Application of diffusion tensor imaging for detecting structural changes in the brain of schizophrenic patients.

OBJECTIVE: Schizophrenia is a severe psychiatric illness. Although magnetic resonance imaging has been widely used for detecting brain structural and functional abnormalities in patients with schizophrenia, the findings are highly inconsistent between reports. This study investigates structural changes in the brains of schizophrenic patients. METHODS: The brains of fifty male adults with schizophrenia and fifty age- and gender-matched healthy controls were scanned by diffusion tensor imaging. The differences in fractional anisotropy (FA) values between schizophrenic patients and healthy controls were analyzed. RESULTS: Schizophrenic patients exhibited significantly decreased FA values in the right middle frontal gyrus, right inferior frontal gyrus, right superior temporal gyrus, left sub-temporal gyrus, left middle temporal gyrus, left cingulate gyrus, and left precentral gyrus compared with the control group. We did not find any brain regions with higher FA values in the patient group than in the control group. CONCLUSION: This study suggested that structural abnormalities in the frontal region of gray matter and white matter are present at the same time in patients with schizophrenia.

Exosome-derived miR-23a-5p inhibits HCC proliferation and angiogenesis by regulating PRDX2 expression: MiR-23a-5p/PRDX2 axis in HCC progression.

microRNAs (miRNAs) are closely related to the progression of hepatocellular carcinoma (HCC). Cancer-derived exosomes play an essential role in the establishment of the HCC microenvironment. However, the possible effects and underlying mechanisms of exosome (exo) microRNA-23a-5p (miR-23a-5p) in the progression of HCC remain unknown. In this study, we aimed to determine the role and specific molecular mechanism of exo miR-23a-5p in regulating HCC progression and to investigate whether exo miR-23a-5p levels can serve as an indicator of the prognosis of transarterial chemoembolization in patients with HCC. Our findings illustrated that miR-23a-5p was downregulated in exosomes separated from the serum of HCC patients and that miR-23a-5p carried by exosomes inhibited HCC cell proliferation and angiogenesis. Mechanistically, miR-23a-5p negatively targeted peroxiredoxin-2 (PRDX2). Functionally, PRDX2 overexpression relieved exosome-induced inhibition of HCC cell proliferation and angiogenesis by promoting vascular endothelial growth factor (VEGF) expression. In conclusion, Exo miR-23a-5p inhibited HCC proliferation and angiogenesis by regulating PRDX2 expression. Our results revealed the role and specific molecular mechanism of exo miR-23a-5p in regulating HCC progression.

Postoperative rehabilitation and quality of life evaluation for transoral endoscopic thyroidectomy vestibular approach.

There are no targeted rehabilitation training modalities and assessment tools for patients after transoral endoscopic thyroidectomy vestibular approach (TOETVA). Herein, we develop a new assessment questionnaire and rehabilitation training modality and evaluate its safety and effectiveness. The THYCA-QoL-TOETVA questionnaire was compiled, and reliability and validity analyses were performed. Patients were divided into the new rehabilitation training group (N) or the conventional rehabilitation training group (C), and 1:1 propensity score matching (PSM) was performed after administering questionnaires to patients in both groups. Cervical range of motion (CROM) data were also measured and collected for statistical analysis. The questionnaire used in this study showed good expert authority, coordination, internal consistency, and questionnaire reliability. A total of 476 patients were included after PSM, and the questionnaire results showed that recovery and quality of life were better in the N group than in the C group (124.55 ± 8.171 vs. 122.94 ± 8.366, p = 0.026). Analysis of cervical spine mobility showed that rehabilitation was better in the N group compared to the C group at postoperative one month (flexion: 1.762°, extension: 4.720°, left lateral bending: 3.912°, right lateral bending: 4.061°, left axial rotation: 5.180°, right axial rotation: 5.199°, p value all of these < 0.001), and at postoperative three months (flexion: 2.866°, extension: 2.904°, left lateral bending: 3.927°, right lateral bending: 3.330°, left axial rotation: 4.395°, right axial rotation: 3.992°, p value all of these < 0.001). The THYCA-QoL-TOETVA provides an appropriate and effective tool for measuring the postoperative quality of life of TOETVA patients. This new rehabilitation training can effectively alleviate the problem of limited neck movement and improve the quality of life of patients after TOETVA surgery.Trial registration: ChiCTR2300069097.

A quantitative study of magnetic susceptibility-weighted imaging of deep cerebral veins.

OBJECTIVE: To evaluate the value of magnetic susceptibility-weighted imaging (SWI) for measuring deep cerebral venous diameter. METHODS: The diameters of 150 deep cerebral veins were measured by SWI and digital subtraction angiography (DSA) in 50 patients. RESULTS: SWI showed whole cerebral veins as clear soft vessels, but with a crooked hypointense linear structure along the sulcus. Venous vessel diameter as measured by SWI was greater than that by DSA, but values from the two different techniques showed significant linear correlation (r=0.905). CONCLUSION: SWI is reliable and suitable for quantitative measurements of deep cerebral veins, and more sensitive for measuring smaller vessels deep within the brain.

The Predictive Role of Inflammatory Biomarkers for Treatment Response and Progression-Free Survival in Patients with Hepatocellular Carcinoma Receiving Hepatic Arterial Infusion Chemotherapy with FOLFOX Regimen: A Preliminary Study.

Objective: This retrospective study aimed to investigate whether pre-treatment inflammatory biomarkers, including the prognostic nutritional index (PNI), monocyte-lymphocyte ratio (MLR), systemic immune inflammation index (SII), and platelet-lymphocyte ratio (PLR), could predict treatment response and prognosis in patients with hepatocellular carcinoma (HCC) receiving hepatic arterial infusion chemotherapy (HAIC) with the oxaliplatin, leucovorin, and fluorouracil (FOLFOX) regimen. Methods: Based on the cut-off values identified using the receiver-operating characteristic (ROC) curve, 124 patients with HCC who received HAIC with the FOLFOX regimen were divided into low- and high-score MLR, PLR, PNI, and SII groups. Univariate and multivariate regression analyses were performed to identify independent predictors of treatment response and progression-free survival (PFS). Results: The cut-off values were 0.569 for MLR (area under the curve [AUC]: 0.621), 177.01 for PLR (AUC: 0.554), 713.05 for SII (AUC: 0.570), and 46.85 for PNI (AUC: 0.665). Multivariate Cox regression analysis revealed that the modified albumin-bilirubin (mALBI) grade (hazard ratio [HR]: 2.027; P=0.032), high MLR (HR: 7.250; P=0.002), and low PNI (HR: 0.296; P=0.003) were independent predictors of HAIC non-response, with an AUC value of 0.746 (95% CI: 0.658-0.833). A high MLR (HR: 1.714, 95% CI: 1.086-2.704, P=0.021) was also an independent predictor of PFS. Kaplan-Meier analysis showed that the patients with a high MLR had shorter PFS than those with a low MLR (median PFS: 6 vs 10 months, P=0.011). Conclusion: The pre-treatment MLR and PNI were predictors of non-response in patients with HCC receiving HAIC with the FOLFOX regimen. The MLR also was an independent predictor of PFS.

Prediction of therapeutic response of unresectable hepatocellular carcinoma to hepatic arterial infusion chemotherapy based on pretherapeutic MRI radiomics and Albumin-Bilirubin score.

PURPOSE: To construct and validate a combined nomogram model based on magnetic resonance imaging (MRI) radiomics and Albumin-Bilirubin (ALBI) score to predict therapeutic response in unresectable hepatocellular carcinoma (HCC) patients treated with hepatic arterial infusion chemotherapy (HAIC). METHODS: The retrospective study was conducted on 112 unresectable HCC patients who underwent pretherapeutic MRI examinations. Patients were randomly divided into training (n = 79) and validation cohorts (n = 33). A total of 396 radiomics features were extracted from the volume of interest of the primary lesion by the Artificial Kit software. The least absolute shrinkage and selection operator (LASSO) regression was applied to identify optimal radiomic features. After feature selection, three models, including the clinical, radiomics, and combined models, were developed to predict the non-response of unresectable HCC to HAIC treatment. The performance of these models was evaluated by the receiver operating characteristic curve. According to the most efficient model, a nomogram was established, and the performance of which was also assessed by calibration curve and decision curve analysis. Kaplan-Meier curve and log-rank test were performed to evaluate the Progression-free survival (PFS). RESULTS: Using the LASSO regression, we ultimately selected three radiomics features from T2-weighted images to construct the radiomics score (Radscore). Only the ALBI score was an independent factor associated with non-response in the clinical model (P = 0.033). The combined model, which included the ALBI score and Radscore, achieved better performance in the prediction of non-response, with an AUC of 0.79 (95% CI 0.68-0.90) and 0.75 (95% CI 0.58-0.92) in the training and validation cohorts, respectively. The nomogram based on the combined model also had good discrimination and calibration (P = 0.519 for the training cohort and P = 0.389 for the validation cohort). The Kaplan-Meier analysis also demonstrate that the high-score patients had significantly shorter PFS than the low-score patients (P = 0.031) in the combined model, with median PFS 6.0 vs 9.0 months. CONCLUSION: The nomogram based on the combined model consisting of MRI radiomics and ALBI score could be used as a biomarker to predict the therapeutic response of unresectable HCC after HAIC.

Predictive value of DCE-MRI and IVIM-DWI in osteosarcoma patients with neoadjuvant chemotherapy.

Objective: To investigate the predictive value of dynamic contrast enhanced MRI (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for clinical outcomes of osteosarcoma patients with neoadjuvant chemotherapy. Methods: The present prospective single-arm cohort study enrolled 163 patients of osteosarcoma during July 2017 to July 2022. All patients received the same treatment strategy of neoadjuvant chemotherapy. Both DCE-MRI and IVIM-DWI were conducted for the patients before the chemotherapy, as well as after one or two chemotherapy treatment cycles. The imaging parameters of contrast agent transfer rate between blood and tissue (Ktrans ), contrast agent back-flux rate constant (Kep ), extravascular extracellular fractional volume (Ve ), as well as pure diffusion coefficient (D value), pseudo-diffusion coefficient (D* value), apparent diffusion coefficient (ADC) and the perfusion fraction (f value) were recorded. RECIST standard [complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD)] was used as the main clinical outcome. Results: After two treatment cycles, 112 (68.71%) cases were with CR and PR, 31 (19.02%) cases were with SD and 20 cases (12.27%) were with PD. After 1~2 treatment cycles, patients with CR/PR showed significantly markedly lower Ktrans , Kep , Ve values, while higher D, ADC and f values compared with SD or PD patients. Alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were positively correlated with values of Ktrans , Kep , and Ve , while negative correlation was observed between ALP and values of D, ADC and f, as well as between LDH and D and ADC after the whole treatment. D and Kep values after two treatment cycles showed the best predictive value for diagnosis of PD. The values of Ktran , Kep , ADC as well as ALP and LDH were all risk factors for PD after neoadjuvant chemotherapy. Conclusion: DCE-MRI and IVIM-DWI have the potential to predict clinical outcomes of osteosarcoma patients with neoadjuvant chemotherapy.