ABSTRACT
Objective@#To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). @*Materials and Methods@#Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. @*Results@#The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). @*Conclusion@#The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.
ABSTRACT
Objective:To explore the quantitative characteristics and vulnerable features on coronary CT angiography (CCTA) of coronary atherosclerotic plaques according to age-based classification.Methods:A total of 2 660 consecutive out-patient patients after screening for exclusion criteria were enrolled in a single-center prospective cohort study from January to December of 2017 in Fuwai Hospital. They were all suspected with coronary heart disease and referred for CCTA examinations. There were 5 078 main branches of coronary artery with atherosclerosis plaque. 2 660 patients and 5 078 branches were individually divided into five groups according to their age: ≤40, 41-50, 51-60, 61-70, >70-year-old group. The plaque burden and volume percentage of fibrous, lipid and calcified components of plaques were measured, as well as the incidence of CT vulnerable signs. Chi-square test and rank sum test were used to compare the differences of baseline data and the distribution characteristics of the above imaging parameters in different age groups. The correlation between routine risk factors of coronary heart disease and vulnerable plaque of CT was also analyzed by logistic regression.Results:The characteristics of each plaque component of age-based groups were different. The main component of coronary plaques in all age groups was fibrous and the proportion was 83.33% (75.42%, 91.60%), 81.51% (74.44%, 89.07%), 81.85% (74.88%, 88.88%), 82.33% (74.03%, 89.20%),80.99% (73.43%, 88.19%) (χ 2=9.775, P=0.044) respectively. The calcification volume percentage of plaque increased significantly with aging: 1.10% (0, 5.53%),1.19% (0, 7.58%), 2.29% (0, 10.45%), 3.97% (0, 14.25%), 6.84% (0.40%, 17.55%) (χ 2=146.719, P<0.001); the lipid volume percentage first increased and then decreased with aging, and the value was highest in 40-50-year-old group: 10.94% (5.71%, 19.31%), 12.18% (5.81%, 19.56%), 10.48% (4.83%, 17.14%), 8.14% (3.23%, 15.11%), 7.20% (2.44%, 13.68%) (χ 2=137.470, P<0.001).The results of CT vulnerable characteristics of plaques showed that the incidence of positive remodeling and low-attenuation plaque sign and also the percentage of vulnerable plaque identified by CT all first increased and then decreased, also reached the maximum at 41-50 years old (73.9%, 91.9%, 73.4%) (χ 2=8.678, 3.970, 21.577; P=0.07, P<0.001, P<0.001). Age and sex (male) were independent risk factors for vulnerable plaques identified by CT according to logistic regression analysis. The proportion of CT vulnerable plaques decreased with age (regression coefficient was-0.08). However, the percentage of CT vulnerable plaque in male was higher than that in female patients (regression coefficient was 0.188). Conclusions:The plaque burden increased with age. The lipid volume percentage and incidence of vulnerable plaques identified by CT both increased firstly and then decreased with the highest values in 40-50-year-old group.
ABSTRACT
Objective:To explore risk factors of death in type A intramural hematoma (IMH) patients with conservative therapy and provide important information for clinical risks stratification and decisions-making.Methods:This retrospectively study enrolled 130 patients diagnosed with type A IMH in the first CT examination at Fuwai Hospital of Chinese Academy of Medical Sciences and only received conservative therapy between September 2009 and June 2018. Baseline clinical and CT characteristics were recorded. All patients enrolled were followed up. The endpoint was aortic disease-related death, patients were divided into endpoint group and non-endpoint group according to whether or not an endpoint event occurs. Difference between two groups of normally distributed continuous variables, non-normally distributed continuous variables and categorical variables were tested by independent sample t test, Mann-Whitney U test and chi-square test or Fisher′s exact test, respectively. Independent risk factors related to outcomes were assessed with Cox regression analysis and survival analysis. Results:In baseline CT data, the mean value of the maximum aortic diameter (MAD) was (49.2±6.9) mm, and the median value of the maximum hematoma thickness (MTH) was 11.0 (8.5, 13.2) mm. There were 56 and 30 patients with ulcer-like projection (ULP) and intramural blood pool (IBP), respectively, which including 36 patients with ULP of ascending aorta, 51 patients with pericardial effusion and 50 patients with pleural effusion. During a median follow-up time of 1 050 (242, 1 949) days, 26 patients experienced aortic disease-related death. Compared with non-endpoint group patients, patients who experienced aortic disease-related death showed older age and larger MAD( t=2.363, 3.640, P=0.020,<0.001), higher proportion of aortic atherosclerosis, ULP and pericardial effusion (χ 2=5.275, 6.596, 9.325, P=0.022, 0.010, 0.002).In Cox regression multivariate analysis shows that aortic atherosclerosis [hazard ratio (HR)=3.48, P=0.043], ULP (HR=2.66, P=0.019) and pericardial effusion (HR=2.49, P=0.030) were independent risk factors for aortic disease-related death. Conclusions:Aortic atherosclerosis, ULP and pericardial effusion are independent predictors of subsequent aortic disease-related death for type A IMH patients with conservative therapy, identifying these risk factors is helpful for further risk stratification and decisions-making.
ABSTRACT
Objective To investigate the feasibility of using a specific iodine delivery rate in coronary computed tomography angiography(CCTA) to obtain high and uniform image quality in patients with different body weight, according to the latest guideline of contrast medium injection protocol. Methods A total of 159 consecutive patients who had undergone CCTA for ruling out coronary heart disease were prospectively enrolled and divided into five subgroups according to body weight: ≤60, 60-70, 70-80, 80-90,>90 kg, the former three subgroups were scanned using 100 kV tube voltage, the latter two subgroups were scanned using 120 kV tube voltage. All patients were injected with the contrast agent of which concentration was 370 mgI/ml, using a specific iodine delivery rate (1.0, 1.2, 1.4, 2.0 and 2.2 mgI/s, respectively). The Shapiro?Wilk test was performed to assess the normality of data distribution, including the CT attenuations in the aortic root, proximal left anterior descending artery, the distal segments of the right coronary artery, signal?to?noise ratio (SNR), contrast?to?noise ratio (CNR) and subjective image quality scores. Parameters accorded with normal distribution were compared by analysis of variance (ANOVA). Results There were no statistical differences in the CT attenuations (HU) of the aortic root (368.7±32.4, 356.7±30.8, 366.0±34.6, 360.7±25.0, 352.3±28.4, respectively, F=1.541, P=0.19); This was also true for the proximal segments of the left anterior descending arteries and the distal segments of right coronary arteries (all P>0.05). Also, there were no statistical differences of SD, CNR and SNR in neither the proximal part of the left anterior descending coronary arteries nor the distal right coronary arteries in these five groups (all P>0.05); There were no statistical differences in subjective scores of each group (3.91±0.23, 3.83±0.30, 3.94± 0.21, 3.90±0.27, 3.95±0.20, respectively, F=1.202, P=0.36). Conclusion For patients undergoing CCTA with different body weights, using guideline introduced iodine delivery rate injection protocol of contrast medium could achieve consistent vascular enhancement with satisfied image quality. This protocol is promising to make personalized and standardized CCTA possibly.
ABSTRACT
Objective To investigate the feasibility, image quality, and safety of low?tube?voltage, low iodine load iso?osmolar contrast comprehensive cardiac and aortoiliac CT angiography (CTA) for transcatheter aortic valve replacement (TAVR) planning. Methods Ninety?eight consecutive TAVR candidates prospectively underwent combined contrast?enhanced CTA of the aortic root complex and vascular access route. Patients were assigned to group A (2nd generation dual?source CT, 100 kV, contrast 270 mgI/ml iodixanol) or group B (2nd generation dual?source CT, 120 kV, contrast 370 mgI/ml). Mean vascular attenuation, noise, signal?to?noise ratio (SNR), and contrast?to?noise ratio (CNR) of aorta including aortic root, aortic arch, descending aorta at level of diaphragm, abdominal aorta at level of renal artery and femoral artery were compared. Patient creatinine levels before the examination of CTA and during follow?up (24—48 h) were measured. Results The image quality score of aortic root and whole aorta was (4.2±0.7) and (4.3±0.4) respectively in experimental group, (4.3±0.6) and (4.3±0.3) in control group. No significant difference in subjective image quality score between two groups including aortic root image and whole aorta image (t=-0.130,-0.155,P=0.694, 0.822). The image noise of aortic root and femoral artery were higher in experimental group than that in control group (P<0.05). Radiation dose in experimental group was higher than that in control group [(6.1 ± 0.4) vs. (8.0 ± 0.4) mSv, t=-9.253, P=0.001]. There were no significant changes in creatinine levels among groups during the follow?up. Conclusion TAVR candidates can be safely and effectively evaluated by a comprehensive CTA protocol with low iodine load iso?osmolar contrast using low?tube?voltage acquisition.
ABSTRACT
Objective To investigate the possibility of showing coronary bio-degradable stent(BDS) and luminal stenosis by using coronary computed tomography angiography(CCTA). Methods A total of 27 consecutive patients who had undergone CCTA follow-up for BDS implantation were enrolled from January to June of 2015. The duration between CCTA and coronary BDS implantation was 1 year. The patients' age were(54 ± 7)years in average. There were 18 male and 9 female patients. Of those patients, 18 BDS were implanted in left anterior descending coronary artery, and 9 in right coronary artery. Quantitative measurement of luminal stenosis, average areas of noncalcified and calcified plaque in proximal segment of stent (5 mm proximal to the stent), intra-stent, and distal segment of stent (5 mm distal to the stent) were performed and compared, using Kruskal Wallis as well as Mann-Whitney U tests. Results The mean length of BDS was (16.1 ± 4.4)mm. Coronary diameter stenosis (%) of the proximal segment, intra-stent and distal segment to BDS were 14.4%(11.5%, 23.1%), 23.4%(17.4%, 27.4%), and 16.4%(12.7%, 24.1%), respectively(H=10.17,P<0.05). The mean areas of noncalcified plaques were 6.6 (4.8, 8.4), 7.0 (5.4, 9.3) and 5.5 (4.1, 7.6) mm2, respectively in the segments of proximal, intra and distal to the BDS. The mean areas of calcified plaques were 0.5 (0, 1.5), 0.1 (0, 0.8) and 0.1 (0, 0.2) mm2, respectively, whereas no significant differences were found (P>0.05). Conclusion CCTA could be used to assess coronary bio-degradable stent and luminal stenosis without affection of mental artifact. Intra-stent restenosis was more frequently observed than proximal and distal segments of the BDS.calcified plaques were 0.5 (0, 1.5), 0.1 (0, 0.8) and 0.1 (0, 0.2) mm2, respectively, whereas no significant differences were found (P>0.05). Conclusion CCTA could be used to assess coronary bio-degradable stent and luminal stenosis without affection of mental artifact. Intra-stent restenosis was more frequently observed than proximal and distal segments of the BDS.
ABSTRACT
Objective To assess effects of stress dynamic CT myocardial perfusion imaging (CT-MPI) combined with coronary CT angiography (CCTA) on the diagnosis of myocardial perfusion defects in coronary artery disease (CAD). Methods Patients with CAD diagnosed by CCTA underwent ATP stress CT-MPI examination. Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (SPECT-MPI) was performed within one week and set as the reference standard. CT-MPI results were qualitatively analyzed, and myocardial blood flow (MBF), myocardial blood volume (MBV) as well as time to peak (TTP) were quantified according to CT-MPI. Effects of CCTA, CT-MPI, and CT-MPI combined with CCTA on predicting myocardial perfusion defects were assessed in comparison with NMPI. Results Thirty patients [(54.8±8.4)years] were enrolled in our study, 20 were men (68%). MBF [(79.3±18.0) versus (135.1± 35.2) ml·100 ml-1·min-1] and MBV [(8.9±2.9) versus (13.8±8.9) ml/100 ml] were significantly decreased in hypoperfused segments compared with normal segments, while TTP was increased in hypoperfused segments [(13.9 ± 2.5)s] compared with normal segments [(9.1 ± 2.1)s] (t=0.302, 0.866 and 0.024 respectively, all P values<0.01). The sensitivity, specificity of CT-MPI for identifying segments with perfusion defects were 91.3%(147/161), 84.6%(281/332), respectively. On a per-vessel basis, the area under the receiver operating characteristic curve for predicting myocardial perfusion defects were 0.635(95%CI:0.517—0.753) for CCTA, 0.709(95%CI:0.599—0.819)for CT-MPI, and 0.837(95%CI:0.749—0.925)for CT-MPI combined with CCTA, respectively. Conclusions The performance of stress dynamic CT-MPI in the diagnosis of myocardial perfusion defects in CAD was good. One-stop examination of CT-MPI combined with CCTA improves the diagnostic accuracy for identifying flow-obstructing stenosis.
ABSTRACT
Objective@#To compare the characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different bicuspid aortic valve (BAV) morphology.@*Methods@#A total of 197 patients who underwent aortic valve replacement between April 2014 and March 2015 and were diagnosed with BAV by pathology were included, and their clinical data were retrospectively analyzed. Patients were divided into raphe+ group(109 cases) and raphe- group(88 cases) according to the presence or absence of raphe, and L-R group(fusion of left and right cusp, 125 cases) and L/R-N group(fusion of left or right and noncoronary cusp, 72 cases) according to fusion type of the cusps. The characteristics of aortic valve dysfunction and ascending aorta dimension in patients with different BAV morphology were compared.@*Results@#(1) Aortic stenosis incidence was lower in raphe+ group than in raphe- group(22.9%(25/109) vs. 69.3%(61/88), P<0.001). Aortic regurgitation incidence was higher in raphe+ group than in raphe- group (61.5%(67/109) vs. 22.7%(20/88), P<0.001). Incidence of type 1 of aortic root dilation was higher in raphe+ group than in raphe- group (23.9%(26/109)vs.10.2%(9/88), P=0.024). (2) Aortic stenosis incidence was lower in L-R group than in L/R-N group(29.6%(37/125) vs. 68.1%(49/72), P<0.001). Aortic regurgitation incidence was higher in L-R group than in L/R-N group (59.2%(74/125) vs. 18.1%(13/72), P<0.001). Incidence of type 3 of aortic root dilation was lower in L-R group than in L/R-N group(10.4%(13/125) vs. 37.5%(27/72), P=0.006). (3) Aortic stenosis incidence was lower in L-R patients than in L/R-N patients(15.1%(13/86)vs. 52.2%(12/23), P=0.001), and aortic regurgitation incidence was higher in L-R patients than in L/R-N patients in raphe+ group(73.3%(63/86)vs. 17.4%(4/23), P<0.001).@*Conclusion@#There is significant difference in the type of valvular dysfunction and ascending aorta dilatation in patients with different morphological characteristics of BAV.
ABSTRACT
Purpose To detect high mobility group protein A2 (HMGA2) expression in breast cancer, and to analyze its relationship with clinicopathological features and the levels of HMGA2 in different molecular subtypes of breast carcinomas. Methods An immu-nohistochemical study was undertaken for measuring the levels of HMGA2 in 58 breast carcinomas. Results ( 1 ) The expression of HMGA2 was 0, 62. 5%, 60. 0%, 100. 0% and 80. 0% in Lum A, Lum B, HER-2-OE, basal-like breast carcinoma (BLBC) and un-classification phenotype respectively ( triple negative breast cancer, 92. 3%) . High expression of HMGA2 was associated with the tri-ple-negative breast cancer (TNBC) subtypes (P<0. 01). (2) An association was identified between high expression of HMGA2, and high tumor grade, lymph node metastasis (P<0. 05), positive Ki-67, CK5/6 and EGFR (P<0. 05), negative ER and PR (P<0. 01), but no association was observed for tumor size and patients’age. Conclusion An association is identified between high ex-pression, and high tumor grade, lymph node metastasis, positive Ki-67, EGFR and CK5/6, negative ER and PR, that means a high expression of HMGA2 is associated with an adverse outcome in breast cancer. High expression of HMGA2 are associated with the TNBC subtypes. Thus recognizing HMGA2 as a rational target in TNBC. The results of the study have implications for therapeutic target iden-tification and the design of future clinical trials for TNBC.
ABSTRACT
Purpose To study the levels and subcellular localization of β-catenin in 5 different molecular subtypes of breast carcino-mas. Methods An immunohistochemical study was undertaken for measuring the levels and subcellular localization ofβ-catenin in 58 breast carcinomas. Results ( 1 ) The cytoplasmic expression of β-catenin was 21. 1%, 50%, 60%, 100% and 60% ( TNBC 84. 6%) in Lumina A, Lumina B, HER-2-OE, basal-like breast carcinoma ( BLBC) and uncl phenotype respectively. High cytoplas-mic expression was associated with the BLBC and TNBC subtypes ( P<0. 05 ) . ( 2 ) An association was identified between high cyto-plasmic expression of β-catenin, and high tumor grade (P<0. 01), abnormal E-cadherin, positive Ki-67 and CK5/6 (P<0. 05), negative ER and PR (P<0. 01), but no association was observed for lymph node metastasis, tumor size and patients’age. Conclu-sion An association is identified between high cytoplasmic expression, and high tumor grade, positive Ki-67 and CK5/6, negative ER and PR, that means a high cytoplasmic expression ofβ-catenin is associated with an adverse outcome in breast cancer. High cytoplas-mic expression are associated with the BLBC and TNBC subtypes whcih recognizing Wnt signaling as a rational target in TNBC and BLBC. The results of the study have implications for therapeutic target identification and the design of future clinical trials for TNBC and BLBC.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the feasibility of using lower iodine concentration (270 mgI/ml) contrast medium, lower X-ray tube voltage (100 kVp) and iterative reconstruction (IR) to reduce both iodine load and radiation dose but keep the image quality of coronary CT angiography (CCTA).</p><p><b>METHODS</b>A total of 80 consecutive patients with suspected coronary artery disease were prospectively assigned to one of two groups via computer central system from January to May 2013. The control group (n = 40) was scanned using dual-source CCTA protocols of 120 kV, 370 mgI/ml Iopromide and filtered back projection reconstruction with a vascular algorithm (B26f). The study group (n = 40) was scanned using 100 kV, 270 mgI/ml Iodixanol and sinogram affirmed iterative reconstruction with a vascular algorithm (I26f). Other scan parameters and contrast injection protocol were similar between the two groups. Attenuation in the ascending aorta and coronary arteries along with image noise were measured. Images were reconstructed, measured and graded, and iodine load and effective radiation dose were calculated.</p><p><b>RESULTS</b>The body mass index ((25.3 ± 3.0) kg/m² vs. (25.4 ± 3.0)kg/m², P = 0.852), image quality scores (4.70 ± 0.52 vs. 4.63 ± 0.59, P = 0.545), mean signal-to-noise ratios (22.2 ± 5.5 vs. 23.6 ± 5.8, P = 0.277), and contrast-to-noise ratios (35.6 ± 17.6 vs. 41.1 ± 17.6, P = 0.163) were similar between the control group and study group. Mean iodine loads were significantly reduced in the study group ((18.49 ± 0.75)g) compared to control group ((25.27 ± 0.94)g), P< 0.001). Mean effective radiation doses were also significantly reduced in the study group ((2.31 ± 0.73) mSv) compared to that in control group ((3.52 ± 1.16) mSv), P< 0.001).</p><p><b>CONCLUSION</b>Use of low X-ray tube voltage and iterative reconstruction allows lower iodine load and effective radiation dose application at CCTA without image quality reduction.</p>
Subject(s)
Humans , Algorithms , Aorta , Body Mass Index , Contrast Media , Coronary Angiography , Coronary Artery Disease , Feasibility Studies , Fluoroscopy , Injections, Intravenous , Iodine , Iohexol , Tomography, X-Ray Computed , Triiodobenzoic AcidsABSTRACT
Objective To observe the expression of high mobility group A 1(HMGA1)protein in pituitary adenoma(PA)and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index(LI)of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-ag-gressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA (P=0.79), as well as among different immunophenotypical variants of PA(P=0.28).The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA(0.50 ±0.20 vs 0.24 ±0.17, P=0.000).Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA(0.60 ±0.20 vs 0.24 ±0.18, P=0.000).The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA(0.52 ±0.20)and the lowest was in micro-sized PA(0.18 ±0.17).A similar trend was found in Hardy's grade I(0.18 ±0.17),II(0.30 ± 0.20)and III-IV(0.50 ±0.20)(P=0.003).The area under the ROC curve was 0.918(>0.90).When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valua-ble predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make repro-ducible evaluation on prognosis of PA .
ABSTRACT
Objective To investigate the difference of CCAAT/enhancer-binding protein α (C/EBP-α) gene induced apoptosis between hepatocytes and hepatic stellate cells (HSC) in mice with liver fibrosis.Methods Sixty BALB/c mice were evenly divided into normal group,model group,treatment group,blank control group and negative control group,12 mice in each group.Except the mice of normal control group,the mice of other groups were treated with intraperitoneal injection of CCl4 to establish liver fibrosis mice model.Mice of treatment group,blank control group and negative control group were administrated with C/EBP-α carried adenovirus (Ad-C/EBP-α),phosphate buffered solution and empty vector of adenovirus (Ad-EGFP) respectively through tail vein for the first week.The expression of C/EBP-α and α-smooth muscle actin (α-SMA) was detected by immunohistochemistry method.Sinusoidal endothelial structure of peri-portal regions and far from portal regions was observed by transmission electron microscope (TEM).Terminal dexynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was applied to detect apoptosis of cells in liver tissue.The degree of liver fibrosis in mice was determined with sirius red staining and hydroxyproline content measurement.Single factor variance analysis was performed for comparison among multiple groups,and t test was used for comparison between two groups.Results C/EBP-α was expressed in nucleus of hepatocyte in normal control group mice.The expression decreased in model group,blank control group and negative control group.However,the expression of C/EBP-α of treatment group increased,and mainly expressed in cells located in perisinusoidal and perivascular.Hepatic sinusoids was distorted,blood vessel wall thickened.Hepatocyte degeneration and lots of lipid droplets was found in model group,blank control group and negative control group.The thicken degree of endothelial layer of blood vessel of treatment group was lower than that of model group.The percentage of sirius red positive cells of normal group,model group,treatment group,blank control group and negative control group was (0.10±0.03)％,(5.81±0.32)％,(2.32±0.45)％,(6.34± 0.81)％ and (6.10± 0.92)％,respectively; content of hydroxyproline was (0.07±0.00) μg/mg,(0.69 ± 0.10) μg/mg,(0.19±0.06) μg/mg,(0.56±0.03) μg/mg and (0.64±0.08) μg/mg,respectively; the percentage of α-SMA positive cells was (0.50 ±0.03)％,(5.30 ± 0.52)％,(2.15 ± 0.29)％,(5.53 ± 0.43) ％ and (5.42 ± 0.25) ％,respectively; the number of TUNEL positive cells was (0.25 ± 0.08),(0.15±0.02),(7.10±1.53),(0.13±0.03) and (0.18±0.07),respectively.The differences between the groups were statistically significant (F=113.74,148.29,292.43 and 140.25,all P＜0.05).The difference between normal group and model group,between model group and treatment group,between treatment group and blank control group,between treatment group and negative control group were statistically significant (tarirus positive cell =-52.54,-16.20,-10.60 and-7.99,thydroxyproline content =-168.00,11.53,11.07 and 12.54,ta SMA pusitive cells-24.77,-13.82,15.94 and 18.37,tTUNEL positive cells =3.26,-11.91,-11.95 and-11.88,all P＜ 0.05),there was no statistically significant difference between model group and blank control group,between model group and negative control group (both P＞0.05).TUNEL positive cells mainly located in perisinusoidal and perivascular of liver in mice,which was consistent with the distribution of α-SMA-positive cells.Conclusion C/EBP-α could effectively relieve CCl4 induced liver fibrosis in mice mainly through inducing HSC apoptosis,however no apoptosis effect on hepatocytes.
ABSTRACT
Objective To investigate the clinicopathological features of human immunodeficiency virus (HIV) negative plasmablastic lymphoma (PBL) with no-immunosuppression,so as to accelerate the understanding for this group of disease.Methods The histological features of 6 HIV-PBL patients with no-immunodeficiency were retrospectively analyzed.Epstein-Barr virus (EBV) status was detected by in situ hybridization.Then,immunohistochemistry and fluorescence in situ hybridization (FISH) method were used to determine the immunophenotype,latent status of EBV and MYC translocation in PBL,respectively.Results HIV-PBL showed monotonous proliferation of plasmablastoid or immunoblast-like cells.Giant cells and necrosis could be observed,with less reactive cells in the background and higher mitoses.All the cases had EBV infection and type Ⅰ latency status of EBV (LMP1-/EBNA2-),and expressed terminal B-cell differentiation immunophenotype (CD20-/CD3-/CD138+/Kappa or Lambda+).Six HIV-PBL patients were elderly (median age was 69.5 years old),had equal incidence of PBL between male and female and showed high frequency of involvement of extranodal and extraoral lesion sites (6 cases and 5 cases,respectively).Median sutvival was 25.5 months.In addition,3 HIV-PBL patients had IGH/MYC translocations.Conclusions HIV-PBL is a new entity with unique clinical features including no-HIV infection,elderly,EBV positivity,and more involvement in extranodal and extraoral sites.HIV-PBL should be distinguished from HIV+ PBL.
ABSTRACT
Objective To investigate the expression of connective tissue growth factor(CTGF),coll agen I and collagen Ⅲ in sacroiliac joint(SIJ)of patients with spondyloarthropathy(SpA).Methods Thirty patients with SpA,including 17 patients with grade Ⅱ saeroiliitis and 13 patients with grade Ⅰ sacroiliitis,were performed on CT guided needie biopsy of SIJ.After sacroiliitis were confirmed by staining with hematoxylin and eosin in sacroiliac joint tissue sample,immunohistochemical assay was performed to determine the expression of CTGF,collagen Ⅰ and collagen Ⅲ in sacroiliac ioint tissue.Univariate Chi-square test was used for data comparison between multiple groups and t-test was used for two group data comparison.Results Contrast to healthy controls,CTGF were found upexpressed on the cytoplasm of inflammatory cells in pannus and bone marrow of sacroiliac tissue samples of patients with SpA,while collagen I and collagen Ⅲ were found up-expressed in bone,cartilage and ligament tissue[(57.9±42.4)/HP vs(2.7±2.5)/HP P<0.05,0.298±0.080 vs 0.044±0.024 and 28.254±41.165 vs 0.105±0.054.P<0.05 respectively].Conclusion CTGF,collagen Ⅰ and collagen Ⅲ are up-expressed in SIJ of SpA patients.CTGF may play an important role in articular cartilage fibrosis and ossification of SpA.
ABSTRACT
Objective To investigate the expression of transforming growth factor beta (TGF-β) and Smad signaling in ankylosing spondylitis (AS) and to explore their roles in the pathogenesis. Methods Fiftythree patients with AS were included in the study. In these 53 cases, 30 patients were performed computed tomography-guided needle biopsy in sacroiliac joint. Serum TGF-β_1 was determined by enzyme-linked immunosorbent assay (ELISA). Immunohistological studies were performed with the streptavidin-peroxidase conjugated methods to assess the expression of TGF-β_1, p-smad3 and Smad7 in sacroiliac joint tissue sample.One-way ANOVA, two independent samples t test and kolmogoorov-Simimov test were used to do statistical analysis. Results In 53 cases patients with AS, 20 cases were with high level Erythro-cyte sedimentation rate(ESR) and C-reactive protein (CRP), while those of the other 33 cases were normal. Serum average TGF-β_1level [ (15.9±5.6) ng/ml ], in patients with high level ESR/CRP [(5.4±5.8) ng/ml ] was significantly increased as compared to the controls and patients with normal ESR/CRP [(4.1±3.6) ng/ml] (P<0.05). There was no expression of TGF-β_1 could be detected in the pannus and bone marrow in SI joints tissue of 30 cases with AS, while decreased level of smad7 expression was detected. In addition, p-smad3 expression was found in the nuclear. Conclusion TGF-β_1 signaling may play an important role in the inflammatory erosion and cartilage fibrosis of sacrojlitis in AS.
ABSTRACT
Objective To explore the value of bone marrow biopsy ( BMB) in early diagnosis of aggressive NK cell leukaemia( ANKL). Methods The clinical data of ten cases with ANKL were retrospectively analyzed,morphology, immunophenotype and hybridization in situ of bone marrow were analyzed. Results In all cases, BMB showed hypercellular, with 4 cases markedly hypercellular. Atypical neoplastic cells demonstrated focal and fascicle growth pattern and were composed of median-sized cells with a few cytoplasm, slightly irregular nuclei, fine chromatin, indistinct nucleoli and some mitotic counting. Characteristic histocytes with haemophagocytosis were observed in the bone marrow slides. The neoplastic cells were positive for CD2、CD3e、CD7、CD56、TIA-1. EBER was found positive in all cases. Conclusion Bone marrow biopsy and immunochemistry were essential and reliable diagnostic tool in early diagnosis of ANKL.
ABSTRACT
Objective To discuss the effect of correct limb emplacement on the prevention of shoulder pain of patients with cerebral apoplexy. Methods Forty-one patients after cerebral apoplexy with motor dysfunction of upper limbs but with no sensory disability and shoulder pain were randomly divided into the control group (20 cases)and the observation group (21 cases).Both two groups received routine passive activity and massage of limbs.The observation group was given correct limb emplacement based on routine nursing. Then we evaluate the pain of ariticulus humeri when in the full range of anterior flexion movement after two months. Results The incidence of shoulder pain in the control group was 65.0%,which was statistically lower than that of the observation group (19.0%), χ2=8.91,P ＜ 0.01. Conclusion Correct limb emplacement had preventive effect on patients with cerebral apoplexy.
ABSTRACT
Objective To explore the correlation between expression of VEGF in colorectal cancer and pathological factors.Methods The expression of VEGF in 99 cases with colorectal cancer was examined by immunohistochemical staining.Results It showed that the expression of VEGF in colorectal cancer was correlated with depth of invasion and lymph node metastasis and was not correlated with tumor region,and histologic type.The frequency of positive cases in patients with lymph node metastasis was significantly higher than that in patients without lymph node metastasis(P
ABSTRACT
Immunocytochemistry, flowcytometry and nucleic acid in situ hybridization were used to observe the effect of sodium tanshinon Ⅱ-A silate (DS201) on proliferation of pulmonary artery smooth muscle cell (PASMC) induced by hypoxic endothelial cell condition medium (HECCM). The results showed that DS201 could obviously hinder PASMC to enter S phase from G0/G1 phase (P<0.05), and decrease the expression of PCNA and platelet-derived growth factor (PDGF)-A and B chain mRNA in PASMC respectively, (P<0.01). It was suggested that DS201 could probably inhibit the prolifertion of PASMC mediated by HECCM, through down-regulating the expression of PDGF-A and B chain gene.