Association between urinary thallium and nonalcoholic fatty liver disease / 临床肝胆病杂志

ObjectiveTo investigate the association between urinary thallium （TL） and nonalcoholic fatty liver disease （NAFLD）. MethodsRelated data were collected from the registered participants aged ≥18 years in National Health and Nutrition Examination Survey from 2017 to 2020， with th exclusion of the individuals with a lack of liver transient elastography data and urinary TL indicators and those with hepatitis B， hepatitis C or significant alcohol consumption. A total of individuals were divided into NAFLD group and non-NAFLD group. Urinary TL level was quantitatively measured using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry and online solid-phase extraction combined with isotope dilution. The two groups were compared in terms of age， sex， race， marital status， education， family income poverty impact ratio （FMPIR）， body mass index （BMI）， smoking， alcohol consumption， diabetes mellitus （DM）， hypertension （HTN）， hyperlipidemia （HL）， and urinary TL level. The independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. Descriptive analysis， multivariable Logistic regression， restricted cubic spline regression analysis， subgroup analysis， and interaction analysis were conducted to investigate the risk association between urinary TL and NAFLD. ResultsA total of 2 511 individuals were included， with 1 612 （64.20%） in the NAFLD group and 899 （35.80%） in the non-NAFLD group， and the NAFLD group had a significantly higher urinary TL level than the non-NAFLD group ［0.18 （0.11‍ ‍— ‍0.26）μg/L vs 0.16 （0.09 — ‍0.25）μg/L， Z=-2.76， P=0.01］. After adjustment for the covariates of age， sex， race， education， marital status， FMPIR， BMI， smoking， alcohol consumption， DM， HTN， and HL， the urinary TL Q4 group had a significant increase in the risk of NAFLD （odds ratio ［OR］=1.90， 95% confidence interval ［CI］： 1.48‍ — ‍2.44， P<0.01）. There was a positive dose-response relationship （P<0.01） and a non-linear relationship （P<0.01） between urinary TL and the risk of NAFLD. A significant interaction was observed between urinary TL and smoking/BMI （P<0.05）. For individuals taking ≥100 cigarettes in their lifetime， the risk of NAFLD was increased by 50% for every quartile increase in urinary TL （OR=1.50， 95%CI： 1.24‍ — ‍1.80）， and for individuals taking<100 cigarettes in their lifetime， the risk of NAFLD was increased by 20% for every quartile increase in urinary TL （OR=1.20， 95%CI： 1.03‍ — ‍1.40）； for individuals with a BMI of ≥30 kg/m2， the risk of NAFLD was increased by 30% for every quartile increase in urinary TL （OR=1.30， 95%CI： 1.05‍ — ‍1.70）， with a statistical significance （P<0.05）. ConclusionUrinary TL level is significantly associated with the risk of NAFLD.

Mechanism of action of Polygonum multiflorum in inducing liver injury： A study based on signaling pathways / 临床肝胆病杂志

Polygonum multiflorum （PM）， a commonly used Chinese herbal medicine in clinical practice， has been associated with frequent reports of liver injury in recent years， and the medication safety of PM has attracted more and more attention in China and globally. This article reviews the recent research advances in the signaling pathways and mechanisms of PM in causing drug-induced liver injury （DILI） and aims to provide new ideas for the proper and rational use of PM in clinical practice. The results show that PM is involved in the regulation of various signaling pathways， and it leads to the death of hepatocytes by destroying mitochondrial function， exacerbating bile acid accumulation， and inducing immune response， oxidative stress， and endoplasmic reticulum stress， thereby inducing the development and progression of DILI through multiple targets， pathways， and levels.

Identification of ferroptosis as a novel mechanism for antitumor activity of natural product derivative a2 in gastric cancer

Ferroptosis is a type of cell death accompanied by iron-dependent lipid peroxidation, thus stimulating ferroptosis may be a potential strategy for treating gastric cancer, therapeutic agents against which are urgently required. Jiyuan oridonin A (JDA) is a natural compound isolated from Jiyuan

Effect of proprotein convertase subtilisin/kexin type 9 inhibitor on blood lipid profile in patients with extremely high risk atherosclerotic cardiovascular disease / 中华危重病急救医学

Objective:To investigate the lowering effect on lipid and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor in patients with extremely high risk atherosclerotic cardiovascular disease (ASCVD).Methods:The outpatients and in-patients with extremely high risk ASCVD admitted to the Second Affiliated Hospital of Chongqing Medical University from April to October in 2019 were enrolled. The enrolled patients were divided into two groups by random number table method. The patients in the atorvastatin group were given only 20 mg atorvastatin orally every night for 4 weeks. In the combined group, oral atorvastatin was administered with subcutaneous injection of 140 mg evolocumab, a PCSK9 inhibitor, once every 2 weeks, and the course of treatment was 4 weeks. Serum lipid profile was measured before and 4 weeks after treatment, including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein-a (Lp-a). Adverse events were recorded.Results:During the study period, a total of 40 patients were enrolled, with 20 patients in the atorvastatin group and 20 in the combined group. There was no significant difference in blood lipid profile before treatment between the two groups. After 4 weeks of treatment, the levels of TC and LDL-C in the two groups and Lp-a level in the combined group were significantly lower than those before treatment, while the levels of TG and HDL-C in the two groups were not statistically significant. Further analysis showed that the differences in TC, LDL-C and Lp-a between before and after treatment in the combined group were significantly higher than those in the atorvastatin group [TC difference (mmol/L): 2.78±1.98 vs. 0.54±0.83, LDL-C difference (mmol/L): 1.91±1.38 vs. 0.39±0.72, Lp-a difference (mg/L): 115.87±138.93 vs. -84.19±251.85, all P < 0.05]. Only 1 patient in the combined group developed allergic reaction, mainly manifested as skin rash, who alleviated after anti-allergic treatment. No other adverse reactions such as abnormal liver function and increased myozyme occurred in the two groups. Conclusion:PCSK9 inhibitor could rapidly and effectively reduced the levels of TC, LDL-C and Lp-a in extremely high risk ASCVD patients, while had little effect on the levels of TG and HDL-C. It is safe to some extent.

The choice of communication specialist for family member of organ donation and corresponding strategy for work difficulty / 器官移植

Communication with the family members of donors is an integral part of the organ donation and transplantation, and the core of it lies in building trust through interpersonal communication. Every word and deed from the communicator will directly affect the overall impression of family members of potential donors towards organ donation. Regardless of whether or not granted the donation ultimately, family members may share their personal experiences and feelings with friends and relatives around them, which develops a secondary dissemination. Therefore, "the choice of best candidate for communication with family members of organ donation" has been an issue that organ donation practitioners have been working on in clinical practice. Taking into consideration of the experiences from different countries or regions, various advices and practices on this issue have been proposed due to differences in social systems, cultural background, organizational structure, clinical practice, etc. In this paper, we had a discussion on this topic, summarize the difficulties currently encountered in communication with family members and propose corresponding strategies.

Emergency management for kidney transplantation in the epidemic period of coronavirus disease 2019 / 中南大学学报(医学版)

OBJECTIVES@#To summarize the emergency management of the kidney transplantation for a large tertiary first-class hospital in response to the epidemic of coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of inpatients in the Department of Kidney Transplantation from January 24, 2020 to February 29, 2020 were retrospectively analyzed. Since the outbreak of COVID-19, we conducted telephone, Wechat follow-up, and online education for kidney transplant recipients and patients on waiting-list for kidney transplantation one by one. We also strictly screened for COVID-19 in outpatients. To guarantee the security of medical staff and recipients and to reduce the transmission risk of COVID-19, we have made detailed approaches to prevent COVID-19, which mainly included 6 aspects of preventive approaches, such as kidney transplant clinic, kidney transplant ward, patients on waiting-list for kidney transplantation, kidney transplant operation, medical staff self-protection, and postoperative follow-up of kidney transplant recipients.@*RESULTS@#There were altogether 47 inpatients which included 20 recipients who had just received kidney transplantation in the meantime, 2 577 kidney transplant recipients, 1 689 patients on waiting-list for kidney transplantation, and 794 outpatients in our hospital. No case of COVID-19 occurred in this period.@*CONCLUSIONS@#Through strictly implementing proactive and preventive approaches, we avoid the occurrence of COVID-19 in carrying out kidney transplantation in the epidemic period.

Cardiac dosimetric evaluation of tangential VMAT technique in patients with left breast cancer after breast-conserving surgery, including internal mammary lymph node irradiation / 中华放射医学与防护杂志

Objective To investigate the potential heart sparing effects of tangential volumetric modulated arc therapy (T-VMAT) by comparing its dosimetric properties with conventional wedged tangential fields (W-TF) technique and 6-field intensity-modulated radiotherapy (6F-IMRT) in the locoregional radiotherapy of left breast cancer after conserving surgery,including internal mammary nodal irradiation.Methods Fifteen patients with left breast cancer were enrolled in this study.Three plans were generated for each patient:W-TF,6F-IMRT and T-VMAT with two arc segments of 50°.The prescription dose to planning tumor volume (PTV) was 50 Gy in 25 fractions.Dose-volume parameters and indices of conformity were calculated and compared for the PTV and organs at risk (OAR).Results Compared with W-TF,T-VMAT not only significantly decreased D D and the high dose areas (above 10 Gy) of the heart and left anterior descending branch (LAD) (P ＜ 0.05),but also had the trend of sparing the V5Gy although there was statistically significant difference (P ＞ 0.05).T-VMAT also significantly decreased Dmean V5Gy,V10Gy and V20Gy of the heart,as well as the D V5Gy and V10 Gy of LAD (P ＜ 0.05),compared to 6F-IMRT.Furthermore,T-VMAT did not result in higher V20Gy of ipsilateral lung and higher V5Gy of contralateral breast compared with W-TF (P ＞ 0.05).T-VMAT achieved distinctly better target coverage and conformity,meanwhile obviously lowered hot volume of V110 compared to W-TF (P ＜ 0.05).Conclusions T-VMAT not only significantly decreased the high dose areas,but also had the trend of sparing the low dose area for the heat and LAD.Moreover,there was no significant difference for V20Gy of ipsilateral lung and V5Gy of contralateral breast between T-VMAT and W-TF.

Application of 18F-FDG/99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage / 实用医学杂志

Objective To explore the diagnostic value of 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging in early diagnosis of diabetes-induced myocardial damage. Methods 32 patients with diabetes and 26 healthy volunteers received 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging for assessing myocardial ischemia, viability status, and cardiac function. Results Myocardial perfusion abnormalitieswere observed in 47 regions on myocardial perfusion imagingin 21 of 32 (65.6%)patients with diabetes, showing perfusion/metabolism mismatched and suggesting viable myocardium. All the volunteers were normal on DISA. As compared with the normal control group, the positive rate of DISA in diabetic patients was significantly higher (P < 0.01). Left ventricular ejection fraction (LVEF) was (54.3 ± 7.2%) and (67.3±4.9%) respectively, the difference was statistically significant (P < 0.05). Conclusions 18F-FDG/ 99mTc-MIBI dual-isotope SPECT and gated myocardial imaging can assess myocardial ischemia ,viability and cardiac function in diabetic patients, and it is helpful for the early diagnosis of cardiac damage in patients with diabetes mellitus.

Diagnostic value of dual-phase 99Tcm-MIBI scintigraphy in patients with ectopic secondary hyperparathyroidism / 中华核医学与分子影像杂志

Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9％(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2％(1 375/1 415) and 53.1％(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4％ (940/1 415) and 46.9％ (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1％ (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P ＜ 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.

Synthesis and biocompatibility of ethynylated open ring derivatives of polyasparamide / 中国生化药物杂志

Objective To synthesize a new ethynylated open ring derivatives of polyasparamide as functional drug carrier.Methods L-phenylalanine methyl ester hydrochloride was prepared using L-phenylalanine and then was used for ring opening reaction of polysuccinimide.To synthesize the target product of PSI-Phe-OMe-PA, the obtained polyasparamide-g-phenylalanine derivatives ( PSI-Phe-OMe) was further ring opened by propargylamine.The structure of PSI-Phe-OMe-PA was confirmed by 1 H NMR.The biocompatibility of PSI-Phe-OMe-PA was evaluated by MTT method, inverted microscope observation and cell cycles analysis ( propidium iodide staining ) .Results The ring-opening rate of polyasparamide by L-phenylalanine methyl ester and propargylamine was 40%and 100%, respectively.All results of biocompatibility studies indicated that PSI-Phe-OMe-PA may be a good candidate for functional drug carrier.Conclusion Based on the ring-opening capability of amino-group and the specificity of click reaction, L-phenylalanine methyl ester hydrochloride and propargylamine were used successively to react with polyasparamide.PSI-Phe-OMe-PA is a biocompatible functional drug carrier.

Design and clinical application of balloon-type head fixation pillow for interventional neuroradiology operation / 医疗卫生装备

Objective To develop a balloon-type head fixation pillow for interventional neuroradiology operation.Methods Some radiotransparent sponge with high elasticity and strength and some nonopaque cloth with high skin compatibility were employed to make pillow base adaptable to the posterior fossa, neck and shoulder. A inflatable balloon made of anti-tensile airtight nylon was used to fix the underjaw.Results The fixation pillow gained advantages over the common one in imaging times, X-ray exposure dose and abnormal condition.Conclusion The head fixation pillow may decrease operating time, exposure dose and complications during interventional neuroradiology operation, and thus is worth popularizing clinically.

Evaluation of the diagnostic value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the recurrence or postoperative residual lesions of glioma / 实用医学杂志

Objective To evaluate the value of 99mTc-MIBI SPECT positive tumor imaging and MRI in the diagnosis of recurrence and postoperative residual of glioma. Methods Of 30 cases of glioma, 21 cases were residual or recurrent of glioma, while 9 cases were not, confirmed by pathology or follow-up. 99mTc-MIBI SPECT positive tumor imaging and MRI were performed on all patients. Results The sensitivity of 99mTc-MIBI SPECT positive tumor imaging (80.1%)was lower than that of MRI (90.5%) (χ2 = 0.006 4,P = 0.035), while the specificity of 99mTc-MIBI SPECT(88.9%) was much higher than that MRI(77.8%)(χ2= 3.827,P = 0.006). The accuracy in diagnosing residual or recurrent glioma between the two imaging has no significant difference. The sensitivity, specificity and accuracy were 95.2%, 100% and 93.3% when the two imaging methods were combined. Conclusions 99mTc-MIBI SPECT positive tumor imaging has higher specificity in the diagnosis of recurrence and postoperative residual of glioma. The combination of 99mTc-MIBI SPECT positive tumor imaging and MRI has great clinical significance.

Changes of inflammatory factor level in 2-diabetes patients before and after improving glycemic control / 中国综合临床

Objective To investigate the inflammation levels of 2-diabetes patients before and after 3 months of improving glycemic control.Methods A longitudinal study was performed in a subgroup of 48 subjects with T2D and poor glycemic control.Forty-four healthy individuals were taken as control group.The serum concentration of C-reactionprotein (CRP),interleukin-6 (IL-6),interleukin-6 (IL-8),transforming growth factor-β1 (TGF-β1) and transforming growth factor-β1 (MCP1) in all participants were measured simultaneously by multiplexed Luminex assay.Results The serum levels of CRP,MCP-1 of 2-diabetes patients were 3.96 (3.45,5.58) mg/L and (195.0± 129.8) ng/L,significant higher than those in control group (2.25 (1.24,3.22) mg/L,(148.5±85.7) ng/L),and the differences were significant(t=-2.580,P=0.010;t=-2.118,P =0.047).No significant difference was found in the serum levels of IL-6,IL-8,TGF-β lbetween the two groups (P＞0.05).TGF-β1 level in patients with good glycemic control decreased to 26.85 (23.17-31.12) ng/l,significant lower than that before glycemic control (43.5(26.5-62.25) g/L;Z=-2.191,P=0.028),and there were no significant differences among the other 4 kinds of inflammatory factors before and after blood glucose control(CRP:Z =-0.937P =0.372;IL-6:Z =-0.875,P =0.396;IL-8:Z =-1.215,P =0.286;MCP-1:t =-1.846,P=0.065).Conclusion Low grade systemic inflammation status in T2D patients.Improvement of glycemic control reduces TGF-β1 levels and plays a key role in delaying the development of diabetic nephropathy.

ST segment depression fQRS may be a new predictor of mortality of non-ST elevation myocardial infarction / 重庆医学

Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .

Inhibitory effects and tocolysis role of fructus polygoni orientalis on macrophages in uterine of abortion mice induced by LPS / 中国免疫学杂志

Objective:To explore the immunosuppression effects and tocolysis of fructus polygoni orientalis on abortion mice induced by LPS.Methods:Mice of Kunming (55 mice) were divided into control group (group A ,10 mice) and experimental group. Experimental group were divided into group B ( intraperitoneal injection LPS ) , group C ( ingestion fructus polygoni orientalis ) , and group D (ingestion fructus polygoni orientalis and intraperitoneal injection LPS ),each group of 15 mice.Then the pregnancy results were observed ,the positive of α-NAE+and the varity of CD 14+and CD204+macrophages ,TNF-αin the uteri were identified by enzyme-histochemistry ,immunohistochemistry and ELISA.Results:The abortion rate and the embryo resorbing rate were all 100%( P<0.01 ) in group B.But there was the decreased abortion rate of 13.33% in group D .The embryo resorbing rate decreased to 10.39%.The number and positive cell area of α-NAE+and CD14+macrophages in the uteri of gestation mice of group B was greatly increased comparing with group A ( P<0.01 ) .These effects outside of myometrium of group D were remarkably increased comparing with group A (P<0.01),but there was no distinct difference in the inside of myometrium and function layer.The number and positive cell area of CD204+macrophages in group C and D was greatly increased comparing with group A and B ( P<0.01 ) .The TNF-αcontents in the uteri of mice in group B were greatly increased comparing with group A (P<0.01),but the positive cell area of CD14,CD204 were close to normal levels in group D.Conclusion:The effect of miscarriage induced by LPS is antagonized by fructus polygoni orientalis through inhibiting the phenotype ,activity and function characteristics of macrophages in the uteri of gravidity mice.

Clinical effect of endovascular stent placement on intracranial internal carotid artery dissection therapy / 中国综合临床

Objective To evaluate the clinical effect of endovascular stent placement to the treatment of intracranial internal carotid artery dissection.Methods Two patients with intracranial internal carotid artery dissection received the treatment of stent placement,and 1 patient with a dissection of the supra clinoid internal carotid artery received conventional anticoagulation treatment.Results Two patients with intracranial internal carotid artery dissection were given treatment of Apollo stent placement,of which 1 patient had improvement of left limb paresis,the score of NIHSS from 3 before operation to 2 after operation; the other one with episodic left limb weakness was not seen any attack after stent placement.Another one patient without stent placement receiving conventional anticoagulation treatment had some improvement of right limb paralysis.Conclusion The treatment of endovascular stent placement to the intracranial internal carotid artery dissection has better clinical efficacy and especially used for those patients with no effect to the conventional anticoagulation treatment.

The role of dendritic cells in atherosclerosis / 国际脑血管病杂志

Both basic and clinical studies have confirmed that inflammatory response plays an important role in the occurrence and development of atherosclerosis (AS) as well as its caused clinical events.The aggregation phenomena of T lymphocytes,macrophages and dendritic cells (DCs) can be observed in intima and atherosclerotic plaques in the event of atherosclerosis.As the most important antigen-presenting cells activating T lymphocytes,DCs have the important functions of determining T lymphocyte activation,apoptosis,and aggregation.This article reviews the correlation between DCs and atherosclerotic lesions.

Using CTS and PK-PD models to predict the effect of uncertainty about population parameters on clinical trial power / 生物医学工程学杂志

The traditional clinical trail designs always depend on expert opinions and lack statistical evaluations. In this article, we present a method and illustrate how population parameter uncertainty may be incorporated in the overall simulation model. Using the techniques of clinical trail simulation (CTS) and setting up predictions on the basis of pharmacokinetics-pharmacodynamics (PK-PD) models, we advance the modeling methods for simulation, for treatment effects, and for the clinical trail power under the given PK-PD conditions. Then we discuss the model of uncertainty, suggest an ANOVA-based method, add eta2 statistics for sensitivity analysis, and canvass the effect of uncertainty about population parameters on clinical trail power. The results from simulations and the indices derived from this type of sensitivity analysis may be used for grading the influence on the prediction quality of uncertainty about different population parameters. The experiment results are satisfactory and the approach presented has practical value in clinical trails.

Effects of collateral pathways on prognosis of cerebral infarct patients with prior transient ischemic attack / 中国医师进修杂志

Objective To investigate the effects of collateral pathways on prognosis of cerebral infarct patients with prior transient ischemic attack (TIA) and its role in neuroprotective mechanism of TIA. Methods A total of 164 cases of the first ever cerebral infarct patients were consecutively allocated into three groups: A , B and C group according to their age.Three groups were divided into two subgroups respectively based on the absence or presence of prior ipsilateral TIA: A1, A2, B1, B2, C1, C2 group. Neurological dysfunctional scores at admission and 1 month after treatment, barthel index, collateral pathways status, and cerebral infarction volume were evaluated respectively. The relationship between development of collateral pathways and prognosis was assessed at the same time. Results The neurological dysfunctional scores and cerebral infarction volume of patients in A1 group and B1 group were significantly lower than those of A2 group and B2 group (P

Evaluative merit of brain blood perfusion image of single photon emission computed tomography on local brain blood distribution in neonatal hypoxic ischemic encephalopathy / 中国组织工程研究

BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.