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ObjectiveTo explore the mechanism of Buyang Huanwutang combined with bone marrow mesenchymal stem cell (BMSC) transplantation in the treatment of spinal cord injury (SCI). MethodDifferent concentrations (12.5, 25, 50 g·kg-1) of Buyang Huanwutang were administrated to rats by gavage. The spinal cord function of rats was measured by modified Tarlov score, and the most suitable concentration of Buyang Huanwutang was screened out. SD rats were then divided into 6 groups, namely, the sham operation group (gavage of equal amount of normal saline), the model group (gavage of equal amount of normal saline), the Buyang Huanwutang group (gavage of 25 g·kg-1 Buyang Huanwutang), the BMSC transplantation group (tail vein injection of BMSCs 1 mL), the Buyang Huanwutang+BMSC group (gavage of 25 g·kg-1 Buyang Huanwutang and tail vein injection of BMSCs 1 mL), the Buyang Huanwutang+BMSC+LY294002 group (gavage of 25 g·kg-1 Buyang Huanwutang and tail vein injection of BMSCs 1 mL and 40 mg·kg-1 LY294002), with 10 rats in each group. The spinal cord function was measured by the modified Tarlov score, inclined plate test, and latency of cortical somatosensory evoked potential. Immunohistochemistry was used to detect the number of 5-bromo-2-deoxyuracil nucleoside (Brdu)-labeled positive cells in the spinal cord tissue. The protein expression levels of phosphorylated protein kinase B (p-Akt), glycoprotein 130 (gp130), and interleukin-6 (IL-6) in spinal cord were detected by Western blot. ResultAs compared with the sham operation group, the Tarlov score and the critical angle of tilt plane in the model group were significantly decreased (P<0.05), and the latency of cortical somatosensory evoked potential wave and the protein expression levels of p-Akt, gp130, and IL-6 were significantly increased (P<0.05). As compared with the model group, the Tarlov score and the critical angle of tilt plane in the sham operation group and each treatment group were significantly increased (P<0.05), and the latency of cortical somatosensory evoked potential wave and the protein expression levels of p-Akt, gp130, and IL-6 were significantly decreased (P<0.05). As compared with the BMSC group, the Tarlov score and the critical angle of inclined plane in the Buyang Huanwutang+BMSC group increased (P<0.05), the latency of cortical somatosensory evoked potential wave and the protein expression levels of p-Akt, gp130, and IL-6 decreased (P<0.05), and the number of Brdu-labeled positive cells increased 5 weeks after transplantation (P<0.05). As compared with the Buyang Huanwutang+BMSC group, the Tarlov score and the critical angle of the inclined plane in the Buyang Huanwutang+BMSC+LY294002 group increased (P<0.05), and the latency of cortical somatosensory evoked potential wave and the protein expression levels of p-Akt, gp130, and IL-6 decreased significantly (P<0.05). Five weeks after transplantation, the number of Brdu-labeled positive cells increased significantly in the Buyang Huanwutang+BMSC+LY294002 group (P<0.05). ConclusionBuyang Huanwutang can promote BMSCs migration and restore spinal cord function by inhibiting phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signal.
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Objective:To explore the value of apparent diffusion coefficient (ADC) and renal volume in assessing fetal kidney development and disease.Methods:From January 2016 to October 2020, 84 fetuses with congenital anomalies of the kidney and urinary tract (CAKUT) were identified with MRI (CAKUT group), and 97 fetuses with no significant abnormalities on MRI or postnatal follow-up (control group) from the Obstetrics and Gynecology Hospital of Fudan University were enrolled and analyzed retrospectively. ADC value and renal volume were measured to compare the two groups, and the relationship was analyzed between these two parameters in the control group with gestational age, location (left or right kidney), and fetal gender. Two independent or paired sample t-tests, and linear correlation analyses, were adopted for the statistical analysis. Results:(1) There were 84 pregnant women in the CAKUT group, including a twin pregnancy, with an average age of (29±4) years old, ranging from 21 to 39 years old. The gestational age at MRI was (26±4) weeks with a range of 21-34 weeks. Of the 85 fetuses, 52 were male (61.2%), and 33 were female (38.8%). The polycystic dysplastic kidney was found in 32 cases (37.6%), hydronephrosis in 29 cases (34.1%), and an isolated kidney in 24 cases (28.2%). There were 97 singleton pregnancies in the control group, including 45 (46.4%) male and 52 (53.6%) female fetuses. The average maternal age was (30±5) years old, with a range of 19-41 years old, and the gestational week at MRI was (27±4) weeks, with a range of 21-34 weeks. (2) In the control group, the mean ADC value and renal volume were (1.255±0.112)×10 -3 mm2/s and (4 747±2 479) mm 3, which were negatively ( R 2=0.30, P<0.01) and positively correlated ( R 2=0.80, P<0.01) with the gestational age, respectively. There was no significant difference between ADC value and renal volume between different fetal gender in the control group. (3) The ADC value and the renal volume of fetuses with polycystic dysplastic kidney [(1.720±0.200) ×10 -3 mm2/s and (8 154±8 337) mm 3] were higher than those in the control group ( t=-13.11 and-3.08, P<0.001 and P=0.004). Compared with the control group, ADC of fetuses with hydronephrosis [(1.333±0.171) ×10 -3 mm2/s] was higher ( t=-3.90, P<0.001); and the renal volume [(7 201±4 460) mm 3] was larger but without statistical significance. The fetuses with an isolated kidney had an increasing trend in renal volume [(5 239±4 244) mm 3] and a decreasing trend in the ADC value [(1.239±0.125) ×10 -3 mm2/s] when compared with the normal fetuses, but neither difference was significant. Conclusions:In normal fetuses, the ADC value decreases, and the renal volume increases with the gestational age. Fetuses with CAKUT may have a larger kidney than normal.
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ObjectiveTo investigate the effect of calycosin-mediated glucoprotein130/Janus kinase/signal transducer and activator of transcription factor (GP130/JAK/STAT) signaling pathway on oxidative injury of astrocytes in spinal cord. MethodAstrocytes in rat spinal cord were isolated and identified by immunofluorescence detection of glial fibrillary acidic protein (GFAP). The cells were respectively pre-treated with 5, 10, 20 μmol·L-1 calycosin for 12 h, and then 100 μmol·L-1 H2O2 (24 h) was added to induce oxidative injury. Cell counting kit-8 (CCK-8) assay was employed to detect cell proliferation and select the optimal concentration of calycosin. The following experimental groups were designed: control group, model group (100 μmol·L-1 H2O2), calycosin group (20 μmol·L-1 calycosin), calycosin + LY294002 group (20 μmol·L-1 calycosin + 10 μmol·L-1 LY294002), and calycosin + Stattic group (20 μmol·L-1 calycosin + 3 μmol·L-1 Stattic). CCK-8 assay and immunofluorescence method were used to detect the proliferation of cells and flow cytometry was applied to detect cell apoptosis and cycle. The protein expression of phosphorylated (p)-JAK2, p-STAT3, p-protein kinase B (Akt), GP130, and interleukin-6 (IL-6) was detected by Western blotting. ResultCompared with the control group, the model group showed low proliferation activity and high apoptosis rate of cells (P<0.05). Compared with the model group, calycosin (20 μmol·L-1) group displayed high proliferation activity and low apoptosis rate of cells (P<0.05). Compared with calycosin (20 μmol·L-1) group, both phosphatidylinosirtol-3-kinases (PI3K) inhibitor LY294002 and STAT3 inhibitor Stattic significantly reduced the proliferation activity and increased the apoptosis rate of cells (P<0.05). The protein expression of p-JAK2, p-STAT3, p-Akt, GP130, and IL-6 in the model group was higher than that in the control group (P<0.05), and the expression of the above indicators was lower in each treatment group than in the model group (P<0.05). ConclusionCalycosin can promote the proliferation and inhibit the apoptosis of astrocytes with oxidative injury by inhibiting the phosphorylation of PI3K/Akt pathway and JAK2/STAT3 pathway.
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ObjectiveTo investigate the effect of calycosin-mediated glucoprotein130/Janus kinase/signal transducer and activator of transcription factor (GP130/JAK/STAT) signaling pathway on oxidative injury of astrocytes in spinal cord. MethodAstrocytes in rat spinal cord were isolated and identified by immunofluorescence detection of glial fibrillary acidic protein (GFAP). The cells were respectively pre-treated with 5, 10, 20 μmol·L-1 calycosin for 12 h, and then 100 μmol·L-1 H2O2 (24 h) was added to induce oxidative injury. Cell counting kit-8 (CCK-8) assay was employed to detect cell proliferation and select the optimal concentration of calycosin. The following experimental groups were designed: control group, model group (100 μmol·L-1 H2O2), calycosin group (20 μmol·L-1 calycosin), calycosin + LY294002 group (20 μmol·L-1 calycosin + 10 μmol·L-1 LY294002), and calycosin + Stattic group (20 μmol·L-1 calycosin + 3 μmol·L-1 Stattic). CCK-8 assay and immunofluorescence method were used to detect the proliferation of cells and flow cytometry was applied to detect cell apoptosis and cycle. The protein expression of phosphorylated (p)-JAK2, p-STAT3, p-protein kinase B (Akt), GP130, and interleukin-6 (IL-6) was detected by Western blotting. ResultCompared with the control group, the model group showed low proliferation activity and high apoptosis rate of cells (P<0.05). Compared with the model group, calycosin (20 μmol·L-1) group displayed high proliferation activity and low apoptosis rate of cells (P<0.05). Compared with calycosin (20 μmol·L-1) group, both phosphatidylinosirtol-3-kinases (PI3K) inhibitor LY294002 and STAT3 inhibitor Stattic significantly reduced the proliferation activity and increased the apoptosis rate of cells (P<0.05). The protein expression of p-JAK2, p-STAT3, p-Akt, GP130, and IL-6 in the model group was higher than that in the control group (P<0.05), and the expression of the above indicators was lower in each treatment group than in the model group (P<0.05). ConclusionCalycosin can promote the proliferation and inhibit the apoptosis of astrocytes with oxidative injury by inhibiting the phosphorylation of PI3K/Akt pathway and JAK2/STAT3 pathway.
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Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.
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Objective:To investigate the prenatal MRI diagnosis of fetal intracranial hemorrhage (ICH) and the pregnancy outcomes.Methods:This retrospective study included 49 cases of fetal ICH diagnosed by MRI in Obstetrics and Gynecology Hospital of Fudan University from July 2011 to November 2019. Two experts with more than five years of experience in obstetric radiology determined the location, number, area, stage and grade of the hemorrhage based on the MRI findings. Maternal age, gestational age at MRI, and the site, number, stage and grade of hemorrhage as well as other intracranial and extracranial abnormalities of the fetuses were compared between women with fetal germinal matrix-intraventricular hemorrhage (GM-IVH; GM-IVH group, n=39) and those without (non-GM-IVH group, n=10). MRI and ultrasound examination results of 37 cases who had MRI within three days after the ultrasound examination were compared. Postnatal and follow-up outcomes were summarized. Statistical analysis was performed using the independent sample t-test, Mann-Whitney U test and Chi-square test. Results:There was no significant difference in the maternal age, gestational age at MRI, or the site, number or stage of hemorrhage between the GM-IVH group and non-GM-IVH group (all P>0.05). The incidence of ventriculomegaly was higher in the GM-IVH group than that in the non-GM-IVH group [87% (34/39) vs 0/10, t=24.522, P<0.001]. There were 51% (19/37) of the lesions that were missed by ultrasound found by MRI, including GM-IVH in 17 cases, right cerebellar hemisphere hemorrhage in one case and corpus callosum hemorrhage in one case. Among the 49 cases, seven were lost to follow-up, 29 terminated the pregnancy (six in non-GM-IVH group and 23 in GM-IVH group), two experienced intrauterine fetal death in late pregnancy and 11 gave live birth. Ten live births had GM-IVH, among them a relatively good prognosis was noted in fetuses with grade Ⅰ (two cases), grade Ⅱ (four cases), and grade Ⅲ (three cases) GM-IVH, while one case with grade Ⅳ GM-IVH had mental retardation at eight years old; one non-GM-IVH infant had hearing loss at birth and a cochlear was implanted with no other anomalies reported during a three-year follow-up. Conclusions:MRI can provide a more direct view of the location and grade of fetal ICH and is more accurate than prenatal ultrasound in diagnosing fetal ICH, which is a beneficial supplement to ultrasound. The prognosis of cases with grade Ⅳ GM-IVH is not good.
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Objective: To determine the values of diffusion-weighted magnetic resonance imaging [DWI] parameters on differential diagnosis of benign and malignant ovarian tumours with solid and cystic components
Study Design: An observational study
Place and Duration Of Study: Department of Radiology, Obstetrics and Gynecology Hospital of Fudan University, China, from January to December 2017
Methodology: Forty-four cases of malignant and benign ovarian tumours were selected as respective groups. Inclusion criteria were ovarian masses found by pelvic and abdominal imaging examination. Exclusion criteria of two groups were endometriosis and pelvic inflammatory diseases found by relevant examination, those with chronic diseases, tumors in other organs found by relevant examination, and those with family cancer history. Conventional MRI plain scans, enhanced scans and DWI scans, were performed after admission. Apparent diffusion coefficient [ADC] and exponential apparent diffusion imaging [eADC] of solid lesions of two groups were recorded and compared
Results: Solid ADC in malignant group was lower than that in benign group [p<0.001]. Solid eADC in malignant group was higher than that in benign group [p<0.001]
Conclusion: Diffusion-weighted magnetic resonance imaging is of high application value in the differential diagnosis of benign and malignant ovarian tumours with solid and cystic components, and it is worthy of promotion and application
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Objective To analyze the correlations of commonly used biometric parameters of normal fetal brain with fetal gender and gestational age (GA) and to evaluate the feasibility of establishing MRI reference standards for normal fetal brain biometry in second and third trimesters. Methods MRI measurements of 263 fetuses without central nervous system abnormalities were retrospectively collected from the Obstetrics and Gynecology Hospital of Fudan University from June 2012 to April 2017. MRI measurements of fetal biparietal diameter (BPD), occipital-frontal diameter (OFD), head circumference cross-sectional area (HCS), transverse cerebellar diameter (TCD), anterior-posterior diameter of the vermis (APDV), vermian height (VH) and vermian cross-sectional area (VS) were obtained in every standard plane. Head circumference (HC) and (BPD+OFD)/2 were calculated. Spearman correlation analysis, independent samples t-test, Pearson correlation analysis and linear regression analysis were used for statistic analysis. Results Fetal BPD, OFD and HCS were statistically correlated with gender in second and third trimesters (r= - 0.155, - 0.149 and- 0.159; P=0.032, 0.038 and 0.027). The mean values of BPD, OFD and HCS of male fetuses were greater than those of female ones [(7.25±1.22) vs (6.87±1.28) cm, (8.59±1.38) vs (8.18±1.41) cm, (53.62±16.82) vs (48.48±16.84) cm2; t=2.101, 2.011 and 2.102; all P<0.05] and the mean differences between them were 0.38 cm, 0.41 cm and 5.14 cm2, respectively. BPD, OFD, HCS, HC, (BPD+OFD)/2, TCD, APDV, VH and VS were positively correlated with gestational age (r=0.950, 0.947, 0.962, 0.957, 0.957, 0.976, 0.931, 0.943 and 0.960, respectively; all P<0.001). Among them, TCD (r=0.976) was the closest relating factor, followed by HCS (r=0.962) and VS (r=0.960). The linear regression equations were as follows: BPD (cm)=0.276×GA-0.453, R2=0.903; OFD (cm)=0.308×GA+0.010, R2=0.896; (BPD+OFD)/2 (cm)=0.292×GA - 0.222, R2=0.916;HC (cm)=0.473×GA - 0.359, R2=0.916; HCS (cm2)=3.795×GA - 52.232, R2=0.926; TCD (cm)=0.180× GA-1.858, R2=0.952; APDV (cm)=0.047×GA-0.353, R2=0.867; VH (cm)=0.071×GA-0.592, R2=0.890;VS (cm2)=0.143×GA-2.396, R2=0.919, all P<0.001. Conclusions Some fetal brain biometric parameters are correlated with fetal gender. It is essential and conducive to establish different reference values for male and female fetuses to achieve accurate prenatal evaluation and diagnosis. Fetal BPD, OFD, HCS, HC, (BPD+OFD)/2, TCD, APDV, VH and VS have strong linear relationship with gestational age in second and third trimester and can be served as good indicators for evaluating fetal brain growth and development. MRI quantitative measurement of fetal brain biometric parameters can provide more reliable reference data for prenatal evaluation of fetal brain growth and development. It is feasible to establish MRI reference standards for fetal brain biometry.
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Objectives@#To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied.@*Methods@#A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1β, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged.@*Results@#The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1β, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1β, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52.@*Conclusion@#There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.
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Objective To investigate the value of the apparent diffusion coefficient (ADC)measurement in assessment of tumor grade and myometrial invasion of endometrial carcinoma (EC).Methods 80 EC patients and 28 cervical cancer patients with normal endometrium were studied retrospectively.1.5T conventional MRI and DWI (b=0,1 000 s/mm2)were performed,and ADC values were calculated by two radiologists.Statistical analyses were performed by using SPSS 19.0 and Medcalc software.Results The mean ADC values (×10-3mm2/s)were 0.851±0.131,0.752±0.099,0.681±0.089 for G1,G2 and G3 EC,respectively.Significant statistical differences were achieved for the three groups (G1 vs G2:P=0.005;G2 vs G3:P=0.03;G1 vs G3:P< 0.000 1).For the prediction of G3,the area under the curve (AUC)of 0.851 and the cut-off value of ≤0.742×10-3mm2/s were identified,with the sensitivity, specificity and accuracy of 88.24%,76.19% and 85%,respectively.Conclusion There are significant statistical differences between histologic grades of EC.ADC measurement may have the potential to select G3 EC patients.
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Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on social function and life quality of schizophrenia in long-term hospitalization.Methods Sixty patients met with ICD-10 for schizophrenia in long-term hospitalization were enrolled in this study.The group was divided randomly into research (n =40) and control (n =40) groups.They were given rTMS or sham stimulation,respectively.The treatment was given 20 times,and the course of treatment was 4 weeks.The research and control groups were assessed with measured the scale of social function in psychosis inpatients and personal and social function scale and schizophrenia quality of life scale before and'after 4 weeks treatment.Each test result of all groups before and after treatment was compared with each other,respectively.Results Compared to rTMS before treatment,the study group scale of social function in psychosis inpatients (SSPI) total score,factor Ⅰ,Ⅱ and personal and social function scale (PSP) scores were significantly increased (P < 0.05),no change of SSPI factor (P > 0.05);the study group Schizophrenia Quality of Life Scale (SQLS) total score,psychological and social power,the energy scale scores were significantly reduced (P < 0.05),SQLS symptoms and side effects scale showed no significant difference (P > 0.05).No significant change was found in the scores of project SSPI,PSP and SQLS in control group before and after treatment (P > 0.05);the difference of each parameter between two groups after treatment were statistically significant (P < 0.05).Conclusions Repetitive transcranial magnetic stimulation could improve on social function and life quality of schizophrenia in long-term hospitalization,rTMS could provide a new way for the individual rehabilitation of schizophrenia in long-term hospitalization.
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Objective To explore the role of CT scan for the diagnosis of lung metastasis in stage Ⅲ gestational trophoblastic neoplasia (GTN).Methods To figure out the role of CT scan for lung metastasis in GTN initial diagnosis,treatment and follow-up,93 GTN patients with lung metastasis from January,2015 to December,2016 were retrospectively analyzed in Obstetrics and Gynecology Hospital of Fudan University.Results (1) Among 93 GTN patients with lung metastasis,70 patients with the International Federation of Gynecology and Obstetrics (FIGO) score ≤6 were defined as low risk GTN and 23 patients score score ≥7 were defined as high risk GTN.Forty nine patients had negative chest X-ray findings and 39 cases with pulmonary lesions were identified both by chest X-ray compared to CT scan.Five cases were excluded due to no consensus could make for the results of chest X-ray.The true positive rate of chest X-ray for lung metastasis were 41% (29/70) in low risk GTN and 43% (10/23) in high risk GTN patients without statistical difference (x2=0.090,P=0.925).For those patients with positive chest CT scan and negative chest X-ray finding,pulmonary lesions in 32 (65%,32/49) cases were blocked by heart,chest wall or diaphragm in chest X-ray.Seventeen (35%,17/49) patients with lung lesions less than 5 mm had negative chest X-ray results due to the lower sensitivity compared to CT scan.(2) In 88 patients with stage Ⅲ,78 patients had successful initial treatment,but 4 of them were recurrence in twelve months follow-up.Ten patients were chemotherapy resistance for the initial treatment.The initial chemotherapy remission rate in low risk GTN patients was higher than that in high risk ones (x2=4.911,P=0.027).In 49 cases with negative chest X-ray,there was no correlation with the rate of remission,chemotherapy resistance and recurrence in stage Ⅲ patients (P>0.05).(3) For those patients who had poorly response to initial chemotherapy,the diameters of lesions in lung were unchanged or increased during the treatment,form (5.1±4.1) mm to (7.4±2.8) mm.The pulmonary lesions were continuously shrunk from (7.8 ± 5.3) mm to (4.7 ± 4.4) mm for those patients with complete and partial remission including the recurrent GTN patients (Z=-2.713,P=0.007).Conclusions Patients with GTN in stage Ⅲ have down staging if only use chest X-ray for imaging at the initial diagnosis.Chest CT scan is recommended for primary imaging evaluation of FIGO staging in qualified medical organization.For those patients with persistent abnormal serum hCG level and negative chest X-ray,chest CT scan is strongly recommended to identify the persist or resistant lung lesions and follow up.
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Objective To investigate the clinical characteristics of tubal stump pregnancy, and to assess the value of interventional embolization in preventing tubal stump pregnancy. Methods Among the patients who were planned to receive preoperative treatment of hydrosalpinx before the performance of in vitro fertilization-embryo transfer (IVF-ET) at authors' hospital, 35 patients had stump of fallopian tube. Of the35 patients, previous surgery of unilateral fallopian tube was present in 28 and previous surgery of bilateral fallopian tubes in 7. The length of tubal stump ranged from 10mm to 45mm, with a mean of 25mm. Interventional embolization with micro-coils was carried out in all patients, after which IVF-ET was performed. The pregnancy rate and ectopic pregnancy rate were calculated. Results Embolization of both fallopian tubes was successfully accomplished in all 35 patients. The IVF-ET pregnancy rate was 48.5% (17/35), and no tubal stump pregnancy occurred. Conclusion The use of interventional embolization to occlude tubal stump can effectively avoid the occurrence of tubal stump pregnancy.
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Objective To investigate the manifestations and features of CT for glandular cystitis as well as cystic cystitis.Methods Clinical manifestations and CT imaging features of 39 cases with biopsy-proved glandular cystitis or cystic cystitis were analyzed retrospectively.Results Among 39 cases,33 were glandular cystitis and 6 were cystic cystitis.Two out of the 33 cases with glandular cystitis had a negative CT scan,and 31 had a positive CT scan among which 4 cases with extensive lesions showed diffuse thickening of the bladder wall,and 27 were with localized lesions.Furthermore,19 out of the 27 cases showed localized thickening of the bladder wall with smooth edge,which was a continuation of surrounding normal bladder wall;8 showed nodular lesions.17 of the 33 cases with glandular cystitis underwent contrast-enhanced CT scan which showed mildly enhancement consistent with or slightly stronger than the normal bladder wall in 15 cases and moderate uneven enhancement in 2 cases.The 6 cases with cystic cystitis showed diffuse thickened rough bladder wall.There were cystic shadows of various sizes in the inner wall of the bladder partially protruding into the bladder,which presented as a"beaded shape"manifestation.Conclusion The characteristic manifestations of glandular cystitis as well as cystic cystitis on CT scan are of great significance in diagnosing both of the diseases.
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Objective To study the efficacy and safety of Shuganjieyu capsule alone or in combination with other antidepressants for the treatment of post-stroke depression (PSD).Methods Wanfang database,China National Knowledge Infrastructure (CNKI),Chinese VIP journals database,PubMed,EMbase,Cochrane Library,and Chinese dissertations full text database were retrieved by computers.The randomized controlled trials (RCTs) on Shuganjieyu capsule for the treatment of PSD from January 1995 to September 2017 were collected.After literature screening,data extraction,and methodological quality evaluation,RevMan 5.1 software was used to conduct a Meta-analysis.The bias was evaluated with the Stata 12.0 software using Begg's rank correlation and Egger's linear regression.Results A total of 19 RCTs were included,including 1 814 participants.The Meta-analysis results showed that compared with other antidepressants,there were no significant differences in the effective rate and cure rate of Shuganjieyu capsule (combinedeffects:RR=1.04 [95% CI0.97-1.11],Z=0.99,P=0.32 and RR =1.06 [95% CI 0.85-1.32];Z =0.52,P =0.60).Compared with other antidepressants,there were significant differences in the effective rate and cure rate of Shuganjieyu capsule in combination with other antidepressants (combined effects:RR =1.19 [95% CI 1.13-1.26];Z =6.43,P <0.01 and RR =1.54 [95% CI 1.26-1.88];Z =4.17,P <0.01).The incidence of adverse events of Shuganjieyu capsule alone was less than that of other antidepressants (combined effect:RR =0.39 [95% CI 0.27-0.55];Z =5.30,P < 0.01).The incidence of adverse events of Shuganjieyu capsule in combination with other antidepressants was the same as other antidepressants (combined effect:RR =0.99 [95% CI 0.77-1.26];Z =0.10,P =0.92).Conclusions Shuganjieyu capsule is effective for post-stroke depression.The efficacy of Shuganjieyu capsule alone is as effective as other antidepressants,however,Shuganjieyu capsule in combination with other antidepressants is superior to other antidepressants,and the safety is better than other antidepressants.
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Objective To assess the application of MRI in diagnosis of oblique vaginal septum syndrome (OVSS).Methods Clinical and imaging data of 41 patients with OVSS confirmed by surgery from March 2011 to November 2016 were retrospectively analyzed.Results The average age of patients was 20.5 year (10-46 years).The primary clinical symptoms were menorrhalgia (16 cases) and menorrhagia (13 cases).There were 12 cases of type Ⅰ,23 cases of type Ⅱ,5 cases of type Ⅲ and 1 case of type Ⅳamong 41 cases of OVSS.The resections for OVSS were performed in 35 cases.Forty two cases were diagnosed as OVSS by MRI scan,and 41 were confirmed by surgery,the accuracy of MRI diagnosis was 97.6% (41/42).MRI showed uterus didelphys,hydrocolpos or hematocolpos with varying degrees,and revealed ipsilateral renal agenesis in all 41 cases.Conclusion MRI scan can accurately diagnose oblique vaginal septum syndrome and provide comprehensive information for clinical treatment.
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Objective To explore the effect of Valpar occupational assessment training system on cognitive dysfunction in schizophrenia. Methods Sixty patients with schizophrenia were randomly assigned into Valpar therapy group ( experiment group, n=30) and traditional rehabilitation therapy group ( control group, n=30) according to the order number. The duration of the treatment was six weeks. The brief assess?ment of cognition in schizophrenia ( BACS) and Wisconsin card sorting test ( WCST) were conducted as pre?and post?treatment assessment. Results There were significant differences between scores of BASC in pre?and post?treatment assessment in experiment group. More specifically, the BASC scores in symbol coding (37.50±6.50, t=-4.60, P<0.01),token movement(60.80±8.72, t=-2.54, P=0.017),verbal memory (44.40±11.29, t=-2.19, P=0.037)),and word fluency(14.23±4.35, t=-3.39, P=0.002) were signifi?cantly different when comparing pre?and post?treatment assessment outcomes. In control group,the only sig?nificant difference was found in word fluency (14.23±4.35, t=-3.39, P=0.002).In addition,response errors (57.80±10.35, t=-3.06, P=0.005) and repeat errors (34.67±6.96, t=3.41, P=0.002) in WCST in exper?iment group were significantly different in pre?and post?treatment assessment while only repeat errors (34.30 ±7.01, t=4.36, P=0.000) was different in control group. It was further discovered that scores in in symbol cod?ing( t=2.010, P=0.048),token movement ( t=2.124, P=0.038),response errors ( t=2.413, P=0.020) and repeat errors( t=2.009, P=0.047) in WCST were different between two groups. Conclusion Valpar professional evaluation train?ing system can significantly improve the cognitive function of people with schizophrenia.
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Objective To investigate the ability of proton magnetic resonance spectroscopy (1H-MRS) for differentiating benign from malignant solid adnexal tumors. Methods One-hundred and six patients (114 tumors) with surgically and histologically proven solid adnexal tumors (44 benign, 70 malignant) underwent conventional MR imaging and 1H-MRS. Single-voxel spectroscopy was performed using the point resolved spectroscopy localization technique with a voxel size of 2.0 cm × 2.0 cm × 2.0 cm. Resonance peak integrals of choline (Cho), N-acetyl aspartate (NAA), creatine (Cr), lactate (Lac), and lipid (Lip) were analyzed and the Cho/Cr, NAA/Cr, Lac/Cr and Lip/Cr ratios were recorded and compared between benign and malignant tumors using independent two-sample t test. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of Cho/Cr ratio for differentiating benign from malignant tumors. Results A Cho peak was detected in all 114 tumors, NAA peak in 112 tumors (43 benign and 69 malignant), Lip peak in 70 tumors (21 benign and 49 malignant), and Lac peak in 16 tumors (7 benign and 9 malignant). The Cho/Cr and Lip/Cr ratios were 4.8±2.5, 6.4±4.0 in benign versus 9.6 ± 3.3, 10.5 ± 4.6 in malignant solid adnexal tumors, respectively, with a statistically significant difference (t values were-8.826 and-2.915,P malignant solid adnexal tumors, with no statistically significant difference (t=-1.523,P>0.05). When the Cho/Cr threshold was 7.2 for differentiating between benign and malignant tumors, the sensitivity, specificity, accuracy were 80.0%(56/70),88.6%(39/44) and 83.3%(95/114) respectively. Conclusions The 1H-MRS patterns of benign and malignant solid adnexal tumors differ. The Cho/Cr ratio can help clinicians differentiate benign from malignant tumors.
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Acute spinal cord injury can lead to severe motor,sen-sory and sphincter muscle dysfunction.Inflammatory response caused by inflammatory cytokines plays a crucial role in the oc-currence and development of secondary damage.Maintaining the body balance between inflammaion and anti-inflammation through an appropriate anti-inflammatory intervention will be an important strategy for drug therapy of spinal cord injury.This paper mainly introduces the cause,process and participation of inflammatory response in the pathophysiological mechanism of acute spinal cord injury,and also reviews the latest progress of experimental research of anti-inflammatory drugs,aiming to provide reference for finding the safe and effective drugs.
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Objective To explore the effect of non-directed musical therapy on the automatic thoughts and therapeutic effect of depression.Methods 60 people outpatient and inpatient who with depression disorder participated in this research.According to the medical order,we choose the people who with Cardinality order as the group of the musical therapy (study group) and the people with the even order as the group of drug therapy (control group).all the patients was test with the Hamilton's Depression Scale (HAMD-24) and Automatic Thoughts Questionnaire (ATQ) before and after 2,4,8 weeks treatment,and comparison of these questionnaires scores of the two groups.Results After the 2,4,8 weeks treatment,the HAMD scores of the study group was (15.70±2.63),(10.03±2.28),(6.00± 1.98) and the scores of control group was (17.43±2.62),(12.47±2.75),(7.50±2.03).The result of HAMD scores had significant difference(F=11.754,P=0.001).ATQ scores of the study group was (73.27± 17.60),(58.33± 13.66),(47.43± 11.94) and the scores of control group was(84.20±22.30),(72.53±20.86),(58.90± 18.61).The result of ATQ scores had significant difference(F=4.136,P=0.047).Conclusion Non-directive musical imagery could be an effective way to improve the automatic thoughts of people who with depression disorder and improve the effect of treatment.