Objective To assess the image quality of iterative model reconstruction algorithm (IMR) compared with hybrid iterative reconstruction algorithm (iDose4) for hypovascular hepatic metastases.Methods Medical history and pathological results of 33 cases with primary malignant tumor were retrospective analyzed.Follow-up with enhanced CT or enhanced MRI at more than 3 months confirmed hypovascular metastases in these patients.All patients underwent abdominal CT scanning and dynamic enhanced CT scanning.Portal vein phase of low dose scanning data were taken as the research object.According to the different tube currents and reconstruction algorithm,the images were divided into 4 groups.Group A included images with tube current of 175 mAs and IMR post-processing (17 cases).Group B included images with tube current of 175 mAs and iDose4 post-processing (17 cases).Group C included images with tube current of 125 mAs and IMR post-processing (16 cases).Group D included images with tube current of 125 mAs and iDose4 post-processing (16 cases).In the cases with multiple lesions,the largest lesion was selected to evaluate.For each image of the objective evaluation [including noise,the signal-to-noise ratio (SNR),contrast to noise ratio (CNR)] and subjective evaluation (including lesion sharpness,necrosis interface and diagnostic confidence).The CT dose index of each scanning was recorded.The objective evaluation,subjective evaluation indexes were compared by paired samples t test and Wilcoxon signed rank test.Results The tube current of Group A and Group B were (7.7± 1.8) and (12.8±3.7)HU,while CNR were 10.3 ±2.6 and 5.6± 1.4,SNR were 13.2±3.2 and 8.1 ± 2.2,and the differences were statistically significant (t values were 9.966,12.670,9.203;P＜0.01).The tube current of Group C and Group D were (7.2±1.3) and (9.9±1.8)HU,while CNR were 7.4±2.0 and 3.7±0.9,SNR were 13.9±2.9 and 9.8±1.9,and the differences were statistically significant (t values were 9.209,12.320,9.628;P＜0.01).The lesion sharpness score of Group A and Group B were 4.95±0.24 and 4.29±0.59,while the necrosis interface score were 4.76 ± 0.36 and 3.68 ± 0.30,diagnostic confidence score were 4.94± 0.24 and 4.44 ±0.56,and the differences were statistically significant (P＜0.05).The lesion sharpness score of Group C and Group D were 3.94±0.68 and 3.56±0.63,while the necrosis interface score were 3.91±0.64 and 3.03±0.50,diagnostic confidence score were 4.19±0.40 and 3.94±0.44,and the differences were statistically significant (P＜0.05).CTDIvol of 175 mAs group and 125 m As group were (11.83±0.28) and (8.44±0.24) mGy respectively.Conclusion Compared with iDose4,iterative reconstruction technology IMR significantly reduces the image noise and enhances image quality of hypovascular hepatic metastases.

Currently, sorafenib is the multi-target inhibitor for the treatment of advanced primary liver cancer, and can effectively prolong the progression-free survival and overall survival in patients with advanced primary liver cancer. The application of sorafenib in the targeted therapy for liver cancer has become a hot topic. Major targets or signaling pathways include Raf/Mek/Erk, Jak/Stat, PI3K/Akt/mTOR, VEGFR and PDGFR, STAT, microRNA, Wnt/β-catenin, autolysosome, and tumor-related proteins, and sorafenib can regulate the proliferation, differentiation, metastasis, and apoptosis of liver cancer cells through these targets. This article reviews the current research on the action of sorafenib on these targets or signaling pathways to provide useful references for further clinical research on sorafenib.

Occupational silicosis features as irreversible pulmonary fibrosis, which is caused by long-term inhalation of free silica dust. The pathogenesis of silicosis is complex and there is no cure at present. Traditional Chinese medicine classifies silicosis fibrosis into the category of diseases as "pulmonary paralysis" and "pulmonary arthralgia", and its treatment is based on promoting blood circulation and activating qi. Traditional Chinese medicine for activating blood circulation is one of the commonly used medications, which has the effects of anti-oxidation, anti-inflammation, anti-fibrosis and immunomodulation, and has broad application prospect in the prevention and treatment of silicosis. At present, animal experiments and clinical studies have been carried out using the single Chinese herbs extracts that could activate blood circulation such as Salvia miltiorrhiza, Ligusticum chuanxiong Hort., Panax notoginseng, Curcuma longa L., peach kernel and Carthamus tinctorius L. as well as their compound herbs for the prevention and treatment of silicosis. The mechanisms of anti-pulmonary fibrosis and the efficacy and safety of treating silicosis and its complications were explored. There are also scholars studying Salvia miltiorrhiza, Curcuma longa L. and Danhong injection, Taohong Siwu Decoction and others for prevention and treatment of pulmonary fibrosis. Additionally, network pharmacological research, analyzing potential targets and pathways, were carried out to provide scientific rationale for prevention and treatment of silicosis. However, the effectiveness of research is still uncertain, and it cannot meet the clinical needs. In the future, it is necessary to explore the application of more high-quality active components of traditional Chinese medicine monomer or mixture of activating blood circulation in the prevention and treatment of silicosis, to provide new ideas and scientific basis for the prevention and treatment of silicosis using traditional Chinese medicine.

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology