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Objective:To identify the risk factors for simple congenital ptosis.Methods:A case-control study was performed.A total of 106 children diagnosed with simple congenital ptosis at the Second Affiliated Hospital of Zhejiang University School of Medicine from October 2018 to January 2021 were recruited as a case group, and 106 sex-matched children without congenital abnormalities were enrolled as a control group at the same period.Ophthalmic examinations, including interpalpebral fissure height and margin reex distance 1, were performed on all participants.A questionnaire survey was administered to their mothers.The questionnaire included demographic information, prenatal maternal diseases, medical treatments and environmental exposures during pregnancy.Univariate analysis was used to compare the differences in variables between the case and control groups.Variables with P<0.20 were retained for multivariate logistic regression analysis to identify the risk factors for simple congenital ptosis.The goodness of fit of the model was evaluated by the Hosmer-Lemeshow test, and collinearity was assessed by the variance inflation factor (VIF). This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (No.2019-136). The method and purpose of the study were fully explained to the children's guardians and written informed consent was obtained. Results:Comparisons of gestational age <37 weeks, birth order ≥2, maternal age, antibiotic use in the first trimester, paternal smoking ≥half a pack per day, and prenatal maternal passive smoking between the two groups were all with P<0.20.Multivariate logistic regression analysis showed that gestational age <37 weeks (odds ratio [ OR]=4.58; 95% confidence interval [ CI]: 1.24-16.85), paternal smoking ≥half a pack per day ( OR=2.28; 95% CI: 1.22-4.28) and prenatal maternal passive smoking ( OR=3.13; 95% CI: 1.16-8.41) were risk factors for simple congenital ptosis.No significant collinearity was found among these identified factors (all VIF<5). Conclusions:Preterm birth, paternal smoking, and prenatal maternal passive smoking are risk factors for simple congenital ptosis.
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Objective:To explore the role of parental origin verification in chromosomal microarray analysis (CMA) on the determination of the clinical significance of copy number variations (CNVs).Methods:This retrospective study collected clinical information from 73 core families who underwent prenatal diagnosis at Peking University First Hospital from November 2017 to December 2019. Indications for prenatal diagnosis included ultrasound abnormality in 54 cases (including 12 with thickened nuchal translucency (≥2.5 mm), four with fetal growth restriction, seven with abnormal pregnancy history, and 31 with isolated ultrasound abnormality), NIPT indicated high-risk in four cases, advanced age in nine cases, abnormal pregnancy history alone in three cases, intrauterine death in two cases and one with maternal mental retardation. Genomic DNA of amniotic fluid sample, chorionic villi, cord blood, fetal tissues, and fetal heart blood were extracted using genomic DNA extraction kit. The CNVs of prenatal samples in 73 subjects were analyzed using array-based comparative genomic hybridization (array-CGH) analysis and single nucleotide polymorphism array (SNP-array). Peripheral blood DNA of the couples, and relevant families if necessary, were collected and analyzed in the same way. The results of parental origin detection in CMA were summarized.Results:A total of 76 CNVs were detected in these 73 samples, out of which nine were pathogenic and parental origin detection revealed that six were de novo, two were maternally, and one was paternally inherited; six CNVs were likely pathogenic, including three de novo, two maternally inherited and one paternally inherited; 20 CNVs were variants of uncertain significance, including five paternally inherited, three maternally inherited and 12 de novo; 41 CNVs were likely benign, among which 38 were inherited from parents with normal phenotype. Conclusions:Parental origin verification plays an important role in explaining the clinical significance of detected fetal CNVs and thereby can help to analyze its clinical effect and reproductive risk.
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Objective To investigate the value of morphological features in differentiating between tuberculous hydronephrosis and non-tuberculous obstructive hydronephrosis.Methods The abdominal enhanced-CT examination data of 33 patients with renal tuberculosis and 37 patients with non-tuberculous obstructive hydronephrosis were retrospectively collected.All patients were examined in Peking University First Hospital from September 2009 to November 2016 and confirmed by surgical pathology or clinical manifestation.The longest diameter and largest area of all dilated calices,the anteroposterior longest diameter and the area of renal pelvis at the renal hilum level were measured.The standard deviation of dilated calyx's longest diameter and largest area in each case,the ratio of the mean value of dilated calyx's longest diameter to the anteroposterior longest diameter of renal pelvis and the ratio of the mean value of dilated calyx's largest area to the area of renal pelvis were calculated.These data were compared between the two groups with the t test.Based on the ratio of dilated calyx's longest diameter and largest area to those of renal pelvis,receiver operating characteristic (ROC) curves were used to calculate cut-off values for diagnosis of tuberculous hydronephrosis.Results The standard deviation of dilated calyx's longest diameter and largest area were significantly different in the renal tuberculosis group and the non-tuberculosis group (P＜0.01).The ratio of dilated calyx's longest diameter and largest area to those of renal pelvis of tuberculosis group were significantly larger than those of non-tuberculous group (P＜0.01).ROC analysis of the ratio of dilated calyx's longest diameter to that of renal pelvis showed that the area under the curve was 0.87 (95％ confidence interval 0.77-0.94),the best cut-off point was 0.73,with 81.8％ sensitivity (27/33) and 81.1％ specificity (30/37).ROC analysis of the ratio of dilated calyx's largest area to that of renal pelvis,the area under the curve was 0.90 (95％ confidence interval 0.80-0.95),the best cut-off point was 0.42,with 81.8％ sensitivity (27/33) and 86.5％ specificity (30/37).Conclusions In tuberculous hydronephrosis,the dilatation of calices is more obvious than renal pelvis,and the size of dilated renal calices is remarkably different.In non-tuberculous obstructive hydronephrosis,the dilatation of renal pelvis is more obvious than calices,and the size of dilated renal calices is similar.The morphological differences are helpful in differentiating tuberculous and non-tuberculous hydronephrosis.
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Objective Image-guided radiation therapy(IGRT)was performed to investigate the intrafractional body motion and identify the relevant influencing factors during hypofractionated radiotherapy for malignant pulmonary tumors. Methods A total of ninety-six patients with malignant pulmonary tumors receiving hypofractionated radiotherapy in Jiangsu Cancer Hospital were enrolled in this clinical trial. The kilo-voltage cone beam CT(kV-CBCT)was acquired prior to each fraction and matched to the planning CT images to correct the set-up errors. CBCT was performed immediately after the end of treatment to evaluate the intrafractional variation in the mediolateral,anteroposterior and craniocaudal dimensions.The relationship between relevant influencing factors and intrafractional variation was analyzed using multivariate linear regression. Results In the anteroposterior and craniocaudal directions,the intrafractional positioning errors were reduced along with the increase of ordinal number of fraction(P= 0.000). In the mediolateral direction, the intrafractional positioning errors were increased along with the longer duration of hypofractionated radiotherapy(P=0.010).The intrafractional positioning errors were decreased over larger body weight(P=0.003).The intrafractional positioning errors were significantly increased when vacuum bag and thermoplastic film were utilized for fixation(P= 0.009). Conclusions Certain intrafractional positioning errors occur during hypofractionated radiotherapy. Relevant influencing factors differ in different directions. Relevant influencing factors should be modified to reduce intrafractional positioning variation and improve the treatment accuracy.
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Objective To evaluate the clinical and image characteristics of rheumatoid arthritis (RA) patients accompanied with bronchiectasis (BR).Methods By retrospectively analyzing 67 patients admitted to our department,we divided RA patients into RA-BR group and non-BR group,according to the presence of BR or not.For those with interstitial lung disease (ILD),the ILD lesions were classified by inflammatory,fibrosis and mixed pattern.The clinical and image characteristics,as well as the correlation between BR patients with clinical/other lung changes were analyzed.Independent sample t test was used to compare the difference between the two groups if the data was normally distributed and those data that were not distributed normally were analyzed by Mann-Whitney U-test.Spearman correlation analysis was used for variables related analysis.Logistic regression analysis was used to identify independent risk factors for the presence of respiratory symptoms.Results Twenty-nine patients (43％) showed BR in CT scan.There was no statistically significant difference between BR and uon-BR group in age,gender,disease course of RA,smoking history and rheumatoid serology;respiratory symptom was presented in 6 pts in both groups;bronchiectasis involved unilaterallung in 10 patients (34％) and bilaterally in 19 (66％),26 patients (90％) were found to have bronchiectasis in their lower lobe.ILD was presented in 12 (41.4％) and 13 (34％) cases in BR and non-BR group,respectively (P＞0.05).BR in RA was not correlated with clinical parameters and presence of ILD.Logistic regression showed BR [OR:1.201,95％ CI.(1.023-1.411),P＜0.05] and ILD [OR:10.646,95％CI:(1.944-58.305),P＜0.01] were independent risk factors associated with respiratory symptoms in RA pts.Conclusion BR is a common lung lesion in pts with RA in China,and the dose was not correlated with ILD,the number of segment involved by BR is a risk factor for respiratory symptoms.
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Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.
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Objective To analyze the changes of renal apparent diffusion coefficient(ADC)value during development in intact rats.Methods Five intact male Wistar rats(1 month of age)were involved in this study.Using SE-echo planar imaging(EPI)sequence to acquire renal DWI at a 3.0 T MR on day 1,day 5,day 10,day 30,and day 50,respectively.The b value was 0 and 500 s/mm2.The ADCs of the cortex and the medulla were measured on the right kidney and the renal volume was calculated by manually renal outling on each slice.The difference of ADC between the cortex and the medulla was analyzed using a paired student t test,and the changes of renal volume and ADCs with rats development were evaluated with a repeated measurement ANOVA.Results The ADC of the cortex was higher than that of the medulla except on day 1(P＜0.01).when b value 0 and 500 s/mm2 were chosen.Renal volume increased with the rat development.from(0.86±0.02)ml to(1.47±0.21)ml.And the ADCs of both the cortex and medulla increased from(1.66±0.14)×10-3mm2/s to(1.96±0.08)×10-3mm2/s for the cortex and from (1.54±0.12)×10-3mm2/s to(1.91±0.09)×10-3mm2/s for the medulla.Conclusion Renal ADCs of both the cortex and medulla increase during the period from 1 to about 3 months of age in rats.The influence of age on renal ADC should be considered when choosing rats aged from 1 to 3 months for MR study.
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Objective To evaluate the reproducibility of measuring renal oxygenation in rat using blood oxygen level-dependent MR imaging(BOLD MRI).Methods Five intact male Wistar rats were included in this study and their body weights were measured before MRI scans.BOLD MRI were performed ou day 1(d1),day 5(d5),day 10(d10),day 30(d30)and day 50(d50)on a 3.0 T MR scanner to measure the apparent spin-spin relaxation(R2*).On d30 and d50,the differences of R2*(△R2*)were calculated between before and 10 min after furosemide injection through the tail vein.The reproducibility of the baseline R2* of 5 times repeated scans were verified by the repeated-measure ANOVA test.The R2* and △R2* between pre-and post-furosemide iniection on d30 and d50 were measured on the codex and the medulla and a paired t test was run to analyze their responses to furosemide and the reproducibility of △R2*.Results The average body weight on d1,d5,d10,d3 and d50 was(150.4±3.7)g、(170.2±7.0)g、(201.0±5.8)g、(306.2±17.0)g and(352.0±12.2)g,respectively,with statistical difference(F=422.103.P＜0.01).The R2* showed no statistical difference in the cortex and medulla among the five scans(P＞0.05).On d30.the R2* of the cortex and medulla was(25.2±1.2)and(32.8±2.2)Hz before and significantly decreased to(21.1±2.2)and(25.9±3.0)Hz after furosemide administration,respectively(P＜0.01).On d50,the R2* of the cortex and medulla was(25.9±0.8)and(34.3±3.9)Hz before and significantly decreased to(20.2±1.5)and(27.0±3.2)Hz after furosemide administration.respectively(P＜0.01).The △R2* on the codex and medulla was(4.1±1.7)and(6.9 4-2.8)Hz on d30 and(5.8±1.1)and(7.3±2.8)Hz on d50,respectively,but there is no significant difference between eortex and medulla(P＞0.05).Conclusion The baseline R2* in the cortex and medulla were reproducible over 50 days and they were not body weighted.On 3.0 T MR scanners.R2* in the codex and medulla decreased significantly after administration of furosemide.
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OBJECTIVES To analyse the diagnosis and treatment of 24 hereditary nonpolyposis colorectal cancer (HNPCC) kindreds and report mismatch repair gene mutations. METHODS The diagnosis, treatment and follow-up of 24 HNPCC kindreds were reviewed retrospectively, cancer incidence and spectrum were recorded. Clinical characteristics and treatment were analyzed. Peripherial blood and genomic DNA were extracted from family members who had provided informed consent. PCR and SSCP were used to screen coding regions of the hMLH1 and hMSH2 genes. Variant bands were sequenced by 377 DNA sequencer after purification. RESULTS One hundred and 25 malignant neoplasms were diagnosed in 75 patients (multiple cancers in 24) with an average age of 51 years in 24 pedigrees. The onset of the disease occurred earlier than expected with the passing of each generation within large kindreds. The neoplasm mainly included colonic cancer (63 patients), rectal cancer(21), stomach cancer(13), endometric cancer(7), and esophageal cancers(6). 84% patients received radical operations. Of 64 patients with colorectal cancer 16 had metachronous colorectal cancer. 24% colorectal patients developed metachronous cancer within 10 years after initial operation and received re-operation. In 3 detected families with germline hMSH2 and hMLH1 mutations resulting in truncated protein, 12 carriers were found. CONCLUSIONS The main characteristics of hereditary nonpolyposis colorectal cancer include early onset and frequence of cancer; predominance of colorectal cancer, especially right-sided colonic cancer; frequency of multiple primary cancer, especially colorectal cancer; and age anticipation in large HNPCC pedigrees. Segmental resection of colorectal cancer is not suitable for colorectal cancer patient in HNPCC kindred. Intensive follow-up is important for all patients and possible gene carriers.
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Adult , Aged , Female , Humans , Male , Middle Aged , Adaptor Proteins, Signal Transducing , Carrier Proteins , Colorectal Neoplasms, Hereditary Nonpolyposis , Diagnosis , Genetics , Therapeutics , DNA-Binding Proteins , MutL Protein Homolog 1 , MutS Homolog 2 Protein , Mutation , Neoplasm Proteins , Genetics , Nuclear Proteins , Proto-Oncogene Proteins , GeneticsABSTRACT
Objective To quantitatively analyze the ADC values of different types of benign prostatic hyperplasia(BPH) comparatively with ADC values of prostatic carcinoma(Pca).Methods Seventeen cases of BPH(mean age 69.1 years?4.3 years,ranged from 62 to 77 years) underwent transurethral resection of prostate(TURP) were scanned with the sequence of DWI.DWI(b-values = 0 s/mm2and 800 s/mm2) was performed at 1.5-T system.The hyperplasia tissues resected from central gland were divided into two types pathologically: glandular BPH and stromal BPH.According to the pathological results,ROIs were placed on central gland and the ADC values of two types of BPH were measured.In addition,fifteen patients with biopsy-proved Pca were evaluated and the ADC values of Pca regions were measured.Results The mean ADC values of glandular BPH,stromal BPH and Pca were(1.80?0.20)?10-3 mm2/s,(1.56?0.18)?10-3 mm2/s and(1.27?0.21)?10-3 mm2/s,respectively.Statistically significant difference(F=47.366,P
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Objective To investigate MRI characteristics of recurrent prostate cancer after endocrinotherapy.Methods Recurrent prostate cancer after endocrinotherapy was diagnosed clinically in 10 cases.MRI examinations were performed before and after recurrence of tumors.T_2 signal intensity and morphological changes of the prostate,involvement of pelvic tissues,metastasis of bone and lymph metastasiswere analyzed.Results The prostates enlarged in 7 patients after recurrence and maintained the same size in the other three.The pelvictissues,including seminal vesicle,bladder,rectal and obturator internus,were involved in 7 patients after recurrence.Metastasis of bone and lymph node progressed in 7 and 9 patients,respectively,but T_2 signal differences were unremarkable between recurrent regions and otherregions.Conclusion MRI examination can provide sufficient radiologic information in the diagnosis of recurrence of prostate cancer afterendocrinotherapy.
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Objective To evaluate the accuracy of MR in the diagnosis of tumor thrombus in renal cell carcinoma.Methods 22patients with renal cell carcinoma proved pathologically were recruited in this study.All the patients underwent MR examination beforesurgery.The results of the MR were correlated with that of the operation.Results 8 renal veins could be found tumor thrombus during the surgery,and the other 14 renal veins and 22 inferior vena cava were absent of tumor thrombus.MR could found all of the 8 tumor thrombithat detected by the surgeons.In the other 14 cases,13 of them could be excluded of tumor thrombus by MR.Only in 1 patient,the MRresult was equivocal.CT was performed in 9 patients,the diagnosis was accurate in 7 cases,and was inaccurate in 2.Ultrasound wasperformed in 16 patients,the diagnosis was accurate in 13 cases,and was inaccurate in 3.Digital subtraction angiography was performed in 4 cases,the diagnosis was correct in all of them.Conclusion MR is perfect in the diagnosis of tumor thrombus in renal cell carcinoma oncondition that the renal vein is clearly defined by MR.It can be considered as the method of choice in the evaluation of tumor thrombus inrenal cell carcinoma.
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Objective To evaluate three-dimensional reconstruction of MRI images in diagnosis and therapy of prostate cancer. Methods Twenty-eight patients with proven prostate cancers were recruited in this study. Seventeen of them were diagnosed as having prostate cancer according to the ultrasound guided systemic biopsy. Their MR examinations showed fourteen lesions in the peripheral zone and three in the central gland of the prostate. The other eleven patients underwent MR examination after a period of treatment, including endocrinetherapy and brachytherapy. Using endorectal coil, a series of T2-weighted images were acquired on the axial plane. These source images were processed by 3D-Doctor software to reconstruct into three-dimensional images. Results In the fourteen patients with peripheral zone cancer, reconstruction images could display the 3D regions of cancer and the involvement of capsular. The outspread of central gland and the compression of peripheral zone in patients with central gland cancer could be revealed in the same way. The volumetric changes of the lesion and the prostate after endocrinetherapy could also be perceived through these 3D images. Similarly, radioactive seeds were revealed in a spatial manner that could be easily evaluated. Conclusion Three-dimensional reconstruction images were obtained in all patients. They were able to provide stereotyped information about the lesions and their surrounding tissues. MRI three-dimensional reconstruction can be an adjunctive tool in the evaluation of prostate lesions.
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Objective To study the relationship between the renal cortical thickness and age,and to establish the range of the normal renal cortex thickness by using CT measurement in different age groups so as to obtain a best age-related and practicable method for clinical measurement. Methods (1) the accuracy of measuring renal cortical thickness by CT was evaluated; 18 kidneys resected due to renal neoplasm were studied and the cortical thickness of the normal part of these specimens was assessed. The difference between the renal cortical thickness of specimens and preoperative measurements of renal cortex of the same patient by contrast enhanced CT was analyzed statistically. (2) 120 patients without history of renal disease or long term usage of potentially renal toxic drugs or history of hypertention were examined by CT with indication(s) other than renal disease. All the patients were divided into 20-40, 41-60, and 61-80 year-old groups. The renal cortical and parenchymal thickness and renal size were measured in three CT sections. The difference of the measurements among the three groups and their relationship to age was analyzed statistically. Results There was no significant difference between the renal cortical thickness measured by enhanced spiral CT and measured in renal specimens(t =0. 80,P =0. 43). The renal cortical thickness in three groups was 0. 73 cm, 0. 65 cm, and 0. 53 cm, respectively, and the differences among the three groups were significant ( F = 93.430, P 0. 05). Conclusion The measurement of the renal cortical thickness with enhanced spiral CT was reliable and was a sensitive method in investigating the morphologic changes of the kidney. The renal cortical thickness of normal kidney diminishes with age, but the change of the ratio of thickness of renal cortex to renal parenchyma with age was not significant.
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50 years old).DWI was done on a 1.5-T system using single-shot diffusion-weighted echo-planar imaging(b-values = 0,300,500 and 800 s/mm~2).ADC maps were calculated using the manufacturer's software.ROIs placed on peripheral zone contained,average,thirty pixels.Results When b-value was 300 s/mm~2,the ADC of peripheral zone in junior,middle-age and senior group were(2.03?0.29)?10~(-3) mm~2/s,(2.37?0.33)?10~(-3) mm~2/s,(2.75?0.29)?10~(-3) mm~2/s,respectively,and statistically significant different(F=36.66,P
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Objective To investigate the diagnostic efficacy of MRI and bone scintigraphy in the detection of bone metastasis from prostate cancer.Methods One hundred and eighty-three patients suspected of prostate cancer were recruited in this study.All the patients were examined by pelvic MRI and bone scintigraphy.According to the integragted clinical diagnosis,the patients were categorized as metastastic group and non-metastatic group.SPSS 11.0 was used to analyze the data.Results Bone metastasis were identified in 37 of the 183 patients.In the 24 patients whose MRI results demonstrated bone metastasis,all of them were convinced of bone metastasis(24/24,100%).In the 159 patients whose MRI results revealed no bone metastasis,only 4 of them(4/159,2.52%)were detected bone metastasis by bone scintigraphy.The sensitivity,specificity and accuracy of MRI in the detection of bone metastasis was 78.38%,87.0% and 85.25%,respectively.The sensitivity,specificity and accuracy of bone scintigrapy in the detection of bone metastasis was 94.59%,62.33% and 68.85%,respectively.The specificity and accuracy of MRI in the prediction of bone metastasis were higher than that of bone scintigraphy(? 2=23.458,P=0.000;? 2=13.906,P=0.000),whereas the sensitivity of bone scintigraphy in the detection of bone metastasis was higher than that of MRI(? 2=4.163,P=0.041).Conclusion With the negative findings of the pelvic MRI,the probability of bone metastasis diagnosed by bone scintigraphy was fairly low.So even with the limitation range of the pelvic MRI examination,it is useful in the prediction of bone metastasis from prostate cancer.
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AIM: To observe the effects of aortal angiotensin Ⅱ (Ang Ⅱ )levels and AngⅡ receptor in the hy- pertensive rat models. METHODS: Intraperinoneal injection of L - Nw - nitro-arginine (L - NNA) into rats induced hypertensive model, the binding of aortal Ang Ⅱ receptor and the contents of aortal tissue Aug Ⅱ and plasma NO2-+ NO3- (NOx) were determined. RESULTS: Compared with the control group, the bind pressure of the rats treated with L - NNA was significantly increased by 142% (P