Objective To measure changes in the basal ganglia volume,characteristics of neu-romelanin in substantia nigra-1 and iron deposition using susceptibility-weighted imaging(SWI)in Parkinson's disease(PD)patients with freezing of gait at different stages,and to explore their value in evaluating these stages.Methods A total of 178 PD patients with freezing of gait were enrolled.According to Hoehn-Yahr stage,the patients were divided into stage Ⅰ to Ⅱ group(112 cases)and divided into stage Ⅲ to Ⅴ group(66 cases).Additionally,70 healthy volunteers undergoing routine physical examinations were randomly selected as control group.SWI was used to measure basal gan-glia volumes(globus pallidus,putamen and caudate nucleus),disappearance rate of substantia nigra-1(including bilateral display,unilateral display and bilateral non-display),and iron deposition(phase shift values)among groups.Multivariate logistic regression analysis was conducted to identify imaging factors associated with different stages.Receiver operating characteristic(ROC)curve analy-sis was performed to calculate the area under the curve(AUC)for assessing the predictive perform-ance of imaging factors.Results The course of disease in stage Ⅲ to Ⅴ group was significantly lon-ger,and the Parkinson's Comprehensive Assessment Scale(UPDRS)score was significantly higher than that in stage Ⅰ to Ⅱ group(P＜0.05).The volume of pallidum,putamen and caudate nucleus in stage Ⅰ to Ⅱ and stage Ⅲ to Ⅴ groups were significantly lower,and those in stage Ⅲ to Ⅴgroup were significantly lower than that in stage Ⅰ to Ⅱ group(P＜0.05);the disappearance rate of substantia nigra-1 and the deposition amount of pallidum iron,putaminal iron as well as caudate i-ron in stage Ⅰ to Ⅱ and stage Ⅲ to Ⅴ groups were significantly higher,and those in stage Ⅲ to Ⅴgroup were significantly higher than that in stage Ⅰ to Ⅱ group(P＜0.05).Logistic regression analysis indicated that decreased caudate nucleus volume(OR=1.856,95％CI,1.234 to 2.564,P＜0.001),disappearance of substantia nigra-1(OR=2.235,95％CI,1.657 to 2.659,P＜0.001)and increased iron deposition in the globus pallidus(OR=1.562,95％CI,1.234 to 1.989,P＜0.001)were predictors of Hoehn-Yahr staging.ROC showed that the AUC of Hoehn-Yahr stage was 0.889 based on the combination of caudate volume,disappearance of substantia nigra-1 and depo-sition of pallidum.Conclusion SWI is an important non-invasive imaging tool for assessing different stages in PD patients with freezing of gait.Caudate nucleus volume,substantia nigra-1 and iron depo-sition in the globus pallidus are key indicators for predicting Hoehn-Yahr staging.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Humans ; Retrospective Studies ; Pneumonia/diagnostic imaging* ; Analysis of Variance ; Tomography, X-Ray Computed ; Lymphoma/diagnostic imaging*

Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.

OBJECTIVE:To investigate the genetic polymorphisms of cytochrome P4503A4(CYP3A4) in epilepsy patients treated with carbamazepine,and to provide reference for individual drug regimen.METHOD:Blood samples were collected from epilepsy patients treated with carbamazepines.Mutations in CYP3A4 gene were detected by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP).RESULTS:After screening the 141 subjects,the individual mutation rates of the allele CYP3A4*4 and CYP3A4*6 were 0.71%.No allele CYP3A4*5 was found in 141 subjects.CONCLUSION:CYP3A4 genetic polymorphisms may change the activity of CYP3A4 gene.