Objective To explore the application value of dual-energy computed tomography(DECT)pulmonary perfusion parameters in the evaluation of pulmonary hypertension(PH).Methods A retrospective selection was performed on 214 patients with suspec-ted PH who underwent DECT pulmonary perfusion examination,and the patients were divided into PH group(n=97)and non-PH group(n=117)according to the pulmonary artery systolic pressure measured by echocardiography.Inter-group comparison,univari-ate and multivariate logistic regression,and the receiver operating characteristic(ROC)curve were used to analyze the two-phase DECT pulmonary perfusion parameters and traditional CT anatomical parameters of the two groups of patients,so as to obtain the best parameters and models for predicting PH.Results There were statistically significant differences in DECT pulmonary perfusion parameters and traditional CT anatomical parameters between the PH group and the non-PH group(P<0.05).In DECT pulmonary perfusion parameters,the ratio of main pulmonary artery enhancement to whole lung enhancement in the pulmonary arterial phase(MPAenh1/WLenh1),the difference between the whole lung enhancement in the pulmonary venous phase and the whole lung enhancement in the pulmonary arterial phase(WLenh2-WLenh1),and in traditional CT anatomical parameters,the main pulmonary artery diam-eter(MPAD)and the ratio of right ventricular diameter to left ventricular diameter(RVD/LVD)were independent predictors of PH.The DECT pulmonary perfusion parameters model had similar diagnostic efficacy to the traditional CT anatomical parameters model for PH,and the combined model of the two parameters had the best diagnostic efficacy,with an area under the curve(AUC)of 0.955 and sensitivity and specificity of 0.866 and 0.940,respectively.Conclusion DECT pulmonary perfusion parameters can be used to evaluate PH,and the combination of traditional CT anatomical parameters and DECT pulmonary perfusion parameters can significantly improve the diagnostic efficacy of PH.

Objective To explore the application value of dual-energy computed tomography(DECT)pulmonary perfusion parameters in the evaluation of pulmonary hypertension(PH).Methods A retrospective selection was performed on 214 patients with suspec-ted PH who underwent DECT pulmonary perfusion examination,and the patients were divided into PH group(n=97)and non-PH group(n=117)according to the pulmonary artery systolic pressure measured by echocardiography.Inter-group comparison,univari-ate and multivariate logistic regression,and the receiver operating characteristic(ROC)curve were used to analyze the two-phase DECT pulmonary perfusion parameters and traditional CT anatomical parameters of the two groups of patients,so as to obtain the best parameters and models for predicting PH.Results There were statistically significant differences in DECT pulmonary perfusion parameters and traditional CT anatomical parameters between the PH group and the non-PH group(P<0.05).In DECT pulmonary perfusion parameters,the ratio of main pulmonary artery enhancement to whole lung enhancement in the pulmonary arterial phase(MPAenh1/WLenh1),the difference between the whole lung enhancement in the pulmonary venous phase and the whole lung enhancement in the pulmonary arterial phase(WLenh2-WLenh1),and in traditional CT anatomical parameters,the main pulmonary artery diam-eter(MPAD)and the ratio of right ventricular diameter to left ventricular diameter(RVD/LVD)were independent predictors of PH.The DECT pulmonary perfusion parameters model had similar diagnostic efficacy to the traditional CT anatomical parameters model for PH,and the combined model of the two parameters had the best diagnostic efficacy,with an area under the curve(AUC)of 0.955 and sensitivity and specificity of 0.866 and 0.940,respectively.Conclusion DECT pulmonary perfusion parameters can be used to evaluate PH,and the combination of traditional CT anatomical parameters and DECT pulmonary perfusion parameters can significantly improve the diagnostic efficacy of PH.

Objective To explore the value of fractional order calculus(FROC)model diffusion weighted imaging(DWI)for evaluating pathological classification and differentiation degree of cervical cancer(CCA).Methods Totally 74 CCA patients were enrolled and divided into squamous cell carcinoma(SCC)group(n=54)and adenocarcinoma(ACA)group(n=20)based on pathological classification,also low differentiation group(n=33)and medium-high differentiation group(n=41)based on differentiation degree.Conventional MR examination and DWI with 12 b-values were performed,FROC model parameters(D,β,and p value)and the apparent diffusion coefficient(ADC)of mono-exponential model were obtained via software analysis.The parameters were compared between groups,and receiver operating characteristic curve of those being significantly different between groups were drawn,the area under the curves(AUC)were calculated to evaluate the diagnostic efficacy.Results Significant differences of ADC,D,and β values were found between SCC group and ACA group(all P＜0.05),and D value had the highest AUC(0.726)for distinguishing pathological classification CCA.Meanwhile,significant differences of D,β,p values and ADC were observed between low differentiation group and medium-high differentiation group(all P＜0.05),D value also had the highest AUC(0.865).AUC of the combined model constructed based on significant variables β and p values in logistic regression was 0.926,higher than that of each parameter alone(all P＜0.05).Conclusion FROC model DWI could be used to evaluate pathological classification and differentiation degree of CCA.

Objective:To explore the value of coronary artery plaque progression parameters based on coronary CT angiography (CCTA) in predicting the occurrence of major adverse cardiovascular events (MACE) in patients with non-obstructive coronary artery disease.Methods:The study included clinical, imaging, and prognosis (MACE) parameters of non-obstructive coronary artery disease patients who underwent CCTA at the First Affiliated Hospital of Nanjing Medical University from September 2010 to December 2022. Patients were grouped based on the occurrence of MACE, and differences in clinical data, plaque baseline, and progression parameters between the two groups were compared. Univariate and multivariate Cox regression analyses were employed to identify factors that could effectively predict the occurrence of MACE in patients. Models were constructed using plaque baseline parameters, plaque progression parameters, and a combination of both. The concordance index-time curve, net reclassification improvement and integrated discrimination improvement were used to evaluate the risk stratification ability of the models.Results:A total of 258 patients were included, of whom 62 cases experienced MACE during the follow-up period. In comparison to the MACE(-) group, patients in the MACE(+) group exhibited longer lesion length, greater degree of stenosis, larger plaque total volume, calcified plaque volume, non-calcified plaque volume, fibrous plaque volume, total plaque burden, lipid-rich plaque burden, higher peri-coronary adipose tissue attenuation index (FAI), and annual change of diameter stenosis(ΔDS/y). There were also more cases of coronary artery disease reporting and data system upgrades and non-obstructive progression to obstructive status ( P<0.05). Multivariate Cox analysis revealed that FAI, ΔDS/y, and non-obstructive progression to obstructive status were independent predictors of MACE occurrence. Concordance index-time curve results indicated that the combined model had a better predictive efficacy for MACE in patients with non-obstructive coronary artery disease compared to models based on plaque baseline parameters and plaque progression parameters. Conclusion:The plaque progression parameters and FAI based on CCTA have the potential to predict the high-risk population for MACE in patients with non-obstructive coronary artery disease, demonstrating good risk stratification value.

Objective: To study the chemical constituents in the roots of Aconitum iochanicum Ulbr.Methods: The air-dried roots of A.iochanicum were powdered and extracted by methanol with a percolation method.After removing the solvent under reduced pressure, the crude extract was dissolved in1.5% HCl solution, and then extracted by ecetic ether.The acidic solution was basified to pH 9.0 by NaOH (5%) and extracted with ethyl acetate to obtain crude alkaloidal extract after the removal of ethyl acetate.The compounds were isolated and purified by column chromatography and identified based on spectral analysis (1H-NMR, 13C-NMR and MS).Results: Totally 18 compounds were isolated from A.iochanicum and characterized as 14-O-acetylsachaconitine (1), franchetine (2), crassicaudine (3), indaconoitine (4), 14-benzoyl chasmanine (5), 14-O-acetyltalatisamine (6), talatisamine (7), chasmannine (8), crassicauline A (9), bikhaconine (10), 13,15-dideoxyaconitine (11), crassicautine (12), kongboensine (13), liljestrandisine (14), ludaconitine (15), 8-deacetyl-yunaconitine (16), yunaconitine (17) and ouvrardiantine (18).Conclusion: It''s the first time to study the chemical constituents of A.iochanicum, and 18 diterpenoid alkaloids are isolated.

Objective:To study the secondary metabolites of endophytic fungus Alternaria solani from Aconitum Tsaii. Methods:The endogenous fungui fermentation product was extracted by methanol followed by recycling methanol to obtain the extract, and the ex-tract was extracted by ethyl acetate to obtain the crude extract. The compounds were isolated and purified by column chromatography and identified based on the spectral analysis ( MS, 1 H-NMR and 13 C-NMR) . Results:Totally 12 compounds were isolated from A. so-lani and characterized as (22E, 24R)-Ergosta-4, 6, 8 (14), 22-tetraen-3-one (1), 1,3-Diolein (2), 5-(3', 3'-Dimethylallyloxy)-3-methoxy-4-methylphthalide (3), pseudomonas aeruginosa H2-sesquiterpene lactone (4), ergosterol peroxide (5), 7-dehydroxyl-zinni-ol (6), ergosterol-7, 22-diene-3β, 5,6-triol (7), 9-octadecenoic acid -2',3'-dihydroxy propyl ester (8), 8-O-Methyltalatisamine (9), Chasmanine (10), yunaconitine (11) and crassicauline A (12). Conclusion:Totally 12 compounds are isolated from the endo-phytic fungus Alternaria solani, and four of them are isolated for the first time.

Objective:To study the secondary metabolites of endophytic fungus Alternaria solani from Aconitum Tsaii. Methods:The endogenous fungui fermentation product was extracted by methanol followed by recycling methanol to obtain the extract, and the ex-tract was extracted by ethyl acetate to obtain the crude extract. The compounds were isolated and purified by column chromatography and identified based on the spectral analysis ( MS, 1 H-NMR and 13 C-NMR) . Results:Totally 12 compounds were isolated from A. so-lani and characterized as (22E, 24R)-Ergosta-4, 6, 8 (14), 22-tetraen-3-one (1), 1,3-Diolein (2), 5-(3', 3'-Dimethylallyloxy)-3-methoxy-4-methylphthalide (3), pseudomonas aeruginosa H2-sesquiterpene lactone (4), ergosterol peroxide (5), 7-dehydroxyl-zinni-ol (6), ergosterol-7, 22-diene-3β, 5,6-triol (7), 9-octadecenoic acid -2',3'-dihydroxy propyl ester (8), 8-O-Methyltalatisamine (9), Chasmanine (10), yunaconitine (11) and crassicauline A (12). Conclusion:Totally 12 compounds are isolated from the endo-phytic fungus Alternaria solani, and four of them are isolated for the first time.

Objective To investigate the influence of iodixanol-320 and iopromide-370 on the heart rate of patients in coronary dual-source CT angiography (CTA).Methods The data of 389 patients underwent coronary CTA examinations were retrospectively collected and received contrast media (CM) with either iodixanol-320 (group A) or iopromide-370 (group B), randomly.The heart rate before CM injection (predose HR), during injection (postdose HR) were both recorded.As for the preclinical protocol, patients with heart rate less than 75 beats per minute were pretreated with nitrates (n=278),0.25 mg.Mean heart rate changes from pre to postdose HR were assessed.Results The patients whose mean heart rate changes from pre to postdose were larger than 10 beats per minute was 8(4.4%) for group A and 10(4.8%) for group B.No statistically differences were observed between them(P>0.05).With only intravenous injections of two contrast agents, the patients' heart rates decreased in both groups (4.2 vs 2.7 beats per minute,P>0.05), while the effect could be reduced by nitrates.Conclusion There is no difference in the heart rate between the 2 agents after intravenous injection of either iodixanol-320 or iopromide-370 in coronary CTA with approximately 4% patients whose mean heart rate changes from preto postdose were larger than 10 beats per minute in each group.

BACKGROUNDGestational diabetes mellitus (GDM) is a common complication during pregnancy, and gestational weight gain is one of the major and modifiable risk factors. This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM.

METHODSA case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital. GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011. The plasma glucose levels, weights, and covariate data of the women were obtained based on medical records. Univariate analysis and unconditional Logistic regression model were used to estimate the associations.

RESULTSAfter adjusting for age at delivery, parity, and pre-pregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lower rate of gestational weight gain (less than 0.28 kg per week), a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM (odds ratio: 2.03; 95% confidence interval: 1.15 to 3.59). The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester.

CONCLUSIONHigh rates of gestational weight gain, particular during early pregnancy, may increase a woman's risk of GDM.

Adult ; Case-Control Studies ; Diabetes, Gestational ; epidemiology ; etiology ; Female ; Humans ; Pregnancy ; Weight Gain ; physiology

OBJECTIVE: To compare the therapeutic effects of low-temperature plasm radiofrequency and high-intensity focused ultrasound in treatment of perennial allergic rhinitis (PAR) complicated with nasal septum deviation. METHOD: A total of 224 cases of identified PAR who treated in our hospital were randomly divided into 2 matched groups: low-temperature plasm radiofrequency group (n = 140) and high-intensity focused ultrasound group (n = 84). The therapeutic affection were evaluated by clinical symptoms controlled counting-scores. Inferior turbinate mucosa were collected and examined pathologically before and at 15 days and 6 months after the therapy. RESULT: The follow-up data indicated the effective rate in 15 days was 97.1% in high-intensity focused ultrasound group, and 90.4% in low-temperature plasm radiofrequency group, in 6 months was 90.7% and 85.4% respectively. CONCLUSION The treatment of high-intensity focused ultrasound in PAR is minimally invasive and safe with reliable efficacy.
Adolescent ; Adult ; Aged ; Catheter Ablation ; methods ; Humans ; Hypothermia, Induced ; Middle Aged ; Nasal Septum ; abnormalities ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy ; Ultrasonic Therapy ; methods ; Young Adult