Objective To investigate the inttuenee of elevated fasting blood glucose(FBG)on left ventrieular ejection fraction(LVEF)after acute myocardial infarction(AMI).Methods The relationship between FBG(≥8-hour fast within 24 hours of admission)and LVEF in 161 patients with AMI was studied prospectively.Patients were grouped by FBG (group 1,FBG＜6.1 mmol/L,group 2,FBG 6.1-6.9mmol/L,group 3.FBG≥7.0mmol/L).LVEF was measured at admission and at 30 days after AMI onset Results Compared with that of normal FBG(group 1),LYEF of elevated FBG(group 2 and group 3)was lower[for admission:(49.3±6.7)%,(45.8±7.4)% vs (52.4±7.7)%,P＜0.05;for 30day8:(52.7±7.3)%,(49.2±7.2)% vs (55.8±7.4)%.P＜0.05].ConclusionElevated FBG is associated with worse LVEF after AMI.

Male infertility has evolved from a common reproductive system disease to a major social issue. Youjing granule (YG) is a Chinese medicinal material used as a therapy method for tonifying the kidneys and removing dampness due to its pathogenic characteristics. YG has been shown to regulate sperm quality in clinical trials, but the underlying mechanism is not fully understood. The present study was aimed to explore the protective effects and mechanism of action of YG on male reproductive system damage caused by methyl methane sulfonate (MMS). We first established an infertility model of rats through oral administration of MMS and then treated with YG. To determine the effect of YG, spermatogenesis, microvascular density, and secretory function of Leydig cells and Sertoli cells in rats were assessed. Spermatogonial stem cells (SSCs) were co-cultured with mouse embryo fibroblast (MEF) cells as an in vitro cell model before exposure to serum containing YG. Furthermore, the proliferation and apoptosis of SSCs were measured. Results indicated that YG increased the expression of self-renewal and proliferation-related molecules such as glial cell line derived neurotrophic factor (GDNF) and fibroblast growth factor-2 (FGF2), and improved the quality of sperm and the proliferation of SSCs. In conclusion, YG may protect spermatogenetic function of rats through regulating the proliferation and self-renewal of SSCs.
Animals ; Cell Proliferation ; Male ; Mice ; Rats ; Semen ; Spermatogenesis ; Spermatogonia ; Stem Cells

AIM: To investigate the relationship between human cholesteryl ester transfer protein CETP gene polymorphism and postoperative neurocognitive disorders (PND). METHODS: A total of 124 elderly patients over 65 years of age who underwent elective non-cardiac surgery were enrolled in the study while 25 healthy volunteers matching age and sex were recruited as the control group. Neuropsychological tests were performed 1 day before surgery, 7 days, and 3 months after surgery. PND was determined using the Z value method. The venous blood sample of the surgical patient was taken before the operation, followed by direct gene sequencing. Statistical methods were used to calculate the correlation between CETP gene polymorphism (rs5882) and PND. RESULTS: The incidence of PND was 29.3% and 18.2% at 7 days and 3 months after operation respectively. The A allele frequency of PND patients was significantly higher than that of non-PND patients 7 days and 3 months after surgery (65.52% vs. 41.43%, 34.48% vs. 58.57%, P=0.001), while the G allele frequency in PND group lower than that of non-PND (58.33% vs. 37.86%, 41.67% vs. 62.14%, P=0.004).AA genotype in PND patients was 34.48%, 38.89% at 7 days and 3 months after surgery respectively, significantly higher than 14.29%, 16.05% of non-PND (P=0.023, P=0.029). CONCLUSION: CETP rs5882 polymorphism is associated with PND and AA genotype may be a predisposing factor for postoperative PND in Chinese Han elderly patient.

OBJECTIVE: To identify the optimal factors in diffusion tensor imaging for predicting corticospinal tract (CST) injury caused by brain tumors. MATERIALS AND METHODS: This prospective study included 33 patients with motor weakness and 64 patients with normal motor function. The movement of the CST, minimum distance between the CST and the tumor, and relative fractional anisotropy (rFA) of the CST on diffusion tensor imaging, were compared between patients with motor weakness and normal function. Logistic regression analysis was used to obtain the optimal factor predicting motor weakness. RESULTS: In patients with motor weakness, the displacement (8.44 ± 6.64 mm) of the CST (p = 0.009), minimum distance (3.98 ± 7.49 mm) between the CST and tumor (p < 0.001), and rFA (0.83 ± 0.11) of the CST (p < 0.001) were significantly different from those of the normal group (4.64 ± 6.65 mm, 14.87 ± 12.04 mm, and 0.98 ± 0.05, respectively) (p = 0.009, p < 0.001, and p < 0.001). The frequencies of patients with the CST passing through the tumor (6%, p = 0.002), CST close to the tumor (23%, p < 0.001), CST close to a malignant tumor (high grade glioma, metastasis, or lymphoma) (19%, p < 0.001), and CST passing through infiltrating edema (19%, p < 0.001) in the motor weakness group, were significantly different from those of the patients with normal motor function (0, 8, 1, and 10%, respectively). Logistic regression analysis showed that decreased rFA and CST close to a malignant tumor were effective variables related to motor weakness. CONCLUSION: Decreased fractional anisotropy, combined with closeness of a malignant tumor to the CST, is the optimal factor in predicting CST injury caused by a brain tumor.
Anisotropy ; Brain Neoplasms* ; Brain* ; Diffusion Tensor Imaging* ; Diffusion* ; Edema ; Glioma ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Prospective Studies ; Pyramidal Tracts*

Objective To explore the computed tomography (CT)manifestations of adrenocortical oncocytoma (ACO)for better understanding the disease and improving its diagnosis accuracy.Methods The CT manifestations of 9 cases with adrenocortical onco-cytomas confirmed by surgery were retrospectively reviewed and compared with pathological results.Results Five of cases were lo-cated in left side while 4 cases were in right side.Well defined and round or oval border could be found in all the cases.Of all the ca-ses,3 cases were solid lesions with equal density,< 3 cm in diameter,and mild consistent intensification after enhancement.Cystic lesion was detectd in 6 cases with > 3 cm in diameter.The mixed cystic and solid components with polycystic changes could be found on CT image,and remarkable intensification on solid lesion while no intensification on cystic lesion after the enhancement. Moreover,patchy or cotton-like shape could be found on solid lesion in 4 cases and 1 case with island like intensification;reticular pattern could be found in the central of lesion in 3 cases and 1 case with stellate shape.Pathological observation showed that the on-cotytomas were comprised of cells with abundant eosinophilic cytoplasm and necrotic and fibrous capsule without pathological mitosis could be found in some of lesion.Conclusion The characteristic CT features of adrenocortical oncotytoma has a worse specificity,its diagnosis was dependent on pathologic examination.

Objective:To investigate the hippocampal subfield volumes before and after taking hydrochloric donepezil in patients with mild Alzheimer's disease (AD). Methods:From January, 2017 to June, 2018, 25 mild AD patients accepted hydrochloric donepezil (treatment group), 25 patients accepted placebo (placebo group) and 25 age- and gender-matched healthy old people (control group) were scanned with magnetic resonance imaging (MRI) under 3D-T₁ TFE sequence before and after a six-month treatment, and the automated segmentation of the hippocampus subfields was fulfilled with FreeSurfer and the hippocampus subfield volumes were compared, while the patients were assessed with Mini-Mental State Examination (MMSE). Results:Compared with the control group, the volumes of left CA1， CA2-3 and CA4-DG, and right CA1 and CA2-3 were reduced in patients before treatment (t > 2.294, P < 0.05). The volume of left CA4-DG increased in the treatment group compared with that of the placebo group after treatment (t = 2.196, P < 0.05), and the volume of bilateral CA1 and CA2-3 tended to increase but not significantly (t < 1.888, P > 0.065). The MMSE score was more in the treatment group than in the placebo group after treatment (t = 2.764, P < 0.05). Conclusion:The association with asymmetric atrophy in the hippocampal subfields has been found in mild AD patients, especially in left CA4-DG, which may be used as a valuable marker for diagnosis and evaluation for treatment at early stage.

Objective To explore the application value of spectral CT quantitative analysis in differentiating adenocarcinoma or squamous carcinoma from inflammatory myofibroblastic tumor (IMT). Methods A total of 115 patients with 62 adenocarcinomas, 33 squamous carcinomas and 20 IMTs underwent spectral CT scans to obtain spectral images at arterial phase (AP) and venous phase (VP). The imaging data were analyzed retrospectively. The iodine concentration of adenocarcinoma, squamous carcinomas and IMT were measured. The normalized iodine concentration in AP (NICAP), normalized iodine concentration in VP (NICVP) and normalized iodine concentration difference between AP and VP (ICD) were calculated. The above quantitative parameters among three groups were analyzed with analysis of variance and ROC curve. Results NICAP (0.15 ± 0.04), NICVP (0.37 ± 0.08) and ICD(0.23 ± 0.06)of the adenocarcinoma were lower than those of IMT (0.21 ± 0.05,0.50 ± 0.06,0.28 ± 0.08). There were significant differences in NICAP, NICVP and ICD between adenocarcinoma and IMT (P<0.05). NICAP (0.13 ± 0.03), NICVP (0.35±0.06) and ICD (0.22±0.05) of the squamous carcinoma were lower than those of IMT (0.21± 0.05,0.50±0.06,0.28±0.08). The differences in NICAP, NICVP and ICD were significant between squamous carcinoma and IMT (P<0.05). There were no significant differences in NICAP, NICVP and ICD between adenocarcinoma and squamous carcinoma (P>0.05). The best spectral quantitative parameter for differentiating the adenocarcinoma from IMT was NICVP, which yielded a sensitivity of 92.3% and a specificity of 86.7%with the threshold of 0.425. NICVP was also the best spectral quantitative parameter for differentiating squamous carcinomas from IMT. With the threshold of 0.44, a sensitivity of 84.6% and a specificity of 92.3% were found. Conclusion Spectral CT imaging with the quantitative iodine concentration analysis may help to increase the accuracy of differentiating adenocarcinoma and squamous carcinoma from IMT.

Objective To explore the application value of spectral CT quantitative analysis in differentiating adenocarcinoma or squamous carcinoma from inflammatory myofibroblastic tumor (IMT). Methods A total of 115 patients with 62 adenocarcinomas, 33 squamous carcinomas and 20 IMTs underwent spectral CT scans to obtain spectral images at arterial phase (AP) and venous phase (VP). The imaging data were analyzed retrospectively. The iodine concentration of adenocarcinoma, squamous carcinomas and IMT were measured. The normalized iodine concentration in AP (NICAP), normalized iodine concentration in VP (NICVP) and normalized iodine concentration difference between AP and VP (ICD) were calculated. The above quantitative parameters among three groups were analyzed with analysis of variance and ROC curve. Results NICAP (0.15 ± 0.04), NICVP (0.37 ± 0.08) and ICD(0.23 ± 0.06)of the adenocarcinoma were lower than those of IMT (0.21 ± 0.05,0.50 ± 0.06,0.28 ± 0.08). There were significant differences in NICAP, NICVP and ICD between adenocarcinoma and IMT (P<0.05). NICAP (0.13 ± 0.03), NICVP (0.35±0.06) and ICD (0.22±0.05) of the squamous carcinoma were lower than those of IMT (0.21± 0.05,0.50±0.06,0.28±0.08). The differences in NICAP, NICVP and ICD were significant between squamous carcinoma and IMT (P<0.05). There were no significant differences in NICAP, NICVP and ICD between adenocarcinoma and squamous carcinoma (P>0.05). The best spectral quantitative parameter for differentiating the adenocarcinoma from IMT was NICVP, which yielded a sensitivity of 92.3% and a specificity of 86.7%with the threshold of 0.425. NICVP was also the best spectral quantitative parameter for differentiating squamous carcinomas from IMT. With the threshold of 0.44, a sensitivity of 84.6% and a specificity of 92.3% were found. Conclusion Spectral CT imaging with the quantitative iodine concentration analysis may help to increase the accuracy of differentiating adenocarcinoma and squamous carcinoma from IMT.

Objective:To explore the value of spectral CT radiomics quantitative features on differentiating lung cancer nodule from inflammatory nodule.Methods:The spectral CT imaging data of 96 lung cancer nodules and 45 inflammatory nodules from the First Affiliated Hospital of Soochow University were analyzed retrospectively. According to a ratio of two to one, patients were randomly assigned to the training group and validation group, including 64 lung cancer nodules and 30 inflammatory nodules in the training group, 32 lung cancer nodules and 15 inflammatory nodules in the validation group. MaZda software was used for radiomic feature extraction from the 70 keV monochromatic images in arterial phase and venous phase for lung cancer nodules and inflammatory nodules in the training group. Fisher coefficients (Fisher), classification error probability combined average correlation coefficients (POE+ACC) and mutual information (MI) were used to select 10 optimal features for the optimal feature subsets. The optimal feature subsets were analyzed by using linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) to calculate the area under the receiver operating characteristic (ROC) curve (AUC), accuracy, sensitivity, specificity, precise and F1 score in differentiating lung cancer nodule from inflammatory nodule. The prediction model was established using the optimal feature subsets in the training group with artificial neural network (ANN). Then the established prediction model was used to differentiate lung cancer nodule from inflammatory nodule in the validation group. Delong test was used to compare the differences in the AUC of different optimal feature subsets.Results:In arterial phase, the optimal feature subset obtained from MI-NDA had the highest AUC of 0.888 [95% confidence interval (CI) 0.806-0.943], accuracy rate of 88.3%, sensitivity of 87.5% and specificity of 90.0%, on the differential diagnosis of lung cancer nodule and inflammatory nodule in the training group. There was no significant difference in AUC between MI-NDA and Fisher-NDA or (POE+ACC)-NDA method ( Z=1.941, P=0.052; Z=1.683, P=0.092). In venous phase, the optimal feature subset obtained from (POE+ACC)-NDA had the highest AUC of 0.846 (95%CI 0.757-0.912), accuracy rate of 87.2%, sensitivity of 92.2% and specificity of 76.7%, on the differential diagnosis of lung cancer nodule and inflammatory nodule in the training group. There was no significant difference in AUC between(POE+ACC)-NDA and MI-NDA method ( Z=1.354, P=0.18), but significant difference between (POE+ACC)-NDA and Fisher-NDA method ( Z=2.423, P=0.015). In the validation group and training group, the optimal feature subset selected by MI-NDA method had the highest AUC of 0.888(95%CI 0.806-0.943) and 0.871(95%CI 0.741-0.951). Conclusion:Spectral CT radiomics quantitative features have great value on the differential diagnosis of lung cancer nodule and inflammatory nodule.

Objective:To explore the value of gadolinium-ethoxybenzyl- diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI nomogram model for preoperative prediction of Ki-67 expression in hepatocellular carcinoma (HCC).Methods:Data of 85 patients of HCC confirmed by postoperative pathology, who underwent preoperative Gd-EOB-DTPA enhanced MRI between September 2016 and August 2019 in the First Affiliated Hospital of Soochow University were retrospectively evaluated. According to postoperative immunohistochemistry Ki-67 index, the 85 patients were divided into Ki-67 low expression group(Ki-67 index ≤10%, n=20) and Ki-67 high expression group (Ki-67 index >10%, n=65). Clinical data (hepatitis, cirrhosis, etc.), qualitative imaging parameters (tumor margin, capsule, etc.) were compared by χ 2 test and quantitative parameters [lesion-to-normal parenchyma ratio-arterial phase (LNR-AP), lesion-to-normal parenchyma ratio-portal phase (LNR-PP), lesion-to-normal parenchyma ratio-equilibrium phase (LNR-EP) and lesion-to-normal parenchyma ratio-hepatobiliary phase (LNR-HBP)] were compared by independent sample t test. The above statistically significant parameters were included in multivariate logistic regression to identify the independent predictors of Ki-67 high expression and then the nomogram model for predicting Ki-67 expression of HCC was established. Results:alpha-fetoprotein (AFP) tumor margin, arterial rim enhancement between the Ki-67 low expression group and the Ki-67 high expression group had significant differences (χ 2 were 8.196, 10.538 and 4.717, respectively, P<0.05). LNR-AP, LNR-PP, LNR-EP and LNR-HBP between the two groups had significant differences ( t were 2.929, 2.773, 2.890 and 3.437, respectively, P<0.05).The result of multivariate logistic regression revealed that AFP≥20 μg/L, non-smooth tumor margin and low LNR-HBP were the independent predictors of Ki-67 high expression (odds ratio were 4.090, 3.509 and 0.042, respectively, P<0.05).The Gd-EOB-DTPA enhanced MRI nomogram model for predicting Ki-67 expression of HCC was established successfully. The Area under the receiver operating characteristic curve of the nomogram was 0.837 and the corrected predictive curve fitted the ideal curve, which suggested the model had a good predictive efficiency. Conclusion:Gd-EOB-DTPA enhanced MRI nomogram model has great value in preoperative prediction of Ki-67 expression of HCC, which provided a personalized prediction method for Ki-67 expression in patient with HCC.