1.Development of a dual-track predictive model for active ankylosing spondylitis by combining the sacroiliac joint resistance index and systemic immune-inflammation index
Yuhong OUYANG ; Jianxiong ZHENG ; Xing ZHANG ; Wenjiao KANG ; Qianqiong CHEN ; Haili SHEN
Chinese Journal of Rheumatology 2026;30(2):1-8
Objective:To construct a "local-systemic" dual-track prediction model integrating the resistance index (RI) score of bilateral sacroiliac joints and the systemic immune-inflammation index (SII), and to evaluate its predictive efficacy for the active stage of ankylosing spondylitis (AS).Methods:A total of 205 patients with ankylosing spondylitis (AS) from the Second Hospital of Lanzhou University between April 2022 and April 2025 were retrospectively enrolled and categorized into an active group ( n=113) and a remission group ( n=92). Hematological parameters and ultrasound data were collected. The resistance index (RI) of the synovial area in bilateral sacroiliac joints was measured by Doppler ultrasound and scored as follows: RI < 0.5: 3 points; RI 0.5~0.55: 2 points; RI > 0.55: 1 point; undetectable blood flow: 0 points. A total bilateral RI score (range 0 to 6) was calculated. The systemic immune-inflammation index (SII) was derived as (neutrophils× platelets)/lymphocytes. Normality was tested for all continuous variables; normally distributed data were compared using the t-test, while non-normally distributed data were analyzed with the Mann-Whitney U test. Categorical variables were compared using the χ2 test or analysis of variance.Variable selection was performed using Lasso regression, and a multivariate logistic regression model was developed to assess predictive performance. Results:The proportion of patients with a bilateral RI total score≥5 was significantly higher in the active group compared to the remission group (50 of 113, 44.3% vs 2 of 92, 2.2%, χ2=55.63, P<0.001). Multivariate logistic regression analysis, after adjustment for confounding variables, identified the SII [ OR(95% CI)=1.01(1.00, 1.01), P<0.001], bilateral RI total score [ OR(95% CI)=1.67(1.29, 2.26), P<0.001], erythrocyte sedimentation rate [ OR(95% CI)=1.19(1.11, 1.30), P<0.001], and mean corpuscular hemoglobin concentration [ OR(95% CI)=1.09(1.03, 1.17), P<0.001] as independent risk factors for active AS. Conversely, lymphocyte count [ OR(95% CI)=0.42(0.18, 0.92), P=0.030] and globulin [ OR(95% CI)=0.89(0.80, 0.99), P=0.040] were significantly associated with protective effects. The bilateral RI total score demonstrated the strongest predictive effect, with each 1-point increase associated with a 67% elevation in the risk of active disease. ROC curve analysis indicated that the area under the curve (AUC) for predicting whether AS is in the active disease phase was 0.94 for the combined model (SII+bilateral RI total score), compared with 0.93 for the SII-alone model and 0.92 for the bilateral RI total score-alone model, demonstrating superior predictive performance of the combined model (SII+bilateral RI total score). An online prediction tool has been developed based on the combined model. Conclusion:The dual-track prediction model, which integrates local joint hemodynamic characteristics and systemic immune-inflammatory status, facilitates a multidimensional assessment of the risk of active AS and provides an objective basis for early identification.
2.Development of a dual-track predictive model for active ankylosing spondylitis by combining the sacroiliac joint resistance index and systemic immune-inflammation index
Yuhong OUYANG ; Jianxiong ZHENG ; Xing ZHANG ; Wenjiao KANG ; Qianqiong CHEN ; Haili SHEN
Chinese Journal of Rheumatology 2026;30(2):1-8
Objective:To construct a "local-systemic" dual-track prediction model integrating the resistance index (RI) score of bilateral sacroiliac joints and the systemic immune-inflammation index (SII), and to evaluate its predictive efficacy for the active stage of ankylosing spondylitis (AS).Methods:A total of 205 patients with ankylosing spondylitis (AS) from the Second Hospital of Lanzhou University between April 2022 and April 2025 were retrospectively enrolled and categorized into an active group ( n=113) and a remission group ( n=92). Hematological parameters and ultrasound data were collected. The resistance index (RI) of the synovial area in bilateral sacroiliac joints was measured by Doppler ultrasound and scored as follows: RI < 0.5: 3 points; RI 0.5~0.55: 2 points; RI > 0.55: 1 point; undetectable blood flow: 0 points. A total bilateral RI score (range 0 to 6) was calculated. The systemic immune-inflammation index (SII) was derived as (neutrophils× platelets)/lymphocytes. Normality was tested for all continuous variables; normally distributed data were compared using the t-test, while non-normally distributed data were analyzed with the Mann-Whitney U test. Categorical variables were compared using the χ2 test or analysis of variance.Variable selection was performed using Lasso regression, and a multivariate logistic regression model was developed to assess predictive performance. Results:The proportion of patients with a bilateral RI total score≥5 was significantly higher in the active group compared to the remission group (50 of 113, 44.3% vs 2 of 92, 2.2%, χ2=55.63, P<0.001). Multivariate logistic regression analysis, after adjustment for confounding variables, identified the SII [ OR(95% CI)=1.01(1.00, 1.01), P<0.001], bilateral RI total score [ OR(95% CI)=1.67(1.29, 2.26), P<0.001], erythrocyte sedimentation rate [ OR(95% CI)=1.19(1.11, 1.30), P<0.001], and mean corpuscular hemoglobin concentration [ OR(95% CI)=1.09(1.03, 1.17), P<0.001] as independent risk factors for active AS. Conversely, lymphocyte count [ OR(95% CI)=0.42(0.18, 0.92), P=0.030] and globulin [ OR(95% CI)=0.89(0.80, 0.99), P=0.040] were significantly associated with protective effects. The bilateral RI total score demonstrated the strongest predictive effect, with each 1-point increase associated with a 67% elevation in the risk of active disease. ROC curve analysis indicated that the area under the curve (AUC) for predicting whether AS is in the active disease phase was 0.94 for the combined model (SII+bilateral RI total score), compared with 0.93 for the SII-alone model and 0.92 for the bilateral RI total score-alone model, demonstrating superior predictive performance of the combined model (SII+bilateral RI total score). An online prediction tool has been developed based on the combined model. Conclusion:The dual-track prediction model, which integrates local joint hemodynamic characteristics and systemic immune-inflammatory status, facilitates a multidimensional assessment of the risk of active AS and provides an objective basis for early identification.
3.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
4.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
5.Association between insulin resistance and cardiovascular metabolic indicators in middle-aged adults
Rui TIAN ; Jie ZHANG ; Ting ZHENG ; Aixia ZHANG ; Xing LIU ; Hao KANG ; Qingfang DENG ; Sufang WANG
Acta Universitatis Medicinalis Anhui 2026;61(7):1305-1310
ObjectiveTo investigate the association between insulin resistance (IR) and cardiovascular metabolic indicators, including blood pressure, blood lipids, and serum uric acid, in a middle-aged population. MethodsBased on the baseline survey of the Hong Sifang cohort of China National Salt Industry Group, a total of 575 participants were included. According to the homeostasis model assessment of insulin resistance, the participants were divided into an IR group (n=116) and a non-IR group (n=459). Differences between the two groups were compared using the t-test and chi-square test. Multivariate logistic regression analysis was performed to evaluate the associations between IR and abnormalities in metabolic indicators. ResultsA total of 575 participants were included, including 390 men and 185 women, with a mean age of (48.58 ± 5.14) years and a mean body mass index (BMI) of (24.16 ± 2.97) kg/m². Blood pressure, serum uric acid, and blood lipid levels were significantly higher in the IR group than in the non-IR group (P<0.001). After adjusting for potential confounders including age, sex, and BMI, IR was independently associated with hypertension, dyslipidemia, and hyperuricemia, with odds ratios (OR) and 95% confidence intervals (CI) of 2.57 (1.61-4.09), 3.81 (2.36-6.17), and 2.68 (1.53-4.71), respectively (all P<0.001). ConclusionInsulin resistance is significantly associated with multiple cardiovascular metabolic risk factors in the middle-aged population. Monitoring IR may contribute to the early prevention and control of cardiovascular diseases.
6.Toosendanin inhibits the malignant biological behaviors of esophageal squamous cell carcinoma KYSE150 cells by downregulating HIF1A expression via the AKT/mTOR pathway
Yueming CHU ; Maofei ZHU ; Hangyu JIANG ; Qiang YUAN ; Xing LI ; Kang LIU ; Lin LI
Chinese Journal of Cancer Biotherapy 2025;32(7):723-730
Objective:To investigate the effects of toosendanin(TSN)on the proliferation,apoptosis,migration and invasion of esophageal squamous cell carcinoma(ESCC)KYSE150 cells,and to elucidate its underlying molecular mechanisms.Methods:CCK-8 assay,colony formation assay,and EdU assay were used to assess the effects of varying TSN concentrations(0.062 5,0.125,and 0.25 μmol/L)on KYSE150 cell proliferation.The impacts of TSN on the apoptosis,migration,and invasion of KYSE150 cells were evaluated using flow cytometry,wound healing assay,and Transwell chamber assay,respectively.The expression of hypoxia-inducible factor 1 alpha(HIF1A)in esophageal cancer tissues was analyzed using the GEPIA database.qPCR was used to detect the expression level of HIF1A mRNA in human esophageal epithelial Het-1A and KYSE150 cells,and in TSN-treated KYSE150 cells.Western blot(WB)was performed to detect the effects of TSN on the upstream signaling pathway AKT/mTOR of HIF1A and the expression of downstream proteins related to cell migration,invasion,and apoptosis.Results:TSN of varying concentrations significantly inhibited proliferation,migration,and invasion of KYSE150 cells and promoted apoptosis in a dose-dependent manner(P<0.05 or P<0.01).HIF1A mRNA was highly expressed in KYSE150 cells,and its expression was significantly downregulated after TSN treatment(P<0.05 or P<0.01).TSN markedly downregulated the expression of HIF1A and key upstream signaling proteins p-AKT and p-mTOR.In addition,TSN significantly suppressed the expression of downstream proteins associated with cell migration,invasion,and apoptosis,including N-cadherin,vimentin,Bcl-2,and caspase-3,while upregulating the expression of E-cadherin(P<0.05 or P<0.01).Conclusion:TSN inhibits the proliferation,migration,and invasion,and induces apoptosis in ESCC KYSE150 cells by down-regulating HIF1A expression through suppression of the AKT/mTOR signaling pathway.
7.Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion
Yin HU ; Hai-long YU ; Hong-wen GU ; Kang-en HAN ; Shi-lei TANG ; Yuan-hang ZHAO ; Zhi-hao ZHANG ; Jun-chao LI ; Le XING ; Hong-wei WANG
Journal of Regional Anatomy and Operative Surgery 2025;34(11):981-986
Objective To analyze the risk factors for increased drainage volume after open transforaminal lumbar interbody fusion(TLIF),and to establish a predictive model and then validate it.Methods The clinical data of 680 patients who underwent open TLIF at the General Hospital of Northern Theater Command from January 2016 to December 2019 were collected and the patients were randomly divided into the training group(n=476)and the validation group(n=204).Taking the predictive factors screened out by LASSO regression analysis as independent variables,a multivariate Logistic regression predictive model was constructed.The model was internally validated through the receiver operating characteristic(ROC)curve,Hosmer-Lemeshow goodness-of-fit test,and calibration curve,and its clinical utility was assessed via decision curve analysis(DCA).Results LASSO regression analysis screened out four predictive variables:age,number of surgical segments,operative duration,and intraoperative blood loss.The multivariate Logistic regression predictive model demonstrated that age≥60 years,number of surgical segments≥4,operative duration≥2 hours,and intraoperative blood loss≥200 mL were independent influencing factors for the increased postoperative drainage volume in patients undergoing TLIF(P<0.05).ROC curve analysis revealed an area under the curve(AUC)of 0.816(95%CI:0.798 to 0.867)in the training group and 0.783(95%CI:0.685 to 0.823)in the validation group,indicating that the predictive model had good discriminatory ability.Additionally,the Hosmer-Lemeshow goodness-of-fit test and calibration curve indicated that the predictive model had a good degree of fit,and the predicted probability was basically consistent with the actual probability,demonstrating a good calibration.The DCA results confirmed that this predictive model could be applied in clinical practice.Conclusion The risk factors for increased drainage volume after open TLIF include age,number of surgical segments,operative duration,and intraoperative blood loss.The predictive model established based on these factors demonstrates good performance,and it can be applied in clinical guidance for the selection of drainage tube removal time after TLIF.
8.A study of morphological structure of upper airway and temporomandibular joint
Xing QIAO ; Shilong ZHANG ; Yiyuan GE ; Dechao ZHU ; Wenjing KANG ; Jie LIU ; Pengyuan LUO ; Haiyan LU
Journal of Practical Stomatology 2025;41(5):651-655
Objective:To clarify the morphological relationship between the upper airway and TMJ in patients with normal-angle skeletal Ⅱ and skeletal Ⅰ malocclusion.Methods:30 skeletal class Ⅰ and 22 skeletal class Ⅱ patients with normal-angle were included.CBCT examination was performed,and Mimics 21.0 software was used to conduct 3D reconstruction and measurements of the samples.Data was analyzed by using independent t-test and the Pearson correlation test.Results:12 measurements,including the sagittal diameter of nasopharyngeal segment,the sagittal,coronal diameter,minimum cross-sectional area,the volume of palato-pharyngeal segment and glossopharyngeum segment,the total volume of upper airway,posterior oblique slope of the articular eminence and the length of the condylar showed significant differences between skeletal Ⅱ and skeletal Ⅰ subjects with normal-angle(P<0.05).The posterior oblique slope of the articular eminence showed a positive correlation with the sagittal diameter of the palatopharyngeal segment,volume and minimum cross-sectional area of glossopharyngeum lingual segment(P<0.05).The liner ratio showed a negative correction with the coronal diameter of palatopharyngeal and glossapharyngeal segment as well as minimum cross-section area of glos-sapharyngeal segment(P<0.05).Conclusion:The structure of upper airway is correlated with that of TMJ.Differences in the upper airway are statistically significant between skeletal Ⅱ and skeletal Ⅰ malocclusion with normal-angle(P<0.05).
9.Assembly of Protein Nanopore in Microfluidic Tube and Its Application in Single-Molecule Analysis
Peng ZHENG ; Xin-Yu SHI ; Xing-Peng WEI ; Xiao-Feng KANG
Chinese Journal of Analytical Chemistry 2025;53(7):1090-1096
As the simplest label-free single-molecule analytical technique in solution,nanopore technology has been widely used in rapid sequencing of protein and nucleic acid,and single-molecule sensing.However,the main challenge is to get this technology out of the lab and achieve automation,miniaturization as well as rapid analysis at high throughput.In this work,a new microfluidic tubing protein nanopore analysis system was designed and constructed by combining microfluidic and nanopore nanofluidic analysis techniques.An arcuate lipid bilayer was formed in the microfluidic device through lipid monolayer at the oil/water interface by developed aperture processing technology at 10 μm level.The arcuate lipid bilayer with the life span of more than 98 h had high biomimetic fluidity and biological activity by which protein channel could be produced and sealed at 18 GΩ level without leakage.When applied+40 mV potential,relative standard deviation of single proteinα-hemolysin mutant(α-HL(M113F/K147N))channel current was less than 0.16 pA(n=3)in 10 mmol/L Tris-HCl(pH 7.4)buffer containing 1 mol/L NaCl.Single-molecule detection for aptamer and its host-guest interactions with biotin in protein channel demonstrated that this microfluidic tube protein nanopore sensor could well work with high sensitivity without the need of anti-vibration table and shielding cage.
10.DWI and PWI in Differential Diagnosis Between Supratentorial Pilocytic Astrocytoma and WHO Grade 2 Pleomorphic Xanthoastrocytoma
Yaqing KANG ; Xiefeng YANG ; Xiaodan CHEN ; Zhen XING
Chinese Journal of Medical Imaging 2025;33(9):967-973,992
Purpose To investigate the differential diagnosis of diffusion-weighted imaging(DWI),perfusion-weighted imaging(PWI)and DWI combined with PWI in supratentorial pilocytic astrocytoma(PA)and WHO grade 2 pleomorphic xanthoastrocytoma(PXA).Materials and Methods The conventional MRI,DWI and PWI data of 23 cases of supratentorial PA and 11 cases of PXA(WHO grade 2)in the First Affiliated Hospital of Fujian Medical University from January 2010 to February 2022 were retrospectively analyzed.Supratentorial PA was further divided into lobar PA and non-lobar PA based on the lesion location.The basic data(gender,age,cystic degeneration,homogeneous enhancement,lesion size and meningeal involvement),minimum apparent diffusion coefficient,relative apparent diffusion coefficient and relative maximum cerebral blood volume were compared and analyzed between the two groups.Results The probability of leptomeningeal involvement in PXA(WHO grade 2)(36.3%)was higher than that in supratentorial PA(4.3%,P=0.029).Compared with supratentorial PA and lobar PA,PXA(WHO grade 2)had lower minimum apparent diffusion coefficient,relative apparent diffusion coefficient and higher relative maximum cerebral blood volume(t=-4.398-5.828,all P<0.05).The threshold value of minimum apparent diffusion coefficient to discriminate between supratentorial PA and PXA(WHO grade 2)was 1.09×10-3 mm2/s,and its sensitivity,specificity and area under the curve were 90.91%,83.33%and 0.947,respectively.When the differential diagnosis threshold of relative maximum cerebral blood volume was 1.79,its sensitivity,specificity and area under the curve were 90.00%,100.00%and 0.950,respectively.The area under the curve of DWI combined with PWI was 0.993,which did not significantly improve the diagnostic performance compared with DWI and PWI respectively(Z=1.371,0.928,both P>0.05).In subgroup analysis,the area under the curve of DWI combined with PWI in lobar PA and PXA(WHO grade 2)was 0.988,which did not improve the diagnostic performance compared with DWI and PWI respectively(Z=1.322,0.882,both P>0.05).Conclusion DWI and PWI are helpful in the differential diagnosis of PXA(WHO grade 2)from supratentorial PA and lobar PA,but combining DWI and PWI does not significantly improve the efficacy of differential diagnosis.

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