Clinical value of coronary artery tracking freezing technique in improving the quality of CT coronary images / 中国基层医药

Objective To explore the clinical value of cardiac coronary artery tracking and freezing (SSF) in improving the quality of CT coronary images.Methods A total of 52 patients who underwent coronary angiography (CTA) scan from December 2015 to December 2017 in the Maternal and Child Health Care Hospital of Zhuhai were enrolled.The patients were divided into two groups according to the heart rate of the patients .The heart rate in high heart rate group (24 cases) was＞75 beats／min.The heart rate in low heart rate group (28 cases) was ≤75 beats／min.The two groups used the standard algorithm ( STD) and SSF technique to reconstruct the image separately.The obtained images were obtained by multiple names.The diagnostician performed the analysis and scored the quality of the coronary image using the LiKert 5-point scoring system.The score of ＜3 points required CTA examination again to evaluate the value of SSF in improving CT coronary image quality.Results The STD and SSF image quality scores of the high heart rate group were (2.33 ±0.87)points and (3.99 ±0.82)points,respectively,and the difference was statistically significant(t＝-7.347,P＜0.05).The STD and SSF image quality scores of the low heart rate group were (3.15 ±1.06)points and (4.23 ±0.65)points,respectively,and the difference was statistically significant (t＝-4.596,P＜0.05).The STD and SSF image quality scores between the two groups had statistically significant differ -ences (t＝5.723,7.386,all P＜0.05).In the high heart rate group,the image quality scores reconstructed using SSF technique was increased by 71%,which in the low heart rate group was increased by 34%,the difference between the two groups was statistically significant ( χ2 ＝9.668, P ＜0.05).Conclusion SSF algorithm can improve image quality of CTA,especially in patients with high heart rate.

Clinical value of coronary artery tracking freezing technique in improving the quality of CT coronary images / 中国基层医药

Objective@#To explore the clinical value of cardiac coronary artery tracking and freezing(SSF) in improving the quality of CT coronary images.@*Methods@#A total of 52 patients who underwent coronary angiography(CTA) scan from December 2015 to December 2017 in the Maternal and Child Health Care Hospital of Zhuhai were enrolled.The patients were divided into two groups according to the heart rate of the patients.The heart rate in high heart rate group (24 cases) was>75 beats/min.The heart rate in low heart rate group(28 cases) was ≤75 beats/min.The two groups used the standard algorithm(STD) and SSF technique to reconstruct the image separately.The obtained images were obtained by multiple names.The diagnostician performed the analysis and scored the quality of the coronary image using the LiKert 5-point scoring system.The score of <3 points required CTA examination again to evaluate the value of SSF in improving CT coronary image quality.@*Results@#The STD and SSF image quality scores of the high heart rate group were (2.33±0.87)points and (3.99±0.82)points, respectively, and the difference was statistically significant(t=-7.347, P<0.05). The STD and SSF image quality scores of the low heart rate group were (3.15±1.06)points and (4.23±0.65)points, respectively, and the difference was statistically significant(t=-4.596, P<0.05). The STD and SSF image quality scores between the two groups had statistically significant differences (t=5.723, 7.386, all P<0.05). In the high heart rate group, the image quality scores reconstructed using SSF technique was increased by 71%, which in the low heart rate group was increased by 34%, the difference between the two groups was statistically significant(χ2=9.668, P<0.05).@*Conclusion@#SSF algorithm can improve image quality of CTA, especially in patients with high heart rate.

Relationship between Clopidogrel Response ,Early Neurological Deterioration and CYP2C19 Gene Polymorphism in Symptomatic Intracranial Atherosclerotic Stenosis (sICAS)Patients / 中山大学学报(医学科学版)

[Objective]To investigate the relationship between clopidogrel response , early neurological deterioration and CYP2C19 gene polymorphism in sICAS patients.[Methods]116 sICAS patients were divided into deterioration group and non-deterio?ration group by whether appear early nervous function deterioration. Record included the baseline data,the genotypes of CYP2C19, platelet maximum aggregation rate after 7 days of given clopidogrel,CYP2C19 genotype and clopidogrel reaction were compared be?tween two groups.[Results]The deterioration group combination with diabetes ,stroke/TIA were significantly higher than the non-de?terioration group(P<0.05);The frequency of CYP2C19*2 AA genotype and A allele were significantly higher than those in non-dete?rioration group. The frequency of GG genotype were significantly lower than non-deterioration group (27.27% vs 2.13%,50.00% vs 14.84%,27.27% vs 72.34%)(P<0.01);The poor metabolic genotype platelet maximum aggregation rate were significantly higher than that of the fast-metabolic genotype and middle metabolic genotype(P<0.01,P<0.05),Middle metabolic genotype platelet maxi?mum aggregation rate were significantly higher than fast-metabolic genotype(P<0.01);The deterioration group fast-metabolic geno?type were significantly lower than non-deterioration group ,poor metabolic genotype were significantly higher than non-deterioration group(22.73% vs 65.96%,36.36% vs 5.32%)(P<0.01);Clopidogrel resistance rate 59.09% were significantly higher non-deteriora?tion group 28.72%(P<0.05).[Conclusion]Clopidogrel response and early neurological deterioration in sICAS patients is associatedwith CYP2C19 gene polymorphism.

Effects of Separate and Direct Bee Sting Punctures at Acupoints on ESR and RF in Rheumatoid Arthritis / 上海针灸杂志

Objective To investigate the effects of separate and direct bee sting punctures at acupoints on ESR and RF in rheumatoid arthritis. Method Seventy-two patients with rheumatoid arthritis were randomized to observation and control groups, 36 cases each. The observation group received separate bee sting puncture at acupoints and the control group, direct bee sting puncture at acupoints. In both groups, treatment was given once every other day, three times a week, one week as a course, for two courses. ESR and RF were measured in the two groups before treatment and at one and two weeks after. Result ESR and RF changed significantly in both groups after treatment compared with before (P<0.05). The effects of the two treatments on rheumatoid arthritis-related ESR and RF were equal and there was no statistically significant difference between the two groups (P>0.05). Conclusion Both separate and direct bee sting punctures at acupoints can reduce ESR and RF in rheumatoid arthritis. Separate bee sting puncture at acupoints is easy for the patients to accept.

Diagnostic value of dual-tracer PET imaging in Alzheimer's disease / 西安交通大学学报(医学版)

Objective To investigate the diagnostic value of dual-tracer PET imaging in Alzheimer's disease (AD).Methods For this study,we enrolled 11 patients who were diagnosed clinically with AD and 7 age-matched healthy controls who underwent 11 C-PIB and 18 F-FDG PET brain imaging in the same period.Visual evaluation was used to observe the distribution of tracers.ROI technology and brain metabolism analysis software were used to quantify the uptake levels of PIB and FDG.Results Compared with that in HC group,FDG imaging pattern in AD group was presented as focal hypometabolism in posterior cingutate,superior frontal lobe,inferior frontal lobe, superior parietal lobe and lateral temporal lobe.PIB retention was mainly in bilateral superior frontal lobe,inferior frontal lobe,superior parietal lobe,lateral temporal lobe and posterior cingulate gyrus in images of equilibrium phase.The two FDG imaging results were basically in agreement with each other.Conclusion PIB with combined FDG PET imaging can provide more accurate information in diagnosis of AD.Further study is needed to confirm the effectiveness and practicability of this technology.

Diagnostic value of dual-tracer PET imaging in Alzheimer's disease / 西安交通大学学报(医学版)

Objective To investigate the diagnostic value of dual-tracer PET imaging in Alzheimer's disease (AD).Methods For this study,we enrolled 11 patients who were diagnosed clinically with AD and 7 age-matched healthy controls who underwent 11 C-PIB and 18 F-FDG PET brain imaging in the same period.Visual evaluation was used to observe the distribution of tracers.ROI technology and brain metabolism analysis software were used to quantify the uptake levels of PIB and FDG.Results Compared with that in HC group,FDG imaging pattern in AD group was presented as focal hypometabolism in posterior cingutate,superior frontal lobe,inferior frontal lobe, superior parietal lobe and lateral temporal lobe.PIB retention was mainly in bilateral superior frontal lobe,inferior frontal lobe,superior parietal lobe,lateral temporal lobe and posterior cingulate gyrus in images of equilibrium phase.The two FDG imaging results were basically in agreement with each other.Conclusion PIB with combined FDG PET imaging can provide more accurate information in diagnosis of AD.Further study is needed to confirm the effectiveness and practicability of this technology.

Articular cartilage defect repair with particulated juvenile cartilage allograft: existing problems and prospects / 中国组织工程研究

BACKGROUND: Particulated juvenile cartilage allograft is simple and easy to obtain, and chondrocytes can migrate and proliferate as confirmed by in vitro culture.In the Unite States,this technique has been used in the repair of cartilage defects in the hip, knee, ankle, and elbow joints. OBJECTIVE: To review the present situation, application, and value of particulated juvenile cartilage allograft transplantation for articular cartilage repair. METHODS: A computer-based search of CNKI, PubMed, and Elsevier was performed for retrieving articles concerning particulated juvenile cartilage allograft transplantation for articular cartilage repair published from October 1983 to June 2017. The keywords were "allogeneic juvenile cartilage particles; cartilage tissue engineering; articular cartilage defects;repair" in Chinese and English, respectively. After initial screening of titles and abstracts and exclusion of irrelevant articles, 48 eligible articles were included in final analysis. RESULTS AND CONCLUSION: (1) Although a variety of treatments for cartilage repair have achieved good clinical outcomes in short-term follow-up, improving the motor function of patients and relieving pain, patients eventually develop progressive degeneration of the articular cartilage and suffer from osteoarthritis. (2) Chondrocytes from allogeneic juvenile cartilage particles have stronger ability of proliferating and repairing cartilage defects in vitro than mature chondrocytes,and have low antigenicity,which cannot cause a strong rejection after in vivo transplantation.What's more, particulated juvenile cartilage allograft transplantation can be performed as one-stage surgery if cartilage defects are confirmed under arthroscopy. (3) Particulated juvenile cartilage allograft transplantation has achieved good outcomes in basic and clinical studies in the United States. Its potential superiority has gradually been accepted by doctors and patients. (4) There are also risks for being contaminated and spreading diseases during the preparation of particulated juvenile cartilage allograft. This technology has been widely used in the United States, but there are rare data concerning its follow-up studies. Therefore, an investigation on its long-term follow-up is indispensable for the objective assessment of its long-term efficacy, with a view to the extensive promotion of this technology in the clinical practice.

Cervical glandular intraepithelial neoplasia: a clinicopathologic and immunohistochemical analysis of 80 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To assess the clinicopathologic characteristics of cervical glandular intraepithelial neoplasia (CGIN) and to evaluate the usefulness of EnVision immunohistochemistry of various markers in identifying early invasive cervical adenocarcinoma (ICA) and its precursor lesions.</p><p><b>METHODS</b>Clinical and pathological characteristics of 80 cases of high grade CGIN (HCGIN), 20 ICA, and 20 cervicitis were reviewed along with immunohistochemical studies of p16, Ki-67, CEA, CA125 and bcl-2.</p><p><b>RESULTS</b>The clinical features of HCGIN were similar to those of high grade cervical intraepithelial neoplasia (CIN). Fourty four cases (55.0%) accompanied with CIN and 9 cases (11.3%) accompanied with early cervical squamous cell carcinoma (SCC). The positive rates of p16, CEA and Ki-67 in 80 cases of HCGIN were 100.0%, 63.8% and 73.8%, respectively. The positive rates of p16, CEA and Ki-67 in 20 ICA were 18/20, 16/20 and 20/20, respectively. The positive rates of p16, CEA and Ki-67 in 20 cervicitis were 1/20, 1/20 and 3/20, respectively. There was a significantly increased expression of p16, CEA and Ki-67 in ICA and HCGIN compared with cervicitis (P < 0.01). Ki-67 expression increased in ICA compared to HCGIN (P < 0.05). There was no statistical difference in CEA expression between ICA and HCGIN (P > 0.05). CA125 showed strong but nonspecific expression. Bcl-2 was negative or occasionally positive in each groups.</p><p><b>CONCLUSIONS</b>HCGIN is frequently accompanied with CIN and SCC. The combined staining of p16, CEA and Ki-67 provides additional aid in the diagnosis of early stage cervical adenocarcinoma and its precursor lesions. The sensitivity of p16 and Ki-67 markers for HCGIN is higher than that of CEA. CA125 and bcl-2 immunostains offer no helpful in identifying HCGIN.</p>

Value of P16 expression in the triage of liquid-based cervical cytology with atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The management of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) is still controversial and it is advisable to make a triage for these two cytological abnormalities. P16(INK4) (P16) has been shown to be a potential biomarker for predicting high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer. The aim of the study was to determine the value of P16 expression by immunostaining method compared with high-risk human papillomavirus (HR-HPV) DNA test in the triage of ASCUS/LSIL women.</p><p><b>METHODS</b>Totally 86 eligible residual liquid-based cytological specimens with ASCUS and 45 with LSIL were obtained. All specimens were submitted to HR-HPV DNA test (HC2) and P16 immunocytochemical staining simultaneously. And all women underwent colposcopy and biopsy after cytology.</p><p><b>RESULTS</b>The positive rate of P16 staining was 32.6% in ASCUS and 42.2% in LSIL, which was significantly lower than that of HR-HPV test in both ASCUS (P < 0.05) and LSIL (P < 0.05). Moreover, the positive rate of P16 staining was 12.7% in normal histology, 61.5% in CIN 1, 87.0% in CIN 2-3, and 100.0% in cancer, in which P16 positive rate was significantly lower than HR-HPV positive rate in normal group. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of P16 staining for predicting CIN 2 or more were 87.5%, 68.6%, 38.9%, 96.0%, and 72.1%, respectively in the ASCUS; while 90.0%, 71.4%, 47.4%, 96.2% and 54.7%, respectively in the LSIL, in which the specificity and accuracy of P16 staining were significantly higher than those of HR-HPV test in both ASCUS and LSIL (P < 0.05).</p><p><b>CONCLUSION</b>P16 immunostaining had significantly higher specificity and accuracy than HR-HPV DNA test for predicting for high-grade CIN and cervical cancer in ASCUS and LSIL and can be used for the triage of women with ASCUS/LSIL cytological abnormality.</p>

Histological evaluation of cervical carcinomas in FIGO stage Ib2/IIa after neoadjuvant chemotherapy / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the histological changes of cervical cancer after neoadjuvant chemotherapy (NACT) and to establish histological criteria for interpretation of chemotherapeutical effects.</p><p><b>METHODS</b>Fifty-six patients with FIGO stage Ib2-IIa cervical cancers treated by NACT and subsequent radical surgery were retrospectively analyzed, in which the pre- and post-chemotherapeutic histopathological changes were assessed.</p><p><b>RESULTS</b>The post-chemotherapeutic histopathological changes of 56 cases included grade 3 effects in 11 cases (19.6%), grade 2 in 24 cases (42.9%), grade 1 in 13 cases (23.2%) and no response in only 8 cases (14.3%). The histologic response rate was 62.5% (35/56) and the overall clinical response rate was 67.9% (38/56). The overall coincidence by both criteria was 78.6% (44/56). Four cases (7.1%, 4/56) had only histological response and 8 cases (14.3%, 8/56) had response by imaging. In comparison with the pre-chemotherapy specimens, the chemotherapy-associated histological changes included shrinkage and scattering of tumor nests,decrease of tumor cellularity,tumor cell degeneration and necrosis.</p><p><b>CONCLUSIONS</b>The histological changes in locally advanced cervical cancers induced by NACT are significant, which may challenge the diagnosis in the final specimens. There are some discreqancies between the histological criteria and imaging/gynecological ones for the therapeutic evaluation of cervical cancers,and it is thus recommended to use the pathological criteria for clinic practice.</p>

Clinicopathologic analysis of uterine epithelioid trophoblastic tumor / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype, differential diagnosis and prognosis of uterine epithelioid trophoblastic tumor(ETT).</p><p><b>METHODS</b>From 2000 to 2007, 5 ETTs cases were diagnosed in the affiliated Women's Hospital, School of Medicine, Zhejiang University. The pathologic characteristics and immunophenotype of the tumors were analyzed by histological examination and immunohistochemistry of CK18, p63, inhibin-alpha, HCG, HPL, PLAP and Ki-67. The clinical prognostic factors were evaluated based on a following-up data with a period of 11 - 50 months.</p><p><b>RESULTS</b>The overall prevalence of ETT was 0.48% among all the gestational trophoblastic diseases patients received in the same period. Five ETT patients were in the reproductive ages with a median of 33 years. Histologically, the tumor showed an invasive, nodular growth consisting of uniform mononuclear trophoblastic cells. There were zones of hyaline material in the tumour nests. Necrosis was commonly seen with a characteristic geographic pattern. Immunohistochemically, all cases displayed a diffuse CK18 and p63 positivity, to be either positive focally or negative for HCG, HPL and PLAP staining. Inhibin-alpha staining was positive or negative either in the 5 cases. Two patients died of the tumour relapse: one died after 1 year with the tumor having a high mitotic activity (averagely 15 mitotic figures per 10 high-power fields), and the other died of lung metastasis 2 years after the diagnosis.</p><p><b>CONCLUSIONS</b>ETT is a rare trophoblastic disease with distinct clinicopathological features and immunostaining patterns. A high mitotic index and lung metastasis are indicators for an unfavorable prognosis.</p>

Accuracy of tumor grade by preoperative curettage and associated clinicopathologic factors in clinical stage I endometriod adenocarcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Preoperative tumor grading becomes one of the most important predictors for lymphadenectomy at primary surgery for clinical stage I endometriod adenocarcinoma. However, there is an inconsistency of tumor grade between preoperative curettage and final hysterectomy specimens, and its associated factors are poorly understood. This study aimed to evaluate the accuracy of tumor grade by preoperative curettage so as to achieve a better stratified management for clinical stage I endometriod adenocarcinoma.</p><p><b>METHODS</b>Clinical data of totally 687 patients with clinical stage I endometriod adenocarcinoma who underwent preoperative curettage and primary surgery were retrospectively collected. Compared with final hysterectomy specimens, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of tumor grade by preoperative curettage were calculated and their associations with clinicopathologic parameters, including age, status of menopause, position of uterus, location and size of lesion, histological grade, depth of myometrial invasion, cervical invasion, extrauterine spread, peritoneal cytology, metastasis to retroperitoneal lymph node, serum CA125 level, and hormone receptor status, were analyzed.</p><p><b>RESULTS</b>In final hysterectomy specimens, 139 of 259 grade 1 patients by curettage were upgraded to grade 1 or 2; 31 of 296 grade 2 were upgraded to grade 3, with a significantly discrepant rate of 40.9% (281/687) and an upgraded rate of 24.7% (170/687). The specificity and negative predictive value for grade 3 were 90.7% and 89.9%, while the sensitivity and positive predictive value for grade 1 were 67.1% and 40.9%, respectively.</p><p><b>CONCLUSIONS</b>Preoperative tumor grade by curettage does not accurately predict final histological results, especially in those classified as grade 1. Complete surgical staging seems to be necessary for clinical stage I endometriod adenocarcinoma.</p>

Clinicopathologic analysis of 102 cases of mixed epithelial and mesenchymal tumors of the uterus / 中华妇产科杂志

Objective To study the clinical and pathologic features,histological criteria and pathologic factors contributing to diagnosis of mixed epithelial and mesenchymal tumors(mixed m?llerian tumors,MMT)of the uterus.Methods A retrospective study of 102 cases of MMT of the uterus (74 adenofibromas including 9 recurrent cases,3 atypical polypoid adenomyomas,2 carcinofibromas,10 adenosareomas and 13 carcinosarcomas)was undertaken.Clinical records,gross features and tissue slices were reviewed.The follow-up data were analysed.Results The most common symptom was vaginal bleeding.Clinical signs included pelvic mass,uterine polyps,and enlarged uterus.Benign MMT usually presented as exophytic polypoid masses extending into the uterine cavity or protruding through the external os,often broad-based,lobulated and papillary.It was hard to distinguish low-grade malignant MMT from the benign ones by gross appearance.High-grade malignant MMT had the common gross features of carcinoma and sarcoma.Histologically,MMT showed a biphasic differentiation of mesenchymal and epithelial components.MMT were classified according to whether these elements were benign or malignant.Nine cases of adenofibroma without unique features for the diagnosis of adenosarcoma recurred at postoperative intervals of 3 to 96 months.Recurrent tumors were almost always confined to the original site.Conclusions Uterine MMT tumors according to WHO diagnostic criteria are not rare.The differential diagnosis depends on a multifactorial analysis.The recurrent adenofibromas may be a kind of borderline tumors with benign appearances and malignant behavior.