[Clinical observation on the efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis].

To investigate the clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) in China. A small sample self-controlled study before and after treatment was conducted to retrospective analysis patients with moderate to severe AD treated with dupilumab in the department of dermatology of the First Affiliated Hospital of Chongqing Medical University from July 2020 to March 2022. Dupilumab 600 mg was injected subcutaneously at week 0, and then 300 mg was injected subcutaneously every 2 weeks. The condition was evaluated by SCORAD(severity scoring of atopic dermatitis), NRS(numerical rating scale), DLQI(dermatology life quality index) and POEM(patient-oriented eczema measure). The improvement of SCORAD, NRS, DLQI and POEM was analyzed by paired t test and non-parametric paired Wilcoxon. The results showed that a total of 67 patients with moderate to severe AD received dupilumab treatment, of which 41 patients (the course of treatment was more than 6 weeks) had reduced the severity of skin lesions, improved quality of life and reduced pruritus. A total of 23 patients completed 16 weeks of treatment. At 4, 8, 12 and 16 weeks, SCORAD, NRS, DLQI and POEM decreased compared with the baseline, and the differences were statistically significant. SCORAD (50.13±15.19) at baseline, SCORAD (36.08±11.96)(t=6.049,P<0.001) at week 4,SCORAD (28.04±11.10)(t=10.471,P<0.001) at week 8, SCORAD (22.93±9.72)(t=12.428,P<0.001) at week 12, SCORAD (16.84±7.82)(t=14.609,P<0.001) at week 16, NRS 7(6,8) at baseline, NRS 4(3,5)(Z=-3.861,P<0.001) at week 4, NRS 2(1,4)(Z=-4.088,P<0.001) at week 8, NRS 1(0,2)(Z=-4.206,P<0.001) at week 12, NRS 2(0,2)(Z=-4.222,P<0.001) at week 16, DLQI (13.83±5.71) at baseline, DLQI (8.00±4.02)(t=6.325,P<0.001) at week 4, DLQI (5.61±3.50)(t=8.060,P<0.001) at week 8, DLQI (3.96±1.99)(t=8.717,P<0.001) at week 12, DLQI (2.70±1.89)(t=10.355,P<0.001) at week 16, POEM (18.04±6.41) at baseline, POEM (9.70±4.70)(t=7.031,P<0.001) at week 4, POEM (7.74±3.48)(t=8.806,P<0.001) at week 8, POEM (6.35±3.33)(t=10.474,P<0.001) at week 12, POEM (4.26±2.51)(t=11.996,P<0.001) at week 16. In the 16th week, 100%(23 patients), 91.3%(21 patients), 34.8%(8 patients) and 8.7%(2 patients) of 23 patients reached SCORAD30, SCORAD50, SCORAD70, and SCORAD90 statuses, respectively. There were 82.6%(19 patients), 95.7%(22 patients) and 95.7%(22 patients) of 23 patients with NRS, DLQI and POEM improved by≥4 points compared with baseline. Twelve patients with AD who continued to receive dupilumab after 16 weeks showed further improvement in skin lesions. The adverse events were conjunctivitis and injection site reaction. In conclusion, dupilumab is an effective and safe treatment for moderate and severe AD. However, the longer-term efficacy and safety require further studies involving larger sample sizes and a longer follow-up time.

[Research progress on clinical and mechanisms of chronic pruritus with anxiety and depression].

Chronic pruritus seriously affects the quality of life of patients, which is closely related to stress, anxiety and depression. Prolonged and repeated pruritus can induce negative emotions such as anxiety and depression, while continued increased negative emotions can also promote exacerbation of pruritus, which drives the itch scratch cycle, thereby further aggravating skin damage. More and more studies have explored the mechanism of pruritus, anxiety and depression. This article mainly reviews the clinical relationship between pruritus and anxiety, depression and the new progress of its possible mechanism, providing reference for the prevention, control and effective treatment of chronic pruritus, anxiety and depression.

RESOLVE-based radiomics in cervical cancer: improved image quality means better feature reproducibility?

AIM: To compare the reproducibility of apparent diffusion coefficient (ADC)-based radiomic features between readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) and single-shot echo-planar diffusion-weighted imaging (SS-EPI DWI) in cervical cancer. MATERIALS AND METHODS: The RESOLVE and SS-EPI DWI images of 36 patients with histopathologically confirmed cervical cancer were collected retrospectively. Two observers independently delineated the whole tumour on RESOLVE and SS-EPI DWI, and then copied them to the corresponding ADC maps. Shape, first-order, and texture features were extracted from ADC maps in the original and filtered (Laplacian of Gaussian [LoG] and wavelet) images. Thereafter, 1,316 features were generated in each RESOLVE and SS-EPI DWI, respectively. The reproducibility of radiomic features was assessed using intraclass correlation coefficient (ICC). RESULTS: In the original images, RESOLVE showed 92.86%, 66.67%, and 86.67% of features with excellent reproducibility in shape, first-order, and texture features, while SS-EPI DWI showed 85.71%, 72.22%, and 60% of features with excellent reproducibility, respectively. In the LoG and wavelet filtered images, RESOLVE had 56.77% and 65.32% of features with excellent reproducibility and SS-EPI DWI had 44.95% and 61.96% of features with excellent reproducibility, respectively. CONCLUSION: Compared with SS-EPI DWI, the feature reproducibility of RESOLVE was better in cervical cancer, especially for texture features. The filtered images cannot improve the feature reproducibility compared with the original images for both SS-EPI DWI and RESOLVE.

Ultra-low radiation dose CT angiography of the lower extremity using the iterative model reconstruction (IMR) algorithm.

AIM: To investigate the image quality of lower-extremity computed tomography (CT) angiography (CTA) with ultra-low radiation dose using the iterative model reconstruction (IMR) algorithm. MATERIALS AND METHODS: Lower-extremity CTA was acquired using a 256-multidetector CT system from 90 patients assigned into three groups: (1) the routine dose (RD) group: 120 kVp, automatic tube current modulation (ACTM) with an image quality index of 12, and filtered back projection (FBP); (2) the low-dose (LD) group: 80 kVp, ACTM with an image quality index of 1, and IMR; and (3) the ultra-low dose (ULD) group: 80 kVp, 20 mAs, and IMR. CT attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the lower-extremity arteries were calculated. Subjective image quality of lower-extremity segments was assessed. Effective radiation dose was recorded. RESULTS: The radiation dose was reduced by 91.4% and 67.3% in the ULD group (0.15±0.02 mSv) compared to the RD group (1.86±0.51 mSv) and the LD group (0.49±0.08 mSv; both p<0.05). Higher CT attenuation, SNR, CNR, and lower image noise were obtained in the ULD group and the LD group compared to the RD group (all p<0.05). Better subjective image quality in lower leg segments was obtained in the ULD group and the LD group compared to the RD group (all p<0.05). No difference was found between the ULD and LD groups in both objective and subjective image quality (all p>0.05). CONCLUSION: By using IMR during lower-extremity CTA, the radiation dose is reduced by up to 91.4% without compromising image quality.

Topology studies of hydrodynamics using two-particle correlation analysis.

The effects of fluctuating initial conditions are studied in the context of relativistic heavy ion collisions where a rapidly evolving system is formed. Two-particle correlation analysis is applied to events generated with the NEXSPHERIO hydrodynamic code, starting with fluctuating nonsmooth initial conditions (IC). The results show that the nonsmoothness in the IC survives the hydroevolution and can be seen as topological features of the angular correlation function of the particles emerging from the evolving system. A long range correlation is observed in the longitudinal direction and in the azimuthal direction a double peak structure is observed in the opposite direction to the trigger particle. This analysis provides clear evidence that these are signatures of the combined effect of tubular structures present in the IC and the proceeding collective dynamics of the hot and dense medium.

Importance of granular structure in the initial conditions for the elliptic flow.

We show the effects of the granular structure of the initial conditions of a hydrodynamic description of high-energy nucleus-nucleus collisions on some observables, especially on the elliptic-flow parameter v2. Such a structure enhances production of isotropically distributed high-pT particles, making v2 smaller there. Also, it reduces v2 in the forward and backward regions where the global matter density is smaller and, therefore, where such effects become more efficacious.