1.The Predictive Value of Dual-layer Spectral Detector CT Parameters on Lymph Node Metastasis of Nonfunctional Pancreatic Neuroendocrine Tumor
Mingjie CHEN ; Ke LI ; Jiadan LUO ; Jiayi YANG ; Huasong CAI ; Shiting FENG ; Yanji LUO ; Siya SHI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):868-879
ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT (DLCT) parameters in predicting lymph node metastasis (LNM) of non-functional pancreatic neuroendocrine neoplasms (NF-pNENs). MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest (ROIs) were manually delineated on three representative slices of the solid component of the lesion, and the mean values were recorded. Conventional CT parameters, monochromatic energy images (40 keV, 70 keV, 100 keV), iodine concentration maps, and effective atomic number (Zeff) maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters, including clinical characteristics, imaging features, conventional CT and DLCT quantitative parameters, were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC) curves were generated for each predictive model, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled, including 37 males and 45 females, with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression, LASSO regression and multivariate stepwise logistic regression analyses, body mass index (BMI), organ invasion, normalized CT value in the portal venous phase (nCTv) and normalized iodine concentration in the portal venous phase (nICv) were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model (BMI+organ invasion), conventional CT model (nCTv), DLCT model (nICv) and comprehensive model (organ invasion+nICv) were 0.815 (0.719, 0.910), 0.750 (0.642, 0.858), 0.829 (0.733, 0.925) and 0.865 (0.879, 0.953), respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs, enabling non-invasive preoperative prediction and assisting clinical decision-making.
2.The Predictive Value of Dual-layer Spectral Detector CT Parameters on Lymph Node Metastasis of Nonfunctional Pancreatic Neuroendocrine Tumor
Mingjie CHEN ; Ke LI ; Jiadan LUO ; Jiayi YANG ; Huasong CAI ; Shiting FENG ; Yanji LUO ; Siya SHI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):868-879
ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT (DLCT) parameters in predicting lymph node metastasis (LNM) of non-functional pancreatic neuroendocrine neoplasms (NF-pNENs). MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest (ROIs) were manually delineated on three representative slices of the solid component of the lesion, and the mean values were recorded. Conventional CT parameters, monochromatic energy images (40 keV, 70 keV, 100 keV), iodine concentration maps, and effective atomic number (Zeff) maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters, including clinical characteristics, imaging features, conventional CT and DLCT quantitative parameters, were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC) curves were generated for each predictive model, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled, including 37 males and 45 females, with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression, LASSO regression and multivariate stepwise logistic regression analyses, body mass index (BMI), organ invasion, normalized CT value in the portal venous phase (nCTv) and normalized iodine concentration in the portal venous phase (nICv) were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model (BMI+organ invasion), conventional CT model (nCTv), DLCT model (nICv) and comprehensive model (organ invasion+nICv) were 0.815 (0.719, 0.910), 0.750 (0.642, 0.858), 0.829 (0.733, 0.925) and 0.865 (0.879, 0.953), respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs, enabling non-invasive preoperative prediction and assisting clinical decision-making.
3.Relationship between the Platelet Autophagy-related Factor Expression and Peritoneal Metastasis of Gastric Cancer
Xiaoxiao FAN ; Xuan ZENG ; Pingping ZHOU ; Xi LIU ; Feifei ZHU ; Yanji LUO ; Yi WU
Journal of Kunming Medical University 2025;46(7):125-130
Objective To investigate the relationship between the expression of platelet autophagy related factors and peritoneal metastasis of gastric cancer.Methods The data of 360 patients with gastric cancer who underwent surgery in Hunan Provincial People's Hospital from January 2021 to May 2023 were reviewed.Patients were divided into non-peritoneal metastasis group(n=322)and peritoneal metastasis group(n=38)according to whether peritoneal metastasis occurred or not.The following information was collected:patient's personal information(i.e.age,sex,body mass index)and tumor characteristics(i.e.location,size,pathological type,histopathological differentiation,lymphatic infiltration).Platelets were collected from all subjects,and the levels of autophagy-associated protein 7(ATG7),benzalkonium chloride 1(BECN1),microtubule-associated protein 1 light chain 3(LC3)and sequestosome 1(p62)were measured by enzyme-linked immunosorbent assay(ELISA).Results Among the 360 patients included,peritoneal metastasis was detected in 38 cases.Compared with the non-peritoneal metastasis group,the peritoneal metastasis group exhibited decreased BMI(P<0.05),while the tumor size,non-ulcerative tumor,number of lymph node metastasis,infiltration depth,number of cases of lymphatic invasion,platelet count,platelet LC3-Ⅱ level,platelet ATG7 level and CEA level were increased(P<0.05).Multivariate logistic regression analysis showed that BMI(OR=1.094),lymphatic invasion(OR=2.658),and LC3-Ⅱ(OR=3.793)and ATG7(OR=2.010)were independent influencing factors for peritoneal metastasis in patients with gastric cancer(P<0.05).LC3-Ⅱ>2.59ng/ml had the highest ability to predict peritoneal metastasis in patients with gastric cancer(AUC=0.932),followed by ATG7(AUC=0.916).Conclusions Elevated levels of platelet LC3-Ⅱ and ATG7 are independently related to peritoneal metastasis in patients with gastric cancer,and can be used to predict the occurrence of peritoneal metastasis,which is helpful to guide individualized treatment.
4.Protective Effect of Empagliflozin and Dapagliflozin on Palmitic Acid-induced Cardiomyocytes Injury and Its Underlying Mechanism
WEI Yudi ; LUO Shenhe ; JIN Honghua
Chinese Journal of Modern Applied Pharmacy 2023;40(20):2884-2890
OBJECTIVE To investigate the protective effect of sodium-glucose cotransporter 2 inhibitors empagliflozin (EMPA) and dapagliflozin(DAPA) on palmitic acid(PA)-induced injury of rat H9c2 cardiomyocytes and its possible mechanism. METHODS H9c2 myocardial cell injury was induced by PA. CCK-8 method was used to screen the optimal dosage of PA, EMPA and DAPA. The protein expression levels of TLR4, p-AKT, p-mTOR, Nrf2 and HO-1 were detected by Western blotting. The expressions of IL-1β, IL-6, TNF-α were detected by ELISA. ROS levels in PA-induced H9c2 cardiomyocytes were determined by fluorescence microscopy and flow cytometry. RESULTS The survival rate of H9c2 cardiomyocytes decreased significantly after treatment of PA 100 μmol·L-1 for 24 h(P<0.01), the expression of IL-1β, IL-6, TNF-α, TLR4, p-mTOR and ROS were significantly increased(P<0.01), and the protein expression of p-AKT, Nrf2 and HO-1 was significantly decreased(P<0.01). Compared with the model group, the cell survival rate was significantly increased after EMPA and DAPA treatment(P<0.01), the expression of IL-1β, IL-6, TNF-α, TLR4, p-mTOR and ROS levels were significantly decreased(P<0.05 or P<0.01), and the protein expression of p-AKT, Nrf2 and HO-1 was significantly up-regulated(P<0.05 or P<0.01). CONCLUSION EMPA and DAPA have protective effects on PA-induced cardiomyocyte injury, and the mechanism may be related to down-regulation of TLR4 and p-mTOR protein expression, enhancement of AKT protein phosphorylation, activation of Nrf2/HO-1 pathway, and inhibition of ROS generation.
5.Nicotine exacerbates tacrolimus-induced renal injury by programmed cell death
Yu Ji JIANG ; Sheng CUI ; Kang LUO ; Jun DING ; Qi Yan NAN ; Shang Guo PIAO ; Mei Ying XUAN ; Hai Lan ZHENG ; Yong Jie JIN ; Ji Zhe JIN ; Jung Pyo LEE ; Byung Ha CHUNG ; Bum Soon CHOI ; Chul Woo YANG ; Can LI
The Korean Journal of Internal Medicine 2021;36(6):1437-1449
Background/Aims:
Cigarette smoking is an important modifiable risk factor in kidney disease progression. However, the underlying mechanisms for this are lacking. This study aimed to assess whether nicotine (NIC), a major toxic component of cigarette smoking, would exacerbates tacrolimus (TAC)-induced renal injury.
Methods:
Sprague-Dawley rats were treated daily with NIC, TAC, or both drugs for 4 weeks. The influence of NIC on TAC-caused renal injury was examined via renal function, histopathology, oxidative stress, mitochondria, endoplasmic reticulum (ER) stress, and programmed cell death (apoptosis and autophagy).
Results:
Both NIC and TAC significantly impaired renal function and histopathology, while combined NIC and TAC treatment aggravated these parameters beyond the effects of either alone. Increased oxidative stress, ER stress, mitochondrial dysfunction, proinf lammatory and profibrotic cytokine expressions, and programmed cell death from either NIC or TAC were also aggravated by the two combined.
Conclusions
Our observations suggest that NIC exacerbates chronic TAC nephrotoxicity, implying that smoking cessation may be beneficial for transplant smokers taking TAC.
6.Arterial switch operation: A double cohort study of 20 years’ outcomes of 571 patients in a single center
QU Yanji ; LUO Dandong ; LIU Xiaoqing ; WEN Shusheng ; NIE Zhiqiang ; PANG Chengcheng ; CEN Jianzheng ; XU Gang ; MAI Jinzhuang ; OU Yanqiu ; GAO Xiangmin ; WU Yong ; CHEN Jimei ; ZHUANG Jian
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(02):133-141
Objective To define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO). Methods We conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models. Results Several aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%. Conclusion Significant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.
7.New-concept animal vaccines emerging in recent years.
Tengteng ZHANG ; Yuzi LUO ; Yuan SUN ; Taiyuan LI ; Hua-Ji QIU
Chinese Journal of Biotechnology 2018;34(12):1963-1973
Animal infectious diseases pose a serious and continuing threat to the animal health and cause huge economic losses throughout the world. Vaccination is one of the most effective solutions to prevent and control animal infectious diseases. With the development of biotechnologies and the need for disease prevention and control, the focus of vaccine research has been shifted to the development of safe, efficient, broad-spectrum, low-dose and marker vaccines. Novel vaccines capable of inducing high levels of both humoral and cellular immune responses are promising to provide more efficient protection against animal infectious diseases. This minireview summarizes the development, applications, advantages and disadvantages of new-concept animal vaccines emerging in recent years, including mucosal vaccines, long-acting and fast-acting vaccines, chimeric vaccines, nanoparticle vaccines, and so on. Furthermore, we discuss future directions of the vaccines, in order to provide new insights for animal vaccine development.
Animals
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Communicable Diseases
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Immunity, Cellular
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Nanoparticles
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Vaccination
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Vaccines
8.Visceral abdominal adiposity tissue volume quantification using noninvasive MRI in prediction of type 2 diabetes
Meng WANG ; Yanji LUO ; Huasong CAI ; Jinyun GAO ; Yingmei JIA ; Ziping LI ; Quanfei MENG ; Shiting FENG
Chinese Journal of Medical Imaging Technology 2017;33(12):1844-1849
Objective To investigate the feasibility of utilizing visceral abdominal adiposity tissue (VAT) volume quantification using MRI to predict type 2 diabetes mellitus (T2DM).Methods Forty-eight subjects including 15 T2DM (T2DM group),17 impaired glucose tolerance (IGT,IGT group) and 16 normal glucose tolerance (NGT,NGT group) were enrolled in this study.All subjects underwent upper abdominal iterative decomposition of water and fat with echo asymmetry and least square estimation-image quantification (IDEAL-IQ) MRI scanning.VAT volume of the second and third lumber vertebral body ranges (VATV L2,VATV L3),sum of VATV L2 and L3 (total VATV),hepatic and pancreatic fat were measured in fat fraction mapping of T1WI IDAEL-IQ sequence on post-processing workstation.The accuracy of predicting T2DM using VAT was evaluated by Logistic regression equation via ROC curve.Results The mean of VATV L2,VATV L3 and total VATV in T2DM group were significantly higher than those of IGT group and NGT group (P<0.05),while there were no significant difference of these metrics between IGT group and NGT group (P>0.05).Taking 460.34 ml as the cut-off value for VATV L2 to predict T2DM,sensitivity was 73.33%,specificity was 75.76% and accuracy was 75.00%,respectively.Taking 429.46 ml as the cut-off value for VATV L3 to predict T2DM,sensitivity was 86.67%,specificity was 72.73% and accuracy was 77.08%,respectively.Taking 887.83 ml as the cut-off value for total VATV to predict T2DM,the sensitivity,specificity and accuracy were 86.67%,72.73% and 77.08%,respectively.Only VATV L3 was enrolled by Logistic regression equation (P=0.01,OR=1.01),and the sensitivity,specificity and total accuracy of prediction for T2DM were 80.00 %,88.20 %,and 84.40 %,respectively.Conelnsion It is feasible to utilize VAT volume quantification with MRI to predict T2DM.VATV L3 is a better predictor.
9.CT and MRI findings of pancreatic neuroendocrine neoplasm
Yunfei HE ; Yanji LUO ; Shiting FENG ; Cangzheng JIN ; Haijing HU ; Liyun DU ; Xinchao XU
Chinese Journal of Interventional Imaging and Therapy 2017;14(3):159-163
Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.
10.Manifestation of Intestinal Tuberculosis on Multi-slice Computed Tomography Enteroclysis
Weiqiang LIANG ; Jing ZHAO ; Yingmei JIA ; Huasong CAI ; Chenyu SONG ; Yanji LUO
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(3):468-474
[Objective] To summarize image manifestations in intestinal tuberculosis (ITB) examined by multi-slice computed tomography enteroclysis (MSCT) and evaluate the diagnostic value of MSCTE in ITB,[Methods] The imaging findings were retrospectively analyzed in 15 cases of ITB that were confirmed by endoscopy or postoperative pathologic examination,including the location,number,shape,edge,surrounding tissue alterations of ITB and other associated changes in the peritoneum,mesentery and solid abdominal organs,and compared with endoscopy and pathology.[Results] In 15 patients,ileocecum was involved in 13 cases (87%),4 cases (27%) showed multi-segmental symmetric intestinal mural thickening,9 patients (60%) showed solid masses,1 case (7%) showed multi-segmental symmetric intestinal mural thickening and solid masses,1 case (7%) showed homogenous enhanced masses and perforation,12 cases (86%) showed enlarged lymph nodes (LNs) with rim enhancement,and 2 cases (13%) showed the comb sign of enhanced mesenteric vessels.Based on enhancement pattern of MSCTE,ITB was divided into three types:homogenous enhancement type (n=5);target sign type (n=2);caseous necrosis type (n=2).[Conclusion] The imaging features of ITB are diverse.MSCTE can clearly display the shape of intestinal mucosa,the alterations of intestinal wall and the relationship between lesion and adjacent tissues,which provides valuable information for the clinic diagnosis of ITB.


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