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Objective:To investigate the clinical significance of serum glial fibrillary acidic protein(GFAP)level in middle-aged and elderly patients with Parkinson's disease(PD).Methods:In the prospective study, a total of 39 patients with PD hospitalized in the Department of Neurology of Zhejiang Hospital affiliated to Zhejiang University School of Medicine, and 17 healthy subjects from January 2017 to May 2021 were collected.Serum GFAP levels in the PD group and healthy control(CT)group were detected by an ultra-sensitive Simoa hypersensitive protein detection technology.The correlations of serum GFAP level with age, gender, clinical presentation type, depression score, Montreal Cognitive Assessment Scale(MOCA)score and Mini-Mental State Examination(MMSE)score were analyzed.Results:The level of serum GFAP was significantly higher in PD group(219.6±166.2)ng/L than in CT group(109.9±56.6)ng/L( P< 0.01). In PD group, there was no correlation of serum GFAP with age, gender, clinical classification, depression and MOCA score(age: r=0.042, gender: r=-0.142, depression score: r=0.076, MoCA score: r=0.014, all P>0.05); but there was a significant negative correlation between serum GFAP and MMSE score( r=-0.433, P< 0.05). Conclusions:There is a negative correlation between serum GFAP level and MMSE score, suggesting that the increase of serum GFAP might be suggestive of cognitive decline in Parkinson's disease patients to some extent, which should be paid attention to in clinical work.
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Objective To investigate the clinical,laboratory and MRI imaging features of a spontaneous spinal subarachnoid hemorrhage(S-SAH)so as to improve the recognition of spontaneous (S-SAH).Methods The data of clinical,laboratory,MRI imaging features,treatment and prognosis of the spontaneous(S-SAH)were collected and statistically analyzed.Relevant literatures were then reviewed.Results The patient was a 75-year-old woman with neuromyelitisoptica spectrum disorders.During the course of hospitalization for intravenous infusion of high-dose methylprednisolone,the patient suffered from a sudden and severe migrating back pain that gradually progressed from the back to the neck and head,and signs of meningeal irritation occurred.After the exclusion of aortic dissection,acute coronary syndrome,pulmonary embolism,and fractures,further MRI scans of the head and spinal cord were performed.The MRI confirmed subarachnoid hemorrhage located in spinal cord and posterior cranial foss,and the diagnosis was spontaneous S-SAH.Conclusions Migrating back pain combined with signs of meningeal irritation is a characteristic clinical manifestation of S-SAH,and a prompt MRI evaluation of spinal cord is helpful to improve the early diagnosis and treatment.
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Objective To evaluate the diagnostic efficacy of magnetic resonance(MR)-guided prostate biopsy based on abnormal diffusion weighted imaging for prostate cancer in elder men.Methods From July 2014 to Dec 2016,56 patients (age≥ 65 years) with diffusion weighted imaging (DWI)abnormalities undergoing MR-guided prostate biopsy were retrospectively evaluated.According to pathological diagnosis,patients were divided into prostate cancer and non-prostate cancer groups.The clinical data of two groups were analyzed.The correlation of Gleason score,prostate specific antigen(PSA),and the location and number of biopsy were compared.Results Among 56 cases,32 (57.1％)were diagnosed as prostate cancer,and 24 (42.9％)as chronic prostatitis and prostatic hyperplasia (non-prostate cancer).There were statistically significant differences between prostate cancer and non-prostate cancer in age[(73.0±5.7)vs.(70.1±4.3)year]and PSA[(9.3±6.0)μg/L vs.(6.0± 3.9)μg/L] (both P＜0.05),and no statistical differences in biopsy location and biopsy number(t =2.08,2.37,P＞ 0.05).Gleason score had no correlation with PSA level and biopsy location and biopsy number(r=0.189、-0.183、0.082,P＞0.05).Conclusions MR-guided prostate biopsy based on MR-DWI has some merits,such as accurate positioning,fewer numbers of biopsy,and lower false-negative rate.
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Objective To study the value of magnetic resonance vessel wall imaging in assessing the atherosclerotic plaque burden of rabbit model.Methods We built up abdominal atherosclerotic animal model in 30 New Zealand rabbits by high lipid diet combined with abdominal artery denudation.The animals were divided into 3 groups randomly,which were the 1-week group,1-month group and 2-months group.The MRI and histology examination were carried out at relative time points.The correlations of area or thickness of vessel wall by MRI with histology examination were analyzed.Results Among the 30 rabbits,3 died due to anesthesia or surgery,one rabbit model failed because of the thin vessel,and another 3 died of diarrhea or inflammation during the high lipid diet feeding.Eventually,totally 23 rabbits fulfilled the examinations (7 in 1-week group,7 in 1-month group and 9 in 2-months group).The vessel wall area of histology examination grew larger along with the post-surgery duration,from 1.7663 mm2of 1-week group to 2.4371 mm2 of the 1-month group till 3.5978 mm2 of 2-months group,with statistic significant difference among 3 groups (F=5.052,P=0.017).There were strong correlations of area or thickness vessel wall resulted from MRI with histology examination(r=0.688,0.642;P=0.001,0.002).Conclusions High resolution MR vessel wall imaging technique may evaluate and follow up the plaque burden in the early stage of atherosclerosis.
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Objective To evaluate the feasibility of precise hepatic segmentectomy or subsegmentectomy using intraoperative image-guided interventional intravascular segmental vessel balloon catheter occlusion of the segmental hepatic artery and portal vein.Methods 6 patients with liver resection carried out from 2011.3-2011.8 were retrospectively analyzed.Results The mean operating time was (270.83±21.31) min,the median of blood loss was 800 ml,the median of intraoperative transfusion volume was 450 ml.The tumors were mainly located in segments Ⅴ,Ⅵ,Ⅶ,Ⅷ.The mean diameter of tumor was (5.67±1.03) cm.Postoperative liver function in the first postoperative day showed the mean alanine aminotranferase (ALT) was (570.00±157.76) U/L,the mean aspirate aminotrarsferase (AST) was (410.00 ±189.94) U/L,and the mean total bilirubin (TBIL) was (10.83± 1.60) mmol/L.Liver function recovered to normal within 7 days.There was intestinal leakage and wound dehiscence in one patient,pleural and effusion in two patients.Conclusion Imageguided interventional intravascular segmental vessel balloon catheter occlusion was a safe and efficacious maneuver.This technique allowed hepatic segmentectomy or subsegmentectomy to be carried out,decreased intraoperative bleeding,and protected the function of the liver remnant.
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Objective To investigate the difference in occurrence of pneumothorax and bleeding under lung biopsy between the elderly and the non-elderly. Methods A total of 297 consecutive patients were involved in the study and divided into non- elderly group (＜ 60 yrs,122 cases),and elderly group (≥60 yrs,175 cases).Eighteen gauge (18G) cutting needles were used for biopsy with computed tomography (CT) guidance. Biopsy samples were detected by histology and cytology pathology. Results Pneumothorax occured in 108 of 297 biopsies (36.4％),pneumothorax rate was higher in elderly group (76 cases,43.4％) than in non-elderly group(32 cases,26.2％) (x2=9.19,P＜0.01).No statistical significance was found in different degrees of pneumothorax between the two groups.Perifocal hemorrhage occured in 156 of 297 biopsies (52.5％),higher frequency of hemorrhage occurred in elderly group (105 cases,60.0％) than in non-elderly group(51 cases,41.8％)(x2=9.55,P＜0.01),and the more flake bleeding vas found in elderly group than in nonelderly group(x2 =20.28,P＜0.01). Conclusions In CT guided coaxial cutting needle biopsy,the incidence of pneumothorax and considerably bleeding are higher in the elderly than in non-elderly.
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Objective To study the correlation of the incidence of diverticula in the upper gastrointestinal tract and the age increasing among the people without any symptom in digestive system. Methods Six hundred and fourty-five elderly and pre-elderly people(age from 50 to 79 years)with asymptom diverticula were divided into 3 groups basing on their age:50 to 59 years group(206 cases),60 to 69 years group(201cases) and 70 to 79 years group(238 cases).Difference in numbers and locations of the diverticula in each group were analysed. Results The patients with diverticula in each group were found to be 37 cases(18.0%)、56 cases(27.9%)and 68 cases(28.6%), respectively, showing that among these 3 groups, the incidence of diverticula increased with ages (P
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Objective To study the CT appearances in the atypical thoracic sarcoidosis Methods Chest CT findings of 43 patients with proven sarcoidosis were reviewed retrospectively Results 22 cases (51 16%) had atypical thoracic sarcoidosis findings at presentation The atypical patterns on CT included mediastinal adenopathy alone ( n =9) or in combination with unilateral hilar adenopathy ( n =6), and unilateral hilar adenopathy alone ( n =1) 6 patients had abnormal findings in the lung alone without adenopathy, and they all had been misdiagnosed 18 atypical cases (81 82%) occurred in patients older than 50 years, whereas 4 atypical cases (18 18%) occurred in patients younger than 50 years Conclusion Half patients with thoracic sarcoidosis have atypical CT appearances, it frequently occurs in elderly patients, and the diagnosis is easily mistaken on CT scan
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Objective To study the CT features of thoracic sarcoidosis in senile and pre senile patients. Methods The findings in 25 patients(14 elderly patients and 11 pre senile patients) manifesting thoracic sarcoidosis were reviewed. Results Nine patients with typical findings and sixteen patients with atypical findings were reported at retrospective presentation. The atypical patterns at CT included mediastinal adenopathy with unilateral hilar adenopathy( n =3, 3/25), mediastinal adenopathy alone ( n =7, 7/25), unilateral hilar adenopathy alone ( n =1, 1/25), and lung abnormal findings without any mediastinal and/or hilar adenopathy ( n =5, 5/25). The latter 5 patients were misdiagnosed at the first clinical consultation. Conclusions The thoracic sarcoidosis in the elderly often manifests atypical patterns, and the recognition of the key point is of importance and helpful for the definite diagnosis.
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Objective To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis.Methods The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all cases, while enhanced CT in 9 cases , and all images were reviewed by 2 radiologists.Results Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(?2=42.000,P
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Objective To study different e mbolization methods in various aneurys ms with metallic coils. Methods In 6 spherical aneurysms, the e mbolization was p erformed with coils in their bodies, discontinuing the total or part of the bloo d supply to the corresponding viscera. While in 6 diverticulum aneurysms, the em bolization with coils was conducted in their bodies only, maintaining the blood supply of the corresponding viscera. For some pseudoaneurysms, both afferent and efferent arteries were embolized and collateral arterial supplies were prevente d. Results All 19 cases 20 aneurysms, of aneurysms were success fully embolized. Among 8 cases of pseudoaneurysms, bleeding had been stopped in 7 cases. Putting coils in the b odies of aneurysms or embolizing both afferent and efferent arteries improved su ccessful rate. Conclusion Embolizing aneurysms with metallic co ils is an efficient, reliable, and simple interventional method for stopping bleeding.
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Objective To explore the methods of embolism in simple and complex arteriovenous malformation of body.Methods Ten cases with the body arteriovenous malformations treated with interventional embolization were retrospectively analysed. Coil or detached bollon were used in simple arteriovenous malformations which could be embolized directly, while IBCA were used in complex ones, which could embolize the abnormal vascular group, blocking blood supply of multiple arteries and preventing construction of collateral circulation which could lead to recur. Results The abnormal vasculars were embolized completely in all ten cases, and there were no recurrent followed-up for 1～6 years.Conclusion Interventional embolization is a simple and credible therapeutic method for arteriovenous malformations of body , and it should be the primary plan.