Objective:To identify predictors of adverse pregnancy outcomes(APOs)in patients with systemic lupus erythematosus(SLE).Methods:A retrospective analysis was conducted on 318 SLE pa-tients who delivered at Peking University People's Hospital from May 2016 to September 2021.These pa-tients were categorized into two groups:The APOs group(n=85)and the non-APOs group(n=233).Various factors,including disease duration,clinical manifestations,laboratory parameters,and systemic lupus erythematosus disease activity index 2000(SLED AI-2000)scores,were analyzed for their associa-tion with APOs.SPSS 26.0 software was used to analyze the data.Results:The mean age of SLE pa-tients in this study was(24.65±5.26)years.Among the 318 pregnancies studied,302(302/318,94.97％)resulted in live births,while 16(16/318,5.03％)cases ended in stillbirths,with no neonatal deaths reported.Among the live births,206(206/302,68.21％)were full-term infants,65(65/302,21.52％)cases were small for gestational age(SGA),and 31(31/302,10.26％)cases were preterm.The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group(5.82±4.97 vs.3.74±3.72,t=4.019,P=0.001),suggesting greater disease activity as a risk fac-tor.Similarly,glucocorticoid doses were markedly higher in the APOs group[12.50(7.50,50.00)mg vs.10.00(5.00,15.00)mg,P＜0.001],underscoring the link between disease severity and APOs.Univariate analysis revealed that lupus nephritis(31.76％vs.21.03％,x2=3.946,P=0.047),throm-bocytopenia(24.71％vs.9.01％,x2=13.380,P＜0.001),hypocomplementemia(36.47％vs.26.03％,x2=4.847,P=0.028),antiphospholipid antibody positivity(20.00％vs.11.16％,x2=4.163,P=0.041),and absence of pregnancy treatment(21.18％vs.11.59％,x2=4.713,P=0.030)were associated with increased APOs risk.Multivariate Logistic regression identified thrombocyto-penia(OR=2.671,95％CI:1.309-5.449,P=0.007),hypocomplementemia(OR=1.935,95％CI:1.104-3.393,P=0.021),and antiphospholipid antibody positivity(OR=2.153,95％CI:1.054-4.399,P=0.035)as independent predictors of APOs.Conclusion:These findings highlight that certain clinical and laboratory features,including thrombocytopenia,hypocomplementemia,and antiphospholipid antibody positivity,are critical independent predictors of APOs in SLE patients.The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.

Objective To investigate the clinical and radiological features of osteofibrous dysplasia(OFD),and to improve the diagnostic accuracy of OFD and reduce the misdiagnosis rate.Methods A retrospective analysis was conducted on the clinical and radiological data of 21 patients with OFD confirmed by surgical pathology.Results Among the 21 patients,the imaging manifestations showed that the lesions were mainly located within the anterior cortex of the tibia,presenting as cystic expansile bone destruction with corti-cal expansion and thinning,protruding into the medullary cavity.Within the lesions,unequal thickness linear bony septations were visible,resembling soap-bubble changes,along with patchy ground-glass density shadow.A sclerotic rim was observed surrounding the lesions,with a clear boundary from normal tissue.No obvious soft tissue mass or periosteal reaction was noted in all cases.On MRI,the majority of the lesions exhibited prolonged T,and T2 signals,with linear hypointense separations observed within the lesions.No significant edema was noted in the surrounding bone and soft tissues,although a minor degree of bone marrow edema was present.All patients underwent surgical treatment.Fifteen patients were followed up for review,ranging from 3 to 38 months postoperatively.Among them,9 patients had no recurrence,while 6 patients experienced recurrence,manifesting as new lytic bone destruction in the surgical area.Conclusion The radiological manifestations of OFD are characteristic,and an accurate diagnosis can be made for typical cases in combination with the patient's age,location of the lesion and clinical presentation.Due to the high recurrence rate after OFD sur-gery,regular follow-up is recommended.

Objective:To identify predictors of adverse pregnancy outcomes(APOs)in patients with systemic lupus erythematosus(SLE).Methods:A retrospective analysis was conducted on 318 SLE pa-tients who delivered at Peking University People's Hospital from May 2016 to September 2021.These pa-tients were categorized into two groups:The APOs group(n=85)and the non-APOs group(n=233).Various factors,including disease duration,clinical manifestations,laboratory parameters,and systemic lupus erythematosus disease activity index 2000(SLED AI-2000)scores,were analyzed for their associa-tion with APOs.SPSS 26.0 software was used to analyze the data.Results:The mean age of SLE pa-tients in this study was(24.65±5.26)years.Among the 318 pregnancies studied,302(302/318,94.97％)resulted in live births,while 16(16/318,5.03％)cases ended in stillbirths,with no neonatal deaths reported.Among the live births,206(206/302,68.21％)were full-term infants,65(65/302,21.52％)cases were small for gestational age(SGA),and 31(31/302,10.26％)cases were preterm.The SLEDAI-2000 scores were significantly higher in the APOs group compared with the non-APOs group(5.82±4.97 vs.3.74±3.72,t=4.019,P=0.001),suggesting greater disease activity as a risk fac-tor.Similarly,glucocorticoid doses were markedly higher in the APOs group[12.50(7.50,50.00)mg vs.10.00(5.00,15.00)mg,P＜0.001],underscoring the link between disease severity and APOs.Univariate analysis revealed that lupus nephritis(31.76％vs.21.03％,x2=3.946,P=0.047),throm-bocytopenia(24.71％vs.9.01％,x2=13.380,P＜0.001),hypocomplementemia(36.47％vs.26.03％,x2=4.847,P=0.028),antiphospholipid antibody positivity(20.00％vs.11.16％,x2=4.163,P=0.041),and absence of pregnancy treatment(21.18％vs.11.59％,x2=4.713,P=0.030)were associated with increased APOs risk.Multivariate Logistic regression identified thrombocyto-penia(OR=2.671,95％CI:1.309-5.449,P=0.007),hypocomplementemia(OR=1.935,95％CI:1.104-3.393,P=0.021),and antiphospholipid antibody positivity(OR=2.153,95％CI:1.054-4.399,P=0.035)as independent predictors of APOs.Conclusion:These findings highlight that certain clinical and laboratory features,including thrombocytopenia,hypocomplementemia,and antiphospholipid antibody positivity,are critical independent predictors of APOs in SLE patients.The study underscores the importance of close monitoring and proactive management of these risk factors to improve pregnancy outcomes in SLE patients.

Objective To investigate the clinical and radiological features of osteofibrous dysplasia(OFD),and to improve the diagnostic accuracy of OFD and reduce the misdiagnosis rate.Methods A retrospective analysis was conducted on the clinical and radiological data of 21 patients with OFD confirmed by surgical pathology.Results Among the 21 patients,the imaging manifestations showed that the lesions were mainly located within the anterior cortex of the tibia,presenting as cystic expansile bone destruction with corti-cal expansion and thinning,protruding into the medullary cavity.Within the lesions,unequal thickness linear bony septations were visible,resembling soap-bubble changes,along with patchy ground-glass density shadow.A sclerotic rim was observed surrounding the lesions,with a clear boundary from normal tissue.No obvious soft tissue mass or periosteal reaction was noted in all cases.On MRI,the majority of the lesions exhibited prolonged T,and T2 signals,with linear hypointense separations observed within the lesions.No significant edema was noted in the surrounding bone and soft tissues,although a minor degree of bone marrow edema was present.All patients underwent surgical treatment.Fifteen patients were followed up for review,ranging from 3 to 38 months postoperatively.Among them,9 patients had no recurrence,while 6 patients experienced recurrence,manifesting as new lytic bone destruction in the surgical area.Conclusion The radiological manifestations of OFD are characteristic,and an accurate diagnosis can be made for typical cases in combination with the patient's age,location of the lesion and clinical presentation.Due to the high recurrence rate after OFD sur-gery,regular follow-up is recommended.

Pregnancy ; Female ; Humans ; Pregnancy Outcome ; Cross-Sectional Studies ; Lupus Erythematosus, Systemic/epidemiology* ; Pregnancy Complications/epidemiology* ; Menstruation Disturbances

Objective To establish chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography (FFRcT) in Bama miniature pig,and to evaluate its reliability.Methods Sixteen Bama miniature pigs were used to establish chronic coronary stenosis models through placing Ameroid constrictor into proximal or middle segments of left anterior descending arteries (LAD).In the 2nd week after modeling,the degrees of stenosis were monitored with coronary CTA.Invasive coronary angiography was used to verify stenosis degrees and measure fractional flow reserve (FFR) within 2 days of last coronary CTA examination.Computational fluid dynamics model was constructed and FFRcT was calculated by the specialized laboratory based on coronary CTA data respectively.Simulated FFRcT and FFR values were compared to verify this model.Results Models were successfully established in 10 pigs with a total of 24 coronary CT examinations,of which image quality met the diagnostic requirements.All models were with LAD stenosis＜25 ％ in the 2nd week after operation.LAD stenosis ＞50％ was found in the 3rd week in 9 pigs,and the other one was found with LAD stenosis ＞50％ in the 4th week.The results of coronary CTA corresponded to those of coronary angiography.There was no significant difference between simulated FFRcT and FFR value (t =-1.13,P =0.29).Conclusion Through placing Ameroid constrictor into LAD of Bama miniature pig and monitoring the degree of stenosis with coronary CTA,model of chronic coronary stenosis could be successfully established,which are suitable for noninvasive simulating hemodynamics study based on coronary CTA.

Objective To assess the image quality (IQ) of an iterative reconstruction (IR) technique (iDose4) from prospective electrocardiography (ECG)-triggered coronary CTA on a 256 MSCT scanner and determine the optimal dose reduction using IR that can provide IQ comparable to filtered back projection (FBP).Methods Prospectively ECG gated CCTA were performed on 120 patients [76 men,44 women; age:(53 ± 10)y] using a 256-slice MSCT (Brilliance iCT,Philips Healthcare).The control group (Group A,n =30) were scanned using the conventional tube output (120 kVp,210 mAs) and reconstructed using FBP.The other 3 groups were scanned with the same kVp but successively reduced tube output as follows:B (n =30):105 mAs,C (n =30):84 mAs:D (n =30):65 mAs and reconstructed using IR levels of L4 to L6,respectively.All images were reconstructed using the same kernel (XCB).Two radiologists graded IQ in a blinded fashion on a 4-point scale (4-excellent,3-good,2-fair and 1-poor).Quantitative measurements of CT values,image noise,Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were obtained in each group.Analysis of variance (ANOVA) was used for comparisons of objective evaluation indices (noise,CNR) and radiation dose (CTDIvol,DLP,ED) between the four groups.The Kruskal-Wallis test was used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A level of P ＜ 0.05 was considered statistically significant.A ROC analysis was performed to determine a radiation reduction threshold up to which excellent IQ was maintained.Results There was no significant differences in objective noise among Groups A (37.4 ±7.9) HU,B(33.2±7.1) HU,C(35.7±9.8) HU,and D(36.0±6.8) HU (F=1.48,P=0.22).There was no significant differences in CNR among Groups A(15.0 ±2.3),B(16.5 ±3.6),C(16.3 ±3.5),and D(15.3±2.8) (F=1.70,P =0.17).Group B and C had good and excellent scores of the subjective IQ (≥3),and there was no significant differences in the scores of the subjective IQ between Group A,and Groups B,C (P =0.30-1.00).Significant differences in image sharpness and study acceptability were observed between groups A and D (P ＜ 0.01).Using the criterion of excellent IQ (score 4),the ROC curve of dose levels and IQ acceptability established a reduction of 60％ of tube output (Group C) as optimum cutoff point (AUC:0.76,95％ CI:0.65-0.87).The effective dose (ED) of Group C was 61％ lower than that of Group A,(1.2 ± 0.1) mSv vs.(3.1 ± 0.6) mSv.Conclusion Iterative reconstruction techniques can provide 61％ ED reduction in prospectively-triggered coronary CTA using 256-slice MSCT while maintaining excellent image quality.