RÉSUMÉ
Objective:To synthesize non-contrast-enhanced CT images from enhanced CT images using deep learning method based on convolutional neural network, and to evaluate the similarity between synthesized non-contrast-enhanced CT images by deep learning(DL-SNCT) and plain CT images considered as gold standard subjectively and objectively, as well as to explore their potential clinical value.Methods:Thirty-four patients who underwent conventional plain scan and enhanced CT scan at the same time were enrolled. Using deep learning model, DL-SNCT images were generated from the enhanced CT images for each patient. With plain CT images as gold standard, the image quality of DL-SNCT images was evaluated subjectively. The evaluation indices included anatomical structure clarity, artifacts, noise level, image structure integrity and image deformation using a 4-point system). Paired t-test was used to compare the difference in CT values of different anatomical parts with different hemodynamics (aorta, kidney, liver parenchyma, gluteus maximus) and different liver diseases with distinct enhancement patterns (liver cancer, liver hemangioma, liver metastasis and liver cyst) between DL-SNCT images and plain CT images. Results:In subjective evaluation, the average scores of DL-SNCT images in artifact, noise, image structure integrity and image distortion were all 4 points, which were consistent with those of plain CT images ( P>0.05). However, the average score of anatomical clarity was slightly lower than that of plain CT images (3.59±0.70 vs. 4) with significant difference ( Z = -2.89, P<0.05). For different anatomical parts, the CT values of aorta and kidney in DL-SNCT images were significantly higher than those in plain CT images ( t=-12.89, -9.58, P<0.05). There was no statistical difference in the CT values of liver parenchyma and gluteus maximus between DL-SNCT images and plain CT images ( P>0.05). For liver lesions with different enhancement patterns, the CT values of liver cancer, liver hemangioma and liver metastasis in DL-SNCT images were significantly higher than those in plain CT images( t=-10.84, -3.42, -3.98, P<0.05). There was no statistical difference in the CT values of liver cysts between DL-SNCT iamges and plain CT images ( P>0.05). Conclusions:The DL-SNCT image quality as well as the CT values of some anatomical structures with simple enhancement patterns is comparable to those of plain CT images considered as gold-standard. For those anatomical structures with variable enhancement and those liver lesions with complex enhancement patterns, there is still vast space for DL-SNCT images to be improved before it can be readily used in clinical practice.
RÉSUMÉ
Objective:To investigate the CT features of lepidic predominant adenocarcinoma (LPA) and other pathological subtypes in early-stage invasive pulmonary adenocarcinoma appearing as ground glass nodule (GGN); and to provide imaging-derived information for the clinical management of GGN.Methods:The clinical and CT data of patients with early-stage invasive pulmonary adenocarcinoma in the First Medical Center of PLA General Hospital from January to December 2019 were retrospectively reviewed. All patients presented with pure GGNs or mixed GGNs with a consolidation-to-tumor ratio (CTR)<0.5, with the pathological results confirmed by surgery. GGNs were divided into LPA and non-LPA (n-LPA) groups according to pathological subtypes. Univariate analysis was used to compare the clinical data and CT characteristics between the two groups. The multivariate analysis was performed for the indicators with statistically significant differences and a multivariate model was generated using the reverse elimination method. The area under the ROC curve (AUC) was used to evaluate the discriminatory power of this model for differentiation of LPA from n-LPA.Results:A total of 630 GGNs from 589 patients were analyzed, with 367 GGNs in LPA group and 263 GGNs in n-LPA group. In univariate analysis, the diameter [(14±5) mm], CT value [(-566±98) HU], and CTR [13.9% (0, 27.3%)] in the LPA group were significantly smaller than those in the n-LPA group [(15±5) mm, (-499±111) HU, 27.8%(7.7%, 40%)], respectively, P<0.05]. The frequency of mGGN, deep lobulation sign, burrs, vascular changes, bronchial changes, and clear tumor-lung interface were significantly higher in the n-LPA group than those in the LPA group ( P<0.05). Multivariate analysis results showed that mean CT values, CTR, deep lobulation sign, burr, vascular changes, and bronchial changes were independent predictors for predicting n-LPA ( P<0.05), which were included in the logistic model. Using the optimal cutoff value of 3.958, the logistic regression model for differentiate LPA from n-LPA had a sensitivity of 76.4%, a specificity of 78.7%, and an area under the curve of 0.840. Conclusion:The CT features are helpful for differentiating lepidic predominant subtype from other subtypes in early-stage invasive pulmonary adenocarcinoma presenting as a GGN.
RÉSUMÉ
BACKGROUND:Bone marrow mesenchymal stem cel s (BMSCs) are the focus of research on the proliferation and metastasis of hepatocel ular carcinoma cel s. By genetic engineering techniques, the hepatocel ular carcinoma cel s can be induced to reduce the expression of bioactive factors, thereby seeking suitable intervention targets for improving the interventional effect of BMSCs. OBJECTIVE:To silence the expression of transforming growth factor beta1 (TGFβ1) and osteopontin (OPN) in high metastatic potential hepatocel ular carcinoma cel s (MHCC97-H) fol owed by co-culture with BMSCs and then to observe the change of MHCC97-H cel invasion ability as wel as the interventional effect of BMSCs on the animal model of hepatocel ular carcinoma tissue MHCC97-H by fluorescence imaging in vivo. METHODS:MHCC97-H cel s were divided into four groups:MHCC97-H group was set as a blank control group, and MHCC97-H NC siRNA as negative control group, and MHCC97-H siRNA TGFβ1 and siRNA OPN were experimental groups. Transwel s assay was carried out for co-culture experiments. After 48 hours of co-culture, crystal violet staining was performed for cel counting in three randomly selected fields of vision. Combined with the red fluorescence protein gene, MHCC97-H cel lines in each group were inoculated via the right subaxil ary subcutaneous transplantation to make a tumor model in nude mice. When the tumor volume was up to about 50 mm3, BMSCs were injected into the tumor in the nude mice, and 4 weeks later, fluorescence images were analyzed using software for fluorescence intensity. Frozen hepatocel ular carcinoma tissue sections were taken for 4’,6-diamidino-2-phenylindole staining and fluorescence microscope observation. RESULTS AND CONCLUSION:Cel counting results showed that BMSCs significantly decreased MHCC97-H cel s after gene silencing, and crystal violet staining showed that the migration ability of MHCC97-H cel s was significantly decreased. Tumor volume shown by the fluorescence imaging was significantly reduced after the OPN gene transfection, the fluorescence intensity was lower than that in the other groups, and quantitative results showed that the absorbance value of OPN shRNA cel s decreased significantly compared with other groups, indicating the BMSCs exhibit best interventional effectiveness in OPN-silenced MHCC97-H cel s. Pathological sections showed that BMSCs were mainly distributed in the tumor necrosis area, and the fluorescence expression in the OPN siRNA group was more than that in the TGFβ1 siRNA group and the blank control group, indicating that after OPN gene silencing of MHCC97-H cel s, the distribution of BMSCs in the tumor was increased. To conclude, it is able to reduce the invasive ability of hepatocel ular carcinoma cel s by inhibiting the expression of OPN and TGFβ1 factors, and OPN silencing may be more conductive to BMSCs biotherapy.
RÉSUMÉ
<p><b>OBJECTIVE</b>To discuss the effects on detrusor hyperreflexia treated with ginger-salt-isolated moxibustion at "Shenque" (CV 8) and its mechanism.</p><p><b>METHODS</b>Thirty female adult SD rats were selected. The model of detrusor hyperreflexia was prepared with complete spinal transection at T, of which, 20 rats were randomized into a model group (10 rats) and a moxibustion group (10 rats). A sham-operation group (10 rats) was set up for sham-spinal transection. In the moxibustion group, when urine incontinence occurred (about in 2 weeks of modeling), the ginger-salt-isolated moxibustion at "Shenque" (CV 8) was given, 3 moxa cones each time, once a day, continuously for 7 days. After treatment, in each group, the urodynamic parameters were determined, after which, the bladder detrusor was collected. Western blot was used to determine the protein expressions of M2 and M3 receptors.</p><p><b>RESULTS</b>Compared with the sham-operation group, the micturition interval was shortened apparently (<0.01); the maximal bladder pressure was increased apparently (<0.01); the protein expression of M2 receptor in the detrusor was increased significantly (<0.05) and that of M3 receptor had no apparent change (>0.05) in the rats of the model group. Compared with the model group, the micturition interval was longer apparently (<0.01), the maximal bladder pressure was reduced apparently (<0.01), the protein expression of M2 receptor in the detrusor was reduced significantly (<0.05) and that of M3 receptor had no apparent change (>0.05) in the rats of the moxibustion group.Compared with the sham-operation group, the results of the above indicators were not different significantly in the moxibustion group (all>0.05).</p><p><b>CONCLUSIONS</b>The ginger-salt-isolated moxibustion at "Shenque" (CV 8) suppresses the overactive bladder in the rat with spinal transection and its effect mechanism is possibly relevant with reducing the protein expression of detrusor M2 and inhibiting the excessive contraction of the detrusor.</p>
RÉSUMÉ
Objective To observe the effects of acupuncture on oxidative stress and neuronal damage in the prefrontal cortex of chronic cerebral hypoperfusion (CCH) rats; To investigate the molecular mechanisms of acupuncture in cognitive impairment of vascular dementia (VD) rats. Methods The animal model of VD was replicated by permanent bilateral common carotid artery occlusion (2VO) to induce CCH in rats. After modeling, rats were randomized into model group, acupuncture group and non-acupoint group. Sham-operation group was set as control group. Rats of acupuncture group and non-acupoint group were treated with needling for 2 weeks at 3 days after 2VO. Nissl and DHE staining were respectively used to evaluate the numbers of neurons and ROS level. SOD activity was examined by xanthine oxidase technique. Results Compared with sham-operation group, the number of neurons and SOD activity decreased in the model group, while the ROS level increased. Compared with the model group, the number of neurons and SOD activity increased in the acupuncture group, while the ROS level decreased. There were no obvious changes in all indexes in non-acupoint group. Conclusion Acupuncture can inhibit oxidative stress and improve neuronal damage and loss in the prefrontal cortex of VD rats.
RÉSUMÉ
Mesenchymal stem cells (MSCs),progenitor cells with the ability of self replication and differentiation,are able to change into many kinds of cells or tissues.The study of acupuncture combined with MSCs transplantation has made some progress and shown potential application prospect.This article summarized experimental research literatures of acupuncture combined with MSCs transplantation over the past ten years.Biological mechanisms of acupuncture combined with MSCs transplantation might be related to the increase of MSCs survival rate and the directional differentiation of MSCs induced by acupuncture.The combination of acupuncture and MSCs transplantation might be used as a potential routine technique in clinical practice.The underlying mechanisms still need to be further elucidated.
RÉSUMÉ
BACKGROUND:Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative stil deserves further exploration. OBJECTIVE:To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc. METHODS:From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle. RESULTS AND CONCLUSION:Process deflection angle at L 4 and L 5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z=-10.609,-12.074, P0.05). There only was significant difference on lumbosacral angle between male group and female group (P=0.007<0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P<0.01), and there was significant difference between 45-54 age group and 25-34 age group (P<0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.
RÉSUMÉ
BACKGROUND:Bone marrow mesenchymal stem cells have the chemotaxis and homing role that promotes immune system reconstruction, eliminate residual lesions and prevent recurrence in patients. OBJECTIVE:To observe therapeutic effect of human bone marrow mesenchymal stem cells transplantation into high-metastatic potential hepatocellular carcinoma animal models on metastatic potential of high-metastatic potential hepatocellular carcinoma. METHODS:Nude mouse models of high-metastatic potential hepatocellular carcinoma were established in vivo. In the experimental group, 5×105 cells were injected via the tail vein on day 7 after tumor inoculation, twice a week. In the control group, cellculture medium, 0.2 mL per mouse, was injected by the tail vein. After the start of the experiment, tumor volume was measured every 4 days. After tumor inoculation for 14 days, 21 days, 28 days, 35 days, 42 days, animal models were sacrificed, and then tumor mass and body mass were recorded to calculate the inhibition rate. PCR was employed to detect osteopontin, bone sialoprotein, and integrinα Ⅴ mRNA expression, as wel as bcl-2, bax, caspase3 mRNA expression. RESULTS AND CONCLUSION:The inhibition rate of tumor mass showed the best results in week 3. As time went on, the tumor inhibition rate was gradual y decreased. Metastasis-related biological factors showed a gradual down-regulated trend, indicating the polarization of tumor apoptotic indexes, that is, anti-apoptotic factor, bcl-2, showed a decreasing trend, while apoptotic factors, bax and caspase3, appeared to have a gradual y increased trend. These findings suggest that human bone marrow mesenchymal stem cells effects to inhibit high-metastatic potential hepatocellular carcinoma animal models appear to vary with time. After human bone marrow mesenchymal stem cells transplantation for 3 weeks, the inhibition performance on high-metastatic potential hepatocellular carcinoma is the best, and then it weakens with time. Human bone marrow mesenchymal stem cells are found to inhibit the metastatic potential of hepatocellular carcinoma.
RÉSUMÉ
Objective To summarize that the distant interval metastasis of nasopharyngeal carcinoma(NPC) patients who have been examined by 18F-FDG PET/CT and analysis the diagnostic efficacy of doctors using PET/CT device.Methods 75 patients were divided into three groups including primary patients without any treatment and patients in treating and patients after radiotherapied.The distant interval metastasis sits,incidence and their difference were analyzed.We adopt five grades to diagnose distant interval metastasis of NPC.And we choose the difference grade as cut off point to draw ROC curve and then decide the best diagnostic cut off point.Result There are 22patients in the first group and 2patients in the second group and 51patients in the third group in all 75paients.The incidence of distant interval metastasis in the first group is 59.1% and third 68.6% and there are statistical significance between groups(P=0.0001).The most frequent sites of distant interval metastasis is the distant interval lymph nodes(38.67%) and the second is skeleton(36%) and the third is liver(25.33%).ROC curve indicate that third one is the best cut off point because of doctors using PET/CT device can acquire the optimal sensitivity(86.36%)and specificity(88.24%) and accuracy(76.8%).Conclusion The incidence of distant interval metastasis is higher and the most frequent part is distant interval lymph nodes.And the doctors using PET/CT device diagnose the distant interval metastasis of NPC efficacy is higher.
RÉSUMÉ
PET-CT is a functional imaging device with a complicated imaging theory and technique. It attracts some arguments when applied clinically. This paper discusses mainly its technique problems and its prospects in the future.
RÉSUMÉ
Objective To improve the diagnostic accurary of peripheral pulmonary masses before operation. Methods 55 cases of peripheral lung mass with percutaneous puncture biopsy under CT guidance were compared with the postoperative pathology. Results 44 out of 55 cases confirmed by operation were lung cancer. 40 cases showed consistent CT findings with pathology reaching accurate rate to 90.9% (40/44). 5 cases were tuberculous granuloma with accurate rate of 80% (4/5). 6 cases were inflammatory pseudotumor (with 2 cases of cryptococcal granuloma) showing accurate rate of 33.3% (2/6). Altogether 55 cases of peripheral lung masses were diagnosed correctly by CT with accurate rate of 83.6% (46/55). Conclusions Percutaneous puncture biopsy under CT guidance for peripheral lung lesions is safe and reliable especially for planning the management.