Objective To explore the value of 3D and 2D radiomics features models based on multiparameter MRI in predicting Ki-67 expression(with 14%and 20%as the critical values,respectively)in breast cancer.Methods The MRI images of 147 patients with pathologically confirmed Luminal breast cancer were analyzed retrospectively.The patients were randomly divided into training set and test set according to the ratio of 7︰3.The 3D and 2D radiomics features of intratumor and peritumor were extracted from diffusion weighted imaging(DWI),dynamic contrast enhancement(DCE)mask(S0)and DCE phase 3(S3)images.Then the models were constructed by multiple pipeline combinations of three feature normalization methods,two feature dimensionality reduction methods,four feature selection methods,and ten classifiers.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the prediction performance of the models in order to select the best 3D and 2D single parame-ter(DWI,S0,S3)and multiparameter combination(S0+S3,S0+DWI,S3+DWI,S0+S3+DWI)models.Finally,the differ-ences between the models were compared by De Long test.Results With 14%as the critical value,the AUC of 3D and 2D models in the training set were 0.726-0.824 and 0.707-0.835,respectively,and those in the test set were 0.724-0.82 and 0.701-0.805.With 20%as the critical value,the AUC of 3D and 2D models in the training set were 0.743-0.868 and 0.793-0.881,respectively,and those in the test set were 0.738-0.853 and 0.743-0.814.There was no significant statistical difference between 3D and 2D models with the same parameter in the two critical values standards.Conclusion The multiparameter MRI-based radiomics models can bet-ter predict the expression of Ki-67 in breast cancer,and the models based on intratumor and peritumor 3D and 2D features have the same prediction efficiency.

Objective To analyze the correlation between preoperative oxidative stress levels and reperfusion arrhythmia(RA)in post-PCI patients with acute myocardial infarction(AMI).Methods A total of 120 AMI patients undergoing PCI in our hospital from May 2022 to May 2024 were recruited,and according to the occurrence of RA,they were divided into a RA group(46 cases)and a non-RA group(74 cases).The general clinical data were collected in all patients.Multivariate logistic regression was used to screen the influencing factors for the occurrence of RA after PCI in AMI patients.ROC curve analysis was applied to determine the predictive value of the preoperative oxidative stress levels for the occurrence of RA after PCI.Results The RA group had significantly larger proportions of onset-to-PCI time＜6 h,inferior wall infarction,and culprit vessel at thrombolysis in myocardial infarction(TIMI)grade 0 than the non-RA group(P＜0.01).The preoperative level of malondialdehyde(MDA)was obviously higher,while that of superoxide dismutase(SOD)was notably lower in the RA group than the non-RA group(P＜0.01).Multivariate logistic regression analysis showed that culprit vessel at TIMI grade 0(OR=3.484,95％CI:1.043-11.633,P=0.042),onset-to-PCI time＜6 h(OR=4.143,95％CI:1.227-13.989,P=0.022),inferior wall infarction(OR=54.265,95％CJ:2.027-1450.950,P=0.017),and preoperative MDA(OR=2.495,95％CI:1.570-3.966,P=0.001)were risk factors for RA after PCI in AMI patients;preoperative SOD(OR=0.823,95％CI:0.749-0.905,P=0.001)was a protective factor.ROC curve analysis indicated that the AUC value of preoperative MDA and pre-operative SOD in predicting RA after PCI in AMI patients was 0.809 and 0.849,respectively(P＜0.001).Conclusion Culprit vessel at TIMI grade 0,onset-to-PCI time＜6 h,inferior wall infarc-tion,and preoperative MDA and SOD are all influencing factors for RA in post-PCI AMI patients.Moreover,preoperative MDA and SOD levels can effectively predict the risk of RA after PCI in the patients.

Objective To explore the value of 3D and 2D radiomics features models based on multiparameter MRI in predicting Ki-67 expression(with 14%and 20%as the critical values,respectively)in breast cancer.Methods The MRI images of 147 patients with pathologically confirmed Luminal breast cancer were analyzed retrospectively.The patients were randomly divided into training set and test set according to the ratio of 7︰3.The 3D and 2D radiomics features of intratumor and peritumor were extracted from diffusion weighted imaging(DWI),dynamic contrast enhancement(DCE)mask(S0)and DCE phase 3(S3)images.Then the models were constructed by multiple pipeline combinations of three feature normalization methods,two feature dimensionality reduction methods,four feature selection methods,and ten classifiers.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the prediction performance of the models in order to select the best 3D and 2D single parame-ter(DWI,S0,S3)and multiparameter combination(S0+S3,S0+DWI,S3+DWI,S0+S3+DWI)models.Finally,the differ-ences between the models were compared by De Long test.Results With 14%as the critical value,the AUC of 3D and 2D models in the training set were 0.726-0.824 and 0.707-0.835,respectively,and those in the test set were 0.724-0.82 and 0.701-0.805.With 20%as the critical value,the AUC of 3D and 2D models in the training set were 0.743-0.868 and 0.793-0.881,respectively,and those in the test set were 0.738-0.853 and 0.743-0.814.There was no significant statistical difference between 3D and 2D models with the same parameter in the two critical values standards.Conclusion The multiparameter MRI-based radiomics models can bet-ter predict the expression of Ki-67 in breast cancer,and the models based on intratumor and peritumor 3D and 2D features have the same prediction efficiency.

Objective To analyze the correlation between preoperative oxidative stress levels and reperfusion arrhythmia(RA)in post-PCI patients with acute myocardial infarction(AMI).Methods A total of 120 AMI patients undergoing PCI in our hospital from May 2022 to May 2024 were recruited,and according to the occurrence of RA,they were divided into a RA group(46 cases)and a non-RA group(74 cases).The general clinical data were collected in all patients.Multivariate logistic regression was used to screen the influencing factors for the occurrence of RA after PCI in AMI patients.ROC curve analysis was applied to determine the predictive value of the preoperative oxidative stress levels for the occurrence of RA after PCI.Results The RA group had significantly larger proportions of onset-to-PCI time＜6 h,inferior wall infarction,and culprit vessel at thrombolysis in myocardial infarction(TIMI)grade 0 than the non-RA group(P＜0.01).The preoperative level of malondialdehyde(MDA)was obviously higher,while that of superoxide dismutase(SOD)was notably lower in the RA group than the non-RA group(P＜0.01).Multivariate logistic regression analysis showed that culprit vessel at TIMI grade 0(OR=3.484,95％CI:1.043-11.633,P=0.042),onset-to-PCI time＜6 h(OR=4.143,95％CI:1.227-13.989,P=0.022),inferior wall infarction(OR=54.265,95％CJ:2.027-1450.950,P=0.017),and preoperative MDA(OR=2.495,95％CI:1.570-3.966,P=0.001)were risk factors for RA after PCI in AMI patients;preoperative SOD(OR=0.823,95％CI:0.749-0.905,P=0.001)was a protective factor.ROC curve analysis indicated that the AUC value of preoperative MDA and pre-operative SOD in predicting RA after PCI in AMI patients was 0.809 and 0.849,respectively(P＜0.001).Conclusion Culprit vessel at TIMI grade 0,onset-to-PCI time＜6 h,inferior wall infarc-tion,and preoperative MDA and SOD are all influencing factors for RA in post-PCI AMI patients.Moreover,preoperative MDA and SOD levels can effectively predict the risk of RA after PCI in the patients.

Objective To analyze the effects of miR-181a-5p overexpression on metabolites in the small intestines of mice with subcutaneous oral cancer by detecting changes in metabolites and metabolic pathways.Methods Three groups were included in study:Control group,negative control and miR-181a-5p overexpression group.To establish a subcutaneous oral cancer model in mice,variously treated cell suspensions were subcutaneously injected into the upper right of the groin in female M-NSG severely immunodeficient mice.Changes in pathology and small intestinal tissues were assessed by HE staining.Changes in mouse body weight were also assessed.Tandem orbitrap mass spectrometry and ultra-high performance liquid chromatography-tandem time-of-flight mass spectrometry,were used to examine metabolites in the small intestines.By pre-analyzing the original data and quality rating sample data,XCMS was able to assess which metabolites were different among the groups.To identify unique metabolic pathways,KEGG enrichment analysis was used.Results A total of 170 distinct metabolites were found in the small intestinal tissues of Control and NC groups.Choline metabolism,alanine,aspartate,and glutamate metabolism,GABA synaptic metabolism,glycerophospholipid metabolism,cAMP signaling route,cancer center carbon metabolism,and niacin and niacin amine metabolic pathways were important signaling pathways for metabolite enrichment.In the NC group,16 distinct metabolites with VIP values larger than 2 were found in the small intestines compared with the OE group overexpressing miR-181a-5p.Glycerin phosphorylcholine,palmitic acid,3-hydroxybutyl carnitine,and β-hydroxybutyric acid were among the metabolites that significantly varied.The primary enhanced metabolic pathway was the choline pathway.Conclusions Mouse small intestines underwent slight changes from subcutaneous oral cancer with the greatest effect on metabolites critical for energy metabolism.The choline metabolic pathway was the pathway that selected absolutely metabolites in mouse small intestines with subcutaneous grafts of oral cancer.

Objective:To evaluate the safety and efficacy of 225Ac-prostate specific membrane antigen (PSMA) in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Methods:Eleven patients (age (70.0±8.8) years) with mCRPC who were treated with 225Ac-PSMA-617 between July 2021 and October 2023 in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. In order to assess efficacy, the Prostate Cancer Clinical Trials Working Group 3 (PCWG3) criteria were used to evaluate the changes in prostate specific antigen (PSA) level after the treatment. 68Ga-PSMA-11 PET/CT imaging was performed at the baseline and after the treatment, and molecular imaging response was assessed using the modified PET response criteria in solid tumors (PERCIST) 1.0. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Toxicity was assessed by common terminology criteria for adverse events version 5.0 (CTCAE 5.0). The paired t test or Wilcoxon signed rank test was used to compare the parameters before and after treatment. Results:Post-treatment PSA levels were significantly lower than pre-treatment in 9 of 11 patients (17.83(4.74, 41.25) vs 124.33(77.85, 784.22) μg/L; z=-2.67, P=0.008), and 6 of them decreasing by more than 50% and 2 patients experienced progressive disease (PD) with PSA levels rising by more than 25%. Post-treatment 68Ga-PSMA-11 PET/CT showed that 7 patients achieved partial response (PR), 2 patients achieved stable disease (SD), and 2 patients were with PD. The OS was 12.0(10.0, 18.0) months and PFS was 8.0(6.0, 11.0) months in 11 patients. There were no statistically significant differences after therapy in WBC counts, Hb, PLT, creatinine, glomerular filtration rate, alanine aminotransferase, aspartate aminotransferase, total bilirubin ( z values: from -1.07 to 0.00, t values: from -0.77 to 1.76, all P>0.05). No grade Ⅲ/Ⅳ nephrotoxicity or salivary gland toxicity was observed. Conclusion:225Ac-PSMA-617 is a promising novel therapeutic option for mCRPC with favorable safety and tolerability.

Objective To explore the difference in efficacy between multiparametric MRI (Mp-MRI) based on prostate imaging reporting and data system version 2 (PI-RADS v2) and abbreviated biparametric MRI (Bp-MRI) in detecting prostate cancer (PCa) and clinically significant prostate cancer (csPCa), and to evaluate the consistency of image interpretation between different readers. Methods The imaging, pathological and clinical data of patients with prostatic Mp-MRI in our hospital from February 2015 to June 2018 were retrospectively analyzed. At the beginning, 250 patients were randomly selected. Two radiologists visually evaluated the images of those patients using two 5-point scoring schemes based on Mp-MRI and Bp-MRI. The remaining cases were independently proceeded by one of the radiologists using two schemes respectively. Weighted Kappa test was used to assess the consistency of the results interpreted by the two radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of the two scoring schemes in detecting PCa and csPCa, and with Z test to investigate whether there was any difference in detection efficiency between the two schemes. Results Nine hundred and seventy eight patients were eventually enrolled in the study. The results of the consistency assessment showed that there was good agreement between the two radiologists, whether using Mp-MRI or Bp-MRI, with the weighted Kappa coefficient of 0.800 and 0.812, respectively. The ROC curve analysis showed that the area under the curve (AUC) of PCa detected by Mp-MRI and Bp-MRI was 0.873 and 0.879, respectively, and the AUC of csPCa detected was 0.922 and 0.932, respectively. In addition, there was no statistically significant difference between the AUC of PCa and csPCa detected by the two schemes (P>0.05). Conclusion The Bp-MRI scoring scheme has good stability in the evaluation of benign and malignant prostate, and its detection efficiency of PCa or csPCa is not lower than that of standard Mp-MRI based on PI-RADS v2.

Objective To summarize the clinical data of macrophage activation syndrome (MAS) in adult-onset Still's disease (AOSD) patients and provide evidence for clinical diagnosis and treatment. Methods We retrospectively reviewed the clinical data of AOSD with MAS patients in the First Affiliated Hospital of Zhengzhou University from January 2012 to August 2018, and compared with patients with AOSD alone. Data were analyzed by t-test, Mann-Whitney U test, x2 test or Fisher exact test. Results A total of 14 AOSD with MAS patients were enrolled, accounting for 7.6％(14/185) of AOSD patients at the same period, including 2 males and 12 females. The median duration of AOSD in MAS was 1.3 (0.25, 4) months. Compared with the AOSD group, the age of onset was younger in the MAS group (t=-2.038, P=0.037), and the proportion of splenomegaly (t=9.020, P=0.003), pericardial effusion (t=8.663, P=0.003), pleural effusion (t=4.754, P=0.029) was higher. The white blood cell count (t=-4.171, P<0.01), hemoglobin level (t=-2.661, P=0.008), platelet count (t=-5.672, P<0.01), neutrophil count (t=-5.082, P<0.01), albumin (t=-3.426, P<0.01), fibrinogen (t=-5.986, P<0.01), ESR (t=-2.941, P=0.003), CRP (t=-2.014, P=0.044) was significantly decreased, ALT (t=-3.227, P<0.01), AST (t=-3.105, P=0.002), triglyceride (t=-5.612, P<0.01), ferritin>2000 μg/L (t=7.833, P=0.005) was significantly increased. Fourteen patients with AOSD complicated with MAS were treated with glucocorticosteroids, 5 with methylprednisolone, 8 with cyclosporine A, 8 with intravenous immunoglobulin (IVIG), 2 with etoposide, and 1 with tocilizumab. After treatment, 11 cases recovered and 3 cases died. Conclusion Younger AOSD patients tend to complicated with MAS, especially at the early course of the disease, and splenomegaly occur more frequently clinically compared to patients without MAS. When blood cell count, fibrinogen and ESR decreases, triglyceride and ferritin levels increases in AOSD patients, the occurrence of MAS is indicated. Timely treatment can improve the prognosis of patients.

Objective To detect the differences of triggering receptor expressed on myeloid cells-1 (TREM-1) and cyclo-oxygenase-2 (COX-2) expressions in rectal cancer tissues and carcinoma adjacent tissues so as to explore the relationship between the two factors and clinical pathological characteristics and their effects on the patients` survival.Methods The expressions of TREM-1 and COX-2 were analyzed in 68 cases of rectal cancer tissues and 58 cases of carcinoma adjacent tissues with the method of immunohistochemical staining.We made a regular follow-up of the patients, analyzed the relationship between the two factors and prognosis of rectal cancer.Results The positive expression rates of TREM-1 and COX-2 in rectal cancer tissues were higher than those in carcinoma adjacent tissues (P<0.05).The expression of TREM-1 was related to lymph node metastasis, while COX-2 was related to pathological stage and lymph node metastasis (P<0.05).However, the two factors were not related to age, sex, histological differentiation or tumor size.The expressions of the two factors were positively correlated (r=0.550, P<0.001).The overall survival (OS) of TREM-1 and COX-2 positive expression groups was shorter than that of the negative groups (P<0.05).Cox multiple regression analysis showed that the expression of TREM-1, pathological stage, lymph node metastasis and tumor size affected the prognosis.Conclusion The expressions of COX-2 and TREM-1 in rectal cancer increase, suggesting that the two factors may promote the development and lymph node metastasis of rectal cancer, and the expressions of the two factors are related to the patients` poor prognosis.

Objective To clarify the clinicopathological significance and the reversing effects of BTG3 expression on the aggressive phenotype in gastric cancer. Methods BTG3 expression was detected in gastric cancer tissues by on tissue microarray and immunostaining. BTG3?expressing plasmid was transfected into MKN28 and MGC803 cells,the proliferation,cell cycle,differentiation and autophagy were analyzed by CCK?8,PI staining,alkaline phosphatase activity and GFP?LC?3B transfection,respectively. Results BTG3 overexpression inhibited cell proliferation,in?duced S/G2 arrest,differentiation and autophagy in both cells(P<0.05). BTG3 expression was decreased in gastric cancer in comparison with the adjacent mucosa(P<0.05),and positively correlated with venous invasion and dedifferentiation of the cancers(P<0.05). Conclusion BTG3 ex?pression contributes to gastric carcinogenesis and subsequent progression. BTG3 overexpression can reverse the aggressive phenotypes,which could be employed as a potential target for gene therapy of gastric cancer.