Systematic Effect of Modified Renshen Wumeitang in Regulation of GABA Signaling Pathway in Rats with Diarrhea / 中国实验方剂学杂志

ObjectiveTo investigate the effect of modified Renshen Wumeitang（MRWT） on the related regulatory factors of the γ-aminobutyric acid （GABA） signaling pathway in colon tissues of rats with diarrhea， and reveal the mechanism of MRWT in invigorating Qi， generating fluid， and checking diarrhea. MethodForty-eight SD immature rats were randomly divided into a blank group （n=12） and an experimental group （n=36）. The diarrhea model was induced in the experimental group by Sennae Folium combined with overstrain and improper diet for 14 days. Subsequently， the model rats were randomly divided into a model group （normal saline， 20 mL·kg-1）， a western medicine group （Medilac-Vita， 0.7 g·kg-1）， and a Chinese medicine group （MRWT， 35 g·kg-1）， with 12 rats in each group. The rats in the blank group received normal saline at 20 mL·kg-1， and those in the other groups were treated correspondingly， once a day for 7 days. The general condition， loose stool rate， and diarrhea index of the rats were observed daily. Immunohistochemistry was used to detect the optical density expression of GABA protein in the colon of rats. The content of phosphatidylinositol-3 kinase （PI3K）， protein kinase B2 （Akt2）， phosphorylated Akt （p-Akt）， and interleukin-1β （IL-1β） was determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of PI3K， Akt2， and GABA type A receptor subunit β2 （GABRB2） in the colon of rats were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with the blank group， the model group showed worsened general condition， The difference was not statistically significant of loose stool rate and diarrhea index， increased expression of GABA protein （P<0.05）， elevated expression of PI3K， Akt2， p-Akt， and IL-1β （P<0.05， P<0.01）， and up-regulated PI3K， Akt2， and GABRB2 mRNA and protein expression （P<0.01）. Compared with the model group， the western medicine group and the Chinese medicine group showed the improved general condition， decreased loose stool rate and diarrhea index （P<0.01）， and decreased content of PI3K， Akt2， p-Akt， and IL-1β （P<0.05）. The Chinese medicine group displayed decreased mRNA expression of PI3K， Akt2， and GABRB2 （P<0.05， P<0.01） and down-regulated protein expression of GABA， PI3K， and GABRB2 （P<0.05， P<0.01）. The western medicine group exhibited down-regulated mRNA expression of PI3K，Akt2，and protein of PI3K （P<0.05）. ConclusionMRWT can regulate the GABA signaling pathway， reduce Cl- flow in intestinal epithelial cells to the intestinal lumen， and improve the imbalance of colonic fluid metabolism in the colon of diarrhea rats， thereby exerting its effects of invigorating qi， generating fluid， and checking diarrhea.

Spatio-temporal clustering of varicella in Shanghai from 2006 to 2015 / 上海预防医学

Objective:Using a spatio-temporal clustering analysis of varicella in Shanghai from 2006 to 2015 at a subdistrict level， we aim to provide decision support for formulating a reasonable varicella prevention strategy. Methods:Based on the data of varicella cases in Shanghai from 2006 to 2015， SaTScan was employed to detect and analyze the spatial pattern of varicella clusters. Moreover， field investigation was combined to infer and explain the risk factors of varicella clusters. Results:The spread of varicella in Shanghai from 2006 to 2015 had an obvious annual change and spatial differentiation at a subdistrict level. The findings of SaTScan showed that with a confidence level of 99.9%， there were totally 7 spatio-temporal clustering events in Shanghai from 2006 to 2015， in which 3 events were regional events and 4 were independent events. Independent events usually lasted for 2-4 years， while regional events in the "Jiading-Chongming district" and "Songjiang-Minhang district" areas had a longer duration and a larger impact. Conclusions:From 2006 to 2015， there is an obvious temporal and spatial clustering pattern of varicella in Shanghai. Majority of abnormal spatio-temporal clusters occur in rural areas rather than urban areas， which may be related to increasing floating population and migration of susceptible population caused by the implementation of large-scale construction projects.

Prognostic Value of Interim PET/CT in 227 Patients of DLBCL / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic evaluation value of fluorodeoxyglucose (FDG) interim positron emission tomography/computed tomography (PET/CT) for diffuse large B cell lymphoma (DLBCL).@*METHODS@#Two hundred and twenty-seven patients with pathologically diagnosed DLBCL underwent 18F-FDG scans at baseline and before 3 cycles of a rituximab-containing chemotherapy regimen. The Visual Deauville score (DS) and changes in maximum standard uptake values (ΔSUVmax) were calculated for tracer for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS) using Kaplan-Meier method and COX regression.@*RESULTS@#The median follow-up period was 71 months. Receiver operating characteristic analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) was 71%. The sensitivity, specificity and accuracy of DS and ΔSUVmax were 86.9%, 74.3%, 82.8% and 77.8%, 63.5%, 73.1%, respectively in response assessment. Kaplan-Meier analysis showed DS, ΔSUVmax and IPI had significance for prediction of PFS and OS (P = 0.001). The DS 4-5 and IPI 3-5 were independent risk factors of poor prognosis by COX regression analysis.@*CONCLUSION@#Interim PET/CT is important predictor for evaluation therapeutic response and prognosis in DLBCL patients.

Comparison of 3D pseudo-continuous arterial spin labeling and positron emission tomography-computed tomography in the brain disorders / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the diagnostic agreement of 3D pseudo-continuous arterial spin labeling (3D-pCASL) and ¹⁸F-fluorodeoxyglucose and ¹¹C-Methionine positron emission tomography-computed tomography(PET/CT) for brain disorders.</p><p><b>METHOD</b>3D-pCASL and PET/CT were performed on 7 patients with different brain disorders, and the diagnostic agreement was assessed by visual observation.</p><p><b>RESULTS</b>Four tumor lesions presented hyperperfusion on 3D-pCASL, and hypermetabolism on PET/CT. One demyelinated lesion and one metabolic lesion showed hyperperfusion on 3D-pCASL, and one infected lesion showed hypoperfusion on 3D-pCASL ;all these three lesions showed hypermetabolism on PET/CT.</p><p><b>CONCLUSION</b>3D-pCASL can non-invasively evaluate the perfusion state of the brain disorder in vivo and have a good dignostic consistency with PET/CT.</p>

Four-year clinical outcome in asymptomatic patients undergoing coronary computed tomography angiography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Percutaneous coronary intervention (PCI) is indicated for angina with coronary stenosis. However, PCI for asymptomatic coronary stenosis remains controversial. We prospectively followed a group of patients for four years who underwent coronary computed tomography angiography (CCTA) for major adverse cardiac events (MACE). We hypothesized that the results of this trial would reliably reflect the natural outcome of the coronary disease.</p><p><b>METHODS</b>Consecutive patients who underwent CCTA from June 2008 to May 2009 were selected. Those who could not be reached by telephone, had significant angina, had CT images that were not interpretable, or poor kidney and left ventricular (LV) function were excluded. The patients were divided into five groups: group A normal CCTA without stenosis, group B mild stenosis (1% - 49%), group C moderate stenosis (50% - 74%), group D severe stenosis (= 75%) and they were treated with optimal medical therapy (OMT) or PCI. The group E had PCI before the CCTA examination. The patients were then followed for MACE after different treatments. MACE included acute myocardial infarction (MI), heart failure (HF) and death.</p><p><b>RESULTS</b>The patient population consisted of 419 patients. The follow-up time was (51 ± 5) months. The age was (60 ± 31) years. Male made up 67.78% of the population (n = 284). A total of 51 cases of MACE occurred including 25 MI, eight HF and 18 all-cause deaths. There was no MACE in group A. Although MACE occurred in two patients in group B, they were not attributed to cardiac death. We further compared the MACE in groups C-E and no significant difference was found (P > 0.05). However, a difference was detected among patients with unstable angina pectoris (UAP), stable angina pectoris (SAP), re-hospitalization, and cerebrovascular events from groups A-E (P < 0.05). The plaque scores were used to predict MACE. The scores progressively increased significantly with lesion severity (P < 0.05). Receiver operating curve (ROC) was performed to determine the sensitivity and specificity in predicting MACE. Our scores predicted MI with area of 0.76, predicted HF with area of 0.77, and predicted death with area of 0.70.</p><p><b>CONCLUSIONS</b>Normal and mild lesions had very few events. With increased stenosis the MACE rate increased progressively. PCI did not significantly reduce the MACE in comparison with OMT in asymptomatic patients. Furthermore, UAP, re-hospitalization, and re-PCI were significantly increased in patients who were treated with PCI.</p>

An initial study on the feasibility of diagnosing myocardial ischemia with CT first-pass myocardial perfusion imaging at rest / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the feasibility and accuracy of CT first-pass myocardial perfusion imaging (CT first-pass MPI) at rest for diagnosis of myocardial ischemia. Results of adenosine-induced myocardial perfusion scintigraphy (MPS) were used as gold standard.</p><p><b>METHODS</b>Twenty-two patients with suspected or diagnosed coronary artery disease (CAD) were included and CT coronary angiography (CTCA) and MPS were performed within 2 weeks. CT first-pass MPI detected myocardial ischemia results through analyzing the raw date of CTCA were compared with MPS results.</p><p><b>RESULTS</b>The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CT first-pass MPI at rest for detecting myocardial ischemia were 92% (12/13), 78% (7/9), 86% (12/14), 88% (7/8) and 86% (19/22), respectively.</p><p><b>CONCLUSION</b>CT first-pass MPI at rest could detect myocardial ischemia with an accuracy similar to that of MPS.</p>

Value of (18)F-FLT positron emission tomography/computed tomography in diagnosis and staging of diffuse large B-cell lymphoma / 中国实验血液学杂志

The aim of this study was to evaluate the role of (18)F-FLT positron emission tomography/computed tomography (PET/CT) in diagnosis and staging of diffuse large B-cell lymphoma (DLBCL) patients and compare with CT. Thirty-six patients with DLBCL in our hospital from September 2008 to December 2009 were prospectively evaluated. All 36 patients underwent whole body and head (18)F-FLT PET/CT and CT (chest, abdomen cavity and pelvis) were studied before therapy. The maximal standardized uptake value (SUV(max)) of every single focus and the SUV(max) of aortic arch blood pool were measured and used to calculate the median T/MB value (tumor SUV(max)/mediastinal SUV(max)) of every patient. The results showed that the consistency of (18)F-FLT PET/CT and CT examinations in focus of DLBCL was 79.10%, the sensitivity, specificity, positive predictive value, negative predictive value and accurate rate of (18)F-FLT PET/CT were 96.65%, 100%, 100%, 61.11% and 96.82%, respectively, which were much higher than that of CT (85.44%, 57.14%, 96.70%, 21.05% and 83.64%). It is concluded that the (18)F-FLT PET/CT is a good means for DLBCL diagnosis and staging, which is more sensitive and specific than CT.

18F-FDG PET/CT imaging characteristics of sarcoidosis in 22 cases / 中华核医学杂志

Objective To investigate the imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT.Methods From 2007 Aug.to 2009 Nov.,22 patients( 10 males,12 females) with sarcoidosis,confirmed by pathological study and clinical follow-up,underwent 18 F-FDG PET/CT imaging.The imaging patterns of intrathoracic and extrathoracic lesions were analyzed.The patterns were classified as the typical or atypical ( symmetrical or asymmetrical FDG accumulation and enlargement of hilar lymph nodes) based on PET and CT separately.Nonparametric McNemar test,independent t-test and Fisher exact test were applied for statistical analysis.Results For typical pattern vs atypical pattem identification,PET was significantly different from CT ( 18 and 4 vs 12 and 10,P =0.031 ).In those with atypical pattern demonstrated by CT alone at hilar region,PET showed either symmetrical or asymmetrical accumulation of FDG.Except for mediastinal lymph nodes involvement,lung parenchyma was the second common site ( 19/22,86.4％ ),followed by lymph nodes at abdomen and (or) pelvis ( 12/22,54.5％ ).Conclusion The imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT may be helpful for the diagnosis of atypical sarcoidosis on CT image alone.

Value of combined CT coronary angiography and adenosine stress myocardial perfusion scintigraphy for diagnosis of coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the accuracy and feasibility of combination of CT coronary angiography (CTCA) and adenosine stress myocardial perfusion scintigraphy (MPS) for diagnosis of coronary artery disease (CAD).</p><p><b>METHODS</b>CTCA, MPS were performed in 105 patients with suspected or diagnosed CAD within 4 weeks before coronary angiography (CAG) examination.</p><p><b>RESULTS</b>The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 97.1%, 75.0%, 88.2%, 93.1% and 89.5%, respectively, for CTCA; 79.7%, 63.9%, 80.9%, 62.2% and 74.3%, respectively, for MPS and 97.2%, 98.5%, 98.5%, 89.7% and 95.2%, respectively, for CTCA + MPS.</p><p><b>CONCLUSION</b>Combination of CTCA and adenosine stress MPS, which provided both anatomical and functional information of coronary vessels, could significantly increase the specificity and PPV of diagnosing CAD with CTCA.</p>

Correlation between acute coronary syndrome classification and multi-detector CT characterization of plaque / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To determine if multi-detector CT (MDCT) characterization of plaque is correlated with the classification of acute coronary syndrome (ACS).</p><p><b>METHODS</b>Altogether 1900 patients were examined by MDCT from December 2007 to May 2009, of whom 95 patients fulfilled the criteria of ACS. Those patients were divided into the discrete plaque group ( n=61) and diffuse plaque group ( n=34) based on the findings in MDCT. The clinical diagnosis of ACS and CT results were analyzed, including segment stenosis score, segment involvement score, 3-vessel plaque score, left main score, calcification score, and remodeling index. The incidences of major adverse cardiac events in follow-up period were also recorded.</p><p><b>RESULTS</b>The patients of the diffuse plaque group were older than those of the discrete plaque group ( Pü0.0001). The diffuse plaque group presented more cases of hypertension, peripheral artery disease, diabetes, and heart failure than discrete plaque group (all P<0.05). All the 5 patients with ST-segment elevation myocardial infarction were found in discrete plaque group. The segment stenosis score of the discrete plaque group was lower than that of the diffuse plaque group(5.15±3.55 vs. 14.91±5.37, Pü0.001). The other four scores demonstrated significant inter-group difference as well (all P<0.05). The remodeling index of thediscrete plaque group was higher (1.12±0.16 vs.0.97±0.20, Pü0.05). Follow-up data showed that major adverse cardiac events occurred more frequently in diffuse plaque group than in discrete group (29.41% vs. 11.48%, P=0.0288).</p><p><b>CONCLUSIONS</b>Characteristics of discrete and diffuse plaques may be significantly different among different classes of ACS. The diffuse plaque may present higher risk, correlated to higher mortality. The diagnosis of discrete and diffuse plaques by MDCT would provide a new insight into the prognosis and treatment of ACS.</p>

CT coronary angiography combined with adenosine stress myocardial perfusion scintigraphy for detecting flow-limiting coronary stenoses / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the feasibility and accuracy of CT coronary angiography (CTCA) combined with adenosine stress myocardial perfusion scintigraphy (MPS) for diagnosis of flow-limiting coronary stenosis.</p><p><b>METHODS</b>A total of 105 patients with suspected or established coronary artery disease (CAD) underwent CTCA and MPS within 4 weeks before invasive coronary angiography. The accuracy of CTCA/MPS in the diagnosis of flow-limiting coronary stenosis was evaluated in comparison with the results of quantitative coronary angiography and MPS.</p><p><b>RESULTS</b>The sensitivity, specificity, positive predictive value and negative predictive value of CTCA/MPS as a combined approach for detection of flow-limiting coronary stenosis were all 100%. In 16% (9/55) of the patients, revascularization procedures were performed and no flow-limiting stenosis was found.</p><p><b>CONCLUSION</b>Combination of CTCA and MPS has an excellent accuracy for detecting flow-limiting coronary stenosis as compared with quantitative coronary angiography/MPI, and can be a useful gatekeeper for revascularization procedures.</p>