Objective To observe the value of B1 corrected T1 mapping for distinguishing pathological types and differentiation degrees of lung cancers.Methods A total of 74 lesions in 65 patients with lung cancers were prospectively enrolled,including 49 poorly differentiated lesions and 25 moderately or well differentiated ones,i.e.42 adenocarcinomas,14 squamous cell carcinomas and 18 small cell lung cancers(all poorly differentiated).B1 corrected T1 mapping was performed,ROI(ROI1 and ROI2)were delineated using 2 methods,and T1 values of different pathological types and differentiation degrees lung cancers were compared.The receiver operating characteristic(ROC)curves were drawn,and the areas under the curve(AUC)were calculated.Results Significant differences of T1 values were found among different pathological types of lung cancer(all P＜0.05),as well as between small cell lung cancer and the rest 2 types of lung cancer(both P＜0.05).There were significant differences of T1 values between poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)(both P＜0.05).Taken ROI1 T1 value=1 524.21 ms as the cut-off value,the AUC of T1 value for distinguishing poorly differentiated and moderately well differentiated lung cancer(squamous cell carcinoma+adenocarcinoma)was 0.698,with sensitivity of 64.50％and specificity of 76.00％.Taken ROI2 T1 value=1 630.68 ms as the cut-off value,the AUC of T1 value was 0.676,with sensitivity of 54.80％and specificity of 80.00％.Conclusion B1 corrected T1 mapping was helpful for distinguishing pathological types and differentiation degrees of lung cancers.

Objective To compare the value of stack-of-stars-volumetric interpolated breath-hold examination(Star-VIBE)and T1-volumetric interpolated breath-hold examination(T1-VIBE)MRI for displaying peripheral lung cancer.Methods Fifty-two patients with 56 peripheral lung cancer were prospectively enrolled,and chest Star-VIBE and T1-VIBE MRI were acquired.The morphological features were observed,and the subjective scores were recorded.The maximum diameter,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of lesions were measured based on Star-VIBE and T1-VIBE MRI,respectively.Taken CT as the references,the value of Star-VIBE and T1-VIBE MRI for displaying peripheral lung cancer were compared.Results Star-VIBE MRI had higher scores for displaying spiculation sign,lobulation sign,pleural depression sign and halo sign than T1-VIBE(both P＜0.05).CNR and SNR of Star-VIBE MRI were significantly higher than those of T1-VIBE(both P＜0.001).No significant difference of the maximum diameter of lesions measured based on Star-VIBE and T1-VIBE MRI compared with CT was found,nor between Star-VIBE and T1-VIBE MRI(all P＞0.05).Conclusion Star-VIBE MRI had better value for displaying peripheral lung cancer than T1-VIBE.

To investigate the efficacy and safety of modified endoscopic retrograde appendicitis therapy (ERAT) in children with acute uncomplicated appendicitis complicated with intussusception. Data of 6 patients with acute uncomplicated appendicitis complicated with intussusception who received modified ERAT were collected from October 2018 to February 2020 in Pediatrics Department of Tangdu Hospital. The reduction rate of intussusception, the success rate of ERAT appendiceal intubation and endoscopic treatment, the remission time of clinical symptoms, the time of white blood cells return to normal, the length of hospital stay, complications and recurrence were summarized. All the 6 patients were confirmed to be acute uncomplicated appendicitis combined with ileocecal intussusceptions under colonoscopy. Endoscopic intussusception reduction and ERAT were performed successfully. The mean time of disappearance of abdominal tenderness was 1.3 days after the therapy, and the time of white blood cells return to normal was 1 day after surgery. The endoscopic treatment were all successful and the length of hospital stay was 3-6 days. No complications or recurrence of intussusception and appendicitis occurred during the follow-up period of 6-12 months. Modified ERAT can effectively, safely and minimally invitingly treat acute uncomplicated appendicitis with intussusception in children on the basis of definite diagnosis.

Objective:To explore the intervention effect of sensorimotor training on cognitive function, balance and fall risk of elderly patients with schizophrenia.Methods:The 60 hospitalized elderly schizophrenic patients in Wuxi Mental Health Center were randomly divided into experimental group and control group from June to September 2021, with 30 cases in each group. The control group implemented traditional exercise on the basis of routine nursing. The experimental group received 8-week and 24 times sensorimotor training on the basis of the routine nursing. The Chinese version of the Mini Mental State Examination (MMSE) was used to assess the cognitive level of patients, the Modified Morse Fall Scale (MMFS) was used to assess the risk of falls, and the Berg Balance Scale (BBS) was used to assess the balance function.Results:After 8 weeks of intervention, the total score of MMSE was (26.72 ± 1.71), higher than the total score of the control group (22.36 ± 1.93), the factor scores of temporal orientation, spatial orientation, recollection, attention and calculation, memory and language ability in the experimental group were (4.90 ± 0.31), (4.72 ± 0.53), (2.86 ± 0.35), (4.66 ± 0.61), (2.83 ± 0.47), (6.76 ± 1.09), higher than scores of the control group (4.36 ± 0.56), (3.93 ± 0.66), (2.57 ± 0.50), (3.64 ± 1.03), (2.18 ± 0.67), (5.68 ± 1.02), and the difference was statistically significant( t values were 2.53-9.06, all P< 0.05). The total score of MMFS in the experimental group was (5.93 ± 1.49), which was lower than that in the control group (8.75 ± 2.30). The difference was statistically significant ( t=-5.51, P<0.01). The total score of BBS in the experimental group was (38.83 ± 1.71), which was higher than that in the control group (30.89 ± 1.93). The difference was statistically significant ( t=16.43, P<0.01). Conclusions:Sensorimotor training can improve the level of balance, cognitive function and reduce the risk of falls in elderly patients with schizophrenia.

Objective:To develop a multimodal MRI-based radiomics model for the differential diagnosis of benign and malignant lung lesions, and to compare the discriminative abilities of different models.Methods:Totally 114 patients with 115 lesions (44 benign and 71 malignant) in Nantong First Peoples′s Hospital from January 2014 to October 2019 were included in the study. All patients underwent non-enhanced MR examination, and textural features from T 1WI,T 2WI and apparent diffusion coefficient (ADC) imaging were extracted. The feature selection methods included L1 based, mutual information, tree based, recursive feature elimination and F-test. Then we constructed a prediction model by using logistic regression (LR), support vector machine (SVM), random forest (RF) and k-nearest neighbor (KNN) respectively. In order to control the number of modeling features and reduce the ininterpretability of the model, the new model was obtained by manually modifying some parameters of the hyperparameter model. One hundred and fourteen cases were rotated as training and validation sets. The performance of each model was evaluated by confounding matrix and receiver operating characteristic (ROC) curve. Results:The area under the curve (AUC) of T 2WI based LR model for the differential diagnosis of benign and malignant pulmonary nodules/masses was 0.71 and the F1 score was 0.57. Based on T 1WI images, LR and SVM model could be used to identify benign and malignant pulmonary nodules, the AUC before parameter adjustment were 0.77 and 0.78, the accuracy after parameter adjustment (LR a,SVM a) was 0.67, 0.70, and both the AUC were 0.72. However, no matter which feature or classifier was selected, both the AUC and accuracy of ADC-based model were less than 0.70. Conclusion:Multimodal MRI-based radiomics model is valuable for the differential diagnosis of benign and malignant pulmonary nodules/masses, and T 1WI-based model shows the best discrimination.

Objective:To study the value of ultrasound-guided endoscopic retrograde appendicitis therapy in children with uncomplicated appendicitis.Methods:This study was a single center, retrospective study, including all electronic cases of appendicitis diagnosed clinically in Department of Pediatrics, the Second Affiliated Hospital of Air Force Military Medical University from October 2018 to October 2020 and received ultrasound-guided endoscopic retrograde appendicitis therapy.The clinical features, treatment and prognosis of the children were retrospectively analyzed.Results:A total of 152 electronic cases were included, there were 77 males and 75 females, aged(6.84±3.09) years.All the 152 children were treated with ultrasound-guided endoscopic retrograde appendicitis therapy.Intubation success rate and clinical success rate was 98.03%(149/152 cases)and 97.99%(146/149 cases), respectively.The median time of endoscopic therapy was 42.50 (31.00, 56.00) minutes.Mean postoperative hospital stay was (2.81 ±1.41) days, and the mean total hospital stay was (4.19 ±1.71) days.A total of 139 patients were followed up with a median follow-up time of 5 (1, 26) months.During the follow-up, the recurrence rate was 7.19%(10/139 cases), and the median time of recurrence was 2 (1, 3) months.Conclusions:Ultrasound-guided endoscopic retrograde appendicitis therapy had high effective rate and low recurrence rate in children with uncomplicated appendicitis, preserved the physiological function of appendix and avoided radiation damage.It can be used as a safe and effective treatment for acute and chronic uncomplicated appendicitis in children.

Wolfiporia cocos (F. A. Wolf) has been praised as a food delicacy and medicine for cen-turies in China. Here, we present the genome and transcriptome of the Chinese strain CGMCC5.78 of W. cocos. High-confidence functional prediction was made for 9277 genes among the 10,908 total predicted gene models in the W. cocos genome. Up to 2838 differentially expressed genes (DEGs) were identified to be related to sclerotial development by comparing the transcriptomes of mycelial and sclerotial tissues. These DEGs are involved in mating processes, differentiation of fruiting body tissues, and metabolic pathways. A number of genes encoding enzymes and regulatory factors related to polysaccharide and triterpenoid production were strikingly regulated. A potential triter-penoid gene cluster including the signature lanosterol synthase (LSS) gene and its modified compo-nents were annotated. In addition, five nonribosomal peptide synthase (NRPS)-like gene clusters, eight polyketide synthase (PKS) gene clusters, and 15 terpene gene clusters were discovered in the genome. The differential expression of the velevt family proteins, transcription factors,carbohydrate-active enzymes, and signaling components indicated their essential roles in the regu-lation of fungal development and secondary metabolism in W. cocos. These genomic and transcrip-tomic resources will be valuable for further investigations of the molecular mechanisms controlling sclerotial formation and for its improved medicinal applications.

Objective To prospectively evaluate the short-term test-retest reproducibility of intravoxel incoherent motion (IVIM) parameters for lung cancer,and to investigate its impact factors.Methods Thirty-eight lung cancer patients underwent twice free breathing IVIM scanning (0.5-1.0 h interval).Two radiologists independently analyzed IVIM images to obtain true diffusion coefficient (D),pseudo-diffusion coefficient (D*) and perfusion fraction (f).All the parameters were compared between repeated measurements and scans.Intra-and inter-observer,test-retest reproducibility was assessed with interclass correlation coefficients (ICCs).The impact of lung cancer type (peripheral and central),size (the largest diameter ≥2 cm and ＜2 cm) and location (upper,mid,and lower lung field) on short-term reproducibility were compared by using coefficient of variations (WCVs).Results There was no significant difference between repeated measurements for all parameters (all P＞ 0.05).All the parameters showed good intra-and inter-observer agreement.WCVsof D* and f (19.88％-36.83％) were higher than those of D (2.97％-4.62％).WCVs of D were higher for central lung cancer and the largest diameter ＜2 cm,and increasing from apical to lower zone.WCV of f was larger in the central lung cancer and the largest diameter ≥2 cm,while D* was greatly influenced by type,size and location of lung cancer.Conclusion The test retest reproducibility of D is good,while of D* and f are poor in lung cancer.The type,size and location of lung cancers are the impact factors of IVIM parameters.

Objective To investigate the ADC value and intravoxel incoherent motion (IVIM) parameters to predict the early response to chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods Twenty-six patients with pathologically confirmed NSCLC in our hospital from June 2015 to January 2017 were prospectively studied. MR routine scan, DWI and IVIM scans were performed before and at the end of the first cycle of chemotherapy. The ADC value, pure diffusion parameter (D), perfusion parameter (D*) and perfusion fraction (f) before and after chemotherapy were recorded respectively, and the maximum diameter of tumor (MDMRI) was measured on T2WI. The effective group and the ineffective group were divided according to RECIST 1.1. Intra- and interobserver reproducibility were assessed with intraclass correlation coefficient (ICC). The differences of the parameters and their change rate were compared pre-and posttreatment, in the effective and the ineffective groups by using t test. Receiver operating characteristic (ROC) curves were generated to explore the optimal parameters and thresholds for early prediction of the efficacy of chemotherapy. Z test was used to compare the differences in the areas under the ROC curves. Results The repeatability of D*was relatively poor (ICC 0.507-0.716). The ADC and D values of the effective group before chemotherapy were (1.28±0.21)×10-3 and (1.05±0.14)×10-3mm2/s, respectively, and those of the ineffective group were (1.55 ± 0.25) × 10-3 and (1.29 ± 0.18) × 10-3mm2/s, respectively. The differences between two groups were statistically significant (t=-2.989, -3.755, respectively, P all<0.05). While there was no significant difference in f between the effective and ineffective groups before chemotherapy (t=-1.034, P=0.312). The ADC, D and f values of the effective group before chemotherapy were lower than those after chemotherapy, and the differences were statistically significant (t=-3.969,-5.617 and-2.876, respectively, P all<0.05). While there was no significant difference in ADC and D values in ineffective group (t=-0.737, -0.866, P>0.05, respectively). The difference of f was statistically significant (t=-2.731, P<0.05).ΔADC％,ΔD％andΔMDMRI％in effective group were (23.90 ± 22.28)％, (32.58 ± 20.63)％ and (18.77 ± 10.36)％, respectively, and those in ineffective group were (1.19 ± 11.35)％, (6.22 ± 21.63)％ and (9.35 ± 8.26)％, respectively. The differences between two groups were statistically significant (t=3.393, 3.154 and 2.487, respectively, P all<0.05). There was no significant difference inΔf％between two groups (t=1.346, P=0.191). ROC curve analysis showed that the area under curve (AUC) of preADC, preD, ΔADC％, ΔD％ and ΔMDMRI％ was 0.788, 0.848, 0.800, 0.830 and 0.727, respectively. When setting the preD=1.20×10-3 mm2/s as the boundary under the largest AUC, however, there was no significant differences in AUC compared with preADC, ΔADC％, ΔD％ and ΔMDMRI％ (Z=1.336, 0.363, 0.136, 1.395, P>0.05). Conclusion The ADC value, D value before chemotherapy and the early change rate after chemotherapy can better predict the early response of chemotherapy in NSCLC patients.

Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.