Deep learning-based platform performs high detection sensitivity of intracranial aneurysms in 3D brain TOF-MRA: An external clinical validation study.

PURPOSE: To evaluate the diagnostic efficacy of a developed artificial intelligence (AI) platform incorporating deep learning algorithms for the automated detection of intracranial aneurysms in time-of-flight (TOF) magnetic resonance angiography (MRA). METHOD: This retrospective study encompassed 3D TOF MRA images acquired between January 2023 and June 2023, aiming to validate the presence of intracranial aneurysms via our developed AI platform. The manual segmentation results by experienced neuroradiologists served as the "gold standard". Following annotation of MRA images by neuroradiologists using InferScholar software, the AI platform conducted automatic segmentation of intracranial aneurysms. Various metrics including accuracy (ACC), balanced ACC, area under the curve (AUC), sensitivity (SE), specificity (SP), F1 score, Brier Score, and Net Benefit were utilized to evaluate the generalization of AI platform. Comparison of intracranial aneurysm identification performance was conducted between the AI platform and six radiologists with experience ranging from 3 to 12 years in interpreting MR images. Additionally, a comparative analysis was carried out between radiologists' detection performance based on independent visual diagnosis and AI-assisted diagnosis. Subgroup analyses were also performed based on the size and location of the aneurysms to explore factors impacting aneurysm detectability. RESULTS: 510 patients were enrolled including 215 patients (42.16 %) with intracranial aneurysms and 295 patients (57.84 %) without aneurysms. Compared with six radiologists, the AI platform showed competitive discrimination power (AUC, 0.96), acceptable calibration (Brier Score loss, 0.08), and clinical utility (Net Benefit, 86.96 %). The AI platform demonstrated superior performance in detecting aneurysms with an overall SE, SP, ACC, balanced ACC, and F1 score of 91.63 %, 92.20 %, 91.96 %, 91.92 %, and 90.57 % respectively, outperforming the detectability of the two resident radiologists. For subgroup analysis based on aneurysm size and location, we observed that the SE of the AI platform for identifying tiny (diameter＜3mm), small (3 mm ≤ diameter＜5mm), medium (5 mm ≤ diameter＜7mm) and large aneurysms (diameter ≥ 7 mm) was 87.80 %, 93.14 %, 95.45 %, and 100 %, respectively. Furthermore, the SE for detecting aneurysms in the anterior circulation was higher than that in the posterior circulation. Utilizing the AI assistance, six radiologists (i.e., two residents, two attendings and two professors) achieved statistically significant improvements in mean SE (residents: 71.40 % vs. 88.37 %; attendings: 82.79 % vs. 93.26 %; professors: 90.07 % vs. 97.44 %; P < 0.05) and ACC (residents: 85.29 % vs. 94.12 %; attendings: 91.76 % vs. 97.06 %; professors: 95.29 % vs. 98.82 %; P < 0.05) while no statistically significant change was observed in SP. Overall, radiologists' mean SE increased by 11.40 %, mean SP increased by 1.86 %, and mean ACC increased by 5.88 %, mean balanced ACC promoted by 6.63 %, mean F1 score grew by 7.89 %, and Net Benefit rose by 12.52 %, with a concurrent decrease in mean Brier score declined by 0.06. CONCLUSIONS: The deep learning algorithms implemented in the AI platform effectively detected intracranial aneurysms on TOF-MRA and notably enhanced the diagnostic capabilities of radiologists. This indicates that the AI-based auxiliary diagnosis model can provide dependable and precise prediction to improve the diagnostic capacity of radiologists.

BRAF V600E mutation in papillary thyroid microcarcinoma: is it a predictor for the prognosis of patients with intermediate to high recurrence risk?

OBJECTIVE: The BRAFV600E mutation is the universal genetic mutation in papillary thyroid microcarcinoma (PTMC). The present study is to estimate the role of the BRAFV600E mutation in the clinical outcome of PTMC with intermediate to high recurrence risk after radioactive iodine (RAI) therapy, which is considered to be an indolent tumor. METHODS: We conducted a single-center retrospective study. Between May 2016 and March 2019, PTMC patients with known BRAFV600E status who received RAI therapy were reviewed at the Second Hospital of Shandong University. Treatment and follow-up were defined according to criteria used in the 2015 ATA guidelines. The association between the BRAFV600E mutation and clinicopathological characteristics, response to RAI therapy, and recurrence after a period of follow-up were analyzed. Propensity score matching (PSM) and logistic regression were used to control confounding variables. RESULTS: Of the 322 patients with intermediate to high recurrence risk in PTMC, the mean age of the patients were 43.7 ± 12.2 years, and 72.1% were women. BRAFV600E mutation was found in 64.9% (209/322). After PSM, 112 pairs of patients were matched, and except for multifocality (P = 0.001), extrathyroidal invasion (P = 0.003) and tumor size (P = 0.03), there was no significant difference in all baseline characteristics between the two groups. An excellent response (ER) to RAI therapy was observed in 273 patients (84.7%). At the end of the study, 17(5.2%) and 6(1.8%) patients showed structural incomplete response (SIR) and biochemical incomplete response (BIR) status. The proportion of patients who achieved ER status in the BRAFV600E mutation positive and negative groups was 86.6% and 81.4%, respectively. Kaplan-Meier analyses showed that the BRAFV600E mutation was not related to lower ER reached time. The median follow-up was 51 months. CONCLUSIONS: We found the BRAFV600E mutation was associated with multifocality, extrathyroidal invasion, and tumor size in papillary thyroid microcarcinoma. However, the BRAFV600E mutation had no significant association with clinical outcomes in patients with intermediate to high recurrence risk after RAI therapy. Furthermore, the extra-thyroid uptake results and distant metastasis had been proven to be independent factor predicting the clinical response. REGISTRATION NUMBER: ChiCTR2200062911.

Enhanced Light Extraction Efficiency by Self-Masking Technology with Carbonized Photoresist for Light-Emitting Diodes.

This work investigates a self-masking technology for roughening the surface of light-emitting diodes (LEDs). The carbonized photoresist with a naturally nano/micro-textured rough surface was used as a mask layer. After growing the Si3N4 passivation layer on LEDs, the texture pattern of the mask layer was transferred to the surface of the passivation layer via reactive ion beam (RIE) dry etching, resulting in LEDs with nano-textured surfaces. This nano-textured surface achieved by self-masking technology can alleviate the total internal reflection at the top interface and enhance light scattering, thereby improving the light extraction efficiency. As a result, the wall-plug efficiency (WPE) and external quantum efficiency (EQE) of rough-surface LEDs reached 53.9% and 58.8% at 60 mA, respectively, which were improved by 10.3% and 10.5% compared to that of the flat-surface Si3N4-passivated LED. Additionally, at the same peak, both LEDs emit a wavelength of 451 nm at 350 mA. There is also almost no difference between the I-V characteristics of LEDs before and after roughening. The proposed self-masking surface roughening technology provides a strategy for LEE enhancement that is both cost-effective and compatible with conventional fabrication processes.

Studies on the EPR parameters and local angular distortion for the tetragonal Cu2+ center in CaWO4 crystal.

The electron paramagnetic resonance (EPR) parameters-g factors gi (i = || and ⊥) and hyperfine structure constants Ai (M) and Ai (N), with M and N belonging to isotopes 63 Cu2+ and 65 Cu2+ -and local structure of Cu2+ ion occupying W6+ site in CaWO4 crystal are theoretically studied based on the perturbation formulas of these parameters for a 3d9 ion under tetragonally elongated tetrahedra. In these formulas, the ligand orbital (LO) and spin-orbit coupling (SOC) contributions are included due to the shorter impurity-ligand distance R (≈1.83 Å) and hence the strong covalency of the studied [CuO4 ]6- cluster, and the related molecular orbital coefficients are quantitatively determined from the cluster approach in a uniform way; meanwhile, the required crystal field (CF) parameters for the tetragonally distorted tetrahedron (TDT) are estimated from the superposition model and the local structure of the impurity Cu2+ center. According to the calculation, the bond angle θ between the four equivalent Cu2+ -O2- bonds and the C4 axis in the CaWO4 :Cu2+ is found to be about 2.1° smaller than that (θ0 ≈ 54.74°) for an ideal tetrahedron due to the Jahn-Teller (JT) effect and the size mismatch. The fitted results agree well with the observed values, and the validity of the present assignment for the local structure of the Cu2+ center is also discussed.

A comparable study of the optical spectra and EPR parameters for 3d1 - and 3d9 -doped MgNH4 PO4 ·6H2 O.

VO2+ (3d1 ) and Cu2+ (3d9 ) are the two complementary states that usually show opposite distortions when they are doped in crystals. In this work, the optical absorption spectra (OAS), electron paramagnetic resonance (EPR) parameters, and local structure (LS) for VO2+ (and Cu2+ ) in MgNH4 PO4 ·6H2 O (MPPH) are uniformly investigated on the basis of the high-order perturbation formulas for a 3d1 (and 3d9 ) ion in tetragonally compressed (and elongated) octahedra, respectively. In the calculated formulas, the required crystal-field parameters can be obtained from the superposition model and reasonably linked with the LS distortion for VO2+ and Cu2+ centers. Based on the calculations, the tetragonal compressed [VO(H2 O)5 ]2+ cluster (and tetragonal elongated [Cu(H2 O)6 ]2+ cluster) is found to suffer tetragonal compression ratio of 1.65% and tetragonal elongation ratio of 3.8% along C4 -axis, respectively, due to the Jahn-Teller (JT) effect. The theoretical EPR parameters based on the above lattice distortions agree well with the experimental data, and the LS of the VO2+ and Cu2+ centers in MPPH is discussed.

Image quality and radiation dose of different scanning protocols in DSCT cardiothoracic angiography for children with tetralogy of fallot.

The aim of this study was to investigate the image quality and radiation dose of different scanning protocols in dual-source CT cardiothoracic angiography for children with tetralogy of Fallot (TOF). Seventy-five consecutive children with known or suspected TOF were enrolled to undergo prospective ECG-triggering sequential dual-source CT (DSCT) cardiothoracic angiography. According to the scanning protocols, these patients were randomly divided into 3 groups: fixed delay time (FDT, n = 25, group A), automatic bolus-tracking (ABT, n = 25, group B) and manual bolus-tracking (MBT, n = 25, group C). Subjective and objective image quality were evaluated. The radiation doses were recorded. The image quality scores of group C were significantly higher than those of group A and B. The absolute value of difference (D-value) on CT attenuation between left (CTLV) and right ventricle (CTRV) in group C was significantly lower than that in group A and B. The total effective dose of groups A, B and C were 0.39 ± 0.06 mSv, 0.40 ± 0.07 mSv and 0.40 ± 0.08 mSv, respectively. There was no significant difference among 3 groups (P = 0.722). Scanning protocol has significantly impacts on the image quality of cardiovascular structures for TOF patients. Compared with the conventional scanning protocols FDT and ABT, the MBT technique provides high image quality and achieves more homogenous attenuation among different patients with TOF.

Dynamic Indicators That Impact the Outcomes of Thoracic Endovascular Aortic Repair in Complicated Type B Aortic Dissection.

PURPOSE: To investigate dynamic variables obtained from retrospective computed tomography angiography for ability to predict thoracic endovascular aortic repair (TEVAR) outcomes in patients with complicated type B aortic dissection (cTBAD). MATERIALS AND METHODS: Seventy-nine patients with cTBAD who received TEVAR from March 2009 to June 2018 were retrospectively enrolled. Relative true lumen area (r-TLA) was computed at the level of tracheal bifurcation every 5% of all R-R intervals. Parameters that reflect the state of intimal motion were evaluated, including difference between maximum and minimum r-TLA (D-TLA) and true lumen collapse. The endpoints comprised early (≤ 30 days) and late (> 30 days) outcomes after intervention. RESULTS: Overall early mortality rate was 13.9% (11/79), and early adverse events rate was 24.1% (19/79). Patients who received TEVAR within 2 days of symptom onset demonstrated the worst outcomes. A longer time of r-TLA < 25% in 1 cardiac cycle (P = .049) and larger D-TLA (P < .001) were correlated to an increased early death. In addition, D-TLA was an independent predictor of early mortality. Area under the curve of D-TLA was 0.849 (95% confidence interval 0.730-0.967) for predicting early mortality and 0.742 (95% CI 0.611-0.873) for predicting early adverse events. Survival and event-free survival rates during follow-up were decreased in the D-TLA > 21.5% group compared with the D-TLA ≤ 21.5% group (all P < .001). CONCLUSIONS: Larger D-TLA is correlated with worse postoperative outcomes and might be a crucial parameter for future risk stratification in patients with cTBAD.

Dynamic Imaging Features of Retrospective Cardiac Gating CT Angiography Influence Delayed Adverse Events in Acute Uncomplicated Type B Aortic Dissections.

PURPOSE: To investigate the correlation between dynamic morphological parameters of retrospective cardiac gating CT angiography (CTA) and delayed adverse event (DAE) in uncomplicated type B acute aortic dissection (uTB-AAD) patients. MATERIALS AND METHODS: Eighty-seven patients initially diagnosed with uTB-AAD were retrospectively reviewed. Dynamic variables obtained by dose-regulated retrospective CTA were recorded, including the minimum relative true lumen diameter (RTLAmin), ratio of the minimum to maximum true lumen relative area (r-RTLA), the maximum diameter of the descending aorta, false lumen, and primary entry tear. Outcome analysis comprised incidences of DAE and early mortality within 3 to 14 days since symptom occurring. RESULTS: Twenty-six patients (29.9%) developed DAE, and two of which (7.7%) died before any interventions. Smaller values of RTLAmin (P = 0.01) and r-RTLA at the upper thoracic descending aorta (UTDA) (P < 0.001), and r-RTLA at the renal artery level (P = 0.016) demonstrated higher incidences of DAE; maximum diameter of the descending aorta (P < 0.001), the false lumen (P = 0.008), and entry tear size (P = 0.007) were positively associated with the occurrence of DAE. r-RTLA at the UTDA level yielded the highest diagnostic accuracy (82.0%) in detecting DAE at an optimal cutoff value of 61.7% (AUC = 0.839). Performance of dynamic characteristics was superior to static features obtained from single-phase image in the detection of DAE (P < 0.001). CONCLUSION: Dynamic morphological features of retrospective cardiac gating CTA might aid in identifying a high risk of DAE in uTB-AAD patients and guiding early targeted interventions.

Acute type B aortic intramural hematoma: the added prognostic value of a follow-up CT.

OBJECTIVES: To investigate prognostic significance of follow-up CT findings for initially medically treated type B aortic intramural hematoma (IMH). METHODS: We performed a retrospective pooled analysis of individual patient data, including baseline and follow-up CT characteristics. All enrolled patients were followed up for adverse aorta-related events, defined as a composite of aortic disease-related death and surgical or endovascular aortic repair. RESULTS: A total of 238 patients (73.9% men) were included, with a mean age of 58.1 ± 9.8 years. During follow-up, 83 patients (34.9%) experienced adverse aorta-related events, most of the events (83.1%) occurred within 1 month after follow-up CT imaging (n = 69). In the Cox regression model for predicting adverse aorta-related events, baseline maximal aortic diameter (MAD) (HR = 1.05, p = 0.008), ulcer-like projection (ULP) (HR = 2.47, p < 0.001), changes of maximal hematoma thickness (MHT) (HR = 1.22, p < 0.001), newly developed ULP (HR = 4.44, p < 0.001), and newly developed pleural effusion (HR = 2.46, p = 0.002) were powerful independent predictors. In combined predictive model for 1-month aortic events, baseline MHT ≥ 11.8 mm (OR = 4.39, p = 0.001), ULP (OR = 3.98, p < 0.001), changes of MHT (OR = 1.46, p < 0.001), newly developed ULP (OR = 9.27, p = 0.002), and newly developed pleural effusion (OR = 3.45, p = 0.015) were independent predictors. Besides, in patients with pleural effusion at baseline, resorption of pleural effusion was associated with adverse aorta-related events (HR = 0.36, p = 0.027) and 1-month aortic events (OR = 0.23, p = 0.026). CONCLUSIONS: Follow-up CT findings provide strong and incremental prognostic information for initially medically treated type B IMH, which are helpful for risk estimates and decisions-making. KEY POINTS: • Follow-up CT provides strong and incremental prognostic information for initially medically treated type B aortic intramural hematoma. • Follow-up CT is highly recommended for type B intramural hematoma in patients who did not receive urgent invasive therapy. • Follow-up CT is helpful for risk estimates and decisions-making.

Assessment of disease activity in Takayasu arteritis: A quantitative study with computed tomography angiography.

BACKGROUND: Identifying disease activity in Takayasu arteritis (TAK) is challenging. This study aimed to investigate the value of quantitative characterization with computed tomography angiography in the assessment of disease activity in patients with TAK. METHODS: We retrospectively analysed the data on 162 aortic CT angiography from 140 TAK patients. Patients were categorized based on disease activity according to the National Institutes of Health criteria into two groups: active disease group (n = 65) and inactive disease group (n = 97). RESULTS: Patients with active TAK had a thicker wall compared with patients with inactive TAK (5.2 ±â€¯2.4 mm vs. 2.5 ±â€¯0.8 mm, p < 0.001). The relative post-contrast enhancement ratio of the thickened wall was higher in active TAK than in inactive TAK (1.5 ±â€¯0.3 vs. 1.1 ±â€¯0.2, p < 0.001). Given a thickness cutoff of 3.3 mm, sensitivity for active-phase TAK was 83.1%, specificity 89.7%, positive predictive value 84.4%, and negative predictive value 88.8%. With a relative post-contrast enhancement ratio cutoff of 1.2, sensitivity for active-phase TAK was 89.2%, specificity 76.3%, positive predictive value 71.6%, and negative predictive value 91.3%. In receiver-operating characteristic curves comparison, maximal wall thickness and relative post-contrast enhancement ratio were superior to C-reactive protein and erythrocyte sedimentation rate for determining active phase disease (p < 0.05). CONCLUSIONS: Quantitative characterization with CT angiography was a useful tool to assess disease activity in TAK patients. Maximal wall thickness and relative post-contrast enhancement ratio have a high sensitivity and specificity for detecting TAK activity.

Image quality and radiation dose of two prospective ECG-triggered protocols using 128-slice dual-source CT angiography in infants with congenital heart disease.

This study aims to investigate the image quality and radiation dose of prospective ECG-triggered 128-slice dual-source CT (DSCT) angiography in the delineation of coronary arteries in infants with congenital heart disease (CHD). Sixty-three infants with CHD were randomly assigned into two groups: prospective ECG-triggered sequential protocol (group 1) and high-pitch spiral protocol (group 2). Patients were selected to the protocols randomly. A five-point scoring system was applied to study the capability of detecting coronary arteries. A score of < 3 represents non-diagnostic. Effective radiation dose (ED) was calculated. The visualized rate for original, proximal, middle and distal segments of the coronary arteries was 98%, 95%, 94% and 83%, respectively in group 1, 93%, 82%, 53% and 34%, respectively in group 2. There were no significant demographic differences in the identification rate between the two groups as to the original and most of the proximal segments. Significant demographic differences were found in middle and distal segments (p < 0.05). The mean ED of the high pitch group and the sequential group was 0.33 ± 0.11 mSv and 0.63 ± 0.16 mSv, respectively. Both the prospective ECG-gated high-pitch mode and the sequential mode for 128-slice DSCT allow satisfactory delineation of original and most of the proximal segments of coronary arteries in infants with CHD. However, an ECG-gated sequential mode is recommended when detailed anatomic assessment of the whole coronary arteries are needed since the ECG-gated high-pitch mode is limited in the delineation of middle and distal segments of the coronary arteries.

Impact of the Intima Dynamic Motion in Type B Acute Aortic Dissection on Renal Injury: Quantificationally Assessed by Dose-Regulated Retrospective ECG-Gated Dual-Source CT Angiography.

BACKGROUND: Little is known about the influence of intima dynamic motion on organ ischemia and related outcomes. The purpose of this study is to quantitatively evaluate intima oscillation by CT angiography (CTA), determine its impact on acute kidney injury (AKI) in patients with type B acute aortic dissection (TB-AAD) before thoracic endovascular aortic repair (TEVAR), and further analyze its association with early adverse events postoperatively. METHODS: Totally, 108 patients with TB-AAD who underwent retrospective ECG-gated CTA and received TEVAR were enrolled. Patients were divided into AKI and non-AKI groups. Area of the true lumen (TLA) was computed at R-R intervals at the upper level of kidney vessel origin every 5% step from 0% to 95%. Additionally, other morphologic parameters that have been identified as risk predictors for adverse events in uncomplicated TB-AAD were evaluated. RESULTS: Forty-three (39.8%) patients were sorted into the AKI group. Patients with AKI exhibited a larger value for the relative change of TLA (Crel-TLA) than patients in the non-AKI group (p < 0.001), as well as a larger maximum diameter of the descending aorta (p = 0.023) and the primary entry tear (p = 0.012). Crel-TLA and elevated systolic blood pressure were independent predictors of AKI. Patients with Crel-TLA ≥ 42.6% were associated with a high incidence of renal ischemia before TEVAR and early adverse events postoperatively (all p < 0.001). CONCLUSION: Intima dynamic motion, as quantitatively evaluated by CTA, has a significant influence on renal injury before and after the aortic intervention, as well as other adverse events, which might guide clinical therapy in high-risk patients.

Detection of microRNA-200b may predict the inhibitory effect of gefitinib on non-small cell lung cancer and its potential mechanism.

The present study aimed to investigate the association and underlying mechanisms between microRNA-200b level and the inhibitory effect of gefitinib on non-small cell lung cancer. In total, 100 patients (43 males and 57 females; median age, 63 years) with advanced non-small cell lung cancer (NSCLC) were selected. All patients were administered with gefitinib orally (250 mg/day) and the effect of gefitinib was evaluated according to the Response Evaluation Criteria in Solid Tumors guidelines. Tumor tissue and plasma samples were collected prior to and subsequent to therapy. The microRNA-200b levels in tissues and plasma were determined by quantitative polymerase chain reaction (PCR). A549 cells were cultured in vitro and transfected with microRNA-200b mimic. Using Cell Counting Kit-8 assay, the proliferation inhibition detected was induced by 0.1 µM gefitinib in transfected or non-transfected A549 cells. Cell apoptosis and cell cycle progression were analyzed by flow cytometry and the migration of cells was observed by Transwell assay. In addition, mRNA and protein levels of insulin-like growth factor 1 receptor (IGF-1R), protein kinase B (AKT) and extracellular signal-related kinase (ERK), together with the phosphorylation of AKT and ERK in A549 cells, were determined by quantitative PCR and western blot analysis, respectively. The microRNA-200b levels in gefitinib-insensitive patients were decreased compared with gefitinib-sensitive patients. Transfection with microRNA-200b mimic increased the gefitinib induced proliferation inhibition, apoptosis and cell cycle arrest in A549 cells. Also, transfection with microRNA-200b mimic increased the migration inhibitory effect of gefitinib on A549 cells. Decreased IGF-1R expression together with reduced phosphorylation of AKT and ERK were observed following transfection of A549 cells with the microRNA 200b mimic. In conclusion, detection of microRNA-200b may predict the inhibitory effect of gefitinib on NSCLC. Upregulation of microRNA-200b led to the elevated sensitivity of glioma cells to gefitinib, and this effect may be explained as microRNA-200b being able to inhibit the expression of IGF-1R, thereby reducing the activation of downstream phosphoinositide 3-kinase/AKT and mitogen-activated protein kinase signaling pathways.

Rapid mycoplasma culture for the early diagnosis of Mycoplasma pneumoniae infection.

Early diagnosis of Mycoplasma pneumoniae (Mp) plays a pivotal role in its management. We evaluated the role of rapid culture method in early diagnosis of Mp infection and discussed the potential impact factors. A total of 2,600 patients with acute respiratory infection were included, and their pharyngeal swab samples were prepared for Mp rapid culture based on selective Mp fluid culture medium. The clinical contributing factors related to Mp infection were also explored. The positive rate of Mp culture in females was 41.75%, which was higher than that for males (37.63%). Mp infections were incidental to the children and elderly. The positive rates of Mp culture were higher in children aged 3-5 years and adults older than 70 years (54.05 and 31.48%, respectively), compared with other ages. In addition, Mp infection frequently occurred in winter (December-February) and spring (March-May), with significantly higher positive rates of Mp culture by 40.02 and 42.89 vs. 32.15 and 33.50% in summer (June-August) and autumn (September-November), respectively. The positive rate of rapid culture for Mp was slightly higher than that by Mp antibody assay, but the diagnostic accordance was well between these two methods (P>0.05). Furthermore, clinical common symptoms of respiratory tract infection, such as fever, cough, and expectoration, were not found specific in Mp infection, suggesting that they were not independent prognostic predictors for Mp infection. Therefore, rapid culture based on the Mp pathogen detection would have important clinical application for the early diagnosis of Mp infection.

[Effects of Yanggan Lidan Granule on insulin resistance in guinea pigs with induced cholesterol gallstones].

OBJECTIVE: To observe the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine, on insulin resistance in guinea pigs with induced cholesterol gallstones. METHODS: Eighty guinea pigs were randomly divided into normal control group, untreated group, YGLDG group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. The guinea pigs in the normal control group and the untreated group were administered with normal saline. UDCA and YGLDG were given to the guinea pigs in the corresponding groups for seven weeks. Eight guinea pigs of each group were used to measure the glucose infusion rate (GIR) by using hyperinsulinemic-euglycemic clamp technique. At the end the guinea pigs were killed and their gallstone formation was observed. RESULTS: The gallstones in guinea pigs were identified as cholesterol stones by qualitative analysis through infrared spectrum. The incidence rate of cholelithiasis of the untreated group was 82.35% . The GIR of guinea pigs in the untreated group was obviously lowered down as compared with the normal control group. Compared with the untreated group, the GIRs of the YGLDG group and the UDCA group were obviously increased, especially in the YGLDG group. CONCLUSION: YGLDG may improve insulin resistance in guinea pigs with cholesterol gallstones by elevating GIR obviously.