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Objective:To investigate the correlation between aneurysm wall enhancement (AWE) shown on high-resolution magnetic resonance imaging (HR-MRI) and the risk of intracranial aneurysm rupture risk.Methods:Patients with unruptured intracranial aneurysm admitted to the First Affiliated Hospital of Zhengzhou University from October 2014 to October 2019 were enrolled retrospectively. Three-dimensional digital subtraction angiography was used to measure the morphological parameters of aneurysms. HR-MRI was used to evaluate the enhancement mode. Univariate analysis and multivariate logistic regression analysis were used to determine the independent influencing factors of AWE. The 5-year rupture risk of intracranial aneurysms was assessed based on the PHASES score. Spearman rank correlation analysis was used to determine the correlation between the enhancement mode and the risk of aneurysm rupture. Results:A total of 261 patients and 333 unruptured intracranial saccular aneurysms were included. There were significant differences in the proportion of multiple aneurysms, the size and location of aneurysms between the enhanced group and the non-enhanced group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors such as age and gender, multiple aneurysms (odds ratio [ OR] 0.446, 95% confidence interval [ CI] 0.251-0.791; P=0.006), aneurysm size ( OR 1.327, 95% CI 1.218-1.445; P<0.001) and location (anterior cerebral artery/posterior communication artery/posterior circulation: OR 2.058, 95% CI 1.217-3.482; P=0.007) were significantly independently related to AWE. Based on the PHASES score, the 5-year predicted rupture risk of the enhanced group was significantly higher than that of the non-enhanced group (5.2%±6.2% vs. 1.5%±2.0%; P<0.001). Spearman rank correlation analysis showed that there was a significant positive correlation between the extent of aneurysm enhancement and the risk of aneurysm rupture ( r=0.435, P<0.001). Conclusions:AWE shown on HR-MRI is associated with multiple aneurysms, aneurysm size, and location. Application of AWE might predict the risk of rupture of intracranial aneurysms.
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Objective@#To explore whether the proprioceptive sensory cueing delivered by electrical stimulator to common peroneal nerve can improve the freezing of gait of parkinsonian patients.@*Methods@#Thirty patients with Parkinson′s disease experiencing freezing of gait (FOG) admitted to the First Affiliated Hospital of Anhui Medical University from January to December 2018 were included in the trial. Proprioceptive sensory cueing was provided by alternating electrical stimuli to bilateral common peroneal nerves delivered through the wearable electrical stimulator automatically triggered by walking. The modified 12 meters Timed Walking Test, six items of the modified Parkinson Activity Scale (PSA-6), and FOG score were used to test the gait function respectively when the stimulator was turned on and off.@*Results@#Compared to the off status, time duration for two 360° turns (T360), initiating (T1) and the turning (T2) was reduced with statistical significance when the stimulator was turned on in the three trial situations which were walking with no extra task (17.49 (13.55, 23.48) s vs 14.73 (10.31, 21.71) s, 2.16 (1.78, 2.68) s vs 1.70 (1.38, 2.29) s, 6.37 (4.10, 7.45) s vs 4.77 (3.40, 6.85) s; Z=-3.219, -4.206, -2.910, P<0.05), walking with cognitive task (21.35 (16.30, 30.72) s vs 18.36 (13.83, 27.98) s, 2.80 (2.05, 3.75) s vs 2.04 (1.64, 3.00) s, 6.58 (5.23, 8.96) s vs 5.75 (4.59, 7.76) s; Z=-3.486, -4.206, -3.363, P<0.05) and walking with motor task (25.34 (17.79, 30.30) s vs 22.24 (14.11, 29.33) s, 2.46 (2.19, 3.18) s vs 2.35 (1.66, 2.59) s, 7.77 (4.75, 9.93) s vs 6.45 (3.81, 7.66) s; Z=-3.468, -3.983, -3.570, P<0.05). In all the three exercise modes, the maintaining time (T3) was not significantly different. With the stimulator turned on, the total walking time (Tt) was not significantly different when the patients walked without extra task and with cognitive task but obviously improved with motor task (29.26 (20.11, 33.21) s vs 27.66 (17.70, 32.73) s, Z=-2.644, P=0.008). Compared to the off status, patients showed higher PAS-6 scores (18.99±2.55 vs 16.82±2.92, t=-6.617, P=0.000) and lower FOG scores (14.10±5.02 vs 10.61±5.05, t=6.151, P=0.000) with statistical significance when the stimulator was turned on.@*Conclusion@#The wearable electrical stimulator can alleviate FOG in patients with Parkinson′s disease by improving rotation, gait initiation and turning and may be used as a new rehabilitative therapy for patients with FOG.
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Objective To explore whether the proprioceptive sensory cueing delivered by electrical stimulator to common peroneal nerve can improve the freezing of gait of parkinsonian patients. Methods Thirty patients with Parkinson′s disease experiencing freezing of gait (FOG) admitted to the First Affiliated Hospital of Anhui Medical University from January to December 2018 were included in the trial. Proprioceptive sensory cueing was provided by alternating electrical stimuli to bilateral common peroneal nerves delivered through the wearable electrical stimulator automatically triggered by walking. The modified 12 meters Timed Walking Test, six items of the modified Parkinson Activity Scale (PSA?6), and FOG score were used to test the gait function respectively when the stimulator was turned on and off. Results Compared to the off status, time duration for two 360°turns (T360), initiating (T1) and the turning (T2) was reduced with statistical significance when the stimulator was turned on in the three trial situations which were walking with no extra task (17.49 (13.55, 23.48) s vs 14.73 (10.31, 21.71) s, 2.16 (1.78, 2.68) s vs 1.70 (1.38, 2.29) s, 6.37 (4.10, 7.45) s vs 4.77 (3.40, 6.85) s; Z=-3.219,-4.206,-2.910, P<0.05), walking with cognitive task (21.35 (16.30, 30.72) s vs 18.36 (13.83, 27.98) s, 2.80 (2.05, 3.75) s vs 2.04 (1.64, 3.00) s, 6.58 (5.23, 8.96) s vs 5.75 (4.59, 7.76) s; Z=-3.486,-4.206,-3.363, P<0.05) and walking with motor task (25.34 (17.79, 30.30) s vs 22.24 (14.11, 29.33) s, 2.46 (2.19, 3.18) s vs 2.35 (1.66, 2.59) s, 7.77 (4.75, 9.93) s vs 6.45 (3.81, 7.66) s; Z=-3.468,-3.983,-3.570, P<0.05). In all the three exercise modes, the maintaining time (T3) was not significantly different. With the stimulator turned on, the total walking time (Tt) was not significantly different when the patients walked without extra task and with cognitive task but obviously improved with motor task (29.26 (20.11, 33.21) s vs 27.66 (17.70, 32.73) s, Z=-2.644, P=0.008). Compared to the off status, patients showed higher PAS?6 scores (18.99±2.55 vs 16.82±2.92, t=-6.617, P=0.000) and lower FOG scores (14.10 ± 5.02 vs 10.61 ± 5.05, t=6.151, P=0.000) with statistical significance when the stimulator was turned on. Conclusion The wearable electrical stimulator can alleviate FOG in patients with Parkinson′s disease by improving rotation, gait initiation and turning and may be used as a new rehabilitative therapy for patients with FOG.
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Objective To investigate the value of ADC histogram in the differential diagnosis of angiomatous meningioma (AM) and hemangiopericytoma (HPC)and to screen out the best diagnostic parameter.Methods The MRI data of 21 cases with AM and 22 cases with HPC confirmed by surgical pathology were analyzed retrospectively.The ROI were drawn on the maximum cross section of the tumor on ADC maps,and the ADC histogram analysis was performed using the software named Mazda.Then the histogram parameters were statistically analyzed to find out the statistically significant parameters between the two groups,and the ROC curve was drawn to evaluate their diagnostic efficacy.Results ADCvariance ,ADC1th and ADC10th had statistical significances between the two groups (P＝0.030,0.002 and 0.02 1 ). ADC1th had the best diagnostic efficacy among them,with the optimal cut-off value of 0.086×10－3 mm2/s,the AUC was 0.814(P＝0.003),and the sensitivity and specificity were 86.70%and 64.70%,respectively.ADCvariance took the second place,for the AUC was 0.725 (P＝0.030),and the sensitivity and specificity were 7 6.50%and 80.00%,respectively.Conclusion The ADC histogram is of great value in the differential diagnosis of AM and HPC,and the ADC1th is the most effective parameter.
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Objective To investigate the serum levels of dickkopf-related protein 1 (DKK1) and sclerostin (SOST) in patients with axial spondyloarthritis treated with selective cyclo-oxygenase 2 inhibitor and its relation to clinical efficacy.Methods A randomized double-blind controlled trial with axial spondyloarthritis (ax-SpA) was carried out in our hospital.The data from patients in a single center was collected and analyzed.Serum DKK1 and SOST levels were measured by enzyme-linked immuno sorbent assay (ELISA)method before and after 12 weeks treatment,then correlation analysis were conducted for DKK1 and SOST levels with erythrocyte sedimentation rate (ESR),C reactive protein (CRP),Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis functional index (BASFI) and SPARCC of the sacroiliac joint inflammation score.Chi-square tests were used for analyzing of categorical data.Fisher exact tests were performed when the expected frequencies were less than 5.Two independent samples t-test was used to compare the difference between groups.Single sample t-test was used to ompare the differences between data before and after treatment.Pearson or Spearman correlation was used for correlation analysis.Results After 12 weeks of treatment,a total of 116 patients completed the follow-up,including 57 cases of imrecoxib group and 59 cases of the celecoxib group.There were no statistically significant difference between the two groups (P＞0.05).The level of serum DKK1 was significantly increased after treatment [(393±137) pg/ml,vs (542±274)pg/ml,P＜0.05].The serum level of SOST increased significantly [(39±19) pg/ml vs (57±36) pg/ml,t=5.814,P＞0.05],too.The difference between the two groups was not statistically significant (P＞0.05).Spearman correlation analysis showed that serum DKK1 was positively correlated with serum SOST (r=0.226,P=0.015).A significantcorrelation was found between SOST level and ESR,CRP,finger to floor distance,left and fight lumbar side flexion and Schober's test (ESR:r=-0.379,P＜0.01;r=-0.309,P=0.001;r=-0.225,P=0.015;r=0.185,P=0.047;r=0.247,P=0.008;r=0.214,P=0.021).Conclusion Imrecoxib and celecoxib have similar efficacy on relieving the signs and symptoms of patients with ax-SpA.Short-term application of selective COX-2 inhibitors can increase DKK1 and SOST and possibly delay radiographic progression.
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Objective To assess MR characteristics of supratentorial intraparenchymal ependymomas(SIEs)in different age groups.Methods 40 patients with SIEs confirmed by surgery and pathology were analyzed retrospectively.All patients were examined by head MRI without or with contrast.Patients were divided into two groups according to age:child and adult group.T test was used to analyze the difference of tumor volume of two groups.Mann-Whitney U test was used to compare cystic,edema and pathological types of two groups.χ2test was used to distinguish sexual distinction.Results 39 cases of SIEs were located in cerebral surface,1 case located in inside cerebral essence.SIEs of child group(n=13)were male dominance(n=11),5 cases were located in the frontal lobe,all lesions were cystic solid masses.In the adult group(n=27),13 cases were male,9 cases were located in the frontal lobe,solid tumors were seen in 3 cases.There were significant difference among two groups in sexual distinction(χ2=3.921,P=0.048)and cystic change(U=98.50,P=0.02).There were no significant difference in the volume of tumor(t=1.828,P=0.087),edema(U=219.00,P=0.49)and pathological types(U=258.00,P=0.10).Conclusion There are MR characteristics differences in the SIEs in different age groups.Child has a superiority of male,tumors are mainly as cystic-solid mass,edema of the tumor is mild and has a high incidence cystic necrosis,the border is clear.In adult group,tumors are mainly as cystic-solid mass,and can also be solid mass, the solid portion of the lesion is easy to bleed,edema of the tumor is serious.
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Purpose To explore the dynamic contrast-enhanced (DCE) MRI curve type and hydrogen proton magnetic resonance spectroscopy (1H-MRS) in the diagnosis of primary osteosarcoma.Materials and Mothods This was a prospective study.Dynamic contrast enhancement and 1H-MRS scanning wcre performed in forty-one osteosarcoma patients who were eligible for the study.According to the pathological findings,patients were divided into high malignant osteosarcoma group and low malignant osteosarcoma group.The time-signal intensity curves (TIC) were obtained and classified by the analysis software.Among them,18 patients with stable 1H-MRS spectrum were analyzed,and Cho as well as Cho/Cr value was obtained and statistically analyzed,respectively.Results The type Ⅰ and type Ⅱ TIC curves in high malignant osteosarcoma group were 20 and 10 cases,respectively.The type Ⅰ,type Ⅱ and type Ⅲ TIC curves in low malignant osteosarcoma group were 2,5 and 4 cases,respectively.The difference of TIC type distribution between high and low malignant osteosarcoma was statistically significant (x2=10.876,P＜0.05).The difference of Cho/Cr value between high and low malignant osteosarcoma was statistically significant (Z=-2.445,P＜0.05).Consider Cho/Cr value as the diagnostic index,the best cut-off value was 2.3.Conclusion TIC type and Cho/Cr value have certain reference value for evaluating the malignant degree of osteosarcoma.
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Objective To evaluate the accuracy of preoperative MRI in the diagnosis of malformations associated with MRKH syndrome and identification of uterine endometrium to optimize the clinical management.Methods 1 8 females with primary amenor-rhea were studied with MRI performed with a 1.5T or 3.0T imager.All patients were examined in the supine position using a phased-array coil and underwent pelvic MRI.Two experienced radiologists evaluated all the examinations in consensus to assess the pres-ence,position and morphology of vagina,uterus,ovaries and any pelvic abnormalities.Results One or two rudimentary uteri were identified in 17 patients (94.4%).A total of 16 patients (88.9%)had bilateral rudimentary uteri,1 (5.6%)had unilateral rudimentary uteri(it was left sided).1 (5.6%)had no uterine remnants.4 (12.1%)of 33 uterine buds in 4 patients showed differentiation of the center of the uterus into three layer.Bilateral ovaries were present in 1 7 patients,and their shapes,sizes and signals are normal.The vagina and cervix were absent in all cases.Conclusion MRI is a useful diagnostic tool in the preoperative evaluation of MRKH syndrome and the endometrium to further optimize the treatment plan.
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Objective To explore the value of DWI and 1 H-MRS in evaluation of malignant degree of primary osteosarcoma.Methods A retrospective analysis was performed in 41 patients with osteosarcoma confirmed pathologically and examined with DWI and 1 H-MRS.The b values were 0,400,800,1 000 and 1 500 s/ mm2 in DWI,respectively.ADC map was obtained,and ROIs were selected to measure ADC values.Eighteen cases which had stable spectral lines in MRS were selected and analyzed.The spectral lines,Choline (Cho),Creatine (Cr) and Cho/Cr ratio were obtained.Analysis of ADC values of high and low grade osteosarcoma were performed with Kruskal-Wallis H test,and Cho/Cr values were analyzed with Mann-Whitney U test.Results When b values were 400,800,1 000 s/mm2,ADC values of high and low grade osteosarcoma were significantly different (x2=6.26,4.37,4.87,P=0.01,0.04,0.03).When b value was 1 500 s/mm2,ADC value of high and low grade osteosarcoma had no statistical difference (x2 =2.39,P=0.12).Moreover,when 400 s/mm2 was taken as the optimal b value,the specificity and sensitivity of ADC value for identifying high grade osteosarcoma was 73.30 ％ and 72.70 ％,respectively.Cho/Cr values between high and low grade osteosarcoma were significantly different (Z=-2.45,P＜0.05).As a diagnostic parameter,the best threshold value of Cho/Cr was 2.21.And the specificity and sensitivity for diagnosing high grade osteosarcoma was 75.00 ％ and 92.90 ％,respectively.Conclusion ADC (b=400 s/mm2) and Cho/Cr values may be helpful to identifying malignant degree in osteosarcoma.
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Objective To analyze the clinical,radiological and pathological features of primary leiomyosarcoma of bone and to im-prove the diagnostic level.Methods Totally 6 cases of PLB proved by pathology were collected in our study.The clinical,radiologi-cal and pathological findings were retrospectively analyzed,and combined with the relevant literature to have a comprehensive analy-sis.Results The lesions of 6 patients were solitary,located in femoral (1 case),distal femur (1 case),proximal tibia (2 cases),is-chium (1 case)and humerus (1 case).There was no periosteal reaction in all 6 cases but they all had soft tissue mass,sometimes there may have some mineralization within the tumor.Ill-defined osteolytic bone destruction was detected in 5 patients,while expan-sion of cystic bone destruction was found in the other 1 patients.3 cases had hardened edge,2 cases with adjacent bone cortical thickening.The MR imaging in 5 patients showed iso-intensity signal on T1 WI,a slightly inhomogeneously higher signal on T2 WI and a significant heterogeneously enhancement after injected of Gd-DTPA.Another 1 patient showed a double ring sign,the central area onT1 WI and T2 WI expressed heterogeneous slightly higher signal,the peripheral annular zone was iso-intensity on T1 WI and slightly higher on T2 WI,after injected contrast medium,it was inhomogeneous enhancement.In immunohistochemically,all tumors reacted positively with SMA,3 patients with Desmin and Vimentin positive,2 patients with Ki-67 positive,and there had some scat-tered cells with CD68 positive,but the S-100 were all negative.Conclusion The clinical,radiological and conventional histological manifestations of PLB are not specific.Immunohistochemical and/or ultrastructural analysis who displayed smooth muscle differenti-ation can confirm the diagnosis.
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mended to detect possible leakage of fat within central spinal canal.
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Objective To evaluate multi-slice three-dimensional CT angiography (MS 3D-CTA) for the follow-up of intracranial aneurysm clipping.Methods MS 3D-CTA of 16 patients with intracranial aneurysm clipping were retrospectively analyzed.The patients were scanned on a 16-slice spiral CT(GE Lightspeed pro).Volume rendering(VR),thin maximum intensity projection(thin MIP) and multi-planar reconstruction (MPR) were employed in image postprocessing in all cases.Results There were 17 clips in the 16 patients with aneurysm clipping.Six clips were located at the posterior communicating artery,5 at the anterior communicating artery,4 at the middle cerebral artery,and the remaining 2 clips were located at the pericallosal artery in 1 patient.There were no abnormalities found in the aneurysm clipping region in 7 cases by MS 3D-CTA.There were residual aneurysm in 2 cases,parent artery stenosis in 4 cases,and artery spasm in 3 cases.There was no parent artery occlusion and clip displacement in all cases.VR showed excellent 3D spacial relations between the clip and parent artery in 12 cases,and showed good relations in 3 cases.The 1 case with 2 clips in the pericallosal artery showed heavy beam-hardening artifacts.The size and shape of aneurysm clips were clearly depicted by MPR and thin MIP,while 3D spacial relation of aneurysm clip and parent artery were poorly showed.Conclusion MS 3D-CTA is a safe and efficient method for the follow-up of intracranialaneurysm clipping.Combined VR with MPR or thin MIP can well reveal postoperative changes after aneurysm clipping.
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Tetraspanin 2-A(SjTsp2-A) gene was amplified by PCR.pcDNA3.1(+)/SjTsp2-A recombinant plasmids were constructed and transformed into E.coli DH5?.Twenty four BALB/c mice were randomly divided into pcDNA3.1(+) /SjTsp2-A group(A),pcDNA3.1(+)/SjGST group(B) and pcDNA3.1(+) group(C).Each mouse was injected through musculus quadriceps femoris by three times(two weeks interval) respectively with 100 ?g pcDNA3.1(+)/SjTsp2-A,pcDNA3.1(+)/SjGST,or pcDNA3.1(+).At two weeks after the final inoculation,mice were each challenged by 40?2 cercariae of S.japonicum.Forty-five days after infection,all mice were sacrificed,the number of worms collected and eggs in liver tisssue was counted.Anti-pcDNA3.1(+)/SjTsp2-A antibody was detected by ELISA and protein expression in quadriceps muscle by immunohistochemical staining.The worm reduction rate(44.4%) and egg reduction rate(28.4%) of group A was higher than those of group B and C(P
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Objective To clone and express a membrane protein(Tetraspanin 2) gene of Schistosoma japonicum (SjTsp2). Methods A pair of primers was designed to amplify the SjTsp2 gene which was subcloned into prokaryotic plasmid pET28a(+). The recombinant plasmid was transformed into E. coli BL21(D3) and followed by expression of the protein induced by IPTG. The protein was purified by affinity chromatography and used to immunize BALB/c mice. Dilution of antibody against SjTsp2 was determined by ELISA. The protein was also identified by Western blotting. Results Big loop of SjTsp2-A, 228 bp, was amplified in vitro by PCR. Its deduced amino sequence shared 52% similarity with SmTsp2. The soluble recombinant SjTsp2-A was expressed in the experiment and high dilution antibody against the recombinant (1 ∶ 32 000 in maximum) was produced in immunized mice. SjTsp2-A reacted positively with sera of acute and chronic schistosomiasis patients but not with sera from healthy persons by Western blotting. Conclusion SjTsp2 has been expressed and shows certain antigenicity.