Objective:To investigate the application value of photon-counting detector CT (PCD-CT) in preoperative identification of critical anatomical structures and surgical assessment in pancreatic cancer, and to compare its performance with conventional energy-integrating detector CT (EID-CT) in delineating tumor margins, vascular structures, and neural anatomy.Methods:This single-center retrospective matched case-control study included 25 patients with pathologically confirmed pancreatic ductal adenocarcinoma who underwent PCD-CT enhanced scanning and curative surgery at Peking Union Medical College Hospital between February and June 2025 (PCD-CT group). These patients were matched in a 1∶2 ratio to 50 patients who underwent EID-CT between January 2016 and December 2024 and subsequently received curative surgery (EID-CT group). Tumor boundary clarity, vascular visualization scores, and neural structure visibility were subjectively evaluated using the Likert scoring system. The assessed vessels included the celiac artery, common hepatic artery, superior mesenteric artery, splenic artery, portal vein, superior mesenteric vein, splenic vein, and pancreaticoduodenal arterial arcade. Imaging-based assessment of structural involvement was compared with intraoperative findings and pathological results to calculate diagnostic accuracy. Surgeons rated the usefulness of PCD-CT images for identifying key structures and determining resectability using a 5-point Likert scale. The Mann-Whitney U test was used for group comparisons of subjective scores, and categorical data were analyzed using the χ2 test or Fisher exact test. Results:The PCD-CT group showed significantly higher scores for tumor boundary clarity, vascular visualization, and neural structure detectability than those of the EID-CT group (all P<0.05). The accuracy of assessing superior mesenteric vein involvement was 96.0% (24/25) in the PCD-CT group and 72.0% (36/50) in the EID-CT group, with a significant difference ( χ2=6.00, P=0.014). Postoperative surgeon evaluations indicated that PCD-CT provided substantial assistance for both key structure identification [5 (5, 5)] and resectability assessment [5 (4, 5)]. Conclusion:PCD-CT demonstrates superior performance over EID-CT in preoperative delineation of tumor margins, vascular structures, and neural anatomy and in the assessment of structural involvement in pancreatic cancer. It provides valuable anatomical information to support preoperative evaluation and surgical decision-making.

Objective:To investigate the mechanism of ursolic acid (UA) in inhibiting the growth and metastasis of breast cancer MDA-MB-231 (“231”) cells by downregulating ANXA6.Methods:This study conducted relevant in vitro cytology and molecular biology experiments in the Department of Clinical Laboratory and Central Laboratory of Putuo Hospital, Shanghai University of Traditional Chinese Medicine from February 2023 to August 2024. Human breast cancer 231 cells were cultured in vitro, and the effects of different concentrations of UA on the proliferation and invasion and metastasis of 231 cells were detected by CCK-8 and Transwell assays. Western Blot was used to detect the effect of UA on the expression of ANXA6 and invasion and metastasis-related proteins MMP9, β-catenin and N-cadherin in 231 cells. The 231 cells that interfered with and overexpressed ANXA6 were constructed by lentivirus transfection to generate stable ANXA6 interfering and overexpressing 231 cells, which were divided into 231/KD-ANXA6 group, 231/KD-NC group, 231/OE-ANXA6 group, and 231/OE-NC group. CCK-8 assay and Transwell assay were used to detect the proliferation activity, invasion and metastasis ability of 231 cells after interference and overexpression of ANXA6 and the effect of UA on the proliferation ability of 231 cells after interference and overexpression of ANXA6. Western Blot and RT-PCR assays were used to detect the expression of invasion and migration biomarkers such as MMP9, β-catenin, and N-cadherin in 231 cells after interference and overexpression of ANXA6. Immunohistochemistry was used to detect the expression level of ANXA6 in breast cancer tissues, and the relationship between ANXA6 expression and clinicopathological features and prognosis of breast cancer was analyzed.Results:The CCK-8 assay results showed that compared with the control group (0 μmol/L UA, 100.00%±7.37%), the proliferative activity of 231 cells at UA concentrations of 2.5, 5, 10, 20 and 40 μmol/L (90.23%±1.76%, t=2.24, P<0.05; 85.19%±4.23%, t=3.02, P<0.05; 65.45%±0.35%, t=8.11, P<0.01; 37.79%±0.98%, t=14.50, P<0.001; 18.18%±0.15%, t=19.23, P<0.001) were significantly decreased. Furthermore, UA (10, 15, 20 μmol/L) inhibited the invasion and metastasis ability of 231 cells; Western Blot assay showed that compared with the control group (0 μmol/L UA), the protein expressions of MMP9 (1.07±0.03 vs 0.99±0.11, t=1.27, P>0.05), β-catenin (1.21±0.01 vs 0.99±0.07, t=5.47, P<0.05), N-cadherin (1.05±0.09 vs 0.90±0.03, t=2.65, P>0.05) at UA of 10 μmol/L; MMP9 (1.07±0.03 vs 0.79±0.09, t=5.26, P<0.001), β-catenin (1.21±0.01 vs 0.89±0.05, t=10.55, P<0.001), and N-cadherin (1.04±0.09 vs 0.68±0.10, t=4.59, P<0.05) at UA of 15 μmol/L; MMP9 (1.07±0.03 vs 0.52±0.07, t=12.50, P<0.001), β-catenin (1.21±0.01 vs 0.83±0.02, t=24.01, P<0.000 1) and N-cadherin (1.04±0.09 vs 0.49±0.11, t=6.70, P<0.01) at UA of 20 μmol/L. Interfering with ANXA6 inhibits the proliferation, invasion and migration of 231 cells, and overexpression of ANXA6 promotes the proliferation, invasion and migration of 231 cells. Western Blot assay showed that compared with the control group (KD-NC group), the protein expressions of MMP9 (1.07±0.01 vs 0.62±0.16, t=4.86, P<0.01), β-catenin (1.02±0.14 vs 0.64±0.15, t=3.20, P<0.05), N-cadherin (0.98±0.14 vs 0.67±0.12, t=2.85, P<0.05) were decreased expression; Compared with the control group (OE-NC group), the protein expressions of MMP9 (0.54±0.22 vs 1.06±0.08, t=3.90, P<0.05), β-catenin (0.92±0.07 vs 1.06±0.04, t=3.06, P<0.05) and N-cadherin (0.90±0.07 vs 1.06±0.01, t=3.75, P<0.05) were significantly increased. Interference with ANXA6 promoted the inhibitory effect of UA on the proliferation ability of 231 cells ( P<0.05). Overexpression of ANXA6 weakened the inhibitory effect of UA on the proliferation of 231 cells ( P<0.05).The results of immunohistochemistry assay showed that the expression level of ANXA6 in breast cancer tissue was significantly increased, and the expression of ANXA6 was related to tumor size ( P<0.05), but not to age, T stage, N stage, pathological grade, AJCC stage, ER, PR and E-cad. Conclusion:The expression level of ANXA6 in breast cancer tissues is increased, and UA can inhibit the growth, invasion and metastasis of 231 cells by down-regulating the expression of ANXA6.

Objective:To investigate the mechanism of ursolic acid (UA) in inhibiting the growth and metastasis of breast cancer MDA-MB-231 (“231”) cells by downregulating ANXA6.Methods:This study conducted relevant in vitro cytology and molecular biology experiments in the Department of Clinical Laboratory and Central Laboratory of Putuo Hospital, Shanghai University of Traditional Chinese Medicine from February 2023 to August 2024. Human breast cancer 231 cells were cultured in vitro, and the effects of different concentrations of UA on the proliferation and invasion and metastasis of 231 cells were detected by CCK-8 and Transwell assays. Western Blot was used to detect the effect of UA on the expression of ANXA6 and invasion and metastasis-related proteins MMP9, β-catenin and N-cadherin in 231 cells. The 231 cells that interfered with and overexpressed ANXA6 were constructed by lentivirus transfection to generate stable ANXA6 interfering and overexpressing 231 cells, which were divided into 231/KD-ANXA6 group, 231/KD-NC group, 231/OE-ANXA6 group, and 231/OE-NC group. CCK-8 assay and Transwell assay were used to detect the proliferation activity, invasion and metastasis ability of 231 cells after interference and overexpression of ANXA6 and the effect of UA on the proliferation ability of 231 cells after interference and overexpression of ANXA6. Western Blot and RT-PCR assays were used to detect the expression of invasion and migration biomarkers such as MMP9, β-catenin, and N-cadherin in 231 cells after interference and overexpression of ANXA6. Immunohistochemistry was used to detect the expression level of ANXA6 in breast cancer tissues, and the relationship between ANXA6 expression and clinicopathological features and prognosis of breast cancer was analyzed.Results:The CCK-8 assay results showed that compared with the control group (0 μmol/L UA, 100.00%±7.37%), the proliferative activity of 231 cells at UA concentrations of 2.5, 5, 10, 20 and 40 μmol/L (90.23%±1.76%, t=2.24, P<0.05; 85.19%±4.23%, t=3.02, P<0.05; 65.45%±0.35%, t=8.11, P<0.01; 37.79%±0.98%, t=14.50, P<0.001; 18.18%±0.15%, t=19.23, P<0.001) were significantly decreased. Furthermore, UA (10, 15, 20 μmol/L) inhibited the invasion and metastasis ability of 231 cells; Western Blot assay showed that compared with the control group (0 μmol/L UA), the protein expressions of MMP9 (1.07±0.03 vs 0.99±0.11, t=1.27, P>0.05), β-catenin (1.21±0.01 vs 0.99±0.07, t=5.47, P<0.05), N-cadherin (1.05±0.09 vs 0.90±0.03, t=2.65, P>0.05) at UA of 10 μmol/L; MMP9 (1.07±0.03 vs 0.79±0.09, t=5.26, P<0.001), β-catenin (1.21±0.01 vs 0.89±0.05, t=10.55, P<0.001), and N-cadherin (1.04±0.09 vs 0.68±0.10, t=4.59, P<0.05) at UA of 15 μmol/L; MMP9 (1.07±0.03 vs 0.52±0.07, t=12.50, P<0.001), β-catenin (1.21±0.01 vs 0.83±0.02, t=24.01, P<0.000 1) and N-cadherin (1.04±0.09 vs 0.49±0.11, t=6.70, P<0.01) at UA of 20 μmol/L. Interfering with ANXA6 inhibits the proliferation, invasion and migration of 231 cells, and overexpression of ANXA6 promotes the proliferation, invasion and migration of 231 cells. Western Blot assay showed that compared with the control group (KD-NC group), the protein expressions of MMP9 (1.07±0.01 vs 0.62±0.16, t=4.86, P<0.01), β-catenin (1.02±0.14 vs 0.64±0.15, t=3.20, P<0.05), N-cadherin (0.98±0.14 vs 0.67±0.12, t=2.85, P<0.05) were decreased expression; Compared with the control group (OE-NC group), the protein expressions of MMP9 (0.54±0.22 vs 1.06±0.08, t=3.90, P<0.05), β-catenin (0.92±0.07 vs 1.06±0.04, t=3.06, P<0.05) and N-cadherin (0.90±0.07 vs 1.06±0.01, t=3.75, P<0.05) were significantly increased. Interference with ANXA6 promoted the inhibitory effect of UA on the proliferation ability of 231 cells ( P<0.05). Overexpression of ANXA6 weakened the inhibitory effect of UA on the proliferation of 231 cells ( P<0.05).The results of immunohistochemistry assay showed that the expression level of ANXA6 in breast cancer tissue was significantly increased, and the expression of ANXA6 was related to tumor size ( P<0.05), but not to age, T stage, N stage, pathological grade, AJCC stage, ER, PR and E-cad. Conclusion:The expression level of ANXA6 in breast cancer tissues is increased, and UA can inhibit the growth, invasion and metastasis of 231 cells by down-regulating the expression of ANXA6.

Objective:To investigate the application value of photon-counting detector CT (PCD-CT) in preoperative identification of critical anatomical structures and surgical assessment in pancreatic cancer, and to compare its performance with conventional energy-integrating detector CT (EID-CT) in delineating tumor margins, vascular structures, and neural anatomy.Methods:This single-center retrospective matched case-control study included 25 patients with pathologically confirmed pancreatic ductal adenocarcinoma who underwent PCD-CT enhanced scanning and curative surgery at Peking Union Medical College Hospital between February and June 2025 (PCD-CT group). These patients were matched in a 1∶2 ratio to 50 patients who underwent EID-CT between January 2016 and December 2024 and subsequently received curative surgery (EID-CT group). Tumor boundary clarity, vascular visualization scores, and neural structure visibility were subjectively evaluated using the Likert scoring system. The assessed vessels included the celiac artery, common hepatic artery, superior mesenteric artery, splenic artery, portal vein, superior mesenteric vein, splenic vein, and pancreaticoduodenal arterial arcade. Imaging-based assessment of structural involvement was compared with intraoperative findings and pathological results to calculate diagnostic accuracy. Surgeons rated the usefulness of PCD-CT images for identifying key structures and determining resectability using a 5-point Likert scale. The Mann-Whitney U test was used for group comparisons of subjective scores, and categorical data were analyzed using the χ2 test or Fisher exact test. Results:The PCD-CT group showed significantly higher scores for tumor boundary clarity, vascular visualization, and neural structure detectability than those of the EID-CT group (all P<0.05). The accuracy of assessing superior mesenteric vein involvement was 96.0% (24/25) in the PCD-CT group and 72.0% (36/50) in the EID-CT group, with a significant difference ( χ2=6.00, P=0.014). Postoperative surgeon evaluations indicated that PCD-CT provided substantial assistance for both key structure identification [5 (5, 5)] and resectability assessment [5 (4, 5)]. Conclusion:PCD-CT demonstrates superior performance over EID-CT in preoperative delineation of tumor margins, vascular structures, and neural anatomy and in the assessment of structural involvement in pancreatic cancer. It provides valuable anatomical information to support preoperative evaluation and surgical decision-making.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Objective To observe whether there was difference of inferior glenohumeral joint capsule thickness(ICT)measured on coronal and transverse axillary section with high-frequency ultrasound.Methods ICT of 56 patients with frozen shoulder(FS group)and 115 healthy controls(HC group)were measured on coronal and transverse axillary sections with high-frequency ultrasound.The ultrasonic findings were compared between groups,while ICT measured on different sections were compared within groups.Results In FS group,ICT thickened,presented as low echo with poor boundary clarity,with reduced and uneven internal echo.No echo areas could be detected when there was fluid accumulation,and concomitant blood flow signal could be observed.In HC group,the inferior glenohumeral joint capsule presented as moderate echo with clear boundary,with uniform low or equal echo.No significant difference of ICT values measured on coronal or transverse section was found within both groups(both P＞0.05).Conclusion ICT measured on coronal and transverse axillary section with high-frequency ultrasound were not significantly different.

Objective:To explore the dynamic temporal variability of brain functional networks in individuals with internet gaming disorder(IGD)using dynamic functional connectivity density(dFCD).Methods:From January 2019 to December 2021, resting-state functional magnetic resonance imaging data were recruited from 55 patients with IGD and demographically matched 50 healthy controls.Data analysis was performed by IBM SPSS 21.0 software. The functional connectivity density(FCD) combined with sliding window analysis was employed to calculate the temporal variability of global functional connectivity.FCD in whole brain was further devided into ipsilateral and cotralateral parts.The temporal variability of dFCD was further quantified utilizing the standard deviations of whole brain, intra-, and inter-hemispheric FCD. Finally, Pearson correlation analysis was performed between dFCD variance in differential brain regions and clinical behaviors.Results:The inter-hemispheric dFCD in the left posterior cingulate cortex(-0.16±0.24) and the left precuneus(-0.08±0.23) in patients with IGD were lower that those in healthy controls(0.002±0.260, 0.12±0.36)( t=-3.502, -4.160, both P<0.05).And the intra-hemispheric dFCD in the left calcarine, the left precuneus, and the left posterior cingulate cortex in patients with IGD were lower that those in healthy controls( t=-3.809, -4.360, -3.561, all P<0.05).Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC negatively correlated with the severity of IGD( r=-0.380, -0.413, both P<0.05). Conclusion:Patients with IGD show intra-and inter-hemispheric dFCD differences in the visual attention network and default mode network, which may respond to the underlying neurobiological basis for the presence of cognitive dysfunction and impaired concentration.