Study on cerebral oxygen metabolism of healthy volunteers at three altitude areas by MR quantitative susceptibility mapping combined with three-dimensional arterial spin labeling sequence / 中华放射学杂志

Objective:To investigate the differences in cerebral oxygen metabolism in healthy volunteers at three altitude areas by MR quantitative magnetic susceptibility imaging (QSM) combined with three-dimensional arterial spin labeling (3D-ASL).Methods:From March 2019 to October 2020, Zhengzhou Han Chinese volunteers recruited from the First Affiliated Hospital of Zhengzhou University, Xining Han Chinese volunteers recruited from the Fifth People′s Hospital of Qinghai Province, Lhasa Han Chinese volunteers and Tibetan volunteers recruited from Lhasa People′s Hospital were collected. They were divided into 21-30 age group, 31-40 age group, and 41-50 age group. All the volunteers underwent MR QSM combined with 3D-ASL sequence imaging, and oxygen extraction fraction (OEF) and cerebral blood flow (CBF) images of gray matter, and white matter were collected, OEF and CBF values were obtained, and cerebral metabolic rate of oxygen (CMRO 2) values were calculated. The comparison of various indicators among multiple groups was conducted using one-way ANOVA, and pairwise comparisons were conducted using LSD- t test. Results:A total of 132 volunteers were included, including 38 Han Chinese volunteers in Zhengzhou, 9 in the 21-30 age group, 13 in the 31-40 age group and 16 in the 41-50 age group; 27 Han Chinese volunteers in Xining, including 9 in the 21-30 age group, 8 in the 31-40 age group and 10 in the 41-50 age group; 34 Han Chinese volunteers in Lhasa, including 13 in the 21-30 age group, 11 in the 31-40 age group and 10 in the 41-50 age group; and 33 Tibetan volunteers in Lhasa, including 10 in the 21-30 age group, 10 in the 31-40 age group and 13 in the 41-50 age group. In the group aged 21-30 years, the overall difference in brain gray matter OEF values among volunteers from different altitudes was statistically significant ( P<0.05), with statistically significant differences in OEF values between Tibetans in Lhasa and Han Chinese in Xining, Han Chinese in Lhasa ( P<0.05). The overall difference in CMRO 2 values in the gray matter of volunteers at different altitudes was statistically significant ( P<0.05), with significant differences in CMRO 2 values between Lhasa Tibetan and Han Chinese in Zhengzhou, Han Chinese in Xining, Han Chinese in Lhasa ( P<0.05). In the 31-40 age group, there were statistically significant differences in the overall CBF values of gray and white matter among volunteers from different altitudes ( P<0.05). Among them, there were statistically significant differences in the CBF values of gray and white matter between Han Chinese in Zhengzhou and Han in Xining, Han Chinese in Lhasa, Lhasa Tibetan ( P<0.05). The overall differences in OEF values of gray matter and white matter among volunteers at different altitudes were statistically significant ( P<0.05). Among them, there were statistically significant differences in OEF values of gray matter and white matter between the Han Chinese in Zhengzhou and the Han Chinese in Xining, the Han Chinese in Lhasa ( P<0.05). There was also a statistically significant difference in OEF values of gray matter and white matter between the Han Chinese in Lhasa and the Tibetan in Lhasa ( P<0.05). The overall difference in CMRO 2 values in gray and white matter among volunteers from different altitudes was statistically significant ( P<0.05). Among them, there was a statistically significant difference in CMRO 2 values of cerebral gray matter between Lhasa Tibetans and Zhengzhou Han, Xining Han, Lhasa Han ( P<0.05), and there was a statistically significant difference in CMRO 2 values of cerebral white matter between Lhasa Tibetans and Zhengzhou Han, Lhasa Han ( P<0.05). Conclusions:The cerebral oxygen metabolism of Tibetan living in the plateau is characterized by low oxygen consumption, low blood oxygen dependence and high tissue oxygen utilization. The CMRO 2 of the Han people who migrated to the plateau for a long time is maintained at a certain level, similar to that in the plain area. The effects of age factors on CBF, OEF and CMRO 2 are small.

Clinical analysis of early damage in multiple extra-pulmonary organs in COVID-19 / 南方医科大学学报

OBJECTIVE@#To analyze the clinical manifestations of heart, liver and kidney damages in the early stage of COVID-19 to identify the indicators for these damages.@*METHODS@#We analyzed the clinical features, underlying diseases, and indicators of infection in 12 patients with COVID-19 on the second day after their admission to our hospital between January 20 and February 20, 2020.The data including CK-MB, aTnI, BNP, heart rate, changes in ECG, LVEF (%), left ventricular general longitudinal strain (GLS, measured by color Doppler ultrasound) were collected.The changes of liver function biochemical indicators were dynamically reviewed.BUN, UCR, eGFR, Ccr, and UACR and the levels of MA, A1M, IGU, and TRU were recorded.@*RESULTS@#The 12 patients included 2 severe cases, 8 common type cases, and 2 mild cases.Four of the patients presented with sinus tachycardia, ECG changes and abnormal GLS in spite of normal aTNI and LVEF; 1 patient had abnormal CKMB and BNP.On the first and third days following admission, the patients had normal ALT, AST and GGT levels.On day 7, hepatic function damage occurred in the severe cases, manifested by elevated ALT and AST levels.Abnormalities of eGFR, Ccr and UACR occurred in 8, 5 and 5 of the patients, respectively.Abnormal elevations of MA, A1M, IGU and TRU in urine protein were observed in 4, 4, 5, and 2 of the patients, respectively.@*CONCLUSIONS@#In patients with COVID-19, heart damage can be identified early by observing the GLS and new abnormalities on ECG in spite of normal aTNI and LVEF.Early liver injury is not obvious in these patients, but dynamic monitoring of the indicators of should be emplemented, especially in severe cases. In cases with normal CR and BUN, kidney damage can be detected early by calculating eGFR, Ccr and UACR and urine protein tests.

Analysis of MRI features and prognosis for minor stroke and nonGminor stroke of anterior circulation in plateau / 实用放射学杂志

Objective To investigate the MRI manifestations and analyze the prognostic factors of patients with anterior circulation minor stroke and nonGminor stroke in Qinghai plateau.Methods 41 6 cases of the first admission,including 1 9 2 patients with minor stroke and 224 patients with nonGminor stroke.MRI and MRA examinations of the head were completed in all patients within 72 h of admission.Patients were followed up for one year to observe the recurrence of stroke,and the quality of life was evaluated with the help of modified Rankin Scale (MRS)scores.Results (1)MRA showed that 36.98% of the minor stroke and 58.93% of the nonGminor stroke had the stenosis of the responsible artery at the infarction site.The difference was significant (χ2＝ 1 9.94,P＜ 0.00 1 ).(2 )MRI showed that the initial infarction sites of minor stroke and nonGminor stroke were different (χ2＝4.47 ,P＜0.005 ).(3 )The recurrence rate was 10.42% in minor stroke and 12.05% in nonGminor stroke.There was no significance between the two groups (χ2＝ 0.28,P＞0.05).(4) Among patients with poor prognostic outcomes (whose MRS≥3),there were 1 9 cases of minor stroke and 6 1 cases of nonGminor stroke,and the difference was significant (χ2＝20.00,P＜0.0 1 ).Conclusion LesionGrelated vascular stenosis in patients with minor stroke is mild and the primary infarction is more common in isolated subcortical or deep white matter.The stenosis is severe in patients with nonGminor stroke,and the infarct lesion is often subcortical with or without cortical or deep white matter.There is no difference in recurrence risk between minor stroke and nonGminor stroke.The prognosis of minor stroke is better than that of nonGminor stroke.

Comparative study on image diagnosis and pathological results of non-epithelial ovarian tumors / 实用放射学杂志

Objective To improve the imaging diagnosis and differential diagnosis of non-epithelial ovarian tumor.Methods 34 patients with non-epithelial ovarian tumor confirmed by pathology were analyzed retrospectively.The image features of each patients were analyzed and compared with surgical pathology.Results The results exhibited 13 cases of teratoma,6 cases of ovarian granulosa cell tumor, 6 cases of ovarian fibroma, 5 cases of thecoma, 2 cases of dysgerminoma,and 2 cases of endodermal sinus tumor.All kinds of non-epithelial ovarian tumors had its imaging manifestations and clinical features.Conclusion Non-epithelial ovarian tumors have certain characteristic CT and MR performance,and combining the onset age,clinical symptoms and biochemical examination,can make the qualitative diagnosis.

Diffusion kurtosis imaging for demonstrating the microstructure of brain gray and white matter in patients withchronic mountain sickness / 实用医学杂志

Objective To explore the differences between patients withchronic mountain sickness (CMS) and healthy people in the microstructure of brain gray and white matter by using diffusion kurtosis imaging (DKI). Methods 21 CMS patients were recruited to a study group and 20 healthy volunteers were assigned to a control group. Both groups received conventional MRI and DKI sequence scans. The mean kurtosis (MK) values ,radial kurtosis (RK) values and kurtosis anisotropy (KA) values in each region of interest (ROI) in the cerebral gray and white matter were measured and the same part of the left and right side ROI parameters was counted. The data satisfied the normal distribution and the paired samples t?test was used;the ROI parameters between the two groups in the same parts of the same side followed the normal distribution and the two independent samples t?test was used. Results The KA values in both sides of the anterior limb of internal capsule ,the MK values and RK values in bilateral caudate nucleus head and thalamus had side difference in CMS group. In both sides of the anterior limb of the internal capsule′s MK values,KA values and thalamus′s MK values,RK values existed side difference in the control group. The KA values of the right anterior limb in internal capsule were lower than those in the left in both groups;the right thalamus′s MK values and RK values were higher than the other side. The RK value in genu of corpus callosum differed significantly ,and it was lower the CMS group than in the control group. The difference of the KA values in corpus callosum ,the MK value in the left anterior limb of internal capsule ,the RK values in the left posterior limb of internal capsule ,the MK values in the right caudate nucleus head ,the MK values in bilateral lenticular nucleus and the MK values and KA values in the right thalamus were significant ,and they were higher inthe CMS group than in the control group. Conclusions The left and right cerebral hemispheric micro?structure is not exactly symmetrical between patients with CMS and healthy people living in high altitude areas , there are differences in some brain areas. The sensitivity and reactivity of brain tissue to high altitude hypoxia are different in patients with CMS ,there are various degrees of difference between the CMS and the normal in the corpus callosum,basal ganglia region and thalamus.

The study of coronary artery morphology and left heart function of resident population in plateau / 实用放射学杂志

Objective To explore the features of coronary artery morphological changes and left ventricular function indicators of resident population in plateau .Methods 50 plateau healthy adults and 50 plain‐and Dalian‐healthy volunteers completed coronary CTA examination .We measured the pipe diameter of left main coronary atery and right coronary artery and their branches ,respec‐tively .Furthermore ,SV and EF value of left ventricular cardiac function indexes and the wall thickening of free ventricular wall at left ventricular end systolic were measured .Results The average diameter of proximal right coronary of plain‐and Dalian‐healthy volun‐teers thicker than plateau group ,with statistical difference ;Other coronary artery branch did not exhibit any significant between‐group differences ;The two groups did not show significant between‐group differences with heart function indexes .Conclusion The body circulation system have adaptability and compensatory changes of resident population in plateau ,and their coronary artery mor‐phology and left ventricular function are as similar as plain people .

Imaging diagnosis of primary laryngeal amyloidosis / 实用放射学杂志

Objective To investigate imaging findings of primary laryngeal amyloidosis in order to improve the diagnosis of this disease.Methods Findings of plain CT and contrast enhanced CT scanning of three cases of laryngeal amyloidosis confirmed by biop-sy were investigated.Results Of the three cases,one case was located,two cases was diffused.The pharyngeal stenosis,bronchus in-vasion and calcification were showed in one case respectively.All the three cases showed mild homogenous enhancement similaryly. Of the three patients,one case was hospitalized by hoarseness and a serious sense of obstruction,and two cases by feeling pharyngeal pain.Conclusion This disease is rare ,and difficult differentiated from laryngeal carcinoma,but a correct diagnosis can be obtained by combining the CT findings with clinical manifestation.

The influence and correlation analysis between PaCO2 and PET CO2 in prone position surgery / 临床麻醉学杂志

Objective To investigate the correlation between arterial carbon dioxide partial pressure (PaCO2 )and end-tidal carbon dioxide partial pressure (PET CO2 )in prone position operation and calculate the value of PaCO2 according to the PET CO2 .Methods Forty patients with ASA Ⅰ orⅡ undergoing spinal surgery were selected,and the values of PaCO2 and PET CO2 as basic value (T0 ) after induction of general anesthesia in supine position monitor and record the value of PET CO2 and PaCO2 in prone position after 30 min (T1 ),60 min (T2 )and 90 min (T3 ).The correlation between PaCO2 and PET CO2 in each time point were analyzed,and the equation of PaCO2 (y)and PET CO2 (x) with curve fitting and difference of PaCO2 and PET CO2 were calculated.Results There was significant correlation between PaCO2 and PET CO2 in the supine and prone position,their correlation coefficients were r 0 =0.84,r 1 =0.88,r 2 =0.84,r 3 =0.82 (P <0.01).The Pa-ET CO2 was (5.3±2.1)(T0 )in supine position and (6.6± 2.1 )mm Hg (T1 ),(5.8 ± 2.2 )mm Hg (T2 ),(5.9 ± 2.1 )mm Hg (T3 )in prone position.The equation in each time point PaCO2 (y)and PET CO2 (x)were y0 =1.1 x0 +2.5,y1 =1.1 x1 +2.3,y2 =1.1 x2 +2.4,y3 =1.1 x3 +4.6,and the Pa-ET CO2 was 3.7-8.7 mm Hg. There was no significant difference between PaCO2 and PET CO2 at T1-T3 .Conclusion Whenever in prone position or supine position,PET CO2 and PaCO2 have significant correlation in prone position and supine position.The overall range of Pa-ET CO2 is 3.7-8.7 mm Hg,and the PET CO2 can be as indica-tor to estimate PaCO2 in prone position.

Treatment of impacted upper ureteral calculi with minimally invasive percutaneous nephrolithotomy / 中国基层医药

Objective To investigate the feasibility and safety of minimally invasive pereutaneous nephro-lithotomy(MPCNL) in treating impacted upper ureteral calculi. Methods 50 cases with impacted upper ureteral cal-culi treted with MPCNL were analyzed retrospectively. Results All cases were rendered stone free at one session, clearance rate was 100%, 1 case required transfusion,no other major complications was observed. Conclusion MPC-NL was safe and effective in treating impacted upper ureteral calculi with a high clearance rate.

Diagnosis & treatment for ureter behind lower vena cava CAI Hui-wu,ZHANG / 中国基层医药

Objective To improve the level of diagnosis and treatment for Ureter behind Lower Vena Cava.Methods 11 cases of Ureter behind Lower Vena Cava patients′clinical information have been reviewed and analysed.The main symptom for these patients include waist ache,right kidney colic,hematuria and so on.Through visualizating on vein urinary passage,pelvis visualizating conversely and so on,a correct diagnosis can be gained mostly.Results As for 11 cases of patients who have been done ureteroureteral anastomsis,based on respective follow-up visit conducted during 1 to 10 years,their clinical symptom have disappeared,for example,right kidney hydrocele are mending well,ureter becomes smooth and kidney function normal.Conclusion Visualizating on vein urinary passage and pelvis visualizating conversely will bring mostly a correct diagnosis.When it is difficult to diagnose,a correct diagnosis can be obtained by combining such visualization with MRU or CT inspection.Surgical is a top choice for such patients,and can bring a satifactory effect.

Experimental study of neuron specific enolase and BMP4 expression in hippocampus of pentylenetetrazol kindled epilepsy rats / 第三军医大学学报

Objective To investigate the expression of neuron-specific enolase(NSE) and bone morphogenic protein 4(BMP4) in different hippocampal areas of pentylenetetrazol(PTZ) kindled epilepsy rats and explore their relationship with the pathogenesis of epilepsy and brain injury.Methods Fifty male SD rats were divided into experimental group(n=40) and control group(n=10).The rats in experimental group were kindled into epilepsy by chemical method,and according to the kindling process,subdivided into four groups(grade Ⅰ,Ⅲ,Ⅳ,Ⅴ).Immunohistochemistry,in situ hybridization labeled with Dig-oligonucleotide probe and the image analyzing system were used to observe the expressions of NSE and BMP4 in rat hippocampus.Results In PTZ kindled epilepsy rats,the number of cells positive for NSE and BMP4 was increased in many regions of hippocampal formation.Compared with control group,the expressions of NSE and BMP4 in CA3 and DG was elevated obviously in the grade Ⅲ group and grade Ⅳ group(P

CT Virtual Endoscopy:A Research for CHnical Application / 实用放射学杂志

Objective To evaluate clinical applications of CT virtual endoscopy. Methods 60 patients were examined with CTVE includes various body cavities such as air way, digestive tract, nose, pharynx, larynx and vessel. All cases were examined with spiral CT, then transferod the source images to work station dealt with special soft-ware package imitated the examination of fiberoptie endoscopy, some ses were compared with real fiberoptic endoscopy. Results In 30 cases of CT virtual bronchoscopy, all segmental and parts of sub-segm tal bronchi were showed clearly, CTVE could reveal stenosis and bronchi occlusions in 20 patients with pulmonary carcinoma, but missed mucosal metastasis infitration and details in surface of mass showed with bronchiscopy. Digestive tract{ n = 20)CTVE also well revealed mid late carcinoma in stomach and colon { n = 8) , but missed small polypus (n = 1) and stomach ulcer{ n = 2). In 7 cases of nasopharynx and ynx CTVE, carcinoma of nasopharynx (n = 1) and carcinoma of larynx (n = 2) can clearly displayed. Vascular CTVE (n = 3) could display derails of aneurysm, such as the site of the entry tear, false lumen, neck and lumen of aneurysm. Conclusion CTVE plays an important role in the diagnosis of diseases body cavities.

CT Virtual Endoscopy: A Research for Clinical Application / 实用放射学杂志

Objective To evaluate clinical applications of CT virtual endoscopy. Mathods 60 patients were examined with CTVE includes various body cavities such as air way , digestive tract, nose, pharynx,larynx and vessel. All cases were examined with spiral CT, then transfered the source images to work station dealt with special soft - ware package imitated the examination of fiberoptic endoscopy,some cases were compared with real fiberoptic endoscopy. Results In 30 cases of CT virtual bronchoscopy,all segmental and parts of sub - segmental bronchi were showed clearly, CTVE could reveal stenosis and bronchi occlusions in 20 patients with pulmonary carcinoma,but missed mucosal metastasis infitration and details in surface of mass showed with bronchiscopy. Digestive tract(n = 20) CTVE also well revealed mid and late carcinoma in stomach and colon (n = 8), but missed small polypus(n =1) and stomach ulcer(n = 2). In 7 cases of nasopharynx and larynx CTVE, carcinoma of nasopharynx(n =1) and carcinoma of larynx(n = 2) can clearly displayed. Vascular CTVE (n = 3) could display the details of aneurysm, such as the site of the entry tear,false lumen, neck and lumen of aneurysm. Conclusion CTVE plays an important role in the diagnosis of diseases body cavities.