Application of multiple post labeling delay time arterial spin labeling imaging in the quantitative blood flow analysis of brain subregions in healthy adults / 中华内科杂志

Objective:To explore the normal ranges of perfusion parameters between cerebral hemisphere, cerebellar hemisphere and brain anatomical subregions (56 pairs) in different gender and age groups with multiple post labeling delay time (Multi-PLD) arterial spin labeling (ASL) imaging.Methods:From November 2020 to December 2020, 42 healthy adult volunteers (Male 25, Female 17) were recruited to perform 7 PLD ASL imaging, including 21 young adults (15 males and 6 females, aged 23—35 years) and 21 seniors (10 males and 11 females, aged 36—74 years). The data was processed offline by Cereflow software to obtain arterial arrival time (ATT) and corrected cerebral blood flow (CBF) and cerebral blood volume (CBV) perfusion parameters. SimpleITK standardization function was used to standardize the calculated perfusion image according to the anatomical automatic labeling (AAL) template. Therefore, CBF, ATT, CBV perfusion values of brain subregions were obtained. Paired samples t test, Wilcoxon rank sum test, independent samples t test and Mann-Whitney U test were used to compare the differences of perfusion parameters in the cerebral hemisphere, the cerebellar hemisphere, brain subregions depending on side, gender and age. Pearson correlation analysis was used to compare the correlations of perfusion parameters with age. Results:CBF in 62.5% (35/56) subregions and CBV in 44.6% (25/56) subregions were higher in right side than those in left side. ATT in most brain anatomical subregions (16/56) were higher in left side. The CBF [(35.30±8.31) vs. (34.34±7.53) ml·100g -1·min -1, P=0.021], CBV [(0.47±0.11) vs. (0.45±0.09) ml/100g, P<0.001], ATT [(1.30±0.10) vs. (1.24±0.11) s, P<0.001] in left cerebellar hemisphere were higher than that of right side. The CBF (28/56) of cerebral hemisphere, cerebellar hemisphere and brain subregions was higher in females than that in males, while ATT in 83.9% (47/56) subregions was lower than that in males (all P<0.05). CBV in female subjects was higher only in 5 brain regions (superior occipital gyrus, middle occipital gyrus, inferior occipital gyrus, superior parietal gyrus and cerebelum_7b) (all P<0.05). In young subjects, CBF in 44.6% (25/56) subregions and CBV in 33.9% (19/56) subregions were higher than those in the senior group (all P<0.05). The ATT in most subregions in young group were lower than those in senior group, but the difference was statistically significant only in rectus gyrus ( P=0.026) and paracentral lobule ( P=0.006). The CBF ( r=-0.430, P=0.005) and CBV ( r=-0.327, P=0.035) of cerebral hemisphere were negatively correlated with age. The CBF (24/25, r range:-0.497 —-0.343, all P<0.05) and CBV (16/19, r range:-0.474 —-0.322, all P<0.05) in most subregions were negatively correlated with age, while ATT was positively correlated (gyrus rectus: r=0.311, P=0.045; paracentral lobule: r=0.392, P=0.010). Conclusions:Multi-PLD ASL imaging could be applied for quantitative analysis of brain perfusion. The perfusion parameters of anatomical subregions are different depending on side, gender, and age.

Screening and grading of fundus images of diabetic retinopathy based on visual attention / 中华实验眼科杂志

Objective To construct an intelligent analysis system based on visual attention for diabetic retinopathy ( DR) assistant diagnosis and to realize the automatic screening and grading of fundus images of DR. Methods Total of 35126 DR fundus images were downloaded from the Diabetic Retinopathy Detection competition in the Data Modeling and Data Analysis Competition Platform (Kaggle),and 1200 fundus images were downloaded from the Messidor website. Firstly,according to the characteristics of DR fundus images,a series of preprocessing was carried out for retina images. Then,on the basis of VGG16 network,visual attention SENet module was introduced to improve the saliency of lesion features,and a deep convolution neural network SEVGG with complex network structure was generated. The network basically inherited some structural parameters of VGG16,and the parameters of SENet module were adjusted according to the basic network and training data set. Finally, the SEVGG network model was used to screen the DR fundus image,and the fundus image was divided into different levels according to the degree of lesions of DR in different periods. Configure the training platform and environment and perform algorithm performance verification experiments. Results The method proposed in this study was tested on different open standard datasets,and finally achieved high accuracy in image-based classification. The accuracy of 5 classification in Kaggle dataset was 83％,the sensitivity of lesion detection was 99. 86％ and the specificity was 99. 63％. The accuracy rate of the 4 classification in the Messidor data set was up to 88％,the sensitivity of the lesion detection was 98. 17％,and the specificity was 96. 39％. The introduction of visual attention was more significant for the focus of the lesion,which helped the accurate detection of DR. Conclusions This method effectively avoids some shortcomings of traditional artificial feature extraction and fundus image classification,and is more accurate for lesion recognition. It is not only superior to the previous method,but also shows better robustness and generalization.

[Design and arrangement of the CHIP (CHinese In Prato) study]. / Disegno e modalità di realizzazione dello studio CHIP (CHinese In Prato).

Following the rapid economic development, China is experiencing a progressive increase in the incidence of cardiovascular (CV) events and in the prevalence of CV risk factors. According to recent estimations, the prevalence of diabetes sharply increased from 1% in 1980 to 11% in 2013. Migration from China to Europe is now mainly concentrated in Countries of the Southern Europe, e.g., Italy and Spain. The largest Chinese community living in Italy is now settled in Prato, being also one of the largest Chinese community in Europe. Local authorities estimate a number of Chinese citizens living in Prato of over 40,000 individuals, including illegal immigrants. The availability of reliable data on the health needs of Chinese population is thus a recognised priority for the local health system. The creation of a participatory research where Chinese population directly participates in the formation of a group of citizens involved in designing and conducting the survey allows to overcome difficulties due to the lack of official demographic files. Secondly, and most important, this approach makes it possible to effectively pass a prevention message to an elusive population. The purpose of the CHIP (CHinese In Prato) survey is to investigate the prevalence of diabetes and cardiovascular risk factors among Chinese immigrants. Recruitment procedure was started on 8th July 2014.

Increased expression of TGF-beta1 and Smad 4 on oxygen-induced retinopathy in neonatal mice.

Retinal neovascularization (NV) is a major cause of the blindness associated with such ischemic retinal disorders as diabetic retinopathy, retinopathy of prematurity and retinal occlusion. Neovascularization is induced by complex interactions among growth factors and cytokines. Some studies confirm that VEGF play a central role in neovascularization, there remain some questions as to why VEGF antagonists are only partially effective. Transforming growth factor-beta (TGF-beta) has been implicated in the development of neovascularization (Gerard et al. 2000). Smad 4 plays the most important role in the TGF-beta signal transduction (Zimowska 2006). In this study, we used the model of oxygen-induced retinopathy in neonatal mice to investigate the expression of TGF-beta1 and Smad 4 mRNA in the retina, to explore their role in the development of retinal neovascularization.

Intravitreal triamcinolone acetonide for the treatment of diffuse diabetic macular oedema--a case report

<p><b>INTRODUCTION</b>Although laser photocoagulation is the primary treatment for diabetic macular oedema, treatment of eyes with diffuse macular oedema has been disappointing. Intravitreal injection of steroids is being investigated for the treatment of diabetic macular oedema. Preliminary results indicate that steroid injections do improve macular oedema, but it is not clear if they improve visual acuity.</p><p><b>CLINICAL PICTURE, TREATMENT, AND OUTCOME</b>In this report, we describe a patient with a form of diffuse diabetic macular oedema that responded favourably to intravitreal steroid injections, with improvements in both foveal thickness and visual acuity.</p><p><b>CONCLUSION</b>Intravitreal steroids can be useful for the treatment of diffuse diabetic macular oedema.</p>

Expression of a novel immunoglobulin gene SNC73 in human cancer and its significance / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of a new immunoglobulin gene SNC73 in malignant tumor and normal tissue and its significance.</p><p><b>METHODS</b>Expression level of SNC73 in tumors and normal tissues was determined by reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay (RT-PCR-ELISA) in 90 malignant tumors, including colorectal cancer, gastric cancer, breast cancer, lung cancer and liver cancer. Analysis on relation of SNC73 expression with age, sex, site, differentiation grade, depth of invasion and metastasis of colorectal cancer was made to assess the clinical significance of SNC73.</p><p><b>RESULTS</b>Mean ratio of SNC73 expression level in normal mucosa and colorectal cancer tissue was 7.134 (P < 0.01). Expression of SNC73 showed no significant difference among gastric cancer, breast cancer, lung cancer or liver cancer as compared with the control normal tissues (P > 0.05).</p><p><b>CONCLUSION</b>Down-regulation of SNC73 expression is a relatively specific phenomenon in colorectal cancer for which development SNC73 may be a potential genetic marker. The study on relationship of SNC73 expression with development of colorectal cancer is promising.</p>

Combined modality therapy following bladder conservation surgery for bladder cancers / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the efficacy of recurrence prophylaxis using radiation and chemotherapy following bladder conservation surgery for muscle invasive bladder cancer.</p><p><b>METHODS</b>23 patients with muscle invasive bladder cancer were treated with radiotherapy combined with bladder mitomycin infusion after bladder conservation surgery (study group). Radiotherapy was given using an external beam at an average dose of 5148 +/- 462 cGy with conventional fractionation. For comparison, 29 similar patients treated with postoperative bladder mitomycin infusion without radiation served as control (control group). All patients were followed up for more than 3 years, an average of 41.6 months (36 - 60 months).</p><p><b>RESULTS</b>The 3-year pelvic recurrent rate of muscle invasive bladder cancer was 17.4% in the study group and 44.8% (P = 0.036) in the control group. The 3-year distant metastasis rates were 17.4% and 24.1%, respectively (P = 0.554). The 3-year overall survival rates were 81.8% and 86.2%, respectively (P = 0.670). Two patients from the study group had their treatment interrupted, one for 3 days and the other for one week due to acute cystitis, while the rest of the patients were able to complete the treatment according to schedule.</p><p><b>CONCLUSION</b>Radiotherapy plus chemotherapy after bladder conservation surgery for muscle invasive bladder cancer can decrease the rate of pelvic recurrence effectively and be used as a realistic adjuvant treatment.</p>

Results of treatment of multimodality therapy following bladder-preserving surgery for muscle-invasive bladder cancer / 中华放射肿瘤学杂志

Objective To evaluate the local control effect of radiotherapy and intravesical chemotherapy following bladder preserving surgery for musculoinvasive bladder cancer. Methods Twenty three patients with muscle invasive bladder cancer were treated by bladder preserving surgery followed by external radiation ( mean dose 52.5 Gy) combined with intravesical mitomycin infusion after bladder preserving operation (study group).For comparison, 29 similar patients received the same treatment without radiation served as control (control group).Results All patients in the study group completed their designed treatment,except two patients whose protocol was interrupted for 3 days and one week due to acute cystitis. The mean follow up duration was 41.6 months. The 3 year local recurrence rates were 18.8% in the study group and 44.8% in the control group(P=0.026).The 3 year distant metastasis rates were 18.2% and 24.1% (P=0.437),and the 3 year overall survival rates were 81.8% and 86.2% (P=0.670),respectively. Conclusion It is demonstrated that adjuvant radiotherapy and intravesical infusion chemotherapy following organ preserving surgical procedure are encouraging by giving favorable local control for musculoinvasive bladder cancer.