Design and Application of Hospital Cloud Data Center / 医学信息学杂志

The paper takes the new generation of software-defined cloud data center of Tongji Hospital Affiliated to Tongji University as an example to analyze situation and challenge of informatization in hospital,elaborates design idea and application effect of the data center from the aspects including basic architecture,self-service cloud service platform and seamless extension of mixed clouds,discusses issues that need attention.

Abnormal intrinsic brain activity in amnestic mild cognitive impairment revealed by amplitude of low-frequency fluctuation: a resting-state functional magnetic resonance imaging study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies have shown that brain functional activity in the resting state is impaired in Alzheimer's disease (AD) patients. However, alterations in intrinsic brain activity patterns in mild cognitive impairment (MCI) patients are poorly understood. This study aimed to explore the differences in regional intrinsic activities throughout the whole brain between aMCI patients and controls.</p><p><b>METHODS</b>In the present study, resting-state functional magnetic resonance imaging (fMRI) was performed on 18 amnestic MCI (aMCI) patients, 18 mild AD patients and 20 healthy elderly subjects. And amplitude of low-frequency fluctuation (ALFF) method was used.</p><p><b>RESULTS</b>Compared with healthy elderly subjects, aMCI patients showed decreased ALFF in the right hippocampus and parahippocampal cortex, left lateral temporal cortex, and right ventral medial prefrontal cortex (vMPFC) and increased ALFF in the left temporal-parietal junction (TPJ) and inferior parietal lobule (IPL). Mild AD patients showed decreased ALFF in the left TPJ, posterior IPL (pIPL), and dorsolateral prefrontal cortex compared with aMCI patients. Mild AD patients also had decreased ALFF in the right posterior cingulate cortex, right vMPFC and bilateral dorsal MPFC (dMPFC) compared with healthy elderly subjects.</p><p><b>CONCLUSIONS</b>Decreased intrinsic activities in brain regions closely related to episodic memory were found in aMCI and AD patients. Increased TPJ and IPL activity may indicate compensatory mechanisms for loss of memory function in aMCI patients. These findings suggest that the fMRI based on ALFF analysis may provide a useful tool in the study of aMCI patients.</p>

Functional MRI study of mild Alzheimer's disease using amplitude of low frequency fluctuation analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies have shown that the functional brain activity in the resting state is impaired in Alzheimer's disease (AD) patients. However, most studies focused on the relationship between different brain areas, rather than the amplitude or strength of the regional brain activity. The purpose of this study was to explore the functional brain changes in AD patients by measuring the amplitude of the blood oxygenation level dependent (BOLD) functional MRI (fMRI) signals.</p><p><b>METHODS</b>Twenty mild AD patients and twenty healthy elderly subjects participated in the fMRI scan. The amplitude of low frequency fluctuation (ALFF) was calculated using REST software.</p><p><b>RESULTS</b>Compared with the healthy elderly subjects, the mild AD patients showed decreased ALFF in the right posterior cingulate cortex, right ventral medial prefrontal cortex, and in the bilateral dorsal medial prefrontal cortex. No brain region with increased ALFF was found in the AD group compared with the control group.</p><p><b>CONCLUSIONS</b>The reduced activity in the posterior cingulate cortex and medial prefrontal cortex observed in the present study suggest that the functional abnormalities of those areas are at an early stage of AD. The ALFF analysis may provide a useful tool in fMRI study of AD.</p>

Malignant Mesothelioma Presenting as a Giant Chest, Abdominal and Pelvic Wall Mass

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.

The effect of continuous low doses X-ray on the proliferation of pyramidal cell in hippocampus CA1 in prenatal rats / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the effect of low doses X-ray on proliferation of hippocampal pyramidal cell in the area of CA1 in prenatal rat and its relevant mechanism.</p><p><b>METHODS</b>A total of 25 pregnant rats were randomly divided into four experimental groups and one control group. The experimental groups, in a duration of consistent 18 days, respectively received different doses as follows: 0.015 mGy/d, 0.03 mGy/d, 0.06 mGy/d and 0.09 mGy/d. The control group received sham radiation. To observe the density and width of hippocampal pyramidal cell in the area of CA1 by HE stained and observe the expression of the ERK1/2 by IHM.</p><p><b>RESULTS</b>(1) Except C group, all other groups presented increment in width of the level of hippocampal pyramidal cell, compared with C group; H group, M group, L1 group and L2 group were higher than that (F value respectively were 8.475, 33.42, 14.395, 44.955; P value respectively were 0.002, 0.048, 0.030, 0.012). But the phenomenon of inhomogeneity in width in H group was observed, at the same time, the density of cell in H group became looser (F = 4.466, P = 0.017). (2) The expression of ERK1/2 in the hippocampus CA1 was seen in cytoplasm of every group, the average optical density of positive ERK1/2 protein significantly increased in L1 group and L2 group, compared with control group respectively (F value respectively were 4.561, 4.103, P value respectively were 0.044, 0.035).</p><p><b>CONCLUSION</b>Low doses X-ray could promote proliferation of hippocampus CA1 cell in prenatal. The reason could be the increment of the ERK1/2 protein induced by X-ray. When the doses reached 0.09 mGy/d, the excesses proliferation phenomenon was observed.</p>

Effect of HBx antisense oligodeoxynucleotide on formation of transplanted hepatocellular carcinoma in nude mice / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To study the inhibitory effect of HBx antisense oligodeoxynucleotide on the formation of transplanted hepatocellular carcinoma in nude mice.</p><p><b>METHOD</b>50 nude mice were randomly divided into 5 groups: 1 control group and 4 experimental groups. Log-phase Hep3B cells endogenously expressing HBX were injected subcutaneously in nude mice. From the second day, the PAGE purified AS1, AS2, AS3 and AS4 HBx antisense oligodeoxynucleotides were injected intraperitoneally into the 4 experimental groups, respectively, on alternate days for 5 times, and distilled water was injected into the control group. Growth information of subcutaneous transplantation tumor in nude mice was recorded for 30 days. Incidence rate of transplanted tumor in different groups was compared and analyzed by survival analysis. Statistics software SPSS12.0 was used to analyze the data.</p><p><b>RESULTS</b>Incidence rate of transplanted tumor was 100% in AS1, AS2, AS3 and control groups, and 90% in AS4 group (x2 = 3.995, P = 1.0). The median latency period for transplanted tumor formation was 19 days (17.48-20.52), 12 days (9.93-14.07), 11 days (9.45 to 12.55), 21 days (19.48 to 22.52), and 10 days (8.99 to 11.01) in AS1, AS2, AS3, AS4 and control group, respectively. The latency period for tumor formation was prolonged by treatment of mice with AS1 and AS4 antisense oligodeoxynucleotide (P less than 0.01).</p><p><b>CONCLUSION</b>Antisense oligodeoxynucleotide targeting to the appropriate sites of HBx gene can prolong the latency period of subcutaneously transplanted tumor in nude mice, however, the formation of transplanted tumor can not be completely blocked by limited treatment with these antisense oligos. In addition, our results suggest that peritoneal injection may be an effective way to deliver antisense oligodeoxynucleotide to living organisms.</p>

Coben cephalmetric analysis of the 120 Haerbin persons with normal occlusion / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To obtain the normal value of Coben analysis for Haerbin with normal occlusion and analyze the different features of cranio-maxilla-facial structure between male and female, between adults and children.</p><p><b>METHODS</b>120 Haerbin subjects (60 adults and 60 children) who fulfilled specific normal occlusion were seleceted from primary schools and universities students of Haerbin. They were divided into comparison groups on the basis of age and sex. Lateral cephalograms were taken for all subjects, and the mean and standard deviation for each parameter was recorded and compared between groups. Paired t test was used to assess statistical significance.</p><p><b>RESULTS</b>In depth, both sexes exhibited great increment in the middle and lower face. In anterior and posterior face height, the male adults exhibited increment, and in female adults only the posterior face height exhibited increment. The male adults face far exceeded the female in vertical growth, and less than the female in horizontal growth. No statistically significant differences of facial form were found between the sexes in children.</p><p><b>CONCLUSION</b>The normal values of Coben analysis for Haerbin with normal occlusion was established. There were significant differences in normal values of Coben analysis between male and female, between adults and children.</p>

Preliminary result of dynamic contrast-enhanced MR imaging in assessment of cellularity characteristics of bone marrow in patients with haematological malignancies / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the correlation of bone marrow status in haemotological malignancy patient with the variable value of dynamic contrast-enhanced MR (DCE-MRI).</p><p><b>METHODS</b>DCE-MRI result were obtained from 25 patients with pathologically proven haematological malignancies. Time-signal intensity curves (TIC) was generated from the region of the iliac crest corresponding to the planned biopsy site. Enhancement characteristics including peak enhance ratio (PER) , maximum slope (Slopemax), time to peak ( TP) and mean time (MT) were analyzed. The patients received bone marrow biopsy on the crest 30 min after DCE-MRI, and then the parameters of bone marrow histology including cellularity was analyzed.</p><p><b>RESULTS</b>In this series, 3 patients showed type B TIC, 7 type C, 13 type D and 2 type E. The bone marrow cellularity with haematological malignancies cannot be demostrated by TIC type. The mean PER value and Slopemax value in the patients with hypercellularity was significantly higher than that with normal cellularity and hypocellularity. The mean TTP value of the patients with hypercellularity (60.20 +/- 61.62) was significantly lower than that in the patients with hypocellularity (97.43 +/- 1.07) or normal cellularity (78.44 +/- 38.02). There was no significant difference in the mean MT value among three groups.</p><p><b>CONCLUSION</b>Our preliminary findings suggest that the bone marrow cellularity in the patient with haematological malignancies can not be revealed by conventional MR, but it may be demonstrated by semi-quantitative calculation of the variable value from DCE-MR imaging.</p>

Functional MRI in chronic liver disease of hepatitis B patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To estimate the correlations between functional MRI (fMRI) parameters and the severity of chronic liver lesions of hepatitis B patients.</p><p><b>METHODS</b>47 hepatitis B patients [6 with chronic hepatitis, 41 with cirrhosis (14 with Child-Pugh class A cirrhosis; 12 with class B cirrhosis; and 15 with class C cirrhosis)] and 10 normal volunteers, referred for measurements of apparent diffusion coefficient (ADC) values of the liver, perfusion imaging parameters, portal flow parameters and serum markers of hepatic fibrosis were included in the study. Diffusion-weighted imaging (DWI) with different b values and b value remainder was performed. Time to peak (TP), maximum slope of increase (MSI) and distribution volume (DV) were measured with dynamic contrast material-enhanced MR imaging. Portal velocity and portal flow with phase contrast (PC) were measured. The patients' serum hepatic fibrosis markers, including hyaluronic acid (HA), type-III-procollagen (PC III), laminin (LN) and type-IV-collagen (C IV), were measured and analyzed together with the fMRI results.</p><p><b>RESULTS</b>(1) The mean ADC3 in Child A, B, C cirrhosis patients was significantly lower than that in the controls (P < 0.05 in Child A, and P < 0.05 in Child B). (2) There was a significant increase of time to peak and a decrease of maximum slope of increase (P < 0.01) in the Child A, B, C patients than in the normal controls. (3) There was a significant decrease in portal velocity in cirrhotic patients as compared to that of the controls and chronic hepatitis patients (P < 0.01). (4) The mean HA in Child A, B, C cirrhosis patients was significantly higher than that in chronic hepatitis patients and in the controls (P < 0.01); The mean LN in Child A, B, C cirrhosis was also significantly higher than that in chronic hepatitis patients and in normal controls (P < 0.01); The mean PC III in Child A, B, C cirrhosis was significantly higher than that in the normal controls (P < 0.01).</p><p><b>CONCLUSION</b>fMRI parameters can reflect some changes of the livers, therefore fMRI parameters are of value in clinical diagnosis and treatment of chronic hepatitis B patients.</p>

In vivo 1H magnetic resonance spectroscopy in evaluation of hepatocellular carcinoma and its early response to transcatheter arterial chemoembolization / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the value of in vivo proton magnetic resonance spectroscopy (MRS) in the assessment of hepatocellular carcinoma (HCC) and monitor its metabolic change shortly after transcatheter arterial chemoembolization (TACE).</p><p><b>METHODS</b>In this prospective study, 28 consecutive patients with large HCC (> or = 3 cm in diameter) confirmed by fine needle aspiration biopsy were recruited. The 1H MRS of all hepatic lesions and some uninvolved liver parenchyma were performed with 1. 5T whole body MR scanner. Among them, 15 cases were evaluated again about one week after TACE. The main metabolites such as choline and lipid before and after interventional therapy were measured to assess the early response of the tumor.</p><p><b>RESULTS</b>The technical success rate of 1H MRS in liver was high (33/41, 80%), closely related to breath motion, location of lesion, and size of voxel. In spectra, the choline compound peak of HCC elevated compared with uninvolved liver parenchyma. After TACE, both the amplitude and the area of choline resonance peak significantly descended (choline-to-lipid ratios from 0.352 +/- 0.080 to 0.167 +/- 0.030, P = 0.026; from 0.205 +/- 0.060 to 0.070 +/-0.020, P = 0.042, respectively); yet lipid resonance peak ascended.</p><p><b>CONCLUSIONS</b>In vivo 1H MRS is technically feasible for the evaluation of large focal hepatic lesions, however, the reproducibility and stability are not as good as routine MR scan. 1H MRS can monitor the early stage metabolic changes of HCC after TACE but limitation like quantification still exists.</p>

Anti-viral therapy using lamivudine and thymosin is helpful to prevent recurrence in hepatocellular carcinoma with coexisting active hepatitis B / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the effect of postoperative anti-viral therapy using lamivudine and thymosin alpha1 on recurrence of hepatocellular carcinoma (HCC) coexisting with active hepatitis B.</p><p><b>METHODS</b>From Jan. 2000 to Dec. 2002, 33 HCC patients with coexisting with active hepatitis B were randomized into two groups: Group I (n = 17) received hepatectomy only, and Group II (n = 16) received hepatectomy and postoperative therapy using lamivudine plus thymosin alpha1. The suppression of HBV-DNA, HBeAg seroconversion rate, tumor recurrence rate and median survival in the two groups were observed and compared.</p><p><b>RESULTS</b>In Group II and Group I, the 1-year HBV-DNA suppression rate was 100.0% vs 6.0% (P < 0.01), HBeAg seroconversion rate was 62.5% vs 5.9% (P < 0.05), tumor recurrence rate was 81.3% vs 95.5% (P > 0.05), the recurrence time was 7.0 vs 5.0 months (P < 0.01) and median survival 10.0 vs 7.0 months (P < 0.01).</p><p><b>CONCLUSION</b>Anti-viral therapy using lamivudine and thymosin alpha1 postoperatively may suppress the HBV reaction, delay the recurrence and prolong the survival for patients with HCC with coexisting active hepatitis B.</p>

Hepatocellular carcinoma with tumor thrombi in the portal vein. A comparison of therapeutic effects by different treatments / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effects of different treatments for hepatocellular carcinoma (HCC) with tumor thrombus in the portal vein (PVTT).</p><p><b>METHODS</b>From Jan. 2000 to Jan. 2003, a total of 84 HCC patients with PVTT were divided into five groups based on methed of treatment: Group A (n = 9), HCC resection + PVTT removal + postoperative TACE + thymosin alpha(1); Group B (n = 20), HCC resection + PVTT removal + postoperative TACE; Group C (n = 7), HCC resection + PVTT removal; Group D (n = 38), TACE only; Group E (n = 10), conservative treatment only.</p><p><b>RESULTS</b>The rate of PVTT shrinkage or disappearance of groups A, B, C, D and E was 66.7%, 70.0%, 57.1%, 7.9% and 0, respectively with respective median survival time of 10.0, 7.0, 8.0, 5.0 and 2.0 months. The one year survival rate was 44.4%, 15.0%, 14.3%, 10.5% and 0.</p><p><b>CONCLUSION</b>Resection of HCC and removal of tumor thrombus in the portal vein may have the tumor thrombus cleared in most of the patients and postoperative TACE and thymisin alpha(1) treatment may improve their survival.</p>

Transcatheter hepatic arterial chemoembolization and thymosin alpha1 in postoperative treatment of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the effect of postoperative transcatheter hepatic arterial chemoembolization (TACE) and thymosin alpha(1) (T(alpha1)) treatment on recurrence of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>From Jan 2000 to Dec 2002, 57 patients with HCC were randomly divided into three groups: group A (n = 18) received hepatectomy plus postoperative TACE and T(alpha1), group B (n = 23) received hepatectomy plus postoperative TACE and group C (n = 16) received hepatectomy only. The recurrence rate, the time to tumor recurrence and the median survival for the three groups were investigated.</p><p><b>RESULTS</b>For group A, B and C, the 1 year recurrence rate was 83.3%, 87.0% and 87.5% (P = 0.926), respectively. The time to tumor recurrence was 7.0, 5.0 and 4.0 months (P = 0.039), respectively. The median survival was 10.0, 7.0 and 8.0 months (P = 0.002), respectively.</p><p><b>CONCLUSION</b>Postoperative TACE plus Talpha(1) treatment for HCC patients does not decrease the recurrence rate but may delay its occurrence and prolong surviving time.</p>

Pilot study on clinical application of hepatic perfusion with multi-slice spiral CT / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To research the value of hepatic perfusion with multi-slice spiral CT in the diagnosis of liver diseases.</p><p><b>METHODS</b>Among the 48 patients undergone dynamic CT of the liver, 20 were volunteers without hepatic disorder, 17 with cirrhosis, 11 suffered from hepatic cancer. The perfusion indexes were calculated and compared.</p><p><b>RESULTS</b>(1) Compared with the control group, HPP (ml/min/ml), PPI and HPP/HAP of patients with cirrhosis were significant lower (HPP: 0.49+/-0.19 vs 0.60+/-0.16, P=0.038; PPI: 0.58+/-0.14 vs 0.67+/-0.06, P=0.015; HPP/HAP: 1.63+/-0.87 vs 2.12+/-0.65, P=0.04), whereas HPI was higher (0.42+/-0.14 vs 0.33+/-0.06, P= 0.015), which indicated the decrease of portal inflow and the increase of arterial inflow in cirrhosis patients. (2) Patients with hepatic cancer got a significant higher average HAP than that in volunteers and cirrhosis patients (F=11.71, P<0.001), while their HPP and HPP/HAP showed significant declining (F=22.84, P=0.0001; F=20.67, P<0.0001, respectively), which implied that hepatic cancer was mainly supplied by artery.</p><p><b>CONCLUSIONS</b>Hepatic perfusion with multi-slice spiral CT is an non-invasive technique to evaluate the arterial and portal inflow separately, which can inflect the hemodynamic change of the lesion by the perfusion indexes, and identify the condition of the tissue round the lesion prior to morphologic change. This method shows important value of diagnosis and differential diagnosis in hepatic diseases.</p>

Deactivation of medial prefrontal and posterior cingulate cortex in anxiety disorders / 中华放射学杂志

Objective We used blood oxygenation level dependent-functional MR imaging(BOLD- fMRI)to explore the characteristics of deactivation patterns in patients with anxiety disorders and the underlying neural mechanism of this disease.Methods Ten patients and ten healthy controls participated the experiments.All subjects performed the trait portion of the State-Trait anxiety Inventory(STAI-T)prior to the fMRI scans.The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to emotionally neutral words alternating with no words(experiment 1)and threat related-words alternating with emotionally neutral words(experiment2).During fMRI scanning,subjects were instructed to closely listen to each stimuli word and to silently make a judgment of the word's valence.Data were analyzed with statistical parametric mapping(SPM 99).Individual and group analysis were conducted.Results Mean STAI-T score was significantly higher for patients group than that of controls(58?8 for patients group and 33?5 for controls,t=8.3,P

The comparative study of MRI appearances of ovarian thecoma with pathologic findings / 中华放射学杂志

Objective To analyze and compare the MRI appearances of ovarian thecoma with pathologic findings in order to improve the knowledge of the disease.Methods Nineteen cases of ovarian thecoma confirmed by histopathology were analyzed.MRI morphological characteristics and signal intensity of the lesions were observed and compared with findings of pathomorphology.Correlation analysis between tumor size and amount of ascites was made.Results Ovarian thecoma displayed iso-or hypointense signal on T_1WI and significant hypointensity in the focal lesion on T_2WI.Hyperintensity occurred when cystic degeneration of the lesions existed.Fibrous septation was detected in some lesions.After enhancement,most lesions showed mild early enhancement with slight increase on the delayed phase.Pathological necrosis and cystic degeneration were seen in 9 cases which corresponded to the number and shape of the cystic lesions on MRI.A large amount of collagen hyperplastic was found between the oncocytes microscopically in 15 cases, which displayed significant hypointensity in the focal lesion on T_2WI;another 4 cases showed relatively less amounts of collagen hyperplastic and more oncocytes,which appeared moderate intensity in the focal leisom on T_2WI.The amount of ascites was not significantly correlated with the lesion size(r=0.43,P=0.10). Conclusions Hypointensity on T_2WI and mild enhancement pattern due to poor blood supply are the characteristics of ovarian thecoma.The MR findings can reflect the pathologic features of the tumor,which is helpful in the diagnosis and differential diagnosis.