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To clarify the content characteristics of the main active components and mineral elements of Cynomorium songaricum under different habitat conditions, and further explore the relationship between the quality of C. songaricum and habitats, this study took C. songaricum from 25 different habitats in China as the research object, and measured the contents of 8 main active components and 12 mineral elements separately. Diversity analysis, correlation analysis, principal component analysis and cluster analysis were carried out. The results showed that the genetic diversity of total flavonoids, ursolic acid, ether extract, potassium(K), phosphorus(P) and zinc(Zn) in C. songaricum was high. The coefficient of variation of crude polysaccharide, ether extract, gallic acid, protocatechuic aldehyde, catechin, epicatechin, calcium(Ca), sodium(Na), magnesium(Mg), sulfur(S), iron(Fe), manganese(Mn), selenium(Se) and nickel(Ni) were all over 36%, indicating that the quality of C. songaricum was significantly affected by habitats. There were strong synergistic and weak antagonistic effects among the contents of the 8 active components, and complex antagonistic and synergistic effects among the contents of the 12 mineral elements. Principal component analysis revealed that crude polysaccharide, ursolic acid, catechin, epicatechin and total flavonoids could be used as the characteristic components to evaluate the quality of C. songaricum, and Na, copper(Cu), Mn and Ni were the characteristic elements to evaluate the quality of C. songaricum. In cluster ana-lysis, the second group with the main active components as cluster center had better quality in terms of the content of active substances, and the second group with the mineral elements as cluster center had higher utilization potential in the exploitation of mineral elements. This study could provide a basis for resource evaluation and breeding of excellent varieties of C. songaricum in different habitats, and provide a reference for cultivation and identification of C. songaricum.
Subject(s)
Cynomorium , Catechin , Plant Breeding , Selenium , Ethers , Ethyl Ethers , Flavonoids , Plant ExtractsABSTRACT
Purpose: To explore the role and mechanism of curcumin (Cur) in reducing oxidative stress damage in rats with nephrolithiasis induced by ethylene glycol (EG). Methods: Thirty male rats were divided into normal control, model, positive (10% potassium citrate), Cur-10 (10 mg/kg curcumin) and Cur-20 (20 mg/kg curcumin) groups. Results: The results of kidney tissue section stained by hematoxylin-eosin and von Kossa showed that curcumin treatment can inhibit the formation of kidney stones. The biochemical test results showed that the urea (Ur), creatinine (Cr), uric acid (UA), inorganic phosphorus and Ca2+ concentrations in urine decreased after being treated with curcumin. There were significant differences between different doses of curcumin (P < 0.05). Compared with the Cur-10 group, Cur-20 had a more significant inhibitory effect on malondialdehyde (MDA) (P < 0.05). In addition, reverse transcription polymerase chain reaction (PCR) detection and immunohistochemical results indicated that the osteopontin (OPN) in the kidney was significantly reduced after curcumin treatment. Conclusion: Curcumin could reduce the oxidative stress damage caused by EG-induced kidney stones.
Subject(s)
Animals , Male , Rats , Oxidative Stress/drug effects , Ethylene Glycol/analysis , Curcumin/administration & dosage , Osteopontin/analysis , Nephrolithiasis/veterinaryABSTRACT
BACKGROUND@#Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.@*METHODS@#In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared.@*RESULTS@#A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05).@*CONCLUSIONS@#The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Subject(s)
Humans , Retrospective Studies , Pneumonia/diagnostic imaging , Analysis of Variance , Tomography, X-Ray Computed , Lymphoma/diagnostic imagingABSTRACT
Objective@#To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). @*Materials and Methods@#This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. @*Results@#A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). @*Conclusion@#The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.
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Objective:To explore the lesion characteristics and predictors of invasive coronary angiography (ICA)-verified obstructive lesions with fractional flow reserve (FFR)>0.80, that is, anatomy-function mismatch.Methods:A total of 515 obstructive vessels in 419 coronary disease patients from 11 Chinese medical centers undergoing coronary CT angiography and ICA and FFR were retrospectively analyzed. All vessels had one target lesion with diameter stenosis ≥50 % by ICA. There were 229 vessels in the match group (FFR≤0.80) and 286 vessels in the mismatch group (FFR>0.80). The lesion characteristics including lesion territory, the distance of the coronary artery ostium to the proximal end of the lesion, minimum lumen area, reference lumen area, plaque length and burden, plaque volume and component volume, remodeling index and plaque morphological complexity were measured and compared between the two groups. Optimal thresholds of quantitative plaque characteristics were defined by Yoden index. Logistic regression analysis was used to analyze the predictors of anatomy-function mismatch. Area under receiver operating characteristic curve (AUC) was used to analyze the ability of different lesion features to predict mismatched lesions.Results:The coronary stenosis, plaque burden and length, plaque volume (including each component volume) in the mismatch group were smaller than those in the match group, and FFR, minimum lumen area were larger (all P<0.05). Left anterior descending artery (LAD) lesion and severe complex plaque were more common in the match group than the mismatch group with a statistically significant difference. Univariate logistic regression analysis showed that LAD lesion, minimum lumen area>4 mm 2, plaque burden and length, plaque calcification volume<27 mm 3, plaque lipid volume<30 mm 3, plaque fiber volume<150 mm 3 and plaque morphological complexity were predictiors of anatomic function mismatched lesions; Multivariate logistic regression showed that the minimum lumen area>4 mm 2 (OR=3.371, 95%CI 1.903-5.973, P<0.001), plaque lipid volume<30 mm 3 (OR=3.014, 95%CI 1.691-5.373, P<0.001), plaque morphological complexity (mild OR=17.772, 95%CI 8.072-39.128, P<0.001, moderate OR=6.383, 95%CI 3.739-10.896, P<0.001) were independent predictors of mismatched lesions. The AUC of the model based on the minimum lumen area, plaque lipid volume and morphological complexity was 0.824, which was superior to either of the plaque feature alone ( P<0.001). Conclusions:The minimum lumen area, lipid volume and plaque morphological complexity are independent predictors of the anatomical-functional mismatch lesions, and the combination can significantly improve the prediction value.
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Objective:To explore the feasibility in evaluating segmental extracellular volume (ECV) using dual-layer spectral detector CT in patients with heart failure with various percentages of delayed hyper-enhanced volume, using MRI as a reference.Methods:Twenty-seven patients with heart failure in Peking Union Medical College Hospital were prospectively enrolled in this study from July 2019 to January 2021. All the patients underwent both CT late iodine enhancement and MR late gadolinium enhancement imaging within a week. According to percentages of hyper-enhanced volume on cardiac MR image, myocardial segments were classified into 3 groups: 0-4% (group A), 5%-49% (group B) and 50%-100% (group C). ECV images were independently observed by 2 experienced radiologists. The correlation and agreement between CT-ECV and MRI-ECV for the whole myocardial assessment and for the segmental assessment were evaluated using Spearman correlation and Bland-Altman analysis. Inter-observer agreement was assessed using the ICC.Results:Of the 27 patients, 432 segments were analyzed, with 199 segments in group A, 151 segments in group B and 82 segments in group C. In the whole myocardial analysis, the CT-ECV and MRI-ECV were 32.25% (28.04%, 34.28%) and 32.27% (28.35%, 34.77%), respectively. A good correlation was found between CT-ECV and MRI-ECV ( r=0.969, P<0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias (0.4%), with 95% limits of agreement of -6.9% to 7.8%. as for the segmental myocardial assessment, the CT-ECV was 28.23% (26.18%, 29.92%) for group A, 33.29% (30.16%, 35.96%) for group B and 40.22% (34.06%, 46.70%) for group C. There was statistically significant difference in ECV among three groups (all P<0.001). Good correlations between CT-ECV and MRI-ECV were found in group A ( r=0.614, P<0.001), group B ( r=0.852, P<0.001) and group C ( r=0.953, P<0.001). Bland-Altman analysis between CT-ECV and MRI-ECV showed a small bias 2.0% (95% limits of agreement:-17.6%-21.6%) in group A, a small bias -0.4% (95% limits of agreement: -13.8%-12.9%) in group B and a small bias -1.8% (95% limits of agreement: -17.4%-13.9%) in group C. The ICC values between 2 observers were 0.877 and 0.945 on CT-ECV and MRI-ECV, respectively. Conclusions:The larger percentage of hyper-enhanced volume on cardiac MR image, the stronger correlation are between the CT-ECV and MRI-ECV. CT-ECV may be taken as an alternative tool for quantitative evaluation of myocardial tissue in patients with heart failure.
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Objective@#To evaluate the feasibility of texture analysis on non-contrast-enhanced T1 maps of cardiac magnetic resonance (CMR) imaging for the diagnosis of myocardial injury in acute myocardial infarction (MI). @*Materials and Methods@#This study included 68 patients (57 males and 11 females; mean age, 55.7 ± 10.5 years) with acute ST-segment-elevation MI who had undergone 3T CMR after a percutaneous coronary intervention. Forty patients of them also underwent a 6-month follow-up CMR. The CMR protocol included T2-weighted imaging, T1 mapping, rest first-pass perfusion, and late gadolinium enhancement. Radiomics features were extracted from the T1 maps using open-source software. Radiomics signatures were constructed with the selected strongest features to evaluate the myocardial injury severity and predict the recovery of left ventricular (LV) longitudinal systolic myocardial contractility. @*Results@#A total of 1088 segments of the acute CMR images were analyzed; 103 (9.5%) segments showed microvascular obstruction (MVO), and 557 (51.2%) segments showed MI. A total of 640 segments were included in the 6-month follow-up analysis, of which 160 (25.0%) segments showed favorable recovery of LV longitudinal systolic myocardial contractility.Combined radiomics signature and T1 values resulted in a higher diagnostic performance for MVO compared to T1 values alone (area under the curve [AUC] in the training set; 0.88, 0.72, p = 0.031: AUC in the test set; 0.86, 0.71, p = 0.002).Combined radiomics signature and T1 values also provided a higher predictive value for LV longitudinal systolic myocardial contractility recovery compared to T1 values (AUC in the training set; 0.76, 0.55, p < 0.001: AUC in the test set; 0.77, 0.60, p < 0.001). @*Conclusion@#The combination of radiomics of non-contrast-enhanced T1 mapping and T1 values could provide higher diagnostic accuracy for MVO. Radiomics also provides incremental value in the prediction of LV longitudinal systolic myocardial contractility at six months.
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Objective:To investigate the optimal monoenergetic level of spectral reconstructions and contrast agent concentration for the structure and lumen of isolated coronary stents on a dual-layer spectral detector CT (DLCT).Methods:Eighteen scaffolds of different materials were implanted into the artificial simulated coronary artery, and were filled with conventional and low concentration contrast agents (1/2 of the conventional dose). Spectral CT scan was performed, and 50-100 keV (interval 10 keV) and 120 keV single-level reconstruction were performed at the conventional concentration and low concentration, which were recorded as A 50-100, 120 keV group and B 50-100, 120 keV group respectively; Another group of conventional concentration data was reconstructed with conventional iDose 4, which was recorded as conv group. The image was evaluated subjectively, including stent structure score (Likert 5-score) and stent lumen score (Likert 4-score); objective evaluation, including background noise, contrast noise ratio (CNR) and stent inner diameter difference (AlN). The differences of subjective and objective evaluation indexes were analyzed. Results:The stent structure scores of A 80, 90 keV group [(3.56±0.64), (4.11±0.58) points] and B 90 keV group [(3.61±0.50) points] were significantly better than those of other groups ( P<0.01), and the A 90 keV group had the highest score. The scores of stent lumen in A 70 keV group [(3.61±0.50) points] and B 70 keV group [(3.47±0.63) points] were significantly better than other groups ( P<0.01), and the score of A 70 keV group was the highest. There was no significant difference in noise, CNR and AlN ( F=1.67, 0.15, 1.16, P>0.05). The main effect analysis was energy level, there were significant differences in noise, CNR and AlN between groups a, B and conv ( F=83.74, 23.95, 24.63, P<0.01). A 70, 80, 90 keV group [(11.43±0.48), (11.81±0.34), (12.01±0.33) HU] and B 70, 80, 90 keV group [(11.50±0.31), (11.58±0.18), (12.13±0.30) HU], image background noise was significantly lower than other groups ( P<0.01). There was no significant difference between the six groups ( P>0.05). The noise of A 70 keV group was the least. The CNR in stent lumen of A 50, 60, 70 keV groups (26.85±5.19, 26.03±4.29, 24.46±5.40) and B 50, 60, 70 keV groups (25.88±5.67, 24.18±5.46, 24.91±7.67) was significantly higher than that of other groups ( P<0.01). The highest CNR value was found in A 50 keV group. The AlN value of A 90, 100, 120 keVgroup [(32.22±6.16) %, (30.79±5.55) %, (27.05±4.47)%] was higher than that of conv group [(41.76±6.00)%], the difference was statistically significant ( P<0.01). The AlN values of A 90, 100, 120 keV group and B 90, 100, 120 keV group [(34.34±5.73)%, (33.95±5.46)%, (33.92±5.45)%] were lower than those of other subgroups, and the differences were statistically significant ( P<0.01). There was no statistically significant difference between the six groups ( P>0.05). The AlN of A 120 keV group was the lowest. Conclusions:Regarding stent phantom imaging, DLCT monoenergetic imaging was better than conventional mixed energy imaging. When DLCT scanning was performed, 90 keV (structure) and 70 keV (lumen) combined reconstruction could not reduce the imaging quality when the concentration was halved.
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Two new flavonoid glycosides, named viscumneoside XII (1), and viscumneoside XIII (2); a new dihydrogen flavonoid glycoside product named viscumneoside XIV (3), were isolated from the aerial part of Viscum album, along with seven known compounds (4-10). Their structures were identified by analysis of spectroscopic data. In addition, cytotoxicity assay showed that 1, 2 and 3 possessed significant inhibitory activities against C6, A549 and MDA-MB-231 (the inhibition rate arrived about 50%, 70% and 74% respectively with IC ≤ 60.00 μmol·L), while the inhibition of TF-1 and Hela was not significant.
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In order to investigate the application of lattice Boltzmann method (LBM) in the numerical simulation of computed tomography angiography-derived fractional flow reserve (FFR ), an idealized narrowed tube model and two coronary stenosis arterymodels are studied. Based on the open source code library (Palabos), the relative algorithm program in the development environment (Codeblocks) was improved. Through comparing and analyzing the results of FFR which is simulated by LBM and finite element analysis software ANSYS, and the feasibility of the numerical simulation of FFR by LBM was verified . The results show that the relative error between the results of LBM and finite element analysis software ANSYS is about 1%, which vertifies the feasibility of simulating the coronary FFR by LBM. The simulation of this study provides technical support for developing future FFR application software, and lays the foundation for the calculation of clinical FFR .
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Objective To establish chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography (FFRcT) in Bama miniature pig,and to evaluate its reliability.Methods Sixteen Bama miniature pigs were used to establish chronic coronary stenosis models through placing Ameroid constrictor into proximal or middle segments of left anterior descending arteries (LAD).In the 2nd week after modeling,the degrees of stenosis were monitored with coronary CTA.Invasive coronary angiography was used to verify stenosis degrees and measure fractional flow reserve (FFR) within 2 days of last coronary CTA examination.Computational fluid dynamics model was constructed and FFRcT was calculated by the specialized laboratory based on coronary CTA data respectively.Simulated FFRcT and FFR values were compared to verify this model.Results Models were successfully established in 10 pigs with a total of 24 coronary CT examinations,of which image quality met the diagnostic requirements.All models were with LAD stenosis＜25 ％ in the 2nd week after operation.LAD stenosis ＞50％ was found in the 3rd week in 9 pigs,and the other one was found with LAD stenosis ＞50％ in the 4th week.The results of coronary CTA corresponded to those of coronary angiography.There was no significant difference between simulated FFRcT and FFR value (t =-1.13,P =0.29).Conclusion Through placing Ameroid constrictor into LAD of Bama miniature pig and monitoring the degree of stenosis with coronary CTA,model of chronic coronary stenosis could be successfully established,which are suitable for noninvasive simulating hemodynamics study based on coronary CTA.
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Intervertebral disc degeneration (IDD) is one of the main causes of low back pain—a common clinical problem. Alterations of the phenotype, reduction of survival time, decline of metabolic activity, and decrease of extracellular matrix of nucleus pulposus (NP) cells are thought associated with IDD. The intervertebral disc is the largest avascular tissue in the body, with the most distinctive characteristic being low oxygen tension. Hypoxia-inducible factor (I III'') is a transcriptional factor induced by the hypoxia condition to initiate a scries of cellular responses, accommodating the hypoxia environment. HIF can start transcription of target genes by binding the hypoxia response element and may play an important role in the pathological process of IDD and serve as a crucial target for stopping progression or curing IDD. Here we summarized the roles of HIF in regulating metabolism activity of NP cells, including expression of HIF in NP cells, and regulatory roles of HIF in phenotype, survival, metabolism and extracellular matrix accumulation of NP cells.
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Melanoma is one of the most malignant forms of skin cancer; with a rapidly increasing prevalence. Early-stage melanoma is curable, but advanced metastatic melanoma is almost always fatal, and patients with such advanced disease have short median survival. Surgery and radiotherapy play a limited role in the treatment of metastatic melanoma. Rather, chemotherapy remains the mainstay of treatment, although other approaches, including biotherapy and gene therapy, have been attempted. The authors hereby, evaluated the use of temozolomide [TMZ] for treating metastatic melanoma compared to dacarbazine [DTIC], the effectiveness of TMZ for treating brain metastases, as well as TMZ resistance and how the efficacy of TMZ in malignant melanoma can be increased. Two chemotherapeutic regimens are commonly used for palliative treatment of malignant melanoma: intravenous administration of DTIC and oral administration of the alkylating agent temozolomide [TMZ]. Compared to DTIC, TMZ is very well tolerated and has an advantage in terms of improving the quality of life of patients with metastatic melanoma. While the prognosis is currently unpromising, chemotherapy plays a palliative role for patients with metastatic melanoma. The toxicity of treatment regimens based on DTIC and TMZ do not differ significantly, although TMZ is costlier. These findings provide a reference for future researchers via a comprehensive analysis of the relevant literature
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Objective To determine the feasibility and the optimal dose reduction of AIDR 3D on piglet chest CT which can provide image quality (IQ) comparable to filtered back projection (FBP).Methods Twenty-nine normal pigs with the weight of 3-12kg underwent 640-slice MDCT chest CT (Aquilion one,Toshiba) for 5 times with 80 kvp and various mAs.SureExposure3D technique were used and the index of noise were set to SD 10.0,12.5,15.0,17.5,20.0(Group A,B,C,D,E) to reduce dose successively.Group A were reconstructed with FBP,Group B,C,D,E were reconstructed using AIDR 3D (strong level).Quantitative image noise and signal to noise ratio(SNR) were measured in each group.Two radiologists graded subject image quality on both lung images (artifacts,central airway,lung tissue) and mediastinal images (mediastinal structure) and overall image quality using a 5-point scale in a blinded manner.Analysis of variance (ANOVA) and LSD test were used for comparisons of objective evaluation indices (CT value,noise,SNR)and radiation dose(CTDIvo1,DLP,ED) among the five groups.The Friedman test and Wilcoxon test were used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A receiver-operating characteristic (ROC) analysis was performed to establish a radiation reduction threshold up to which comparable IQ(score≥4) was maintained.Results Compared with Group A[noise(15.25 ± 3.14)HU,SNR 3.23 ± 1.07],Group B,C had significant lower noise and higher SNR [noise (12.11 ± 2.75),(13.18 ± 3.16)HU; SNR 4.13 ± 1.38,3.80 ± 1.20;F =7.38,3.11,P ＜0.05].Group D,E showed no significantly different noise and SNR with Group A[noise (15.14±4.51),(15.79 ±4.17)HU;SNR 3.40± 1.56,3.45 ± 1.70;P＞0.05].Group B,C had significant better subject image quality compared with Group A (P ＜0.01).Group D had no significantly different subject image quality compared with Group A (P ＞ 0.05).Group E had 5 pigs with overall image scores of ＜ 3.The ROC curve of IQ established SD 17.5 (Group D) as optimal cut-off point (AUC 0.75,95％ CI 0.58-0.92).Group D provided equivalent subjective image score and objective IQ measurements compared with FBP images in Group A.The ED of group D was 59％ lower than that of group A[CTDIvol (1.14±0.27) mGy vs (0.47 ±0.16)mGy,F=183.83,P＜0.01].Conclusion Using AIDR 3D technique,80 kvp with SureExposure3D (SD 17.5) can provide comparable IQ compared with routine dose with FBP reconstruction,and reduce 59％ dose in piglet model.
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Objective To assess the image quality (IQ) of an iterative reconstruction (IR) technique (iDose4) from prospective electrocardiography (ECG)-triggered coronary CTA on a 256 MSCT scanner and determine the optimal dose reduction using IR that can provide IQ comparable to filtered back projection (FBP).Methods Prospectively ECG gated CCTA were performed on 120 patients [76 men,44 women; age:(53 ± 10)y] using a 256-slice MSCT (Brilliance iCT,Philips Healthcare).The control group (Group A,n =30) were scanned using the conventional tube output (120 kVp,210 mAs) and reconstructed using FBP.The other 3 groups were scanned with the same kVp but successively reduced tube output as follows:B (n =30):105 mAs,C (n =30):84 mAs:D (n =30):65 mAs and reconstructed using IR levels of L4 to L6,respectively.All images were reconstructed using the same kernel (XCB).Two radiologists graded IQ in a blinded fashion on a 4-point scale (4-excellent,3-good,2-fair and 1-poor).Quantitative measurements of CT values,image noise,Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were obtained in each group.Analysis of variance (ANOVA) was used for comparisons of objective evaluation indices (noise,CNR) and radiation dose (CTDIvol,DLP,ED) between the four groups.The Kruskal-Wallis test was used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A level of P ＜ 0.05 was considered statistically significant.A ROC analysis was performed to determine a radiation reduction threshold up to which excellent IQ was maintained.Results There was no significant differences in objective noise among Groups A (37.4 ±7.9) HU,B(33.2±7.1) HU,C(35.7±9.8) HU,and D(36.0±6.8) HU (F=1.48,P=0.22).There was no significant differences in CNR among Groups A(15.0 ±2.3),B(16.5 ±3.6),C(16.3 ±3.5),and D(15.3±2.8) (F=1.70,P =0.17).Group B and C had good and excellent scores of the subjective IQ (≥3),and there was no significant differences in the scores of the subjective IQ between Group A,and Groups B,C (P =0.30-1.00).Significant differences in image sharpness and study acceptability were observed between groups A and D (P ＜ 0.01).Using the criterion of excellent IQ (score 4),the ROC curve of dose levels and IQ acceptability established a reduction of 60％ of tube output (Group C) as optimum cutoff point (AUC:0.76,95％ CI:0.65-0.87).The effective dose (ED) of Group C was 61％ lower than that of Group A,(1.2 ± 0.1) mSv vs.(3.1 ± 0.6) mSv.Conclusion Iterative reconstruction techniques can provide 61％ ED reduction in prospectively-triggered coronary CTA using 256-slice MSCT while maintaining excellent image quality.
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OBJECTIVE@#To explore the clinical effect and safety of internal fixation of steel-wire limited loop in early Achilles tendon rupture.@*METHODS@#Seventy-six patients respectively with early transected and avulsed types of Achilles tendon rupture were selected and treated with internal fixation of steel-wire limited loop. The patients began to take exercise for their lower limbs through continous passive motion as early as possible after surgical repair, and the loops were removed after 3-5 months. Six months later, the condition of complications including Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis, cutaneous sensation in sural nerve dominance region, time back to preinjury work or learning as well as time to physical activities were observed. One year later, the therapeutic effect was evaluated, and the maximum circumferences of bilateral legs and ruptured plane circumferences of Achilles tendon were measured.@*RESULTS@#The wound of all patients healed well, no complications like Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis occured, and the cutaneous sensation in sural nerve dominance region was normal. The mean time back to preinjury work or learning as well as to pysical activities of all patients were respectively 10 and 22 weeks. Seventy out of 76 patients (92.1%) achieved an excellent effect, and 6 (7.9%) good effect. The excellent and good rate came up to 100%. The maximum circumference in the affected leg decreased to 2 mm averagely compared with the offside, while the ruptured plane circumferences of Achilles tendon in the affected side increased to 2.2 mm compared with the offside.@*CONCLUSIONS@#For early Achilles tendon rupture, internal fixation of steel-wire limited loop can recover the ankle function better, return to the preinjury state in the shortest time, and has few complications.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Achilles Tendon , Wounds and Injuries , General Surgery , Exercise Test , Follow-Up Studies , Orthopedic Procedures , Methods , Range of Motion, Articular , Rupture , General Surgery , Severity of Illness Index , Steel , Suture Techniques , Tendon Injuries , General Surgery , Tensile Strength , Treatment Outcome , Weight-BearingABSTRACT
Background The characters of diabetic retinopathy (DR) include capillary occlusion,microcirculation disturbance and retina neovascularization near ischemic areas of the retina.The pathogenic mechanism is still incompletely clear,but the primary mechanism of DR is the change of permeability of retinal blood capillary.Objective The aim of this study was to investigate the effect of lycium bararum polysaccharides (LBP) on the blood glucose,blood fat and permeability of blood-retinal barrier in diabetic rats.Methods Fifty-four clean adult SD rats were randomized into 4 groups.The diabetes mellitus models were created in 36 SD rats by injection of 45 mg/kg streptozotocin(STZ) via caudal vein.The rats with the blood glucose ＞ 16.7 mol/L were defined as the diabetic mellitus in 72 hours after injection.LBP of 200 rmg/( kg · d) was intragastriccally administered in 18 models once a day in LBP group,and equal volume of normal sodium was used at the same way in 18 models in DM group,and 18 normal rats were as normal control group.The rats were killed in 4,8 and 12 weeks respectively for the detect of blood glucose level,triglyceride,total cholesterol.The retina tissue were isolated for the quantification of vascular permeability using Evans blue method.Results The blood glucose level was significantly elevated in the DM group and LBP group compared with normal control group,and that in LBP group was obviously declined in comparison with the DM group with a 57％,40％,36％ fall off in 4,8,12 weeks respectively,showing a statistically significant differences( P＜0.05 ).The triglyceride concentration was considerably raised in the DM group compared with normal control group in all of the time points( P＜0.01 ),however,the rise of triglyceride concentration was found only in 12 weeks in LBP group(P＜0.05).The cholesterol level was increased in 8 and 12 weeks in DM group compared with normal control group and that of LBP group went up only in 12 weeks (P＜0.0l ).The Evans blue contents in dry retina tissue were(26.23±2.00),(29.78± 1.78 ) and( 34.08±3.03 ) μg/g in 4,8,12 weeks in the DM group,and those of LBP were ( 13.27 ±0.77 ),( 18.01 ± 1.77 ),( 25.05 ±:1.50 ) μg/g,showing statistical differences between two groups ( P＜0.01 ).However,in comparison with normal control group ( 12.34 ±4.30,12.76 ± 2.11,12.45 ±4.40 μg/g),the Even blue content were elevated in various time points (P＜0.01 ).Conclusions LBP can suppress the increase of the blood-retinal barrier permeability in STZ-induced diabetic rat by lowing the levels of blood glucose,triglyceride and total cholesterol.These results suggest that LBP has a therapeutical effect on DR.
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Objective To observe the effect of the average heart rate (HR) and the variability of HR on image quality of 3D free-breathing whole-heart coronary MR angiography (MRCA). Methods A total of 65 healthy volunteers underwent retrospectively electrocardiography-gated 3D free-breathing whole-heart coronary MRA with ECG-gated 3D segmented-k-space gradient echo sequence. Two observers evaluated image quality of each coronary segment. Visualization of the proximal coronary arteries (CA) with coronary MRA was qualitatively evaluated using a four point grading scale (1: excellent; 2: good; 3: moderate; 4: non-diagnostic). Pearson correlation analysis was performed to analyze the correlation between image quality of each coronary artery and the average HR and heart rate variability. Results Average HR was 64.5±13.3 beats per minute (bpm) (range 40-86 bpm) with a variability of (6.1%±2.6)%. No significant correlation presented between mean HR and image quality of all segments of the left circumflex and left anterior descending artery except the right coronary artery (P<0.05). heart rate variability significantly correlated with overall image quality (P<0.001) and image quality of each coronary artery. Conclusion heart rate variability influences the image quality of 3D free-breathing coronary MRA more obvious than HR does.
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Objective To retrospectively compare the image quality and radiation dose for coronary CT angiography obtained with a prospectively gated transverse (PGT) CT technique and a retrospectively gated helical (RGH) CT technique. Methods Coronary CT angiography obtained with 256-slice CT were retrospectively evaluated in 177 patients. The main branches of coronary arteries were divided into 9 segments. The image quality was evaluated with a four-point grading scale. The assessability of coronary artery segment, image quality score and radiation dose for prospective and retrospective CT angiography were compared with student t test. Results The PGT technique was used in 86 patients. The routine RGT technique was used in 91 patients. The percentage of assessable coronary artery segments was 98. 8% (765 of 774)with PGT technique versus 99. 6% (816 of 819) with RGH technique (t = 2. 51, P = 0. 01 ). In patients with heart rates under 75 beats per minute, the image quality of coronary artery branches was similar between PGT and RGH techniques (99. 8% versus 99. 7%, t = 1.90, P > 0. 05 ) . In patients with heart rates above 75 beats per minute, the image quality with RGH technique was better than that with PGT technique (99.0% versus 93. 6%, t = 3.57, P < 0. 05 ). Effective dose with prospective CT angiography was 60. 0% lower than that with retrospective CT angiography [ (4. 4 ± 0. 5 ) vs ( 10. 3 ± 1.5 ) mSv, t = 33.4,P <0. 05 ]. Conclusions Prospective CT angiography can reduce effective radiation dose obviously. The PGT technique offers the similar image quality with RGH technique in patients with heart rates under 75 beats per minute and RGH technique has better image quality in patients with heart rates above 75 beats per minute.
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Objective To evaluate the 64-slice CT angiography in characterizing the coronary venous anatomy and the arterio-venous relationship.Methods Sixty-four slice CT coronary veins angiography images of 300 patients(187 men and 113 women,)were analyzed.The visibility of the coronary veins and arterio-venous spatial relationship were assessed qualitatively on two-and three-dimensional displays.The diameter of the coronary sinus ostium(CSO),middle cardiac vein ostium(MCVO)and posterior vein of left ventricle ostium(PVLVO)were measured.All data was statistically processed with SPSS for Windows.Results The CS,great cardiac vein(GCV)and MCV could be clearly visualized in all of the images.1-3 branches of PVLV could be observed in 273 patients(91.0%).Small cardiac vein(SCV)and Marshall vein were found in 56(18.7%)and 24(8.0%)cases respectively.Three patients had permanent vena cava superior on the left and one patient had a CS diverticulum.Posterior descending artery(PDA)was concomitant with MCV in 189 cases(63.0%)and intersected with MCV in 96 cases(32.0%).Left circumflex artery(LCX)was concomitant with CS in 122 cases(40.7%),intersected with MCV in 15 cases(5.0%),and intersected with PVLV in 104 cases(34.7%).There were no significant differences in age,sex and CHD groups among CSO,MCV,PVLV value.The supero-inferior diameter of CSO had a significant difference between male and female(F=6.67,P＜0.05).Conclusion Sixty-four slice CT venous angiography is able to be used for guiding electrophysiological procedures,which is especially useful due to the considerable variations in venous anatomy.