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Myocardial infarction （MI） is a common cardiovascular disease in clinical practice and one of the main causes of cardiovascular mortality. Its pathogenesis is complex and associated with oxidative stress reactions. Nuclear factor E2-related factor 2 （Nrf2） is a key factor in regulating oxidative stress reactions. It can regulate the expression of heme oxygenase-1 （HO-1）， playing a role in maintaining the oxidative-reductive homeostasis in the body. During the course of MI， the biological activity and levels of Nrf2 and HO-1 decrease， leading to weakened tissue antioxidant and anti-inflammatory capabilities， endothelial damage in myocardial blood vessels， release of vascular cell adhesion factors， and impaired endothelial function. In recent years， many basic research studies have explored the role and mechanisms of traditional Chinese medicine （TCM） in treating MI by modulating the Nrf2/HO-1 signaling pathway. The results have indicated that the Nrf2/HO-1 signaling pathway is an important potential target for TCM in the treatment of MI. This article reviewed the mechanism of the Nrf2/HO-1 signaling pathway in MI and the research progress of TCM in targeting and regulating this pathway， aiming to provide a theoretical basis for the prevention and treatment of MI and further drug development.
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Objective@#To assess the diagnostic values of 11C-methionine (MET) PET/CT semiquantitative parameters for detecting recurrence in patients who were diagnosed with suspicious recurrence by MRI after resection of supratentorial gliomas.@*Methods@#A total of 164 patients (107 males, 57 females, age 6-74 years; high-grade 94, low-grade 63, unclear 7) with supratentorial gliomas who underwent 11C-MET PET/CT between June 2015 and June 2017 in Beijing Tiantan Hospital were enrolled respectively. All patients were with suspicious recurrence after surgery showed by MRI and followed up for 6 months at least. The final diagnosis was determined with histopathological analysis or clinical follow-up. The maximum and mean standardized uptake value (SUVmax and SUVmean), tumor-to-background ratios (TBR) of SUVmax and SUVmean (TBRmax and TBRmean) were recorded and compared between patients with recurrence or without recurrence using independent-sample t test. Receiver operating characteristic (ROC) curves were drawn to determine the threshold, and the diagnostic sensitivity and specificity of each parameter were calculated.@*Results@#According to the clinical diagnosis, there were 139 patients with recurrence and 25 without recurrence. SUVmax, SUVmean, TBRmax and TBRmean were significantly higher for patients with recurrence than those without recurrence (4.19±1.95 vs 2.59±1.18, 2.34±1.08 vs 1.46±0.72, 2.95±1.17 vs 1.83±0.79, 2.64±1.11 vs 1.59±0.71; t values: 5.126-6.183, all P<0.01), but there was no difference in the areas under the ROC curve (AUC) for diagnosis of recurrence with the 4 parameters (z values: 0.265-1.674, all P>0.05), for which the optimal cut-off values were 3.05, 1.65, 1.96 and 1.79, respectively, and the corresponding sensitivities/specificities for the diagnosis of recurrence were 67.6%(94/139)/100%(25/25), 67.6%(94/139)/100%(25/25), 79.9%(111/139)/100%(25/25), 74.8%(104/139)/100%(25/25), respectively. Patients with (n=81) or without (n=13) recurrence had different semiquantitative parameters in high-grade glioma group (t values: 5.137-5.871, all P<0.01), and the AUC for TBRmean was greater than that for SUVmean (0.858 vs 0.802; z=1.982, P<0.05). Patients with (n=54) or without (n=9) recurrence in low-grade glioma group showed significant difference in the 4 parameters (t values: 2.730-7.009, all P<0.01), while the AUCs of the 4 parameters were not significantly different (z values: 0.444-1.407, all P>0.05). Among 37 patients with recurrence confirmed by pathology, there were no significant differences in the semiquantitative parameters between the high-grade and low-grade glioma groups and AUCs were not different either (t values: 1.387-1.937, z values: 0.106-1.752, all P>0.05).@*Conclusions@#Semiquantitative parameters of 11C-MET PET/CT are equally accurate in the differentiation of recurrence from radiation injury in patients with gliomas, while TBRmean was superior than SUVmean in patients with the high-grade gliomas. Among the patients with recurrence confirmed by pathology, the value of the semiquantitative parameter is limited for the identification of high- and low- grade gliomas.
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Objective To establish a monitoring database of historical Oncomelania hupensis environments at grass?root lev?el for schistosomiasis prevention based on Google Earth(GE),so as to improve the management efficiency of historical O. hu?pensis environments. Methods GE was labeled with the information about the historical O. hupensis environments through add?ing landmark,path and polygon. Meanwhile,POCO web album was used to storage the practice situation pictures of the environ?ments,which could be imported into GE so that the environments could be monitored dynamically. Results There were 553 historical O. hupensis snail environments in Yangjian Town,Xishan District,Wuxi City and the accumulative area was 506 000 m2. Among these environments,224(40.5%)were Class IV environments,accounting for 40.5%of accumulative area. Conclu?sions The monitoring database of historical O. hupensis environments based on GE at country level is established successfully and it can be used to manage the historical snail environments visually and monitor the changes dynamically.
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Objective To explore the application of 18F-FDG PET/CT combined with high-resolution CT (HRCT) in the same scanner on diagnosis of lung cancer, and its influencing factors. Methods 50 patients, in which some cannot supply HRCT raw date and under highly suspicion of being lung cancer, some were postoperative lung cancer and metastasis of lung cancer, were examined by 18F-FDG PET/CT combined with HRCT in the same scanner. Results 50 patients were all successful (100%) on PET/CT scans after preparation, injection, rest and breathing exercises;46 cases (92%) were successful on PET/CT combined with HRCT scans;4 cases (8%) failed on HRCT scans. Ma-lignant lesions were found in 35 cases, with the metastasis of 21 cases;4 in 6 cases of postoperative lung cancer were found metastasis;9 cases of benign pulmonary nodules need to be observed sequentially. Conclusion 18F-FDG PET/CT combined with HRCT in the same scan-ner is valuable on diagnosis of lung cancer. The diagnostic accuracy and sensitivity significantly increase. It is a non-invasive new imaging technology and systemic metastasis can be observed.
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Objective To investigate the correlation between the uptake of 68Ga-DOTATATE in pituitary adenoma and clinical parameters such as hormonal hypersecretion,and to evaluate the curative effect with 68Ga-DOTATATE imaging after octreotide therapy in patients with growth hormone-secreting adenoma (GH adenoma).Methods A total of 34 patients (15 males,19 females) with pituitary adenoma were recruited,including 5 adrenocorticotropic hormone-secreting adenoma (ACTH adenoma),17 GH adenoma,and 12 non-functioning adenoma (NF adenoma).In the 17 patients with GH adenoma,there were 13 patients treated by octreotide intramuscular injection 3 times with a total dose of 60 mg for 3 months.The finial diagnosis was based on histology.68Ga-DOTATATE imaging was performed,and SUV tumor volume and density index (DI) were recorded in all patients.The DI was the ratio of tumor SUVmean to tumor volume.The effective therapy was defined as more than 50％ of hormonal suppression or more than 20％ of tumor shrinkage.Non-parametric Mann-Whitney u test was used.Results NF adenoma showed greater tumor volume than secretory adenoma,((9.10±7.00) cm3 vs (2.92±1.60) cm3,u=43.0,P＜0.05),whereas DI of secretory adenoma was higher than that of NF adenoma (7.16±4.52 vs 1.08±1.40,u=48.5,P＜0.05).Additionally,DI was significantly higher(3.55±0.91 vs 1.38±0.69,u =2.0,P＜0.05) in patients (n =8) with effective treatment than that in patients without effective treatment (n =5).Conclusion 68 Ga-DOTATATE may be a useful probe for PET imaging in patients with pituitary adenoma,and may be valuable for predicting the therapeutic effect of somatostatin analog treatment.
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Objective To synthesize 68 Ga-1,4,7,10-tetraazacyclododecane-N,N',N,N()-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (68Ga-DOTATATE) manually and automatically,validate its qualities in vitro,and evaluate its biodistribution in ICR mice and the microPET imaging in nude mice bearing pancreatic AR42J tumor.Methods 68Ga-DOTATATE was synthesized by automatic method using commercial metal isotope multifunctional module with strong cation exchange (SCX) column and by manual method.Both the products were measured for quality control.For the biodistribution study 5 groups of ICR mice were injected with 68Ga-DOTATATE(1.11 MBq) and executed at 10,30,60,120 and 240 min postinjection,respectively.The organs were weighted,and ％ ID/g was calculated.Nude mice bearing pancreatic AR42J tumor were intravenously injected with 3.7 MBq 68Ga-DOTATATE,and then microPET imaging was acquired at 10,30,60,120,18 and 240 min.Results 68Ga-DOTATATE could be successfully synthesized by the automatic and manual methods.Both the product injections were colorless and clear.The pH value was 6.5±0.1.For the products obtained from the two methods,the radiochemical purities were over 99％,and the products were stable for 4 h at room temperature.For the automatic method,68Ga-DOTATATE was synthesized within 30 min and with the radiochemical yield of (51.8±3.2)％ (time decay corrected).For the manual method,the time used for the synthesis was 20 min,and the labeling yield was over 99％.Three batches of the products were aseptic and pyrogen-free.In ICR mice,68Ga-DOTATATE was excreted by the kidney,and showed relatively high accumulation in the liver,spleen,pancreas and adrenal glands,while lower in the bone and soft tissue.The clearance from blood was fast with (4.41±0.81) ％ID/g at 10 min postinjection and (0.78 ± 0.32) ％ ID/g at 1 h.MicroPET imaging showed increased uptake of 68GaDOTATATE in the tumor tissues,and T/NT were 2.01±0.29(10 min),6.74±2.90(30 min) and 4.46±2.05 (60 min),respectively.Conclusions 68 Ga-DOTATATE could be successfully synthesized manually and automatically.The products reach to the specification of radioactive drugs and could be used as an attractive positron emitting radiotracer for detection of the somatostatin receptor-positive tumors.
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BACKGROUND: A new method, i.e., heparin slow-release stent implantation combined with myocardium drilling, is discovered for myocardial revasculadzation, which remarkably improves myocardial perfusion. OBJECTIVE: To investigate the effect of heparin slow-release stent implantation combined with myocardium drilling on myocardial regeneration of pigs with acute myocardial infarction.METHODS: Anterior descending coronary of pig was ligated to induce myocardial infarction model, which was randomly divided into control and implantation groups, with 6 pigs for each group. Self-made borer was used in the implantation group to drill two transmural channels (3.5 mm diameter) on epicardium. A heparin slow-release stent was fixed in the transmural channel. Following intravenous injection, BrdU was used to label DNA duplication so as to observe stromal cell-derived factor-1 (SDF-1) mRNA expression, myocardial perfusion, newborn yocardium, and heart function prior to and following implantation. RESULTS AND CONCLUSION: As compared with control group, SDF-1 expression was enhanced in the implantation group at 6 weeks after stent implantation (P < 0.001), perfusion mass defect percentage was significantly decreased (P < 0.001), ejection fraction of left ventricle was increased (P < 0.05), newborn myocardium was increased (P< 0.001), and survival myocardium in the ischemic region was increased (P < 0.001). The results demonstrated that heparin slow-release stent implantation combined with myocardium drilling could repair damaged myocardial cells and improve heart function through increasing SDF-1 expression and myocardial perfusion.
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Objective To evaluate the therapeutic effect of intramyocardial controlled releasing base fibroblast growth factor (b-FGF) stent combined with transplanting bone marrow-derived mesenchymal stem cells (BM-MSCs) in porcine acute myocardial infarction (AMI) models. Methods Eighteen porcines were divided into three groups (each n=6):transmyocardial revascularization (TMR)+naked stent (control group), TMR+b-FGF stent (b-FGF group) and TMR+b-FGF stent+BM-MSCs (b-FGF+BM-MSCs group). Acute myocardial infarction models were induced by ligating the left anterior descending artery in 18 porcine. In the control and b-FGF group, naked stents, b-FGF stents and b-FGF stent+BM-MSCs were implanted into TMR channels in the infarct and border zone. ~(99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging were performed to evaluate changes in myocardial blood flow, and echocardiography and immunohistochemical studies were also performed. Results After 6 weeks, the quality of myocardial infarction, fractional shortening, neovascular density in b-FGF and b-FGF stent+BM-MSCs group were higher than those of control gruop (P<0.05), and in b-FGF stent+BM-MSCs group was higher than those in b-FGF group (P<0.05). Conclusion BM-MSCs combined with controlled releasing intramyocardial b-FGF stent can improve the flow of myocardial infarction area, promote angiogenesis and heart function, and the therapeutic effect which can be evaluated with myocardial SPECT imaging.
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Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.