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Objective To investigate the value of ADC histogram analysis in the assessment of response to neoadjuvant chemotherapy (NACT) in patients with in locally advanced breast cancer (LABC). Methods Thirty?five female patients with invasive ductal carcinoma proved by pathology before NACT and treated with operation after NACT were retrospectively analyzed. All patients were received MR examination (including non?enhanced MRI, enhanced?MRI, and DWI) breast before NACT. After neoadjuvant chemotherapy, 19 of 35 patients were categorized as responders and 16 were categorized as non?responders according response evaluation criteria in solid tumors criteria. Per?patient weighted ADC histograms were generated. Mean ADC, mode ADC, maximum ADC, minimum ADC, median ADC, skewness, and kurtosis were analyzed by using t test between responders and non responders groups. ROC curves were constructed to determine the optimum threshold for each histogram parameter to differentiate non?responders and responders in breast cancers. The optimal threshold values, determined by maximal Youden index were selected when significant differences existed in two groups. Results Mean, minimum, skewness, and kurtosis of ADC between responders and non?responders group were(0.955 ± 0.135)× 10?3mm2/s,(0.535 ± 0.115)×10?3mm2/s,0.85±0.61, 2.93±0.17,and(1.103±0.233)×10?3 mm2/s,(0.650±0.104)×10?3mm2/s,-0.42± 0.17, 3.11 ± 0.25,respectively. Significant differences were found mean ADC, minimum ADC, skewness, and kurtosis (t=2.345, 3.096, 8.051 and 2.524,P0.05).We set the optimal threshold criteria of mean ADC (0.956×10?3mm2/s), minimum ADC (0.580×10?3mm2/s), skewness (0.890), sensitivity, specificity of three parameters for predicting responders in LABC were 73.7%,62.5%, 78.9%,68.8%, and 63.2%,75.0%, respectively, and the areas under ROC curve of mean ADC, minimum ADC, skewness was 0.678, 0.770, and 0.890, respectively. Kurtosis of responders and non?responders did not get cutoff value for much more overlap. Conclusion ADC histogram analysis is valuable in predicting LABC in patients with NACT effect, the minimum and skewness of ADC is highest sensitivity, specificity, respectively.
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Objective To analyze the clinical profiles of lupus mesenteric vasculitis (LMV).Methods Thirty-six SLE patients diagnosed with LMV and 72 SLE patients (1:2) without LMV at West China Hospital between October 2009 and January 2012 were enrolled.The imaging,clinical manifestation,laboratory examinations data were analyzed retrospectively.Quantitative differences were analyzed by the Student's t and Z tests and qualitative data were compared with Chi-square.P value less than 0.05 was considered as statistically significant.Results ① The prevalence of LMV in patients with SLE was 1.2％(36/3 051),while 47％(17/36) as the initial symptom of SLE.Thirty-six LMV patients were all female.The prevalence of abdominal pain was 78％(28/36),nausea or vomitting was 58％(21/36),abdominal distension was 50％(18/36),diarrhea was 47.2％ (17/36),intestinal perforation was 3％ (1/36) and incomplete obstruction was 8％ (3/36).Enhanced CT scan showed 81％(25/31) patients suffered from intestinal dilation and (or) mesenteric edema;SLEDAI (17±5),C3 (0.44±0.25) g/L,C4 (0.10±0.09) g/L,Z value on above items were 4.30,-3.85 and-2.94 respectively compared to SLE patients without LMV,and all P＜0.05,the differemces were significant.In addition,Also,the proportion of ANA and anti-ENA antibody showed no significant difference.68.6％(13/36) patients were also diagnosed with lupus nephritis;61％(22/36) patients were treated with methylprednisolone more than 200 mg/d resulting in relief of symptom.Conclusion Female patients with SLE may be more likely to suffer from LMV;Enhanced abdominal CT scan is still essential to the diagnosis of LMV.LMV is correlated with urinary system malfunction.LMV always occurs in active lupus with low C3 and C4 level.More than half patients should be treated with corticosteroid and cyclophosphamide pulse therapy.
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Objective To investigate the value of diffusion weighted imaging (DWI)in identification of different molecular sub-types for breast cancer classifications.Methods All patients with breast cancer were divided into four subtypes groups by immuno-histochemistry results including Luminal A subtype,Luminal B subtype,HER2-over expressing (HER2-OE)subtype,and triple negative breast cancer (TNBC),respectively.The means of maximum,average,and minimum ADC of the lesions in all patients were recorded.The analysis of ANOVA and least significant difference test (LSD-t )were used for the statistical evaluation.Results There were significant differences in maximum ADC,average ADC,and minimum ADC among Luminal A subtype (n=21),Lu-minal B subtype (n=22),HER2-OE subtype (n=1 7)and TNBC subtype (n=12)groups (P =0.025,0.039 and 0.041,respec-tively).However,paired comparison in mean of maximum ADC,average ADC and minimum ADC by LSD-t multiple comparisons among Luminal A,Luminal B,HER2-OE and TNBC respectively were not significantly different.Conclusion DWI may be difficult to discriminate the molecular subtypes of breast cancer classification before surgery or biopsy.
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Objective To analyze the expression of IFIT4,PRKR and investigate the clinical and immunology features of different types of liver involvement in patients with systemic lupus erythematosus (SLE).Methods Clinical data of 62 cases of SLE with liver damage and 62 cases of SLE without liver damage were collected.Peripheral venous blood samples were obtained and total RNA were extracted and transcribed into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression levels of IFIT4,PRKR in patients with SLE.Clinical parameters were analyzed by ANOVA,Chi-square test,Pearson's or Spearman's test.Results ① The increase of γ-GT or ALP was correlated with rash and oral ulcer (x2=5.625,P=0.018),lupus nephritis (x2=5.631,P=0.019),anemia,thrombocytopenia (99±21,P=0.028; 81±45,P=0.004,),CRP (33±43,P=0.004).The positive rate of nRNP (x2=4.862,P=0.027 ) and SSA (x2=8.087,P=0.004) was higher in patients with liver damage than other groups; ② The positive rate of anti-Rib antibody in SLE with liver damage was significantly higher than SLE without liver damage (x2=19.542,P=0.000); ③ There was no difference in the expression of IFIT4 among these groups,but higher expression of PRKR was detected in the group of patients with increased γ-glutamyl transpeptidase (γ-GT) or ALP(F=3.54,P=0.018).Conclusion The different types of liver damage in SLE patients have different clinical and immunology characteristics.The expression of PRKR is higher in patients with increased γ-GT or ALP.
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Objective To investigate the expression of the double-stranded RNA-dependent protein kinase (PKR) gene in the peripheral blood leukocyte of patients with systemic lupus erythematosus (SLE),and to evaluate the relationship between the gene expression and the disease activity.Methods The clinical data of 100 SLE patients,40 non-SLE patients with rheumatic diseases,and 40 normal controls were collected.Total RNA was extracted from the peripheral blood and then reverse transcribed into cDNA.Sybr green dye based real-time quantitative PCR method was used to compare the expression levels (indicated as 2-△Ct value) of PKR in the three groups.Results (1) The 2-△Ct value of PKR expression level in the SLE patients was (14.69 ± 7.62),which was significantly higher than those in the non-SLE patients (5.09 ±4.73,P =0.012) and normal controls (4.79 ± 3.49,P =0.005).(2) The 2-△Ct value of PKR expression level in the SLE patients with severe activity was (22.57 ±2.61),which was significantly higher than those in the SLE patients with mild activity and no activity(12.94±2.41,P =0.000 ;8.85 ± 2.17,P =0.000).(3) The 2 △Ct value of PKR expression level in the SLE patients with lupus nephritis was significantly higher than that in the SLE patients without lupus nephritis (16.85 ± 7.32 vs 8.35 ± 2.04,P =0.034).(4) The 2-△Ct value of PKR was correlated with the systemic lupus erythematosus index(SLEDAI) scores(r =0.32,P =0.000),WBC (r =0.46,P =0.000),Hb (r =-0.22,P =0.035),the quantitation of urine protein in 24 hours (r =0.21,P =0.000),HDL-C (r =0.21,P =0.022),and anti-RNP antibody (rs =-0.21,P =0.025).Conclusions The expression of PKR in the SLE patients is up-regulated,especially in those with severe activity.The expression level of PKR gene is associated with SLE disease activity.
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Objective To investigate the expression of the genes correlated with interferon induced genes virus (MX1, OAS1, IFI44) in the peripheral blood leukocytes of patients with systemic lupus erythematosus (SLE), and to evaluate the relationships between the expression levels of these genes and diseaseactivity. Methods The clinical data of 100 SLE patients, 40 non-SLE patients with rheumatic diseases, and 40 normal controls were collected. Peripheral blood samples were collected. Total RNA was extracted and transcribed into cDNA. SYBR green dye based real-time quantitative PCR method was used to compare the expression levels (indicated as △CT value) of MX1, OAS1 and IFI44 in patients with SLE and those in the controls. Comparisons between groups were performed with ANOVA and Spearman correlations. Results ①The △CT value of MX1, OAS1 and IFI44 expression level of the SLE patients (3.4±1.8, 4.2±1.5, 8.8±2.2)was significantly higher than those of the non-SLE patients (2.4±0.4, 3.4±0.7, 5.4±2.1 ) and normal controls (2.3±1.1, 2.6±0.7, 5.2±2.0). ② The △CT value of OAS1 and IFI44 expression level of the SLE patients in severe disease was significantly higher than those of the SLE patients in mild disease and the SLE patients with stable disease. ③The ACT value of OASI and IFI44 were correlated with the SLEDAI scores (r=0.038,0.380). ④ The △CT values of MX1, OAS1 and IFI44 expression level of the SLE patients with arthritis were significantly higher than those of SLE patients without arthritis. ⑤ The △CT value of IFI44 expression level of the SLE patients with lupus nephritis (3.2±2.1,2.2±1.1) was significantly higher than that of the SLE patients without lupus nephritis. ⑥ There was correlations among these genes in SLE patients (P＜0.05). Conclusion The value of MX1, OAS1 and FFF44 expression level of SLE patients is up-regulated. The real time expression levels of OAS1, IFI44 genes are associated with SLE disease activity and there are close correlation among these genes with interferon induce virus-relationed genes (MX1, OAS1, IFI44) in SLE patients.
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Objective To investigate the expression of interferon-induced protein 44 (IFI44) gene in the leukocytes of the peripheral blood samples from patients with systemic lupus erythematosus (SLE), and to evaluate the relationship between the expression level and disease activity. Methods Mononuclear cells in the peripheral blood samples from 100 SLE patients were compared with those of 40 disease controls and 40 healthy donors (HD) and the expression of the IFI44 was evaluated by quantitative real-time PCR.Comparisons between groups were performed with ANOVA, and the correlation analysis between the level of expression was higher in SLE patients than disease controls and healthy donors (26.8±5.3, 7.4±2.7, 5.2±2.0,respectively) (P=0.0012, P=0.005), but no difference was found between disease controls and healthy donors. Mild disease activity and the SLE patients with stable disease (63.1±22.4, 28.0±7.2, 9.2±1.8, respectively)and 24 hours urine protein level (r=0.42, P=0.000). Conclusion IFI44 is demonstrated to be highly expressed in SLE patients. The level of IFI44 may be a promising candidate biomarker for identifying SLE activity.
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Objective To investigate the effect of persistent ST-segment elevation after successful direct percutanous coronary intervention (PCI) on the late phase of left ventricular (LV) systolic function in acute anterior wall myocardial infarction.Methods Serial electrocardiograms were record before PCI and 1 hour after reperfusion in 72 patients with acute anterior wall myocardial infarction. The reduction of ST-segment elevation after successful PCI more than 50% was defined as ST-segment resolution (ST reduction group). Persistent ST-segment elevation was defined as ≥50% of peak ST elevation (ST elevation group). Echocardiography was performed on 2 to 3 weeks (early phase) and 5 to 6 months(late phase)after PCI to evaluate the LV function and ventricular wall motion abnormality (VWMA). Results Fifty-three patients (74%) had early ST segment elevation resolution and 19 patients (26%) did not. The LV function and VWMA were similar in two groups during early phase. But during the late phase, ST elevation group patients had lower LVEF and higher LVEDVI, LVESVI, VWMA index compared with ST reduction group (P