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ObjectiveTo analyze the value of grey-scale reversed T1-weighted (rT1) MRI in the detection of structural lesions of the sacroiliac joint (SIJ) in patients with axial spondyloarthritis (ax-SpA). MethodsFifty-two ax-SpA patients who underwent both MRI and CT in our hospital within a week from February 2020 to December 2022 were retrospectively included. Both sacral and iliac side of each SIJ on oblique coronal images were divided into anterior, middle and posterior portion. Two radiologists reviewed independently three groups of MRI including T1-weighted imaging (T1WI), rT1 and T1WI + rT1 images to evaluate the structural lesions like erosions, sclerosis and joint space changes in each of the 6 regions of the SIJ. One of the radiologist did the evaluation again one month later. CT images were scored for lesions by a third radiologist and served as the reference standard. Intra-class correlation coefficients (ICC) were calculated to test the inter- and intra-reader agreement for the assessment of SIJ lesions. A Friedman test was performed to compare the lesion results of MRI and CT image findings. We examined the diagnostic performance [accuracy, sensitivity (SE) and specificity] of different groups of MRI in the detection of lesions by using diagnostic test. A McNemar test was used to compare the differences of three groups of MRI findings. ResultsCT showed erosions in 71 joints, sclerosis in 65 and joint space changes in 53. Good inter-and intra-reader agreements were found in three groups of MRI images for the assessment of lesions, with the best agreement in T1WI + rT1. There were no difference between T1WI + rT1 and CT for the assessment of all lesions, nor between rT1 and CT for the assessment of erosions and joint space changes (P>0.05). T1WI + rT1 yielded better accuracy and SE than T1WI in detection of all lesions (Accuracy erosions: 90.3% vs 76. 9%; SE erosions: 91.6% vs 76.1%; Accuracy sclerosis: 89.4% vs 80.8%; SE sclerosis: 84.6% vs 73.9%; Accuracy joint space changes: 86.5% vs 73.1%; SE joint space changes: 84.9% vs 60.4%; P<0.05). rT1 yielded better accuracy and SE than T1WI in detection of erosions and joint space changes (Accuracy erosions: 87.5% vs 76.9%; SE erosions: 88.7% vs 76.1%; Accuracy joint space changes: 85.6% vs 73.1%; SE joint space changes: 83.0% vs 60.4%; P<0.05). ConclusionsIn the detection of SIJ structural lesions in ax-SpA, rT1 improves the diagnostic performance and T1WI + rT1 is more superior to others.
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Objective:To analyze whether patients with myasthenia gravis (MG) have cognitive impairment and changes of brain structure, and explore the possible mechanisms of cognitive impairment in MG patients from the perspective of brain structure.Methods:Twenty-eight patients with MG admitted to Department of Neurology, First Affiliated Hospital of Soochow University from July 2019 to December 2021 were selected as MG group, and 30 family members from MG patients or healthy subjects who underwent physical examination in Physical Examination Center during the same period were selected as healthy control group. Neuropsychological test was used to evaluate the cognitive function. VBM was used to analyze the changes of brain structure on structural MRI (sMRI). Correlations of gray matter volumes of different brain regions with cognitive function between the two groups were analyzed.Results:Compared with the healthy control group, the MG group had significantly decreased scores of Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clock Painting Test (CDT), and Verbal Fluency Test (VFT), and significantly decreased Rey Auditory Verbal Learning Test (RAVLT) immediate memory and delayed memory scores, while statistically increased time consuming in Making Track Test Part A (TMT-A), and Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores ( P<0.05). Compared with healthy control group, MG group had significantly decreased gray matter volumes of the left orbital superior frontal gyrus, right orbital middle frontal gyrus, right triangular inferior frontal gyrus, left insula, left middle frontal gyrus, right superior limbic gyrus, right anterior cingulate gyrus, right lateral cingulate gyrus, left medial cingulate gyrus, left lateral cingulate gyrus, left medial superior frontal gyrus, and left dorsalateral superior frontal gyrus ( P<0.05). Correlation analysis showed that gray matter volume in the left insula was negatively correlated with time consuming in Stroop Color-Word Test-A ( r=-0.407, P=0.035). Conclusion:Patients with MG may have cognitive decline and gray matter cortical atrophy of some brain regions, and brain areas with gray matter cortical atrophy correspond to areas of cognitive impairment.
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<p><b>OBJECTIVE</b>To evaluate the effects of acupoint massage for postpartum hypogalactia in puerpera.</p><p><b>METHODS</b>A total of 60 puerpera of cesarean section were randomized into an observation group and a control group, 30 cases in each one. In the observation group, 2 cases were dropped out. Finally, there were 28 cases in the observation group and 30 cases in the control group. In the control group, the routine nursing after operation in obstetrics department was given, guiding maternal breastfeeding and postpartum health education. In the observation group, on the basis of the treatment as the control group, the corresponding acupoints were selected from the breast related meridians for massage. Acupoint massage was given since the 3rd day after operation, 8:00 am to 9:00 am, once a day, 1 min at one acupoint, continuously for 5 days. The lactation volume, breast filling, galactostasis and milk viscosity were compared in the parturient of the two groups. The clinical therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>From the 1st to the 2nd days, the differences were not significant in lactation volume, breast filling and galactostasis score between the two groups (all>0.05). From the 3rd to 5th days, the lactation volume, breast filling and galactostasis score in the observation group were all lower than those in the control group (all<0.01). The difference in milk viscosity was not significant in the first 4 days between the two groups (all>0.05). On the 5th day, the score of milk viscosity in the observation group was lower than that in the control group (<0.01). The cured rate was 64.3% (18/28) in the observation group, which was better than 13.3% (4/30) in the control group (<0.05).</p><p><b>CONCLUSION</b>Massage at the acupoints from the breast related meridians effectively promotes the lactation secretion in puerpera of postpartum hypogalactia and alleviates breast distention.</p>
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Objective:To investigate the changes of PERK,Runx2,osterix,RANKL and OPG in bone tissue of the female rats with experimental postmenopausal osteoporosis(PMOP)before and after treatment,and to elucidate the role of PERK signaling pathway in PMOP.Methods:The ovariectomized rats were reproduced to osteoporosis models.A total of 45 rats were divided into normal control group(the rats didn't receive any treatment,n=15),osteoporosis group(the rats were ovariectomized,n=15)and osteoporosis treatment group (the ovariectomized rats were injected with estrogen through caudal vein,n=15).The changes of serum collagenⅠ(Col Ⅰ),alkaline phosphatase(ALP)and osteocalcin(OCN)of the rats in various groups were observed. Three months after feeding,the femoral shaft of the rats in various groups were taken for pathological section.The gene expression levels of PERK,ATF4,Runx2,osterix,RANKL and OPG in bone tissue of the rats in various groups were detected by RT-PCR;the protein expression levels of PERK,ATF4,Runx2,osterix,RANKL and OPG were detected by Western blotting method.Results:Compared with control group,the levels of serum Col Ⅰ,ALP and OCN in the rats in osteoporosis group were significantly decreased(P<0.05 or P<0.01);compared with osteoporosis group,the levels of serum ColⅠ,ALP and OCN of the rats in osteoporosis treatment group were significantly increased(P<0.01).Compared with control group,the gene expression levels of PERK, ATF4,Runx2 and osterix in bone tissue of the rats in osteoporosis group were significantly decreased(P<0.01), and the gene expression level of RANKL was increased(P<0.01);compared with osteoporosis group,the gene expression levels of PERK,ATF4 Runx2 and osterix in bone tissue of the rats in osteoporosis treatment group were significantly increased(P<0.01),and the gene expression level of RANKL was significantly decreased(P<0.01).Compared with control group,the protein expression levels of PERK,Runx2 and osterix in bone tissue of the rats in osteoporosis group were significantly decreased(P<0.05 or P<0.01),and the protein expression level of RANKL were increased(P<0.05 or P<0.01);compared with osteoporosis group,the protein expression levels of PERK,Runx2 and osterix in bone tissue of the rats in osteoporosis treatment group were significantly increased(P<0.05 or P<0.01),and the protein expression level of RANKL was significantly decreased(P<0.01).The HE staining results showed that compared with control group,the bone resorption pits in bone tissue of the rats in osteoporosis group became large with the increased bone absorption,which caused bone loss;compared with osteoporosis group,the resorption in bone tissue of the rats in osteoporosis treatment group was decreased,and the bone structure returned to normal.Conclusion:After the female rats are ovariectomized and injected with estrogen,the expression trends of PERK and osteoblast transcription factors Runx2 and osterix are consistent,in contrast with the osteoclast transcription factor RANKL expression,suggesting that the osteoblast function is reduced and it is related to the decreased expression of PERK in PMOP onset.
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Objective To investigate the relation among clinical nurses′resilience, emotional, the pressure load and self-efficacy with the 10-item Connor-Davidson Resilience Scale. Methods A total of 449 nurse in Guangzhou were recruited to investigate by 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Kessler 10 Scale (K10), General Self-Efficacy Scale (GSES), Chinese Stress Overload Scale (SOS). Results The average score was 23.6±6.7 for CD-RISC-10 , 24.4±8.2 for K10,24.7±5.7 for GSES , 63.3 ±16.6 for SOS ,and the individual vulnerability scoring was (31.2±10.0) points, events load was (32.0±7.5) points. High mental toughness of nurses in general self-efficacy scores higher than that of low mental toughness group (t=-8.53, P<0.01), in the K10 dated, S0S scores were lower than low mental toughness group (t=11.23, 7.70, P<0.01). Nurse relevant regression analysis results showed that gender, general self-efficacy, K10 dated, SOS as the main factors influencing nurses mental toughness, could explain 40%of variances. Conclusions The CD-RISC-10 can better reflect the level of clinical nurses′resilience, and the gender, self-efficacy were the main effects, as well as effectively predict the nurses′emotional distress and stress level. However how to improve the toughness of the clinical nurses need more research.
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Objective To investigate the level of caregivers′burden and the coping style among parents of cancer children. Methods Totally, 229 parents of cancer children participated in the investigation by Chinese version of zarit burden interview (ZBI), Chinese version of coping health inventory for parents (CHIP) and self-designed general information questionnaire. The associations between caregivers′burden and coping styles were tested by Spearman correlation analysis. Results The caregiver′s burden on the parents was in the middle level with a total score of (30.50 ± 12.24). The coping style the parents took most frequently was to unite the family and keep a positive attitude and regard it as most effective. The caregiver′s burden was negatively associated with the positive coping style . Conclusion The parents of cancerous children suffer from middle level of burden . Nurses should assess the caregiver′s burden, provide targeted interventions to relieve it, help the to establish effective coping style and change their psychological and mental state and ultimately improve their quality of life.
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BACKGROUND:With the deepen understanding on the biological function of Rho/ROCK pathway, new ROCK inhibitors continue to be discovered, and ROCK inhibitors show good promoting effects on the survival, proliferation and migration of keratocytes. Research on ROCK inhibitors wil provide more donor materials or seed cels for regenerative medicine and clinical cel transplantation. OBJECTIVE:To summarize and explore the progress in the treatment and application of corneal disease using the ROCK inhibitors Y-27632 and Y-39983. METHODS:The PubMed database and CNKI database were retrieved by computer to search the relevant literature published between 2008 to 2015 using the key words of “corneal endothelial cel, corneal epithelial cel, ROCK inhibitor, Y-39983, Y-27632” in English and Chinese, respectively. Relevant articles in line with the theme were screened and analyzed. RESULTS AND CONCLUSION:Totaly 264 papers were initialy searched. At last, 45 papers were selected. Currently there are two main ROCK inhibitors: Y-27632 and Y-39983, but both of which are stil in basic research stage and clinical testing stage. Y-27632 promotes the proliferation and activity of corneal epithelial stem cel after resuscitation; Y-39983 as a novel ROCK inhibitor can be better to inhibit Rho kinases activity than Y-27632, thereby more effectively promoting the healing of the corneal endothelium. There are many studies on the application of ROCK inhibitors in corneal treatment, but not a stable method established to obtain seed cels. Each method has its own advantages and disadvantages, and how to overcome these disadvantages and to find fast and stable access to seed cels is the future direction of development.
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BACKGROUND: The problem to be solved firstly in adipocyte implantatior after its in vitro adherent ulture f preadipocyte with scaffold using tissue-engineered technique is the biocompatibility of scaffold and dipocyte.OBJECTIVE: To investigate the feasibility of poly-β-hydroxybutyric acid (PHB) used for readipocyte implantation.DESIGN: Randomized controlled trial.SETTING: Medical College of Wuhan University.MATERIALS: This trial was carried out in Medical College, Wuhan University during October 2003 o June 2005. Twelve male SD rats(Experimental Animal Center, Medical College, Wuhan University), weighing rom 200 to 250 g, were involved.PHB scaffold was provided by Institute of Polymer Materials, Department f hemical Engineering, Tsinghua University.METHODS: The preadipocytes of rats were isolated, purified and ultured in vitro for use. PHB scaffold was made into 0.75 cm×0.75 cm ×0.2 cm lamellar cell biological caffold, then which were soaked by DMEM/F12 culture medium containing 150 g/L fetal bovine serum and laced in culture plate, one piece each well, 12 wells totally. 1.0 mL cultured cell suspension was added n each well to prepare cell scaffold complex. Eight rats were selected. The prepared complexes were implanted into right-side back tissue of a rat and fixed with 5-0 silk, serving as adipocyte scaffold roup; the biological scaffolds without adipocyte adherence were implanted into left-side back tissue of he same rat with the same method, serving as blank scaffold group. One lamellar biological scaffold was mplanted into each side. Eight weeks later, the appearance and structural change of grafts were observed, nd the grafts were weighted and their volumes were measured. Four lamellar biological scaffolds were mplanted into the other 4 rats separately and taken out after 3 weeks, then they were fixed by 100 g/L eutral formalin, sliced, and stained by haematoxylin and eosin (HE). Their histological changes were observed.MAIN OUTCOME MEASURES: ① Gross and histological observation of grafts in adipocyte scaffold roup and blank scaffold group. ② Comparison of volume and mass of grafts in two groups.RESULTS: Twelve ets were involved in the result analysis ,without deletion. ①Gross observation: In the adipocyte scaffold group, grafts presented flesh-color appearance and peplos in the peripheral region, and newly ormed minute blood vessels ingrowing into the scaffold. In the blank scaffold group, grafts presented rey ppearance, which was coated by peplos. ② HE staining: Three weeks later, a few scattered adipocytes were ound in the peripheral region of the grafts,there were very few vessels. Eight weeks later, lamellar ibrous peplos was found around the complex. Adipocytes ingrew from the peripheral region of scaffold into caffold, partial scaffold was nearly full of adipocytes and many vessels formed;In the blank scaffold roup, only peplos and vessels were found, scaffold was full of fibrous connective tissue and adipocytes ere not found. ③ Comparison of volume and mass: adipocyte scaffold group was superior to blank group in scaffold volume and mass [(257.5±70.2)vs.(144.6±62.6)mm3,(245.6±58.2) vs.(148.7±60.3)mg, both P<0.01].CONCLUSION: Preadipocyte can adhere to PHB scaffold, proliferate and differentiate into mature dipocytes. It is feasible for PHB material to serve as a carrier for preadipocyte.
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An accurate edge extraction method for the ultrasound breast tumor image is useful for classifying tumors as benign or malignant. This paper refers to a fast technique to extract edge of breast tumor from ultrasound image. This method uses the triangular fuzzy number to build up a fuzzy number plane whose basic unit is the marching square. It is possible to visualize at once the results obtained using different presumption levels. Experiments of benign and malignant breast tumor in ultrasound images have shown that our method can extract the breast tumor edge faster than many conventional methods can do separately, and the results are reliable and credible. Our experiments demonstrate that it can be efficiently used to extract the edge of breast tumor from the ultrasound image.