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OBJECTIVE: To establish a novel standardized magnetization transfer ratio (MTR) parameter which considers the element of the normal bowel wall and to compare the efficacy of the MTR, normalized MTR, and standardized MTR in evaluating intestinal fibrosis in Crohn's disease (CD).MATERIALS AND METHODS: Abdominal magnetization transfer imaging from 20 consecutive CD patients were analyzed before performing elective operations. MTR parameters were calculated by delineating regions of interest in specified segments on MTR maps. Specimens with pathologically confirmed bowel fibrosis were classified into one of four severity grades. The correlation between MTR parameters and fibrosis score was tested by Spearman's rank correlation. Differences in MTR, normalized MTR, and standardized MTR across diverse histologic fibrosis scores were analyzed using the independent sample t test or the Mann-Whitney U test. The area under the receiver operating characteristic curve (AUC) was computed to test the efficacies of the MTR parameters in differentiating severe intestinal fibrosis from mild-to-moderate fibrosis.RESULTS: Normalized (r = 0.700; p < 0.001) and standardized MTR (r = 0.695; p < 0.001) showed a strong correlation with bowel fibrosis scores, followed by MTR (r = 0.590; p < 0.001). Significant differences in MTR (t = −4.470; p < 0.001), normalized MTR (Z = −5.003; p < 0.001), and standardized MTR (Z = −5.133; p < 0.001) were found between mild-to-moderate and severe bowel fibrosis. Standardized MTR (AUC = 0.895; p < 0.001) had the highest accuracy in differentiating severe bowel fibrosis from mild-to-moderate bowel wall fibrosis, followed by normalized MTR (AUC = 0.885; p < 0.001) and MTR (AUC = 0.798; p < 0.001).CONCLUSION: Standardized MTR is slightly superior to MTR and normalized MTR and therefore may be an optimal parameter for evaluating the severity of intestinal fibrosis in CD.
Subject(s)
Humans , Crohn Disease , Fibrosis , Magnetic Resonance Imaging , ROC CurveABSTRACT
@#【Objective】To measure the orbital fat fraction（FF）of Graves ophthalmopathy（GO）patients and normal individuals with MR Water- fat separation（Dixon） technology ，and to explore the value of orbit MR quantitative fat analysis in diagnosis and treatment for GO patients.【Methods】Forty GO patients and 20 normal individuals who underwent orbital MR imaging were analyzed prospectively from February 2017 to February 2019 in the First Affiliated Hospital of Sun Yat- sen University. All participants received bilateral orbital MR examination with oblique coronary FSE T2- weighted imaging combined with two-point Dixon technique，and then the signal intensity values of ipsilateral extraocular muscles and lacrimal glands on water and fat phase images were measured to calculate FF. The differences of mean FF between the two groups were evaluated，and the correlation between FF of GO and TRAb，CAS score，and the course of GO were conducted by Spearman rank correlation analysis. 【Results】 The median FF of extraocular muscles in GO patients was higher than that of normal individuals，and the result showed a statistically significant difference（P < 0.05）， while the FF of lacrimal glands in the two groups showed no statistical difference. The FF of extraocular muscles in the GO group were correlated with TRAb，CAS score and the course of GO（P < 0.05），especially the course was more correlative.【Conclusions】The fat content of extraocular muscles in GO patients were higher than that of normal individuals ，and there was a positive correlation in the fat content among TRAb，CAS score and the course of GO，suggesting that MR fat quantitative analysis may provide a new reference indexes for the evaluation of clinical staging ，curative effect assessment in GO patients.
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@#【Objective】 To investigate the predictive value of preoperative Gd- EOB- DTPA enhanced MRI in the expression of cytokeratin 19（CK19）in hepatocellular carcinoma（HCC）.【Methods】A total of 102 patients，including 94 male and 8 female，with single HCC confirmed by pathology after operation who underwent preoperative enhanced MRI were retrospectively analyzed. A total of 25 were CK19-positive HCC and 77 were CK19-negative HCC. Two radiologists evaluated MR features including tumor size，tumor margin，intratumoral vessels，signal intensity（SI）on arterial phase （AP） ，enhancement pattern ，arterial rim enhancement ，peritumoral enhancement ，internal cystic or necrotic portion，hemorrhage，intratumoral fat，tumor capsule，vascular invasion，lymph node metastasis，intratumoral septum， target sign on diffusion weighted imaging（DWI）or hepatobiliary phase（HBP），peritumor hypointensity，SI on ADC，SI on HBP ，T1 relaxation times and T1 reduction rate between pre- and post- contrast enhancement. The associations between these imaging features and CK19 expression were investigated. 【Results】SI on AP（P = 0.013），arterial rim enhancement（P = 0.018），target sign on DWI（P = 0.001）and target sign on HBP（P = 0.005）were significantly associated with CK19 expression. Delayed enhanced intratumoral septum（P = 0.042）was associated with CK19 expression between HCCs less than 5 cm. Target sign on DWI（P = 0.001，OR = 4.875，95%CI：1.838~12.927）were independent significant factors of CK19- positive HCC.【Conclusion】Preoperative enhanced MRI with Gd- EOB- DTPA is helpful to predict CK19 expression of HCC.
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Leucine-rich glioma-inactivated protein 1(LGI1)antibody-associated encephalitis is an autoimmune brain disease mainly seen in mid-aged and elderly people.Its main clinical manifestations include abnormal mental behaviors,facial-arm dystonia,hyponatremia,and hypokalemia.Immunotherapy with gamma globulin and/or hormone is effective.Two patients with LGT1 antibody-associated encephalitis were diagnosed in our center between January 2018 and October 2018,with typical clinical findings.The disease was cursed after immunoglobulin and hormone treatments.
Subject(s)
Humans , Autoantibodies , Allergy and Immunology , Encephalitis , Diagnosis , Therapeutics , Proteins , Allergy and ImmunologyABSTRACT
[Objective]To investigate the value of"pericardium crescent sign"in the diagnosis of non-calcified con-strictive pericarditis in CT.[Methods]Twenty-seven patients with non-calcified constrictive pericarditis and forty-six cardiac tumors confirmed by surgical pathology were analyzed retrospectively. All patients underwent non-enhanced and enhanced CT scan preoperatively.Pericardial morphology,density,enhancement features,appearance of atrium,ventri-cle and inferior vena cava of non-calcified constrictive pericarditis were analyzed. Pericardial morphology of cardiac tumors was also analyzed.[Results]Of the 27 patients with non-calcified constrictive pericarditis,18 patients developed"pericardium crescent sign",accounting for 66.7%,ventricular varying degrees of deformation in 13 cases,accounting for 48%;venous dilatation in 26 cases,accounting for 93%;atrial enlargement in 7 cases,accounting for 26%. In 46 patients with cardiac tumors,only 1 patient had a similar"pericardial crescent"sign.For the diagnosis of constrictive pericarditis using pericardial crescent sign,the sensitivity was 66.7%,the specificity was 97.8%,Youden index was 0.64. The area under the ROC curve was 0.82([0.71-0.94],P<0.001).[Conclusion]"Pericardium crescent sign"is important CT features of non-calcified constrictive pericarditis. It has high specificity for differentiating non-calcified constrictive pericarditis from pericardial tumor imaging.
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Objective To investigate the clinical effectiveness of disease-syndrome combination therapy for anovulatory infertility through randomized controlled trial, thus to provide high-level evidence-based medical reference for the diagnosis and treatment of WHO typeⅡovulation disorder infertility. Methods Eighty-six patients with WHO typeⅡovulation disorder infertility were randomized into treatment group and control group , 43 cases in each group. Both groups were given the treatment for correcting endocrinic disorder if necessary. Additionally, by following the principle of combination of disease differentiation and syndrome differentiation , Zhuyun Recipe 1, Zhuyun Recipe 2, and Zhuyun Recipe 3 were separately given orally to the patients with kidney-yang deficiency (WHO type Ⅱ ovulation disorder without PCOS), patients with liver-kidney insufficiency(WHO typeⅡovulation disorder complicated with hyperandrogenitic lean-PCOS),and patients with kidney-deficiency complicated with phl egm-dampness (WHO type Ⅱ ovulation disorder complicated with insulin-resistant obesity-PCOS) in the treatment group respectively. The patients in the control group was given oral use of the first-rate ovulation induction drug Clomiphene. The treatment covered 3 menstruation cycles. Ovulation rate,pregnancy rate and alive fetus rate were used as the indicators for evaluating the effectiveness,and the safety was also monitored. Results(1)Of the 86 cases,5 cases dropped out(loss to follow-up or being excluded),with the drop-out rate being 6%. Of the 5 drop-out cases,3 were from the control group,and 2 were from the treatment group. (2)Ovulation rate of the treatment group was 70.7%,and that of the control group was 85.0%. The ovulation rate of the two groups was enhanced,but the difference between the two groups was insignificant(P > 0.05).(3)Pregnancy rate of the treatment group was 51.2%,and that of the control group was 30.0%, the differen ce being significant between the two groups(P < 0.05).(4)Alive fetus rate of the treatment group was 45.2%,and that of the control group was 22.5%,the difference being significant between the two groups(P < 0.05).(5)No adverse reaction was found in the two groups during the treatment. Conclusion The disease-syndrome combination therapy for WHO type Ⅱanovulatory infertility shows the advantages of higher pregnancy rate and alive fetus rate, which makes up for the disadvantages of low pregnancy rate and high abortion rate of Clomiphene.
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<p><b>OBJECTIVE</b>To examine the plasma lipid level and distribution of dyslipidemia in workers of Chongqing enterprises and institutions.</p><p><b>METHODS</b>By using cluster sampling method, 20 000 workers of Chongqing enterprises and institutions aged 18 to 60 were selected as target population from January to October, 2009. We conducted questionnaire survey, physical and laboratory examinations including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Workers were divided into 18 - 29 years old group, 30 - 39 years old group, 40 - 49 years old group and 50 - 60 years old group. Characteristic and distribution of dyslipidemia were analyzed.</p><p><b>RESULTS</b>Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were significantly different in various age group (all P < 0.01). TC, TG, HDL-C and LDL-C levels in the 30 years and over groups were all significantly higher than in the under 30 years old group(all P < 0.01). The TG levels in the 40 - 49 years old group and the 50 - 60 years old group were similar (P > 0.05). After adjusting for age, TC, TG, HDL-C and LDL-C levels in males were all significantly higher than in females (all P < 0.01). The incidence of dyslipidemia in this population was 35.01% and significantly higher in males than that of females (58.27% vs. 11.01%, P < 0.01). The incidence of dyslipidemia increased with aging (P < 0.01).</p><p><b>CONCLUSIONS</b>The prevalence of dyslipidemia is high in Chongqing enterprises and institutions. The incidence of dyslipidemia is higher in males than in females and higher among the 30 years and over workers than that of under 30 years old workers.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Cholesterol , Blood , Cholesterol, HDL , Blood , Cholesterol, LDL , Blood , Dyslipidemias , Epidemiology , Lipids , Blood , Lipoproteins, HDL , Blood , Lipoproteins, LDL , Blood , Prevalence , Risk Factors , Triglycerides , BloodABSTRACT
<p><b>OBJECTIVE</b>To investigate the prevalence of vitamin D receptor (VDR) gene polymorphism in pre-menopausal women in Guangzhou and study its relationship with bone mineral density(BMD).</p><p><b>METHODS</b>The genotypes of VDR gene in 193 per-menopausal women in Guangzhou were analyzed by polymerase chain reaction-restriction fragment length polymorphism. BMD of the lumbar spine, femoral neck, greater trochanter and Ward's triangle were measured by dual-energy X-ray absorptiometry.</p><p><b>RESULTS</b>In the 193 subjects, 120 (66.2%) were identified as VDR bb genotype, 64 (33.2%) as Bb, and 9 (4.6%) as BB. The b allele frequencies reached 78.76%, and B allele frequencies was 21.24%. The distribution followed the Hardy-Weinberg equilibrium. No significant difference was found in BMD among the subjects with different genotypes.</p><p><b>CONCLUSION</b>VDR genotype is not related to BMD, and VDR polymorphism can not be used as a genetic marker for predicting the risk of osteoporosis in pre-menopausal women in Guangzhou.</p>
Subject(s)
Adult , Female , Humans , Middle Aged , Absorptiometry, Photon , Analysis of Variance , Bone Density , China , Gene Frequency , Genotype , Osteoporosis , Genetics , Metabolism , Polymorphism, Genetic , Premenopause , Receptors, Calcitriol , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate collagen type I alpha 1 (COL1A1) and alpha 2 (COL1A2) gene polymorphisms in Chinese and their relationship with bone mineral density.</p><p><b>METHODS</b>Totalling 628 residents of Han nationality in Guangzhou aged 53.4-15.9 (range 20-79) years were surveyed for COL1A1 and COL1A2 gene genotypes by polymerase chain reaction-restriction fragment length polymorphism. Bone mineral density of the lumbar vertebrae, greater trochanter, femur neck and Ward's triangle was measured by dual-energy X-ray absorptiometry.</p><p><b>RESULTS</b>COL1A1 Sp1 polymorphism was not found in these subjects, and the genotype of all samples were type SS. COL1A2 genotyping revealed the distribution of EE genotype in 49.7%, Ee in 40.9% and ee in 9.4% of the subjects. The frequency distribution of EcoR1 alleles followed the Hardy-Weinberg equilibrium. The mean bone mineral density did no significantly differ among these genotype groups (P>0.05 by analysis of variance).</p><p><b>CONCLUSION</b>COL1A1 Sp1 binding site polymorphism is absent and COL1A2 EcoR1 site polymorphism is not associated with bone mineral density in Chinese of Han nationality.</p>