Application of dual-energy CT in differential diagnosis of lung metastases and benign nodules in breast cancer / 中华放射学杂志

Objective:To investigate the application value of dual-energy CT in the differential diagnosis of lung metastases and benign nodules in breast cancer.Methods:The data of 96 patients with pathology-confirmed breast cancer at the Fifth Affiliated Hospital of Wenzhou Medical University from March 2017 to June 2021 were analyzed retrospectively. All patients received dual-energy chest CT scans within 2 weeks before surgery. All 96 patients were female, aged 31-84 (56±12) years. A total of 207 pulmonary nodules from 96 patients were classified into 81 lung metastases and 126 benign nodules according to pathological findings. Conventional CT features [longest diameter, boundary, location and CT value difference between arterial and venous phases (ΔCT) of nodules] and dual-energy CT parameters [standardized iodine concentration (NIC), slope of energy spectrum (λ HU) and normalized effective atomic number (nZ eff) in arterial and venous phases] were analyzed and measured. The χ 2 test, independent samples t test and Kruskal-Wallis rank-sum test were used to analyze the differences of conventional CT features and dual-energy CT parameters between lung metastases and benign nodules. First, the least shrinkage and selection operator (LASSO) regression method was used to screen conventional CT features and dual-energy CT parameters, and then logistic regression analysis was performed to screen out independent risk factors for lung metastases. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of CT parameters alone and logistic model in differentiating lung metastases from benign lung nodules. Results:There were statistically significant differences between lung metastases and benign nodules in longest diameter, ?CT, NIC, λ HU and nZ eff in arterial and venous phases (all P<0.05). LASSO regression and binary logistic regression analysis showed that the venous phase λ HU (OR=59.413, 95%CI 14.233-248.002, P<0.001) and the venous phase nZ eff (OR=4.508, 95%CI 2.787-7.290, P<0.001) were independent risk factors for predicting lung metastases. Among them, the venous phase λ HU had the highest diagnostic efficiency, with an area under curve (AUC) of 0.794 and an accuracy of 74.88%. The AUC of the logistic model constructed by combining the venous phase λ HU and the venous phase nZ eff could reach 0.958, and the accuracy was improved to 92.27%, which was significantly higher than the efficacy of the two alone ( Z=6.02, 9.54, all P<0.001). Conclusion:Dual-energy CT has great application value in the identification of lung metastases and benign nodules in patients with breast cancer, especially when combined with venous phase λ HU and venous phase nZ eff, the diagnostic efficiency is further improved.

Correlation analysis between short-term invasive recurrence and functional MRI after radiofrequency ablation of hepatocellular carcinoma / 中华放射学杂志

Objective:To explore and clarify the correlation between short-term aggressive intrasegmental recurrence (AIR) and functional magnetic resonance imaging after radiofrequency ablation of hepatocellular carcinoma (HCC).Methods:A retrospective analysis of 1 262 patients with HCC who underwent radiofrequency ablation (RFA) in our hospital from January 2012 to June 2018, all patients were confirmed by pathology as HCC, of which 30 patients were found to have AIR during radiographic follow-up within 3 months after surgery, another 35 patients with disease progression who were controlled in a short period of time were randomly selected as the control group. All the enrolled patients underwent dynamic enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) scanning before surgery, and the differences in clinical data, lesion location, and functional magnetic resonance parameters between the two groups were compared, and their correlation with AIR after RFA was analyzed. Chi-square test, t test and Pearson test were used. Results:The lesions in the AIR group were significantly more in the Ⅰand Ⅳsegments than that in the control group ( P<0.05), and there was no significant difference in other liver segments ( P>0.05). There was no significant difference in the lesion morphology between the two groups ( P>0.05), and there was a significant difference in the early enhancement pattern of the lesions ( P<0.05), and the early arterial enhancement rate and apparent diffusion coefficient (ADC) value of the AIR group were significantly lower than the control group ( P<0.05). Further correlation analysis found that early enhancement of the arterial artery, early arterial enhancement rate, ADC value and lesion location were associated with AIR and were positively correlated, r values were 0.455, 0.633, 0.518, 0.375 and 0.287 ( P<0.05). Conclusion:The short-term AIR and functional imaging parameters (arterial early enhancement, early arterial enhancement rate, ADC value) and the liver segment (Ⅰ and Ⅳ) were highly correlated with radiofrequency ablation.

Correlation analysis between short-term invasive recurrence and functional MRI after radiofrequency ablation of hepatocellular carcinoma / 中华放射学杂志

Objective@#To explore and clarify the correlation between short-term aggressive intrasegmental recurrence (AIR) and functional magnetic resonance imaging after radiofrequency ablation of hepatocellular carcinoma (HCC).@*Methods@#A retrospective analysis of 1 262 patients with HCC who underwent radiofrequency ablation (RFA) in our hospital from January 2012 to June 2018, all patients were confirmed by pathology as HCC, of which 30 patients were found to have AIR during radiographic follow-up within 3 months after surgery, another 35 patients with disease progression who were controlled in a short period of time were randomly selected as the control group. All the enrolled patients underwent dynamic enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) scanning before surgery, and the differences in clinical data, lesion location, and functional magnetic resonance parameters between the two groups were compared, and their correlation with AIR after RFA was analyzed. Chi-square test, t test and Pearson test were used.@*Results@#The lesions in the AIR group were significantly more in the Ⅰand Ⅳsegments than that in the control group (P<0.05), and there was no significant difference in other liver segments (P>0.05). There was no significant difference in the lesion morphology between the two groups (P>0.05), and there was a significant difference in the early enhancement pattern of the lesions (P<0.05), and the early arterial enhancement rate and apparent diffusion coefficient (ADC) value of the AIR group were significantly lower than the control group (P<0.05). Further correlation analysis found that early enhancement of the arterial artery, early arterial enhancement rate, ADC value and lesion location were associated with AIR and were positively correlated, r values were 0.455, 0.633, 0.518, 0.375 and 0.287 (P<0.05).@*Conclusion@#The short-term AIR and functional imaging parameters (arterial early enhancement, early arterial enhancement rate, ADC value) and the liver segment (Ⅰ and Ⅳ) were highly correlated with radiofrequency ablation.

The feasibility of the applications of dual-low-dose with low tube voltage for head and neck CT angiography / 中华放射学杂志

Objective To explore the clinical value of the dual-low-dose with low tube voltage for head and neck CTA. Methods One hundred and sixty patients who were clinically suspected head and neck vascular disease underwent CTA procedure were propective selected, and whose body mass index (BMI) was also lower than 25 kg/m2. Forty cases were randomly selected as conventional group(120 kV,150 mAs, iodine 320 mg/ml), the other 120 cases were as the low dose group. The low dose group divided into three subgroups according to the random number table method, which were low iodine group (37 cases;120 kV,150 mAs, iodine 270 mg/ml), low tube voltage group (42 cases;100 kV,150 mAs, iodine 320 mg/ml) and low iodine and tube voltage group (41 cases;100 kV,150 mAs, iodine 270 mg/ml). The carotid bifurcated CT value, standard deviation (SD), signal-to-noise ratio (SNR), iodine intake and effective radiation dose (ED) of the four groups were recorded,all data undertook statistical analysis useing one-way ANOVA. Meanwhile, the subjective image quality score was applied to evaluate the image quality, and the differences among groups were compared by Wilcoxon signed ranks test. Results The image quality score were (2.85±0.19),(2.33 ± 0.34),(2.26 ± 0.32),(2.87 ± 0.22) in the four groups, and there was no statistical difference between groups(P>0.05).The carotid bifurcated CT value were respectively (380±30),(314±27),(514±52) and (425±28) HU in conventional, low iodine, low tube voltage and dual-low-dose groups, and the iodine intake were (18.85±2.10), (15.75±1.78), (18.53±1.98), (15.62±1.92) g, the ED of the four groups were (1.74±0.14), (1.73± 0.11), (1.32 ± 0.08) and (1.35 ± 0.09) mSv, the difference were all statistically significant (P<0.01). Furthermore, the iodine intake and the effective radiation dose in dual-low-dose group were significantly lower than the conventational group. Conclusions Head-and-neck CTA with dual-low-dose scan can provide same quality images as using 100 kV and high dose iodine contrast agent, and which also significantly reduced the ED and iodine intake greatly. Thus, this scanning program has great clinical value.

Evaluation of a Chest Circumference-Adapted Protocol for Low-Dose 128-Slice Coronary CT Angiography with Prospective Electrocardiogram Triggering

OBJECTIVE: To assess the effect of chest circumference-adapted scanning protocol on radiation exposure and image quality in patients undergoing prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). MATERIALS AND METHODS: One hundred-eighty-five consecutive patients, who had undergone prospective ECG triggering CCTA with a 128-slice CT, were included in the present study. Nipple-level chest circumference, body weight and height were measured before CT examinations. Patients were divided into four groups based on kV/ref.mAs = 100/200, 100/250, 120/200, and 120/250, when patient's chest circumference was 95.0 (n = 32), respectively. Image quality per-segment was independently assessed by two experienced observers. Image noise and attenuation were also measured. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The effective radiation dose was calculated using CT dose volume index and the dose-length product. RESULTS: A significant correlation was observed between patients' chest circumference and body mass index (r = 0.762, p < 0.001). Chest circumference ranged from 74 to 105 cm, and the mean effective radiation dose was 1.9-3.8 mSv. Diagnostic image quality was obtained in 98.5% (2440/2478) of all evaluated coronary segments without any significant differences among the four groups (p = 0.650). No significant difference in image noise was observed among the four groups (p = 0.439), thus supporting the validity of the chest circumference-adapted scanning protocol. However, vessel attenuation, SNR and CNR were significantly higher in the 100 kV groups than in the 120 kV groups (p < 0.05). CONCLUSION: A measure of chest circumference can be used to adapt tube voltage and current for individualized radiation dose control, with resultant similar image noise and sustained diagnostic image quality.

Study on Antibacterial Activity and Immunomodulation Effect ofRe-Du-Ning Injection / 世界科学技术-中医药现代化

This study was aimed to discuss the antibacterial and immunomodulation effect ofRe-Du-Ning (RDN) injection. Mice were randomly divided into the normal group, model group,Shuang-Huang-Lian (SHL) group (7.8 mL·kg-1), RDN high dose group (20.30 g·kg-1), middle dose group (10.15 g·kg-1), and low dose group (5.08 g·kg-1), in order to observe the death protective effect of mice with bacterial infection on antibacterial experimentin vivo. Mice were randomly divided into the normal group, model group,Xiang-Gu Duo-Tang (XGDT) group (0.19 mg·kg-1), RDN high dose group (20.30 g·kg-1), middle dose group (10.15 g·kg-1), and low dose group (5.08 g·kg-1). The 2, 4-dinitrochlorobenzene was used to induce delayed hypersensitivity. Immunomodulation was observed by the content of serum hemolysin and the carbon particle clearance index. The results showed that the RDN high dose group and middle dose group had antibacterial effect, which reduced the mortality of mice. The RDN high dose, middle dose and low dose group can enhance the phagocytosis of macrophage in immunosuppressive mice, increase the formation of hemolysin, and strengthen delayed hypersensitivity reaction among immunocompromised mice. It was concluded that RDN injection had antibacterial effect. Its immunomodulation effect was through the enhancing of non-specific immunity, humoral immunity and cellular immunity of mice.

Release difference of calcitonin gene-related peptide,substance P and prostaglandin E2 in orbital venous plexus plasma and brain tissues from rats with dura mater of superior sagittal sinus following electrical stimulation / 中国药理学与毒理学杂志

OBJECTIVE Toexplorethefeasibilityofpreparingamigrainemodelusingratdura materofsuperiorsagittalsinusinfollowingelectricalstimulation.METHODS MaleSDratswereexposed to 1 h electrical stimulation after brain electrode implantation,at 3 V,6 Hz,and a pulse of 0.25 ms.At 0, 1 5,30 min,and 1 h,orbital blood and brain tissue were taken.The content of calcitonin gene-related peptide (CGRP),substance P and prostaglandin E2 (PGE2 )in the plas ma and brain tissue was detec-tedbyradioimmunoassay.RESULTS ThebraintissuecontentofCGRP,substancePandPGE2in the sham group and normal group was not significantly different.CGRP,substance P and PGE2 in brain tissue of model group were 3.41 ±0.93,1 .80 ±0.64,3.41 ±0.93 and (1 .80 ±0.64)ng·g -1 respec-tively,significantly different from sham group(P<0.05).At different time points,the content of CGRP, substance P and PGE2 in plasma orbital venous plexus showed no significant difference between sham groupandmodelgroup.CONCLUSION ThereleaseofCGRP,PGE2andsubstancePinbraintissue is significantly different fro m that of plas ma after electrical sti mulation.The results suggest that a model of migraine can be constructed by electrical stimulation.

Study on Analgesic and Antipyretics Effect of Re-Du-Ning Injection / 世界科学技术-中医药现代化

This article was aimed to study the analgesic and antipyretic effect of Re-Du-Ning (RDN) Injection. Heating model was building on SD rats after subcutaneous injection of yeast. And then, RDN Injection was intravenous injected at the dose of 10.16 g·kg-1, 5.08 g·kg-1, and 2.54 g·kg-1, respectively. Observation was made on changes of rats' temperature. RDN Injection was intravenous injected into ICR mice at the dose of 20.30 g·kg-1, 10.15 g·kg-1, 5.08 g·kg-1 for 7 consecutive days. The methods of mice twist, hot plate and jaw pain were used in the testing of analgesic action of RDN Injection. The results showed that RDN Injection at high and middle dose can significantly reduce the temperature of heating rats models (P < 0.05 or P < 0.01). It can also significantly reduce the twisting times of mice by acetic acid (P< 0.05 or P< 0.01). It can also significantly increase the pain threshold of mice by hot plate and jaw pain (P< 0.05 or P< 0.01). It was concluded that RDN Injection had a good analgesic and antipyretic effect in mice.

Impact of conflict psychological stress on rats'sleep time and sleep phrase / 中华行为医学与脑科学杂志

ObjectiveTo discuss the impact of conflict psychological stress on rats'sleep time and sleep phrase.Methods20 Wistar male rats were randomly divided into vehicle group and model group,10 in each group.The improved experiment of Vogel drinking water conflict was used to establish the model of conflict psychological stress in rats and monitoring the changes of rats'weight and concentration of corticosterone (CORT) in serum after a week.After one week,the 12 h EEG and EMG of rats were traced by the polygraph in order to clarify the effect of conflict psychological stress on rats′ sleep time and sleep phrase.ResultsAfter one week,compared with vehicle group the weight of model group decreased significantly ( t =2.87,P ＜ 0.05 ),the concentration of CORT in serum raised significantly( t=5.19,P ＜ 0.05 ).A week later,compared the vehicle group,total sleep time( TST),light sleep,slow wave sleep(SWS) and rapid eye movement sleep (REM) time in model group rats ( (337.8 ±84.2)min,( 169 ±49.2) min,( 136.9 ±40.8)min,(33.1 ± 10.1 ) min for vehicle group; ( 155.4 ±16.7 ) min,( 111.6 ± 16.4 ) min,( 30.6 ± 4.9 ) min,( 12.6 ± 3.3 ) min for model group) were significantly reduced ( t =6.75,2.43,5.51,5.78,P ＜ 0.05 ),and the proportion of lightsleep increased ( (49.6 ± 3.4 ) ％,( 71.7 ±5.4)％ ) ( t =6.90,P＜0.05),the proportion of SWS decreased( (40.3 ± 10.9)％,( 19.8 ±3.2)％ ) ( t=6.74,P ＜ 0.05 ) ;but no significant change in the proportion of REM ( t =1.57,P＞ 0.05 ).Rats,sleep-wake rhythm figure indicated that the rats'sleep duration reduced and the number of awakening increased ; sleep tended to be fragmentation.ConclusionsConflict psychological stress lead to hypothalamus-pituitary-adrenal axis hyperactivity,weight loss,and the rhythm of sleep and sleep phase change in rats.