Objective: To investigate the value of texture analysis of iodine-based material decomposition images with spectral CT imaging for predicting microsatellite instability (MSI) status in colorectal cancer (CRC). Methods: Data of 23 patients with MSI status CRC and 46 patients with microsatellite stability (MSS) status CRC confirmed by postoperative pathology were retrospectively analyzed. All CRC patients underwent preoperative abdominal gemstone spectral imaging. Iodine-based material decomposition images in arterial and venous phases were produced with Viewer software, and the images were imported into Omni-Kinetics software for ROI sketching and feature extraction. The texture parameters included minimum intensity, maximum intensity, mean intensity, median intensity, standard deviation, kewness, kurtosis, uniformity, energy and entropy. The differences of parameters between the two groups were compared. Logistic regression was used to combine texture parameters. Diagnostic performances of various texture parameters and the combination of multiple parameters were studied with ROC analysis. Results: Both in arterial and venous phases, the minimum, maximum, mean, median, and uniformity in MSI group were significantly lower than those in MSS group (all P<0.05), and there was no significant difference of standard deviation, skewness, kurtosis and energy between the two groups (all P>0.05). In venous phase, entropy in MSI group was significantly higher than that in MSS group (t=1.81, P=0.04). In arterial phase, there was no significant difference in entropy between the two groups (t=0.22, P=0.80). ROC analysis showed that the range of AUC for predicting MSI status in CRC patients using single texture parameter as minimum, maximum, mean, median, uniformity in arterial and venous phase or entropy in venous phase was 0.64~0.82. Multi-parameter combined diagnosis Logistic regression model was -2.598-0.124×arterial phase minimum-0.039×arterial phase maximum-0.774×arterial phase median+1×arterial phase mean-1.892×arterial phase uniformity+0.14×venous phase minimum+0.2×venous phase maximum+0.343×venous phase median-0.61×venous phase mean+13.711×venous phase uniformity-2.598×venous phase entropy. When combined multiple texture parameters, the AUC was 0.83. Conclusion: Texture analysis of iodine-based material decomposition image with spectral CT can serve as a preoperative non-invasive method for predicting MSI status in CRC patients. And the optimal predictive value was observed when combined all significant texture parameters.

Objective To study the characteristics of DWI in nude mice models of hepatic Bel7402 tumors after treatment with adenovirus-mediated cytosine diaminase-thymidine kinase ( Ad.CD-TK) double suicide gene therapy, and then to identify whether DWI can be used for assessing curative effect of postoperative tumors.Methods Thirty nude mice models of hepatic Be17402 tumors were successfully created using cell suspension method,after the tumor grew to more than 1 cm in diameter,20 tumor models were treated by intratumoral administration of Ad.CD-TK for 3 days plus intraperitonea( i.p.) treatment with 5-Fc and GCV for the duration of the study.Then they were randomly divided into three groups during 5-Fc and GCV treatment.The remaining 10 tumor models were used as controls.MR scanning were performed in 10th day before and after tumor implantation in all models by using EPI-SE series and SENSE technology for treatment group. Tumor volumes and ADC values were calculated pretreatment and posttreatment. Cell apoptosis were determined by using TUNEL method.Analyze the change of ADC and apoptosis index (AI) in different times,t test was used for comparison the difference of AI and ADC values respectively. Results After 10 days,the tumor volumes of the treatment groups and controls were respectively (724.16 ±57.45 ) mm3,( 754.57 ± 66.84 ) mm3,with no significant difference ( t =0.488,P ＞ 0.05 ).The ADC values of the treatment groups were (0.98 ±0.11 ) × 10-3 mm2/s,the ones of the control groups were (0.68 ±0.04) × 10 -3mm2/s;AI of the treatment groups were(23.25 ±6.57)％,the ones of the control groups were (2.57 ± 0.58) ％.There were difference in both groups ( t =4.473,5.874 ; P ＜ 0.01 ).Conclusion DWI can be effectively to monitor the early pathological changes of hepatic Bel7402 tumors after Ad.CD-TK double suicide gene therapy,and provide experimental evidences for clinical application.

OBJECTIVE To understand and use reasonably the strategy of prevention and management of overwhelming postsplenectomy infection(OPSI). METHODS According to intervention to patients with postsplenectomy by means of education,vaccination,antibotic prophylaxis after April 1998,clinical and follow-up data were reviewed and analyzed from 337 cases patients with traumatic splenectomy from Jan 1992 to Jan 2004,and correlative factors of four OPSI cases were further analyzed. RESULTS Incidence of OPSI descended obviously after intervention(P

Objective To analyze the clinical data of brucellosis,and to provide references for brucellosis therapy.Methods The patients definitely diagnosed brucellosis at the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2016 were assessed,data of clinical features,laboratory examination,treatment and prognosis were analyzed.Results Of all 99 cases,the mean age was (46.7 ± 15.7) years old,83 cases had a history of closely contacted with sheep,2 cases with pig and 1 case with cattle.The occupational distribution of patients included 90 farmers,1 veterinarian,2 cooks,6 children and students.All patients had clinical manifestations such as fever,fatigue,and sweating.There were 18 patients with back and joint pain,13 cases had abnormal manifestation on magnetic resonance imaging (MRI).Blood culture was positive in 54 (71.05％,54/76) and serum test tube agglutination test was positive in 61 (98.39％,61/62).Eighty-one patients received doxycycline combined with rifampicin treatment,six months laters,all patients were cured.Conclusions Sheep are the main sources of infection for brucellosis.Fatigue,sweaty and fever are the most common symptoms,and osteoarticular is the most frequently involved.Serum agglutination test and blood culture are important tests for diagnosis of brucellosis.Doxycycline combined with rifampicin was the most common used antibiotics regimen.Early,combined,regular,full-course antibiotic treatment has a better prognosis.

Objective To investigate the impact of deep machine learning Pixel Shine (PS) algorithm on image quality of abdominal low-dose plain CT scanning in BMI≥25 kg/m2 patients.Methods A total of 59 patients (BMI≥25 kg/m2) who underwent abdominal CT scan were collected.The patients were divided into group A (100 kVp,n=30) and B (120 kVp,n=29) according to the tube voltage.According to different reconstruction algorithms and treatment methods,patients in group A were divided into A1 (FBP),A2 (FBP+PS),A3 (50％ASiR-V) and A4 (50％ASiR-V+PS) subgroups,while in group B were divided into B1 (FBP) and B2 (50％ASiR-V) subgroups.CT and SD values of right hepatic lobe and right erector spinae were measured,then SNR and CNR of liver and CT dose index of volume (CTDIvol) were calculated.The consistency of parameters measured by two observers was evaluated.Results The consistency of parameters measured by two observers was good (all ICC＞0.80).There was no statistical difference of CT values of liver and erector among A1-A4 subgroups (all P＞0.05),whereas statistical differences of SD values of liver and erector spinae,also of SNR and CNR of liver were found (all P＜0.001).Among A1-A4 subgroups,SDA4 ＜SDA2 ＜SDA3 ＜SDA1,SNRA4 ＞SNRA2 ＞SNRA3 ＞ SNRA1 (all P＜0.001) was observed.There was no significant difference of CNR between A1 and A3 subgroup (P=0.078),while CNRA4＞ CNRA2＞ CNRA3 or CNRA1 (P＜0.001) was noticed.SD values of the liver in subgroup A2 was lower than subgroup B1,and A4 was lower than B2 subgroup (all P＜0.001),and SNR and CNR increased significantly in A2 and A4 subgroups (all P＜0.001).CTDIvol of group A was lower than that of group B (P＜0.001).Conclusion Deep machine learning PS algorithm can improve image quality of abdominal low-dose plain CT scanning in high-BMI patients.

Objective:To study the use of radioactive I-125 seed implantation in the treatment of transarterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC).Methods:A retrospective study was conducted on 70 patients with HCC who were initially treated with TACE between July 1, 2016 and August 31, 2019 at the Second Affiliated Hospital of Guangzhou Medical University. After these patients were found to be refractory to TACE, 29 patients were converted to radioactive I-125 seed implantation (the 125I seed group), and 41 patients were continued with TACE (the TACE group). The objective response rate, progression-free survival (PFS), overall survival (OS), total overall survival (TOS) of the two groups were compared. Results:There were 59 males and 11 females, aged (60.5±11.9 ) years in this study. At 1, 3, 6 months after treatment, the objective response rates of the 125I seed group were 20.7%, 40.7%, 34.6%, respectively, which were significantly higher than that of the TACE group of 2.6%, 3.3%, 5.0%, respectively. The PFS, OS, TOS in the 125I seed group were 7.6, 21.1, 32.1 months, respectively, which were significantly better when compared with the TACE group (3.5, 8.5, 14.8 months, respectively, all P<0.05). There was no significant difference in the embolization syndrome between the two groups [93.1%(27/29) vs 100.0%(41/41), P>0.05]. Child-Pugh B grading ( HR=0.311, 95% CI: 0.160-0.603, P=0.005) and TACE ( HR=0.308, 95% CI: 0.159-0.597, P=0.002) were independent risk prognostic factors for survival. Conclusion:This study showed better treatment efficacy and safety using radioactive I-125 seed implantation in TACE-refractory HCC and this treatment significantly improved survival of patients when compared with TACE alone.