Chronic hypoperfusion due to intracranial large artery stenosis is not associated with cerebral β-amyloid deposition and brain atrophy / 中华医学杂志(英文版)

BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.

Clinical significance of bone marrow immunopathologic detection: analyses of 266 newly diagnosed lymphoma cases / 白血病·淋巴瘤

Objective To investigate the clinical significance of bone marrow immunopathogenesis in the diagnosis and staging of lymphoma. Methods Clinical data of 266 patients with newly diagnosed lymphoma admitted to Department of Hematology in the First Hospital of Jilin University from August 2015 to December 2017 were retrospectively analyzed. The results of lymphoma diagnosis and staging in different bone marrow detection methods were compared, SPSS 22.0 software was used to make statistical analysis and χ2 test was used to compare the positive rates of lymphoma bone marrow infiltration in different methods. Results In the 266 patients, 64 cases (24.1 %) were diagnosed with lymphoma by using bone marrow detection on the condition that no lymph node pathology was available and all the immunophenotypes of 64 cases were identified by bone marrow immunopathology. Bone marrow infiltration was identified in 121 patients (45.5 %), among which the rate of bone marrow infiltration was 0 (0/12) in Hodgkin lymphoma (HL) and 47.6 % (121/254) in non-Hodgkin lymphoma (NHL). The rate of bone marrow infiltration was 50.0 % (105/210) and 36.4 % (16/44) in B type and T type NHL respectively. The positive rate of bone marrow infiltration detected by bone marrow smear, bone marrow biopsy, bone marrow flow cytometry and bone marrow immunopathology were 78.5 % (95/121), 87.6 % (106/121), 89.3 % (108/121), 96.7 % (117/121) respectively. Bone marrow immunopathology was more advantageous than any other methods, and there was a statistical difference (χ2＝18.38, 9.09, 3.76; all P < 0.05). Among 121 patients who were identified with bone marrow infiltration by bone marrow detection, the staging of 42 patients (34.7 %) were amended, including the staging of 39 amended patients (32.2 %) through bone marrow immunopathologic detection. Conclusion Bone marrow immunopathology can be used for the diagnosis and classification of lymphoma, which has an obvious advantage in detecting bone marrow infiltration of lymphoma compared with bone marrow smear, bone marrow biopsy, bone marrow flow cytometry, and it can be used to amend the clinical staging.

Application of minimally invasive arthroscopy in knee joint injuries caused by longitudinal impact of military training / 重庆医学

Objective To explore the applicationof minimally invasive arthroscopy in the knee joint injuries caused by longitudinal impact of military training.Methods A total of 538 consecutive soldier outpatients diagnosed as knee joint injuries caused by longitudinal impact of daily military training in our hospital from January 2006 to January 2015 were retrospectively analyzed.According to the Principles about Diagnosis and Treatment of Military Training Injury,the general condition,injuries types and injury subject were performed the statistical analysis.The grading diagnosis and treatment strategy of impact injuries was proposed at first time according to the MRI examination results,injury type and severity.The patients needing operative therapy were screened out for conducting the arthroscopic operation according to this strategy.All the patients receiving surgeries were evaluated by the Lysholm scoring before and after operation.The subjective evaluation satisfaction investigation was performed.Results Seventy six cases received the arthroscopic surgeries,and all the cases were followed up successfully.The duration of following-up ranged 12-35 months.The Lysholm scores before operation was[46.3 ± 5.3]which were lower than [83.7±3.8] after operation,the difference was statistically significant(P＜0.01).The wounds healed at the first stage,and no complications of nerve and blood vessel injury,infections,etc.occurred.The patients subjectively felt that the knee joint function was significantly improved,71 cases satisfied with the arthroscopic operation effect,the satisfactory rate was 93.4％.All the cases went back to the normal training life after surgeries.Conclusion For the knee joint injuries caused by longitudinal impact of military training,the prevention is the key role.On the basis of preliminary diagnosis by the physical examination and imaging examination,the treatment should be combined with the grading diagnosis.and treatment strategy.In the operation therapy,the minimally invasive arthroscopy as an examination and treatment means can more comprehensively evaluate the knee injury condition,timely repair injured meniscus and conduct the ligament reconstruction,which has small trauma and recovers rapidly,the patient can recover the routinemilitary training as soon as possible.The arthroscopy is the first choice of treatment scheme for the patients with grade Ⅲ or more injury.

Tumor-associated Neovascularization in C6 Glioma Tumor Margin Measured with Dynamic Contrast-enhanced MRI / 中国医学影像学杂志

PurposeTo investigate the formation of neovascularization using dynamic contrast-enhanced MRI (DCE-MRI) in C6 glioma margin in rats, and to explore its utility.Materials and MethodsC6 glioma model was created in 24 SD rats. Routine and DCE-MRI was performed 4 days, 8 days, 12 days, 16 days, 20 days and 24 days after transplantation. Pathology and immunohistochemistry exams were also obtained to evaluate marginal tumor cells and neovascularization.ResultsNeovascularization was observed in C6 glioma margin within (257.658±53.663)μm range. Vessel co-option index difference was statistically significant (P0.05).Conclusion The neovascularization in tumor margin demonstrates vessel co-option. DCE-MRI parameters Ktrans and Kep are negatively correlated with co-option index, indicating that Ktrans and Kep could be a well-defined imaging-based biomarker for glioma neovascularization.

Effect of High Flow Oxygen Uptake on the Quality of Coronary Artery Imaging / 中国医学影像学杂志

Purpose To compare the difference of CT coronary artery imaging quality under highflow oxygen uptake and normal breathing, and to investigate the effect of high flow oxygen uptake on the quality of CT coronary artery imaging.Materials and Methods 132 patients underwent coronary CTA examination using 256-slice CT (Philips), among them 71 patients were supplied with highflow oxygen, and the other 61 were asked to breathe normally. Coronary arteries were post-processed and reconstructed on AW 4.4 workstation. Scanning completion rate, signal to noise ratio (SNR), contrast to noise ratios(CNR) and image quality score ofcoronary segment using these two prospective ECG-gating techniques were compared.Results The scanning completion rate and image quality score of the highflow oxygen uptake group were significantly superior to those of the normal breathing group (P0.05).Conclusion Imaging quality of coronary CTA can be improved using highflow oxygen uptake with reduced patient radiation dose, thus worth being used clinically as a simple and practicable method.