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Objective: To exlpore the value of voxel-based quantitative CT in evaluation on injury degree and spatial distribution in different lobes of chronic obstructive pulmonary disease (COPD) patients. Methods: COPD patients who underwent inspired and expired CT scanning were consecutively recruited from the multi-center study named Digital Lung.Quantitative parametres of functional small-airway disease (fSAD) and emphysema (Emph) were measured. The degree and distribution of pulmonary lobar injury were analyzed according to Emph and fSAD among different pulmonary lobes. At the same time, the correlation of quantitative CT distribution and lung function of each lobe was analyzed. Results: A total of 50 COPD patients were eventually included. Emph and fSAD of the right middle lobe (RML) was the most severe, followed by the upper lobes of the two lungs, while the lowest degree of injury were seen in both lower lobes of the lungs. Emph and fSAD were both mainly distributed in the left upper lobe (LUL), followed by in the right upper lobe (RUL), while in the right middle lobe (RML) was the least. Either fSAD or Emph showed better correlations with FEV1% in both lower lobes. Conclusion: The injury of the lobes in COPD patients mainly distribute in the RML and both upper lobes, especially the former. Emph and fSAD mainly distribute in the LUL, followed by the RUL. The lower lobes of the lungs have greater influence on pulmonary function in COPD patients.
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Objective To establish and validate a voxel-based method for the quantitative detection of air trapping (AT),and to explore its diagnostic value by preliminarily apply this method in chronic obstructive pulmonary disease (COPD) patients.Methods From March 2015 to February 2016,fifty healthy young volunteers and eighteen COPD patients who underwent both end-inspiratory and end-expiratory CT were included from the Digital Lung Multi-center Study.The quantitative parameters of AT and emphysema were measured by both the voxel-based quantitative method and the conventional threshold method,respectively.All subjects underwent pulmonary function examination within 3 days after CT examination.For healthy volunteers,paired sample rank-sum test was used to compare the difference of quantitative parameters between voxel-based method and threshold method,Spearman rank correlation analysis was used to investigate the correlation between quantitative parameters of the two methods and pulmonary function.For COPD patients,the distribution and extent of AT and emphysema in patients with similar degree of pulmonary function (PFT) injury were observed.Results There were varying degrees of AT in the asymptomatic youth,with a median value of 5.70％ for the voxel-based method and with a median value of 7.96％ for the conventional threshold method,there was significant difference(Z=-4.015,P＜0.001).The correlation between AT and emphysema parameters of the voxel-based method and PFT parameters (r=-0.399 and-0.494,-0.335 and-0.439 separately,P＜0.05) were higher than that of the conventional threshold method,respectively (r=-0.357 and-0.453,-0.284 and-0.391,respectively;all P＜0.05).Furthermore,the voxel-based method can classify COPD patients with similar degree of pulmonary function injury into three subtypes:AT-dominant,emphysema-dominant,and mixed.Conclusions The voxel-based AT quantitative measurement method not only has high sensitivity and accuracy,but also provides imaging phenotype for the diagnosis of COPD and provides assistant decision-making for clinical management.
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Objective To study the effect and mechanism of endoplamic reticulum stress on the auditory cortex injury after focal cerebral ischemia-reperfusion injury in rats.Methods 30 healthy male adult SD rats were chosen and randomly divided into 2 groups,ischemia-reperfusion(I/R) group and sham operated control,with each group 15 rats.The rats in I/R group were operated for suture-occluded method to establish middle cerebral artery occlusionmodel(MCAO),with ischemia for 60 mins followed by reperfusion for 24 h.And the control group was only to be isolated cervical vessels,with no thread embolism inserted.The auditory brainstem response (ABR) was tested before operation and at 24 h post-operation respectively.The neurological deficits,ratio of infarct volume were evaluated.The pathological changes were observed by HE.Neurocyte apoptosis were observed by Tunel,and the AI were determined.The expression of GRP78,Caspase-12 were detected by immunohistochemistry and Western blotting.Results Compared with the sham group,the neurological function scores,the infarct volume of brain of I/R group increased significantly.The threshold of ABR elevated significantly and AI rised in I/R group.HE staining showed that the neurons in the sham group were arranged in order,the shape was normal,but in the I/R group the normal structure disappeared,the nuclei were condensed.The expression of GRP78,Caspase-12 protein were significantly up-regulated.All of the differences above have statistical significance(P＜0.05).Conclusion The mechanism of hearing loss after focal cerebral ischemia-reperfusion injury in rats is perhaps related to endoplamic reticulum stress,and GRP78,Caspase-12 participate in the process of neuron apoptosis on auditory cortex caused by ERS.
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Objective To evaluate the extent and anatomic distribution of air trapping in lung in young asymptomatic female subjects to achieve early diagnosis of small airway diseases.Methods Fifty young females with normal pulmonary function were included retrospectively in this study.All subjects underwent both inspiratory and expiratory CT scans,the percentage of the area of air trapping(AT)and the percentage of the area of emphysema(Emph)were quantitatively analyzed.Comparison between bilateral lungs was analyzed using independent-samples t test;Comparisons among lobes were done using one-way ANOVA or Kruskal-Wallis rank sum test;Pairwise comparisons between lobes were conducted using LSD test or paired comparison;The effects of each lobe on AT were analyzed using Spearman's rank correlation coefficient,simple linear regression and multiple stepwise regression.Results There was a certain degree of air trapping in lung and a small amount of emphysema in young asymptomatic females.Air trapping was mainly located in the right middle lobe (RML)and bilateral upper lobes.The ratio of air trapping to volume was the highest in RML and the change of air trapping in the bilateral upper lobes had the greatest influence on the air trapping degree of the whole lung.Conclusion There is a certain degree of air trapping in lung in young asymptomatic females.The occurrence and development of air trapping in RML may be a sensitive biomarker for the early detection of pathophysiological changes in small airway diseases using imaging procedures.
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Objective To study the mechanism of endoplamic reticulum stress(ERS)pretreatment induced by 2-DG on the auditory cortex injury after focal cerebral ischemia-reperfusion injury in rats. Methods The SD rats were randomly divided into 3 groups,sham group,I/R group,and ERS pretreatment group. Tread occlusion was used to prepare the model of MCAO in the mice for 60 min followed by reperfusion for 24 h. Neurological assessment was exercised and brain infarction volume was evaluated. The auditory brainstem response was tested. The pathological changes were observed by HE staining. Neurocyte apoptosis was observed by Tunel ,and the apop-tosis index(AI)was determined. Expression of GRP78 and Caspase-12 were detected by immunohistochemistry. Results Compared with the sham group,the neurological scores,ratio of infarct volume and the hearing thresh-olds in I/R group increased significantly. HE staining showed the normal structure disappeared ,and apoptotic index increased significantly. Expression of GRP78 and Caspase-12 protein significantly up-regulated. Compared with I/R group,the indicators above showed improvement to some degrees. Conclusions The ERS pretreatment can alleviate the ischemia-reperfusion injury and neuron apoptosis in auditory cortex ,and reduce the possibility of hearing loss.