ABSTRACT
Among ankle injuries, the injury to the distal tibiofibular syndesmosis is common and likely neglected. The stability of the distal tibiofibular syndesmosis is related to the depth of the fibular notch. In imaging diagnosis, X-ray examination cannot be used for a definite diagnosis of the injury to the distal tibiofibular syndesmosis. For diagnosis of the distal tibiofibular separation>3 mm, CT scan can be accurate but is not sensitive enough for a separation<1 mm while MRI is more sensitive in diagnosis of the injury. Arthroscopy has gradually been used as the "gold standard" in diagnosis of the injury to the distal tibiofibular syndesmosis due to its advantage of direct vision. The distal tibiofibular separation occurs in the injuries of pronation external rotation Ⅳ°, supination external rotation Ⅲ° and Ⅳ°, and pronation abduction Ⅱ° and Ⅲ° by the Lange-Hansen classification. Most patients with simple stable injury to the distal tibiofibular syndesmosis may have a good prognosis after nonoperative treatment. Surgical anatomic reduction and maintenance of stability of the distal tibiofibular syndesmosis are the basic management principles for unstable distal tibiofibular syndesmosis or the injury to the distal tibiofibular syndesmosis combined with ankle fracture. Screw fixation is the most commonly used in the surgical treatment of the injury. Elastic fixation has the advantages of maintaining the biological characteristics of the distal tibiofibular syndesmosis fretting joint, better reduction fault tolerance, and lower rates of complications and long-term reduction loss. The angle of nail placement is the key to maintaining good reduction of the distal tibiofibular syndesmosis, but there has been little description of the specific methods to ensure the theoretical angle of nail placement in practice. This article also reviews the prospects of the future treatment of the injury to the distal tibiofibular syndesmosis.
ABSTRACT
OBJECTIVE To explore t he protective mechanism of Yangxin dingji capsules on the cardiomyocytes of diabetic cardiomyopathy（DCM）model golden hamsters. METHODS In this study ，golden hamsters were divided into control group （n＝ 10，no modeling ，no drug administration ），model group （n＝9，modeling，no drug administration ），TCM high-dose group [ n＝8， modeling，Yangxin dingji capsules 2 g/（kg·d）]，TCM low-dose group [ n＝8，modeling，Yangxin dingji capsules 1 g/（kg·d）] and empagliflozin group [ n＝9，positive control ，modeling，10 mg/（kg·d）]. All the golden hamsters were gavaged continuously for 8 weeks. The general conditions of golden hamsters were observed during the experiment. Blood glucose ，total cholesterol （TC）and creatine kinase MB （CK-MB），ejection fraction （EF），fractional shortening （FS），interleukin 1β（IL-1β）and transforming growth factor β1（TGF-β1）were detected ；the histopathological changes of myocardium were observed. mRNA and protein expression of nucleotide-binding oligomerization domain-like receptor protein 3（NLRP3），caspase-1，aspirin D （GSDMD），nuclear factor κB （NF-κB）and IL- 1β were detected and observed；DNA damage in myocardial was detected. RESULTS Compared with control group，the blood glucose ，TC，CK-MB，serum IL- 1β，TGF-β1 levels，the mRNA expressions and positive protein expression of NLRP 3，caspase-1，GSDMD，NF-κ B and IL-1 β and protein expression of GSDMD in golden hamsters were significantly increased in model group （P＜0.05 or P＜0.01） EF and FS were significantly decreased （P＜0.01）；the fibers of myocardial cells was disordered ， and the blue-stained collagen fibers between the myocardium increased ； DNA damaged positive cells in myocardial tiss ue of gold hamsters increased significantly. Compared with model group，the above indexes of administration groups were reversed to varying degrees ；the gap of myocardial cells were clear ，and the fibers disorder was improved ；the DNA damaged positive cells in the myocardial tissue were reduced to varying degrees. CONCLUSIONS Yangxin dingji capsule can inhibit the cardiomyocyte pyroptosis and relieve the inflammatory injury of DCM in DCM model golden hamsters by regulating the NLRP 3/caspase-1/GSDMD signaling pathway ，so as to protect the cardiomyocytes.
ABSTRACT
Objective:To investigate the clinical value of radiomics based on computed tomography (CT) examination in preoperative differential diagnosis of pancreatic serous cystadenoma (SCA) and mucinous cystadenoma (MCA).Methods:The retrospective case-control study was conducted. The clinicopathological and imaging data of 154 patients with pancreatic cystic neoplasms who were admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from January 2012 to December 2019 were collected. There were 24 males and 130 females, aged (50±13)years. Of the 154 patients, 99 cases were diagnosed as SCA and 55 cases were diagnosed as MCA. All the 154 patients underwent plain and enhanced CT scan of pancreas before operation. The clinical characteristics, radiology features and radiomics features of all patients were collected to construct the clinical characteristics model, radiology model, radiomics model and fused model. The receiver operating characteristic (ROC) curve of each model was drawn, and those constructed models were evaluated by area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value. Based on the optimal model, the nomogram was constructed. Observation indicators: (1) establishment and validation of clinical characteristics model; (2) establishment and validation of radiology model; (3) establishment and validation of radiomics model; (4) establishment and validation of fused model; (5) nomogram of fused model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Establishment and validation of clinical characteristics model: 3 clinical characteristics, including age, symptoms and preoperative serum CA19-9, were selected using multinomial logistic linear regression analysis to construct the clinical characteristics model. Result of the multinomial logistic linear regression analysis was expressed by formula ①: clinical characteristics model score=0.635-0.007×age+0.054×clinical symptoms+0.108×preoperative serum CA19-9. The ROC curve for the test dataset of clinical characteristics model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of clinical characteristics model were 0.611(95% confidence interval as 0.488?0.734, P<0.05), 56.6%, 66.7%, 56.3%, 41.5%, 78.4% for the training dataset and 0.771(95% confidence interval as 0.624?0.919, P<0.05), 77.8%, 63.1%, 88.5%, 80.1%, 76.7% for the test dataset, respectively. (2) Establishment and validation of radiology model: 5 radiology characteristics, including tumor location, the number of tumors, tumor diameter of cross section, lobulated tumor and polycystic tumor (more than 6), were selected using multinomial logistic linear regression analysis to construct the radiology model. Result of the multinomial logistic linear regression analysis was expressed by formula ②: radiology model score=?0.034+0.300×tumor location+0.202×the number of tumors+0.014×tumor diameter of cross section?0.251×lobulated tumor?0.170×polycystic tumor (more than 6). The ROC curve for the test dataset of radiology model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of radiology model were 0.862(95% confidence interval as 0.791?0.932, P<0.05), 78.8%, 81.8%, 77.5%, 62.8%, 90.2% for the training dataset and 0.853(95% confidence interval as 0.713?0.994), P<0.05), 88.9%, 89.4%, 88.5%, 85.0%, 92.0% for the test dataset, respectively. (3) Establishment and validation of radiomics model: 4 categories of a total 1 067 radiomics features were extracted from 154 patients with pancreatic cystic neoplasms, including 7 first-order histogram features, 53 texture features, 848 wavelet features and 159 local binary pattern features. A total of 896 stable radiomics features were retained to construct the model, based on the condition of intraclass correlation coefficient >0.9. After selected by variance threshold and correlation coefficient threshold, 350 radiomics features were retained. Fifty synthetic radiomics features were constructed based on the original features in order to obtain potential radiomics features, and the total number of radiomics features was 400. After analyzed by the five-fold recursive feature elimination, 22 radiomics features were screened out, including 13 wavelet features, 7 synthetic radiomics features and 2 local binary pattern features. The support vector machine algorithm was used to construct the radiomics model. The penalty coefficient 'C' and parameter 'γ' of the radiomics model were 35.938 and 0.077, respectively. The kernel function of the radiomics model was 'radial basis function kernel'. The ROC curve of radiomics model using 5-fold cross validation was drawn. The average AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the radiomics model were 0.870 ( P<0.05), 83.1%, 81.8%, 83.8%, 73.8% and 89.2%, respectively. (4) Establishment and validation of fused model: the fused model was constructed after selecting the tumor location and lobulated tumor of radiology characteristics and radiomics score. Result of the multinomial logistic linear regression analysis was expressed by formula ③: fused model socre=?0.154+0.218×tumor location?0.223×lobulated tumor+0.621×radiomics score. The ROC curve for the test dataset of fused model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of fused model were 0.893(95% confidence interval as 0.828?0.958, P<0.05), 83.7%, 81.8%, 84.5%, 71.1%, 90.9% for the training dataset and 0.966(95% confidence interval as 0.921?0.999, P<0.05), 91.1%, 84.2%, 96.2%, 94.1%, 89.3% for the test dataset, respectively. (5) Nomogram of fused model: the nomogram of fused model was illustrated with the Youden index of 0.416. Conclusion:The prediction model based on the radiomics signature and radiological features extracted from preoperative CT examination can make the differential diagnosis of pancreatic SCA from MCA.
ABSTRACT
OBJECTIVE@#To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19).@*METHODS@#Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed.@*RESULTS@#The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%).@*CONCLUSIONS@#The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.
ABSTRACT
OBJECTIVE@#To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19).@*METHODS@#Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed.@*RESULTS@#The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%).@*CONCLUSIONS@#The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.
Subject(s)
Humans , Betacoronavirus , China , Coronavirus Infections , Diagnostic Imaging , Pathology , Disease Progression , Pandemics , Pneumonia, Viral , Diagnostic Imaging , Pathology , Tomography, X-Ray ComputedABSTRACT
Since the establishment of the People’s Republic of China, the development of China’s official de-velopment assistance for health has been going through three phases. To date, it has developed in many forms, inclu-ding the dispatch of medical team and the construction of health facilities. Since the market reforms, the global con-text together with the domestic socioeconomic foundations have changed; the impact of China’s relatively simple and segmented development assistance for health on the development of health systems in developing countries is limited;the effectiveness of assistance has been watered-down due to segmentation and vague management and accountability systems, as well as the lack of an overarching strategy;China’s health institutions, techniques and products suffer va-rious obstacles in their transfer to other countries where rules are dominated by western countries;compared with the increasing and multiple demands of development assistance for health from developing countries, the capacities of co-operation need to be further developed. As the paper suggests, use the “new major-country” and “new morality-in-terest” and“human oriented” concepts, as well as the ideology of“aid in order to develop, develop in order to coop-erate, so as to develop hand-in-hand” to guide China’s development assistance for health;innovate stereo-aid models to adapt to the changed foreign and domestic socioeconomic context; reform the development assistance for health management system and define rights and obligations appropriately;strengthen coordination and information sharing;link development assistance for health with global health governance to promote a maximized spillover effect;mobilize the civil society with strengthened guidance and supervision.
ABSTRACT
With the rapid economic growth and social development in the BRICS countries, the role of devel-opment assistance for health is becoming more and more significant. This paper describes the scales, recipient coun-tries, mechanisms and characteristics and management systems of development assistance for health in BRICS coun-tries. The paper suggests that a) it is necessary to set up a centralized international aid management agency;b) the mode of development assistance for health must be optimized;c) the scale of development assistance for health shall be increased ( over time);d) each BRIC country should use its own comparative advantages and development experi-ence to carry out development assistance for health while strengthening the cooperative power among the BRICS coun-tries;e) development assistance for health data should be more transparent and open;f) the evaluation of develop-ment assistance for health must be established and perfected.
ABSTRACT
Objective To study the image features and clinical significance of 3-dimensional (3-D)and multiplanar reconstruction with spiral CT(SCT) in cervical spinal fractures.MethodPlain film radiography and spiral CT scanning were taken for 26 cases of cervical spinal fractures.The type of fractures, diagnositic successful rate, parameter of scanning and late stage managing methods were investigated retrospectively to find out the effective difference between the diagnosis of plain X-ray and SCT. The imagin location of fractures,sequence of cenrum, heighth of centrum, fracture line, auxillary structure and rotation/dislocation of the fractures were emphasized to evaluate the advantages of 3-D imaging.ResultIn the 26 cases, there were 4 Jefferson fractures, (in which 1 combined with articular dislocations), 17 C2 spinous process fractures, (in which 1 had failure of plain X-ray diagnostic), 1 Hangman fracture, 2 C1～2 imbalance, (in which 1 had failure of plain X-ray diagnostic).There were 2 cases of axoid longitudinal fractures without obvious dislocation. The diagnositic successful rate were 100% in SCT group, while 65% in X-ray group in which 6 cases had diagnostic failure and 3 cases had fracture mis-diagnozing as dislocation.The anatomical structure of upper cervical spine was complicated and was significantly different from other cervical spine constructions. Spiral CT could reveal high resolution images of the upper cervical spine, morphosis of vertibral canal, dislocation information of fracture mass and its relation with neighbouring tissues. Especially in C1 burst fracture,C2 dens fracture and C1～2 dislocation, SCT could provide clear 3-D information of the size of collateral mass and the dislocation degree, furthermore, images could be rotated freely to observe the fracture in any proper section. That provides important information for the decision of operation, selection of operation types and evaluation of operation dager.ConclusionThe spiral CT scan and 3D reconstruction can reveal fracture better.The advantages of SCT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the upper cervical spine injury.
ABSTRACT
<p><b>OBJECTIVE</b>To study the mechanism of anti-tumor activity of Acanthopanax gracilistylus extract (Age).</p><p><b>METHODS</b>The tumor cells proliferation was detected by using (3H)-TdR incorporation method, and the effects of Age on cell cycle of tumor cells, retinoblastoma (Rb) protein and cyclin-dependent kinases (Cdk) were analyzed by flow cytometry and Western blotting assay, respectively.</p><p><b>RESULTS</b>It was indicated by cytoactivity test in vitro that Age only had effect in inhibiting the proliferation of tumor cells, it couldn't lead to death of cells. Under action of Age, the proliferation of tumor cells was halted at G0/G1 stage of cell cycle, and showed no direct cytotoxic effect by Age. Age could induce lowering of the expression of Rb, Cdk2 and Cdk4, cause halt of tumor cell proliferation.</p><p><b>CONCLUSION</b>The tumor inhibitory effect of Age is realized by way of regulating the activity of cell cycle controlling enzymes to suspend the proliferation of tumor cells.</p>
Subject(s)
Humans , Adenocarcinoma , Pathology , Antineoplastic Agents, Phytogenic , Pharmacology , Cell Proliferation , Cyclin-Dependent Kinase 2 , Cyclin-Dependent Kinase 4 , Drugs, Chinese Herbal , Pharmacology , Eleutherococcus , Chemistry , Leukemia, T-Cell , Pathology , Mouth Neoplasms , Pathology , Retinoblastoma Protein , Stomach Neoplasms , Pathology , Tumor Cells, CulturedABSTRACT
Objective To investigate the inhibitory effect of dauricine on the growth of human bladder cancer T-24 cell and its mechanism.Methods The T-24 cells were treated with dauricine(Dau) at different concentrations.The proliferation of T-24 cells was assayed with MTT colorimetric method.The apoptosis of T-24 cells induced by Dau was studied by fluorescent staining,flow cytometry(FCM) and DNA agarose gel electrophoresis.Results Dau effectively inhibited the proliferation of T-24 cells in a concentration dependent manner.A characteristic DNA ladder was observed in Dau treated groups.Dau at the concentration of 5-30 ?g/ml induced the apoptosis of T-24 cells and the apoptosis rate increased in a time-dependeut manner.Cell cycle was arrested at G_0/G_1 phase.The expression of bcl-2 was inhibited and the expression of bax was up-regulated.Conclusion Dauricine significantly inhibits the growth of bladder cancer cells.Cell cycle arrest and apoptosis might be the functional mechanisms.
ABSTRACT
Objective:To study the immunoregulatory activity and mechanisms of Chinese medicinal herb Rhizoma Menipermi extracts.Compare the biological activity of Rhizoma Mednispermi extract with water (RMW),ethanol (RME) and Rhizoma Menispermi Polysaccharide (RMP).Methods:The chemical composition of Rhizoma Menipermi extract was separated with water,ethanol extraction and distillation methods.The effect of Rhizoma Menipermi extracts on lymphocytes and the effect on the metabolism and phagocytosis of mouse macrophages were studied by MTT colorimetric method and neutrol red method.Results:RMP can stimulate the proliferation of mouse spleen cells and human lymphocytes and enhance the metabolism and phagocytosis of mouse macrophages.RMW and RME have inhibitory effect on mouse spleen cells and human lymphocytes and mouse in vitro,and inhibited the metabolism and phagocytosis of mouse macrophages.Conclusion:Diffrent Rhizoma Menipermi composition showed diffrent effects on lymphocytes,RMW and RMP can be used for the supplementary treatment of cancer. [