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Objective:To explore the value of nomogram based on dual-layer detector spectral CT quantitative parameters and conventional CT feature in evaluating high-grade pattern (HGP) of pulmonary invasive non-mucinous adenocarcinoma.Methods:This study was a case-control study. A total of 71 patients with pathologically confirmed pulmonary invasive non-mucinous adenocarcinoma in the First Affiliated Hospital of Soochow University from February 2022 to May 2023 were retrospectively enrolled, which were divided into HGP and non-HGP groups according to pathological results. Conventional CT features were analyzed, including size, shape, density, internal signs, margins, and pleural retraction. The iodine concentration (IC), electron density (ED), and normalized iodine concentration (NIC) of the lesions in both the arterial phase (AP) and venous phase (VP) were measured. Differences between the two groups were analyzed using independent sample t-test, Mann-Whitney U test, or χ2 test. Multivariate logistic regression analysis was used to select the independent influencing factors of HGP in pulmonary invasive non-mucinous adenocarcinoma, and the conventional CT feature model, the spectral CT quantitative parameter model, and the combined model were constructed and expressed in a nomogram. The area under the curve (AUC) of receiver operating characteristic curve was used to assess the performance of each model, and was compared by DeLong test. Decision curves (DCA) was used to assess the clinical net benefit of the models. Results:There were significant differences between HGP group and non-HGP group in terms of density, lobulation, spiculation, IC AP, IC VP, NIC AP, ED AP and ED VP (all P<0.05). The multivariate logistic regression analysis showed that the solid nodule ( OR=15.452, 95% CI 4.246-56.235, P<0.001), lobulation ( OR=7.069, 95% CI 1.618-30.883, P=0.009), ED AP( OR=1.183, 95% CI 1.064-1.315, P=0.002) and IC VP ( OR=0.231, 95% CI 0.072-0.744, P=0.014) were independent influencing factors for predicting HGP in pulmonary invasive non-mucinous adenocarcinoma. The AUC of the conventional CT feature model, spectral CT quantitative parameter model, and the combined model were 0.835, 0.890, and 0.915, respectively. The AUC of the combined model was better than that of the conventional CT feature model ( Z=2.67, P=0.008). The DCA analysis demonstrated that the nomogram had higher clinical net benefit than the conventional CT feature model. Conclusions:The nomogram based on the quantitative parameters of dual-layer detector spectral CT and conventional CT features have favorable diagnostic efficacy in predicting HGP in pulmonary invasive non-mucinous adenocarcinoma, and can be used as a reliable tool for non-invasive diagnosis of HGP before surgery.
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Objective:To investigate the clinical value of multiparametric myocardial imaging using a dual-layer detector spectral CT in the non-invasive preoperative assessment of patients with coronary atherosclerotic heart disease (CHD) undergoing percutaneous coronary intervention (PCI).Methods:The clinical and imaging data of 90 patients who underwent coronary CT angiography (CCTA) with dual-layer spectral detector CT and invasive coronary angiography (ICA) within 30 days at the Affiliated Changshu Hospital of Nantong University from January 2021 to October 2022 were retrospectively analyzed. A total of 189 coronary arteries were included in the study cohort. The patients were divided into PCI ( n=44) and non-PCI groups ( n=46) according to whether they received PCI after evaluation with ICA. The diameter stenosis rate of the coronary arteries, myocardial iodine concentration (IC) and effective atomic number (Z eff) values were obtained from CCTA conventional and spectral images. The IC values and Z eff values of the myocardium in the areas with abnormal perfusion were compared with those in the areas with normal perfusion. The diagnostic performance of these parameters, as well as their combined model, was evaluated and compared using receiver operating characteristic (ROC) curve and area under the curve (AUC) in the pre-PCI assessment of patients with CHD. Results:Baseline patient data did not show statistically significant differences between the PCI and non-PCI groups (all P>0.05). There were statistically significant differences in IC values [(0.42±0.28) and (2.26±0.48) mg/ml] and Z eff values (7.39±0.33 and 8.50±0.25) between the myocardium areas with abnormal perfusion and the myocardium areas with normal perfusion in all patients (all P<0.001). The AUC for assessing whether patients with CHD need PCI treatment using myocardial IC and Z eff values were 0.865 and 0.853, respectively, which were significantly higher than assessment based only on lumen diameter stenosis rate (AUC=0.726, P<0.001). Conclusions:The IC and Z eff derived from myocardial spectral images can be used to diagnose myocardial perfusion abnormalities in patients with CHD. The spectral myocardial multi-parameters imaging shows promising potentials in pre-PCI assessment of patients with CHD, which can improve the efficiency of evaluation and may help to avoid unnecessarily invasive procedures.
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Objective:To investigate the value of the nomogram based on quantitative parameters of dual-layer detector spectral CT and conventional CT features in preoperatively predicting tumor deposits (TDs) in colorectal cancer.Methods:This study was a case-control study. A total of 126 patients with pathologically confirmed colorectal cancer who underwent preoperative spectral CT scan from January 2022 to March 2023 in the First Affiliated Hospital of Soochow University were enrolled retrospectively. Patients were divided into TDs-positive group ( n=38) and TDs-negative group ( n=88) based on pathological results. The following conventional CT features were assessed: cT stage, cN status, uniformity of enhancement in the venous phase, pericolorectal fat invasion (PFI), maximum tumor diameter, and tumor location. The following quantitative parameters were also measured and calculated: the normalized iodine concentration (NIC) of lesions, the normalized effective atomic number (NZ eff), and the slope of the 40-100 keV spectral curve (K) in the arterial and venous phases, and the difference in NIC between the arterial and venous phases. Multivariate logistic regression analysis was used to select independent predictors of TDs and the nomogram based on spectral CT quantitative parameters and conventional CT features was constructed. The receiver operating characteristic curve was performed to evaluate the diagnostic performance of each parameter and model. DeLong test was used to compare the differences of area under the curve (AUC). Results:Statistically significant differences were found between the TDs-positive and TDs-negative groups for the cT stage, cN status, uniformity of enhancement in the venous phase, PFI, NIC, NZ eff, K in the venous phase and the difference in NIC between the arterial and venous phases ( P<0.05). After multivariate logistic regression analysis, the conventional CT feature model incorporated two features: uniformity of enhancement in the venous phase (OR=9.602, 95% CI 3.728-24.734, P=0.001) and PFI ( OR=2.881, 95% CI 1.177-7.049, P=0.020). The combined model of conventional CT features and spectral CT quantitative parameters incorporated three features: the difference in NIC between the arterial and venous phases ( OR=37.599, 95% CI 8.320-169.912, P=0.001), uniformity of enhancement in the venous phase ( OR=14.978, 95% CI 3.848-58.295, P=0.001), and PFI ( OR=4.013, 95% CI 1.320-12.760, P=0.015), and the nomogram was constructed. The AUC, sensitivity, and specificity of the nomogram for predicting TDs were 0.919 (95% CI 0.865-0.973), 84.2%, and 86.5%, respectively. The AUC of the conventional CT feature model was 0.796 (95% CI 0.707-0.885), which was lower than that of the nomogram, and the difference was statistically significant ( Z=3.87, P=0.001). Conclusion:Dual-layer spectral detector CT can be used to predict TDs in colorectal cancer preoperatively, and the nomogram based on quantitative parameters of dual-layer detector spectral CT and conventional CT features shows good diagnostic performance.
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Aim To explore the role of SIRT1/Nrf2 / HO-1 in alleviating the cognitive function impairment by sevoflurane treatment in a mouse model of postoperative cerebral reperfusion. Methods C57BL/6J mice were randomly divided into five groups: sham operation group, hemorrhagic shock reperfusion group, sevoflurane postconditioning group, sevoflurane postcondition-ing + SIRT1 inhibitor group and sevoflurane postconditioning + Nrf2 inhibitor group. Mice were subjected to Morris water maze test after cerebral ischemia reperfusion. The ATP, superoxide dismutase (SOD), ROS and MDA contents in tissue of mice were detected. SIRT1, Nrf2 and HO-1 proteins in tissue were detected by Western blot. Results After hemorrhagic shock, the learning and memory ability of mice was reduced.ATP and SOD concentration in hippocampus was reduced , MDA and ROS concentration increased, and the SIRT, Nrf2 and HO-1 concentration was reduced. Sevoflurane improved the cognitive dysfunction and oxi-dative damage in postoperative mice, and the neuro-protective effect of sevoflurane on hemorrhagic shock and resuscitation mice was weakened followed with SIRT1 and Nrf2 inhibitors. Conclusion Sevoflurane probably alleviates the oxidative reaction damage and cognitive impairment caused by cerebral reperfusion in mice through SIRT1/Nrf2/H0-1 pathway.
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Objective:To evaluate the relationship between methyltransferase-like 3(METTL3)-mediated RNA N6-Methyladenosine (m6A) methylation modification and silent information regulator factor 1 (SIRT1) during sevoflurane post-conditioning-induced mitigation of cognitive impairments in a mouse model of hemorrhagic shock and resuscitation(HSR).Methods:Forty clean-grade healthy male C57BL/6 mice, aged 8-10 weeks, with a body weight ranging from 22-26 g, were assigned into 5 groups ( n=8 each) using a random number table method: sham operation group, HSR group, sevoflurane post-conditioning + HSR group (SP+ HSR group), over-expression of METTL3 gene rAAV + sevoflurane post-conditioning + HSR group (METTL3+ SP+ HSR group), and over-expression of METTL3 gene rAAV negative control + sevoflurane post-conditioning + HSR group (NC+ SP+ HSR group). The HSR model was established by withdrawing 40% of the total blood volume from mice through the right carotid artery within 30 min, followed by reinfusion of the withdrawn blood over 30 min 1 h later. The SP+ HSR group underwent HSR modeling first and then inhaled sevoflurane (end-tidal concentration 2.4%) for 30 min starting from the time point immediately after blood transfusion. The Sham group and HSR group inhaled a mixture of 70% O 2 and 30% CO 2 for 30 min at the corresponding time points. In METTL3+ SP+ HSR group and NC+ SP+ HSR group, the corresponding virus 450 nl was injected into bilateral hippocampus at 4 weeks before establishing the model.Morris water maze and novel object recognition tests were conducted at 72 h after developing the model to assess the learning and memory abilities. After the end of behavioral tests, the expression of METTL3 and SIRT1 in hippocampal tissues was detected using Western blot, the expression of SIRT1 mRNA was measured using qRT-PCR, and the methylation of RNA m6A was detected using Dot blot. Results:Compared to Sham group, the escape latency was significantly prolonged at 1-6 days, the time spent in the target quadrant was shortened, the number of crossing the original platform was decreased, the novel object recognition index was decreased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased in HSR group( P<0.05). Compared to HSR group, the escape latency was significantly shortened at 1-6 days, the time spent in the target quadrant was prolonged, the number of crossing the original platform was increased, the novel object recognition index was increased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased, the novel object recognition index was increased, the expression of METTL3 was down-regulated, the expression of SIRT1 protein and mRNA was up-regulated, and the methylation of RNA m6A was decreased in SP+ HSR group( P<0.05). Compared to SP+ HSR group, the escape latency was significantly prolonged at 2-6 days, the time spent in the target quadrant was shortened, the number of crossing the original platform was decreased, the novel object recognition index was decreased, the expression of METTL3 was up-regulated, the expression of SIRT1 protein and mRNA was down-regulated, and the methylation of RNA m6A was increased in METTL3+ SP+ HSR group( P<0.05), and no significant change was found in the aforementioned indicators in NC+ SP+ HSR group ( P>0.05). Conclusions:The mechanism by which sevoflurane post-conditioning alleviates cognitive dysfunction is associated with down-regulation of METTL3 expression, reduction of RNA m6A methylation, and up-regulation of SIRT1 expression in HSR mice.
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Objective:To investigate the predictive value of thrombus enhancement (TE) and thrombus permeability in cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.Methods:The clinical and image data of 93 patients with acute middle cerebral artery occlusion who were admitted to the First Affiliated Hospital of Soochow University within 12 hours after onset from January 2020 to July 2022 were retrospectively analyzed. According to the TOAST criteria, the patients were divided into the cardioembolism (CE) group (43 cases) and the large artery atherosclerosis (LAA) group (50 cases). All patients received noncontrast CT and CT angiography, and then thrombus permeability [thrombus attenuation increase (TAI), void fraction (ε)] and TE were assessed. Independent sample t-test, Mann-Whitney U test and χ2 test were used in univariable analysis between two groups. Multivariable logistic regression analysis was used to explore the independent influencing factors for cardioembolic stroke and establish a logistic model. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive value of TAI, ε, TE and the logistic model in cardioembolic thrombus with acute middle cerebral artery occlusion. Results:There were statistically significant differences in sex, atrial fibrillation, hypertension, diabetes mellitus, smoking, baseline National Institutes of health stroke scale (NIHSS), TAI, ε and TE between the CE group and the LAA group ( P<0.05). Binary logistics regression analysis showed that TAI (OR=1.300, 95%CI 1.147-1.473, P<0.001), hypertension (OR=0.116, 95%CI 0.025-0.535, P=0.006) and baseline NIHSS (OR=1.165, 95%CI 1.040-1.304, P=0.008) were independent influencing factors for cardioembolic thrombus. The ROC curve indicated that the logistic model predicted cardioembolic thrombus with the highest AUC of 0.907 (95%CI 0.848-0.966). TE predicted cardioembolic thrombus with the highest sensitivity of 90.7%. Conclusion:TE and thrombus permeability have application value for predicting cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.
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Objective:To explore the predictive value of deep learning (DL)-based coronary artery calcification score (CACS) for obstructive coronary artery disease (CAD) and noncalcified plaque/mixed plaque in type 2 diabetes mellitus (T2DM).Methods:Forty hundred and twenty-four consecutive T2DM patients who accepted CACS scan and coronary CT angiography (CCTA) from December 2012 to December 2019 were included retrospectively, with clinical risk factors and plaque features collected. Plaque composition was classified as calcified, non-calcified or mixed plaque. Obstructive CAD was defined as maximum diameter stenosis≥50%. CACS was calculated with a fully automated method based on DL. Univariate and multivariate logistic regressions were applied to select statistically significant factors and the odds ratios(ORs) were measured. Receiver operating characteristic (ROC) curve was evaluated to assess the predictive performance.Results:Increased CACS was associated with a significantly higher odds of obstructive CAD in CCTA (adjusted ORs were 2.22, 6.18 and 16.98 for CACS=1-99, 100-299, 300-999 vs. CACS=0, and P values were 0.009,<0.001,<0.001 respectively). The area under ROC curve (AUC) of CACS to predict obstructive CAD was 0.764. Compared with 0, increased CACS was associated with increased risk of non-calcified/mixed plaque (adjusted ORs were 2.75, 4.76, 5.29 for CACS=1-99, 100-299, 300-999 respectively and P values were 0.001,<0.001,<0.001 respectively). The AUC of CACS to predict non-calcified/mixed plaque was 0.688. It took 1.17 min to perform automated measurement of CACS based on DL in total, which was significantly less than manual measurement of 1.73 min ( P<0.001). Conclusion:DL-based CACS can predict obstructive CAD and non-calcified plaque/mixed plaque in T2DM, which is economical and efficient, and has important value for clinical diagnosis and treatment.
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Objective:To evaluate the role of silent information regulator-1 (SIRT1)/nucleotide-binding domain (NOD)-like receptor protein-3 (NLRP3) signaling pathway in sevoflurane postconditioning-induced attenuation of oxygen-glucose deprivation and restoration (OGD/R) injury in mouse hippocampal neuronal cell line (HT22) cells.Methods:The HT22 cells were seeded in a culture plate (96-well plate, 100 μl/well; 6-well plate, 2 ml/well) at the density of 5×10 4 cells/ml or in a culture dish (6 cm in diameter) and then divided into 4 groups ( n=24 each) using a random number table method: control group (Control group), OGD/R group, sevoflurane postconditioning group (SPC group), and SIRT1 small interfering RNA group (si-SIRT 1 group). In Control group, cells were cultured at 37 ℃ in normal culture atmosphere. In OGD/R group, the culture medium was replaced with glucose-free serum-free culture medium, and cells were exposed to 95% N 2+ 5% CO 2 for 4 h in an incubator at 37 ℃, and then the glucose-free serum-free culture medium was replaced with the primary culture medium, and cells were cultured for 24 h at 37 ℃ in normal culture atmosphere. In SPC group, the glucose-free serum-free culture medium was replaced with the primary cell culture medium after 4-h oxygen and glucose deprivation, the cells were put into the hypoxia incubator chamber which was filled with 2% sevoflurane immediately after start of reoxygenation, then the chamber was placed in an incubator and the cells were cultured for 1 h at 37 ℃ in normal culture atmosphere, and finally the cells were removed from the chamber and cultured for 23 h at 37 ℃ in normal culture atmosphere. In si-SIRT1 group, SIRT1 small interfering RNA 150 pmol was added at 24 h before surgery, cells were then incubated, and the other procedures were the same as those previously described in group SPC. The cell survival rate was determined using MTT assay. TUNEL assay was used to detect cell apoptosis, and the apoptosis rate was calculated. The expression of SIRT1, NLRP3, IL-1β and IL-18 mRNA was determined using polymerase chain reaction. The expression of SIRT1, NLRP3, interleukin-1beta (IL-1β) and IL-18 was detected using Western blot. Results:Compared with Control group, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of SIRT1 protein and mRNA was down-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was up-regulated in OGD/R group ( P<0.05). Compared with OGD/R group, the cell survival rate was significantly increased, the apoptosis rate was decreased, the expression of SIRT1 protein and mRNA was up-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was down-regulated in SPC group ( P<0.05). Compared with SPC group, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of SIRT1 protein and mRNA was down-regulated, and the expression of NLRP3, IL-1β and IL-18 protein and mRNA was up-regulated in si-SIRT1 group ( P<0.05). Conclusions:Activation of SIRT1-NLRP3 signaling pathway is involved in sevoflurane postconditioning-induced attenuation of OGD/R injury in HT22 cells.
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Objective:To investigate the difference in the peri-coronary fat attenuation index (FAI) between using coronary calcium score (CCS) images and coronary CT angiography (CCTA) images, and to explore the feasibility and befitting threshold of FAI measured on CCS images.Methods:The clinical and imaging data of patients who underwent CCTA examination from August 2019 to August 2020 were retrospectively analyzed in the First Affiliated Hospital of Soochow University. According to the inclusion and exclusion criteria, there were 122 cases in non-calcified plaque group (144 coronary arteries) and 97 cases in none-plaque group (186 coronary arteries). The coronary arteries were delineated both on CCS and CCTA images with Perivascular Fat Analysis Tool; the regions of interest of peri-coronary adipose tissue were generated automatically after setting the threshold of fat tissue. Then the FAI value was calculated. The thresholds were set in four levels (-190--30, -185--25, -180--20 and -175--15 HU) for CCS images and one level (-190--30 HU) for CCTA images. The intra-class correlation coefficient (ICC) was used to evaluate the consistency of the measurements of FAI values on CCS and CCTA images between the two physicians. Paired t test was used to compare the differences of FAI values between CCS and CCTA images, and Pearson correlation coefficient was used to evaluate the correlation between CCS-FAI and CCTA-FAI. Results:(1) FAI values measured on CCS and CCTA images by 2 physicians showed good consistency; (2) At the threshold of -185--25 HU, there was no significant difference in FAI values between the CCS and CCTA images for non-calcified plaque group [(-84.15±5.99)HU vs. (-83.83±5.98)HU, t=0.79, P=0.429], as well as for the none-plaque group [(-83.41±5.75)HU vs.(-83.84±6.25)HU, t=-1.08, P=0.280]; (3) There were significant differences on FAI values between the CCS images and CCTA images at the threshold of -190--30、-180--20 and -175--15 HU (all P<0.05); (4) There were moderate correlations on FAI values between the CCS images and CCTA images under different thresholds both in non-calcified plaque group and none-plaque group. Conclusion:It is feasible to measure FAI on CCS images, and the befitting threshold is -185--25 HU.
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Objective:To explore the value of different machine learning models based on Gd-EOB-DTPA enhanced MRI hepatobiliary phase radiomics features in preoperative prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Methods:The data of 132 patients with HCC confirmed by pathology in the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were retrospectively analyzed, including 72 cases of positive MVI and 60 cases of negative MVI. According to the proportion of 7∶3, the cases were randomly divided into training set and validation set. The radiomics features of hepatobiliary phase images for HCC were extracted by PyRadiomics software. The clinical and radiomics features of the training set were screened by the least absolute shrinkage and selection operator (LASSO) regression with 5 fold cross-validation, and then the optimal feature subset was obtained. Six machine learning algorithms, including decision tree, extreme gradient boosting, random forest, support vector machine (SVM), generalized linear model (GLM) and neural network, were used to build the prediction models, and the ROC curves were used to evaluate the prediction ability of the models. DeLong test was used to compare the differences of area under the curve (AUC) for 6 machine learning algorithms.Results:Totally 14 features selected by LASSO regression were obtained to form the optimal feature subset, including 2 clinical features (maximum tumor diameter and alpha-fetoprotein) and 12 radiomics features. The AUCs of decision tree, extreme gradient boosting, random forest, SVM, GLM and neural network based on the optimal feature subset were 0.969, 1.000, 1.000, 0.991, 0.966, 1.000 in the training set and 0.781, 0.890, 0.920, 0.806, 0.684, 0.703 in the validation set, respectively. There were significant differences in the AUCs between extreme gradient boosting and GLM or neural network ( Z=2.857, 3.220, P=0.004, 0.001). The differences in AUCs between random forest and SVM, GLM, or neural network were significant ( Z=2.371, 3.190, 3.967, P=0.018, 0.001,<0.001). The difference in AUCs between SVM and GLM was statistically significant ( Z=2.621 , P=0.009). There were no significant differences in the AUCs among the other machine learning models ( P>0.05). Conclusion:Machine learning models based on Gd-EOB-DTPA enhanced MRI hepatobiliary phase radiomics features can be used to preoperatively predict MVI of HCC, particularly the extreme gradient boosting and random forest models have high prediction efficiency.
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In this study, a high performance thin-layer chromatography/single quadrupole mass spectrometry QDa (HPTLC-QDa) method for robust authentication of Ganoderma lucidum, a popular and valuable herbal medicine, has been developed. This method is simple and practical, which allows direct generation of characteristic mass spectra from the HPTLC plates automatically with the application of in situ solvent desorption interface. The HPTLC silica gel plates were developed with toluene-ethyl formate-formic acid (5 : 5 : 0.2, V/V) and all bands were transferred to QDa system directly in situ using 80% methanol with 0.1% formic acid as desorption solvent. The acquired HPTLC-QDa spectra showed that luminous yellow band b3, containing ganoderic acid B/G/H and ganodeneric acid B, the major active components of Ganoderma, could be found only in G. lucidum and G. lucidum (Antler-shaped), but not in G. sinense and G. applanatum. Moreover, bands b13 and b14 with m/z 475/477 and m/z 475/491/495, respectively, could be detected in G. lucidum (Antler-shaped), but not in G. lucidum, thus allowing simple and robust authentication of G. lucidum with confused species. This method is proved to be simple, practical and reproducible, which can be extended to analyze other herbal medicines.
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Gentiana is an important but complicated group in Gentianaceae. The genus covers numerous medicinal plants which are difficult to be identified. In the present study, several medicinal species in Gentiana from Yunnan province, including G. rigescens, G.rhodantha, and G. delavayi, were sequenced using the Illumina HiSeq 2500 system. Three complete chloroplast genome sequences were obtained after assembly and annotation. According to several published genome sequences of G. crassicaulis, the DNA super-barcoding of species in Gentiana was preliminarily carried out. The results revealed that chloroplast genomes of the three species were conservative with short lengths(146 944, 148 992, and 148 796 bp, respectively). The genomes encoded 114 genes, including 78 protein-coding genes, 30 tRNA genes, 4 rRNA genes, and 2 pseudogenes. Furthermore, these medicinal species in Yunnan province were identified using DNA super-barcoding based on chloroplast genomes. The results showed that the Gentiana species could be gathered into monophyletic branches with a high support value(100%). It indicated that DNA super-barcoding possessed obvious advantages in discriminating species in complicated genera. This study is expected to provide a scientific basis for the identification, utilization, and conservation of Gentiana species.
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China , DNA , Genoma de Cloroplastos/genética , Gentiana/genética , FilogeniaRESUMO
OBJECTIVE@#To investigate the relationships between caspase-8 (CASP8), fatty acid synthetase (Fas) gene polymorphisms and prognosis of non-Hodgkin's lymphoma patients in Han nationality.@*METHODS@#The clinical data of 85 patients with non-Hodgkin's lymphoma were analyzed retrospectively. The polymorphisms of CASP8 and Fas gene were detected, and prognosis of the patients were analyzed. The polymorphisms of CASP8 and Fas gene in patients with different prognosis were compared, and the relationships between gene polymorphisms and the poor prognosis of the patients were investigated.@*RESULTS@#The incidence rate of poor prognosis of the patients enrolled in the study was 65.88%. The polymorphisms of CASP8 and Fas genes in the patients with poor or good prognosis were in accordance with Hardy Weinberg's law of genetic balance. The frequencies of GG genotype and G allele at rs 1035142 of CASP8 gene, GA genotype and A allele at rs 1377 of Fas gene in patients with poor prognosis were lower than those of the patients with good prognosis (P<0.05). The frequencies of GT, TT and T alleles at rs 1035142 of CASP8 gene, GG and G alleles at rs 1377 of Fas gene in patients with poor prognosis were higher than those of the patients with good prognosis (P<0.05). The proportions of Ann Arbor stage III-IV and high malignancy in patients with poor prognosis were higher than those of the patients with good prognosis (P<0.05). Logistic multiple regression analysis showed that Ann Arbor stage III-IV, moderate malignant, high malignancy, CASP8 rs 1035142 GT genotype, CASP8 rs 1035142 TT genotype and Fas rs 1377 GG genotype were all the risk factors for the poor prognosis of the patients (P<0.05).@*CONCLUSION@#The poor prognosis rate of non-Hodgkin's lymphoma patients in Han nationality is relatively high, and the risk factors for the prognosis of the patients include Ann Arbor stage III-IV, moderate and high malignancy, CASP8 rs 1035142 GT genotype, CASP8 rs 1035142 TT genotype and Fas rs 1377 GG genotype.
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Humanos , Caspase 8/genética , Etnicidade , Ácidos Graxos , Ligases , Linfoma não Hodgkin/genética , Polimorfismo Genético , Prognóstico , Estudos Retrospectivos , Receptor fasRESUMO
Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.
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Objective:To explore the value of spectral CT radiomics quantitative features on differentiating lung cancer nodule from inflammatory nodule.Methods:The spectral CT imaging data of 96 lung cancer nodules and 45 inflammatory nodules from the First Affiliated Hospital of Soochow University were analyzed retrospectively. According to a ratio of two to one, patients were randomly assigned to the training group and validation group, including 64 lung cancer nodules and 30 inflammatory nodules in the training group, 32 lung cancer nodules and 15 inflammatory nodules in the validation group. MaZda software was used for radiomic feature extraction from the 70 keV monochromatic images in arterial phase and venous phase for lung cancer nodules and inflammatory nodules in the training group. Fisher coefficients (Fisher), classification error probability combined average correlation coefficients (POE+ACC) and mutual information (MI) were used to select 10 optimal features for the optimal feature subsets. The optimal feature subsets were analyzed by using linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) to calculate the area under the receiver operating characteristic (ROC) curve (AUC), accuracy, sensitivity, specificity, precise and F1 score in differentiating lung cancer nodule from inflammatory nodule. The prediction model was established using the optimal feature subsets in the training group with artificial neural network (ANN). Then the established prediction model was used to differentiate lung cancer nodule from inflammatory nodule in the validation group. Delong test was used to compare the differences in the AUC of different optimal feature subsets.Results:In arterial phase, the optimal feature subset obtained from MI-NDA had the highest AUC of 0.888 [95% confidence interval (CI) 0.806-0.943], accuracy rate of 88.3%, sensitivity of 87.5% and specificity of 90.0%, on the differential diagnosis of lung cancer nodule and inflammatory nodule in the training group. There was no significant difference in AUC between MI-NDA and Fisher-NDA or (POE+ACC)-NDA method ( Z=1.941, P=0.052; Z=1.683, P=0.092). In venous phase, the optimal feature subset obtained from (POE+ACC)-NDA had the highest AUC of 0.846 (95%CI 0.757-0.912), accuracy rate of 87.2%, sensitivity of 92.2% and specificity of 76.7%, on the differential diagnosis of lung cancer nodule and inflammatory nodule in the training group. There was no significant difference in AUC between(POE+ACC)-NDA and MI-NDA method ( Z=1.354, P=0.18), but significant difference between (POE+ACC)-NDA and Fisher-NDA method ( Z=2.423, P=0.015). In the validation group and training group, the optimal feature subset selected by MI-NDA method had the highest AUC of 0.888(95%CI 0.806-0.943) and 0.871(95%CI 0.741-0.951). Conclusion:Spectral CT radiomics quantitative features have great value on the differential diagnosis of lung cancer nodule and inflammatory nodule.
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Objective:To explore the value of gadolinium-ethoxybenzyl- diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI nomogram model for preoperative prediction of Ki-67 expression in hepatocellular carcinoma (HCC).Methods:Data of 85 patients of HCC confirmed by postoperative pathology, who underwent preoperative Gd-EOB-DTPA enhanced MRI between September 2016 and August 2019 in the First Affiliated Hospital of Soochow University were retrospectively evaluated. According to postoperative immunohistochemistry Ki-67 index, the 85 patients were divided into Ki-67 low expression group(Ki-67 index ≤10%, n=20) and Ki-67 high expression group (Ki-67 index >10%, n=65). Clinical data (hepatitis, cirrhosis, etc.), qualitative imaging parameters (tumor margin, capsule, etc.) were compared by χ 2 test and quantitative parameters [lesion-to-normal parenchyma ratio-arterial phase (LNR-AP), lesion-to-normal parenchyma ratio-portal phase (LNR-PP), lesion-to-normal parenchyma ratio-equilibrium phase (LNR-EP) and lesion-to-normal parenchyma ratio-hepatobiliary phase (LNR-HBP)] were compared by independent sample t test. The above statistically significant parameters were included in multivariate logistic regression to identify the independent predictors of Ki-67 high expression and then the nomogram model for predicting Ki-67 expression of HCC was established. Results:alpha-fetoprotein (AFP) tumor margin, arterial rim enhancement between the Ki-67 low expression group and the Ki-67 high expression group had significant differences (χ 2 were 8.196, 10.538 and 4.717, respectively, P<0.05). LNR-AP, LNR-PP, LNR-EP and LNR-HBP between the two groups had significant differences ( t were 2.929, 2.773, 2.890 and 3.437, respectively, P<0.05).The result of multivariate logistic regression revealed that AFP≥20 μg/L, non-smooth tumor margin and low LNR-HBP were the independent predictors of Ki-67 high expression (odds ratio were 4.090, 3.509 and 0.042, respectively, P<0.05).The Gd-EOB-DTPA enhanced MRI nomogram model for predicting Ki-67 expression of HCC was established successfully. The Area under the receiver operating characteristic curve of the nomogram was 0.837 and the corrected predictive curve fitted the ideal curve, which suggested the model had a good predictive efficiency. Conclusion:Gd-EOB-DTPA enhanced MRI nomogram model has great value in preoperative prediction of Ki-67 expression of HCC, which provided a personalized prediction method for Ki-67 expression in patient with HCC.
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Objective To analyze the imaging features of several rare primary renal tumors.Methods The CT and MR images of 1 3 cases with pathologically proved rare primary renal tumors were analyzed retrospectively.The imaging features including location, number,size,shape,margin,density or intensity,internal structures and pattern of enhancement were observed.Results Of the 13 cases,4 were primary renal lymphoma (PRL),which performed as renal hilar mass involving the renal parenchyma in 3 cases and multiple nodules at bilateral kidney in 1 case.3 were hemanyiopericytoma (HA),which located in the renal parenchyma in 1 case and protruded from renal surface in 2 cases.All the HA showed obvious enhancement,with small vessels within the tumor in 2 cases.Two cases of inflammatory myofibroblastic tumor (IMT)were mainly located in renal sinus,among which the renal parenchyma was involved in 1 case. One case with adult Wilms tumor showed mixed heterogeneous signal intensity in both T1-and T2-weighted images,indicating intratumoral hemorrhage.One case of neuroendocrine tumor was located in the renal parenchyma with ipsilateral adrenal and regional lymph node metastasis. One case of metanephric adenoma (MA)demonstrated as renal parenchymal mass with slightly enhancement.One case of meoblastic nephroma (MN)showed as a heterogeneous mass with continuous enhancement.Conclusion The imaging features of rare primary renal tumors are characteristical.It is important to analyze the imaging characteristics carefully in order to improve the diagnostic accuracy.
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Objective To explore the application value of spectral CT quantitative analysis in differentiating adenocarcinoma or squamous carcinoma from inflammatory myofibroblastic tumor (IMT). Methods A total of 115 patients with 62 adenocarcinomas, 33 squamous carcinomas and 20 IMTs underwent spectral CT scans to obtain spectral images at arterial phase (AP) and venous phase (VP). The imaging data were analyzed retrospectively. The iodine concentration of adenocarcinoma, squamous carcinomas and IMT were measured. The normalized iodine concentration in AP (NICAP), normalized iodine concentration in VP (NICVP) and normalized iodine concentration difference between AP and VP (ICD) were calculated. The above quantitative parameters among three groups were analyzed with analysis of variance and ROC curve. Results NICAP (0.15 ± 0.04), NICVP (0.37 ± 0.08) and ICD(0.23 ± 0.06)of the adenocarcinoma were lower than those of IMT (0.21 ± 0.05,0.50 ± 0.06,0.28 ± 0.08). There were significant differences in NICAP, NICVP and ICD between adenocarcinoma and IMT (P<0.05). NICAP (0.13 ± 0.03), NICVP (0.35±0.06) and ICD (0.22±0.05) of the squamous carcinoma were lower than those of IMT (0.21± 0.05,0.50±0.06,0.28±0.08). The differences in NICAP, NICVP and ICD were significant between squamous carcinoma and IMT (P<0.05). There were no significant differences in NICAP, NICVP and ICD between adenocarcinoma and squamous carcinoma (P>0.05). The best spectral quantitative parameter for differentiating the adenocarcinoma from IMT was NICVP, which yielded a sensitivity of 92.3% and a specificity of 86.7%with the threshold of 0.425. NICVP was also the best spectral quantitative parameter for differentiating squamous carcinomas from IMT. With the threshold of 0.44, a sensitivity of 84.6% and a specificity of 92.3% were found. Conclusion Spectral CT imaging with the quantitative iodine concentration analysis may help to increase the accuracy of differentiating adenocarcinoma and squamous carcinoma from IMT.
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Objective To explore the application value of spectral CT quantitative analysis in differentiating adenocarcinoma or squamous carcinoma from inflammatory myofibroblastic tumor (IMT). Methods A total of 115 patients with 62 adenocarcinomas, 33 squamous carcinomas and 20 IMTs underwent spectral CT scans to obtain spectral images at arterial phase (AP) and venous phase (VP). The imaging data were analyzed retrospectively. The iodine concentration of adenocarcinoma, squamous carcinomas and IMT were measured. The normalized iodine concentration in AP (NICAP), normalized iodine concentration in VP (NICVP) and normalized iodine concentration difference between AP and VP (ICD) were calculated. The above quantitative parameters among three groups were analyzed with analysis of variance and ROC curve. Results NICAP (0.15 ± 0.04), NICVP (0.37 ± 0.08) and ICD(0.23 ± 0.06)of the adenocarcinoma were lower than those of IMT (0.21 ± 0.05,0.50 ± 0.06,0.28 ± 0.08). There were significant differences in NICAP, NICVP and ICD between adenocarcinoma and IMT (P<0.05). NICAP (0.13 ± 0.03), NICVP (0.35±0.06) and ICD (0.22±0.05) of the squamous carcinoma were lower than those of IMT (0.21± 0.05,0.50±0.06,0.28±0.08). The differences in NICAP, NICVP and ICD were significant between squamous carcinoma and IMT (P<0.05). There were no significant differences in NICAP, NICVP and ICD between adenocarcinoma and squamous carcinoma (P>0.05). The best spectral quantitative parameter for differentiating the adenocarcinoma from IMT was NICVP, which yielded a sensitivity of 92.3% and a specificity of 86.7%with the threshold of 0.425. NICVP was also the best spectral quantitative parameter for differentiating squamous carcinomas from IMT. With the threshold of 0.44, a sensitivity of 84.6% and a specificity of 92.3% were found. Conclusion Spectral CT imaging with the quantitative iodine concentration analysis may help to increase the accuracy of differentiating adenocarcinoma and squamous carcinoma from IMT.
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Purpose To analyze the correlation of right subclavian artery ultrasound and individual blood lipid level with coronary atherosclerosis (CA) using carotid ultrasound as control so as to explore the clinical value of them in predicting CA.Materials and Methods Coronary CT angiography (CCTA) and right subclavian artery/neck vessel ultrasound in 55 patients were retrospectively analyzed.Gensini score was used to calculate the degree of coronary artery lesions.According to the result of CCTA,patients were divided into normal group,mild coronary atherosclerosis group,severe coronary artery stenosis group.The intina-media thickness (IMT) at the origin of right subclavian artery and carotid artery bifurcation on ultrasound was measured to evaluate carotid lesions.The correlation between the IMT and Gensini score of coronary artery was analyzed.The blood lipid levels of the 3 groups were analyzed,and the efficacy of right subclavian artery,carotid artery ultrasound and blood lipid in predicting CA was evaluated.Results ① The IMT at right subclavian artery and carotid artery bifurcation were positively correlated with Gensini score,and the former had higher correlation than the latter (r=0.636,r=0.462,P＜0.01);the prediction efficacy of the IMT at right subclavian artery was slightly higher than that at carotid artery bifurcation (with sensitivity and specificity of 78.3％,64.5％,and 77.5％,60.0％ respectively).② Compared with normal control group,the levels of low-density lipoprotein cholesterol,triglycerides,total cholesterol were higher,but the level of highdensity lipoprotein cholesterol (HDL-C) was lower in mild coronary atherosclerosis and severe coronary artery stenosis group,and the difference between the severe coronary artery stenosis group and normal groups was bigger,among which the level of triglycerides had the largest difference among the three groups with no statistical significance (P＞0.05).The HDL-C had a more significant correlation with Gensini score than other index of blood lipid (r=-0.151).③ The combination of IMT and HDL-C had a sensitivity of 81.0％ and specificity of 66.7％ in predicting CA,which were higher than that of each individual index (with sensitivity of 78.3％,64.5％ and specificity of 64.3％,55.5％respectively).Conclusion The IMT at right subclavian artery has a better predictive value in determining the degree of coronary artery lesions than that at carotid artery bifurcation.The combined application of blood lipid levels and the IMT at right subclavian artery can improve the sensitivity and specificity of predicting CA.