Comprehensive characterization of hemicelluloses obtained from Gleditsia sinensis Lam. pods and the application of moderately degraded hemicelluloses in galactomannan film

The Gleditsia sinensis Lam. pods (GSP) are consistently discarded as waste after saponin extraction due to a lack of industrial or high-value utilization. Herein, the hemicelluloses were extracted from two varieties of GSP and subjected to comprehensive characterization. The molar mass of DMSO-soluble hemicelluloses (53.3-66.0 kDa) was higher compared to that of alkali-soluble ones (24.9-32.6 kDa). The presence of minimal acetyl substitution (3.85-4.49 %) on xylan was unequivocally confirmed. NMR spectroscopic analysis indicated that the hemicelluloses in GSP predominantly consist of a 1,4-β-ᴅ-Xyl backbone with arabinose substituents at O-3 and 4-O-methyl-α-ᴅ-GlcA substituents at O-2 of the xylose residues. p-Coumaric acid substitution also occurred on the 1,4-β-ᴅ-Xyl backbone. Hydrothermal treatment significantly reduced the hemicelluloses' relative molar mass and produced 7-10 % xylo-oligosaccharides. Furthermore, the moderately degraded hemicelluloses exhibited significantly enhanced biological activity. Finally, the incorporation of the moderately degraded hemicelluloses imparted the galactomannan film with exceptional antioxidant properties (81.1 % DPPH scavenging activity), while negligibly affecting its transparency. Our study's findings will contribute to a comprehensive understanding of the structural and biochemical properties of hemicellulose in waste G. sinensis pods, thereby facilitating their enhanced utilization in industrial applications.

[Analysis of clinical effect of arthroscopic release at different time in treating knee adhesion after arthroscopic surgery]

Objective: To explore the efficacy of arthroscopic release in treating postoperative knee adhesion and investigate the influence of release timing on the treatment outcomes. Methods: A total of 50 patients who accepted arthroscopic release in Peking University Third Hospital from February 2017 to December 2021 were included in the retrospective cohort. The study cohort comprised 28 men and 22 women, with a mean age of (30.8±11.9) years. All the primary surgeries were manipulated under arthroscopes. A comparison was made between pre-and postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) scores, and Tegner activity scale scores for the patients. According to the interval between the appearance of adhesion and arthroscopic release, the patients were divided into four groups:<3 months group (n=12), 3-6 months group (n=16),>6-12 months group (n=14), and>12 months group (n=8). Inter-group comparisons on postoperative ROM, IKDC scores, and Tegner activity scale scores and improvement values of each outcome were conducted. Results: All the patients were followed up for (36.4±19.7) months. Patients gained significant improvement in flexion, extension, IKDC scores, and Tegner scores (125.0°±20.0° vs 75.7°±27.5°, 2.3°±4.8° vs 7.4°±7.3°, 69.8±17.7 vs 51.4±12.8, 4.1±2.1 vs 2.2±1.1) (all P<0.05), while the VAS scores did not show significant improvement. There were no significant differences among different groups in postoperative extension, IKDC scores or Tegner scores, nor in their improvements. However, patients in the ≤6 months group could gain better postoperative flexion and improvement in flexion than those in the >6 months group (129.9°±20.0° vs 118.8°±17.4°, 58.6°±32.8° vs 37.3°±23.1°) (P<0.05). Conclusions: Arthroscopic release presents a great effect in treating knee adhesion after arthroscopic operation. Once the symptoms of adhesion appear and physical rehabilitation fails to improve the ROM, one should accept early surgical intervention (less than 6 months) for a better outcome.

Predictive effect of net water uptake on futile recanalisation in patients with acute large-vessel occlusion stroke

AIM

To determine whether net water uptake (NWU) based on automated software evaluation could predict futile recanalisation in patients with acute anterior circulation large-vessel occlusion (LVO).

MATERIALS AND METHODS

Patients with acute anterior circulation LVO undergoing mechanical thrombectomy in Jinling Hospital were evaluated retrospectively. NWU and other baseline data were evaluated by performing univariate and multivariate analyses. The primary endpoint was 90-day modified Rankin scale score ≥3. A nomogram to predict poor clinical outcomes was developed based on multivariate logistic regression analysis.

RESULTS

Overall, 135 patients who underwent thrombectomy with a TICI grade ≥2b were enrolled. In multivariate logistic regression analysis, the following factors were identified as independent predictors of futile recanalisation: age (odds ratio [OR]: 1.055, 95 % confidence interval [CI]: 1.004-1.110, p=0.035), female (OR: 0.289, 95 % CI: 0.098-0.850, p=0.024), hypertension (OR: 3.182, 95 % CI: 1.160-8.728, p=0.025), high blood glucose level (OR: 1.36, 95 % CI: 1.087-1.701, p=0.007), admission National Institutes of Health Stroke Scale score (OR: 1.082, 95 % CI: 1.003-1.168, p=0.043), and NWU (OR: 1.312, 95 % CI: 1.038-1.659, p=0.023).

CONCLUSIONS

NWU based on Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) could be used to predict the occurrence of futile recanalisation in patients with acute anterior circulation LVO ischaemic stroke.

Efficient production of xylooligosaccharides from Camellia oleifera shells pretreated by pyruvic acid at lower temperature

XOS production from lignocellulose using organic carboxylic acids and alkyd acids has been widely reported. However, it still faces harsh challenges such as high energy consumption, high cost, and low purity. Pyruvic acid (PYA), a carbonyl acid with carbonyl and carboxyl groups, was used to produce XOS due to its stronger catalytic activity. In this work, XOS was efficiently prepared from COS in an autoclave under the condition of 0.21 M PYA-121 °C-35 min. The total yield of XOS reached 68.72 % without producing any toxic by-products, including furfural (FF) and 5-hydroxymethylfurfural (5-HMF). The yield of xylobiose (X2), xylotriose (X3), xylotetraose (X4), and xylopentaose (X5) were 20.58 %, 12.47 %, 15.74 %, and 10.05 %, respectively. Meanwhile, 89.05 % of lignin was retained in the solid residue, which provides a crucial functional group for synthesizing layered carbon materials (SRG-a). It achieves excellent electromagnetic shielding (EMS) performance through graphitization, reaching -30 dB at a thickness of 2.0 mm. The use of a PYA catalyst in the production of XOS has proven to be an efficient method due to lower temperature, lower acid consumption, and straightforward operation.

Structural characterization of lignin from the green pretreatments for co-producing xylo-oligosaccharides and glucose: Toward full biomass utilization

Three green non-enzymatic catalysis pretreatments (NECPs) including autohydrolysis, subcritical CO2-assisted seawater autohydrolysis, and inorganic salt catalysis were utilized to simultaneously produce xylo-oligosaccharides (XOS), glucose, and cellulolytic enzyme lignin (CEL) from sugarcane bagasse (SCB). The yield of XOS in all three NECPs was over 50 % with a competitive glucose yield of enzymatic hydrolysis. And the effects of different pretreatments on the chemical structure and composition of CEL samples were also investigated. The pretreatments significantly increased the thermal stability, yield, and purity of the CEL samples. Moreover, the net yield of lignin was 58.3 % with lignin purity was 98.9 % in the autohydrolysis system. Furthermore, there was a decrease in the molecular weight of CEL samples as the pretreatment intensity increased. And the original lignin structural units sustained less damage during the NECPs, due to the cleavage of the β-O-4 bonds dominating lignin degradation. Meanwhile, these pretreatments increased the phenolic-OH in CEL samples, making the lignin more reactive, and enhancing its subsequent modification and utilization. Collectively, the described techniques have demonstrated practical significance for the coproduction of XOS and glucose, and lignin, providing a promising strategy for full utilization of biomass.

Fabrication of multi-functional biodegradable liquid mulch utilizing xyloglucan derived from tamarind waste for agricultural application

Biodegradable liquid mulch is considered a promising alternative to plastic mulch for sustainable agriculture. This work proposed a xyloglucan-based liquid mulch with multi-function using a combination of chemical modification and blending methods. The esterification product of tamarind xyloglucan (TXG) from forestry wastes was synthesized with benzoic anhydride (BA). The effect of esterification modification was investigated, and BA-TXG was utilized as a film-forming and sand-fixation agent. The rheological properties, thermal stability, and hydrophobicity were improved following esterification. Additionally, waterborne polyurethane and urea were incorporated into the mulch to enhance its mechanical strength (23.28 MPa, 80.71 %), and homogeneity, as well as improve its nutritive properties. The xyloglucan-based liquid mulch has excellent UV protection, a high haze value (approximately 90 %), and retains water at a rate of 80.45 %. SEM and immersion experiment showed the effect of xyloglucan-based liquid mulch on sustainable sand-fixation. Moreover, the liquid mulch treatment demonstrated an impressive germination rate of 83.8 % and degradation rate of 51.59 % (60 days). The modified polysaccharide film increases stability and slows down the degradation rate. Tamarind xyloglucan-based liquid mulch exhibits powerful and diverse optical properties as well as sand fixation functions, indicating their great potential in sustainable agriculture as an alternative to plastic mulch.

Global trends in coronary artery disease and artificial intelligence relevant studies: a bibliometric analysis

OBJECTIVE

Coronary artery disease (CAD) is a major global cause of death, greatly affecting life expectancy and quality of life for populations. With the advent of artificial intelligence (AI), there is new hope for accurately managing CAD. While recent studies have shown remarkable progress in AI and CAD research, there is a gap in comprehensive bibliometric analysis in this field. Therefore, this study aims to provide a thorough analysis of trends and hotspots in AI and CAD-related research utilizing bibliometrics.

MATERIALS AND METHODS

Publications on AI and CAD relevant research from 2009 to 2023 were searched through the WoS core database (WoSCC). CiteSpace, VOSviewer and Excel 365 were used to conduct the bibliometric analysis.

RESULTS

The bibliometric analysis included 1,248 publications, indicating a steady increase in AI and CAD-related publications annually. The United States of America (USA), China, and Germany were identified as the most influential countries in this field. Research institutions such as Cedars Sinai Med Ctr, Med Univ South Carolina, Harvard Med Sch and Capital Med Univ were the main contributors to research production. FRONT CARDIOVASC MED is the top-ranked journal, while J AM COLL CARDIOL emerged as the most cited journal. Schoepf, U. Joseph, Slomka, Piotr J., Berman, Daniel S. and Dey, Damini were the most prolific authors, while U. Rajendra Acharya was the most frequently co-cited author. Research related to the AI calculation of coronary flow reserve fraction and coronary artery calcification, based on coronary CT to identify CAD and cardiovascular risk, was a key research topic in this field. The potential link between cardiovascular risk stratification and radiomics is currently at the forefront of the field.

CONCLUSIONS

This study is the first to use a bibliometric approach to visualize and analyze AI and CAD-related research. The findings provide insights into recent research trends and hotspots in the field and can serve as a reference for scholars to identify critical issues in this field.

Structural variations of lignin and lignin-carbohydrate complexes from the fruit shells of Camellia oleifera during ripening

Camellia oleifera fruit shell (CFS), a waste lignocellulosic biomass resulting from Camellia oleifera oil production industry, is abundantly available in Southern China. Herein, to understand the structural variations of CFS lignins and lignin-carbohydrate complexes (LCC) during ripening, the native lignin and LCC fractions from CFS (harvested every seven days from October 1 to 30, 2022) were isolated and characterized systematically. The molecular weights of both MWL and DEL fractions steadily increased during ripening. CFS lignins contained abundance of β-O-4' linkages (maximum of 58.6 per 100Ar in DEL-2), and had low S/G ratios (S/G < 0.6). Moreover, the amounts of β-O-4' linkages in MWL, DEL, and LCC-AcOH fractions increased first and then decreased during ripening. The main lignin-carbohydrate linkages in the LCC-AcOH fractions were benzyl-ether (7.0-9.4 per 100Ar) and phenyl-glycoside (4.5-5.2 per 100Ar) bonds. Based on the quantitative results, the potential structural diagrams of lignins from different ripening stages of CFS were proposed. Additionally, the LCC-AcOH fractions exhibited pronounced antioxidant capacity and were promising as natural antioxidants. The properties and functions of lignin in plant cell walls, as well as its further appreciation, are crucial for the design and selection of feasible pretreatment strategies for the lignocellulosic materials.

A risk model based on the tumor microenvironment to predict survival and immunotherapy efficacy for ovarian cancer

OBJECTIVE

Based on the interactions between immune components in the tumor microenvironment and ovarian cancer (OC) cells, immunotherapies have been demonstrated to be effective in dramatically increasing survival rates. This study aimed to identify landmark genes, develop a prognostic risk model, and explore its relevance to the efficacy of immunotherapy.

MATERIALS AND METHODS

A risk model was built based on the immune- and stromal-related genes, which were extracted from the OC gene expression data of "The Cancer Genome Atlas" (TCGA) database. Survival analysis and receiver operating characteristic (ROC) analysis were then conducted through the model's risk score pattern, which was established depending on the TCGA training cohort and verified based on the internal TCGA cohort and external "Gene Expression Omnibus" (GEO) datasets. Furthermore, the immune-related characteristics and prognostic values of the risk model were evaluated.

RESULTS

The prognostic risk model for ovarian cancer demonstrated excellent performance in predicting survival rates, as validated in both the TCGA and GEO databases. The model showed significant associations with 17 functional immune cells, 17 immune checkpoints, PD-1, and several immune pathways, suggesting its potential to enhance the efficacy of immunotherapy in OC.

CONCLUSIONS

The risk model developed in this study has the potential to serve as a prognostic marker for OC, enabling the development of personalized immunotherapy protocols and providing a theoretical basis for novel combinations of immunotherapeutic approaches.

[Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation]

Objective: To explore the value of the aMAP risk score (age, male, albumin-bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods: This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors. Results: Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group (P=0.001). Conclusions: The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..

Coproduction of xylooligosaccharides, glucose, and less-condensed lignin from sugarcane bagasse using syringic acid pretreatment

Current strategies for the production of xylooligosaccharides (XOS) from biomass through non-enzymatic catalysis often led to a certain degree of lignin condensation, which severely restrains subsequent enzyme hydrolysis of cellulose. Herein, syringic acid (SA) pretreatment was investigated to coproduce XOS, glucose, and less-condensed lignin from sugarcane bagasse. SA acted as a catalyst and lignin condensation inhibitor during the pretreatment. The highest XOS yield of 58.7% (27.7% xylobiose and 24.7% xylotriose) was obtained at 180 °C - 20 min - 9% SA, and the corresponding xylose/XOS ratio was only 0.42. Compared with the pretreatment at 180 °C - 20 min - 0% SA, the addition of 9% SA increased the glucose yield from 85.7% to 92.4% and decreased the degree of lignin condensation from 0.55 to 0.42. Moreover, 26.7% of SA could be easily recovered. This work presents a pretreatment strategy in which the efficient production of XOS and the suppression of lignin condensation are achieved simultaneously.

[The association between cortical venous outflow and futile recanalization in patients with acute ischemic stroke due to large vessel occlusion in the anterior circulation]

Objective: To explore the association of baseline venous outflow (VO) profile with futile recanalization in patients with acute ischemic stroke due to large vessel occlusion in the anterior circulation. Methods: The clinical and imaging data of patients presented with large vessel occlusion in the anterior circulation and underwent emergency endovascular treatment at Huashan Hospital from March 2015 to December 2021 were retrospectively included in the study. All patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) at baseline.Baseline VO profile was determined by a 0-6 semi-quantitative scoring system which assessed opacification of the ipsilateral superficial middle cerebral vein, vein of Labbé and vein of Trolard on single-phase CT angiography (CTA) images. A 90-day telephone follow-up was performed and functional outcome was evaluated by 90 d modified Rankin scale (mRS). Successful recanalization of the occluded artery, defined as final modified Thrombolysis in Cerebral Infarction scale (mTICI) 2b-3, was considered to be futile if patients failed to achieve functional independence (90 d mRS 0-2). Univariate analysis and receiver operating characteristic (ROC) curve analysis were used to explore the optimal cutoff predicting functional indendence. The associations between cortical VO in ischemic area and futile recanalization were evaluated using binary logistic regression analysis and backward linear regression based on Akaike information criterion (AIC). Results: A total of 150 patients met the inclusion criteria, with 92 males (61.3%) and 58 females (38.7%). The median age [M(Q1, Q3)]was 71 (61, 78) years and the median baseline National Institute of Health Stroke Scale (NIHSS) score [M(Q1, Q3)]was 15 (11, 18). Univariate logistic regression analysis showed that baseline VO was associated with 90-day functional independence (OR=1.587, 95%CI: 1.185-2.1873). After classifying VO into two categories based on the receiver operating characteristic (ROC) curve, VO≥4 showed an independent association with functional independence (OR=5.133, 95%CI: 1.530-9.361) after adjusting for age, baseline glucose, NIHSS score, baseline infarct core volume, modified Tan (mTan) score, hypoperfusion intensity ratio (HIR), etiological classification, recanalization, presence of any hemorrhagic transformation and final infarct volume. Futile recanalization was observed in 44 (48.4%) of the 91 patients who achieved successful recanalization. Stepwise logistic regression revealed that VO≥4 was an independent protective factor for futile recanalization (OR=0.234, 95%CI: 0.054-0.878). Moreover, in patients with mTICI 2c-3, VO≥4 showed a stronger association with futile recanalization (OR=0.018, 95%CI: 0-0.255). Conclusion: A favorable VO profile at onset protects against futile recanalization in patients with large vessel occlusion in the anterior circulation, and provides a simple and feasible auxiliary method for predicting the prognosis of endovascular therapy in such patients.

The Mechanism of the Anti-Cardiac Hypertrophy Effect of Glycyrrhizic Acid Is Related to Reducing STIM1-Dependent Store-Operated Calcium Entry

We explored the anti-cardiac hypertrophy mechanism of glycyrrhizic acid from the perspective of calcium regulation under pathological conditions. For this purpose, we used a rat model of myocardial hypertrophy induced by pressure overload. The effect of glycyrrhizic acid on BP was measured non-invasively with a sphygmomanometer and recorded in PC. In rats with modeled cardiac hypertrophy, the effect of GA on expression of type 1 matrix interaction molecules was determined in horizontal tissues and cultured cardiomyocytes of the left ventricle. The laser confocal microscopy and calcium ion probe Fluo-4 AM were used to assess the effect of glycyrrhizic acid on stromal interaction molecule 1 (STIM1)-dependent store-operated calcium entry in cultured cardiomyocytes derived from the hypertrophic myocardium. Glycyrrhizic acid exerted the anti-hypertrophic effect in rats with hypertrophic myocardium by down-regulating STIM1 protein expression and reducing the intensity of STIM1-dependent store-operated calcium entry.

[Visceral leishmaniasis in Xinjiang Uygur Autonomous Region during the COVID-19 pandemic: a case report]

OBJECTIVE

To perform an epidemiological investigation on a case of visceral leishmaniasis reported from Shule County, Kashi Prefecture, Xinjiang Uygur Autonomous Region in 2021, so as to provide insights into differential diagnosis of visceral leishmaniasis during the COVID-19 pandemic.

METHODS

The epidemiological history of this case was collected, and the case was diagnosed for Leishmania infection with the immunochromatographic (rK39) strip test, bone marrow smear microscopy and PCR assay.

RESULTS

The patient had typical clinical symptoms of leishmaniasis, including irregular fever, hepatosplenomeg- aly, low serum albumin and elevated globulin. Bone marrow smear microscopy identified L. donovani amastigotes, and both rK39 strip test and PCR assay were positive, while the case was tested negative for SARS-CoV-2. COVID-19 was therefore excluded and visceral leishmaniasis was diagnosed. Standard full-dose treatment with sodium stibogluconate was given, and no Leishmania was found on blood smears during the reexamination. No recurrence was found during the followup after discharge for hospital.

CONCLUSIONS

During the COVID-19 pandemic, it is recommended to increase the perception of differential diagnosis of visceral leishmaniasis among first-contact doctors, and reinforce the capability of differential diagnosis and health education of visceral leishmaniasis among medical and healthcare institutions at all levels, to prevent missed diagnosis and misdiagnosis of visceral leishmaniasis.

Ultra-high-resolution observations of persistent null-point reconnection in the solar corona

Magnetic reconnection is a key mechanism involved in solar eruptions and is also a prime possibility to heat the low corona to millions of degrees. Here, we present ultra-high-resolution extreme ultraviolet observations of persistent null-point reconnection in the corona at a scale of about 390 km over one hour observations of the Extreme-Ultraviolet Imager on board Solar Orbiter spacecraft. The observations show formation of a null-point configuration above a minor positive polarity embedded within a region of dominant negative polarity near a sunspot. The gentle phase of the persistent null-point reconnection is evidenced by sustained point-like high-temperature plasma (about 10 MK) near the null-point and constant outflow blobs not only along the outer spine but also along the fan surface. The blobs appear at a higher frequency than previously observed with an average velocity of about 80 km s^-1 and life-times of about 40 s. The null-point reconnection also occurs explosively but only for 4 minutes, its coupling with a mini-filament eruption generates a spiral jet. These results suggest that magnetic reconnection, at previously unresolved scales, proceeds continually in a gentle and/or explosive way to persistently transfer mass and energy to the overlying corona.

[Research advances on invasive fungal infections after burns]

Invasive fungal infection (IFI) is one of the serious complications in burn patients. The gradual development and application of broad-spectrum antibiotics in recent years has led to a serious dysbiosis of the flora, while the widespread prophylactic use of antifungal drugs has led to an increasing number of drug-resistant fungi. The clinical treatment of IFI is difficult and the prognosis is poor. The mortality of burn patients caused by IFI is increasing year by year. This paper reviews the epidemiologic characteristics, related risk factors, diagnostic methods, and treatment progress of IFI after burns, aiming to provide new ideas and reference for the prevention and treatment of IFI after burns.

Production of xylooligosaccharides from Camellia oleifera Abel fruit shell using a shell-based solid acid catalyst

This study aimed to produce xylooligosaccharides (XOS) from Camellia oleifera Abel fruit shell (CFS) using a shell-based solid acid derived from CFS (CFS-BSA). CFS-BSA preparation was optimized by incomplete carbonization at 450 °C for 1 h, followed by sulfonation at 130 °C for 8 h to yield a -SO₃H functional group concentration of 1.04 mmol/g. When CFS-BSA was used to hydrolyze CFS with a 1:5 ratio of CFS-BSA to CFS at 170 °C for 20 min, a maximum XOS yield (X₂-X₅) of 51.41 % was achieved, which was notably higher than when using subcritical H₂O solely. CFS-BSA can be recycled and reused at least six times by sieving without a substantial loss in its catalytic activity. CFS-BSA can also be used to produce XOS from other lignocellulosic materials such as corncob (41.04 %), sugarcane bagasse (45.03 %), corn stalk (45.89 %), birchwood (46.05 %), and poplar (40.10 %).

[Construction of prediction model combined dual-energy CT quantitative parameters and conventional CT features for assessing the Ki-67 expression levels in invasive breast cancer]

Objective: To develop a model combined with dual-energy CT quantitative parameters and conventional CT features for evaluating the expression level of Ki-67 in invasive breast cancer. Methods: A total of 191 patients with histologically confirmed invasive breast cancer in Lishui Central Hospital from March 2019 to December 2020, were retrospectively enrolled, all of them were females, aged from 25 to 77 (53.2±11.3) years. All patients underwent preoperative non-contrast chest and contrast-enhanced Dual energy CT scans, and the normalized iodine concentration (NIC) of lesions on arterial and venous phase, spectral curve slope (λ_HU), and normalized effective atomic number (nZ_eff) were measured and calculated, and their conventional CT characteristics were assessed. According to the results of immunohistochemistry (IHC), the patients were divided into Ki-67 high expression group (n=129 patients) and low expression group (n=62 patients) level. The differences in clinical data, conventional CT characteristics and dual-energy CT quantitative parameters between the two groups were analyzed. The receiver operating characteristic curve (ROC) curve was conducted to assess the efficacy of each individual model and joint model in evaluating Ki-67 expression levels, and the area under the curve (AUC), sensitivity, specificity, and accuracy were calculated, respectively. Results: In the analysis of CT features, the longest diameter, shape and enhancement pattern of the tumor were significantly difference between the two groups (all P<0.05). The NIC, nZ_eff on the arterial phase and NIC, nZ_eff and λ_HU [M(Q₁,Q₃)] on the venous phase were higher in the high Ki-67 expression group compared to the low expression group [0.13 (0.12, 0.16) vs 0.11 (0.08, 0.14), 0.71 (0.70, 0.75) vs 0.70 (0.67, 0.72), 0.40 (0.32, 0.48) vs 0.23 (0.17, 0.32), 3.10 (2.58, 3.63) vs 2.86 (2.19, 3.48), 0.88 (0.85, 0.92) vs 0.85 (0.84, 0.86), all P<0.05]. The logistic regression model, which integrated significant conventional CT features and dual-energy CT quantitative parameters, demonstrated the highest diagnostic performance for assessing Ki-67 expression levels, with an AUC of 0.924, sensitivity of 88.37%, specificity of 83.87%, and accuracy of 86.91%; the AUC of the dual-energy CT parameter model was 0.908, sensitivity of 82.17%, specificity of 88.71%, and accuracy of 84.29%. Though the diagnostic efficacy was no significant difference (P=0.238), both models showed superior to the conventional CT feature model (all P<0.001). Conclusion: A dual-energy CT quantitative parameter combined with a conventional CT feature model was successfully constructed, which has a good evaluation performance on the expression level of Ki-67 in invasive breast cancer.