Objective:To compare and analyze the parameters of image quality of virtual mono-energetic images(VMIs)and conventional computed tomography(CT)images of dual-energy CT(DECT)imaging for the coracoclavicular ligament,and to optimize the image quality of DECT imaging for coracoclavicular ligament.Methods:The DECT image data of shoulder joints of 50 patients who received DECT scan in the First People's Hospital Affiliated to Shanghai Jiao Tong University were retrospectively analyzed.450 VMIs at energy levels of 40 to 120 keV were obtained through the Syngo.via VB20 workstation,and these VMIs were divided into three groups:low energy level(40,50,60 keV),medium energy level(70,80,90 keV),and high energy level(100,110,120 keV).The contrast-to-noise ratio(CNR),the direction of coracoclavicular ligament's rows,and the displayed subjective quality scores of attachment points of VMIs were compared with those of conventional CT images.The results of MRI examination were used as the"gold standard"to assess the effectiveness of VMIs in diagnosing coracoclavicular ligament injuries of patients with acromioclavicular joint dislocation.The diagnostic efficacies of VMIs'the three groups and conventional images were assessed by using receiver operating characteristic(ROC)curve.Results:The CNR values of diagonal ligament and conical ligament at 40 keV of low energy level group of VMIs for coracoclavicular ligament were respectively 14.09±3.27 and 13.9±3.06,and those of medium energy level group were respectively 11.89±4.01 and 12.17±4.08,and those of high energy level were respectively 9.69±4.25 and 9.78±4.33.The CNR value of low energy level group was significantly higher than that of medium and high energy level groups,and the differences were statistically significant(t=21.1,16.3,P<0.05),respectively.The results of ROC curve analysis indicated that the sensitivity,specificity and area under curve(AUC)value of the low energy level group were relatively higher in diagnosing coracoclavicular ligament injury,which were respectively 90.05%,91.95%and 0.965.There was high consistence in assessing coracoclavicular ligament injury between DECT's VMIs and MRI examination(Kappa=0.896).Conclusion:DECT's VMIs can better display the rows and attachment points of diagonal ligament and conical ligament,and the VMIs quality at low energy level(40 to 70 keV)is the best,which has better diagnostic efficacy in diagnosing coracoclavicular ligament injury.

Objective:To compare and analyze the parameters of image quality of virtual mono-energetic images(VMIs)and conventional computed tomography(CT)images of dual-energy CT(DECT)imaging for the coracoclavicular ligament,and to optimize the image quality of DECT imaging for coracoclavicular ligament.Methods:The DECT image data of shoulder joints of 50 patients who received DECT scan in the First People's Hospital Affiliated to Shanghai Jiao Tong University were retrospectively analyzed.450 VMIs at energy levels of 40 to 120 keV were obtained through the Syngo.via VB20 workstation,and these VMIs were divided into three groups:low energy level(40,50,60 keV),medium energy level(70,80,90 keV),and high energy level(100,110,120 keV).The contrast-to-noise ratio(CNR),the direction of coracoclavicular ligament's rows,and the displayed subjective quality scores of attachment points of VMIs were compared with those of conventional CT images.The results of MRI examination were used as the"gold standard"to assess the effectiveness of VMIs in diagnosing coracoclavicular ligament injuries of patients with acromioclavicular joint dislocation.The diagnostic efficacies of VMIs'the three groups and conventional images were assessed by using receiver operating characteristic(ROC)curve.Results:The CNR values of diagonal ligament and conical ligament at 40 keV of low energy level group of VMIs for coracoclavicular ligament were respectively 14.09±3.27 and 13.9±3.06,and those of medium energy level group were respectively 11.89±4.01 and 12.17±4.08,and those of high energy level were respectively 9.69±4.25 and 9.78±4.33.The CNR value of low energy level group was significantly higher than that of medium and high energy level groups,and the differences were statistically significant(t=21.1,16.3,P<0.05),respectively.The results of ROC curve analysis indicated that the sensitivity,specificity and area under curve(AUC)value of the low energy level group were relatively higher in diagnosing coracoclavicular ligament injury,which were respectively 90.05%,91.95%and 0.965.There was high consistence in assessing coracoclavicular ligament injury between DECT's VMIs and MRI examination(Kappa=0.896).Conclusion:DECT's VMIs can better display the rows and attachment points of diagonal ligament and conical ligament,and the VMIs quality at low energy level(40 to 70 keV)is the best,which has better diagnostic efficacy in diagnosing coracoclavicular ligament injury.

Background::Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods::Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher’s exact test was used for comparison of categorical variables. Results::A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk.Conclusions::PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

Objective:To investigate the clinical, neuropsychological and regional cerebral blood flow (rCBF) characteristics in patients with psychiatric symptoms caused by nitrous oxide abuse.Methods:Twelve patients with psychiatric symptoms caused by nitrous oxide abuse were enrolled from February 2018 to February 2020 in the Department of Neurology, China-Japan Friendship Hospital and the First Hospital of Tsinghua University.All patients were scored with the brief psychiatric rating scale (BPRS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). The SPECT/CT images were collected with low-energy and high-resolution collimator.After the pictures were reconstructed, 18 brain regions were automatically sketched and calculated by Database Comparison software.The statistical value of the difference between the general mean value of each brain region and that of the corresponding region of interest in the same age group was estimated.Results:(1)The clinical manifestations of 12 patients were anxiety, depression, hallucination, delusion, and 7 patients were accompanied by cognitive decline.(2)Neuropsychological examination: BPRS score was 57.83±11.15 (anxiety depression factor was 3.94±0.47; lacking active factor was 3.25±0.85; thinking disturbance factor was 3.21±1.27; activity factor was 2.28±0.56; hostility factor was 3.14±1.24). The score of self-knowledge impairment was 2.92±1.08, the score of inability to work was 4.50±1.17, the score of HAMD was 32.75±10.13, the score of HAMA was 18.67±5.80, the score of MMSE was 27.67±2.50, and the score of MoCA was 24.58±3.78.(3)SPECT showed that compared with the general mean value of the corresponding regions of interest of normal people, the patients showed hypoperfusion in the frontal lobe (7 patients, 58.30%) and the temporal lobe (8 patients, 66.70%).Conclusion:Nitrous oxide abuse has an obvious effect on rCBF.The psychiatric symptoms include anxiety, depression, hallucination, delusion and so on, which affect the ability to work and learn.SPECT has important value in the diagnosis of nitrous oxide abuse, and indicates changes in local brain functional activity.

AIM To observe the clinical efficacy of Huazhi Rougan Granules (Artemisiae scopariae Herba,Cassiae Semen,Rhei Radix et Rhizoma,etc.) in the treatment of damp-heat accumulation type non-alcoholic steatohepatitis (NASH) and its influence on insulin resistance.METHODS During January 2014-January 2016,a total of one hundred and twenty patients with damp-heat accumulation type NASH,given diet and exercise guidance,were randomly and equally divided into control group (polyene phosphatidylcholine) and treatment group (Huazhi Rougan Granules),administrated for twelve weeks.The levels of serum alanine aminotransferase (ALT),aspartate aminotranferase (AST),gamma-glutamyltransferase (GGT),total cholesterol (TC),triglyceride (TG),γ-glutamyl transpeptadase (GGT),fasting plasma glucose (FPG),fasting insulin (FINS),HOMA-IR index,adiponectin (ADPN) and leptin,body mass index (BMI) and uhrasound examination were detected before and after the treatment,respectively.These data were compared in two groups.RESULTS Compared with the control group,the serum ALT,AST,GGT,TC,TG,FPG,FINS and HOMA-IR of the patients in the treatment group decreased significantly,and liver fat were effectively reduced,while serum adiponectin increased markedly (P ＜ 0.05).After the treatment,remarkable reductions in the levels of BMI,leptin were observed in both groups (P ＜ 0.05).CONCLUSION Huazhi Rougan Granules combined with lifestyle modulation can effectively improve the syndrome of damp-heat accumulation type NASH by lowing insulin resistance.

Objective To investigate the neurological and cerebrospinal fluid interleukin-6 effects of butylphthalide on brain hemorrhage.Methods Ninety cerebral hemorrhage patients in principle based on a random draw were equally divided into the treatment group (45 cases) and the control group (45 cases).Two groups were given basic treatment, the control group were treated with nimodipine tablets adjuvant therapy, the treatment group were treated with butylphthalide soft capsules adjuvant therapy, all patients were treated for 30 days.Results After treatment, the national institutes of health stroke scale (NIHSS) score was shown significant downward trend in the two groups((9.45±0.44) to (2.09±0.45) scores;(9.44±0.21) to (4.58±0.65) scores) and compared with pre-treatment differences were significant (t=16.983, P=0.000;t =8.112, P =0.000), and the NIHHS score in treatment group was significantly lower than in control group(P =0.000).The mini-mental state examination (MMSE) score and activities of daily living (ADL) scores were shown significant upward trend in the two groups,compared with pre-treatment differences were significant(P ＜0.05).MMSE score(26.98±3.91) and ADL scores(34.29±6.42) scores in the treatment group were significantly lower in the control group((23.09±5.33) scores, (30.28±5.33)scores) after treatment(t =6.498, P =0.000;t =8.123, P =0.000).After treatment, the values cerebrospinal fluid interleukin-6 (IL-6) expression in the two groups were significantly reduced (P ＜ 0.05), while the value of cerebrospinal fluid IL-6 expression in the treatment group were significantly lower than the control group ((45.38 ± 13.02) ng/L vs (122.87± 17.42) ng/L, t =18.334, P =0.000).The adverse reactions of the two groups were mild, and were significantly improved after symptomatic treatment.Conclusion Butylphthalide adjuvant treatment of cerebral hemorrhage can improve nerve function, cognitive function and activities of daily living, its safety is also better.It plays its role may related to effectively reduce the IL-6 expression.

Objective To investigate the effects of 17-methoxyl-7-hydroxy-benzene-furabcgakcone( MHBFC ) on isoproterenol-induced ventricular remodeling in mice. Methods Isoproterenol(ISO)was given subcutaneously(1 mg·kg-1, twice per day for 7 d)to induce ventricular remodeling in mice. Mice were divided into normal control group,model group, captopril group,MHBFC low and high-dose groups. 65 mg·kg-1 captopril was given by intragastric administration in captopril group,2. 5,5. 0 mg·kg-1 MHBFC were given by intravenous injection in MHBFC low and high-dose groups. At the end of the 7th day,the hearts of the mice were weighted,and myocardial hypertrophy index was expressed as heart weight/body weight, double kidneys weight/body weight and lung weight/body weight( HW/BW,KW/BW and LW/BW). Colorimetric method was used to determine the content of hydroxyproline( Hyp)in heart,the activity of superoxide dismutase( SOD)and the content of malondialdehyde( MDA)in serum. The histological changes were observed by HE and Masson’s staining,the changes of cross section area( CSA),collagen volume fraction,( CVF)and perivascular circumferential collagen area( PVCA)were determined. Results Compared with the model group,MHBFC potently inhibited cardiomyocyte hypertrophy,decreased the HW/BW, KW/BW and LW/BW,improved cardiac pathology changed,increased the of activity SOD,decreased the content of MDA in serum and the content of Hyp in heart tissue(P﹤0. 01 or P﹤0. 05),decreased the CVF and PVCA(P﹤0. 01). Conclusion MHBFC possesses protective effects against ISO-induced ventricular remodeling in mice,which may be related to its actions in reducing the oxidative stress and improving the antioxidant activity of the body.

Objective:To observe the protective effect of Yulangsan polysaccharide ( YLSP) on liver injury induced by cyclophos-phamide(CTX) in mice. Methods:Liver injury induced by CTX in mice was used as the animal model and the mice were randomly di-vided into the normal group, CTX model group, biphenyldicarboxylate ( BPDC) group, YLSP group respectively with high, medium and low dose. Except the normal group, the other groups were injected with CTX, i. p. , for 7 days to make the model. Then the ani-mals in the YLSP groups were intragastrically administered with YLSP for 7 days. The activities of alanine aminotransferase( ALT) , as-partate aminotransferase( AST) in serum, malondialdehyde( MDA) , superoxide dismutase( SOD) , glutathione( GSH) and glutathione peroxidase ( GSH-Px) in liver tissue were investigated. Hematoxylin and eosin ( HE) stain was used to study the changes in hepatic tissue of the pathological mice. Results:Compared with the model group, YLSP could obviously reduce the activities of ALT, AST and the content of MDA, and increase the content of GSH, SOD and GSH-Px (P<0. 05 or P<0. 01). HE staining showed that YLSP had significant protective effect on liver injury induced by CTX. Conclusion:YLSP has protective effect on liver injury induced by CTX.

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

BACKGROUND: Uncontrolled-rate freezing in -80 ℃ refrigerator is convenient, while controlled-rate freezing in -196 ℃ liquid nitrogen is reliable and long-term, the combination of the two can simplify the process and has been successfully used in clinics. OBJECTIVE: To explore the influences of different cryoprotectants by ladder-style freezing from -80 ℃ low temperature refrigerator to liquid nitrogen on the cryopreservation of hemopoietic stem cells. METHODS: The experiments were divided into four groups: 10% dimethyl sulfoxide (DMSO) group, 5% DMSO combined with 3% hydroxyethyl starch group, 5% DMSO combined with 0.25 mol/L trehalose group, 5% DMSO combined with 3% hydroxyethyl starch and 0.25 mol/L trehalose group. Peripheral hemopoietic stem cells were cryopreserved by ladder-style freezing from -80 ℃ low temperature refrigerator to liquid nitrogen. The ultrastructural changes were examined by transmission electron microscopy, the expressions of Annexin-V, PI and Caspase-3 were detected by flow cytometry. RESULTS AND CONCLUSION: There was no significant difference in survival rate, apoptotic rate and necrotic rates of the cryopreserved cells in the four groups (P > 0.05). The ultrastructural changes had no significant difference under the transmission electron microscopy. The viability was more than 90% in frozen-thawed mononuclear cell colonies, and the apoptosis was roughly 50% in the frozen-thawed CD45+ cell population, which contained many mature cells. Of hemopoietic stem cells, early stage cells have greater resistance to damage of cryopreservation than late stage cells. It is concluded that the addition of hydroxyethyl starch or trehalose into DMSO exhibits no synergistic protective effect on the cryopreservation of hemopoietic stem cells.