Acta Academiae Medicinae Sinica
Objective To investigate the clinical value of diffusion-weighted imaging (DWI) for evaluating the activity of sacroiliitis in ankylosing spondylitis (AS).
Methods Totally 73 AS patients were prospectively enrolled and divided into active group (n=43) and chronic group (n=30) according to Bath ankylosing spondylitis disease activity index (BASDAI) scores and laboratory findings. Conventional magnetic resonance imaging (MRI) and DWI were performed in all subjects. Apparent diffusion coefficient (ADC) values of subchondral lesions in sacroiliac joint were independently measured by two radiologists,and the relative ADC (rADC) values were calculated. ADC and rADC values were compared between active and chronic groups. The efficiencies of ADC and rADC values for differentiating the activity of sacroiliitis were analyzed. In addition,the correlation coefficients of ADC values,rADC values,and BASDAI scores were calculated.
Results The ADC and rADC values in the active group were (0.667±0.122)×10 -3 mm 2/s and (1.715±0.343)×10 -3 mm 2/s,respectively,which were significantly higher than those of the chronic group [(0.492±0.0651)×10 -3 mm 2/s and (1.289±0.209)×10 -3 mm 2/s,respectively)] (P<0.0001). The agreement of measurement results between two radiologists was good,and all the interclass correlation coefficients were >0.81. The correlation coefficients of ADC value and rADC value with BASDAI scores were 0.82 and 0.80,respectively (P<0.0001). The optimal cutoff values of ADC value and rADC value for differentiating AS activity were 0.545×10 -3 mm 2/s and 1.467×10 -3 mm 2/s,respectively,The specificity was 81.8% for both indicators,and the sensitivity was 92.0% and 88.0%,respectively.
Conclusion DWI is helpful in the quantitative assessment of the activity of sacroiliitis in AS patients.
Objective To evaluate the feasibility and safety of enhanced recovery after surgery (ERAS) in elderly patients with colorectal cancer (CRC).
Methods A retrospective analysis was conducted on 230 CRC patients undergoing ERAS from January 2017 to January 2018. These subjects included 120 young patients (<70 years) and 110 elderly patients (≥70 years).The rates of ERAS compliance,anastomotic leakage,re-operation,and re-hospitalization,the mortality,and the average hospital stay were compared between these two groups.
Results The elderly group had significantly higher incidences including diabetes (20.9% vs. 10.8%,P=0.045),heart disease (24.5% vs. 11.7%,P=0.039),respiratory diseases (20.0% vs. 10.0%,P=0.041),and hypertension (26.4% vs. 15.0%,P=0.035) than the young group. However,these two groups were not statistically significant in terms of ERAS compliance rate (79% in the young group vs. 74% in the elderly group,P=0.574),incidence of anastomotic leakage (2.5% vs. 1.8%,P=1.000),re-operation rate (1.7% vs. 2.7%,P=0.672),re-hospitalization rate (2.5% vs. 4.5%,P=0.484),mortality rate within 30 days after operation (1.7% vs. 2.7%,P=0.672). The average hospital stay was 5 days in the young group and 7 days in the elderly group (P=0.000).
Conclusions Although the elderly patients tend to have poor general status,their ERAS compliance rate and main treatment indicators including incidence of anastomotic leakage,re-operation rate,re-hospitalization rate,and mortality rate within 30 days after surgery are not different from young patients. Thus,the ERAS program is safe and feasible for elderly CRC patients.
Objective To explored the risk factors of lymph node metastasis in papillary thyroid microcarcinoma (PTMC) by analyzing the data from the Surveillance,Epidemiology and End Results (SEER) database.
Methods The data of 31 017 patients with PTMC in the SEER database from 2002 to 2012 were retrospectively analyzed. Logistic and Cox regression analyses were used to explore the associations of the factors and the risk of lymph node metastasis in PTMC.
Results Multivariate analysis revealed that male (OR=0.673,95%CI=0.605-0.748,P=0.001),age<55 years (OR=0.683,95%CI =0.623-0.749,P=0.001),tumor size >5 mm(OR=1.172,95%CI=1.153-1.191,P=0.001),follicular variant (OR=0.641,95%CI =0.574-0.716,P=0.001),and multifocal (OR=1.662,95%CI=1.516-1.821,P=0.001) and external thyroid extension (ETE) (capsular invasion OR=1.232,95%CI=1.183-1.543,P=0.001;minor invasion OR=2.119,95%CI=1.377-3.263,P=0.001;and gross invasion OR=2.546,95%CI=2.218-2.921,P=0.001) were significantly associated with central lymph node metastasis (CLNM). Multivariate analysis revealed that tumor size >5 mm(OR=1.112,95%CI =1.091-1.133,P=0.001),male (OR=0.36,95%CI=0.322-0.401,P=0.001),age<55 years (OR=0.503,95%CI=0.453-0.559,P=0.001),follicular variant (OR=0.625,95%CI =0.549-0.711,P=0.001),multifocal (OR=2.265,95%CI =2.039-2.517,P=0.001),ETE (capsular invasion OR=2.105,95%CI=1.681-2.637,P=0.001;minor invasion OR=4.601,95%CI=3.994-5.300,P=0.001;and gross invasion OR=7.093,95%CI=4.910-10.246,P=0.001),and distant metastasis (OR=11.948,95%CI=7.523-18.975,P=0.001) were significantly associated with lateral lymph node metastasis.
Conclusions Male,young age(<55 years),large tumor(>5 mm),follicular variant-PTMC,ETE,and multifocality are the risk factors for cervical lymph node metastasis. Distant metastasis is associated with lateral lymph node metastasis. For patients at high risk of PTMC,prophylactic neck lymph node dissection is recommended.
Objective To assess the value of CT angiography using low-voltage and low-concentration contrast media (CM) combined with knowledge-based iterative model reconstruction (IMR) in patients with coronary artery bypass grafts (CABG).
Methods Totally 71 patients after CABG undergoing CT angiography in our center from June to November 2016 were prospectively enrolled and randomly assigned into groups A and B. The scan protocol for group A was 80 kVp with 300 mgI/ml contrast at an injection rate of 4 ml/s;images were reconstructed by IMR algorithm. The scan protocol for group B was 100 kVp with 370 mgI/ml contrast at an injection rate of 5 ml/s;images were reconstructed by hybrid iterative reconstruction technique. Aorta,left ventricular,and grafts were chosen as regions of interest. The image quality,radiation dose,and contrast load were compared between two groups.
Results The signal to noise ratio (SNR) and contrast to noise ratio (CNR) of the ascending aorta,descending aorta,left ventricular,and venous bridge in group A [SNR:19±5,20±5.7,19.1±4.9,and 37±34;CNR:17±4.7,18±5,16±5.4,and 34±32] were significantly higher than those in group B [SNR:16±6 (P=0.012),15.6±5.5 (P=0.002),15±6 (P=0.002),24±8.3 (P=0.035);CNR:14±5.5 (P=0.010),13.8±5(P=0.002),13±5.7 (P=0.014),21±7.8 (P=0.031)],except for left internal mammary artery graft (LIMA),which was not inferior to that in group B. An effective radiation dose reduction of 49% was achieved in group A [(2.3±0.4) mSv,compared with group B (4.5±0.5) mSv (P=0.000)]. The iodine load of group A was (20±1.4) g compared with (29±1.6) g in group B,resulting in a reduction of 31% (P=0.000).
Conclusions The low tube voltage (80 kVp) and low contrast protocol combined with IMR in patients with CABG can reduce radiation dose and improve image quality of aorta,left ventricular and venous graft. The image quality of LIMA graft in low dose group is not inferior to that in regular dose group.
Objective To investigate the college students’awareness of acquired immune deficiency syndrome (AIDS) and its influencial factors in universities implementing “Red Ribbon in Colleges” event.
Methods A multistage random sampling method was used to select 2057 students from 8 universities. Among them,1977 students were surveyed by quantitative questionnaires and 80 students were interviewed qualitatively. SPSS 24.0 software was used for data processing and analysis.
Results A total of 1977 students was investigated,among whom the overall awareness rate of AIDS-related knowledge was 88.21%. The awareness rate of the three major routes of AIDS transmission (i.e. sexual transmission,blood transmission,and mother-to-child transmission) were more than 90%,and the awareness rate of “Can mosquito bites spread AIDS” was lowest (72.99%). The awareness rate of AIDS-related knowledge was significantly higher among students who had attended the “Red Ribbon in Colleges” event (95.36%,P<0.001),followed by those who had received AIDS prevention education as a freshman (92.22%,P<0.001),had filled in AIDS prevention questionnaires (91.42%,P<0.001),and had attended other AIDS-related health education events in schools or colleges (91.36%,P<0.001),and the differences were statistically significant when compared with students who had not attended any of these events. Multivariate unconditional Logistic regression analysis showed that attending the “Red Ribbon in Colleges” event (OR=2.973,95%CI=1.684-5.249,P<0.001),receiving AIDS prevention education as a freshman (OR=2.944,95%CI=2.073-4.181,P<0.001),attending other AIDS-related health education in schools or colleges (OR=1.590,95%CI=1.141-2.217,P=0.006),majoring in engineering disciplines (OR=2.756,95%CI=1.846-4.114,P<0.001),junior students (OR=1.916,95%CI=1.216-3.020,P=0.005),living in central China (OR=1.868,95%CI=1.085-3.218,P=0.024),and living in northern China (OR=1.774,95%CI=1.159-2.716,P=0.008) were favourable factors for high awareness rate. Qualitative analysis indicated that students rated highly of the “Red Ribbon in Colleges” event.
Conclusion The “Red Ribbon in Colleges” event and other AIDS education programs help to increase the college students’awareness of AIDS-related knowledge.
Objective To analyze 68Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) imaging features of tumor-indud osteomalacia (TIO) patients with negative 99mTc-HYNIC-TOC single photo emission computed tomography (SPECT) findings and to investigate the value of 68Ga-DOTA-TATE PET/CT in accurate localization of culprit tumors.
Methods We retrospectively analyzed 68Ga-DOTA-TATE PET/CT imaging features including location,size,density,the maximum and mean standardized uptake value in 37 TIO patients with negative 99mTc-HYNIC-TOC SPECT findings.
Results Totally 37 solitary TIO tumors,including 35 phosphaturic mesenchymal tumors and 2 spindle cell tumors confirmed by pathological examinations,were detected via 68Ga-DOTA-TATE PET/CT scans in the included 37 cases. These 37 TIO tumors showed obviously increased activities,with an maximum standardized uptake value of 7.2±4.3 and mean standardized uptake value of 4.3±2.4. The average maximum diameter was (1.9±0.7) cm. The majority of the tumors occurred in the lower extremities (19/37),followed by the trunk (11/37),maxillary/mandibular bone (5/37),and upper extremities (2/37). In addition,24 bone lesions were located in long bones of lower extremities (13/24),most of which demonstrated eccentric growth (8/13). Osteolytic changes (14/24) were observed mainly in the lesions via the corresponding CT imaging;meanwhile,sclerotic changes presented in nine cases. Of the 13 soft-tissue lesions,the majority (10/13) showed well-circumscribed isodense or hypodense nodules on the CT images,with spot calcification in one lesion located in the pleura.
Conclusions 68Ga-DOTA-TATE PET/CT scans can detect the TIO culprit tumors miss-diagnosed by 99mTc-HYNIC-TOC SPECT. Somatostatin-receptors highly expressed lesions with focal osteolytic or osteosclerotic change in bone and isodense or hypodense nodules in soft tissue will favor the diagnosis of TIO tumors.
Objective To investigate the correlation between CYP2C19 gene polymorphism and elderly cerebral infarction.
Methods Two polymorphisms including rs4244285 and rs4986893 of the CYP2C19 gene were detected by gene chip technology in 72 elderly patients with acute cerebral infarction (stroke group) and 77 otherwise healthy controls. The clinical data and the polymorphism distribution of CYP2C19 were compared,and the potential association between genetic polymorphism and cerebral infarction was analyzed by Logistic regression.
Results The frequencies of rs4244285 GG (45.83% vs. 63.64%,χ 2=4.766,P=0.029) and rs4244285 A allele (34.03% vs. 22.73%,χ 2=4.695,P=0.030) were significantly higher in stroke group than in control group. There were no significant differences in the distribution of the alleles of rs4986893 or the rs4244285 GA and AA between these two groups (all P>0.05). After the conventional cerebrovascular risk factors including gender,age,body mass index,smoking,and total cholesterol were adjusted,Logistic regression analysis showed that rs4244285 A allele significantly increased the stroke risk [the additive model AA vs. GG:OR=2.564,95%CI=1.181-5.566,P=0.017;the dominant model AA/AG vs. GG:OR=2.763,95%CI=1.343-5.685,P=0.006].
Conclusion CYP2C19 genetic polymorphism may be associated with the increased risk of cerebral infarction in the elderly,although future well-designed studies with larger sample sizes are warranted.
Objective To verify the expressions of genes associated with colorectal cancer with hyperglycemia and evaluate their diagnostic values.
Methods Tumor tissues,distal normal intestinal mucosa,and peripheral blood samples were harvested from 109 colorectal cancer patients and peripheral blood samples from 30 diabetes patients and 30 healthy volunteers. The mRNA expressions of glucose regulated protein 78 (GRP78),NADPH oxidase-1 (NOX1),carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5),heat shock protein 60 (HSP60),and histone deacetylase 1(HDAC1) were detected by real-time quantitative polymerase chain reaction. The correlation between the gene expressions and clinicopathological parameters in colorectal cancer patients were analyzed using Pearson’s correlation analysis. Diagnostic test accuracy evaluation was used to calculate the sensitivity,specificity,accuracy,predictability,Youden index,and likelihood ratio of serum gene expressions in colorectal cancer patients,and the receiver operating characteristic (ROC) curves were drawn. The area under the ROC curve was calculated to evaluate the diagnostic efficiency of the combined detection of multiple genes.
Results The mRNA levels of GRP78 (P=0.001),NOX1 (P=0.022),CEACAM5 (P=0.000),HSP60 (P=0.044),and HDAC1 (P=0.047) were positively correlated with the fasting blood glucose level. The mRNA expressions of NOX1 (P=0.000,P=0.008) and HDAC1 (P=0.000,P=0.037) in tissues and serum were significantly higher in colorectal cancer patients than in patients with normal blood glucose levels. The NOX1 mRNA expression was positively correlated with the diameter of colorectal cancer (P=0.013),and the HDAC1 mRNA expression was significantly correlated with the tumor site (P=0.049),depth of primary tumor invasion (P=0.025),and TNM stage (P=0.042). The areas under the ROC curves of NOX1,CEACAM5,and HDAC1 were 0.931,0.852,and 0.860 respectively (all P=0.000). The specificity,accuracy,and negative predictive value of NOX1,HDAC1 mRNA expression in colorectal cancer patients with hyperglycemia were all above 90%. The diagnostic sensitivity and specificity of the combined detection of NOX1,CEACAM5,and HDAC1 were 98.82% and 99.93%,respectively.
Conclusion Combined detection of genes associated with colorectal cancer accompanied by hyperglycemia can improve the diagnostic efficiency of early screening.
Objective To identify and verify the distribution of Telocytes derived from heterogeneous interstitial cells in the vital organs of ApoE -/- mice.
Methods Heart,kidney,and liver tissues were harvested from ApoE -/- adult mice. Immunohistochemical assays were performed by using different immunobiological markers.
Results Telocytes were found in these vital organs. The expressions of immunobiological markers differed among different organs. CD34,CD117,and CD28 were positively expressed in Telocytes in cardiac tissue;CD117 and plateled-derived growth factor-α were negatively expressed in Telocytes in renal tissue;and CD117 and plateled-derived growth factor receptor-α had negative expression in Telocytes in hepatic tissue. Furthermore,the distribution of Telocytes also differed in the same organ.
Conclusions Telocytes exist in the vital organs of ApoE -/- mice,as demonstrated by immunohistochemisty assay. The expressions of immunobiological markers differ among Telocytes in different organs.
Objective To investigate the characteristics of nocturnal intermittent hypoxemia in patients with heart failure(HF) with preserved ejection fraction(HFpEF).
Methods Patients(n=854) who completed sleep test and echocardiography from January 2011 to December 2014 were retrospectively studied. HF patients with an ejection fraction(EF) of ≥50% were included in the HFpEF group(n=112) while HF patients with an EF of <50% included in the group of HF patients with reduced EF(HFrEF)(n=104). Respiratory events and minimum nocturnal saturation(minSaO2) were recorded by home sleep testing,and the percentage of total sleep time with saturation <90%(T90SaO2) were calculated.
Results Compared with patients without HF,subjects with HFpEF and HFrEF had more breathing events[13(5,29)/h vs. 18(6,36)/h,and 21(8,45)/h,P<0.001],lower minSaO2[85(80,87)% vs. 82(77,86)% and 83(78,87)%,P<0.001] and relatively longer T90SaO2[3.0(0.4,15.5)% vs. 6.0(1.5,24.8)% and 6.7(1.3,14.4)%,P<0.001]. The HFpEF group had significantly higher odds of moderate-severe hypoxemia(minSaO2<85%) during sleep than those without HF(OR=2.02,95%CI=1.34-3.11,P<0.001),with the significance persisting after adjusting for covariates including age,gender,hypertension,diabetes,coronary heart disease,renal dysfunction,and smoking(OR=1.85,95%CI=1.20-2.90,P=0.006).
Conclusion Patients with HFpEF have frequent nocturnal intermittent hypoxemia,which warrants further investigations to evaluate if remission of night-time hypoxemia may improve long-term prognosis in this cohort.
Objective To investigate the effect of adipose mesenchymal stem cells(AMSCs) on the peripheral blood lymphocyte(PBL) in psoriasis vulgaris(PV) patients and the expression and secretion profiles of related inflammatory cytokines in the PBL.
Methods AMSCs from three PV patients were co-cultured with PBL. Peripheral blood regulatory cells(Treg) and T helper cell 17(Th17)ratio was measured by flow cytometry. The anti- and pro-inflammatory cytokines expressed and secreted by PBL were detected by quantitative real-time polymerase chain reaction(qRT-PCR) and enzyme-linked immunosorbent assay(ELISA).
Results The Treg/total lymphocyte ratio was significantly higher in the healthy people AMSCs+PBL co-culture group[(3.2±0.5)%;P=0.001],but AMSCs in patients had a tendency to promote the proliferation of Treg cells [(1.3±0.2)%],with no significant difference(P=0.485) when compared with the PBL culture alone group[(1.0±0.1)%]. qRT-PCR showed that the ability of PBL in expressing Treg transcription factor forkhead box p3 and transforming growth factor(TGF)-β mRNA was significantly lower in psoriasis AMSCs+PBL co-culture group than in the healthy people AMSCs+PBL co-culture group(P=0.00,P=0.03),AMSCs had a tendency to promote the expression of interlukin(IL)-10 in peripheral blood lymphocytes,but there was no significant difference(P=0.09).ELISA showed the PBL in healthy people AMSCs+PBL co-culture group secreted the anti-inflammatory cytokine IL-10[(156.9±41.8) ng/μl] and TGF-β[(2774.1 ± 526.4) ng/μl];in contrast,the abilities of PBL in PV patient AMSCs+PBL co-culture group in secreting the anti-inflammatory cytokines has a downward trend:IL-10[(90.4±28.8) ng/μl] and TGF-β[(1597.9±55.7) ng/μl],although the differences were not statistically significant. After the co-culture,the proportion of Th17 cells in the psoriasis AMSCs+PBL co-culture group[(0.8±0.3)%] showed a decreasing trend when compared with the PBL culture alone group[(1.1±0.1)%],although the results were not statistically significant. Also,the proportion of Th17 cells showed no significant difference between PV patient AMSCs+PBL co-culture group and healthy people AMSCs+PBL co-culture group. Finally,both the psoriasis AMSCs+PBL co-culture group and the healthy people AMSCs+PBL co-culture group showed no obvious inhibitory effect on the expression and secretion of Th17 transcription factor retinoid-related orphan nuclear receptor γt and pro-inflammatory cytokines IL-17 and IL-23 in PBL,and there was no significant difference between these two groups.
Conclusions AMSCs in PV patients have decreased ability in regulating the anti-inflammatory function of peripheral blood Treg lymphocytes. However,they have no effect on the proinflammatory effect of peripheral blood Th17 lymphocytes.
Objective To investigate the risk factors of asthma attack.
Methods In this open cohort study,74 492 initially healthy subjects aged 20 years or more in a longitudinal multi-center health management cohort in Shandong province from January 2007 to December 2015 were enrolled in this study. These subjects had no baseline bronchial asthma or other chronic airway disease and did not migrate to other provinces in the past 10 years. All subjects were followed up till 2016,and the asthma attack and its influencing factors were analyzed. The baseline data including sociodemographic data,smoking history,disease histories,and family disease histories were collected and analyzed by Poisson regression analysis.
Results The regression analysis showed that age between 40 and 50 years(RR=3.3,95%CI=1.8-6.0),female(RR=1.6,95%CI=1.1-2.3),nasal polyps(RR=9.5,95%CI=2.3-39.6),pneumonia(RR=6.5,95%CI=3.7-11.2),bronchitis(RR=8.7,95%CI=5.1-14.7),and chronic obstructive pulmonary disease(RR=6.6,95%CI=3.1-13.8) significantly increased the risk of asthma attack.
Conclusion Age,gender,and previous histories of certain respiratory tract diseases increase the risk of asthma attack.
Objective To analyze the risk factors of multidrug-resistant bacterial infections in patients with chronic rhinosinusitis.
Methods The clinical data of 221 patients with chronic rhinosinusitis who were treated in our center from January 2010 to January 2017 were collected retrospectively. Specimens were collected for bacterial culture and antibiotic susceptibility testing. The risk factors for multidrug-resistant bacterial infections were analyzed.
Results Univariate analysis showed that combined use of 3 or more antibiotics,high visual analogue scale score,high Lund-Kennedy score,long disease course(>5 years),high frequency of acute infections(more than 3 times a year),long duration of acute infection(>7 days),recurrent upper respiratory tract infections(>3 times per year),chronic otitis media,smoking history,allergic rhinitis,poor drainage,high frequency of antimicrobial use(≥3 times/year),use of multiple antibiotics(more than 3 types),aged over 60 years,and use of antibacterial drugs for over 7 days were the risk factors for production of multi-drug-resistant organism(MDRO) in patients with chronic sinusitis(all P<0.05). After adjusting for other factors,combined use of 3 or more antibiotics,high frequency of acute infections(more than 3 times a year),recurrent upper respiratory tract infections(>3 times per year),smoking history,allergic rhinitis,poor drainage,and high frequency of antimicrobial use(≥3 times/year) remained the risk factors for MDRO in patients with chronic sinusitis(all P<0.05).
Conclusions Multidrug-resistant bacterial infections in patients with chronic sinusitis can be caused by a variety of factors. In the clinical practice,by focusing on the major risk factors,a comprehensive management strategy should be adopted to reduce the production of MDRO and improve the therapeutic outcomes.
Objective To investigate the value of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in detecting different stages of liver fibrosis in rats.
Methods Rat models of liver fibrosis were induced by carbon tetrachloride intraperitoneal injection for 4 - 12 weeks (n=45). The control group was applied with 0.9% saline (n=15). The MRI protocol contained both dynamic contrast-enhanced sequence (60 continuous scans within 3 minutes,including three pre-contrast measurements) and multiple hepatobiliary-phase acquisitions (every 5 minutes after contrast injection,60 minutes in total). METAVIR score was used to grade liver fibrosis:normal (F0),mild fibrosis (F1 - F2),and advanced fibrosis (F3 - F4). Liver perfusion parameters [transfer constant (K trans),extravascular extracellular volume fraction (Ve),initial area under curve (iAUC),maximum relative enhancement (REmax),and time of maximum RE (Tmax)] as well as hepatobiliary-phase parameters [RE at different time point,the decrease of RE (REchange=RE3 min - RE60 min),and elimination half-life of RE (TRE1/2)] were measured and compared with ANOVA analysis and Spearman rank correlation.
Results Thirty-one rats completed MRI exams and were then divided into normal (n=10),mild fibrosis (n=10),and advanced fibrosis (n=11) groups. K trans,Ve and iAUC decreased as liver fibrosis progressed (r=-0.631,P=0.002;r=-0.503,P=0.017;r=-0.446,P=0.037). K trans and Ve showed significant differences among three groups(F=7.011,P=0.005;F=4.656,P=0.023). K trans and Ve were significantly lower in advanced fibrosis group than in normal group (P=0.001,P=0.009). There were statistical significant differences of Tmax,TRE1/2 and REchange among groups(F=6.633,P=0.005;F=5.493,P=0.010;F=5.343,P=0.014). Compared to normal and mild fibrosis groups,advanced fibrosis group had significantly longer Tmax and TRE1/2 (P=0.005,P=0.004;P=0.008,P=0.008)and significantly lower REchange(P=0.007,P=0.012).
Conclusion Perfusion and multi-hepatobiliary-phase parameters such as K trans,Ve,Tmax, TREI/2 and REchange obtained from Gd-EOB-DTPA-enhanced MRI,may be valuable for detecting and staging liver fibrosis.
Objective To analyze the infection status of human papilloma virus (HPV),Ureaplasma urealyticum (UU),Chlamydia trachomatis (CT),and Neisseria gonorrhoeae (NG) in clinical patients.
Methods The laboratory specimens including urine,urethral swabs,and cervical swabs from 870 patients from January 1st 2014 to December 31st 2017 were retrospectively analyzed. HPV-DNA was detected by multiplex fluorescent PCR,and the UU-RNA,CT-RNA,and NG-RNA were determined by isothermal nucleic acid amplification. The positive rate of each pathogen and the distribution of positive rate between male and female patients were calculated. The samples were further divided into HPV-positive group and HPV-negative group,and the positive rates of UU-RNA,CT-RNA,and NG-RNA in these two groups were compared.
Results The highest positive rate was 53.68%(467/870) for UU-RNA,followed by HPV-DNA [32.41%(282/870) ]and NG-RNA [2.18%(19/870)]. The total positive rate of high-risk (HR)-HPV(subtypes:16,18,31,33,35,39,45,51,52,56,58,59,and 68) [31.52%(209/663)]and UU in female patients [60.93%(404/663)] was significantly higher than that in male patients [17.39%(36/207),30.34%(63/207)](both P<0.001). The male patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [22.58%(7/31) vs. 4.54%(8/176)](P<0.001). The female patients had significantly higher CT positive rate in HR-HPV-positive group than in HR-HPV-negative group [10.5%(21/200) vs. 5.61%(26/463)](P=0.024). The UU-RNA positive rate of females in the low-risk (LR)-HPV (subtypes:6 and 11) positive group was significantly higher than that in LR-HPV negative group [70.83%(34/48) vs.2.11%(13/615)](P<0.001).
Conclusions Women are more susceptible to HR-HPV and UU infections. HR-HPV-positive patients are more likely to experience CT infection. In contrast,co-infection with UU is more common in LR-HPV-positive females.
Hepatocyte growth factor (HGF) is a multifunctional cytokine that is related to many diseases. HGF mainly contributes to cell migration,proliferation,and survival and regulates vascular angiogenesis,matrix deposition,and degradation of wound healing. HGF also promotes wound reepithelialization and reduces scar formation. This review article summarizes the role of HGF in wound repair and the relationship between HGF and other growth factors,especially when applied for the clinical treatment of chronic skin ulcers.
Long non-coding RNA (lncRNA) refer to transcripts longer than 200 nucleotides that have a low coding potential. Autophagy,a unique life phenomenon of eukaryotic cells,removes excess or damaged organelles during cell growth and development and plays a key role in maintaining homeostasis. As a key regulator of cellular metabolism,lncRNA are involved in disease treatment by regulating autophagy. This article summarizes the role of lncRNA in the treatment of cancer,cardiovascular and cerebrovascular diseases,neurodegenerative diseases,and bacterial infections and analyzes the molecular mechanisms of lncRNA in regulating autophagy,along with prospects of its applications in other areas.
Exosomes are 40 - 100 nm vesicular bodies that are formed by the fusion of the multi-vesicular bodies and the plasma membrane and can be released into the extracellular space by a variety of cells through exocytosis. With rich active genetic substances such as proteins,mRNAs,and microRNAs,exosomes can exert their biological functions by transferring cargos to the recipient cells. In recent years,the roles of exosomes in oncology have been rapidly recognized. Some of them have been investigated in phase I trials. Preliminary studies have demonstrated that exosomes play important roles in the physiological and pathological processes of chronic inflammatory airway diseases such as bronchial asthma and chronic obstructive pulmonary disease. Meanwhile,exosomes may serve as useful biomarkers in the diagnosis and treatment of chronic inflammatory airway diseases.
While thyroid nodules have relatively low incidence in children and adolescents,they are at high risk of malignancy. In addition,the clinical manifestations,biological behaviors,assessment methods,indications of fine-needle aspiration,and treatment principles also differ from those in adults. In the past,the assessment,treatment,and follow-up of thyroid nodules in children and adolescents follow the guidelines for adult patients,which are actually not applicable for children and adolescents in the real-world clinical settings. Based on the latest international guidelines on the management of thyroid nodules and differentiated thyroid cancer,this article summarizes the clinical features,pathological characteristics,evaluation methods,treatments,and follow-up of thyroid cancer in children and adolescents.
Heart failure is a serious condition with high prevalence and mortality. The application of the novel big data analysis in heart failure can improve the management of this condition,especially in terms of diagnosis,classification,and prognostic prediction. This articles reviews relevant literature and validates the role of big data analysis for heart failure patients.
We reported a case of supratentorial extra-axial hemangioblastoma diagnosed by magnetic resonance imaging (MRI). As a simple solid mass,this tumor has its unique MRI features due to its tissue structures.
Peripheral neurogenic tumors can be featured by entering-and-exiting-nerve sign,which,however,is rarely seen in patients with spinal schwannoma. In this article we report a spinal schwannoma case with entering-and-exiting-nerve sign.
