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Objective:To evaluate the effectiveness and safety of the home-made umbrella-shaped Octoparms inferior vena cava filter in the prevention of pulmonary embolism.Methods:A multicenter, randomized, positive parallel controlled, non-inferiority clinical trial was conducted in ten hospitals in China from October 2017 to March 2019. A total of 188 subjects were enrolled according to the same inclusion and exclusion criteria in different institutes. The 188 subjects were randomly divided into the trial group or the control group according to 1∶1 by the central randomization system, with 94 cases in each group. Octoparms inferior vena cava filter was used in the trial group, and the Celect inferior vena cava filter in the control group. The primary effective index was clinical success rate,including the clinical success rate of filter placement and filter retrieval. The secondary index included the rate of manual success of the delivery sheath system,incidence of pulmonary embolism(within 6 months), incidence of filter fracture,migration (>20 mm),tilt(>15°) on insertion/retrieval,and the situation of inferior vena cava flow(within 6 months). Safety evaluation included the incidence of filter related complications and device-related adverse events immediately after surgery and during follow-up.Results:The success rate of implantation was 100% in 188 subjects. Filter retrieval was performed in 87 cases (92.55%) in the trial group and 91 cases (96.81%) in the control group. The clinical success rate of the trial group was 97.87%(92/94) and that of the control group 98.94%(93/94). There was no significant difference between the two groups (χ 2=0.77, P=0.380). The success rate of delivery sheath system was 96.81%(91/94) and 98.94%(93/94) in the trail group and the control group,respectively. There was no significant difference between the two groups( P=0.621). There was 1 case (1.22%) of new asymptomatic pulmonary embolism in the trial group after filter placement and 2 cases (2.44%) in the control group. There was no significant difference between the two groups ( P>0.05). No filter fracture or migration (>20 mm) occurred in either group. The tilting of filter (>15°) was found in 1 case (1.06%) in the test group and 1 case (1.06%) in the control group when the filter was placed. The tilting of filter (>15°) was found in 0 case in the test group and 2 cases (2.44%) in the control group when the filter was retrieved. There was no significant difference between the two groups ( P>0.05). Inferior vena cava thrombosis before filter retrieval was found in 5 cases (5.75%) in trial group and 3 cases (3.30%) in control group. There was no significant difference between the two groups ( P=0.489). There were no immediate serious complications during filter placement/removal in either group. No filter obstruction,migration,deformation,penetration and occlusion of inferior vena cava. The incidence of device-related adverse events was low in both group. There was no significant difference between the two groups ( P>0.05). Conclusion:The home-made umbrella-shaped Octoparms inferior vena cava filter is effective and safe in preventing pulmonary embolism, and is not worse than Celect filter.
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Interventional medicine plays an important role in the diagnosis and treatment of cardiovascular and cerebrovascular diseases, hepatobiliary tumors and other diseases, which has become the third largest type of treatment technology besides internal and surgical treatment. In recent years, with technological breakthroughs in imaging technology, robotic surgical system, artificial intelligence, Internet of Things and other fields, unprecedented opportunities have been provided for interventional/minimally invasive+robotics. Interventional robotic surgical systems have mushroomed around this field. The authors discuss the current status and future of interventional robotic surgical system with high recognition worldwide, especially the three categories of specialized robotic surgical system for vascular intervention, percutaneous puncture intervention and natural non-vascular luminal intervention.
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Interventional therapy has become an important palliative therapy for advanced liver cancer, and meanwhile, interventional therapy is playing an important role in the downstaging of liver cancer. Local interventional therapy can help patients meet the criteria for transplantation or resection by reducing tumor volume and number in patients with advanced liver cancer. Interventional downstaging techniques include transarterial chemotherapy, drug-eluting beads, transarterial radioembolization, and various ablation techniques (radiofrequency ablation, microwave ablation, cryoablation, and ethanol ablation). No consensus has been reached on the optimal interventional downstaging strategy, while high-level evidence-based clinical studies are needed to screen out the optimal candidates for different methods and evaluate the complexity, safety, and long-term efficacy of subsequent liver transplantation after interventional downstaging therapy, so as to improve the effect of interventional therapy in the downstaging of advanced liver cancer.
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Objective@#To investigate the feasibility of GE11 peptide targeting to brain metastases from epidermal growth factor receptor (EGFR)-positive breast cancer and thereby explore the potential for the construction of specific targeting molecular probe.@*Methods@#The EGFR expression level of triple negative breast cancer cell line (MDA-MB-231-BR) was detected using Western blot and flow cytometry. GE11 peptide targeting property was tested using immunofluorescence staining and flow cytometry in MDA-MB-231-BR cells and in the subcutaneous tumor model. GK-13 peptide was selected as the control peptide. Two-sample t test was used for data analysis.@*Results@#Western blot and flow cytometry showed that EGFR expression in MDA-MB-231-BR cells was 88.60%, significantly higher than those in other cells. Flow cytometry results indicated that the cell binding rate of MDA-MB-231-BR with GE11 peptide (10 μmol/L) was significantly higher than that with control peptide (38.4% vs 0.6%; t=16.941, P<0.01). Cell immunofluorescence staining results showed GE11 peptides were detected with stronger signal after being incubated with cells, and the combination was concentration- and temperature-dependent. In vivo experiment results showed that the signal of GE11 peptide was stronger in tumor site than that in other organs or tissues.@*Conclusion@#GE11 peptide may specifically target the brain metastases of EGFR-positive breast cancer.
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Intrahepatic cholangiocellular carcinoma (ICC) is a primary tumor originating from the epithelial cells of bile duct. In recent years, incidence of ICC in the world is on the rise, and it has become the second common malignant tumors of the liver, with its incidence being next only to hepatocellular carcinoma (HCC). The onset of ICC is insidious, its clinical manifestations are lack of specificity, most of the patients are already in the advanced stage when the diagnosis is confirmed, thus, affecting the treatment and prognosis. Therefore, early diagnosis and treatment is essential. The radical treatment plan is mainly surgical excision, and other treatment options include systemic chemotherapy, local ablation, transcatheter arterial chemoembolization (TACE), selective intraarterial radiotherapy with yttrium-90 microspheres (SIRT-90Y), 125I seed implantation, etc. This article aims to make a comprehensive introduction about the recent advances in the diagnosis and treatment of ICC. (J Intervent Radiol, 2018, 27:285-289)
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Bacterial liver abscess is a rare and life-threatening disease, and, clinically, its incidence has gradually increased in recent years. In terms of its treatment, percutaneous puncturing drainage combined with antibiotics has been the first-line therapeutic means, and surgical procedures are often used for patients in whom the interventional drainage is ineffective or in whom the liver abscess is complicated by abdominal disease that needs surgical management. Percutaneous catheter drainage and percutaneous fine needle aspiration, regarded as the two most commonly used interventional drainage methods, have been widely employed in the treatment of bacterial liver abscess; and percutaneous catheter drainage is more commonly adopted in clinical practice. Although the prognosis of bacterial liver abscess has been improved significantly, there is still a certain fatality rate. There is still no a well-accepted consensus on treatment guidelines. Moreover, there are still many controversies over the indications of percutaneous puncturing drainage. Based on a comprehensive review of the domestic and foreign literature, this paper aims to make a detailed introduction concerning percutaneous puncturing drainage for the treatment of bacterial liver abscess, focusing on its development history, curative effect and prognosis, and, in order to guide the clinical practice, the principles of the use of antibiotics, the comparison of clinical effect with surgery and the therapeutic indications will be also discussed.
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Objective To preliminary evaluate the mid-term clinical effect of endovascular repair in treating spontaneous extracranial internal carotid artery (ICA) dissection,and to observe the patency of stent.Methods The clinical data and imaging materials of 6 patients with spontaneous extracranial ICA dissection,who were treated with endovascular repair during the period from March 2012 to December 2012,were retrospectively analyzed.The U.S.National Institute of Heahh Stroke Scale (NIHSS) scores were determined before and after endovascular repair,and the postoperative stent patency condition was assessed,the results were analyzed.Results A total of 6 patients,including 4 males and 2 females with a median age of 50 years old (40.75-54.75 years old),received endovascular repair therapy.The median interval from the onset of disease to accept endovascular treatment was 10 days (one week-3 months).After the implantation of stent,the blood flow in the true lumen returned to normal immediately,although part of the false lumen was still filled with contrast agent.Embolism of retinal artery occurred in one patient during the operation,no death occurred.The median follow-up time was 54.4 months (49.7-57.9 months).The NIHSS score determined at the last follow-up visit was not significantly different from the preoperative one (P=0.102).Imaging reexamination revealed that the false lumen at the ICA stent segment disappeared in all 6 patients,and no obvious in-stent stenotic changes were observed.Conclusion Endovascular therapy of selected symptomatic extracranial carotid artery dissection with bare stents can effectively prevent the recurrence of clinical symptoms and promote ICA remodeling with excellent mid-term patency.
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Objective To compare the prognostic ability of Hong Kong Liver Cancer (HKLC) staging system with that of Barcelona Clinic Liver Cancer (BCLC) staging system for Chinese patients with hepatocellular carcinoma (HCC) after receiving transarterial chemoembolization (TACE).Methods The clinical data of 180 Chinese patients with primary HCC,who were treated with TACE during the period from August 2008 to December 2015,were retrospectively analyzed.HCC staging of each patient was scored by two staging methods separately.Kaplan-Meier analysis was adopted to separately calculate the median survival time of each stage that was judged by the two staging methods.The likelihood ratio (LR) x2 values,the Akaike information criterion (AIC) value and Harrell's C value of the two staging methods were calculated.Results Statistically significant differences in the survival time of each period existed between the two staging systems.AIC value,LRx2 value and Harrell's C value of HKLC staging system were 1360,66.6,and 0.813 respectively,while those of BCLC staging system were 1365,61.8,and 0.772 respectively.Conclusion Compared with BCLC staging,HKLC staging is more suitable for predicting the survival time of Chinese patients with primary liver cancer treated with TACE.
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Transarterial chemoembolization (TACE) is a standard treatment for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma (HCC),and TACE has already been widely accepted in clinical practice.Recently,more and more researches have indicated that TACE,as a palliative therapeutic regimen,carries certain defects,e.g.after several times of TACE treatment the HCC lesions become poorly-controlled.Therefore,some scholars put forward the concept of "TACE refractory".This paper aims to make a further discussion on the concept of TACE refractory and its treatment.
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Colorectal liver metastasis (CRLM) is one of the most difficult and key points in the treatment of colorectal cancer. Approximately 50% to 60% of patients diagnosed as colorectal cancer develops metastasis, and 80% to 90% of CRLM is unresectable. Surgical resection is the first-line treatment for CRLM, while it is only suitable for about 15% patients. Systemic chemotherapy can prolong the survival of CRLM patients, however, a part of CRLM patients are resistant to chemotherapy. With the development of technology and the update of clinical evidence, individual therapy with target drugs and multidisciplinary treatment (MDT) have became a tendency, and minimally invasive interventional therapy has gained more acceptance in the MDT mode of the treatment for CRLM. Basically, the interventional treatment for CRLM is divided into two groups: vascular intervention and local minimally invasive intervention. Vascular approaches encompass portal vein embolization (PVE), hepatic artery infusion chemotherapy (HAIC), transarterial chemoembo- lization (TACE), and transarterial radioembolization (TARE). Local minimally invasive intervention includes radiofrequency ablation (RFA), microwave ablation(MWA), cryoablation (CRA), and irreversible electroporation (IRE). Thevefore intervention treatment is an important complement to the comprehensive therapy of CRLM.
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Transcatheter renal sympathetic denervation with radiofrequency ablation has become a new treatment for refractory hypertension.Recent studies have showed that renal sympathetic denervation can also treat the diseases that are related to increased sympathetic nerve activity, such as metabolic diseases, cardiac disfunction, arrhythmia, obstructive sleep apnea syndrome, polycystic ovary syndrome, renal failure, etc. This paper aims to make a general review on the recent clinical research progress about renal sympathetic denervation with radiofrequency ablation.
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Objective To investigate the feasibility and preventive effect of benign esophageal restenosis by binding 125I seeds to upper esophageal stent through animal experiments.Methods Eight 125I seeds were evenly bound to upper normal esophageal stents for the animal experiments.A total of 32 beagle dogs were randomly assigned to 2 groups:experimental group,implanted with esophageal stents with eight 125I seeds (33.3 MBq),and the control (stents without 125I seeds).Four dogs of each group were killed at the 1 st,2nd,4th,and 8th week after imaging studies.The tissue of 2 cm upper stent underwent pathology analysis.Results All the novel stents were successfully implanted.No radioactive leak was detected by ECT.The lumen diameter of the top stent showed the tract gradually narrowed and at the 4th and 8th weeks,the experiment group narrowed more seriously compared with the control group and the difference was statistically significant (P ＜ 0.05).PCNA,ot-SMA mean optical density were significantly different in the 4th week.Both hydroxyproline and total amino acid increased progressively,with significant difference at the 4th and 8th weeks.The macroscopic and optical findings of the trachea and major vessels were basically the same in both groups.Conclusion The novel stent is feasible and safe for preventing benign esophageal restenosis and preventing benign esophageal stent restenosis.
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Objective To label neural stem cells (NSCs) with superparamagnetic iron oxides (SPIO) and to explore the tropism of NSCs after transplantation into the hippocampus of APP/PS1 AD mice by MRI.Methods NSCs from C57BL/6 mouse were cultured and identified.Feridex and Poly-L-Lysine were added into the medium to be co-cultured to make magnetic labeled NSCs and transmission electron microscopy was used to identify the iron particles in NSCs.Transgenic (tg) and wild-type (wt) mice at 12 months of age were divided into three groups: SPIOs labeled NSCs group (A and C),unlabeled NSCs group(B).Feridex-labeled NSCs were migrated into the hippocampus of APP/PS1 AD mice to monitor in vivo by MRI.After 1,2,4 and 6 weeks,the mice were sacrificed and their brain tissues were sectioned to investigate the migration of SPIO labeled NSCs and compared with MRI.Results NSCs of C57BL/6 mice were cultured successfully.Transmission electron microscope showed visible iron granules in cytoplasm.MRI detection of labeled cells: T2WI and T2* WI showed remarkable low signal intensity at the hippocampus injection points 1 week after transplantation,particularly on T2* WI.Area of low signal intensity enlarged increasingly along the injection points after 2 weeks.At 4 weeks,area of low signal intensity spread throughout the hippocampus,but intensity shadowed Six weeks later,low signal intensity almost disappeared.There was no obvious low signal change in unlabeled cell transplantation group.For wt mice,size and location of low signal did not appear obvious change at all designated time points.Prussian blue positive cells were observed in the hippocampus,indicating that NSCs labeled with SPIO could survive,migrate and differentiate in the brain of the APP/PS1 AD mice.Changes of pathology were well correlated with the area where a signal intensity loss was observed in MRI 1,2,4 and 6 weeks after transplantation Conclusions Diffuse migration of transplanted NSCs labeled with SPIO is observed in the hippocampus in APP/PS1 tg mice,and MRI technique is an ideal method for tracking labeled stem cells after grafting in vivo.
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Objective To evaluate the effects of low-dose 125I seeds to the esophagus fibroblast cell proliferation in vitro.Methods The titanium wire was implanted in the beagle dog's esophagus to induce fibroblast proliferation,and the esophageal tissue was removed after two weeks and cultured in vitro.The 125I seeds with different dose commonly used were chosen to irradiation fibroblast in group B (11.1 MBq × 9)、C (22.2 Mbq ×9) 、D (33.3 MBq ×9) for 72 hours,while in control group no 125I seeds were used.After irradiation,cells were collected.MTT and AnnexinV/PI double staining were performed respectively to evaluate the effects of 125I seeds in cell proliferation and apoptosis.Results The inhibition rate respectively:(26.81 ± 1.96) ％、(34.52 ± 3.21) ％ and (45.33 ± 2.59) ％ ; the apoptosis rate respectively:(6.73 ±0.57)％ 、(13.11 ± 1.39)％ and (15.23 ± 0.90)％.There were significant differences among the experimental groups and between every experimental group and the control group.Conclusion The three doses of 125I seeds could significantly inhibit the fibroblast proliferation and promote cells apoptosis,of which 33.3 MBq 12sI seed was the most significant.
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Objective To isolate,culture,and identify the synthetic phenotype vascular smooth muscle cells (VSMC) and identify the specific marker protein (tropomyosin-4,TPM-4) of synthetic phenotype.To employ the immune molecular imaging technique to develop MRI of probe targeted with TPM-4 antibody VSMC in vitro.Methods The synthetic phenotype VSMC and endothelial cells (EC) were isolated and cultured in vitro,respectively.Immunocytochemistry (ICC) staining for α-smooth muscle actin (SMA) and Ⅷ factor was performed for cell identification,respectively.The high expression level of TPM-4 protein was tested by immunofluorescence double staining.The MRI molecular probe was built by chemical cross-linking,TPM-4 conjuncted probe (TPM4-USPIO) as the experimental group,IgG conjuncted probe (IgG-USPIO) as the negative group,unconjuncted probe (USPIO) as the control group,and PBS as the blank group.The synthetic VSMC were incubated with probes within experimental group,negative group,control group,respectively,and EC were incubated with experimental group as another control group.Prussian blue staining was employed to analyze the specific-targeting and MTT assay was used to test bioactivity of the probe under different concentrations (0,5,10,20,40 μg/ml) in vitro.7.0 T MRI scanner was used to detect the magnetic properties.With 7.0 T MRI scanner,the T2WI images of different probes labeled synthetic VSMC and different concentration gradient (1 × 103,5 × 103,1 × 104,5 × 104)TPM4-USPIO labeled cells were obtained and analyzed.T2 signal and MTT data among groups were compared using single factor analysis of variance (ANOVA) and LSD test.Results The synthetic phenotype of VSMC were isolated and cultured successfully,and the VSMC could express the TPM-4 protein.The synthetic phenotype VSMC had a high level of the protein expression.The probe was made successfully.The T2 relaxivity of TPM4-USPIO and IgG-USPIO were 0.0350 × 106,0.0316 × 106 mol/s,respectively,with high stability as USPIO (0.0292 × 106 mol/s).Prussian blue staining results showed that the experimental group probe could specifically bind to the synthetic VSMC.MTT results showed that iron concentration within 40 μg/ml or less had no effect on VSMC proliferation activity.The T2 WI of experimental group showed lower signal than the control group.The T2 relaxivity was (116.67 ± 2.08) ms,which was less than the control group [(217.67 ±2.52),(219.33 ±2.08)ms,respectively] and the blank group [(205.33 ± 1.53)ms](F =1670.43,P ＜ 0.01).The T2 relaxivity of the different concentration gradient labeled cells (1 × 103 、1 × 104 、1 × 105) were (184.33 ± 2.08),(169.67 ± 1.15),(116.67 ± 2.08) ms,respectively (F =684.35,P ＜0.01).No significant difference of the T2WI gradual signal dim was found between cells with the same order concentration(P ＞ 0.05).Conclusions The synthetic phenotype of VSMC can be obtained by PDGF-BB treatment.TPM4-USPIO probe is efficient,specific and targeted at combination with synthetic VSMC.The T2WI signal changed obviously under high field MRI scanner,which provides a new way for molecular imaging research.
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Objective To explore the effect of neural stem cell(NSCs) transplantation on proton magnetic resonance spectroscopy (1H-MRS) and the behavior in APP/PS1 double transgenic AD mice.Methods NSCs from C57BL/6 mice were cultured and amplified.APP/PS1 double transgenic AD mice (n=30) aged 12 months were used as the study group,and mild-type mice (n=15) were used as the control group(group C).Animals in the study group were randomly divided into two subgroups:one receiving NSCs (group A) and the other receiving PBS transplantation (group B) in bilateral hippocampal CA1 of the AD model mice.Animals in the group C were not treated.1 H-MRS and Morris water maze (MWM) were performed before transplantation and 4 weeks after transplantation,and compared with the histopathological results.Results 1H-MRS showed that there was no significant change in NAA/Cr(1.01±0.08 and 1.03±0.05) and mI/Cr (0.69±0.05 and 0.71±0.06) ratios between group A and group B before transplantation (P＞ 0.05),but the changes were significant compared with the group C (NAA/ Cr:1.21±0.05; mI/Cr:0.58±0.06) (P＜0.05).Four weeks after transplantation,NAA/ Cr ratio(1.18± 0.09) was increased and mI/Cr ratio (0.53±0.04) was decreased in group A.The difference was significant compared with the group B at the same time points (P＜0.05).MWM showed the escape latency in group A was significantly shorter than that in group B after transplantation (P＜0.05).In addition,group A also showed an exclusive preference for the target quadrant,and spent more time ((35.21±5.44) s) in the 3rd quadrant compared with group B (P＜0.05).For number of platform crossings,similar results were also shown (5.75± 3.23).Nissl's staining showed that the number of neurons in the hippocampal area increased more significantly in group A than those in group B(P＜0.05).Conclusion NSCs transplantation can improve spatial learning and memory via neurons regeneration in APP/PS1 double transgenic AD mice,and 1H-MRS is able to display intracranial metabolite changes after NSCs transplantation.
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Objective To explore the value of 1H-MRS on the evaluation of Alzheimer's disease (AD) with neural stem cells (NSCs) transplantation in an APP-PS1 double transgenic (tg) AD mouse model.Methods NSCs from C57BL/6 mice were cultured and amplified.APP-PS1 tg mice (n =30) aged 12 months were used as the study group,and mild-type mice (n =15) were used as the control group.Animals in the study group were randomized into two subgroups,the AD mice in one subgroup received NSCs transplantation (NSCs group) and in another subgroup received phosphate buffer saline (PBS,PBS group)in bilateral hippocampal CA1.Animals in the control group were not treated.Using a 7.0 T high-fieldstrength MR imager,1H-MRS was performed before and 6 weeks after transplantation to measure the area under the peak of n-acetyl aspartate (NAA),glutamate (Glu),myo-inositol ( mI),choline (Cho) and creatine (Cr) in the hippocampal area,NAA/Cr,Glu/Cr,mI/Cr and Cho/Cr ratio were calculated and compared with histopathological results (including Nissl's staining and electron microscope examination).Comparisons among NSCs,PBS and control groups were conducted by one-way ANOVA.Results NSCs from C57BL/6 mice were cultured successfully. Before transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in NSCs,PBS and control groups were 0.89 ± 0.05,0.88 ± 0.04 and 1.15 ± 0.05,0.40 ± 0.03,0.39 ± 0.03 and 0.45 ± 0.05,0.67 ± 0.05,0.67 ± 0.05 and 0.52 ± 0.04,respectively,and differences were statistically significant (F =148.918,7.529,59.468,P ＜ 0.01 ). There were no significant differences in NAA/Cr,mI/Cr and Glu/Cr ratios between NSCs and PBS groups before transplantation (t =0.147,0.096,0.207,P ＞ 0.05 ),but the differences were significant compared with the control group (t =0.255,0.467,0.171 and t =0.269,0.527,0.151,P ＜0.05).Six weeks after transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in three groups were 1.13 ±0.07,0.86 ±0.05 and 1.14 ±0.05,0.45 ± 0.04,0.38 ± 0.02 and 0.44 ± 0.03,0.58 ± 0.04,0.67 ± 0.04 and 0.53 ± 0.04,respectively,and differences were statistically significant ( F =112.092,23.076,44.367,P ＜ 0.01 ).NAA/Cr and Glu/Cr ratios were increased and mI/Cr was decreased in NSCs group,and the difference was significant compared with PBS group at the same time point ( t =0.271,0.071,0.089,P ＜ 0.05 ).There were no significant differences in NAA/Cr and Glu/Cr ( t =0.013,0.012,P ＞ 0.05 ),but there was a significant difference in mI/Cr between NSCs and control groups ( t =0.046,P ＜ 0.05).There were no significant differences in Cho before and after transplantation among the three groups (P ＞ 0.05 ). Nissl's staining showed that the number of neurons in the hippocampal area increased more significantly in tg mice receiving NSCs than that without receiving NSCs.Electron microscopy showed that most hippocampal NSCs in NSCs group were morphologically normal with abundant organelles,while hippocampal NSCs in PBS group were swollen with sparse synapses.Conclusion 1H-MRS is able to display intracranial metabolite changes before and after NSCs in APP-PS1 double transgenic AD mice and has an applicable value in evaluating the therapeutic effect of NSCs on AD.
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Objective To observe the spatiotemporal characteristics of the micro-structural injury in a rat model of diffuse axonal injury (DAI) and quantitatively assess the axonal injury severity in the vulnerable areas. Methods The 7.0 T MRI was performed in rats in DAI group (n =20) and control group ( n = 15 ) to synthesize the diffusion tensor imaging ( DTI) parameter map and calculate the parameter value of the vulnerable areas. Immunohistochemistry was used to detect β-APP expression in the vulnerable areas and the IPP software to quantitatively assess the axonal injury severity. Results Compared with the control group, FA and AD maps showed local signal defection or reduction in the corpus callosum and their values decreased significantly in the brain stem and corpus callosum in the DAI group (P ＜0.01 ). The integrated optical density (IOD) value of the vulnerable areas in the DAI group was significantly higher than that of the control group ( P ＜ 0. 01 ) , with the highest level in the brain stem (P＜0.05). The normalized FA, AD and ADC in the vulnerable areas were correlated negatively with the IOD (P ＜ 0.05). Conclusion DTI can detect invisible micro-structural injury in the vulnerable areas and quantitatively assess the axonal injury severity in vivo in the early stage.
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Objective To evaluate the nse of CT angiography in the diagnosis of hemoptysis and guiding the treatment of it with 64-slice spiral CT.Methods Twenty-two patients with repeated and massive hemoptysis underwent chest CT angiography.Results The blood supply of hemoptysis was nonbronchial systemic arteries in 3 patients,single or multiple bronchial arteries in 15 patients,mixed arteries of nonbronchial systemic and bronchial arteries in 3 patients and abnormal systemic arteries in 1 patient.Conclusion With 64-slice spiral CT,CT angiography provided useful information for the treatment of hemoptysis by guiding bronchial arterial embolization.
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Objective To explore the impact of the variable number of tandem repeats of monoamine oxidase A gene (MAOA-uVNTR) on the concentration of gray matter in patients with major depressive disorders.Methods 56 cases of depression, as well as 37 healthy controls who were matched in gender, age and years of education were divided into low-activity genotype (3R or 3R/4R), and high-activity genotype (4R) with the methods of polymerase chain reaction (PCR) amplification and 1.5％ agarose gel electrophoresis separation. 93 cases all were performaned structural magnetic resonance imaging scanning. Results ① The difference of genotype and allele frequency between the depression group and the healthy group was not statistically significant(P＞0.05 ). ②Compared with the healthy,the concentration of gray matter( GMC ) of bilateral caudate nucleus (K = 11/68, Z =3.76/4.76 ), bilateral thalamus ( K = 21/181, Z = 3.26/3.63 ) and right hypothalamus ( K = 38/12, Z = 4.20/3.60) reduced significantly in depressed patients. ③ In patients with depression, cases with the high-activity genotype showed reduced GMC bilateral caudate nucleus (K = 17/33, Z = 3.23/4.36 ), left putamen ( K = 16, Z =3.42 ) and right hypothalamus( K = 12, Z = 3.62 ) in comparision with patients with low-activity genotype. In highactivity genotype group,compared with the healthy,patients with depression had reduced GMC in left caudate nucleus ( K = 11, Z = 4.13 ), bilateral thalamus ( K = 13/14, Z = 3.53/3.23 ) and left parahippocampal gyrus ( K = 13,Z = 4.04). Conclusion High-activity genotype may be an important factor contributing to the structural abnormalitily of the limbic-striatum-globus pallidus-thalamus loop.