OBJECTIVE To investigate the effect of Guanxinning tablets(GXN) on early heart failure model rats, and to explore the protective mechanism of GXN on heart failure rats from the perspective of intestinal flora. METHODS Six rats who underwent sham operation were set as sham operation group. Took 80 SD rats to undergo aortic arch stenosis and established a heart failure rat model. The surviving rats were divided into 4 groups, namely the model control group, the positive control group(captopril tablets 12.5 mg·kg–1), high-dose and low-dose of GXN group(600, 1 200 mg·kg–1). The 4 groups were administered continuously for 8 weeks. Cardiac ultrasonography was performed every 4 week. Serum NT-proBNP, hs-CRP, IL-6, TNF-α, SOD and MDA levels were measured. The effects of GXN on the structure and function of intestinal flora were observed based on the high-throughput sequencing technology and bioinformatics analysis of 16S gut microbiome. RESULTS Compared to the model control group, after giving different doses of GXN, the survival rate of rats increased, and the thickness of the ventricular wall decreased to varying degrees. The weight of the heart and coefficient of the heart were all reduced. GXN could also reduce the level of inflammatory factors, inhibit the level increase of NT-proBNP in rats, and increase the activity of serum SOD. In addition, GXN intervention could significantly improve the intestinal flora diversity of rats with heart failure, the possible target genera of GXN were Akkermansia genera, Phascolarctobacterium genera and Oxalobacter genera. The effect of GXN on intestinal function in rats with heart failure might be concentrated in non-homologous end-joining, influenza A, carotenoid synthesis, indole alkaloids biosynthesis, betalain biosynthesis, renin-angiotensin system and other biological pathways. CONCLUSION The protective effect of GXN on early heart failure rats may be related to the regulation of intestinal flora pathway.

Objective To evaluate which factors may affect magnetic resonance imaging(MRI)performance in the detection of pathologic complete response(pCR)after neoadjuvant chemotherapy(NAC).Methods This retrospective study involved 89 patients diagnosed with invasive breast carcinoma who received NAC at The Second Affiliated Hospital of Xi'an Jiaotong University from July 2019 to December 2021.Breast MRI was performed before and after NAC.Based on the pathological results obtained surgery after the completion NAC and using Miller-Payne classification as the evaluation standard,the patients were divided into two subgroups:pCR and non-pathological complete response(npCR).Chi-square test was used to compare the MRI characteristics of pre-NAC lesions between the two groups.ROC curve analysis was made to analyze the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of MRI after NAC;the diagnostic performance of MRI in predicting pCR in different tumor subtypes was analyzed.We made univariate and multivariate analyses of factors affecting radiographic complete response(rCR)and pCR concordance.Results MRI analysis after NAC showed rCR in 20 cases(22.5％)and pCR in 28 cases(31.5％).Considering rCR as a"positive"result of MRI analysis,MRI assessment was accurate in 79 cases,including 19 true positive cases and 60 true negative cases.MRI assessment was inaccurate in 10 cases,including 9 false negative cases and 1 false positive case.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI assessment of pCR were 67.86％,98.36％,88.76％,95.00％,and 86.96％.MRI had the lowest diagnostic efficiency in evaluating pCR of ERBB2+breast cancer after NAC.Single factor analysis showed that estrogen receptor(ER),clinical stage,background parenchymal enhancement,and maximum tumor diameter all affected the consistency of rCR and pCR(P＜0.05).Multivariate Logistic regression analysis showed that the independent influencing factor affecting the consistency of rCR and pCR was clinical stage.Conclusion MRI demonstrated good accuracy in predicting pCR after NAC in the breast cancer patients examined.Pre-treatment MRI characteristics and tumor subtypes may be related to the diagnostic accuracy of post-NAC MRI in breast cancer patients.

【Objective】 To explore the clinical features of dermatomyositis and diagnostic value of MRI. 【Methods】 The clinical and imaging data of 61 patients with dermatomyositis were analyzed retrospectively. 【Results】 Among the 61 patients， there were 15 males and 46 females with the average age of 45.3 years. The course of disease was 10 days to 12 years. All of them had different degrees of skin lesions， including 57 cases of myasthenia and or myalgia， 4 cases of dysphagia， 2 cases of dyspnea， and 2 cases of drinking water and coughing. There were 18 cases complicated with interstitial lung disease， 1 case complicated with Sjogren’s syndrome， 1 case complicated with arthritis， 1 case complicated with rhabdomyolysis， and 1 case complicated with kidney damage and liver insufficiency. MRI examination performed in 46 patients with dermatomyositis detected 43 cases of abnormal manifestations， 41 cases of muscle inflammatory edema， 37 cases of subcutaneous adipose tissue edema， and 40 cases of myofascitis. 【Conclusion】 The clinical manifestations of dermatomyositis are complex and have certain imaging features. Combined with the laboratory examinations of muscle enzymes and autoantibodies， electromyography， skin and muscle biopsy， they can provide clinical diagnostic evidence. MRI is an important means to diagnose and evaluate the extent and progression of dermatomyositis.

Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.

OBJECTIVE: To evaluate the diagnostic efficacy of Kaiser score for breast lesions presenting as non-mass enhancement. METHODS: We collected data from patients with breast lesions presenting as non-mass enhancement on preoperative DCE-MRI between January, 2014 and June, 2019. All the cases were confirmed by surgical pathology or puncture biopsy. With pathology results as the gold standard, we evaluated the diagnostic efficacy of Kaiser score and MRI BI-RADS classification and the consistency between the diagnostic results by the two methods and the pathological results. RESULTS: A total of 90 lesions were detected in 88 patients, including 28 benign lesions (31.1%) and 62 malignant lesions (68.9%). For diagnosis of the lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Kaiser Score were 100%, 75%, 89.9%, 100% and 92%, as compared with 93.5%, 46.4%, 79.5%, 76.5% and 78.9% of MRI BI-RADS, respectively. The diagnostic specificity of Kaiser score was significantly higher than that of BI-RADS classification (=0.021). CONCLUSIONS The Kaiser score system provides a diagnostic strategy for BI-RADS classification of breast lesions with non-mass enhancement and has a better diagnostic efficacy than BI-RADS classification alone. The use of Kaiser score can significantly improve the diagnostic specificity of such breast lesions for inexperienced radiologists.
Breast ; Breast Diseases ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging

Objective:To investigate the clinical characteristics of patients complicated with Hashimoto’s thyroiditis (HT) and papillary thyroid micro-carcinoma (PTMC) and risk factors for central lymph node metastasis (CLNM) by analyzing the clinical data.Methods:Clinical data of 770 patients with PTMC admitted to Head and Neck Surgery Center of Sichuan Cancer Hospital from May. 2015 to Nov. 2017 were retrospectively analyzed, including 250 HT-PTMC patients (observation group) and 520 non-HT-PTMC patients (control group) . There were 197 males and 573 females, with a male to female ratio of 1.00:2.91. Into observation indexes included patient’s age, gender, serum thyroid stimulating hormone (TSH) , thyroglobulin antibody (TG-Ab) , thyroid peroxidase antibody (TPO-Ab) , number of foci, diameter of foci, calcification of foci, location of foci (with or without extra-glandular invasion) , number of nodules (no matter benign or malignant) , and lymph node metastasis in central and lateral cervical regions. SPSS 22.0 software was used for statistical analysis. Normally distributed data were expressed ± s. The difference between observation group and control group was compared by chi-square test of single factor analysis. The risk factors of CLNM of the observation group were analyzed with multivariate Logistic regression, the difference was statistically significant if P<0.05. Results:There were statistically significant differences between the observation group and the control group in age ( P=0.006) , gender ( P<0.001) , TSH ( P<0.001) , TG-Ab ( P<0.001) , TPO-Ab ( P<0.001) , number of nodules ( P=0.016) , and central lymph node ( P<0.001) . Compared with non-HT-PTMC group, HT-PTMC group had a higher proportion of women under 55 years old, and both TG-Ab and TPO-Ab had higher positive rates. Patients with HT-PTMC were more likely to show polynodule changes, but their central lymph node metastasis rate was lower than that of the non-HT-PTMC group. Single-factor analysis showed that the number of cancer foci, calcification of cancer foci, and location of cancer foci were significantly correlated with the CLNM of HT-PTMC patients (all P<0.001) . Multivariate Logistic regression analysis showed that multiple cancer foci ( P<0.001) , invasion and capsule ( P<0.001) , and cancer foci with calcification ( P=0.005) were independent risk factors for CLNM. Conclusions:HT-PTMC is more common in women under 55 years of age, and most of them show multiple nodules in bilateral glandular lobes, often accompanied by elevated serum TSH, TG-Ab and TPO-Ab levels. Meanwhile, the lymph node metastasis rate of HT-PTMC is relatively low, and the prognosis may be relatively good. In HT-PTMC, the risk of multiple carcinoma foci, cancer foci with calcification, cancer foci invasion and the occurrence of CLNM is higher. Preventive central lymph node dissection helps to reduce the occurrence of postoperative cervical lymph node recurrence.

Although the combination of surgery, radiotherapy and chemotherapy is the main methods of cancer treatment, it still fails to solve certain tumors, especially metastatic tumors. With the in-depth study of tumorigenesis and development mechanism, and the exploration and clinical application of tumor immunotherapy, the survival period of patients with malignant tumors has been significantly prolonged. Tumor immunotherapy has become an effective anti-tumor method by activating the body′s own immune system to achieve tumor suppression. The combination of chemotherapy and immunotherapy has a significant effect and has become a feasible solution for cancer treatment. The rationally designed nanomedicines can effectively combine chemical drugs and immunological preparations, and have become an effective delivery carrier basis and treatment means for clinically targeting tumor tissues, synergistic immune mechanisms to kill tumor cells, and treating tumors. In this paper, the types of multifunctional nanomedicines used in chemotherapy and various immunotherapies in recent years and their advantages in cancer therapy were reviewed.

Objective To investigate the clinical value of dualGsource CT coronary angiography in evaluation of left ventricular function.Methods A total of 5 5 patients with clinically suspected coronary heart disease in our hospital were enrolled.All patients underwent dualGsource CT coronary angiography and ultrasonic cardiogram.The measured values and correlation of the indicators of left ventricular function in dualGsource CT coronary angiography and ultrasonic cardiogram were analyzed.Results Pearson correlation analysis showed that dualGsource CT coronary angiography and ultrasonic cardiogram were highly correlated in left ventricular function measurements (r＝ 0.607－0.840,P＜0.05);The paired sample t test showed that there were no significant differences in the ej ection fraction (EF) and endGdiastolic volume (EDV)between two methods.Conclusion DualGsource CT coronary angiography is reliable in the quantitative evaluation of left ventricular function.The "oneGstop"acquiring of coronary stenosis degree and cardiac function index can provide more diagnostic information to clinic.

Objective To analyze the correlation between the molecular subtypes of non-mass enhancement (NME)breast cancer and MRI findings.Methods A retrospective analysis of MRI images and clinicopathological data of 62 patients with NME breast cancer who received 3.0T breast MRI multimodal scan from January 201 5 to June 201 9 was conducted.Molecular subtypes were classified by immunohistochemical staining.The differences between MRI findings of NME breast cancer and molecular subtypes were compared by ch-i square test and Fisher exact probability method,and the correlation between them was analyzed by cross contingency table.Results The differences of molecular subtypes of NME breast cancer in the internal enhancement and peritumoral edema were statistically significant (P＜0.05),while the differences in the TIC,lesion distribution type and peritumoral vascular were not statistically significant (P＞0.05).Conclusion Luminal A type was less prone to peritumoral edema in NME breast cancer.Luminal B type was mainly heterogeneous enhancement. HER-2 overexpression type and triple negative type are mainly clustered ring enhancement,and prone to peritumoraledema.Different molecular subtypes of NME breast cancer have certain MRI characteristics,which is expected to provide a non-invasive evaluation for the preoperative treatment of NME breast cancer.

Objective To study the distribution characteristics of myocardial fat infiltration and to analyze the function of the left ventricle (LV).Methods The images of patients who performed coronary CT angiography (CTA)in Siemens DSCT were reviewed retrospectively.The imaging characteristics and location of myocardial fat infiltration were recorded and the LV function was analyzed by Siemens Syngo.via software.Results Totally 4 477 patients were enrolled in this study.Among them,myocardial fat infiltration of the LV was found in 94 (accounting for 2.1%)patients.The fat infiltration was mainly located underlying the endocardium,including the inferior,anterior,lateral and posterior walls of the LV,as well as the inferior part of the interventricular septum.The enhancement image showed low intensity in the myocardium with fat infiltration.Conclusion The characteristics of myocardial fat infiltration can be well displayed by DSCT,as well as the LV function.DSCT can provide both morphological and functional information of the heart via one scan.