Objective:To assess the preventive and therapeutic effects and primary mechanisms of Danshen injections in the treat-ment of hepatic encephalopathy ( HE) . Methods:The acute ammonia poisoning model induced by ammonium chloride was established in mice, and HE model with liver injury induced by carbon tetrachlorie and high blood ammonia induced by thioacetamide was made in rats. The time of death was detected in the first model, and the histamine levels in blood and brain, liver function and liver pathologi-cal histology changes were detected respectively in the other model. Results:In the acute ammonia poisoning experiment, the time of death in Danshen injections group was longer than that in the control group. Furthermore, Danshen injections could notably decrease the histamine levels in blood and brain, reduce the levels of ALT, AST, ALP and Tbil in serum and improve the function of liver to show the preventive and therapeutic effects on HE. Conclusion:Danshen injections exhibit promising preventive and therapeutic effects on HE, which may be related to decreasing histamine levels in blood and brain.

Objective To compare the clinical efficacy of invisible appliance and fixed appliance in the treatment of skeletal class I malocclusion.Methods A prospective cohort study with a minimum sample size of no less than 19 subjects in each group was used,and 46 adult patients with bone type I were eventually enrolled.According to the type of appliance,they were divided into the invisible appliance group(group A)with 25 patients and the fixed appliance group(group B)with 21 patients.Data were analyzed before orthodontic treatment(T0)after(T1)between invisible and traditional fixed orthodontics.Results The static occlusion index and PAR score were improved after treatment,and the differences were statistically significant(P<0.01).The occlusal dynamic parameters including OT,OFAT,OFPT,AOF and DT were significantly improved after treatment(P<0.01).There were significant differences in AOF,forward and lateral DT between the two groups(P<0.01),the invisible group was better than the fixed group.Conclusion Both the dynamic and static occlusal changes can be greatly improved with invisible and fixed appliance in the treatment of patients with class I malocclusion.Invisible appliance is better than fixed appliance in balancing occlusion,eliminating and reducing occlusal interference.

We report a case of a male patient who developed persistent fever and central nervous system symptoms after eating raw snails for 10 days. The patient was diagnosed with Angiostrongyliasis depended on the clinical presentation, epidemiological history, and etiological results. The patient recovered after receiving albendazole anthelmintic and dexamethasone anti-inflammatory therapy. This article incorporates literature review to sort out the diagnosis and treatment of this patient, in order to provide feasible reference for clinicians.

Objective To explore the application value of deep learning image reconstruction(DLIR)algorithm in low-dose deep inferior epigastric artery(DIEA)computed tomography angiography(CTA).Methods A total of 59 patients undergoing DIEA CTA were prospectively selected and randomly divided into two groups:group A(29 cases)and group B(30 cases).Group A was the conventional radiation dose group(tube voltage 120 kVp),the tube current was dose modulation 3,and the iterative reconstruction algo-rithm was Karl 5.Group B was the low radiation dose group(tube voltage 120 kVp),the tube current was dose modulation 2,with DLIR reconstruction algorithm,and four levels of DLIR(1-4)were reconstructed and labeled as groups B1 to B4.The mean tube current,vol-ume CT dose index(CTDIvol),and dose length product(DLP)of group A and group B were recorded,and the effective dose(ED)was calculated.The CT and standard deviation(SD)values of the external iliac artery and psoas major muscle were measured on axial images of each group,and signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.Two observers using double-blind method independently evaluated the DIEA on volume rendering(VR)and maximum intensity projection(MIP)images of each group using a 3-point scale,and a 5-point scale was used to evaluate the overall image quality on axial images.Results Compared with group A,the mean tube current and ED in group B were decreased by 39.33％and 44.09％,respectively(P＜0.05).With the increasing of DLIR level from groups B1 to B4,the SD value of the image gradually decreased,while SNR and CNR gradually increased(P＜0.05).The CNR in groups B3 and B4 was higher than that in group A(P＜0.05).The subjective scores of the two observers were consistent(Kappa value 0.779-0.889,P＜0.05),and there was no statistical significance between group A and group B in the perforating vessels from the DIEA,intramuscular course,and the point of emergence(P＞0.05).With the increase in DLIR level,the subjective score of the overall image quality from group B1 to group B4 showed a trend of first increasing and then decreasing,and the score of group B3 was the highest(4.50±0.51)points,which had no statistical significance compared with group A(4.45±0.51)points(P＞0.05).Conclusion DLIR can effectively reduce the radiation dose of the DIEA CT A scan and ensure the image quality,among which DLIR 3 is the recommended best reconstruction grade.

Objective To explore the application value of 1 024×1 024 reconstruction matrix combined with iterative reconstruc-tion algorithm(Karl)in deep inferior epigastric artery(DIEA)computed tomography angiography(CTA).Methods A total of 40 patients who underwent DIEA CTA were prospectively selected and the original data were reconstructed by grouping.Group A was reconstructed using a conventional 512×512 matrix combined with Karl 5 grade.Group B was reconstructed using 1 024×1 024 recon-struction matrix combined with Karl 5,7,and 9 grades,respectively,and 3 subgroups B1-B3 were obtained.The CT and standard devia-tion(SD)values of the external iliac artery and psoas major muscle were measured on axial images,and signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.A 3-point scale was used to evaluate the perforating vessels from the DIEA,intramuscular course,point of emergence,superficial inferior epigastric artery(SIEA)and superficial inferior epigastric vein(SIEV)on volume ren-dering(VR)and maximum intensity projection(MIP)images by two observers,and a 5-point scale was used to evaluate the overall image quality on axial images.Results With the increase of Karl grade in groups B1 to B3,the SD value of the external iliac artery decreased gradually(P＜0.05),while SNR and CNR increased gradually(P＜0.05).The SD values of the external iliac artery in group B2 and group B3 were lower than those in group A(P＜0.05),and SNR and CNR were higher than those in group A(P＜0.05).There was a good consistency in the subjective evaluation between the two observers(Kappa values=0.773-0.872,P＜0.05).The perforating vessels from the DIEA,intramuscular course,point of emergence,SIEA and SIEV display and overall image quality subjective scores of group B2 and group B3 were better than those of group A(P＜0.05),and the scores of group B2 showed the greatest improvement.Conclusion The 1 024 × 1 024 reconstruction matrix combined with the Karl 7 reconstruction algorithm can optimize the image quality and improve the display of the DIEA and perforator microvessels.

Objective To investigate the clinical application value of posterior adaptive statistical iterative reconstruction-Veo(ASIR-V)algorithm combined with full-field organ dose modulation(ODM)technique in low-dose computed tomography urography(CTU).Methods Ninety patients who underwent urological contrast-enhanced and CTU examination were prospectively selected and divided into conventional dose group(group A,NI=11,posterior ASIR-V of 60％),low-dose group(group B,NI=15,posterior ASIR-V of 60％-100％with 10％interval,denoted as B1-B5 groups);full-field ODM low-dose group(group C,NI=15,posterior ASIR-V of 60％-100％with 10％interval,denoted as C1-C5 groups)according to the noise index(NI).The volume rendering(VR)and maximum intensity projection(MIP)images were reconstructed.The CT values and standard deviation(SD)values of the renal cortex and para-spinal muscles were measured,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were cal-culated.The CT values of the renal pelvis,ureter,and bladder were measured,and the SNR and CNR were calculated with the para-spinal muscles as background.The subjective score was performed on the two-dimensional and three-dimensional images to evaluate the ability of CTU to display lesions.The volume CT dose index(CTDIvol),dose length product(DLP),and effective dose(ED)of the three groups were compared.Results The bladder SNR and CNR of groups B1,C1,and C2 were lower than those of group A(P＜0.05).There was no statistically significant difference in the SNR and CNR of each tissue between groups B2,C3 and group A(P＞0.05).The SNR and CNR of each tissue in groups B4,B5,and C5 were higher than those in group A(P＜0.05).The display rate of lesions in urinary system in groups B2 and C3 could reach 100％.There was no statistically significant difference in the axial image scores between groups B2,C3 and group A(P＞0.05),while the VR and MIP image scores in each group were comparable to those in group A(P＞0.05).The CTDIvol of groups A,B and C were(6.08±2.11)mGy,(3.15±1.15)mGy,and(2.9±0.92)mGy,respectively.Conclusion CTU using the full-field ODM technique combined with posterior 80％ASIR-V can reduce the CTDIvol by 52.30％,and further reduce by 7.93％compared with group B,which is effective to reduce radiation to the gonads.

Objective To observe the value of energy spectrum CT angiography(CTA)optimal single energy imaging combined with adaptive statistical iterative reconstruction V(ASIR-V)for optimizing visualization of thoracodorsal artery(TDA).Methods Energy spectrum CTA was prospectively performed in 60 patients to observe TDA.The images were reconstructed as 120 kVp-like combined with 40%post-set ASIR-V(group A),as well as totally 18 kinds of single energy images ranging from 45 to 70 keV(with interval of 5 keV)combined with 40%,60%and 80%post-set ASIR-V(group B),and the subjective and objective evaluation results of the images were compared between and within groups.Results Under the same post-set ASIR-V weight,significant differences of subjective scores of axial and 3D images were found among different keV levels(all P＜0.001).With the increase of keV level,subjective scores of axial images increased first and then decreased,among which subjective score of 50 keV was the highest(all P＜0.001).Under the same keV levels,with the increase of ASIR-V weight,the subjective scores of overall axial images and 3D images for displaying the main trunk of TDA,as well as contrast-to-noise ratio of axillary artery increased(all P＜0.01).Conclusion Performing CTA using 50 keV single energy imaging combined with 80%ASIR-V reconstruction could balance image contrast and noise better,hence improving visualization of TDA and its branches.

Objective:To explore the effects of the auto-prescription technique combined with noise index (NI) and adaptive statistical iterative reconstruction algorithm-veo (ASIR-V) on the radiation dose and image quality in the computed tomographic angiography (CTA) of the deep inferior epigastric artery (DIEA).Methods:The data of 150 cases who underwent DIEP CTA in the First Affiliated Hospital of Dalian Medical University were prospectively collected, and were randomized into groups A, B, and C, with 50 cases in each group. For group A, the conventional tube voltage was 120 kVp, and images were reconstructed using 40% ASIR-V. For group B, the tube voltage based on the auto-prescription technique was adopted, and images were reconstructed using 40%, 60%, and 80% ASIR-V (corresponding to the three subgroups B1-B3, respectively). For group C, the tube voltage based on the auto-prescription technique was employed, NI = 13, and images were reconstructed by 40%, 60%, and 80% ASIR-V (corresponding to subgroups C1, C2, and C3, respectively). Subsequently, the CT and SD values of the originating femoral artery of DIEA and the rectus abdominis at the same level as DIEA were measured on axial images of each group, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated, and the radiation doses of the three groups were recorded. Finally, the image quality and noise of DIEA in each group were independently and subjectively scored by two radiologists in a blinded manner.Results:Compared to group A, groups B and C exhibited higher CT values of femoral artery ( t= -5.18, -5.17, -5.06, -6.08, -6.08, -6.07, P < 0.05) and higher image SNR and CNR ( P < 0.05), which increased gradually with the upgrading of ASIR-V ( F = 55.45, 49.70, 53.47, 68.89, P < 0.05). The two radiologists offered consistent subjective evaluations (Kappa = 0.76-0.92, P < 0.05). The images of groups B and C displayed more distinct perforating branches and emerging points of DIEA and received higher subjective scores of intramuscular course compared to those of group A. The subjective scores of image noise in subgroups B2, B3, and C2 were not significantly different from those in group A. The radiation doses in groups B and C decreased by 15.10% and 52.85%, respectively compared to those in group A ( H = 75.21, P < 0.05). Conclusion:The combination of the auto-prescription technique with NI = 13 and 60% ASIR-V can reduce the radiation dose by 52.85% while ensuring a clear display of DIEA.

Objective:To investigate the clinical, genetic, and pathological features of nemaline myopathy type 8 (NEM8) caused by KLHL40 gene variation. Methods:The clinical data, gene sequencing results, and musculoskeletal pathophysiology of two cases (a pair of twins) with NEM8 admitted to our hospital in July 2022 were collected. CNKI, VIP, Wanfang, Yiigle, PubMed, Embase, and Web of Science Database were searched with the English and Chinese terms "nemaline myopathy type 8", "nemaline body myopathy type 8", and " KLHL40" from January 2007 to February 2023. The clinical, genetic, and musculoskeletal characteristics of the NEM8 cases were summarized using the descriptive statistical analysis method. Results:(1) Case report: The mother (G2P2) of the twins (Ⅳ-2 and Ⅳ-3) was conceived by IVF-embryo transfer and delivered at 37 +1 gestational weeks. The two cases were dizygotic twins whose maternal grandmother had lip and palate cleft. The first baby (Ⅳ-1) of the woman exhibited absent left pinna, contracture at the end of both fingers, talipes equinovarus in both feet and died of respiratory failure two hours after birth. Fetal edema and fetal movement delay in the twins and varus right foot in one twin were found during pregnancy. Both cases developed intrapartum asphyxia with the clinical manifestations of generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fractures. The families withdrew the treatment and the twins died after maintaining life with ventilators for 53 days after birth. Whole exome sequencing of the pedigree found c.1779G>T (p.W593C) homozygous variants of the KLHL40 gene in the twins and c.1779G>T (p.W593C) heterozygous variants of the KLHL40 gene in the parents, both were de novo. Musculoskeletal pathophysiology indicated that muscle fibers are thin and round with a fetal shape and absent rod. (2) Literature review: Among the 29 cases of NEM8, including two current cases and 27 cases retrieved from 15 papers, eight cases terminated the pregnancies, and 21 were live births; seven cases (24.1%) with positive family history; 19 cases (65.5%) were found with abnormalities during pregnancy, including abnormal fetal movements, polyhydramnios, joint contracture, and fetal edema. Of the 21 live births, 20 cases had intrapartum asphyxia, 21 had postnatal respiratory failure, 20 had generalized muscle weakness, and 19 had dysphagia. Among the 29 cases, 17 cases (58.6%) were homozygous variants of the KLHL40 gene, and 12 cases (41.4%) were compound heterozygous variants. The detection rate of c.1516A>C(p.Thr506Pro) was the highest [72.4% (21/29)], followed by c.602G>A(p.Trp201*) [17.2% (5/29)]. Out of the 15 cases who underwent musculoskeletal pathological examination, all had abnormal muscle fiber size and morphology; 10 cases had rods. Conclusions:NEM8 should be considered for those with abnormal fetal movements, polyhydramnios, joint malformation, fetal edema during the fetal period and failure to establish respiration at birth as well as postnatal generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fracture. Moreover, genetic detection should be performed as soon as possible. NEM8 can be diagnosed in ones with KLHL40 gene homozygous or compound heterozygous variants and musculoskeletal pathological results of abnormal size and shape of muscle fibers, regardless of the presence of rods.

Fibroblast activation protein(FAP)can overexpress in activated fibroblasts.In recent years,radiolabeled FAP inhibitor(FAPI)had become important new positron imaging agents in nuclear medicine following 18F-FDG,and increasingly used for non-malignant diseases.The research progresses of FAPI PET imaging for diagnosis of non-malignant diseases were reviewed in this article.