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ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.
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Objective To investigate the relationship between the expression of CENPF in NSCLC adenocarcinoma (LUAD) and the clinical prognosis of patients and its effect on the metastasis of lung adenocarcinoma cells. Methods The expression of CENPF in LUAD and its relationship with patient prognosis were analyzed by online bioinformatics. The expression of CENPF was verified by LUAD tissue microarray immunohistochemical staining. Kaplan-Meier analysis was performed to analyze the relationship between the expression of CENPF and the prognosis of patients with lung adenocarcinoma. Cox survival hazard ratio was used to analyze the factors affecting the survival of patients. Chi-square analysis was adopted to examine the relationship between CENPF expression and clinicopathological stage and grade of patients. The expression of CENPF in NCI-H2126 cells were knocked out by lentivirus, and then the proliferation, invasion, and migration abilities of the cells were detected. Changes in mRNA expression profiles after CENPF knockout were detected by RNA-seq. Bioinformatics analysis of downstream signaling pathways and the target genes of CENPF was also performed. Western blot was used to verify the target gene. Results CENPF was significantly upregulated in LUAD tumor tissue (P < 0.05) and significantly correlated with pathological stage (P=0.013). The higher expression of CENPF, the worse the prognosis of patients (P=0.01, P=0.027). After the expression was CENPF of knocked out, the cell proliferation, migration, and invasion abilities significantly reduced (P < 0.01). The expression of chemokine pathway genes in cells was enriched significantly (P < 0.001). ACKR3/CXCR7 and CDH2/N-cadherin were significantly downregulated, whereas CDH1/E-cadherin was significantly upregulated. After CENPF was knocked out, ACKR3/CXCR7 and N-cadherin were significantly downregulated, whereas E-cadherin significantly increased. Conclusion The expression of CENPF is negatively correlated with the clinical prognosis of patients with LUAD, and it promotes the occurrence of EMT by regulating the expression levels of N-cadherin and E-cadherin related to EMT through ACKR3/CXCR7.
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@#Objective To diagnose crossed cerebellar diaschisis (CCD) after supratentorial cerebral infarction with intravoxel incoherent motion (IVIM) magnetic resonance imaging. Methods From May, 2016 to May, 2017, 120 patients with unilateral supratentorial cerebral infarction were divided as CCD positive and CCD negative, and investigated with IVIM. Results The cerebral infarction volume (CIV) was more in CCD positive patients than in CCD negative patients in acute and chronic phase (t>13.943, P<0.05). The apparent diffusion coefficients (ADC) was significantly different between affected and unaffected lateral cerebellar in CCD positive patients (t=11.413, P<0.05), and it was significantly different between CCD positive and negative patients in unaffected lateral cerebellar (t=10.026, P<0.05). Conclusion CIV and ADC can be the indexes of IVIM to evaluate the cerebral perfusion in patients with cerebral infarction.
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Objective Annexin A3 (ANXA3) is a member of the annexin family,As the existing studies suggest,ANXA3 is closely related to tumor genesis,development,invasion,metastasis and prognosis.ANXA3 is down-regulated in prostate and kidney cancer,but it is up-regulated in breast cancer,liver cancer and other tumors.ANXA3 is related to tumor size,staging,lymphatic metastasis and prognosis.Silencing ANXA3 expression can not only inhibit the proliferation and invasion of colorectal cancer and hepatocellular carcinoma cells,but also restrain the migration of breast cancer cells.ANXA3 may also be involved in the regulation and maintenance of hepatocellular stem cells through HIF1a / Notch and JNK signaling pathways.The current studies have shown that ANXA3 can serve as a potential biological marker of tumor diagnosis,prediction of chemotherapy sensitivity,and provide a new target for oncotherapy.
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Objective To investigate the MRI findings of perihip heterotopic ossification (HO) in the early, mid and late stages. Meth-ods The MRI of 44 inpatients with HO from February, 2011 to September, 2013 were reviewed, in which 20 cases (28 joints) were in early stage, 18 cases (24 joints) in mid stage and 6 cases (8 joints) in late stage. For the enhanced T1WI, 9 cases (11 joints) were in early stage, 6 cases (7 joints) in mid stage, and 3 cases (4 joints) in late stage. Theχ2 trend test was used to evaluate the MRI signal change with the HO maturity. Results With the maturity of hip HO, the signal intensity of T2WI reduced (χ2=16.773, P<0.001), fat signal on T1WI increased, the enhancement reduced (χ2=16.048, P=0.007). Conclusion The MRI findings of perihip HO are characteristic in MRI in all the stages. MRI is useful for the diagnosis of perihip HO, especially for the early HO.
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Objective To compare the clinical and follow-up results of different ways of operation for the treatment of patients with hilar cholangiocarcinoma ,and to explore its e key technology and related prognosis .Methods 31 out of 50 patients with biliary and partial liver resection(control group) ,19 patients with hemihepatectomy (observation group) .Radical resection rate and surviv-al rate were compared in the two groups .Results radical resection rate control group and observation group was 35 .48% (11/31) and 68 .42% (13/19) ,the difference was statistically significant (P=0 .014);the difference of 1 ,3 ,5 year survival rates between the two groups were statistically significant (P= 0 .03) ,observation group :85 .4% ,58 .6% ,32 .2% ,control group:86 .1% ,65 .2% , 20 .0% .Conclusion Radical resection is still the most important measures the patients for cure and long-term survival ,radical re-section rate ,survival rate ,and prognosis could be improved greatly by improving operation skills and experience accumulation ,com-bined with hepatectomy .
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@#Intracerebral hemorrhage is a disease with high mortality and morbidity. This article discussed the application of magnetic resonance diffusion tensor imaging for intracerebral hemorrhage clinical research, and its limitations and prospect.
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Objective To investigate the feasibility and accuracy of enhanced magnetic resonance pulmonary perfusion imaging(MRPP) in the diagnosis and follow-up of pulmonary embolism(PE). Methods Sixty patients suspected of PE underwent MRPP. Twenty-seven patients also underwent radionuclide perfusion imaging. 22 patients repeated MRPP examination after 3 day to 1 month anticoagulation or thrombolytic therapy. The feasibility and accuracy of MRPP in the diagnosis and follow-up of PE were evaluated according to the transformation rate of signal (TROS), time-signal curve and some parameters of main pulmonary artery(such as peak value of flow,mean flow velocity and flow rate). The t test and rank sum test were used for the statistics. Results MRPP showed a high agreement with radionuclide perfusion imaging. TROS was (2. 86 ± 2. 48 ) vs ( 6. 72 ± 2. 54) ( t = 3. 370, P ＜ 0. 01 ), the peak time was ( 13.98 ±5.60) vs ( 12. 33 ± 3.63 ) s ( t = 3. 930, P ＜ 0. 01 ), the peak value of main pulmonary blood flow was (60.39 ± 15. 17) vs (69.93±13.22) cm/s(t=2.930, P＜0. 01) and mean flow velocity (11.68±5.46) vs ( 13.54 ± 4. 18 ) cm/s ( t = 2. 380, P ＜ 0. 05 ) before and after anticoagulation or thrombolytic therapy. The flow rate per unit was (80. 57 ± 24. 87) vs ( 85.48 ± 11.81 ) ml/s ( t = 0. 86,P ＞ 0. 05 ) . Conclusion MRPP shows a high agreement with radionuclide perfusion imaging and is a useful method for the diagnosis and follow-up of PE.
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@#ObjectiveTo investigate the imaging findings of Charcot neuroarthropathy. Methods9 cases with Charcot neuroarthropathy determined clinically or pathologically were reviewed. ResultsThe findings of X-ray and CT including: soft tissue swelling in 9 cases, bone absorption in 5, bone proliferation in 7, periosteal reaction in 7, ectopic calcification or ossification in 9, luxation or semiluxation in 4. For MRI: soft tissue swelling, edema of joint capsule in 2, bone marrow dropsy in 1, sclerotin damage in 1. The joint capsule and periarticular soft tissue unevenly enhanced after Gd-DTPA. Nuclear medicine displayed radioactivity aggregation in 1 case. ConclusionX-rays plain film is the first choice for the diagnosis of Charcot neuroarthropathy, while CT, MRI and nuclear medicine may be helpful.
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BACKGROUND: Autologous vein transplantation is a common means for clinical treatment of coronary atherosclerotic heart disease. Identification of basic pathological changes of autologous vein transplantation will provide basis for further studies on how to protect transplanted vein and reduce the possibility of restenosis of transplanted vein.OBJECTIVE: This study was designed to investigate effects of hyperlipemia, an independent influential factor, on venous endothelial functions and histomorphology.DESIGN, TIME AND SETTING: This study, a randomized controlled animal experiment, was performed at the key laboratory of Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA.MATERIALS: A total of 50 healthy adult male rabbits were randomly and equally divided into a control group and a hyperlipemia group.METHODS: In the control group, rats were daily fed with normal diet 100-120 g. In the hyperlipemia group, rats were daily fed with normal diet 100-120 g plus cholesterol 1g. For all rats, water was freely available.MAIN OUTCOME MEASURES: Prior to and 2,4,8, and 12 weeks after feeding, blood sample and cervical vein specimens were taken for detection of blood lipid levels and observation of endothelial nitricoxide synthase (eNOS)expression, nitric oxide (NO) production, and histomorphologic change. Prior to harvesting vein sample, blood flow of jugular vein and carotid artery was examined using ultrasonic Doppler flowmeter. Simultaneously, histopathological changes including the thickness of intima and media, the diameter of the veins, and the presence of lipid or atherosclerotic plaque were observed.RESULTS: Eight weeks after feeding, blood lipid levels in the hyperlipemia group were significantly higher than those prior to feeding and in the control group (P<0.01), and maintained at this level. Obvious lipid plaques formed in the carotid artery of rabbits in the hyperlipemia group. Eight and twelve weeks after feeding, eNOS expression levels and NO production in the jugular veins were lower than those prior to feeding and in the control group (P<0.05). Simultaneously, endothelial denudation was noticed and the elastic fibers almost disappeared in the hyperlipemia group; there were no foam cells or lipid plaques.CONCLUSION: Hyperlipemia may result in endothelium dysfunction and histomorphological change of venous conduit.Nevertheless, autogenous vein transplanted into artery system, will greatly influence the remodeling of transplanted vein,even lead to restenosis of transplanted vein.