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Objective To analyze the causes and manifestations of non-pulmonary embolism induced perfusion defects (PDs) on dual-energy perfusion imaging (DEPI) using dual source CT.Methods Consecutive 208 patients without pulmonary embolism who underwent DEPI were reviewed retrospectively.The causes of PDs were analyzed by two radiologists, the pulmonary segment numbers, the proportion and the perfusion patterns of each case were recorded and analyzed respectively.Results 1 118 of 3 716 pulmonary segments showed the PDs.Among them, 752(67.26%), 36(3.22%), 308(27.55%) and 22(1.97%) pulmonary segments had PDs due to intra-pulmonary lesions, vascular diseases, artifacts and unidentifiable causes, respectively.In PDs resulted from intra-pulmonary lesions, vascular diseases and unidentifiable causes, three patterns (wedge-shaped, heterogeneous and regionally homogeneous) were identified,and most of those PDs were heterogeneous and regionally homogeneous, which were largely in accordance with the lesions showed on non-contrast enhanced scans.Artifacts included the beam hardening artifacts and artifacts caused by heart beat or diaphragmatic movement.The PDs caused by artifacts usually had particular locations and shapes.Conclusion Understanding of the manifestations and causes of PDs in patients without pulmonary embolism can improve the diagnosis accuracy of pulmonary embolism on DEPI.
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Objective To investigate the application of semi-quantitative analysis of dual energy lung perfusion imaging(DEPI)in patients with acute pulmonary embolism(PE)before and after treatment.Methods 25 patients with acute PE diagnosed by dual source CT were recruited consecutively.All of them underwent CT pulmonary angiography(CTPA)and DEPI before and after treatment. Radiologists visually evaluated the PE numbers,its distribution(central or peripheral)and its nature(occlusive or non-occlusive)on CTPA.DEPI visual analysis and semi-quantitative analysis before and after treatment in different types of PE evaluated by CTPA were analyzed statistically.Results Four types of PE(central occlusive PE,central non-occlusive PE,peripheral occlusive PE and peripheral non-occlusive PE)were classified according to embolic sites and the extent of embolization.Comparing to CTPA as a standard reference,the positive rates of DEPI visual analysis were 100.00%,70.54%,87.23%,76.19% before treatment,100.00%, 76.67%,86.67%,77.78% after treatment,respectively.Significant differences were found in central occlusive PE,central non-occlusive PE and peripheral occlusive PE with mean difference of CT values before and after treatment[(70.7 ± 10.1)HU vs(29.8 ± 6.0)HU,P<0.01;(50.1 ± 9.6)HU vs(29.3 ± 7.8)HU,P< 0.01;(53.4 ± 11.4)HU vs(27.4 ± 8.9)HU,P<0.01,respectively].Although(24.5 ± 8.2)HU (after treatment)were lower than(28.5 ± 9.0)HU(before treatment),no significant difference was found in the type of peripheral non-occlusive PE(P> 0.05).Conclusion The combination of CTPA and DEPI can offer more comprehensive information of the acute PE therapeutic evaluation before and after treatment.
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Objective To analyze the related factors associated with the effect of Roux-en-Y gastric bypass in Goto-Kakizaki rats.Methods In GK rats undergoing Roux-en-Y gastric bypass,the weight,food intake,and the fasting blood glucose were retrospectively analyzed before surgery and 1,3,6,12,24 weeks after surgery,and the glycosylated haemoglobin concentrations were retrospectively analyzed before surgery and 4,12,24 weeks after surgery.According to preoperative glycosylated haemoglobin concentrations,GK rats were divided into 3 groups(group A,HbAlc 6.5％-7.9％; group B,HbAlc 8.0％-9.9％ ; group C,HbAlc ＞ 10％).Results The fasting blood glucose and the glycosylated haemoglobin concentrations significantly decreased 1 week after surgery(P ＜ 0.01),on 24 weeks after operation,the fasting blood glucose levels decreased from(12.1 ± 3.0)mmol/L to(7.6 ± 1.3)mmol/L,and the glycosylated haemoglobin concentrations declined from(9.2％ ± 1.8％)to(6.3％ ± 0.8％).Preoperative fasting blood glucose was(11.1 ± 2.2)mmol/L and(15.8 ± 2.3)mmol/L respectively,and the preoperative glycosylated haemoglobin concentration was(8.6％ ± 1.4％)and(11.5％ ± 1.4％)respectively(P ＜ 0.01).Non-conditional Logistic regression analysis identified preoperative glycosylated haemoglobin concentrations as an independent predictor for the cure rate(P ＜ 0.01); Differences were significant between group A and group C,and group B and group C on the efficiency of the surgery(P ＜0.01).Conclusions Significant correlation established between glycosylated haemoglobin concentrations and the efficiency of the surgery,especially for those rats with preoperative HbAlc ＜ 10％.
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Objective To observe therapeutical effects of gastric bypass on non-obese type 2 diabetes patients.Methods From June 2008 to April 2010,data of 47 patients with both gastric lesions and non-obese type 2 diabetes mellitus undergoing gastric bypass in the Institute of General Surgery were studied.The patients were divided into 3 groups according to the operation type:total stomach resection plus Roux-en-Y anastomosis ( n =20),partial stomach resection plus Roux-en-Y anastomosis(n =13)and Billroth Ⅱ gastrectomy(n =14).They were followed for 6 months after surgery.Level of body mass index (BMI),fasting blood glucose (FBG) and GLP-1 was measured before operation and on the 1 st week,2nd week,1 st month,3rd month,and 6th month after operation.The level of glycosylated hemoglobin was measured before operation and on the 3rd and 6th month after operation.The prognosis of the patients on the 6th month after surgery was evaluated.Results Compared with preoperative level,FBG level in all the 3 groups significantly decreased on the 1 st week after surgery and maintained a similar level during the follow-up period (P ＜ 0.01 ).GLP-1 level was elevated after operation (P ＜0.01 or P ＜ 0.05).On the 3rd and 6th month after operation,glycosylated hemoglobin level in all the 3 groups significantly decreased (P ＜ 0.01 or P ＜ 0.05 ).The change of the above parameters was greater in groups undergoing Roux-en-Y anastomosis than in Billroth Ⅱ group(P ＜ 0.05 ).The control rate of T2DM for Billroth Ⅱ,partial stomach resection plus Roux-en-Y anastomosis and total stomach resection plus Roux-en-Y anastomosis was 78.5％(11/14),100％ (13/13) and 100％ (20/20)respectively on the 6th month after surgery,indicating Roux-en-Y gastric bypass had better effect of blood glucose control than Billroth Ⅱ (P ＜ 0.05 ).Postoperative BMI decreased significantly in all groups (P ＜ 0.05) and there was no statistical difference between all the groups (P ＞ 0.05 ).Conclusions All groups of gastric bypass are effective in terms of glucose control.Roux-en-Y gastric bypass is more effective than Billroth Ⅱ on diabetes control and its therapeutic effect is independent of weight loss.
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Objective To evaluate the effect of Roux-en-Y gastric bypass on patients with different preoperative glycosylated hemoglobin (HbAlc) level.Methods From Jan.2008 to Dec.2009,54 patients with gastric lesions and type 2 diabetes mellitus were preoperatively divided into 3 groups:group A (HbAlc:6.5％ -7.9％ ),group B ( HbAlc:8.0％ - 9.9％ ),and group C ( HbAlc ＞ 10％ ).They all underwent Roux-en-Y gastric bypass.The fasting plasma glucose(FPG) and HbAlc concentration were measured before surgery and 12,24,48 weeks after surgery.The antidiabetic medication was analyzed before surgery and 48 weeks after surgery.Results FPG and HbAlc concentration decreased significantly after surgery ( P ＜ 0.01 ).FPG and HbAlc concentration differed greatly between the different groups ( P ＜ 0.01 ).With the increase of preoperative HbAlc,FPG and HbAlc concentrations were poorly controlled after surgery.Conclusion Roux-en-Y gastric bypass surgery can effectively improve glucose metabolism for patients with preoperative HbAlc ＜ 10％.
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Objective To investigate the effect of gastric bypass on plasma glucose and glucagonlike peptide-1 (GLP-1) during oral glucose tolerance test (OGTT) in non-obese type 2 diabetes mellitus (T2DM) patients suffering from gastric ulcer necessitating a gastrectomy.Methods Thirty-two T2DM patients undergoing gastric bypass (GBP) for gastric ulcer were enrolled in this study.All patients underwent a 3-h OGTT with 75 g glucose (in a total volume of 300 ml) preoperatively and 1 week,1 month,3 months and 6 months after operation.Plasma glucose (PG) and GLP-1 concentrations were measured before (baseline) and then 30,60,120,and 180 minutes after OGTT.Areas under curves (AUC) were calculated by trapezoidal integration.The turnover of the diabetes conditions six months after the surgery were also measured.Results FPG level was (9.5±1.0) mmol/L before surgery,and significantly decreased to (7.4±1.0) mmol/L,one week,(6.5±1.2) mmol/L,one month,(8.0±1.6) mmol/L three months and (5.8±1.0) mmol/L,six months respectively after GBP(P ＜0.01).Peak level and AUC of PG during OGTT significantly decreased at aforementioned four time points after sugery (P ＜ 0.01).Oral glucosestimulated peak levels of GLP-1 was (20±3) pmol/L before GBP,and markedly increased to (83±15)pmol/L,(86±20) pmol/L,(87±22) pmol/L and (92±20) pmol/L respectively after GBP(P＜0.01).Stimulated AUC levels of GLP-1 significantly increased from (2457±395) pmol· min/L to (6499±1227)pmol·min/L,to (7275±1475) pmol·min/L,to (7307±1575) pmol·min/L and to (7974±1594)pmol· min/L during the study respectively(P ＜0.01).BMI levels were similar before and after GBP(P＞0.05).Two patients experienced complications(infection of incision and intractable hiccup).T2DM control rate was 78% when assessed at a time point of six months later.Conclusion Gastric bypass is effective in terms of glucose control and improving gucose tolerance in non-obese T2DM,and the hypoglycemic effect may be contributed to more GLP-1 secretion after GBP,but not to weight loss.
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AIM: To study the effect of decanoyl acetaldehyde against atherosclerosis and the relative mechanisms in rats.METHODS: Rats were randomly assigned into 5 groups,That were the control,model,low and high dose of decanoyl acetaldehyde and ibuprofen groups.The model rats were intraperitoneally injected with 600 000 IU/kg vitamine Ds and intragastricly administrated with high-fat emulsion 10 mL/( kg·d) for 70 days.At the same time,the model rats treated with drugs were orally given 39 mg/( kg·d),78 mg/( kg·d) decanoyl acetaldehyde and 144 mg/( kg·d) ibuprofen suspension respectively.After 70 days,the rats were euthakilled,and the serum level of TC,LDL-C,HDL-C/LDL-C ,TNF-α,IL-1β,IL-6,IL-10,the expression of NF-κB in rat aorta and the pathological change in aorta were measured.RESULTS: Decanoyl acetaldehyde could lower the serum level of TC,LDL-C,TNF-α,IL-1β and IL-6.It increased the level of IL-10 and the ratio of HDL-C/LDL-C,inhibited the expression of NF-κB and reduced the thickness of the artery wall.CONCLUSION : Decanoyl acetaldehyde has an effect on anti-atherosclerosis.The mechanism may be related with inhibiting inflammation and lowering serum lipid.
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The results of RT-PCR and immunohistochemistry showed that the expressions of vascular endothelial growth factor (VEGF) and its receptor ( flk-1 ) in the renal cortex of insulin-resistant rats during the phase of normal blood glucose were significantly increased, which were decreased by telmisartan. The result suggests that telmisartan may ease kidney damage via decreasing VEGF and flk-1 expressions.
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This study is to investigate the protein and mRNA expressions of pro-inflammatory and anti-inflammatory cytokines in U937 foam cells and effects of Ginkgo biloba extract (GbE) on the cytokines.U937 cells were cultured with different concentrations of GbE (0.1,1,and 10 μg·L-1),and stimulated by 100 mg·L-1 oxidized low density lipoprotein (ox-LDL) for 24 h.The expressions of interleukin-1β (IL-1β),tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) in culture solution were detected by enzyme-linked immunosorbant assay (ELISA) and reverse transcriptase polymerase chain reaction (RT-PCR).The results showed that incubated with 100 mg·L-1 ox-LDL for 24 h,the U937 cells became foam cells,the protein or mRNA expressions of IL-1β,TNF-α,IL-10,and its receptor IL-10R in U937 foam cells were higher markedly than those in normal U937 cells.When the cells were pretreated with GbE (0.1,1,and 10 μg·L-1),the increases of IL-1β and TNF-α in U937 foam cells were remarkably inhibited,but IL-10 expression increased greatly.Especially when cells were pretreated with 10 μg·L-1 GbE,the protein and mRNA expressions of IL-1β and TNF-α were markedly lower than those in U937 foam cells.The protein expression of IL-10 and mRNA expressions of IL-10 and its receptor IL-10R were markedly higher than those in U937 foam cells.GbE inhibited production of pro-inflammatory cytokines IL-1β and TNF-α,but up-regulated the production of anti-inflammatory cytokine IL-10 and its receptor IL-10R in U937 foam cells,which might be related with its anti-atherosclerotic actions.
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Objective: To establish an experimental model of atherosclerosis in rats and to study the atherosclerotic lesions in the aorta,heart and liver.Methods: The rats in experimental groups were injected with a single dose of vitamin D (600 000 IU/kg) and loaded with high fat diet;control group was given saline and basic food.The pathological changes were observed in the aorta,heart and liver after 2,4,6 weeks.The scores were evaluated according to the pathological degrees.Results: No changes were observed after 2 weeks,but after 4 weeks atheroslerotic plaques were seen in the aorta and the score of the lesions were 0.50?0.39; a little lipid were found in coronary arteries;deposition of lipid was seen in the myocardium; many positive red pellets were found in the plasma of cells in the liver.After 6 weeks,more atheroslerotic plaques were observed in the aorta,and atheroslerotic plaques in coronary arteries were formed (pathological score 1.12?0.48); abundant positive red pellets were found in the plasma of the cardiac myocyte.The pathological changes occurred in rats were very similar to that of man.Conclusion: The experimental model of atherosclerosis in rat may be conveniently established by injection of vitamin D with loading of high fat diet,which can be used for the pathological and pharmacological study of atherosclerosis.
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AIM:To study the effect of decanoyl acetaldehyde against atherosclerosis and the relative mechanisms in rats.METHODS:Rats were randomly assigned into 5 groups,That were the control,model,low and high dose of decanoyl acetaldehyde and ibuprofen groups.The model rats were intraperitoneally injected with 600 000 IU/kg vitamine D_3 and intragastricly administrated with high-fat emulsion 10 mL/(kg?d)for 70 days.At the same time,the model rats treated with drugs were orally given 39 mg/(kg?d),78 mg/(kg?d)decanoyl acetaldehyde and 144 mg/(kg?d)ibuprofen suspension respectively.After 70 days,the rats were euthakilled,and the serum level of TC,LDL-C,HDL-C/LDL-C,TNF-?,IL-1?,IL-6,IL-10,the expression of NF-?B in rat aorta and the pathological change in aorta were measured.RESULTS:Decanoyl acetaldehyde could lower the serum level of TC,LDL-C,TNF-?,IL-1? and IL-6.It increased the level of IL-10 and the ratio of HDL-C/LDL-C,inhibited the expression of NF-?B and reduced the thickness of the artery wall.CONCLUSION:Decanoyl acetaldehyde has an effect on anti-atherosclerosis.The mechanism may be related with inhibiting inflammation and lowering serum lipid.