Objective:To explore the value of deep learning (DL) models based on conventional MRI in differentiating orbital solitary fibrous tumors (SFT) from schwannomas.Methods:This was a case-control study. A retrospective analysis was conducted on patients with pathologically confirmed orbital SFT and schwannoma admitted to Eye & ENT Hospital, Fudan University (institution 1) from December 2014 to January 2022 and Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine (institution 2) from July 2015 to May 2022. A total of 140 patients were included, with 104 patients from institution 1 comprising the training cohort for building DL models and 36 patients from institution 2 comprising the external validation cohort for assessing model performance. Based on the preoperative cross-sectional fat-suppressed T 2WI and contrast-enhanced T 1WI (ceT 1WI), tumor contours were outlined on all tumor-containing slices. Six diagnostic models were constructed using residual networks (ResNet) and split-attention residual networks (ResNeSt) with 18 layers (ResNet-18 and ResNeSt-18), based solely on individual T 2WI and ceT 1WI, as well as a combination of both. A radiology resident and an attending radiologist independently reviewed conventional MRI images to determine the tumor type. The performance of the DL models and radiologists in differentiating orbital SFT from schwannoma in the external validation cohort was evaluated using receiver operating characteristic curves, and the areas under the curves (AUC) were compared using the DeLong test. Results:In the external validation cohort, the AUC (95% CI) of the ResNet-18 models based on T 2WI, ceT 1WI, and their combination were 0.861 (0.719-1), 0.896 (0.774-1), and 0.885 (0.755-1), respectively, while the AUC (95% CI) of the ResNeSt-18 models were 0.889 (0.748-1), 0.872 (0.726-1), and 0.910 (0.801-1), respectively. Among these, the ResNeSt-18 model based on the combined sequences achieved the best performance in differentiating the two tumors. The AUC (95% CI) for the individual interpretation of the radiology resident and attending radiologist were 0.729 (0.571-0.887) and 0.771 (0.618-0.923), respectively. The AUC of the ResNeSt-18 model based on the combined sequences was statistically significantly higher than those of the resident and attending radiologist ( Z=1.96, P=0.049; Z=2.00, P=0.045). Conclusion:The ResNeSt-18 model based on conventional MRI can effectively differentiate orbital SFT from schwannoma, demonstrating better performance than those of the radiology resident and the attending radiologist.

Objective:To explore the value of deep learning (DL) models based on conventional MRI in differentiating orbital solitary fibrous tumors (SFT) from schwannomas.Methods:This was a case-control study. A retrospective analysis was conducted on patients with pathologically confirmed orbital SFT and schwannoma admitted to Eye & ENT Hospital, Fudan University (institution 1) from December 2014 to January 2022 and Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine (institution 2) from July 2015 to May 2022. A total of 140 patients were included, with 104 patients from institution 1 comprising the training cohort for building DL models and 36 patients from institution 2 comprising the external validation cohort for assessing model performance. Based on the preoperative cross-sectional fat-suppressed T 2WI and contrast-enhanced T 1WI (ceT 1WI), tumor contours were outlined on all tumor-containing slices. Six diagnostic models were constructed using residual networks (ResNet) and split-attention residual networks (ResNeSt) with 18 layers (ResNet-18 and ResNeSt-18), based solely on individual T 2WI and ceT 1WI, as well as a combination of both. A radiology resident and an attending radiologist independently reviewed conventional MRI images to determine the tumor type. The performance of the DL models and radiologists in differentiating orbital SFT from schwannoma in the external validation cohort was evaluated using receiver operating characteristic curves, and the areas under the curves (AUC) were compared using the DeLong test. Results:In the external validation cohort, the AUC (95% CI) of the ResNet-18 models based on T 2WI, ceT 1WI, and their combination were 0.861 (0.719-1), 0.896 (0.774-1), and 0.885 (0.755-1), respectively, while the AUC (95% CI) of the ResNeSt-18 models were 0.889 (0.748-1), 0.872 (0.726-1), and 0.910 (0.801-1), respectively. Among these, the ResNeSt-18 model based on the combined sequences achieved the best performance in differentiating the two tumors. The AUC (95% CI) for the individual interpretation of the radiology resident and attending radiologist were 0.729 (0.571-0.887) and 0.771 (0.618-0.923), respectively. The AUC of the ResNeSt-18 model based on the combined sequences was statistically significantly higher than those of the resident and attending radiologist ( Z=1.96, P=0.049; Z=2.00, P=0.045). Conclusion:The ResNeSt-18 model based on conventional MRI can effectively differentiate orbital SFT from schwannoma, demonstrating better performance than those of the radiology resident and the attending radiologist.

Objective:To investigate the biological effects of acute high-dose radon exposure on mice.Methods:BALB/c male mice aged 6 to 8 weeks were exposed once in an HD-3 ecological radon chamber with an average radon concentration of 7 × 10 5 Bq/m 3 for 10 h. Mice were weighed, their lung tissues and blood samples were collected at 1, 2 and 3 months after exposure. Control groups were set up at the three time points with four mice in each group. For these mice, the lung tissue pathology was observed using hematoxylin-eosin (HE) staining method, routine blood tests were conducted using a hematology analyzer and the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the serum and lung tissues were measured using corresponding assay kits. Results:The HE staining result revealed that compared to the control groups, the experimental groups exhibited thickening of alveolar walls and increased infiltration of granulocyte, whose degrees, however, reduced over time and displayed no significant difference at 3 months after exposure. There was no significant difference in body weight or blood routine between the experimental and control groups. The detection result revealed decreased SOD levels in the lung tissues at 2 months after exposure, which were (11.34 ± 1.03) U/mgprot and (9.75 ± 0.71) U/mgprot, respectively for the control and experimental groups ( t = 2.54, P < 0.05). The MDA levels in lung tissue increased at 1 month after exposure, which were(2.30 ± 0.24) and (2.77 ± 0.29) nmol/mgprot, respectively for the control and experimental groups ( t = 2.49, P < 0.05). At 3 months after exposure, the SOD and MDA levels differed insignificantly between the control and experimental groups ( P > 0.05). Conclusions:After acute high-dose radon exposure, the mice suffered damage to the lung tissue, with changes in their oxidative stress indicators being detected. However, these effects gradually diminished at 3 months after exposure. Additionally, acute high-dose radon exposure did not give rise to significant changes in the body weight or routine blood result of the mice.

Objective:To explore the value of conventional MRI radiomics for predicting occult cervical lymph nodes (LNs) metastases in early-stage oral tongue squamous cell carcinoma (OTSCC).Methods:The preoperative MRI data of 77 cases of early-stage OTSCCs (cT1-2N0M0) in Shanghai Ninth People′s Hospital from January 2015 to December 2019 were retrospectively analyzed. All patients underwent primary lesion resection with selective neck dissection and the pathologic reports of LNs couldal be obtained. In total, 168 LNs (51 positive and 117 negative metastases) were enrolled and allocated into training set ( n=112) and validation set ( n=56) with a ratio of 2∶1 using random number table. The volumes of interest of LNs on T 2WI and contrast enhanced T 1WI (ceT 1WI) were delineated by two doctors using ITK-SNAP software. The 1 046 radiomics features of each sequence were extracted using 3D Slicer software. Data dimension reduction was done by inter-observer agreement analysis and univariate analysis. The least absolute shrinkage and selection operator regression analysis were used for selecting optimal feature subsets and constructing radiomics signature for each sequence. Mann-Whitney U test was used to compare the differences of node size and radiomics scores between the LNs with positive and negative metastases. The receiver operating characteristic (ROC) curve was used to explore the performance of LNs size, T 2WI radiomics signature and ceT 1WI radiomics signature in predicting occult LNs metastases. Stepwise logistic regression was used to determine the independent predictors. Results:Fifteen and 10 optimal features were selected to construct radiomics signature for T 2WI and ceT 1WI respectively. The short diameter, T 2WI radiomics signature and ceT 1WI radiomics signature showed significant differences between LNs with positive and negative metastases in the both training and validation sets (all P<0.05), with the areas under the ROC curve of 0.67, 0.83 and 0.82 in the training set, and 0.69, 0.78 and 0.70 in the validation set, respectively. In the stepwise logistic regression analysis, T 2WI radiomics signature was identified as the independent predictor in the both sets (training set: OR=5.92, P<0.001; validation set: OR=2.53, P=0.012). Conclusion:Conventional MRI radiomics can provide a good potential to predict occult LNs metastases in early-stage OTSCC.

Objective To explore the value of texture analysis on ADC maps in the preoperative prediction of histological grade of tongue and mouth floor squamous cell carcinoma (SCC). Methods Forty?nine pathologically confirmed tongue and mouth floor SCC with definite grading from May 2015 to June 2018 were retrospectively analyzed, including 21 cases of gradeⅠ, 21 cases of gradeⅡand 7 cases of gradeⅢ. All subjects underwent preoperative MRI examination with DWI included. Two doctors delineated whole tumor region of interest and extracted texture parameters by the 3D Slicer software, including 8 histogram parameters, 11 grey?level co?occurrence matrix (GLCM) parameters and 7 gray?level run?length matrix (GLRLM) parameters. Intraclass correlation coefficient (ICC) was used to evaluate the inter?observer delineation agreement, and the texture parameters with excellent reproducibility (ICC>0.8) were used for analysis only. Mann?Whitney U test was used to compare the differences of ADC texture parameters between grade Ⅰ and grade Ⅱ?Ⅲ SCCs. Stepwise logistic regression was used to determine the independent predictors and to build combined model. ROC analysis was used to explore the performance of texture parameter and model in predicting histological grade of tongue and mouth floor SCCs. Pearson correlation coefficient was used to evaluate the correlation between texture parameters with statistical significance. Results (1) Excellent inter?observer delineation agreement (ICC: 0.81-0.98) was observed in 69.23% (18/26) texture parameters, including 6 histogram parameters, 7 GLCM parameters and 5 GLRLM parameters. (2) Among histogram parameters, significantly higher 10 percentile ADC value (ADC10) and significantly lower energy and entropy were shown in gradeⅠcompared with gradeⅡandⅢSCCs (all P<0.05). Among GLCM parameters, significantly lower joint entropy, difference entropy, sum entropy, difference variance, difference average and contrast were shown in grade Ⅰ SCCs (all P<0.05). Among GLRLM parameters, significantly lower gray?level nonuniformity and run?length nonuniformity were shown in gradeⅠSCCs (all P<0.05). ADC10 and entropy were identified as independent predictors. The ADC10 and entropy were 960(913, 1 178)×10?6mm2/s and 4.32(4.06, 4.76) in gradeⅠSCCs, and 888(816, 987)×10?6mm2/s and 4.88(4.57, 5.29) in gradeⅡ?ⅢSCCs respectively. The area under ROC curve (AUC) of ADC10, entropy and combined model were 0.72, 0.75, 0.81. (3) Significant correlation (|r|≥0.5) was observed among 52.73% (29/55)texture parameters with statistical significance. Conclusion Texture analysis on ADC maps can provide more quantitative information, which can be more accurately in discriminating grade Ⅰfrom gradeⅡ?Ⅲtongue and mouth floor SCCs.

Objective To evaluate the value of conventional and functional MRI in the diagnosis of orbital solitary fibrous tumor (SFT).Methods MR images of 8 patients with pathologically confirmed orbital SFT were analyzed retrospectively.The lesion shape, size,location and signal features on conventional MRI were evaluated.Apparent diffusion coefficient(ADC)values and DCE-MRI parameters(time-signal intensity curve pattern,maximum ratio of enhancement and washout ratio)were calculated.Results The majority of tumors(6/8)showed regular shape with maximum diameters varying from 2.5 cm to 3.7 cm.Of 8 cases,there was 1 case in intraconal space,2 cases involved with intra and extraconal space,5 cases in extraconal space.On T1WI,all lesions demonstrated isointense to gray matter.On T2WI,5 lesions showed isointensity and 3 lesions showed slight hypointensity,of which 6 cases showed heterogeneous signal.After contrast enhancement,8 lesions showed marked enhancement.Plateau pattern of time-signal intensity curve was observed in 6 cases with maximum ratio of enhancement of 1.37 ± 0.54 and washout ratio of 6.58% ± 3.66%.Mean ADC value was(1.28 ± 0.25)×10-3mm2/s.Conclusion Combination of conventional MRI,DWI and DCE-MRI can assist the diagnosis of orbital SFT.

Objective To discuss the application value of texture analysis of conventional MRI in differential diagnosis of orbital lymphoma from inflammatory pseudotumor.Methods The conventional MRI data of 15 patients with lymphoma and 17 patients with inflammatory pseudotumor proven by pathology or clinical follow-up were retrospectively reviewed.The texture features of lesions based on axial T1WI,fat-saturated T2WI and contrast enhanced fat-saturated T1WI were extracted by manually drawn ROIs with software MaZda.The subsets of optimized texture parameters were chosen by four different methods:Fisher coefficient,probability of classification error and average correlation coefficient (POE+ ACC),mutual information measure (MI) and the combination of the above three methods (FPM),respectively.Linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were performed for texture classification.The texture features from the sequence with the best classification result of orbital lymphoma and inflammatory pseudotumor were compared.Results The optimal texture parameters were mainly derived from co occurrence matrix and run-length matrix on T1WI and T2WI.The optimal texture parameters were mainly derived from co-occurrence matrix and histogram on contrast enhanced T1WI.The best classification of MRI texture was obtained within T2WI with lowest classification error of 1.56％ achieved by FPM in combination with NDA.Comparing the texture parameters of orbital lymphoma and inflammatory pseudotumor on T2WI,the angular second moment and long length emphasis were significantly higher in orbital lymphoma (both P＜0.005),while the entropy and short length emphasis were significantly lower in orbital lymphoma (both P＜0.005).Conclusion It is feasible to use texture analysis on conventional MRI for the differentiation of orbital lymphoma and inflammatory pseudotumor.

OBJECTIVETo observe the difference in acupuncture for pain threshold at different time points among the groups of 9 TCM constitutions.

METHODSThe cross-sectional survey was adopted to investigate TCM constitutions among 600 subjects and determine 9 TCM constitution types (neutral constitution, qi-deficiency constitution, yang-deficiency constitution, yin-deficiency constitution, phlegm-damp constitution, damp-heat constitution, blood-stagnation constitution, qi-stagnation constitution, special diathesis constitution). The same acupuncture manipulation was applied to Zusanli (ST 36) on the left side in the subjects and the needle was retained for 30 min. The tenderness threshold was detected with 2390 type Von Frey apparatus at different time points, named before acupuncture, at the moment after qi arrival, in 10 min of needle retaining, in 30 min of needle retaining and in 15 min after needle withdrawal in the subjects of 9 TCM constitutions.

RESULTSThe interactive effect happened between the constitution type and time point (P < 0.05). Among the groups of 9 TCM constitutions, the pain threshold values at the moment after qi arrival (except blood-stagnation constitution, qi-stagnation constitution, special diathesis constitution) in 10 min of needle retaining and in 30 min of needle retaining were increased as compared with those before acupuncture separately (P < 0.01), among which, the value increase was the most significant in 30 min of needle retaining. The differences in the pain thresholds were significant in 15 min after needle withdrawal in the groups of neutral constitution and damp-heat constitution as compared with those before acupuncture (both P < 0.01). In 10 min of needle retaining and in 30 min of needle retaining, as compared with the group of neutral constitution, the changes in pain thresholds of the rest abnormal constitutions were apparently lower (all P < 0.05).

CONCLUSIONAcupuncture at Zusanli (ST 36) presents different effects among the groups of different constitution types. The effect maintaining durations are different.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Pain Management ; Pain Threshold ; Yang Deficiency ; therapy ; Yin Deficiency ; therapy ; Young Adult

Aim To observe the effects of benazepril and irbesartan on myocardial collagen in chronic heart failure ( CHF ) rats and the possible mechanisms. Methods CHF model in rats was made by partially banding abdominal aorta to induce pressure overload cardiac hypertrophy. The rats were given benazepril or/and irbesartan for 8 weeks. Systolic blood pressure ( SBP) was monitored by rat tail artery. The ultrastruc-ture of myocardium was detected by transmission elec-tron microscope. The content of myocardial hydroxyproline and amount of cross-linked collagen were measured by hydrolysis method. The expression of type Ⅰ and Ⅲ collagen protein in myocardium was investigated by immunohistochemistry. The expression of p-38 MAPK and p-p38 MAPK proteins was detected by Western blot. Results Compared with the model of CHF, there was no significant difference in SBP af-ter treatment. The content of hydroxyproline in myocar-dium, degree of cross-linked collagen, as well as ex-pression of type I collagen, type Ⅲ collagen and p-p38 MAPK proteins were significantly decreased after treatment with benazepril or irbesartan ( P <0. 05 ) , and the combined treatment of them had better effects. Conclusion There is a synergistic effect of attenua-ting the quantity and quality of myocardial collagen in CHF rats by combined use of benazepril and irbesar-tan, which may be related to the down regulation of p-p38MAPK protein expression.

Adiponectin is an adipocyte-derived secretory protein. It was found to be associated with insulin resistance, inflammation and arteriosclerosis. To further study the biological function and expression of adiponection in vivo, adipoenctin gene knock-out and LacZ gene knock-in mouse model was constructed. Gene targeting strategy was designed to replace part of exon 2 and exon 3 of adiponectin gene with full length LacZ gene in frame with remaining upstream ATG and signal peptide sequence of exon 2. The targeting vector (Adipo-LacZ-XpPNT) was constructed and verified by restriction enzyme digestion and sequencing. CJ7 ES cells were transfected with targeting vector linearized by NotⅠ digestion, selected in the medium containing both G418 and ganciclovoir. Resistant clones were screened by PCR and further confirmed by Southern blot for correct homologous recombinants. Chimera mice were obtained by routing microinjection of homologous recombined ES cells into blastocysts. After mating, mice heterozygous and further homozygous for adiponectin knockout and LacZ gene knock-in were established. Expression of both endogenous adiponectin and exogenous LacZ gene in mouse tissues and sera were detected by RT-PCR, Northern-blot, Western blot and ELISA. The results show that adiponectin was disrupted at both mRNA and protein levels. LacZ gene is expressed exclusively in adipose tissue of mutant mice. Its expression profile is identical to endogenous adiponection. Unexpectedly, LacZ activity could not be detected in both adipose tissue and serum although LacZ protein can be detected in adipose tissue but not in serum of mutant mice. In conclusion, mice homozygous for adiponectin knockout and LacZ gene knock-in have been successfully constructed. Mutant mice display LacZ expression profile identical to endogenous adiponectin albeit neither LacZ activity nor protein can be detected in serum of mutant mice.