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Objective:To investigate the characteristics of multimodal ultrasound imaging in elderly hyperlipidemia patients with statin-related myopathy and to provide a reference of new method for non-invasive quantitative evaluation on statin myopathy.Methods:We collected 20 elderly hyperlipidemia patients with statin-related myopathy(the statin-related myopathy group), 20 elderly hyperlipidemia patients without statin-related myopathy after taking statins during the same period(the non-statin-related myopathy group), and 20 healthy volunteers who matched the age and sex of the above two groups during the same period(the healthy control group)in our hospital.Two-dimensional ultrasound, shear wave elastography and superb microvascular imaging were used to obtain thickness, echo, pinnation angle and shear wave velocity(SWV)values as well as vascular index(VI)values of the medial gastrocnemius during relaxation, dorsiflexion, and plantar flexion for each group, which were then analyzed.Results:There were no significant differences among the three groups in general conditions such as age, height, weight, and body mass index(all P>0.05). The mean thickness of the medial gastrocnemius in the statin-related myopathy group was about(1.04 ± 0.20)cm, which was less than(1.34 ± 0.16)cm in the non-statin-related myopathy group and(1.35 ± 0.15)cm in the healthy control group( F=22.03, P<0.001). The pinnation angle in the statin-related myopathy group was about(12.50 ± 1.10), which was less than(18.55 ± 1.28)in the non-statin-related myopathy group and(18.60 ± 1.35)in the healthy control group( F=158.03, P<0.001). Compared with the non-statin-related myopathy group and the healthy control group, SWV during resting, dorsiflexion and plantar flexion in the statin-related myopathy group decreased( F=61.71, 111.96 and 8.69, respectively, P<0.01). The average value of VI in the statin-related myopathy group was about(0.43 ± 0.12)%, which was less than that in the non-statin-related myopathy group(0.75 ± 0.20)% and in the healthy control group(0.93 ± 0.17)%( F=48.93, P<0.001). However, there was no significant difference in values from the parameters between the non-statin-related myopathy group and the healthy control group(all P>0.05). Conclusions:Multimodal ultrasound imaging of statin-related myopathy in elderly hyperlipidemia patients shows distinct characteristics and can be used to evaluate muscle damage of statin-related myopathy.
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@#The PI3K signaling pathway is frequently over-expressed in a variety of hematologic malignancies, so the development of PI3K inhibitors for the treatment of hematologic malignancies has broad application prospects. In this study, a novel PI3K inhibitor, JN-65, was identified through the investigation effects in the inhibition to hematologic malignancies. By MTT assays, JN-65 was found to effectively suppress the proliferation of hematologic malignancies, especially leukemia cell lines. The cell-free enzymatic studies demonstrated that JN-65 cloud inhibit PI3K and specifically inhibited PI3Kγ at low micromolar concentrations. Western blot confirmed that JN-65 could effectively inhibit the PI3K/Akt signaling pathway and the flow cytometry assays verified that JN-65 could induce the apoptosis of tumor cells through the suppression of PI3K signaling pathway. Finally, the molecular docking simulation method was used to explore the interaction between JN-65 and PI3K, and the inhibition mechanism of PI3K was revealed at the molecular level. In general, JN-65 would be a potential PI3K inhibitor for the treatment of hematologic malignancies.
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Objective To compare the characteristics,complications and outcomes of the modified lapa-roscopic Swenson(MLSw)and laparoscopic Soave(LS)procedures for children with short-segment Hirschsprung disease(HD). Methods Seventy-seven pediatric patients with HD who underwent surgery from March 2007 to December 2016 were enrolled in this retrospective study. Twenty-six patients were treated with LS and 51 cases un-derwent MLSw. The preoperative,operative and postoperative data was collected,with follow-up periods ranging from 12 to 48 months. The perioperative/operative characteristics,postoperative complications,and outcomes were compared between the two groups. Results On average,the patients in the LS group had a longer operating time than that in the MLSw group(P < 0.05). Blood loss was significantly less in the MLSw group than that in the LS group(P < 0.05). There was no significant difference in feeding time between the two groups(P > 0.05). The MLSw group was discharged after a shorter hospitalization time than that in the LS group(P < 0.05). The MLSw group had lower incidences of postoperative complications than those in the LS group in the early postoperative period,with no significant difference in the rate of complications during the late postoperative period was found between the two groups. Conclusions Both LS and MLSw are suitable for treatment of children with short-segment HD. However,the MLSw operation is much simpler,with less operating time,less intraoperative blood loss,shorter hospitalization time and better bowel control in the early postoperative period. We favor this approach because it allows complete removal of the entire original aganglionic bowel,without leaving behind a cuff.
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Objective Two Chinese pedigrees with congenital factor Ⅻ(FⅫ)deficiency were enrolled in the present study,and studies on the clinical manifestations,family survey,biochemical examinations and gene diagnosis of these pedigrees were performed.Methods In October 2014-2015 March,two cases of hereditary FⅫ deficiency patients were included in Xinhua hospital.Activated partial thromboplastin time(APTT),FⅫ procoagulant activity(FⅫ:C),FⅫ antigen(FⅫ:Ag)and other parameters of coagulant were detected.The FⅫ deficiency pedigree members,exons 1-14,boundary introns including the splice junctions of the F12 gene were amplified with polymerase chain reaction(PCR).Direct sequencing was exerted to purified PCR product to detect the gene mutation.If the gene mutations were found,polymorphism should be ruled out by directing sequence.One hundred and three healthy persons as normal controls.Results The two probands were manifested prolonged APTT(101 s and 143 s).They showed lower FⅫ activity and FⅫ antigen(2％and 6％,0.4％and 4％,respectively).FⅡ:C,FⅦ:C,FⅧ:C,FⅨ:C,FⅩ:C and Fg are normal in the two probands.LAC is negative.Proband 1 has c.1285C>T(p.Q429 stop)mutation.His parents and son have the heterozygous mutation in the same position.Proband 2 has c.1556T>C(p.L519P)mutation.Her two sons have the heterozygous mutation in the same position.In the promoter regions of F12 gene,there were common 46C/T and 619 G/C polymorphisms in two pedigrees.Conclusion c.1285C>T(p.Q429 stop)and c.1556T>C(p.L519P)are the cause of FⅫ deficiency.
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Detection of biomarkers benefited many advanced non-small cell lung cancer (NSCLC ) patients .In recent years ,epidermal growth factor (EGFR) tyrosine kinase inhibitors (TKIs) represented by Gefitinib ,Erlotinib ,Afatinib and an-aplastic lymphoma kinase (ALK) TKIs represented by Crizotinib have remarkable efficacy .However ,the efficacy for most first-generation EGFR-TKI and ALK-TKI is weakened due to secondary resistance .Currently ,the third-generation EGFR-TKI which successfully against drug resistance is based on research and development of the second-generation .In addition ,there are many other targeted inhibitors of mutation sites for advanced NSCLC .Unfortunately ,the largest proportion of Kirsten rat sar-coma viral oncogene homolog (K-RAS) mutation is not targetable with small molecule inhibitors currently .Therefore ,based on mechanisms exploration of tumor driven gene mutation ,its target drug research and development will be greatly addressed in the future .
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Objective ToinvestigatemechanismofWentilactoneA (WA)inhibitionofsmallcelllungcancer(SCLC)cell line NCI-H1688 migration .Methods The migration and proliferation were analyzed by wounding-healing assay and MTT assay [3-(4 ,5-Dimethylthiazol-2-yl)-2 ,5-diphenyltetrazolium bromide ,MTT] .Immunofluorescence was used to confirm the ex-pression of ATF3 protein after WA treatment .Western blot was used to examine the expression of key proteins in ATF3/Nrf2/AKR1C1 signal pathway .Results WA inhibits the proliferation and migration of SCLC .MTT analysis showed WA in-hibits the proliferation of NCI-H1688 cell line in a time-dependent manner .The number of migrated cells in WA treatment group was (8 .73 ± 1 .06) mm ,which was lower than that of control group (15 .63 ± 3 .11) mm ,The number of migrated cells in AKR1C1 expression group was (24 .37 ± 0 .90) mm ,the number of migrated cells in AKR1C1 expression and WA treatment group was (14 .17 ± 1 .31) mm ,with significant difference (P<0 .05) .WA enhances the nuclear expression of ATF3 ,and then reduces the expression of p-Nrf2 and AKR1C1 .Conclusion WA inhibits the proliferation and migration of SCLC through ATF3/Nrf2/AKR1C1 signal pathway .
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Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3％) and 6 in group A (20％) (P ＜ 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P ＞ 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P ＜ 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.
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Objective To evaluate the value of preoperative color Doppler flow imaging findings for predicting possible difficuulties encountered during laparoscopic cholecystectomy (LC).Methods Eighty-six Datients with acute cholecystitis underwent color Doppler flow imaging examination were divided into operation difficult group(67 cases)and operation easy group(19 cases)according to the diffculty score.The parameters were measured pre-operation including the volume of gallbladder,the thickness of the gallbladder wall,the condition of arterial flow in the gallbladder wall,the conditions of gallbladder cavity and gallbladder fossa and the intra-and extra-hepatic bile duet.The relationships among imaging results,operation difficulties and operation findings were investigated.Results Gallbladder volume,gallbladder wall thickness.the presence rates of plentiful arterial flow in the gallbladder wall,adhesion of gallbladder and stone incarceration In operation difficult group were significantly different from those in operation easy group [(52.6±14.6)mm~3 vs(32.6±10.4)mm~3,(9.7±4.1)mm vs(3.8±0.9)mm,89.5%(17/19)vs 17.9%(12/67),78.9%(15/19)vs 11.9%(8/67),10.5%(2,19)vs 0(0/67)](P<0.05 or<0.01).The accurate rate was 94.2%(81/86)in predicting.Conclusion Preoperative color Doppler flow imaging is helpful in predicting difficulties of LC.
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Objective To evaluate the changes of morphology, hemodynamics and endothelial function of the dorsal artery of foot in patients with early-stage type 2 diabetic mellitus (T2DM) by high-resolution ultrasound. Methods The changes of morphology, homodynamics and endothelial function of the dorsal artery of foot were measured in 25 elderly and 35 non-elderly T2DM patients and 35 elderly and 30 non-elderly healthy persons. Results (1) The change percentage of inside diameter of foot dorsal artery under reactive hyperemia situation was obviously reduced in elderly T2DM patients compared with elderly healthy controls [(10.52±2.79)% vs. (15.43±4.69)%, P<0.01] and there was significant difference between non-elderly T2DM versus healthy persons [(12.89±4.68)% vs. (17.97±4.61)%, P<0.01],and it was lower in elderly versus non-elderly T2DM ones (P<0.05). The change percentage of inside diameter of foot dorsal artery wassignificantly lower in elderly T2DM versus healthy subjects after taning nitroglycerin [(12.40± 3.23)% vs. (16.11±5.74)% , P<0.01]. (2) Compared with control groups, the intima-medial thickness (IMT) of dorsal artery of foot was thickened significantly, and the peak reverse velocity (PRV) in early diastole, the velocity in end diastole (EDV) and pulsatility index(PI) were reduced significantly in T2DM groups (P<0.05). The peak systolic velocity (PSV) had no significant differences among all the groups (P>0. 05). (3) In T2DM groups, the PI was correlated positively with the change percentage of inside diameter of dorsal artery of foot under reactive hyperemia situation (r=0.79, P<0.01) and after having taken nitroglycerin (r=0.71, P<0.01), respectively. Conclusions The changes of morphology, hemodynamics and the injuries of endothelial function of the dorsal artery of foot can be detected in patients with early-stage T2DM byhigh-resolution ultrasound, which has clinical significance and applicable value.
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Objective To explore the relationship among left ventricular(LV) peak systolic strain rate,the mitral annular motive amplitude(MAMA) and left ventricular ejection fraction(LVEF) in essential hypertension patients with different left ventricular patterns.Methods According to level of LV mass index and relative wall thickness,40 patients with hypertension were divided into patterns of normal geometric LV(LVN) and remodeling LV(LVR),20 normal patients were on control group. The apical views were used to determine MAMA and peak systolic strain rate(SSR).MAMA was determined by anatomic M-mode(AMM) and strain rate imaging was applied for obtaining SSR of LV basal and middle segments.LVEF was determined by Simpson rule.The LV systolic function was evaluated by mean of MAMA,SSR and LVEF. Results In all subjects,mean SSR by strain rate imaging of LV wall correlated negatively with mean MAMA(r=(-0.91),P(0.05)).Conclusions Strain rate imaging provides a sensitive,simple and trust tool to assess globle LV function in patients with essential hypertension.
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Objective To evaluate the value of predicting functional improvement of viable myocardium after percutaneous transluminal coronary angioplasty(PTCA) by strain rate imaging(SRI) combining with low-dose dobutamine stress echocardiography(LDDSE).Methods PTCA was performed in 20 patients with old myocardial infarction and 72 segments of resting dyskinetic wall motion at baseline were observed.Peak systolic strain rate(SSR) and systolic peak velocity(Vs) were measured in abnormal walls at baseline and SRI combined with LDDSE one day before PTCA.Increment of SSR and Vs was defined during stress echocardiography(?SSR% and ?V_S%).The follow-up analysis was performed 6 weeks after PTCA.Results The dyskinetic motion of 48/72 segments was improved according to the follow-up echocardiography 6 weeks after PTCA while that of 24/72 segments was not.Considering ?SSR%≥(2.02%),?V_S%≥(8.5%) in 5 ?g?kg~(-1)?min~(-1) stress and ?SSR%≥(24.7%),?V_S%≥(28.5%) in 10 ?g?kg~(-1)?min~(-1)stress as cut-offs for motion improvement of the left ventricular dyskinetic segments,the sensitivities were(93.8%),(89.6%) and(95.8%),(91.7%),respectively.At baseline SSRs of two groups were significantly different while Vs did not have significant difference.Conclusions Combined with LDDSE,SRI can more accuratly predict the motion improvement of viable myocardium than tissue velocity imaging can.