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Prognostic value of coronary atherosclerosis progression evaluated by coronary CT angiography in patients with stable angina
Gu, H; Gao, Y; Hou, ZH; Schoepf, UJ; Snyder, AN; Duguay, TM; Wang, XM; Lu, B
EUROPEAN RADIOLOGY 2018年 28卷3期 页码:1066-1076
MULTIDETECTOR COMPUTED-TOMOGRAPHY; ARTERY CALCIUM; INTRAVASCULAR ULTRASOUND; PLAQUE CHARACTERIZATION; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; AMERICAN-COLLEGE; NATURAL-HISTORY; RISK; ASSOCIATION
To investigate the progression of coronary atherosclerosis burden by coronary CT angiography (CCTA) and to demonstrate its association with the incidence of major adverse cardiac events (MACE). We retrospectively studied patients with stable angina who had undergone repeat CCTA due to recurrent or worsening symptoms. Lipid-rich, fibrous, calcified and total plaque burden as well as coronary diameter stenosis were quantitatively analysed. The incidence of MACE during follow-up was determined. The final cohort consisted of 268 patients (mean age 52.9 +/- 9.8 years, 71 % male) with a mean follow-up period of 4.6 +/- 0.9 years. Patients with lipid-rich, fibrous, calcified and total plaque burden (%) progression, as well as coronary diameter stenosis (%) progression had a significantly higher incidence of MACE than those without (all p < 0.05). The progression of lipid-rich plaque (HR = 1.601, p = 0.021), total plaque burden (HR = 2.979, p = 0.043) and coronary diameter stenosis (HR = 4.327, p < 0.001) were independent predictors of MACE (all p < 0.05). Patients presenting with recurrent or worsening symptoms associated with coronary artery disease who have coronary atherosclerosis progression on CCTA are at an increased risk of future MACE. aEuro cent Repeat CCTA can provide information regarding the progression of coronary atherosclerosis. aEuro cent Coronary atherosclerosis progression at CCTA is independently associated with MACE. aEuro cent CCTA findings could serve as incremental predictors of MACE.
Identification of a novel mutation in the FGFR3 gene in a Chinese family with Hypochondroplasia
Chen, J;Yang, JF;Zhao, SZ;Ying, H;Li, GM;Xu, C
GENE 2018年 641卷 页码:355-360 影响因子:2.319
GROWTH-FACTOR RECEPTOR-3; MISSENSE MUTATIONS; ACHONDROPLASIA; DOMAIN; DYSPLASIAS; PHENOTYPE; DWARFISM
Background: Hypochondroplasia (HCH; OMIM 146000) is a common autosomal dominant skeletal dysplasia characterized by disproportionate short stature, short extremities, relative macrocephaly, and lumbar lordosis. Because of its clinical and genetic heterogeneity, gene mutational analysis is particularly important in diagnosis and the phenotypes may be ameliorated if diagnosed early.;-;Materials and methods: In this study, we examined a Chinese family with HCH, performed an inductive analysis of their clinical features and radiographic results, and applied targeted exome sequencing (TES) technology to perform a molecular diagnosis.;-;Results: The proband and his mother all presented disproportionate short stature, short, stubby extremities, unchanged interpedicular distances from L1 - L5, and short iliac bones, with a 'fish mouth -shaped' sciatic notch. The mother received induced abortion recently because an ultrasound showed short femur length of her fetus at 24-week gestation. Eventually, a novel heterozygous mutation (c.1145G > A) in FGFR3 was identified by TES in the proband, his mother, and her fetus; this causes the substitution of glycine with aspartic acid in codon 382.;-;Conclusions: In this study, we diagnosed a Chinese pedigree with HCH based on clinical data, radiographic features, and genetic testing results. Our results extend the genetic mutation spectrum of FGFR3 and demonstrate that TES is an effective method for the diagnosis of skeletal dysplasia in clinical practices.
Effects of Melatonin Levels on Neurotoxicity of the Medial Prefrontal Cortex in a Rat Model of Parkinson's Disease
Li, Y;Wang, SM;Guo, L;Zhu, J;Wang, Y;Li, L;Zhao, YX
CHINESE MEDICAL JOURNAL 2017年 130卷22期 页码:2726-2731
COGNITIVE IMPAIRMENT; DOPAMINERGIC-NEURONS; OXIDATIVE STRESS; CEREBELLUM; DISORDERS; DEMENTIA; DEATH; BAX
Background: Damage of the medial prefrontal cortex (mPFC) results in similar characteristics to the cognitive deficiency seen with the progress of Parkinson's disease (PD). Since the course of mPFC damage is still unclear, our study aimed to investigate the effects of melatonin (MT) on neurotoxicity in the mPFC of a rat model of PD.;-;Methods: One hundred and fifty-four normal, male Wistar rats were randomly divided into the following five groups: normal + normal saline (NS), normal + 6-hydroxydopamine (6-OHDA), sham pinealectomy (PX) + 6-OHDA, PX + 6-OHDA, and MT + 6-OHDA. 6-OHDA was injected into the right substantia nigra pars compacta (SNc) and ventral tegmental area (VTA) of each group, except normal + NS, 60 days after the PX. In the MT treatment group, MT was administered immediately after the intraperitoneal injection at 4 p.m. every day, for 14 days. Neuronal apoptosis in the mPFC was examined using the TUNEL method, while the expression of tyrosine hydroxylase (TH), Bax, and Bcl-2 in this region was measured using immunohistochemistry. The concentration of malondialdehyde (MDA) in the mPFC was examined using the thiobarbituric acid method.;-;Results: Rats in the normal + 6-OHDA and sham PX + 6-OHDA groups were combined into one group (Group N + 6-OHDA) since there was no significant discrepancy between the groups for all the detected parameters. Apoptosis of cells in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups was successively significantly increased (Hc = 256.25, P < 0.001). The gray value of TH (+) fibers in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups was also successively significantly increased (F = 99.33, P < 0.001). The staining intensities of Bax and Bcl-2 were as follows: Group NS +/+, Group MT + 6-OHDA ++/+, Group N + 6-OHDA ++/+, and PX + 6-OHDA+++/+. The concentrations of MDA in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups were significantly increased in sequence (Hc = 296.309, P < 0.001).;-;Conclusions: Neuronal damage of the VTA by 6-OHDA might induce VTA-mPFC nerve fibers to undergo anterograde nerve damage, in turn inducing transneuronal damage of the mPFC. PX significantly exacerbated the neurotoxicity in the mPFC, which was induced by the neuronal injury of the VTA. However, MT replacement therapy significantly alleviated the neurotoxicity in the mPFC.
Rhabdoid Meningioma Arising Concurrent in Pulmonary and Intracranial with a Rare Malignant Clinical Progression: Case Report and Literature Review
Zhao, P;Li, N;Cao, JF;Lin, XT;Liang, CH
WORLD NEUROSURGERY 2017年 107卷
OF-THE-LITERATURE; METASTASES; FEATURES
BACKGROUND: Rhabdoid meningioma (RM) is an unusual variant of meningioma, classified as World Health Organization grade III. Although its recurrence is common, extracranial metastasis is rare and usually misdiagnosed. The transfer mechanism and pathway are ambiguous; once the metastasis occurs, the prognosis is poor, and there is no effective management. The present case is the first report of concurrent intracranial and pulmonary RM with rapid and widespread metastasis. We hope this report can serve as a helpful reference for clinicians and radiologists.;-;CASE DESCRIPTION: A 39-year-old woman presented to our hospital complaining of headache and memory disturbances. Magnetic resonance imaging (MRI) of the brain revealed a well-defined, inhomogeneous signal tumor with intense enhancement and severe peritumoral edema. Postoperatively, RM (grade III) was confirmed by histopathology. A chest CT performed 2 weeks later revealed an isolated lung mass, which was confirmed as RM on subsequent surgery. Three months after the first radiotherapy, the cancer had progressed uncommonly rapidly with widespread metastasis to the cerebellum, lung, kidney, and thigh. Gamma knife radiosurgery, chemotherapy, and moleculartargeted therapy were performed; however, the patient's condition continued to worsen, and she died 1 year after the initial operation.;-;CONCLUSIONS: Intracranial RM is a relatively rare tumor with the potential for wide intracranial and extracranial transfer. Cystic components and necrosis can be seen in this type of meningioma. Metastatic meningioma should be kept in mind when dealing with isolated lung lesions. This case report may serve as a helpful reference for clinicians and radiologists.
Effects of Pinealectomy and Gonadectomy on Olfactory Bulb Dopaminergic Neurons in Rats
Li, Y;Zhu, J;Wang, Y;Guo, L;Li, L;Wang, D
CHINESE MEDICAL JOURNAL 2017年 130卷19期 页码:2302-2306
CELL-DEATH; OXIDATIVE STRESS; MELATONIN; DISEASE; APOPTOSIS; MECHANISM
Background: Olfactory disorder is an early manifestation of Parkinson's disease (PD), likely to be associated with abnormalities of the dopaminergic neurons in the olfactory bulb (OB); however, the causes of olfactory disorder in PD are not entirely clear. Some studies showed that melatonin (MT) and androgens (mainly testosterone, T) might participate in the pathogenesis of PD. The research aimed to investigate effects of MT or T deficiency on OB dopaminergic neurons in rats.;-;Methods: One hundred and twenty normal male Wistar rats were randomly divided into the control, sham operation pinealectomy (PX), sham operation gonadectomy (GDX), PX, GDX, and PX + GDX groups. After 60 days, glial cell hyperplasia and neuronal apoptosis were examined with hematoxylin and eosin and the TUNEL method; the expression levels of tyrosine hydroxylase (TH), Bax, and Bcl-2 were measured using immunohistochemistry (IH) by the streptavidin peroxidase conjugated method. Comparison among multiple sets used analysis of variance and LSD method or Kruskal-Wallis test and Nemenyi method.;-;Results: There were no significant differences between the sham operation groups and the control group; thus, they were merged into Group A. There was no significant glial cell hyperplasia (P > 0.05) or change in shape in any of the groups after PX or GDX. The number of apoptotic cells in Groups A (1.41 +/- 0.56), PX (12.31 +/- 4.68), GDX (20.52 +/- 5.13), and PX + GDX (30.23 +/- 5.25) successively significantly increased (P < 0.05). The number of TH (+) cells in Groups A (42.62 +/- 5.63), PX (37.31 +/- 4.32), GDX (31.07 +/- 4.21), and PX + GDX (25.22 +/- 3.66) was successively significantly decreased (P < 0.05). The gray value of TH (+) cells and fibers in Groups A (98.51 +/- 10.36), PX (108.96 +/- 13.01), GDX (119.02 +/- 12.98), and PX + GDX (128.99 +/- 13.39) was successively significantly increased (P < 0.05). The results of Bax staining were as follows: Group A+, Group PX++, Group GDX++, and Group PX+ GDX+++, the results of Bcl-2 in all groups were +.;-;Conclusions: PX or GDX could lead to OB neurotoxicity in the following groups of rats in the following order: PX < GDX < PX + GDX. PX or GDX increased the ratio of Bax/Bcl-2. The effect of PX and GDX was equal, but both were less than that of PX + GDX. Neurotoxicity as a result of PX or GDX was not related to inflammation.
Correlation Between Bone Marrow Blasts Counts With Flow Cytometry and Morphological Analysis in Myelodysplastic Syndromes
Huang, M;Zhao, XY;Xu, HZ;Liu, SQ;Wang, Z;Sui, XH;Li, J
ANNALS OF LABORATORY MEDICINE 2017年 37卷5期 页码:450-453
Relationships between urinary electrolytes excretion and central hemodynamics, and arterial stiffness in hypertensive patients
Han, WZ;Han, X;Sun, NL;Chen, YC;Jiang, SL;Li, M
HYPERTENSION RESEARCH 2017年 40卷8期 页码:746-751
CONTROLLED DIETARY INTERVENTION; PREDICTS CARDIOVASCULAR EVENTS; RANDOMIZED CONTROLLED-TRIAL; TARGET-ORGAN DAMAGE; PULSE-WAVE VELOCITY; LOW-SALT DIET; BLOOD-PRESSURE; POTASSIUM SUPPLEMENTATION; ENDOTHELIAL FUNCTION; SODIUM-EXCRETION
High sodium intake plays an important role in the onset and exacerbation of hypertension. However, the relationships between urinary electrolytes excretion and central hemodynamics and between urinary electrolyte excretion and arterial stiffness are still the subject of debate. This study sought to clarify the associations of salt intake with central aortic pressure and arterial stiffness indicators. A total of 431 untreated hypertensive individuals were recruited into the study. Twenty-four-hour urinary samples were collected to measure the excretion of urinary electrolytes. Central hemodynamics parameters and brachial-ankle pulse wave velocity (baPWV) were measured. We evaluated the independent relationship between urinary sodium or potassium excretion and the abovementioned indices. The mean 24-h urinary sodium of all subjects was 166.6 +/- 70.0 mmol/24 h. With increases in urinary sodium excretion, central blood pressure and baPWV values markedly increased. Multiple regression analysis showed that urinary sodium was independently associated with increases in central systolic blood pressure, central diastolic blood pressure, the augmentation index, and baPWV. Significant correlations were identified between high dietary sodium and central hemodynamics and between high dietary sodium and arterial elasticity. Prospective interventional studies in hypertensive patients may be required to determine the effect of salt intake on central hemodynamics.
Pulmonary pleomorphic carcinoma A case report and review of the literature
Zhang, XW;Wang, Y;Zhao, LP;Jing, HY;Sang, SW;Du, JJ
MEDICINE 2017年 96卷29期
LUNG
Rationale: Pleomorphic carcinoma (PC) is a rare malignancy of the lung. It has a dual-cell component of spindle and/or giant cells, and of epithelial cells.;-;Patient Concerns and Diagnoses: We presented a case of PC. A 69-year-old healthy asymptomatic woman who was occasionally found an abnormal shadow on her chest X-rays. A computerized tomography scan showed a mass located in the left lingular lobe and the percutaneous lung biopsy pathology confirmed sarcomatoid cancer.;-;Interventions and Outcomes: The patient underwent pneumonectomy. A diagnosis of PC was confirmed after surgery through immunohistochemistry. The pathological stage was T2aN0M0 (Ib). Due to the patient's refusal, adjuvant chemotherapy was not taken and she has been living disease free for 12 months after the surgery.;-;Lessons: PC of the lung represents a rare pathological entity. Surgical resection remains the cornerstone of the treatment and may offer the possibility of long-time survival in early-stage patients. More cases of PC should be reported to establish an optimal management.
The impact of dual-source parallel radiofrequency transmission with patient-adaptive shimming on the cardiac magnetic resonance in children at 3.0T
Wang, HP;Qiu, LY;Wang, GB;Gao, F;Jia, HP;Zhao, JY;Chen, WB;Wang, CY;Zhao, B
MEDICINE 2017年 96卷23期
CONGENITAL HEART-DISEASE; RF TRANSMISSION; FEASIBILITY; 3T; EXPERIENCE; ARTIFACTS; MRI; CMR
The cardiac magnetic resonance (CMR) of children at 3.0T presents a unique set of technical challenges because of their small cardiac anatomical structures, fast heart rates, and the limited ability to keep motionless and hold breathe, which could cause problems associated with field inhomogeneity and degrade the image quality. The aim of our study was to evaluate the effect of dual-source parallel radiofrequency (RF) transmission on the B1 homogeneity and image quality in children with CMR at 3.0T. The study was approved by the institutional ethics committee and written informed consent was obtained. A total of 30 free-breathing children and 30 breath-hold children performed CMR examinations with dual-source and single-source RF transmission. The B1 homogeneity, contrast ratio (CR) of cine images, and off-resonance artifacts in cine images between dual-source and single-source RF transmission were assessed in free-breathing and breath-hold groups, respectively. In both free-breathing and breath-hold groups, higher mean percentage of flip angle (free-breathing group: 104.2 +/- 4.6 vs 95.5 +/- 6.3, P<.001; breath-hold group: 101.5 +/- 5.1 vs 92.5 +/- 6.3, P<.001) and lower coefficient of variation (free-breathing group: 0.06 +/- 0.02 vs 0.09 +/- 0.03, P<.001; breath-hold group: 0.07 +/- 0.03 vs 0.10 +/- 0.04, P=.005) were found with dual-source than with single-source RF transmission. Both the CRs in the horizontal long axis (HLA) and short axis of cine images with dual-source RF transmission was improved (P<.05 for all). The scores of off-resonance artifacts in the HLA with dual-source RF transmission were higher in both free-breathing and breath-hold groups (P<.05 for all), with substantial interreader agreement (kappa values from 0.68 to 0.74). Compared with conventional single-source, dual-source parallel RF transmission could significantly improve the B1 homogeneity and image quality for CMR in children at 3.0T. This technology could be taken into account in CMR for children with cardiac diseases.
Semiquantitative Parameters in PSMA-Targeted PET Imaging with F-18-DCFPyL: Variability in Normal-Organ Uptake
Li, X;Rowe, SP;Leal, JP;Gorin, MA;Allaf, ME;Ross, AE;Pienta, KJ;Lodge, MA;Pomper, MG
JOURNAL OF NUCLEAR MEDICINE 2017年 58卷6期 页码:942-946
METASTATIC PROSTATE-CANCER; TUMOR-ASSOCIATED NEOVASCULATURE; MEMBRANE ANTIGEN-EXPRESSION; RADIATION-DOSIMETRY; BODY-WEIGHT; THERAPY; IMPACT; STRATEGIES; DIAGNOSIS; TISSUES
F-18-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of F-18-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring.;-;Methods: Sixty-five consecutive F-18-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver.;-;Results: The average SUVmean for all selected organs measured was 6.6 +/- 1.8 for the right lacrimal gland, 6.4 +/- 1.8 for the left lacrimal gland, 9.1 +/- 2.0 for the right parotid gland, 9.0 +/- 2.1 for the left parotid gland, 9.6 +/- 2.3 for the right submandibular gland, 9.4 +/- 2.2 for the left submandibular gland, 5.0 +/- 0.7 for the whole liver, 5.1 +/- 0.7 for a 3-cm sphere in the liver, 4.0 +/- 1.5 for the spleen, 20.1 +/- 4.6 for the right kidney, and 19.4 +/- 4.5 for the left kidney. SULmean was lower overall, although demonstrating similar trends. The COV of SUVmean and SULmean was lower in the liver (13.8% and 14.5%, respectively) than in any other organ and was less than the comparable COV for F-18-FDG PET. The COV of SUVmean and SULmean in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver ( 14.2% and 14.7%, respectively). Conclusion: 18F- DCFPyL uptake in normal liver demonstrates less variability than in other F-18-DCFPyL-avid organs, and its variability is less than the reported variability of F-18-FDG in liver. Variability was slightly less for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantification of images obtained with F-18-DCFPyL.
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