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Objective: To explore the application value of MRI quantitative analysis in evaluation on therapeutic effect of rheumatoid arthritis (RA) of the wrist. Methods: Totally 30 patients with RA after regular treatment for 1 year were enrolled. The wrist joint was scanned before and after treatment, and the volume of synovitis and bone marrow edema before and after treatment were measured by using the quantitative analysis software. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and disease activity score of 28 (DAS28) were also obtained. Changes of synovitis, bone marrow edema, CRP, ESR and DAS28 were analyzed before and after treatment, correlation analysis was performed on the changes of synovitis and bone marrow edema with changes of CRP, ESR and DAS28. Results: After treatment, the volume of synovitis, the range of bone marrow edema, CRP, ESR and DAS28 of the patients reduced significantly (all P0.05), while changes in synovitis and bone marrow edema were moderately correlated with changes of DAS28 (r=0.50, 0.56, P=0.01,<0.01). Conclusion: MRI quantitative analysis can be used as accurate and Objective: quantitative indices for monitoring and evaluating therapeutic effect of RA.
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Objective@#To investigate the difference in the microstructure of gray matter nucleus in different movement subtypes of Parkinson’s disease (PD) by diffusion kurtosis imaging (DKI) technique, and to analyze the correlation with clinical manifestations.@*Methods@#Ninety-seven patients with PD and 83 healthy controls performed conventional MRI sequence and DKI sequence scan. The PD patients were classified into gait disorder subtype (PIGD, n=57) and tremor dominant subtype (TD, n=40)subtypes according to motor symptoms. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity(Dr), mean kurtosis (MK), axial kurtosis (Ka) and radial kurtosis (Dr) maps and data were generated by software after processing. DKI was performed for all subjects and data was collected from different brain regions in both hemispheres, including red nucleus(RN), substantia nigra pars reticulate(SNr), substantia nigra pars compacta(SNc), putamen(PUT), globus pallidus(GP), head of caudate nucleus (CN)and thalamus(THA).@*Results@#TD showed a higher MMSE score(P=0.019), but lower modified Hoehn-Yahr score than that in PIGD (P<0.001), there was no significant difference of age of onset, sex, limbs of onset or disease duration between two PD subgroups. Compared with healthy controls, both TD and PIGD showed down-regulated MD, Da and Dr and up-regulated Ka values(P<0.001); MK(0.83±0.26, 0.80±0.18) was increased in SNr both in TD and PIGD, while SNc, PUT and GP (0.84±0.20, 0.75±0.07, 0.81±0.14)were decreased only in TD (P=0.017, P=0.010, P=0.020, P<0.001, P=0.002). The Kr values of PUT and CN(0.71±0.17, 0.72±0.14) were reduced in PIGD, while CN(0.70±0.14) were reduced in TD respectively (P=0.002, P=0.031, P=0.007). The MK was lower in TD than that in PIGD (t=-2.214, P=0.029), and no significant difference was found in other grey matter nuclei between TD and PIGD(P>0.05). Moreover, there was no significant correlation between DKI value and disease duration, MMSE score or Hoehn-Yahr scale (P>0.05) in TD and PIGD.@*Conclusion@#There is heterogeneity of clinical symptoms between these two subgroups of PD. DKI can quantify the microstructural changes of grey matter nucleus in different type PD patient.
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Objective To investigate the difference in the microstructure of gray matter nucleus in different movement subtypes of Parkinson’s disease (PD) by diffusion kurtosis imaging ( DKI) technique, and to analyze the correlation with clinical manifestations. Methods Ninety-seven patients with PD and 83 healthy controls performed conventional MRI sequence and DKI sequence scan. The PD patients were classi-fied into gait disorder subtype (PIGD,n=57) and tremor dominant subtype (TD,n=40)subtypes according to motor symptoms. Fractional anisotropy (FA),mean diffusivity (MD),axial diffusivity (Da),radial diffu-sivity(Dr),mean kurtosis (MK),axial kurtosis (Ka) and radial kurtosis (Dr) maps and data were genera-ted by software after processing. DKI was performed for all subjects and data was collected from different brain regions in both hemispheres,including red nucleus(RN),substantia nigra pars reticulate( SNr),sub-stantia nigra pars compacta(SNc),putamen(PUT),globus pallidus(GP),head of caudate nucleus (CN)and thalamus(THA). Results TD showed a higher MMSE score(P=0. 019),but lower modified Hoehn-Yahr score than that in PIGD (P<0. 001),there was no significant difference of age of onset,sex,limbs of onset or disease duration between two PD subgroups. Compared with healthy controls, both TD and PIGD showed down-regulated MD,Da and Dr and up-regulated Ka values(P<0. 001); MK(0. 83±0. 26,0. 80±0. 18) was increased in SNr both in TD and PIGD,while SNc,PUT and GP (0. 84± 0. 20,0. 75± 0. 07,0. 81± 0. 14) were decreased only in TD (P=0. 017,P=0. 010,P=0. 020,P<0. 001,P=0. 002). The Kr values of PUT and CN(0. 71±0. 17,0. 72±0. 14) were reduced in PIGD,while CN(0. 70±0. 14) were reduced in TD re-spectively (P=0. 002,P=0. 031,P=0. 007). The MK was lower in TD than that in PIGD (t=-2. 214,P=0. 029),and no significant difference was found in other grey matter nuclei between TD and PIGD ( P>0. 05). Moreover,there was no significant correlation between DKI value and disease duration,MMSE score or Hoehn-Yahr scale (P>0. 05) in TD and PIGD. Conclusion There is heterogeneity of clinical symptoms between these two subgroups of PD. DKI can quantify the microstructural changes of grey matter nucleus in different type PD patient.
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Objective To explore the diagnostic value of qualitative and quantitative analysis for wrist and hand changes of rheumatoid arthritis (RA) patients based on 3.0T MR images.Methods A total of 39 RA patients were enrolled and divided into 2 groups according to the course of the diseases,including 20 cases defined as early stage group (≤24 months) and 19 cases defined as middle-late stage group (＞24 months).MRI features such as joint synovitis,bone marrow edema,bone erosion,the tenosynovitis in wrists and hands were observed emphatically.Volumes of synovitis and bone marrow edema for all patients were quantified with the software developed by Kunming University of Science and Technology.Results Among the 78 sides of hands and wrists in 39 patients,the incidence rate of synovitis,bone marrow edema,bone erosion,tenosynovitis was 94.87％ (37/39),64.10％ (25/39),61.54％ (24/39) and 76.92％ (30/39),respectively.The highest incidence rate of synovitis,bone marrow edema and bone erosion was respectively found in the wrist (72/78,92.31 ％),carpus (48/78,61.54 ％) andtriangular bone (50/78,64.1 ％).There was no statistical significance difference of the occurrence of peritendinitis between the flexor tendons (74.36％ [58/78]) and extensor tendons (61.54％ [48/78];x2 =2.94,P=0.09).No statistical difference of the incidence rates of synovitis,bone marrow edema,bone erosion and tenosynovitis was found between the early stage group and middle-late stage group (all P＞0.05).There was no significant difference of synovitis and bone marrow edema volumes between the early stage group and the middle-late stage group (both P＞0.05) with MRI quantitative analysis.Conclusion 3.0T MRI can clearly demonstrate the pathological changes of the wrists and hands in RA patients.The quantitative analysis software can provide more accurate indicators for the assessment of disease severity.
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Objective To explore the diagnostic value of qualitative and quantitative analysis for wrist and hand changes of rheumatoid arthritis (RA) patients based on 3.0T MR images.Methods A total of 39 RA patients were enrolled and divided into 2 groups according to the course of the diseases,including 20 cases defined as early stage group (≤24 months) and 19 cases defined as middle-late stage group (＞24 months).MRI features such as joint synovitis,bone marrow edema,bone erosion,the tenosynovitis in wrists and hands were observed emphatically.Volumes of synovitis and bone marrow edema for all patients were quantified with the software developed by Kunming University of Science and Technology.Results Among the 78 sides of hands and wrists in 39 patients,the incidence rate of synovitis,bone marrow edema,bone erosion,tenosynovitis was 94.87％ (37/39),64.10％ (25/39),61.54％ (24/39) and 76.92％ (30/39),respectively.The highest incidence rate of synovitis,bone marrow edema and bone erosion was respectively found in the wrist (72/78,92.31 ％),carpus (48/78,61.54 ％) andtriangular bone (50/78,64.1 ％).There was no statistical significance difference of the occurrence of peritendinitis between the flexor tendons (74.36％ [58/78]) and extensor tendons (61.54％ [48/78];x2 =2.94,P=0.09).No statistical difference of the incidence rates of synovitis,bone marrow edema,bone erosion and tenosynovitis was found between the early stage group and middle-late stage group (all P＞0.05).There was no significant difference of synovitis and bone marrow edema volumes between the early stage group and the middle-late stage group (both P＞0.05) with MRI quantitative analysis.Conclusion 3.0T MRI can clearly demonstrate the pathological changes of the wrists and hands in RA patients.The quantitative analysis software can provide more accurate indicators for the assessment of disease severity.
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OBJECTIVE:To provide reference for clinical individual medication of voriconatole. METHODS:The distribution of MIC of voriconazole to Aspergillus fumigatus and Candida albicans were summarized as well as the pharmacokinetic parameters of voriconazole in different populations. Using probability of target attainment(PTA)and cumulative fraction of response(CFR)as indexes,crystal ball software 11.1.2.4 was used for Monte Carlo simulation of different dosage regimens of same population and same dosage regimen of different populations. RESULTS:For children with impaired immunity,when the drug doses of were 4,6 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%;when the drug doses was increased to 8 mg/kg and MIC was lower than 0.125 mg/L,PTA was higher than 90%. For different populations receiving same dosage regimens(4 mg/kg),MIC of teenagers with impaired immunity was lower than 0.25 mg/L and those of healthy adults,patients underwent hematopoietic stem cell transplantation and adults with impaired immunity were all lower than 0.5 mg/L,PTA was higher than 90%. CFR to A. fumigatus were 42.53%,58.41%,77.74%,70.16%,89.40%,93.72%,95.42% and CFR to C. albicans were 96.68%,97.13%,97.94%, 97.54%,98.07%,98.28%,98.35%among children with impaired immunity receiving different drug doses(4,6,8 mg/kg)and dif-ferent populations receiving drug dose of 4 mg/kg(teenagers with impaired immunity,healthy adults,patients underwent hemato-poietic stem cell transplantation,adults with impaired immunity). CONCLUSIONS:Various dosage regimens of different popula-tions included in this study could effectively control C. albicans infection. It is necessary to increase the drug dose of children and teenagers with impaired immunity in order to meet the needs of A. fumigatus infection treatment.
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At present,the study of intestinal absorption of oral drugs mainly includes in vitro,in vivo and in situ methods.In view of the advantages of in situ intestinal perfusion such as simple operation,mature technology,controllable,ensure the neuroendocrine regulation and blood supply,and so on,which could better reflect the true situation of drug absorption.In this study,the research methods and characteristics of intestinal absorption of oral drugs were systematically introduced.The recirculating perfusion method and single-pass perfusion method were compared,and several volume correction methods were also introduced.In order to ensure the operability and accuracy of experimental results,proper experiment method of intestinal absorption will be adopt according to the factors such as drug characters,experiment requirements,experimental conditions,and so on.The article provides a scientific basis for the development of pharmaceutical dosage and clinical rational drug use.
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Objective To assess the effectiveness of Chinese materia medica (CMM) as adjuvant therapy of antibacterial for pediatric mesenteric lymphadenitis.Methods Retrieved RCT research of CMM as adjuvant therapy of antibacterial for pediatric mesenteric lymphadenitis from CNKI,Wanfang,VIP,PubMed,and Medline database from 1980 to 2016.Literatures were selected according to the inclusion and exclusion crteria,Jadad scores method was used to evaluate the literatures and meta-analysis was performed by RevMan 5.3.Results A total of 34 randomized controlled trials were included.Meta-analysis showed that the trial group was superior to the control group in terms of efficiency,cure rate,remission time of main symptoms,mesenteric lymph node recovery,and recurrence rate,there was statistical difference.Conclusions CMM as adjuvant therapy of antibacterial for pediatric mesenteric lymphadenitis is more effective than the use of antibacterial alone.
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Bladder cancer is the most common malignant solid tumor in urinary system. More than 75% cases of bladder cancer have been diagnosed as non-muscle-invasive bladder cancer ( NMIBC ) . Transurethral resection of bladder tumor ( TURBT ) is the standard method for the diagnosis and treatment for bladder cancer, however, due to its problem of recurrence, adjuvant intravesical therapy with either immunotherapy or chemotherapy has been used to reduce recurrence and achieve better efficacy for the patients in appropriate stages. The review focused on current progress in chemotherapy agents, targeted bladder drug delivery systems and treat-ment strategies for NMIBC, which would provide guidance for clinical intravesical chemotherapy.
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Objective To analyze quantitatively the iron deposition in deep brain gray nucleus and frontal white matter in healthy population and to explore its correlation with age using ESWAN with 3.0 Tesla scanner.Methods 157 healthy subjects (age 20 to 85)had been manned with routine sequences and ESWAN sequences.The subjects were divided into 6 groups according to their ages:Group A (age 20-29),Group B (age 30-39),Group C (age 40-49),Group D (age 50-59),Group E (age 60-69)and Group F (age ≥70).T2 ?value was measured in both sides of the frontal white matter,red nucleus,substantia nigra pars reticulate,substantia nigra pars compacta,putamen,globus pallidus,head of caudate nucleus and thalamus,and the correlations between the T2 ? value and age were also analyzed.Results The T2 ? value of globus pallidus and substantia nigra pars reticulata were the lowest.The highest T2 ?value was observed in the frontal white matter.The difference of T2 ? value among some age groups had statistical significance in red nucleus putamen,globus pallidus,head of caudate nucleus and thalamus (P <0.05).Obvious negative correlations between age and T2 ? value was shown in red nucleus (r=-0.258),substantia nigra pars reticulate (r=-0.229),substantia nigra pars compacta (r=-0.231), putamen(r=-0.584),globus pallidus (r=-0.320),and head of caudate nucleus (r=-0.437,P <0.001),while positive correlation was displayed in thalamus (r=0.31 9),frontal white matter (r=0.161,P <0.05 ).Conclusion ESWAN can clearly display the morphology of cerebral nuclei,evaluate the brain iron content accurately and present the age-related iron concentration changes.
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Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.
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Objective The purpose of the study was to investigate clinical manifestation and the characters of diagnosis and treatment among children with primary angiitis of the central nervous system (cPACNS) in order to improve awareness of the disease.Methods Clinical data of 5 children with cPACNS in the First People's Hospital of Yunnan Province from January 2009 to December 2013 were collected,and the clinical manifestations and laboratory test results were analyzed and summarized.Results Five cases of children with cPACNS were misdiagnosed at the first clinic visit,and were confirmed a clear diagnosis on the average of (4±6) months; clinical manifestations of five cases of varying degrees of headache,one case with severe headache,2 patients with decreased visual acuity,a cases with hearing were loss,two cases with secondarily generalized seizures; five cases with mild abnormal cerebrospinal fluid examination; 1 case with elevated ESR and CRP level,1 case with elevated immunoglobulin IgG level; 5 cases with abnomal MRI examinations,which showed multiple bilateral lesions,diffuse,lesions,involving the cortex and deep white matter; 4 cases had vascular abnormalities on MRA,treated with corticosteroids alone or in combination with cyclophosphamide and achieved good results.Conclusion Children of primary central nervous system vasculitis is ar are autoimmmune disease primarily involving the central nervous system.It is difficult for the clinical diagnosis.Children need to be wary of the major manifestation of headache associated with vision loss,hearing loss,seizures and other focal neurological system damage.
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Objective To evaluate the application of measurement of T2*value,width of substantia nigra pars compacta (SNc) and the ratio of the width to the midbrain diameter in diagnosing Parkinson disease (PD) in early stage with susceptibility weighted imaging ( SWI) by 3T MR. Methods 59 patients with early stage idiopathic PD patients and 59 healthy controls,ranging in same ages and gender,had been scanned with routine sequences and SWI sequences by 3T MR. T2*value,width and the ratio of the width to the midbrain diameter of SNc were measured. The results of measurement were analyzed and compared. Results (1) The T2*values, width and the ratio of the width to the midbrain diameter was decreased in homolateral side SNc of symptoms of subjects with PD compared with the healthy controls ( 0.05) . Conclusion Measurement of T2*value, width and the ratio of the width to the midbrain diameter of SNc with SWI is reliable to diagnose PD.
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Objective To study the antidepressant effect of total timosaponin(TT)and its mechanism.Methods The antidepressant effect of TT was examined by mice forced swimming test(FST),learned helplessness(LH)experiment,chronic mild stress(CMS)model,yohimbine induced lethality test and 5-HTP induced head-twitches test.Results TT(25 or 50 mg?kg-1,ig,qd?14 d)markedly shortened the immobility time in the FST,but didn't affect the autonomic activity.TT(12.5,25 or 50 mg?kg-1,ig,qd?14 d)significantly decreased the number of escape deficits in the LH mice.TT(25 or 50 mg?kg-1,ig,qd?21 d)markedly enhanced the locomotor activity and increased consumption of sucrose solution in CMS mice.TT(50 mg?kg-1,ig,qd?14 d)enhanced the mortality of mice after administration of yohimbine for 4 h,and distinctly increased the head-twitch number in the 5-HTP induced head-twitches test.Conclusion TT has antidepressant effects in various depression mouse models.Its mechanism may be related to the reinforcement of NE and 5-HT nerves system.