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The oral Janus kinases inhibitor (JAKi) has improved the management of skin manifestations in systemic sclerosis (SSc), and our study aimed to explore the efficacy of non-selective JAKi tofacitinib in ameliorating interstitial lung disease (ILD) in the patients with SSc. The hospitalization data of the SSc-ILD patients from April 2019 to April 2021 were collected, and the changes of pulmonary function and the radiological findings in pulmonary high-resolution CT (HRCT) from the 9 patients who received tofacitinib for at least 6 months and a matched group of 35 SSc-ILD patients treated with conventional immunosuppressants or glucocorticoids, were compared and analyzed. There were no significant differences in demographic data and clinical characteristics between the tofacitinib-treated group (tofa-group) and the matched group. However, in the tofa-group, the changes in serum lactate dehydrogenase (LDH) concentration and serum interleukin-6 levels were significantly lower than those in the matched group. Moreover, the tofa-group showed amelioration in decreased diffusing capacity of the lung for carbon monoxide (DLCO) (62.05 ± 9.47 vs. 66.61 ± 12.39, p = 0.046), reductions in ground-glass attenuation involvement (1.00 ± 0.86 vs. 0.33 ± 0.50, p = 0.024) and irregular pleural thickening (1.33 ± 0.50 vs. 0.67 ± 0.51, p = 0.004) in pulmonary HRCTs, alleviated modified Rodnan skin score (mRSS) of skin sclerosis (9.22 ± 3.81 vs. 7.11 ± 3.92, p = 0.048), and reduced HRCT scores of pulmonary fibrosis (15.00 ± 3.87 vs. 12.66 ± 4.92, p = 0.009). Logistic regression analysis showed that the involvement of ground-glass attenuation (OR 11.43) and the add-on therapy of tofacitinib (OR 9.98) were the relevant factors in the amelioration of HRCT. Our results indicate that the use of JAKi (tofacitinib) may be relevant to significant improvement of the sclerosis and early radiological abnormalities in SSc-ILD patients. Further studies are needed to confirm these findings and to explore its efficacy more precisely. Key Points • The currently available therapies for SSc-ILD have limited therapeutic benefits. • The add-on therapy of the oral JAK inhibitor is available in the real world. • The tofacitinib was promising in the improvement of the sclerosis and early radiological abnormalities in SSc-ILD patients.

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Objective To evaluate the clinical application value of multi-slice helical CT volumetric (VH) scanning in lumber spine. Methods One thousand of patients with back and leg pain who underwent CT examinations were selected as subjects. We simulated the traditional protocol of single-slice(SS) discrete scanning for L3/4, L4/5, and LS/S1 intervertebral discs. The VH scanning mode was performed with 120 kV, 210 mAs,pitch of 1.5 and coverage of 97. 5 mm. The simulated SS scanning mode was performed with 120 kV, 240 mAs and coverage of 45.0 mm. The diagnostic outcomes and the radiation doses were compared between the two scanning modes. Two groups doctors observed ten terms, including the osseous spinal stenosis,narrowed intervertebral space and so on in two scanning modes respectively. Then consistency analysis of the data was carried out. Results The VH scanning mode showed far more features than the SS mode. The detection rates of the VH mode in the osseous spinal stenosis, narrowed intervertebral space,herniated nucleus pulposus, narrowed lateral recess, vertebral lesion, hypertrophy of L5 transverse process,abnormal direction of facet, facet degeneration, lumbar spondyloschisis, and paraspinal soft tissue were 11.8% (n =118), 38. 5% (n =385), 9. 3% (n =93), 46. 8% (n =468), 31.4% (n =314), 5.7% (n =57), 25.4% (n = 254), 49. 7% (n = 497), 9.9% (n = 99), and 0. 6% (n = 6) respectively, while the detection rates of the SS mode in ten terms were 5.6% (n = 56), 0, 0. 6% (n = 6), 27. 9% (n = 279),22.4% (n =224), 1.2% (n = 12), 16.7% (n = 167), 37.2% (n =372), 0.5% (n =5), and 0.2%(n = 2) respectively. The difference between the two groups had statistically significance (average P <0.05), except the paraspinal soft tissue abnormal (P > 0.05). The detection rates of the VH mode were higher than the SS mode in the osseous spinal stenosis, narrowed intervertebral space, herniated nucleus pulposus, lumbar spondyloschisis, being 6.2% (n = 62) , 38. 5% (n = 385) , 8.7% (n = 87), and 9.4%(n =94), respectively. In addition, VH mode only partially showed the articular facets, narrowed lateral recess, hypertrophy of L.5 transverse process, and paraspinal soft tissue. We could not acquire the imaging slices paralleling to intervertebral discs in SS mode in 467 patients (46.7%) with lumbosacral angle greater than 35°. The radiation dose of VH mode (164.9 mGy/em) was slightly higher than SS mode (147.0 mGy/cm) Conclusion MSCT VH scanning mode can significantly improve the diagnostic rate of lumbar spine diseases compared with SS mode, and was not restricted by the lumbosacral angle with slightly increasing radiation dosage.

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Objective To study the imaging findings of pulmonary lymphangitic carcinomatosis (PLC) and discuss it′s clinical value. Methods The imaging materials of 40 cases with PLC which were proved by bronchoscopic or pleural or open-lung biopsy were retrospectively analyzed, and the clinical application of imaging diagnosis were investigated. Results The primary tumorous pathological types of PLC included:13 cases peripheral type carcinoma of lung,2 cases central type carcinoma of lung,11 cases mammary cancer,6 cases gastric carcinoma,4 cases pancreatic carcinoma,3 cases renal carcinoma,1 case colon carcinoma. The major imaging features of PLC were showed as pleural nodes, lobular core nodes, intralobular small reticular and nodular shadows, small beaded thickened interlobular septums, beaded thickened bronchovascular bundles, tumescent pulmonary hilar and/or mediastinal lymph nodes. Conclusion PLC possess relative imaging feature, particularly HRCT may accurately reflect pathological feature of PLC. Imaging diagnosis is a satisfactory method in diagnosing pulmonary lymphangial metastasis of malignant tumor.

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Objective To assess the value of clinical application of CT pulmonary angiography(CTPA) in diagnosing pulmonary damage of Behcet’s syndrome.Methods 17 patients with Behcet’s syndrome underwent MSCT(Light Speed Plus, GE)with conventional CT scan and CTPA. The two kinds of imaging materials were comparatively studied by chi-square test , and diagnosed by comprehensive imaging appearances. Results The major feature of conventional CT included:bilateral or unilateral pulmonary density were nonhomogeneous in all cases,solitary or multiple pulmonary aneurysmal ecctasia in 9 cases,pulmonary artery growed in 12 cases,irregular and constrictive vascular wall in 6 cases and segmental infiltration in 5 cases.The features of CTPA included:irregular and constrictive pulmonary vascular wall in 15 cases,pulmonary aneurysms in 15 cases,pulmonary artery expansion in 16 cases,pulmonary artery thrombosis in 8 cases.There were statistical differences between conventional CT and CTPA in pulmonary aneurysm and arterial wall changes(?_1~2=5.10,P_10.05).Conclusion CTPA can diagnose pulmonary damage of Behcet’s syndrome in combination with clinic and conventional CT.

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Objective To study the X-ray signs of pulmonary lymphangitis carcinomatosa (PLC).Methods X-ray and HRCT signs of PLC proved by bronchoscopic or pleural or open-lung biopsy in 37 cases were retrospectively analyzed in order to find out some X-ray signs that suggested the PLC.Results The major X-ray features of PLC included:(1)Multiple thickened bronchovascular bundles in the bilateral lung in 37 cases;(2)Irregular thickened kerley A distributed over the bilateral lung in 28 cases;(3)The reticular and inosculating shadows(kerley C) extensively distributed over the bilateral lung in 19 cases;(4)The multiple irregular thickened kerley B distributed over the bilateral lung in 15 cases ;(5)Pulmonary hilar lymph adenopathy in 18 cases ;(6)Pleurae irregularly thickened in 16 cases;(7)Hydrothoraxes in 9 cases.Conclusion HRCT is the most satisfactory method in diagnosing PLC,but the super-quality thoracic plane film can supply some useful signs of PLC.

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Objective To study the role of esophageal dynamic double contrast radiography(DDCR) in diagnosing early esophageal carcinoma(EEC).Methods The patients with clinical suspected EEC underwent conventional double contrast radiography(CDCR) and DDCR using digital fluoroscopic imaging unit.The radiographic materials including CDCR and DDCR in 40 cases of EEC proved by endoscopy or pathologic histology were analyzed by a blind study,and the reliability of CDCR and DDCR was evaluated.Results The major findings of EEC included the mucosal irregularity and tortuous,small niches and filling defect,the soft and expansive extent of esophageal wall reduced or disappeared.In showing the esophageal function,DDCR was significantly superior to CDCR(?~2=4.50,?

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Objective To analyse imaging appearances of chest in AIDS and to supply the evidence for imaging diagnosis this lesions. Methods 46 cases of AIDS who had chest X-ray films and CT were collected and their imaging appearances were reviewed. Results 20 cases showed bilateral lung diffuse lesions which were network shadow with mottle, punctate, patchy, nodular and opacification. 10 cases showed unilateral lung field lesions,of them,cavity in the left upper lung was presented in one patient. 5 cases showed thickness or turbulence of texture in bilateral lungs. 11 cases were negative on chest film.Conclusion The characteristics of X-ray film or CT of lung can reflect the chest pathological changes in patient with AIDS.