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Objective:To explore the value of dual-input perfusion imaging (DI-CTP) in differential diagnosis of single inflammatory pseudotumor and peripheral lung cancer with 320-slice CT. Methods: Totally 52 patients with single pathological proved peripheral lung cancer (28 with adenocarcinoma, 24 with squamous cell carcinoma) and 21 patients with inflammatory pseudoaneurysm were enrolled. Pulmonary artery flow (PF) and bronchial artery flow (BF) were obtained, the perfusion index (PI) and total perfusion (TLP) were calculated. Time-density curve was obtained from DI-CTP, and the enhanced time to peak (TTP) were calculated. The above indexes were analyzed among squamous cell carcinoma, adenocarcinoma and inflammatory pseudotumor, and their values in differential diagnosis of peripheral lung cancer and inflammatory pseudotumor were evaluated. Results: There were significant differences of PF and TTP among squamous cell carcinoma, adenocarcinoma and inflammatory pseudotumor (all P<0.01), also of PF, TLP and TTP between inflammatory pseudotumors and peripheral lung cancer (all P<0.01). AUC of TTP was 0.99 (P<0.01), which had high diagnostic value. Taken TTP=16.3 s as the critical value, the sensitivity and specificity in predicting inflammatory pseudotumors and peripheral lung cancer was 100% and 95.0%, respectively. AUC of PF and TLP was 0.76 (P<0.01) and 0.71 (P<0.01), respectively, which had moderate diagnostic value. Conclusion: Inflammatory pseudotumor and peripheral lung cancer both have pulmonary artery and bronchial artery blood supply. TTP is helpful to differential diagnosis of inflammatory pseudotumor and peripheral lung cancer.
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BACKGROUND:A series of inflammatory signal pathways are activated accompanied by increasing expressions of inflammatory factors after periodontal tissues being stimulated by exogenous substances like bacterium. Inflammation is closely related to periodontal tissue repair and regeneration. OBJECTIVE:To il ustrate the correlation of immune response of periodontitis and periodontitis-related inflammatory cytokines to p38 mitogen activated protein kinase (p38MAPK) pathway, and to provide a new idea and method for the treatment of periodontitis in the future. METHODS:The related literatures of periodontitis and p38MAPK pathway published from January 1990 to January 2016 were retrieved from the databases of CBM, CNKI, SWIC and PubMed. The research and progress of periodontal tissue repair and regeneration after periodontitis were analyzed. RESULTS AND CONCLUSION:Total y 36 literatures were enrol ed final y. Inflammation-regulated and inflammation-associated signaling pathways as wel as subsequent expression of inflammatory mediators can partly control the excessive disease-induced inflammation and immune responses of the host, among which p38MAPK signaling pathway may be involved in the occurrence and development of periodontitis. More studies, however, are needed to validate these findings. The regulation of p38MAPK signaling pathway is stil of great significance in the treatment of periodontal disease, and we hope to provide a new insight and basis for clinical diagnosis and treatment of periodontitis.
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Objective To observe the changes of hepatic CT perfusion parameters and their correlation with serum aspartate transaminase( AST),alanine transaminase(ALT) and alkaline phosphatase (ALP) in a rabbit hepalic ischemia reperfusion injury (IRI) model.Methods Hepatic IRI was produced in rabbits by inducing left liver lobe ischemia (60 min) followed by 6 h,12 h and 24 h reperfusion (6 rabbits were used for each reperfusion interval ).Additional 6 rabbits were served as sham-operatedcontrols.All the rabbits were scanned with a dynamic iCT protocol.Blood samples were taken from the superior mesenteric vein to measure the levels of serum amylase (ALT,AST,and ALP) in various groups,and liver samples were taken for histological examinations after scanning.One-way analysis of variance (ANOVA) was used to determine differences between groups.The correlations of CT perfusion parameters with serum levels were analyzed using Pearson correlation coefficient.Results Heterogeneity of CT perfusion patterns appeared in the 6 h groups,which presented as low enhanced area [ ( 25.1 ± 9.3 ) ml · 1min-1 · 100mg-1].In reduced perfusion regions of IRI group,HAP of 12 h IRI group [ ( 19.5 ± 13.6) ml · min-1 · 100 mg-1],24 h IRI group [(8.0+2.7) ml · min-1 · 100 mg-1 ],HPP of 6 h IRI group [(10.8±5.5) ml · min-1 · 100 rng-1],12 h IRI group [(14.4±5.2) ml · min-1 · 100 mg-1],24 h IRI group [(7.8±3.3) ml · min-1 · 100 mg-1] and TLP of 6 h IRI group [(35.9 ±14.0) ml ·min-1 · 100 mg-1 ],12 h IRI group [ (33.9 ± 16.1) ml · min-1 · 100 mg-1 ],24 h IRI group [ (16.0 ±5.5) ml · min- 1 · 100 mg-1 ] were lower than those of sham group [ HAP (21.2 + 10.5 ) ml · min-1100mg-1,HPP(63.5±24.0) ml · min-1 · 100 mg-1,TLP (81.4±24.8) ml · min-1 · 100 mg-1](F=8.376,25.950,16.925,P＜0.01).However,HPI of 6 h IRI group [(65.9±3.9)％],12 h IRIgroup [ (54.2 ± 16.7)％ ],and 24 h IRI group [ (48.9 ± 10.0)％ ] were higher compared to sham group [ ( 24.1 ± 7.5 ) ％ ] ( F =43.664,P ＜ 0.01 ).But,the perfusion parameters in the relatively normal area of IRI groups showed decline compared with sham group.The levels of AST,ALT and ALP in IRI groups were significantly higher than those in the sham group ( P ＜0.05).In poorly enhancing tissues,TLP and HPP of IRI groups were inversely correlated with AST and ALP respectively ( P ＜ 0.01 ),and HPI was closely related to the increase of AST ( r =0.751,P ＜ 0.01 ).Conclusion These results demonstrate CT perfusion is sensitive to detect the hemodynamic changes.Perfusion parameters are closely correlated to the degree of liver injury in the rabbit IRI model.
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Objective To explore the value of DWI ADC in the diagnosis of hepatic ischemia reperfusion injury (IRI) at 3.0 T and investigate the mechanism by comparison with liver enzyme and pathological findings. MethodsForty-two New Zealand white rabbits were divided randomly into ( n ＝ 6,each) six IRI groups by rank sum test. The IRI animals underwent left lobar ischemia for 60 min and were reperfused 0. 5 h, 2. 0 h, 6. 0 h, 12. 0 h, 24. 0 h and 48. 0 h later. One Sham operative group underwent laparotomy without liver ischemia. T2 WI, T1 WI, DWI and contrast-enhanced T, WI were performed with 3.0 T magnetic resonance imaging scanner in each group respectively. For DWI, b-values of 20, 50, 100,200,300,400,500 and 600 s/mm2 were used respectively. Blood samples were taken to detect the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at different time points. Liver samples were examined histologically after MRI scanning. One-way analysis of variance (ANOVA) was used to determine differences, followed by LSD-t test for multiple comparisons. ResultsOverall, ADC decreased markedly at the early IRI phase ( 0. 5 h), drastically increased in the 2.0 h group, and then ascended slightly from 6. 0 h to 48.0 h after reperfusion, except for a transient decrease at the time point of 24. 0 h. When b values were 20, 50, 100,200 and 300 s/mm2, the ADC values in the Sham group were (3.47 ±0.53) × 10-3, (3.11 ±0.39) ×10-3, (2.87 ±0.19) ×10-3, (2.56 ±0.37) × 10-3 and (1.95 ±0.33) ×10-3mm2/s, (2.63±0.31)±10-3, (2.47±0.32) ×10-3, (2.12±0.38) ×10-3, (2.01±0.51) ×10-3and (1.61 ±0.17) ×10-3mm2/s in the 0.5 h group, (2.72 ±0.09) ×10-3, (2.51±0. 11) ×10-3, (2.28 ±0.30) ± 10-3, (1.96 ±0. 14) × 10-3 and (1.58 ±0. 17) × 10-3mm2/s in the 24.0 h group, respectively. ADC of 0. 5 h and 24. 0 h groups were significantly lower than that of Sham group (P＜0.05) when b value was under 300 mm2/s.In the Sham, 0.5 h, 2.0 h, 6.0 h, 12.0 h,24.0 h and 48. 0 h IRI groups, they were (80±8), (181 ±34), (413 ±62), (474 ±83), (424 ±41 ),(332 ±41 )and(302 ±39) U/L for the levels of ALT,and (79 ± 10), (454 ±55), (547 ±72), (607±31 ), (649 ±79), (785 ±49) and ( 1526 ± 167) U/L for the AST respectively. The levels of AST and ALT in IRI groups were significantly higher than those in the Sham group ( P ＜ 0. 01 ).Histological findings showed diffuse hepatocytes swelling and erythrocytes depositing in the hepatic sinusoids, portal area, central venous and arterials at the initial phase.With the injury aggravated, inflammatory cell infiltration,hepatocyte nuclear condensation of apoptosis, sinusoidal dissociation and coagulation necrosis developed eventually. Conclusion 3.0 T DWI can monitor the pathological process of rabbit liver ischemia reperfusion injury dynamically, and provides a feasible imaging modality for clinical diagnosis and treatment.
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BACKGROUND: The levels of superoxide dismutase (SOD) and nitric oxide (NO) in serum reflect the efficacy of drugs on anti-ischemic damage.Fumai yin improves significantly the prognosis of visual function in ischemic hemorrhagic fundus disease.OBJECTIVE: To observe the effects of f umaiyin on ultrastructure of ischemic retina and serum SOD and NO activity in experimental rats.DESIGN: Randomized controlled observation on single sample was designed.SETTING: Department of Ophthalmology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine,MATERIALS: The experiment was performed in Experiment Room of affiliated hospital of Shandong University of Chinese Medicine and Ultrastructure Room of Shandong University from November 2002 to July 2003.60 male Wistar rats were employed and randomized into fumaiyin group,fuming pian control group (fuming pian group) and the control group with physiological saline (PS group), 20 rats in each. Fumai yin is the concentrated decoction 2g/ml, composed of gouqizi (Fructus Lycii), huangjing (Rhizoma Polygonati), danshen (Radix Salviae Miltiorrhizae), wuweizi(Fructus Schisandrae), huangqi (Radix Astragali seu Hedysari), etc.METHODS: The model of retina ischemia was prepared by increasing in traocular pressure in 3 groups of rats. 0.5% pentobarbital 10 mL/kg was injected abdominally to anesthetize ocular surface. No.7 needle of tube with PS transfusion was inserted directly to bilateral anterior chambers of rats, and the infusion bottle was 145 cm above both eyes of rats, by which, 14kPa intraocular pressure was formed. It was observed that bulbar conjunctiva was pale, fundus blood flow was broken off and retina was is chemic. 1.5 hours later, the needle was withdrawn and perfusion was restored. In fumai yin group and fuming pian group, the drug was adminis trated 10 mL/kg (medicine concentration was 2 g/mL) and in PS group, PS of equal amount was applied. Gastric perfusion was done with different materials successively after modeling for 3 weeks. Colorimetry was used for assay of SOD activity and nitrate reductase method was used for assay of NO activity.MAIN OUTCOME MEASURES: ① Comparison of serum SOD and NO activities in each group. ② Alternation of ultrastructure of ischemic retina in 3 weeks of modeling observed with transmission electron microscope (TEM) in each group.RESULTS: Totally 60 rats were employed in the experiment. During breeding, in PS group, 2 rats were died of gastric perfusion and1 rat was died of biting, the rest 57 rats all entered result analysis. ① Comparison of serum SOD and NO activities in each group: Compared with fuming pian group, in fumai yin group, SOD activity was not changed remarkably (t=-1.165, P ＞ 0.05), but, NO activity was reduced significantly [(41.06±13.54), (27.39±7.45)μmol/L,t=3.958,P ＜ 0.01]. Compared with PS group, infumaiyin group, SOD activity was increased remarkably (t=4.628,P ＜ 0.01) and NO activity was reduced significantly (t=-3.767, P ＜ 0.01). ② Alternation of ultrastructure of ischemic retina in 3 weeks of modeling in each group: In fumaiyin group, retina was distinct in layer, newlyborne membrane discs were orderly in arrangement, membrane structure was normal, the numbers of retinal ganglion cells (RGCs) and organelle structure was basically normal and there was no obvious vacuole in neu rofibrous layer. In fuming pian group, retina was distinct in layer, newly borne membrane discs were slightly disturbed in arrangement, the numbers of RGCs and each organelle structure were mostly normal and there was no obvious vacuole in neurofibrous layer. In PS group, retina was not so distinct in layers, newly-borne membrane discs were disturbed in arrangement, the structure was abnormal, the numbers of RGCs was less,organalle structure was not integrative and large vacuole presented remarkably in neurofibrous layer.CONCLUSION: In fumaiyin group, SOD in serum was increased significantly and NO was reduced remarkably, explaining that fumaiyin provides good protection on injury of ischemic retina, which is probably related to that fumaiyin affects SOD and NO levels in serum and alleviates the damage of retinal ultrastructure induced by ischemia.