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Objective:To investigate the value of preoperative MRI measurements of hamstring (semitendinosus+gracilis) tendon cross-sectional area in predicting intraoperative graft diameter for anterior cruciate ligament reconstruction (ACLR).Methods:A total of 265 preoperative MRI were retrospectively collected in the Third Affiliated Hospital of Southern Medical University from January 2013 to August 2020 for patients who underwent single-bundle ACLR of hamstring tendon. Patients were divided into a graft diameter≥8 mm group (129 patients) and a graft diameter<8 mm group (136 patients) according to intraoperative graft diameter. The cross-sectional areas of the semitendinosus and gracilis tendons were measured at the largest level of the femoral condyle on preoperative MRI cross-sectional images, and the two were summed to obtain the cross-sectional area of the hamstring tendon. The independent samples t-test was used to compare the differences in the cross-sectional area of each tendon between the graft diameter≥8 mm group and the graft diameter<8 mm group. The Spearman correlation analysis was used to assess the correlation between tendon cross-sectional area and intraoperative graft diameter. Multi-factor logistic regression analysis was used to screen the influence of tendon cross-sectional area on intraoperative graft diameter. The effectiveness of intraoperative graft diameter≥8 mm was assessed by plotting the receiver operating characteristic curves. Results:Intraoperative measurement of graft diameter was 7.5 (7.5, 8.0) mm. The cross-sectional area of the popliteal tendon was (21.4±4.6) mm 2 in the graft diameter≥8 mm group and (15.6±3.7) mm 2 in the graft diameter<8 mm group. Statistically significant differences were found in the cross-sectional areas of the semitendinosus, soleus and hamstring tendons between the graft diameter≥8 mm group and graft diameter<8 mm group ( t=-10.26, -10.29, -11.47, P<0.001). Intraoperative graft diameter was positively correlated with the cross-sectional area of the semitendinosus, gracilis, and hamstring, with correlation coefficients of 0.57 ( P<0.001), 0.58 ( P<0.001), and 0.62 ( P<0.001), respectively. Multi-factor logistic regression showed that popliteal tendon cross-sectional area was a predictor of intraoperative graft diameter (OR=1.45, 95%CI 1.32-1.59, P<0.001). The area under the curve for popliteal tendon cross-sectional area to predict intraoperative graft diameter≥8 mm was 0.838 (95%CI 0.792-0.885), with a critical value of 20.0 mm 2, a sensitivity of 0.581, and a specificity of 0.941. Conclusion:The measurement of the cross-sectional area of the hamstring muscle on preoperative MRI can predict the diameter of the autologous hamstring graft of ACLR.
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Objective:To investigate the prognostic value of serum levels of miR-320 in sepsis children complicated with acute kidney injury (AKI).Methods:A total of 158 sepsis children with complicated with AKI who were admitted to Hainan Women and Children′s Medical Center from January 2017 to June 2019 were divided into survival group (105 cases) and death group (53 cases) according to their 28-day survival.Serum levels of miR-320, neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and serum creatinine (Scr) were detected in the two groups.Multivariate Logistic regression was used to analyze the risk factors of death in children with sepsis complicated with AKI.The receiver operating characteristic curve (ROC) was drawn to analyze the value of serum levels of miR-320, NGAL, KIM-1 and Scr in predicting the death of children with sepsis complicated with AKI.The correlation between serum levels of miR-320 and NGAL, KIM-1 and Scr was analyzed using Pearson correlation analysis. Results:The serum levels of miR-320 (1.28±0.47 vs. 0.54±0.12), NGAL [(537.40±48.26) mg/L vs. (285.60±29.40) mg/L], KIM-1 [(26.80±5.72) μg/ L vs. (16.35±3.17) μg/L] and Scr[(573.70±105.46) μmol/L vs. (390.64±74.38) μmol/L] in the death group were significantly higher than those in the survival group (all P<0.001). Multivariate Logistic regression analysis showed that serum levels of miR-320 ( OR=2.280, 95% CI: 1.483-4.380), NGAL ( OR=2.753, 95% CI: 1.826-5.227), KIM-1 ( OR=1.985, 95% CI: 1.274-3.518) and Scr ( OR=1.714, 95% CI: 1.105-2.986) were independent risk factors for death in sepsis children with AKI (all P<0.001). ROC curve analysis showed that the area under the curve (0.952, 95% CI: 0.894-0.990) of serum miR-320, NGAL, KIM-1 and Scr levels combined to predict the death of children with sepsis and AKI was the largest, with a high sensitivity and specificity of 95.8% and 90.6%.Correlation analysis showed that the expression level of serum miR-320 in the death group was positively correlated with NGAL, KIM-1 and Scr ( r=0.874, 0.830, 0.702, all P<0.01). Conclusions:Serum levels of miR-320 are significantly increased in sepsis children with AKI, which is an independent risk factor for death in sepsis children with AKI.The combination of NGAL, KIM-1 and Scr levels has important value in predicting the prognosis of children with AKI.
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Objective:To investigate the expression of miR-151a-3p in peripheral blood mononuclear cells (PBMCs) of children with lupus nephritis (LN) and its correlation with activity and vascular damage.Methods:A total of 87 children with LN admitted in Hainan Women and Children′s Medical Center from January 2016 to March 2019 were enrolled, including 16 cases of type Ⅱ, 14 cases of type Ⅲ, 34 cases of type Ⅳ, 17 cases of type Ⅴ and 6 cases of type Ⅵ.Besides, additional 40 children with normal physical examination were selected as the healthy control group.The 87 children with LN were divided into the LN stable group (31 cases) and LN active group (56 cases) by using systemic lupus erythematosus disease activity index (SLEDAI) scores.According to different proportions of the medium membrane, the patients were classified into the mild group (25 cases), moderate group (34 cases) and severe group (28 cases). Real time quantitative PCR (qPCR) was used to detect the expression level of miR-151a-3p in PBMCs of each group.The correlation of the expression level of miR-151a-3p in PBMCs of LN children with the SLEDAI score and renal interstitial damage score was studied by Pearson correlation analysis. Results:The expression levels of miR-151a-3p in the LN group, LN active group and LN stable group (0.47 ± 0.06, 0.30 ± 0.04, and 0.75±0.12, respectively) were significantly lower than that in the healthy control group (1.62±0.35) (all P<0.01), and the expression level of miR-151a-3p in the LN active group (0.30±0.04) was significantly lower than that in the LN stable group (0.75±0.12) ( P< 0.01). The SLEDAI score [(14.35±4.60) points vs.(8.25±2.24) points] and renal interstitial damage score [(52.70±6.30) points vs.(34.80±4.10) points] in the LN active group were significantly higher than those in the LN stable group (all P<0.01). The expression levels of miR-151a-3p (0.18±0.02, 0.41±0.05 vs.0.83±0.16) in type Ⅴ-Ⅵ and type Ⅳ groups were significantly lower than that in the type Ⅱ-Ⅲ group (all P<0.01). The SLEDAI scores [(16.50±5.28) points, (12.36±3.74) points vs.(6.40±1.70) points] and renal interstitial damage scores [(62.70±7.40) points, (47.20±5.80) points vs.(25.80±3.50) points] in type Ⅴ-Ⅵ and type Ⅳ groups were significantly higher than those in the type Ⅱ-Ⅲ group (all P< 0.01). The expression levels of miR-151a-3p (0.20±0.02, 0.39±0.04, 0.86±0.18 vs.1.62±0.35) in severe, moderate and mild groups were significantly lower than that in the healthy control group (all P<0.01), and the expression level of miR-151a-3p decreased with the aggravation of vascular damage.The SLEDAI scores [(15.20±5.10) points, (12.85±3.90) points vs.(6.70±1.82) points] and renal interstitial damage scores [(57.30±6.80) points, (51.60±6.30) points vs.(27.20±3.60) points] in the severe and moderate groups were significantly higher than those in the mild group (all P<0.01). The expression level of miR-151a-3p in LN children was negatively correlated with the SLEDAI score and renal interstitial damage score ( r=-0.682, -0.627, all P<0.001). Conclusions:The expression level of miR-151a-3p in PBMCs of LN children is significantly decreased.The declined miR-151a-3p level is closely related to disease activity and vascular damage, and may be involved in the occurrence and development of LN.
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Objective:To evaluate the value of adenosine triphophate (ATP)stress/rest nuclide myocardial perfusion imaging (MPI)in the diagnosis of female patients with coronary heart disease (CHD).Methods:The clinical materials of 47 female suspected CHD patients were retrospectively analyzed,aged from 39 to 74 years,and the average age was (53.7±6.3)years old.All patients were hospitalized and underwent two-day ATP stress and rest nuclide MPI and coronary angiography (CAG)in two weeks. The results and images of MPI and CAG were evaluated by more than 2 attending physicians. Using CAG as the “gold standard”, the diagnostic efficiency (sensitivity, specificity and accuracy) of MPI for CHD was evaluated. Results:Compared with CAG, the sensitivity,specificity and accuracy of ATP stress MPI in diagnosing the female CHD patients were 81.3% (13/16),77.4% (24/31)and 78.7% (37/47)individually;the positive predictive value and negative predictive value were 65.0% (13/20)and 88.9% (24/27).There were no severe adverse effects in the ATP stress test and the incidence of adverse effects was 85.1%.Conclusion:There is a highly diagnostic efficiency of ATP stress MPI in the CHD patients.It can be the first choice of examination methods for screening without injury and diagnosing the myocardial ischemia in the female patients.
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Objective To determine whether the use of 18F-FDG PET/CT alters staging and management of nasopharyngeal carcinoma (NPC) when compared with MRI staging practice;and to explore the relation of standard uptake value (SUV) of 18F-FDG PET/CT and the pathological classification and T staging of NPC. Methods The study was performed retrospectively on a group of 41 patients with a new diagnosis of NPC. All the patients underwent whole body PET/CT scanning and head & neck MRI scanning within 3 weeks of each other. The AJCC protocol was introduced to stage NPC and the results of the PET/CT were compared with MRI based on pathologic diagnosis. Results ①Primary tumor:the accuracy of T staging of PET/CT was significantly higher than MRI (85.37% vs 60.98%,U=2.49,P