Magnetic resonance imaging ( MRI ) findings were studied in 19 patients with non-dementia Parkinson′s disease ( PD) Hoehn-Yahr Stage 1 and 1.5 and 38 healthy subjects.The width and area of pars compacta of substantia nigra ( SNc) , substantia nigra ( SN) and midbrain were measured.The width and area ratios of SNc to SN were calculated.Compared with controls, the widths of right SNc was narrower, bilateral ratios of SNc to SN width were decreased in PD group.As to the area of substantia nigra, there was no significant difference between PD and controls.The width of left SN and the ratio of right SNc to SN width was negatively correlation with age of patients.The ratio of left SNc to SN width, the area of bilateral SNc and left SN, as well as the ratio of right SNc to SN area had negative correlation with the disease duration;however, there was no correlation with gender, Hoehn-Yahr Stage, the Unified Parkinson disease rating scale score, mini mental state scale, education years, levodopa equivalent daily dose, Hamilton Depression Scale or Hamilton Anxiety Scale in PD group.The results indicate that there are bilateral structural changes of SN in unilateral PD patients, which may be more significant with increasing disease duration.The measurement of SNc width and SN area can be used as an objective indicator for diagnosis and disease progression monitoring of PD.

Objective To observe the rotation of subendocardium and subepidium by two-dimensional speckle tracking imaging(2D-STI),and to evaluate its performance in diastolic heart failure patients(DHF)with a normal left ventricular ejection fraction. MethodsNinety-seven consecutive clinically stable patients were enrolled in this study [41 healthy controls,36 with diastolic heart failure,20 with systolic heart failure (SHF)]. High frame rate dynamic two-dimensional images were recorded at the left ventricular short-axis view,including basal, papillary muscle and apical planes. Subendocardial and subepicardial global rotation were measured using Q-lab 7.0 software offline. Results ① In all the subjects, the rotation of the subendocardium was obviously greater than that of subepicardium. ②As seen from the apex,left ventricular subendocardium and subepicardium performed a wringing motion with a clockwise rotation at the base and countclockwise rotation at the apex. ③In the apical plane, subendocardial rotation was significantly lower in both heart failure groups than in controls,and was depressed to a larger extent in SHF patients than in those with DHF. Subepicardial rotation was no significant difference between the DHF group and the control group, though it was significantly lower in patients with SHF. ④At the base, the rotation of subendocardium and subepicardium were not different between DHF and control groups, but it was significantly reduced in patients with SHF. Conclusions The subendocardial rotation is reduced, but subepicardial rotation is normal in DHF patients. On the other hand, in patients with SHF, subendocardial and subepicardial rotation are both reduced. The left ventricular systolic properties are impaired in DHF patients.

Objective To explore the clinical efficacy of intensity-modulated radiotherapy combined with chemotherapy in the treatment of advanced cervical cancer.Methods All 121 patients with advanced cervical cancer (stage Ⅱ B &Ⅲ A & Ⅲ B) selected in our hospital from June 2012 to June 2014, who were treated with combined chemoradiotherapy, were divided into observation group [intensity modulated radiation therapy (IMRT)group)] and control group [3-dimensional conformal radiation therapy (3D-CRT) group].There was no significant difference between two groups in mean age, body mass index, International Federation of Gynecology and Obstetrics (FIGO) clinical stage, pathological type and chemotherapy mode (P ＞ 0.05).The clinical features of two groups were compared.The treatment and follow-up of two groups were recorded.Results The bone marrow suppression [32.2％ (19/59) vs 51.6％ (32/ 62)], gastrointestinal reaction [42.4％ (25/59) vs 62.9％ (39/62)], and rectal reaction rate [27.1％ (16/59) vs 45.2％ (28/62)] of the observation group were significantly less than that of the control group (P ＜ 0.05).The incidences of genitourinary tract injury [18.6％ (11/59) vs 24.2％ (15/62)], radiation proctitis [23.7％ (i4/59) vs 25.8％ (16/62)] and radiation cystitis [16.9％ (10/59) vs 20.9％ (13/ 62)] of two groups had no significant difference (P ＞ 0.05).Two groups were followed up for 3 years, the local control rate of the observation group was significantly higher than that of the control group (86.3％ vs 70.1％) (P ＜ 0.05).Conclusions IMRT combined with chemotherapy in the treatment of advanced cer vical cancer can improve the local control rate of tumor, protect the endangered organ, and reduce the side effects of radiotherapy.

Objective:To investigate the effect of calcification on the diagnostic accuracy of the quantitative flow fraction (CT-QFR) derived from coronary CT angiography (CCTA).Methods:A total of 244 patients (471 coronary arteries) who underwent both CCTA and invasive coronary angiography (ICA) for suspected coronary artery disease between 2019 and 2021 were included in the study. All analyses were conducted at the vessel level using CCTA and ICA images, and the morphological and hemodynamic parameters of all enrolled vessels were assessed. The group was divided into severe calcification (206 cases) and non-severe calcification (265 cases) based on whether the arc of lesion calcification was greater than 180°. Subsequently, the two groups were evaluated to the degree of coronary stenosis, the length of the target lesion, the length of calcification, the ratio of the length of calcification, the remodeling index of calcification, the quantitative flow fraction (QFR), the CT-QFR, and the distribution of the involved vessels. Pearson correlation analysis and the Bland-Altman scatterplot were used to analyze the correlation and consistency between CT-QFR and QFR values from different subgroups. The benchmark for coronary ischemia was QFR≤0.80, and the criteria for diagnosing coronary ischemia were CT-QFR≤0.80 and luminal stenosis≥50%, respectively, and the effectiveness of CT-QFR for coronary ischemia was evaluated by plotting the ROC curves in various calcification subgroups.Results:The degree of luminal stenosis, lesion length, calcification length ratio, and calcification remodeling index were substantially higher in the severely calcified group than in the non-severely calcified group (all P<0.05). The results of the Pearson correlation analysis demonstrated a significant association between CT-QFR and QFR in both the severe and non-severe calcification groups ( r=0.85, 95%CI 0.81-0.88, P<0.001; r=0.91, 95%CI 0.89-0.93, P<0.001); in contrast, the Bland-Altman analysis indicated that the CT-QFR and QFR measurements in the severely calcified group exhibited a high level of agreement, with a mean difference of -0.01 (95% limits of agreement -0.22 to 0.20) for measurements in the severely calcified group and 0 (95% limits of agreement -0.15 to 0.16). The specificity, positive predictive value, negative predictive value, and area under the curve (AUC) for the diagnosis of ischaemic lesions by CT-QFR and CCTA alone were lower in the severely calcified group than in the non-severely calcified group, but the difference in AUC between the two groups for CT-QFR was not statistically significant ( P>0.05), and the difference in AUC for the morphological assessment of CCTA was statistically significant. The diagnostic effectiveness of CCTA alone was considerably worse than the specificity and AUC of CT-QFR for the various calcified subgroups for the diagnosis of ischemic lesions (all P<0.001). Conclusions:Severe calcification somewhat affected the diagnosis of ischaemic lesions by CT-QFR, but there was still a high correlation and concordance between CT-QFR and QFR within the severely calcified group, and the diagnostic efficacy was significantly better than that assessed by CCTA morphology alone.

Objective To explore the structural changes of basal ganglia(subcortical nuclei of cerebral hemisphere)in Parkinson's disease(PD)based on magnetic resonance imaging(MRI)and their relationship with clinical status,and to find neuroimaging biomarkers that are valuable for early diagnosis and disease progression monitoring in PD.Methods Three-dimensional-T1WI and T2WI were applied to 54 PD patients(35 in tremor-dominant PD group,19 in akinetic-rigid-dominant PD group)and 35 healthy controls using 3.0 T MRI scanner.Voxel-based morphometry was used to investigate the volume changes of basal ganglia(subcortical nuclei of cerebral hemisphere, including caudate nucleus, putamen, and globus pallidus).Results Compared with the controls(caudate nucleus: left(6.94 ±1.00)mm3, right (6.93 ±0.88)mm3;putamen:left(5.64 ±0.69)mm3,right(6.03 ±0.86)mm3;globus pallidus: left (3.49 ±0.26)mm3,right(3.60 ±0.25)mm3,PD patients(caudate nucleus:left(5.99 ±1.78)mm3, right(6.11 ±1.65)mm3;putamen:left(4.99 ±1.50)mm3,right(5.56 ±1.68)mm3;globus pallidus:left(3.12 ±0.72)mm3,right(3.23 ±0.72)mm3)exhibited volume reduced in bilateral caudate nuclei(left t=2.871, P=0.005;right t=3.045, P=0.003), left putamen(t=2.773, P=0.007), and bilateral globus pallidus(left t=3.439, P=0.001; right t=3.493, P=0.001).Early stage of PD patients exhibited these changes.In addition,atrophy was showed mainly in left putamen(t=2.136, P=0.038)and globus pallidus(left t=2.683, P=0.010; right t=2.637, P=0.011)in the early stage, while in the later stage,caudate nucleus volume reduction(left t=3.260,P=0.002;right t=3.089,P=0.003)was also found.Moreover,no significant differences were found between tremor-dominant PD group and akinetic-rigid-dominant PD group.However, bilateral volume changes of basal ganglia in PD patients were not explicitly relevant to age,gender,Mini-Mental State Examination score,levodopa equivalent doses, disease duration,Hoehn-Yahr stages,Unified Parkinson's Disease Rating Scale-Ⅲ score, Hamilton Rating Scale for Depression score or Hamilton Rating Scale for Anxiety score.Conclusions The phenomenon of reduced basal ganglia volume was found in patients with PD.The measurement of basal ganglia volume by MRI could be an objective way for early diagnosis of PD.

Objective:To investigate the value of CT features in predicting the invasion and degree of invasiveness of lung pure ground-glass nodules (pGGN) in the new histological classification in 2021.Methods:A total of 281 patients (304 lesions) with pGGN confirmed by surgical pathology from December 2018 to January 2021 in Shandong Provincial Hospital Affiliated to Shandong First Medical University were retrospectively analyzed. According to the pathological types, the patients were divided into prodromal lesion group [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS), 129 cases], minimally invasive group [minimally invasive adenocarcinoma (MIA), 116 cases] and invasive group [invasive adenocarcinoma (IAC), 59 cases]. Clinical data (age, gender, smoking history, family history of cancer), and CT parameters [shape, boundary, lobulation, burr, vacuolar sign, bronchial abnormality sign, internal vessel sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT values in venous phase, the degree of enhancement (ΔCT A-N, ΔCT V-N)] were recorded and measured. The ANOVA, Kruskal-Wallis H and χ 2 test were used to compare the differences among the three groups. Binary logistic regression analysis was used to evaluate the independent risk factors of nodular invasion [prodromal lesion and invasive lesion (MIA and IAC)] and the degree of nodular invasion (MIA and IAC), and receiver operating characteristic (ROC) curve analysis was performed for each parameter. Results:There were statistically significant differences in age, pGGN morphology, lobulation, vacuolar sign, bronchial abnormality sign, internal vascular sign, pleural traction sign, longest diameter, shortest diameter, unenhanced CT value, contrast-enhanced CT value in arterial phase, contrast-enhanced CT value in venous phase among the precursor lesion group, minimally invasive group and invasive group ( P<0.05). Binary logistic regression analysis showed that vacuole sign (OR=2.832, 95%CI 1.363-5.887, P=0.005), internal vascular sign (OR=3.021, 95%CI 1.909-4.779, P<0.001) and unenhanced CT value (OR=1.003, 95%CI 1.001-1.006, P=0.019) were independent risk factors for invasion. Lobulation (OR=5.739, 95%CI 2.735-12.042, P<0.001), internal vascular sign (OR=1.968, 95%CI 1.128-3.433, P=0.017) and unenhanced CT value (OR=1.004, 95%CI 1.001-1.008, P=0.012) were independent risk factors for the degree of invasiveness. ROC curve analysis showed that the efficiency of internal vascular sign was the highest in distinguishing precursor lesion and the invasive, the area under the curve (AUC) was 0.757, the sensitivity was 50.3%, the specificity was 89.8%. The efficiency of lobulation was the highest in distinguishing MIA and IAC (AUC=0.702), with a sensitivity of 61.0% and specificity of 79.3%. Conclusions:CT features are of certain value in predicting the invasion and degree of invasiveness of lung pGGN in the new histological classification in 2021, and internal vascular sign is more effective in predicting the invasion of lung pGGN. Lobulation can predict the degree of invasiveness of pGGN better.

Qizhi Weitong granules composed of Bupleuri Radix， Paeoniae Radix Alba， Aurantii Fructus， Cyperi Rhizoma （processed）， Corydalis Rhizoma （processed）， and Glycyrrhizae Radix et Rhizoma have the effects of soothing the liver， regulating Qi movement， and harmonizing the stomach to relieve pain. This preparation is thus used for the treatment of liver depression， Qi stagnation， chest distension， and epigastric pain. It has become a first-line medication for the treatment of epigastric pain after years of clinical practice. At present， researchers have carried out extensive studies on Qizhi Weitong granules， including the optimization of the extraction and purification process， identification of chemical components， characterization of absorbed components， establishment of quality control methods， validation of pharmacological effect on digestive system diseases， exploration of the mechanism， and observation of clinical efficacy. The studies have achieved fruitful results. This article summarizes the research achievements related to Qizhi Weitong granules in recent years from pharmacological substances， quality control， pharmacological effect， mechanism of action， and clinical efficacy， aiming to provide ideas for in-depth research and modern development of Qizhi Weitong granules.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Humans ; Retrospective Studies ; Pneumonia/diagnostic imaging* ; Analysis of Variance ; Tomography, X-Ray Computed ; Lymphoma/diagnostic imaging*

With the recent ongoing autumn/winter 2022 COVID-19 wave and the adjustment of public health control measures, there have been widespread SARS-CoV-2 infections in Chinese mainland. Here we have analyzed 369 viral genomes from recently diagnosed COVID-19 patients in Shanghai, identifying a large number of sublineages of the SARS-CoV-2 Omicron family. Phylogenetic analysis, coupled with contact history tracing, revealed simultaneous community transmission of two Omicron sublineages dominating the infections in some areas of China (BA.5.2 mainly in Guangzhou and Shanghai, and BF.7 mainly in Beijing) and two highly infectious sublineages recently imported from abroad (XBB and BQ.1). Publicly available data from August 31 to November 29, 2022 indicated an overall severe/critical case rate of 0.035% nationwide, while analysis of 5706 symptomatic patients treated at the Shanghai Public Health Center between September 1 and December 26, 2022 showed that 20 cases (0.35%) without comorbidities progressed into severe/critical conditions and 153 cases (2.68%) with COVID-19-exacerbated comorbidities progressed into severe/critical conditions. These observations shall alert healthcare providers to place more resources for the treatment of severe/critical cases. Furthermore, mathematical modeling predicts this autumn/winter wave might pass through major cities in China by the end of the year, whereas some middle and western provinces and rural areas would be hit by the upcoming infection wave in mid-to-late January 2023, and the duration and magnitude of upcoming outbreak could be dramatically enhanced by the extensive travels during the Spring Festival (January 21, 2023). Altogether, these preliminary data highlight the needs to allocate resources to early diagnosis and effective treatment of severe cases and the protection of vulnerable population, especially in the rural areas, to ensure the country's smooth exit from the ongoing pandemic and accelerate socio-economic recovery.