Objective:To explore the feasibility of deep learning image reconstruction (DLIR) in reducing radiation dose and improving image quality in 100 kV portal vein CT angiography (CTPV), and compare the image quality with traditional 120 kV CTPV.Methods:Consecutive 100 patients who underwent upper abdominal CTPV examinations at the Third Affiliated Hospital of Sun Yat-sen University from June 2021 to December 2022 were prospectively enrolled in this study. They were divided into two groups: the standard dose group (S group) using 120 kV and the low dose group (L group) using 100 kV. In the S group, adaptive statistical iterative reconstruction-Veo (ASIR-V) was employed with weights of 40%, 60%, and 80% (S-AV40, S-AV60, and S-AV80, respectively), along with a medium-level DLIR (S-DM). The L group used two weights of 60% and 80% of ASIR-V (L-AV60 and L-AV80) and medium to high-intensity DLIR (L-DM and L-DH) for reconstruction. Objective evaluation measurements, including CT values and standard deviation (SD) of the main portal vein (MPV), right portal vein (RPV), left portal vein (LPV), hepatic parenchyma, and right vertical muscle, were independently measured by two radiologists. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated. The images of eight groups were blindly evaluated using a 5 points scale by three radiologists. The Volume CT dose index (CTDIvol) and dose length product (DLP) were recorded for both protocol groups, and the effective dose (ED) was calculated. Statistical analysis was performed using Single factor variance analysis for objective indicators and Kruskal-Wallis H test for subjective scores. Results:The effective dose in the L group was reduced by 51% compared to the S group. There were significant statistical differences in SD, SNR and CNR among eight groups for MPV, RPV, and LPV ( P<0.001 for all). The SD of L-DH showed no statistical difference compared to the S-AV80 group ( P>0.05), but it was significantly lower than the other six groups ( P<0.05 for all). Except for CNR in the MPV, which showed no statistically significant difference between the L-DH and S-AV80 groups ( P>0.05), both SNR and CNR were significantly higher in the L-DH group compared to the other groups ( P<0.001 for all). The L-DH (4.61±0.16) achieved the highest subjective image quality score, which was statistically higher than the scores in the other six groups ( P<0.001 for all) except for the S-DM group (4.31±0.19). There was good consistency among the radiologists regarding objective parameter measurements and subjective image quality scores ( ICC=0.584-0.960). Conclusion:Compared to standard-dose CTPV at 120 kV, the combination of 100 kV with the DLIR algorithm significantly reduced the radiation dose by 51% in CTPV while maintaining higher SNR, CNR and subjective scores. The high-level DLIR algorithm produced the best image quality for 100 kV CTPV.

Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) at admission for stroke associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the First Affiliated Hospital of Kunming Medical University from January 2019 to June 2020 were retrospectively included. The demographic information, vascular risk factors, severity of stroke at admission, and NLR data of the patients were collected. Multivariate logistic regression was used to analyze the independent correlation between NLR and SAP. The NLR was divided into quartile groups to further analyze the trend relationship between NLR and SAP. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NLR for SAP. Results:A total of 316 patients with AIS were enrolled, including 200 males (63.29%) with an age of 63.86±13.78 years. The median baseline Nationanl Institutes of Health Stroke Scale score was 4 (interquartile range, 2-9), and the median NLR was 4.42 (interquartile range, 3.17-6.70). Ninety-three patients (29.43%) experienced SAP. Multivariate logistic regression analysis showed that NLR was an independent risk factor for SAP in patients with AIS (odds ratio 1.189, 95% confidence interval 1.077-1.313; P<0.001). Moreover, SAP risk increases with the increase of NLR ( Ptrend<0.001). Compared to the first quartile, the risk of SAP increased 9.991 times in the fourth quartile (95% confidence interval 2.912-34.279; P<0.001). ROC curve analysis showed that the area under the curve of NLR for SAP prediction was 0.793 (95% confidence interval 0.737-0.850), with an optimal cutoff value of 5.475. The sensitivity and specificity for predicting SAP were 66.67% and 79.82%, respectively. Conclusion:NLR at admission is an independent risk factor for SAP in patients with AIS and has certain predictive value for SAP.

The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) signaling exert essential regulatory function in microbial-and onco-immunology through the induction of cytokines, primarily type I interferons. Recently, the aberrant and deranged signaling of the cGAS-STING axis is closely implicated in multiple sterile inflammatory diseases, including heart failure, myocardial infarction, cardiac hypertrophy, nonalcoholic fatty liver diseases, aortic aneurysm and dissection, obesity, etc. This is because of the massive loads of damage-associated molecular patterns (mitochondrial DNA, DNA in extracellular vesicles) liberated from recurrent injury to metabolic cellular organelles and tissues, which are sensed by the pathway. Also, the cGAS-STING pathway crosstalk with essential intracellular homeostasis processes like apoptosis, autophagy, and regulate cellular metabolism. Targeting derailed STING signaling has become necessary for chronic inflammatory diseases. Meanwhile, excessive type I interferons signaling impact on cardiovascular and metabolic health remain entirely elusive. In this review, we summarize the intimate connection between the cGAS-STING pathway and cardiovascular and metabolic disorders. We also discuss some potential small molecule inhibitors for the pathway. This review provides insight to stimulate interest in and support future research into understanding this signaling axis in cardiovascular and metabolic tissues and diseases.

Platelets buoy up cancer metastasis via arresting cancer cells, enhancing their adhesion, and facilitating their extravasation through the vasculature. When deprived of intracellular and granular contents, platelet decoys could prevent metastatic tumor formation. Inspired by these, we developed nanoplatesomes by fusing platelet membranes with lipid membranes (P-Lipo) to restrain metastatic tumor formation more efficiently. It was shown nanoplateletsomes bound with circulating tumor cells (CTC) efficiently, interfered with CTC arrest by vessel endothelial cells, CTC extravasation through endothelial layers, and epithelial-mesenchymal transition of tumor cells as nanodecoys. More importantly, in the mouse breast tumor metastasis model, nanoplateletsomes could decrease CTC survival in the blood and counteract metastatic tumor growth efficiently by inhibiting the inflammation and suppressing CTC escape. Therefore, nanoplatelesomes might usher in a new avenue to suppress lung metastasis.

Objective To investigate the epidemiological characteristics of chronic obstructive pulmonary disease (COPD) in patients aged 65 years and above in Liaoning Province. Methods Between January 2019 and December 2020, a cluster random sampling method was used to investigate residents ≥ 65 years old in Sujiatun Community, Shenyang City, Liaoning Province. The pulmonary function tests of the selected residents were conducted. Questionnaire surveys were carried out and 5738 questionnaires with complete data were analyzed. Results A total of 620 COPD cases were diagnosed among 5738 people investigated in the present study, with a total prevalence rate of 10.81%, of which the prevalence rate in men was 12.58% (371/2950), and the prevalence rate in women was 8.93% (249/2950). According to the GOLD classification of lung function, 620 patients can be divided into 186 (30.49%) cases of grade I, 266 (43.61%) grade II, 118 (19.34%) grade III, and 50 (8.20%) cases of grade IV. The problem with lung function in males was more serious than that in females, which increased gradually with age (P<0.05). Multivariate logistic regression analysis showed that gender, age, BMI, smoking, childhood respiratory history, family history, occupational exposure, indoor oil fume and use of polluted fuel for heating were independent risk factors affecting the onset of COPD (P<0.05). Conclusion The prevalence of COPD in patients aged 65 years old and above in Liaoning is relatively high. Gender, age, BMI, smoking, childhood respiratory history, family history, occupational exposure, indoor oil fume, and use of polluted fuel for heating are related to the onset of COPD. Clinical attention should be paid to early screening and prevention of COPD in those populations to reduce the prevalence of COPD..

Objective:To investigate the relationship between neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte (LMR) ratio and prognosis in patients with advanced non-small cell lung cancer (NSCLC).Methods:Total 96 NSCLC patients with stage Ⅲ B and above confirmed by pathological examination in our hospital from March 2014 to 2016 were selected as the research objects. According to the 24-month follow-up results, the patients were divided into survival group (30 cases) and death group (66 cases). The NLR and LMR values of the two groups before chemotherapy were compared. The critical value of NLR and LMR in predicting the prognosis of patients was analyzed by drawing receiver operating curve (ROC); The clinicopathological characteristics of NSCLC patients with different levels of NLR and LMR were analyzed, and Cox proportional hazard regression model was used to analyze the effect of NLR and LMR on the prognosis of patients.Results:The NLR value of survival group was lower than that of death group ( P<0.05), and there was no significant difference between survival group and death group in LMR value ( P>0.05). The area under curve (AUC) value of NLR was 0.785, and the corresponding critical value was 3.19; the AUC value of LMR was 0.536, and the corresponding critical value was 3.66. There were significant difference in tumor node metastasis (TNM) stage and differentiation between NSCLC patients with different NLR values (NLR≥3.19 group and NLR<3.19 group) ( P<0.05), but there were no significant differences in age, gender, smoking, pathological type and lesion location ( P>0.05). There was no significant difference in TNM stage, differentiation degree, age, gender, smoking, pathological type and lesion location in NSCLC patients with different LMR values (LMR ≥ 3.66 group and LMR<3.66 group) ( P>0.05). The increase of TNM stage, differentiation degree and NRL were independent risk factors of poor prognosis in patients with advanced NSCLC ( P<0.05). Conclusions:Increased NLR values in peripheral blood of patients with advanced NSCLC may increase the risk of poor prognosis in patients.

An analytical method was developed for the simultaneous extraction and determination of eighteen fluoroquinolones (FQs), tetracyclines (TCs) and sulfonamides (SAs) antibiotics from soils using solid phaseextraction and liquid chromatography tandem mass spectrometry.Soil sample was firstly extracted by phosphate buffer at pH 3 in combination with 50% of organic modifier acetonitrile, then purified and concentrated by SAX and HLB column.Qualitative and quantitative analysis were carried out for the analyte under the MRM mode after the chromatography separation on Kromasil C_(18)(250 mm x4.6 mm, 5 μm) column.The range of recoveries (in percent) for FQs, TCs, SAs, in the soil matrix was 67.20%-88.98%, 62.23%-85.36%, 55.76%-97.37% with 1.1%-17.2% of relative standard deviation respectively in two different concentra tions.The limits of quantification (LOQ, S/N = 3) were 3.36-8.88 jig/kg, 0.56-0.91 μg/kg and 0.07-1.85 μg/kg for FQs, TCs and SAs, respectively.This method was successfully used to detect 18 anti biotics in 6 soil samples with different land types in Tianjin.Results showed some of the antibiotics in the arable soil were detected, with concentrations of 1.72-119.57 μg/kg.

OBJECTIVEUse HPLC to study the permeation of ingredients of Shuanghuanglian injection powder (SHL) through placental barriers of rats at different stages of pregnancy.

METHODThe pregnant rats were administered SHL for 5 d through caudalis vena at different stages of pregnancy. Plasma and embryonic tissues were obtained 12 h after the final administration of SHL. The componds in biological specimen were identified by HPLC.

RESULTBaicalin, luteolin and wogonoside were the main compounds in plasma. Wogonoside retained in first trimester embryonic tissues, and baicalin retained in the embryonic tissues of different pregnant stages.

CONCLUSIONBaicalin is the main compound of SHL through placental barriers of rats. Embryotoxicity of baicalin should be considered as the key point to evaluate the safety of SHL.

Animals ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; metabolism ; Female ; Humans ; Injections ; Male ; Models, Animal ; Permeability ; Placenta ; drug effects ; metabolism ; Pregnancy ; Rats ; Rats, Wistar

Objective To evaluate the clinical effects of free dorsalis pedis flap on the repair of two skin and soft tissue defects in hand. Methods From February 2003 to February 2009, free dorsalis pedis flap was used to repair two skin and soft tissue defects in 11 patients. Six cases were males and 5 females.Two was used the hand skin and soft tissue defects in 4 cases; back of the hand skin and soft tissue defect with the middle finger proximal palmar skin and soft tissue defect in 1 case, the hand ripped through injury to the back of the hand of the hand ripped through skin and soft tissue defects in 3 cases, were cut flap:proximal flap 3 cm× 3 cm-8 cm × 7 cm, distal flap 4 cm × 2 cm-6 cm × 5 cm. Foot for the area will adopt the lower abdominal full-thickness skin grafting. Results Uniform flap survival period of the wound healing class, foot skin graft donor sites were successfully survived. Ten patients were followed up from 6 to 19 months, with an average follow-up of 9 months. Follow-up flap fine texture, appearance of natural, nonbloated, feeling to restore S2-S3, hand function recovered satisfactorily, for the district of foot healed well without ulceration and ulcer formation,had no effect on walking function. Conclusion The dorsalis pedis flap for hand two series of skin and soft tissue defects, with design flexibility, excellent texture flaps, etc., is to repair the hand skin and soft tissue defects of the two better way.

Objective To determine the surgical approaches and evaluate the clinical efficacy of skin defects of the emergency thumb, finger reconstruction.Methods Emergency in 11 cases complicated skin defect of the thumb and the hand, fingers missing injured patients by using the method of combined of toenail flap of biped dorsalis pedis flap or the second toe.The implantation of thumbnail flap of dorsalis pedis flap combined with the second toenail flap was applied on 5 cases.3 cases had received the implantation of thumbnail flap of dorsalis pedis flap combined with the second toe and 3 cases with combined repair of the second toe of biped dorsal flap.Of all the cases, reconstruction of 3 fingers in 1 case, reconstruction of 2 fingers in 10 cases,5 cases with reconstruction by means of implantation of toenail flap of same pediele splitting flap or the second toe, 6 cases with repair of toenail flap of dorsalis pedis flap or second toe.Results Except for 1 necrosis occurred in 1 finger in 1 case of 3 fingers reconstruction, the rest of tissue flaps and fingers all survived.The primary healing was achieved postoperatively.The patients were followed up for 5-24 months.The functions such as grabbing, grasping, nipping were basically restored after the repair.The appearance of hand was also restored to a certain degree.Sensory recovery S2-S4 of reconstruction finger and flap was achieved.Healing was satisfying in the donor area, no obvious cicatricial contracture was seen, while the walk function was not affected.Conclusion The application of combined implantation of toenail flap of biped dorsalis pedis flap or the second toe in the repair of overall hand skin degloving injury could restore the function and appearance of the injured hands to a certain degree.It is proved to be an effective treatment method.