Objective To explore the effect of different scan parameters and algorithm on detection of iron deposition with coexsiting fat by dual soure CT.Methods One ml homogenate of normal rat liver tissues and 1 ml iron dextran solution with different concentrations (50.000,25.000,12.500,6.250,3.125,and 1.560 mg/ml) were fully mixed respectively.The 6 test tubes were scanned by dual source CT in the mode of dual energy to gain the iron specific slope.Different concentrations of dextran iron(50,40,30,20,10,and 5 mg/ml),triglyceride(volume percent were 60％,30％,and 10％,respectively),and homogenate of normal rat liver tissues were mixed.All 18 tubes were scanned by dual source CT with 80-140 kVp and 100-140 kVp,and all these images were reconstructed by filtered back projection (FBP) and singogram affirmed iterative reconstruction(SAFIRE).Raw data were reconstructed by filtering and iterative method.△H value (△H =CT value low kVp-CT valuehigh kVp) and overlay value of three substances decomposition algorithm were measured and analyzed by t test.The Spearmen correlation was applied in iron concentration and measured values.Results Iron specific slope was found to be 1.9392.When 80-140 kVp and 100-140 kVp were applied,△H values were (198 ± 28) and (152 ± 18) HU by using FBP reconstruction,and △H values were (191 ± 23) and (149 ± 17) HU by using SAFIRE reconstruction.The differences were statistically significant(t =-2.934 and-3.492,P =0.032 and 0.017).Overlay values were (381 ±54) and (236 ±31) HU by using FBP reconstruction,and overlay values were (399 ±53) and (276 ± 43) HU by using SAFIRE reconstruction.The differences were also statistically significant (t =-5.739 and-7.949,P =0.002 and 0.001).Under the same energy portfolio but different reconstruction,both △H and overlay value showed no differences (P ＞ 0.05).Except for the conditions with 100-140 kVp tube voltage,△H had no correlation with iron solution concentration (P ＞ 0.05) under either FBP or SAFIRE reconstruction.When other reconstruction methods and tube voltage combination were used,overlay or △H value showed correlation with iron solution concentrations (r value ranged from 0.959 to 0.997,P values ＜ 0.01).Conclusions Different energy portfolios of dual source CT will act on the measured value of iron deposition.The measured values will not be affected by ways of reconstruction.For the detection of iron coexisting in fat,overlay values of material decomposition algorithm is better.

Objective To assess the volumetric variation of liver and spleen in early diagnosis of liver fibrosis and cirrhosis.Methods One hundred and thirty-seven subjects underwent dynamic enhanced examination of liver and spleen using multi-slice CT(MSCT).Forty potential living liver donors were served as controls.Sixty-three histologically proved fibrotic patients were divided into slight liver fibrosis(F≤2,n=44)and advanced liver fibrosis(F≥3,n=19)according to the Ishak system.Liver cirrhosis group consisted of 34 patients diagnosed clinically and radiologically.The measurement of total liver volume(TLV),right liver lobe volume(RV),left lateral liver segment volume(LLV),left medial liver segment volume(LMV),eaudate lobe volume(CV)and spleen volume(SV)were obtained bv MSCT.The ratios of segmental liver and SV to TLV were also calculated.Results The values of liver volumes(TLV,RV and LMV)reduced gradually among control(1470.38 cm3,933.34 cm3,216.20 cm3,respectively),slight liver fibrosis(1239.99 cm3,799.74 cm3,184.69 cm3,respectively),advanced liver fibrosis(1219.76 cm3,765.22 cm3,179.44 cm3,respectively)and cirrhosis(1078.21 cm3,543.73 cm3,163.12 cm3,respectively) groups.The volume of SV and the ratios of CV/TLV and SV/TLV increased gradually among control (256.29 cm3,3.09%,17.53%),slight liver fibrosis(284.41 cm3,3.20%,22.91%),advanced liver fibrosis(343.13 cm3,3.58%,28.80%)and cirrhosis(863.38 cm3,4.16%,82.91%)groups.There was significant difference among control,liver fibrosis and cirrhosis group in TLV,RV,LMV and SV/TLV(P＜0.05),but there was no significant difference in all parameters between the slight liver fibrosis group and the advanced liver fibrosis group(P＞0.05).There was significant correlation of TLV,LMV,SV,RV,CV/TLV,SV/TLV,RV/TLV and LLV/TLV with liver cirrhosis and its staging.Conclusion Variations in liver and spleen volume,the ratios of segmental liver and SV/TLV are correlated with the extent of liver fibrosis and cirrhosis.which will be helpful in early detection of liver fibrosis and cirrhosis.

Objective To evaluate the role of multi-slice CT (MSCT) perfusion in early diagnosis of liver fibrosis. Methods Thirty-three subjects underwent CT perfusion of the liver. Among whom, 11 subjects were volunteers without hepatic disease and the other 22 subjects were pathologically confirmed with liver fibrosis who were further divided into slight (n= 10) and severe (n=12)liver fibrosis according to the lshak system. Parameters of CT perfusion were measured and compared among three groups. Results The mean hepatic arterial fraction in controls, light and severe fibrosis tended to increase with the severity of liver fibrosis[(18. 49 ± 9. 69) %, (19. 92 ± 6.01) % and (21.31±7.47)% ,respectively], and the mean mean transit time tended to decrease with the severity of liver fibrosis [(13.80 ± 2. 60) s, (12.35 ± 1.31) s and (12.19 ± 3.33) s, there was no significant difference in all parameters between any two groups (P>0.05). Conclusions Quantitative measurement of hepatic blood supply can be obtained by CT perfusion. Some parameters will be helpful in staging fibrosis to a certain extent. But its clinical usefulness for the evaluation of the early diagnosis may not be affirmed yet.

Objective:To examine the effect of FAM83D knockdown on proliferation, survival ability and invasion of human esophageal squamous cell carcinoma after X-ray radiation, and explore the mechanism.Methods:The expression of FAM83D, E-cadherin and vimentin in tumor tissues was detected in 69 cases of esophageal squamous cell cancer by using immunohistochemical method. The siRNA based on the sequences of the FAM83D mRNA were synthesized to transfect into the cultured ECA109 cells as FAM83D shRNA group. The effect of silencing FAM83D gene was evaluated to determine the protein levels of FAM83D in the human oesophageal squamous cell carcinoma ECA109 and KYSE30 cells using western blotting. MTS, clone formation, and Transwell assay were employed to examine the proliferation, survival ability and invasion of ECA109 and KYSE30 cells in vitro, respectively. We used flow cytometry assay to analyze distribution of cell apoptosis in different groups. Western blotting was used to examine the expression of cell metastasis-related molecules and apoptosis-related protein. Results:The strong expression rates of FAM83D, E-cadherin, and vimentin were 55%(38/69), 36%(25/69) and 61%(42/69) in the tumor tissues, respectively. FAM83D protein expression was significantly and negatively correlated with the expression of E-cadherin ( r=-0.350, P<0.01), and positively with the expression of vimentin ( r=0.470, P<0.01). Western blotting results demonstrated that silencing FAM83D gene significantly reduced the FAM83D protein expression ( P<0.01). MTS data demonstrated that FAM83D knockdown after irradiation significantly inhibited the proliferation of esophageal squamous cell carcinoma ECA109 and KYSE30 cells ( P<0.05). The data from the clone formation assay revealed that the radiosensitivity was increased after downragulation of FAM83D expression ( P<0.01). In addition, the invasive abilities of oesophageal carcinoma cells transfected with FAM83D shRNA after irradiation were significantly inhibited compared with those of the NC group ( P<0.01), followed by the downregulation of N-cadherin, vimentin, Snail, p-Akt and p-GSK-3β expression, and the upregulation of E-cadherin expression ( P<0.01). The apoptosis rate of tumor cells in FAM83D shRNA group after irradiation was markedly increased ( P<0.01), followed by a decrease of Bcl-2 and Mcl-1 expression and an increase of Cleaved caspase-3 expression ( P<0.01). Conclusions:FAM83D expressions was found to be closely related to the invasion and development of ESCC. Furthermore, siRNA interference technology inhibited the expression of FAM83D gene in oesophageal squamous cell carcinoma cells, reduced the proliferation, invasion of cells, induced cell apoptosis, and increased radiosensitivity, which may be associated with regulating the epithelial-mesenchymaltransition via Snail/Akt/GSK-3β signaling pathways.

Objective:To investigate the features of median arcuate ligament syndrome (MALS) in computed tomography angiography (CTA).Methods:The retrospective and descriptive study was conducted. The clinical and imaging data of 56 patients with MALS who were admitted to Ruijin Hospital, Shanghai JiaoTong University School of Medicine from November 2019 to October 2020 were collected. There were 30 males and 26 females, aged from 19 to 78 years, with a median age of 54 years. All 56 patients underwent CTA. Observation indicators: (1) CTA examination; (2) correlation analysis; (3) surgical situations. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers or percentages. Spearman correlation analysis with test level of 0.05 was used to analyze the correlation between celiac trunk stenosis and the distance between the original location of celiac trunk and original location of superior mesenteric artery and the minimum distance of celiac trunk and superior mesenteric artery. Results:(1) CTA examination. ① Celiac trunk stenosis: results of cross sectional examina-tion of CTA showed that of 56 patients, there were 2 cases of celiac trunk occlusion, 10 cases of severe stenosis, 9 cases of moderate stenosis and 35 cases of mild stenosis. Results of sagittal examination of CTA showed that of 56 patients, there were 2 cases of celiac trunk occlusion, 21 cases of severe stenosis, 15 cases of moderate stenosis and 18 cases of mild stenosis. ② Examination of patients with different degree of vascular stenosis: according to the results of sagittal examination of CTA, the 2 cases with celiac trunk occlusion were negative for aneurysms, aortic dissection or vascular variations but positive for compensated varix of the anterior and posterior pancreatico-duodenal arches. Of the 21 cases with celiac trunk severe stenosis, 2 cases were positive for aneurysms, 1 case was positive for aortic dissection, 7 cases were positive for compensated varix of the anterior and posterior pancreaticoduodenal arches, 8 cases were positive for collateral circula-tions of anterior and posterior pancreaticoduodenal archs and 8 cases were positive for vascular variation. Of the 15 cases with celiac trunk moderate stenosis, 2 cases were positive for aneurysms, 3 cases were positive for aortic dissection, 2 cases were positive for compensated varix of the anterior and posterior pancreaticoduodenal arches, 4 cases were positive for collateral circulations of anterior and posterior pancreaticoduodenal archs and 7 cases were positive for vascular variation. Of the 18 cases with celiac trunk mild stenosis, 1 case was positive for aneurysms, 2 cases were positive for aortic dissection, 7 cases were positive for collateral circulations of the anterior and posterior pancreaticoduodenal arches, 6 cases were positive for vascular variation. All 56 patients were negative for ischemia of liver, spleen and stomach. ③ Original location of celiac trunk: of 56 patients, there were 43 cases had celiac trunk originated horizontally from the lower edge of T12 vertebral body, 2 cases had celiac trunk originated from the middle of T12 vertebral body, 1 case had celiac trunk originated from the upper part of T12 vertebral body, 7 cases had celiac trunk originated from the upper part of L1 vertebral body, 1 case had celiac trunk originated from the middle of L1 vertebral body and 2 cases had occluding celiac trunk. (2) Correlation analysis: results of sagittal observation on CTA examination showed the distance between the original location of celiac trunk and original location of superior mesenteric artery of the 56 patients was (6.0±4.0) mm. The distance between the original location of celiac trunk and original location of superior mesenteric artery of patients with celiac trunk mild, moderate or severe stenosis were (6.2±2.8)mm, (8.1±4.4)mm and (5.3±3.2)mm respectively. There were 23 cases of the 56 patients had the distance between the original location of celiac trunk and original location of superior mesenteric artery <5 mm. Results of correlation analysis showed that the degree of celiac trunk stenosis was not related to the distance between the original location of celiac trunk and original location of superior mesenteric artery ( r=?0.205, P>0.05). Results of sagittal observation on CTA examination showed the shortest distance between celiac trunk and superior mesenteric artery of the 56 patients was (3.8±2.4)mm. The shortest distance between celiac trunk and superior mesenteric artery of patients with celiac trunk mild, moderate or severe stenosis were (4.2±2.0)mm, (4.4±3.3)mm and (3.0±1.9)mm, respectively. There were 45 cases of the 56 patients had the shortest distance between celiac trunk and superior mesenteric artery <5 mm. Results of correlation analysis showed that the degree of celiac trunk stenosis was not related to the shortest distance between celiac trunk and superior mesenteric artery ( r=?0.249, P>0.05). (3) Surgical situations: of 56 patients, 2 cases were positive for clinical symptoms of abdominal pain, 54 cases were negative for clinical symptoms, 4 cases under-went surgical treatment and 52 cases not underwent surgical treatment. Of the 4 cases undergoing surgical treatment, 2 cases with abdominal pain were diagnosed as MALS by upper abdominal CTA. Celiac trunk of the 2 cases were severe stenosis and stents implantation under celiac arteriography were performed. Results of postoperative CTA showed celiac trunk was negative for obvious stenosis. The other 2 cases who were negative for clinical symptoms of MALS were planed to pancreaticoduo-denectomy for pancreatic head tumor. Results of preoperative CTA showed severe stenosis of celiac trunk and arterial bypass grafting was performed for the 2 cases during pancreaticoduodenectomy to alleviate liver ischemia caused by gastroduodenal artery ligation which would avoid the incidence of postoperative MALS associated complications. Result of postoperative CTA three-dimensional reconstruction showed the bypass vessel was unobstructed. Conclusion:Based on sagittal result of CTA examination, the stenosis of celiac trunk, the anatomical relationship between celiac trunk and arcuate ligament and the original location of celiac trunk of MALS patients can be evaluated.

Objective:To evaluate the effects of high mobility group protein box 1 (HMGB1) on clinical prognosis of esophagus squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy and the radiosensitivity of xenograft in nude mice.Methods:A total of 90 endoscopic biopsy specimens were obtained from ESCC patients treated with chemoradiotherapy. The expression level of HMGB1 was determined by immunohistochemical staining. High expression level was defined when staining was observed on ≥50% of the tumor cells. All patients were divided into the high expression group ( n=48) and low expression group ( n=42), and their survival information was retrospectively analyzed. Cell transfection was performed with the plasmid carrying human HMGB1-shRNA to knockdown HMGB1 expression in ECA109 cells and xenograft mouse models were established. The tumor volume and mass were calculated after irradiation with a dose of 15 Gy. The cell apoptosis in xenograft tissues were detected. Survival analysis was performed using Kaplan-Meier method. Univariate prognostic analysis was conducted by log-rank test. Intergroup comparison was performed by analysis of variance (ANOVA). Results:The expression level of HMGB1 was significantly associated with gross tumor volume, longest diameter of tumor, T staging and distant metastasis ( χ2=9.663, 5.625, 4.068, 7.146, all P<0.05). In the low expression group, the overall survival (OS) ( χ2=4.826, P=0.028), progression-free survival (PFS) ( χ2=4.390, P=0.036) were longer compared with that in the high expression group. Further analysis of HMGB1-high expression patients showed that the radiation dose and the combination of chemoradiotherapy did not significantly affect the OS or PFS of ESCC patients. We observed that knockdown of HMGB1 slowed the growth rate of xenograft, decreased the tumor volume and increased the apoptosis rate after irradiation. Conclusions:ESCC patients with high expression level of HMGB1 obtain poor prognosis after chemoradiotherapy, which can be enhanced by increasing the sensitivity to radiotherapy and chemotherapy. HMGB1 knockdown can effectively increase the radiosensitivity of xenograft in ESCC nude mice.

Objective: To evaluate the effect of X-ray radiation on cell proliferation, migration, survival ability and cell cycle of human esophageal squamous cell carcinoma after RNA interference-mediated down-regulation of HMGB1 gene expression. Methods: The expression of HMGB1 at mRNA and protein levels in the human esophageal squamous cell carcinoma cell lines ECA109 and KYSE30 was determined using RT-PCR and Western blot assays. MTS and Transwell assays were employed to examine the proliferation and migration of ECA109 and KYSE30 cell lines. The cellular survival ability in vitro was assessed by clone formation assay. The cell cycle after X-ray radiation in different groups was detected by flow cytometry. Results: The expression of HMGB1 at mRNA and protein levels in ECA109 and KYSE30 cells were markedly higher in a dose-dependent and time-dependent manner in the radiation group than that in the control group (all P<0.05). MTS results demonstrated that the proliferation of ECA109 and KYSE30 cells was obviously lower at each time point after radiation than that in the group without radiation (all P<0.01). The expression of HMGB1 at mRNA and protein levels was significantly inhibited in the HMGB1 siRNA group than those in the control and NC groups (both P<0.01). The data from the clone formation assay revealed that the radiosensitivity was significantly increased after down-regulation of HMGB1 expression (P<0.01). Transwell migration assay revealed that the number of migrating cells at the fourth hour after X-ray irradiation in the HMGB1 siRNA group was significantly lower than those in the control and negative groups (both P<0.01). In the HMGB1 siRNA group, the percentage of cells at G₀/G₁ phase was obviously higher, whereas the percentage of S phase was significantly lower than those in the control and NC groups, and the trend was even more significant after X-ray radiation (all P<0.01). Conclusion Inhibition of HMGB1 expression by siRNA can suppress the proliferation and migration of ECA109 and KYSE30 cells and enhance the radiosensitivity by increasing the cell cycle arrest at G₀/G₁ stage after X-ray irradiation in vitro.