Objective To investigate the clinical efficacy and mechanism of Weiwei Decoction in treating patients with precancerous lesions of gastric cancer(PLGC)differentiated as deficiency-stasis-turbidity syndrome.Methods From August 2021 to August 2023,a clinical observation was performed on 60 patients diagnosed as chronic atrophic gastritis accompanied by mild to moderate dysplasia and differentiated as deficiency-stasis-turbidity syndrome through traditional Chinese medicine(TCM)syndrome differentiation,electronic gastroscopy,and histopathological examination at the Department of Gastroenterology,Guangdong Second Traditional Chinese Medicine Hospital.The patients were randomly divided into a treatment group and a control group using a random number table,with 30 patients in each group.The control group was treated with oral use of Weifuchun Tablets,while the treatment group was given modified Weiwei Decoction according to syndrome differentiation.The treatment course lasted 24 weeks.Before and after treatment,the changes in TCM syndrome scores,gastroscopy and histopathological grading,and expression levels of markers of cancer-associated fibroblasts(CAFs)in gastric mucosal tissues of the two groups were observed.After treatment,the efficacy of TCM syndromes and medication safety were evaluated in both groups.Results(1)After 24 weeks of treatment,the total effective rate in the treatment group was 93.33%(28/30),and that in the control group was 63.33%(19/30).The TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P＜0.05).(2)After treatment,the TCM syndrome scores in both groups were significantly decreased compared to those before treatment(P＜0.01),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the histopathological grading of gastric mucosal atrophy,intestinal metaplasia,and dysplasia in the treatment group was significantly improved compared to that before treatment(P＜0.05),while no significant improvement was presented in the control group(P＞0.05).The improvement in histopathological grading of gastric mucosal atrophy,intestinal metaplasia,and dysplasia in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the expression levels of CAFs markers of fibroblast activation protein(FAP)and α-smooth muscle actin(α-SMA)in the treatment group were significantly decreased(P＜0.05),while the expression levels of FAP and α-SMA in the control group were significantly increased(P＜0.05)compared to those before treatment.The decrease in FAP and α-SMA expression levels of the treatment group was significantly greater than that of the control group(P＜0.01).(5)During the treatment period,no adverse drug events occurred in either group,indicating high safety.Conclusion Weiwei Decoction has significant therapeutic effect on PLGC patients with deficiency-stasis-turbidity syndrome.Its mechanism may be related to the down-regulation of FAP and α-SMA levels and inhibition of the expression of CAFs.

Objective To observe the feasibility of cardiac MR tissue tracking(CMR-TT)technique for quantitatively evaluating myocardial strain of patients with myocardial amyloidosis(CA).Methods Cardiac MRI were collected from 20 patients of immunoglobulin amyloid light-chain CA(AL-CA,group A),20 cases of transthyretin CA(ATTR-CA,group B)and 20 healthy subjects(group C),and myocardial strain parameters were obtained using CMR-TT technique.Left ventricular cardiac function parameters were compared among 3 groups,so were strain parameters of each myocardial segment of left ventricle and global myocardium,including 3D longitudinal strain(LS),3D radial strain(RS)and 3D circumferential strain(CS).Results Compared with those in group C,significant differences of left ventricular cardiac function parameters were found in both group A and B(all P＜0.01),while no statistical difference was found between group A and B(all P＞0.05).Except for apical segment RS(P=0.81),strain parameters in group A and B were both lower than those in group C(all P＜0.01),while no significant difference was detected between group A and B(all P＞0.05).Conclusion CMR-TT technique could be used to quantitatively evaluate left ventricular myocardial strain of CA patients.

Objective:To investigate the diagnostic performance of continuous-time random-walk (CTRW) diffusion model combined with vesical imaging-reporting and data system (VI-RADS) in the diagnosis of muscle invasion of bladder cancer.Methods:In this case-control study, 64 patients with pathologically confirmed bladder urothelial carcinoma in Peking University First Hospital were retrospectively enrolled from August 2022 to March 2023. The patients were divided into the muscle invasive bladder cancer (MIBC) group and the nonmuscle invasive bladder cancer (NMIBC) group (29 cases and 35 cases, respectively) according to the pathological results. All patients underwent bladder MRI within 4 weeks before surgery, including T 2WI, conventional diffusion weighted imaging (DWI), and multi-b-value DWI. The CTRW model was used to obtain three quantitative diffusion parameters, including D m (an anomalous diffusion coefficient), α (related to temporal diffusion heterogeneity), and β (related to spatial diffusion heterogeneity). The apparent diffusion coefficient (ADC) was calculated using a mono-exponential model. The VI-RADS scores were evaluated based on T 2WI and conventional DWI. The Mann-Whitney U test was used to compare the diffusion parameters between the MIBC group and the NMIBC group. The combination of the parameters was investigated with logistic regression analysis. The diagnostic performance for muscle invasion of bladder cancer was evaluated by receiver operating characteristic analysis and the area under the curve (AUC). The difference between AUC was compared using the DeLong test. Results:There were statistically significant differences in ADC, D m, and α between the MIBC group and the NMIBC group ( Z=-2.31, -2.91, -3.97, P=0.021, 0.004,<0.001). No significant difference was found in β between the two groups ( Z=1.69, P=0.091). The AUC (95% CI) of D m and α for diagnosing MIBC were 0.712 (0.587-0.838) and 0.790 (0.676-0.904) respectively, both of which were higher than that of ADC (AUC 0.669, 95% CI 0.537-0.801) with statistically significant differences ( Z=2.86, 2.27, P=0.004, 0.023). The AUC (95% CI) of CTRW (D m+α) was 0.782 (0.661-0.876), which was significantly higher than that of ADC ( Z=2.35, P=0.019). The AUC (95% CI) of VI-RADS score and VI-RADS combined with CTRW parameter (VI-RADS+D m+α) were 0.823 (0.716-0.930) and 0.900 (0.799-0.961) respectively, with a statistically significant difference between them ( Z=2.16, P=0.031). Conclusion:The D m and α parameters in the CTRW diffusion model show better performance than the ADC in the mono-exponential model for muscle-invasive evaluation of bladder cancer, and the CTRW diffusion model can enhance the diagnostic performance of VI-RADS.

Background and objective Both of lung cancer incidence and mortality rank first among all cancers in China.Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers.Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia.This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer.Methods Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography(LDCT)for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography(2018 version).The detection rate of positive nodules was calculated.Before the LDCT examination,residents were required to complete a"lung cancer risk factors questionnaire".The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator(LASSO)penalized Logistic regression analysis.Results A total of 6256 residents were included in this study.1228 positive nodules(19.63％)and 117 lung cancers were confirmed,including 6 cases of Tis,103 cases of stage Ⅰ(accounting for 88.03％of lung cancer).The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr(OR=1.07,95％CI:1.06-1.07),history of cancer(OR=3.29,95％CI:3.22-3.37),textile industry(OR=1.10,95％CI:1.08-1.13),use coal for cooking in childhood(OR=1.14,95％CI:1.13-1.16)and food al-lergy(OR=1.10,95％CI:1.07-1.13)were risk factors of lung cancer for female in this district.Conclusion This study highlighted that numerous early stages of lung cancer cases were detected by LDCT,which could be applied to screen-ing of lung cancer in women.Besides,age ≥50 yr,personal history of cancer,textile industry and use coal for cooking in childhood are risk factors for women in this district,which suggested that it's high time to raise the awareness of early lung cancer screening in this group.

Objective Exploring the feasibility and effectiveness of collaborative visits between doctors and nurses in tra-ditional Chinese medicine specialty nursing clinics for spleen and stomach diseases.Methods Using the principle of hospital se-lection to determine the visiting caregiver,and collaborating with specialist physicians to establish a specialized Traditional Chi-nese Medicine specialty nursing clinic for spleen and stomach diseases.By conducting a questionnaire survey on patients who visi-ted the Traditional Chinese Medicine specialty nursing outpatient clinic for spleen and stomach disease in 2023 through medical and nursing collaboration and in 2019 through individual visits by caregivers,we analyzed their satisfaction with medical nursing services.Results Since the implementation of collaborative visits between traditional Chinese medicine specialty nursing clinics for spleen and stomach diseases,the number of nursing clinics has increased from 35 people/month in 2019 to 148 people/month in 2023,and the visit time has been increased from 1 time/week in 2019 to 3 times/week in 2023.The satisfaction level of medi-cal nursing services among patients who received collaborative visits from nursing clinics in 2023 was higher than that of patients who received individual visits from nurses in 2019,and the difference was statistically significant(P＜0.05).Conclusion The implementation of collaborative outpatient visits for traditional Chinese medicine specialty nursing in the spleen and stomach dis-ease specialty has expanded the connotation of traditional Chinese medicine nursing services,met the growing individualized and diversified needs of patients,and improved their satisfaction with medical nursing services.

Objective To investigate the incidence and related factors of contrast media extravasation during CT and MR enhanced examinations.Methods A retrospective collection of 234 728 consecutive patients who underwent CT and MR enhanced examina-tions.Firstly,the patients with contrast media extravasation were divided into female group and male group according to gender for comparison.Further,the two groups were subdivided into＜50 years old subgroup and≥50years old subgroup according to age for inter-subgroup comparison.Results Among 234 728 patients in this study,258(0.11％)developed contrast media extravasation.Among them,the female group accounted for 62.02％of contrast media extravasation,while the male group accounted for 37.98％.The incidence of contrast media extravasation in the female group(0.15％)was significantly higher than that in the male group(0.08％),and the difference was statistically significant(P＜0.001).Further inter-subgroup analysis revealed that the incidence of contrast media extravasation in the female patients age ≥50 years old subgroup(0.18％)was significantly higher than that in the female patients age＜50 years old subgroup(0.07％),with statistical significance(P＜0.001).The incidence of contrast media extravasation in the female patients age ≥50 years old subgroup(0.18％)was significantly higher than that in the male patients age ≥50 years old subgroup(0.07％),and the difference was statistically significant(P＜0.001).However,there was no statistically significant difference in the incidence of contrast media extravasation between the male＜50 years old and ≥50 years old subgroups(P=0.23).Conclusion The incidence of contrast media extravasation is higher in female patients age≥50 years old.

Pulmonary mucinous adenocarcinoma (PMA) is relatively rare. On chest CT, it can be divided into two types: mass type and pneumonia type. Mass type PMA is more common and is difficult to distinguish from other nonsmall cell lung cancer. It is a solid or partial solid nodule or mass, predominantly located in the peripheral field of the lung with lobulation, spiculation, and more prone “vacuole sign”. Pneumonia type PMA has a poor prognosis and is more likely to develop into diffuse, multifocal and multilobular lesions similar to inflammatory manifestations, indicating dissemination along the airway. Typical signs include large areas of low density, low enhancement consolidation, and “dead tree sign”.

Objective:To compare the imaging features of renal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion (Xp11.2 RCC) with chromophobe RCC.Methods:From November 2016 to January 2020, 28 patients with Xp11.2 RCC and 28 patients with chromophobe RCC confirmed by pathology were retrospectively analyzed in Peking University First Hospital. All 23 patients underwent preoperative CT examination, and 5 patients underwent routine MRI in each group. The clinical and imaging features were observed and recorded. The CT features including side, location, size, boundary, shape, uniform density, composition (solid, cystic-solid, cystic), hemorrhage, calcification, lymph node metastasis of the lesions and distant metastasis were observed, and the CT value of the solid part of the tumor at each stage was measured. On MRI images, the signal of the lesion in each sequence and enhancement mode were observed. The differences in clinical and imaging characteristics between the 2 groups were compared using independent samples t test or χ 2 test. Results:The Xp11.2 RCC more frequently affected young [(27±10) years] patients, while chromophobe RCC more frequently involved middle-aged [(37±7) years] patients asymptomatically, and the difference was statistically significant ( t=-4.99, P<0.001). The lesion size of Xp11.2 RCC [(5.4±2.2) cm] were significantly smaller than that of chromophobe RCC [(6.9±1.8) cm] ( t=-2.93, P=0.005). There were significant differences in the density and composition of lesions between Xp11.2 RCC and chromophobe RCC (χ 2=4.60, 18.67, P=0.032,<0.001). There were no significant differences in the side, location, boundary, shape, hemorrhage, calcification, fat, lymph node metastasis and distant metastasis between the 2 kind of lesions (all P>0.05). The CT values of solid components in Xp11.2 RCC in cortico-medullary phase and delayed phase were higher than those in chromophobe RCC, and the difference were statistically significant ( t=11.80, 20.15, both P<0.001). Five cases of Xp11.2 RCC showed iso- or slightly hyperintense signal on T 1WI and slightly hypointense signal on T 2WI. Two cases showed delayed enhancement after enhancement, and 3 cases showed a slight decrease in delayed phase enhancement. Conclusion:Compared with chromophobe RCC, Xp11.2 RCC has certain characteristics in imaging manifestations (lesion size, density uniformity, composition, CT value of post-enhanced cortico-medullary phase and delayed phase). Imaging manifestations combining the clinical manifestations (age of onset) are helpful for preoperative diagnosis of Xp11.2 RCC.

Objective:To investigate the feasibility of single breath-hold TFE-EPI in non-contrast coronary MRA on 3.0 T MRI.Methods:Both single breath-hold TFE-EPI and free breathing TFE were conducted in 23 healthy volunteers. Acquisition time between the two sequences were compared by paired- t-test analysis. Signal-noise-ratio (SNR), contrast-noise-ratio (CNR),image artifacts and distortion,vessel acuity were evaluated on the aorta(Ao), right coronary artery proximal(RCA-pro), right coronary artery middle (RCA-mid), left anterior descending proximal(LAD-pro) and left circumflex proximal(LCX-pro). Nonparametric analyses were conducted for the comparison. Results:The acquisition time decreased 96.51% in TFE-EPI compared with TFE [(16.3±2.2)s vs.(466.9±101.3)s, t=21.49, P<0.01]. There was no statistical significance in SNR comparison in all the vessel evaluation (all the P>0.05). TFE-EPI showed better CNR in RCA-mid than TFE ( Z=2.65, P=0.008). TFE-EPI showed less image artifacts and distortion in RCA-mid than TFE ( Z=2.00, P=0.046). TFE-EPI also showed better vessel acuity in both RCA-pro and RCA-mid than TFE ( Z=3.88, P<0.001; Z=3.42, P=0.001). Conclusion:Single breath-hold TFE-EPI could greatly shorten scan time while ensuring image quality in coronal artery imaging and has a broad application in future.

Lung adenosquamous carcinoma (ASC) is a rare histological subtype of lung cancer, which has a worse prognosis than simple lung adenocarcinoma and lung squamous cell carcinoma. ASC was predominantly located in the peripheral field of the lung with heterogeneous attenuation and the most common features included lobulation, spiculation, pleural tail sign, necrosis and cavitation on chest CT images. However, the imaging features of ASC are not specific. Therefore, acquring accurate pathological diagnosis and adequate treatment as soon as possible are very important.