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【Objective】 To evaluate the evolution and correlation of CT imaging signs and clinical features of non-severe coronavirus disease 2019 (COVID-19). 【Methods】 We retrospectively analyzed CT images and clinical features of 24 non-severe COVID-19 patients from the onset at a 5-day interval. We recorded CT image signs, clinical manifestations and laboratory results at each stage, and analyzed their dynamic changes and correlations. Categorical variables were presented by rates. The correlation of the total CT score and the total number of lesions with clinical manifestations was analyzed. P20 days. The main CT signs of COVID-19 patients were subpleural and ground-glass opacity; the accompanying CT signs included paving stone sign, thickened blood vessels, fibrous cord shadow, air bronchial sign, leaflet center nodule, halo sign, reversed halo sign, bronchial wall thickening, and lung volume shrinking. On days 0-5, the number of lesions was the largest, acute symptoms were the most severe, the lymphocyte count and ratio were the lowest, and the concentration of high-sensitivity C-reactive protein (H-sCRP) was the highest. On days 5-10, the total CT score, the concentration of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were the highest, and the white blood cell count was the lowest. There were a positive correlation between the CT score and the number of lesions with temperature, ESR, CRP, H-sCRP, and negative correlation with WBC count. 【Conclusion】 CT imaging signs were similar to the change of the clinical features on days 0-10. The total CT score and the number of lesions had correlation with the clinical manifestations.
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To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (％), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.
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Objective To explore the role of magnetic resonance spectroscopy in evaluating the severity and prognosis of patients with brain stem injury. Methods A total of 45 patients with brain injury (the study group)and 10 healthy people(the control group)were retrospectively analyzed in Affiliated Anqing Hospital,Anhui Medical University during March 2015 to October 2016 using magnetic resonance spectroscopy.The NAA/Cr,NAA/Cho and Cho/Cr value in brain stem were analyzed. The clinical severity score (GCS) and Glasgow outcome scale (GOS)were also analyzed in our study. Results Compared with the normal group,patients in the study group had lower NAA level, NAA/Cho value but higher Cho/Cr value (P < 0.05). The severer the injury, the more obvious in NAA peak decrease. Cho peak increased and NAA/Cho ratio decreased. NAA/Cho, NAA/Cr and Cho/Cr values in the group with good prognosis were similar to those in the normal control group, but significantly different to the group with poor prognosis (P < 0.05). NAA/Cr, NAA/Cho and Cho/Cr values correlates with GOS in patients with brain stem injury. Conclusions Magnetic resonance spectroscopy can be used to measure the metabolic status of patients with brain stem injury,which is of great significance in the evaluation the severity of brain stem injury and prognosis.
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Objective To observe the expression of aquaporin 4 (AQP-4) in contused brain tissue and its relationship with brain edema following brain trauma.Methods A retrospective case control analysis was made on 42 patients with severe brain trauma admitted from January 2015 to March 2016.There were 23 males and 19 females,aged from 23 to 62 years [(35.5 ± 5.6) years].Glasgow coma score (GCS) was 3-5 points in 7 patients,6-8 points in 23 and 9-10 points in 12.Brain tissue removed from the area 1 cm near the contusion during the cranial surgery were allocated to study group (n =42),while brain tissue removed far from the contusion after internal decompression were used as control (n =8).Ultrastructure of brain tissues was observed under electron microscope.Water content of brain tissue was measured by dry-wet weight method and expression of AQP-4 was measured by immunohistochemical method at postinjury hours ＜ 6,6-12,12-24,24-72,72-96 and ＞ 96.Results Morphology and structure of brain tissue in control group were normal.Whereas in study group,the intracellular and interstitial edema were obvious and morphological structure were damaged.Water content and AQP-4 expression in control group showed no obvious increase after operation(73.55 ±0.10,0.193 ±0.016).Water content in study group increased significantly compared to control group and reached the peak value (81.28 ± 0.56) at postinjury 24-72 hours (P ＜ 0.01).AQP-4 expression in study group increased at postinjury 6 hours (0.242 ±0.023) and reached a peak at postinjury 24-72 hours (0.338 ± 0.013),with significant difference compared to control group (P ＜ 0.05).Correlation analysis showed change of brain water content was positively correlated with expression level of AQP-4 (r =0.931,P ＜ 0.01).Conclusion Expression of AQP-4 in the injured area of brain trauma is significantly increased along with the increase of water content,suggests that the upregulation of AQP-4 plays an important role in traumatic brain edema.
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Objective To investigate the CT signs of small intracranial aneurysm and the application value of multi-slice spiral CT angiography (MSCTA) before and after clipping surgery and in follow-up.Methods MSCTA imaging data of 81 patients with highly suspected small intracranial aneurysms from March 2013 to March 2015 were analyzed retrospectively.The confirmed patients underwent clipping surgery of small intracranial aneurysms.The imaging findings before and after clipping surgery were analyzed and compared with those by DSA and what observed during surgery.Results The relative accuracy,sensitivity and specificity of MSCTA over DSA and surgical diagnosis were 93.83％,93.75％ and 94.12％respectively,and MSCTA gained high relative consistency over DSA and surgical diagnosis (Kappa=0.825).The accuracy of MSCTA for diagnosing small intracranial aneurysm was not significantly different from those by DSA and surgical diagnosis.MSCT plain scan mainly showed subarachnoid or intracranial hemorrhage,and found 71 rhomboic or saccular aneurysms in 60 patients before operation.Totally 64 patients went through clipping surgery,60 ones had satisfactory results in the reexamination by MSCTA 2 weeks after surgery,and there were no abnormality found in 36 patients in 6 to 12-month follow-up.Conclusion MSCTA can provide abundant information for clipping surgery of small intracranial aneurysms,and can be used as the preferred imaging method for postoperative evaluation and follow-up.
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Objective To investigate altered microstructural integrity in acute carbon monoxide(CO)intoxication by diffusion tensor imaging (DTI).Methods A total of 25 CO intoxication patients (5.0±1.44 post-intoxication)and 37 healthy volunteers matched with age, sex and educational level were involved and underwent DTI.The fractional anisotropy (FA)and apparent diffusion confficient (ADC) of total 26 regions of bilateral cerebellum,substantia nigra,hippocampus,white matter of frontal lobe,head of caudate nucleus,pallidum,thalamus, anterior limb of internal capsule,posterior limb of internal capsule,white matter of occipital lobe,white matter of parietal lobe,and genu of corpus callosum,splenium of corpus callosum were measured.Compared the patients against control for FA and ADC by paired t-test.Results FA of patients with CO intoxication decreased in bilateral pallidum,anterior limb of internal capsule,substantia nigra,right cerebellum,left below frontal white matter,right frontal white matter and genu of corpus callosum (P <0.05).ADC decreased in right substantia nigra,and left pallidum (P <0.05).ADC increased in right frontal white matter and bilateral occipital lobe white matter (P<0.05).Conclusion There is loss of microstructural integrity in acute CO intoxication,perhaps representing the underlying mechanism of delayed encephalopathy after carbon monoxide poisoning.
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Objective To investigate the effect and mechanism of human amniotic epithelial cells (hAECs) transplantation in treatment of cerebral hemorrhage in rabbits.Methods Thirty New Zealand white rabbits were used to induce cerebral hemorrhage.Animals were divided into hAECs group and isotonic saline group according to random number table,with 15 rabbits per group.Before transplanted to rabbits,hAECs were transfected with the retrovirus carrying green fluorescent protein (GFP).Morphologic and behavioral changes in both groups were noted periodically.Survival of transplanted hAECs and expressions of glial fibrillary acidic protein (GFAP) and microtubule-associated protein 2 (MAP-2)in focal cerebral tissues were observed.Results In hAECs group,the rabbits obtained progressive recovery in walking,supporting and coordinated motion.Restoration period mostly ranged from 2-3 weeks.Most of the rabbits in hAECs group had limb motor function recovered to grade Ⅱ-Ⅲ,while the recovery is slow in isotonic saline group with most ranging from grade Ⅰ-Ⅱ.According to Tarlov score,limb motor function presented significant difference between hAECs group and isotonic saline group (P ＜ 0.05).Immunohistochemical staining showed positive expressions of GFAP and MAP-2 in hAECs group,but no expressions in isotonic saline group (P ＜ 0.05).Conclusion hAECs transplantation effectively improves neural behavior and reduces nerve function impairment in treatment of cerebral hemorrhage in rabbits.
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Objective To investigate the immunomodulatory effect of mesenchymal stem cells (MSCs) and their role in prolonging allograft survival in rat heart transplantation. Methods Inbred Wistar rats were used as donors, and Fisher 344 as recipients. MSC were isolated from femur and tibia bone marrow of donors and cultured in vitro. Mixed lymphocyte reaction assays were performed to assess the immunosuppressive effects of different concentrations of MSC on allogeneic T cell proliferation. Cardiac allograft model was established and according to different intervention measures recipients were divided into two groups (MSC treatment group and control group) (n=8 in each group). In MSC treatment group, recipients were infused with 2×106 MSC via the tail vein at designated intervals (one week before operation, during operation and consecutive three days postoperation), while in control group, the recipients were treated with Ringer's solution at the same interval& At day 5 posttransplantation real-time PCR was used to detect the changes in the expression of Thl and Th2 cytokine genes in transplanted hearts. Results In vitro allogeneic T cell response was greatly suppressed by MSC in a dose-dependent manner. Real-time PCR revealed that IL-1β,IFN-γ, IL-4 and IL-10 were expressed in MSC treatment group, while IL-4 and IL-10 were not expressed in control group but with significantly higher expression of IL-1β and IFN-γ. As compared with control group, survival of MSC-treated allografts was markedly prolonged as compared with control group (mean survivaldays: 12.4±5.3 vs 6.4±2.0, P＜0.05). Conclusion Intravenous adrninistmtion of MSC can prolong the survival of transplanted heart possibly by induction of allograft tolerance through changing Th1/Th2 balance.
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Objective:To investigate the efficiency of maternal serum triple screening for the genetic abnormality in second-trimester and the morbidity of adverse pregnancy outcome in false positive results of the test. Methods: A total of 4 680 pregnant women with singleton pregnancies assigned in Obs & Gyn Hospital, Fudan University, underwent triple screening test (alpha fetoprotein, AFP; human chorionic gonadotropin, HCG and unconjugated estriol, uE3) by fluorescence enzyme immunoassay between 2003 and 2005. The valid MoM (Multiples of Median) value of mid-trimester serum AFP, uE3, and hCG and risk assessments was provided by Beckman Coulter Co. When applied in the prenatal Down syndrome screening service. The study compares the incidence of chromosomal abnormalities with Down syndrome in screen positive women and compares to the MoM value established in the literature. The risks of having a fetus with congenital abnormalities or of developing obstetric complications in the screen positive women with their matched controls.Results:The MoM values for the triple tests of our study are similar to established values of literature. Only 51.01% women with pregnancies agree to receive screening. Amniocentesis utilization rate was 55.12% in the screen-positive pregnancies. The false positive rate was 6.89% and the median of maternal age of the women was 28.13 (range 19 to 49) years old. Chromosomal abnormalities were identified in 21 pregnancies, including 9 cases of trisomy 21.The detection rate was 77.77%. Pregnancies with positive screening results had a significantly higher risk of adverse outcomes than those with negative results (P< 0.05). Whereas there was no difference in the incidences of fetal congenital appearance or skeleton abnormality. Conclusion: Adjusting MoM values of local unaffected populations is limited to increasing the detection rate. Because chromosomal defects have variable exhibitions, amniocentesis utilization is still a choice for screen-positive pregnancies. Screen-positive pregnancies had increased risk of chromosomal abnormalities.
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Objective To investigate the effects of micro alcohol on serum enzymes in vitro and vitro Methods Serum alcohol and ALT?AST?GGT?ALP?CK?LDH?AMY?LIPA activities were measured before and after alcohol consuming (1 ml/kg) in 14 volunteers Meanwhile, the direct inhibitory effects of alcohol on the serum enzymes were studied by comparing the serum enzyme activities with or without alcohol Results Alcohol consuming could depress the serum AST activity from (24 04?3 66) U/L to (22 25?3 27) U/L and LIPA activities from (155 86?93 51) U/L to (128 35?84 85) U/L, whereas increase the other serum enzyme activities, but only serum AMY were found statistic difference [from (48 78?10 66) U/L to (55 50?12 60) U/L] The inhibitory effects of alcohol on all the measured enzymes were found in vitro studies Conclusions Alcohol could obvious influence the serum enzyme activities both in vivo and vitro Avoiding the contamination of alcohol during sample collection and routine laboratory work is necessary