Evaluation of left ventricular blood flow kinetic energy in patients with acute myocardial infarction by 4D Flow MRI: a preliminary study.

PURPOSE: To evaluate the intracavity left ventricular (LV) blood flow kinetic energy (KE) parameters using four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) in patients with acute myocardial infarction (AMI). METHODS: Thirty AMI patients and twenty controls were examined via CMR, which included cine imaging, late gadolinium enhancement (LGE) and global heart 4D flow imaging. The KE parameters were indexed to LV end-diastolic volume (EDV) to obtain average, systolic and diastolic KE as well as the proportion of LV in-plane KE (%). These parameters were compared between the AMI patients and controls and between the two subgroups. RESULTS: Analysis of the LV blood flow KE parameters at different levels of the LV cavity and in different segments of the same level showed that the basal level had the highest blood flow KE while the apical level had the lowest in the control group. There were no significant differences in diastolic KE, systolic in-plane KE and diastolic in-plane KE between the anterior wall and posterior wall (p > 0.05), only the systolic KE had a significant difference between them (p < 0.05). Compared with those in the control group, the average (10.7 ± 3.3 µJ/mL vs. 14.7 ± 3.6 µJ/mL, p < 0.001), systolic (14.6 ± 5.1 µJ/mL vs. 18.9 ± 3.9 µJ/mL, p = 0.003) and diastolic KE (7.9 ± 2.5 µJ/mL vs. 10.6 ± 3.8 µJ/mL, p = 0.018) were significantly lower in the AMI group. The average KE in the infarct segment was lower than that in the noninfarct segment in the AMI group (49.5 ± 18.7 µJ/mL vs. 126.3 ± 50.7 µJ/mL, p < 0.001), while the proportion of systolic in-plane KE increased significantly (61.8%±11.5 vs. 42.9%±14.4, p = 0.001). CONCLUSION: The 4D Flow MRI technique can be used to quantitatively evaluate LV regional hemodynamic parameters. There were differences in the KE parameters of LV blood flow at different levels and in different segments of the same level in healthy people. In AMI patients, the average KE of the infarct segment decreased, while the proportion of systolic in-plane KE significantly increased.

Vitamin E reduces inflammation and improves cognitive disorder and vascular endothelial functions in patients with leukoaraiosis.

BACKGROUND: Leukoaraiosis (LA) is a disease manifested by demyelination and gliosis in white matter, mainly caused by cerebrovascular diseases. LA is closely related to the expression level of inflammatory factors, oxidative stress, and vascular endothelial dysfunction in patients. Vitamin E may play antioxidant and anti-inflammatory roles in various diseases. We aimed to explore the effects of vitamin E on the patients with LA. METHODS: A total of 160 patients with LA were recruited in this research. Matrix metalloproteinase-9 (MMP-9), MMP-2, C-reactive protein (CRP), complement 3 (C3), C4, nitric oxide (NO), and endothelin (ET) levels were evaluated by ELISA. The Mini-Mental State Examination (MMSE) was used for cognitive impairment assessment. Superoxide dismutase (SOD) and malondialdehyde (MDA) concentrations were analyzed by commercial kits. RESULTS: The levels of CRP, C3, and C4 significantly decreased in the serum of LA patients after the administration of vitamin E. The levels of MMP-2 and MPP-9 showed a significant decrease in the administered group. Vitamin E significantly inhibited the expression of MDA, while significantly upregulated the expression of SOD. Significant increase in NO production and significant downregulation of ET expression occurred in vitamin E groups. MMSE score was significantly increased by vitamin E. CONCLUSION: In conclusion, vitamin E showed effects on the alleviation of inflammatory response, oxidative stress, endothelial damage, and cognitive dysfunction. Thus, vitamin E could be a potential drug for the clinical treatment of LA patients.

MRI changes and expressions of neuron-specific enolase and monocyte chemoattractant protein-1 in cerebrospinal fluid in patients with severe herpes simplex virus encephalitis.

The objective of this research was to analyze the MRI changes and the expression of neuron-specific enolase (NSE) and monocyte chemoattractant protein-1 (MCP-1) in cerebrospinal fluid (CSF) of patients with severe herpes simplex encephalitis. For this purpose, 68 patients with severe herpes simplex virus encephalitis diagnosed and treated in our hospital from April 2020 to April 2021 were selected as the study objects of the study group. In addition, 68 healthy people who underwent normal physical examinations in our hospital were selected as the control group at the same time. They were examined by magnetic resonance imaging (MRI) within one week after the study group was enrolled. CSF samples were collected one week after the onset of the disease in the study group and 2-4 days after the first spinal anesthesia in the control group, Enzyme linked immunosorbent assay (ELIEA) was used to detect the expression of NSE and MCP-1 in cerebrospinal fluid of the two groups, and the linear correlation between NSE and MCP-1 were analyzed. Results showed that compared with the control group, the expression of NSE and MCP-1 in the cerebrospinal fluid of the study group increased significantly (P<0.05). The expression of NSE and MCP-1 in patients with severe herpes simplex encephalitis in a coma was significantly higher than that in patients without severe herpes simplex encephalitis in a coma (P<0.05). NSE and MCP-1 were positively correlated (r=0.597, P=0.001). NSE and MCP-1 were risk factors for severe herpes simplex encephalitis, and the difference was statistically significant (P<0.05). In conclusion, magnetic resonance imaging of patients with severe herpes simplex encephalitis is characterized by multiple lesions in the temporal lobe, insula, and frontal lobe base (especially the marginal system involved) with unilateral or bilateral asymmetric distribution, and abnormal high expression of NSE and MCP-1 in the cerebrospinal fluid of such patients, which has important value in the early diagnosis of this disease.

Computed tomography-based radiomics model for discriminating the risk stratification of gastrointestinal stromal tumors.

PURPOSE: The pathological risk degree of gastrointestinal stromal tumors (GISTs) has become an issue of great concern. Computed tomography (CT) is beneficial for showing adjacent tissues in detail and determining metastasis or recurrence of GISTs, but its function is still limited. Radiomics has recently shown a great potential in aiding clinical decision-making. The purpose of our study is to develop and validate CT-based radiomics models for GIST risk stratification. METHODS: Three hundred and sixty-six patients clinically suspected of primary GISTs from January 2013 to February 2018 were retrospectively enrolled, among which data from 140 patients were eventually analyzed after exclusion. Data from patient CT images were partitioned based on the National Institutes of Health Consensus Classification, including tumor segmentation, radiomics feature extraction and selection. A radiomics model was then proposed and validated. RESULTS: The radiomics signature demonstrated discriminative performance for advanced and nonadvanced GISTs with an area under the curve (AUC) of 0.935 [95% confidence interval (CI) 0.870-1.000] and an accuracy of 90.2% for validation cohort. The radiomics signature demonstrated favorable performance for the risk stratification of GISTs with an AUC of 0.809 (95% CI 0.777-0.841) and an accuracy of 67.5% for the validation cohort. Radiomics analysis could capture features of the four risk categories of GISTs. Meanwhile, this CT-based radiomics signature showed good diagnostic accuracy to distinguish between nonadvanced and advanced GISTs, as well as the four risk stratifications of GISTs. CONCLUSION: Our findings highlight the potential of a quantitative radiomics analysis as a complementary tool to achieve an accurate diagnosis for GISTs.

Inhibition of miR146b-5p suppresses CT-guided renal cell carcinoma by targeting TRAF6.

Renal cell carcinoma (RCC) is one of the most common malignancies in the urinary system. Due to the lack of early symptoms, diagnosis of RCC usually occurs at late stages or after cancer metastasis leading to poor prognosis. Therefore, it is crucial to study early molecular mechanisms and biomarkers. Previous studies have suggested that microRNAs are involved in RCC initiation and development, making them a good candidate for early diagnosis and therapy. MiR146b-5P plays important roles in the progression of multiple cancers including thyroid cancer, pancreatic cancer, cervical cancer. However, it is not clear whether and how miR146b-5P is involved in RCC. In this study, we aimed to investigate the function of miR146b-5P in RCC. We examined the expression levels of miR146b-5p in renal cancer tissue and cell lines. We also explored the effects of blocking miR146b-5p in renal tumor growth and inflammatory signaling. Finally, we determined if miR146b-5p regulates tumorigenesis through TRAF6. We found that miR146b-5p levels were significantly increased in renal cancer tissue and renal cancer cells. Blocking miR146b-5p suppressed renal tumor growth and enhanced inflammatory response through increased TRAF6 expression. These effects were eliminated in TRAF6 knockout mice. Our results suggest that enhanced miR146b-5p expression may be a biomarker for RCC and modulating miR146b-5p and TRAF6 levels represent a potential therapeutic strategy for RCC.

Long noncoding RNA HOTTIP alleviates oxygen-glucose deprivation-induced neuronal injury via modulating miR-143/hexokinase 2 pathway.

HOXA transcript at the distal tip (HOTTIP), which is a long noncoding RNA, plays an important role in multiple cancers and in coronary artery disease. Elevated microRNA-143 (miR-143) expression causes impaired glucose uptake that is responsible for the ischemic cerebral injury. However, the role and mechanism of HOTTIP in ischemic stroke are still unknown. The expression of HOTTIP and miR-143 was first detected in mouse models of transient middle cerebral artery occlusion and in primary neurons exposed to oxygen-glucose deprivation (OGD). We used gain-of function and loss-of function approaches in vitro to investigate the effect and mechanism of HOTTIP on ischemic stroke by evaluating cell viability, apoptosis, and glycolytic metabolism of neurons exposed to OGD. The HOTTIP expression was decreased, whereas miR-143 increased in experimental ischemic stroke models. Overexpression of HOTTIP by the pcDNA3.1-HOTTIP plasmid significantly increased cell viability, glucose uptake, and the expression of hexokinase 2 (HK-2) and pyruvate kinase M2 that were reduced by OGD insult. The HOTTIP overexpression also diminished OGD induced the apoptosis and the caspase-3 activity of neurons. The miR-143 mimic reversed these effects, and anti-miR-143 enhanced them. In addition, we found that HOTTIP could function as a competing endogenous RNA for miR-143 to modulate HK-2 expression. In conclusion, the HOTTIP expression was reduced in ischemic stroke. The HOTTIP overexpression attenuated OGD-induced neuronal injury and imbalanced glycolytic metabolism by sponging miR-143, resulting in the de-repression of its endogenous target HK-2. Taken together, these findings improve understanding of the pathogenesis of ischemic stroke.

Validation of Renal Function using Multiphasic Ratios between Renal Cortex and Medulla in Kidney Recipients.

OBJECTIVE: To verify the multiphase ratio of Computer Tomography-value between the renal cortex and renal medulla, which can be used to concisely evaluate renal function in kidney recipients. METHODS: Fifty-eight kidney recipients were retrospectively enrolled and divided into the Normal group(eGFR≥90 mL/min/1.73m2) and Abnormal group(eGFR<90 mL/min/1.73m2) according to Chronicle Kidney Disease Epidemiology Collaboration (eGFR(CKD-EPI)) and the Modular of Diet in Renal Disease (eGFR(MDRD)) formulas respectively. The multiphasic ratios between the renal cortex and medulla in the arterial phase and venous phase were noted as A(RatioC/M) and V(RatioC/M), and the difference between those two was recorded as D(RatioC/M). Correlation/regression analysis, student t-test, and ROC curves analysis were used to test the ability of multiphasic ratios to assess renal function. RESULTS: Both A(RatioC/M) and V(RatioC/M) were moderately correlated with eGFR(CKD-EPI) (Y =20.41*X + 28.20, r=0.40 (95%Cl, 0.13-0.58), P<0.01; Y =-16.57*X + 109.8, r=-0.29 (95%Cl, -0.51--0.04), P=0.03) and eGFR(MDRD) (Y =23.72*X + 23.52, r=0.38 (95%Cl, 0.13-0.58), P<0.01; Y =-19.88*X + 119.5, r=-0.30 (95%Cl, -0.52--0.05), P=0.02). However, D(RatioC/M) was strongly positive correlated with eGFR(CKD-EPI) (Y = 30.95*X + 60.71, r=0.61 (95%Cl,0.42-0.75), P<0.001) and eGFR(MDRD) (Y = 36.47*X + 61.01, r=0.62 (95%Cl, 0.44-0.76), P<0.001), respectively, and both regression lines were not significant different (slope: P=0.496, intercept: P=0.378). The differences in D(RatioC/M) between the two groups were significant (all P<0.05). The ROC curve analysis provided the cutoff values of D(RatioC/M) for assessing eGFR (AUC:0.863 and AUC:0.822, all P<0.001). CONCLUSION: The D(RatioC/M) can be used to assess renal function for kidney recipients.

WHSC1L1-mediated epigenetic downregulation of VMP1 participates in herpes simplex virus 1 infection-induced mitophagy impairment and neuroinflammation.

Microglia are the first-line defenders against invading pathogens in the brain whose activation mediates virus clearance and leads to neurotoxicity as well. This work studies the role of Wolf-Hirschhorn syndrome candidate 1-like 1 (WHSC1L1)/vacuole membrane protein 1 (VMP1) interaction in the activation of microglia and neuroinflammation following herpes simplex virus 1 (HSV-1) infection. Aberrantly expressed genes after HSV-1 infection were screened by analyzing the GSE35943 dataset. C57BL/6J mice and mouse microglia BV2 were infected with HSV-1 for in vivo and in vitro assays. VMP1 was downregulated but WHSC1L1 was upregulated in HSV-1-infected mouse brain tissues as well as in BV2 cells. The VMP1 overexpression enhanced mitophagy activity and suppressed oxidative stress and inflammatory activation of BV2 cells, but these effects were blocked by the autophagy antagonist 3-methyladenine. WHSC1H1 suppressed VMP1 transcription through H3K36me2-recruited DNMT3A. Downregulation of WHSC1H1 similarly enhanced mitophagy in BV2 cells, and it alleviated microglia activation, nerve cell inflammation, and brain tissue damage in HSV-1-infected mice. However, the alleviating roles of WHSC1H1 silencing were negated by further VMP1 silencing. Taken together. this study demonstrates that WHSC1L1 upregulation following HSV-1 infection leads to mitophagy impairment and neuroinflammation through epigenetic suppression of VMP1.

The value of CMR Left ventricular strain analysis in evaluating ICM.

The purpose of this article is to investigate the value of cardiac magnetic resonance imaging (CMR) derived left ventricular strain parameters in evaluation of ischemic cardiomyopathy (ICM). Thirty-one ICM patients and nineteen non-cardiomyopathy (non-CM) patients who performed CMR examinations during the same period were selected for this retrospective study. The basic clinical data, CMR left ventricular function parameters, left ventricular strain parameters were compared among the left ventricular ejection fraction (LVEF) preserved ICM group, the LVEF impaired ICM group and the non-CM group. The differences of MyoGCS (-21.9 ± 1.9 vs. -18.9 ± 2.7 P<0.001), MyoGLS (-20.8 ± 2.3 vs. -17.0 ± 2.9 P<0.001) and EndoGLS (-22.2 ± 3.1 vs. -17.6 ± 3.7 P<0.001) between LVEF preserved ICM group and non-CM group were statistically significant, while the differences of left heart function parameters between the two groups were not statistically significant (P > 0.05). The left ventricular strain analysis can be used to assess cardiac functional and morphological alterations in ICM patients prior to changes of left ventricular function parameters, which has high clinical significance.

Magnetic Resonance Imaging and Serum AFP-L3 and GP-73 in the Diagnosis of Primary Liver Cancer.

Objective: To investigate the combined application value of magnetic resonance imaging (MRI) combined with serum alpha-fetoprotein (AFP)-L3 and Golgi protein (GP)-73 in the diagnosis of primary liver cancer. Methods: The data of 200 patients with suspected liver cancer admitted to our hospital from February 2020 to February 2021 were retrospectively analyzed, and they were randomly divided into an experimental group and a control group, with 100 cases in each group. The experimental group received a combined detection of MRI with serum AFP-L3 and GP-73, and the control group adopted traditional diagnostic methods (spiral computed tomography and serum AFP). The diagnostic yields of the two groups were compared. Surgical resection was performed after the diagnosis of primary liver cancer, and the correlation between the efficacy and combined detection of MRI with serum AFP-L3 and GP-73 levels was analyzed. Results: The two groups presented comparable general information (P >0.05). The surgical results showed 160 cases of primary liver cancer, including 75 cases in the experimental group and 85 cases in the control group, and 40 cases of benign liver lesions. The diagnostic accuracy of the experimental group (73/75, 95%) was significantly higher than that of the control group (76/85, 86%) (P < 0.05). The serum levels of AFP-L3, GP-73, and AFP in patients with primary liver cancer were remarkably decreased after surgery (P < 0.001). The preoperative and postoperative AFP-L3, GP-73, and AFP levels of patients with primary liver cancer were significantly higher than those of patients with benign liver lesions. The AUC (95% CI) for the combined detection of MRI and serum AFP-L3 and GP-73 levels in patients with surgically confirmed primary liver cancer was 0.747 (0.619-0.874). Conclusion: MRI combined with serum AFP-L3 and GP-73 presents favorable diagnostic efficiency in the diagnosis of primary liver cancer, which is worthy of clinical application.

Effects of resistance exercise on treatment outcome and laboratory parameters of Takayasu arteritis with magnetic resonance imaging diagnosis: A randomized parallel controlled clinical trial.

BACKGROUND: Elevated tumor necrosis factor-α (TNF-α) is correlated with refractory Takayasu arteritis (TA), and resistance exercise have been shown to inhibit TNF-α. HYPOTHESIS: We aimed to explore the effect of resistance exercise in the clinical management of TA. METHODS: This clinical trial enrolled a total of 342 acute TA patients, who were subsequently randomized to undergo either resistance exercise or relaxation control twice per week for 12 weeks. The disease activity was defined using the primary outcome of Birmingham Vascular Activity Score (BVAS). Secondary outcomes included levels of plasma TNF-α and C-reactive protein (CRP), and the erythrocyte sedimentation rate (ESR). RESULTS: BVAS scores along with other laboratory parameters obtained from the patients in the resistance exercise group showed a gradual decline throughout the course of the trial. By contrast, outcomes appeared largely unaltered in the relaxation control group patients. Analyses also revealed that plasma TNF-α displayed strong linear correlations with ESR, BVAS scores, and plasma CRP levels. CONCLUSION: Resistance exercise could substantially improve treatment outcomes as well as laboratory parameters in patients with acute TA, probably through decreasing TNF-α.

Intravoxel incoherent motion diffusion-weighted imaging evaluated the response to concurrent chemoradiotherapy in patients with cervical cancer.

To evaluate the application of multiple b values diffusion-weighted imaging based on biexponential signal decay model to predict the response to concurrent chemoradiotherapy in cervical cancer patients.This prospective study enrolled 28 patients (mean age: 50.89 ±â€Š10.70 years) with cervical cancer confirmed by biopsy who received concurrent chemoradiotherapy. Pelvic magnetic resonance scans were performed 2 weeks before, 7 days and 21 days after the initiation of therapy, and 1 month after the end of the treatment. Diffusion-weighted imaging with b values of 0, 50, 450, and 850 s/mm were performed, and tumor volume, means of tumor apparent diffusion coefficient (ADC)min, ADCmean, ADCslow, ADCfast, and Ffast were measured.Pretreatment ADCmin and ADCslow of good outcome group were significantly higher than those of poor outcome group (P < .05). At the 7th day of the treatment, Ffast and its change rate of good outcome group were significantly higher than those of poor outcome group (P < .05). At the 7th day and 21st day of the treatment, Ffast showed a slowly increasing tendency with no significant difference compared with pretreatment value in poor outcome group (P < .05). One month post-treatment, only ADCslow change rate was significantly higher in good outcome group than that in poor outcome group.Intravoxel incoherent motion-related ADC values could be utilized to better predict the outcome of cervical cancer chemoradiotherapy.

Application of a novel targeting nanoparticle contrast agent combined with magnetic resonance imaging in the diagnosis of intraductal papillary mucinous neoplasm.

Intraductal papillary mucinous neoplasm (IPMN) is a severe disease with macroscopic visible mucin secretion that primarily occurs in biliary tracts or pancreatic ducts. In comparison with standard diagnostic imaging, probing the molecular abnormalities associated with the initial stages of diseases rather than imaging the end effects markedly improves the accuracy of diagnosis. In the present study, magnetic resonance imaging (MRI) in combination with the contrast agent PEGylated magnetoliposome consisting of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) and target molecules of IPMN were investigated in the diagnosis of patients with suspected IPMN. The present investigation indicated that the novel targeting nanoparticle contrast agent targeted platelet-derived growth factor receptor-ß and RET, and maintained a high affinity with tumor markers located on the IPMN surface. The novel targeting nanoparticle contrast agent combined with MRI exhibited increased sensitivity in diagnosing early-stage patients with IPMN. Furthermore, image quality was improved following the use of the novel targeting nanoparticle contrast agent combined with MRI compared with standard MRI. The targeting nanoparticle contrast agent retained sufficient affinity and was present for an adequate amount of time to observe the tumor mass in papillae using MRI. Notably, the targeting nanoparticle contrast agent was metabolized at 12 h post-injection. In conclusion, these outcomes indicate that the novel targeting nanoparticle contrast agent combined with MRI improved image quality and sensitivity compared with standard MRI, which suggests that this approach may be promising for clinical detection in patients with suspected IPMN.