Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed...Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all P<0.001),46%(63/136)achieved NASH resolution.Patients with baseline body mass index(BMI)≥23 kg/m2(Asian criteria)[odds ratio(OR):0.414;95%confidence interval(95%CI):0.190-0.899;P=0.012]and weight gain(OR:0.187;95%CI:0.050-0.693;P=0.026)were less likely to have NASH resolution.Among patients without NASH at baseline,22(3.7%)developed NASH.Baseline BMI≥23 kg/m2(OR:12.506;95%CI:2.813-55.606;P=0.001)and weight gain(OR:5.126;95%CI:1.674-15.694;P=0.005)were predictors of incident NASH.Conclusions:Lower BMI and weight reduction but not virologic factors determine NASH resolution in CHB.The value of weight management in CHB patients during antiviral treatment deserves further evaluation.展开更多
The frequent occurrence of rockburst and the difficulty in predicting were considered in deep engineering and underground engineering.In this work,laboratory experiments on rockburst under true triaxial conditions wer...The frequent occurrence of rockburst and the difficulty in predicting were considered in deep engineering and underground engineering.In this work,laboratory experiments on rockburst under true triaxial conditions were carried out with granite samples.Combined with the deformation characteristics of granite,acoustic emission(AE)technology was well applied in revealing the evolution law of micro-cracks in the process of rockburst.Based on the comprehensive analysis of acoustic emission parameters such as impact,ringing and energy,the phased characteristics of crack propagation and damage evolution in granite were obtained,which were consistent with the stages of rock deformation and failure.Subsequently,based on the critical point theory,the accelerated release characteristics of acoustic emission energy during rockburst were analyzed.Based on the damage theory,the damage evolution model of rock under different loading conditions was proposed,and the prediction interval of rock failure time was ascertained concurrently.Finally,regarding damage as an intermediate variable,the synergetic prediction model of rock failure time was constructed.The feasibility and validity of model were verified.展开更多
Background： The detection of solitary pulmonary nodules （SPNs） that may potentially develop into a malignant lesion is essential for early clinical interventions. However, grading classification based on computed t...Background： The detection of solitary pulmonary nodules （SPNs） that may potentially develop into a malignant lesion is essential for early clinical interventions. However, grading classification based on computed tomography （CT） imaging results remains a significant challenge. The 2-[^18F]-fluoro-2-deoxy-D-glucose （^18F-FDG） positron emission tomography （PET）/CT imaging produces both false-positive and false-negative findings for the diagnosis of SPNs. In this study, we compared 18F-FDG and 3-deoxy-3-[^18F]-fluorothymidine （^18F-FLT） in lung cancer PET/CT imaging. Methods： The binding ratios of the two tracers to A549 lung cancer cells were calculated. The mouse lung cancer model was established （n = 12）, and micro-PET/CT analysis using the two tracers was performed. Images using the two tracers were collected from 55 lung cancer patients with SPNs. The correlation among the cell-tracer binding ratios, standardized uptake values （SUVs）, and Ki-67 proliferation marker expression were investigated. Results： The cell-tracer binding ratio for the A549 cells using the ^18F-FDG was greater than the ratio using 18F-FLT （P 〈 0.05）. The Ki-67 expression showed a significant positive correlation with the ^18F-FLT binding ratio （r = 0.824, P〈 0.01）. The tumor-to-nontumor uptake ratio of ^18F-FDG imaging in xenografts was higher than that of ^18F-FLT imaging. The diagnostic sensitivity, specificity, and the accuracy of ^18F-FDG for lung cancer were 89%, 67%, and 73%, respectively. Moreover, the diagnostic sensitivity, specificity, and the accuracy of ^18F-FLT for lung cancer were 71%, 79%, and 76%, respectively. There was an obvious positive correlation between the lung cancer Ki-67 expression and the mean maximum SUV of ^18F-FDG and ^18F-FLT （r = 0.658, P〈 0.05 and r = 0.724, P〈 0.01, respectively）. Conclusions： The ^18F-FDG uptake ratio is higher than that of ^18F-FLT in A549 cells at the cellular level.^18F-FLT imaging might be superior for the quantitative diagnosis展开更多
Hepatic encephalopathy(HE) is a neuropsychiatric complication of cirrhosis or acute liver failure. Currently, HE is regarded as a continuous cognitive impairment ranging from the mildest stage, minimal HE to overt HE....Hepatic encephalopathy(HE) is a neuropsychiatric complication of cirrhosis or acute liver failure. Currently, HE is regarded as a continuous cognitive impairment ranging from the mildest stage, minimal HE to overt HE. Hyperammonaemia and neuroinflammation are two main underlying factors which contribute to the neurological alterations in HE. Both structural and functional impairments are found in the white mater and grey mater involved in HE. Although the investigations into HE pathophysiological mechanism are enormous, the exact pathophysiological causes underlying HE remain controversial. Multimodality magnetic resonance imaging(MRI) plays an important role in helping to understand the pathological process of HE. This paper reviews the up-to-date multimodality MRI methods and predominant findings in HE patients with a highlight ofthe increasingly important role of blood oxygen level dependent functional MRI.展开更多
BACKGROUND Traumatic internal carotid artery dissection(TICAD)is rare and can result in severe neurological disability and even death.No consensus regarding its diagnostic screening and management has been established...BACKGROUND Traumatic internal carotid artery dissection(TICAD)is rare and can result in severe neurological disability and even death.No consensus regarding its diagnostic screening and management has been established.AIM To investigate the clinical presentation,imaging features,diagnostic workup,and treatment of TICAD.METHODS In this retrospective case series,emergency admissions for TICAD due to closed head injury were analyzed.The demographic,clinical,and radiographic data were retrieved from patient charts and the picture archiving and communication system.RESULTS Six patients(five males and one female,age range of 43-62 years,mean age of 52.67 years)presented with TICAD.Traffic accidents(4/6)were the most frequent cause of TICAD.The clinical presentation was always related to brain hypoperfusion.Imaging examination revealed dissection of the affected artery and corresponding brain infarction.All the patients were definitively diagnosed with TICAD.One patient was treated conservatively,one patient underwent anticoagulant therapy,two patients were given both antiplatelet and anticoagulant drugs,and two patients underwent decompressive craniectomy.One patient fully recovered,while three patients were disabled at follow-up.Two patients died of refractory brain infarction.CONCLUSION TICAD can cause catastrophic outcomes and even refractory brain hernia.Early and efficient diagnosis of TICAD is essential for initiating appropriate treatment.The treatment of TICAD is challenging and variable and is based on clinician discretion on a case-by-case basis.展开更多
基金supported by grants from the National Major Special Project for the Prevention and Treatment of Major Infectious Diseases:AIDS and viral hepatitis(2013ZX10005002,2018ZX10725506)the National Key Research and Development Program(2017YFC0908903)。
文摘Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all P<0.001),46%(63/136)achieved NASH resolution.Patients with baseline body mass index(BMI)≥23 kg/m2(Asian criteria)[odds ratio(OR):0.414;95%confidence interval(95%CI):0.190-0.899;P=0.012]and weight gain(OR:0.187;95%CI:0.050-0.693;P=0.026)were less likely to have NASH resolution.Among patients without NASH at baseline,22(3.7%)developed NASH.Baseline BMI≥23 kg/m2(OR:12.506;95%CI:2.813-55.606;P=0.001)and weight gain(OR:5.126;95%CI:1.674-15.694;P=0.005)were predictors of incident NASH.Conclusions:Lower BMI and weight reduction but not virologic factors determine NASH resolution in CHB.The value of weight management in CHB patients during antiviral treatment deserves further evaluation.
基金Projects(52074294,51574246,51674008)supported by the National Natural Science Foundation of ChinaProjects(2017YFC0804201,2017YFC0603000)supported by the National Key Research and Development Program of ChinaProject(2011QZ01)supported by the Fundamental Research Funds for the Central Universities,China。
文摘The frequent occurrence of rockburst and the difficulty in predicting were considered in deep engineering and underground engineering.In this work,laboratory experiments on rockburst under true triaxial conditions were carried out with granite samples.Combined with the deformation characteristics of granite,acoustic emission(AE)technology was well applied in revealing the evolution law of micro-cracks in the process of rockburst.Based on the comprehensive analysis of acoustic emission parameters such as impact,ringing and energy,the phased characteristics of crack propagation and damage evolution in granite were obtained,which were consistent with the stages of rock deformation and failure.Subsequently,based on the critical point theory,the accelerated release characteristics of acoustic emission energy during rockburst were analyzed.Based on the damage theory,the damage evolution model of rock under different loading conditions was proposed,and the prediction interval of rock failure time was ascertained concurrently.Finally,regarding damage as an intermediate variable,the synergetic prediction model of rock failure time was constructed.The feasibility and validity of model were verified.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81271607）, and the National Postdoctoral Science Foundation of China （No. 2015M572810）.
文摘Background： The detection of solitary pulmonary nodules （SPNs） that may potentially develop into a malignant lesion is essential for early clinical interventions. However, grading classification based on computed tomography （CT） imaging results remains a significant challenge. The 2-[^18F]-fluoro-2-deoxy-D-glucose （^18F-FDG） positron emission tomography （PET）/CT imaging produces both false-positive and false-negative findings for the diagnosis of SPNs. In this study, we compared 18F-FDG and 3-deoxy-3-[^18F]-fluorothymidine （^18F-FLT） in lung cancer PET/CT imaging. Methods： The binding ratios of the two tracers to A549 lung cancer cells were calculated. The mouse lung cancer model was established （n = 12）, and micro-PET/CT analysis using the two tracers was performed. Images using the two tracers were collected from 55 lung cancer patients with SPNs. The correlation among the cell-tracer binding ratios, standardized uptake values （SUVs）, and Ki-67 proliferation marker expression were investigated. Results： The cell-tracer binding ratio for the A549 cells using the ^18F-FDG was greater than the ratio using 18F-FLT （P 〈 0.05）. The Ki-67 expression showed a significant positive correlation with the ^18F-FLT binding ratio （r = 0.824, P〈 0.01）. The tumor-to-nontumor uptake ratio of ^18F-FDG imaging in xenografts was higher than that of ^18F-FLT imaging. The diagnostic sensitivity, specificity, and the accuracy of ^18F-FDG for lung cancer were 89%, 67%, and 73%, respectively. Moreover, the diagnostic sensitivity, specificity, and the accuracy of ^18F-FLT for lung cancer were 71%, 79%, and 76%, respectively. There was an obvious positive correlation between the lung cancer Ki-67 expression and the mean maximum SUV of ^18F-FDG and ^18F-FLT （r = 0.658, P〈 0.05 and r = 0.724, P〈 0.01, respectively）. Conclusions： The ^18F-FDG uptake ratio is higher than that of ^18F-FLT in A549 cells at the cellular level.^18F-FLT imaging might be superior for the quantitative diagnosis
基金Supported by Grants from National Natural Science Foundation of China,Nos.30700194,81171313,81322020 and 81230032(to Zhang LJ)Program for New Century Excellent Talents in University,No.NCET-12-0260(to Zhang LJ)
文摘Hepatic encephalopathy(HE) is a neuropsychiatric complication of cirrhosis or acute liver failure. Currently, HE is regarded as a continuous cognitive impairment ranging from the mildest stage, minimal HE to overt HE. Hyperammonaemia and neuroinflammation are two main underlying factors which contribute to the neurological alterations in HE. Both structural and functional impairments are found in the white mater and grey mater involved in HE. Although the investigations into HE pathophysiological mechanism are enormous, the exact pathophysiological causes underlying HE remain controversial. Multimodality magnetic resonance imaging(MRI) plays an important role in helping to understand the pathological process of HE. This paper reviews the up-to-date multimodality MRI methods and predominant findings in HE patients with a highlight ofthe increasingly important role of blood oxygen level dependent functional MRI.
文摘BACKGROUND Traumatic internal carotid artery dissection(TICAD)is rare and can result in severe neurological disability and even death.No consensus regarding its diagnostic screening and management has been established.AIM To investigate the clinical presentation,imaging features,diagnostic workup,and treatment of TICAD.METHODS In this retrospective case series,emergency admissions for TICAD due to closed head injury were analyzed.The demographic,clinical,and radiographic data were retrieved from patient charts and the picture archiving and communication system.RESULTS Six patients(five males and one female,age range of 43-62 years,mean age of 52.67 years)presented with TICAD.Traffic accidents(4/6)were the most frequent cause of TICAD.The clinical presentation was always related to brain hypoperfusion.Imaging examination revealed dissection of the affected artery and corresponding brain infarction.All the patients were definitively diagnosed with TICAD.One patient was treated conservatively,one patient underwent anticoagulant therapy,two patients were given both antiplatelet and anticoagulant drugs,and two patients underwent decompressive craniectomy.One patient fully recovered,while three patients were disabled at follow-up.Two patients died of refractory brain infarction.CONCLUSION TICAD can cause catastrophic outcomes and even refractory brain hernia.Early and efficient diagnosis of TICAD is essential for initiating appropriate treatment.The treatment of TICAD is challenging and variable and is based on clinician discretion on a case-by-case basis.
