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Objective:To elucidate the phenomenon that epileptic seizure occurs in patients with epilepsy without definite diagnosis when driving a motor vehicle and its hazards.Methods:From January 2020 to June 2022, 7 epileptic patients who experienced traffic accidents caused by seizures were selected from the First Affiliated Hospital of Soochow University, and their demographic data, traffic accident related data and epilepsy diagnosis and treatment data were summarized and analyzed.Results:A total of 7 adult patients with epilepsy were collected, including 6 males, 4 of whom had been driving for more than 10 years. Among them, 1 patient drove a bus, and the other 6 patients drove private cars. Totally 5/7 of the accidents resulted in personal injury, and 3/7 of the accidents resulted in personal death. In 5 patients, video electroencephalogram showed interictal epileptiform discharges. In 2 patients, the imaging findings suggested the presence of cerebral cortical lesions that may lead to seizures. In terms of the form of seizure, 3 patients′ seizure type was focal to bilateral tonic-clonic, and the other 4 patients were very probable to be focal impaired awareness seizure.Conclusions:Undiagnosed epileptic seizures lead to traffic accidents, endanger patients and public safety, which need to attract attention from both doctors and patients, as well as the whole society.
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Objective:To explore the characteristics of cerebellar metabolites of autistic children using the magnetic resonance spectrum (MRS) and analyze their correlation with clinical symptoms.Methods:An autism group ( n=14) and a control group ( n=8) both underwent bilateral MRS scans of their cerebella. The NAA, Cho and Cr absolute values were recorded along with the NAA/Cr and Cho/Cr ratios. Those values were correlated with clinical symptoms of autism (the CARS and ABC scales), as well as with age. Results:There were no significant differences between the two groups in cerebellar metabolite levels, but the autism group exhibited significantly higher Cho/Cr ratios in the right cerebellum than in the left. There was a significant positive correlation between the Cho/Cr ratio in the right cerebellum and CARS scores, and between the NAA/Cr ratio in the right cerebellum and age.Conclusions:There is metabolic abnormality in the left and right cerebellar hemispheres of autistic children. The metabolic abnormality is related to the severity of clinical symptoms. However, metabolism in the cerebellum improves gradually with age.
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Spinal cord injury (SCI), especially the complete SCI, usually results in complete paralysis below the level of the injury and seriously affects the patient's quality of life. SCI repair is still a worldwide medical problem. In the last twenty years, Professor DAI Jianwu and his team pioneered complete SCI model by removing spinal tissue with varied lengths in rodents, canine, and non-human primates to verify therapeutic effect of different repair strategies. Moreover, they also started the first clinical study of functional collagen scaffold on patients with acute complete SCI on January 16th, 2015. This review mainly focusses on the possible mechanisms responsible for complete SCI. In common, recovery of some sensory and motor functions post complete SCI include the following three contributing reasons. ① Regeneration of long ascending and descending axons throughout the lesion site to re-connect the original targets; ② New neural circuits formed in the lesion site by newly generated neurons post injury, which effectively re-connect the transected stumps; ③ The combined effect of ① and ②. The numerous studies have confirmed that neural circuits rebuilt across the injury site by newborn neurons might be the main mechanisms for functional recovery of animals from rodents to dogs. In many SCI model, especially the complete spinal cord transection model, many studies have convincingly demonstrated that the quantity and length of regenerated long descending axons, particularly like CST fibers, are too few to across the lesion site that is millimeters in length to realize motor functional recovery. Hence, it is more feasible in guiding neuronal relays formation by bio-scaffolds implantation than directing long motor axons regeneration in improving motor function of animals with complete spinal cord transection. However, some other issues such as promoting more neuronal relays formation, debugging wrong connections, and maintaining adequate neural circuits for functional recovery are urgent problems to be addressed.
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Objective To investigate the CT spectral imaging features of benign and malignant ovarian tumors and to assess the value of spectral CT in differentiating between benign and malignant ovarian tumors.Methods This study was granted by the institutional review board with a waiver for informed consent.34 patients with ovarian tumor(11 benign tumors and 23 malignant tumors)underwent preoperative CT scanning that included arterial phase (AP)and venous phase (VP)with GSI mode.Measurements were performed on the GSI viewer.The iodine concentration (IC,100 ug/cm3)was saved,and the normalized iodine concentration (NIC)and the spectral curve(spectral Hounsfield unit curve)were recorded.The slope of the curve was calculated as the formula:(CT attenuation (40 keV)-CT attenuation(100 keV))/60.The CT value was measured at 70 keV in Mono image.CT values,the slope of the spectral curve,the iodine concentration and NIC were compared between the two groups by using independent sample t-test with software SPSS 2 1.0.Receiver operating characteristic (ROC)was used to determine the threshold of slope of the spectral curve,the iodine concentration and NIC for differentiating benign and malignant ovarian tumors in VP.Results The slope of the spectral curve,the iodine concentration and NIC of malignant ovarian tumors in VP were 1.72±0.77,14.50±6.44 (100 μg/cm3),and 0.33±0.12.The slope of the spectral curve,the iodine concentration and NIC of benign ovarian tumors in VP were 1.05±0.48,8.86±4.04 (100 μg/cm3),and 0.22±0.13.Significant differences were found between the slope of spectral curve,the iodine concentration and NIC of the malignant ovarian tumors and those of the benign ovarian tumors in VP (P=0.01).CT values in double phases revealed no difference between these two groups (P>0.05).Conclusion There is a significant difference between the solid component of benign ovarian tumors and that of malignant ovarian tumors in spectral CT.GSI scan mode can provide more information for the differential diagnosis of benign and malignant ovarian tumors.
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Objective To determine the consistency of spectral CT parameters in advanced gastric cancer using different region of interests (ROIs) and their relationship with tumor micro-vessel density (MVD).Methods Thirty patients with histologically proven gastric cancer were prospectively enrolled.All the patients were examined using spectral-dual-phase-abdominal CT and treated successfully with radical surgery within 2 weeks after CT scanning.Two observers independently acquired iodine concentration(IC), normalized IC(nIC),and CT value at workstation using three different ROI protocols:10 mm2 circular ROI near tumor border where enhanced obviously,30 mm2 near the tumor center and the freehand outline ROI. The Data of the two observers were tested with interclass correlation coefficient (ICC) and Bland-Altman plot.The mean value of each parameter was documented as the final result.Differences of each group of ROI data were compared using ANOVA test. All the specimen were pathologically examined and MVD was counted. The relationship of each parameter to tumor MVD was analyzed by Pearson correlation. Results All of the IC,nIC and CT values obtained by the 2 observers using three ROI measurements were consistent well,and the ROI-outline had the highest ICC than that of smaller circular ROIs(ICC:0.991 to 0.997).The 95% differences confident interval of nIC-AP and nIC-VP using freehand outline ROI by two observers were-0.003 to 0.002 and -0.001 to 0.012, respectively. The outline-ROI method had better inter-observer accuracy. There were significant differences between the means of the all parameters with three ROI protocols (P<0.05). Values of ROI-10 mm2 were highest, while the values of ROI-outline were lowest (P<0.05).The mean counts of tumor MVD was(29.0±8.4)/high magnification.The nIC in venous phase(VP)had good correlations with intra-tumoral MVD, especially the ROI-outline (r=0.670, P<0.01), within different ROI measurements.Conclusions The different ROI selection in tumor has significant impact on the final CT parameters. Outlined ROI protocol improves inter-observer consistency and nIC-VP obtained by this method can indirectly reflect the condition of tumor angiogenesis.
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Objective To investigate the value of spectral CT with iodine parameters in distinguishing moderately-differentiated adnocarcinoma from poorly-differentiated adenocarcinoma.Methods 61 patients with gastric adenocarcinoma underwent preoperative CT scanning that included arterial phase(AP) and venous phase(VP) with gemstone spectral imaging(GSI) mode.All measurements were performed on the GSI viewer.The iodine concentration (IC) and the water concentration (WC) of the primary lesion were measured.Then the normalized iodine concentration (NIC) and contrast enhancement ratio (CER) were calculated.The CT values were measured at 70 keV Mono image.All the values of CER, NIC, IC and WC in the primary lesion were recorded and assessed by independent-samples t test.Receiver operating characteristic (ROC) was used to determine the threshold of IC and NIC for differentiating poorly-differentiated adenocarcinoma and moderately-differentiated adnocarcinoma.Results The IC values between moderate differentiation group and poor differentiation group were 8.73±4.05 vs 11.07±4.80(100 μg/cm3) in AP and 16.89±4.89 vs 21.18±5.96(100 μg/cm3) in VP.The values of NIC between moderately differentiated group and poorly differentiated group were 0.10±0.06 vs 0.13±0.06 in AP and 0.38±0.10 vs 0.49±0.12 in VP respectively.Significant difference of NIC (tVP=3.38, PVP0.05) in double phases revealed no significant difference between the two groups.Conclusion Iodine quantitative parameters of spectral CT can be potentially used to preoperatively evaluate the differentiation degree of gastric adenocarcinoma.Thus, the iodine parameters can reflect the differentiation degree of gastric adenocarcinoma.
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Objective To investigate the effects of glutamine (Gln) on proliferation and survival of small cell lung cancer H446 cells, and further to explore the potential mechanism. Methods The proliferation of H446 cells was detected at different time points (0, 24, 48, 72 and 96 h) by CCK-8 assay in Gln (+) group and Gln (-) group, and an optimal time was selected. Under the optimal time, Annexin V-FITC/PI staining, CellTiter-Glo? assay kit and flow cytometer were used to detect cell survival, cellular adenosine triphosphate (ATP) and reactive oxygen species (ROS) levels. Gln (-) group was used as the control group, under the condition of Gln deficiency, cellular ATP, cell proliferation and survival were detected after adding oxaloacetic acid (OAA) or dimethyl-α-ketoglutarate (DM-αKG). Gln (-) group was used as the control group, cellular ROS, cell proliferation, colony and survival were detected after treated with ROS scavenger N- acetyl cysteine (NAC). With different concentrations (0, 2, 5, 10 μmol/L) of glutaminase inhibitor BPTES, the optimal concentration was selected through the colony assay. The cellular ATP and ROS levels and cell proliferation were detected under the optimal concentration. H446 cells were treated with bis-2-(5-phenylacetamido-1,2,4-thiadiazol-2-yl) ethyl sulfide (BPTES), ROS inducer hydrogen peroxide (H2O2) or the combination of them, and cell survival ratio was compared between two groups. Results The proliferation levels of H446 cells at 24, 48, which were decreased most significantly in 72 h in Gln (-) group. When 72 h was used as the optimal time, the cell survival ratio and ATP level were decreased, and the ROS level was increased, in Gln (-) group compared with those of Gln (+) group (P<0.05). There was a higher survival ratio in H446 cells in Gln (-)+OAA group and Gln (-)+DM-αKG group than that of Gln (-) group (P<0.05), but there were no significant differences in cell proliferation and ATP levels between Gln (-) group, Gln (-)+OAA group and Gln (-)+DM-αKG group. The ROS level was reduced, the cell proliferation, colony level and survival ratio were increased in Gln (-)+NAC group compared with those of Gln (-) group (P<0.05). Cloning assay showed that 10μmol/L was the optional concentration. Under this concentration, the proliferation and ATP level were decreased in Gln(+)+BPTES group (P<0.05), and cellular ROS level was up-regulated compared with Gln(+) group. The survival ratio was significantly lower in BPTES+H 2O2 group compared with BPTES (+) group or H2O2 (+) group. Conclusion Glutamine deficiency inhibits the proliferation and survival ratio of H446 cells through enhancing ROS level. BPTES and H2O2 show synergistically inhibitory effect on the survival of H446 cells.
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<p><b>OBJECTIVE</b>To investigate the value of CT perfusion imaging in differential diagnosis between Borrmann types II( and III( gastric cancer.</p><p><b>METHODS</b>All the patients were proven as ulcerated gastric cancer by preoperative gastroscopy and underwent CT perfusion scanning with Aquilion ONE 320 spiral CT from October 2013 to June 2014 in The First Affiliated Hospital of Zhengzhou University, including 19 patients as Borrmann type II( gastric cancer and 23 patients as Borrmann type III( gastric cancer by pathology. Lesions were divided into three parts by two tangent lines perpendicular to the gastric wall of the ulcer edge, including proximal part (close to cardia), ulcer part and distal part (close to pylorus). All the perfusion images were analyzed in the Toshiba 4.7 post processing workstation. Blood flow (BF), blood volume (BV), and clearance (CL) were measured according to Patlak-plot mode, and arterial flow (AF) was measured according to Single-input maximum mode. Differences in all the parameters between Borrmann type II( and III( groups were analyzed. Receiver operating characteristic (ROC) curve was used to determine the threshold of perfusion parameters for differentiating Borrmann type II( and III( gastric cancer.</p><p><b>RESULTS</b>There were no significant differences in AF, BV and BF of ulcer part between the two groups (all P>0.05). While the CL of ulcer part in Borrmann type III( group was (7.17±2.41) L/s, which was significantly higher than (4.82±2.26) L/s in Borrmann type II( group (P=0.00). There were no significant differences for all the parameters at proximal part and distal part between the two types (all P>0.05). According to the ROC curve, area under the curve of CL was 0.78. Taking 0.59 L/s as the threshold of CL value, the corresponding sensitivity and specificity for diagnosing Borrmann type III( were 70% and 80%, respectively.</p><p><b>CONCLUSION</b>The CL value has certain diagnostic value in differential diagnosis between Borrmann types II( and III( gastric cancer.</p>
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Female , Humans , Male , Middle Aged , Diagnosis, Differential , Gastroscopy , Perfusion Imaging , ROC Curve , Sensitivity and Specificity , Stomach Neoplasms , Diagnostic Imaging , Tomography, Spiral Computed , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE:To study invalid medical order warned by Prescription automatic screening system (PASS),and to improve rational drug use monitoring. METHODS:The infusion medical order warned with black light,red light and orange light by PASS were extracted from Pharmacy intravenous admixture services(PIVAS)of our hospital during Oct. to Dec. 2014. Invalid warning items were analyzed statistically in respect of warning level,problem types and reasons. RESULTS & CONCLUSIONS:There are 3 392 warnings items,468 were invalid (13.80%) which include 10 items by black light,219 items by red light and 239 items by orange light;by problem types,there are 218 items of overdose and 136 items of repeated treatment,etc. The main causes of invalid warning include 191 items caused by wrong system prompt,126 items by incomplete system information,143 items by insufficient auditing standards,etc. There are still some defects of invalid warning in practical application of PASS. It is suggested that user and developer add the function of self-defined drug list or user-defined system data by,and unify auditing stan-dards of rational drug use,etc.,so as to timely update the system information,and improve the accuracy of software system moni-toring and warning function.