Objective To compare and analyze the application value of brain black blood technology three-dimensional BrainVIEW(3D-BrainVIEW)and conventional three-dimensional turbo field echo T1 weighted imaging(3D-TFE T1WI)in brain metastases of lung cancer.Methods A total of 60 patients with pathologically confirmed lung cancer were selected.All patients underwent brain enhanced MRI using 3D-BrainVIEW and 3D-TFE T1WI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two groups were compared and analyzed,respectively.The diagnostic efficacy(including number,size,and location)of the two groups of images in detecting brain metastases was evaluated by two experienced radiologists via double-blind method.Results The diagnostic consistency between the two radiologists was excellent[intraclass correlation coefficient(ICC)=0.998,P<0.001].There were significant differences in SNR,CNR,and the number and location of brain metastases between 3D-BrainVIEW sequence and 3D-TFE T1WI sequence(P<0.05),and 3D-BrainVIEW sequence was significantly superior to 3D-TFE T1WI sequence.In addition,the number of brain metastases detected by 3D-Brain VIEW sequence was significantly higher than that detected by 3D-TFE T1WI sequence in lesions with minimum diameter(Dmin)<5 mm(P<0.001).There was no difference in the number of lesions detected by the two sequences in lesions with Dmin>5 mm(P>0.05).Conclusion The SNR and CNR of 3D-Brain VIEW enhanced scan images are significantly higher than those of 3D-TFE T1WI,which has higher detection efficiency for lung cancer brain metastases,and can effectively reduce misdiagnosis caused by microvascular enhance-ment,which has high clinical application value.

OBJECTIVES: Renal cell carcinoma (RCC) is a malignant renal tumor that poses a significant threat to patient health. Accurate preoperative pathological grading plays a crucial role in determining the appropriate treatment for this disease. Currently, deep learning technology has become an important method for pathological grading of RCC. However, existing methods primarily rely on single-phase computed tomography (CT) imaging for analysis and prediction, which has limitations such as missing small lesions, one-sided evaluation, and local focusing issues. Therefore, this study proposes a multi-modal deep learning algorithm that integrates multi-phase enhanced CT images with clinical variable data, aiming to provide a basis for predicting the pathological grading of RCC. METHODS: First, the algorithm took four-phase enhanced CT images from the plain scan, arterial phase, venous phase, and delayed phase, along with clinical variables, as inputs. Then, an embedding encoding module was used to extract heterogeneous information from the clinical variables, and a 3-dimensional (3D) ResNet50 model was employed to capture spatial information from the multi-phase enhanced CT image data. Finally, a Fusion module deeply integrated the feature information from clinical variables and each phase's CT image features, further utilizing a cross-self-attention mechanism to achieve multi-phase feature fusion. This approach comprehensively captures the deep semantic information from the patient data, fully leveraging the complementary advantages of multi-modal and multi-phase data. To validate the effectiveness of the proposed method, a total of 1 229 RCC patients were approved by ethics review were included to train the model. RESULTS: Experimental results demonstrated superior performance compared to traditional radiomics and state-of-the-art deep learning methods, achieving an accuracy of 83.87%, a recall rate of 95.04%, and an F1-score of 82.23%. CONCLUSIONS The proposed algorithm exhibits strong stability and sensitivity, significantly enhancing the predictive performance of RCC pathological grading. It offers a novel approach for accurate RCC diagnosis and personalized treatment planning.
Humans ; Carcinoma, Renal Cell/pathology* ; Deep Learning ; Kidney Neoplasms/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; Algorithms ; Neoplasm Grading ; Male ; Female ; Middle Aged

Objective To compare and analyze the application value of brain black blood technology three-dimensional BrainVIEW(3D-BrainVIEW)and conventional three-dimensional turbo field echo T1 weighted imaging(3D-TFE T1WI)in brain metastases of lung cancer.Methods A total of 60 patients with pathologically confirmed lung cancer were selected.All patients underwent brain enhanced MRI using 3D-BrainVIEW and 3D-TFE T1WI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two groups were compared and analyzed,respectively.The diagnostic efficacy(including number,size,and location)of the two groups of images in detecting brain metastases was evaluated by two experienced radiologists via double-blind method.Results The diagnostic consistency between the two radiologists was excellent[intraclass correlation coefficient(ICC)=0.998,P<0.001].There were significant differences in SNR,CNR,and the number and location of brain metastases between 3D-BrainVIEW sequence and 3D-TFE T1WI sequence(P<0.05),and 3D-BrainVIEW sequence was significantly superior to 3D-TFE T1WI sequence.In addition,the number of brain metastases detected by 3D-Brain VIEW sequence was significantly higher than that detected by 3D-TFE T1WI sequence in lesions with minimum diameter(Dmin)<5 mm(P<0.001).There was no difference in the number of lesions detected by the two sequences in lesions with Dmin>5 mm(P>0.05).Conclusion The SNR and CNR of 3D-Brain VIEW enhanced scan images are significantly higher than those of 3D-TFE T1WI,which has higher detection efficiency for lung cancer brain metastases,and can effectively reduce misdiagnosis caused by microvascular enhance-ment,which has high clinical application value.

Objective:To explore the needs of nurses participating in acute ischemic stroke (AIS) intravenous thrombolysis to optimize the AIS intravenous thrombolysis nursing model.Methods:This research adopted phenomenological research method. Objective sampling method was used to interview 15 nurses from 5 designated hospitals for stroke treatment in Shenzhen from June to July 2020, and the data were analyzed by the Colaizzi content analysis method.Results:The needs of nurses for optimizing the AIS intravenous thrombolysis nursing model could be summarized into five themes: the need to configure stroke emergency nurses, the need to standardize the training for stroke nursing staff, the need to build an intelligent information platform for AIS treatment, the need to optimize the green channel for stroke, and the need to improve the quality control system of AIS intravenous thrombolysis.Conclusions:It is necessary to configure stroke emergency nurses, standardize stroke nursing related training, and build an intelligent information platform for AIS treatment to optimize the AIS intravenous thrombolysis nursing model.

Objective:To explore the value of multi-parametric MRI for thyroid gland in differentiating benign and malignant thyroid nodules.Methods:From December 2018 to May 2020, 78 patients with 91 post-surgically pathologically confirmed thyroid nodules were enrolled in Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. For each patient, the following MRI findings were obtained including the nodules′ location, size, shape, margin, signal intensity, cystic change, degree and pattern of contrast enhancement, involvement of surrounding structure, and ADC values. The time-intensity curve (TIC) were plotted and subtyped based on dynamic contrast enhancement MRI. The MRI findings between the benign and malignant thyroid nodules were compared using Mann-Whitney U test, χ 2 test or Fisher exact test. Multiple logistic regression analysis was used to select independent predictive variables and build a combined model, and the ROC curve was used to evaluate the diagnostic performance of each MRI finding and the combined model. Results:Between the benign and malignant thyroid nodules, the significant differences were found in size, shape, margin, presence of cystic changes, T 1WI signal intensity, ADC value, enhancement homogeneity, TIC subtypes and presence of thyroid capsule involvement ( P<0.05). Multivariate logistic analysis showed that ill-defined margin (OR=77.61), no presence of cystic changes (OR=36.11) and difference between TIC subtypes (OR=83.41) were independent predictive variables, and the area under the ROC curve (AUC) was 0.879, 0.788, and 0.751, respectively. The AUC, sensitivity and specificity of the combined model were 0.977, 0.986, and 0.904, respectively. Conclusions:Thyroid multi-parametric MRI derived findings can be used for the differential diagnosis of benign and malignant nodules. Combined with the independent risk factors with ill-defined margin, no presence of cystic changes, TIC of type plateau or washout, the diagnostic model has a higher diagnostic efficiency.

Objective:To investigate the feasibility and reproducibility of using three-dimensional arterial spin labeling (3D-ASL) technique to evaluate the thyroid blood flow (TBF) in healthy adults and compare the difference in TBF between subjects with different gender and age.Methods:In this prospective study, 100 healthy adult subjects were enrolled from November 2018 to June 2019 in Chinese Academy of Medical Sciences Cancer Hospital, Shenzhen Hospital. All subjects received thyroid 3D-ASL MRI scanning, but several subjects were excluded from analysis for reasons including intolerance to examination ( n=1), overt artifacts ( n=11), abnormality detected in thyroid gland during conventional MRI ( n=15), resulting in 73 subjects included. Two attending radiologists independently evaluated the quality of ASL images and measured the TBF in upper, middle and lower poles of each lobe in thyroid gland bilaterally. Cohen’s Kappa was used to test the agreement in image quality between 2 radiologists, while intraclass correlation (ICC) analysis was implemented to evaluate the consistency in TBF measurements. Univariate variance analysis was used to compare the TBF in upper, middle and lower pole of thyroid gland unilaterally, and student t-test was performed to test the difference in TBF between two lobes, or in the same lobe but between different gender or age groups. Results:For image quality, 2 radiologists have good agreement (Kappa=0.753, P<0.001). In terms of TBF, consistency was moderate in the lower pole of left lobe between 2 radiologists (ICC=0.648, P<0.001), but good in the remaining parts of thyroid gland (all ICC>0.75, P<0.001). Unilaterally, TBF in the middle pole was significantly higher than those in the upper or lower pole ( P<0.001), but no significant difference was found between the upper and lower pole ( P>0.05). Regardless of upper, middle or lower pole, TBF in the right lobe was higher than the counterpart in the left lobe ( t=6.182, 6.294, 4.896, P<0.001). Between male subjects ( n=31) and female subjects ( n=42), no significant difference was found in the corresponding upper, middle or lower pole of thyroid lobe unilaterally ( P>0.05). As for age group, TBF in the middle pole of thyroid gland was higher in the middle age group (45-59 years old, n=12) than that in the young adult group (18-44 years old, n=61) ( t=3.868, P=0.003 for the left lobe, and t=2.647, P=0.022 for the right lobe), but no significant difference was found in the upper or lower pole of the unilateral thyroid lobe ( P>0.05). Conclusion:ASL can accurately measure blood flow perfusion in the thyroid gland with good reproducibility.

Objective To investigate the predictive value of D-dimer for early neurological deteriora- tion (END) in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke admitted to the Department of Neurology, the Second People ' s Hospital of Shenzhen between January 2015 and December 2017 were enrolled retrospectively. END was defined as an increase ≥2 in the National Institutes of Health Stroke Scale (NIHSS) score or an increase ≥1 in the motor function score within 7 days after admission compared with the baseline score. Demographics, baseline clinical data, and primary treatment options during hospitalization were compared between the END group and the non-END groups. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of D-dimer for END. Results A total of 625 patients were enrolled in the study, including 40 in the END group (including 3 deaths) and 585 in the non-END group. The mean hospital stay, international normalized ratio, D-dimer, uric acid, NIHSS score and modified Rankin Scale (mRS) score at admission, and the proportion of patients with complete anterior circulation infarction, large atherosclerotic stroke, and pulmonary infection were significantly higher than those in the non-END group (all P < 0. 05). There was no significant difference in the proportion of patients receiving thrombolysis, antiplatelet,anticoagulation, and statins between the two groups. ROC curve analysis showed that the area under the curve of D-dimer predicting END was 0. 810 (95％ confidence interval [CI] 0. 736-0. 884; P < 0. 001); the optimal cut-off value was 2. 35 mg/L, and the sensitivity and specificity were 54. 74％ and 96. 13％ respectively. Multivariate logistic regression analysis showed that large atherosclerotic stroke (odds ratio [OR] 1. 115, 95％ CI 1. 005-1. 390; P = 0. 003 ), D-dimer ≥2. 35 mg/L (OR 1. 055,95％ CI 1. 012-1. 150; P = 0. 001 ), NIHSS score at admission (OR 1. 191, 95％ CI 1. 006-1. 410; P <0. 001), mRS score > 1 at admission (OR 1. 755, 95％ CI 1. 139-3. 656; P = 0. 037 ), and pulmonary infection (OR 2. 598, 95％ CI 1. 132-3. 081; P = 0. 012) were the independent risk factors for END in patients with acute ischemic stroke. Conclusion D-dimer ≥2. 35 mg/L at admission has higher predictive value for END in patients with acute ischemic stroke.

Objective To establish fingerprint of Radix Euphorbiae Fischerianae by high performance liquid chromatography (HPLC) .Methods The samples were separated on Hypersil ODS(250 mm × 4 .6 mm ,5 μm) column with gradient mobile phase of acetic-water ,the column temperature was 20 ℃ with the flow rate of 1 .0 mL/min and UV detection wavelength was 210 nm .the sample injection was 20 μL .Results 15 samples of different origin Radix Euphorbiae Fischerianae were detected and each chroma-tographic peak was separated well with conforming to the requirements of fingerprint by calibrating the 15 peaks .15 common peak retention time RSD ,relative peak area RSD were 3 .7% ,3 .6% or less respectively ;The chromatographic peak separation degree was better ,similarity was higher ,15 batches of different sources of stellera medicinal materials ,in addition to the Guangxi nanning medi-cine material similarity was 0 .858 ,other origin medicine material similarity above 0 .95 .Have reached the technical requirements of traditional Chinese medicine (TCM ) fingerprint .Conclusion The method is accurate ,reliable ,and the HPLC fingerprint shows good repeatability ,which can be used for one of the quality control of Radix Euphorbiae Fischerianae .

Objective To investigate the methylation situation of let‐7a‐3 promoter in patients with chronic myeloid leukemia (CML) and its clinical significance .Methods The methylation level of let‐7a‐3 promoter in the bone marrow mononuclear cells of 52 CML patients and 25 controls was detected by using the real‐time quantitative methylation‐specific PCR (RQ‐PCR) .Results The non-hypomethylation of let‐7a‐3 promoter was positive in 31 cases(59 .6% ) of 52 CML patients ,while only 1 case(4% ,1/25) in the control group ,the difference between the two groups were statistically significant (P< 0 .01) .The ROC curve analysis showed that the non -hypomethylation of let‐7a‐3 has better specificity for the auxiliary diagnosis of CML .The significantly posi‐tive correlation was found between the non -methylation level of let‐7a‐3 promoter and the BCR/ABL transcription level (r=0 .641 ,P=0 .001) .In contrast ,there was no obvious correlation between the non -methylation level of let‐7a‐3 promoter and the WBC count ,platelet count and hemoglobin levels(P>0 .05) .The non-hypomethylation level of let‐7a‐3 in chronic phase and accel‐erate phase was significantly higher than that in blastic crisis of CML .Conclusion The hypomethylation level of let‐7a‐3 promoter is decreased with disease progression .

Objective To observe the interfering effect of different doses of penehyclidine hydrochloride (PHC) on the mRNA expressions of nuclear factor kappa B (NF-κB) and inducible nitric oxide synthase (iNOS) in the lung tissue of rats with traumatic shock so as to investigate the protective role of PHC in secondary long injury following traumatic shock and the underlying mechanism.Methods The traumatic shock model was established.A total of 104 Wistar rats were randomly divided into four groups:control group,shock group,low dose PHC group ( P1 group) and high dose PHC group ( P2 group).At the beginning of resuscitation,the rats in P1 and P2 groups were given transjugular intravenous injection of 2 ml/kg isotonic saline containing 0.15 mg/kg and 0- 45 mg/kg PHC respectively,while the rats in shock and control groups were injected only isometric isotonic saline.The rats in the four groups were killed at 2 h,6 h,12 h and 24 h after resuscitation respectively to detect the mRNA expressions of NF-κB and iNOS by using RT-PCR and determine the lung wet/dry weight (W/D) ratio,lung permeability index (LPI) and lung injury score (LIS).Results The mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS at all the time intervals in the shock,P1 and P2 groups were all significantly increased as compared with those in the control group (P＜0.05).Howerver,the P2 group showed significant reduction in aspects of the mRNA expressions of NF- κB and iNOS,lung W/D ratio,LPI and LIS at all time points and P1 group also had significant decrease regarding the mRNA expressions of NF-κB and iNOS,lung W/D ratio at2 h,6 h,and LPI and LIS at 2 h,6 h,12 h,as compared with the shock group.Meanwhile,P2 group showed evident decrease at 6 h concerning the mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS as compared with P1 group (P ＜ 0.05 ).Conclusions PHC,especially at a large dosage,can significantly mitigate the long injury secondary to traumatic shock,and the mechanism may be associated with the inhibition of mRNA expressions of NF-κB and iNOS.