Objective To investigate the clinical value of gemstone spectral imaging (GSI) associated with patient-based low dose of contrast medium protocol in carotid CTA. Methods One hundred and twenty patients who were suspected with stenotic carotid artery or carotid plaque were prospectively enrolled in the study. All of them were divide into two groups by random number table. Group A (routine group): 60 were scanned with 120 kVp after the administration of moderate-concentration CM(320 mg/ml) with 5 ml/s injection velocity, Group B (low dose group):60 were scanned with GSI which was reconstructed using 50%ASiR after the administration of the same CM with 3 ml/s injection velocity. The contrast dose [(test bolus peak time +2 s – 5 s) × injection velocity] was calculated. Images of the two groups were compared in terms of arterial attenuation, signal-noise-ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) score. The value of CT dose index volume (CTDIvol), dose length product (DLP) and effective dose (ED) was recorded, respectively. Data were analyzed by using independent samples t test or Mann-Whitney U test. Results The mean attenuation, noise, SNR, CNR, subjective image quality score, contrast dose, CTDIvol, DLP and ED of routine group was (363 ± 56)HU, (13 ± 4)HU, 30 ± 10, 38±13, 3.0 score, (69 ± 13) ml, 13.61 mGy,527 mGy · cm and 3.11 mSv, respectively. The above variables of low-dose-group was (378 ± 69) HU, (9 ± 4)HU, 48 ± 19, 62 ± 24, 2.0 score,(49 ± 7)ml, 12.72 mGy, 478 mGy · cm and 2.82 mSv, respectively. The mean attenuation and subjective IQ score of carotid artery had no significant differences statistically between two groups (P>0.05), respectively. The noise, SNR, CNR, contrast dose, CTDIvol, DLP and ED had significant differences statistically between two groups (P<0.05), respectively. Conclusion Compared with 120 kVp protocol, the use of GSI associated with patient-based low dose of contrast medium protocol in carotid CTA could provide equivalent image quality and higher SNR and CNR of carotid artery with a smaller amount of iodine and a lower radiation dose.

Objective To analyze on the efficacy and toxicity of MAAE (MIT ,Ara-C,AMSA,VP16)regimens on treating refractory and relapsed acute leukemia in adult patients. Methods MAAE (MIT, Ara-C,AMSA, VP16) regimen, which consisted of MIT 10mg/d (d1～3), intravenousdrop, Ara-C 200mg/d (d1～7),intravenousdrop, AMSA 75 mg/d (d1～3), intravenousdrop VP16 100 mg/d(d1～4), intravenousdrop were used to treat 25 cases of adults with refractory and relapsed acute leukemia (AL). G-CSF 5 μg/kg were used every day when WBC＜0.5×109/L. Results In the 25 cases with refractory and relapsed acute leukemia, 14 cases (56 %) reached complete remission, 5 patients(20 %) reached partial remission, the total effective rate was 76 %. Conclusion MAAE regimen was a very effective alternative treatment for CR induction in adult patients with refractory and relapsed AL and low toxicity.

Objective To explore the changes in serum energy metabolites in patients with peripheral T-cell lymphoma,and investigate serum biomarkers for monitoring peripheral T-cell lymphoma from the perspective of energy metabolism.Methods Multiple/selected reaction monitoring(MRM/SRM)was used to detect the energy-related metabolites in the sera of 16 patients with newly diagnosed peripheral T-cell lymphoma admitted in the Hematology Medical Center of the Second Affiliated Hospital of Army Medical University from November 2020 to December 2021,as well as 10 recruited healthy volunteers.The corresponding clinical data including medical history,laboratory results and image data were collected and retrospectively analyzed.Results Significant differences were seen in the contents and expression profiles of serum energy metabolism-related products between the patients and the healthy volunteers.The patients had significantly reduced serum contents of cyclic AMP,succinate,citrate and cis-aconitate(P＜0.05),and elevated D-glucose 6-phosphate content(P＜0.05).The serum contents of citrate and succinate were negatively correlated with the risk stratification(low-,moderate-and high-risk)and clinical stage of the disease(P＜0.05).Meanwhile,there was a negative correlation between the contents of L-malic acid and citrate and the mid-term efficacy evaluation results,such as complete/partial response(CR/PR)or stable disease(SD)(P＜0.05).For patients with extranodal NK/T cell lymphoma(n=10),there were also significant reductions in the contents of cyclic AMP,succinate,citrate,isocitrate and cis-aconitate in the sera of patients compared with healthy volunteers(P＜0.05),and the contents of citrate and succinate were negatively correlated with the clinical stage(P＜0.05)and were rather correlated with mid-term efficacy evaluation results(CR/PR or SD)(P＜0.05).For patients with angioimmunoblastic T-cell lymphoma(n=6),the serum contents of cyclic AMP,citrate and succinate were significantly lower,while the content of D-glucose 6-phosphate was higher when compared with the healthy volunteers(P＜0.05),and the content of succinate was negatively correlated with both clinical stage and risk grade of the patients(P＜0.05).Conclusion There are 5 serum differential metabolites identified between patients with peripheral T-cell lymphoma and healthy controls,and succinate and citrate are expected to be serum biomarkers of peripheral T-cell lymphoma.