Objective To evaluate the value of low-dose computed tomographic colonography (CTC) performed with 64-slice CT in the diagnosis of incidental extracolonic lesions and its clinical significance .Methods The image data in 158 CTC examinations with two positions were retrospectively analyzed .All abdominal extracolonic lesions were recorded .According to the age ,the pa-tients were divided into two groups :elderly and non-elderly groups .The extracolonic lesions were divided into 4 groups(E1- E4) according to the clinical importance .The incidence rates in two groups were calculated respectively .Results The incidence rate of the E2-E4 level extracolonic lesions in the elderly group was higher than that in the non -elderly group ,the difference between them had statistical signficance (P< 0 .05) .Conclusion Low-dose CTC has the high diagnostic value in finding extracolonic le-sions ,and the incidence rate of extracolonic lesions with important clinical significance is increased with the age increase ,especially for the elder patients over the age of 60 years .

Objective:To investigate the value of ADC map-based radiomics model for identifying the ischemic penumbra (IP) in acute ischemic stroke (AIS).Methods:From January 2014 to October 2019, data of 241 patients with AIS involving the anterior cerebral circulation within 24 h after stroke onset in the First People′s Hospital of Nantong City was analyzed retrospectively. All patients received routine T 1WI, T 2WI, DWI and dynamic susceptibility contrast-perfusion weighted imaging (DSC-PWI). Considering the PWI-DWI mismatch model as the gold standard for determining IP, patients were divided into the PWI-DWI mismatch (84 cases) and PWI-DWI non-mismatch (157 cases) groups. The ROI of the low signal area and the surrounding area was drawn by two doctors at the maximum level of the lesions on the ADC maps. Then the images were imported into AK analysis software to extract the features. Firstly, the inter-class correlation coefficient was used to screen out the features with high consistency, then the maximum relevance and minimum redundancy (mRMR) and least absolute shrinkage and selection operator (Lasso) regression analysis were used to screen the features. The selected features were used to construct their own radiomics model. ROC curve was used to evaluate the performance of the models, and Delong test was used to compare the area under the curve (AUC) of the two models. Results:After screening, 12 features (LongRunLowGreyLevelEmphasis_angle135_offset7, LongRunLowGreyLevelEmphasis_AllDirection_offset7, GLCMEntropy_AllDirection_offset4_SD, GLCMEnergy_angle45_offset1, ColGE_W11B25_16, ColGE_W11B25_24, HaraEntropy, SurfaceVolumeRatio, Sphericity, Quantile0.025, uniformity and Percentile75) were used to construct the radiomics model based on the low signal area of the ADC map. The area under the ROC curve in the training set was 0.900, and the sensitivity, specificity and accuracy were 84.5%, 81.4% and 83.4%, respectively. The area under the ROC curve in the validation set was 0.870, and the sensitivity, specificity and accuracy were 80.9%, 84.0% and 81.9%, respectively. Eleven features(RunLengthNonuniformity_AllDirection_offset1_SD, ShortRunLowGreyLevelEmphasis_angle45_offset1, HighGreyLevelRunEmphasis_AllDirection_offset1_SD, ShortRunLowGreyLevelEmphasis_AllDirection_offset7, HaralickCorrelation_AllDirection_offset4_SD, ClusterShade_angle45_offset7, InverseDifferenceMoment_AllDirection_offset7_SD, ColGE_W3B20_0, sumAverage, SurfaceVolumeRatio and VolumeMM) were used to construct the radiomics model based on the surrounding area of ADC map. The area under ROC curve in training set was 0.820, the sensitivity, specificity and accuracy were 80.5%, 80.2% and 80.4%, respectively; the area under ROC curve in validation set was 0.800, the sensitivity, specificity and accuracy were 78.7%, 80.0% and 79.2%, respectively. The AUC of the radiomics model based on the low signal area of the ADC map was larger than that based on the surrounding area of the ADC map (training set: Z=3.017, P=0.003; validation set: Z=0.604, P=0.002). Conclusion:The radiomics model based on ADC map has a good diagnostic efficacyin identifying the IP.

Objective To evaluate the diagnostic value of intra-arterial thrombi under went susceptibility weighted imaging(SWI) in patients with acute ischemic stroke(AIS).Methods The MRI images of 133 patients with AIS was analyzed,included time of flight MR angiography(TOF-MRA )and SWI.The patients were divided into two groups according to the time between onset of symptoms and MR imaging (group A,interval time<24 h;group B,interval time 24-72 h).Two neuroradiologists who were blin-ded to the patients clinical information,documented the number and location of susceptibility vessel sign (SVS)in SWI and embolic occlusion or stenosis on TOF-MRA in AIS patients.Results The thrombus detection rate in group A was higher than that in group B.There was no significant difference in the overall detection rate of thrombi between SWI and TOF-MRA in all AIS patients,but the thrombi detection rate in M3 segement of middle cerebral artery(MCA)with SWI was higher than that with TOF-MRA in group A(P <0.05).Conclusion SWI performs a high diagnostic value for thrombus detection in AIS patients,especially for the thrombus detection of M3 segement in early period of AIS.

Objective The aim of this study was to describe the FICE application on gastric mucosa characteristics including normal and pathological changes, with or without H.pylori infection, and its corre-lation with histopathoingical evidence. Methods A total of 32 patients with dyspepsia symptoms and 5 healthy controls were enrolled into study. Each one underwent esophngogastreduedenoscopy (EGD) examina-tion with FICE and magnified observation. The whole stomach was examined by 3 steps: including conven-tional endoscopy followed by magnifying and FICE observation of the gastric antrum and body as well as biop-sies. All the patients were asked to take the rapid urease test (RUT) 、13C -urea breath test (13C-UBT) . Gastric antrum and body were both sub-classified into following 3 patterns by FICE observation and high reso-lution magnifying endoscopy. The sensitivity, specificity of each FICE pattern of both gastric antrum and body were analysed for the assessment of H. pylori infection, and the consistency with the results of RUT and 13C-UBT. Furthermore, the histopathologic parameters including inflammation、activity、atrophy and intestinal metaplasia were also assessed, Results FICE patterns of gastric antrum and body of all 5 control subjects were type Ⅰ, corresponded to an H. pylori negative and non-atrephy gastric mueosa. In study group on gastric antrum, 14 cases of FICE type Ⅰ pattern were noted and only 1/14(7. 1%) corresponded to an H. pylori positive gastric mucosa. 13 cases of FICE type Ⅱ pattern were noted and 10/13 (76. 9%) corresponded to an H.pylori positive mucosa and 9/13(69. 2%) were positive for both gastric atrophy. 5 cases of FICE type Ⅲ pattern were noted and 5/5 (100%) corresponded to an H. pylori positive mucosa and 3/5 (60%) were positive for both gastric atrophy and intestinal metaplasia. There was statistical difference in prediction of H. pylori infection between type Ⅰ FICE pattern and type Ⅱ or type Ⅲ pattern on gastric antrum (P <0. 01). In study group on gastric body, 15 cases of FICE type Ⅰ pattern were noted and only 1/14(7. 1%) corre-sponded to an H. pylori positive gastric mucosa. 13 cases of FICE type Ⅱ pattern were noted and 11/13 (84. 6%) corresponded to an H. pylori positive mucosa. 4 cases of FICE type Ⅲ pattern were noted and 4/4 (100%) corresponded to an H.pylori positive mucosa. There was statistical difference in prediction of H. pylori infection between type Ⅰ FICE pattern and type Ⅱ or type Ⅲ pattern on gastric body (P < 0. 01). Conclusion FICE in combination with high resolution magnifying endoscopy is valuable for identifying the normal gastric mucosa, H.pylori infection and its associated gastritis, gastric atrophy as well as intestinal metaplasia.

ObjectiveTo explore the function of intraoperative monitoring by brainstem auditory evoked potential and free electromyography during the operation of large acoustic neuroma for improving the operation more accurately and safely. MethodsThe intraoperative monitoring of affected cranial nerve and brainstem function respectively by brainstem auditory evoked potential and free electromyography was performed in 26 patients with large acoustic neuroma. According to the monitoring result the strategy and method of surgery was adjusted. Facial nerve function was assessed using the House-Brackmann facial nerve grading system immediately after two weeks of surgery.Results23 cases (88 ％) achieved total resection,3 cases(12 ％)achieved subtotal resection. The facial nerve was preserved anatomically in 25 patients.According to the House-Brackmann facial nerve grading system,21 cases (80 ％) got preserve of facial nerve function in grade Ⅰ - Ⅱ, 3 cases(12 ％)got preserve of facial nerve function in grade ]Ⅲ-Ⅳ and 1 cases (4 ％) got preserve of facial nerve function in grade Ⅴ after two weeks of surgery.ConclusionIntraoperative physiological monitoring may increase the anatomical and functional preservation rate of affected cranial nerve and also may improve the operation more accurately and safely.

Objective To evaluate the diagnostic ability of fusion images of SWI and DWI in ischemic penumbra(IP)of patients with acute ischemic stroke(AIS).Methods 47 AIS patients were retrospective analyzed.Two neuroradiologists analyzed the fusion images of SWI and DWI respectively.SDM was defined as that the hypo-intensity signals of intramedullary or sulcal veins were dilated or increased on fusion images compared with contralateral areas.The results compared with the PDM,which was considered as the“gold standard”.Areas under the receiver operating characteristic curve(AUC)were used to assess the efficacy of SDM which determined by fusion images and compared to PDM.Chi-square test was used to analyze the consistency between the two neuroradiologists and also the consistency between SDM and PDM in IP assessment Results The fusion images of SWI and DWI had a high diagnostic efficacy compared to PDM, AUC of the two radiologists were 0.885,0.877,the diagnostic sensitivity were 84.2%,78.9% and specificity were 92.9%,96.4%respectively.There was also a high consistency in SDM assessment through fusion images between the two neuroradiologists (Kappa=0.908,P >0.05). Conclusion Fusion images of SWI and DWI have a high diagnostic efficacy in IP assessment,which may be considered as a simple approach for IP assessment in patients with AIS.

Objective To investigate the effects of human urinary kallidinogenase (HUK) on cerebral perfusion,inflammatory marker level,neurological deficits,and short-term clinical outcomes in patients with acute ischemic stroke who exceeded the time window of thrombolytic therapy.Methods Patients with acute ischemic stroke exceeded the time window of thrombolytic therapy and treated in the Department of Neurology,the Second Affiliated Hospital of Nantong University from June 2016 to March 2018,and performed magnetic resonance perfusion imaging on the 1st and 14th d after admission were enrolled retrospectively.Patients were divided into HUK and control groups according to whether they received HUK treatment or not.All patients underwent magnetic resonance perfusion imaging and serum inflammatory markers measurement on the 1st and 14th d after admission.The National Institute of Health Stroke Scale (NIHSS) scores,cerebral perfusion levels,and serum inflammatory marker levels were compared between the 2 groups.On the 14thd after admission,the outcome was determined according to the modifiel Rankin Scale (mRS) scores.0-2 was defined as good outcome and ＞2 was defined as poor outcome.Multivariate logistic regression analysis was used to determine the independent influencing factors of outcome.Results A total of 62 patients with acute ischemic stroke exceeded the time window of thrombolytic therapy were enrolled,including 37 patients in the HUK group and 25 in the control group.There were no significant differences in the demographic and other baseline data between the HUK group and the control group,except for baseline NIHSS score (P =0.049).The reduction of NIHSS score after treatment in the HUK group was more significant than that in the control group (P ＜0.01).Serum high-sensitivity C-reactive protein level in the HUK group decreased significantly after treatment (P ＜ 0.01),and plasma lipoprotein-associated phospholipase A2 also showed a downward trend.In terms of perfusion imaging parameters,the relative cerebral blood flow was significantly increased after treatment in the HUK group,and the relative mean transit time and relative peak time were significantly decreased.The above increase and decrease were statistically significant compared with the control group (all P＜0.05).On the 14th d after admission,the mRS score showed that 51 patients had a good outcome and 11 had a poor outcome.Multivariate logistic regression analysis showed baseline NIHSS scores (odd ratio [OR] 2.545,95％ confilence interval [CI]1.124-5.541;P=0.024),atrial fibrillation (OR 5.712,95％ CI 1.737-24.685;P=0.039),and cardiogenic embolism (OR 4.485,95％ CI 1.148-18.262;P =0.040) were the independent risk factors for poor outcomes,and whether using HUK was not significantly associated with the outcomes.Conclusion For patients with acute ischemic stroke that exceeds the time window for thrombolysis,HUK improves cerebral perfusion,reduces inflammation,and improves neurological deficits in patients,but does not improve short-term neurological outcomes.

Purpose: Explore the causal relationship between the gut microbiota and erectile dysfunction (ED) at phylum, class, order, family, and genus levels, and identify specific pathogenic bacteria that may be associated with the onset and progression of ED. Materials and Methods: The genetic variation data of 196 human gut microbiota incorporated in our study came from the human gut microbiome Genome Wide Association Studies (GWAS) dataset released by the MiBioGen Consortium. The GWAS statistics for ED were extracted from one study by Bovijn et al., which included 223,805 participants of European ancestry, of whom 6,175 were diagnosed with ED. Subsequently, Mendelian randomization (MR) analysis was carried out to explore whether a causal relationship exists between the gut microbiota and ED. Additionally, bidirectional MR analysis was performed to examine the directionality of the causal relationship. Results: Through MR analysis, we found that family Lachnospiraceae (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.05–1.52, p=0.01) and its subclass genus LachnospiraceaeNC2004 group (OR: 1.17, 95% CI: 1.01–1.37, p=0.04) are associated with a higher risk of ED. In addition, genus Oscillibacter (OR: 1.17, 95% CI: 1.02–1.35, p=0.03), genus Senegalimassilia (OR: 1.32, 95% CI: 1.06–1.64, p=0.01) and genus Tyzzerella3 (OR: 1.14, 95% CI: 1.02–1.27, p=0.02) also increase the risk of ED. In contrast, the inverse variance weighted estimate of genus RuminococcaceaeUCG013 (OR: 0.77, 95% CI: 0.61–0.96, p=0.02) suggests that it has a protective effect against the occurrence of ED. Conclusions This study preliminarily identified 6 bacterial taxa that may have a causal relationship with ED, including family Lachnospiraceae, genus Lachnospiraceae NC2004 group, Oscillibacter, Senegalimassilia, Tyzzerella 3 and Ruminococcaceae UCG013. These identified important bacterial taxa may serve as candidates for microbiome intervention in future ED clinical trials.

Purpose: Explore the causal relationship between the gut microbiota and erectile dysfunction (ED) at phylum, class, order, family, and genus levels, and identify specific pathogenic bacteria that may be associated with the onset and progression of ED. Materials and Methods: The genetic variation data of 196 human gut microbiota incorporated in our study came from the human gut microbiome Genome Wide Association Studies (GWAS) dataset released by the MiBioGen Consortium. The GWAS statistics for ED were extracted from one study by Bovijn et al., which included 223,805 participants of European ancestry, of whom 6,175 were diagnosed with ED. Subsequently, Mendelian randomization (MR) analysis was carried out to explore whether a causal relationship exists between the gut microbiota and ED. Additionally, bidirectional MR analysis was performed to examine the directionality of the causal relationship. Results: Through MR analysis, we found that family Lachnospiraceae (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.05–1.52, p=0.01) and its subclass genus LachnospiraceaeNC2004 group (OR: 1.17, 95% CI: 1.01–1.37, p=0.04) are associated with a higher risk of ED. In addition, genus Oscillibacter (OR: 1.17, 95% CI: 1.02–1.35, p=0.03), genus Senegalimassilia (OR: 1.32, 95% CI: 1.06–1.64, p=0.01) and genus Tyzzerella3 (OR: 1.14, 95% CI: 1.02–1.27, p=0.02) also increase the risk of ED. In contrast, the inverse variance weighted estimate of genus RuminococcaceaeUCG013 (OR: 0.77, 95% CI: 0.61–0.96, p=0.02) suggests that it has a protective effect against the occurrence of ED. Conclusions This study preliminarily identified 6 bacterial taxa that may have a causal relationship with ED, including family Lachnospiraceae, genus Lachnospiraceae NC2004 group, Oscillibacter, Senegalimassilia, Tyzzerella 3 and Ruminococcaceae UCG013. These identified important bacterial taxa may serve as candidates for microbiome intervention in future ED clinical trials.

Purpose: Explore the causal relationship between the gut microbiota and erectile dysfunction (ED) at phylum, class, order, family, and genus levels, and identify specific pathogenic bacteria that may be associated with the onset and progression of ED. Materials and Methods: The genetic variation data of 196 human gut microbiota incorporated in our study came from the human gut microbiome Genome Wide Association Studies (GWAS) dataset released by the MiBioGen Consortium. The GWAS statistics for ED were extracted from one study by Bovijn et al., which included 223,805 participants of European ancestry, of whom 6,175 were diagnosed with ED. Subsequently, Mendelian randomization (MR) analysis was carried out to explore whether a causal relationship exists between the gut microbiota and ED. Additionally, bidirectional MR analysis was performed to examine the directionality of the causal relationship. Results: Through MR analysis, we found that family Lachnospiraceae (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.05–1.52, p=0.01) and its subclass genus LachnospiraceaeNC2004 group (OR: 1.17, 95% CI: 1.01–1.37, p=0.04) are associated with a higher risk of ED. In addition, genus Oscillibacter (OR: 1.17, 95% CI: 1.02–1.35, p=0.03), genus Senegalimassilia (OR: 1.32, 95% CI: 1.06–1.64, p=0.01) and genus Tyzzerella3 (OR: 1.14, 95% CI: 1.02–1.27, p=0.02) also increase the risk of ED. In contrast, the inverse variance weighted estimate of genus RuminococcaceaeUCG013 (OR: 0.77, 95% CI: 0.61–0.96, p=0.02) suggests that it has a protective effect against the occurrence of ED. Conclusions This study preliminarily identified 6 bacterial taxa that may have a causal relationship with ED, including family Lachnospiraceae, genus Lachnospiraceae NC2004 group, Oscillibacter, Senegalimassilia, Tyzzerella 3 and Ruminococcaceae UCG013. These identified important bacterial taxa may serve as candidates for microbiome intervention in future ED clinical trials.