Abstract:Total pelvic exenteration (TPE) has become an important modality for the treatment of locally advanced/recurrent rectal cancer. With the advancement of surgical techniques, the improvement of perioperative management, and the development of multidisciplinary treatment, the radicality and long-term survival of TPE were improved under the guidance of accurate anatomical levels, and the recurrence rate was decreased. The resection of the pelvis (especially the high sacrum) and the sciatic nerve further improved the R0 resection rate. Due to the removal of more pelvic organs and tissue, the incidence of empty-pelvic syndrome after TPE was high and difficult to manage, and the reconstruction of pelvic floor defect with biological patches or myocutaneous flaps might help to reduce postoperative complications. Urinary system reconstruction and vascular reconstruction were difficult for TPE, and it was particularly important to select the appropriate reconstruction method.

Abstract:The progression of ultrasonic medicine and nanomedicine has led contrast-enhanced ultrasound technology to a brand new stage. The design of new materials and preparation of fine nano-materials further promote the clinical application of nanoscale ultrasound contrast agents. Compared with traditional ultrasound contrast agents, nanotechnology-based novel ultrasound contrast agents have advantages such as excellent biocompatibility, serum stability, and long-lasting time. The technology of nanoscale ultrasound contrast agent was found to have an impressive role in the accurate diagnosis and treatment of malignant tumors. The authors, based on long-term clinical experience and literature, reviewed the potential value of nanoscale ultrasound contrast agents in managing musculoskeletal joint diseases, hoping to provide reliable guidance for the diagnosis and treatment of musculoskeletal joint diseases.

Abstract:Photoacoustic imaging (PAI) has the characteristics of both structural and functional imaging and is a new focus in medical imaging research at present. Its research direction covers microscopic cell molecules and macroscopic tissue and organs. PAI can quantitatively evaluate the oxygen saturation of myoglobin, which can reflect the repair status of damaged muscles; it can also clearly display 2D and 3D structure and morphology of the articular cartilage, synovium, blood vessels, and bone tissue; and the trials with patients affected by inflammatory arthritis have also suggested that PAI can detect the degree of cartilage damage non-invasively. Furthermore, by coupling the antibody with photoacoustic contrast agent, PAI can accurately distinguish the spatial information of molecular markers of inflammation, which is helpful to the diagnosis and staging of arthritis.

Abstract:Neuromuscular disease (NMD) is a heterogeneous disease that can affect the peripheral nervous system including motor neurons, sensory neurons, muscles and neuromuscular junctions, seriously affecting the quality of life of patients, and its outcome is irreversible. Early diagnosis and treatment are critical to the formulation of NMD treatment strategies and the guarantee of quality of life of patients. In the past, the diagnosis of NMD mainly relied on the determination of creatine kinase, electromyography, the measurement of nerve conduction velocity, genetic testing, and muscle biopsy. However, these methods are not effective or invasive or affected by gene variation. In recent years, skeletal muscle ultrasound imaging has been increasingly used as a useful supplement to clinical and electrophysiological examination of NMD, but the quantitative evaluation of skeletal muscle structure and function needs to be detailed. This article reviews the current research status of quantitative ultrasound in the evaluation of skeletal muscle structure and function of NMD.

Abstract:Objective To dynamically observe the characteristics of contrast-enhanced ultrasound (CEUS) of rat skeletal muscle at different stages of injury and repair, and to analyze the correlation between them and microvascular density. Methods Forty-eight male SD rats were randomly divided into 8 groups, including 6 rats in normal control group and 42 in injured groups (groups of 1 h, 12 h, 24 h, 48 h, 7 d, 14 d and 28 d after injury). A one-time free fall of an 800 g self-made gravity hammer struck the muscle belly of the right rectus femoris of the rats in the injured groups, thus establishing a model of blunt contusion of the skeletal muscle of the lower limb. At 1 h, 12 h, 24 h, 48 h, 7 d, 14 d and 28 d after the injury, CEUS was performed on the injured sites of skeletal muscle of rats in the injured groups and the corresponding sites in the normal control group. The changes of CEUS characteristics were quantitatively analyzed by computer, and the mean gray scale value of echo intensity (Mean) was obtained. After ultrasound examination, the rats in the injured groups were sacrificed to collect the muscle tissue for hematoxylin-eosin staining, and the microvessel average optical density (MVD) was calculated. Pearson correlation analysis was used to analyze the correlation between MVD and Mean in skeletal muscle injury area. Results The contrast agent signals of skeletal muscle in the injured area of rats in the 1 h group and 12 h group were weak, and most of them showed filling defects. In the 24 h group, the contrast agent in the injured area showed star-shaped distribution, which was low enhancement. In the 48 h group, the contrast agent in the injured area showed patchy distribution, which was slightly enhanced. In the 7 d group, the contrast agent signal in the injured area increased intensively, showing obvious enhancement. In the 14 d group, the contrast agent signal in the injured area was slightly enhanced and was lower than that in the 7 d group. In the 28 d group, the signal of contrast agent in the injured area was similar to that in the normal control group, showing low enhancement. Compared with the normal control group, the Mean of the injured area were significantly decreased in the 1 h, 12 h and 24 h groups (all P＜0.05), the Mean of the injured area was increased in the 48 h group without a significant difference (P＞0.05), and the Mean of the injured area was further increased to the peak in the 7 d group and was still higher in the 14 d group with significant differences (both P＜0.05). The Mean of the injured area in the 28 d group was similar to that in the normal control group (P＞0.05). Compared with the 1 h group, the MVD of the 12 h group was not significantly changed (P＞0.05). The MVD of the 24 h to 28 d groups was all significantly increased (all P＜0.05), with the highest in the 7 d group. The Mean was positively correlated with the MVD in the injury area of rats (r＝0.840, P＜0.001). Conclusion CEUS can dynamically observe the microcirculation perfusion of injured skeletal muscle in different periods, and computer-aided image analysis can quantitatively describe the change of the signal intensity of contrast agent, which has good correlation with the distribution of microvessels in the muscle.

Abstract:Objective To investigate the feasibility of photoacoustic imaging for quantitative evaluation of blood oxgen saturation changes in skeletal muscle injured by blunt contusion. Methods Twenty-five SD rats were randomly divided into 5 groups: normal control group and 1, 2, 3 and 7 d post-injury groups, with 5 rats in each group. The skeletal muscle blunt contusion model was established by striking the right hind limb with a heavy object in each injury groups, and the rats in the normal control group were not given any treatment. Color Doppler flow imaging (CDFI) was used to observe the blood supply of the skeletal muscle of injured area at each time point in the injury groups and the corresponding sites in the normal control group, and Alder semi-quantitative grading was used to record the blood supply parameters of each group. The photoacoustic imaging mode was performed to measure the average blood oxygen saturation and the total blood oxygen saturation within each region of interest. The correlations between Alder semi-quantitative grading of CDFI and average blood oxygen saturation and total blood oxygen saturation were analyzed by Fisher exact test. Results The CDFI blood flow Alder semi-quantitative grades of skeletal muscle in the normal control group and 1, 2, 3 and 7 d post-injury groups were Ⅰ, 0 -Ⅰ, Ⅱ, Ⅱ-Ⅲ and Ⅲ, respectively. The average blood oxygen saturation and total blood oxygen saturation in the 2, 3 and 7 d post-injury groups were significantly higher than those in the normal control group and the 1 d post-injury group (all P＜0.05), and those in the 7 d post-injury group were significantly higher than the 2 and 3 d post-injury groups (all P＜0.05), while there was no statistical significance between the 2 and 3 d post-injury groups (both P＞0.05). The CDFI blood flow Alder semi-quantitative grading results were: grades 0 to Ⅰ in 10 and grades Ⅱ to Ⅲ in 15 of 25 rats. There were 11 rats with average blood oxygen saturation＜ 55%, including 8 rats with grades 0 to Ⅰ; and 14 rats with average blood oxygen saturation≥55%, including 12 rats with grades Ⅱ to Ⅲ. There were 11 rats with total blood oxygen saturation＜55%, including 9 rats with grades 0 to Ⅰ; and 14 rats with total blood oxygen saturation≥55%, including 13 rats with grades Ⅱ to Ⅲ. CDFI blood flow Alder semi-quantitative grading was positively correlated with both average blood oxygen saturation and total blood oxygen saturation (P＝0.005, 0.002). Conclusion Photoacoustic imaging can dynamically assess the changes of oxygen saturation in the skeletal muscle with blunt contusion at different time points, which correlates well with CDFI blood flow Alder semi-quantitative grading.

Abstract:Objective To establish a preoperative prediction model which can effectively predict the risk of occult abdominal metastatic disease of pancreatic ductal adenocarcinoma. Methods The clinical data of 986 patients with pancreatic ductal adenocarcinoma who underwent surgery in our department from Sep. 2018 to Dec. 2020 were retrospectively analyzed. The variables with P≤0.2 in univariate analysis were included in binary logistic regression model, and independent predictors of occult abdominal metastatic disease were screened out; finally a nomogram prediction model was established. Then receiver operating characteristic (ROC) curve was used to evaluate the prediction efficiency. Results The incidence of occult abdominal metastatic disease was 8.42% (83/986) in the pancreatic ductal adenocarcinoma patients (593 ［60.14%］ males and 393 ［39.86%］ females). The average age of the patients was (62.40±9.43) years old. The results of univariate analysis showed that occult abdominal metastatic disease was associated with abdominal pain, duration of abdominal pain, total bilirubin, prealbumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase, carcinoembryonic antigen, α-fetoprotein, carbohydrate antigen (CA)125, CA19-9, CA724, ascites, tumor size, tumor site, breakthrough of capsule, the invasion of surrounding organs, the degree of invasion of celiac trunk, superior mesenteric artery, splenic artery and splenic vein, suspected metastasis in the No. 9, No. 13, No. 14 and No. 17 lymph nodes, suspected metastasis of retroperitoneal lymph nodes, suspected metastatic tumor and the sites in the liver, abdominal lesions of unknown nature, and history of abdominal surgery (all P＜0.05). Multivariate analysis showed that age, ascites, short cross-sectional diameter of tumor, the invasion of surrounding organs, the degree of invasion of superior mesenteric artery, suspected metastasis in the No. 13 lymph nodes, suspected liver metastases, uncertain lesions in abdominal cavity and history of abdominal surgery were independent predictors of occult abdominal metastatic disease. Based on the above independent predictors, a nomogram prediction model has been constructed, and the area under the ROC curve was 0.783 (P＝0.001). The optimal risk score, sensitivity and specificity of the model were 77.68, 0.650 and 0.787, respectively. Conclusion The nomogram prediction model can help to improve the preoperative diagnosis rate of occult abdominal metastatic disease of pancreatic ductal adenocarcinoma.

Abstract:Objective To systematically evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and prognosis of patients with lower extremity peripheral arterial disease (PAD). Methods Studies on NLR and lower extremity PAD were retrieved from PubMed, Scopus, Web of Science, CNKI, Wanfang data, VIP and SinoMed till Dec. 31, 2021. First author, publication year, country, study type, sample size, gender, age, smoking, comorbidity, average NLR, NLR threshold, outcome and follow-up time were collected. The quality of the included studies was evaluated with Newcastle-Ottawa scale. Stata 16.0 software was used to calculate the effect size of different outcomes in lower extremity PAD patients with high or low NLR by random-effect model. Results A total of 17 articles were included (n＝4 554). Meta analysis showed that all-cause death, amputation and restenosis were closely associated with high NLR and the combined effect sizes were hazard ratio (HR)＝1.93 (95% confidence interval ［CI］ 1.21-3.10), HR＝1.92 (95% CI 1.43-2.59) and odds ratio (OR)＝1.76 (95% CI 1.13-2.75), respectively. Subgroup analysis suggested that high NLR was predictive of all-cause death, amputation and restenosis in lower extremity PAD patients within 1 year after intervention, with HR being 3.24 (95% CI 1.96-5.35), HR being 2.64 (95% CI 2.10-3.31) and with OR being 2.44 (95% CI 1.09-5.43), respectively. HR of all-cause death in lower extremity PAD patients with high NLR treated conservatively was 2.82 (95% CI 2.08-3.84), while high NLR was not associated with amputation. Conclusion High NLR is closely associated with all-cause death, amputation and restenosis after intervention, which can be used as a predictor of amputation, all-cause death and in-stent restenosis in lower extremity PAD patients 1 year after intervention.

Abstract:Objective To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) defined by ZJU index and serum 25-hydroxyvitamin D levels in patients with type 2 diabetes mellitus (T2DM). Methods The clinical data of 917 T2DM patients diagnosed in Department of Endocrinology, First Hospital of Lanzhou University from Apr. 2016 to Oct. 2020 were collected. The patients were divided into non-NAFLD group (ZJU index＜32.0), uncertain group (ZJU index 32.0-38.0) and NAFLD group (ZJU index＞38.0), and the serum 25-hydroxyvitamin D levels of the 3 groups were compared. The association between 25-hydroxyvitamin D levels and NAFLD defined by ZJU index was analyzed by generalized linear model. Results There were 570 NAFLD patients (62.16%) defined by ZJU index in 917 T2DM patients. The ZJU index defined 336 (81.55%) patients as NAFLD in 412 T2DM patients who were diagnosed with fatty liver by ultrasound. The prevalence rates of NAFLD in T2DM patients with hypertension, hyperlipidemia, overweight or obesity were significantly higher than those in T2DM patients without hypertension, hyperlipidemia or with normal weight (64.92% ［396/610］ vs 56.68% ［174/307］, 68.18% ［480/704］ vs 42.25% ［90/213］, and 76.83% ［315/410］ and 99.08% ［108/109］ vs 38.03% ［143/376］; all P＜0.01). The prevalence of NAFLD in T2DM patients with poor glycemic control was significantly higher than that with good glycemic control (69.33% ［495/714］ vs 36.95% ［75/203］, P＜0.001). The prevalence of NAFLD in T2DM patients with normal 25-hydroxyvitamin D levels was significantly higher than that with 25-hydroxyvitamin D inadequacy or deficiency (79.90% ［163/204］ vs 56.99% ［367/644］ and 57.97% ［40/69］, P＜0.001). After adjusting for confounding factors such as age, fasting blood glucose, blood glucose 2 h after meals, glycosylated hemoglobin (HbA1c), body mass index (BMI), systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), analysis of covariance showed that there were no significant differences in 25-hydroxyvitamin D levels between male and female NAFLD groups and non-NAFLD groups in either male or female patients (P＝0.065 and 0.197). The generalized linear model suggested that BMI, blood glucose 2 h after meals, HbA1c, homeostasis model of assessment for insulin resistance index, triglyceride and ALT/AST were the risk factors for NAFLD defined by ZJU index (OR＝2.754, 1.499, 1.341, 1.067, 2.871, and 22.346). There was no correlation between serum 25-hydroxyvitamin D level and ZJU index (P＝0.802). Conclusion ZJU index has application value in the diagnosis of NAFLD in T2DM patients. The prevalence of NAFLD defined by ZJU index is higher in T2DM patients with poor glycemic control, hypertension, hyperlipidemia, overweight or obesity, but serum 25-hydroxyvitamin D level is not associated with NAFLD.

Abstract:Objective To evaluate the effects of intestinal barrier function indicators (diamine oxidase ［DAO］, D-lactic acid ［DLA］, and endotoxin ［ET］) on common adverse reactions and nutritional status of patients with gastrointestinal tumor after chemotherapy, and to determine the best predictive values of intestinal barrier function indicators for them. Methods A total of 77 patients with gastrointestinal tumors who were admitted to Anqing First People’s Hospital of Anhui Medical University from Sep. 2019 to May 2022 were enrolled. DAO, DLA and ET of patients before chemotherapy and pre- and post-chemotherapy patient generated subjective global assessment (PG-SGA) scores were collected. The effects of intestinal barrier function on adverse reactions and nutritional status after chemotherapy were analyzed by comparing the levels of DAO, DLA and ET in patients with different clinical characteristics. The influencing factors of adverse reactions and nutritional deterioration were screened using binary logistic regression analysis. The best predictive values of DAO, DLA and ET for adverse reactions and nutritional deterioration were determined using receiver operating characteristic curve and Youden index. Results The occurrence of myelosuppression was not affected by the levels of DAO, DLA and ET. Patients with vomiting, diarrhea or nutritional deterioration after chemotherapy had significantly higher DAO and DLA before chemotherapy (all P＜0.05). Patients with diarrhea or elevated transaminase after chemotherapy had significantly higher ET before chemotherapy (both P＜0.001). Regression analysis showed that DAO and DLA before chemotherapy and gastrointestinal surgery within 3 months were related to the occurrence of vomiting (all P＜0.05). DLA is an independent influence factor of diarrhea after chemotherapy (P＝0.001). Late cycle chemotherapy and elevated DLA were the influencing factors of nutritional deterioration after chemotherapy (both P＜0.05). The best predictive value of ET for transaminase elevation after chemotherapy was 17.36 U/L (area under curve ［AUC］ ＝0.850, P＜0.001). The best predictive values of DAO and DLA for vomiting were 10.47 U/L (AUC＝0.727, P＝0.001) and 18.55 mg/L (AUC＝0.708, P＝0.003), respectively. The best predictive value of DLA for diarrhea was 17.63 mg/L (AUC＝0.920, P＜0.001). The best predictive value of DLA for nutritional deterioration was 12.77 mg/L (AUC＝0.684, P＝0.006). Conclusion Intestinal barrier function indicators (DAO, DLA, and ET) have predictive value for vomiting, diarrhea, elevated transaminase and nutritional deterioration after chemotherapy.

Abstract:Objective To establish and evaluate a standardized animal model of femoral fracture combined with sciatic nerve injury in mice. Methods A total of 96 male C57BL/6J mice were randomly divided into 2 groups: femoral fracture combined with sciatic nerve injury group (n＝48) and femoral fracture group (n＝48). The left sciatic nerves were crushed by hemostatic forceps, and the ipsilateral femurs were cut and fixed with intramedullary nails in the bone marrow. And then, the mouse model of femoral fracture combined with sciatic nerve injury was established in femoral fracture combined with sciatic nerve injury group. Mice in the femoral fracture group underwent fracture of the left femurs by intramedullary nails fixation, and the left sciatic nerves were dissociated, but not clamped. Behavioral observation of postoperative mice was performed in both groups. The left sciatic nerves of mice were collected in both groups (36 mice each) on the 3^rd, 5^th, 7^th, 10^th, 14^th and 18^th d after operation, with 6 mice in each group at each time point, and the histological changes of the sciatic nerves were observed by immunohistochemical staining. On the 7^th, 14^th, 21^st and 28^th d after operation, the fracture healing was analyzed by femoral X-ray radiographs, micro-CT, hematoxylin-eosin staining and safranine-fast green staining. Results A mouse model of femoral fracture combined with sciatic nerve injury was successfully established. Behavioral observation and assessment revealed that the gait of mice in the femoral fracture combined with sciatic nerve injury group basically returned to normal on the 14^th d after operation. The immunohistochemical results of sciatic nerves showed that the structural continuity of sciatic nerve fibers was basically recovered in the mice of femoral fracture combined with sciatic nerve injury group on the 14^th d after operation. Micro-CT showed that the bone volumes of femoral fracture combined with sciatic nerve injury group were significantly lower than those of femoral fracture group at all time points (all P＜0.01), and so were the bone volume/tissue volume (all P＜0.01). The histomorphological results of bone sections showed that on the 7^th d calluses almost disappeared at the fracture site; however, a small amount of cartilage calluses appeared on the 14^th d, which were mainly composed of undifferentiated mesenchymal stem cells; the cartilage calluses began to calcify on the ²¹st d, and there were some hypertrophic chondrocytes in the calluses; and on the ²⁸th d, new bone formed, containing a large number of hypertrophic chondrocytes, osteoblasts and osteocytes. Conclusion A mouse model of femoral fracture combined with sciatic nerve injury is successfully constructed, and it has a good healing process and delayed healing compared with that of simple femoral fracture, and can better simulate the bone repair and healing process after clinical fracture combined with peripheral nerve injury.

Abstract:Objective To explore the relationship between meteorin-like protein (Metrnl) and colorectal cancer and its role in the development and progression of colorectal cancer. Methods Expression and distribution of Metrnl in the colorectal cancer and paracancerous tissue were analyzed by human tissue microarray (n＝30). Fifteen clinical colorectal cancer tissue samples and 15 normal human colorectal tissue samples were collected, and the expression level of Metrnl mRNA was detected by quantitative polymerase chain reaction. In the cell experiment, the expression of Metrnl in human colon cancer epithelial cell line Caco-2 was knocked down by lentivirus-mediated short hairpin RNA (shRNA) interference technology (Metrnl shRNA group), and unrelated sequence was used as control (Scr shRNA group). Cell counting kit 8, cysteine aspartic acid specific protease 3 (caspase 3) activity assay kit and annexin Ⅴ-fluorescein isothiocyanate/propidium iodide flow cytometry apoptosis detection kit were used to detect the cell viability and apoptosis under the treatment of 5-fluorouracil. Results Metrnl protein was significantly higher in the human colorectal cancer tissue compared with the paracancerous tissue (P＜0.000 1), but the level of Metrnl mRNA in the colorectal cancer tissue was significantly lower compared with the normal colorectal tissue (0.09±0.02 vs 0.22±0.06, P＜0.05). Knockdown of Metrnl blocked the decline of cell viability induced by 5-fluorouracil (P＜0.05). The activity of caspase 3 and the proportion of apoptotic cells in the Metrnl shRNA group were significantly lower than those in the Scr shRNA group (1.04±0.27 vs 1.67±0.44, ［12.53±6.69］% vs ［26.56±10.89］%, both P＜0.05). Conclusion Secretory protein Metrnl is accumulated in the colorectal cancer tissue, but Metrnl transcription decrease in colorectal cancer may promote the development and progression of colorectal cancer.

Abstract:Chronic subdural hematoma (CSDH) is one of the most common diseases in neurosurgery, and its incidence is increasing every year with the aging of the population and the widespread use of antithrombotic drugs. The majority of patients with CSDH have a good outcome with surgical treatment, but 5%-30% of patients still experience recurrence of hematoma and require readmission to the hospital. Common risk factors of hematoma recurrence include the patient factors such as gender, age and underlying disease, the imaging pattern of the hematoma at admission, the use of antithrombotic drugs, the mode of anesthesia, different surgical procedures, and adjuvant medications.

Abstract:Thyroid disease is one of the common causes of recurrent spontaneous abortion (RSA), and it is involved in the occurrence of RSA mainly from the endocrine and immune levels. Abnormal thyroid hormone levels and the presence of anti-thyroid autoantibody (ATA) can affect the normal physiological changes of the mother and embryonic development during pregnancy, leading to abortion. For RSA patients with abnormal thyroid dysfunction, diagnosis and treatment should be given before pregnancy, and pregnancy should be considered when thyroid function is normal. For RSA patients with normal thyroid function but with positive ATA, the use of levothyroxine before pregnancy remains controversial.

Abstract:In recent years, immunotherapy represented by programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors has shown remarkable efficacy for lung cancer. However, there are significant differences in the efficacies of PD-1/PD-L1 inhibitors in different patients with lung cancer. Studies have found that exosomal PD-L1 (ePD-L1) can replace the PD-L1 from lung cancer cells to inhibit the activation of T cell and produce immune resistance. At the same time, it can transfer PD-L1 to secondary cells to play the role of immune tolerance and affect the efficacy of immunotherapy. This paper reviews the methods of separation and detection of exosomes and ePD-L1, the immunosuppressive effect of ePD-L1, and the mechanism of ePD-L1 in the progress of lung cancer and immunotherapy.

Abstract:As a new technology that connects reality and virtuality, solves the integration of physical information, and promotes the concept of smart manufacturing, digital twin has become a focus in various industries. As a mature diplomatic model, foreign medical aid has become an important way for our country to participate in global health governance, share medical experience, and fulfill international obligations. By introducing the characteristics of digital twin and the shortcomings of the current foreign medical aid work, this paper discusses the possibility of applying digital twin for the pre-departure training of foreign medical aid teams, and also explores the application requirements and current challenges.

Abstract:Objective To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of extra-adrenal retroperitoneal ganglioneuroma. Methods CT and MRI data of 50 patients with extra-adrenal retroperitoneal ganglioneuroma in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Dec. 2011 to Aug. 2021 were retrospectively analyzed and compared with the pathological findings. Among the 50 cases, 31 cases underwent CT plain scan and enhanced scan, 35 cases underwent MRI plain scan and enhanced scan, and 16 cases underwent CT and MRI scan at the same time. Results The tumors in 50 patients were all single and 47 (94%) had clear boundary. The average maximum diameter of the mass was (9.1±3.8) cm. Thirty-two (64%) cases showed pseudopodial and embedded growth along the perivascular space and 18 (36%) cases showed expansive growth. Twenty-one (42%) cases surrounded the abdominal great vessels. Eight (16%) cases showed a little cystic change, 13 (26%) cases were accompanied by spotty calcification, and 6 (12%) cases contained patchy fat. Thirty-one cases showed equal or low density on plain CT images. On MRI T2 weighted images, 30 (86%) cases showed uneven high or slightly high signal. Among the 50 cases, 39 (78%) cases had no obvious or mild enhancement and 11 (22%) cases had moderate or obvious enhancement. All enhancement cases showed progressive delayed enhancement. The enhancement patterns were flake flocculent and line interleaving enhancement in 10 (20%) cases, flake flocculent enhancement in 15 (30%) cases, line interleaving enhancement in 12 (24%) cases, and swirl-like enhancement in 3 (6%) cases. Conclusion Extra-adrenal retroperitoneal ganglioneuroma has certain characteristic imaging manifestations. Preoperative CT and MRI are of great value in diagnosing ganglioneuroma and evaluating the relationship between adjacent large vessels.

Abstract:Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types with chest high resolution computed tomography (HRCT) stages and scores and pulmonary function of interstitial lung disease (ILD). Methods The TCM syndrome types, chest HRCT image stages and scores and pulmonary function results of 259 ILD patients were retrospectively analyzed to explore the relationship between the 3 factors. Results Early ILD patients according to HRCT staging had a high proportion of excess syndrome; the proportion of deficiency syndrome in the middle and late stage patients increased gradually, and the latter was mainly characterized by deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi, accounting for 30.2% (13/43) and 20.9% (9/43), respectively. The HRCT scores of patients with deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi were the highest (18.67±2.64 and 14.06±2.28, respectively), which were significantly different from those of other TCM syndrome types (all P＜0.01). The forced vital capacity (FVC) as a percentage of predicted (FVC%pred) and diffusing capacity for carbon monoxide of lung (DLCO) as a percentage of predicted (DLCO%pred) of the ILD patients with both deficiency of lung and kidney qi and yin and deficiency of lung and kidney qi were the lowest, which were significantly different compared with the patients with other TCM syndrome types (P＜0.01, P＜0.05). HRCT score was strongly negatively correlated with DLCO%pred (r＝－0.695, P＜0.01), moderately negatively correlated with FVC%pred and forced expiratory volume in one second (FEV₁) as a percentage of predicted (r＝－0.468, －0.402, both P＜0.01), weakly negatively correlated with FEV₁/FVCpred as a percentage of predicted and DLCO/alveolar ventilation as a percentage of predicted (r＝－0.364, －0.294, both P＜0.01), and very weakly negatively correlated with total lung volume as a percentage of predicted (r＝－0.116, P＜0.01). Conclusion There is a certain relationship between TCM syndrome types, HRCT stages and scores, and pulmonary function in patients with ILD. The HRCT stage and score of the patients with lung and kidney _qi and _yin deficiency syndrome or lung and kidney _qi deficiency syndrome are the highest, and their pulmonary function is the worst.

Abstract: