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Objective:To investigate the effects and potential mechanism of vitamin D supplementation on testicular function in aging rats induced by D-galactose.Methods:The aging rats were induced by D-galactose with subcutaneous injection. The animals were randomly divided into 6 groups: aging rats (DG), aging rats with low-dose vitamin D supplementation (LD), aging rats with high-dose vitamin D supplementation (HD), normal control rats(NC), normal rats with low-dose vitamin D supplementation(LN), normal rats with high-dose vitamin D supplementation (HN). The body weight, testicular weight, serum testosterone concentrations and sperm quality of the rats in each group were measured. The testis morphological changes were detected using light microscopy. The activity of superoxide dismutase (SOD) and level of malondialdehyde(MDA) were determined with spectrophotometer. The expression levels of Nrf2, GCLC, SOD2 and VDR in testis were detected by western blot.Results:At baseline, compared with NC group, testicular weight, serum testosterone level, SOD activity, Nrf2, GCLC and SOD2 expression levels were significantly decreased in DG group, while MDA level was significantly increased. After vitamin D supplementation, testicular weight, testosterone levels and SOD activity in both of HD and LD groups were significantly increased, while the MDA level was significantly decreased. The expression levels of Nrf2, GCLC, SOD2 and VDR were significantly increased.Conclusion:Vitamin D supplementation may enhance the testicular antioxidant capacity through activating Nrf2-ARE signaling pathway, and improve the testicular function in D-galactose-induced aging rats.
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The diagnosis and treatment of complex biliary and pancreatic diseases is still one of the major problems and challenges faced by modern medicine. The concept of "precision surgery" proposed by academician Jiahong Dong provides a new way to solve this problem. With the rapid development of biliary and pancreatic endoscopy, it has become an important vehicle for the diagnosis and treatment of complex biliary and pancreatic diseases. In recent years, the authors have combined accurate endoscopy with precision surgery in the treatment of clinical complex biliary and pancreatic diseases, achieving good effects.
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Objective:To investigate the application value of digital single-operator peroral cholangioscopy on the preoperative evaluation of extrahepatic cholangiocarcinoma.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 172 patients with extrahepatic cholangiocarcinoma who were admitted to the First Affiliated Hospital of Army Medical University from December 1, 2017 to April 1, 2022 were collected. There were 91 males and 81 females, aged 65(range, 45?68)years. Of 172 patients, 36 cases undergoing preoperative digital single-operator peroral cholangioscopy examination were allocated into the experimental group, and 136 cases not undergoing preoperative digital single-operator peroral cholangioscopy examination were allocated into the control group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) surgical conditions. Propensity score matching was done by the 1:1 nearest neighbor matching method and caliper setting as 0.02. Measurement data with normal distribution were expressed as Mean± SD, and t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M( Q1,Q3), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. The rank sum test was used for comparison of ordinal data. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of 172 patients, 60 cases were successfully matched, including 30 cases in the experiment group and 30 cases in the control group, respectively. Before propensity score matching, cases with or without preoperative bile drainage were 27, 9 in the experiment group, versus 62, 74 in the control group, showing a significant difference between the two groups ( χ2=9.86, P<0.05). The above indicators were 23, 7 in the experiment group, and 23, 7 in the control group after propensity score matching, showing no significant difference between the two groups ( χ2=0.00, P>0.05). The elimination of preoperative bile drainage confounding bias ensured comparability between the two groups. (2) Surgical conditions. After propensity score matching, there were 10 cases and 0 case without surgery in the two groups. Cases undergoing radical operation including R 0, R 1, R 2 resection were 16, 0, 4 in the experiment group, versus 18, 6, 6 in the control group, showing a significant difference between the two groups ( χ2=6.85, P<0.05). Conclusions:Preoperative digital single-operator peroral cholangioscopy exami-nation can improve the R 0 resection rate of extrahepatic cholangiocarcinoma.
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Objective To study the role of dynamic contrast enhanced MRI (DCE-MRI) in assessing early curative effect of rosuvastatin on carotid atherosclerotic plaques.Methods Twenty-five patients with lipid-rich necrotic core carotid atherosclerotic plaques received intensive rosuvastatin treatment (5-20 mg/d) for 2 years,and carotid artery DCE-MRI at baseline before treatment and at months 3,12 and 24 after rosuvastatin treatment.Their adventitial transfer constant (K) and fractional plasma volume (Vp) were measured and compared during the rosuvastatin treatment.Results The Vp was significantly smaller at months 3,12 and 24 after rosuvastatin treatment than at baseline before rosuvastatin treatment (0.09±0.05,0.07±0.04 and 0.06±0.05 vs 0.12± 0.06,P＜0.05) with a reduction of 25.0％ after 3 months of rosuvastatin treatment and a gradual reduction after 24 months of rosuvastatin treatment (P＜0.05).The adventitial K was mildly reduced after 24 months of rosuvastatin treatment (P＞0.05).Conclusion DCE-MRI can assess the early curative effect of rosuvastatin on carotid atherosclerotic plaques.
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Objective:To report one case of renal clear cell carcinoma transferred to the nasal cavity and sinuses treated by low temperature coblation assisted nasal malignant tumor resection under nasal endoscopye, and to review the associated literatures.Methods: Under nasal endoscope, the tumor was removed along the lateral wall of the nasal cavity with bipolar electrocautery and coblation.The vaseline gauze was used to stop bleeding, and the tumor was completely removed.Results: The intraoperative frozen section showed a capillary hemangioma.The patient was diagnosed as metastatic renal cell carcinoma to the nasal cavity and sinuses by the results of pathology and immunohistochemical staining.The postoperative recovery was uneventful and the nasal packing was removed 3 d after operation.Conclusion: Renal clear cell carcinoma transferred to the nasal cavity and sinuses is rare;under nasal endoscope, surgical resection is a good procedure to control metastasis.
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<p><b>OBJECTIVE</b>To reduce the acquisition time of carotid high-resolution contrast-enhanced magnetic resonance imaging (CEMRI), we designed a small field-of-view (FOV) quadruple-inversion-recovery (SF-QIR) T1WI and evaluated the image quality.</p><p><b>METHODS</b>Twenty-four subjects with carotid plaque were enrolled in our study. All the subjects were imaged using the same 3.0T MRI by SF-QIR and standard rectangular FOV QIR (SrF-QIR) with identical parameters except for the phase-encoding step numbers and the RF excitation methods. Three independent readers qualitatively evaluated the differences between the two sequences in regard of the carotid outer wall border delineation, fibrous cap and lipid-rich necrotic core (LR-NC) border delineation, and diagnostic confidence. The quantitative measurements included maximal stenosis, wall area, LR-NC area, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The inter-reader variability was assessed.</p><p><b>RESULTS</b>The application of SF-QIR combined with orthogonal radio frequency excitation resulted in nearly half of the scan time with the SrF-QIR. Both qualitative and quantitative assessment by the readers revealed no significant differences between the two sequences except for SNR and CNR (Pgt;0.05). Since the mean loss of SNR with SF-QIR was 37.7%, SrF-QIR demonstrated a superior performance in SNR (P<0.001).</p><p><b>CONCLUSION</b>The small FOV QIR sequence is effective in high-resolution CEMRI for evaluating carotid plaques and can effectively reduce the scan time and eliminate motion artifacts.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carotid Artery Diseases , Diagnosis , Pathology , Image Enhancement , Methods , Magnetic Resonance Imaging , MethodsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the feasibility by oblique sagittal T(1)-weighted (QIR-FSE) black-blood sequence for measurement of the carotid bifurcation angle.</p><p><b>METHODS</b>Twenty-three patients undergoing carotid magnetic resonance imaging (MRI) were divided in normal group and plaque group. Carotid bifurcation angle was measured by both 2D-TOF and oblique sagittal T(1)W (QIR-FSE) black-blood sequence, and the measurement was repeated after 3 months to evaluate the reproducibility. The measurement results using 2D-TOF and oblique sagittal T(1)W (QIR-FSE) black-blood sequence were compared to assess the consistency of the two sequences. Four different angles of each carotid artery were measured from different locations on oblique sagittal T(1)W. The ratio of the bilateral carotid bifurcation angle (Right/Left) was compared.</p><p><b>RESULTS</b>Ten patients in each group were enrolled after excluding 3 patients. Strong correlations were found between the results of the first and the second measurements for both 2D-TOF and oblique sagittal T(1)W sequences. No significant difference was found between the two sequences in the ratio of bilateral carotid bifurcation angle (right/left), nor in the 4 angles from different locations.</p><p><b>CONCLUSION</b>Oblique sagittal T(1)-weighted (QIR-FSE) black-blood sequence can be used to measure the carotid bifurcation angle.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carotid Arteries , Pathology , Carotid Artery Diseases , Pathology , Feasibility Studies , Magnetic Resonance Imaging , Methods , Reproducibility of ResultsABSTRACT
<p><b>OBJECTIVE</b>To assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging (3D-BB-MRI) in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood magnetic resonance imaging (2D-BB-MRI).</p><p><b>METHODS</b>Forty patients were scanned with routine 2D and oblique-sagittal 3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial 2D-like dataset. Two experienced radiologists identified the interested slice in consensus for every patient (unilateral carotid artery) in 2D-BB-MRI images and matched the axial reformatted 3D images with 2D black-blood images. Plaque thickness (PT), lumen area (LA) and total vessel area (TVA) were measured, and lumen stenosis (LS) and normalized wall index (NWI) were calculated.</p><p><b>RESULTS</b>There was no measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI (P>0.05), and these two methods had a good correlation (r<0.9). The Bland-Altman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the measurement of PT, LA and TVA.</p><p><b>CONCLUSION</b>3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carotid Artery Diseases , Pathology , Imaging, Three-Dimensional , Magnetic Resonance Imaging , MethodsABSTRACT
Objective To explore the effect of biliary stenting combined with ademetionine on malignant obstructive jaundice.Methods According to the digital table,60 patients of malignant obstructive jaundice were randomly divided into the control group and the observation group.The patients in the control group were treated with biliary stenting individually,and the observation group received biliary stenting and combined treatment with ademeotionine.The variety of liver function and C-reactive protein were observed.Results The liver function and index of Creactive protein of patients in the observation group were significantly superior to those in the control group (all P ＜0.01).Conclusion The treatment of malignant obstructive jaundice by biliary stenting combined with ademetionine is effective.The mechanism may be related to the effect of ademetionine on promoting cytothesis,glutathione synthesis and eliminating free-radicals.
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Objective To investigate the efficacy of holmium laser coagulation under choledochoscope for the treatment of intrahepatic hemobilia.Methods The clinical data of 55 patients with intrahepatic hemobilia who received holmium laser coagulation under choledochoscope at the General Hospital of Chengdu Military Area from June 2003 to August 2011 were retrospectively analyzed.After the hemobilia was confirmed with choledochoscopy,an optical fiber of holmium laser was inserted into the intrahepatic bile duct from the hole of choledochoscope.The top of the optical fiber was posed close to the bleeding region,and then the laser was stimulated for coagulation under direct vision.If the observation of the bleeding area was influenced by the bleeding,the porta hepatis was temporarily occluded with a rubber hose combined with pressurized liquid injection bag.For patients with distal bile duct stenosis and bleeding,the narrow area was first expanded by biliary balloon or laser,then hemostasis was completed after the flow of bile duct was restored.Results The hemorrhage of the 55 patients was controlled,with an average time of 5.5 minutes (range,2-15 minutes).Temporary hepatic portal clamping was applied for 16 patients (27 times),and the average blocking time was 2.2 minutes (range,1-4 minutes).Biliary rehaemorrahagia occurred after operation in 2 patients,and they were cured by non-surgical treatment.All patients were discharged after successful hemostasis.The time of follow-up was 35-49 days.The epithelium of the bile duct coagulated by intraoperative holmium laser restored flat in 41 patients,and new biliary stricture was not found in the other 14 patients.Conclusion Holmium laser coagulation under choledochoscope for intrahepatic hemobilia is simple and effective.
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Objective To evaluate intra-biliary tunnel electro-resection and aspiration approach during ERCP for severe biliary stricture.MethodsA total of 14 patients with severe benign or malignant biliary stricture,which failed in previous ERCP,were recruited. First the guide wire was passed gently through the narrow segment under fluoroscopy,then the double-lumen needle knife was placed near the stricture and wire cutter was protruded.The tunnel electro-resection and aspiration was performed along the guide wire until the narrow segment could be passed through under fluoroscopy by the expanding balloon dilator for the following procedures.ResultsOf 14 patients with severe biliary strictnres,electro-resection and aspiration procedure were successful in 12 (85.7％).Metal stents were implanted in all 7 patients with malignant biliary strictures.Plastic stents were placed after balloon dilatation in 5 patients with benign stenosis.Three out of 5 patients received double plastic stents,while the two others only needed a single plastic stent.The procedure was failed in 2 patients ( 14.3％ ) with malignant biliary strictures as hilar cholangiocarcinoma invaded the left and right hepatic duct,forming a right angle in biliary stenosis,so that needle knife could not go through,and the following procedure was aborted.There were no severe complications like massive bleeding,perforation or death observed.ConclusionThe intra-biliary tunnel electro-resection and aspiration approach can significantly increase the success rate of ERCP in severe biliary strictures.