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Objective@#To analyze the correlation between the Spondyloarthritis Research Consortium of Canada (SPARCC) magnetic resonance imaging (MRI) sacroiliac joint inflammation score (SPARCC score)/structural score (SSS) and the disease activity as well as the functional indexs. The correlation between the MRI score and inflammatory indicators [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] in patients with active axial spondyloarthritis (axSpA) before and after treatment was explored. In addition, the contribution of the two MRI scoring method in evaluating conditions was also explored.@*Methods@#According to the inclusion criteria, 24 patients with active axial SpA were recruited and received the recombinant hauman tumor necrosis factor (TNF)-α receptor Ⅱ: IgG Fc fusion protein(rhTNFR:Fc), sulfasalazine and thalidomide for 12 weeks. Subjects were scored at week 0 and 12 by SPARCC/SSS scores. Bath ankylosing spondylitis disease activity index (BASDAI), Assessment of Spondyloarthritis Intemational Society (ASAS)-endorsed disease activity score(ASDAS)-CRP, bath ankylosing spondylitis functional index (BASFI). Bath ankylosing spondylitis metrology index(BASMI), ESR and CRP. The correlation between the SPARCC/SSS scores and that of clinical indicators were analyzed. Paired sample t test, Wilcoxon signedrank test, Spearman correlation analysis and Pearson correlation analysis were used for statistical analysis, and receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of SPARCC score decline as a response to treatment.@*Results@#① Compared with baseline, after 12 weeks treatment, SPARCC scores [(15±4) and(33±10)], BASDAI [(3.2±0.9) and (5.2±1.1)], BASFI [(2.3±0.6) and (4.6±1.0)], BASMI [(2.3±0.7) and (4.1±1.1)], ASDAS-CRP scores [(2.0±0.8) and (3.7±0.9)], ESR [(16±12) mm/1 h and (49±26) mm/1 h], CRP [(7.2±2.8) mg/L and (30.4±19.3) mg/L] were significantly decreased (t values were 7.822, 6.950, 10.707, 7.204, 6.281,-4.015 and-4.257, respectively), and the differences were statistically significant (P=0.000). There was no significant difference in SSS scores between baseline [(20±6) and (19±7)] and after 12 weeks treatment (t=-0.761, P=0.455). ② Before treatment, SPARCC score showed positive linear correlation with BASDAI (r=0.630, P=0.001), ASDAS-CRP (r=0.646, P=0.001), CRP (r=0.574, P=0.003) and ESR (r=0.559, P=0.004), and the correlation of the above indexes disappeared after treatment (P>0.05). The association between SPARCC structral scores and the above indicators was not significant before and after treatment. ③ Areas under curve(AUC) of ROC for assessing treatment response by reduced SPARCC scores was 0.809. The cut-off value for response to treatment was 20.5, with the sensitivity of 68.8% and specificity of 75.0%.@*Conclusion@#The SPARCC MRI SIJ inflamm-ation score has certain value in evaluating disease activity and efficacy, while the SPARCC SSS is not.
Résumé
Objective To analyze the correlation between the Spondyloarthritis Research Consortium of Canada (SPARCC) magnetic resonance imaging (MRI) sacroiliac joint inflammation score (SPARCC score)/structural score (SSS) and the disease activity as well as the functional indexs.The correlation between the MRI score and inflammatory indicators [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] in patients with active axial spotdyloarthritis (axSpA) before and after treatment was explored.In addition,the contribution of the two MRI scoring method in evaluating conditions was also explored.Methods According to the inclusion criteria,24 patients with active axial SpA were recruited and received the recombinant hauman tumor necrosis factor (TNF)-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR:Fc),sulfasalazine and thalidomide for 12 weeks.Subjects were scored at week 0 and 12 by SPARCC/SSS scores.Bath ankylosing spondylitis disease activity index (BASDAI),Assessment of Spondyloarthritis Intemational Society (ASAS)-endorsed disease activity score (ASDAS)-CRP,bath ankylosing spondylitis functional index (BASFI).Bath ankylosing spondylitis metrology index (BASMI),ESR and CRP.The correlation between the SPARCC/SSS scores and that of clinical indicators were analyzed.Paired sample t test,Wilcoxon signedrank test,Spearman correlation analysis and Pearson correlation analysis were used for statistical analysis,and receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of SPARCC score decline as a response to treatment.Results ① Compared with baseline,after 12 weeks treatment,SPARCC scores [(15±4) and (33±10)],BASDAI [(3.2±0.9) and (5.2±1.1)],BASFI [(2.3±0.6) and (4.6±1.0)],BASMI [(2.3±0.7) and (4.1±1.1)],ASDAS-CRP scores [(2.0±0.8) and (3.7±0.9)],ESR [(16±12) mm/1 h and (49±26) mm/1 h],CRP [(7.2t2.8) mg/Land (30.4±19.3) mg/L] were significantly decreased (t values were 7.822,6.950,10.707,7.204,6.281,-4.015 and-4.257,respectively),and the differences were statistically significant (P=0.000).There was no significant difference in SSS scores between baseline [(20±6) and (19±7)] and after 12 weeks treatment (t=-0.761,P=0.455).② Before treatment,SPARCC score showed positive linear correlation with BASDAI (r=0.630,P=0.001),ASDAS-CRP (r=0.646,P=0.001),CRP (r=0.574,P=0.003) and ESR (r=0.559,P=0.004),and the correlation of the above indexes disappeared after treatment (P＞0.05).The association between SPARCC structral scores and the above indicators was not significant before and after treatment.③ Areas under curve(AUC) of ROC for assessing treatment response by reduced SPARCC scores was 0.809.The cut-off value for response to treatment was 20.5,with the sensitivity of 68.8％ and specificity of 75.0％.Conclusion The SPARCC MRI SIJ inflammation score has certain value in evaluating disease activity and efficacy,while the SPARCC SSS is not.
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Objective Stem cell transplantation is a new approach to the treatment of lower limb ischemia ( LLI) .This study was to investigate the therapeutic effect of the transplantation of autologous bone marrow mesenchymal stem cells ( BM-MSCs) in the treatment of LLI. Methods We established the left LLI model in 12 New Zealand rabbits and divided them into a control and a trial group of equal number.The control animals were injected with DMEM, while the rabbits in the trial group with autologous BM-MSCs, into the ischemic skeletal muscle.Four weeks after injection, we performed CT angiography and perfusion imaging of both lower limbs of the rabbits and conducted HE staining of the paraffin sections of the skeletal muscle of the ischemic limbs. Results Dynamic ob-servation revealed different degrees of ecderon necrosis in 2 of the LLI models in the control group, even with toenail coloboma, but no necrosis in the trial group except for some slight muscular atrophy. Both collateral arteries and blood perfusion were obviously increased in the ischemic lower limbs in the trial than in the control group.HE stai-ning showed a significantly higher density and percentage of capillaries in the skeletal muscle fibers in the former than in the latter ([6.500 ± 1.049]/HP vs [3.670 ±0.816]/HP, [9.68 ±0.56]%vs [5.87 ± 0.86]%, P<0.01), with no necrosis in either group, nor hematoma, bony tissue, or fibroid tumor in the trial group. Conclusion Autologous transplantation of BM-MSCs can improve neovascularization in ischemic lower limbs in rabbits and can be used as a safe and effective treatment of limb ischemia.
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ObjectiveTo investigate the changes of high resolution computerized tomography (HRCT) of chest and quality of life and the main correlated factors of HRCT for interstitial lung disease(ILD) in patients with rheumatoid arthritis(RA).MethodsTwenty-six initial treatment patients with RA-ILD were enrolled.The following parameters were noted at baseline,12 and24 weeks for each patient:clinical features,HRCT,quality of life.ANOVA was used for repeated measurement data and stepwise multiple regression analysis were used to analyze the relativity between HRCT and other parameters.ResultsTwentysix patients were included.Twelve male(46％) patients were followed up for 24 weeks and pulmonary infection occurred in 11 patients,so the frequency rate was 42％.After being treated with prednisone and cyclophosphamide for 24 weeks,the HRCT scores were lower than before [(8+6) vs(12±5),respectively] and 16 patients' condition were improved,6 were in stable and 4 had deteriorated disease.For quality of life,the impact scores,symptom scores,activity scores,and total scores of St.George's respiratory questionnaire (SGRQ) were significantly decreased(F=3.783,6.362,4.217,4.426,P＜0.05) and all domains of the short form-36 health survey questionnaire(SF-36) had significant improvement after treatment.Stepwise multiple regression analysis showed that the impact scores(P=0.000) and symptom scores(P=0.001) of SGRQ,vitality (P=0.012) of questionnaire,globulin (P=0.027) in prior treatment and symptom scores (P--0.001 ) of SGRQ,course of disease (P=0.002),MRC score (P=0.011),vitality (P=0.036) of SF-36 questionnaire in post-treatment were the main correlated factors with HRCT features.ConclusionMale RA patients are prone to develop ILD and RA-ILD is susceptible to pulmonary infection.After early treatment,HRCT and quality of life in most patients can be improved.Respiratory symptoms,severity of dyspnea,globulin level,course of disease and vitality of patients are significantly correlated with HRCT.
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Objective To study the imaging features of meningiomas of ethmoid sinuses. Methods Six cases of meningiomas of ethmoid sinuses verified pathologically were analyzed retrospectively. Results CT scans of 6 cases exhibited huge cystic masses ( n =3), huge cystic solid masses ( n =2), huge solid mass ( n =1). The cystic walls were remarkable osteosclerosis. The density of solid masses were homogeneous, or heterogeneous with calcifications and cystic changes, and prominent contrast enhancement. MR images of 1 case (1/6) showed a cystic solid mass, the cystic portion was highsignalintensity on T 2WI and lowsignalintensity on T 1WI, while the solid mass was isosignalintensity on T 1WI and T 2WI. The solid portion was enhanced. X ray plain films of 3 cases (3/6) displayed ethmoid sinuses enlargement and high density. Conclusion For the meningiomas of ethmoid sinuses, CT finding was specific, MRI was helpful in differential diagnosis, and X ray plain film was of no qualitative value.
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Objective To study the relationship among SCT features of tumor margin and tumor size, immunohistochemical findings, grade of cell differentiation, and to explore the potency of tumor marginal features on multiphase spiral CT for evaluating biological behavior of small hepatocellular carcinoma (SHCC).Methods Multiphase spiral CT scans were performed in 30 patients with 33 lesions of SHCC (≤3.0 cm in diameter) confirmed histopathologically. Of these patients,26 were male and 4 were female. Immunohistochemical and HE staining were performed in surgical samples of all patients with SHCC. All samples' size was measured and the number of masses in each patient was counted.Results Of all masses, 6 were complete capsule, 15 incomplete capsule and 12 non-capsule. In multiple linear regression analysis, the pseudocapsula presentation and completion of SHCC on SCT were positively related with tumor size and VEGF expression, negatively with CD34 and p21, and were not in association with p53 and histological grade. Tumor size was the strongest contributor to pseudocapsula completion(R=0.5115), and then VEGF(R=0.2917), CD34(R=-0.2981) and p21(R=-0.2726), which had the similar standardized regression coefficients.Conclusion Tumor size is the strongest relative factor that influenced pseudocapsula presentation and completion of SHCC. VEGF always expressed positively in SHCC with complete pseudocapsula, and negatively in the group of SHCC with incomplete pseudocapsula or without pseudocapsula. In the group of SHCC with incomplete pseudocapsula or without pseudocapsula, p21 always express positively. Neither p53 expression nor histological grade is in association with the pseudocapsula presentation and completion of SHCC on SCT.
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0.05).Singnificant difference of p21 positive rates was showed between tumor lack of blood supplies and arterial blood (?