Medical imaging plays a very important role in the diagnosis, treatment and prognosis of digestive diseases. This manuscript aimed to explore the value of a teaching model based on an image case database in improving the image interpretation skills of non-radiology residents training in gastroenterology department. From October 2023 to March 2024, all the residents training in the gastroenterology department were selected as the research subjects. Using the implementation date of the teaching model based on an image case database as the cutoff point, the experimental group comprised 27 residents (January–March 2024), while the control group included 24 (October–December 2023). The experimental group learned by using a teaching mode based on an image case database, whereas the control group learned by using conventional teaching methods. The effects of the two teaching modes were evaluated through the examination of admission, mid-term and exit performance scores, and questionnaires were used to feedback the evaluation of the residents of the experimental group on the teaching mode of the case database. The scores of non-radiology residents in the experimental group and the control group showed no difference in the admission examination ( P = 0.728), but the scores in the experimental group were significantly higher than those in the control group at the mid-term (P = 0.006) and exit examination (P = 0.002), respectively. In the experimental group, 100

This study aims to propose a radiomics model to identify male patients suffering from renal pelvis urothelial carcinoma (RPUC) with preoperative lymph node (LN) metastasis. In a study involving 133 male RPUC patients, 94 were assigned to a training group and 39 to a testing group. Their arterial-phase computed tomography (CT) images were analyzed to extract radiomics features, which were then refined through data reduction and feature selection. Using the least absolute shrinkage and selection operator (LASSO), a radiomics signature was created, which was then incorporated into a Logistic regression classifier in the training group to predict pathologic lymph node metastases. A comprehensive radiomics model was developed using multivariate logistic regression, integrating clinical risk factors. The model’s efficacy was evaluated in both sets using discrimination, calibration and decision curve analyses in both the training and testing sets. The constructed signature, composed of eight promising imaging-derived features, showed strong discrimination ability in both sets (training: area under the curve (AUC) 0.836 and testing: AUC, 0.817). When combined with CT-reported tumor status, the radiomics model demonstrated excellent calibration and discrimination, achieving an AUC of 0.849 in the training set and 0.851 in the testing set. The radiomics model, incorporating both the radiomics signature and the CT-reported tumor status, could help in the preoperative individualized prediction of LN metastasis in male patients with RPUC.

Abstract Background Process-based teaching is a new education model. SPARK case database is a free medical imaging case database. This manuscript aimed to explore the application of the process-based teaching based on SPARK case database in the practice teaching of radiology in the musculoskeletal system. Methods 117 third year medical students were included. They were divided into Group A, B, C and D according to the curriculum arrangement. Group A and B attended the experimental class at the same time, A was the experimental group, B was the control group. Group C and D attended experimental classes at the same time, C was the experimental group, D was the control group. The experimental group used SPARK case database, while the control group used traditional teaching model for learning. The four groups of students were respectively tested after the theoretical class, before the experimental class, after the experimental class, and one week after the experimental class to compare the results. Finally, all students used SPARK case database to study, and were tested one month after the experimental class to compare their differences. Results The scores after the theoretical class of Group A and B were (100.0 ± 25.4), (101.0 ± 23.8)(t=-0.160, P > 0.05), Group C and D were (94.7 ± 23.7), (92.1 ± 18.6)(t = 0.467, P > 0.05). The scores of Group A and B before and after the experimental class and one week after the experimental class were respectively (84.1 ± 17.4), (72.1 ± 21.3)(t = 2.363, P < 0.05), (107.6 ± 14.3), (102.1 ± 18.0)(t = 1.292, P > 0.05), (89.7 ± 24.3), (66.6 ± 23.2)(t = 3.706, P < 0.05). The scores of Group C and D were (94.0 ± 17.3), (72.8 ± 25.5)(t = 3.755, P < 0.05), (107.3 ± 20.3), (93.1 ± 20.9)(t = 2.652, P < 0.05), (100.3 ± 19.7), (77.2 ± 24.0)(t = 4.039, P < 0.05). The scores of Group A and B for one month after the experimental class were (86.6 ± 28.8), (84.5 ± 24.0)(t = 0.297, P > 0.05), and Group C and D were (95.7 ± 20.3), (91.7 ± 23.0)(t = 0.699, P > 0.05). Conclusions The process-based teaching based on SPARK case database could improve the radiology practice ability of the musculoskeletal system of students.

This study investigates the efficacy of the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) score combined with quantitative metrics from Diffusion Weighted Imaging (DWI) and Dynamic Contrast Enhancement Magnetic Resonance Imaging (DCE-MRI) in differentiating between benign prostatic hyperplasia (BPH) and prostate cancer (PCa). The data of 65 patients with prostate diseases were retrospectively analyzed, and they were divided into a BPH group (n = 34) and a PCa group (n = 31). All patients underwent a multiparametric MRI (mpMRI) examination, which included conventional MRI, DWI and DCE-MRI scans. Variables analyzed included the PI-RADS v2.1 score, apparent diffusion coefficient (ADC), volume transfer constant (Ktrans), rate constant (Kep) and extravascular space volume ratio (Ve). The diagnostic performance of the PI-RADS v2.1 score, DWI, DCE-MRI and their combined metrics in differentiating BPH from PCa was assessed using Receiver Operating Characteristic (ROC) curve analysis. The results demonstrated that the PI-RADS v2.1 scores, Ktrans and Kep values of the PCa group were significantly higher than those of the BPH group (p < 0.001), while the ADC value of the PCa group was significantly lower than the BPH group (p < 0.001). No significant difference was observed in the Ve value between the two groups (p = 0.596). ROC analysis indicated that the area under the curve (AUC) values for the PI-RADS v2.1 score, ADC, Ktrans, Kep , Ve and their combination parameters were 0.824, 0.916, 0.903, 0.904, 0.625 and 0.990, respectively, with the combined parameters showing higher sensitivity and specificity than any single parameter. These findings suggest that the PI-RADS v2.1 score, along with DWI and DCE-MRI sequences, are valuable tools for differentiating BPH from PCa. The quantitative parameters, including ADC, Ktrans and Kep values, offer significant imaging references for clinical assessment, and the combination parameters can significantly enhance diagnostic accuracy.

BACKGROUD:Our study aimed to assess the impact of inter- and intra-observer variations when utilizing an artificial intelligence (AI) system for bone age assessment (BAA) of preschool children. METHODS:A retrospective study was conducted involving a total sample of 53 female individuals and 41 male individuals aged 3-6 years in China. Radiographs were assessed by four mid-level radiology reviewers using the TW3 and RUS-CHN methods. Bone age (BA) was analyzed in two separate situations, with/without the assistance of AI. Following a 4-week wash-out period, radiographs were reevaluated in the same manner. Accuracy metrics, the correlation coefficient (ICC)and Bland-Altman plots were employed. RESULTS:The accuracy of BAA by the reviewers was significantly improved with AI. The results of RMSE and MAE decreased in both methods (p < 0.001). When comparing inter-observer agreement in both methods and intra-observer reproducibility in two interpretations, the ICC results were improved with AI. The ICC values increased in both two interpretations for both methods and exceeded 0.99 with AI. CONCLUSION:In the assessment of BA for preschool children, AI was found to be capable of reducing inter-observer variability and enhancing intra-observer reproducibility, which can be considered an important tool for clinical work by radiologists. IMPACT:The RUS-CHN method is a special bone age method devised to be suitable for Chinese children. The preschool stage is a critical phase for children, marked by a high degree of variability that renders BA prediction challenging. The accuracy of BAA by the reviewers can be significantly improved with the aid of an AI model system. This study is the first to assess the impact of inter- and intra-observer variations when utilizing an AI model system for BAA of preschool children using both the TW3 and RUS-CHN methods.

目的 探讨深度学习模型在儿童应用TW3法进行骨龄评估的临床效能.方法 回顾性收集180例儿童左手X线片.评估基于Tanner-WhitehouseⅢ(TW3)法的掌指骨和腕骨骨龄.以3位高年资主任医师的评估均值为金标准组,计算并比较深度学习模型(模型组)及2位低年资医师(医师组,分别记作医师1、医师2)与金标准组评估时间差异,掌指骨骨龄、腕骨骨龄的均方误差(MSE)及平均绝对误差(MAE);采用组内相关系数(ICC)分析模型组和医师组与金标准组结果一致性.结果 骨龄评估所用时间模型组明显少于医师组(P<0.05).掌指骨骨龄评估,模型组和医师1、医师2与金标准组相比MSE、MAE差异有统计学意义(P<0.05).腕骨骨龄评估,模型组和医师1、医师2与金标准组相比MSE、MAE差异有统计学意义(P<0.05).掌指骨骨龄评估,模型组与金标准组ICC为0.988,医师1、医师2与金标准组的ICC分别为0.986、0.977.腕骨骨龄评估,模型组与金标准组ICC为0.971,医师1、医师2与金标准组ICC分别为0.970、0.953.结论 对于儿童,应用TW3法深度学习模型在评估掌指骨和腕骨骨龄有临床价值.

Background Bone age assessment (BAA) is an essential tool utilized in outpatient pediatric clinics. Three major BAA methods, Greulich–Pyle (GP), Tanner–Whitehouse 3 (TW3), and China 05 RUS–CHN (RUS–CHN), were applied to comprehensively compare bone age (BA) and chronological age (CA) in a Chinese sample of preschool children. This study was designed to determine the most reliable method. Methods The BAA sample consisted of 207 females and 183 males aged 3–6 years from the Zhejiang Province in China. The radiographs were estimated according to the GP, TW3, and RUS–CHN methods by two pediatric radiologists. The data was analyzed statistically using boxplots, the Wilcoxon rank test, and Student’s t -test to explore the difference (D) between BA and CA. Results According to the distributions of D, the boxplots showed that the median D of the TW3 method was close to zero for both male and female subjects. The TW3 and RUS–CHN methods overestimated the age of both genders. The TW3 method had the highest correct classification rate for males but a similar rate for females. The GP method did not show any significant difference between the BA and CA when applied to 3-year-old males and 4-year-old females while the TW3 method showed similar results when applied to 6-year-old females. The RUS–CHN method showed the least consistent results among the three methods. Conclusion The TW3 method was superior to the GP and RUS–CHN methods but not reliable on its own. It should be noted that a precise age diagnosis for preschool children cannot be easily made if only one of the methods is utilized. Therefore, it is advantageous to combine multiple methods when assessing bone age.

Acute abdomen is a series of acute and severe abdominal diseases commonly encountered in clinic. It is important to strengthen the image teaching of acute abdomen for undergraduates. This study aimed to explore the application effect of SPARK[sub-speciality (S), problem-based learning (P), assessment (A), report (R) and reading skill (K)] teaching mode in the experimental teaching of acute abdomen for undergraduate medical students. We selected a total of 58 third year medical students for observation. The students were divided into experimental group and control group. Among them, 29 students in the experimental group studied in SPARK teaching mode, 29 students in the control group studied in traditional teaching mode. The two groups of students were tested after the theory class, before and after the experimental class, and one week after the experimental class, to compare the application effects of the two teaching modes. After the test one week after the experimental class, the two groups of students jointly adopted SPARK mode to learn, and were tested again one month after the experimental class to compare whether the two groups of students achieved the same results. The total score of all tests was 150. The average scores of the experimental group and the control group after theory class were (69.0 ± 26.4) and (72.1 ± 24.1) respectively, with no statistical difference (t = 0.468, P = 0.642). The average scores of the experimental group before, after and one week after the experimental class were higher than those of the control group. The experimental group was (84.5 ± 23.1), (109.7 ± 23.8), (105.5 ± 31.0) respectively, and the control group was (52.8 ± 15.1), (93.8 ± 17.0), (80.0 ± 22.8) respectively. The differences were statistically significant (t = -6.195, P = 0.00; t = -2.919, P = 0.05; t = -3.569, P = 0.01). The average scores of the experimental group and the control group after one month were (99.0 ± 31.0) and (95.5 ± 25.6) respectively, and there was no significant difference between the two groups (t = -0.462, P = 0.646). The SPARK teaching mode was helpful for undergraduate medical students to consolidate image foundation, improve image reading skills.

目的 探讨磁共振扩散加权成像(DWI)联合三维动脉自旋标记(3D-ASL)成像的多模态MRI功能成像在急性脑梗死(ACI)诊断中的应用价值.方法 收集ACI患者68例,进行磁共振常规序列、DWI和3D-ASL成像检查,测量DWI异常高信号面积(SDWI)和3D-ASL异常灌注面积(S3D-ASL),比较两者差异;选取DWI扩散受限及3D-ASL灌注异常感兴趣区(ROI)和对侧镜像区,测量表观扩散系数(ADC)及脑血流(CBF)值,采用配对t检验,观察病变区和镜像区ADC、CBF值差异性;采用pearson检验,分析ADC和CBF值相关性;绘制受试者工作特征(ROC)曲线,并通过回归分析,比较ADC、CBF值及两参数联合检测对ACI的诊断效能.结果 45例S3D-ASL/SDWI≥1.1,23例S3D-ASL≈SDWI,无S3D-ASL

INTRODUCTION:The leaves of Morus alba L is a traditional Chinese medicine widely applied in lung diseases. Moracin N (MAN), a secondary metabolite extracted form the leaves of Morus alba L, is a potent anticancer agent. But its molecular mechanism remains unveiled. OBJECTIVE:In this study, we aimed to examine the effect of MAN on human lung cancer and reveal the underlying molecular mechanism. METHODS:MTT assay was conducted to measure cell viability. Annexin V-FITC/PI staining was used to detect cell apoptosis. Confocal microscope was performed to determine the formation of autophagosomes and autolysosomes. Flow cytometry was performed to quantify cell death. Western blotting was used to determine the related-signaling pathway. RESULTS:In the present study, we demonstrated for the first time that MAN inhibitd cell proliferation and induced cell apoptosis in human non-small-cell lung carcinoma (NSCLC) cells. We found that MAN treatment dysregulated mitochondrial function and led to mitochondrial apoptosis in A549 and PC9 cells. Meanwhile, MAN enhanced autophagy flux by the increase of autophagosome formation, the fusion of autophagsomes and lysosomes and lysosomal function. Moreover, mTOR signaling pathway, a classical pathway regualting autophagy, was inhibited by MAN in a time- and dose-dependent mannner, resulting in autophagy induction. Interestingly, autophagy inhibition by CQ or Atg5 knockdown attenuated cell apoptosis by MAN, indicating that autophagy serves as cell death. Furthermore, autophagy-mediated cell death by MAN can be blocked by reactive oxygen species (ROS) scavenger NAC, indicating that ROS accumulation is the inducing factor of apoptosis and autophagy. In summary, we revealed the molecular mechanism of MAN against lung cancer through apoptosis and autophagy, suggesting that MAN might be a novel therapeutic agent for NSCLC treatment.

Guangsangon E (GSE) is a novel Diels-Alder adduct isolated from leaves of Morus alba L, a traditional Chinese medicine widely applied in respiratory diseases. It is reported that GSE has cytotoxic effect on cancer cells. In our research, we investigated its anticancer effect on respiratory cancer and revealed that GSE induces autophagy and apoptosis in lung and nasopharyngeal cancer cells. We first observed that GSE inhibits cell proliferation and induces apoptosis in A549 and CNE1 cells. Meanwhile, the upregulation of autophagosome marker LC3 and increased formation of GFP-LC3 puncta demonstrates the induction of autophagy in GSE-treated cells. Moreover, GSE increases the autophagy flux by enhancing lysosomal activity and the fusion of autophagosomes and lysosomes. Next, we investigated that endoplasmic reticulum (ER) stress is involved in autophagy induction by GSE. GSE activates the ER stress through reactive oxygen species (ROS) accumulation, which can be blocked by ROS scavenger NAC. Finally, inhibition of autophagy attenuates GSE-caused cell death, termed as "autophagy-mediated cell death." Taken together, we revealed the molecular mechanism of GSE against respiratory cancer, which demonstrates great potential of GSE in the treatment of representative cancer.

我国前列腺癌的患病人数不断上升,早发现、早治疗能明显提高患者生存率并改善其预后.超声及前列腺特异性抗原(PSA)检查作为筛查前列腺癌的方法临床上被广泛应用,然而在辨别前列腺良恶性病变上,两者特异性都较低.MRI因有较高的软组织分辨率,已被临床广泛应用于包括前列腺在内的软组织检查中.

Pain and inflammation are associated with the pathophysiology of different clinical conditions. The Lysimachia capillipes Hemsl. capilliposide (LCc) is the main bioactive component of this Chinese medicinal herb, which is widely used as a remedy for the treatment of colds and arthritis. This study investigated the analgesic and antiinflammatory activities of LCc in an animal model. LCc had no significant influence on the spleen, lung, liver and stomach coefficients in mice. Pharmacological studies showed that LCc at all doses (40, 60 and 90 mg/kg) increased the latency period of paw licking induced by thermal stimulation, and at the dose of 40 mg/kg it significantly suppressed abdominal writhing episodes of mice induced by intraperitoneal (i.p.) injection of acetic acid. LCc also had antiinflammatory effect on inflammation models. Doses of 60 and 90 mg/kg suppressed paw edema induced by subcutaneous (s.c.) injection of carrageenan. Mechanistic studies revealed that the antiinflammatory effect of LCc was associated with inhibition of the production of malondialdehyde (MDA), prostaglandin E2 (PGE2), tumor necrosis factor (TNF-?), cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in paw tissue of carrageenan-injected mice. These results show that LCc has analgesic and antiinflammatory effects in mice.

脑梗死在我国是一种常见疾病,脑动脉病变引起组织局部缺血坏死,在临床上发病率高、致残率高、病死率高,严重威胁患者的生命安全[1].急性脑梗死(acute cerebral infarct,ACI)发病迅速且凶险,而发病前常无任何征兆,因此,进行合理的影像学检查,对疾病的早发现、早诊断、早治疗具有重要的意义.目前常规CT和MRI检查难以确诊,且一般不易发现缺血半暗带(ischemic penumbra,IP),所获取的影像学信息有限.而多模态MRI检查技术,是指在常规MRI平扫的基础上合理选用功能成像技术,通过综合分析,较好反映ACI的病理和生理改变,从而为ACI的早期诊断、治疗指导和预后评价提供依据.本文主要对多模态MRI在ACI诊断和疗效评估中的研究进展进行相关的综述分析.