Objective:To explore the efficacy and influencing factors of radiofrequency ablation (RFA) in the treatment of colorectal cancer liver metastases (CRLM).Methods:The clinical and imaging data of 281 patients (477 intrahepatic metastatic tumors) who received percutaneous RFA treatment in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from December 2009 to December 2020 were retrospectively analyzed. Factors that may affect the efficacy of RFA were recorded, including carcinoembryonic antigen (CEA), differentiation, extrahepatic metastasis, tumor location and size, complications and other information. Patients were followed up through hospital admissions, telephone, etc. The primary endpoints were overall survival (OS) and local tumor progression-free survival (LTPFS). Univariate and multivariate logistic regression models were used to identify predictors of residual tumor. Univariate and multivariate Cox proportional hazards regression were used to identify the influencing factors of LTPFS and OS. The median LTPFS and OS were estimated by the Kaplan-Meier curve and compared by the log-rank test.Results:After RFA, 68 (14.3%) tumor residues were observed. Multivariate logistic regression showed that the risk factors for residual tumor were size ≥20 mm, high-risk and perivascular location, and minimal ablative margin<5 mm. During the follow-up period, the main complication rate was 4.3% (12/281) and the fatality rate was 31.3% (88/281). At the same time, local tumor progression was found in 167 (35.0%) lesions post-RFA. The median time of LTPFS and OS estimated by the Kaplan Meier method were 35.0 (95%CI 26.53-43.48) and 44.0 (95%CI 29.70-58.30) months, respectively. The cumulative proportion of LTPFS and OS were 37.2% and 40.4% respectively in the 5th year. Multivariate Cox proportional hazard regression showed that CEA≥30 ng/ml, tumor size ≥20 mm, and minimal ablative margin<5 mm were risk factors for LTPFS; extrahepatic metastasis, tumor burden>30 mm, and lesion with minimal ablative margin<5 mm were independent risk factors for OS; re-intervention was an independent protective factor for OS.Conclusions:Adequate ablative margin and less tumor burden were beneficial to local tumor control and long-term survival of patients in the RFA treatment; the existence of extrahepatic metastasis was an important risk factor for OS, and re-interventional therapy was beneficial to extend OS.

Objective:To explore the application effect of case-based learning (CBL) in teaching magnetic resonance imaging (MRI) for non-imaging clinical professional postgraduates.Methods:Eighty non-imaging clinical professional postgraduates who had standardized residency training from 2017 to 2019 were selected as the participants and were randomly divided into two groups, experimental group and control group. The experimental group adopted CBL, and the control group adopted traditional teaching mode. After the standardized training in the radiology department, the differences in image reading scores, theoretical scores and course evaluation were compared between the two groups. SPSS 25.0 statistical software was used for analysis. Independent t test was used for the measurement data of normal distribution, Mann-Whitney U test was used for the measurement data of skewed distribution, and categorical variables were compared by chi-square test. Results:In the reading scores of MRI, the scores of the experimental group and the control group were (82.53 ± 5.72) points and (77.38 ± 6.14) points respectively, and the number of students in the experimental group whose reading scores were between 80-100 segment was 63.6% higher than that in the control group, with significant differences between the two groups ( P < 0.001), but without significant differences in theoretical average scores between the two groups ( P > 0.05). In addition, in the course evaluation, except for the index of learning burden, there were significant differences in other indexes between the experimental group and the control group ( P < 0.05). Conclusion:In the teaching of MRI, the application of the CBL helps non-imaging clinical professional postgraduates improve their MRI diagnostic thinking and independent reading ability.

【Objective】 To explore the application value of preoperative gastroscopic carbon nanoparticles labeling in patients undergoing laparoscopic radical gastric cancer surgery. 【Methods】 We included cases of laparoscopic radical gastric cancer surgery at The First Affiliated Hospital of Xi’an Jiaotong University from January 2017 to December 2019. Some cases received submucosal injection of carbon nanoparticles under the gastroscope before surgery. The effects of carbon nanoparticles labeling on the number of lymph nodes detected， operation duration and surgical complications were compared and analyzed. 【Results】 A total of 397 patients undergoing laparoscopic radical gastric cancer surgery were enrolled. Among them， 78 cases underwent gastroscopic carbon nanoparticles tracer labeling before operation. No complications were observed. The total number of lymph nodes detected by pathology after surgery in the carbon nanoparticles group significantly increased ［（22.0（4.0） vs. 22.0（3.0）， P=0.033）］ while the operation time significantly reduced ［（185.0±37.48）min vs. （213.4±23.66）min， P<0.001］ compared with those in the control group. New gastric cancer lesions were revealed by gastroscopy in three cases （3.8%） of carbon nanoparticles labeling， and the original planned operation method was changed in two cases （2.6%）. 【Conclusion】 Preoperative endoscopic carbon nanoparticles tracer labeling can not only help shorten the time of laparoscopic radical surgery for gastric cancer and increase the number of total lymph nodes detected for more accurate TNM staging， but also provide an opportunity for the discovery of synchronous multiple gastric cancer.

Objective To investigate the value of multiple parameter analysis in spectral CT scanning for the diagnosis of pulmonary nodules or masses.Methods The spectral CT scanning data in arterial phase of 319 patients with pulmonary nodules or masses confirmed by pathology and/or follow-up were analyzed retrospectively.The patients were divided into 3 groups:inflammatory group,lung cancer group and tuberculosis group.The Iodine(water)concentration,water(Iodine)concentration,the effective atomic number and the CT value of 60,70 and 80 keV single energy in the leisons were measured.One way A NOVA and LSD-t test were used for statistical analysis.Results One way A NOVA showed that the Iodine(water)concentration,water(Iodine)concentration,the effective atomic number and the CT value of 60,70 and 80 keV single energy among 3 groups in the arterial phase were all statistically different(P<0.05).T he LSD-t test showed there were statistical differences of Iodine content and effective atomic number between tuberculosis group and inflammatory group,lung cancer group and inflammation group(P<0.05).There were statistical differences between tuberculosis group and lung cancer group,inflammation group and lung cancer group in water concentration(P<0.05).The statistical differences in CT value of 60,70 and 80 keV single energy between tuberculosis group and inflammatory group,inflammation group and tuberculosis group were also found(P<0.05).Conclusion Multiple parameter analysis of spectral CT scanning in arterial phase could attribute to the diagnosis and differential diagnosis of pulmonary nodules or masses.

Objective To investigate the effects of X-ray beam hardening from contrast agent on CT values on CTA images.Methods The 20 mL syringes were numbered 1 to 26.The syringe 1,4,7,23 and 20 were filled with 1 mL,0.8 mL,0.6 mL,0.4 mL and 0.2 mL of iodine contrast medium (300 mg I/mL),respectively,and then mixed each of them with 0.9％ NaC1 solution to get a total of 20 mL solution in each syringe.The rest of 26 syringes were filled with 20 mL of 0.9％ NaC1 solution,as the experimental group to simulate carotid artery CTA examination.Matched 26 numbered syringes were filled with 20 mL 0.9％ NaC1 solution respectively,as control group to simulate plain scan.CT scans were performed,CT values were measured,and then the difference of CT values of 0.9 ％ NaCl solution in two groups was analyzed statistically.Results The mean,maximum and minimum CT values of saline in the experimental group vs control group were (-0.139±10.322) HU vs (5.585±2.939) HU,14.6 HU vs 9.7 HU,-23.8 HU vs-2.4 HU,respectively,and the differences were significant (t=2.695,P＜0.05).The CT values of saline around the high concentrations of iodine solution showed a large fluctuation range.Conclusion The X ray beam hardening effects caused by high concentration of iodine contrast on carotid artery CTA phase,may cause significant fluctuations of CT values.

Atrioventricular node is responsible for conducting impulse from atria to ventricles.Connexin within atri-oventricular junction play a key role in conducting function of atrioventricular junction;because it presents diversi-fied expression,so its conducting junction is diversified in different areas of atrioventricular junction.Knowing ex-pression type of connexins can approximately determine conductive function in atrioventricular junction area.

Bone Neoplasms ; pathology ; Carcinoma, Neuroendocrine ; pathology ; Humans ; Osteosarcoma ; pathology ; Ureter ; pathology ; Ureteral Neoplasms ; pathology

Objective To investigate the value of the adaptive statistical iterative reconstruction (ASIR) algorithm for reducing the radiation dose and optimizing the image quality in the low-dose spectral CT scanning in GSl (Gemstone spectral imaging) of the liver.Methods A total of 60 patients who underwent hepatic spectral CT scanning in GSI were enrolled in this study.The patients were randomly divided into two groups according to priority with 30 cases per group.Low-dose spectral CT scanning was used for group A, and images were reconstructed by ASIR 0 and 50％ , marked as A1 and A2.Group B was scanned with conventional dose of spectral CT, and images were reconstructed by Filtered back projection (FBP).Effective doses (E) for each group were calculated.Image quality was assessed by two radiologists, and the radiation doses were compared between groups A and B.Results All image quality of each group were good enough for clinical diagnosis.E for group A and B were (3.2 ±0.2) and (5.8 ± 0.2) mSv, respectively.There was statistical difference with image noise between group A and B(Z =-6.784,P ＜ 0.05).The image noise, SNR and CNR had statistical differences between group A and B (F =24.013, 15.646, 8.285, P ＜0.05).Compared with group A1, the image noise was lower, and the SNR and CNR were higher in groups A2 and B(P ＜ 0.05).There were no statistical differences of image noise, SNR and CNR between groups A2 and B (P ＞ 0.05).There were no statistical differences of the image quality score between groups A1, A2 and B (F =102.38,105.768, P ＜ 0.05).Conclusions ASIR combined with low-dose spectral CT scanning was helpful to reduce radiation dose and could obtain better image quality in hepatic CT examination.

Objective To investigate the effect of β-elemene on SGC7901 gastric cancer cell line and the potential proteins involved. Methods Human SGC7901 gastric cancer cells were treated with different concentrations ofβ-elemene.Cell viability was assessed.A proteomic method,isobaric tags for relative and absolute quantitation (iTRAQ),was employed to detect the proteins altered by β-elemene.Protein expression was validated by Western blot.Results β-elemene inhibited the viability of SGC7901 gastric cancer cells in a dose-dependent manner.Altogether,147 upregulated proteins and 86 downregulated proteins were identified in response to β-elemene treatment in SGC7901 gastric cancer cell line.Among them,the expressions of p21-activated protein kinase-interacting protein 1 (PAK1IP1 ),Bcl-2-associated transcription factor 1 (BTF)and topoisomerase 2-alpha (TOPIIα)were validated by Western blot and the trends were consistent with iTRAQ results.Top pathways involved inβ-elemene treatment in SGC7901 gastric cancer cell line included ribosome signaling,peroxisome proliferator-activated receptors (PPARs)signaling pathway,regulation of actin cytoskeleton,phagosome,biosynthesis and metabolism of some amino acids.Conclusion Our results suggest a promising therapeutic role of β-elemene for gastric cancer.The differentially expressed proteins give us better insights into the potential mechanisms involved in gastric cancer treatment using β-elemene.

Objective To explore the effect of modified Zexie Decoction on renal aquaporin-2 (AQP2) expression in high-salt hypertensive rat. Methods Hypertensive rats model was established by feeding rat with 8%high salt. Rats (n=50) were divided into model group, modern medicine group, traditional Chinese medicine groups of high, medium, low dose, with 10 rats in each group. The other 10 rats were fed with ordinary diet as normal group. Rats in traditional Chinese medi?cine of high, medium, low groups were given Zexie Decoction suspension of 16.2, 10.8 and 5.4 g/(kg·d) respectively;Rats in modern medicine group was given Valsartan hydrochlorothiazide 16.65 mg/(kg·d);the model group and normal group was ad?ministered with equal volume of distilled water. Animals were feed with medications at 1 mL/100 g by gavage for 4 weeks. On the 1st , 4th , 7th , 14th and, 28th day of administration, we measured SBP and collected 24 h urine. We employed immunohis?tochemistry to detect renal AQP-2 protein expression level and RT-PCR to detect renal AQP-2 mRNA transcription level. Results The rank of SBP from high to low is:model group>traditional Chinese medicine medium and low dose groups>traditional Chinese medicine high dose group and western medicine group>normal group. The rank of urine volume from high to low is:Western medicine group and traditional Chinese medicine high dose group>traditional Chinese medicine me?dium and low dose group > normal group, the difference was not statistically significant between traditional Chinese medi?cine medium and low dose group , or between western medicine group and traditional Chinese medicine high dose group. The renal AQP-2 in epithelial cells along the collecting duct wall of rats in model group show brown particles which are darker and wider distributed than those in normal group and traditional Chinese medicine of high, medium, low dose groups. RT-PCR results show that AQP-2 mRNA expression is highest in rats of model group and lowest in rats of traditional Chi?nese medicine high dose group (P<0.05). No statistical significance of AQP mRNA level was found between traditional Chi?nese medicine low group and model group (P < 0.05). Conclusion Modified Zexie Decoction can lower blood pres?sure by inhibiting the expression of AQP-2.