IntroductionGastric schwannoma is a rare benign tumor accounting for only 1–2% of alimentary tract mesenchymal tumors. Owing to their low incidence rate, most cases are misdiagnosed as gastrointestinal stromal tumors (GISTs), especially tumors with a diameter of less than 5 cm. Therefore, this study aimed to develop and validate a diagnostic nomogram based on computed tomography (CT) imaging features for the preoperative prediction of gastric schwannomas and GISTs (diameters = 2–5 cm).MethodsGastric schwannomas in 47 patients and GISTs in 230 patients were confirmed by surgical pathology. Thirty-four patients with gastric schwannomas and 167 with GISTs admitted between June 2009 and August 2022 at Hospital 1 were retrospectively analyzed as the test and training sets, respectively. Seventy-six patients (13 with gastric schwannomas and 63 with GISTs) were included in the external validation set (June 2017 to September 2022 at Hospital 2). The independent factors for differentiating gastric schwannomas from GISTs were obtained by multivariate logistic regression analysis, and a corresponding nomogram model was established. The accuracy of the nomogram was evaluated using receiver operating characteristic and calibration curves.ResultsLogistic regression analysis showed that the growth pattern (odds ratio [OR] 3.626; 95% confidence interval [CI] 1.105–11.900), absence of necrosis (OR 4.752; 95% CI 1.464–15.424), presence of tumor-associated lymph nodes (OR 23.978; 95% CI 6.499–88.466), the difference between CT values during the portal and arterial phases (OR 1.117; 95% CI 1.042–1.198), and the difference between CT values during the delayed and portal phases (OR 1.159; 95% CI 1.080–1.245) were independent factors in differentiating gastric schwannoma from GIST. The resulting individualized prediction nomogram showed good discrimination in the training (area under the curve [AUC], 0.937; 95% CI, 0.900–0.973) and validation (AUC, 0.921; 95% CI, 0.830–1.000) datasets. The calibration curve showed that the probability of gastric schwannomas predicted using the nomogram agreed well with the actual value.ConclusionThe proposed nomogram model based on CT imaging features can be used to differentiate gastric schwannoma from GIST before surgery.

AIM: To evaluate the feasibility and image quality of intravoxel incoherent motion diffusionweighted imaging (IVIM) using gradient- and spin-echo (GRASE) in solitary pulmonary lesions (SPLs) compared to echo planar imaging (EPI) and turbo spin-echo (TSE) at 3 T. MATERIALS AND METHODS: Forty-two patients with SPLs underwent lung magnetic resonance imaging (MRI) using TSE-IVIM, GRASE-IVIM, and EPI-IVIM at 3 T. Signal ratio (SR), contrast ratio (CR), and image distortion ratio (DR) of three sequences were compared. The reproducibility and repeatability of the apparent diffusion coefficient (ADC) and IVIM-derived parameters were assessed using the interclass correlation coefficient (ICC) and coefficient of variation (CV). The repeatability of the ADC and IVIM-derived parameters between all sequences was evaluated using the Bland-Altman method. RESULTS: EPI-IVIM had a higher SR, lower CR, and higher DR (p<0.05); however, there was no significant difference between TSE-IVIM and GRASE-IVIM (p>0.05). Compared to the D and f values of TSE-IVIM (ICC lower limit >0.90), GRASE-IVIM and EPI-IVIM showed poor reproducibility (ICC lower limit<0.90). The repeatability of the ADC and D values obtained by TSEIVIM (CV, 1.93-2.96% and 2.44-3.18%, respectively) and GRASE-IVIM (CV, 2.56-3.12% and 3.21 -3.51%, respectively) were superior to those of EPI-IVIM (CV, 10.03-10.2% and 11.30-11.57%). The repeatability of D* and f values for all sequences was poor. Bland-Altman analysis showed wide limits of agreement between the ADC and IVIM-derived parameters for all sequences. CONCLUSION: GRASE-IVIM reduced the DR, improved the stability of the ADC and D values on repeated scans, and had the shortest scanning time. (c) 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

目的 探讨酰胺质子转移加权(APTw)MRI用于评估亚急性期脑梗死梗死核心(IC)和缺血半暗带(IP)有关酸碱度(pH)改变的临床价值.方法 选取亚急性期脑梗死91例患者为观察组,另选取同时间段健康志愿者90例为对照组,均予以常规MRI、DWI和APTw检查,其中观察组26例患者开展灌注加权成像(PWI),将DWI、PWI以及APTw图像当作基础明确观察组IC区域、PWI-DWI不匹配区域和APT-DWI不匹配区域,将观察组的梗死侧和对侧、对照组两侧IC区域、PWI-DWI不匹配区域以及APT-DWI不匹配区域的APTw值开展对比.结果 两组各个区域的APTwmax、APT-wmin、APTwmax-min相比差异有统计学意义(P＜0.05).观察组IC区和IC对侧的各个APTw值和对照组相比差异无统计学意义(P＞0.05);IC区域内各个APTw数值和对侧相比差异无统计学意义(P＞0.05).PWI-DWI不匹配区域、APT-DWI不匹配区域有关APTwmax、APTwmin、APTwmax-min均较对侧低差异有统计学意义(P＜0.05).PWI-DWI不匹配区域、APT-DWI不匹配区域有关APTwmax、APTwmin、APTwmax-min值相比差异无统计学意义(P＞0.05).IC区的APTwmax、APTwmin、APTwmax-min均较PWI-DWI不匹配区域、APT-DWI不匹配区域低差异有统计学意义(P＜0.05).观察组IC区的APTwmean和ADC值之间为正相关关系(r=0.530,P＜0.05).结论 亚急性期脑梗死患者IC酸碱代谢改变不明显,但IP局部伴随酸碱代谢失衡现象.

Regulatory T cells (Tregs) are an important component of the tumor microenvironment; however, the interaction between Tregs and gastric cancer cells is not completely understood. Recent studies have shown that Tregs participate in cancer cell stemness maintenance. In this study, we performed single-cell RNA sequencing of gastric cancer and adjacent tissues and found that Tregs with high TNF expression were recruited to gastric cancer tissues and were significantly correlated with patient survival. TNF+ Tregs significantly contribute to tumor growth and progression. Our studies have further demonstrated that TNF+ Tregs promote the stemness of gastric cancer cells through the IL13/STAT3 pathway. Therefore, blocking the interaction between TNF+ Tregs and gastric cancer cells may be a new approach in the treatment of gastric cancer.

目的 探讨扩散峰度成像(DKI)联合动态增强磁共振成像(DCE-MRI)对乳腺癌分子分型的诊断价值.方法 选取经病理证实的乳腺癌患者148 例,所有病例均行DKI及DCE-MRI检查.分析两组间的临床病例资料和平均扩散峰度值(MK)、平均扩散率(MD)、容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)和速率常数(Kep),绘制受试者工作特征曲线比较其诊断效能.结果 Luminal A型和Luminal B型的MD值小于HER-2 阳性型、三阴型(P<0.05);Luminal B型的MK值大于HER-2 阳性型(P =0.021);HER-2 阳性型的Ktrans和Ve 值均大于其他分子分型(P<0.05);三阴型组Ve 值均小于其他分子分型(P<0.05).当 MD≤1.96×10-3 mm2/s、MK≥0.70/min、Ktrans≤0.36(min-1)、Kep≤0.41(min-1)时,对鉴别Luminal A/B型与非Luminal型有价值,联合后受试者工作特征曲线下面积(AUC)为0.811,诊断效能高于单一参数(Z =2.040～3.352,P =0.001～0.041).当MD≥2.28×10-3mm2/s、MK≤0.66/min、Ktrans≥0.36(min-1)、Ve≥0.49 时,对鉴别HER-2 阳性型与非HER-2 阳性型有价值,联合后AUC为0.872,诊断效能高于单一参数(Z =2.038～3.397,P =0.001～0.048).当MD≥1.96×10-3 mm2/s、Kep≥0.39(min-1)、Ve≤0.59 时,对鉴别三阴型与非三阴型有价值,Ve 的诊断效能高于MD及Kep值(Z = 2.032,P =0.042;Z =2.562,P =0.01);三者联合后AUC为 0.834,与单一参数差异有统计学意义(Z =2.051～3.852,P =0.001～0.042).结论 DKI联合DCE-MRI可用于乳腺癌分子分型的预测,有利于患者的个体化治疗.

The present study aimed to explore the function of microRNA (miR)-204 in modulating cyclin-dependent kinase inhibitor 1B (p27) mRNA stability in head and neck squamous cell carcinoma (HNSCC). Briefly, reverse transcription quantitative polymerase chain reaction and western blot analysis were used to detect miR-204 and Brd4 level. Cell viability, cell cycle and cell apoptosis were used to investigate the effects of miR-204. Additional luciferase reporter and mRNA stability assays were used to explore the mechanisms contributing to miR-204 effects. Here, miR-204 was downregulated in HNSCC tissues compared with the adjacent normal tissues. The expression levels of miR-204 and bromodomain-containing protein 4 (Brd4) were negatively associated in HNSCC tissues. Ectopic expression of miR-204 inhibited HNSCC cell proliferation, promoted cell cycle arrest at the G1/S phase and promoted cell apoptosis compared with control cells. Additionally, upregulation of miR-204 expression levels enhanced p27 mRNA stability. Notably, Brd4 was identified as a target of miR-204, and the co-expression of Brd4 with miR-204 mimics attenuated the inhibitory effects of miR-204 on cell proliferation and enhanced p27 mRNA stability compared with control cells. Thus, it was concluded that miR-204 functions as a tumor suppressor by enhancing p27 mRNA stability through targeting Brd4 in HNSCC.

<正>患儿女,16个月,主因"发现左顶部肿物12月余"入院。体检:左顶部触及鹌鹑蛋大小包块,质硬、位置固定,无压痛,皮肤无红肿热。影像学检查:CT平扫见左顶骨内类圆形膨胀性骨质破坏影,病变呈均匀的软组织密度影,CT值45HU,境界清楚,肿块突破颅内外板,向颅外突出,边缘硬化

Objective To investigate the CT characteristics of skull chlesteatoma,and explore its diagnostic accuracy.Methods CT characteristics of 15 skull chlesteatomas confirmed by surgery and pathology were retrospectively analyzed.CT plain scan were performed in all the patients,while extra enhanced CT scan was done in 2 cases.Results On the CT images,all cases were solitary.14 cases originated from intradiploe,and one case from skull suture.Extensive destruction of the skull with hard margin was found in 15 patients.7 cases presented crater-form deossificatio.11 cases demonstrated inhomogeneous density in which 6 cases showed calcification.The fat-like density was noticed mainly in one case,the water-like density mainly in 2 cases,the iso-density mainly in 2 cases,and homogeneous density in 4 cases.MPR and VR images could display the shape and scope of destruction.2 cases showed mild enhancement on contrast CT.Conclusion CT scanning of skull chlesteatomas has some features,CT combining with post-processing techniques are very effective in the diagnosis of skull chlesteatomas.

小儿异物吸入是常见的危重急症,诊断不及时常给患儿造成严重的痛苦,甚至危及生命.该病诊断除根据临床病史外,还须影像学检查.普通X线检查对金属异物可作出明确诊断,而对非金属异物只能根据间接征象推测诊断,缺乏可靠的诊断方法,因此确诊率低,易误诊或漏诊.随着多层螺旋CT软件及硬件技术的飞速发展,其在小儿气道异物中的诊断价值日益提高.