacy of transarterial chemoembolization for hepatocellular carcinoma.

Objective:To explore the application of energy spectrum CT single energy combined with adaptive statistical iterative reconstruction-Veo (ASIR-V) for optimizing inferior vena cava imaging.Methods:Thirty patients with negative diagnosis or minimal inferior vena cava lesions who underwent CT venography (CTV) of inferior vena cava in the Second Hospital of Harbin Medical University from August 2021 to April 2022 were enrolled in the study, including 11 males and 19 females with the age of (55.4±8.8) years and the body mass index of (23.2±2.8) kg/m2. The mixed energy group images and 5 single energy groups of 50, 55, 60, 65 and 70 keV images were reconstructed from the images in the inferior vena cava phase. The subcutaneous fat noise, CT values, signal to noise ratio (SNR) and contrast to noise ratio (CNR) for each segment of the inferior vena cava in 5 sets of single-energy images were measured and evaluated subjectively to determine the best single energy level. The images were reconstructed by combining different weight ASIR-V (20%, 30%, 40%, 50%, 60%, 70% and 80%) algorithms, and images from different weight groups and mixed energy groups were evaluated objectively to determine the best ASIR-V weights which was matched with the best single energy level. All images were scored subjectively by 2 senior radiologists based on image noise, uniformity of vessel filling, sharpness of vessel margins and diagnostic confidence.Results:There were significant differences in subcutaneous fat noise and objective evaluation indexes of each segment of inferior vena cava among the monoenergetic groups (all P<0.05), each objective evaluation index increased with the decrease of energy level, the maximum value was obtained in the 50 keV group. The subjective scores of the 5 groups were consistent by the 2 radiologists(all κ≥0.75). The highest subjective scores were obtained in the 60 keV group, the best single energy level is 60 keV in a comprehensive analysis. The differences in objective evaluation indicators among the 7 groups of best single energy combined with different weights ASIR-V image group and the mixed energy group were all statistically significant (all P<0.01). Image noise decreased with increasing ASIR-V weights for different weight groups, all differences among groups were statistically significant (all P<0.01), and the minimum noise was minimal in 80% weight group. There was no significant change in CT value of each segment of inferior vena cava (all P>0.05). The SNR and CNR of each segment of inferior vena cava increased, all differences among groups were statistically significant (all P<0.01), and the SNR and CNR of 80% weight group was the highest. The subjective scores of the 8 groups were consistent evaluated by the 2 radiologists (all κ≥0.75), and the subjective score of 60% weight group was the highest, 60% was the best ASIR-V weight for matching 60 keV in a comprehensive analysis. Conclusions:The study indicates that the best energy level for optimizing energy spectrum CT single energy imaging of the inferior vena cava is 60 keV, on the basis of which the best weighting for combined ASIR-V is 60%.

As a key measure for the diagnosis of HIV infection, HIV testing is essential for AIDS prevention and control. During the COVID-19 pandemic, the number of HIV testing provided through medical health institutions and social organizations was significantly decreased. The demand for HIV self-testing increased rapidly during the COVID-19 pandemic, and HIV self-testing has become an important supplement to HIV testing in medical institutions. During the COVID-19 pandemic, HIV testing was mainly affected by medical services, COVID-19 prevention and control measures, individual's willingness to undergo testing, the number of sex partners and other factors in terms of both supply and demand. This article summarizes the overall impact of the COVID-19 pandemic on HIV testing, including different testing methods, the related factors and strategies for the improvement of HIV testing. The goal is to provide evidence-based insights for strengthening HIV testing services during infectious diseases pandemic.

Objective:To evaluate the residual risk (RR) of transfusion transmitted HIV (TT-HIV) after the implementation of nucleic acid amplification test (NAT) in blood screening test among blood centers in China.Methods:The data of blood donors and HIV infection markers from 2017 to 2020 were collected from 28 blood centers via the Platform of Comparison of blood establishments Practice in Chinese Mainland. The new infection rate/window period mathematical model was used for two types of blood screening strategies, namely, two rounds ELISA plus individual NAT take turn with pooling NAT (2ELISA+ ID-NAT/MP-NAT) and two ELISA plus one round pooling NAT (2ELISA+ MP-NAT), and the RR of HIV infection was estimated also based on first donors (FDs) and repeated donors (RDs) in different blood donation years. T-test analyses were conducted for comparing TT HIV RR among FDs and RDs in different blood donation years with two blood screening strategies, and the variation trend of RR in HIV test was observed.Results:From 2017 to 2020, the RR of FDs in 2ELISA+ ID-NAT/MP-NAT blood screening strategy was 2.869/10 6 person-year, 3.795/10 6 persons-year, 3.879/10 6 person-year, and 2.890/10 6 person-year respectively. The RR of RDs was 1.797/10 6 person-year, 1.502/10 6 person-year, 1.857/10 6 person-year, and 1.483/10 6 person-year respectively. Significant difference exists between RR of FDs and RDs, with F=9.898 and p<0.05. In 2ELISA+ MP-NAT strategy, the RR of FDs was 3.508/10 6 person-year, 1.868/10 6 person-year, 2.204/10 6 person-year, and 1.765/10 6 person-year respectively. The RR of RDs was 0.948/10 6 person-year, 0.926/10 6 person-year, 0.748/10 6 person-year, and 0.682/10 6 person-year respectively. Statistical difference existed between RR of FDs and RDs, with F=17.126 and P<0.05. There was no significant difference between the RR of FDs in these two strategies with F=3.493 and P>0.05, while there was a difference between the RR of RDs in these two strategies with F=24.516 and P<0.05, and a difference between the RR of total donors (TDs) in these two strategies F=20.216 and P<0.05. Conclusions:The RR of TT HIV significantly decreased after the introduction of NAT into blood test among blood centers in China. There were some differences in the RR of HIV testing among different blood screening strategies. There could be significant differences in the RR of HIV testing among different groups of blood donors. Compared with FDs, RDs is the low risk group for HIV.

Small renal cell carcinoma refers to a renal malignant tumor with a maximum diameter of 4 cm.Due to the small size, its diagnosis and differential diagnosis have been difficult points in clinical work. CT texture analysis is an emerging technique, it determines the tumor heterogeneity by analyzing the distribution and relationship of pixel or voxel gray-scale levels in the CT images, it acts to more accurately predict the benign and malignant tumors and the classification of tumors.This paper reviews CT texture analysis on the diagnosis and differential diagnosis of small renal cell carcinoma, in order to guide the correct diagnosis of doctors and effectively clinical treatment.

【Objective】 To compare three kinds of platelet antibody detection methods used to identify alloantibodies in patients with platelet transfusion refractory(PTR). 【Methods】 The 83 samples from PTR patients were analyzed base on three different methods, including solid phase ELISA, Luminex, and capture. The sensitivity, reproducibility, and consistency of different kits were evaluated. 【Results】 A total of 71 (62 positive and 9 negative) out of 83 samples showed consistent results by three methods. The consistency between Luminex and solid phase ELISA was 95.2% (Kapp value=0.829, P<0.05), between solid phase ELISA and capture method was 85.5% (Kapp value=0.512, P<0.05), and between Luminex and capture method was 90.3% (kappa value=0.636, P<0.05). Among the 12 samples with inconsistent results, 3 cases presented positive results by capture method alone and negative by other methods, which had incompatible cross-matching results with 6 random blood donors; 5 cases with HLA antibodies showed negative results by capture method alone and positive by both Luminex and solid phase ELISA; the other 4 cases were positive in both capture and Luminex, but negative in solid phase ELISA. 【Conclusion】 The consistency of three methods was 85.5%, and each has its limitations. The capture method is rapid, economic and registered domestically, which can be used for preliminary screening.Luminex has the optimal diagnostic performance, which can be used for high-throughput and HPA/HLA antibody analysis. The solid phase ELISA is convenient. The combination of them can detect platelet antibodies effectively.

Objective:To inhibit the Itch gene expression of T-lymphocytes and investigate the immune activity of T lymphocytes using ultrasound-targeted microbubble destruction (UTMD).Methods:T lymphocytes were separated by magnetic bead, and to establish an Itch gene targeted short hairpin RNA (shRNA) plasmid. There were three groups in this study: ①experimental group, Itch-shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ②control group, negative control shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ③blank group, untreated. Forty-eight hours after UTMD transfection, transfection efficiency was detected and analyzed by fluorescence microscopy and flow cytometry, the expression of Itch protein was measured with Western blotting.Seventy-two hours after UTMD transfection, the secretion of interleukin 2 (IL-2) and interferon γ (IFN-γ) in the cell supernatant were measured by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA was used to compare the differences between groups, and LSD- t test was used to compare the differences between groups. Results:The UTMD mediated shRNA transfection rate was 52.3%, and the relative expression levels of Itch protein in the experimental group, control group and blank group were 0.301±0.080, 0.773±0.101 and 0.719±0.090, respectively, and the difference was statistically significant( F=24.441, P<0.01). The Itch gene expression can be effectively suppressed in the experimental group. Seventy-two hours after transfection, the concentrations of IL-2 in the experimental group, control group and blank group were (417.3±37.1)ng/L, (158.7±17.3)ng/L and (147.0±10.2)ng/L, respectively, and the difference was statistically significant( F=118.701, P<0.001) and the concentrations of IFN-γ were (168.3±12.1)ng/L, (74.3±3.7)ng/L and (74.6±7.1)ng/L, respectively, and the difference was statistically significant ( F=126.833, P<0.001). The expression levels of IL-2 and IFN-γ in the experimental group were significantly higher than those in the control group and the blank group. Conclusions:UTMD mediated shRNA transfection can significantly decrease the expression of Itch and promote immune activity of T lymphocyte.

Objective:To evaluate the oncologic and functional outcomes of postcricoid carcinoma treated by surgical treatment, and to summarize our clinical experience in surgical treatment and reconstructive techniques.Methods:Medical files of 45 patients were collected and retrospectively analyzed. The patients received surgical treatments between January 2010 and May 2017 in the Qilu Hospital of Shandong University, including 39 males and 6 females, the age ranged from 41 to 78 years old. T1, T2, T3 and T4 staging tumors represented respectively for 2,13,23 and 7 cases. And cervical metastasis was histologically identified in 33 cases (8 for N1 and 25 for N2). Advanced staging patients (10 in Stage Ⅲ and 30 in Stage Ⅳ) accounted for 88.9% of the cohort, while early staging cases (1 in Stage Ⅰand 4 in Stage Ⅱ) for 10.1%. All patients received cervical lymph node dissection. After tumor excision without compromising margins, hypopharyngeal functions were reconstructed by residual mucosa, pectoralis major myocutaneous flap, laryngotracheal tissue flap or gastric tissue flap, and laryngeal functions were reconstructed by epiglottis, sternohyoid myofascial flap or thyroid perichondrium. Survival rates were analyzed by the Kaplan-Meier method.Results:Postoperatively 23 patients received radiotherapy and 13 patients received chemoradiotherapy. All patients were followed up for more than 3 years. Total 3-year and 5-year survival rates were 60.5% and 49.0%, respectively. Patients obtaining the conservation of laryngeal functions accounted for 44% (20/45) of all cases. The neck lymph node positive rate was 73.3%(33/45), and log-rank test demonstrated that cervical lymph node metastasis was significantly associated with prognosis of patients (χ 2=4.364, P=0.037). Conclusion:Appropriate surgical approaches and excision methods and comprehensive application of flaps are critical to precise tumor excision and reconstruction of laryngeal functions, thereby improving the quality of life of patients with posterior carcinoma.