Effect of hippocampal brain derived neurotrophic factor precursor in mice cognitive dysfuction induced by social isolation / 解剖学报

[Abstract] Objective To investigate the effect of hippocampal brain derived neurotrophic factor precursor (proBDNF) in cognitive dysfuction induced by social isolation. Methods Thirty C57BL / 6 J male mice (4-week old) were randomly divided into group house (GH,n = 15) and socially isolated (SI,n = 15) groups. The GH group (5 mice / cage) and SI group (1 mice / cage) were reared separately under the same conditions. The novel object recognition test and the novel place recognition test were used to evaluate the cognitive function. The expression of BDNF mRNA in the hippocampus was detected by Real-time PCR. The expression of BDNF and proBDNF in hippocampus was detected by Western blotting. Matrix metallopeptidase-9 (MMP-9) and tissue plasminogen activator (tPA) were extracellular enzymes that catalyzed the transformation of proBDNF into mature BDNF. Expression of MMP-9 and tPA mRNA in the hippocampus were detected by Real-time PCR. Results Compared with the GH group, the SI group showed significantly reduced discrimination ratio in the novel object recognition test and novel place recognition test. The result of Real-time PCR showed that there was no difference in the expression of BDNF mRNA between SI group and GH group. The result of Western blotting showed that the expression level of proBDNF in the hippocampus of SI group increased significantly compared with the GH group (P<0. 01),and no difference in BDNF expression was found between the two groups; Compared with the GH group, the BDNF/ proBDNF ratio in the hippocampus of SI group decreased. In addition, the result of Real-time PCR showed that the expression level of MMP-9 and tPA mRNA in the hippocampus of SI group decreased significantly compared with the GH group. Conclusion The social isolation-induced cognitive dysfuction in mice may be related to the up-regulation of proBDNF in the hippocampus.

Feasibility of wait and watch strategy for patients with high-risk factors after endoscopic submucosal dissection for early colorectal cancer / 国际外科学杂志

Objective:To explore the feasibility of wait and watch treatment for patients with high-risk pathology factors after endoscopic submucosal dissection (ESD) for early colorectal cancer.Methods:From December 2012 to June 2020, 104 patients, including 62 males and 42 females, aged from 31 to 89 years old, with the average of (59.5±10.8) years with early colorectal cancer after ESD operation were selected from the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University. According to the follow-up treatment, the patients were divided into two groups: the additional surgical resection group and the wait and watch group. The measurement data of normal distribution were shown by mean standard deviation, the comparison between groups adopted t test, and the comparison of counting data between groups adopted χ2 test. The types of pathological high-risk factors after ESD were compared between the two groups, and the overall survival (OS) and progression free survival (PFS) of the two groups were compared by Log-Rank test. Results:The median follow-up time was(40.6±15.3) months. The OS and PFS of the additional surgical resection group and the wait and watch group were 100.0% vs 98.4% and 90.7% vs 90.2%, respectively, and there was no statistically significant difference between the two groups (OS: χ2=0.875, P=0.35; PFS: χ2=0.017, P=0.80). Conclusion:The wait and watch strategy is expected to be one of the follow-up choices for some patients with high risk factors after ESD operation for early colorectal cancer.

Effect of increased visceral fat on the perioperative period of laparoscopic-assisted distal gastric cancer radical resection / 国际外科学杂志

Objective:To explore the effect of excessive visceral fat area (VFA) on the intraoperative risk and postoperative outcome of laparoscopic-assisted distal gastric cancer surgery (LADG).Methods:A retrospective selection of 82 patients who underwent LADG at the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from June 2017 to March 2018 was selected. The patients were divided into two groups according to the VFA value calculated by preoperative CT: high VFA group ( n=31) and the low VFA group ( n=51). Patients in the high-VFA group had VFA≥100 cm 2, and those in the low-VFA group had VFA<100 cm 2. The differences in operation time, blood loss, number of lymph node dissections, and postoperative complications (including intestinal obstruction, anastomotic fistula, pancreatic fistula, and abdominal infection) were statistically compared between the two groups. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square test. The factors related to pancreatic fistula were tested by one-way variance test, and the factors with differences were entered into the multivariate Logistic regression analysis as independent variables. Results:In terms of surgical bleeding ( P=0.061), lymph node dissection ( P=0.089), postoperative anastomotic leakage ( P=0.210), intestinal obstruction ( P=0.275) and abdominal infection ( P=0.130), the comparison between the two groups showed no significant statistical difference ( P>0.05), but compared with the low VFA group, the operation time of the high VFA group was prolonged [(258±91)min vs (230±82)min, P=0.018], and the onset of pancreatic fistula rate was significantly higher (11/31 vs 3/51, P=0.001), and there was statistical significance between the two groups ( P<0.05). The results of univariate analysis showed that gender and VFA were risk factors for pancreatic fistula; the results of multivariate analysis showed that VFA was a predictor of pancreatic fistula. Conclusion:Excessive VFA prolongs LADG operation time and is more valuable in predicting the occurrence of postoperative pancreatic fistula.

Progress in diagnosis and treatment of primary hyperparathyroidism / 国际外科学杂志

Primary hyperparathyroidism (PHPT) is a disorder of calcium metabolism, which is characterized by elevated blood calcium and PTH urine calcium, which is easy to involve multiple systems. The disease is mainly caused by a benign adenoma of parathyroid tissue, a few of which are parathyroid hyperplasia or parathyroid adenocarcinoma. As awareness of physical examination increased, the proportion of asymptomatic PHPT patients gradually increased. The disease can be cured by surgical resection of the parathyroid gland, most of which is a real good prognosis, but a few of them are complex and difficult to diagnose and treat. At present, there continue to be many controversies about the diagnosis and treatment of PHPT.This article is a review of the progress in the diagnosis and treatment of PHPT.

Study on the relationship between protective ileostomy and anastomotic leakage after neoadjuvant radiotherapy and chemotherapy for rectal cancer / 国际外科学杂志

Objective:To explore whether the protective ileostomy can reduce the incidence of anastomotic leakage after neoadjuvant treatment of rectal cancer and the relationship between protective ileostomy and anastomotic leakage.Methods:From May 2011 to August 2020, a total of 108 patients who underwent rectal cancer neoadjuvant radiotherapy and chemotherapy and then received anterior resection in Beijing Friendship Hospital, Capital Medical University were selected. Sixty-three cases were treated with protective ileostomy (Treatment group), while 45 cases were not (Control group). The chi-square test was used to compare the incidence of anastomotic leakage between the two groups. At the same time, Logistic regression was used to analyze the related factors of anastomotic leakage, and the rate of permanent stoma was calculated. SPSS19.0 software was used for statistical analysis.Results:The total incidence of postoperative anastomotic leakage in the Treatment group and Control group was 9.52% (6/63) and 6.66% (3/45) ( P=0.59). Among them, 2 cases of anastomotic leakage occurred in the Treatmentgroup, no A-grade anastomotic leakage occurred in the Control group, and there was no significant difference between the two groups (33.33% vs. 0, P=0.77). There were 4 cases of grade B anastomotic leakage occurred in the Treatment group, 2 cases in the Control group, there was no significant difference between the two groups (66.67% vs. 66.67%, P=0.45). There was no grade C anastomotic leakage in the Treatment group, and one case of grade C anastomotic leakage occurred in the Control group, there was no significant difference between the two groups (0 to 33.33%, P=0.70). Logistic regression analysis showed that whether protective stoma was implemented or not was not statistically related to the occurrence of anastomotic leakage ( P=0.26). The distance between the tumor and the anal margin ( P=0.01) affected the occurrence of anastomotic leakage. The permanent stoma rate in the Treatment group was 9/63 (16.67%). Conclusion:Protective ileostomy has no significant advantage in reducing the incidence of anastomotic leakage in patients with rectal cancer neoadjuvant radiotherapy and chemotherapy, and may lead to permanent stoma.

Correlation between the Polymorphism of Coagulation-Related Genes and Lower Extremity Deep Venous Thrombosis / 法医学杂志

Objective To investigate the correlation between the polymorphism of 4 coagulation-related genes, rs1799963 （coagulation factor V gene Leiden）, rs6025 （prothrombin gene G20210A）, rs1042579 （thrombomodulin protein gene c.1418C>T） and rs1801131 （methylenetetrahydroflate reductase gene） and lower extremity deep venous thrombosis （LEDVT）. Methods The 4 genotypes mentioned above of 150 LEDVT patients and 153 healthy controls were detected by the kompetitive allele specific polymerase chain reaction （KASP）, then related blood biochemical indicators were collected, binary Logistic regression was established to screen the independent risk factors of LEDVT, and the correlation between polymorphism of 4 coagulation-related genes and LEDVT and its indicators under different genetic modes after adjusting confounding factors were analyzed. Results Five variables, D-dimer, fibrinogen degradation product, homocysteine, sex and age might be the risk factors of LEDVT. These variables were put into 4 genetic inheritance models, and adjusted in binary Logistic regression. The results suggested that the mutations of rs1042579 were correlated with LEDVT under dominant inheritance mode. Conclusion The gene polymorphism of rs1799963, rs6025 and rs1801131 has no significant correlation with the formation of LEDVT. The gene polymorphism of rs1042579 plays a role under dominant inheritance mode, and might be an independent risk factor for formation of LEDVT.

The Value of Corpus Callosum Measurement in the Diagnosis of Cerebral Atrophy.

OBJECTIVE: The study aimed to investigate the relationship between the corpus callosum area (CCa) and the degree of cerebral atrophy in patients with cerebral atrophy. METHODS: 119 patients with brain atrophy were grouped according to the degree of brain atrophy. Median sagittal CCa and intracranial area (ICa) were measured, and the ratio of corpus callosum to the intracranial area (CCa-ICa ratio) was calculated. The data were analyzed using ANOVA. RESULTS: CCa significantly reduced in patients with cerebral atrophy, and the degree of cerebral atrophy was found to be positively correlated with the degree of reduction in the CCa. CONCLUSION: The reduction in the CCa and the CCa-ICa ratio in the median sagittal can be used as a reference indicator for the diagnosis and grading of brain atrophy in clinical practice.

Glioblastoma presenting only as cortical "ribbon sign" in the early stage: a case report / 中华神经科杂志

Glioblastoma, which is the most common primary malignant brain tumor, usually occurs in the white matter of the brain. In this case, magnetic resonance imaging (MRI) only showed abnormal cortical signal in the first hospital examination, so he was diagnosed as viral encephalitis. Seven months later, he was admitted to hospital again because of memory loss and slow response. MRI showed obvious mass in the original lesion area. Pathology confirmed glioblastoma (the World Health Organization classification of central nervous system tumors: grade Ⅳ). By analyzing this case, it is considered that some glioblastomas may only have cortical lesions in the early stage. Therefore, if cortical abnormal signals are found, glioblastoma should also be included in the differential diagnosis.

Multimodal magnetic resonance imaging features of eight cases of epithelioid glioblastoma / 中华神经科杂志

Objective:To analyze the magnetic resonance imaging (MRI) features of epithelioid glioblastoma (eGBM), and to quantitatively analyze the characteristics of apparent diffusion coefficient (ADC) , perfusion-weighted imaging (PWI) and magnetic resonance spectrum (MRS) of eGBM patients.Methods:The MRI results of eight cases of eGBM confirmed by pathology in the Affiliated Hospital of Qingdao University from October 2016 to November 2018 were analyzed retrospectively. The location, edge, signal, peritumoral edema, adjacent meningeal invasion and enhancement of the patients were observed, and the changes of ADC value, relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV) and the ratio of choline (Cho)/N-acetyl-L-aspartic acid (NAA) were analyzed.Results:Among the eight patients, the main tumors were located in temporal lobe ( n=3), frontal lobe ( n=3) and parietal lobe ( n=2). The boundary of the lesion was clear in six cases and unclear in two cases. The lesions were superficial in five cases and in deep white matter in three cases. Bleeding could be seen in four cases. There were three cases with cystic change and four cases with necrosis, and there was no cystic necrosis only in one case. There was no edema around the lesion in one case, severe edema in five cases and moderate edema in two cases. The adjacent meninge was involved in four cases and the ependyma was involved in one case. Two patients had leptomeningeal metastasis within two months after operation. The average ADC value of tumor parenchyma in eight patients was 7.15×10 -4 mm 2/s, which was 17.6% lower than that of the contralateral side. MRS showed that the ratio of Cho/NAA in the lesions of two patients were 5.27, 0.81. PWI showed that the rCBV in the lesions of two patients was 3.51 ml/100 g and 3.32 ml/100 g, respectively, which was 36% and 29% higher than that of the contralateral side, respectively. And the rCBF of the lesions was 31.5 ml·100 g -1·min -1and 82.1 ml·100 g -1·min -1, respectively, which increased by 49% and 203% respectively compared with the contralateral side. Conclusions:eGBM has the characteristics of superficial location, easy to be cystic, but the wall of the cyst is not smooth and uneven, the boundary of the mass is clear, the adjacent meninges are easy to be involved and the meningeal tail sign appears, and it is easy to be spread by cerebrospinal fluid. ADC value, PWI and MRS can provide some help for preoperative tumor grading.

Recurrent type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion: a case report / 中华神经科杂志

Mild encephalitis/encephalopathy with reversible splenial lesion has special clinical-imaging features. According to the extent of lesion involvement, it can be divided into type Ⅰ and type Ⅱ. Clinically, type Ⅰ is more common, and type Ⅱ is rare. A rare case of recurrent type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion is reported. The patient presented with typical type Ⅱ mild encephalitis/encephalopathy with reversible splenial lesion for the first time, involving the corpus callosum and the deep white matter, and the lesions disappeared after a short-term reexamination. Two years later, the lesions recurred, and the scope of the lesions was similar to that of the first time, and the lesions disappeared after a short-term reexamination. The clinical and imaging findings are analyzed in combination with relevant literatures review in order to deepen the understanding of the disease and improve the level of diagnosis and treatment.

The value of contrast enhanced MRI radiomics in predicting the IDH 1 genotype in high-grade gliomas / 中华放射学杂志

Objective:To explore the predictive value of a radiomics model based on preoperative contrast enhanced MRI in the assessment of the isocitrate dedydrogenase 1 (IDH 1) genotype in high-grade glioma.Methods:A retrospective analysis was performed on a dataset including 182 patients with high-grade glioma confirmed by surgical pathology between December 2012 and January 2018 in the Affiliated Hospital of Qingdao University. There were 79 patients with IDH1-mutant glioma (45 cases with WHO grade Ⅲ, 34 with WHO grade Ⅳ) and 103 with IDH 1 wild-type glioma (33 cases with WHO grade Ⅲ, 70 cases with WHO grade Ⅳ). All patients had complete preoperative brain contrast enhanced MRI.The cases were divided into a training dataset and a validation dataset at a ratio of 7∶3 using stratified random sampling. Radiomic features were initially extracted using A.K (Analysis Kit, GE healthcare) software, and were selected and excluded using Kruskal-Wallis and Spearman analyses. Using R softwear " GLM" function, the Lasso-logistic model was finally conducted to obtain the optimized subset of the feature to build the radiomics model, and the model was then tested with cross-validation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of the model in differentiating IDH1-mutant type and wild-type gliomas.Results:The radiomics model showed good performance in IDH genotype differentiation in both the training dataset (AUC 0.870, 95% CI: 0.754 to 0.855, accuracy rate 79.8%, sensitivity 85.5%, specificity 75.4%, positive predictive value 0.734, negative predictive value 0.867) and the validation dataset (AUC 0.860, 95% CI: 0.690 to 0.913, accuracy rate 78.9%, sensitivity 91.3%, specificity 69.0%, positive predictive value 0.700, negative predictive value 0.909).Conclusion:The radiomics model based on the preoperative enhanced MR can provide a way to predict the IDH1 genotype in high-grade gliomas.

Environmental enrichment ameliorates lipopolysaccharide-induced cognitive impairment by inhibiting NOD-like recepter protein 3 in fla mmasome activation in mice / 解剖学报

Objective To investigate the effect of environmental enrichment (EE) on lipopolysaccharide (LPS) induced cognitive dysfunction in mice. Methods A total of thirty six 3 weeks old Kunming mice experienced 8 weeks of EE or standard environment (SE) feeding. After 8 weeks, they were divided into three groups: standard environment+ normal saline (SE+NS) group, standard environment+lipopolysaccharide (SE+LPS) group, environmental enrichment+ lipopolysaccharide (EE+LPS) group. The open field test was used to measure the locomotive of mice, and the cognitive function was determined by novelty object recognition test. The expression of microglial marker ionized calcium binding adaptor molecule-1 (IBA-1) in hippocampus was determined by immunohistochemical staining. The expression of microglial activation marker CD68 and NOD-like receptor protein 3 (NLRP3) inflammasome related protein in the hippocampus was detected by Western blotting. Results In the open field test, there was no difference in the activity among the three groups. Compared with the SE + NS group, SE + LPS group showed decreased discrimination ratio in novelty object recognition task, with remarkably up-regulated expression of CD68 in the hippocampus (P< 0. 01) . In addition, SE+LPS group exhibited significantly enhanced expression of NLRP3, apoptosis associated speck-like protein (ASC), Caspase-1 and interleukin-1β(IL-1β) in the hippocampus compared with SE + NS group (P < 0. 05) . Compared with the SE + LPS group, EE+LPS group showed enhanced discrimination ratio in the object recognition task, with down-regulated expression of CD68, NLRP3, ASC, Caspase-1, IL-1β and IL-18 in the hippocampus (P < 0. 01) . Conclusion Environmental enrichment can alleviate LPS induced cognitive dysfunction, which might be attributed to the inhibiting of microglia and NLRP3 activation in the hippocampus.

Effect and mechanism of caloric restriction on early social isolation-induced cognitive impairment in mice / 解剖学报

Objective: To investigate the effect and mechanism of caloric restriction (CR) on early social isolation (SI) induced cognitive dysfunction in mice. Methods: Thirty-six kunming mice (3-weeks old) were randomly divided into group house (GH, n= 12), early socially isolated (SI, n= 12), caloric restriction and socially isolated (SI+CR, n= 12). The GH group (6 mice/cage) and SI group (1 mice/cage) were reared separately under the same conditions, while the SI+CR group (1 mice/cage) were given food every other day. The open field experiment was used to measure the locomotive of mice; The object recognition task was used to evaluate the cognitive function; The expression of microglial marker ionized calcium-binding adapter molecule 1 (IBA-1) in hippocampus was detected by immunohistochemistry. The expression of microglial activation marker CD68 and interleukin-lÎ2 (IL-lÎ2) in hippocampus was detected by Western blotting. Results: In the open field test, there was no difference in the activity of the three groups of mice. Compared with the GH group, the SI group showed significantly reduced discrimination ratio in object recognition task, with remarkably upregulated expression of IL-1Î2 in hippocampus (P<0. 01). In addition, SI group exhibited over-activated microglia in hippocampus indicated by increased number of IBA-1-positive cells and high expression of CD68 (P<0.01). Compared with the SI group, SI+CR group enhanced discrimination ratio in object recognition task, with down-regulated expression of IL-1Î2 in hippocampus (P<0. 01), and the number of IBA-1-positive cells and the expression of CD68 significantly reduced (P<0. 01). Conclusion: Caloric restriction alleviates Si-induced cognitive dysfunction, which might be attributed to the inhibiting of microglia activation in the hippocampus.

Safety awareness and use of child safety seats among parents after the legislation in Shanghai / 中华创伤杂志(英文版)

PURPOSE@#To investigate the changes and underlying mechanisms in parents' safety awareness and the use of child safety seats after the mandatory legislation in Shanghai city, China.@*METHODS@#This study was carried out by Shanghai Key Laboratory of Environment and Children's Health using a multi-stage, simple random sampling method. Volunteers with children aged 0-12 months were recruited. Child safety seats were sent to each volunteer's family. Telephone encounters and/or on-site visits were used to collect data from parents using a phased survey on children's safety during car use.@*RESULTS@#Among all respondents, 91.2% had heard of motor vehicle accidents involving children, and 97.2% could describe the appropriate use of a safety seat to minimize the risk of child injury in a collision. Among 1078 families with newborns, awareness of child safety seats was 91.9%. There were 86% patients aware that new laws and regulations have been released regarding the use of child safety seats, and 98.5% of them plan to comply with the new laws. Moreover, 61% patients think that taxis should be routinely equipped with child safety seats.@*CONCLUSION@#The parents in Shanghai obtained a high level of awareness of children's traffic safety after the introduction of child safety seats legislation, and had a positive experience related to the use of child safety seats. Taxi may be an important area of focus for implementation of child traffic safety. Traffic safety laws and regulations with further impact should be continuously studied.

Application of 3.0T multiparametric MRI in the diagnosis of prostate cancer / 实用放射学杂志

Objective To analyze the features and diagnostic value of 3.0T multiparametric MRI for prostate cancer(PCa).Methods The clinical and MRI data of 48 patients with PCa and 52 patients with benign prostatic hyperplasia (BPH)were analyzed retrospectively. All patients underwent plain MRI,DWI,DCE-MRI and MRS.Results The PCa were hyperintensity on DWI and hypointensity on ADC,respectively.There was significant difference in the ADC values between the benign and malignant lesions.DWI using the high b-value was sensitivitive to diagnosing the PCa.The distribution of the S-I T was significant difference between the two groups.The SI-T curves of the PCa were type Ⅲ in 40 cases,type Ⅱ in 5 cases and type Ⅰ in 3 cases.The SI-T curves of the BPH were type Ⅰ in 27 cases,type Ⅱ in 23 cases and type Ⅲ in 2 cases.The peak value of choline (Cho)increased and citrate (Cit)decreased on MRS.The ratio of (Cho+Cre)value/Cit value of the PCa was increased.Conclusion DWI,DCE-MRI and MRS can present the specific findings of PCa.The combining application of the three technics could increase the accuracy in diagnosing PCa.

Intravoxel incoherent motion DWI in differential diagnosis of high-grade gliomas and metastasis / 中国医学影像技术

Objective To investigate the value of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of high-grade gliomas and brain metastases.Methods Conventional MRI,contrast-enhanced MRI and IVIM-DWI were performed before surgery or chemoradiotherapy in 24 patients with high-grade gliomas and 28 patients with brain metastases.The diffusion constant (D),pseudodiffusion coefficient of perfusion (D*) and the perfusion fraction (f) in the parenchyma and peritumoral edema region within 1 cm and the normal centrum semiovale in the opposite side were measured,then the relative values of all parameters in each region (rD*,rD,rf) were calculated.Independent sample t test was used to analyze the parameters.ROC curve analysis of the parameters statistically different between high grade gliomas and brain metastases were performed,and the diagnostic efficacies were evaluated.Results The D* and rD* values of tumor parenchyma and in peritumoral edema within 1 cm of high-grade gliomas were higher than those of brain metastases (all P＜0.05).The f and rf values of tumor parenchyma and in peritumoral edema within 1 cm of highgrade gliomas were lower than those of brain metastases (all P＜0.01).The AUC of D* value in peritumoral edema within 1 cm was the highest,but there was no statistically different between any two AUC except the rD* value of peritumoral edema within 1 cm (P =0.033).Conclusion IVIM-DWI can distinguish the differences of diffusion and perfusion information in parenchyma and edema area between high-grade gliomas and brain metastases,therefore providing the basis for differential diagnosis of them.

MSCT findings of thoracic Castleman's disease / 实用放射学杂志

Objective To evaluate the imaging findings of thoracic Castleman's disease (CD)to improve the diagnostic accuracy. Methods The imaging findings of 14 cases of thoracic CD confirmed by pathology were analyzed retrospectively.Plain and dynamic contrast-enhanced CT scans were performed in all patients before surgery.Results Among the 14 cases,10 cases were hyaline vascular type (HVT)and other 4 cases were plasma cell type (PCT).HVT-CD showed well-define,homogeneous soft-tissue lesion with different sizes of lymph nodes around the lesions in 2 cases,mottled calcification in 2 cases and coarse calcification in 1 case.Dynamic enhanced CT showed HVT-CD had obvious enhancement in arterial phase,and sustained enhancement in venous phase and delayed phase.PCT-CD all showed enlarged lymph nodes in the mediastinum and bilateral axillary,associated with interstitial pneumonia,pulmonary nodules,ground glass opacity and pleural effusion,with marked and sustained enhancement 1 case.Conclusion Thoracic HVT-CD presents equal density on CT plain scan,and obvious and durative enhanement on multiphase contrast-enhanced CT,which can be accompanied by lymphnodes around the lesions and intratumoral calcification.With the above imaging findings,we should consider the possibility of HVT-CD.CT features of PCT-CD are non-specific,a comprehensive evaluation of the clinical data should be combined,but the obviously enhanced PCT-CD can be diagnosed.

Evaluation of cerebral hemodynamics by computed tomography perfusion imaging before and after cranioplasty in patients with brain injury.

OBJECTIVE: To assess the clinical significance of computed tomography perfusion (CTP) imaging by evaluating cerebral hemodynamic changes quantitatively and qualitatively both before and after cranioplasty in patients with brain injury. METHODS: Sixteen patients with cerebral trauma underwent CTP imaging 2 days before and 10-15 days after cranioplasty. The cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time and time to peak were analysed in both the affected and corresponding contralateral regions, including the basal ganglia, thalamus, cortex and white matter. Quantitative analyses were performed before and after cranioplasty. RESULTS: The CBF in the cortex of the affected side was significantly increased after cranioplasty (p < 0.05), while that in the white matter on the affected side was slightly lower than that on the contralateral side (p < 0.05). The CBV in the corresponding contralateral area of the basal ganglia decreased post-cranioplasty (p < 0.05). No other difference in blood flow parameters was found between the two sides before or after cranioplasty. CONCLUSION: CTP imaging can accurately reflect changes in cerebral hemodynamics before and after cranioplasty in patients with trauma. Cranioplasty can significantly improve CBF in the cortex on the affected side for a short time (10-15 days) to meet the prevailing metabolic demand.

Comparison of the localization diagnosis between 1H-magnetic resonance spectroscopy and electroencephalogram in temporal lobe epilepsy without lesion / 中华神经科杂志

Objective To evaluate the value of localization diagnosis of 1H-magnetic resonance spectroscopy (MRS) in the patients with structural MRI-negative temporal lobe epilepsy (TLE) based on the results of localization diagnosis of electroencephalogram (EEG) in patients with TLE without lesion.Methods Thirty-three patients with MRI-negative TLE and 33 age-and sex-matched healthy control subjects underwent MRS and took the side localized by scalp/video EEG as standard,to evaluate the value of N-acetyl-L-aspartic acid (NAA)/creatine (Cr),NAA/(Cr + choline (Cho)) in the localization diagnosis of TLE.Results There was no significant difference in NAA/Cr,Cho/Cr and NAA/(Cr + Cho) in bilateral hippocampi of 33 healthy controls,and the mean values of them in bilateral hippocampi were regarded as normal values.The NAA/Cr and NAA/(Cr + Cho) ratios were significantly decreased in both sides of the hippocampi ipsilateral and contralateral to the seizure side.Taking NAA/Cr and NAA/(Cr +Cho) as an index to localize respectively and comparing with the localization diagnosis of EEG,spectral anomalies were found in 28 cases and 29 cases respectively,and the abnormal rate reached 85％ and 88％.The localization diagnosis of 17 and 18 cases was consistent with the EEG,the rate being 52％ and 55％ respectively,but 12％ (4/33) and 18％ (6/33) were opposite.There were 36％ (12/33) and 27％ (9/33) cases who could not be localized.The localization diagnosis results by NAA/Cr and NAA/(Cr +Cho) were not significantly different.Conclusions The existence of mirror-image foci may be the main reason of the failure of localization diagnosis.1H-MRS has higher value for localization of TLE foci,and combining 1H-MRS with other techniques can further improve the accuracy and reliability of localizing the epileptic foci in patients with TLE.Compared with EEG in the diagnosis of TLE,there are no significant differences in the localization diagnosis of TLE by NAA/Cr and NAA/(Cr + Cho),which can all be the standard indices of localization diagnosis.

Dynamic contrast-enhanced MRI in the differential diagnosis of high-grade gliomas and metastasis / 实用放射学杂志

Objective To discuss the value of dynamic contrast-enhanced MRI (DCE-MRI)in differential diagnosis of high-grade gliomas (HGG)and metastasis.Methods 27 cases of HGG and 46 cases of metastasis were enrolled.All patients took contrast MRI and DCE-MRI before operation.Using the pharmacokinetic model of Extended Tofts Linear to quantitative analyze the data,volume transfer constant (Ktrans ),extracellular extravascular volume fraction (Ve )and blood plasma fraction (Vp )of the lesion's solid components and perilesional edam were obtained.Ktrans value,Ve value and Vp value were compared to judge whether there were significant differences between the two kinds of tumors.Results The values of the Ktrans ,Ve and Vp in parenchyma of HGG and metastasis were not statistically significant (P >0.05).The values of Ktrans and Ve in peritumoral edema of HGG were significantly higher than that of metastasis (P <0.05);Vp values in the peritumoral edema of HGG were lower than that of metastasis,but the difference was not statistically significant (P >0.05). Conclusion DCE-MRI can effectively distinguish HGG from metastasis through quantitative analysis of the perilesional edema.