Objective:To investigate the correlation of multi-slice spiral CT(MSCT)blood flow parameters including blood volume(BV),blood flow(BF),permeability surface(PS),mean transit time(MTT)and serum carbohydrate antigen 199(CA199)level with clinical pathological features of gastric cancer patients,and the diagnostic efficiency of their combined detection.Methods:A total of 58 patients with gastric cancer confirmed by pathological biopsy admitted to Suixian People's Hospital from Jun 2022 to Dec 2023 were collected as the gastric cancer group,and 58 patients with gastric benign lesions during the same period were collected as the benign control group.The MSCT blood flow parameters BV,BF,PS,MTT values,and serum CA199 levels were compared between the two groups and among different clinical pathological features.The correlation of BF,PS,and serum CA199 level with different clinical pathological features was analyzed.The diagnostic efficiency of the combined detection of BF,PS,and serum CA199 level for gastric cancer was analyzed.Results:The proportion of mass diameter≥5 cm,marginal obscurity,malignant niche,mucosal invasion and muscle invasion in the gastric cancer group were higher than those in the benign control group(P＜0.05).The BF,PS,and serum CA199 level in the gastric cancer group were higher than those in the benign control group(P＜0.05).No significant differences were found in BV and MTT between the two groups(P＞0.05).The BF,PS,and serum CA199 level in patients with stage Ⅰ-Ⅱ,middle and high differentiation,and no lymph node metastasis were lower than those in patients with stage Ⅲ-Ⅳ,low differentiation,and lymph node metastasis(P＜0.05).There were no significant differences in BV and MTT among different clinical pathological features(P＞0.05).Spearman correlation analysis showed that BF,PS and serum CA199 level were positively correlated with clinical stage and lymph node metastasis,and negatively correlated with differentiation degree(P＜0.05).The receiver operating characteristic(ROC)curve results showed that the AUC of combined detection of BF,PS,and serum CA199 level for diagnosing gastric cancer was 0.928,which was significantly higher than the AUCs of individual detection:BF(0.787),PS(0.829),and CA199(0.816).Conclusion:The MSCT blood flow parameters BF,PS,and serum CA199 level are all correlated with clinical pathological features of gastric cancer patients,and combined detection of these three indicators has high diagnostic efficiency for early diagnosis of gastric cancer.

Objective:To explore the value of material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation, in order to provide reference for the evaluation of postoperative recurrence of fractures.Methods:A total of 80 cases with percutaneous vertebroplasty (PVP) treated in the First People’s Hospital of Shangqiu, Henan Province from Jan. 2020 to Dec. 2021 were selected for pre-operative CT material separation examination and postoperative follow-up for at least 2 years. The patients were divided into recurrence group and no recurrence group according to the recurrence of fracture. The clinical data and the results of material separation technique by energy spectrum CT were compared. The relevant factors for fracture recurrence was assessed by Logistic regression analysis, and ROC curve was used to evaluate the predictive value of material separation technique based on energy spectrum CT in the recurrence of fracture.Results:After a follow-up of at least 2 years, 26 of the 80 patients had a recurrence of the fracture. The age, calcium water and hydroxyapatite (HAP) -water values in recurrent group were higher than those in no recurrent group, and the proportion of bone cement leakage was higher ( t/ Fisher=2.57, 5.40, 3.96, - P = 0.012 < 0.001, < 0.001, 0.033) . Logistic regression analysis showed that calcium-water ( OR=2.321, 95%CI: 1.464-3.679) and HAP-water ( OR=1.784, 95%CI: 1.246-2.554) values were the factors for postoperative fracture recurrence in osteoporotic fractures ( P<0.001) . ROC curve showed that AUC, sensitivity and specificity of combined calcium-water and HAP-water values in predicting postoperative fracture recurrence were 0.868, 88.46% and 79.63%, respectively ( P<0.001) . Conclusions:The material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation has high clinical application value, and provides a new idea for the clinical evaluation of postoperative recurrence of fractures.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

Objective:To explore the predictive value of dual-energy CT lumbar quantitative measurement combined with serum bone alkaline phosphatase (BALP), osteocalcin (BGP), and β-type I collagen carboxy-terminal peptide ( β-CTx) for the risk of fractures in patients with osteoporosis. Methods:A total of 90 patients with osteoporosis who underwent dual-energy CT lumbar quantitative detection at the First People’s Hospital of Shangqiu from Jan. 2020 to Jan. 2023 were selected as the research subjects. According to the occurrence of fractures within one year of follow-up, the patients were divided into the fracture group ( n=36) and the non-fracture group ( n=54). The clinical data, dual-energy CT lumbar quantitative parameters, and serum BALP, BGP, and β-CTx levels of the two groups were compared. Logistic multivariate regression analysis was used to analyze the risk factors for fractures in patients with osteoporosis, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of dual-energy CT lumbar quantitative parameters combined with serum BALP, BGP, and β-CTx for fractures in patients with osteoporosis. Results:There were no statistically significant differences in gender, age, body mass index (BMI), smoking history, drinking history, or bone marrow CT value parameters between the fracture group and the non-fracture group ( χ2=0.66, t=1.86, t=1.59, χ2=0.19, χ2=0.98, t=0.40, all P > 0.05). However, there were statistically significant differences in the history of fragility fractures, regular calcium supplementation, lumbar bone mineral density (BMD), calcium CT value, mixed energy image CT value, calcium concentration, fat fraction, BALP, BGP, and β-CTx ( χ2=9.73, χ2=4.17, t=3.14, t=7.06, t=7.92, t=6.50, t=3.26, t=8.12, t=12.66, t=11.37, all P < 0.05). Logistic multivariate regression analysis showed that the history of fragility fractures ( OR=1.863, P=0.023), regular calcium supplementation ( OR=1.728, P=0.031), fat fraction ( OR=1.685, P=0.009), BALP ( OR=1.815, P=0.002), BGP ( OR=1.605, P=0.003), and β-CTx ( OR=1.636, P < 0.001) were risk factors for fractures in patients with osteoporosis, while lumbar bone BMD ( OR=0.456, P=0.025), calcium CT value ( OR=0.486, P=0.005), mixed energy image CT value ( OR=0.490, P < 0.001), and calcium concentration ( OR=0.509, P=0.010) were protective factors. The ROC curve showed that the sensitivity of dual-energy CT lumbar quantitative measurement parameters combined with serum BALP, BGP, and β-CTx in predicting fractures in patients with osteoporosis was 94.68%, the specificity was 92.16%, the Youden index was 0.868, the area under the curve (AUC) was 0.947, and the 95% confidence interval ( CI) was 0.905 to 0.982. Conclusion:Dual-energy CT lumbar quantitative parameters and serum BALP, BGP, and β-CTx levels have certain predictive value for the risk of fractures in patients with osteoporosis, and the combined prediction value is higher.

Objective:To explore the value of material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation, in order to provide reference for the evaluation of postoperative recurrence of fractures.Methods:A total of 80 cases with percutaneous vertebroplasty (PVP) treated in the First People’s Hospital of Shangqiu, Henan Province from Jan. 2020 to Dec. 2021 were selected for pre-operative CT material separation examination and postoperative follow-up for at least 2 years. The patients were divided into recurrence group and no recurrence group according to the recurrence of fracture. The clinical data and the results of material separation technique by energy spectrum CT were compared. The relevant factors for fracture recurrence was assessed by Logistic regression analysis, and ROC curve was used to evaluate the predictive value of material separation technique based on energy spectrum CT in the recurrence of fracture.Results:After a follow-up of at least 2 years, 26 of the 80 patients had a recurrence of the fracture. The age, calcium water and hydroxyapatite (HAP) -water values in recurrent group were higher than those in no recurrent group, and the proportion of bone cement leakage was higher ( t/ Fisher=2.57, 5.40, 3.96, - P = 0.012 < 0.001, < 0.001, 0.033) . Logistic regression analysis showed that calcium-water ( OR=2.321, 95%CI: 1.464-3.679) and HAP-water ( OR=1.784, 95%CI: 1.246-2.554) values were the factors for postoperative fracture recurrence in osteoporotic fractures ( P<0.001) . ROC curve showed that AUC, sensitivity and specificity of combined calcium-water and HAP-water values in predicting postoperative fracture recurrence were 0.868, 88.46% and 79.63%, respectively ( P<0.001) . Conclusions:The material separation technique based on energy spectrum CT in predicting the recurrence of osteoporotic vertebral fractures after operation has high clinical application value, and provides a new idea for the clinical evaluation of postoperative recurrence of fractures.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

Objective:To explore the predictive value of dual-energy CT lumbar quantitative measurement combined with serum bone alkaline phosphatase (BALP), osteocalcin (BGP), and β-type I collagen carboxy-terminal peptide ( β-CTx) for the risk of fractures in patients with osteoporosis. Methods:A total of 90 patients with osteoporosis who underwent dual-energy CT lumbar quantitative detection at the First People’s Hospital of Shangqiu from Jan. 2020 to Jan. 2023 were selected as the research subjects. According to the occurrence of fractures within one year of follow-up, the patients were divided into the fracture group ( n=36) and the non-fracture group ( n=54). The clinical data, dual-energy CT lumbar quantitative parameters, and serum BALP, BGP, and β-CTx levels of the two groups were compared. Logistic multivariate regression analysis was used to analyze the risk factors for fractures in patients with osteoporosis, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of dual-energy CT lumbar quantitative parameters combined with serum BALP, BGP, and β-CTx for fractures in patients with osteoporosis. Results:There were no statistically significant differences in gender, age, body mass index (BMI), smoking history, drinking history, or bone marrow CT value parameters between the fracture group and the non-fracture group ( χ2=0.66, t=1.86, t=1.59, χ2=0.19, χ2=0.98, t=0.40, all P > 0.05). However, there were statistically significant differences in the history of fragility fractures, regular calcium supplementation, lumbar bone mineral density (BMD), calcium CT value, mixed energy image CT value, calcium concentration, fat fraction, BALP, BGP, and β-CTx ( χ2=9.73, χ2=4.17, t=3.14, t=7.06, t=7.92, t=6.50, t=3.26, t=8.12, t=12.66, t=11.37, all P < 0.05). Logistic multivariate regression analysis showed that the history of fragility fractures ( OR=1.863, P=0.023), regular calcium supplementation ( OR=1.728, P=0.031), fat fraction ( OR=1.685, P=0.009), BALP ( OR=1.815, P=0.002), BGP ( OR=1.605, P=0.003), and β-CTx ( OR=1.636, P < 0.001) were risk factors for fractures in patients with osteoporosis, while lumbar bone BMD ( OR=0.456, P=0.025), calcium CT value ( OR=0.486, P=0.005), mixed energy image CT value ( OR=0.490, P < 0.001), and calcium concentration ( OR=0.509, P=0.010) were protective factors. The ROC curve showed that the sensitivity of dual-energy CT lumbar quantitative measurement parameters combined with serum BALP, BGP, and β-CTx in predicting fractures in patients with osteoporosis was 94.68%, the specificity was 92.16%, the Youden index was 0.868, the area under the curve (AUC) was 0.947, and the 95% confidence interval ( CI) was 0.905 to 0.982. Conclusion:Dual-energy CT lumbar quantitative parameters and serum BALP, BGP, and β-CTx levels have certain predictive value for the risk of fractures in patients with osteoporosis, and the combined prediction value is higher.

Objective:To investigate the correlation of multi-slice spiral CT(MSCT)blood flow parameters including blood volume(BV),blood flow(BF),permeability surface(PS),mean transit time(MTT)and serum carbohydrate antigen 199(CA199)level with clinical pathological features of gastric cancer patients,and the diagnostic efficiency of their combined detection.Methods:A total of 58 patients with gastric cancer confirmed by pathological biopsy admitted to Suixian People's Hospital from Jun 2022 to Dec 2023 were collected as the gastric cancer group,and 58 patients with gastric benign lesions during the same period were collected as the benign control group.The MSCT blood flow parameters BV,BF,PS,MTT values,and serum CA199 levels were compared between the two groups and among different clinical pathological features.The correlation of BF,PS,and serum CA199 level with different clinical pathological features was analyzed.The diagnostic efficiency of the combined detection of BF,PS,and serum CA199 level for gastric cancer was analyzed.Results:The proportion of mass diameter≥5 cm,marginal obscurity,malignant niche,mucosal invasion and muscle invasion in the gastric cancer group were higher than those in the benign control group(P＜0.05).The BF,PS,and serum CA199 level in the gastric cancer group were higher than those in the benign control group(P＜0.05).No significant differences were found in BV and MTT between the two groups(P＞0.05).The BF,PS,and serum CA199 level in patients with stage Ⅰ-Ⅱ,middle and high differentiation,and no lymph node metastasis were lower than those in patients with stage Ⅲ-Ⅳ,low differentiation,and lymph node metastasis(P＜0.05).There were no significant differences in BV and MTT among different clinical pathological features(P＞0.05).Spearman correlation analysis showed that BF,PS and serum CA199 level were positively correlated with clinical stage and lymph node metastasis,and negatively correlated with differentiation degree(P＜0.05).The receiver operating characteristic(ROC)curve results showed that the AUC of combined detection of BF,PS,and serum CA199 level for diagnosing gastric cancer was 0.928,which was significantly higher than the AUCs of individual detection:BF(0.787),PS(0.829),and CA199(0.816).Conclusion:The MSCT blood flow parameters BF,PS,and serum CA199 level are all correlated with clinical pathological features of gastric cancer patients,and combined detection of these three indicators has high diagnostic efficiency for early diagnosis of gastric cancer.

Objective To investigate the effect of LAG-3 deficiency (LAG3^-/-) on natural killer (NK) cell function and hepatic fibrosis in mice infected with Echinococcus multilocularis. Methods C57BL/6 mice, each weighing (20 ± 2) g, were divided into the LAG3^-/- and wild type (WT) groups, and each mouse in both groups was inoculated with 3 000 E. multilocularis protoscoleces via the hepatic portal vein. Mouse liver and spleen specimens were collected 12 weeks post-infection, sectioned and stained with sirius red, and the hepatic lesions and fibrosis were observed. Mouse hepatic and splenic lymphocytes were isolated, and flow cytometry was performed to detect the proportions of hepatic and splenic NK cells, the expression of CD44, CD25 and CD69 molecules on NK cell surface, and the secretion of interferon γ (IFN-γ), tumor necrosis factor α (TNF-α), interleukin (IL)-4, IL-10 and IL-17A. Results Sirius red staining showed widening of inflammatory cell bands and hyperplasia of fibrotic connective tissues around mouse hepatic lesions, as well as increased deposition of collagen fibers in the LAG3-/-group relative to the WT group. Flow cytometry revealed lower proportions of mouse hepatic (6.29% ± 1.06% vs. 11.91% ± 1.85%, P < 0.000 1) and splenic NK cells (4.44% ± 1.22% vs. 5.85% ± 1.10%, P > 0.05) in the LAG3^-/- group than in the WT group, and the mean fluorescence intensity of CD44 was higher on the surface of mouse hepatic NK cells in the LAG3^-/- group than in the WT group (t = −3.234, P < 0.01), while no significant differences were found in the mean fluorescence intensity of CD25 or CD69 on the surface of mouse hepaticNK cells between the LAG3^-/- and WT groups (both P values > 0.05). There were significant differences between the LAG3^-/- and WT groups in terms of the percentages of IFN-γ (t = −0.723, P > 0.05), TNF-α (t = −0.659, P > 0.05), IL-4 (t = −0.263, P > 0.05), IL-10 (t = −0.455, P > 0.05) or IL-17A secreted by mouse hepatic NK cells (t = 0.091, P > 0.05), and the percentage of IFN-γ secreted by mouse splenic NK cells was higher in the LAG3^-/- group than in the WT group (58.40% ± 1.64% vs. 50.40% ± 4.13%; t = −4.042, P < 0.01); however, there were no significant differences between the two groups in terms of the proportions of TNF-α (t = −1.902, P > 0.05), IL-4 (t = −1.333, P > 0.05), IL-10 (t = −1.356, P > 0.05) or IL-17A secreted by mouse splenic NK cells (t = 0.529, P > 0.05). Conclusions During the course of E. multilocularis infections, LAG3^-/- promotes high-level secretion of IFN-γ by splenic NK cells, which may participate in the reversal the immune function of NK cells, resulting in aggravation of hepatic fibrosis.

Objective To discuss the diagnostic performance of MSCT in cystic nephroma(CN).Methods The MSCT findings of CN in 7 patients proved by operation and pathology were retrospectively reviewed.Results All of 7 cases were isolated cystic lesion, including 5 males and 2 females.MSCT scanning showed cystic tumor in the renal parenchyma with well-defined boundary.All cases showed regular cystic wall and septa with no attached cystic wall nodule.The cystic wall and septa appeared homogeneous enhancement on contrast-enhanced CT,while the cystic space showed inhomogeneous density and lack of enhancement.Conclusion The MSCT findings of CN may benefit the definite diagnosis.