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Objective:To investigate the clinical value of virtual monoenergetic images (VMI) and electron density map (EDM) derived from the dual-layer spectral detector CT (DLCT) in the differential diagnosis of benign and malignant pulmonary ground glass nodules (GGN).Methods:From July 2019 to August 2020, a total of 65 patients with lung GGN (27 benign GGNs and 38 malignant GGNs) confirmed by pathology were retrospectively enrolled in Gulou Clinical Medical College of Nanjing Medical University. All the patients underwent DLCT plain scanning within two weeks before the surgery. The conventional 120 kVp polyenergetic image (PI), EDM and 40-80 keV VMI were reconstructed. The differences of CT and electron density (ED) values between benign and malignant lesions on different images were compared by Mann-Whitney U test. Independent t-test was used to compare the lesion size and χ 2 test was used to analyze the CT features (including lesion location, shape, edge, internal structure, adjacent structure, nodule type) between benign and malignant lesions. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of different energy spectrum quantitative parameters in the differential diagnosis of benign and malignant GGN. The statistically significant CT signs and energy spectrum quantitative parameters were analyzed by logistic regression analysis to find out the independent risk factors of malignant GGN, and then ROC curve analysis was performed for each independent risk factor alone or in combination. Results:There were significant differences in lesion shape, spiculation, lobulation, location and size between benign and malignant groups ( P<0.05). The CT value of pulmonary GGN in PI, 40-80 keV VMI and the ED value in EDM were statistically different between benign and malignant lesions ( P<0.05). The area under ROC curve (AUC) were 0.680, 0.682, 0.683, 0.686, 0.694, 0.676 and 0.722, respectively, among which the ED value had the highest AUC. Binary logistic regression analysis was carried out with GGN shape, spiculation, lobulation, location, size, ED value and CT value in PI, 40-80 keV VMI as independent variables, and malignant GGN as dependent variables. The results showed that ED value (OR=1.045, 95%CI 1.001-1.090, P=0.044), lesion size (OR=1.582, 95%CI 1.159-2.158, P=0.004), spiculation sign (OR=11.352, 95%CI 2.379-54.172, P=0.002) were independent risk factors for malignant GGN. ROC curve analysis showed the AUC of ED value, lesion size, spiculation sign and combination of the three for differential diagnosis of benign and malignant GGN were 0.722, 0.772, 0.698 and 0.885. The AUC for the combined parameters was the largest, with sensitivity of 92.1% and specificity of 74.1%. Conclusion:The diagnostic efficacy of EDM is higher than that of other VMI in the differential diagnosis of pulmonary GGN by DLCT images; The efficacy is further improved when EDM is combined with lesion size and spiculation sign for comprehensive diagnosis.
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O'Sullivan-Mcleod syndrome is a very rare variant of MND with a good prognosis. Its clinical feature is distal lower motor neuron syndrome of both upper limbs, and there is no effective treatment at present. We reported a case of O'Sullivan-Mcleod syndrome in this paper.The patient exhibited with middle-aged progressive distal muscle weakness and atrophy of both upper limbs, without sensory, cognitive or behavioral impairment and without pyramidal tract sign. Laboratory examination, imaging and genetic tests showed no obvious abnormalities. EMG revealed neurogenic damage to the small muscles of both hands. Now we retrospectively analyzed the clinical features of a patient with O'Sullivan-McLeod syndrome, and data from 18 cases for comparative analysis, in order to improve its understanding by clinicians.
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Objective:To explore the characteristics of cognitive emotion regulation in patients with hepatolenticular degeneration, and the relationship with brain lesions.Methods:The Chinese version of cognitive emotion regulation (CERQ-C) was used to investigate 78 patients with hepatolenticular degeneration(WD group) and 84 healthy adults, and all patients were examined with brain 3.0 T magnetic resonance.The characteristics of cognitive and emotional regulation in WD group were analyzed when they encounterd negative life events, and the differences between WD group and healthy people.The relationship was further analyzed between different brain structure damage and cognitive emotion regulation combined with brain MRI.Results:(1)The scores of self censure, contemplation and catastrophes in WD group((11.41±2.46), (11.27±3.09), (9.53±2.85), respectively) were significantly higher than those in healthy control group(respectively(9.57±2.81), (9.79±2.63), (8.05±2.42))( t=4.417, 3.409, 3.563, P<0.01). The scores of refocus planning and positive reevaluation ((13.26±3.41), (13.49±3.14)) in MD group were significantly lower than those of the healthy control group ((14.88±2.57), (14.42±2.41))( t=-3.404, -2.103, P<0.05). (2)Multiple linear regression analysis showed that frontal lobe injury was the influencing factor of the score of positive re-evaluation ( B=-2.142, P=0.035), thalamic injury ( B=2.058, P=0.037) and putamen injury ( B=-2.348, P=0.011) were the influencing factors of the score of contemplation. Conclusion:WD patients are more likely to choose self censure, contemplation and catastrophes than healthy people when they encounter negative life events.Different brain regions have different effects on the choice of cognitive emotion regulation in WD patients.
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Objective To investigate the safety and efficacy of embolization of inferior phrenic artery as nonbronchial systemic artery(NBSA) for hemoptysis.Methods Imaging and clinical data of 1 1 patients with inferior phrenic artery as NBSA were analyzed retrospectively, and complications and hemoptysis recurrence rate were recorded.Results Seven patients underwent enhanced CT examination and 4 patients underwent plain CT examination before embolization.Six of those patients who underwent enhanced CT examination were found abnormal arteries,and were confirmed as NBSA by angiography.The other 5 patients were found unmatch of lesion distribution and bronchial arteries during procedure,and inferior phrenic artery as NBSA were found by expanding angiography.All procedure were successfully performed,3 cases occurred hiccup and need not treatment.No serious complications occurred,such as incontinence and paraplegia.During (1 8.7 ± 1 3.8)months follow-up,only 1 patient recurrence of hemoptysis,and successful after conservative treatment,and the other 10 patients had no recurrence of hemoptysis.Conclusion The inferior phrenic artery as NBSA can induce hemoptysis.It is safe to embolization of the inferior phrenic artery,which can reduce the recurrent rate of hemoptysis.
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Abdominal aortic aneurysm (AAA) is an inflammatory vascular disorder with high mortality. Accumulating evidence shows that toll-like receptor 2 (TLR2) plays a critical role in the regulation of wound-repairing process after tissue injury. We wondered if TLR2 signaling contributed to the pathogenesis of AAA and that targeting TLR2 would attenuate AAA development and progression. In this study, enhanced expression of TLR2 and its ligands were observed in human AAA tissue. Neutralization of TLR2 protected against AAA development and caused established AAA to regress in mouse models of AAA. In addition, TLR2-deficient mice also failed to develop AAA. The prophylactic and therapeutic effects of blocking TLR2 were accompanied by a significant resolution of inflammation and vascular remodeling, as indicated by the decreased expression or activity of MMP-2/9, α-SMA, inflammatory cytokines, and transcription factors NF-κB, AP-1 and STAT1/3 in AAA tissue. Mechanistically, blocking TLR2 decreased the expression and interaction of TLR2 and several endogenous ligands, which diminished chronic inflammation and vascular remodeling in the vascular tissue of AAA. Our studies indicate that the interactions between TLR2 and its endogenous ligands contribute to the pathogenesis of AAA and that targeting TLR2 offers great potential toward the development of therapeutic agents against AAA.
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Objective To observe the vertebrobasilar artery and its branch courses,diameters and the included angles in the starting part,offering morphological basis for clinic intervention and vascular image.Methods Layer by layer dissecting head,neck and chest of nine adult specimens affused with red latex,and after affused carotid artery with red latex,the origin,course,branches,distribution,anastomosis,and accompanying of the vertebrobasilar artery were observed in three normal adult corroded specimens.Results The degree of the left included angle between subclavian artery and vertebral was (91.70 ± 0.90) ° and that of the right one was (115.80 ± 1.60) ° (P ＜ 0.05).A percentage (14.1％) of them contacted with vagus and glosssopharyngeal nerve.The degree of the left included angle between posterior cerebal lower artery and vertebral artery was (118.60 ± 3.70) ° and that of the right one (77.60 ± 7.90) °.A percentage (27.6 ％) of itself contacted or pressed by root of facial nerve.The degree of the included angle on the left side between anterior cerebellar lower artery and brobasilar artery was (91.60 ± 2.40) ° and that of the right one was (27.10 ±2.70)°(P ＜0.05).The degree of the left included angle between posterior cerebral artery and basilar artery was (93.90 ± 3.40) ° and that of its right one was (130.80 ± 3.20) ° (p ＜ 0.05).Conclusions Both vertebral artery in every part out of skull and the data of the each branch pipe diameter,the starting included angle of vertebrobasilar artery had statistical significance,which should select personalized catheter or operation method in endovascular intervention or craniocervical surgery.
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To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.
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BACKGROUND: Total isoflavones of pueraria (TIP) possesses estradiol-like structures and has inhibition effect on bone loss or osteopenia in ovariectomized rats. However, studies have demonstrated that the prevention and treatment effect of TIP on osteoporosis in ovariectomized rats is poor, especially in single utilization. OBJECTIVE: To investigate the combination effect of TIP and vitamin D on the treatment of osteoporosis in ovariectomized rats. METHODS: Totally 81 female sprague-drawly (SD) rats of 3-month-old were randomly assigned into 9 groups. Exception those in the sham-surgery group, all rats were prepared for ovariectomized models. Vitamin D or low-, middle- and high-dose TIP or low-, middle- and high-dose TIP combined with vitamin D were intragastric administrated in the vitamin D, TIP or combination groups, respectively. There was no drug medication in the model and sham-surgery groups. The uterus coefficient was calculated at 3 months after medication. The serum alkaline phosphatase (ALP) activity, calcium, phosphonium, bone gla protein, estradiol levels, as well as bone mineral density of femur was determined. RESULTS AND CONCLUSION: Compared with the model group, the uterus coefficient and estradiol level was obviously increased in the middle- and high-dose TIP groups and all combination groups (P < 0.05); the ALP and bone gla protein levels significant decreased (P < 0.05); and the bone mineral density of central and distal femur were notably increased (P < 0.05); in particular, the result was more manifest in the high-dose combination group. TIP and vitamin D presented with synergism in uterus coefficient, estradiol, ALP, bone gla protein levels and bone mineral density of distal femur, but the effect was not significant in the calcium and phosphonium levels in the TIP and/or vitamin D groups. The findings demonstrated that Tip combined with vitamin D can induce synergism on prevention and cure of osteporosis in ovariectomized rat.