Development and validation of a CT-based radiomics model for differentiating pneumonia-like primary pulmonary lymphoma from infectious pneumonia: A multicenter study / 中华医学杂志(英文版)

BACKGROUND@#Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.@*METHODS@#In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared.@*RESULTS@#A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05).@*CONCLUSIONS@#The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.

Impact of calcification on the diagnostic accuracy of quantitative flow fraction based on coronary CT angiography / 中华放射学杂志

Objective:To investigate the effect of calcification on the diagnostic accuracy of the quantitative flow fraction (CT-QFR) derived from coronary CT angiography (CCTA).Methods:A total of 244 patients (471 coronary arteries) who underwent both CCTA and invasive coronary angiography (ICA) for suspected coronary artery disease between 2019 and 2021 were included in the study. All analyses were conducted at the vessel level using CCTA and ICA images, and the morphological and hemodynamic parameters of all enrolled vessels were assessed. The group was divided into severe calcification (206 cases) and non-severe calcification (265 cases) based on whether the arc of lesion calcification was greater than 180°. Subsequently, the two groups were evaluated to the degree of coronary stenosis, the length of the target lesion, the length of calcification, the ratio of the length of calcification, the remodeling index of calcification, the quantitative flow fraction (QFR), the CT-QFR, and the distribution of the involved vessels. Pearson correlation analysis and the Bland-Altman scatterplot were used to analyze the correlation and consistency between CT-QFR and QFR values from different subgroups. The benchmark for coronary ischemia was QFR≤0.80, and the criteria for diagnosing coronary ischemia were CT-QFR≤0.80 and luminal stenosis≥50%, respectively, and the effectiveness of CT-QFR for coronary ischemia was evaluated by plotting the ROC curves in various calcification subgroups.Results:The degree of luminal stenosis, lesion length, calcification length ratio, and calcification remodeling index were substantially higher in the severely calcified group than in the non-severely calcified group (all P<0.05). The results of the Pearson correlation analysis demonstrated a significant association between CT-QFR and QFR in both the severe and non-severe calcification groups ( r=0.85, 95%CI 0.81-0.88, P<0.001; r=0.91, 95%CI 0.89-0.93, P<0.001); in contrast, the Bland-Altman analysis indicated that the CT-QFR and QFR measurements in the severely calcified group exhibited a high level of agreement, with a mean difference of -0.01 (95% limits of agreement -0.22 to 0.20) for measurements in the severely calcified group and 0 (95% limits of agreement -0.15 to 0.16). The specificity, positive predictive value, negative predictive value, and area under the curve (AUC) for the diagnosis of ischaemic lesions by CT-QFR and CCTA alone were lower in the severely calcified group than in the non-severely calcified group, but the difference in AUC between the two groups for CT-QFR was not statistically significant ( P>0.05), and the difference in AUC for the morphological assessment of CCTA was statistically significant. The diagnostic effectiveness of CCTA alone was considerably worse than the specificity and AUC of CT-QFR for the various calcified subgroups for the diagnosis of ischemic lesions (all P<0.001). Conclusions:Severe calcification somewhat affected the diagnosis of ischaemic lesions by CT-QFR, but there was still a high correlation and concordance between CT-QFR and QFR within the severely calcified group, and the diagnostic efficacy was significantly better than that assessed by CCTA morphology alone.

The value of CT features in predicting the invasion and invasive degree of lung pure ground-glass nodules based on the new classification of lung tumor in 2021 / 中华放射学杂志

Objective:To investigate the value of CT features in predicting the invasion and degree of invasiveness of lung pure ground-glass nodules (pGGN) in the new histological classification in 2021.Methods:A total of 281 patients (304 lesions) with pGGN confirmed by surgical pathology from December 2018 to January 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University were retrospectively analyzed. According to the pathological types, the patients were divided into prodromal lesion group [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS), 129 cases], minimally invasive group [minimally invasive adenocarcinoma (MIA), 116 cases] and invasive group [invasive adenocarcinoma (IAC), 59 cases]. Clinical data (age, gender, smoking history, family history of cancer), and CT parameters [shape, boundary, lobulation, burr, vacuolar sign, bronchial abnormality sign, internal vessel sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT values in venous phase, the degree of enhancement (ΔCT A-N, ΔCT V-N)] were recorded and measured. The ANOVA, Kruskal-Wallis H and χ 2 test were used to compare the differences among the three groups. Binary logistic regression analysis was used to evaluate the independent risk factors of nodular invasion [prodromal lesion and invasive lesion (MIA and IAC)] and the degree of nodular invasion (MIA and IAC), and receiver operating characteristic (ROC) curve analysis was performed for each parameter. Results:There were statistically significant differences in age, pGGN morphology, lobulation, vacuolar sign, bronchial abnormality sign, internal vascular sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT value in venous phase among the precursor lesion group, minimally invasive group and invasive group ( P<0.05). Binary logistic regression analysis showed that vacuole sign (OR=2.832, 95%CI 1.363-5.887, P=0.005), internal vascular sign (OR=3.021, 95%CI 1.909-4.779, P<0.001) and unenhanced CT value (OR=1.003, 95%CI 1.001-1.006, P=0.019) were independent risk factors for invasion. Lobulation (OR=5.739, 95%CI 2.735-12.042, P<0.001), internal vascular sign (OR=1.968, 95%CI 1.128-3.433, P=0.017) and unenhanced CT value (OR=1.004, 95%CI 1.001-1.008, P=0.012) were independent risk factors for the degree of invasiveness. ROC curve analysis showed that the efficiency of internal vascular sign was the highest in distinguishing precursor lesion and the invasive, the area under the curve (AUC) was 0.757, the sensitivity was 50.3%, the specificity was 89.8%. The efficiency of lobulation was the highest in distinguishing MIA and IAC (AUC=0.702), with a sensitivity of 61.0% and specificity of 79.3%. Conclusions:CT features are of certain value in predicting the invasion and degree of invasiveness of lung pGGN in the new histological classification in 2021, and internal vascular sign is more effective in predicting the invasion of lung pGGN. Lobulation can predict the degree of invasiveness of pGGN better.

Parapapillary atrophy, choroidal vascularity index and their correlation in different degrees of myopia / 中华眼底病杂志

Objective:To observe the peripapillary atrophy (PPA) and peripapillary choroidal vascularity index (CVI) in patients with different degrees of myopia and to analyze their correlations.Methods:A cross-sectional clinical study. From September 2021 to December 2021, 281 mypoic patients of 281 eyes treated in Eye Hospital of Wenzhou Medical University at Hangzhou were included in this study, and the right eye was used as the treated eye. There were 135 eyes in 135 males and 146 eyes in 146 females. The age was 28.18±5.78 years. The spherical equivalent refraction (SE) was -5.13±2.33 D. The patients were divided into three groups: low myopia group (group A, -3.00 D <SE≤-0.50 D), moderate myopia group (group B, -6.00 D≤SE≤-3.00 D);high myopia group (group C, SE<-6.00 D). The spherical equivalent refraction was statistically different among the three groups ( H=241.353, P<0.05). All of the affected eyes were examined by swept-source optical coherence tomography. Combined with B-scan image,assessment and area measurement of β area, γ area (β-PPA and γ-PPA) were carried out on the en-face image. After binarization of the collected images, the nasal, superior, temporal and inferior CVI of the optic disc were calculated. For comparison between groups, one-way ANOVA was used for continuous variables with normal distribution, Kruskal-Wallis test was used for continuous variables with abnormal distribution, and categorical variables were used χ2 inspection. Linear regression analysis was used for the relationship between β-PPA and γ-PPA area and peripapillary CVI of different regions. Linear regression analysis was used to evaluate the relationships between the area of peripapillary atrophy and peripapillary choroidal vascularity index in different regions. Results:There was no statistical difference in the incidence of β-PPA among the three groups ( χ2=4.672, P=0.097). The incidence of γ-PPA in group A was lower than that in group B anc C, and the difference was statistically different ( χ2=33.053, P<0.001), in which both group A was lower than group B and C. Among the three groups, the area of β-PPA and γ-PPA was statistically significant ( H=36.535, 39.503; P<0.001, 0.001); the β-PPA area of group A and B was lower than that of group C; the γ-PPA area was group A <group B <group C. Peripapillary CVI of different regions in group A, group B and group C was statistically significant ( F=11.450, 5.037, 6.018, 4.489; P<0.05). The temporal CVI in group C was lower than that in group A and B; The inferior CVI of group C was lower than that of group A, and the superior and nasal CVI of group B and C were lower than that of group A. In multivariate analysis, SE ( β=0.374, P<0.001), temporal CVI ( β=-0.299, P<0.001) were correlated with the area of β-PPA (adjusted R2=296, P<0.001); AL ( β=0.452, P<0.001), temporal CVI ( β=-0.220, P<0.001) were correlated with the area of γ-PPA (adjusted R2=0.309, P<0.001). Conclusions:The incidence and area of γ-PPA are increased in the higher degree of myopia group. The area of γ-PPA is positively correlated with the axial length, and both the area of β-PPA and γ-PPA are negatively correlated with temporal CVI.

Correlation study of triglyceride-glucose index and plaque burden and characteristics of vulnerable plaque based on coronary CT angiography plaque quantitative analysis / 中华放射学杂志

Objective:To explore the relationship between triglyceride-glucose (TyG) index with plaque components, plaque burden and characteristics of vulnerable plaque using coronary plaque analysis based on coronary artery computed tomography (CCTA).Methods:A total of 498 patients(male 296, female 202), the age ranged from 33 to 87 (63±9) years who underwent CCTA from January 2020 to September in Shandong Provincial Hospital Affiliated to Shandong First Medical University were included. The enrolled patients were divided into three groups according to the tertiles of TyG index: T 1 group (the lowest one-third), T 2 group (middle one-third) and T 3 group (the highest one-third). The plaque burden, volume and ratio of calcified, lipid and fibrous components of plaques as well as the incidence of vulnerable plaques were measured based on CCTA images. Chi-square test, ANOVA and Kruskal-Wallis test were used to compare whether the differences of indexes among the three groups were statistically significant. Multiple stepwise regression was used to analyze the influencing factors of coronary atherosclerotic plaque burden and multiple logistic regression was used to analyze the risk factors of CT high-risk plaque. Finally, ROC curve was used to evaluate the value of TyG index in the diagnosis of CT high-risk plaque, and the best diagnostic threshold of TyG index was determined. Results:The plaque burden, non-calcified plaque volume and ratio had positive relationship with TyG index ( P<0.001).TyG index was significantly correlated with plaque burden according to multiple stepwise regression analysis (regression coefficient 7.267, P<0.001). The results of CT vulnerable characteristics of plaques showed that positive remodeling, low-attenuation plaque sign and the incidence of vulnerable plaque increased with TyG index ( P<0.05). Multivariate Logistic regression analysis showed that TyG index was an independent risk factor for CT vulnerable plaque(OR=2.324,95 %CI 1.533-3.523, P<0.001). The cut-off value of TyG index that can predict vulnerable plaque was 8.43(sensitivity 77.24%, specificity 45.60%, AUC 0.645, P<0.001). Conclusions:With the increase of TyG index, the burden of coronary atherosclerosis plaque and the incidence of CT vulnerable plaque increased. TyG index is expected to be a simple and effective predictor of cardiovascular disease and adverse cardiovascular events.

Correlation study of coronary plaque quantitative analysis and myocardial ischemic injury based on coronary CT angiography / 中华放射学杂志

Objective:To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease.Methods:Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury ( n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined. Results:For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant ( Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm 3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm 3, LPV 32.18 (18.93,54.55) mm 3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm 3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm 3, 16.64 (13.26, 24.73) mm 3, 18.44%±7.09% respectively with statistically significant ( Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR =1.55, P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant ( P<0.05). Conclusions:In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury.

Clinical application of dual-source CT in coronary angiography with contrast medium injection based on automatic tube voltage technique / 中华放射学杂志

Objective:To explore the clinical value of auto-tube voltage controlled contrast medium injection based on 3rd generation dual source CT coronary angiography.Methods:Patients with suspected coronary heart disease were prospectively enrolled from March to December, 2019 at Shandong Provincial Hospital and coronary CT angiography (CCTA) images were acquired from 220 patients, including 107 male, 113 female, aged from 34 to 82 years. Patients were divided into experimental and control groups with the random number table. In experimental group (113 patients), automatic tube voltage selection technology was used, the contrast agent dosage was set according to tube voltage. The injection time was 10 s; In control group (107 patients), tube voltage and contrast agent dosage were set according to weights. The injection time was 12 s. Images were acquired by ECG gating using the 3rd generation dual source CT (DSCT) with intravenous injection of 350 mg/L contrast medium, followed up with saline of the same dose. Interclass correlation coefficient (ICC) was used to evaluate the individual bias of raters. The rank sum test was used to evaluate the group-level differences of subjective image quality and contrast agent dosage. The t-test was used to evaluate the group-level differences of objective image quality and effective radiation dose (ED). Results:The noise of aortic root in the two groups were (27±4), (26±5) HU, respectively, with no statistical difference ( t=1.017, P=0.284). All ICC values were more than 0.5 indicating good correlation batween 2 raters. The objective image quality score was no significant differences( P>0.05). The subjective image quality scores of the two groups were 1.15±0.10 and 1.18±0.12, respectively, with no statistical difference (Z=-0.231, P=0.818). The ED value (2.2±0.6) mSv of experimental group was statistically lower than that of control group (4.6±1.8) mSv ( t=-13.107, P<0.001); the contrast dosage (35±7) ml of experimental group was statistically lower than that of control group（46±6）ml ( t=-8.699, P<0.001). Conclusions:The novel scanning protocol with auto-tube voltage based contrast agent setting is more convenient and practical with reduced radiation dose and contrast dose, while maintaining image quality.

Correlation study of coronary plaque quantitative analysis and myocardial ischemic injury based on coronary CT angiography / 中华放射学杂志

Objective@#To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease.@*Methods@#Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury (n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined.@*Results@#For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant (Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm3, LPV 32.18 (18.93,54.55) mm3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm3, 16.64 (13.26, 24.73) mm3, 18.44%±7.09% respectively with statistically significant (Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR=1.55,P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant (P<0.05).@*Conclusions@#In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury.

Diagnostic value of GATA3, MGB and GCDFP-15 in breast cancer / 中华内分泌外科杂志

Objective:To investigate the diagnostic value of GATA binding protein 3 (GATA3) , mammaglobin (MGB) and gross cystic disease fluid protein-15 (GCDFP-15) in breast cancer.Methods:Immunohistochemistry was performed to detect the expression of GATA3, MGB, GCDFP-15, estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor 2 (HER2) and Ki-67 in breast cancer. The breast cancer was divided into primary/metastatic breast cancer, hormone receptor positive/negative, or different molecular types of breast cancer according to the tissue origin and immunophenotype. The positive rates of GATA3, MGB and GCDFP-15 were statistically analyzed.Results:The positive rate of GATA3 in primary/metastatic breast cancer (92.5%; 94.25%) was significantly higher than that of MGB (42.11%; 29.17%) and GCDFP-15 (55.77%; 31.34%) ( P<0.01) , and GATA3 had better sensitivity for evaluating the tumor of unknown origin, especially in malignant hydrops. In addition, the positive rate of MGB and GCDFP-15 in hormone receptor negative and triple negative breast cancer was low, which further increased the difficulty of diagnosis of these two kinds of metastatic breast cancer. However, the positive rate of GATA3 in hormone receptor negative (90.38%) or triple negative breast cancer (85.29%) was significantly higher than that of MGB (20.00%; 5.00%) and GCDFP-15 (35.09%; 33.33%) ( P<0.01) , suggesting that it had great potential diagnostic value in hormone receptor negative and triple negative metastatic breast cancer and was a specific marker superior to MGB and GCDFP-15. Conclusion:GATA3 has a higher diagnostic value than MGB and GCDFP-15 for the assessment of tumors of unknown origin, especially in malignant hydrops, or breast cancer with an immunophenotype of hormone receptor negative and triple negative breast cancer.

Different region genotyping of 15 Yersinia pestis in Inner Mongolia / 中华地方病学杂志

Objective:To study the different region (DFR) genotyping of 15 strains of Yersinia pestis from Inner Mongolia. Methods:Fifteen strains of Yersinia pestis isolated from Otog Banner and Darhan Muminggan Joint Banner in Meriones unguiculatus plague foci in Inner Mongolia Plateau, Zhengxiangbai Banner in Spermophilus dauricus plague foci in the Songliao Plain in 2019 were amplified by PCR, and identified DFR genotyping. Results:Two strains of Yersinia pestis in Otog Banner jointly deleted DFR loci 1, 6, 7, 13, 15, 16, 17, 18, 23, and 13 strains of Yersinia pestis in Darhan Muminggan Joint Banner and Zhengxiangbai Banner jointly deleted DFR loci 1, 6, 7, 12, 13, 15, 16, 17, 18 and 23. G17 and G20 were classified as genotyping by comparison with DFR locus distribution and genotyping results. Conclusion:The genotyping of Yersinia pestis in the natural foci of Meriones unguiculatus plague foci in Inner Mongolia Plateau and Spermophilus dauricus plague foci in the Songliao Plain is the same as that of the historical strain.

Niacin accelerates LDL-C uptake in HepG2 cells via downregulation of PCSK9 / 中国药理学通报

Aim To explore the effects of niacin on LDL-C uptake and metabolism in HepG2 cells,and to clarify the functions of niacin in lipid-lowering and slo-wing the atherosclerosis process,thus to provide a sci-entific basis for niacin as a lipid-lowering drug in clini-cal development.Methods Oil red O staining was used to observe HepG2 cells after lipid uptake.Enzy-matic method was used to determine the content of in-tracellular free cholesterol (FC)and total cholesterol (TC).The LDLR levels on the surface of cell mem-brane were detected by immunofluorescence flow cy-tometer.The mRNA and protein expressions of LDLR, SREBP2 and PCSK9 were analyzed by qPCR and Western blot.Results The results of oil red O staining showed that the rate of oil red O-positive cells and the number of red lipid droplets were significantly in-creased in niacin group than control group.Niacin sig-nificantly increased the levels of TC and FC in HepG2 cells(P <0.05 ).What’s more,niacin significantly upregulated the expression of LDLR and significantly downregulated the protein expression of PCSK9,while it had no effect on the expression of SREBP2.Conclu-sion Niacin accelerates LDL-C uptake probably via downregulating the expression of PCSK9 and reducing the degradation of LDLR protein in HepG2 cells.

Analysis of early dental implant failure and retreatment of 6 cases / 实用口腔医学杂志

Objective:To analyse the causes of early implantation failure and the therapeutic measures with re-implantation after the failures.Methods:6 cases of implantation failure including early infections,loosening and non-osteointegration were reviewed and trea-ted by re-implantation therapy,and the causes of failure were discussed and the effects of re-treatment were evaluated.Results:2 cases were found to be with infection of adjacent teeth after implantation and were treated by removal of the implant,socket curettage,root ca-nal therapy(RCT)and antibiotics followed by reimplantation.Implant loosening and non-osteointegration were observed in 4 cases, which were treated by the similar methods for the implant socket.Reimplantation was successful in all 6 cases followed-up for 1 -3 years.Conclusion:Preventive measure for implantation failure should include indication selection,control of infections in adjacent teeth and periodontosis,use of GBR technic and so on.Re-implantation following proper treatment of adjacent teeth and the socket of implant is effective for the treatment of implantation failure.

Relation ship between the changes of platelet parameters and intracranial hemorrhage in premature children with low birth weight / 中国基层医药

Objective To investigate the relation ship between the changes of platelet parameters and intracranial hemorrhage in premature children with low birth weight. Methods 73 premature children with low birth weight were selected as research subjects and divided into PIVH group (35 cases) and non PIVH group (38 cases) according to intracranial hemorrhage or not,and 20 normal newborns were selected as controls. The neonatal platelet parameters of three groups were detected and compared. Results There were 35 cases of 73 premature children with low birth weight occurred intracranial hemorrhage, the incidence rate was 47. 9%. The gestational age and birth weight of PTVH group were (29.3 ± 1.2) weeks and (1 653.0 ± 182. 1) g and which were significantly lower than the non PIVH group( all P ＜0.05) ; the asphyxia rate of PIVH group was 60.0% and which was significantly higher than the non PIVH group(P＜0.05). The PLT and PCT of PIVH group were (187.52 ±52.03) × 109/L and (0.127 ± 0.05) % and which were significantly lower than the control group (all P ＜ 0. 05) ; The PLT and PCT of non PIVH group were(223.48 ±42.15) × 109/L and (0. 189 ±0. 06)% and which were significantly lower than the control group(all P＜0. 05) ; The PLT and PCT of PIVH group were significantly lower than the non PIVH group(all P ＜ 0.05) ; while the MPV and PDW among the three groups had no significant difference ( all P ＞ 0. 05 ). Conclusion The abnormal decrease of PLT and PCT should be involved in the pathogenesis of intracranial hemorrhage in premature children with low birth weight, clinical attention should be paid to the monitoring of platelet parameters in premature children so as to alert and minimize its incidence.

To explore the methods of clinical skill training and assessment for students of clinical medicine in psychophylaxis speciality / 中华医学教育探索杂志

According to teaching outline and clinical training characteristic of psychophy-laxis speciality(including Psychiatry and Medicopsychology),we explored how to strengthen the clinical thinking ability and clinical skill training for clinical medicine students based on cultiva-tion of elementary knowledge and theory,and we also established a set of more appropriate item system of clinical skills assessment so as to improve the practice quality in psychiatry and medical psychology departments.

The Development of Healthy Personality Scale for Undergraduates / 中国临床心理学杂志

Objective: To develop a healthy personality scale for undergraduates.Methods: A healthy personality scale was developed based on interviews,open questionnaires and theory hypothesis.The test-retest reliability,split-half reliability,internal consistency reliability,construct validity were examined.Results: Exploratory principle factor analysis of the items indicated that the scale had three factors: self consistency and congruence,self-social harmony,practical ability,which explained 54.8% of the total variance.The Cronbach's ? coefficient ranged from 0.82 to 0.94,split-half reliability ranged from 0.70 to 0.85,and retest reliability ranged from 0.73 to 0.84.In the confirmatory factor analysis of the three factor model,fit statistics(RMSEA=0.07,NFI=0.95,NNFI=0.96,CFI=0.94,GFI=0.95) for the model best explained the observed relationship.The three dimensions and the total scale had significant positive correlations with self-esteem and subjective well-being and significant negative correlations with SCL-90.Conclusion: The results suggest the healthy personality scale with eligible psychometric quality,can be applicable to Chinese undergraduates.