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<p><b>BACKGROUND</b>Conventional magnetic resonance imaging (MRI) is the preferred neuroimaging method in the evaluation of neuropsychiatric systemic lupus erythematosus (NPSLE). The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE, to screen for the value of conventional MRI in NPSLE.</p><p><b>METHODS</b>A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study. All patients were classified into different groups according to MRI abnormalities. Both clinical and immunological features were compared between MRI abnormal and normal groups. One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index (SLEDAI) score for MRI abnormalities. Multivariate logistic regression analysis investigated the correlation between immunological features, neuropsychiatric manifestations, and MRI abnormalities.</p><p><b>RESULTS</b>Thirty-six NPSLE patients (61%) showed a variety of MRI abnormalities. There were statistically significant differences in SLEDAI scores (P < 0.001), incidence of neurologic disorders (P = 0.001), levels of 24-h proteinuria (P = 0.001) and immunoglobulin M (P = 0.004), and incidence of acute confusional state (P = 0.002), cerebrovascular disease (P = 0.004), and seizure disorder (P = 0.028) between MRI abnormal and normal groups. In the MRI abnormal group, SLEDAI scores for cerebral atrophy (CA), cortex involvement, and restricted diffusion (RD) were much higher than in the MRI normal group (P < 0.001, P = 0.002, P = 0.038, respectively). Statistically significant positive correlations between seizure disorder and cortex involvement (odds ratio [OR] = 14.90; 95% confidence interval [CI], 1.50-151.70; P = 0.023) and cerebrovascular disease and infratentorial involvement (OR = 10.00; 95% CI, 1.70-60.00; P = 0.012) were found.</p><p><b>CONCLUSIONS</b>MRI abnormalities in NPSLE, especially CA, cortex involvement, and RD might be markers of high systemic lupus erythematosus activity. Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Middle Aged , Lupus Erythematosus, Systemic , Allergy and Immunology , Pathology , Lupus Vasculitis, Central Nervous System , Allergy and Immunology , Pathology , Magnetic Resonance Imaging , Retrospective StudiesABSTRACT
Objective To analyze patterns of functional bundles in anterior and posterior cruciate ligaments during knee joint movement, so as to provide important references for studying injury mechanism of cruciate ligaments and implant reconstruction. Methods Five healthy knee cadavers were elaborately dissected to expose insertions of functional bundles in anterior and posterior ligaments on both the femur and tibia. CT scans and 3D finite element reconstruction with Mimics and ANSYS were conducted at 0°, 30°,60°, 90°, and 120° flexion angle of the knee joint. The center points of insertions and parallel sections of functional bundles defined by the software ANSYS and CATIA were connected to the centerlines, and at five different knee flexion angles, the lengths of centerlines, defined as the bundle lengths, were measured. Results The length of anterior medial bundle (AMB) of anterior cruciate ligament (ACL) increased gradually as the flexion angle grew from 0° to 90°, but slightly decreased at 120° flexion angle; whereas the length of posterior lateral bundle (PLB) of ACL decreased as flexion angle went from 0° to 90° and slightly increased at 120° flexion angle. In posterior cruciate ligament (PCL), both anterior lateral bundle (ALB) and posterior medial bundle (PMB) extended in length as the flexion angle went from 0° to 120°. The change of ACL and PCL bundle’s length was statistically significant (P<0.05). Conclusions ACL bundles functioned in a reciprocal manner and PCL bundles functioned in a complementary manner during knee flexion. Through establishing the finite element model of functional bundles in cruciate ligaments, the actual length of cruciate ligaments could be reflected, which provided a reasonable method for studying the changes of actual length of functional bundles in cruciate ligaments during knee flexion.
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Objective To compare the medical expenditure and its trend for diabetes mellitus and non-diabetes mellitus and to assess the direct economic burden of diabetes for individuals and families.Methods Using data from the China Health and Nutrition Survey (CHNS),propensity scores matching (PSM) was used to match diabetes mellitus and non-diabetes mellitus according to the related characteristic variables.Data from 679 pairs of objects was then compared.Results From 2000 to 2009,gaps of annual medical expenditure from diabetes mellitus and non-diabetes mellitus showed an increase,from 3361.93 to 6608.48 Yuan,with the ratios of medical expenditure about 4 times.The ratios of personal economic burden and family economic burden had an increase of about 4-5 times.Conclusion Compared with non-diabetes mellitus,the annual medical expenses was significantly higher among patients with diabetes mellitus.The absolute cost appeared a dramatic increase,along with the personal and familiar economic burden.
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Objective To study the role of medial collateral ligament (MCL) in maintaining the stability of the knee joint by constructing the three-dimensional (3D) finite element model of the knee joint. Method sCT scans were performed after the MCL was marked by steel wires and the end point was marked by the dill hole. Then the 3D finite element model of the knee joint including ligaments was constructed with Mimics, Geomagic and Ansys software to simulate the anterior-posterior translation, valgus and internal-external rotation of the knee joint at different flexion angles. Results With the knee at 0, 30, 60, 90 and 120 degree of flexion，the initial stresses of MCL were 4.84, 3.55, 2.17, 1.26 and 0 MPa, respectively. When the knee joint was subjected to anterior translation loading, the stresses were 7.22, 5.78, 4.07, 2.84 and 1.4 MPa, respectively. When the knee joint was subjected to posterior translation loading, the stresses were 8.14, 6.45, 4.19, 2.92 and 1.6 MPa, respectively. When the knee joint was subjected to internal rotation loading, the stresses were 6.81, 5.23, 3.29, 2.25 and 0.97 MPa, respectively. When the knee joint was subjected to external rotation loading, the stresses were 6.28, 5.00, 3.34, 2.21 and 0.82 MPa, respectively. When the knee joint was subjected to valgus loading, the stresses were 11.00, 9.55, 7.25, 5.94 and 3.11MPa, respectively. Conclusions The biomechanical function of MCL can be effectively analyzed by establishing the 3D finite element model of the knee joint to simulate the anterior-posterior translation, valgus and internal-external rotation of the knee joint.
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OBJECTIVE@#To investigate the changes of iron content in serum and liver, ferritin content in serum, percentage of myeloperoxidase (MPO) positive granulocyte in rabbits after different serious trauma and to explore the relationship between these changes and multiple organ failure (MOF).@*METHODS@#Rabbit trauma models were established. Iron content in serum and liver, ferritin content in serum and the percentage of MPO positive granulocyte were measured at different time after trauma.@*RESULTS@#After trauma, iron content in serum decreased sharply in early period (12-36h) and increased gradually to normal level in mild traumatic group after 60 h. Iron content in serum remained lower level in severe traumatic and death group 60 h after trauma. Iron content in liver obviously increased in death group. The changes of ferritin content in serum in mild traumatic were not obvious. Ferritin contents in serum in severe injury group and death group were slightly higher in early period and decreased in later period. The percentage of MPO positive granulocyte increased in early period after trauma. The percentage began to decrease 6 d after trauma and returned to normal level in mild traumatic group. The percentage obviously was significantly lower than normal levels in severe traumatic group and death group 6 d after trauma. Some rabbits died 60 h-6 d after severe trauma, and the pathological changes in the other organs were consistent with MOF.@*CONCLUSION@#Trauma can cause the serum iron, ferritin levels and percentage of MPO positive granulocyte changes. Severe trauma can cause uncompensated changes of these indicators, which could be the main mechanisms of MOF and death.
Subject(s)
Animals , Male , Rabbits , Disease Models, Animal , Ferritins/metabolism , Injury Severity Score , Iron/metabolism , Leukocyte Count , Liver/metabolism , Multiple Organ Failure/pathology , Multiple Trauma/pathology , Peroxidase/metabolism , Time Factors , Wounds and Injuries/pathologyABSTRACT
<p><b>OBJECTIVE</b>To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL) with or without displaced movements at different knee flexion conditions.</p><p><b>METHODS</b>A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0 degree, 30 degree, 60 degree, 90 degree, 120 degree) and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured.</p><p><b>RESULTS</b>The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30 degree of knee flexions. The stress values were smaller than the peak value of natural stress at 0 degree (knee full extension) when knee bending was over 60 degree of flexion in anterior-posterior tibial translation and internal-external rotation.</p><p><b>CONCLUSION</b>LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to anterior-posterior tibial translation or internal-external rotation at early 30 degree of knee flexions.</p>
Subject(s)
Humans , Anterior Cruciate Ligament , Physiology , Collateral Ligaments , Physiology , Finite Element Analysis , Knee Joint , Physiology , Stress, MechanicalABSTRACT
The aim of the present study is to investigate the differences in cardiac function, and the expression and activity of calcium regulatory proteins between rabbit systolic heart failure (SHF) and diastolic heart failure (DHF) models. New Zealand white rabbits were randomly divided into three groups: sham operation (SO) group, DHF group (receiving abdominal aortic constriction) and SHF group (receiving aortic valve destruction and abdominal aortic constriction). The cardiac function was detected by echocardiographic and hemodynamic assays. The mRNA expression levels of sarcoplasmic reticulum Ca(2+) ATPase 2a (SERCA2a) and phospholamban (PLB) were evaluated by RT-PCR. The protein expression levels of SERCA2a, PLB, phosphoserine 16-PLB (pSer-16-PLB) and protein kinase A (PKA) were evaluated by Western blot, and the phosphorylation status of PLB was determined by the ratio of pSer-16-PLB protein level to that of PLB. The activity of SERCA2a was measured through inorganic phosphate. The activity of PKA was measured by gamma-(32)P ATP-binding assays. Compared with SO group, there were significantly increased ventricular wall thickness, raised left ventricular end diastolic pressure (LVEDP), reduced diastolic function in DHF group (P<0.05 or P<0.01), and significantly increased ventricular cavity size and LVEDP, reduced systolic function in SHF group (P<0.05 or P<0.01). The expression levels of SERCA2a in DHF and SHF groups were lower than that in SO group (P<0.05), while the expression and activity of PKA in DHF and SHF groups were higher than that in SO group (P<0.05 or P<0.01), and there was no significant difference between DHF and SHF groups. The expression levels of PLB and pSer-16-PLB as well as the phosphorylation status of PLB and activity of SERCA2a in SHF group were lower than those in DHF and SO groups respectively. Posing a contrast, the phosphorylation status of PLB and activity of SERCA2a in DHF group were higher than that in SO group (P<0.05). These results indicate that the SHF and DHF models were successfully established, and there are some differences in the expression and activity of calcium regulatory proteins between two models.
Subject(s)
Animals , Rabbits , Calcium-Binding Proteins , Metabolism , Disease Models, Animal , Heart Failure, Diastolic , Metabolism , Heart Failure, Systolic , Metabolism , Sarcoplasmic Reticulum , Metabolism , Sarcoplasmic Reticulum Calcium-Transporting ATPases , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic principles and prognosis of synchronous primary colorectal carcinomas (SCC).</p><p><b>METHODS</b>The data of 66 SCC patients surgically treated from 1984 to 2003 were retrospectively reviewed.</p><p><b>RESULTS</b>The synchronous primary colorectal carcinomas were diagnosed and resected simultaneously in 65 patients except one that was misdiagnosed. Thirty patients underwent combined resection, 35 patients segmental resection. Sixty-two patients received radical resection, while three patients had palliative resection due to hepatic metastasis. The overall postoperative 3-, 5-, 10-year survival rates were 70.3%, 60.0%, 40.6%, respectively. In the patients who had simultaneous radical resection, the 3-, 5-, 10-year survival rates were 76.0%, 65.9%, 46.4% respectively.</p><p><b>CONCLUSION</b>The extent of resection should be individually determined by the lesion location, extent and distance between the lesions, as well as the patient's general condition. More extensive bowel resection, such as total or subtotal colectomy are suggested for those patients with hereditary nonpolyposis colorectal carcinoma syndrome in order to reduce or avoid the risk of metachronous colorectal carcinoma. The postoperative survival in patients with synchronous primary colorectal carcinoma is similar to those with solitary lesion.</p>