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Objective:To investigate endoscopic treatment and its effects on non-varicose upper gastrointestinal bleeding in elderly patients.Methods:From June 2018 to September 2019, 86 elderly patients with non-varicose upper gastrointestinal bleeding treated in our hospital were enrolled and underwent endoscopic hemostasis.They were divided into the observation group(n=45, receiving endoscopic hemostasis combined with somatostatin treatment)and the control group(n=41, only receiving endoscopic hemostasis treatment). Clinical effects were evaluated in the two groups.Results:The immediate hemostasis rate was higher and the rebleeding rate within 1 week was lower in the observation group than in the control group(95.6% or 43/45 vs.80.5% or 33/41, 11.1% or 5/45 vs.29.3% or 12/41, χ2=4.740 and 4.460, P=0.030 and 0.035). Arrhythmias, multiple organ failure, and death during treatment occurred in 1 case, 0 cases, and 0 cases in the observation group and 4 cases, 2 cases, and 1 case in the control group, respectively.The incidence of complications was lower in the observation group than in the control group(2.2% or 1/45 vs.17.1% or 7/41, χ2=5.608, P=0.018). Conclusions:Endoscopic hemostasis combined with somatostatin treatment can not only achieve satisfactory hemostatic effects, but also reduce the incidence of rebleeding in elderly patients with non-varicose upper gastrointestinal hemorrhage, and thus plays an important role in alleviating suffering and ensuring safety in elderly patients.
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Objective To explore the value of SPECT/CT in evaluation on long-term healing of limb fractures.Methods SPECT/CT imaging characteristics of 68 patients with limb fractures 6 months after treatment were analyzed retrospectively,and the self-healing property of fractures was evaluated.Compared with clinical follow-up results or surgical findings,the accuracy of SPECT/CT in evaluation on long-term healing of fractures was calculated.Results For all 68 patients with limb fractures,X-ray and CT were not able to determine whether the fractures would heal in the future.On SPECT/CT fusion images,radioactivity concentrations through the fracture lines and cross on both sides of fracture were found in 52 patients,which indicated that the fractures were in the process of healing and had the ability of healing in the future.Clinical follow-up confirmed that fractures then healed in 46 patients,while in 6 patients did not.Another 16 patients showed no nuclide concentrations on the fractures,indicated that the fractures were nonunion and had little ability of healing in the future,and were finally confirmed with surgery.The accuracy of SPECT/CT in evaluation on fracture healing was 91.18％ (62/68).Conclusion SPECT/CT imaging can accurately evaluate the long-term healing of limb fractures,which contributes to therapeutic planning in the clinic.
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Objective To observe the characteristics of magnetic resonance angiography of(MRA) ophthalmic artery in patients with diabetic retinopathy (DR).Methods A total of 36 eyes of DR patients (DR group) diagnosed by clinical examination were included in the study.Among them,there were 42 eyes in 21 males and 15 eyes in 15 females.The average age was 55.2 years old.The average duration of diabetes was 7.56 years.All eyes were examined by MRA and fluorescein fundus angiography (FFA) in the ophthalmic artery.At the same time,24 eyes of 12 patients were examined by computed tomography angiography (CTA).Twenty-two healthy volunteers with age and gender matching were selected as the control group.Among them,there were 13 males and 9 females.All patients underwent MRA examination of the ophthalmic artery;at the same time,5 eyes of 5 eyes were examined by CTA.MRA and CTA were classified into three grades according to the development condition and shape change of the ophthalmic artery.0 grade:no abnormality;grade Ⅰ:mild lesion;grade Ⅱ:obvious lesion.According to the results of FFA examination,it was divided into no obvious disease stage,background stage,proliferative stage,proliferative stage.The morphological features of the MRA of the ophthalmic artery in the DR group and the control group were compared.The relationship between the MRA grading of the ophthalmic artery and the FFA staging was observed in the DR group.The consistency analysis between the MRA and CTA grades of the ophthalmic artery in the DR group was performed by Kappa test;the relationship between the MRA grade and the FFA staging of the ophthalmic artery was analyzed by Spearson correlation analysis of the same data with two-way ordered attributes.Results In 44 eyes of the control group,the MRA in grade 0 and Ⅰ of the ophthalmic artery were 41 and 3 eyes,respectively;all eyes of the CTA examination of the ophthalmic artery were grade 0.In 72 eyes of the DR group,the MRA in grade 0,Ⅰ,and Ⅱ of the ophthalmic artery were 28,28,and 16 eyes,respectively.Among the 24 eyes examined by CTA,there were 13,6,and 5 eyes in grade 0,Ⅰ,and Ⅱ,respectively.In the DR group,the classification of MRA and CTA of the ophthalmic artery was highly consistent (Kappa value =0.86).There were significant differences in the number of eyes with different grades of MRA in the DR group and the control group (Z=-5.74,P=0.000).In 72 eyes of the DR group,there were 8,12,22,and 30 eyes in no obvious disease stage,background stage,proliferative stage,and proliferative stage,respectively.Correlation analysis showed that there was a significant correlation between MRA grading and FFA staging in the DR group (r=0.405,P=0.000).Conclusions MRA can show the changes of ophthalmic artery morphology and reflect DR staging to a certain extent.It has a high consistency with FFA vascular changes.
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Objective To evaluate the value of SPECT/CT for detecting the causes of lumbago in post-lumbar spinal fusion patients. Methods From January 2009 to December 2015, 53 patients (31 males, 22 females, age: (42.3±5.3) years) with lumbago after lumbar spinal fusion, without positive CT and digital radiography (DR) findings, were included in this study and were further examined by SPECT/CT imaging. The final diagnosis was made according to clinical symptoms, multimodality imaging findings, and treatment outcome. All patients were followed up for at least 6 months. Results Thirty-eight patients had positive findings with SPECT/CT imaging, including 23 patients with screw loosening, 6 patients with lumbar fusion cage aseptic inflammation and 9 patients with impingement. The other 15 patients had negative results. The diagnostic sensitivity of SPECT/CT for detecting causes of lumbago was 71.7% (38/53). The diagnostic sensitivity and positive predictive value of SPECT/CT for complications caused by internal fixators were both 100% (38/38). Conclusion SPECT/CT scanning could be a clinical valuable tool for inspecting the cause of lumbago in post-lumbar spinal fusion patients.
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Objective To evaluate the effect and mechanism of ginkgolide injection combined with edaravone on acute cerebral infarction.Methods 120 acute cerebral infarction patients were divided into observation group and control group,60 cases in each group.The control group was treated with edaravone,and the observation group was treated with ginkgolide injection combined with edaravone.The neuron specific enolase (NSE),S100β,tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),C reactive protein (CRP),National Institutes of Health stroke scale(NIHSS) and clinical efficacy were compared between the two groups.Results After treatment,the levels of NSE,S100β,CRP,IL-6 and TNF-α of the observation group were (7.1 ± 1.5) μg/L,(0.2 ±0.1) μg/L,(14.5 ± 3.7) mg/L,(20.9 ± 5.3) ng/L and (11.2 ± 3.0)μg/L,respectively,which of the control group were (8.9 ± 2.0) μg/L,(0.4 ± 0.2) μg/L,(21.3 ± 4.2) mg/L,(29.7 ± 3.2) ng/L and (18.8 ± 3.6) μg/L,respectively,those of the observation group were significantly lower than comrol group (t =2.898,2.894,3.012,2.998,3.025,all P ＜0.05).After treatment for 7d and 14d,the NIHSS scores of the observation group were (11.8 ± 3.0) points and (7.3 ±2.2) points,respectively,which of the control group were (15.2 ± 3.9) points and (10.5 ± 3.0) points,respectively,the observation group were significantly lower than control group(t =2.984,3.037,all P ＜ 0.05).The clinical efficacy of the observation group was significantly better than that of the control group (83.3 ％ vs.61.7％) (x2 =7.064,P ＜0.05).Conclusion Ginkgolide injection combined with edaravone in the treatment of acute cerebral infarction caninhibit inflammation reaction,alleviate nerve function damage,its effect is better than edaravone.
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Objective To investigate the MRI characteristics of primary myxofibrosarcoma (MFS) in the extremity soft-tissues.Methods The MRI of 14 cases of MFS confirmed by operation and pathology were analyzed retrospectively.Results In the 14 cases,9 were in the thigh,3 in the lower leg,and 2 in the upper arm.The volumes of the tumors were relatively big and all located in the subcutaneous fat or superficial inter-muscular space.The tumor showed expanding growth and had well-defined boundary.On T1 WI,one case showed isosignal intensity,one showed equal signal intensity mostly,and 12 cases showed patch slightly low signal intensity;On fat suppression T2 WI and STIR,tumors showed high-low mixed signal intensity,which mainly showed high signal intensity;On MRI enhanced study,inhomogeneous enhancement was observed in most of the tumors,and "tail sign" was showed in 11 cases.Conclusion MFS is of characteristics on MRI,the position of tumor is shallow,the tumor is relatively big and has clear boundary.On T1 WI,most tumors show iso-low mixed signal intensity.On fat suppression T2WI and STIR,tumors show high-low mixed signal intensity;On enhanced MRI,inhomogeneous enhancement and "tail sign" are its characteristic signs.
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Objective To evaluate the MRI findings of synovial hemangioma.Methods Twenty-three patients with synovial hemangioma were analyzed retrospectively,and MRI characteristics were summarized.Results Of the 23 patients,there were localized type in 6 and diffuse type in 17.Localized tumors located in the articular synovial tissue and didn't invade articular capsule and peripheral tissues.T hey had envelope,well-defined margin and regular shape.5 cases showed heterogeneous signal with iso-intense or hypo-intense on T1WI,hyper-intense and internal patchy or multiple pinstripe hypo-intense on T2WI and fat-suppression sequence.Diffuse tumors distributed inside and outside the articulation,and invaded the articular capsule or peripheral tissues.17 cases were heterogeneous signal with iso-intense or hypo-intense and internal patchy or sinuous hyper-intense on T1WI,hyper-intense and internal patchy,nodular and multiple pinstripe hypo-intense on T2WI and fat-suppression sequence.Thick flow void of the vessels were showed in 6 cases and phlebolithes were showed in 3 cases.15 cases underwent contrast-enhanced scan,and the tumors showed patchy,nodular or tortuous vascular heterogeneous enhancement with internal patchy,nodular or cord-like non-enhanced areas.Conclusion Fatty-fibrous tissues and flow void of the vessels in the tumor are valuable MRI features for diagnosis of the synovial hemangioma.
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Objective To explore the value of MRS and DWI in diagnosis of cervical spinal cord injury.Methods The MRI plain scan images of 95 cases who suffering from cervical spinal cord injury were analyzed.They were divided into two groups according to the T2 signal of cervical cord,63 cases in Group A(incomplete injury group)with no abnormal on T2 ,32 cases in Group B(complete injury group)with high signal on T2 .The other 50 cases with no injury of cervical cord were recruited as control group (Group C). All the cases were performed with MRS and DWI.The N-acetyl aspartic acid(NAA),choline compounds(Cho)and creatine(Cr)as well as the peak area of lactic acid (Lac)on MRS,and apparent diffusion coefficient(ADC)on DTI were measured separately.Mean-while,NAA/Cho,NAA/Cr,Cho/Cr,Lac/Cho and ADC were analyzed.Results On MRS sequence,the values of NAA/Cho and NAA/Cr were lower in Group B (P <0.05)when compared with Group A.The values of NAA/Cho and NAA/Cr were also lower in Group B,when compared Group C.However,the value of Lac/Cho in Group B was higher than it in Group C(P <0.05).When com-pared Group A with Group C,the value of Lac/Cho only increased in the former.However,on DWI,the value of ADC in Group A was(0.79±0.1 7)×10 -3 mm2/s,lower than that of Group C(0.93±0.1 5)×10 -3 mm2/s (P =0.026);the value of ADC in Group B was(1.21±0.20)×10 -3 mm2/s,significantly higher than that of Group C(P =0.01 7).When compared with Group B,the value of ADC in Group A was a lightly lower (P =0.143)with no statistical significance.Conclusion MRS can noninvasively and quantita-tively reflect the changes of metabolism of medium in injured cervical cord and help characterize the severity and degree of cervical cord injury from metabolic and molecular level.DWI has high sensitivity on early diagnosis of cervical cord injury.The combination of MRS and DWI has important value for formulating reasonable treatment plan and prognostic evaluation.
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Background:C-MET is expressed in a variety of tumor,and its expression may help to predict the prognosis of patients with gastric cancer. Aims:To explore the association of C-MET protein expression with survival in patients with stage Ⅲ gastric cancer. Methods:A total of 178 consecutive initially treated patients with stage Ⅲ gastric cancer from April 2010 to April 2014 at Beijing Pinggu Hospital were enrolled in this study. The expression of C-MET protein was determined by immunohistochemistry. Kaplan-Meier method was used to analyze the survival in patients with high C-MET protein expression and low C-MET protein expression,COX proportional hazards model was used to analyze the influence of various factors on prognosis. Results:C-MET protein was low expressed in 139 patients(78. 1%),and high expressed in 39 patients(21. 9%). Median survival(25. 1 months vs. 45. 0 months),1-year survival rate(69. 2% vs. 91. 4%),2-year survival rate(41. 0% vs. 84. 0%)were significantly decreased in high C-MET protein expression group than in low C-MET protein expression group(P all 0. 05). Conclusions:C-MET protein expression rate is 21. 9% in patients with stageⅢgastric cancer,C-MET expression is significantly associated with survival;1-year survival rate is lower in patients with high C-MET protein expression.
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Resveratrol is a natural phytoalexin with special pharmacological and health functions. Stilbene synthase (STS) is a key and rate-limiting enzyme in the biosynthesis of resveratrol that is present only in a limited number of plants. The content of resveratrol from Polygonum cuspidatum is more than 1000 times higher than grapes and peanuts. We speculate that the catalytic ability of different STS may be one of the reasons causing differences in the content of resveratrol. To verify the above speculation, Vitis vinifera stilbene synthase gene (VvSTS) was amplified according to overlap PCR protocol with genomic DNA as template. VvSTS and PcSTS (PcPKS5) were analyzed through heterologous expression in Escherichia coli. The expression products were purified with Ni-NTA sepharose affinity chromatography and desalted through PD-10 column. The molecular weight of the two fusion proteins was about 43 kDa. Enzyme reaction and product analysis showed that the two products were resveratrol. The enzyme kinetic analysis showed that the catalyze efficiency (Kcat/Km) of PcPKS5 was 2.4 times of the VvSTS. Our findings confirms that STS from certain plants has much higher catalytic capability.
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Acyltransferases , Metabolism , Fallopia japonica , Recombinant Fusion Proteins , Stilbenes , Metabolism , VitisABSTRACT
Objective To evaluate the feasibility and safety of mediastinum examination with flexible endoscope via suprasternal fossa.Methods A total of 20 healthy pigs were enrolled.Mediastinocosopy was performed via a tunnel to thoracix through a 1.5 cm incision on suprastemal fossa.Mediastinum was observed and complications were recorded.Results Mediastinocosopy was successfully achieved in all pigs.No severe bleeding or death occurred during the procedure.Five pigs got fever after the procedure with elevated white blood cell count.Four pigs had pneumothorax and three of them died in 1-6 days.Conclusion Mediastinocosopy with flexible endoscope through suprastemal fossa is feasible to diagnose mediastinal diseases,which can be important experimental evidence for the mini-invasive therapy of mediastimum diseases.
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Objective To study the imaging characteristics of localized myositis ossificans for improving its diagnosis and differen-tial diagnosis ability.Methods The Clinical and radiographic data of 45 cases with localized myositis ossificans proved by pathology or clinical follow up were analyzed retrospectively,summarize its imaging features.Results Of the 45 cases,1 7 cases occurred in the elbow joint,1 5 in the hip joint,13 in the other parts of the body.X-ray showed lining or lamellar high-density ossification in soft tis-sues in 34 cases,of those 12 cases with “shell”ossification.Compared with the X-ray,CT showed more clear ossification.MRI showed the soft tissue mass with peripheral edema in 18 cases;3 cases obvious ossification,no edema around.SPECT/CT showed abnormal imaging agent concentration in soft tissue within 12 cases,of those 5 cases concentration range greater than the range of ossification,4 cases concentration range less than the range of ossification.Conclusion Localized myositis ossificans have certain im-aging characteristics.Integrated application of a variety of imaging combined with the clinical can fully display the evolution of the disease,and improve its diagnosis rate.
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In the past few years, many techniques were used to study brain perfusion imaging;each of them has its own advantages and disadvantages. The principle, specification, clinical application, contradistinction and the current research situation of these techniques were reviewed in this article.
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Objective: We observed the influence of recombinant human growth hormone(rhGH) on protein metabolism in hepatocirrhotic rats and investigated mechanisms. Methods: Ninety rats were randomized into three groups(n=30 for each group): group A(normal rats), B(cirrhotic rats) and C(cirrhotic rats receiving rhGH). Rats in group C were subcutaneously given rhGH with a dosage of 1 U/(kg?d) for up to 1 week. The plasma concentrations of albumin(ALB), prealbumin(PA), transferrin(TF) and insulin-like growth factor-1(IGF-1) were detected on experimental day 14. And liver biopsy was taken to examine the expression level of albumin mRNA with TR-PCR. Results: The albumin, prealbumin, transferrin and IGF-1 levels in groups A and C were significantly higher than those in group B. The expression level of albumin mRNA in grup C was significantly higher than that in group B. Conclusions: The rhGH can improve the level of IGF-1 in plasma and improve the expression of albumin mRNA. Moreover, it may significantly improve the synthesis of protein and attenuate hypoproteinemia in cirrhotic rats.
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Objective To investigate the effect of the 8-bromum-c yc lic adenosine monophosphate (8-Br-cAMP) on the telomerase activity and changes of cell cycle in retinoblastoma (RB) cells. Methods The cul tured RB cells were divided into the experimental group (8-Br-cAMP) and contro l group. After cultured for 24, 48 and 72 hours in vitro, the telomerase activit y of RB cells was detected by polymerase chain reaction enzyme-linked immunosor bent assay (PCR-ELISA) and the changes of cell cycle were detected by flow-cyt ometry. Results The difference of telomerase activity was sign ificant between the experimental groups and control group (P
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Objective To explore the safety, therapeutic-effect-evaluating standards and clinical value of the interventional treatment used as preoperative chemotherapeutic embolism of pelvic tumors and palliative treatment of the patient unsuitable for surgery. Methods Twenty-nine cases of pelvic tumors with complete materials were selected from the cases treated by Seldinger’s interventional techniques from March 1997 to March 2002 and comprehensively analyzed. Results After the chemotherapeutic embolism, most of the arterial supply to the tumors were blocked off; the tumor stains were decreased by more than 75 %; the intra-operating bleeding ranged from 820 to 1530 ml and averaged 1220 ml; the surgical removals were successful. The pathological examinations of the postoperative specimens showed that the necrostic rate of tumor ranged 91%～98%; the remission rate of painful symptoms reached 100%. No severe complications were found in this series.Conclusion The interventional treatment of pelvic tumors is safe, reliable and simple in operation, and can reduce the intra-operative bleeding and improve the successful rate of the surgery. It is regarded not only as the effective auxiliary therapy before surgical removal, but also as the first-selected method for the palliative treatment of the patient unsuitable for the surgery.
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Objective To study MRI findings of both normal and injured knee meniscus.Methods MRI in twenty-six cases (n=32) with meniscal injuries proved by surgery,or by arthroscopy or by clinical examinations and in 15 cases of normal knee menisci were observed.Results The results showed that normal knee menisci,were triangular low signal intensity on T_1WI and T_2WI.Thirty-two injured meniscal injuries included 15 medial injuries,11 lateral injuries and 3 cases(n=6) of bilateral injuries.32 injured menisci according to the Stoller's four-grade classification as followed :grade 0 in 0,grade one in 6,grade two in 12 and grade three in 14.Eighteen cases were complicated by meniscus cyst in 6,medial accessory ligament injury in 10,lateral accessory ligament injury in 9,anterior cruciate ligament injury in 7,posterior cruciate ligament injury in 6,bone bruise in 8,fracture in 5,intracapsular hydrops and ecchymosis in the soft tissues around the knee in 6.Conclusion MRI can clearly show the anatomical structure of knee meniscus and accurately dagnose meniscal injuries and its complications.
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Objective To investigate the clinical applied value of the early slope value of MR contrast-enhancement in differentitating benign from malignant musculoskeletal neoplasms.Methods 48 patients with benign or malignant musculoskeletal masses(26 benign,22 malignant) confirmed by pathology underwent dynamic contrast-enhanced scanning.The largest slope of dynamic enhancement in early stage and SI-Time curve type were gained and the difference of them in benign and malignant musculoskeletal tumours were analysed.Spearman rank correlation analysis was used to determine the relation between slope and microvessel density of tumor tissues.Results There were 3 SI-Time curve types in all cases with typeⅠ(precipitous rise) in 22 cases,type Ⅱ(slow rise) in 21 cases and type Ⅲ(slight rise) in 5 cases.The average early slope value of enhancement was(4.23?2.68)% per second(range 0.96%~10.53%)in malignant tumors,and(1.44?0.99)% per second(range 0.36%~3.76%)in benign tumors.There was an apparent statistical significance between benign and malignant tumors(P
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Objective To explore the value of imaging diagnosis of nerve-root-type cervical spondylosis(NRTCS)and to study the relative factors to the nerve root disturbance.Methods 188 cases of NRTCS clinically proved and with complete imaging data were retrospectively analyzed.The imaging characteristics of CR,CT and MRI of NRTCS were compared and the relative factors to the nerve root disturbance were analyzed in combination with the clinical characteristics.Results ①CR films in six-position could show the whole expression of the cervical spine.The anterior-posterior and functional position CR showed the physiological curvature change in 122(64.9%),narrowing of intervertebral space in 96(51.2%)and vertebral-body unstability or slide in 49(26.1%).The oblique CR showed the intervertebral-foramen lessening or narrowing in(26.1%)and Luschka-or intervertebral-joint osteophyte in 82(43.2%);②CT scans showed Luschka-or intervertebral-joint osteophyte in 76(40.4%),disc herniation and calcification of cartilage nodus in 80(42.6%)and hypertrophy or calcification of ligamenlum flavum in 66(39.8%);③MRI showed intervertebral-disk degeneration and protrusion in 105(55.8%),hypertrophy or calcification of ligamentum flavum in 51(27.1%),the nerve root and spinal cord compressed in 69(36.7%)and edema or degeneration of spinal cord in 23(12.2%).Conclusion The nerve root disturbance is closely correlated with the imaging appearances in NRTCS.It is of importance in early diagnosis and treatment for NRTCS to analyse synthetically the imaging data and clinical characteristics.
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75% compared with the pre-embolism;the intra-operative bleeding ranged 500 to 2000 ml and averaged 810 ml;the surgical removal was successful;the tumor cell necrotic rate was 91% to 95% through post-operative sample pathological examination;and the painful remission rate was 95% to 100%.No severe complications occurred in this series.Conclusion The pre-operative chemotherapy and SAE for spinal tumor are effective,simple,safe and reliable methods