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Malignant tumors are one of the main causes of human death worldwide and pose a serious threat to human health. The current treatment methods are mainly the combination of chemotherapeutics， surgery， radiotherapy， or hormone therapy. The treatment process has limitations such as multidrug resistance， non-selective targeting of cancer cells， and drug toxicity. With the development and application of traditional Chinese medicine （TCM）， Chinese medicine has the characteristics of multi-angle and multi-mechanism coordination and slight toxic and side effects. It can effectively inhibit tumor proliferation， differentiation， and metastasis， and avoid drug resistance， serving as the focus of current tumor treatment research. Hedysari Radix， one of the genuine medicinal materials in Gansu province， is a tonic Chinese medicine with a wide range of pharmacological effects such as anti-inflammation， immune regulation， anti-oxidation， prevention and treatment of diabetic complications. In the majority of the ancient works on herbs of the past dynasties， Hedysari Radix was included under the item of Astragali Radix and used as Astragali Radix. Hedysari Radix is superior to Astragali Radix in enhancing immunity， scavenging free radicals， and resisting liver fibrosis. Studies have found that the effective components of Hedysari Radix have a prominent anti-tumor effect and a significant inhibitory effect on various malignant tumors such as liver cancer， bladder cancer， gastric cancer， breast cancer， and colorectal cancer. They can also combine with clinical anti-cancer drugs to reduce the toxic and side effects of chemotherapy drugs and improve the tolerance of patients during chemotherapy. On the basis of current research， this study summarized the mechanism of Hedysari Radix active components in inducing cell apoptosis， blocking cell cycle， inhibiting tumor cell proliferation， migration， and invasion， regulating micro mRNA （miRNA）， inducing cell autophagy， enhancing immune regulation， as well as reducing toxicity and enhancing efficiency and sensitization with clinical chemotherapeutics， and systematically explained the anti-tumor mechanism of Hedysari Radix active components， aiming to provide a basic reference for the further exploration of the anti-tumor mechanism of Hedysari Radix and the further development and utilization of its effective components.
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Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.
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Objective@#To investigate the value of multi-arterial phase differential sub-sampling with cartesian ordering (DISCO) technique in the evaluation of hepatic vascular anatomy with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA).@*Methods@#Forty-eight patients with suspected hepatic malignancy were prospectively enrolled and underwent both of Gd-EOB-DTPA enhanced DISCO MRI and CTA within two weeks. The hepatic arterial anatomy of two examination methods were evaluated by four-point scoring method. The arterial scores between DISCO and CTA images were compared by Wilcoxon test. The difference among multiple arterial scores of DISCO and CTA were compared by Kruskal-Wallis H test respectively.@*Results@#There was no difference of arterial scores in celiac artery, common hepatic artery, proper hepatic artery, left hepatic artery, right hepatic artery, first branch of right hepatic artery, splenic artery, left gastric artery and gastroduodenal artery between DISCO and CTA (P>0.05), but the arterial score of first branch of left hepatic artery [2 (2,2)] was lower than that of CTA [2 (2,3)] (Z=-3.138,P=0.002). In the multiple comparison among different arteries, there were differences between PHA and LAH (P<0.05), B-LHA and B-RHA (P<0.05) in DISCO, but no difference was found in CTA (P>0.05).@*Conclusion@#The DISCO sequence with Gd-EOB-DTPA enhancement MRI can supply comparable image quality to CTA in hepatic artery and its main branches display, which has no ionizing radiation and can also provide more diagnostic information for clinic.
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Objective@#To investigate the application value of multiple-arterial-phase imaging technique with differential sub-sampling with cartesian ordering (DISCO) in the gadoxetate acid disodium enhanced liver MRI.@*Methods@#From September 2017 to March 2018, 56 patients with suspected malignant focal liver disease diagnosed with ultrasound or CT in West China Hospital of Sichuan University were enrolled prospectively, and underwent preoperative enhanced MRI with gadoxetate acid disodium. Patients were divided into 2 groups by random-number table method. Twenty nine patients in group A underwent liver multiple-arterial-phase imaging with DISCO. Twenty seven patients in group B underwent single-arterial-phase imaging with liver acquisition with volume acceleration-flex (LAVA-Flex). The display rate of late-arterial-phase and respiratory motion artifacts of dynamic enhancement images were evaluated. The categorical variables was compared by Chi-square test. The respiratory motion artifacts between the single-arterial-phase and multiple-arterial-phases were compared by Mann-Whitney U test. The artifact scores among the various phases of the multi-arterial phase were compared by Kruskal-Wallis H.@*Results@#Compared to LAVA-Flex [74.1%(20/27)], a higher display rate of late-arterial phase [96.6%(28/29)] was found in DISCO (Group A), and the difference was statistically significant (χ2=5.770, P=0.016). In the evaluation of respiratory motion artifacts, the motion artifacts of the late-arterial images obtained by LAVA-Flex [3(3,4)] were more severe than the DISCO [2(2,3)], and the difference was statistically significant (Z=-3.250, P<0.01). Among the scores of motion artifacts in the 6 phases of DISCO, the artifact scores of phase 1, 2, 3, 4, 5, 6 were [3(3,4)], [2(2,3)], [2(2,3)], [3(2,3)], [3(3,4)] and [3(3,4)], respectively. The motion artifacts of phase 2, 3, 4 were better than phase 1, 5, 6, the differences were statistically significant (P<0.05), but there was no statistical differences among phase 2, 3 and 4 (P>0.05).@*Conclusion@#Compared with single-arterial-phase imaging, multiple-arterial-phases with DISCO using gadoxetate acid disodium can improve the capture rate of late arterial phase and reduce motion artifacts.
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Objective To investigate the value of multi?arterial phase differential sub?sampling with cartesian ordering (DISCO) technique in the evaluation of hepatic vascular anatomy with gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA). Methods Forty?eight patients with suspected hepatic malignancy were prospectively enrolled and underwent both of Gd?EOB?DTPA enhanced DISCO MRI and CTA within two weeks. The hepatic arterial anatomy of two examination methods were evaluated by four?point scoring method. The arterial scores between DISCO and CTA images were compared by Wilcoxon test. The difference among multiple arterial scores of DISCO and CTA were compared by Kruskal?Wallis H test respectively. Results There was no difference of arterial scores in celiac artery, common hepatic artery, proper hepatic artery, left hepatic artery, right hepatic artery, first branch of right hepatic artery, splenic artery, left gastric artery and gastroduodenal artery between DISCO and CTA (P>0.05), but the arterial score of first branch of left hepatic artery [2 (2,2)] was lower than that of CTA [2 (2,3)] (Z=-3.138,P=0.002). In the multiple comparison among different arteries, there were differences between PHA and LAH (P<0.05), B?LHA and B?RHA (P<0.05) in DISCO, but no difference was found in CTA (P>0.05). Conclusion The DISCO sequence with Gd?EOB?DTPA enhancement MRI can supply comparable image quality to CTA in hepatic artery and its main branches display, which has no ionizing radiation and can also provide more diagnostic information for clinic.
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Objective To investigate the application value of multiple?arterial?phase imaging technique with differential sub?sampling with cartesian ordering (DISCO) in the gadoxetate acid disodium enhanced liver MRI. Methods From September 2017 to March 2018, 56 patients with suspected malignant focal liver disease diagnosed with ultrasound or CT in West China Hospital of Sichuan University were enrolled prospectively, and underwent preoperative enhanced MRI with gadoxetate acid disodium. Patients were divided into 2 groups by random?number table method. Twenty nine patients in group A underwent liver multiple?arterial?phase imaging with DISCO. Twenty seven patients in group B underwent single?arterial?phase imaging with liver acquisition with volume acceleration?flex (LAVA?Flex). The display rate of late?arterial?phase and respiratory motion artifacts of dynamic enhancement images were evaluated. The categorical variables was compared by Chi?square test. The respiratory motion artifacts between the single?arterial?phase and multiple?arterial?phases were compared by Mann?Whitney U test. The artifact scores among the various phases of the multi?arterial phase were compared by Kruskal?Wallis H. Results Compared to LAVA?Flex [74.1%(20/27)], a higher display rate of late?arterial phase [96.6%(28/29)] was found in DISCO (Group A), and the difference was statistically significant (χ2=5.770, P=0.016). In the evaluation of respiratory motion artifacts, the motion artifacts of the late?arterial images obtained by LAVA?Flex [3(3,4)] were more severe than the DISCO [2(2,3)], and the difference was statistically significant (Z=-3.250, P<0.01). Among the scores of motion artifacts in the 6 phases of DISCO, the artifact scores of phase 1, 2, 3, 4, 5, 6 were [3(3,4)], [2(2,3)], [2(2,3)], [3(2,3)], [3(3,4)] and [3(3,4)], respectively. The motion artifacts of phase 2, 3, 4 were better than phase 1, 5, 6, the differences were statistically significant (P<0.05), but there was no statistical differences among phase 2, 3 and 4 (P>0.05). Conclusion Compared with single?arterial?phase imaging, multiple?arterial?phases with DISCO using gadoxetate acid disodium can improve the capture rate of late arterial phase and reduce motion artifacts.