Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Objective This study aims to explore the application value of spectral CT and perfusion CT parameters in the pathological classification and prognostic assessment of lung cancer.Methods A total of 94 lung cancer patients confirmed by pathology at Shanghai Chest Hospital from January 2023 to November 2024 were included in the study,including 49 cases of lung adenocarcinoma(LUAD),30 cases of lung squamous cell carci-noma(LUSC),and 15 cases of small cell lung cancer(SCLC).All patients underwent spectral CT combined with perfusion scanning using a 256-slice Revolution Apex from GE.Two radiologists independently measured the spectral and perfusion parameters of the three groups of images,including spectral curve slope(K),iodine concentration in the lesion area(ICL),effective atomic number(Zeff),surface permeability(PS),and perfusion index(PI),and established a lung cancer pathological subtype discrimination prediction model based on spectral CT radiomics features.All subjects were randomly divided into a training group and a validation group at a ratio of 3∶1.The discrimination efficacy of the spectral discrimination model between different pathological subtypes and the discrimination efficacy of arterial and venous phase images were compared in multiple dimensions.The performance of the model was evaluated using the receiver operating characteristic(ROC)curve.Results Statistical analysis showed that the spectral curve slope,ICL,NIC,and Zeff of LUAD patients were significantly higher than those of LUSC and SCLC patients(P<0.05),while there were no significant differences in these parameters between LUSC and SCLC patients(P>0.05).Among the perfusion CT parameters,surface permeability(PS)showed significant differences among the three groups(P<0.05),while blood volume(BV),blood flow(BF),perfusion index(PI),time to peak(TTP),and mean transit time(MTT)did not show statistical differences.The multi-factor logistic regression model based on spectral parameters showed strong discriminatory performance:the area under the curve(AUC)of the LUAD and LUSC discrimination model was 0.806/0.77(training group/test group)in the arterial phase and 0.867/0.9(training group/test group)in the venous phase;the AUC of the LUAD and SCLC discrimination model was 0.885/0.883(training group/test group)in the arterial phase and 0.851/0.776(training group/test group)in the venous phase.Conclusion This study indicates that the multi-dimensional functional metabolic analysis indicators of spectral and perfusion CT imaging have significant value in the differential diagnosis of lung cancer pathological subtypes.The diagnostic model constructed by combining multiple spectral parameters can significantly improve the discrimination efficacy of lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer,providing precise imaging evidence for the formulation of individualized treatment plans.

Objective:To investigate a time series deep learning model for respiratory motion prediction.Methods:Eighty pieces of respiratory motion data from lung cancer patients were used in this study. They were divided into a training set and a test set at a ratio of 8∶2. The Informer deep learning network was employed to predict the respiratory motions with a latency of about 600 ms. The model performance was evaluated based on normalized root mean square errors (nRMSEs) and relative root mean square errors (rRMSEs).Results:The Informer model outperformed the conventional multilayer perceptron (MLP) and long short-term memory (LSTM) models. The Informer model yielded an average nRMSE and rRMSE of 0.270 and 0.365, respectively, at a prediction time of 423 ms, and 0.380 and 0.379, respectively, at a prediction time of 615 ms.Conclusions:The Informer model performs well in the case of a longer prediction time and has potential application value for improving the effects of the real-time tracking technology.

Objective To improve differential diagnosis of tumefactive demyelinating lesions (TDL) and primary central nervous system lymphoma (PCNSL) by analyzing the clinicopathological features of the diseases.Methods The clinical features,neuroimaging findings and pathological characteristics of 4 patients with pathologically proven TDL and 9 patients with pathologically proven PCNSL were retrospectively analyzed.Computer tomography and magnetic resonance imaging were used for neuroimaging studies.The hematoxylin and eosin staining,Luxol Fast Blue staining and immunohistochemistry were used for pathological studies.Results (1) The features of lesions on brain imaging scan:CT in TDL patients showed low density.Enhanced MRI demonstrations were different in different courses:3 cases with ring enhancement,1 case with spotty strengthen;5 PCNSL cases showed hyperdensity in CT,1 case showed isodensity,and 3 cases low-density.MRI showed enhancement of uniform enhancement in PCNSL patients.(2) The features of lesions on pathology:the plaques of lesions in TDL patients were characterized by massive demyelination with relatively axonal preservation associated with prominent astrocytosis and profound infiltrates composed.Typical pathological features in PCNSL cases were that tumor cells around blood vessels showed the cuff-like arrangement.Due to use of hormones and other causes,pathological demonstrations of a part of PCNSL cases were atypical,which were easily confused with TDL.There were 4 cases with more than one biopsy for diagnosis.Conclusions (1) PCNSL with low or equal density in CT needs to be differentiated with TDL.(2) The pathological features of some cases of PCNSL after hormone therapy were similar to TDL.It is better not to use hormone before definite diagnosis.(3) The pathology of PCNSL may be related to the progression of the disease.Some of patients need to be re-biopsied.It is important to combine clinical imaging and pathology for diagnosis of the disease,and attention should be paid to followup.

Objective To explore the distribution and genotypes of plasmid-mediated quionlone resistance (PMQR)genes and intI1 integrase genes in Enterobacteriaceae isolates.Methods The PMQR genes and intI1 integrase genes were identified by polymerase chain reaction in the nonduplicate strains of E.coli (80),E.cloacae (18)and K.pneunoniae (27).The positive PCR products were subj ect to DNA sequencing analysis.The gene-positive strains were tested by conj ugation experiment.The minimum inhibitory concentrations (MICs)of donor,recipient strains and transconj ugants were tested by agar dilution method with quinolones and other antimicrobial agents.Results Sixteen (12.8%)of the 125 Enterobacteriaceae isolates were qnr gene positive,including 8 qnrS1 positive and 8 qnrB6 positive.Furthermore,the aac(6′)-Ib-cr gene was identified in 15 (12.0%) strains.Twenty PMQR-positive isolates harbored intI1 integrase gene.The conjugation experiments were successful in 12 of the 26 PMQR-positive isolates and 7 of the 20 intI1-positive isolates.The MICs of quinolones and other antimicrobial agents against the transconj ugants were higher than the MIC values against recipient strains.Conclusions The PMQR genes are prevalent in Enterobacteriaceae isolates.The PMQR-positive isolates can co-harbor integrase genes.These resistance genes have the feature of horizontal transfer,to which close attention should be paid.

Objective To evaluate the safety of thrombolytic treatment using rt-PA at early stage of acute cerebral infarction in Chinese patients, and to analyze the significance of intra - cerebral hemorrhage after therapy. Methods 206 patients within 6 hours after the onset of stroke were divided into 3 groups: group A (thrombolytic treament using rt - PA with dosage of 0.9 mg/kg over 60 minutes) , group B (thrombolytic treatment using rt-PA with dosage of 0.7 mg/kg over 60 minutes) and group C (control group without rt-PA). Group A, group B, group C were divided into two subgroups according to using Clexane or not. Patients in subgroups A1, B1, C1 were treated with Clexane and in subgroups A2, B2, C2 were not. The Chinese Stroke Scale (CSS) and Barthel Index (BI) were used to evaluate the neurological function before and 24 hours, 3 days, 7 days, and 90 days rt-tPA. Results There was significant difference on hemorrhagic rate and cerebral hemorrhagic rate at the 48 hours and 14 days between group A, group B and group C. There was no significant difference on symptomatic cerebral hemorrhage in groups A, B and group C. There were significant differences between thrombolytic groups and group C on the effective and curative rate at 90 days after therapy. The mortality was lower in thrombolytic groups than in group C at 90 days. There was no significant difference between group A and group B , and also between the subgroups. Conclusion Thrombolytic treatment using rt-PA intravenously in patients with acute cerebral infarction within 6 hours was effective and safe. The dosage of 0.7mg/kg was suitable for Chinese patients.

Objective To analyze the death causes of the burn patients so as to explore the effective procedures which can raise burn management level. Methods One hundred patients died of burn injury during the past 20 years were enrolled in the study. The died patients were grouped as A (1984～1993) and B (1994～2003) groups, each group containing 50 cases. The mortality, burn area and depth, etiology, pre-hospital treatment, admission time, survival time, tracheostomy, the application of respirator and fibrobronchoscope, operation times, continuous renal replace treatment (CRRT), the incidence of inhalation injury and the pathogenesis of burn death were analyzed and compared between A and B groups. Results There were no differences in burn severity (area and degree), etiology and causes of burn death between the two groups. But the mortality in B group (1%) was evidently lower than that in A group (2%, P

Objective:To detect the expression of IDO, iNOS, gp91 NADPH ox releated with IFN-? function following Chlamydia trachomatis lung infection in mice and to investigate the immunological defense mechanism of IFN-?. Methods:A murine model of pneumonia induced by intranasal inoculation of Chlamydia trachomatis,mouse pneumonitis (MoPn) biovar,was used for this study. Chlamydial growth in the lung was assessed by inoculating HeLa 229 cell monolayer with lung homogenates followed by HRP conjugate anti-Chlamydial LPS mAb.The mRNA expressions of IDO, iNOS, gp91 NADPH ox and IFN-? in the lung were determined by RT-PCR on day 7 and 14 postinfection.Results:Chlamydial growth in the lung was observed on day 2 postinfection, peaking at day 7 with subsequent decline in quantity. At day 21 following inoculation, the IFU declined to the baseline. Contrast with the uninfected group, Th1-like cytokine IFN-? underwent a significant increase at day 7 and a decrease on day 14 postinfection. mRNA expression for IDO, iNOS, gp91 NADPH ox was significantly increased in the lungs on day 7 and 14 postinfection, IDO and gp91 mRNA expression was significantly highler at day 7(P

Object To determine the content of muscone in preparation Methods Standard addition, DNP derivatization and HPLC with electrospray ionization tandem mass spectrometry (LC/ESI MS/MS) were utilized Results Identification of muscone hydrazone in the sample was based on the unique mass spectra of the standard Under an optimum condition peak corresponding to + ion and characteristic fragments for muscone hydrazone were observed ESI and APCI full scan m/z 419 MS/MS had the same relative molecular mass and fragmentation pattern The recovery was 102 5% with RSD ≤ 2 76% (n=5) Conclusion The qualitative and quantitative determination on muscone could be fulfilled simultaneously