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Objective:To investigate the predictive value of infiltrating zone contrast-enhanced ultrasound(CEUS) gradient features in Nottingham grading and pathologically true infiltration of invasive ductal carcinoma(IDC).Methods:A retrospective analysis was performed on 78 female breast cancer patients (95 masses) confirmed by surgical and pathology in the Affiliated Hospital of Jiangsu University from July 2019 to June 2022, which were divided into Grade-Ⅰ (22 masses), Grade-Ⅱ (28 masses), and Grade-Ⅲ (45 masses) according to the Nottingham histological grading system. The differences in the maximum diameter of the infiltration zone and the characteristic parameters of the gradient of the inner and outer edges of the infiltration zone among the three groups of masses were compared, and the differential gradient features among them were analyzed by multivariate ordered Logistic regression and ROC curves. The relationship between the differential gradient characteristics of the infiltration zone and the pathologically true infiltration of the mass was further explored.Results:The univariate analysis showed statistically significant differences among the three groups for peak-arrival time gradient (ΔTTP), ascending branch slope gradient (ΔRS), peak intensity gradient (ΔPI) and area gradient under the curve (ΔAUC) (all P<0.05). Multiple ordered logistic regression analysis showed that ΔTTP, ΔPI and ΔAUC had independent influences on the histologic grading of IDC (all P<0.05), and the area under the curve for the combination of the three in predicting IDC histology grades Ⅰ, Ⅱ and Ⅲ was 0.692, 0.705 and 0.765, respectively. In addition, the maximum diameter of pathologically true infiltration of the mass was positively correlated with ΔTTP ( r=0.621, P<0.05) and negatively correlated with ΔPI ( r=-0.605, P<0.05) and ΔAUC ( r=-0.719, P<0.05). Conclusions:Infiltration zone CEUS gradient features are effective in predicting the histologic grade of IDC and strongly correlate with the degree of pathologically true infiltration of the mass.
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Objective:To investigate the effect of bone mesenchymal stem cells derived exosomes (BMSC-Exo) on improving hippocampal microangiogenesis, energy metabolism, and behaviors in depression mouse models.Methods:(1) Mouse bone marrow mesenchymal stem cells were isolated and cultured to extract BMSC-Exo; BMSC-Exo morphology was observed by transmission electron microscopy, BMSC-Exo particle diameter ranges were determined by Zetaview analyzer, and expressions of CD9 and CD63 in BMSC-Exo were detected by Western blotting. (2) Depression models were established in 2 mice by chronic unforeseeable mild stress (CUMS); 24 h after stereotaxic injection of phosphate buffer solution (PBS) or DiR labeled BMSC-Exo, BMSC-Exo uptake was detected by in vivo imaging system. (3) Thirty-six mice were randomly divided into control group, model group and BMSC-Exo group ( n=12); CUMS was used to establish depression models in the latter 2 groups; brain stereotaxic injection of 1 μL BMSC-Exo was given to mice in the BMSC-Exo group after modeling, and same amount of PBS was given to the control group; behaviors were observed by forced swimming test (FST), tail suspension test (TST) and open field test (OFT); hippocampal microvascular length and number were detected by alkaline phosphatase staining; energy metabolism in the hippocampus was detected by micro positron emission tomography/computed tomography (mPET/CT); glucose transporter 1 (GLUT1) expression in the hippocampus was detected by Western blotting. Results:(1) BMSC-Exo had a typical disk-like vesicle-like structure with particle size of (100.5±1.4) nm; Western blotting confirmed that CD9 and CD63 expressed in BMSC-Exo. (2) In vivo imaging showed no fluorescence in the brain and liver after PBS injection, but obvious local fluorescence after BMSC-Exo injection. (3) Compared with the control group, the model group and BMSC-Exo group had significantly longer rest time in FST and TST and shorter movement distance and time in the central region of OFT ( P<0.05); compared with the model group, BMSC-Exo group had significantly shorter rest time in FST and TST and longer movement distance and time in the central region of OFT ( P<0.05). Compared with the control group, the model group and BMSC-Exo group had significantly decreased standard uptake value (SUV) of regions of interest, microvascular length and number, and GLUT1 expression in the hippocampus ( P<0.05); compared with the model group, the BMSC-Exo group had significantly higher SUV, microvascular length and number, and GLUT1 expression in the hippocampus ( P<0.05). Positive correlations were noted between hippocampal microvascular length and SUV and between microvascular number and SUV in the 3 groups ( r=0.540, P<0.001; r=0.600, P<0.001). Conclusion:BMSC-Exo could promote microangiogenesis energy metabolism in the hippocampus to improve depression-like behaviors in depression mouse models.
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Objective To explore the mechanism of micro ribonucleic acid(miR)-3197 in diabetic retinopathy(DR)on the basis of the nuclear factor κB(NF-κB)signaling pathway.Methods A total of 47 DR patients admitted to Heng-shui People's Hospital from January 2021 to December 2021 were selected as the DR group,and 47 healthy individuals in the same period were collected as the control group.Their information in gender,age,fasting blood glucose(FBG),fast-ing insulin(FINS),triglycerides(TG),total cholesterol(TC)and miR-3197 were compared.The correlation between miR-3197 in DR patients and laboratory data was analyzed,and the receiver operating characteristic(ROC)curve of miR-3197 for DR diagnosis was drawn.The human retinal microvascular endothelial cells(hRMECs)were cultured in vitro and treated with 5.5 mmol·L-1 glucose[low glucose(NG)group]and 30 mmol·L-1 glucose[high glucose(HG)group],respectively.After transfecting with anti-miR-NC and anti-miR-3197,the cells were treated with 30 mmol·L-1 glucose(HG+anti-miR-NC group and HG+anti-miR-3197 group).Real-time fluorescence quantitative PCR was used to detect the relative expression level of miR-3197,flow cytometry was used to detect the apoptosis rate of hRMECs,enzyme-linked im-munosorbent assay was used for detecting tumor necrosis factor-a(TNF-a)and interleukin-6(IL-6),and Western blot was adopted to detect the expressions of aspartic protease 3 containing cysteine(cleaved caspase-3)protein,Bax protein and NF-κB signaling pathway-related proteins[phospho-NF-KB p65(p-p65),p65,phospho-NF-KB inhibited protein(p-IκBα),and NF-κB inhibited protein(IκBα)].Results The levels of FBG,FINS,TC and TG in the DR group were higher than those in the control group,and the differences were statistically significant(all P＜0.001).The relative expression level of miR-3197 in the peripheral blood of patients in the DR group(2.76±0.67)was higher than that of the control group(1.03±0.34),and the difference was statistically significant(P＜0.05).The miR-3197 level of patients in the DR group was positively correlated with FBG,FINS,TC and TG levels(r=0.672,0.587,0.511 and 0.423;all P＜0.05).The ROC curve graph showed that the area under the curve was 0.919,with sensitivity and specificity of 85.11％and 89.36％,respectively.Compared with the NG group,the HG group showed a significant increase in cell apoptosis rate and the pro-tein expressions of cleaved caspase-3,Bax,TNF-a,IL-6,p-IκBa and p-p65(all P＜0.05);compared with the HG+anti-miR-NC group,the HG+anti-miR-3197 group showed a significant decrease in cell apoptosis rate and the protein expres-sions of cleaved caspase-3,Bax,TNF-a,IL-6,p-IκBa and p-p65(allP＜0.05).Conclusion The miR-3197 is highly ex-pressed in the peripheral blood of DR patients and high glucose-induced hRMECs.Down-regulation of miR-3197 can allevi-ate high glucose-induced hRMEC apoptosis and inflammatory injury,and its mechanism of action may be related to the inhi-bition of the NF-κB signaling pathway.
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Objective To investigate the expression of circular ribonucleic acid carnitine palmitoyltrans-ferase 1A(circRNA CPT1A)in patients with diabetic retinopathy(DR)and its mechanism of action on neuropathy.Methods To-tally 80 patients(102 eyes)with type 2 diabetes admitted to our hospital from January 2019 to January 2022 were selected,including 22 patients(28 eyes)with no DR(NDR group),38 patients(48 eyes)with non-proliferative DR(NPDR group),and 20 patients(26 eyes)with proliferative DR(PDR group).Optical coherence tomography angiography was used to measure the thickness of the peripapillary retinal nerve fiber layer(pRNFL)and macular ganglion cell complex(GCC),the level of phosphatase and tensin homolog(PTEN)in peripheral blood was detected by Western blot,and the circRNA CPT1A level in peripheral blood was detected by fluorescence quantitative polymerase chain reaction.The levels of circRNA CPT1A and PTEN in peripheral blood,as well as the thickness of pRNFL and GCC,were compared among three groups,and Pearson correlation analysis was used to investigate the correlation between circRNA CPT1A and PTEN,pRNFL and GCC thickness.Results The circRNA CPT1A in the peripheral blood of the PDR group was higher than that in the NDR group and NPDR group;the PTEN in the peripheral blood of the PDR group was lower than that in the NDR group and NP-DR group(all P＜0.05).There was no statistically significant difference in the expression of circRNA CPT1A and PTEN be-tween NDPR group and NDR group(all P＞0.05).The Pearson correlation analysis showed that the expression level of cir-cRNA CPT1A in peripheral blood was negatively correlated with PTEN(P＜0.05).With the increase in disease severity,the thickness of pRNFL and GCC showed a decreasing trend;the thickness of pRNFL and GCC in the whole,upper and lower parts of eyes in the NDR group were higher than those in the NPDR group(all P＜0.05),while those in the NPDR group were higher than the PDR group(all P＜0.05).Pearson correlation analysis showed that the expression level of cir-cRNA CPT1A in peripheral blood was negatively correlated with the thickness of pRNFL and GCC in the whole,upper and lower parts of the observed eyes(all P＜0.05).Conclusion With the increase in the severity of DR,circRNA CPT1A in the peripheral blood of DR patients shows an increasing trend and is negatively correlated with peripheral blood PTEN lev-el,as well as macular pRNFL and GCC thickness.The mechanism of action may be that circRNA CPT1A negatively regu-lates the expression of PTEN and thus participates in the occurrence and development of DR.
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ObjectiveTo understand the current situation and hot spots of research on the treatment of constipation by traditional Chinese medicine （TCM） in China and foreign countries， and provide references and directions for future research. MethodIn this study， the data analysis software CiteSpace 5.8.R3C was used to conduct bibliometrics analysis of the relevant papers on the treatment of constipation by TCM from January 1， 2000 to December 31， 2021 in China National Knowledge Infrastructure （CNKI） and Web of Science core database. The visual display was carried out. ResultAfter retrieval， 2 133 papers were included in CNKI database and 224 papers were included in Web of Science core database. The statistical analysis showed that the overall annual publication volume in China and foreign countries was on the rise， but the publication volume in China had been declining for the past two consecutive years. The author co-occurrence analysis showed that the authors with the largest number of publications in China and foreign countries were LIU Chunqiang and CHUNGWAH CHENG， respectively. The institution co-occurrence analysis showed that the institutions with the largest number of publications in China and foreign countries were the Anorectal Department of Longhua Hospital Affiliated to Shanghai University of TCM and Beijing University of Chinese Medicine， respectively. The keyword analysis showed that research in this field in China and foreign countries mainly focused on TCM therapy， clinical research， etiology and pathogenesis， etc. ConclusionThe research on the treatment of constipation by TCM is mainly concentrated in China， but there is no closely-related scientific research team. The research in this field in China and foreign countries is still developing. With the continuous deepening of research， all research institutions should pay attention to interdisciplinary intersection， highlight technological innovation， and strive to achieve greater breakthroughs in this field.
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Objective:To investigate the predictive value of perfusion defect gradient features of early breast cancer using contrast-enhanced ultrasound (CEUS) in sentinel lymph node (SLN) metastasis.Methods:A retrospective analysis was performed on 147 patients with single early breast cancer confirmed by surgery and pathology in the Affiliated Hospital of Jiangsu University from January 2017 to December 2022, which were divided into SLN positive group (78 cases) and SLN negative group (69 cases) according to whether there are positive lesions in the biopsy SLN. The quantitative characteristics of CEUS in the perfusion defect and marginal high perfusion area of breast cancer in the two groups were analyzed. The differential gradient features between them were analyzed by multivariate Logistic regression and ROC curves.Results:The univariate analysis revealed statistically significant differences between the two groups for peak-arrival time gradient (ΔTTP), peak intensity gradient (ΔPI), ascending branch slope gradient (ΔRS) and area gradient under the curve (ΔAUC) (all P<0.05). Multivariate Logistic regression analysis showed that ΔTTP, ΔPI and ΔAUC were independent predictors of SLN status in early breast cancer (all P<0.05). The sensitivity (74.57%), specificity (84.42%) and area under the curve (0.789) of that combination of the three indexes for predicting SLN status were higher than the prediction efficiency of a single index.In addition, ΔTTP ( r=-0.578, P<0.05) was negatively correlated with average positive rate of SLN, and ΔPI ( r=0.629, P<0.05) and ΔAUC ( r=0.703, P<0.05) were positively correlated with average positive rate of SLN. Conclusions:The perfusion defect gradient features of early breast cancer are closely related to the SLN status and can effectively predict whether SLN metastasis occurrs.
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Objective:To investigate the effects of human umbilical cord mesenchymal stem cells exosomes (hucMSC-Exo) on depression-like behavior and polarization dynamic transition of hippocampal microglia in chronic unpredictable mild stress(CUMS) mice.Methods:The hucMSC was isolated, cultured, and the 5th generation hucMSC-Exo was extracted by ultracentrifugation and identified.Biological markers of CD9 and CD63 of hucMSC-Exo were detected by Western blot.A total of 12 SPF grade male C57BL/6J mice were randomly selected to establish depression model by CUMS method at the same time, and relevant behavioral experiments, including opening field test (OFT) and forced swimming test (FST) were used to detect changes of depression-like behavior in CUMS mice. After modeling, 12 mice were randomly divided into two groups, with 6 mice in each group. One group of mice was the exosome treatment group (CUMS+ Exo group) after stereotactic brain injection of hucMSC-Exo in the hippocampus, and the other group was the CUMS group. The expression of inflammatory signals in the hippocampus of mice in both groups were detected by micro PET/CT scanning technique. The proportion of M2-type microglia and M1-type microglia in the hippocampus of mice was detected by tissue immunofluorescence. β3-tubulin immunofluorescence staining was used to detect the length changes of neuronal axons in the depressed cell model constructed with corticosterone (CORT). EdU staining was used to detect neuronal proliferation. TUNEL staining was used to observe the apoptosis of neurons in the hippocampus of mice.Statistical analysis was conducted by GraphPad 8.0 software, and t-test was used for inter group comparison. Results:Under the electron microscope, hucMSC-Exo showed typical " double-layer cup-like" small vesicle-like changes and the particle diameter was about 100 nm.Western blot confirmed the expression of lconic proteins of CD9 and CD63. In the micro PET/CT scans, the uptake of [18F]DPA-714 in the CUMS+ Exo group was lower than that of the CUMS group, and the difference was statistically significant ((0.91±0.02)g/mL, (0.81±0.05)g/mL, t=4.54, P=0.001 1). In the opening field test, the percentage of central path length ((3.40±0.44)%, (5.17±0.90)%, t=4.33, P=0.001 5) and the time spent on the central path ((7.04±0.60)s, (10.22±1.41)s, t=6.02, P=0.000 1) in CUMS+ Exo group were higher than those in CUMS group, while the total distances of the two groups were not statistically significant ( t=0.48, P>0.05). In the forced swimming test, the immobility time in the CUMS+ Exo group was less than that in the CUMS group ((152.33±7.28) s, (133.50±4.32) s, t=5.45, P=0.000 3). In tissue immunofluorescence experiments, compared with the CUMS group, the proportion of M2-type microglia of hippocampus in the CUMS+ Exo group((0.33±0.04), (0.59±0.12), t=5.11, P=0.000 5)increased and the proportion of M1-type microglia ((0.56±0.06), (0.41±0.03), t=5.15, P=0.000 4) decreased in the CUMS+ Exo group. β3-tubulin-labeled immunofluorescence results showed an increase of neuronal axon length in the CORT+ Exo group compared with that in the CORT group((3.99±0.99) μm, (6.76±1.11) μm, t=6.10, P=0.000 1). The results of cell proliferation test showed an increase of proliferation rate in the CORT+ Exo group compared with that in the CORT group((0.74±0.07), (0.64±0.03), t=3.32, P=0.001 8). In the TUNEL staining experiment, the apoptosis rate of neurons in the hippocampal region of mice in the CUMS+ Exo group was lower than that of CUMS group ((0.24±0.04), (0.39±0.04), t=6.11, P=0.000 1). Conclusion:hucMSC-Exo can promote the conversion of M1 polarized microglia to M2 type microglia to alleviate depression-like behavior and reduce neuronal apoptosis in CUMS mice.
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Objective:To explore the structural brain network changes in healthy first-degree relatives of depressed patients and their relationship with depressive episodes.Methods:Prospectively, 200 healthy first-degree relatives of depressed patients admitted to Jiangsu University Hospital from May 2017 to June 2018 were collected. Meanwhile, 50 matched healthy controls without family history of depression (HC/FH-) were collected by questionnaire in the nearby community as study subjects. All study subjects underwent systemic magnetic resonance imaging scans and assessment of relevant scales after enrollment, followed by longitudinal follow-up (every 3 months) for up to 3 years. The diagnostic and statistical manual of mental disorders, 4th edition, structured interview was used to assess whether the subjects became depressed during the follow-up period. First-degree relatives who experienced depression during follow-up were included in the group of first-degree relatives who experienced depression (DD/FH+), whereas first-degree relatives who did not experience depression were included in the group of first-degree relatives who did not experience depression (HC/FH+). Subjects′ depression severity and whether they experienced major stressful life events were assessed by the 24-item Hamilton Depression Rating Scale (HDRS) and the Holmes and Rahe Social Readjustment Rating Scale, respectively. Correlations between subjects′ brain structural networks and HDRS scores were explored based on Pearson correlation analysis. Logistic regression models were constructed to investigate the predictive efficacy of brain structural network attributes on depression.Results:Significant group differences existed in the HC/FH- group (50 cases), HC/FH+ group (115 cases), and DD/FH+ group (21 cases) in feeder connectivity (17.62±1.34, 17.03±1.39, 15.82±1.12, F=13.63, P<0.001), global efficiency (0.24±0.03, 0.23±0.03, 0.22±0.03, F=4.73, P=0.010), right insula node efficiency (0.20±0.02, 0.21±0.01, 0.20±0.01, F=4.62, P=0.011), left hippocampal node efficiency (0.27±0.01, 0.27±0.01, 0.24±0.02, F=18.56, P<0.001), and left amygdala node efficiency (0.24±0.02, 0.24±0.02, 0.23±0.01, F=3.40, P=0.036). Logistic regression models showed feeder connectivity ( OR=0.55, 95% CI 0.38-0.78, P=0.001) and left hippocampal nodal efficiency ( OR=0.58, 95% CI 0.40-0.81, P<0.001) predicted the occurrence of final depression and had good predictive efficacy with an area under the curve of 0.75, 0.78, respectively. Correlation analysis showed that feeder connectivity ( r=-0.58, P=0.006) and left hippocampal node efficiency ( r=-0.60, P=0.004) at baseline in the DD/FH+ group correlated with their HDRS scores at the first follow-up. Conclusion:Among healthy first-degree relatives of depressed patients, those who exhibit decreased feeder connectivity and left hippocampal nodal efficiency are susceptible to developing this disease.
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Objective:To investigate the predictive values of serum fibroblast growth factor 22 (FGF22) levels and electrical P300 in depression patients occurred mild cognitive impairment (MCI).Methods:A prospective study was performed. A total of 94 depression patients without cognitive impairment admitted to our hospital from January 2020 to August 2021 were chosen. These patients were followed up for one year; Hamilton Depression Scale (HAMD)-24 items and Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the neuropsychological function of the patients every 3 months; according to the occurrence of MCI, the patients were divided into depression with MCI group ( n=57), and depression without MCI group ( n=32). All patients underwent baseline P300 examination and baseline serum FGF22 levels were detected by enzyme-linked immunosorbent assay (ELISA), and the differences in clinical data, P300 examination results and serum FGF22 levels were compared between the two groups. Correlation analysis was performed to analyze the correlations of P300 latency and serum FGF22 level with MoCA scores. Multivariate Logistic regression analysis was used to screen the independent influence factors for MCI in patients with depression. The predictive value of P300 latency and serum FGF22 level in MCI in patients with depression was analyzed by receiver operating characteristic (ROC) curve. Results:As compared with the depression without MCI group, patients in the depression with MCI group had significantly lower years of education and serum FGF22 level, and significantly higher proportion of patients living alone, and statistically higher P300 latency ( P<0.05). The results of correlation analysis showed that the MoCA scores at MCI period were positively correlated with serum FGF22 level ( r=0.665, P<0.001) and negatively correlated with P300 latency ( r=-0.621, P<0.001) in patients from the depression with MCI group. Multivariate Logistic regression analysis showed that serum FGF22 level was a protective factor for MCI in patients with depression ( OR=0.805, 95%CI: 0.737-0.862, P=0.003), and P300 latency was a risk factor for MCI in patients with depression ( OR=1.136, 95%CI: 1.115-1.163, P=0.001). ROC curve analysis showed that the areas under the curve (AUC) of serum FGF22 level, P300 latency, serum FGF22 level combined with P300 latency in predicting MCI in depression patients were 0.779, 0.724, and 0.852, respectively. Conclusion:The abnormal serum FGF22 level and P300 latency are closely related to the occurrence of MCI in patients with depression, and the combination of the two can be used to predict the occurrence of MCI in patients with depression.
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Objective:To explore the value of dilated Virchow-Robin spaces (dVRS) in the basal ganglia in predicting basal ganglia atrophy.Methods:A total of 120 patients accepted head MRI and conformed as having dVRS in the basal ganglia in our hospital from May 1, 2015 to April 30, 2016 were chosen in our study; these patients were followed up for 5 years. The basal ganglia volume was observed by 3.0T MRI; according to whether the basal ganglia had atrophy or not, these patients were divided into normal group ( n=82) and atrophy group ( n=38). The general data and dVRS grading between the normal group and the atrophy group were compared. The basal ganglia volume at baseline and 5 years later in patients with different dVRS grading and the difference value of basal ganglia volume at baseline and 5 years later (△basal ganglia volume) were recorded for comparative analysis. Spearman analysis was used to evaluate the correlation between △ basal ganglia volume and dVRS grading. Independent influencing factors for basal ganglia atrophy were analyzed by Logistics regression; receiver operating characteristic (ROC) curve was drawn to evaluate the predictive values of independent influencing factors and their combination in basal ganglia atrophy. Results:Patients in the atrophy group had significantly older age, significantly higher percentage of patients with diabetes history, and significantly higher dVRS grading in the basal ganglia than those in the normal group ( P<0.05). There were significant differences in basal ganglia volume and △ basal ganglia volume at baseline and 5 years later among patients with different dVRS grading ( P<0.05); △ basal ganglia volume gradually increased with the increase of dVRS grading. Correlation analysis showed that △ basal ganglia volume was positively correlated with dVRS grading in basal ganglia ( r s=0.695, P<0.001); after adjusting for age and history of diabetes, the correlation was still positive ( r s=0.667, P<0.001). Logistics regression showed that age ( OR=1.776, 95%CI: 1.372-2.141, P=0.008), diabetes history ( OR=1.513, 95%CI: 1.129-1.954, P=0.011) and dVRS grading in the basal ganglia ( OR=2.855, 95%CI: 2.367-3.283, P=0.006) were independent influencing factors for basal ganglia atrophy. The area under the ROC curve of dVRS grading for predicting the basal ganglia atrophy was 0.709 ( 95%CI: 0.611-0.792, P<0.001), with sensitivity of 61.89% and specificity of 83.59%; that of combined age, diabetes history and dVRS grading in the basal ganglia was 0.783 ( 95%CI: 0.687-0.878, P<0.001), with sensitivity of 73.68% and specificity of 85.19%. Conclusion:The dVRS in the basal ganglia has certain predictive value in basal ganglia atrophy after 5 years.
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Objective:To clarify the evidences of hippocampal injury after radiotherapy avoiding hippocampus and explore its relationships with cognition.Methods:A prospective design was adopted in this study.A total of 183 patients with nasopharyngeal carcinoma treated by intensity modulated radiation therapy (IMRT group) and 30 matched healthy control (HC group)were collected in the Affiliated Hospital of Jiangsu University and Southeast University Affiliated Zhongda Hospital from January 2017 to December 2019. All subjects were assessed by Montreal Cognitive Assessment (MoCA-B) at baseline and 6 months after radiotherapy, then the patients with nasopharyngeal carcinoma were divided into cognitive impairment group and non-cognitive impairment group. Subjects were scanned with Siemens 3.0 T MR, and T 1WI was used as analysis sequence.The individual standardized hippocampus ROIs were extracted based on Montreal Neurological Institute(MNI) brain template.All texture features were calculated using the Radiomics developed by C++and Delphi, and the intra group correlation coefficients (ICC), average direction, machine learning (random forest) and autocorrelation matrix were used for reducing the features dimension. One-way ANOVA and generalized linear models were used to compare the differences among different groups. Pearson correlations analyses were used to evaluate the relationships between important texture features and clinical data. Logistic regressions were used to calculate the abilities of texture features to predict cognitive impairment. Results:After 9 patients who lost follow-up were excluded, a total of 164 patients with nasopharyngeal carcinoma were included as IMRT group.Texture features of ROIs were extracted and dimensionally reduced successfully. Five differences features (Variance, Entropy, GlevNonU, RLNonUni and Contrast)were found among HC group, cognitive impairment group and non-cognitive impairment group, and the last three further showed significant differences within IMRT group (GlevNonU, P=0.011;RLNonUni, P<0.001;Contrast, P<0.001). Hippocampal doses were positively correlated with Variance ( r=0.448, P<0.05), and negatively correlated with Entropy ( r=-0.461, P<0.05). There was a positive correlation between MoCA-B scores with GlevNonU, RLNonUniand Contrast ( r=0.503, P<0.05; r=0.587, P<0.05; r=0.531, P<0.05). GlevNonU and Contrast were independent predictors of cognitive impairment in hippocampal avoidance of radiotherapy (OR=0.731, 95%CI 0.610-0.857; OR=0.651, 95%CI 0.496-0.853). Conclusion:Results of texture analysis could be used as micro imaging evidences of hippocampal injury in radiotherapy avoiding hippocampus, and could also effectively predict the occurrences of cognitive impairment.
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Objective:To explore the diagnostic value of radiomics features based on chest CT plain scan in differentiating thymoma from other anterior mediastinal lesions.Methods:The data of 128 patients with anterior mediastinal lesions from January 2018 to January 2021 in the Affiliated Hospital of Jiangsu University were retrospectively analyzed. According to the pathological criteria, all patients were divided into thymoma group (67 cases) and non-thymoma group (61 cases). The radiomics analysis module based on MATLAB platform was used to analyze images of CT plain scan, and then radiomics features of the whole lesions were extracted. The radiomics features were screened by using group difference analysis, Boruta algorithm and collinearity detection stepwise. The receiver operating characteristic (ROC) curves for the single diagnosis and the combined diagnosis of thymoma were plotted with the selected features, and the area under the curve (AUC) was calculated to analyze the diagnostic performance of the selected features.Results:A total of 851 radiomics features were extracted, and 4 radiomics features with statistically significant differences were finally selected after multi-step dimensionality reduction, including robust mean absolute deviation, gray level non-uniformity, wavelet-LLH run variance and wavelet-HLL dependence non-uniformity. ROC curves analysis showed that the AUC of 4 radiomics features was 0.712, 0.634, 0.660 and 0.699, respectively in the single diagnosis; the specificity was 70.2%, 61.2%, and 61.2%, respectively; and the sensitivity was 60.7%, 60.6%, 68.8% and 70.5%, respectively. AUC value of the four combined detection was 0.881, the sensitivity and specificity was 75.4% and 89.6%, respectively; and the diagnostic efficiency was significantly improved.Conclusion:The radiomics features based on CT plain sans have a certain value and application potential in the differential diagnosis of thymoma and other anterior mediastinal lesions.
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Objective:To investigate the influences of abnormal white matter micro-structures and stressful life events in relapse status of patients with major depressive disorder (MDD).Methods:A prospective sutdy was performed; 108 patients with MDD were chosen as study subjects in our hospital from May 2017 to June 2018. All subjects underwent MR imaging scanning, and were followed up for 2 years after treatment (once every 3 months). Their relapse status were assessed by 4 th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The degrees of depression and existence and level of stressful life events in MDD patients were assessed by Hamilton Depression Rating Scale (HDRS) and Life Events Scale (LES). The differences of clinical data and white matter micro-structures between relapse and non-relapse patients were compared. Binary Logistic regression analysis was used to determine the independent influencing factors for MDD relapse. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of influencing factors in MDD relapse. The correlations of white matter fractional anisotropy (FA) values with follow-up HDRS scores and follow-up LES scores were analyzed by Pearson correlation analysis. Results:In the end, 92 patients were enrolled in the study, including 38 relapse patients and 54 non-relapse patients. As compared with those in the non-relapse group, patients in the relapse group showed younger onset age, higher incidence of disease onset, longer course of disease, higher LES scores (baseline), and higher HDRS and LES scores (follow-up), with significant differences ( P<0.05). FA values of the right superior longitudinal fasciculus and corpus callosum in the relapse patients were significantly decreased as compared with those in the non-relapse patients ( P<0.05). Binary Logistic regression analysis showed that FA values of the right superior longitudinal fasciculus ( OR=0.350, 95%CI: 0.168-0.728, P=0.005) and FA values of the corpus callosum ( OR=0.646, 95%CI: 0.438-0.951, P=0.027), and LES scores (follow-up) ( OR=1.483, 95%CI: 1.226-1.793, P=0.000) were independent influencing factors for relapse in MDD patients. ROC curve showed that the area under curve (AUC) of FA values of the right superior longitudinal fasciculus, FA values of the corpus callosum, and LES scores (follow-up) to predict MDD relapse were 0.655, 0.661 and 0.841, respectively. Correlation analysis showed that FA values of the superior right longitudinal fasciculus and FA values of the corpus callosum were significantly negatively correlated with HDRS scores (follow-up) ( r=-0.470, P=0.000; r=-0.398, P=0.004), and LES scores (follow-up) were significantly positively correlated with HDRS scores (follow-up) ( r=0.429, P=0.000). Conclusion:Abnormal white matter micro-structures and stressful life events are closely related to the relapse of MDD.
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Objective To investigate the practical value of a logistic regression model of serum indexes in distinguishing between geriatric depression and geriatric depressive state. Methods A total of 160 patients were recruited from the outpatient department from January 2013 to January 2016 ,and were divided into a depression group (n= 80)and a depressive state group (n= 80) ,with retrospective diagnoses based on the Chinese Classification of Mental Disorders-Third-Edition(CCMD-3).Serum samples were collected and enzyme linked immunosorbent assays (ELISA)were used to determine the concentrations of brain-derived neurotrophic factor (BDNF ) ,glial cell line-derived neurotrophic factor(GDNF) ,fibroblast growth factor 2(FGF-2) ,vascular endothelial growth factor (VEGF) ,interleukin-1β(IL-1β) ,interleukin-6 (IL-6) ,interleukin-10 (IL-10) ,tumor necrosis factor-α(TNF-α) ,cortisol (CORT ) ,and platelet-derived growth factor (PDGF).Binary logistic regression analysis was used to establish the regression model ,and the ROC curve was drawn to explore its value of differentiating geriatric depression from depressive state. Results The levels of serum BDNF , GDNF and VEGF in the depression group were lower than those in the depressive state group (BDNF :208.7 ± 41.4 vs.262.9 ± 84.6 ng/L ,GDNF :92.3 ± 18.6 vs. 101.4 ± 30.9 ng/L ,VEGF :223.1 ± 98.2 vs. 257.8 ± 77.2ng/L) ,while the levels of IL-1βand CORT in the depression group were higher than in the depressive group(IL-1β:27.0 ± 4.9 vs.19.6 ± 5.7 μg/L ,CORT :96.3 ± 16.7 vs.83.0 ± 17.3 nng/L).In multivariate logistic regression analysis ,BDNF(OR = 0.987 ,P = 0.001) ,IL-1β(OR =1.29 ,P = 0.000)and CORT (OR = 1.065 ,P = 0.000)were selected to build the regression model. The regression equation was P=1/[1+e-(- 8.546 - 0.013(BDNF)+ 0.258(IL -1β)+ 0.063(CORT)) ]and the area under the ROC curve was 0.966.Compared with retrospective diagnoses made two weeks later ,the correct diagnosis rate of the logistic model was 90.47％. Conclusions The Logistic regression model of serum indexes can further differentiate between geriatric depression and depressive state which also offers additional benefits for the diagnosis ,differential diagnosis ,and treatment of depression.
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Objective To explore the differences of two types of depressions through observing brain nerve cells metabolism of 18F-fludeoxyglucose (18F-FDG) uptake and utilization in the first-episode depression patients and recurrent depression patients.Methods Thirty-five first-episode depression patients,35 recurrent depression patients and 35 healthy volunteers,collected in our hospital from January 2014 to January 2016,were chosen in our study;intravenous injection of 18F-FDG was performed,and the glucose uptake data in various brain regions were collected by PET/CT;the brain regions with different absorption were analyzed through SPM software;dynamic metabolic rate of glucose after identifying the overlapping absorb different brain regions in these two types of depression was measured and compared.Results As compared with that in the healthy control group,the glucose uptake in the bilateral cingulate gyrus,the left striatum,the bilateral hippocampus,the right thalamus,the left middle frontal gyrus,the left middle temporal gyrus and the right superior temporal gyrus were decreased in the first-episode depression group.As compared with that in the healthy control group,the glucose uptake in the bilateral cingulate gyrus,the bilateral striatum,the bilateral hippocampus,the right thalamus,the left superior frontal gyrus,the right middle temporal gyrus,the left inferior temporal gyrus and the right lingual gyrus were decreased in the recurrent depression group.As compared with those in the first-episode depression group,the metabolic clearance rates at 60-80 min and 60-100 min in the left cingulate gyrus and left hippocampus were significantly decreased in the recurrent depression (P＜0.05).Conclusion The disorder of ~F-FDG uptake appears in multiple brain regions in the first-episode depression and recurrent depression patients;there are some overlap regions;the 18F-FDG metabolism rate decreases in the left cingulate gyrus and left hippocampus in the recurrent depression,the glucose energy utilization disorder in nerve cells maybe a potential mechanism causing the differences between the two kinds of depression.
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Objective To investigate the variation of serum fibroblast growth factor-22 (FGF-22) of first episode depressive patients before and after treatment,and its relations with serotonin (5-HT) and interleukin-1[β (IL-1β) levels and Hamilton's depression scale (HAMD) scores to provide assistance for further study of pathogenesis of depression.Methods Ninety patients with first episode depression accepted treatment in our hospital from June 2015 to June 2016 and 90 healthy controls were enrolled.The serum FGF-22 level was detected and Hamilton's depression scale (HAMD) was performed before and after drug treatment.The relations of FGF-22 level with 5-hydroxytryptamine (5-HT) and interleukin (IL)-1[β levels were analyzed.Results (1) Before treatment,the first episode depressive patients had significantly lower scrum FGF-22 level ([180.44±17.02] ng/mL) and statistically higher HAMD scores (17.84±5.92) as compared with the healthy controls ([200.74±16.63] ng/mL,1.88±2.67,P＜0.05).(2) The serum FGF-22 level after treatment ([195.74+19.57] ng/mL) was significantly higher than that before treatment,and the HAMD scores after treatment (7.64±4.09) were significantly lower than those before treatment (P＜0.05).(3) In the patient group,serum FGF-22 level and HAMD scores were negatively correlated (r=-0.644,P=0.000);serum FGF-22 level had positive correlation with 5-HT level (r=0.718,P=0.000),and negative correlation with IL-1β level (r=-0.763,P=0.000).Conclusion The serum FGF-22 level is abnormal in first episode depressive patients,and it could be a good indicator of peripheral blood in response to depression,which plays an important role in the pathogenesis of depression.
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@#Objective To apply the MRI T2 signal intensity of hippocampal subfield in patients with amnestic mild cognitive impairment (aMCI) as early imageology. Methods From October, 2014 to August, 2015, 20 aMCI patients accepted cognitive training (training group), 20 aMCI patients accepted speech communication (speech group), and 20 age-and gender-matched healthy old people (control group) were scanned with MRI using FSE-T2 sequence. The margin of hippocampal subfields were outlined manually for each side to measure the T2 sig-nal intensity. The correlation between hippocampal T2 signal intensity and the scores of Mini-Mental State Examinatlon (MMSE) was ana-lyzed in the training group. Results Before treatment, T2 signal intensity in the bilateral hippocampal head was significantly high in the aM-CI patients compared with that in the control group (P<0.05). After treatment, T2 signal intensity in left hippocampal head decreased in the training group compared with that in the speech group (P<0.05), similar to the control group (P>0.05). There was negative correlation be-tween left hippocampal head's T2 signal intensity and the scores of MMSE in the training group before and after treatment (r=-0.61, r=-0.54, P<0.05). Conclusion The T2 signal intensity in left hippocampal head may respond to the cognitive function in patients with aMCI in the early stage, that could be used for diagnosis and evaluation in clinic.
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Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.
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Objective To compare the effects of different methods of honey sunburn on the contents of calycosin and formononetin in Hedysari Radix; To provide the basis for the establishment of the optimum processing technology. Methods By frying (traditional method), baking, and microwave methods put Hedysari Radix under honey sunburn. Agilent HC-C18 column (4.6 mm × 250 mm, 5 μm) was used; the mobile phase was acetonitrile-0.01% phosphoric acid solution, gradient elution (0–12 min, 30%–33% acetonitrile; 12–13 min, 31%–40% acetonitrile; 13–25 min, 40% acetonitrile) with velocity of 1.0 mL/min; detection wavelength was 248 nm;the column temperature was 30 ℃; sample volume was 10 μL. Results There was statistical significance in the contents of calycosin and formononetin of different methods of honey sunburn for Hedysari Radix. Among them, the contents of calycosin and formononetin in Hedysari Radix processed by honey roast were the highest, 7.9116 and 49.6996 μg/g, respectively; the contents of calycosin and formononetin in Hedysari Radix processed by traditional method were the lowest, 4.7767 and 37.2910 μg/g, respectively; the contents of calycosin and formononetin in raw Hedysari Radix and Hedysari Radix by honey microwave method were the same, 5.0802, 42.7989 μg/g, and 3.9839, 42.3145 μg/g, respectively. Conclusion Different honey sunburn methods for the contents of calycosin and formononetin in Hedysari Radix have certain effects, and honey roast method is the optimum method.
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Objective To observe the dynamic changes of 18F-FDG uptake and clearance in the amygdala and hippocampus in patients with first-episode depression (FED),and explore the neurobiology mechanism of FED.Methods i8 F-FDG PET/CT imaging was performed on 35 patients with FED and 35 healthy volunteers from January 2014 to January 2016.SUV in the amygdala and hippocampus at different time points were collected.The clearance rates were calculated and the difference between patients and healthy volunteers were compared by two-sample t test.Results The FDG uptake in the left amygdala of patients reached the peak earlier compared with that in the healthy group,with the SUVmax of 12.94±2.03 at 25 min and 10.50±1.79 at 40 min,respectively.FDG uptake in the left amygdala at 10,25,40,55,70,85 min between the 2 groups were significantly different (t values:12.92,8.65,6.99,12.34,28.87,13.87;all P＜ 0.05).The clearance rate in the left amygdala of patients at different time interval was increased compared with that of the healthy group(40-55 min:t=32.53;56-70 min:t=32.73;71-85 min:t=11.10;all P＜ 0.05).Compared with the healthy group,FDG uptake in the left hippocampus of patients was decreased significantly at 10,25,40,55,85 min (t values:2.70,7.75,7.78,8.81,7.00;all P＜0.05) for FDG uptake,and the clearance rate was also decreased significantly at different time interval(40-55 min:t =6.02;56-70 min:t=62.15;71-85 min:t=37.39;all P＜0.05).Differences of metabolic changes in the right amygdala and the right hippocampus were not significant.Conclusions 18F-FDG metabolism in the amygdala and hippocampus of patients with FED may be abnormal,which is characterized by earlier peak uptake and quicker clearance in the left amygdala while lower uptake and slower clearance in the left hippocampus.