CT-Based Radiomics for the Preoperative Prediction of Occult Peritoneal Metastasis in Epithelial Ovarian Cancers.

RATIONALE AND OBJECTIVES: The objective of this study was to develop a comprehensive combined model for predicting occult peritoneal metastasis (OPM) in epithelial ovarian cancers (EOCs) using radiomics features derived from computed tomography (CT) and clinical-radiological predictors. MATERIALS AND METHODS: A total of 224 patients with EOCs were randomly divided into training dataset (N = 156) and test dataset (N = 86). Five clinical factors and seven radiological features were collected. The radiomics features were extracted from CT images of each patient. Multivariate logistic regression was employed to construct clinical and radiological models. The correlation analysis and least absolute shrinkage and selection operator algorithm were used to select radiomics features and build radiomics model. The important clinical, radiological factors, and radiomics features were integrated into a combined model by multivariate logistic regression. Receiver operating characteristics curve with area under the curve (AUC) were used to evaluate and compare predictive performance. RESULTS: Carbohydrate antigen 125 (CA-125) and human epididymal protein 4 (HE-4) were independent clinical predictors. Laterality, thickened septa and margin were independent radiological predictors. In the training dataset, the AUCs for the clinical, radiological and radiomics models in evaluating OPM were 0.759, 0.819, and 0.830, respectively. In the test dataset, the AUCs for these models were 0.846, 0.835, and 0.779, respectively. The combined model outperformed other models in both the training and the test datasets with AUCs of 0.901 and 0.912, respectively. Decision curve analysis indicated that the combined model yielded a higher net benefit compared to the other models. CONCLUSION: The combined model, integrating radiomics features with clinical and radiological predictors exhibited improved accuracy in predicting OPM in EOCs.

Value of CT­derived fractional flow reserve in identifying patients with acute myocardial infarction based on coronary computed tomography angiography.

The aim of the present study was to determine whether coronary stenosis and computed tomography-derived fractional flow reserve (CT-FFR), detected by coronary computed tomography angiography (CCTA), can potentially contribute to distinguish acute myocardial infarction (AMI) from unstable angina (UA). The study retrospectively collected data from consecutive patients who were admitted with obstructive coronary artery disease (CAD) and who received CCTA and invasive coronary angiography (ICA) as part of their clinical workup. According to the inclusion criteria, the patients were divided into the AMI group and UA group, and the basic clinical data, CCTA stenosis degree and CT-FFR values were compared between the two groups. Univariate and multivariate logistic regression methods were used to analyze the association between ≥70% CCTA stenosis, ≤0.80 CT-FFR and AMI. A diagnostic model of AMI was established (model 1, ≤0.80 CT-FFR; model 2, ≥70% CCTA stenosis; and model 3, ≤0.80 CT-FFR combined with ≥70% CCTA stenosis), and the diagnostic efficacy of the three models for AMI was compared. The significance level was set at P<0.05. A total of 116 participants were finally enrolled in this study. There were 37 patients in the AMI group, with an average age of 62.06±7.74 years, and 79 patients in the UA group, with an average age of 58.11±10.0 years; there was no significant difference in age (P>0.05). The multivariate regression analysis revealed that ≤0.80 CT-FFR (HR=28.074; 95% CI: 5.712-137.973; P<0.001), and ≥70% CCTA stenosis (HR=10.796; 95% CI: 2.566-45.425; P=0.001) were independent risk factors for AMI. The diagnostic model of ≤0.80 CT-FFR combined with ≥70% CCTA stenosis (AUC=0.914; 95% CI: 0.847-0.958) exhibited increased diagnosis performance than the ≤0.80 CT-FFR model (AUC=0.865; 95% CI: 0.790-0.922; P=0.0060) and the ≥70% CCTA stenosis model (AUC=0.827; 95% CI: 0.745-0.891; P=0.0008). Collectively, it was demonstrated that ≤0.80 CT-FFR and ≥70% CCTA stenosis were independent risk factors for the diagnosis of AMI, and the combination of CT-FFR and CCTA stenosis further improved AMI diagnosis performance.

Mycobacterial DnaQ is an Alternative Proofreader Ensuring DNA Replication Fidelity.

Remove of mis-incorporated nucleotides ensures replicative fidelity. Although the ε-exonuclease DnaQ is a well-established proofreader in the model organism Escherichia coli, proofreading in mycobacteria relies on the polymerase and histidinol phosphatase (PHP) domain of replicative polymerase despite the presence of an alternative DnaQ homolog. Here, we show that depletion of DnaQ in Mycolicibacterium smegmatis results in increased mutation rate, leading to AT-biased mutagenesis and elevated insertions/deletions in homopolymer tract. We demonstrated that mycobacterial DnaQ binds to the b-clamp and functions synergistically with the PHP domain to correct replication errors. Further, we found that the mycobacterial DnaQ sustains replicative fidelity upon chromosome topological stress. Intriguingly, we showed that a naturally evolved DnaQ variant prevalent in clinical Mycobacterium tuberculosis isolates enables hypermutability and is associated with extensive drug resistance. These results collectively establish that the alternative DnaQ functions in proofreading, and thus reveal that mycobacteria deploy two proofreaders to maintain replicative fidelity.

Downregulation of apoptotic repressor AVEN exacerbates cardiac injury after myocardial infarction.

Myocardial infarction (MI) is a leading cause of heart failure (HF), associated with morbidity and mortality worldwide. As an essential part of gene expression regulation, the role of alternative polyadenylation (APA) in post-MI HF remains elusive. Here, we revealed a global, APA-mediated, 3' untranslated region (3' UTR)-lengthening pattern in both human and murine post-MI HF samples. Furthermore, the 3' UTR of apoptotic repressor gene, AVEN, is lengthened after MI, contributing to its downregulation. AVEN knockdown increased cardiomyocyte apoptosis, whereas restoration of AVEN expression substantially improved cardiac function. Mechanistically, AVEN 3' UTR lengthening provides additional binding sites for miR-30b-5p and miR-30c-5p, thus reducing AVEN expression. Additionally, PABPN1 (poly(A)-binding protein 1) was identified as a potential regulator of AVEN 3' UTR lengthening after MI. Altogether, our findings revealed APA as a unique mechanism regulating cardiac injury in response to MI and also indicated that the APA-regulated gene, AVEN, holds great potential as a critical therapeutic target for treating post-MI HF.

Associating Serum IgM, IgA Levels with Thoracic CT Indicators and Pulmonary Function Indexes in Acutely Exacerbated Chronic Obstructive Pulmonary Disease Patients.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a respiratory condition characterized by acute exacerbations and reduced lung function. This study investigates the link between serum markers (Immunoglobulin M (IgM) and Immunoglobulin A (IgA)), thoracic computed tomography (CT) scan findings, and pulmonary function indexes during these episodes, aiming to improve our understanding and identify new diagnostic indicators. METHODS: From the First Affiliated Hospital of Hebei North University, we selected 89 COPD patients experiencing acute exacerbation within the past two years for our Acute Exacerbation Group (AG). Meanwhile, 96 COPD patients, initially treated at the same hospital and currently deemed stable, were chosen for the Stable Group (SG). Both groups underwent serum IgM and IgA tests, thoracic CT examinations, and pulmonary function assessments. RESULTS: In the AG Group, the serum IgM levels were marginally lower than in the Stable Group (SG), though the difference wasn't statistically significant (p = 0.097). Conversely, serum IgA levels in the AG were significantly lower than in the SG (p < 0.001). The AG also showed markedly reduced lung volume, inspiratory lung density, and pulmonary function indexes compared to the SG while having considerably higher values for emphysema index (EI) and air trapping index (ATI) (all p < 0.001). Pearson correlation analysis revealed that lung volume, average inspiratory lung density, and IgA levels had strong positive correlations with one-second forced expiratory volume (FEV1), FEV1/forced vital capacity (FVC), and diffuse carbon monoxide (DLCO) (with respective r-values of 0.824, 0.841, and 0.829; all p < 0.001). In contrast, EI and ATI exhibited significantly negative correlations with FEV1, FEV1/FVC, and DLCO (with r-values ranging from -0.837 to -0.885; all p < 0.001). CONCLUSIONS: The assessment of serum IgA combined with thoracic CT parameters offers valuable insights for diagnosing and evaluating acute exacerbations of COPD, presenting a straightforward clinical utility.

Predictive value of reduced pulmonary arterial elasticity in acute pulmonary embolism for right ventricular dysfunction.

BACKGROUND: Computed tomography pulmonary angiography (CTPA) yields indices, such as the right ventricular/left ventricular (RV/LV) ratio > 1.0, which are commonly used for risk stratification of patients with acute pulmonary embolism (APE). Although pulmonary artery elasticity (PAE) has been previously described, its relationship with right ventricular dysfunction (RVD) has not been explored. Here, we investigated whether PAE, measured using CTPA, is associated with RVD. METHODS: Patients who underwent retrospective electrocardiogram-gated CTPA and had a definitive diagnosis of APE were included in the study. The subjects were classified into RVD and non-RVD groups according to the RVD on echocardiography. PAE, involving aortic distensibility (AD), aortic compliance (AC), and aortic stiffness (ASI), and right heart function indices were compared between the two groups, and their correlations were examined. Receiver operating characteristic (ROC) curves were generated to evaluate the specificity and sensitivity of the RVD prediction. RESULTS: Thirty-five patients with APE were enrolled in the study (RVD: 18, non-RVD: 17). The groups showed no significant differences in age, sex, number of patients receiving thrombolysis, and number of high-risk conditions (P > 0.05). Regarding PAE parameters, AD was significantly reduced in the RVD group compared to that in the non-RVD group (P < 0.05), whereas AC and ASI were not statistically different (P > 0.05). The ratio of the maximum cross-sectional area of PA and AA (PA/AAmax),the ratio of the minimum cross-sectional area of PA and AA(PA/AAmin), diameter of the coronary sinus, RV/LV diameter, RV/Lvarea, the ratio of the end-diastolic volume of right ventricular and left ventricular (RV/LVDV), the ratio of the end-systolic volume of right ventricular and left ventricular (RV/LVSV) were significantly greater in the RVD group than in the non-RVD group (P < 0.05). Correlation analysis of AD and right heart function parameters showed that AD was negatively correlated with PA/AAmax, PA/AAmin, RV/LV diameter, RV/LVDV, and PAE measured by ultrasound, with correlation coefficients ranging from - 0.336 to - 0.580 (P < 0.05). The ROC curves of AD and RV/LVdiameter to predict RVD had areas under the curve of 0.748 and 0.712, sensitivities of 82.35% and 70.59%, specificities of 66.67% and 72.22%, and cutoff values of 4.9433 and 1.1105, respectively. CONCLUSION: AD obtained by retrospective ECG-gated CTPA may be helpful in assessing RVD in patients with APE while accurately diagnosing APE. It contributes to timely diagnosis and treatment and improves the prognosis of patients with APE.

Predictive value of coronary stenosis degree combined with CT-FFR and resting-state CTP for major adverse cardiac events in obstructive coronary artery disease.

CT-based flow reserve fraction (CT-FFR) and CT perfusion (CTP), as a complement to coronary computed tomographic angiography (CCTA) have been revealed to be associated with the prognosis of patients with obstructive coronary artery disease (CAD). However, the prognostic value of coronary stenosis combined with CT-FFR and resting-state CTP based on CCTA for major adverse cardiac events (MACE) is not known and requires further investigation. Fifty-two patients with obstructive CAD (50%-90% stenosis) examined by CCTA were retrospectively collected and followed-up for the occurrence of MACE. Logistic regression was performed to analyze the effects of the degree of coronary stenosis, resting-state CTP, and CT-FFR in predicting the risk of MACE. MACE prediction models were developed, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive validity of different models for MACE. Ethics approval was provided by the First Affiliated Hospital of Hebei North University (Zhangjiakou, China; No. K2020237). Logistic regression analysis showed that coronary artery stenosis ≥ 70%, CT-FFR ≤ 0.80, and perfusion index (PI) were independent predictors for MACE in patients with obstructive CAD (P < .05). The model based on coronary stenosis combined with PI and CT-FFR (AUC = 0.944) was better than those based on the degree of coronary stenosis combined with PI (AUC = 0.874), coronary stenosis degree combined with CT-FFR (AUC = 0.895), and any single index (P < .05). The combined model established by coronary stenosis, CT-FFR, and resting-state CTP based on a "1-stop" CCTA examination for predicting MACE among patients with obstructive CAD has good diagnostic efficacy and shows incremental discriminatory power.

Comparison of value of 640-slice CT kidney scan and kidney ultrasound in the diagnosis of chronic kidney disease.

To explore the value of 640-slice CT kidney scan and kidney ultrasound (KUS) in the diagnosis of chronic kidney disease (CKD). The data of 120 CKD patients at our institution between June 2019 and September 2020 were analyzed, and they were randomly divided into ultrasound (US) group (n = 40, KUS), CT group (n = 40) first receiving a plane CT scan to determine the scope of dynamic volume scan, which was performed for scans in cortical, parenchymal, and delayed phases with bolus injection of contrast medium, and combined group (n = 40, KUS and 640-slice CT kidney scan), with the images obtained read and analyzed. The subjective scores and effective radiation doses of 640-layer CT kidney scan were counted to calculate the detection rates. The subjective scores of 640-slice CT kidney scan in plane scan, cortical phase, parenchymal phase, and delayed phase were (1.23 ± 0.42), (1.80 ± 0.40), (2.08 ± 0.26), (2.18 ± 0.38) in the CT group and (1.18 ± 0.38), (1.85 ± 0.36), (2.08 ± 0.26), (2.20 ± 0.40) in the combined group. The effective radiation doses in the CT and combined groups were (1.92 ± 0.32) mSv and (1.95 ± 0.35) mSv. The reading results showed that 26 cases (65.0%), 30 cases (75.0%), and 38 cases (95.0%) were detected in the US, CT and combined groups, respectively, with remarkably higher detection rate in the combined group than the US and CT groups (P < 0.05). 640-slice CT kidney scan and KUS can be adopted for the diagnosis of CKD; with low radiation dose, good image quality, and higher detection rate in the former, their combination can improve the clinical detection rate of CKD and is worth promoting.

Computed tomography-based radiomics machine learning classifiers to differentiate type I and type II epithelial ovarian cancers.

OBJECTIVES: To compare computed tomography (CT)-based radiomics for preoperatively differentiating type I and II epithelial ovarian cancers (EOCs) using different machine learning classifiers and to construct and validate the best diagnostic model. METHODS: A total of 470 patients with EOCs were included retrospectively. Patients were divided into a training dataset (N = 329) and a test dataset (N = 141). A total of 1316 radiomics features were extracted from the portal venous phase of contrast-enhanced CT images for each patient, followed by dimension reduction of the features. The support vector machine (SVM), k-nearest neighbor (KNN), random forest (RF), naïve Bayes (NB), logistic regression (LR), and eXtreme Gradient Boosting (XGBoost) classifiers were trained to obtain the radiomics signatures. The performance of each radiomics signature was evaluated and compared by the area under the receiver operating characteristic curve (AUC) and relative standard deviation (RSD). The best radiomics signature was selected and combined with clinical and radiological features to establish a combined model. The diagnostic value of the combined model was assessed. RESULTS: The LR-based radiomics signature performed well in the test dataset, with an AUC of 0.879 and an accuracy of 0.773. The combined model performed best in both the training and test datasets, with AUCs of 0.900 and 0.934 and accuracies of 0.848 and 0.823, respectively. CONCLUSION: The combined model showed the best diagnostic performance for distinguishing between type I and II EOCs preoperatively. Therefore, it can be a useful tool for clinical individualized EOC classification. KEY POINTS: • Radiomics features extracted from computed tomography (CT) could be used to differentiate type I and II epithelial ovarian cancers (EOCs). • Machine learning can improve the performance of differentiating type I and II EOCs. • The combined model exhibited the best diagnostic capability over the other models in both the training and test datasets.

Synergistic value of fractional flow reserve and low­density non­calcified plaque based on coronary computed tomography angiography for the identification of lesion­specific ischemia.

Increasing evidence has suggested that plaque characteristics are closely associated with ischemia, and coronary computed tomography (CT) angiography-derived fractional flow reserve (FFRCT) based on deep machine learning algorithms has also been used to identify lesion-specific ischemia. Therefore, the aim of the present study was to explore the predictive ability of plaque characteristics in combination with deep learning-based FFRCT for lesion-specific ischemia. To meet this end, invasive FFR was used as a reference standard, with the joint aims of the early prediction of ischemic lesions and guiding clinical treatment. In the present study, the plaque characteristics, including non-calcified plaque (NCP), low-density NCP (LD-NCP), plaque length, total plaque volume (TPV), remodeling index, calcified plaque, fibrous plaque and plaque burden, were obtained using a semi-automated program. The FFRCT values were derived based on a deep machine learning algorithm. On the basis of the data obtained, differences among the values between the atopic ischemia and the non-significant lesions groups were analyzed to further determine the predictive value of independent predictors for atopic ischemia. Of the plaque features, FFRCT, LD-NCP, NCP, TPV and plaque length differed significantly when comparing between the lesion-specific ischemia and no hemodynamic abnormality groups, and LD-NCP and FFRCT were both independent predictors for ischemia. Additionally, FFRCT combined with LD-NCP showed a greater ability at discriminating ischemia compared with FFRCT or LD-NCP alone. Taken together, the findings of the present study suggest that the combination of FFRCT and LD-NCP has a synergistic effect in terms of predicting ischemia, thereby facilitating the identification of specific ischemia in patients with coronary artery disease.

Comparison of Diagnostic Value for Chronic Kidney Disease between 640-Slice Computed Tomography Kidney Scan and Conventional Computed Tomography Scan.

Objective: To explore the diagnostic value for chronic kidney disease (CKD) between 640-slice computed tomography (CT) kidney scan and conventional CT scan. Methods: A total of 120 CKD patients who received kidney plain scan plus enhanced examination in the CT room of the Medical Imaging Department of our hospital from June 2019 to September 2019 were selected and randomly divided into the experimental group (n = 60) and the control group (n = 60). Patients in the control group received the conventional CT plain scan and enhanced scan, and for patients in the experimental group, CT plain scan was performed first, the range of 640-slice CT dynamic volume scan was determined, and after bolus injection of contrast agent, dynamic volume scan was performed for scanning in the cortical phase, myeloid phase, and secretory phase. The imaging quality and effective scanning dose were compared between the two modalities, and the relationship between CT values obtained from 640-slice CT scan and conventional CT scan and the renal impairment was analyzed. Results: Compared with the control group, the image quality of 640-slice CT scan conducted in the experimental group was significantly better (P < 0.05); the effective radiation doses of the experimental group and the control group were, respectively, (1.89 ± 0.32) mSv and (3.26 ± 0.47) mSv, indicating that the dose was significantly lower in the experimental group than in the control group (t = 18.664, P < 0.001), and the correlation analysis showed that the relationship between the sum of CT values in the cortical phase of both kidneys and kidney injury in the experimental group was r = 0.835, P < 0.001. Conclusion: Both 640-slice CT kidney scan and conventional CT scan can be used in the diagnosis of CKD. 640-slice CT has a lower radiation dose, better image quality, and higher application value.

The Value of 320-Slice Spiral Computed Tomography Perfusion Imaging in Staging and Long-Term Dynamic Evaluation of Breast Cancer.

The value of 320-slice spiral computed tomography (CT) perfusion imaging in staging and long-term dynamic evaluation of breast cancer was explored. 120 breast cancer patients who underwent preoperative CT examination and were confirmed by surgery and pathology were selected. All patients underwent preoperative TNM staging of breast cancer, with 120 cases in each stage. According to the results of 320-slice spiral CT, the postoperative pathology and surgical methods were compared and analyzed. CT diagnosis of breast cancer showed that T1 sensitivity was 71% and accuracy was 61%, T2 sensitivity was 74% and accuracy was 64%, T3 sensitivity was 94% and the accuracy was 84%, and the T4 sensitivity was 100% and the accuracy was 91%. The sensitivity of N1 stage was 71%, and the accuracy was 61%; and the sensitivity of N2 ~ N3 stage was 81%, and the accuracy was 76%. There were 7 cases of M1 with distant metastasis, the sensitivity was 71%, and the accuracy was 71%. At T1 stage, blood flow (BF) was 39.2 ± 16.7 mL/min/100 g, blood volume (BV) was 2.66 ± 1.4 mL/100 g, mean transit time (MTT) was 8.16 ± 2.7 s, and permeability surface (PS) was 16.6 ± 9.7 mL/min/100 g. 320-slice spiral CT perfusion imaging technology provided a new diagnostic mode for everyone, which can quantitatively identify breast cancer with multiple parameters, which was of great significance for clinical auxiliary diagnosis.

Dynamic contrast-enhanced MRI radiomics nomogram for predicting axillary lymph node metastasis in breast cancer.

PURPOSE: The goal of this study is to develop and validate a radiomics nomogram integrating the radiomics features from DCE-MRI and clinical factors for the preoperative diagnosis of axillary lymph node (ALN) metastasis in breast cancer patients. PROCEDURES: A total of 432 patients with breast cancer were enrolled in this retrospective study and divided into a training cohort (n = 296) and a validation cohort (n = 136). Radiomics features were extracted from the second phase of dynamic contrast enhanced (DCE) MRI images. The least absolute shrinkage and selection operator (LASSO) regression method was used to screen optimal features and construct a radiomics signature in the training cohort. Multivariable logistic regression analysis was used to establish a radiomics nomogram model based on the radiomics signature and clinical factors. The predictive performance of the nomogram was quantified with respect to discrimination and calibration, which was further evaluated in the independent validation cohort. RESULTS: Fourteen ALN metastasis-related features were selected to construct the radiomics signature, with an area under the curve (AUC) of 0.847 and 0.805 in the training and validation cohorts, respectively. The nomogram was established by incorporating the histological grade, multifocality, MRI report lymph node status and radiomics signature and showed good calibration and excellent performance for ALN detection (AUC of 0.907 and 0.874 in the training and validation cohorts, respectively). The decision curve, which demonstrated the radiomics nomogram, displayed promising clinical utility. CONCLUSIONS: The radiomics nomogram can be used as a noninvasive and reliable tool to assist clinicians in accurately predicting ALN metastasis in breast cancer preoperatively.

Golgi Phosphoprotein 3 Confers Radioresistance via Stabilizing EGFR in Lung Adenocarcinoma.

PURPOSE: Radioresistance is a major cause of treatment failure in tumor radiation therapy, and the underlying mechanisms of radioresistance are still elusive. Golgi phosphoprotein 3 (GOLPH3) has been reported to associate tightly with cancer progression and chemoresistance. Herein, we explored whether GOLPH3 mediated radioresistance of lung adenocarcinoma (LUAD) and whether targeted suppression of GOLPH3 sensitized LUAD to radiation therapy. METHODS AND MATERIALS: The aberrant expression of GOLPH3 was evaluated by immunohistochemistry in LUAD clinical samples. To evaluate the association between GOLPH3 and radioresistance, colony formation and apoptosis were assessed in control and GOLPH3 knockdown cells. γ-H2AX foci and level determination and micronucleus test were used to analyze DNA damage production and repair. The rescue of GOLPH3 knockdown was then performed by exogenous expression of small interfering RNA-resistant mutant GOLPH3 to confirm the role of GOLPH3 in DNA damage repair. Mechanistically, the effect of GOLPH3 on regulating stability and nuclear accumulation of epidermal growth factor receptor (EGFR) and the activation of DNA-dependent protein kinase (DNA-PK) were investigated by quantitative real-time polymerase chain reaction, western blot, immunofluorescence, and coimmunoprecipitation. The role of GOLPH3 in vivo in radioresistance was determined in a xenograft model. RESULTS: In tumor tissues of 33 patients with LUAD, the expression of GOLPH3 showed significant increases compared with those in matched normal tissues. Knocking down GOLPH3 reduced the clonogenic capacity, impaired double-strand break (DSB) repair, and enhanced apoptosis after irradiation. In contrast, reversal of GOLPH3 depletion rescued the impaired repair of radiation-induced DSBs. Mechanistically, loss of GOLPH3 accelerated the degradation of EGFR in lysosome, causing the reduction in EGFR levels, thereby weakening nuclear accumulation of EGFR and attenuating the activation of DNA-PK. Furthermore, adenovirus-mediated GOLPH3 knockdown could enhance the ionizing radiation response in the LUAD xenograft model. CONCLUSIONS: GOLPH3 conferred resistance of LUAD to ionizing radiation via stabilizing EGFR, and targeted suppression of GOLPH3 might be considered as a potential therapeutic strategy for sensitizing LUAD to radiation therapy.

Effects of electrical stimulation on human skin keratinocyte growth and the secretion of cytokines and growth factors.

Electrical stimulation (ES) has been widely explored and found effective in promoting wound healing. However, the role of ES on keratinocytes, a major player in wound healing, has not been well established. The present work investigated the cellular and molecular behaviors of human skin keratinocytes being exposed to ES. HaCaT keratinocytes were seeded on a novel electrically conductive and soft PPy-PU/PLLA membrane and cultured under electrical intensities of 100 or 200 mV mm-1for 6 and 24 h. The factors assessed after ES include cell proliferation, colony formation, cytokines, keratins, as well as phosphorylated ERK1/2 (pERK1/2) kinases. The results showed that the electrically stimulated cells exhibited a higher proliferative ability and secreted more IL-6, IL-1α, IL-8, GROα, FGF2, and VEGF-A. Interestingly, the 24 h ES induced a 'stimulus memory' by showing a significant rise in colony-forming efficiency in post-ES cells that were sub-cultured. Additionally, after stopping the 24 h ES, the productions of keratin 5 and keratin 14 were continuously increased for 3 d. The productions of keratin 10 and keratin 13 were significantly increased post the 6 h ES. Finally, the ES increased pERK1/2 kinases. The overall results demonstrated that the proliferation of keratinocytes and their secretion of cytokines and growth factors can be activated through appropriate ES to benefit skin wound healing.

Decreased pulmonary artery distensibility as a marker for severity in acute pulmonary embolism patients undergoing ECG-gated CTPA.

To investigate the characteristics of pulmonary artery distensibility (PAD) in patients with acute pulmonary embolism (APE) and to assess whether a relationship exists between PAD and the disease severity. Clinical and radiological data of 30 APE patients who underwent retrospective electrocardiogram (ECG)-gated computed tomography pulmonary angiography (CTPA) with a definite diagnosis of APE were retrospectively reviewed in the present study, including 15 subjects in severe (SPE) group and 15 subjects in non-severe (NSPE) group. PAD and cardiac function parameters were compared between the two groups, their relationships were investigated, and receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of the above parameters for the diagnosis of APE severity. The PAD decreased in the following order: NSPE group (6.065 ± 2.114) × 10-3 (%/mmHg), and SPE group (4.334 ± 1.777) × 10-3 (%/mmHg) (P < 0.05). All the cardiac function parameters except RA/LAdiameter showed statistically significant different values between the two groups (P < 0.05). As APE severity increased, the cardiac morphological measurements of RV/LVdiameter, RV/LVarea, RVEDV/LVEDV and RVESV/LVESV increased. There was a weak to moderate negative correlation between PAD and PAmax, PAmin, PA/AAmin, PA/AAmax, RV/LVdiameter, RV/LVarea (r = -0.393 to -0.625), that is, PAD was inversely correlated with cardiac function parameters. There was a moderate negative correlation between PAD and hemoptysis(r = -0.672). The area under the ROC curve (AUC) of PAD was 0.724, the critical value was 4.137 × 10-3  mm/Hg, and the sensitivity and specificity were 60.0% and 93.3%, respectively. PAmin showed the strongest discriminatory power to identify high-risk patients (AUC = 0.827), with the highest sensitivity of 100%, which was also achieved by RA/LAarea. The PAD obtained by retrospective ECG-gated CTPA could be an indicator to be used in the evaluation of the presence and severity of APE.

CTPA pulmonary artery distensibility in assessment of severity of acute pulmonary embolism and right ventricular function.

ABSTRACT: To investigate the characteristics of pulmonary artery distensibility (PAD) in patients with acute pulmonary embolism (APE) and to assess the correlation of PAD with APE severity and right ventricular function. A total of 33 patients who underwent retrospective electrocardiogram (ECG)-gated computed tomography pulmonary angiography (CTPA) with a definite diagnosis of APE were included in the study. According to APE severity, the patients were divided into severe (SPE) and non-severe (NSPE) groups. Data from a control group without APE matching the basic demographics of the APE patients were collected. Pulmonary artery distensibility (PAD) and right ventricular function parameters were compared among the 3 groups, their relationships were investigated, and receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of the above parameters for the diagnosis of APE severity. The PAD values of the control, NSPE, and SPE groups were (7.877 ±â€Š2.637) × 10-3 mm/Hg, (6.050 ±â€Š2.011) × 10-3 mm/Hg, (4.321 ±â€Š1.717) × 10-3 mm/Hg, respectively (P < .01). There were statistically significant differences in right ventricular function parameters among the 3 groups (P < .05). The correlation analysis between PAD and right ventricular function parameters showed a weak negative correlation (r = -0.281--0.392). The area under the ROC curve of PAD was 0.743, the critical value was 4.200, and the sensitivity and specificity were 62.5% and 94.1%, respectively. The PAD obtained by retrospective ECG-gated CTPA could accurately evaluate APE severity and right ventricular function. As the severity of APE increases, PAD decreases, which is helpful to identify patients at high risk of APE.

A biocompatible polypyrrole membrane for biomedical applications.

Polypyrrole (PPy) is the most widely investigated electrically conductive biomaterial. However, because of its intrinsic rigidity, PPy has only been used either in the form of a composite or a thin coating. This work presents a pure and soft PPy membrane that is synergically reinforced with the electrospun polyurethane (PU) and poly-l-lactic acid (PLLA) fibers. This particular reinforcement not only renders the originally rather fragile PPy membrane easy to manipulate, it also prevents the membrane from deformation in an aqueous environment. Peel and mechanical tests confirmed the strong adhesion of the fibers and the significantly increased tensile strength of the reinforced membrane. Surface electrical conductivity and long-term electrical stability were tested, showing that these properties were not affected by the reinforcement. Surface morphology and chemistry were analyzed with scanning electron spectroscopy (SEM), X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR). Material thermal stability was investigated with thermogravimetric analysis (TGA). Finally, the adhesion and proliferation of human skin keratinocytes on the membrane were assessed by Hoechst staining and the methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay. In conclusion, this membrane proves to be the first PPy-based soft conductive biomaterial that can be practically used. Its electrical conductivity and cytocompatibility promise a wide range of biomedical applications.

[Values of Apparent Diffusion Coefficient and Fractional Anisotropy in the Diagnosis of Brucella Spondylitis].

Objective To compare the differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) between brucella spondylitis (BS) groups at different stages before treatment and the normal control group and to evaluate the change trend of ADC value and FA value at different time points before and after treatment. Methods Totally 53 patients suspected of BS by conventional magnetic resonance imaging (MRI) and later confirmed as BS patients by serological tests were enrolled in this study. These patients underwent conventional MRI and diffusion tensor imaging scans,and the ADC value and FA value were measured. Independent sample t test was used to compare the ADC value and FA value between the BS group and the control group,the ADC value and FA value between the BS group at each stage. Repeated measurement ANOV was used to compare the ADC values and FA values at different time points before and after treatment. Results FA imaging showed that the color code of BS was different from that of the normal control group,and the color code of FA imaging showed increased singal. The ADC values of BS in the acute,subacute,and chronic stages [(1.45±0.02)×10 -3 mm 2/s,(1.35±0.03)×10 -3 mm 2/s,(1.26±0.05)×10 -3 mm 2/s,respectively] were significantly higher than those in the control group [(1.06±0.09) ×10 -3 mm 2/s](t=2.538,P=0.009;t=1.998,P=0.032;t=1.575,P=0.004),and the FA value (0.55±0.02,0.65±0.03,0.71±0.04,respectively) were significantly lower than those of the control group (0.78±0.02) (t=2.440,P=0.012; t=1.847,P=0.041;t=2.102,P=0.003). Repeated measurement analysis showed that there were statistically significant differences in ADC values and FA values at different time points before and after treatment in the acute,subacute,and chronic stages (ADC:F=12.100,P<0.001;F=8.439,P=0.005;F=9.704,P=0.004,respectively;FA:F=7.080,P=0.002;F=6.607;P=0.003;F=8.868,P=0.001,respectively). The ADC values at different time points after treatment were significantly lower than those before treatment or at a previous time point after treatment (F=332.14,P<0.001),and the FA values were significantly higher than those before treatment or at a previous time point after treatment (F=134.26,P<0.001). Conclusions FA color code can intuitively display differences in BS and normal vertebral bodies and show change of color code before and after treatment. Also,the ADC values and FA values can quantitatively reveal differences between BS and normal vertebral body in different time points and quantify BS vertebral lesion changes before and after treatment. In particular,in BS patients who are recovering from treatment,it can quantify microscopic edema. Therefore,diffusion tensor imaging may be useful objective indicator in evaluating the effectiveness of a specific treatment for BS.