Clinical value of ultrasonic indicators in predicting the outcome of caesarean scar pregnancy after pregnancy termination.

BACKGROUND: To investigate the predictive value of ultrasound indicators in early pregnancy for the outcome of caesarean scar pregnancy (CSP) after pregnancy termination. METHODS: This study retrospectively analysed the ultrasound images of 98 CSP patients who underwent transabdominal ultrasound-guided hysteroscopic curettage during early pregnancy at Changsha Hospital for Maternal and Child Health Care between January 2017 and October 2021. Patients were equally divided into a case group and a control group. The case group included 49 CSP patients with postoperative complications, such as intraoperative blood loss ≥ 200 ml or retained products of conception (RPOC). The remaining 49 CSP patients, with similar age and gestational age and with good postoperative outcomes, such as intraoperative blood loss ≤ 50 ml and no RPOC, were included in the control group. CSP was classified into three types according to the location of the gestational sac (GS) relative to the uterine cavity line (UCL) and serosal contour. Differences in ultrasound indicators between the case and control group were compared. RESULTS: There were significant differences between the case and control groups in the mean gestational sac diameter (MGSD), residual myometrium thickness (RMT) between the GS and the bladder, blood flow around the GS at the site of the previous caesarean incision, and types of CSP (P < 0.05). The rs of each ultrasound indicator were as follows: 0.258, -0.485, 0.369, 0.350. The optimal threshold for predicting good postoperative outcomes, such as intraoperative blood loss ≤ 50 ml and no RPOC, by receiver operating characteristic (ROC) curve analysis of the RMT was 2.3 mm. CONCLUSION: Our findings show that the RMT, blood flow around the GS at the site of the previous caesarean incision, and types of CSP have a low correlation with postoperative complications, such as intraoperative blood loss ≥ 200 ml or RPOC, of early pregnancy termination in patients with CSP. To some extent, this study may be helpful for clinical prognostic prediction of patients with CSP and formulation of treatment strategies. Given the low correlation between these three indicators and postoperative complications, further studies are needed to identify indicators that can better reflect the postoperative outcomes of CSP patients.

Comparison of the clinical outcomes of skin bridge loop ileostomy and traditional loop ileostomy in patients with low rectal cancer.

To compare the clinical results of patients with low rectal cancer who underwent skin bridge loop ileostomy and traditional loop ileostomy, and provide clinical evidence for choosing a better ostomy method. We retrospectively collected data of 118 patients with rectal cancer who underwent low anterior resection and loop ileostomy. To investigate the patients characteristics, postoperative stoma-related complications and the frequency of exchanged ostomy bags. The differences of these indicators between the two groups of patients who underwent skin bridge loop ileostomy and traditional loop ileostomy were compared. The Visual Analog Scale (VAS) score of the skin bridge loop ileostomy group was lower than that of the traditional ileostomy loop group (P < 0.05). The skin bridge group had a lower Discoloration, Erosion, Tissue overgrowth (DET) score and incidence of mucocutaneous separation than the traditional group at the 1st and 2nd weeks after operation (P < 0.05). The average number of weekly exchanged ostomy bags was significantly less in the skin bridge group than in the traditional group within 4 weeks after surgery (P < 0.05). Our experience demonstrates that the skin bridge loop ileostomy may significantly reduce early postoperative stoma-related complications, the frequency of exchanged ostomy bags and patients' medical costs after discharge.

Fetal double aortic arch: prenatal sonographic and postnatal computed tomography angiography features, associated abnormalities and clinical outcomes.

BACKGROUND: Fetal double aortic arch (DAA) malformation is a rare congenital heart disease with few reported cases in the literature. We aimed to investigate the characteristics of prenatal ultrasound and postnatal computed tomography angiography (CTA) of DAA and to describe the associated anomalies and clinical outcomes to improve prenatal diagnosis and assist in perinatal management. METHODS: The obstetric ultrasound imaging databases of seven tertiary referral centers were reviewed retrospectively to identify fetuses with a prenatal diagnosis of DAA between January 2013 and December 2018. Ultrasonographic findings, associated anomalies, genetic abnormalities, postnatal CTA images, and long-term postnatal outcomes were evaluated. RESULTS: A total of 36 cases out of 40 prenatally diagnosed DAA fetuses were confirmed by postnatal diagnosis (fetal autopsy, CTA, and surgery). In this cohort of 36 confirmed cases, 24 (67%) were isolated anomalies, while 12 (33%) were associated with intracardiac or extracardiac anomalies, and 2 (6%) had a 22q11.2 chromosome deletion. Among nine cases of pregnancy termination with a fetal autopsy, 7 had other abnormalities. Among the remaining 27 live births, 16 (59%) were asymptomatic and 11 (41%) received surgical treatment due to tracheal or esophageal compression symptoms, all with satisfactory outcomes. Prenatal echocardiography showed that DAA was mainly characterized by a bifurcation of the ascending aorta into the right and left aortic arch and the formation of a complete O-shaped vascular ring around the trachea on the three-vessel tracheal view. A variant in the aortic arch branching pattern was found for the first time. The airway obstruction, branching pattern, and atretic arch of DAA were clearly shown by postnatal CTA. CONCLUSIONS: Fetal DAA has unique features on prenatal echocardiography and postnatal CTA, and systematic prenatal examination and timely postnatal CTA evaluation are required. A certain proportion of intracardiac and extracardiac abnormalities are associated with DAA, but the probability of chromosome abnormalities is low, especially for isolated DAA.The clinical outcomes of isolated DAA are favorable, even if surgery is performed due to symptoms. Determining whether other malformations or chromosomal anomalies exist is crucial for prognosis evaluation and prenatal counseling.

Prenatal diagnosis of a "living" oropharyngeal fetus in fetu: a case report.

BACKGROUD: Fetus in fetu (FIF) is a rare malformation in which a parasitic twin within its more mature twin. Most of the FIF locate in the retroperitoneum and are acardiac and anencephalic. CASE PRESENTATION: Here, we describe a unique case of oropharyngeal fetus in fetu with a rudimentary two-chambered heart detected by prenatal ultrasonography. The parents terminated this pregnancy after counseling. Macroscopic examination found a solid mass between the oral and fetal chest, with a rudimentary two-chambered heart at the lowest part of the mass. Microscopic findings showed amniotic membrane, skin, cartilage, gastrointestinal and neural tissue. CONCLUSIONS: Prenatal ultrasound can identify rudimentary organs suspecting FIF from early pregnancy. Detection of fetal heart beat facilitates differential diagnosis with teratomas, providing essential information for parental consulting and management.

SNHG20/miR-140-5p/NDRG3 axis contributes to 5-fluorouracil resistance in gastric cancer.

5-fluorouracil (5-FU)-based chemotherapy is the first line treatment for advanced gastric cancer. However, the effectiveness of 5-FU is limited by drug resistance. The N-myc downstream-regulated gene, family member 3 (NDRG3) is a member of the NDRG family and has been implicated in numerous types of cancer. However, the role of NDRG3 in gastric cancer remains unclear. In the present study, NDRG3 mRNA expression in gastric cancer and adjacent normal tissues was analyzed using the Gene Expression Profiling Interactive Analysis web tool. NDRG3 expression was silenced using short hairpin RNAs to examine the effect of NDRG3 on the growth of gastric cancer cells. Potential regulators of NDRG3 were identified using the TargetScan and MicroRNA tools and verified by a luciferase assay and reverse transcription-quantitative PCR analysis. The current study demonstrated that NDRG3 was upregulated in gastric cancer specimens and promoted cell proliferation in gastric cancer cell lines. Furthermore, the present study revealed that the small nucleolar RNA host gene 20 (SNHG20)/microRNA (miR)-140-5p signaling pathway may regulate the expression of NDRG3. SNHG20 was revealed to be involved in mediating resistance to 5-FU in gastric cancer cell lines via NDRG3. In conclusion, the results of the present study suggest that the SNHG20/miR-140-5p/NDRG3 axis may be involved in mediating resistance to 5-FU in gastric cancer.

Prenatal diagnosis of fetal intraabdominal extralobar pulmonary sequestration: a 12-year 3-center experience in China.

To provide useful information for diagnosing and predicting fetal intraabdominal extralobar pulmonary sequestration (IEPS), a retrospective review of diagnostic approaches was conducted. Ultrasonography was performed serially in 21 fetuses with IEPS from 2005 to 2017. Prenatal sonographic features, treatment, and outcomes of each case were evaluated and collected. These cases of IEPS were also compared to 43 cases previously reported by other researchers from 1986 to 2017. Of the 21 sonographic features, 14 (67%) were hyperechoic, 21 (100%) were well circumscribed, and 17 (81%) depicted a mass that shifted with fetal breaths/hiccups non-synchronized with adjacent organs (sliding sign). Feeding arteries were detected prenatally in 18 patients (86%). The lesion volume was 10.17 ± 4.66 cm3, the congenital cystic adenomatoid malformation volume ratio and cardiothoracic ratio were in normal range. The gestational age at diagnosis, location and echotexture of the lesion, and rate of surgical treatment were similar to previous studies, but with a significantly higher rate of detected feeding arteries (P < 0.01), and associated anomalies (P < 0.01). All infants who underwent surgery after birth had satisfactory outcomes. The sliding sign and feeding artery are essential features of IEPS in prenatal diagnosis.

Migration of a foreign body to the rectum: A case report and literature review.

RATIONALE: Rectal foreign bodies are not an uncommon finding in outpatient departments globally. Most such objects are inserted through the anus. Occasionally, a foreign body may be ingested and may successfully pass through the entire gastrointestinal tract and be held up in the rectum. In extremely rare cases, foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. We report a rare case that the IUCD had migrated and was embedded in the rectal wall. A part of the IUCD was loosened and deformed into a metallic wire that protruded through the anus. PATIENT CONCERNS: A 45-year-old woman presented with complaints of a metallic wire protruding through her anus when she used the washroom. The wire would become longer when she manually pulled it; however, this process was associated with pain in the lower abdomen, and she therefore stopped manipulating it. DIAGNOSES: A rectal foreign body secondary to intrauterine contraceptive device (IUCD) migration and rectal perforation, as well as a pelvic cyst. INTERVENTIONS: Under general anesthesia, she underwent laparoscopic removal of the rectal foreign body, pelvic adhesiolysis, pelvic cyst resection, and ileostomy combined with colonoscopy. OUTCOMES: Her postoperative recovery was uneventful. LESSONS: Foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. Regular follow-up after IUCD insertion is very important. We report this rare case that would increase awareness among clinicians regarding the differential diagnosis and treatment in such cases.

Phase-shifted paclitaxel-loaded multifunctional contrast agent for US/MR imaging and synergistic hyperthermal/chemotherapy of metastasis in lymph nodes.

The existing approaches used to detect a tumor-induced sentinel lymph node and treat metastasis have limitations. In this study, by encapsulating perfluoropentane (PFP), magnetic iron oxide nanoparticles (Fe3O4) and the chemotherapy drug paclitaxel (PTX), we fabricated novel polymer nanoparticles (NPNs) that can effectively absorb heat after irradiation by near-infrared irradiation (NIR), thereby synergistically enhancing tumor therapy via a phase-shift thermoelastic expansion effect. These NPNs can be used for dual-modal ultrasound (US) and magnetic resonance (MR) imaging and to treat metastasis in lymph nodes under NIR irradiation-triggered drug delivery. The enhancement of US/MR imaging proved effective in vitro and in vivo, and NIR irradiation proved valid, promoting PTX release at the target site. A lower proliferation index and density and a higher tumor cell apoptotic index in the histopathology results confirmed the effectiveness of NPN chemotherapy for lymph nodes.

The efficacy of automated breast volume scanning over conventional ultrasonography among patients with breast lesions.

OBJECTIVE: To compare the efficacy of automated breast volume scanning (ABVS) with that of conventional ultrasonography in the detection of breast cancer lesions. METHODS: In a retrospective study, patients aged 18-78 years who had breast cancer, had undergone screening using ABVS and conventional ultrasonography, and provided a biopsy sample at a center in Changsha, China, between July 22, 2011, and September 20, 2014, were identified. Results of ultrasonography and ABVS were compared. RESULTS: A total of 417 lesions were detected among 300 patients. Ultrasonography detected 326 lesions, whereas ABVS detected all 417 (P<0.001). ABVS detected all 32 malignant lesions and ultrasonography detected 31 (P=0.158). Conventional ultrasonography identified microcalcifications in only two cases, whereas ABVS reported these in eight cases (P<0.001). CONCLUSION: ABVS detects significantly more breast lesions than conventional ultrasonography does.

Automated breast volume scanning versus conventional ultrasound in breast cancer screening.

RATIONALE AND OBJECTIVES: To assess the diagnostic value of automated breast volume scanning (ABVS) versus conventional ultrasound (US) in breast cancer screening. MATERIALS AND METHODS: This study retrospectively analyzed the ABVS and US images from 200 women who underwent breast examination and were recommended for biopsy in our health management centers between July 22, 2011, and October 20, 2013. We retrospectively assessed whether breast lesions from 200 women, which were detected and classified by US, could be detected and classified by an independent examiner using only ABVS findings. The sensitivity and specificity of ABVS versus US in determining lesion malignancy were calculated using biopsy as the gold standard. RESULTS: In the 200 cases, 273 and 194 individual lesions were detected by ABVS and US, respectively. All 194 US-detected lesions were detected by ABVS. Pathologic examination determined that, of the 273 total lesions, 251 lesions were benign and 22 lesions were malignant. US detected 21 of the 22 malignant lesions and ABVS detected all 22 malignant lesions. The sensitivity and specificity of ABVS relative to biopsy (gold standard) were 28.95% and 100%, whereas the sensitivity and specificity of US relative to biopsy were 43.06% and 98.36%. CONCLUSIONS: US displays superior sensitivity to ABVS across all Breast Imaging Reporting and Data System (BI-RADS) density categories while displaying equivalent specificity with the exception of BI-RADS density category 1, in which ABVS displayed a slightly superior specificity. As ABVS possesses several advantages and limitations with respect to US, ABVS may serve as an effective, adjunct, screening tool to mammography and conventional sonography.

Tumor size of breast invasive ductal cancer measured with contrast-enhanced ultrasound predicts regional lymph node metastasis and N stage.

PURPOSE: This study aimed to determine the role of breast invasive ductal cancer (BIDC) size measured with Contrast-enhanced Ultrasound (CEUS) in the prediction of regional lymph node metastasis (LNM) and N stage. METHODS: One hundred and six consecutive patients with breast lesions underwent ultrasound imaging within 2 weeks before mastectomy and axillary lymph node dissection. The largest transverse (width) and anteroposterior (depth) diameter were measured under CEUS by using calipers. The correlation between tumor size and regional LNM metastasis and N stage was evaluated. RESULTS: Univariate analysis showed the diameters measured with CEUS were associated with lymph node metastasis (P < 0.05). The tumor size could distinguish grouped N stage (all P < 0.05). Tumor area (TA) might be an indicator that can differentiate No BIDC from N1-3 BIDC (cutoff = 5.37 cm(2)), N0-1 BIDC from N2-3 BIDC (cutoff = 6.48 cm(2)), and N0-2 BIDC from N3 BIDC (cutoff = 8.23 cm(2)) with the sensitivity of 71%, 72% and 83%, respectively, and the specificity of 79%, 68% and 84%, respectively. CONCLUSIONS: The TA of BIDC measured with CEUS may be a predictor of regional LNM and N stage.

Echocardiographic follow-up and pregnancy outcome of fetuses with cardiac asymmetry at 18-22 weeks of gestation.

OBJECTIVE: The goal of our study was to evaluate the evolution of cardiac findings and assess the pregnancy outcome of fetuses with cardiac asymmetry at midgestation. METHODS: We reviewed all fetuses with cardiac asymmetry at echocardiograms performed at 18-22 weeks of gestation from 2006 to 2013. The data collected included the gestational age at diagnosis, serial echocardiographic findings, karyotype testing, and pregnancy outcome. Excluded were cases of classical hypoplastic left heart syndrome (HLHS) at initial echocardiogram (i.e., aortic (AO) and/or mitral atresia or dysplasia with normal intracardiac connections), heterotaxy syndrome, twin pregnancy, fetal growth restriction, and coarctation of the aorta. RESULTS: Our study included 278 fetuses with cardiac asymmetry (defined as Z-scores of left ventricle length or diameter of less than -2). A total of 202 (72%) fetuses had normal variations in cardiac growth by prenatal and neonatal echocardiography, 69 (25%) fetuses were confirmed to have HLHS variant by autopsy or neonatal echocardiography (with an overall survival of 4.3%), and seven (3%) fetuses were terminated before 24 weeks of gestation because of abnormal karyotypes. None of the cardiac measurements at the initial echocardiogram was significantly different between HLHS variant and normal cases. In the 69 fetuses ultimately diagnosed with HLHS variant, but not in the 202 normals, the Z-scores of all measured left heart structures decreased progressively between the first and the last prenatal echocardiograms (P < 0.01). CONCLUSIONS: The majority of the fetuses with cardiac asymmetry at 18-22 weeks have a good outcome. A minority of them progress to develop HLHS variant with advancing gestation.

Accuracy of Endorectal Endoscopic Ultrasound (EUS) for Locally Advanced Rectal Cancer (LARC) Restaging After Neoadjuvant Chemoradiotherapy (NAT): A Meta-Analysis.

BACKGROUND/AIMS: Endorectal endoscopic ultrasound (EUS) can provide accurate and reliable information for initial staging of locally advanced rectal cancer (LARC) in both the depth of rectal cancer penetration (T-stage) and regional lymph node involvement (N-stage). However, there is still no consensus about its accuracy in retagging LARC after neoadjuvant chemoradiotherapy (NAT). METHODOLOGY: In this study, we retrieved previous studies and performed a meta-analysis for assessing the accuracy of EUS for retagging of LARC after NAT. RESULTS: It was found the accuracy of EUS for T restaging of LARC was relatively low and over-staging was common, although the accuracy for assessing T3/4 was significantly higher than T0-T2 stage. The specificity of EUS for assessing N stage was relatively high, but the sensitivity was relatively low. CONCLUSIONS: Data obtained in this study confirmed the overall accuracy of EUS is not sufficient to serve as a basis for decisions on restaging Exploring the possible application of new techniques is necessary for better restaging.

[Velocity vector imaging assessment of early epirubicin-induced myocardial damage].

OBJECTIVE: To assess the left ventricular (LV) longitudinal systolic and diastolic function in patients treated by epirubicin by velocity vector imaging (VVI) and to discuss the important clinical value of VVI in quantitatively evaluating the regional longitudinal function. METHODS: Thirty patients with breast cancer treated with epirubicin chemotherapy and 30 normal controls were included in the study. Dynamic images of apical long axis, four-chamber and two chamber view were obtained in all subjects, and the longitudinal systolic and diatolic parameters were measured in all subjects, including systolic maximum velocity (Vs), systolic maximum strain (SS), systolic maximum strain rate (SSR), diastolic maximum velocity (Vd), and diastolic maximum strain rate (DSR). The parameters were compared between the 2 groups. The conventional echcardiographic parameters were also obtained. RESULTS: There was no significant change in all baseline parameters before the chemotherapy in 30 breast cancer patients compared with the normal controls (P>0.05). After the second chemotherapy cycle, DSR was lower in every segment, Vd was lower in the free wall, mainly the lateral, anterior and inferior wall (P<0.05), while Vd didn't change significantly in the septum wall (P>0.05). After the third chemotherapy cycle, Vd, DSR and SSR decreased significantly in all segments (P<0.05). Vs and SS didn't change significantly (P>0.05). CONCLUSION: VVI can monitor the epirubicin cardiotoxicity early and is more sensitive than echocardiograph.

Primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery.

Primary tumors of the heart are rarely seen. Cardiac angiosarcomas are malignant tumors that almost always have a poor prognosis. Atrium rupture and coronary artery fistula are very rare complications of primary cardiac angiosarcoma. We describe a 57-year-old man suffering from primary cardiac angiosarcoma with spontaneous ruptures of the right atrium and right coronary artery (RCA). Theoretically, either of these ruptures invariably results in pericardial effusion and tamponade that is rare but potentially life threatening. In this instance, however, the patient might have developed fibrous adhesions resulted from previous bloody pericardial effusion. A massive pericardial effusion was localized, which consequently prevented cardiac tamponade and hemodynamic collapse. Echocardiography revealed the tumor progression leading to detectable infiltration of solid mass into the right atrial (RA) wall, which is close to RCA. And color Doppler displayed the flow into the pericardial cavity through a disrupted RA wall and perforated RCA. Echocardiography remains the primary method of choice for evaluation of cardiac masses.

[Contrast-enhanced ultrasound in the diagnosis of benign and malignant hepatic tumors].

OBJECTIVE: To determine the value of contrast-enhanced ultrasound in the diagnosis of benign and malignant hepatic tumors. METHODS: A total of 83 patients with 123 focal liver lesions (FLLs) underwent contrast enhanced ultrasound (CEUS) examination. The contrast enhanced characterization of FLLs were compared. RESULTS: All the 103 lesions in hepatocallular carcinoma improved quickly in the arterial phase or portal phase. Altogether 98 lesions (95%) washed out during the late phase but the rest 5 lesions (5%) did not. Of the 69 lesions of hepatocellular carcinoma, 53(77%) enhanced global in the arterial phase or portal phase, and the rest 16 (23%) showed inhomogeneous enhancement but no enhancement in the central area during arterial phase or portal phase. A total of 66(96%) presented wash-out during the late phase, and 3(4%) had no wash-out. Of the 34 lesions of metastatic hepatic carcinoma, 24(71%)presented inhomogeneous enhancement in the arterial phase or portal phase, 10(29%) enhanced globally in the arterial phase or portal phase, 32 (94%) presented wash-out during the late phase, and 2(6%) had no wash-out in the late phase. Of the 20 lesions of benign hepatic tumor, 18(90%) presented inhomogeneous enhancement slowly in the arterial phase or portal phase, 14 (70%) slightly enhanced, and 20 (100%) presented no wash-out in the the late phase. CONCLUSION: CEUS can improve the accuracy of diagnosis of benign and malignant hepatic tumors.

Pathological and MR-DWI study of the acute hepatic injury model after stem cell transplantation.

AIM: To investigate apparent diffusion coefficient (ADC) values as an indication of reconditioning of acute hepatic injury (AHI) after allogeneic mononuclear bone marrow cell (MBMC) transplantation. METHODS: Three groups were used in our study: a cell transplantation group (n = 21), transplantation control group (n = 21) and normal control group (n = 10). AHI model rabbits in the cell transplantation group were injected with 5 mL of MBMC suspension at multiple sites in the liver and the transplantation controls were injected with 5 mL D-Hanks solution. At the end of the 1st, 2nd and 4th wk, 7 rabbits were randomly selected from the cell transplantation group and transplantation control group for magnetic resonance diffusion-weighted imaging (MR-DWI) and measurement of the mean ADC values of injured livers. After MR-DWI examination, the rabbits were sacrificed and the livers subjected to pathological examination. Ten healthy rabbits from the normal control group were used for MR-DWI examination and measurement of the mean ADC value of normal liver. RESULTS: At all time points, the liver pathological scores from the cell transplantation group were significantly lower than those in the transplantation control group (27.14 ± 1.46 vs 69.29 ± 6.16, 22.29 ± 2.29 vs 57.00 ± 1.53, 19.00 ± 2.31 vs 51.86 ± 6.04, P = 0.000). The mean ADC values of the cell transplantation group were significantly higher than the transplantation control group ((1.07 ± 0.07) × 10⁻³ mm²/s vs (0.69 ± 0.05) × 10⁻³ mm²/s, (1.41 ± 0.04) × 10⁻³ mm²/s vs (0.84 ± 0.06) × 10⁻³ mm²/s, (1.68 ± 0.04) × 10⁻³ mm²/s vs (0.86 ± 0.04) × 10⁻³ mm²/s, P = 0.000). The pathological scores of the cell transplantation group and transplantation control group gradually decreased. However, their mean ADC values gradually increased to near that of the normal control. At the end of the 1st wk, the mean ADC values of the cell transplantation group and transplantation control group were significantly lower than those of the normal control group [(1.07 ± 0.07) × 10⁻³ mm²/s vs (1.76 ± 0.03) × 10⁻³ mm²/s, (0.69 ± 0.05) × 10⁻³ mm²/s vs (1.76 ± 0.03) × 10⁻³ mm²/s, P = 0.000]. At any 2 time points, the pathological scores and the mean ADC values of the cell transplantation group were significantly different (P = 0.000). At the end of the 1st wk, the pathological scores and the mean ADC values of the transplantation control group were significantly different from those at the end of the 2nd and 4th wk (P = 0.000). However, there was no significant difference between the 2nd and 4th wk (P = 0.073 and 0.473, respectively). The coefficient of correlation between the pathological score and the mean ADC value in the cell transplantation group was -0.883 (P = 0.000) and -0.762 (P = 0.000) in the transplantation control group. CONCLUSION: Tracking the longitudinally dynamic change in the mean ADC value of the AHI liver may reflect hepatic injury reconditioning after allogeneic MBMC transplantation.

[The experimental study of magnetic resonance diffusion-weighted imaging to the treatment of acute hepatic injury with allogeneic MBMCs transplantation into liver].

OBJECTIVE: To investigate the therapeutic effect of mononuclear bone marrow cells (MBMCs) transplantation to rabbit liver with acute hepatic injury (AHI) and the feasibility that evaluated the functional recovery of acute hepatic injury model with MR-DWI. METHODS: 10 healthy rabbits were chosen to be normal control group which was only carried out MR-DWI scan of normal liver. 42 model rabbits of acute liver injury were randomly selected and divided into 2 groups:transplanted group (n = 21) and control group(n = 21). Each rabbit of the transplanted group was infused 5 ml MBMCs suspension (about containing 2 × 107 MBMCs) into its liver at multiple sites. All manipulations to each rabbit in the control group were as same as those in the transplanted group except that 5 ml of D-Hanks solution was injected instead of MBMCs suspension.7 model rabbits respectively chosen from the transplanted group and the control group were carried out MR-DWI scan and calculated the mean ADC value of the injury liver and then were killed on day 7, day 14 and day 28 of AHI establishment after transplantation. Other comparative assays were performed including: functional assay of liver, pathological examination of liver sections. RESULTS: Before MBMCs transplantation, the difference of liver function was not significant between the transplanted group and the control group. But after MBMCs transplantation, the liver functions of the transplanted group were significantly better than those of the control group at all time points tested (P < 0.05). On day 7 of AHI establishment after MBMCs transplantation, the mean ADC values of the transplanted group and the control group were significant lower than those of the normal control group (P < 0.05). The mean ADC values of the transplanted group and the control group increased to the mean ADC values of the normal control group over time. At the same time point, the mean ADC values of the transplanted group were significantly higher than those of the control group. In the transplanted group, the difference of average ADC values between any two time points were significantly (P < 0.05). In the control group, the mean ADC values on day 7 were lower than those on day 14 and day 28 (P < 0.05), the mean ADC values on day 14 were lower than those on day 28 (P = 0.417). The correlation between the average ADC value and the ALT or AST was negative (P < 0.05), the correlation between the average ADC value and the ALB was positive (P < 0.05). Along with the increase of the average ADC value, the liver function of the AHI model rabbit gradually got better. CONCLUSION: Transplantation of MBMCs promoted the recovery of liver function of AHI model rabbit. The recovery of the injury liver could be detected with observing dynamic change of its mean ADC value.

[Impact of selective fetoscopic laser photocoagulation for twin-twin transfusion syndrome on myocardial deformation].

OBJECTIVE: To investigate the changes in myocardial deformation in donor and recipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS). METHODS: Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software. Global longitudinal strain (S), systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles. RESULTS: In the donor, SFLP resulted in increase in cardiothoracic ratio (CTR, 0.29 ± 0.03 versus 0.34 ± 0.05, P < 0.01), with development of new onset tricupid regurgitation (n = 7) and pericardial effusion (n = 5) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [LV-S: (-19.24 ± 3.68)% versus (-13.78 ± 3.64)%, P < 0.01; LV-SRs: (-2.28 ± 0.53) versus (-1.43 ± 0.41) s(-1), P < 0.01; LV-SRd: (1.67 ± 0.43) versus (1.15 ± 0.70) s(-1), P < 0.01; RV-S: (-20.20 ± 3.19)% versus (-16.10 ± 3.07)%, P < 0.01; RV-SRs: (-2.03 ± 0.65) versus (-1.72 ± 0.38) s(-1), P < 0.05; RV-SRd: (1.71 ± 0.30) versus (1.50 ± 0.36) s(-1), P < 0.05]. In the recipient, CTR decreased (0.42 ± 0.04 versus 0.37 ± 0.04, P < 0.01) and all parameters for both LV and RV improved substantially [LV-S: (-10.62 ± 2.72)% versus (-16.46 ± 3.23)%, LV-SRs: (-1.09 ± 0.30) versus (-1.60 ± 0.31) s(-1), LV-SRd: (0.99 ± 0.34) versus (1.53 ± 0.32) s(-1), RV-S: (-11.66 ± 4.56)% versus (-17.96 ± 3.97)%, RV-SRs: (-1.26 ± 0.39) versus (-1.74 ± 0.45) s(-1), RV-SRd: (1.15 ± 0.49) versus (1.63 ± 0.44) s(-1); all P < 0.01]. CONCLUSION: Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.

MVD and VEGF expression in the acute liver injury treated with allogeneic MBMCs transplantation.

OBJECTIVE: To investigate the dynamical expression of vascular endothelial cell growth factor (VEGF)and the value of microvessel density (MVD) in acute liver injury model after the transplantation of mononuclear bone marrow cells (MBMCs). METHODS: Forty-two model rabbits with acute liver injury were randomly divided into 2 groups: a transplanted group and a control group (n=21). Seven rabbits from each group were killed on day 7, 14, and 28 after the transplantation of MBMCs. A series of comparative assays were performed, including functional assay of liver, immunohistochemical pathological examination of liver sections, VEGF positive cells count, and quantification of MVD value. RESULTS: Before the MBMCs transplantation, the difference in liver function was not significant between the transplanted group and the control group. But after the MBMCs transplantation, the liver function of rabbits in the transplanted group were significantly better than that in the control group (P<0.05). More VEGF positive cells and higher MVD value were observed in the transplanted group than in the control group (P<0.05). In the transplanted group, the number of VEGF positive cells gradually reduced, the number on day 7 was higher than that on day 14 (P>0.05), while both were significantly higher than that on day 28 (P<0.05). In contrast, the value of MVD increased gradually in the transplanted group, the value on day 28 was higher than that on day 14 (P>0.05), while both were significantly higher than that on day 7 (P<0.05). In the control group, the number of VEGF positive cells also gradually reduced, that on day 7 was higher than that on day 14 or 28 (P<0.05), and that on day 14 was higher than that on day 28 (P>0.05). The MVD value significantly increased between each time point (P<0.05). CONCLUSION: Transplantation of MBMCs promotes the expression of VEGF, up-regulates the MVD value in the acute injury livers, and facilitates the recovery of liver function.