Relationship between carotid intima-media thickness (cIMT) and dual-system imbalance in tobacco dependence: An rs-fMRI research.

BACKGROUND AND PURPOSE: According to the classic cognitive behavioral theory proposes, dysfunctional goal-directed and habit control systems are considered central to the pathogenesis of dependent behavior and impair recovery from addictions. The functional connectivity (FC) of the brain circuits for goal-directed or habitual behavior has not been clearly reported in tobacco-dependent groups. Smoking is one of the factors in the formation of atherosclerosis. Studies have shown that the thickness of carotid intima-media (cIMT) is associated with attention-executive-psychomotor functioning. Therefore, we hypothesized whether cIMT in tobacco-dependent individuals is associated with changes in the FC of the dual-system network. METHODS: A total of 29 male tobacco-dependent subjects (tobacco-dependent group) (mean age: 64.20 years, standard deviation [SD]: 4.81 years) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Exactly 28 male nonsmokers (control group) (mean age: 61.95 years, SD: 5.52 years) were also recruited to undergo rs-fMRI. We used the dorsolateral striatum (putamen) and dorsomedial striatum (caudate) as regions of interest for whole-brain resting-state connectivity to construct habitual and goal-directed brain networks, respectively. In addition, all participants were evaluated by carotid artery ultrasound to obtain the cIMT values. Then, we compared the dual-system brain networks between the tobacco dependence and control groups and the relationship between cIMT and imbalance of dual-system brain networks in tobacco dependence. RESULTS: The results showed a reduction in the connection between the caudate and precuneus and an increased connection between the putamen and prefrontal cortex; and supplementary motor area. The bilateral connectivity between the caudate and inferior frontal gyrus showed a significant negative correlation with the cIMT, and no positive correlation was observed with cIMT in the brain region that connects to the caudate. However, for the putamen, increased connectivity with the inferior temporal and medial frontal gyri was strongly associated with a high cIMT. CONCLUSIONS: The results indicate that the formation of tobacco dependence behavior is related to changes in the dual-system brain network. Carotid sclerosis is associated with the weakening of the goal-directed network and enhancement of the habit network in tobacco dependence. This finding suggests that tobacco dependence behavior and clinical vascular diseases are related to changes in brain functional networks.

Predictive value of a novel Asian lung cancer screening nomogram based on artificial intelligence and epidemiological characteristics.

BACKGROUND: To develop and validate a risk prediction nomogram based on a deep learning convolutional neural networks (CNN) model and epidemiological characteristics for lung cancer screening in patients with small pulmonary nodules (SPN). METHODS: This study included three data sets. First, a CNN model was developed and tested on data set 1. Then, a hybrid prediction model was developed on data set 2 by multivariable binary logistic regression analysis. We combined the CNN model score and the selected epidemiological risk factors, and a risk prediction nomogram was presented. An independent multicenter cohort was used for model external validation. The performance of the nomogram was assessed with respect to its calibration and discrimination. RESULTS: The final hybrid model included the CNN model score and the screened risk factors included age, gender, smoking status and family history of cancer. The nomogram showed good discrimination and calibration with an area under the curve (AUC) of 91.6% (95% CI: 89.4%-93.5%), compare with the CNN model, the improvement was significance. The performance of the nomogram still showed good discrimination and good calibration in the multicenter validation cohort, with an AUC of 88.3% (95% CI: 83.1%-92.3%). CONCLUSIONS: Our study showed that epidemiological characteristics should be considered in lung cancer screening, which can significantly improve the efficiency of the artificial intelligence (AI) model alone. We combined the CNN model score with Asian lung cancer epidemiological characteristics to develop a new nomogram to facilitate and accurately perform individualized lung cancer screening, especially for Asians.

CT Texture Analysis for Preoperative Identification of Lymphoma from Other Types of Primary Small Bowel Malignancies.

OBJECTIVES: To explore the application of computed tomography (CT) texture analysis in differentiating lymphomas from other malignancies of the small bowel. METHODS: Arterial and venous CT images of 87 patients with small bowel malignancies were retrospectively analyzed. The subjective radiological features were evaluated by the two radiologists with a consensus agreement. The region of interest (ROI) was manually delineated along the edge of the lesion on the largest slice, and a total of 402 quantified features were extracted automatically from AK software. The inter- and intrareader reproducibility was evaluated to select highly reproductive features. The univariate analysis and minimum redundancy maximum relevance (mRMR) algorithm were applied to select the feature subsets with high correlation and low redundancy. The multivariate logistic regression analysis based on texture features and radiological features was employed to construct predictive models for identification of small bowel lymphoma. The diagnostic performance of multivariate models was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: The clinical data (age, melena, and abdominal pain) and radiological features (location, shape, margin, dilated lumen, intussusception, enhancement level, adjacent peritoneum, and locoregional lymph node) differed significantly between the nonlymphoma group and lymphoma group (p < 0.05). The areas under the ROC curve of the clinical model, arterial texture model, and venous texture model were 0.93, 0.92, and 0.87, respectively. CONCLUSION: The arterial texture model showed a great diagnostic value and fitted performance in preoperatively discriminating lymphoma from nonlymphoma of the small bowel.

Resting-State Functional Magnetic Resonance Imaging Reveals Overactivation of the Habitual Control Brain System in Tobacco Dependence.

INTRODUCTION: We studied the regulatory mechanism of the habitual brain network in tobacco dependence to provide a theoretical basis for the regulation and cessation of tobacco dependence. METHODS: We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the Fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC) of the habitual brain network in tobacco-dependent subjects and to evaluate the relationship between the FC level and tobacco selection preference behavior. In total, 29 male tobacco-dependent participants and 28 male nonsmoking participants were recruited. rs-fMRI was used to collect blood oxygen level-dependent signals of the participants in the resting and awake states. After rs-fMRI, all subjects completed cigarette/coin selection tasks (task 1 and task 2). RESULTS: Compared with the control group, the tobacco dependence group showed increased fractional amplitude values of fALFF in the left posterior cingulate cortex and right parahippocampus. FC in the tobacco-dependent group was increased in the right inferior temporal gyrus, left middle frontal gyrus, left cingulated gyrus, and bilateral superior frontal gyrus, compared with that in the control group. Moreover, the preference selection behavior was associated with the enhancement of FC about parts of the brain regions in the habitual brain network of the tobacco-dependent participants. Thus, habitual network activity was significantly enhanced in tobacco-dependent participants in the resting state. Moreover, a positive correlation was found between the cigarette selection preference of the smokers and certain brain regions related to the habitual network. DISCUSSION: This suggests that increased activity of the habitual brain network may be essential in the development of tobacco-dependent behavior.

Clinical value of CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions.

BACKGROUND: To investigate the clinical value of CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions of unknown nature. METHODS: A retrospective analysis was conducted of 84 patients with peritoneal thickening for unknown reasons. There were 26 males and 58 females who underwent CT-guided percutaneous fine-needle aspiration biopsy for peritoneal lesions. RESULT: Among these 84 patients, no definite pathologic diagnosis was made in 3 patients, who were lost to the follow-up. The accuracy rate of CT-guided percutaneous fine-needle aspiration biopsy was 95.1% (77/81). Sixty lesions were pathologically-diagnosed with malignancies (74.1%), including 55 with peritoneal metastases, 4 with malignant mesotheliomas, and 1 with a lymphoma. Twenty-four patients (33.8%) were diagnosed as benign lesions, including 11 with tuberculosis and 13 with inflammatory lesions. The complications of CT-guided percutaneous fine-needle aspiration biopsy included bleeding in 1 patient and ascites leakage in 2 patients. CONCLUSION: CT-guided percutaneous fine-needle aspiration biopsy is a safe and effective method for diagnosing peritoneal lesions.

Application value of coaxial biopsy system in needle cutting biopsy for focal ground glass-like density nodule.

OBJECTIVE: The objective of the study is to evaluate the clinical efficacy and accuracy of coaxial biopsy puncture applied to make a diagnosis in 76 patients diagnosed with focal ground-glass density nodule (GGN). MATERIALS AND METHODS: In total, 76 patients were diagnosed with pure GGN (pGGN), 24 males and 52 females, aged (52 ± 1.2) years on average (range: 47-72 years). All patients underwent computed tomography (CT)-guided coaxial biopsy puncture to localize the position and measure the size of pGGN. The maximal diameter of the pGGN and the length of puncture needle into the lung were quantitatively measured. The diagnostic accuracy rate of CT-guided biopsy was subsequently validated by histological pathological examination. The incidence of postoperative complications was observed after biopsy. RESULTS: The pGGN diameter was measured from 5 to 45 mm, 21 mm on average. The pGGN depth ranged from 0 to 48 mm with a mean depth of 15 mm. Compared with the final diagnosis, the sensitivity, specificity, and accuracy rates of CT-guided needle aspiration biopsy in the diagnosis of pGGN were calculated as 97.3% (54/56), 85.0% (17/20), and 93.4% (71/76), respectively. Fourteen cases (18.4%) suffered from slight pneumothorax, 17 (22.4%) with mild errhysis surrounding the biopsy needle or lesions. CONCLUSION: CT-guided needle aspiration biopsy yields higher diagnostic accuracy and similar postoperative complications compared with the conventional histological diagnosis. For those undiagnosed by conventional CT scan and nontolerable of surgery, CT-guided needle aspiration biopsy serves as a safe and effective intervention.

Biodegradable polymersomes with an ionizable membrane: facile preparation, superior protein loading, and endosomal pH-responsive protein release.

Novel biodegradable polymersomes containing an ionizable membrane were developed for efficient loading and rapid intracellular release of proteins. The polymersomes were prepared from poly(ethylene glycol)-b-poly(trimethylene carbonate) (PEG-PTMC) block copolymer derivatives containing acrylate, carboxylic acid, and amine groups along PTMC block, which are denoted as PEG-PTMC(AC), PEG-PTMC(COOH), and PEG-PTMC(NH(2)), respectively. Notably, nano-sized polymersomes (95.1-111.6nm) were formed by directly dispersing these copolymers in phosphate buffer at room temperature. Both FITC-labeled bovine serum albumin (FITC-BSA) and cytochrome C (FITC-CC) were readily loaded into PEG-PTMC(COOH) and PEG-PTMC(NH(2)) polymersomes with remarkably high loading levels. Interestingly, in vitro release studies showed that PEG-PTMC(COOH) and PEG-PTMC(NH(2)) polymersomes had pH-responsive protein release behaviors in which significantly faster protein release was observed at endosomal pH than at physiological pH. MTT assays indicated that these polymersomes had low cytotoxicity. Furthermore, confocal laser scanning microscope (CLSM) observations revealed that FITC-CC loaded polymersomes efficiently delivered proteins into MCF-7 cells following 24h incubation. Importantly, flow cytometry showed that CC-loaded polymersomes induced markedly enhanced apoptosis in MCF-7 cells as compared to free CC. These novel membrane ionizable biodegradable polymersomes have appeared as highly promising nanocarriers for efficient intracellular protein delivery.

[Radiological diagnosis of primary malignant fibrous histiocytoma of bone].

OBJECTIVE: To explore the radiological diagnosis of primary malignant fibrous histiocytoma (MFH) of bone. METHODS: Sixteen patients with biopsy-or surgery-confirmed MFH received both plain X-ray and CT examinations, among whom six patients simultaneously received MRI. The imaging features were analyzed and the differential diagnoses were assessed. RESULTS: (1) Plain X-ray findings: All these lesions showed irregularly osteolytic, accompanied by cortical destruction. Five patients had varied degrees of cortical expansion, 12 had large soft tissue masses adjacent to the lesions, and only 2 had periosteal reaction. (2) CT findings: All lesions were osteolytic areas but had no evidences that its internal architecture had been replaced by soft tissue mass, and the cortical adjacent to the lesions were permeative osteolysis. Four patients had internal or marginal crest within the lesions and marginal inconsecutive osteosclerosis. Twelve had large soft tissue masses but without any calcification and residual architecture adjacent to the lesions, among which 3 patients had solitary or multiple cystic attenuation areas within the masses. No clear periosteal reaction was observed on CT. (3) MRI findings: All of lesions in 6 patients who received MRI showed inhomogeneous long T1 and long T2 abnormal signal intensity with soft tissue masses adjacent to the osteo-destructions. CONCLUSIONS: The imaging manifestations of MFH were specific to some extent. Combined utilization of plain X-ray, CT, and MRI is helpful for the diagnosis and differential diagnosis of MFH.