Objective To observe the value of intravoxel incoherent motion(IVIM)histogram parameters for predicting perineural invasion(PNI)of rectal cancer.Methods Fifty-five patients with rectal cancer were retrospectively enrolled and divided into positive group(n=23)and negative group(n=32)according to PNI or not.Histogram parameters of apparent diffusion coefficient(ADC),perfusion fraction(f),true diffusion coefficient(D)and pseudo diffusion coefficient(D*)were obtained based on MR IVIM images,including the mean,skewness,kurtosis,entropy,as well as the 25th,50th and 75th percentiles(25th,50th,75th).The above IVIM histogram parameters were compared between groups,and those with significant difference were included in binary stepwise logistic regression analysis to screen independent factors for predicting PNI status of rectal cancer.Then a combined parameter model was established.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of IVIM histogram parameters and combined parameter model for predicting PNI of rectal cancer.Results ADCmean,ADC25th,ADC50th,ADC75th,fmean,f25th,f50th,f75th and Dentropy in positive group were all lower than those in negative group(all P＜0.05).AUC of the above parameters for predicting PNI of rectal cancer was 0.693,0.665,0.701,0.675,0.831,0.847,0.835,0.722 and 0.785,respectively.The sensitivity,specificity and AUC of combined parameter model based on f25th and Dentropy for predicting PNI of rectal cancer was 95.65％,65.63％and 0.897,respectively.Conclusion IVIM histogram parameters could be used to predict PNI of rectal cancer effectively.

Objective To observe the value of intravoxel incoherent motion(IVIM)histogram parameters for predicting perineural invasion(PNI)of rectal cancer.Methods Fifty-five patients with rectal cancer were retrospectively enrolled and divided into positive group(n=23)and negative group(n=32)according to PNI or not.Histogram parameters of apparent diffusion coefficient(ADC),perfusion fraction(f),true diffusion coefficient(D)and pseudo diffusion coefficient(D*)were obtained based on MR IVIM images,including the mean,skewness,kurtosis,entropy,as well as the 25th,50th and 75th percentiles(25th,50th,75th).The above IVIM histogram parameters were compared between groups,and those with significant difference were included in binary stepwise logistic regression analysis to screen independent factors for predicting PNI status of rectal cancer.Then a combined parameter model was established.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of IVIM histogram parameters and combined parameter model for predicting PNI of rectal cancer.Results ADCmean,ADC25th,ADC50th,ADC75th,fmean,f25th,f50th,f75th and Dentropy in positive group were all lower than those in negative group(all P＜0.05).AUC of the above parameters for predicting PNI of rectal cancer was 0.693,0.665,0.701,0.675,0.831,0.847,0.835,0.722 and 0.785,respectively.The sensitivity,specificity and AUC of combined parameter model based on f25th and Dentropy for predicting PNI of rectal cancer was 95.65％,65.63％and 0.897,respectively.Conclusion IVIM histogram parameters could be used to predict PNI of rectal cancer effectively.

ObjectiveTo explore the effect of virtual reality on upper limb function in stroke patients through diffusion tensor imaging (DTI). MethodsFrom September, 2021 to March, 2023, 80 stroke patients in the Fuzhou Second General Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, while the experimental group received virtual reality training additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) before treatment, after treatment and after four-week follow-up; and they were scaned with DTI to measure the fractional anisotropy (FA) and relative anisotropy (RA) of cerebral peduncle and posterior limb of inner capsule of the affected side before and after treatment. ResultsTwo cases dropped in each group. The FMA-UE and ARAT scores increased in both groups after treatment and follow-up (F > 2.790, P < 0.001), and increased more in the experimental group than in the control group (t > 2.297, P < 0.05). FA and RA in the posterior limb of inner capsule increased in both groups after treatment (t > 21.013, P < 0.001), and increased more in the experimental group (t > 2.006, P < 0.05). The d-value of FA of the posterior limb of internal capsule before and after treatment (ΔFA) was positively correlated with the d-value of FMA-UE score (r > 0.362, P < 0.05) in both groups, the ΔFA of the posterior limb of internal capsule was positively correlated with the d-value of ARAT score (r = 0.459, P < 0.01). ConclusionVirtual reality training can promote the recovery of upper limb function in stroke patients, which may associate with the conductivity of posterior limb of inner capsule.

Objective:To utilize usculoskeletal ultrasound technology for real-time assessment of related muscle characteris-tics in patients with chronic nonspecific low back pain(NLBP)and to analyze the correlation with visual ana-logue scale(VAS)and Oswestry disability index questionnaire(ODI).Method:A total of 180 patients diagnosed with chronic NLBP in the department of rehabilitation of the Sec-ond Hospital in Fuzhou from December 2022 to June 2023 were selected as NLBP group,and 120 healthy subjects who underwent physical examination at the same time period were selected as the control group.VAS and ODI questionnaires were used to assess the two groups of subjects.Based on musculoskeletal ultrasound technology,the muscle thickness and elastic modulus of transverse abdominal muscle and multifidus muscle in resting and contraction positions were detected in real time.Finally,the correlation analysis was performed be-tween the real-time muscle characteristics monitoring indexes of musculoskeletal ultrasound and the VAS and ODI scores in NLBP patients.Result:The VAS score showed that the healthy group was 0.58±0.73 and the NLBP group was 3.29±0.42.There was a significant difference in VAS score between the two groups(t=40.729,P＜0.001).The ODI score showed that the healthy group was 4.25±0.36 and the NLBP group was 14.41±1.63.The difference of ODI score between the two groups was statistically significant(t=-67.162,P＜0.001).The transverse abdominal muscle test showed that the thickness of the healthy group was 3.89±0.31 mm,and the thickness of the NLBP group was 2.85±0.26 mm.At the contraction position,the thickness of the healthy group was 5.18±0.35 mm,and the thickness of the NLBP group was 3.64±0.29 mm.The multifidus muscle test showed that the thickness of the healthy group was 2.19±0.14 cm,and the thickness of the NLBP group was 1.82±0.16 cm.At the contraction position,the thickness of the healthy group was 3.15±0.22 cm,and the thickness of the NLBP group was 2.41±0.21 cm.Compared with the healthy group,the muscle thickness of the transverse abdominis of the NLBP group(t=-31.401,-48.751;P＜0.001)and multifidus muscle thickness were significantly reduced(t=-20.610,-29.335;P＜0.001).The correlation analysis showed that there was a significant negative correlation between VAS score and transverse abdominal muscle thickness(r=-0.69,P＜0.001)and multifidus muscle thickness(r--0.45,P＜0.001)at rest.There was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.59,P＜0.001)and the thickness of the multifidus muscle(r=-0.31,P＜0.001).At rest,there was a significant negative correlation between ODI score and transverse abdominal muscle thickness(r=-0.58,P＜0.001)and multifidus muscle thickness(r=-0.36,P＜0.001).In the contractile position,there was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.54,P＜0.001)and the thickness of the multifidus muscle(r=-0.22,P=0.0029).Conclusion:Musculoskeletal ultrasonography can be used as a real-time detection method to evaluate the rele-vant characteristic indexes of NLBP in subjects.

Objective:To utilize usculoskeletal ultrasound technology for real-time assessment of related muscle characteris-tics in patients with chronic nonspecific low back pain(NLBP)and to analyze the correlation with visual ana-logue scale(VAS)and Oswestry disability index questionnaire(ODI).Method:A total of 180 patients diagnosed with chronic NLBP in the department of rehabilitation of the Sec-ond Hospital in Fuzhou from December 2022 to June 2023 were selected as NLBP group,and 120 healthy subjects who underwent physical examination at the same time period were selected as the control group.VAS and ODI questionnaires were used to assess the two groups of subjects.Based on musculoskeletal ultrasound technology,the muscle thickness and elastic modulus of transverse abdominal muscle and multifidus muscle in resting and contraction positions were detected in real time.Finally,the correlation analysis was performed be-tween the real-time muscle characteristics monitoring indexes of musculoskeletal ultrasound and the VAS and ODI scores in NLBP patients.Result:The VAS score showed that the healthy group was 0.58±0.73 and the NLBP group was 3.29±0.42.There was a significant difference in VAS score between the two groups(t=40.729,P＜0.001).The ODI score showed that the healthy group was 4.25±0.36 and the NLBP group was 14.41±1.63.The difference of ODI score between the two groups was statistically significant(t=-67.162,P＜0.001).The transverse abdominal muscle test showed that the thickness of the healthy group was 3.89±0.31 mm,and the thickness of the NLBP group was 2.85±0.26 mm.At the contraction position,the thickness of the healthy group was 5.18±0.35 mm,and the thickness of the NLBP group was 3.64±0.29 mm.The multifidus muscle test showed that the thickness of the healthy group was 2.19±0.14 cm,and the thickness of the NLBP group was 1.82±0.16 cm.At the contraction position,the thickness of the healthy group was 3.15±0.22 cm,and the thickness of the NLBP group was 2.41±0.21 cm.Compared with the healthy group,the muscle thickness of the transverse abdominis of the NLBP group(t=-31.401,-48.751;P＜0.001)and multifidus muscle thickness were significantly reduced(t=-20.610,-29.335;P＜0.001).The correlation analysis showed that there was a significant negative correlation between VAS score and transverse abdominal muscle thickness(r=-0.69,P＜0.001)and multifidus muscle thickness(r--0.45,P＜0.001)at rest.There was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.59,P＜0.001)and the thickness of the multifidus muscle(r=-0.31,P＜0.001).At rest,there was a significant negative correlation between ODI score and transverse abdominal muscle thickness(r=-0.58,P＜0.001)and multifidus muscle thickness(r=-0.36,P＜0.001).In the contractile position,there was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.54,P＜0.001)and the thickness of the multifidus muscle(r=-0.22,P=0.0029).Conclusion:Musculoskeletal ultrasonography can be used as a real-time detection method to evaluate the rele-vant characteristic indexes of NLBP in subjects.

Objective:To observe any effect of transplanting bone marrow mesenchymal stem cells (BMSCs) on microglia and neuron expression in newborn mice with hypoxic-ischemic brain damage (HIBD).Methods:Sixty 10-day-old C57BL/6 mice were randomly divided into a sham operation group, a hypoxic-ischemia group, a placebo group and a stem cell group, each of 15. The hypoxia-ischemia model was induced in the hypoxia-ischemia, placebo and stem cell groups, while the sham operation group was sutured after the neck incision. After successful modeling, the rats in the stem cell group were injected with BMSCs into the bregma while those in the placebo group received phosphate buffered saline. Seven days later, brain tissue was resected and its structure was observed using transmission electron microscopy. Immunofluorescence staining was performed to observe the expression of microglia and neurons in the left cerebral cortex.Results:Seven days after stem cell transplantation, the neuron morphology had improved and nerve fiber swelling was relieved in the stem cell group. The average expression of neurons was significantly greater in the stem cell group compared with the hypoxic-ischemia and placebo groups, while the expression of microglia was significantly lower.Conclusions:Bone marrow mesenchymal stem cells may induce neuron regeneration and reduce inflammatory response by inhibiting the expression of microglia, at least in neonatal rats modeling hypoxic-ischemic brain injury.

Objective To investigate the value of dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion(PNI)of colorectal adenocarcinoma.Methods Preoperative whole-abdominal CT data of 79 patients with colorectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed.The patients were divided into PNI group(n=31)or no PNI group(n=48).Univariate analysis was used to compare CT features and dual-energy CT quantitative parameters between groups,and the variables with significant differences were included in binary logistic regression analysis to construct a combined model.Receiver operating characteristic(ROC)curves were drawn and area under the curve(AUC)were calculated,the efficacy of single CT parameters and combined model for predicting PNI of colorectal adenocarcinoma were evaluated.Results There were significant differences of the location of the primary lesion,the maximum thickness of the diseased intestinal wall,the presence or absence of peritumoral lymph node metastases,peritumoral mesenteric streak shadow and tumor deposits shown on CT between groups(all P＜0.05).Significant differences of the arterial phase slope of energy spectrum curve(λHU),iodine concentration(IC),normalized IC(NIC),dual energy index and the venous phase NIC of dual energy index were found between groups(all P＜0.05).AUC of the above single parameters for predicting PNI of colorectal adenocarcinoma ranged from 0.615 to 0.698,while of the combined model was 0.864.Conclusion Dual-energy CT quantitative parameters combined with CT features could be used to effectively predict PNI of colorectal adenocarcinoma.

[摘 要] 目的：探讨表皮生长因子受体（epidermal growth factor receptor，EGFR）基因突变与非小细胞肺癌（non-small cell lung cancer，NSCLC）伴脑转移患者预后的相关性，为改善NSCLC合并脑转移患者预后、指导个体化治疗提供临床依据。方法：回顾性分析福建省立医院2013年1月1日至2018年9月30日期间收治的88例NSCLC合并脑转移患者的临床资料，随访取得患者的死亡时间，随访截止日期为2019年10月31日。收集和分析的临床资料包括性别、年龄、吸烟史、病理类型、基因检测、治疗情况、无进展生存期（progression free survival，PFS）、总生存期（overall survival，OS）等。运用生存分析（Kaplan-Meier生存时间曲线）评价EGFR突变型患者的预后，以单因素分析（log-rank检验）预测影响EGFR-TKI治疗效果的因素。结果：88例NSCLC脑转移患者有57例为EGFR突变型，其中位PFS（MPFS）为13.0个月（95%CI：11.951~14.049），明显高于EGFR野生型患者（P=0.003），患者中位生存期（median survival time，MST）为29.0个月（95%CI：20.531~37.468），明显高于EGFR野生型（P=0.001）。EGFR突变型中，Exon19-del突变组患者较Exon21 L858R突变组患者OS有延长趋势（P=0.05），Exon19-del+Exon20T790M突变组患者OS较Exon21 L858R突变组有延长趋势（P=0.077）。结论：EGFR突变组较野生型组NSCLC脑转移患者预后相对好些，且携带19外显子单一缺失突变的患者预后最好。

Objective:To explore effects of family aerobic exercise combined with respiratory training on pulmonary function, self-care ability and quality of life in chronic obstructive pulmonary disease (COPD) patients with frailty.Methods:A total of 86 COPD patients with frailty who were treated in the Outpatient Department in the First Affiliated Hospital of Zhengzhou University from September 2018 to March 2019 were selected by the convenient sampling method. They were randomly divided into the control group ( n=43) and the observation group ( n=43) . The control group was given routine health education while the observation group was given family aerobic exercise combined with respiratory training guidance. After 3 months of intervention, pulmonary function meters were used to compare lung function indexes between two groups. Barthel index and COPD Assessment Test (CAT) were used to compare activity of daily living (ADL) and quality of life of patients. Results:38 patients in the observation group and 40 patients in the control group completed the study. After 3 months of intervention, there was no statistically significant difference in lung function indexes between the observation group and the control group ( P> 0.05) . After 3 months of intervention, the Barthel index score of the observation group (71.28±10.02) was higher than that of the control group while CAT score (13.68±5.16) was lower than that of the control group. The differences between the two groups were statistically significant ( t=-2.102, 2.736; P< 0.05) . Conclusions:Family aerobic exercise combined with respiratory training can improve the lung function of COPD patients with frailty and improve their self-care ability and quality of life, which has certain clinical application values.

Heart failure is the leading cause of death in cardiovascular diseases.Despite effectiveness of current clinical treatment,it is not satisfactory in general,so more effective and optimal therapies are under seeking.All available evidences show that cardiac muscles have limited regenerative capacity in adult mammals,while some vertebrates,such as zebrafish and salamander,can completely recover through perfect regeneration following myocardial injury.In-depth investigation into underlying mechanism may facilitate the development of human heart's potential of scarless healing.In this review paper,we summarized recent progresses in distinct cardiac regenerative capacity and their main influencing factors of several model animals through comparative analysis.