Objective To observe the value of deep learning image reconstruction(DLIR)algorithm in brain CT perfusion(CTP)using a protocol of 70 kVp and 40 ml contrast agent dose.Methods Totally 105 patients with suspected acute ischemic stroke(AIS)were prospectively enrolled and randomly divided into 3 groups,who underwent standard dose CTP scanning with 80 kVp and 150 mA combined with reconstruction as adaptive statistic iterative reconstruction V(ASIR-V)at 50％level(CN group,n=35),low dose(LD)scanning with 70 kVp and 100 mA combined with DLIR reconstruction at the highest level(DLIR-H)(LD group,n=35),or ultra-low dose(ULD)scanning with 70 kVp and 70 mA combined with DLIR-H reconstruction(ULD group,n=35).Radiation doses were compared among 3 groups.CT values and standard deviations(SDCT)of ROI of gray matter and white matter in the frontal,parietal and temporal lobes were measured.Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)between gray and white matter were calculated and compared among groups.Then pseudo-color images of cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to maximum of the tissue residual function(Tmax)were generated.The imaging quality of CTP pseudo-color images was evaluated,and the compatibility of the subjective scores within every kind of CTP pseudo-color images were assessed using Kappa test.Quantitative perfusion parameters were measured and compared among groups.Results Compared with CN group,both LD and ULD groups demonstrated significantly reduced volume CT dose index(CTDIvol),dose-length product(DLP)and effective dose(ED)(all adjusted P＜0.05).In ULD group,SDCT of white matter in frontal,parietal and temporal lobes were higher than those in CN group,and SDCT of white matter in parietal lobe was also higher than that in LD group(all adjusted P＜0.05).No significant difference of SDCT of gray matter was observed among groups(all P＞0.05).SNR of white matter in parietal and temporal lobes in both LD and ULD groups were lower than those in CN group(all P＜0.05),while no significant difference of SNR of white matter in frontal lobe,nor of gray matter in frontal,parietal and temporal lobes was found among groups(all P＞0.05).CNR of gray and white matter in the frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).High consistency of inter-observer subjective scores of CBV maps,CBF maps and Tmax maps(Kappa of 0.623,0.644 and 0.638,respectively)were noticed,which of MTT maps had moderate consistency(Kappa=0.560).No significant difference of intra-obsever subjective scores of CTP pseudo-color images was found among groups(all P＞0.05).CBV,CBF,MTT and Tmax values of gray and white matter in frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).Conclusion DLIR algorithm applicated in low radiation dose and reduced contrast agent dosage might ensure imaging quality.

BACKGROUND:Osteonecrosis of the femoral head is a common complication in patients with systemic lupus erythematosus.The prediction and validation of the risk in advance will help to avoid or delay the progression of osteonecrosis of the femoral head.OBJECTIVE:To analyze risk factors for the occurrence of osteonecrosis of the femoral head in systemic lupus erythematosus patients and to construct and validate a nomogram prediction model of systemic lupus erythematosus patients with osteonecrosis of the femoral head.METHODS:A retrospective study was conducted to analyze the medical records of 914 systemic lupus erythematosus patients who first visited First Affiliated Hospital of Henan University of Chinese Medicine between January 2013 and December 2022.All patients were divided into osteonecrosis of the femoral head(n=100)and non-osteonecrosis of the femoral head(n=814)groups according to whether they had suffered from osteonecrosis of the femoral head or not.Univariate,LASSO regression,and multifactorial logistic regression analyses were used to screen and identify the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head.The dataset was also randomly divided into training and test sets in a ratio of 7:3.A nomogram prediction model of the risk of systemic lupus erythematosus complicating osteonecrosis of the femoral head was constructed based on the results of the multifactorial logistic regression analysis.The performance of the nomogram was evaluated using the receiver operating characteristic curve,Hosmer-Lemeshow calibration curve,and decision curve analysis.RESULTS AND CONCLUSION:(1)There were significant differences in disease duration of systemic lupus erythematosus,systemic lupus erythematosus disease activity,lupus nephritis,respiratory involvement,gastrointestinal involvement,Sj?gren's syndrome,osteoporosis,anti-ribonucleoprotein,complement C3 decrease,cyclophosphamide,mycophenolate mofetil,biologics,maximum daily dose of glucocorticosteroids,and pulses of intravenous methylprednisolone between the osteonecrosis of the femoral head and non-osteonecrosis of the femoral head groups(P＜0.05).(2)Ten predictor variables related to the risk of osteonecrosis of the femoral head in patients with systemic lupus erythematosus were screened using LASSO regression analysis.Multivariate logistic regression analysis further confirmed disease duration of systemic lupus erythematosus,respiratory involvement,Sj?gren's syndrome,osteoporosis,anti-ribonucleoprotein,cyclophosphamide,mycophenolate mofetil,biologics,and maximum daily dose of glucocorticosteroids were independent risk factors for osteonecrosis of the femoral head in systemic lupus erythematosus patients(P＜0.05).(3)The area under the receiver operating characteristic curve for predicting the risk of occurrence of osteonecrosis of the femoral head in systemic lupus erythematosus patients was 0.802(95％CI=0.742-0.862)in the training set and 0.811(95％CI=0.745-0.876)in the testing set.The Hosmer-Lemeshow calibration curve fit was well(P=0.447 in raining set;P=0.870 in testing set).Decision curve analysis showed that it was beneficial in predicting the risk of osteonecrosis of the femoral head in systemic lupus erythematosus patients using the nomogram prediction model.(4)Menstrual abnormalities were one of the risk factors for osteonecrosis of the femoral head in female systemic lupus erythematosus patients.(5)The results suggest that the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head are multi-factorial,and a nomogram prediction model containing nine risk factors was also developed,which could be used to predict the risk of osteonecrosis of the femoral head in systemic lupus erythematosus patients.In addition,we reported for the first time that menstrual abnormalities were one of the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head in female.

Objective To observe the value of deep learning image reconstruction(DLIR)algorithm in brain CT perfusion(CTP)using a protocol of 70 kVp and 40 ml contrast agent dose.Methods Totally 105 patients with suspected acute ischemic stroke(AIS)were prospectively enrolled and randomly divided into 3 groups,who underwent standard dose CTP scanning with 80 kVp and 150 mA combined with reconstruction as adaptive statistic iterative reconstruction V(ASIR-V)at 50％level(CN group,n=35),low dose(LD)scanning with 70 kVp and 100 mA combined with DLIR reconstruction at the highest level(DLIR-H)(LD group,n=35),or ultra-low dose(ULD)scanning with 70 kVp and 70 mA combined with DLIR-H reconstruction(ULD group,n=35).Radiation doses were compared among 3 groups.CT values and standard deviations(SDCT)of ROI of gray matter and white matter in the frontal,parietal and temporal lobes were measured.Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)between gray and white matter were calculated and compared among groups.Then pseudo-color images of cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to maximum of the tissue residual function(Tmax)were generated.The imaging quality of CTP pseudo-color images was evaluated,and the compatibility of the subjective scores within every kind of CTP pseudo-color images were assessed using Kappa test.Quantitative perfusion parameters were measured and compared among groups.Results Compared with CN group,both LD and ULD groups demonstrated significantly reduced volume CT dose index(CTDIvol),dose-length product(DLP)and effective dose(ED)(all adjusted P＜0.05).In ULD group,SDCT of white matter in frontal,parietal and temporal lobes were higher than those in CN group,and SDCT of white matter in parietal lobe was also higher than that in LD group(all adjusted P＜0.05).No significant difference of SDCT of gray matter was observed among groups(all P＞0.05).SNR of white matter in parietal and temporal lobes in both LD and ULD groups were lower than those in CN group(all P＜0.05),while no significant difference of SNR of white matter in frontal lobe,nor of gray matter in frontal,parietal and temporal lobes was found among groups(all P＞0.05).CNR of gray and white matter in the frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).High consistency of inter-observer subjective scores of CBV maps,CBF maps and Tmax maps(Kappa of 0.623,0.644 and 0.638,respectively)were noticed,which of MTT maps had moderate consistency(Kappa=0.560).No significant difference of intra-obsever subjective scores of CTP pseudo-color images was found among groups(all P＞0.05).CBV,CBF,MTT and Tmax values of gray and white matter in frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).Conclusion DLIR algorithm applicated in low radiation dose and reduced contrast agent dosage might ensure imaging quality.

Objective To explore the predictive value of quantitative parameters of dual-layer detector spectral CT(DLCT)for Ki-67 expression in solid lung adenocarcinoma.Methods The data of 103 patients were retrospectively collected,and the patients were divided into Ki-67 high expression and Ki-67 low expression groups according to Ki-67 proliferation index.The quantitative parame-ters of DLCT were measured and calculated,and the differences in these parameters between the two groups were compared.The parameters with statistically significant differences were assessed for correlation with Ki-67 expression.The efficacy of DLCT param-eters and combined parameters in predicting Ki-67 expression in solid lung adenocarcinoma were evaluated by receiver operating character-istic(ROC)curve and compared by DeLong test.Results Long diameter,short diameter and smoking history were positively corre-lated with the Ki-67 expression in solid lung adenocarcinoma(r>0,P<0.05).Gender and quantitative parameters of DLCT were nega-tively correlated with the Ki-67 expression in solid lung adenocarcinoma(r<0,P<0.05).The combined parameters of convention and spectral CT had the highest prediction efficiency.Conclusion The quantitative parameters of DLCT can be used to evaluate the Ki-67 expres-sion in solid lung adenocarcinoma.

Sjogren's syndrome (SS) is a common autoimmune disorder that primarily targets exocrine glands, leading to hallmark manifestations of xerostomia and xerophthalmia, with potential progression to multisystem involvement. The rapid advances in omics technologies-including metabolomics, proteomics, and transcriptomics-have yielded substantial insights into SS pathophysiology. This review consolidates current evidence on omics-derived biomarkers in SS. Studies consistently implicate aberrant glucose metabolism, neutrophil-derived enzyme activity, mitochondrial bioenergetic impairment, ferroptosis, and apoptotic pathways as central to SS development. These findings refine our understanding of disease mechanisms and the heterogeneity of therapeutic responses. Hydroxyproline has emerged as a candidate marker for distinguishing SS from IgG4-related disease, whereas distinct cytokine and chemokine signatures may enable earlier diagnosis. Genomic analyses demonstrate a robust association between expression of the rs11797 locus and SS-related lymphomagenesis, and several genes controlling DNA methylation represent promising therapeutic targets. Collectively, these findings lay the groundwork for personalized risk stratification and intervention in SS. The review concludes by summarizing existing progress and outlining priorities for future omics-based investigations.
Humans ; Sjogren's Syndrome/diagnosis* ; Biomarkers/analysis* ; Metabolomics/methods* ; Proteomics/methods* ; Genomics ; Multiomics

Objective:To investigate the value of quantitative parameters of dual-layer detector spectral CT (DLCT) in preoperative prediction of lymphovascular invasion (LVI) in invasive lung adenocarcinoma.Methods:This study employed a cross-sectional design. The data of 91 patients with primary lung adenocarcinoma confirmed by postoperative pathology who underwent DLCT enhanced scanning in the First Affiliated Hospital of Zhengzhou University from March 2022 to July 2024 were retrospectively collected. The patients were divided into LVI positive group and LVI negative group according to the postoperative pathology. Gender, age, smoking status, and lesion location were recorded,the clinical T-stage and N-stage were evaluated. Spectral base data images were generated based on the spectral reconstruction algorithm. Conventional CT features such as the size and density of the lesions were analyzed. The DLCT quantitative parameters such as 40 keV single-energy CT value (CT 40 keV), iodine density (ID), standardized iodine density (NID), and effective atomic number (Z eff) were measured. The differences of parameters between the two groups were compared using t-test, Mann-Whitney U test, or χ2 test. Multivariate logistic regression analysis was used to identify independent factors for predicting invasive lung adenocarcinoma LVI. The predictive performance of individual parameters and their combinations for LVI in invasive lung adenocarcinoma was evaluated using receiver operating characteristic curve analysis and area under the curve (AUC) measurements. Results:There were significant differences in age, T stage, N stage, maximum diameter, focal density, and arteriovenous stage NID and Z eff between the LVI positive group and the LVI negative group ( P<0.05). Multiple logistic regression analysis showed that age ( OR=0.890, 95% CI 0.821-0.966), N stage( OR=12.721, 95% CI 2.676-60.473) and venous stage Z eff( OR=0.012,95% CI 0-0.668) were independent factors for predicting invasive lung adenocarcinoma LVI ( P<0.05). The combination of age, N stage, and venous-phase Z eff values demonstrated the highest predictive efficacy for LVI in invasive lung adenocarcinoma, with an AUC of 0.916. Conclusions:The quantitative parameters of DLCT are helpful for preoperative prediction of LVI status of invasive lung adenocarcinoma. The Z eff in the venous stage is an independent predictor, the combination of multiple parameters can further improve the diagnostic efficiency.

BACKGROUND:Osteonecrosis of the femoral head is a common complication in patients with systemic lupus erythematosus.The prediction and validation of the risk in advance will help to avoid or delay the progression of osteonecrosis of the femoral head.OBJECTIVE:To analyze risk factors for the occurrence of osteonecrosis of the femoral head in systemic lupus erythematosus patients and to construct and validate a nomogram prediction model of systemic lupus erythematosus patients with osteonecrosis of the femoral head.METHODS:A retrospective study was conducted to analyze the medical records of 914 systemic lupus erythematosus patients who first visited First Affiliated Hospital of Henan University of Chinese Medicine between January 2013 and December 2022.All patients were divided into osteonecrosis of the femoral head(n=100)and non-osteonecrosis of the femoral head(n=814)groups according to whether they had suffered from osteonecrosis of the femoral head or not.Univariate,LASSO regression,and multifactorial logistic regression analyses were used to screen and identify the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head.The dataset was also randomly divided into training and test sets in a ratio of 7:3.A nomogram prediction model of the risk of systemic lupus erythematosus complicating osteonecrosis of the femoral head was constructed based on the results of the multifactorial logistic regression analysis.The performance of the nomogram was evaluated using the receiver operating characteristic curve,Hosmer-Lemeshow calibration curve,and decision curve analysis.RESULTS AND CONCLUSION:(1)There were significant differences in disease duration of systemic lupus erythematosus,systemic lupus erythematosus disease activity,lupus nephritis,respiratory involvement,gastrointestinal involvement,Sj?gren's syndrome,osteoporosis,anti-ribonucleoprotein,complement C3 decrease,cyclophosphamide,mycophenolate mofetil,biologics,maximum daily dose of glucocorticosteroids,and pulses of intravenous methylprednisolone between the osteonecrosis of the femoral head and non-osteonecrosis of the femoral head groups(P＜0.05).(2)Ten predictor variables related to the risk of osteonecrosis of the femoral head in patients with systemic lupus erythematosus were screened using LASSO regression analysis.Multivariate logistic regression analysis further confirmed disease duration of systemic lupus erythematosus,respiratory involvement,Sj?gren's syndrome,osteoporosis,anti-ribonucleoprotein,cyclophosphamide,mycophenolate mofetil,biologics,and maximum daily dose of glucocorticosteroids were independent risk factors for osteonecrosis of the femoral head in systemic lupus erythematosus patients(P＜0.05).(3)The area under the receiver operating characteristic curve for predicting the risk of occurrence of osteonecrosis of the femoral head in systemic lupus erythematosus patients was 0.802(95％CI=0.742-0.862)in the training set and 0.811(95％CI=0.745-0.876)in the testing set.The Hosmer-Lemeshow calibration curve fit was well(P=0.447 in raining set;P=0.870 in testing set).Decision curve analysis showed that it was beneficial in predicting the risk of osteonecrosis of the femoral head in systemic lupus erythematosus patients using the nomogram prediction model.(4)Menstrual abnormalities were one of the risk factors for osteonecrosis of the femoral head in female systemic lupus erythematosus patients.(5)The results suggest that the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head are multi-factorial,and a nomogram prediction model containing nine risk factors was also developed,which could be used to predict the risk of osteonecrosis of the femoral head in systemic lupus erythematosus patients.In addition,we reported for the first time that menstrual abnormalities were one of the risk factors for systemic lupus erythematosus complicating osteonecrosis of the femoral head in female.

Objective To explore the predictive value of quantitative parameters of dual-layer detector spectral CT(DLCT)for Ki-67 expression in solid lung adenocarcinoma.Methods The data of 103 patients were retrospectively collected,and the patients were divided into Ki-67 high expression and Ki-67 low expression groups according to Ki-67 proliferation index.The quantitative parame-ters of DLCT were measured and calculated,and the differences in these parameters between the two groups were compared.The parameters with statistically significant differences were assessed for correlation with Ki-67 expression.The efficacy of DLCT param-eters and combined parameters in predicting Ki-67 expression in solid lung adenocarcinoma were evaluated by receiver operating character-istic(ROC)curve and compared by DeLong test.Results Long diameter,short diameter and smoking history were positively corre-lated with the Ki-67 expression in solid lung adenocarcinoma(r>0,P<0.05).Gender and quantitative parameters of DLCT were nega-tively correlated with the Ki-67 expression in solid lung adenocarcinoma(r<0,P<0.05).The combined parameters of convention and spectral CT had the highest prediction efficiency.Conclusion The quantitative parameters of DLCT can be used to evaluate the Ki-67 expres-sion in solid lung adenocarcinoma.

Objective:To investigate the value of quantitative parameters of dual-layer detector spectral CT (DLCT) in preoperative prediction of lymphovascular invasion (LVI) in invasive lung adenocarcinoma.Methods:This study employed a cross-sectional design. The data of 91 patients with primary lung adenocarcinoma confirmed by postoperative pathology who underwent DLCT enhanced scanning in the First Affiliated Hospital of Zhengzhou University from March 2022 to July 2024 were retrospectively collected. The patients were divided into LVI positive group and LVI negative group according to the postoperative pathology. Gender, age, smoking status, and lesion location were recorded,the clinical T-stage and N-stage were evaluated. Spectral base data images were generated based on the spectral reconstruction algorithm. Conventional CT features such as the size and density of the lesions were analyzed. The DLCT quantitative parameters such as 40 keV single-energy CT value (CT 40 keV), iodine density (ID), standardized iodine density (NID), and effective atomic number (Z eff) were measured. The differences of parameters between the two groups were compared using t-test, Mann-Whitney U test, or χ2 test. Multivariate logistic regression analysis was used to identify independent factors for predicting invasive lung adenocarcinoma LVI. The predictive performance of individual parameters and their combinations for LVI in invasive lung adenocarcinoma was evaluated using receiver operating characteristic curve analysis and area under the curve (AUC) measurements. Results:There were significant differences in age, T stage, N stage, maximum diameter, focal density, and arteriovenous stage NID and Z eff between the LVI positive group and the LVI negative group ( P<0.05). Multiple logistic regression analysis showed that age ( OR=0.890, 95% CI 0.821-0.966), N stage( OR=12.721, 95% CI 2.676-60.473) and venous stage Z eff( OR=0.012,95% CI 0-0.668) were independent factors for predicting invasive lung adenocarcinoma LVI ( P<0.05). The combination of age, N stage, and venous-phase Z eff values demonstrated the highest predictive efficacy for LVI in invasive lung adenocarcinoma, with an AUC of 0.916. Conclusions:The quantitative parameters of DLCT are helpful for preoperative prediction of LVI status of invasive lung adenocarcinoma. The Z eff in the venous stage is an independent predictor, the combination of multiple parameters can further improve the diagnostic efficiency.

Objective: To investigate whether acupoint penetration acupuncture (APA) could regulate chondrocyte autophagy and apoptosis via the PI3K/Akt-mTOR signaling pathway to reduce cartilage degeneration in knee osteoarthritis (KOA) rats. Methods: KOA was induced in rats via intra-articular injection of sodium iodoacetate resolution. Forty male Sprague-Dawley rats were randomly assigned to blank control, model, APA, electro-acupuncture (EA), and sham model groups (n = 8) and those in the APA and EA groups received their respective therapies. Following completion of the treatment course, histological examinations of cartilage and muscle were conducted. Levels of apoptosis- and autophagy-related factors, including Bax, Bcl-2, mTOR, ULK-1, and Beclin-1 protein, and mRNAs were assessed. Additionally, β-endorphin (β-EP) concentrations in the brain and serum were measured. Results: Histological analysis revealed that APA alleviated cartilage and muscle damage compared with the model group. APA inhibited cartilage degeneration by modulating the expression of apoptosis- and autophagy-related proteins and mRNA, thus preventing chondrocyte apoptosis. In the APA group, Bax and mTOR protein levels were significantly lower than those in the model group (both P = .024). Conversely, the Bcl-2 expression level was significantly higher than that in the EA group (P = .035). Additionally, ULK-1 expression was significantly lower than that in the EA group (P = .045). The mRNA level of Bax was significantly higher than that in the blank control group (P < .001). However, Beclin-1 levels were significantly higher than those in both the model and EA groups (both P < .001). ELISA results showed a significant decrease in the concentration of β-EP in the brains of the rats in the APA group compared with those in the model group (P = .032). Conclusions APA reduced osteoarthritis-related pain and alleviated cartilage damage by upregulating chondrocyte autophagy and down-regulating apoptosis via signaling pathways involving PI3K/Akt-mTOR in KOA rats.