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ObjectiveTo investigate the value of reduced field-of-view DWI （r-FOV DWI） in quantitative assessment of axial spondyloarthritis. MethodsA total of 112 patients with chronic back pain or suspected axial spondyloarthritis receiving full field-of-view DWI （f-FOV DWI） and reduced field-of-view DWI （r-FOV DWI） from December 2019 to December 2021 were enrolled. Next， subjective image quality assessment （anatomical detail， artifacts， distortion， overall image quality） and objective image quality assessment including （signal to noise ratio and contrast to noise ratio） were conducted by two experienced radiologists. In addition， the Apparent Diffusion Coefficient （ADC） values of three groups （active group， inactive group， and control group） on the two DWI sequences were measured by the two radiologists， respectively. Finally， the consistency of measurement between the two researchers was evaluated and the differences in ADC values was compared. Results102 patients were included and were divided into three groups， including the active group （n=32）， inactive group （n=29）， and control group （n=41） according to ASAS diagnostic criteria. All subjective and objective image quality metrics were rated in favor of r-FOV DWI images compared with f-FOV DWI images ［overall image quality： DWI 4（3~4） vs. 3（3~3） and SNR： 6.58（5.05~10.38） vs. 4.46（2.37~10.04）， CNR： 2.04（-1.14~8.29） vs. 0.97（-8.19~7.12）；P＜0.05］. Inter-rater consistency of the two researchers were 0.60~0.74. According to the AUC curve， group inactive vs. control showed r-FOV DWI was better than f-FOV DWI. In other groups （lesion vs. control， active vs. inactive）， there were no differences between both sequences（P＜0.05）. ConclusionThe subjective image quality score and signal to noise ratio of r-FOV DWI were higher than those of f-FOV DWI， which could be used for quantitative assessment of axial spondyloarthritis.
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Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.
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Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.
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<p><b>OBJECTIVE</b>To evaluate the outcome of Titanium Elastic intramedullary nailing(TEN) for the treatment of refracture of clavicle.</p><p><b>METHODS</b>From March 2010 to March 2016, 9 cases of clavicle fracture, postoperative re-fracture (plate broken before fracture healing, plate and screw pull out or refracture after fracture union and internal fixation removal) included 6 males and 3 females with a mean age of 38.6 years old ranging from 20 to 62 years old; 3 cases were sports injury, 5 cases were traffic injury, 1 case was severe injury. All cases were closed fractures, and 2 cases were multiple fractures. According to OTA(Orthopaedic Trauma Association classification), 2 cases were 06-A1, 1 case was 06-A2, 1 case was 06-A3, 2 cases were 06-B1, 2 cases were 06-B2, and 1 case was 06-B3. Among them, 4 cases were treated with AO titanium elastic intramedullary nail (TEN), and 5 cases of early internal fixation failure of clavicle fracture were treated with plate and screw internal fixation plus bone graft. The time of bone union, VAS score and Constant Shoulder Score were observed and recorded.</p><p><b>RESULTS</b>All incisions healed at stage I without infection. All 9 patients were followed up for a period of 14 months. All patients' implants were removed at 12 months after the second operation without refractures. The Constant score of shoulder joint was from 64 to 94 at 4 weeks after the second operation, 91 to 100 at 4 weeks after implants removal. The average bone healing time was 4.3 months from 3 to 6 months. The pain VAS score decreased significantly and the pain was relieved significantly.</p><p><b>CONCLUSIONS</b>Titanium elastic intramedullary nail (TEN) for the treatment of clavicle fracture after internal fixation of refracture patients can be achieved better outcomes, less trauma, good fracture healing, good postoperative recovery of shoulder joint function, but need to pay attention to the reasonable selection of patients.</p>
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<p><b>OBJECTIVE</b>To investigate the stability of internal fixation for femoral neck fracture(FNF) using two or three cannulated screws directed to different fracture lines, and to provide a theoretical basis for the clinical decision making.</p><p><b>METHODS</b>Fifteen fresh frozen human femur samples were selected and the FNF model was established with Pauwels angle of 30°, 50° and 70° respectively. The models were fixed with three or two cannulated screws, and their differences at tensile strength, subsidence, shear strength and composite displacement, gap distance, torsional angle and stiffness values of four types of femur were evaluated to identify their biomechanical stability.</p><p><b>RESULTS</b>With Pauwels angle of 30° and 50°, no statistical differences at the referenced outcomes were observed between two and three cannulated screw fixation for FNF(>0.05). With the Pauwels angle of 70 °, three cannulated screws fixation were significantly superior to two cannulated screws fixation for FNF(<0.05). Nevertheless, when Pauwels angle was 70°, three cannulated screws fixation turned out to be relative instable compared with Pauwels angle of 30° and 50°.</p><p><b>CONCLUSIONS</b>With Pauwels angle of 30° and 50°, two cannulated screws fixation was similarly stable as using three cannulated screws for FNF. Three cannulated screws fixation were obviously superior to two cannulated screws fixation when Pauwels angle was 70°, but the application of three cannulated screws could still be insufficiently stable when only such routine fixations were utilized. Therefore, Angle Stabilizing System or anti-sliding screws were needed to enhance the stability of FNF fixation.</p>
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<p><b>BACKGROUND</b>Plasma galectin-3, a mediator of fibrogenesis and inflammation, its potential to associate with type 2 diabetes (T2DM) is poorly investigated. Here, we explored its interaction with the serum galectin-3 and vascular complications.</p><p><b>METHODS</b>We conducted a population-based cross-sectional survey in Zhejiang, China involving 165 men and 119 women (age range, 43 - 84 years), investigating the relationship between serum galectin-3 and vascular disease in patients with T2DM.</p><p><b>RESULTS</b>Serum galectin-3 was higher in subjects with T2DM than that in control participants (27.4 vs. 17.6 ng/ml, P < 0.001). Compared with subjects with galectin-3 values in the lowest quartile, those with values in the highest quartile had an increased likelihood of vascular complications (4th quartile odds ratio (OR) 2.52, 95% confidence interval (CI), 1.25 - 4.07). Increased risk of micro- or macrovascular complications correlated with serum galectin-3 concentration (ORs 11.4 and 8.5, respectively). An increased number of vascular complications was associated with high serum galectin-3 levels (P < 0.05). Patients with serum galectin-3 levels > 25 ng/ml had an elevated risk of diabetes relative to patients with levels < 10 ng/ml (OR for any vascular complication 2.64, for heart failure 3.97, for nephropathy 4.09, for peripheral arterial disease (PAD) 4.18; all P < 0.05). Complication risk was higher in patients with neurogenic, stroke, or retinopathy complications, but this difference was not significant after risk factor adjustment. Serum galectin-3 levels correlated with diabetes duration, C-reactive protein (CRP) levels, and albuminuria.</p><p><b>CONCLUSION</b>High galectin-3 values were associated with increased odds of developing heart failure, nephropathy, and peripheral arterial disease in patients with T2DM.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , C-Reactive Protein , Cross-Sectional Studies , Diabetes Mellitus, Type 2 , Diabetic Angiopathies , Blood , Galectin 3 , Blood , Risk FactorsABSTRACT
<p><b>BACKGROUND</b>Some studies found that cholinesterase (ChE) can be an independent risk factor for patients with multiple organ dysfunction syndrome. To assess aged patients with systemic inflammatory response syndrome (SIRS) early and predict their prognosis, the predictive value of ChE for the prognosis of aged patients with SIRS was analyzed.</p><p><b>METHODS</b>From September 2009 to September 2010, all aged patients with SIRS in the ICU of the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed if they met inclusion criteria: patients aged ≥ 65 years and met American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference criteria for SIRS. Serum ChE, albumin, D-dimer, lactic acid and C-reactive protein (CRP) were measured, and the Acute Physiology and Chronic Health Evaluation (APACHE) II and Glasgow Coma Scale (GCS) scores were evaluated within the first 24 hours in the ICU. Fisher's exact test was used for comparison of the primary disease between the deceased group and surviving group. For comparison of study variables between the two groups, the Student's t test or Mann-Whitney U test was used. Multivariate significance was tested with binary Logistic regression analysis.</p><p><b>RESULTS</b>The clinical data of 124 aged patients with SIRS were collected and analyzed. Sixty-six patients (46 male, 20 female, mean age (78.70 ± 8.08) years) who died were included in the deceased group and 58 patients (34 male, 24 female, mean age (76.02 ± 6.57) years) who survived were included in the surviving group. There were no significant differences in age, gender, APACHE II score and GCS score between the deceased group and surviving group (all P > 0.05), but there were significant differences in lactic acid (P = 0.011), D-dimer (P = 0.011), albumin (P = 0.007), CRP (P = 0.008), and ChE (P < 0.0001). The correlation analysis showed that the APACHE II score and CRP were not correlated with ChE (both P < 0.05). D-dimer and albumin were correlated with ChE (Spearman's rho correlation coefficients were -0.206 and 0.324, the corresponding P values were 0.022 and < 0.0001). Multiple Logistic regression analysis showed that age, gender, lactic acid, D-dimer, albumin, CRP, APACHE II score, and GCS score were not independent risk factors for prognosis of aged patients with SIRS, but that ChE was (P < 0.0001). The receiver operating characteristic curve of ChE had an area under the curve of 0.797 (standard error = 0.04; P < 0.0001), and a ChE of 103.00 U/L was the cut-off value with sensitivity = 0.793, specificity = 0.742.</p><p><b>CONCLUSION</b>Serum ChE might be a predictive marker for the prognosis of aged patients with SIRS, with low serum ChE levels indicating poor prognosis.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Cholinesterases , Blood , Prognosis , Systemic Inflammatory Response Syndrome , Blood , PathologyABSTRACT
<p><b>OBJECTIVE</b>To determine risk factors of capillary leak syndrome(CLS) in children with tetralogy after operation.</p><p><b>METHODS</b>Clinical data were retrospectively collected and analyzed from 32 tetralogy cases with CLS and 50 cases without CLS(control group), who received operation under cardiopulmonary bypass (CBP) in our hospital from October 2002 to December 2006. Risk factors with statistical significance were screened with univariate logistic regression analysis, independent risk factors of CLS were determined with multivariate logistic regression analysis. Postoperative outcome was compared between CLS group and control group.</p><p><b>RESULT</b>Logistic analysis showed that the risk factors for CLS were age(OR=6.783), duration of CBP(OR=4.756)and MGoon index (OR=3.826). There were statistical differences in injection of colloid, time of inotropic drugs and ventilation between CLS and control groups(P<0.01). Eight CLS cases underwent peritoneal dialysis and 2 CLS cases died.</p><p><b>CONCLUSION</b>The risk factors of CLS in children with tetralogy after CBP are age, duration of CBP and MGoon index.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Capillary Leak Syndrome , Therapeutics , Cardiopulmonary Bypass , Logistic Models , Postoperative Complications , Retrospective Studies , Risk Factors , Tetralogy of Fallot , General SurgeryABSTRACT
The aim of this study was to detect the expression and cell cycle specificity of Fas, TNFRI and TNFRII in human peripheral blood lymphocytes (PBL), and to study the potential role of Fas, TNFRIand TNFRII in cell cycle specific apoptosis. The improved double-parameter flow cytometry was used to detect the expressions of Fas, TNFRI and TNFRII and cell cycle specificity in PBL which were incubated for 24 hours in the presence or absence of phytohaematoagglutinin (PHA) respectively. Apoptosis induced by IgM type anti-Fas and TNF-alpha was detected by API method. The results showed that compared with PBL treated in the absence of PHA in G(0) phase, the ratio of Fas, TNFRI and TNFRII expressions in PHA-stimulated PBL entering cell cycle increased (35.55 +/- 6.63)%, (30.63 +/- 2.66)%, (26.62 +/- 5.14)% respectively (P < 0.01), and mainly appeared at G(1)-phase; no apoptosis was induced by anti-Fas and TNF-alpha in G(0)-phase PBL cultured in the absence of PHA. On the contrary, the apoptosis was induced by anti-Fas and TNF-alpha in PBL which entered cell cycle after stimulation with PHA and mainly initiated at G(1)-Phase. It is concluded that there is evident dose-effect relationship between apoptotic receptor and receptor-mediated apoptosis. Moreover, the cell cycle specificity of receptor-mediated apoptosis is correlated with the cell cycle specific expressions of apoptotic receptor. The induction of apoptosis by apoptotic factors (anti-Fas and TNF-alpha) depends on whether cell entering cell cycle or not.
Subject(s)
Humans , Apoptosis , Cell Cycle , Lymphocytes , Cell Biology , Receptors, Tumor Necrosis Factor, Type I , Metabolism , Receptors, Tumor Necrosis Factor, Type II , Metabolism , fas Receptor , MetabolismABSTRACT
Objective: To develop a high efficient expression, purification system of recombinant arginine deiminase(ADI).Methods: cDNA fragment encoding for mycoplasma ADI was obtained by artificial synthesis and was cloned into prokaryotic expression vector(pBV220). The recombinant ADI was generated by the transformation of the recombinant vector into the host strain DH5?. Anion exchange and gel filtration chromatography was carried out for purification of the recombinant ADI. The biological activity of final product was detected by the assay of agrinine degradation in vitro. Results: A prokaryotic expression plasmid pBV220-ADI was generated successfully, and was identified by DNA sequencing; the recombinant protein was highly expressed in DH5?, the proportion of the recombinant protein is exceeded 35% of the whole protein. The inclusion bodies were solubilized with 6mol/L guanidine hydrochloride under reducing conditions in order to avoid incorrect disulfide-bond formation of the recombinant ADI molecules. Dilution and dialysis at lower degrees temperature were the optimum renaturation methods. After gel filtration, the purity and specific activity of rADI reached 95% and 80 IU/mg respectively. Conclusions: A set of protocols for high efficient rADI expression and purification has been established, which is simple, efficient and applicable.
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<p><b>BACKGROUND</b>Improvement of clinical symptoms following hyperbaric oxygen (HBO) treatment of neuropsychiatric disorders arising from traumatic brain injury was proved by our previous study. This study was aim to obtain the evidence of other changes.</p><p><b>METHODS</b>Three hundred and ten patients with neuropsychiatric disorders arising from traumatic brain injury were treated twice with hyperbaric oxygen. Cerebral single photon emissions computed tomography (SPECT) images and computed tomography scans (CT) before and after hyperbaric oxygen treatment, were compared.</p><p><b>RESULTS</b>Before treatment, the proportion of abnormal cerebral changes detected by SPECT was 81.3% but only 15.2% by CT. After HBO treatment, 70.3% of SPECT scans showed no abnormalities and these patients were clinically improved. Treatment improved regional cerebral blood flow.</p><p><b>CONCLUSION</b>SPECT was much more sensitive than CT in the diagnosis of neuropsychiatric disorders following hyperbaric oxygen treatment of neuropsychiatric disorders arising from traumatic brain injury.</p>