The Role of Whole Body DWI in the Evaluation of Bone Disease in Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To explore the characteristics of ADC value changes in DWI of newly diagnosed symptomatic MM patients and its correlation with R-ISS stage.@*METHODS@#The data of 148 newly diagnosed symptomatic MM patients treated by whole-body DWI scan at The First Affiliated Hospital of Soochow University from June 2016 to June 2019 were selected and retrospectively analyzed and 30 cases of age-matched healthy people were selected as controls. The differences of ADC values between the patients in normal control group, DWI- group and DWI+ group were compared, and the relationship between ADC values and R-ISS stage in MM patients was compared.@*RESULTS@#The plasma cell percentage of the patients in DWI+ group was higher than those in DWI- group. ADC values of vertebra, sternum, rib, pectoral girdle, pelvic girdle of the patients in DWI+ group were significantly higher than those in DWI- group and normal control group. The ADC values of each part of the patients in DWI- group were higher than those in normal control group. ADC values of sternum, rib and pectoral girdle in the patients at R-ISS stage III were higher than those at R-ISS stage I and II, while, there was no statistical difference between R-ISS stage I and II groups. And there was no significant difference in ADC values of other bone parts such as vertebra and pelvic girdle in patients at R-ISS stage Ⅰ-Ⅲ.@*CONCLUSION@#DWI+ in MM patients is related to higher tumor invasion. The ADC values of the DWI+ group are higher than those of the DWI- group; the bone ADC values of the DWI- patients are still higher than the normal ones. And there is a certain relationship between ADC value and R-ISS stage.

Bone regeneration imaging after bone grafting using phase-contrast computed tomography with synchrotron radiation / 中国组织工程研究

BACKGROUND: With a clear distinction from traditional computed tomography (CT) imaging with information absorption, phase-contrast CT with synchronous radiation has implemented the microstructure imaging of soft tissues in organisms with an unprecedented imaging mechanism. OBJECTIVE: To explore the synchrotron radiation phase-contrast CT imaging technology in the bone regeneration imaging after bone grafting. METHODS: Four New Zealand white rabbits were used to make a metaphyseal defect model. Then, model rabbits were randomized into a group with calcium phosphate bone grafting and a group with Bio-Oss bone grafting in the defects. The specimens were imaged by the synchrotron radiation phase-contrast CT and stained with hematoxylin-eosin and sirius red 2 weeks after bone grafting. RESULTS AND CONCLUSION: (1) Bio-Oss bone graft material group: Osteoid was observed not only around the graft material but also in the area far from the graft bone material as reticulate structure by the synchrotron radiation phase-contrast CT. Hematoxylin-eosin staining showed a large amount of red osteoid tissues arranged as trabecular bone, and a large amount of osteoblasts with obvious osteogensis. Sirius red-stained pathological sections were largely stained yellow, and there were round or oval osteoblasts with strongly expressed type I collagen. (2) Calcium phosphate bone graft material group: There was no reticulate structure shown by the synchrotron radiation phase-contrast CT, and the creep of osteoid tissues was only around the bone graft. Hematoxylin-eosin staining showed a large amount of red osteoid tissues, and sirius red-stained pathological sections were stained yellow and red. To conclude, the synchronous radiation phase-contrast CT can clearly display the regenerated structure of bone grafts.

An Appreciation for the Rabbit Ladderlike Modeling of Radiation-induced Lung Injury with High-energy X-Ray / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To evaluate the utility of rabbit ladderlike model of radiation-induced lung injury (RILI) for the future investigation of computed tomography perfusion.</p><p><b>METHODS</b>A total of 72 New Zealand rabbits were randomly divided into two groups: 36 rabbits in the test group were administered 25 Gy of single fractionated radiation to the whole lung of unilateral lung; 36 rabbits in the control group were sham-radiated. All rabbits were subsequently sacrificed at 1, 6, 12, 24, 48, 72 h, and 1, 2, 4, 8,1 6, 24 weeks after radiation, and then six specimens were extracted from the upper, middle and lower fields of the bilateral lungs. The pathological changes in these specimens were observed with light and electron microscopy; the expression of tumor necrosis factor-α (TNF-a) and transforming growth factor-β₁ (TGF-β₁) in local lung tissue was detected by immunohistochemistry.</p><p><b>RESULTS</b>(1) Radiation-induced lung injury occurred in all rabbits in the test group. (2) Expression of TNF-a and TGF-β₁ at 1 h and 48 h after radiation, demonstrated a statistically significant difference between the test and control groups (each P < 0.05). (3) Evaluation by light microscopy demonstrated statistically significant differences between the two groups in the following parameters (each P < 0.05): thickness of alveolar wall, density of pulmonary interstitium area (1 h after radiation), number of fibroblasts and fibrocytes in interstitium (24 h after radiation). The test group metrics also correlated well with the time of postradiation. (4) Evaluation by electron microscopy demonstrated statistically significant differences in the relative amounts of collagen fibers at various time points postradiation in the test group (P < 0.005), with no significant differences in the control group (P > 0.05). At greater than 48 h postradiation the relative amount of collagen fibers in the test groups significantly differ from the control groups (each P < 0.05), correlating well with the time postradiation (r = 0.99318).</p><p><b>CONCLUSIONS</b>A consistent and reliable rabbit model of RILI can be generated in gradient using 25 Gy of high-energy X-ray, which can simulate the development and evolution of RILI.</p>

Comparison of enhanced magnetic resonance imaging and magnetic resonance cholangiopancreatography in the differential diagnosis of benign and malignant intraductal papillary mucinous neoplasms of the pancreas / 中国医学科学院学报

<p><b>OBJECTIVE</b>To compare the value of liver acquisition with volume acceleration (LAVA) and magnetic resonance cholangiopancreatography (MRCP) in diagnosing benign and malignant intraductal papillary mucinous neoplasms (IPMN) of the pancreas.</p><p><b>METHODS</b>The MR findings of 35 IPMN patients confirmed by pathology were analyzed retrospectively, and the sequences included T1WI, T2WI, LAVA, and MRCP. All patients were divided into two groups: the group of MRI enhancement (including T1WI, T2WI, and MRI enhancement) and the group of MRCP (including T1WI, T2WI, and MRCP). Two groups were evaluated by the receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>Totally 23 cases of intraductal papillary mucinous tumors and 12 cases of intraductal papillary mucinous carcinomas were diagnosed. Finally, 29 cases (29/35) of IPMN were diagnosed correctly in the group of MR enhancement, and 25 cases (25/35) diagnosed correctly in the group of MRCP. The differential diagnostic accuracy of the group of MRI enhancement (82.9%) was higher than that of the group of MRCP (71.4%), although the difference was not statistically significant (P=0.068). The sensitivity, specificity, positive predictive value, and the area under the ROC curve (AUC) of the group of MRI enhancement were 83.3%, 82.6%, 71.4%, and 0.850, and those of the group of MRCP were 75.0%, 69.6%, 52.3%, and 0.723. The AUC of the group of MRI enhancement was significantly larger than that of the group of MRCP (P=0.0465).</p><p><b>CONCLUSION</b>MRI enhancement is more valuable than MRCP in the differential diagnosis of benign and malignant IPMN.</p>

MRI Features of Spinal Epidural Angiolipomas

OBJECTIVE: To describe the MRI findings in ten patients of spinal epidural angiolipoma for differentiated diagnosis presurgery. MATERIALS AND METHODS: Ten surgically proved cases of spinal epidural angiolipomas were retrospectively reviewed, and the lesion was classified according to the MR findings. RESULTS: Ten tumors were located in the superior (n = 4), middle (n = 2), or inferior (n = 4) thoracic level. The mass, with the spindle shape, was located in the posterior epidural space and extended parallel to the long axis of the spine. All lesions contained a fat and vascular element. The vascular content, correlating with the presence of hypointense regions on T1-weighted imaging (T1WI) and hyperintense signals on T2-weighted imaging, had marked enhancement. However, there were no flow void signs on MR images. All tumors were divided into two types based on the MR features. In type 1 (n = 3), the mass was predominantly composed of lipomatous tissue (> 50%) and contained only a few small angiomatous regions, which had a trabeculated or mottled appear. In type 2 (n = 7), the mass, however, was predominantly composed of vascular components (> 50%), which presented as large foci in the center of the mass. CONCLUSION: Most spinal epidural angiolipomas exhibit hyperintensity on T1WI while the hypointense region on the noncontrast T1WI indicates to be vascular, which manifests an obvious enhancement with gadolinium administration.

A phase II prospective randomized controlled trial of weekly paclitaxel combined with S-1 or fluorouracil for advanced gastric carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of weekly paclitaxel combined with S-1 or fluorouracil in the first line treatment of advanced gastric carcinoma.</p><p><b>METHODS</b>Two hundred and forty patients with untreated advanced gastric carcinoma were randomized into two arms, patients in the experimental arm were given paclitaxel and S-1, while those in the control arm received paclitaxel and fluorouracil. The regimen of experimental arm was paclitaxel 60 mg/m(2) by intravenous infusion, day 1, 8, 15; S-1 80 - 120 mg/day given by oral administration, day 1 - 14. The regimen of control arm was fluorouracil 500 mg/m(2) by intravenous infusion continuously, day 1 - 5; CF 20 mg/m(2) by intravenous infusion, day 1 - 5. The regimens in both arms were repeated every 28 days. The efficacy and safety of both arms were assessed.</p><p><b>RESULTS</b>Two hundred and twenty-eight patients were analyzed in the full analysis set, and 192 patients were analyzed in per-protocol set (experimental arm 100 patients, control arm 92 patients). The overall response rates of experimental and control arms were 50.0% and 28.3% (P = 0.002), and the disease control rates were 82.0% and 70.7% (P = 0.064), respectively. The primary endpoints of experimental arm were non-inferior to that of the control arm. The secondary endpoint of experimental arm in terms of median progression free survival was significantly better than that of control arm (5 months versus 4 months, P = 0.006). The experimental arm had a higher incidence of grade III-IV bone marrow suppression than the control arm, but the incidence of fever in both arms was not significantly different.</p><p><b>CONCLUSIONS</b>Oral administration of S-1 is an alternative option of venous infusional fluorouracil. Weekly paclitaxel combined with S-1 is a safe regimen and has a promising efficacy.</p>

Practical value of intravenous urography combined with add-on CT in diagnosing ureteral abnormalities / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intravenous urography (IVU) combined with add-on CT (IVU-CT) can help to provide more diagnostic information for determining the localization and nature of ureteral abnormalities with less irradiation dose. This study aimed to determine the value of IVU-CT for diagnosis of ureteral diseases, where IVU is insufficient to determine the diagnosis.</p><p><b>METHODS</b>Two hundred and eighty patients underwent IVU for suspected ureteral disorders, which identified a definite diagnosis in 184 cases and was insufficient for definite diagnosis in 96 cases designated as indeterminate diagnosis. Subsequently 90 patients (six patients declined CT) with indeterminate diagnosis consented to undergo immediate or delayed helical CT scan. The CT data were transferred to the workstation for post-processing, and the cost and mean effective dose for each imaging method were calculated and compared indirectly.</p><p><b>RESULTS</b>Of the 90 indeterminate diagnosis cases, diagnosis was determined in 86 cases by IVU-CT with a diagnostic accordance rate of 95.6%, while 184/280 (65.7%) had diagnosis determined by IVU alone. There was a significant difference between IVU and IVU-CT in the determination of the diagnosis of ureteral diseases (c(2) = 36.4, P < 0.05). The cost of IVU equals to 1/8 - 1/9 of that for CT urography (CTU), and the cost of IVU-CT is as much as 1/3 of CTU. CTU results in the highest mean effective dose, approximately nine times that for IVU and three times that for IVU-CT.</p><p><b>CONCLUSION</b>IVU-CT provides valuable information for the localization and diagnosis of ureteral abnormalities and may be considered as an efficient, cost-effective and low-dose diagnostic technique in this setting.</p>

Reversal effect of 5-Aza-dc on cisplatin-resistance in human NSCLC cells in vitro / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate the effect of 5-aza-2'-deoxycytidine (5-Aza-dc), a methylation inhibitor, on cisplatin-resistance in non-small cell lung cancer cell line A549/DDP and to explore its possible mechanism.</p><p><b>METHODS</b>MTT assay was used to test the cytotoxicity of 5-Aza-dc on A549/DDP cells, and the IC(50) and cisplatin resistance index of A540/DDP cells at 48 hours after 5-Aza-dc (0 µmol/L, 20 µmol/L, 40 µmol/L) treatment at different concentrations. MSP, fluorescence quantitative RT-PCR (real-time RT-PCR) and Western blot were used to detect the hMLH1 methylation status, mRNA and protein expressions, respectively.</p><p><b>RESULTS</b>The IC(50) value of cisplatin in A549/DDP cells was 30.15 ± 0.76 µmol/L. The MTT assay results demonstrated that during the 5-Aza-dc treatment for 48 hours, the dose of 20 µmol/L was non-toxic and 40 µmol/L was low-toxic. 5-Aza-dc at those two doses reduced IC(50) value of cisplatin to 16.54 ± 0.35 µmol/L (RI = 1.82) and 6.82 ± 0.16 µmol/L (RI = 4.42), respectively. MSP, real-time RT-PCR and Western blot showed that 5-Aza-dc at non-toxic and low-toxic doses removed the partial hMLH1-hypermethylation, and up-regulated hMLH1 mRNA and protein expressions.</p><p><b>CONCLUSIONS</b>Low dose 5-Aza-dc can partially reverse the cisplatin-resistance in A549/DDP cells, which may be achieved through removal of hMLH1 hypermethylation and increased expression of hMLH1 gene. 5-Aza-dc may have a role in increasing the efficacy of chemotherapy for patients whose tumors are lack of hMLH1 expression because of hMLH1 promoter hypermethylation.</p>

Expression profile of heat shock proteins in tissues and cells of lung adenocarcinoma / 中南大学学报(医学版)

OBJECTIVE@#To observe the expression profile of heat shock proteins (HSPs) including HSP70, inducible HSP90 (HSP86) and aB-crystallin in cells and tissues of lung adenocarcinoma.@*METHODS@#Western blotting and reverse transcriptional-polymerase chain reaction (RT-PCR) were performed to detect the expression of HSP70, HSP86 and aB-crystallin both in the protein and mRNA level respectively.@*RESULTS@#Compared with normal lung tissue and human bronchial epithelium (HBE) cells, RT-PCR and Western blotting showed that the expression of HSP70, HSP86 and alphaB crystallin increased significantly in both the mRNA and protein level in the cancer tissue and A549 human lung adenocarcinoma cells. Among the 3 sub-families of HSPs, the expression of HSP70 mRNA and protein increased most in both the lung tissue of cancer and A549 human adenocarcinoma cell lines.@*CONCLUSION@#The expression of HSPs is higher in the lung adenocarcinoma and A549 cells than that in the normal lung tissues and HBE cells. Among the HSP family, HSP70 is the most up-regulated member in the tissue and cells of lung adenocarcinoma.

Herceptin plus adjuvant chemotherapy for the prognosis of patients with human epithelial growth factor receptor 2 positive early-stage breast cancer: a meta-analysis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of herceptin(trastuzumab) plus adjuvant chemotherapy on the prognosis of patients with human epithelial growth factor receptor 2 (HER2) positive early-stage breast cancer by Meta-analysis.@*METHODS@#Search all of randomized clinical trials (RCTs) on herceptin plus adjuvant chemotherapy for HER2 positive early-stage breast cancer in MEDLINE, EMBase, Cochrane library, Clinical Trails, ASCO Conference data, CHKD, Wanfang Database, VIP information, scholar.google.com and SIGLE. A Meta-analysis was carried out by collecting information based on the inclusion and exclusion criteria from all papers available.@*RESULTS@#The Meta-analysis included 4 trials. A total of 9116 patients were included in the analysis(4555 in the study group and 4561 in the control group). There were statistical differences between the study group(herceptin plus adjuvant chemotherapy) and the control group(adjuvant chemotherapy) in the disease-free survival rate [relative risk(RR)=1.08, 95% CI, 1.06-1.09, P<0.001], the overall survival rate(RR=1.01, 95% CI, 1.01-1.02, P=0.0003), the distant recurrence rate(RR=0.49, 95% CI, 0.42-0.57, P<0.001), and the cardiac events rate (RR=3.93,95% CI, 1.03-15.06, P=0.05).@*CONCLUSION@#Herceptin plus adjuvant chemotherapy can improve the disease-free survival rate and the overall survival rate, decrease distant recurrence rate of patients with HER2 positive early-stage breast cancer, but may cause heart toxicity, especially when combined with anthracycline (doxorubicin).

Therapeutic effect of whole body hyperthermia combined with chemotherapy in patients with advanced cancer / 中南大学学报(医学版)

OBJECTIVE@#To determine the short-term efficacy and security of whole body hyperthermia (WBH) combined with chemotherapy for advanced cancer.@*METHODS@#Different chemotherapy regimens were applied in 138 patients with advanced cancer. Among them, 68 patients (Group A) didn't receive any other therapies. The other 70 patients (Group B) received WBH together with chemotherapy. WBH was maintained at 40 degrees C approximately 42 degrees C for 50 approximately 60 min (once or twice every week and 4 times a cycle).@*RESULTS@#In Group A, the rate of complete remission (CR) was 2.9%, partial remission (PR) was 36.8%, stable disease was 35.3%, progressive disease was 25.0%, the overall response rate (CR + PR) was 39.7%; while in Group B, the corresponding figures were 5.7%, 52.9%, 25.7%, 25.0%, and 58.6%, respectively. There was significant difference between the two groups (P < 0.05). The rates of III + IV gastrointestinal tract andmyelosuppression toxicities were 26.5% and 16.2% in Group A, while 27.1% and 18.6% in Group B. No significant difference was found.@*CONCLUSION@#WBH combined with chemotherapy is efficient and safe for advanced cancer, and is worth generalizing extensively.

An improved method of quantitative assessment of regional cerebral blood flows by perfusion CT at the general infusion rate / 中华放射学杂志

Objective To improve the conventional method of quantitative assessment of regional cerebral blood flows(rCBF)by a perfusion CT study based on maximal slope model at the general infusion rate(