The rapid screening of bioactive constituents within traditional Chinese medicine (TCM) presents a significant challenge to researchers. Prevailing strategies for the screening of active components in TCM often overlook trace components owing to their concealment by more abundant constituents. To address this limitation, a fishing strategy based on offline two-dimensional liquid chromatography (2D-LC) combined with surface plasmon resonance (SPR) was utilized to screen bioactive trace components targeting peroxiredoxin 3 (PRDX3), using Uncaria alkaloids (UAs) as a case study. Initially, an orthogonal preparative offline 2D-LC system combining a positively charged C₁₈ column and a conventional C₁₈ column under disparate mobile phase conditions was constructed. To fully reveal the trace alkaloids, 13 2D fractions of UAs were prepared, and their components were characterized using mass spectrometry (MS). Subsequently, employing PRDX3 as the targeting protein, a SPR-based screening approach was established and rigorously validated with geissoschizine methyl ether (GSM) serving as a positive control for binding. Employing this refined strategy, 29 candidate binding alkaloids were fished from the 13 2D fractions. Notably, combining offline 2D-LC with SPR increased the yield of candidate binding components from 10 to 29 when compared to SPR-based screening alone. Subsequent binding affinity assays confirmed that PRDX3 was a direct binding target for the 12 fished alkaloids, with isovallesiachotamine (IV), corynoxeine N-oxide (CO-N), and cadambine (CAD) demonstrating the highest affinity for PRDX3. Their interactions were further validated through molecular docking analysis. Subsequent intracellular H₂O₂ measurement assays and transfection experiments confirmed that these three trace alkaloids enhanced PRDX3-mediated H₂O₂ clearance. In conclusion, this study introduced an innovative strategy for the identification of active trace components in TCM. This approach holds promise for accelerating research on medicinal components within this field.

Objective:To investigate the safety and efficacy of FOLFOX (5-fluorouracil + calcium folinate + oxaliplatin) hepatic arterial infusion chemotherapy (FOLFOX-HAIC) combined with immune and targeted therapy as triple combination therapy for patients with single China Liver Cancer Staging (CNLC) Ⅰb hepatocellular carcinoma.Methods:A total of 20 patients with single CNLC Ⅰb hepatocellular carcinoma who received FOLFOX-HAIC combined with immune and targeted therapy as triple combination therapy in the First Affiliated Hospital of Guangxi Medical University from October 2021 to August 2022 were included. The clinical data of all patients was retrospectively analyzed. There were 18 males and 2 females, with the age of (55.1±9.9) years. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Modified Response Evaluation Criteria in Solid Tumors (mRECIST) were used to evaluate the efficacy of FOLFOX-HAIC combined with immune and targeted therapy, and the clinical safety of triple combination therapy was evaluated by common terminology criteria for adverse events 4.0.Results:According to RECIST 1.1, objective response rate of 20 patients was 70.0% (14/20) and disease control rate was 100.0% (20/20) after 2 cycles of treatment (one cycle of FOLFOX-HAIC plus programmed death-1 antibody). According to mRECIST, objective response rate was 90.0% (18/20) and the disease control rate was 100.0% (20/20) after 2 cycles of treatment. Following the treatment, 12 patients (60.0%) received liver tumor resection, and all of them achieved R 0 resection, 2 patients (10.0%) received radiotherapy, 3 patients (15.0%) stopped drug treatment for surgery, 2 patients (10.0%) refused surgery, and 1 patient (5.0%) died of multiple organ failure caused by immune hepatitis. According to pathological results, 3 patients (25.0%, 3/12) achieved pathological complete response, and 4 patients (33.3%, 4/12) achieved major pathological response. In the safety evaluation, the overall incidence of adverse events was 100.0% (20/20). Seven patients (35.0%) had grade 3 adverse events and 1 patient (5.0%) died of multiple organ failure due to immune hepatitis (grade 5). Grade 1-3 adverse events could be relieved after symptomatic treatment. Conclusion:The triple combination therapy of FOLFOX-HAIC combined with immune and targeted therapy is safe and has high objective response rate and disease control rate, which could be a new strategy for the neoadjuvant treatment of hepatocellular carcinoma.

Objective:To evaluate the diagnostic performance of the prostate imaging reporting and data system version 2.1 (PI-RADS v2.1) based on multiparametric MRI (mpMRI) in the detection of clinically significant prostate cancer (csPCa).Methods:A total of 561 patients who underwent prostate mpMRI in the First Affiliated Hospital of Guangxi Medical University from June 2015 to December 2020 due to elevated prostate specific antigen were collected ambispectively. The patients were divided into csPCa group (276 cases) and non-csPCa group (285 cases) according to pathological findings. Prostate were scored according to the PI-RADS v2.1 scoring standard by a junior and a senior radiologist. The prostate volume was measured and the prostate specific antigen density (PSAD) was calculated. The diffusion-weighted imaging and dynamic contrast-enhanced MRI images were processed to measure the quantitative parameters of the index lesion, including apparent diffusion coefficient (ADC), volume transfer constant (K trans) and rate constant (K ep) values. The Mann-Whitney U test was used to compare the difference in parameters between the two groups. The predictors of csPCa were screened by logistic regression analysis. Predictive model of multi-parameter was established. The receiver operator characteristic curves were used to evaluate the efficacy of PI-RADS v2.1 and the model in diagnosing csPCa, and the comparisons of area under the curve (AUC) were conducted by DeLong test. Results:Compared with non-csPCa group, the patients in csPCa group had higher PI-RADS score of senior physician, PSAD, K trans and K ep value, lower ADC value ( Z=-16.69, -12.49, -3.43, -4.67, 13.91, all P<0.001). The PI-RADS scores of senior physician (OR=3.064, 95%CI 2.428-3.866, P<0.001), PSAD (OR=1.554, 95%CI 1.170-2.064, P=0.002) and ADC value (OR=0.095, 95%CI 0.032-0.288, P<0.001) were the predictors of csPCa. The AUC of junior, senior physician PI-RADS and combined prediction model were 0.861 (95%CI 0.830-0.892), 0.895 (95%CI 0.868-0.922) and 0.923 (95%CI 0.898-0.944). The pairwise difference was statistically significant (the PI-RADS score between the junior and senior physicians Z=3.24, P=0.001, the difference between the PI-RADS score of junior physician and prediction model Z=5.54, P<0.001, the difference between the PI-RADS score of senior physician and prediction model Z=4.20, P<0.001). Conclusion:Based on mpMRI, the application of PI-RADS v2.1 by junior and senior radiologists has the high diagnostic efficacy for csPCa, and the multi-parameter model has the best diagnostic efficacy for csPCa.

Objective:To investigate the diagnostic performance of MRI Liver Imaging Reporting and Data System version 2018 in high-risk hepatocellular carcinoma (HCC) patients with intrahepatic parenchymal substantial lesions ≤3.0 cm.Methods:A retrospective analysis was conducted in hospitals between September 2014 to April 2020. 131 pathologically confirmed non-HCC cases with lesions ≤3.0 cm in diameter were randomly matched with 131 cases with lesions ≤3.0 cm in diameter and divided into benign (56 cases), other hepatic malignant tumor (OM, 75 cases), and HCC group (131 cases) in a 1:1 ratio. MRI features of the lesions were analyzed and classified according to LI-RADS v2018 criteria (tie-break rule was applied to lesions with both HCC and LR-M features). Taking the pathological results as the gold standard, the sensitivity and specificity of the LI-RADS v2018 classification criteria and the more stringent LR-5 criteria (with three main signs of HCC at the same time) were calculated for HCC, OM or benign lesions diagnosis. Mann -Whitney U test was used to compare the classification results. Results:The number of cases classified as LR-M, LR-1, LR-2, LR-3, LR-4, and LR-5 in HCC group after applying the tie-break rule were 14, 0, 0, 12, 28, and 77, respectively. There were 40, 0, 0, 4, 17, 14 and 8, 5, 1, 26, 13, 3 cases in benign and OM group, respectively. There were 41 (41/77), 4 (4/14) and 1 (1/3) lesion case in the HCC, OM and benign group, respectively, that met the more stringent LR-5 criteria. The sensitivity of LR-4 combined with LR-5 (LR-4/5) criteria, LR-5 criteria and more stringent LR-5 criteria for HCC diagnosis were 80.2% (105/131), 58.8% (77/131) and 31.3% (41/131), respectively, and the specificity were 64.1% (84/131), 87.0% (114/131) and 96.2% (126/131), respectively. The sensitivity and specificity of LR-M were 53.3% (40/75) and 88.2% (165/187), respectively. The sensitivity and specificity using LR-1 combined with LR-2 (LR-1/2) criteria for the diagnosis of benign liver lesions were 10.7% (6/56) and 100% (206/206), respectively.Conclusions:LR-1/2, LR-5, and LR-M criteria have high diagnostic specificity for intrahepatic lesions with a diameter of ≤3.0 cm. Lesions classified as LR-3 are more likely to be benign. The specificity of LR-4/5 criteria is low, while the more stringent LR-5 criteria has a high specificity for HCC diagnosis.

Objective ToinvestigatetheenhancedCTfindingsandpathologicalfeaturesoflocalized malignantperitonealmesothelioma (LMPM)andimprovetheaccuracyofdiagnosis.Methods Theimagingandclinicaldataof5casesofLMPMconfirmedbypathology werecollected,thefeaturesofCTenhancedimagingwereanalyzedretrospectivelyandcomparedwiththepathologicalresults.Results Allofthe5caseswereisolatedsolidandcysticmasswithirregularshape,andtherangeofmaximumdiameterofthelesionbeing 8.4-13.3cm,inwhich1casewaspolycystic,andtheother4casesweresolidandcysticmass.CTvalueofthecysticpartwasabout 13.0-27.8 HU,andnoenhancementshowedoncontrast-enhancedphase.Thethicknessofcysticwallandseparationwasuneven, whiletheCTvalueofsolidpartwasabout32.6-40.8HU,andmoderateenhancementwasseeninarterialphase(△CTvaluewasabout30.9-38.4HU ),followedbyslightlyincreaseofenhancementdegreeinvenousphase,andthedecreaseofenhancementdegreeinequilibriumphase. Separationandalotofvesselshadowwereseenin3caseswhileperitonealcavity,pelviceffusionandintraperitonealimplantmetastasiswereseen in1case.Forthepathologicaltypesofpatientsinthisgroup,1casewasepithelialtype,mainlycomposedofcysticcomponent,andthe other4caseswerefibroustypeorbiphasictype,mainlycomposedofcysticandsolid,withsmallcysticdegeneration,necrosis,fibrousseptum, bloodsupplyvessels,andetc.Somelesionsinvadedthesurroundingstructure.Conclusion Thepathologicaltypesoflocalizedmalignantperitoneal mesotheliomaaremostlyfibroustypeandbiphasictypewhichCTfindingsaremostlymanifestedascysticandsolidmasses.Lobulatedand wallnodules,uneventhicknessofcysticwallandseptumcanbeseen,andthedensityofcysticpartialisrelativelyhigher.Solidpartis moderateenhancement,andinvenousphaseismoreobviouswithenhancedvascularseenintheseptum.CTenhancementcombined withclinicalmanifestationsarehelpfultomakeinsuggestivediagnosis.

Objective To investigate the value of diffusion kurtosis imaging (DKI) in diagnosing early diabetic nephropathy. Methods Twelve pigs were divided into the experimental group (7 pigs) and the control group (5 pigs), used the random number table method. The experimental group was fed with high?fat high?sugar diet,and then repeatedly injected small doses(50 mg/kg) of Streptozotocin (STZ) through the ear vein. Meanwhile,the control group was fed with normal diet and injected with the same dose of citric acid?sodium citrate buffer solution.After the type 2 diabetes was established successfully, T1WI, T2WI and DKI sequence imaging were performed every month for 2 pigs from the experimental group and the control group,respectively.Mean kurtosis(MK), axial kurtosis (K∥), radial kurtosis (K⊥), fractional anisotropy (FA) and mean diffusivity(MD) were measured on the pseudo?color map of the post?processing workstation. fasting blood glucose(GLU),insulin (INS),renal function, urine routines and random albumin creatinine ratio(RACR) were measured before MRI scan. Specimens from bilateral kidneys were taken for pathological examination after MRI scan. The paired t test was used to compare the parameter values of the cortex and medulla. Independent sample t test was used tocompare the parameter values of the experimental group and the control group. Results In the experimental group,the MK, FA values of medulla were 0.66±0.07 and 0.19± 0.04, the MK, FA values of cortex were 0.60±0.06 and 0.16±0.03.In the control group,the MK, FA values of medulla were 0.59±0.03 and 0.20±0.04, the MK, FA values of cortex were 0.53±0.03 and 0.17±0.04.The MK and FA values of medulla were increased compared with the cortex and the difference were statistically significant (P<0.01). The MK, K⊥ values of cortex and medulla were increased in the experimental group compared with the control group and the difference were statistically significant (P<0.05). There was no significant differences in the K∥, FA and MD values between two groups (both cortex and medulla, P>0.05). Conclusion DKI sequencehas certain value in the diagnosis of early diabetic nephropathy, and to some extent reveals the pathological change in early diabetic nephropathy.

Objective To explore the significance of ADC value combined with MRI signs on identifying benign and malignant breast lump lesions with the type of TICⅡ.Methods 187 patients with breast lump lesions of TICⅡ,which were confirmed by surgical pathology,proceeded MRI.The ADC value,early-phase enhancement rate,length of lesions,lobulated appearance and spiculation, inverted nipple,thickening of the skin and the length of ipsilateral axillary lymph nodes were analyzed and recorded.T-tests was used to analyzed the measurement data,χ2test was used to analysis the attribute data.The ROC curves were used to evaluate the diagnostic efficiency of ADC value and MRI signs.Results The ADC value was (1.418±0.299)×10-3mm2/s and(0.860±0.142)× 10-3mm2/s (P<0.01)for breast benign and malignant lesions respectively,while the early-phase enhancement rate were (170.387± 74.580)% and (160.778±39.786)%(P=0.258)respectively.When ADC values were used for differential diagnosis of breast benign and malignant lesions with a threshold of 1.017×10-3mm2/s,the area under the sensitivity and specificity were 89.0% and 98.0% The sensitivity and specificity of lobulated appearance,spiculation,inverted nipple and thickening of the skin were 92.6% and 33.3%, 88.2% and 88.2%,20.5% and 94.1%,35.3% and 88.2%,respectively.When the 1.0 cm was used as the threshold of the length of ipsilateral axillary lymph,its sensitivity and specificity were 47.8% and 80.4%.The ROC curve of early-phase enhancement rate showed no diagnostic capability(P>0.05).Conclusion ADC value combined with MRI features are helpful to improve the sensitivity and specificity in breast lesions with the type of TICⅡ.

Objective To investigate the diagnostic value of some measured values of CT for nutcracker syndrome(NCS).Methods 28 patients with NCS confirmed by clinical diagnosis and other 81 normal controls were enrolled in the study.The angle between the superior mesenteric artery and the abdominal aorta,and the diameter and the area of left renal vein before/within this angle were measured on enhanced CT and MPR reconstruction images.The ratios of the diameter and the area before the angle to those within the angle were calculated.ROC curve was established to calculate the cut-off value and to evaluate the sensitivity,specificity,positive predictive value and negative predictive value of these parameters.Results In patient group,the mean aortomesenteric angle was 22.4°± 7.16°,mean diameter ratio was 5.10 ± 1.76 and the mean area ratio was 4.07 ± 2.10.In control group,the mean aortomesenteric angle was 61.32°± 22.82°,mean diameter ratio was 1.38 ± 0.40 and mean area ratio was 1.29 ± 0.49.The area under the ROC of the aortomesenteric angle,and the diameter ratio and area ratio were 0.979,1.000 and 0.989 respectively with corresponding cut-off values of 32.5°,2.63 and 2.06,sensitivity of 92.8%,100% and 96.4%,specificity of 95.1%,100% and 92.6%,positive predictive value of 86.7%, 100% and 81.8%,and negative predictive value of 97.5%,100% and 98.7%,respectively.Conclusion The aortomesenteric angle, the diameter and area ratios of left renal vein before/within the aortomesenteric angle have significant diagnostic value in the patients with NCS,and the value of diameter ratio is the highest.

Objective: To explore the value of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced MRI T₁ mapping in diagnosing and distinguishing dysplastic nodule (DN) and hepatocellular carcinoma (HCC) with different degrees of differentiation. Methods: A retrospective study in the first affiliated Hospital of Guangxi Medical University from September 2015 to December 2017 was conducted. Seventy-one patients with HCC or DN (a total of 79 lesions) that confirmed by biopsy or surgical pathology findings. Seventy-nine lesions were divided into DN (n=10), well differentiated HCC (n=15), moderately differentiated HCC (n=36) and poorly differentiated HCC (n=18) according to histopathology. All the patients underwent plain MRI scan and Gd-EOB-DTPA-MRI T₁ mapping before surgery or needle biopsy. The T₁ values of each lesion and non-tumorous liver parenchyma were measured on 20 min hepatobiliary phase (HBP) T₁ mapping after Gd-EOB-DTPA administration, respectively. The increment rate of T₁ value in lesions relative to non-tumorous liver parenchyma were calculated. One-way ANOVA was used to compare the differences of T₁ value and the increment rate of T₁ value of DN and 3 groups of HCC with different degrees of differentiation. Spearman correlation was used to evaluate the correlation between T₁ mapping parameters and the malignancy degree of DN and HCC. Area under the receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T₁ mapping parameters in the differential diagnosis of DN and HCC with different degree of differentiation. Results: Significant differences were found in T₁ value and increase rate of T₁ value of DN and HCC with different degrees of differentiation (P< 0.05). The T₁ value and increase rate of T₁ value showed an increasing trend from DN to poorly differentiated HCC after enhancement. The T₁ value and increase rate of T₁ value were positively correlated with the malignancy of DN and HCC (r=0.418 and 0.634, P<0.01). There were significant differences in the increase rate of T₁ value between well-differentiated HCC and moderately-differentiated, well-differentiated HCC and poorly-differentiated HCC, respectively (P<0.05). The area under ROC curve of T₁ value and the increase rate of T₁ value for differentiating DN from well-differentiated, moderately differentiated and poorly differentiated HCC was 0.933, 0.928, 0.939 and 0.867, 0.961, 0.961, respectively. The area under ROC curve of the increase rate of T₁ value for differentiating well-differentiated HCC from moderately-differentiated, well-differentiated HCC from poorly-differentiated HCC was 0.770 and 0.844, respectively. Conclusions Gd-EOB-DTPA enhanced MRI combined with T₁ mapping can provide valuable diagnostic information for identifying DN and HCC with different degrees of differentiation.

Objective To explore the value of MRI T2*quantification of visceral iron deposition in patients with β-thalassemia major. Methods A total of one hundred and two patients with β-thalassemia major were retrospectively analyzed. They underwent genetic testing and the cardiac and (or) abdominal MRI scanning. Among them, 47 patients underwent splenectomy operation, 95 patients underwent cardiac MRI scanning, 102 underwent abdominal MRI scanning for their livers, pancreases and kidneys, and 55 underwent splenic MRI scanning. The T2* values of the hearts, livers, pancreases and kidneys were measured, meanwhile the liver iron concentrations (LIC) were measured. The levels of serum ferritin (SF) patients were measured in 81 patients. The Spearman rank correlation was employed to analyze the relationship between SF, LIC, age and each organs T2* values. Independent sample t test (normal distribution) or the Mann- Whitney U test (non-normal distribution) were used to compare the hepatic, cardiac, renal and splenic T2* values differences between patients with splenectomy and those without. Results Serum ferritin were highly positively correlated with LIC, moderately correlatied with age, moderately negatively correlated with hepatic and pancreatic T2* values, with r values of 0.833, 0.537,-0.623 and -0.403, respectively (P<0.05). There was significantly negative correlation between hepatic T2*value and LIC (r=-0.925, P<0.01). There were moderately correlations between hepatic and splenic T2*values (r=0.634, P<0.01), hepatic and pancreatic T2*values (r=0.530, P<0.01). However, those T2*values of other organs had no correlation (P>0.05). The hepatic and pancreatic T2*values were reduced (P<0.05), the renal T2* value was increased (P<0.05) in the patients with splenectomy. The cardiac T2* value was not statistically different (P>0.05). Conclusions The patients with β-thalassemia major have prone to suffer from excessive iron deposition in the heart and abdominal organs. The technology of MRI quantification of T2*values could reflect the body iron overload.