Objective To investigate the application value of spectral computed tomography venography(CTV)in the display and staging of deep venous thrombosis(DVT)in the lower extremity.Methods Eighty-two patients with CTV were selected and ran-domly divided into group A(42 patients)and group B(40 patients).Group A:tube voltage 120 kVp.Group B:gemstone spectral ima-ging(GSI)mode,reconstruction of 50 keV and iodine(water)maps.The CT and standard deviation(SD)values of the veins were measured,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated in 120 kVp images of group A and in 50 keV images of group B.Two observers scored the image quality of the 2 groups subjectively,and Kappa test was used to examine the con-sistency.Based on the duration from the occurrence of clinical symptoms,the DVTs were classified.The CT values and iodine con-centration(IC)of DVT were measured in the 120 kVp images of group A and in the iodine(water)maps of group B,respectively.The receiver operating characteristic(ROC)curve was drawn to compare the effectiveness of CT values and IC in diagnosing DVT staging.Results CT values,SNR,and CNR of veins in group B were higher than those in group A(P<0.05).The subjective scores of the two groups were consistent(Kappa=0.926-0.955,P<0.05).The score for the display of veins and thrombus clarity in group B was 5(4,5),which was better than the score of 4(3,4)in group A(P<0.05).The efficiency of IC in diagnosing DVT staging[area under the curve(AUC)=0.973]was better than that of CT values(AUC=0.891).Conclusion The spectral CTV can improve the contrast of lower extremity deep veins and the clarity of thrombus,and can provide more objective indicators for the diagnosis of thrombus staging,which is conducive to accurate clinical diagnosis and treatment.

Objective To screen key autophagy-related genes in alcoholic hepatitis (AH) and investigate potential biomarkers and therapeutic targets for AH. Methods Two AH gene chips in Gene Expression Omnibus (GEO) and autophagy-related data sets obtained from MSigDB and GeneCards databases were used, and the key genes were verified and obtained by weighted gene co-expression network analysis (WGCNA). The screened key genes were subject to gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), protein-protein interaction (PPI) and immune infiltration analyses. Messenger RNA (mRNA)- microRNA (miRNA) network was constructed to analyze the expression differences of key autophagy-related genes during different stages of AH, which were further validated by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) in the liver tissues of AH patients and mice. Results Eleven autophagy-related genes were screened in AH (EEF1A2, CFTR, SOX4, TREM2, CTHRC1, HSPB8, TUBB3, PRKAA2, RNASE1, MTCL1 and HGF), all of which were up-regulated. In the liver tissues of AH patients and mice, the relative expression levels of SOX4, TREM2, HSPB8 and PRKAA2 in the AH group were higher than those in the control group. Conclusions SOX4, TREM2, HSPB8 and PRKAA2 may be potential biomarkers and therapeutic targets for AH.

Objective To investigate the application value of energy spectral CT low energy(keV)targeted reconstruction tech-niques combined with adaptive statistical iterative reconstruction-Veo(ASIR-V)algorithm in lower extremity computed tomography venography(CTV).Methods Forty patients with lower extremity CTV examination were retrospectively selected.Gemstone spec-tral imaging(GSI)mode was used with a transient tube voltage of 80 kVp/140 kVp and tube current in GSI Assist mode.Group A(conventional group):70 keV combined with 40％ASIR-V mono-energy images,conventional display field of view(DFOV)inclu-ding both lower extremity.Group B(low keV group):50 keV combined with 50％ASIR-V mono-energy images,DFOV as in group A.Group C(low keV targeted reconstruction group):50 keV combined with 50％to 80％ASIR-V mono-energy images(10％interval,called as groups C1-C4),targeted reconstruction(small DFOV,covered one lower extremity with left and right femurs as the center).The CT and standard deviation(SD)values of the bilateral lower extremity veins were measured on each axial image and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.Two observers scored the venous images and the sharpness of embolus display subjectively using a 5-point scale and Kappa test was used to examine the consistency.Results In terms of vein dis-play,the score of groups B and C was better than that of group A(P＜0.05).In terms of embolus display sharpness,the scores of large and small embolus in group C increased with the increase of ASIR-V percentage initially and then gradually decreased(P＜0.05).The scores in group C2 were the highest which were superior to the scores of group B and group A(P＜0.05).The CT values of each venous segment in groups B and C were higher than those in group A(P＜0.05).In groups C1 to C4,with the increasing weight of ASIR-V,the SNR and CNR increased gradually(P＜0.05),but slightly lower than those in group B(P＜0.05).Conclusion 50 keV targeted reconstruction techniques combined with 60％ASIR-V algorithm significantly improves the contrast of lower extremity veins and the embolus display sharpness,providing more accurate clinical imaging information.

Objective To investigate the influence of spectral CT monochromatic imaging technique on image quality and liver vol-ume measurement in computed tomography portal venography(CTPV).Methods A total of 120 patients who underwent contrast-enhanced abdominal CT examination were prospectively selected and randomly divided into group A and group B.The group A(n=60)was scanned with conventional parameters such as 120 kVp,Smart mA mode,and image reconstruction of 60％adaptive statistical iterative reconstruction-Veo(ASIR-V);while the group B(n=60)was with instantaneous switching 80/140 kVp,gemstone spectral imaging(GSI)Assist mode,and image reconstruction of 60％ASIR-V.In group B,six subgroups of images from 75 to 50 keV(with 5 keV interval)were recorded as subgroups B1 to B6.On the axial images,the CT values and standard deviation(SD)values of por-tal vein,liver and erector spinae were measured,and then the contrast-to-noise ratio(CNR)of portal vein and liver were calculated.The Liver Segmentation software was used to segment the liver in groups A and B,the liver volumes by automatic segmentation and manual segmentation(golden standard)were recorded,and then the volume difference rate was calculated.The overall image quality and automatic liver segmentation results were evaluated by two radiologists using a 5-point scale.Results In terms of overall image quality,subgroup B6 achieved the highest score and was superior to group A(P＜0.001).In terms of liver segmentation,subgroup B3 had the highest score and was superior to group A(P＜0.001).With the decrease of keV,the CT values,SD values and CNR of portal vein and liver in group B were gradually increased(P＜0.05),in which subgroup B6 was higher than that in group A(P＜0.001).The volume difference rate initially decreased and then increased with the decrease of keV.Except for subgroups B2 and B3,the differences were statistically significant between other subgroups and group A(P＜O.001),and the subgroup B3 had the lowest volume difference rate.Conclusion Spectral CT monochromatic ima-ging technique has an influence on CTPV image quality and liver volume measurement.The 50 keV images are the best for displaying portal vein,and the automatic liver segmentation volume of 65 keV images is closest to the real liver volume.

Objective To investigate the influence of individualized low-dose CT imaging parameters on quantitative computed tomography(QCT)liver fat content measurement and image quality by using the combined technique of Auto-prescription and adaptive statistical iterative reconstruction(ASIR-V)algorithm with different weights.Methods A total of 231 patients who underwent both chest and abdominal CT scans were prospectively selected.The overlapping liver of two-position scans in the same case was studied,in which the chest was scanned with an individualized low-dose protocol(group A)and the upper abdomen was scanned with a routine 120 kVp protocol(group B).Patients with group A were scanned by using 80 kVp and 100 kVp based on Auto-prescription technique,and divided into the subgroups of A1 and A2;meanwhile the same patients with group B were scanned by using 120 kVp and divided into the subgroups of B1 and B2.The images were transferred to AW4.6 and QCTpro workstations for measuring CT values,standard deviation(SD)values and Fat％QCT values of the left lobe,right anterior lobe,and right posterior lobe of the liver in the overlapping regions.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were also calculated using the same-level erector spinae as background.Paired sample t-test was employed to compare the differences in Fat％QCT measurements between groups A and B.Spearman correlation analysis was conducted,and linear regression equations were established.Two observers evaluated image quality using a five-point scale and Kappa test was conducted to test inter-observer consistency.Results In group A,the Fat％QCT values showed no statistically significant difference among different weights of ASIR-V.However,the statistically significant difference was found between groups A and B(P＜0.05),and there were highly positive correlations between subgroups A1 and B1 and between subgroups A2 and B2(r=0.939 7,0.987 2,P＜0.05).The linear regression equation under 80 kVp and 100 kVp were as follows:y=0.976x+3.119,y=1.007x+2.041.The SNR and CNR of group A combined with post-60％ASIR-V were higher than those of group B combined with post-40％ASIR-V under conventional tube voltage.The subjective scores between groups A and B had no statistically significant difference.Conclusion Low-dose chest imaging based on Auto-prescription technique combined with post-60％ASIR-V can not only satisfy clinical diagnostic requirement,but also realize quantitative analysis of Fat％QCT under low tube voltage(80 kVp/100 kVp).

Purpose To explore the application value of 1 024×1 024 reconstruction matrix combined with iterative reconstruction algorithm(Karl)in computed tomography angiography(CTA)of gastric vessels and tumor-supplying arteries.Materials and Methods Thirty patients with gastric tumors who underwent clinical gastric CTA from March to June 2022 at the First Affiliated Hospital of Dalian Medical University were prospectively collected.The original data of CT scan images were grouped and reconstructed.Group A used the conventional 512×512 matrix combined with Karl-5 reconstruction;group B used 1 024×1 024 large reconstruction matrix combined with different levels of Karl algorithm reconstruction,obtaining three subgroups:B1(Karl 5),B2(Karl 7)and B3(Karl 9).The CT and SD values of abdominal aorta at the origin of the left gastric artery,celiac trunk,splenic artery,hepatic artery and the subcutaneous fat tissue of the abdominal wall were measured,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The image quality of each group was assessed by two observers using a 5-point scale.Results The two observers had good consistency in the evaluation of image quality(Kappa=0.782-0.789,P<0.05).Subjective scores for groups B1 to B3 were all better than those for group A,with the highest score in group B2(two-dimensional scores:χ2=27.309,24.250;three-dimensional scores:χ2=21.964,21.294;all P<0.05).The gastric artery system was involved in tumor blood supply in 25 cases of 30 gastric tumors,with the clarity rate of each vessel in group B2 being superior to group A.There were no statistically significant differences in CT values of vessels between groups A,B1 and B2(t=-1.918-2.720,P>0.05),and apart from the SD of the abdominal aorta and CNR of the hepatic artery,differences in SD values,SNR,CNR,and background noise between group B2 and group A were not significant(t=-5.909-5.768,P>0.05);images from B1 to B3 showed a gradual decrease in SD values(F=2.881-27.109,P<0.05)and a gradual increase in SNR and CNR(F=3.612-12.149,P<0.05)as the level of Karl algorithm increased.Conclusion 1 024×1 024 reconstruction matrix combined with Karl-7 can improve the image quality and enhance the display effect of gastric microvessels and tumor-supplying artery branches,which have good clinical application value.

Purpose To explore the value of CT large reconstruction matrix 1024×1024 combined with iterative reconstruction algorithm Karl in the diagnosis of pulmonary nodules.Materials and Methods A total of 500 patients who underwent chest CT examination at the First Affiliated Hospital of Dalian Medical University from October 2021 to May 2022 were prospectively collected,and the raw data of CT scans were reconstructed to divide into group A and B.Group A was reconstructed using a conventional 512×512 matrix combined with Karl 5 reconstruction;group B was reconstructed using a large 1 024×1 024 reconstruction matrix combined with different levels of Karl algorithm to obtain four subgroups,including B1(Karl 6),B2(Karl 7),B3(Karl 8)and B4(Karl 9)subgroup.The signal-to-noise ratio was calculated by measuring the CT and standard deviation values of the tracheal lumen above the arch of the aorta(tracheal area)and the avascular area of the upper lobe of the left lung(lung parenchyma).The overall image quality of the lungs in group A and B was evaluated by two physicians.The best image quality subgroup in group B was compared with the lesion display in group A.The diagnostic efficacy was analyzed based on the surgical pathology results.Results In group B,the standard deviation values of trachea and lung parenchyma gradually decreased and the signal-to-noise ratio gradually increased as the Karl grade increased compared with group A(F=675.002-2 020.903,all P<0.05).All subjective scores in group B were significantly higher than those in group A(Z=-15.361--6.465,all P<0.05),and the highest subjective scores were found in group B4.Some solid nodules(≤3 mm)and solid nodules(6.1 mm-≤3 cm)showed no statistically significant difference in clarity(Z=-2.000,-0.378,both P>0.05).Compared with group A,group B4 showed a 12%-100%improvement in nodule clarity.Only pleural depression sign showed the difference was not statistically significant(χ2=2.143,P>0.05).Taking 43 cases of surgical pathology as the gold standard,the diagnostic accuracy of group B4 was 65.12%,which was better than that of group A,which was 41.86%(χ2=4.674,P<0.05).Conclusion The combined application of the large reconstruction matrix and the Karl iteration algorithm results in superior image quality and facilitates the diagnosis of lung nodules.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Objective To explore heterogeneous subtypes of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation and the characteristics differences of different types of children after liver transplantation. Methods Seven hundred and forty-one children who underwent living-related liver transplantation were enrolled. The self-designed general information questionnaire, Chinese version of 5-Item World Health Organization Well-Being Index (WHO-5) and the parent-report version of the Strengths and Difficulties Questionnaire (SDQ) were filled out by their guardians. The scores of five dimensions of SDQ were used as the manifest variables of the model. The classification model of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation was constructed by latent profile analysis. The latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation were analyzed. The influencing factors of latent categories were analyzed by univariate analysis and logistic regression model. Results There were three latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation, including peer communication problem group (n=302), psychological and behavioral adaptation group (n=145) and psychological and behavioral adjustment difficulty group (n=294). The first two groups were merged into the psychological and behavioral health group (n=447), which had significant differences in the five dimensions and the total score of difficulties of SDQ compared with the psychological and behavioral adjustment difficulty group (n=294) (all P<0.001). Logistic regression analysis showed that age≤5 years old, primary disease of non-cholestatic liver disease, stem family were the risk factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation. Female gender, high education levels of parents and high WHO-5 score of guardians were the protective factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation (all P<0.05). Conclusions The psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation are heterogeneous. Medical staff should pay extensive attention to different characteristics of pediatric recipients after liver transplantation with different psychological and behavioral adaptation categories and adopt targeted screening and intervention strategies, aiming to improve psychological and behavioral adaptation outcomes of pediatric recipients after liver transplantation.

Humans ; Transcranial Magnetic Stimulation ; Pain Management ; Psychotic Disorders/therapy* ; Depressive Disorder, Major ; Treatment Outcome ; Transcranial Direct Current Stimulation