Glioma represents a notoriously aggressive and malignant tumor that targets the central nervous system, with a poor prognosis for patients. In this research, we set out to examine the role of hydroxyacyl-CoA dehydrogenase trifunctional multienzyme complex subunit alpha (HADHA) in glioma, its clinical significance, as well as its potential biological mechanisms. In this study, we used immunohistochemistry staining to assess the expression level of HADHA in glioma tissues. We also evaluated the correlation between HADHA expression and patient survival using the Kaplan-Meier method. To determine the role of HADHA in glioma cells, we conducted loss-of-function assays in vitro and in vivo. Additionally, we utilized co-immunoprecipitation and protein stability assays to investigate the potential mechanisms involving HADHA, MDM2, and p53 in glioma. Our research findings indicate that gliomas exhibit high levels of HADHA. Clinically, high expression of HADHA suggests an increased risk of malignant tumors, recurrence, and reduced survival rates. Functionally, knocking down HADHA can lead to decreased proliferation, enhanced apoptosis, and inhibited migration of glioma cells. Mechanistically, HADHA accelerates MDM2-mediated p53 ubiquitination through interaction with MDM2. Consistently, MDM2 knockdown or overexpression of p53 can attenuate the promoting effect of HADHA overexpression on the malignant progression of glioma. We have discovered a novel role of HADHA in promoting MDM2-mediated p53 ubiquitination, which contributes to the progression of glioma. This finding provides a new perspective to understand the pathogenesis of glioma and offers a potential target for developing innovative therapeutic strategies.

Objective: To shorten acquisition time of readout segmentation of long variable echo trains (RESOLVE)-based diffusion kurtosis imaging (DKI) via Readout Partial Fourier (RPF) and b-value combinations. Methods: The RESOLVE-based DKI images of 38 patients with nasopharyngeal carcinoma (NPC) were prospectively enrolled. For RESOLVE-based DKI images with 5/8 RPF and without RPF, objective and subjective evaluations of image quality were performed. A total of nine groups with different b-value combinations were simulated, and the influence of different b-value combinations for RESOLVE-RPF-based DKI sequences was assessed using the intraclass correlation coefficient (ICC). Results: The mean values of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in DKI images without RPF were higher than those with 5/8 RPF (252.9 +/- 77.7 vs 247.3 +/- 85.5 and 5.8 +/- 2.8 vs 5.4 +/- 2.3, respectively), but not significantly (p = 0.460 and p = 0.180, respectively). In comparing the ICCs between nine groups of different b-value combinations in RESOLVE-RPF-based DKI, group (200, 800, 2000 s/mm(2)), group (200, 400, 800, 2000 s/mm(2)) and group (200, 800, 1500, 2000 s/mm(2)) were not significantly different (p > 0.001) and showed excellent agreement (0.81-1.00) with that of group (200, 400, 800, 1500, 2000 s/mm(2)). Using b-value optimization and RPF technology, the group with RPF (200, 400, 800, 2000 s/mm(2)) showed a 56% reduced scanning compared with the group without RPF (200, 400, 800, 1500, 2000 s/mm(2); 3 min 46 s vs 8 min 31 s, respectively). Conclusion: DKI with RPF did not significantly affect image quality, but both RPF and different b-value combinations can affect the scanning time. The combination of RPF and b-value optimization can ensure the stability of DKI parameters and reduce the scanning time by 56%. Advances in knowledge: This work is to optimize scan parameters, e.g. RPF and b-value combinations, to reduce acquisition time for RESOLVE-based DKI in NPC. To our knowledge, the effect of RESOLVE-RPF and b-value combinations on DKI has not been reported.

Background The reproducibility of intravoxel incoherent motion (IVIM)-based radiomics studies in humans has not been reported. Purpose To determine the inter- and intra-observer variability on the reproducibility of IVIM-based radiomics features in cervical cancer (CC). Material and Methods The IVIM images of 25 patients with CC were retrospectively collected. Based on the high-resolution T2-weighted images, the regions of interest (ROIs) were independently delineated twice in diffusion-weighted images at a b value of 1000 s/mm 2 (interval time was one month) by two radiologists. This was done at the largest transversal cross-sections of the tumors. The ROI was subsequently used in apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) maps derived from IVIM images. In total, 105 radiomics features were then finally extracted from the IVIM-derived maps. The inter- and intra-observer reproducibility of IVIM-derived features was then evaluated using the intraclass correlation coefficient. Results Inter- and intra-observer variability affected the reproducibility of radiomics features. D* map had 100% and 95% reproducible features, ADC map had 89% and 93%, D map had 97% and 86%, while f map had 54% and 62% reproducible features with good to excellent reliability in the intra-observer analysis. Similarly, D* map had 90% and 94%, ADC map had 85% and 70%, D map had 81% and 78%, while f map had 41% and 93% reproducible features with good to excellent reliability in the inter-observer analysis. Conclusion Inter- and intra-observer variability can affect radiomics analysis. Cognizant to this, multicenter studies should pay more attention to intra- and inter-observer variability.

Background The impact of variable b-value combinations on apparent diffusion coefficient (ADC)-based radiomics features has not been fully addressed in literature. Purpose To investigate the correlation between radiomics features extracted from ADC maps and various b-value combinations in cervical cancer. Material and Methods Diffusion-weighted images (b-values: 0, 600, 800, and 1000 s/mm2) of 20 patients with cervical cancer were included. Tumors were identified with the largest transversal cross-section and manually segmented by radiologist. For each b-value combination, 92 radiomics features were extracted and coefficient of variance (CV) was used to evaluate the robustness of radiomics features with different b-value combinations. Features with CV > 5% were normalized by the mean feature variation across the group. Results Out of a total of 92 radiomics features, 18 were classified as robust features with CV ≤5%. Among the rest (CV > 5%), 11, 23, and 40 features demonstrated 5%< CV ≤10%, 10%< CV ≤20%, and CV > 20%, respectively. A subset of features in each category (CV > 5%) showed strong correlation with the b-value combination variation, including 44% (7/16) features in gray level co-occurrence matrix, 62% (8/13) features in gray level dependence matrix, 64% (9/14) features in first order, 50% (8/16) features in gray level run length matrix, 57% (8/14) features in gray level size matrix, and 20% (1/5) features in neighborhood gray-tone difference matrix. Conclusions Variations in b-value combinations demonstrated impact on radiomics features extracted from ADC maps for cervical cancer. The radiomics features with CV <5% can be considered as robust features and are recommended to be used in multicenter radiomics studies.

OBJECTIVE To observe the differences in the clinical therapeutic effects on cervical spondylosis of vertebral artery type (CSA) between the modified acupuncture and the routine acupuncture at unilateral/bilateral Renying (ST 9) as well as the impacts on the concentrations of plasma neuropeptide Y (NPY) and urotensinⅡ(UⅡ) in the patients. METHODS A total of 160 patients were divided into a modified bilateral acupuncture group, a modified unilateral acupuncture group, a routine bilateral acupuncture group and a routine unilateral acupuncture group, 40 cases in each one according to the random number table. In the modified bilateral acupuncture group, the modified acupuncture was applied bilaterally to Renying (ST 9). In the modified unilateral acupuncture group, the modified acupuncture was applied unilaterally to Renying (ST 9). In the routine bilateral acupuncture group, the routine acupuncture was applied bilaterally to Renying (ST 9). In the routine unilateral acupuncture group, the routine acupuncture was applied unilaterally to Renying (ST 9). The treatment was given once every day, continuously for 6 days as one course. Two courses of treatment were required at the interval of 1 day. In each group, before and after treatment, we observed the peak systolic blood flow velocity (Vs) of the vertebral artery (VA) and the basilar artery (BA), cervical vertigo symptoms and functional assessment scales (ESCV) and the concentration of plasma NPY and UⅡ. The clinical therapeutic effects were compared among the groups. RESULTS After treatment, the clinical therapeutic effect in the modified bilateral acupuncture group was 90.0% (36/40), which was better than 80.0% (32/40) in the modified unilateral acupuncture group, 77.5% (35/40) in the routine bilateral acupuncture group and 65.0% (26/40) in the routine unilateral acupuncture group (all P<0.05). After treatment, Vs of VA and BA was improved remarkably in every group (all P<0.01), and the result in the modified bilateral acupuncture group was higher than those in the other groups (all P<0.01). After treatment, ESCV scores were all increased remarkably in every group (all P<0.01). ESCV score and improvement index in the modified bilateral acupuncture group were all higher than those in the other groups (P<0.05, P<0.01). After treatment, the concentrations of plasma NPY and UⅡ were all reduced remarkably in every group (all P<0.01) and the differences were significant among the groups (all P<0.01). CONCLUSION The modified bilateral acupuncture at Renying (ST 9) effectively regulates the blood supply of the vertebral basilar artery and improves the cerebral circulation. The effects are superior to those of the unilateral acupuncture at Renying (ST 9).