Objective To investigate the spiral CT findings in hemopathic patients with druginduced pulmonary injury.Methods CT images obtained in 11patients with drug-induced pulmonary injury were retrospectively analyzed.Six patients had antineoplastic agent-induced pulmonary injury and 5 patients had non-neoplastic agent-induced pulmonary injury (immunosuppressor in 2 patients,antifungal in 2 patients,antineoplastic immunomodulators in 1 patient).CT findings were reviewed by a chest radiologist.Results All 11patients had parenchymal abnormalities on MSCT scans,including ground-glass opacities( n =8 ),consolidation( n =5 ),interlobular septal thickening( n =3 ) and focal fibrosis ( n =2 ).The abnormalities were bilateral and asymmetric in all patients.They were mainly in the peripheral lung regions in 6 patients,in the central lung regions in four,and irregularly located in one.The abnormalities involved mainly the lower lung zones in six patients,the upper lung zones in two,and all lung zones homogeneously in three.One patient had fluid in bilateral pleural cavities.Three patients were given the same agent once more after the imaging turned to normal,and they presented with same clinical symptoms and similar but more serious imaging findings.Conclusions Drug-induced pulmonary injury usually manifests as areas of ground-glass opacity and consolidation,which most commonly involves the peripheral lungs and lower lung zones.Drug-induced pulmonary injury shows reproducible but more serious lesions when the patient is given the same agent once more.

Objective To investigate the changes of quantitative parameters of dynamic enhanced CT in non-small cell lung cancer before and after targeted therapy,and compare them with the traditional evaluation criteria,in order to find the parameters which can be exploited for timely,objective evaluation of the effect of targeted therapy.Methods The study included 21 patients with targeted therapy who had received dynamic enhanced CT before and after treatment.Enhancement time-density curves were obtained based on the CT values of the lesion at individual time points,and the functional indices:peak height (PH),the time to peak height (Tp),the ratio of PH of the mass to aorta (M/A) and perfusion value were calculated.The effects of the treatment on these indices were evaluated and compared with the effect of the treatment on lesion diameter. Results Twenty-one patients had 33 rechecking results. There was a statistically significant agreement between lesion diameter-based treatment evaluation and perfusion-based treatment evaluation ( U =8.761,P ＜ 0.01 ). The perfusion value decreased in patients with disease regression[before treatment:(0.28 ±0.11 ) ml · min-1 · ml-1,after targeted therapy(0.18 ±0.09) ml ·min-1 · ml-1,t =- 3.2722,P =0.0042],but increased in patients with disease progression[before treatment(0.21 ±0.08) ml · min-1 · ml-1,after targeted therapy:(0.34 ±0.11 ) ml · min-1 · ml-1,t =2.6064,P =0.0403].Conclusions On dynamic enhanced CT in non-small cell lung cancer patients after targeted therapy,perfusion value changed in the same trend as the diameter of tumor.The effectiveness of targeted therapy may be evaluated by perfusion value changes.

Objective To study the imaging features and possible aetiology of osteonecrosis in adults with acute leukemia.Methods Ten adult patients with acute leukemia for osteonecrosis were reviewed retrospectively.All the lesions were confirmed with MRI.Results Four patients with ALL had accepted chemotherapy contained corticosteroids,two of them were performed HSCT,and one patient suffered GVHD.Six patients with AML had accepted chemotherapy without steroids,five of them were performed HSCT,and four patients suffered GVHD.One patient with AML-M3 had accepted chemotherapy including four courses of ATRA.The mean time between diagnosis of osteonecrosis and leukemia was 25.1 months.Nine cases had multiple lesions,one case had single lesion.The lesions involved femurs,tibias,patellas,iliums,and lumbars.Plain radiographs in six patients can not detect any lesion.Circinal reaction ossification could be detected in CT images of four cases.All the cases had typical feature in MRI.Conclusions In adult leukemia patients,osteonecrosis is a complication after chemotherapy or HSCT.Steroids in chemotherapy protocols or treatment for GVHD,ATRA for APML,chemotherapy-induced direct cytotoxic effect or leukemia itself can be the possible risk factor.For the diagnosis,MRI is the most effective way,and CT features of osteonecrosis in leukemia patients are different from those in non-leukemia patients.

Purpose T o analyze the characteristics of different segments of vertebral-basilar artery lesions in posterior circulation cerebral infarction(PCCI)based on CT angiography,and to study its risk factors to improve the early recognition rate.Materials and Methods A total of 199 patients with acute cerebral infarction in Beijing Friendship Hospital,Capital Medical University from January 2022 to March 2023 were enrolled,retrospectively.98 with PCCI,and 101 with anterior circulation cerebral infarction.The groups were compared for differences in vertebral artery dominance,stenosis incidence and stenosis degree in the various vertebrobasilar artery segments.A binary Logistic regression analysis was applied to identify the risk factors for PCCI.Results The rate of vertebral artery dominance(63.3％vs.48.5％)and the incidence of basilar artery stenosis(33.7％vs.20.8％)were significantly higher in the PCCI group than in the anterior circulation cerebral infarction group(x2=4.387,4.174,both P＜0.05).The groups differed significantly in the degree in the vertebral artery segments V1(Z=2.029,P=0.042)and V4(Z=3.315,P=0.001)and in the basilar artery(Z=2.254,P=0.024),with a higher percentage of severe stenosis in the PCCI group.Vertebral artery dominance(OR=4.285,95％CI 1.530-12.003)and right vertebral artery V4 segment moderate to severe stenosis/occlusion(OR=5.883,95％CI 1.458-21.022;OR=5.537,95％CI 1.623-21.329)were independent risk factors for PCCI.Conclusion PCCI is related to morphological changes of the vertebrobasilar artery,right vertebral artery dominance and moderate to severe stenosis/occlusion of V4 segment of right vertebral artery have a higher risk of PCCI.

Objective:To describe and analyze the relationship between traditional and new obesity related anthropometric indicators and all-cause death in centenarians in Hainan, the traditional and new obesity related anthropometric indicators included BMI, waist circumference (WC), waist hip ratio (WHR), waist height ratio, calf circumference (CC), waist-calf ratio (WCR), lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), a body shape index (ABSI), a body shape index of Chinese (CABSI) and body roundness index.Methods:A total of 1 002 centenarians in Hainan were selected by cluster sampling. The M( Q1,Q3) follow-up time was 4.16 (1.31, 5.04) years and the outcome was all-cause death. Multiple Cox regression model was used to analyze the relationship between the obesity related anthropometric indicators and all-cause death, and the area under receiver operating characteristic curve was used for comparison. Results:In all the centenarians, CC had the strongest power to predict death, with area under curve (AUC) of 0.61 (95% CI:0.57-0.64), the gender specific results were consistent with that in overall population ( P<0.05), followed by WCR with AUC of 0.58, and then BMI, LAP and WC with AUC of 0.55, 0.55 and 0.54 respectively, while CABSI, WHR and VAI had the weaker power to predict death with AUC of 0.51, 0.50 and 0.50 respectively. Conclusions:This was the first study to prospectively compare and analyze the association between 12 obesity related anthropometric indicators and all-cause death in a large sample cohort of centenarians in China. It was found that CC had the best prediction power for death, and the risk for death decreased with the increase of CC value in a dose-response manner. It is suggested that CC can be used as a reference index for death risk monitoring in the elderly.

Objective:To investigate basic characteristics of diabetes prevalence and associated factors in centenarians in Hainan province of China.Methods:All the subjects were from China Hainan Centenarian Cohort Study. A total of 1 002 centenarians were included in the final analysis, who were divided into three groups: diabetes group, impaired fasting glucose (IFG) group, and normal glucose group according to the guideline.Results:The average age of centenarians was (102.77±2.55) years, and the proportion of females was 82.0%. There were 95 centenarians who suffered from diabetes, and the prevalence rate was 9.5%. There were 81 centenarians who had IFG, and the prevalence rate was 8.1%. The mean fasting plasma glucose (FPG) level of centenarians was (5.12±1.44) mmol/L, while 43.5% of centenarians had FPG levels ranging from 4.00 to 5.00 mmol/L and 22.1% of centenarians had the FPG levels ranging from 5.00 to 6.00 mmol/L. Increased triglyceride level and abdominal obesity might be associated with the risk for diabetes.Conclusion:The glycometabolism in centenarians in Hainan was better than that in other age groups, and no gender specific difference was observed.

Objective:To explore the blood pressure levels and the influencing factors of hypertension among Hainan centenarians, and provide basic data for the further blood pressure related studies of the centenarian population.Methods:The baseline data were from China Hainan Centenarian Cohort Study (CHCCS). This cross-sectional data, based on the community population, was a complete sample study of centenarians, including questionnaire survey, physical examination and physiological index detection. A total of 1 002 centenarians were recruited to describe the blood pressure level. According to the guidelines for the prevention and treatment of hypertension in Chinese adults in 2018, the prevalence of hypertension was analyzed.Results:The median levels of systolic blood pressure, diastolic pressure and pulse pressure were 152.0, 76.0 and 76.5 mmHg, respectively. Blood pressure level was higher in females than in males. The prevalence of hypertension was 71.9%, mainly in isolated systolic hypertension with the prevalence of 60.1%. The results of multivariate analysis showed that the risk of hypertension in women was higher than that in men ( OR=1.624, 95% CI: 1.155-2.283), and the risk of hypertension in the northern ( OR=0.625, 95% CI: 0.434-0.901) and central areas ( OR=0.586, 95% CI: 0.346-0.993) was lower than that of the Eastern. Conclusion:The prevalence of hypertension, mainly in isolated systolic hypertension, showing gender and regional distribution differences.

Objective:To explore the prevalence of lipid profile and the influencing factors of dyslipidemia in centenarians in Hainan province, and provide basic data for the study of the lipid profile in centenarians.Methods:The data of this study were from the baseline data of China Hainan Centenarian Cohort Study from June 2014 to December 2016. A total of 1 002 centenarians were recruited. According to the guidelines for the prevention and treatment of dyslipidemia in Chinese adults in 2016, the prevalence of lipid profile were described and the prevalence of dyslipidemia with different clinical classifications were compared, and the main influencing factors were analyzed.Results:The median levels of TC, TG, LDL-C and HDL-C were 4.60 mmol/L, 1.05 mmol/L, 2.77 mmol/L and 1.41 mmol/L, respectively, in centenarians in Hainan. Blood lipid profile level was higher in females than in males. With the increase of BMI, TC, TG and LDL-C increased significantly, while HDL-C decreased significantly. The total prevalence of dyslipidemia was 19.1%. Smoking, BMI and area distribution were the main influencing factors of dyslipidemia.Conclusion:The prevalence of dyslipidemia in centenarians in Hainan was at a low level compared with other countries, and the blood lipid profile level was higher in females than in males.

Objective:To analyze the association of waist circumference, BMI, waist-hip ratio, waist-height ratio, calf circumference and waist-calf circumference ratio (WCR) with depression risk in centenarians in Hainan province.Methods:A total of 1 002 centenarians in Hainan were selected by cluster sampling. GDS-15 was used to investigate the depression. Multivariate linear regression and logistic regression analyses were conducted to evaluate the correlation between anthropometric indicators and depression risk. Restricted cubic spline was used to analyze and visualize the linear relationship.Results:After adjusting demographic characteristics (gender, age, ethnic group, marital status, educational level and type of residence) and lifestyle (smoking and drinking), the standard β of BMI, WC, WHR, WHtR, calf circumference and WCR associated with GDS-15 were -0.069, -0.032,0.009, -0.009, -0.099 and 0.060, respectively, and the P values of BMI and calf circumference were <0.05. With the increase of calf circumference, the risk of depression decreased, OR value was 0.94 (95% CI:0.90-0.98), and after adjustment, the results were still significant. Classified variable analysis indicated with the decrease of calf circumference and the increase of WCR, the risk of depression increased gradually, the trend P values were 0.038 and 0.042, respectively. Conclusion:Central obesity (waist circumference and WCR) and periphery obesity (calf circumference) have differed effects on depression in centenarians, and increased calf circumference is a protective factor for depression in female centenarians, attention should be paid to the mental health of the elderly women with lower calf circumference.