ABSTRACT
Objective:To explore the value of diffusion tensor imaging (DTI) in evaluating the effects of hyperbaric oxygen therapy (HOT) in treating spinal cord injury.Methods:The modified Allen′s method was used to induce a traumatic spinal cord injury in 30 rats who were then divided randomly into an injured group and a treatment group, each of 15. The treatment group was given HOT twice a day for 3 days, then once a day for a total of 4 weeks. The injured group did not receive HOT. DTI was performed (along with Basso-Beattie-Bresnahan (BBB) evaluation) at 0h, 6h, 24h, as well as 3, 7, 14, 21 and 28 days after the operation. Two-factor repeated measures ANOVA was conducted to analyze any differences in the DTI results: the fractional anisotropy, mean apparent diffusivity, radial diffusivity and axial diffusivity, as well as the BBB scores. LSD t-tests were performed to analyze the significance of the differences at different time points.Results:At each time point after 24h the average FA value of the treatment group was significantly higher than the injured group′s average, while its average MD and RD values were significantly lower. Beyond 14 days the average AD value of the treatment group was significantly higher than that of the injured group. The treatment group′s average BBB score was also significantly higher at all the time points beyond 3 days.Conclusions:DTI results can evaluate spinal cord function and provide valuable information for the dynamic assessment of hyperbaric oxygen therapy after a traumatic spinal cord injury, and the therapy promotes the recovery of motor function, at least in rats.
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Objective@#The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). @*Materials and Methods@#The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. @*Results@#Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). @*Conclusion@#Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.
ABSTRACT
Objective To explore the value of DTI quantitative parameters in evaluating neurological function changes of acute traumatic spinal cord injury (TSCI)in rat models.Methods The modified Allen's dropping weight technique was used to establish TSCI rat models.Then the rats were divided into mild injury group,moderate injury group and severe injury group (each n=10).DTI examination and Basso-Beattie-Bresnahan (BBB) score were performed pre-TSCI and 0 h,6 h,24 h,3 day,7 day and 14 day post-TSCI,respectively.The BBB scores and DTI parameters,including FA,mean apparent diffusivity (MD),radial diffusivity (RD) and axial diffusivity (AD) were measured and compared among groups.The correlation between BBB scores and the parameters was evaluated.Results The differences of FA,MD and RD value were statistically significant among varying injury degree groups and different time points after TSCI (all P＜0.05).AD value had statistical difference among different time points (F=12.720,P＜0.001),whereas no difference was found among varying injury degree groups (F=0.469,P=0.630).FA and MD values decreased while RD increased 0 h post-TSCI.Then RD and MD increased continuously,whereas FA decreased continuously until 24 h post TSCI (all P＜0.05),and the parameters kept stable after 24 h post-TSCI (all P＞ 0.05).The BBB scores were lowest on 0 h post-TSCI,then maintained increasing (all P＜0.05).In addition,the BBB scores and MD values had good correlation (r=0.958,P＜ 0.01).Conclusion DTI can quantitatively evaluate function changes of TSCI in rat models.Moreover,treatment within 24 h post-TSCI might be recommended for TSCI therapy.