Objective:To assess the value of amide proton transfer weighted (APTw) imaging in the evaluation of pH changes in infarct core (IC) and ischemic penumbra (IP) in subacute cerebral infarction.Methods:The data of twenty-three subacute cerebral infarction patients with unilateral steno-occlusive disease of the middle cerebral artery (subacute infarction group) from April to November 2019 in the First Affiliated Hospital of Dalian Medical University were prospectively analyzed. Fifteen healthy volunteers were enrolled in this study as the control group. All subjects underwent conventional MRI, DWI, 3D-pseudo continuous arterial spin labeling (3D-pCASL) and APTw sequences. Based on DWI images, relative cerebral blood flow (rCBF) and APTw images to determine the region of IC, blood flow penumbra [cerebral blood flow(CBF)-DWI mismatch area, IP CBF] and metabolic penumbra (APTw-DWI mismatched area, IP APT). 3D ROIs were used to semi-automatically measure the APTw signals and the volume of IC and IP CBF of the patients in subacute infarction group. The comparison of APTw signals between the infarct side and the contralateral side in the subacute infarction group, the comparison of bilateral APTw signals in the control group, and the comparison of APTw signals in the IC and IP CBF regions were performed by paired-sample t test or Wilcoxon signed-rank test. The paired-sample t test or Mann-Whitney U test was used to compare the APTw signals between the two groups. The Friedman test was applied to compare the difference of volumes among IP CBF1.5, IP CBF2.5 and IP APT . Results:There was no significant difference of the APTw signals among the IC, the contralateral side in the subacute infarction group and the control group ( P>0.05). The APTw signals of IP CBF and IC of the infarction group were statistically different ( P<0.05). Compared with the contralateral side of IP CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the APTwmax (3.07±1.41, t=-3.012, P=0.006), APTw min [-1.30 (-1.74, -0.57), Z=-2.099, P=0.036], and APTwmax-min(4.51±2.58, t=-3.273, P=0.003) signals in the IP CBF1.5 were decreased ( P<0.05). Compared with the contralateral side of IP CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTw min [-1.08 (-1.60, -0.49), Z=-2.616, P=0.009] and APTwmax-min (4.41±2.72, t=-3.228, P=0.004) signals in the IP CBF2.5 were decreased. The volumes of IP CBF1.5 [107.51(50.08, 138.61)mm 3], IP APT [99.00 (53.27, 121.335) mm 3] and IP CBF2.5 [89.91 (51.53, 139.87) mm 3] were successively reduced (χ2=7.913, P=0.019), and the volume of IP CBF2.5 was significantly smaller than that of IP CBF1.5 ( P=0.037). Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.

Objective To evaluate the feasibility of adaptive statistical iterative reconstruction-V (ASIR-V) to improve image quality in low-dose CT colonography.Methods A series of thirty artificial polyps were established by ligation in an isolated segment of porcine colon.Volume data was acquired on Revolution CT scanner (GE,USA) with High Definition scan mode and different scan parameter combinations:120 kVp with different mAs (10,30,50,70,90,100,120,140,160,180,200,220,240,260,respectively).Images were reconstructed with six different ASIR-V levels of 0 (filtered back projection,FBP),10％,30％,50％,70％ and 90％.Two radiologists were blinded to measure and analyze the objective data independently,including image noise (SD),signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).The kappa test was used to assess interobserver agreement in subjective image quality score.ICC test was used to examine the consistency of the measurements between two observers.SD,SNR,CNR were performed for statistical analysis in different tube current and different levels of ASIR-V using variance analysis (ANOVA).Results Interobserver agreement for subjective image quality score was good with a kappa value of 0.683.The variation of the tube current(r =0.734,P =0.000) and ASIR-V level(r =0.220,P =0.044) is related to the subjective score of image quality.Under the condition of the same tube current,image quality score of 50％ ASIR-V reconstruction was the highest.Two objective data consistency is good.The differences of image noise (F =423.58,P ＜ 0.05),SNRs(F =124.26,P ＜ 0.05) and CNRs (F =1 030.17,P ＜ 0.05) of different tube current and different levels of ASIR-V reconstruction were statistically significant.In the same tube current,with increased levels of ASIR-V,image noise reduced,CNRs increased.Only in 10,120,140,160,220,240,260 mA,the differences of SNRs were statistically significant(F =8.75-31.36,P ＜ 0.05).For the same level of ASIR-V reconstruction,with the increase of tube current,the image noise decreased,SNR and CNR increased gradually.Conclusions In the CT colonography,the application of ASIR-V algorithm can significantly reduce the noise and enhance the image contrast noise ratio and improve image quality.ASIR-V algorithm with 50％ has better performance in reducing CT image noise.

Objective To study the effect of a new immunomodulator composed of muramyl dipeptide(MDP) and anti-CD10monoclonal antibody(MDP-Ab)on the dendritic cells(DC)of children with acute leukemia. Methods DC was adopted to divide the children with acute lymphoblastic leukemia into 6 groups,including the control group,unconjugated anti-CD10alone,unconjugated MDP alone,MDP-Ab alone,lipopolysaccharide(LPS)alone and MDP-Ab + LPS.The immunophenotypes,the endocytosis interleukin-12(IL-12)were detected.The stimulation index of autologous lymphocytes was assayed by adopting 5-(and 6)-carboxyfluorescein diacetate,succinimidyl es-ter(CFSE)-staining method.The supernatants of DC and autologous lymphocytes were used to detect the level of in-terferon-γ(IFN-γ)by using enzyme-linked immunosorbent assay.Results (1)DC immunophenotype:The ex-pressions of human leukocyte antigen-DR(HLA-DR),mature molecule(CD83)and co-stimulatory molecules (CD80and CD86)were increased significantly upon DC triggered with MDP-Ab,compared with the control group,un-conjugated anti-CD10group,and unconjugated MDP group,but lower than those in LPS and combination of MDP-Ab with LPS(F=629.62,P=0.000).(2)The level of IL-12:a significant increase in IL-12 level was detected in MDP-Ab group,LPS group,and combination of MDP-Ab with LPS group,compared with the control group,uncon-jugated anti-CD10group,and unconjugated MDP group(F=857.87,P=0.000). There were significant differences among the first three groups.(3)Endocytosis assay:The uptake of DCs stimulated by unconjugated anti-CD10,un-conjugated MDP,MDP-Ab immunoconjugate,LPS or combination was lower than that of immature DC in the control group which was(81.3 ± 10.1)%.(4)Mixed lymphocyte reaction and IFN-γ level:DC,treated with MDP-Ab, LPS and combination,stimulated more CFSE positive cells and higher level of IFN-γ secretion than the control group and unconjugated anti-CD10group,unconjugated MDP group. The most significance was observed in combination of MDP-Ab with LPS(F=393.36,P=0.000;F=2 497.18,P=0.000).Conclusion It is concluded that MDP-Ab could promote the proliferation and maturation of DC derived from blood of children with acute leukemia.

Objective To establish a rat model of spinal root avulsion and to validate the model by brain-derived neurotrophic factor(BDNF)treatment. Methods To evaluate the motor neuron loss,5 male SD rats were used to undergo spinal root avulsion surgery. One week later, the number of motor neurons in the ventral horn of the spinal cord was as-sessed by histopathology using immunohistochemical staining with a choline acetyl transferase(ChAT)antibody. After this pilot study,40 male SD rats at 7 weeks of age were randomly divided into 4 groups:two control groups,BDNF preventive and treatment groups. Results All rats recovered well post-surgery and no obvious abnormality was observed. Compared with the contralateral side,the number of motor neurons in the ipsilateral avulsed side was significantly decreased at one week after surgery(20.06%,P<0.05). Compared with the control group,there was a significant increase in ChAT posi-tive neurons in the BDNF preventive group(17.85% vs. 93.06%,P<0.0001)or BDNF treatment group(1week after surgery)(26.94% vs. 86.87%, P<0.0001), indicating that the motor neurons were effectively protected by BDNF. Conclusions A rat model of spinal root avulsion is successfully established,which can be valuable for studies of amyotro-phic lateral sclerosis and drug discovery efforts.

Objective To explore the effects of hydrocolloid dressing on neonatal scleredema.Methods Forty patients with neonatal scleredema were enrolled from Department of Neonatology,Affiliated Hospital of Qingdao University from February 2015 to February 2017.The patients were assigned to the experimental group and the control group by random number table with 20 cases in each group.The experimental group was treated with hydrocolloid dressing besides routine comprehensive treatment,and the hydrocolloid dressing was changed every 3～4 d until swelling disappeared.The control group was treated with routine comprehensive treatment.Body temperature,response and swelling of two groups were observed.Results For therapeutic effects between two groups,the total effective rate of the experiment group was 95％,and was significantly better than that of the control group which was 65％(P＜0.05).The recovery time of body temperature and the time of swelling disappear in the experiment group were 38.25±17.33 h and 3.05±1.00 d;while those in the control group were 57.35±32.21 h and 4.65±1.57 d,and the differences were statistically significant(P＜0.05).Conclusion Applying hydrocolloid dressing at swelling site in premature infants can significantly shorten the time of skin swelling,promote body temperature recovery,and improve treatment effects.

Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study.All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI,T2WI,DWI and DTI.The values of ADC,fractional anisotropy (FA),diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers,and were compared between two groups.The ROC curve was used to evaluate the di agnostic efficiency.Results The border clear percentage of ICC group (9/20,45.00％) had no significant difference compared with that of HCC group (15/32,46.88％;x2 =0.02,P=0.90),the detection rate of bile duct expansion in ICC group (11/20,55.00％) was higher than that in HCC group (4/32,12.50％;x2=10.83,P=0.001).Theintraclasscor relation coefficient value of ADC,D and FA in the ICC group and HCC group were all more than 0.90.The mean FA of ICCgroup (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13;P=0.001),while the mean ADC and D values in ICC and HCC groups had no significant difference (both P＞0.05).The area under the ROC curve of FA was 0.76.And when FA=0.31,there was a higher sensitivity (85.0％) in identifying ICC and HCC.Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC.

Objective To evaluate the value of ADC and FA of diffusion tensor imaging (DTI) in differentiating clear cell renal cell carcinoma (ccRCC) and transitional cell carcinoma (TCC) of kidney pelvis.Methods Thirty-eight histopathology proven ccRCC and TCC patients (29 cases of ccRCC and 9 cases of TCC) were retrospectively enrolled.All the patients were performed abdominal MR fat saturation T1WI,fat saturation T2WI,LAVA and DTI (b=0,600 s/mm2).MR images were reviewed and analyzed by two radiologists in a double-blind manner with the value of ADC and FA measured using the Functool on AW 4.4 workstation.The data of two observers were analyzed with intra-class correlation coefficients (ICC) to assess inter-observer consistency.The differences of ADC values and FA values between ccRCC and TCC were compared by independent t-test.The ROC curves were used to analyze and compare the diagnostic value of DTI in differentiating ccRCC and TCC.Results The inter-observer agreements were good (ICC＞0.75).The ADC value of ccRCC was statistically higher than that of TCC ([2.03 ± 0.49] × 10-3 mm2/s vs [1.57 ± 0.43] × 10-3 mm2/s,P =0.015).But the FA value of ccRCC was statistically lower than that of TCC ([0.24±0.10] vs [0.42±0.22],P=0.002).The area under the ROC curve of ADC was 0.761 (P＜0.05),and the sensitivity and specificity were 79.3％ and 77.8％.The ADC threshold for differentiating ccRCC from TCC was 1.59× 10-3 mm2/s.The area under the ROC of FA was 0.762 (P＜ 0.05),and the sensitivity and specificity were 66.7 ％ and 93.1％.The FA threshold for differentiating ccRCC from TCC was 0.326.Conclusion MR DTI can effectively discriminate ccRCC and TCC.FA values has good diagnostic specificity in differentiating between ccRCC and TCC.

Objective To investigate the value of diffusion kurtosis imaging (DKI)quantitative parameters in evaluating patholog-ical grade of cervical squamous cell carcinoma (CSCC).Methods The DKI images of 45 patients with CSCC were analyzed retrospec-tively.According to the results of pathology,22 cases were divided into poorly differentiated group and 23 cases well-moderately dif-ferentiated group.The DKI parameters of two groups were measured by two observers,which included mean kurtosis (MK),axial kurtosis (Ka),radial kurtosis (Kr),fractional anisotropy of kurtosis (FAk),mean diffusivity (MD),axial diffusivity (Da),radial diffusivity (Dr)and fractional anisotropy (FA).The intra-class correlation coefficients (ICC)was used to test the consistency of the parameters measured results on two observers.The two independent samples t test was used to compare the parameters of two groups,and the ROC curve was used to evaluate the effectiveness of each parameter in order to evaluate the poorly differentiated CSCC and find the boundary values.Results The data consistency of two observers were good (ICC>0.75).The MK,Ka and Kr values on poorly differentiated CSCC were greater than that on well-moderately differentiated (P<0.05),the MD,Da and Dr values were less than that on well-moderately differentiated (P<0.05),the FAk and FA values had no difference (P>0.05).Thearea un-der curve (AUC)of MK,Ka,Kr,MD,Da and Dr values to diagnose poorly differentiated CSCC were 0.914,0.831,0.865,0.850, 0.778 and 0.865,respectively.The boundary values of diagnosing poorly differentiated CSCC were MK≥0.973,Ka≥1.075,Kr≥0.823, MD≤0.974μm2/ms,Da≤1.185μm2/ms and Dr≤0.762μm2/ms,respectively.Conclusion DKI can effectively predict the patho-logical grading of CSCC,which has a good clinical application prospects.

Objective To explore the efficacy of fluconazole mouthwash by means of oxygen-driven atomizing inhalation for treating the pediatric oral fungal infections. Methods A total of 60 cases of child patient from the department of Pediatrics of Jiaozhou People's Hospital have been selected and divided into control group and test group with 30 cases for each group by the method of random number table. The sodium bicarbonate solutions as well as the fluconazole capsules were used for the two groups of children patients. Everyday there were five doses of sodium bicarbonate solution as follows:one after getting up in the morning, one after breakfast/lunch/dinner, and one before bedtime by gargling for three minutes followed by spitting. Daily dose of fluconazole capsules was 3 mg/kg, with 50 ml of NS added for preparing a solution of 1-3 mg/ml. Differences between the two groups are as follows. The control group used the traditional method of gargling. The prepared fluconazole solution was divided into five doses for gargling followed by swallowing which were carried out two hours after the sodium bicarbonate solution. The test group used the oxygen-driven atomizing inhalation therapy. The intervals with the sodium bicarbonate solution were two hours. Before the oxygen-driven atomizing inhalation therapy, the children patients had gargled with water to remove the food debris inside the mouth. Next, the daily dose was divided into five doses to be added into the nebulizers for carrying out the oxygen-driven atomizing inhalation therapy focusing on the exposed ulcer areas. The difference in healing time of oral fungal infection of different position and degree between both groups of child patient has been observed. Results The healing time of oral mucositis at different position of both groups has been compared with each other, with the exception of gingival position, the healing time of child patients in test group at the position of cheek, palate, tongue, pharynx, lips and so on was respectively (6.67±1.68) d, (6.38±1.80) d, (6.36±1.96) d, (6.50±1.60) d and (5.00±0.82) d, which were all better than that of the control group, which was (8.13 ± 2.13) d,(8.00 ± 2.14) d,(8.23 ± 2.13) d, (8.67 ± 1.75) d and (7.20 ± 1.48) d, the difference between both groups was statistically significant(t=2.14-2.64, P<0.05);the healing time of child patients in test group with a degree ranging from I to IV was respectively (5.10±0.88) d, (7.92±1.32) d,(8.00±1.00 )d and (10.25±0.96)d,which were all better than that of the control group, which was(6.36±0.81)d,(9.00±1.29) d,(10.33 ± 0.58)d and(12.33 ± 0.58)d,the difference between both groups was statistically significant(t=2.10-3.50,P<0.05). Conclusions It's suitable for oral care of children patients if we replace the fluconazole mouthwash with the oxygen-driven atomizing inhalation therapy which can reduce the severity of oral mucositis and shorten the healing time.

Objective To assess the value of spectral CT imaging in distinguishing mass type colorectal adenocarcinoma from colorectal adenoma. Methods Forty patients underwent preoperative abdominal dual energy spectral CT scan were analyzed restrospectively, including 17 with colorectal adenomas and 23 with mass type colorectal adenocarcinomas proven by endoscopic and surgical pathology. All patients underwent plain and three-phase enhanced CT scanning. The conventional polychromatic CT value and its pre- and postcontrast CT values, monochromatic CT value of 40 to 100 keV, the slope of spectral curve and iodine(water) concentration were measured, and the maximum diameter of the lesion was recorded. The maximum diameters of the lesions and imaging parameter differences between the adenomas and adenocarcinomas in plain and three-phase enhanced scan were analyzed with independent sample t tests. The data of the parameters with significant differences were further analyzed by ROC curves. Results The maximum diameters of the adenomas and mass type adenocarcinomas were (1.97 ± 0.54), (2.32±0.53) cm respectively, and there was no statistically significant difference (t=-2.011, P=0.051). There was no statistically differences of the conventional polychromatic CT value and its pre-and postcontrast CT values between the two groups in 4 phases (P>0.05). However, in the arterial phase, the CT values of adenomas were significantly lower than those of adenocarcinomas at low (40, 50 keV) energy (P<0.05). The values did not differ significantly between these two groups at other phases (P>0.05). The slope of spectral curve and the iodine(water) concentration both showed significant differences in the arterial phase between the two groups (P<0.05), while they were not significantly different at other phases (P>0.05).The largest area under the ROC curve of the iodine(water) concentration in the arterial phase was 0.757 in differentiating adenomas and mass type adenocarcinomas, with sensitivity of 73.9%and specificity of 82.4%at the cut-off of 21.02 mg/cm3. Conclusion Spectral CT imaging is valuable in differentiating colorectal adenoma from mass type colorectal adenocarcinoma with the parameters of the arterial phase.