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Objective To study classification of vascular sign of tiny ground glass nodules-like lung adenocarcinoma in HRCT, and explore its value to differentiate benign from malignant of the ground glass nodules(GGN).Methods 87 patients with tiny ground glass nodules-like lung adenocarcinoma examined on HRCT were retrospectively evaluated.According to the new pathological classification standard of lung adenocarcinoma,they were divided into three groups:(1)pre-invasive group(n=25),including 14 cases of atypical adenomatous hyperplasia(AAH)and 11 cases of adenocarcinoma in situ(AIS);(2)minimally invasive adenocarcinoma (MIA)group(n=35);(3)invasive adenocarcinoma(IAC)group(n=27).The lesions were divided into three types according to the grinding of glass composition proportion:Type A,pure ground glass nodules(pGGN);Type B,mixed ground glass nodules (mGGN)which contained glass composition≥50%;Type C,mGGN which contained glass composition < 50%.The vascular sign of GGN were divided into four types:Type 1,without vessels passing through the GGN,or vessels passing by GGN;Type 2,intact vessels passing through GGN,but vascular morphology is normal;Type 3,single vessels passing through GGN,and distorted,stiff vessels seen within GGN;Type 4,two or more vessels passing through GGN,and branches between vessels formed in GGN,and the diameter of vessel was irregular,partial enlargement.The relationship among the size of the GGN,content of the grinding of glass proportion and the vascular sign of GGN were analyzed both in axial images and reconstruction images.Results There were significant differences in size among the three groups(P=0.032,P=0.000,P=0.000).There were significant differences between content of the grinding of glass proportion and classification of vascular sign of GGN(P=0.000).Type 1 and type 2 vascular sign were dominant in the infiltrating former group,a total of 24 cases(96%).The incidence of type 3 and type 4 vascular sign in MIA group and IAC group was 60% and 74% respectively,and there were significant differences with the infiltrating former group(P=0.000,0.000).Further analysis indicated that type 3 was more commonly seen in MIA with comparison to type 4 which was more likely seen in IAC,the difference was statistically significant(P=0.043).Conclusion To study HRCT vascular sign of tiny ground glass nodules-like lung adenocarcinoma can improve the ability of the GGN benign and malignant diagnosis,provide reliable basis for clinical diagnosis and treatment.
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Objective To evaluate the application of abbreviated protocol (AP) of magnetic resonance imaging (MRI) in screening of breast cancer with dense breast tissue.Methods Total 478 patients with dense breast tissue,who had negative X-ray mammography (MG),underwent dynamic contrast-enhanced MRI (DCE-MRI).The AP MRI,which consisted of first postcontrast subtracted (FAST) and maximum-intensity projection (MIP),and full diagnostic protocol (FDP) MRI images were analyzed by Breast Imaging Reporting and Data System (BI-RADS).Among 478 patients the histopathological diagnosis was available in 39 cases (41 breast lesions).With pathological diagnosis as gold standard,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of AP and FDP in breast cancer detection were evaluated.Results In 41 breast lesions there were 16 malignant lesions and 25 benign lesions.FDP detected all 16 malignant lesions,including 9 cases of ductal carcinoma in situ,6 cases of invasive ductal carcinoma and 1 case of mucinous carcinoma;AP detected 15 out of 16 cases of breast cancer.The sensitivity of FDP and AP in detection of breast malignant lesions was 16/16 and 15/16,respectively (x2 =0.725,P =0.224).The specificity of FDP and AP was 92％ (23/25) and 76％ (19/25),respectively (x2 =6.327,P =0.012).Conclusion For women with dense breast tissue AP of MRI can be used in early screening of breast cancer.
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Objective To explore the multi-modal MRI characteristics of breast cancers in dense breasts.Methods 120 patients with breast cancer shown on mammography underwent breast MRI,which were solitary and confirmed by pathological examination. According to the BI-RADS classification of breast,the 120 cases were divided into two groups including dense type breast and non-dense type one.The differences in morphological features,ADC values (b=1 000 s/mm2 )and time-signal intensity curve (TIC)of the lesions between two groups were analyzed and compared.Statistical analysis was performed using SPSS1 6.0.Results The breast cancers in dense breast were vulnerable to have a spiculated margin (44/68 in the dense breast group vs.1 6/52 in the non-dense breast group,P =0.000).The size of the lesion in dense breast (1.83 ±0.98)cm was bigger than that in non-dense breast (1.40±0.46)cm (P =0.005).The non-mass-like enhancement of the lesion in dense breast was much more than that in non-dense breast (P =0.000).In addition,the average ADC values of the lesion in dense breast (0.89±0.12)×10 -3 mm2/s were lower than in non-dense breast (0.95±0.10)×10 -3 mm2/s(P =0.01 6).Conclusion The breast cancer in the dense breast has different MRI findings in comparison with non-dense breast.
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Objective To evaluate the value of proton magnetic resonance spectrum (1H-MRS) in the differential diagnosis of Alzheimer's disease (AD) and vascular dementia (VD) patients with white matter lesions (WMLs).Methods Multi voxel 1H-MRS were performed to 30 patients with AD,30 patients with VD,and 30 normal control volunteers.The levels of the N-acetylaspartate (NAA),myo-inositol (mI),glutamate (Glu),and creatine (Cr) were measured in the white matter adjacent to the lateral ventricles.The ratios of NAA/Cr,mI/Cr and Glu/Cr were calculated and compared among the group.Comparisons of the 1H-MRS indexes among AD,VD and NC group were conducted by one-way ANOVA.Results NAA/Cr ratios of the region of interesting in AD (1.59±0.15)and VD(1.53±0.12) group were significantly decreased compared with NC (1.79±0.22)group (P＜0.05),and Glu/Cr ratios of the region of interesting in AD(0.41±0.03) and VD(0.49±0.04) group were significantly decreased compared with NC(0.57±0.05) group (P＜0.05).However,there were not significant differences for NAA/Cr ratios of the paraventricular white matter region between AD and VD group (P＞0.05),and Glu/Cr ratios in AD and VD groups were significantly different (P＜0.05).A significantly increased mI/Cr was found in AD (0.68±0.05) group than in VD(0.57±0.04) and NC(0.55±0.03) groups (P＜0.05),and there were no significant changes in mI/Cr ratios between VD and NC groups (P＞0.05).Conciusion Multi-voxel 1H-MRS is an effective method in the differential diagnosis of dementia,and changes of the mI/Cr and Glu/Cr ratios of the white matter adjacent to the lateral ventricles may help to identify the AD and VD patients.
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Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in diagnosis of internal abdominal hernia (IAH).Methods The MSCT findings in 1 5 patients with IAH confirmed by surgery were retrospectively analyzed.Results MSCT showed intestinal obstruction in 14 patients with strangulating intestinal obstruction in 8.The typical features of MSCT were as follows:translocated position of intestines (occupying effect),closed loop intestinal obstruction (gathered intestinal loops with different forms),assembled,expanded and translocated blood vessels of mesenteries,and thickened intestinal walls with ischemic edema and abnormal density.Surgical results showed paraduodenal hernia in 2,transomental hernia in 2,transmesenteric hernia in 5,ankylenteron strap hernias in 4,pericecal hernia in 1 and hernia through the Douglas fossa in 1,Intestinal obstruction in 14 and strangulating intestinal obstruction in 8 were also confirmed by surgery.The CT findings of IAH were correlated with the surgical results,and the accurate rate of grading of intestinal obstruction with CT was also consistent with the surgical results (Kappa=0.758,t=3.462,P=0.001).Conclusion IAH can be diagnosed accurately by MSCT in most patients,MSCT is helpful for guiding the surgical programs.
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Objective] To conclude Yan Zhongqing clinical academic experience. [Methods] Discussed in terms of etiology and pathogenesis, treatment, therapies of Yan Zhongqing teacher using classical treatment of insomnia clinical experience, herbal prescription summed up its characteristics, citing the case evidence. [Results] Yan Zhongqing teacher believes that the main pathogenesis of this disease is not paying for the yin yang, and heart, lung, liver, kidney closely linked to inadequate blood deficiency and liver yang common causes of insomnia are caused clinically. The main syndromes of heart and lung deficiency heat, heart and kidney Huo, heart and liver blood deficiency, lack of liver stagnation of liver-yang, etc., are used to support the heart and lungs, cooling heat; yin and clearing fire, balance between kidney and heart; Yin and Yang blood, Anshen; liver qi, yang Yixin of the law, and achieves better therapeutic effect on clinical practice. [Conclusion] With appropriate clinical prescription of Mr. Yan, the treating method has clinical value.
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Objective To label neural stem cells (NSCs) with superparamagnetic iron oxides (SPIO) and to explore the tropism of NSCs after transplantation into the hippocampus of APP/PS1 AD mice by MRI.Methods NSCs from C57BL/6 mouse were cultured and identified.Feridex and Poly-L-Lysine were added into the medium to be co-cultured to make magnetic labeled NSCs and transmission electron microscopy was used to identify the iron particles in NSCs.Transgenic (tg) and wild-type (wt) mice at 12 months of age were divided into three groups: SPIOs labeled NSCs group (A and C),unlabeled NSCs group(B).Feridex-labeled NSCs were migrated into the hippocampus of APP/PS1 AD mice to monitor in vivo by MRI.After 1,2,4 and 6 weeks,the mice were sacrificed and their brain tissues were sectioned to investigate the migration of SPIO labeled NSCs and compared with MRI.Results NSCs of C57BL/6 mice were cultured successfully.Transmission electron microscope showed visible iron granules in cytoplasm.MRI detection of labeled cells: T2WI and T2* WI showed remarkable low signal intensity at the hippocampus injection points 1 week after transplantation,particularly on T2* WI.Area of low signal intensity enlarged increasingly along the injection points after 2 weeks.At 4 weeks,area of low signal intensity spread throughout the hippocampus,but intensity shadowed Six weeks later,low signal intensity almost disappeared.There was no obvious low signal change in unlabeled cell transplantation group.For wt mice,size and location of low signal did not appear obvious change at all designated time points.Prussian blue positive cells were observed in the hippocampus,indicating that NSCs labeled with SPIO could survive,migrate and differentiate in the brain of the APP/PS1 AD mice.Changes of pathology were well correlated with the area where a signal intensity loss was observed in MRI 1,2,4 and 6 weeks after transplantation Conclusions Diffuse migration of transplanted NSCs labeled with SPIO is observed in the hippocampus in APP/PS1 tg mice,and MRI technique is an ideal method for tracking labeled stem cells after grafting in vivo.
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Objective To explore the effect of neural stem cell(NSCs) transplantation on proton magnetic resonance spectroscopy (1H-MRS) and the behavior in APP/PS1 double transgenic AD mice.Methods NSCs from C57BL/6 mice were cultured and amplified.APP/PS1 double transgenic AD mice (n=30) aged 12 months were used as the study group,and mild-type mice (n=15) were used as the control group(group C).Animals in the study group were randomly divided into two subgroups:one receiving NSCs (group A) and the other receiving PBS transplantation (group B) in bilateral hippocampal CA1 of the AD model mice.Animals in the group C were not treated.1 H-MRS and Morris water maze (MWM) were performed before transplantation and 4 weeks after transplantation,and compared with the histopathological results.Results 1H-MRS showed that there was no significant change in NAA/Cr(1.01±0.08 and 1.03±0.05) and mI/Cr (0.69±0.05 and 0.71±0.06) ratios between group A and group B before transplantation (P＞ 0.05),but the changes were significant compared with the group C (NAA/ Cr:1.21±0.05; mI/Cr:0.58±0.06) (P＜0.05).Four weeks after transplantation,NAA/ Cr ratio(1.18± 0.09) was increased and mI/Cr ratio (0.53±0.04) was decreased in group A.The difference was significant compared with the group B at the same time points (P＜0.05).MWM showed the escape latency in group A was significantly shorter than that in group B after transplantation (P＜0.05).In addition,group A also showed an exclusive preference for the target quadrant,and spent more time ((35.21±5.44) s) in the 3rd quadrant compared with group B (P＜0.05).For number of platform crossings,similar results were also shown (5.75± 3.23).Nissl's staining showed that the number of neurons in the hippocampal area increased more significantly in group A than those in group B(P＜0.05).Conclusion NSCs transplantation can improve spatial learning and memory via neurons regeneration in APP/PS1 double transgenic AD mice,and 1H-MRS is able to display intracranial metabolite changes after NSCs transplantation.
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Objective To explore the value of 1H-MRS on the evaluation of Alzheimer's disease (AD) with neural stem cells (NSCs) transplantation in an APP-PS1 double transgenic (tg) AD mouse model.Methods NSCs from C57BL/6 mice were cultured and amplified.APP-PS1 tg mice (n =30) aged 12 months were used as the study group,and mild-type mice (n =15) were used as the control group.Animals in the study group were randomized into two subgroups,the AD mice in one subgroup received NSCs transplantation (NSCs group) and in another subgroup received phosphate buffer saline (PBS,PBS group)in bilateral hippocampal CA1.Animals in the control group were not treated.Using a 7.0 T high-fieldstrength MR imager,1H-MRS was performed before and 6 weeks after transplantation to measure the area under the peak of n-acetyl aspartate (NAA),glutamate (Glu),myo-inositol ( mI),choline (Cho) and creatine (Cr) in the hippocampal area,NAA/Cr,Glu/Cr,mI/Cr and Cho/Cr ratio were calculated and compared with histopathological results (including Nissl's staining and electron microscope examination).Comparisons among NSCs,PBS and control groups were conducted by one-way ANOVA.Results NSCs from C57BL/6 mice were cultured successfully. Before transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in NSCs,PBS and control groups were 0.89 ± 0.05,0.88 ± 0.04 and 1.15 ± 0.05,0.40 ± 0.03,0.39 ± 0.03 and 0.45 ± 0.05,0.67 ± 0.05,0.67 ± 0.05 and 0.52 ± 0.04,respectively,and differences were statistically significant (F =148.918,7.529,59.468,P ＜ 0.01 ). There were no significant differences in NAA/Cr,mI/Cr and Glu/Cr ratios between NSCs and PBS groups before transplantation (t =0.147,0.096,0.207,P ＞ 0.05 ),but the differences were significant compared with the control group (t =0.255,0.467,0.171 and t =0.269,0.527,0.151,P ＜0.05).Six weeks after transplantation,the mean NAA/Cr,Glu/Cr and mI/Cr in three groups were 1.13 ±0.07,0.86 ±0.05 and 1.14 ±0.05,0.45 ± 0.04,0.38 ± 0.02 and 0.44 ± 0.03,0.58 ± 0.04,0.67 ± 0.04 and 0.53 ± 0.04,respectively,and differences were statistically significant ( F =112.092,23.076,44.367,P ＜ 0.01 ).NAA/Cr and Glu/Cr ratios were increased and mI/Cr was decreased in NSCs group,and the difference was significant compared with PBS group at the same time point ( t =0.271,0.071,0.089,P ＜ 0.05 ).There were no significant differences in NAA/Cr and Glu/Cr ( t =0.013,0.012,P ＞ 0.05 ),but there was a significant difference in mI/Cr between NSCs and control groups ( t =0.046,P ＜ 0.05).There were no significant differences in Cho before and after transplantation among the three groups (P ＞ 0.05 ). Nissl's staining showed that the number of neurons in the hippocampal area increased more significantly in tg mice receiving NSCs than that without receiving NSCs.Electron microscopy showed that most hippocampal NSCs in NSCs group were morphologically normal with abundant organelles,while hippocampal NSCs in PBS group were swollen with sparse synapses.Conclusion 1H-MRS is able to display intracranial metabolite changes before and after NSCs in APP-PS1 double transgenic AD mice and has an applicable value in evaluating the therapeutic effect of NSCs on AD.
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Objective To study whether the leakage of polymethylmethacrylate (PMMA) can lead to pulmonary embolism in vertebroplasty (VP), and to observe the correlation of embolism degree with the doses of PMMA. Methods Fifteen canines were randomly divided into 3 groups: group A, B, C, and were injected 0.5, 1.0, 2.0 ml PMMA into the femoral veins, respectively. Before and after the injection, chest CT and angiography of pulmonary artery were performed, the pressure of pulmonary artery was measured, and the blood gas analysis of femoral artery was done. At last, the canines were euthanized and examined and histologically after HE-stained. Results In group C, the pressure of O_2 decreased obviously, and significant difference was found between before and 10 min after injection (P<0.05). The pressure of CO_2 increased quickly in group C, significant difference was detected between before and 1 min after injection (P<0.05). Pressure of pulmonary artery in both group B and C were significantly different between before and after injection (P<0.05). Conclusion The leakage of PMMA can lead to pulmonary embolism. The degree of pulmonary embolism is correlated to the doses of PMMA. The large dose of bone cement leakage can lead to disorder of respiratory function.
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Objective:To investigate the role and its mechanism of Toll-like receptor4(TLR4) mutation on acute lung injury induced by hemorrhagic shock without resuscitation.Methods:The hemorrhagic shock model of 20 toll-like receptor 4(TLR4) mutant mice and 20 wild type mice(CBA) was reproduced by heart puncture.The lung tissues were collected at 0,1,2,4,and 6 hours after hemorrhagic shock for pathologic analysis,TLR4 mRNA was measured by semi-quantitative reverse transcription-polymerase chain reaction and NF-?B activation was determined by electrophoretic mobility shift assay.Results:The lung neutrophil infiltration and erythrocyte effusion in toll-like receptor 4 mutant mice were milder than those in wild type mice.The expression of TLR4 mRNA and activation of NF-?B were increased following hemorrhagic shock in wild type mice,while there was no significant change in TLR4 mutant mice.Conclusion:TLR4 plays an important role in ALI induced by hemorrhagic shock,and TLR4 mutant alleviates ALI.