OBJECTIVE To compare the ability of ultra-high-resolution CT(U-HRCT)and multi-slice spiral CT(MSCT)to display key vocal transmission structures in the middle ear.METHODS Subjects with normal middle ear structures who underwent 0.1 mm layer thickness U-HRCT and 0.625 mm layer thickness MSCT scans at the same time in Beijing Friendship Hospital affiliated to Capital Medical University from December 2019 to August 2024 were retrospectively enrolled.Two experienced head and neck radiologists reconstruct standard transsectional,coronal images based on the thinnest layer thickness.According to the 5-point method,16 key sound transmission structures of the middle ear,including malleus,incus and stapes,as well as joints,ligaments and tendons,were evaluated for image quality scoring.The standard deviation(SD)value,signal noise ratio(SNR),and contrast noise ratio(CNR)of bone in the malleus region and intratympanic gas were measured and calculated on the two examination images.RESULTS Thirty patients(47 sides)with normal middle ear structure were included,including 18 males and 12 females.The two physicians compared the results of U-HRCT in showing malleus head,malleus neck,malleus handle,incus body,long process,and short process,5 points accounted for 100%,and the 5-point scores of incudomalleolar joint space,incudostapedial joint space,stapes footplate and annular ligament were 100%,98.29%,75.83%and 77.83%,respectively,which were significantly higher than those of MSCT(P<0.001).In addition,U-HRCT showed higher scores for lenticular process,stapes head,anterior arch of stapes,posterior arch of stapes,annular ligament,stapes muscle,and tendo musculi tensoris tympani than MSCT(P<0.001),and the lenticular process showed a 100%display rate.There was no significant difference in the SNR between the two groups(P>0.05),but the SD value of the malleus in U-HRCT was 161.6±36.4,which was significantly lower than that in MSCT(297.8±128.1),and the difference was statistically significant(P<0.001).CONCLUSION U-HRCT can clearly visualize the key sound transmission structures of the middle ear,and its visualization ability is significantly better than that of MSCT.

Objective To retrospectively evaluate the clinical efficacy and safety of brentuximab vedotin(BV) combined with chemotherapy in the treatment of malignant lymphoma. Methods We collected the data of 32 lymphoma patients with CD30-positive status, including 14 cases of Hodgkin's lymphomas, 2 cases of diffuse large B-cell lymphomas, and 16 cases of mature T/NK cell lymphomas. Chemotherapy combined with BV was administered to all patients for a minimum of two cycles. The efficacy of the treatment was evaluated according to Lugano criteria every two cycles. Results Complete response rate and overall response rate after four cycles of treatment were 22% and 50%, respectively. Sixteen cases (50.0%) had grades 1 and 2 toxicity, and 16 cases (50.0%) had grade 3 toxicity or higher. The most common adverse events were neutropenia (50.0%), pneumonia (46.9%), and anemia (43.8%). The most common grade 3 or higher adverse events were pneumonia (18.8%) and febrile neutropenia (12.5%). Four patients discontinued brentuximab vedotin because of severe adverse events. Conclusion BV is effective in treating relapsed and refractory CD30- positive Hodgkin's lymphoma and peripheral T-cell lymphoma, and its overall safety is acceptable.

Humans ; Computed Tomography Angiography ; Deep Learning ; Coronary Angiography ; Coronary Artery Disease ; Tomography, X-Ray Computed ; Coronary Stenosis/diagnosis* ; Retrospective Studies ; Fractional Flow Reserve, Myocardial ; Predictive Value of Tests

Objective:To evaluate the reporting quality of clinical practice guidelines in medical imaging.Methods:Medical imaging guidelines were searched in CNKI, Wanfang data, CBM, Web of Science, PubMed, and other guideline-related websites. The search period is from January 1, 2017 to February 26, 2022. According to the reporting items for practice guidelines in healthcare (RIGHT) checklist, two researchers separately extracted information from the included guidelines and evaluated the reporting quality, and cross-checked them.Results:Eighteen guidelines in Chinese were included. The average reporting rate was (56.2±14.3) %. The reporting rate of basic information in Domain 1 (75.9%, 82/108) and other information in Domain 7 (68.5%, 37/54) were the highest, while funding and declaration and management of interests in Domain 6 (25.0%, 18/72) had the lowest reporting rate. The included guidelines had a lower reporting rate in item 2 (executive summary of recommendations, 27.8%, 5/18), item 11a (type of systematic review on which the guideline is based, 5.6%, 1/18), item 14a (patient preferences and values, 22.2%, 4/18), item 15 (evidence to decision processes recommendations, 22.2%, 4/18), and item 16 (external review, 16.7%, 3/18).Conclusions:The overall reporting quality of medical imaging guidelines needs to be improved. It is recommended that future guideline developers master the guideline research and evaluation tools, such as the RIGHT statement, and fully report the details and key information to improve the transparency and comprehensiveness of the guidelines.

Purpose: There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. Materials and Methods: Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. Results: The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

Objective:To explore the incidence and occurrence time of gallstone disease after bariatric surgery.Methods:Retrospectively analyzed the clinical data of 187 patients with morbid obesity who underwent bariatric surgery in the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from Dec. 2017 to Aug. 2019. All patients did not receive prophylactic ursodeoxycholic acid. All patients were underwent abdominal ultrasound and MRI examination preoperatively, and at least one abdominal ultrasound, MRI examination postoperatively. The incidence and occurrence time of gallstones and biliary sludge in patients with different bariatric surgery were analyzed respectively. Measurement data conforming to the normal distribution were described as mean ± standard deviation ( Mean± SD). Measurement data consistent with skewed distribution were described as median (lower quartile, upper quartile). Counting data were described as a percentage (%). Kruskal-Wallis test was used for comparison among groups, and then Bonferroni correction was used for pairwise comparison. Results:The follow-up time was up to Dec. 31, 2020, with a median follow-up time of 27.0 (22.0, 31.0) months. Thirty-four patients (18.2%, 34/187) developed gallstones after bariatric surgery. Individually, it was 18.0%(30/167) in LSG group, 22.2%(2/9) in LRYGB group, 11.1%(1/9) in LOAGB group and 50.0%(1/2) in LOAGB revisional surgery group. Eighteen patients (9.6%, 18/187) were found biliary sludge formation, among which 8.4% (14/167), 22.2% (2/9), and 22.2% (2/9) underwent LSG, LRYGB, and LOAGB, respectively. The rates of weight loss and BMI loss in patients with postoperative gallstone-formation were 21.4 (18.7, 23.6)% and 21.4 (18.6, 23.5) %, respectively. Three patients (1.6%, 3/187) had newly developed symptomatic gallstones, and all of them underwent LSG. The mean occurrence time for biliary sludge and gallstone was 85.5 (28.8, 98.8) and 103.5 (93.0, 179.3) days, respectively. Statistical difference in occurrence time was only found between postoperative gallstone and biliary sludge formation ( P=0.009). Conclusion:Without drug intervention, the incidence of gallstone after bariatric surgery was about 18.2% (34/187), which requires close clinical attention. Abdominal ultrasonography and the T2WI sequence of upper abdominal MRI can help to diagnose gallstone and monitor its changes.

Purpose: There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL. Materials and Methods: Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test. Results: The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001). Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

Objective:To analysis the expression of CD7 in NK/T-cell lymphoma as well as study the correlations between CD7 and clinical survival and prognosis.Methods:The clinical and pathological indicators of 112 NKTCL patients who were admitted to or consulted at the First Affiliated Hospital of Zhengzhou University between May 2008 and December 2019 were analyzed retrospectively. The CD7 expression in the tumor tissues was detected using immunohistochemistry staining, and the influence of CD7 expression on the survival and prognosis in the patients was analyzed.Results:The CD7 expression rate was 84.82% in 112 NKTCL patients, and its expression was not influenced by sex, age, and the primary site. An analysis of the complete clinical data of 72 patients showed that the CD7 expression was significantly correlated with the PINK score, tumor metastasis, and peripheral blood EBV-DNA level. However, the Ann Arbor stage, bone marrow involvement, B symptoms, IPI/aaIPI score, Ki-67, EBER, TIA-1, Granzyme B, LDH, and β 2-MG were not associated with the CD7 expression. The 1-year, 3-year, and 5-year overall survival (OS) rates of the 72 patients were 81.2%, 61.8%, and 58.8%, respectively, and the progression-free survival (PFS) rates were 53.5%, 29.4%, and 24.0%, respectively. The median overall survival (median-OS, mOS) was 81 mon, and the median progression-free survival (median-PFS, mPFS) was 14 mon. The 3-year OS rates in the CD7-positive group and the CD7-negative group were 58.1% and 83.9%, respectively, ( P>0.05) . The 3-year PFS rates were 21.7% and 51.9%, respectively ( P<0.05) . The univariate analysis showed that age, primary tumor site, Ann Arbor stage, IPI/aaIPI score, PINK score, LDH, β 2-microglobulin, EBV-DNA, Ki-67, and CD7 influenced patient prognosis. The multivariate analysis showed that Ann Arbor stage and CD7 were independent prognostic factors for PFS, while PINK score and Ki-67 were independent prognostic factors for OS. Conclusions:The expression rate of CD7 in NKTCL was high and was closely related to poor patient prognosis. The patients with high levels of EBV-DNA, metastatic disease, or high PINK score were more likely to express CD7.

OBJECTIVETo compare the efficacy differences between manual acupuncture (MA) and electroacupuncture (EA) in the treatment of hemiplegia after acute ischemic stroke.

METHODSSixty-eight patients of hemiplegia after acute ischemic stroke were randomized into a MA group (34 cases) and an EA group (34 cases). The routine western medication and bilateral Dingnieqianxiexian (MS 6) were adopted in the two groups. The needles were retained for 30 min. In the MA group, the even-needling technique was used for 3 times during the needle retaining, 1 min each time. In the EA group, on the basis of manual stimulation, EA therapy was added, with disperse-dense wave, 5 Hz/20 Hz. The treatment was given once every day, 6 treatments a week, totally for 2 weeks. US National Institutes of Health stroke scale (NIHSS) score, the simplified Fugl-Meyer motor function (FMA) score and Barthel index (BI) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSNIHSS score was reduced apparently after treatment in the two groups (both<0.01). The score in the EA group was lower than that in the MA group (<0.05). After treatment, FMA score and BI score were all increased apparently in the two groups (all<0.01) and the scores in the EA group were higher than those in the MA group (both<0.01). The total effective rate was 94.1% (32/34) in the EA group and was 85.3% (29/34) in the MA group. The efficacy in the EA group was better than that in the MA group (<0.05).

CONCLUSIONSEA acts on the rehabilitative effect on nerve defect function in the patients of hemiplegia after acute ischemic stroke. It improves limb motor function and the ability ofdaily life activity. The efficacy is better than that of MA.

The phosphoinositide-3 kinase (PI3K)/protein kinase B (PKB/AKT)/mammalian target of rapamycin (mTOR) pathway is asso-ciated with cell growth, proliferation, differentiation, apoptosis and metabolism. The abnormalities of this signal pathway are found in various malignant tumors. This pathway has also been investigated as an anti-tumor target. Recently, novel inhibitors have been stud-ied in clinical trials of lymphoma. This review summarizes the activation status of the PI3K/AKT/mTOR pathway and its use for targeted therapy of lymphoma.