ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndromes in intrahepatic cholestasis of pregnancy （ICP） and its association with perinatal outcomes， and to provide a basis for precise treatment based on TCM syndrome differentiation. MethodsA cross-sectional study was conducted among 275 patients with ICP who were admitted to The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from April 2023 to April 2025. A hierarchical cluster analysis was used to summarize TCM syndromes. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. A multivariate Logistic regression analysis was used to identify the clinical features significantly associated with TCM syndrome. ResultsThe cluster analysis identified three core TCM syndromes among the 275 patients with ICP， i.e.， liver-gallbladder damp-heat syndrome （45.8%）， syndrome of blood deficiency generating wind （30.9%）， and liver depression and spleen deficiency syndrome （23.3%）. There was a significant difference in the distribution of TCM syndromes between different groups stratified by maternal age at delivery， parity， history of ICP recurrence， gestational weeks at disease onset， total bile acid （TBA）， alanine aminotransferase （ALT）， and comorbidity with gestational diabetes mellitus （GDM） （all P<0.05）. The multivariate Logistic regression analysis showed that<34 gestational weeks at disease onset was significantly associated with all three syndromes （damp-heat： odds ratio ［OR］=3.769， P<0.001； blood deficiency： OR=4.031， P<0.001； liver stagnation： OR=3.552， P<0.001）. Liver-gallbladder damp-heat syndrome was associated with maternal age ≥35 years at disease onset （OR=2.048， P=0.014）， parity ≥2 times （OR=1.921， P=0.034）， history of ICP recurrence （OR=2.404， P=0.030）， ALT ≥200 U/L （OR=2.051， P=0.018）， comorbidity with GDM （OR=1.944， P=0.029）， and TBA ≥40 μmol/L （OR=2.542， P=0.024）. The syndrome of blood deficiency generating wind syndrome was associated with maternal age ≥35 years （OR=2.939， P=0.003）， parity ≥2 time （OR=3.222， P=0.003）， history of ICP recurrence （OR=3.809， P=0.010）， ALT ≥200 U/L （OR=2.889， P=0.006）， comorbidity with GDM （OR=3.711， P=0.001）， and comorbidity with hypertensive disorders of pregnancy （OR=4.472， P=0.011）. Liver depression and spleen deficiency syndrome was associated with TBA ≥40 μmol/L （OR=2.995， P=0.044）. The analysis of perinatal outcomes showed that there were significant differences in mode of delivery， gestational weeks at the time of delivery， postpartum blood loss， and neonatal birth weight between the three groups with different TCM syndromes （all P<0.05）. ConclusionLiver-gallbladder damp-heat syndrome， syndrome of blood deficiency generating wind， and liver depression and spleen deficiency syndrome are the main TCM syndrome types in ICP， and the distribution of TCM syndromes is closely associated with clinical factors and perinatal outcomes， which provides a basis for precise TCM syndrome differentiation and individualized treatment.

Objective:To investigate alterations in static regional homogeneity(ReHo) and dynamic regional homogeneity (dReHo) and glucose metabolism in MRI-negative refractory temporal lobe epilepsy (TLE) patients using resting-state PET-MRI, and to evaluate their efficacy in predicting surgical outcomes.Methods:This study was a cross-sectional design. A retrospective analysis was conducted on the clinical and imaging data of 30 patients with MRI-negative refractory TLE (patient group) treated at Xuanwu Hospital, Capital Medical University, between 2016 and 2020, and data from 30 healthy controls (control group). All MRI-negative refractory TLE patients underwent surgical treatment and were further divided into a good prognosis subgroup (Engel Class I, 16 cases) and a poor prognosis subgroup (Engel Class Ⅱ-Ⅳ, 14 cases) based on postoperative Engel classification. Analysis of variance was used to compare differences in static ReHo, dReHo, and glucose metabolism(SUVR) among the three groups. The correlation of static ReHo, dReHo, and SUVR values of differential brain regions with Engel grading was analyzed using Spearman. A support vector machine (SVM) model was constructed using the static ReHo, dReHo, and SUVR values from these differential regions to classify and predict patient prognosis. The predictive performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC).Results:Differential dReHo regions among the good prognosis subgroup, poor prognosis subgroup, and control group were located in the right lateral middle temporal gyrus temporal pole, the right fusiform gyrus, the right insula subfrontal gyrus, the left cuneate lobe, the right medial and paracortical cingulate gyrus, and the right supraparietal gyrus; the differential static ReHo regions were primarily found in the bilateral inferior temporal gyrus, the supraparietal gyrus, and the right subfrontal gyrus, the left medial supraparietal gyrus, the left median frontal gyrus, and the right marginal supraparietal gyrus; SUVR differences were in the affected superior, middle and inferior temporal lobes, the internal olfactory cortex and the temporal pole region. dReHo of right middle temporal gyrus temporal pole in patients with MRI-negative TLE showed a positive correlation with Engel classification ( r=0.421, P=0.020). The SVM model based on dReHo combined with SUVR values classified patients with good and poor prognosis with an AUC of 0.825 and an accuracy of 73.3%. Conclusions:In MRI-negative refractory TLE patients, abnormal dReHo regions are predominantly located in the contralateral default mode network areas and are associated with Engel classification. Combined with glucose metabolism values, dReHo can predict postoperative outcomes in MRI-negative TLE patients.

Gastroblastoma (GB) is a rare gastric epithelial tumor without special clinical manifestations, whose histologic origin and pathogenesis remain unclear due to less related reports.Low-grade cell forms with biphasic differentiation are typical histological characteristics of GB.Immunohistochemistry and molecular tests can help with its differential diagnosis.GB is an invasive low-grade malignant tumor and the first treatment is surgical resection.However, there is no uniform standard treatment plan at present and most patients have a good prognosis.In this article, the histopathology, diagnosis and identification diagnosis of GB was reviewed to provide a theoretical basis for its origin, development, treatment and patient prognosis.

Objective To explore the value of 18F-flortaucipir tau PET combined with APOE ε4 genotype status for diagnosing mild cognitive impairment(MCI).Methods A total of 213 MCI patients(MCI group)and 402 healthy controls(HC group)were selected from Alzheimer's disease neuroimaging initiative(ADNI)database.The neuropsychological information,APOE ε4 gene carrier status,tau PET and high-resolution structural MRI data were recorded.The random forest algorithm was used to screen the most informative brain regions of tau PET for diagnosing MCI,and the efficacy of tau PET for distinguishing MCI with or without APOE ε4 gene and HC were compared.Results Amygdala,parahippocampal gyrus,entorhinal cortex,posterior cingulate gyrus,inferior temporal gyrus,fusiform gyrus and middle temporal gyrus in turn were the important brain regions of tau PET for diagnosing MCI.The accuracy and the area under the curve(AUC)of tau PET standardized uptake value ratio(SUVR)model for identifying MCI with APOE ε4 gene and HC was 86.68％and 0.784,respectively,both higher than those for identifying MCI and HC,as well as MCI without APOE e4 gene and HC(with accuracy of 70.57％and 75.05％,and AUC of 0.711 and 0.609).Conclusion 18F-flortaucipir tau PET SUVR model established based on amygdala,parahippocampal gyrus,entorhinal cortex,posterior cingulate gyrus,inferior temporal gyrus,fusiform gyrus and middle temporal gyrus could be used to diagnosing MCI.Combining with APOE ε4 gene could further improve its efficacy.

Objective To explore the value of 18F-flortaucipir tau PET combined with APOE ε4 genotype status for diagnosing mild cognitive impairment(MCI).Methods A total of 213 MCI patients(MCI group)and 402 healthy controls(HC group)were selected from Alzheimer's disease neuroimaging initiative(ADNI)database.The neuropsychological information,APOE ε4 gene carrier status,tau PET and high-resolution structural MRI data were recorded.The random forest algorithm was used to screen the most informative brain regions of tau PET for diagnosing MCI,and the efficacy of tau PET for distinguishing MCI with or without APOE ε4 gene and HC were compared.Results Amygdala,parahippocampal gyrus,entorhinal cortex,posterior cingulate gyrus,inferior temporal gyrus,fusiform gyrus and middle temporal gyrus in turn were the important brain regions of tau PET for diagnosing MCI.The accuracy and the area under the curve(AUC)of tau PET standardized uptake value ratio(SUVR)model for identifying MCI with APOE ε4 gene and HC was 86.68％and 0.784,respectively,both higher than those for identifying MCI and HC,as well as MCI without APOE e4 gene and HC(with accuracy of 70.57％and 75.05％,and AUC of 0.711 and 0.609).Conclusion 18F-flortaucipir tau PET SUVR model established based on amygdala,parahippocampal gyrus,entorhinal cortex,posterior cingulate gyrus,inferior temporal gyrus,fusiform gyrus and middle temporal gyrus could be used to diagnosing MCI.Combining with APOE ε4 gene could further improve its efficacy.

Gastroblastoma (GB) is a rare gastric epithelial tumor without special clinical manifestations, whose histologic origin and pathogenesis remain unclear due to less related reports.Low-grade cell forms with biphasic differentiation are typical histological characteristics of GB.Immunohistochemistry and molecular tests can help with its differential diagnosis.GB is an invasive low-grade malignant tumor and the first treatment is surgical resection.However, there is no uniform standard treatment plan at present and most patients have a good prognosis.In this article, the histopathology, diagnosis and identification diagnosis of GB was reviewed to provide a theoretical basis for its origin, development, treatment and patient prognosis.

Objective:To investigate alterations in static regional homogeneity(ReHo) and dynamic regional homogeneity (dReHo) and glucose metabolism in MRI-negative refractory temporal lobe epilepsy (TLE) patients using resting-state PET-MRI, and to evaluate their efficacy in predicting surgical outcomes.Methods:This study was a cross-sectional design. A retrospective analysis was conducted on the clinical and imaging data of 30 patients with MRI-negative refractory TLE (patient group) treated at Xuanwu Hospital, Capital Medical University, between 2016 and 2020, and data from 30 healthy controls (control group). All MRI-negative refractory TLE patients underwent surgical treatment and were further divided into a good prognosis subgroup (Engel Class I, 16 cases) and a poor prognosis subgroup (Engel Class Ⅱ-Ⅳ, 14 cases) based on postoperative Engel classification. Analysis of variance was used to compare differences in static ReHo, dReHo, and glucose metabolism(SUVR) among the three groups. The correlation of static ReHo, dReHo, and SUVR values of differential brain regions with Engel grading was analyzed using Spearman. A support vector machine (SVM) model was constructed using the static ReHo, dReHo, and SUVR values from these differential regions to classify and predict patient prognosis. The predictive performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC).Results:Differential dReHo regions among the good prognosis subgroup, poor prognosis subgroup, and control group were located in the right lateral middle temporal gyrus temporal pole, the right fusiform gyrus, the right insula subfrontal gyrus, the left cuneate lobe, the right medial and paracortical cingulate gyrus, and the right supraparietal gyrus; the differential static ReHo regions were primarily found in the bilateral inferior temporal gyrus, the supraparietal gyrus, and the right subfrontal gyrus, the left medial supraparietal gyrus, the left median frontal gyrus, and the right marginal supraparietal gyrus; SUVR differences were in the affected superior, middle and inferior temporal lobes, the internal olfactory cortex and the temporal pole region. dReHo of right middle temporal gyrus temporal pole in patients with MRI-negative TLE showed a positive correlation with Engel classification ( r=0.421, P=0.020). The SVM model based on dReHo combined with SUVR values classified patients with good and poor prognosis with an AUC of 0.825 and an accuracy of 73.3%. Conclusions:In MRI-negative refractory TLE patients, abnormal dReHo regions are predominantly located in the contralateral default mode network areas and are associated with Engel classification. Combined with glucose metabolism values, dReHo can predict postoperative outcomes in MRI-negative TLE patients.

Objective:To evaluate the value of time-of-flight (TOF) combined with point spread function (PSF) reconstruction for the improvement of brain PET images and lesion localization in patients with temporal lobe epilepsy (TLE).Methods:A retrospective collection of brain 18F-FDG PET imaging data of 52 hospitalized patients with TLE (30 males, 22 females, age: (26.7±7.1) years) and 26 healthy volunteers (14 males, 12 females, age: ( 31.7±6.8) years) from Xuanwu Hospital between 2017 and 2019 was conducted. Images were reconstructed and divided into 4 groups based on different algorithms: ordered subset expectation maximization (OSEM), OSEM+ TOF, OSEM+ PSF, and OSEM+ TOF+ PSF. The image quality, clarity, noise, and the clarity of lesion display of all subjects were visually analyzed using a four-point scale. The signal-to-noise ratio (SNR), contrast, and asymmetry index (AI) of the lesions were calculated. Differences in visual scores, SNR, contrast, and AI among the 4 groups were analyzed using one-way analysis of variance. The ROC curve was used to analyze the efficiency of PET images in localization of epileptogenic foci. Results:The visual score of OSEM+ TOF+ PSF group was the highest (4.0±0.0) among healthy volunteers; compared with OSEM group, OSEM+ TOF+ PSF group showed lower SNR (decreased by 46.6%; the lower the SNR value, the better the image quality) and contrast (increased by 29.8%). Visual assessment of PET images of patients with TLE showed that the scores of OSEM+ TOF+ PSF group , OSEM+ PSF group , OSEM+ TOF group and OSEM group were decreased in order (4.0±0.0 vs 3.4±0.5 vs 2.3±0.4 vs 1.0±0.0; F=884.0, P<0.001); SNRs of those 4 groups were increased in order ((5.2±2.4)% vs (6.2±2.4)% vs (7.9±2.6)% vs (8.9±3.5)%; F=18.82, P<0.001). The contrast and AI of the lesions in 4 groups were as follows: OSEM+ TOF+ PSF (contrast: 0.81±0.03; AI: 0.28±0.05) > OSEM+ TOF (0.74±0.05; 0.23±0.06) > OSEM+ PSF (0.72±0.06; 0.22±0.07) > OSEM (0.64±0.05; 0.19±0.06) ( F values: 107.10, 19.94, both P<0.001). MRI found unilateral hippocampal sclerosis in 32 patients, and the rest 20 patients with TLE were MRI-negative. ROC curve analysis showed that visual analysis and SUV ratio (SUVR) of lesion/contralateral ROI based on OSEM+ TOF+ PSF PET image could localize epileptogenic foci efficiently, with AUC of 0.874 in MRI-positive patients, and AUC of 0.932 in MRI-negative patients. Conclusions:The application of TOF and PSF significantly improves the quality of PET images. The combined use of both techniques yields the best results and aids in the localization of epileptogenic foci in patients with TLE.

AIM:To investigate the effect of a disintegrin and metalloproteinase(ADAM)domain-like decy-sin 1(ADAMDEC1)knockdown on the proliferation,migration and invasion of pancreatic carcinoma cells.METHODS:Expression levels of ADAMDEC1 in pancreatic carcinoma tissues were analyzed using the GEPIA and UALCAN online da-tabases.Western blot analysis was employed to detect the protein expression levels of ADAMDEC1 in pancreatic carcino-ma cell lines(MIA PaCa-2 and PANC-1)and pancreatic ductal cell line(hTERT-HPNE).The effects of ADAMDEC1 knockdown on cell proliferation,migration and invasion were evaluated using CCK-8,colony formation,wound-healing and Transwell assays.Additionally,Western blot analysis was used to detect the effects of ADAMDEC1 knockdown on the expression levels of migration and invasion markers,as well as Wnt/β-catenin signaling pathway-related proteins in pancre-atic carcinoma cells.Furthermore,a recovery experiment was conducted to assess the role of Wnt/β-catenin signaling path-way agonist CHIR-99021 in ADAMDEC1 knockdown-induced inhibition of pancreatic carcinoma cell growth and migra-tion.RESULTS:(1)ADAMDEC1 was highly expressed in pancreatic carcinoma cells.(2)Knockdown of ADAMDEC1 led to a significant reduction in the proliferation,migration and invasion of pancreatic carcinoma cells.(3)Knockdown of ADAMDEC1 resulted in increased E-cadherin protein expression and decreased levels of matrix metalloproteinase 9,N-cadherin and vimentin proteins,alongside a reduction in the expression of Wnt/β-catenin signaling pathway-related pro-teins.(4)Co-treatment of pancreatic carcinoma cells with CHIR-99021 and ADAMDEC1 small interfering RNA reversed the inhibitory effects of ADAMDEC1 knockdown on cell proliferation,migration,and invasion.CONCLUSION:ADAMDEC1 is highly expressed in pancreatic carcinoma.Targeted silencing of ADAMDEC1 has the potential to inhibit the prolifera-tion,migration and invasion of pancreatic carcinoma cells by regulating the Wnt/β-catenin signaling pathway.

Objective To explore the main factors affecting the MV imager projection offset in the machine performance check(MPC)for Varian Vital Beam linear accelerator.Methods The MV imager projection offsets in the MPC after repairing the MV imaging arm encoder of shoulder motor,locking the treatment couch,and isocenter calibration were analyzed.Results MPC results revealed that the MV imager projection offset after repairing the MV imaging arm encoder of shoulder motor was(0.310±0.001)mm,significantly less than(0.450±0.010)mm in the blank group.The difference in MV imager projection offset between the isocenter calibration group and the blank group was trivial.The MV imager projection offset after locking the treatment couch was(0.240±0.030)mm,significantly less than(0.450±0.010)mm in the blank group.When MPC was carried out after repairing the imaging arm encoder and performing isocenter calibration,there was no significant statistical difference in MV imager center offset between the locked and unlocked treatment couch.Conclusion The damage of MV imaging arm encoder of shoulder motor is the main factor causing abnormal MV imager projection offsets.Locking the treatment couch before the MV imaging center check can reduce the results,but it cannot eliminate the MV imager projection offset.