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Objective:To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) for Trousseau’s syndrome (TS) in patients with acute multiple cerebral infarctions (AMCI).Methods:The patients with AMCI in Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from July 2013 to March 2022 were retrospectively enrolled. The demographic and baseline clinical data of patients with TS and those without TS were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of TS-AMCI, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR for TS-AMCI. Results:A total of 59 patients with AMCI were enrolled, including 43 males and 16 females, aged 64.9±14.0 years. There were 16 patients in the TS-AMCI group and 43 in the non-TS-AMCI group. The proportions of patients with diabetes mellitus, hypertension and previous stroke or transient ischemic attack in the TS-AMCI group were significantly lower than those in the non-TS-AMCI group (all P<0.05), while the proportion of patients with ischemic heart disease were significantly higher than that in the non-TS-AMCI group ( P<0.05). The proportion of patients with bilateral infarction in the TS-AMCI group was significantly higher than that in the non-TS-AMCI group ( P<0.001). The D-dimer, NLR, white blood cell count, neutrophil count, monocyte count, percentage of neutrophils, total cholesterol and low-density lipoprotein cholesterol in the TS-AMCI group were significantly higher than those in the non-TS-AMCI group (all P<0.001), while the lymphocyte count, lymphocyte percentage, red blood cell count, hemoglobin and hematocrit were significantly lower than those in the non-TS-AMCI group (all P<0.001). Multivariate logistic regression analysis showed that high NLR was an independent predictor of TS-AMCI (odds ratio [ OR] 2.897, 95% confidence interval [ CI] 1.270-6.527; P=0.011), while high hemoglobin was independently negatively correlated with TS-AMCI ( OR 0.839, 95% CI 0.723-0.975; P=0.022). ROC curve analysis showed that the area under the curve of NLR for predicting TS-AMCI was 0.929 (95% CI 0.831-0.979; P<0.001). When the NLR cutoff value was 4.01, the corresponding Youden index was 0.744. At this time, the sensitivity and specificity were 100% and 74.42% respectively. Conclusion:NLR has high predictive value for TS-AMCI.
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Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.
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Objective To investigate the significance of MRI T2 fluid-attenuated inversion recovery hyperintense vessel sign (FLAIR HVS)in clinical prognosis evaluation of the patients with acute middle cerebral artery irnfarction.Methods The data in 57 inpatients with acute middle cerebral artery infarction in our hospital from Aug.2013 to Aug.2015 were retrospectively analyzed.All cases were performed the intact MRI examination(ineluding FLAIR,DWI and MRA)and CTA.The infarct volume with DWI,national institute of health stroke scale(NIHSS)score and modified Rankin Scale(mRS)score on 30 d after discharge were performed the comparative analysis.Results Fifty-seven cases of middle cerebral artery occlusion were divided into the distal HVSgroup and non-distal HVS group(8 cases in proximal HVS group,21 cases in HVS negative group).The infarction volume of DWI sequence,NIHSS scores at admissiom and discharge and mRS score on 30 d after discharge in the distal HVS group were superior to those in the non-distal HVS group(P＜0.05).Conclusion MRI-T2 FLAIR sequence HVS has certain reference value in the prognosis evaluation in the patients with middle cerebral artery occlusion.
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Objective To study the immunoreactivity of fascin and Ki-67 proteins in bladder carcinoma and the correlation between their expression and the pathological features.Methods The immunohistochemistry of fascin and Ki-67 proteins were detected in 111 cases of bladder carcinoma and 42 cases of normal bladder tissues.The correlation between their expression and the pathological features were analyzed statistically.Results There was no expression of fascin and Ki-67 in normal bladder tissues.The immunoreactivities of fascin and Ki67 were detected respectively in 94 and 92 of 111 bladder carcinomas.The immunoreactivity of fascin was correlated with TNM staging and the size of the tumor(P0.05).The expression of fascin was positively correlated with the expression of Ki-67 in bladder carcinoma(P<0.01).Conclusion Fasicn and Ki-67 were expressed in bladder carcinoma.The combined detection of fascin and Ki-67 expression might be helpful to assess the prognosis of bladder carcinoma.Targeting the fascin and Ki-67 pathway could be a novel therapeutic strategy of bladder carcinoma.
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Objective To study on the directing role of multi-slice spiral CT and multiplanar reformation(MPR)in bronchoscopy and enhance the yield of peripheral pulmonary carcinoma(PPC).Methods This study was carried in 60 PPC patients from Respiratory Department in the First Hospital Affilliated to Suzhou University during 2002—2005.They underwent MSCT.Images were reconstructed with MPR(CPR)to evaluate the relationship between PPC and bronchi and the type of BS was identified.Compare the diagnosed yields of bronchoscopic multiple diagnostic procedure(BMDPs)with types of BS.Results (1)In all patients the third to the seventh level branches of the bronchi were clearly shown.The tumor-bronchus relationship was identified as four types on MSCT.(2)MSCT demonstrated the BS in 22 of 25 adenocarcinomas and 13 of 17 squamous-cell carcinomas and 4 of 6 small cell lung carcinomas and 4 of 8 bronchiolo-alveolar carcinomas.(3)BS typeⅠwas shown in 15of 48(31.3%).Type Ⅱ was seen in 7 of 48(14.6%).Type Ⅲ was shown in 12 of 48(25%)squamous tumors.Type Ⅳ was seen in 14 of 48(29.2%).(4)Total positive rate of bronchoscopy was 58.3%,73.3% with BS and 13.3% without BS.Type of BS was closely associated with positive rate of BMDPs.Conclusion Axial CT and MPR can show the relationship between PPC and bronchi better.BS can direct fiberoptic bronchoscopy(FOB)diagnosis procedure and enhance the yield of PPC.