Evaluation of influencing factors for the severity of cerebral microbleed and its relationship with cognitive impairment in end-stage renal disease using MRI semi-automatic quantitative susceptibility imaging / 中华放射学杂志

Objective:To investigate the influencing factors for total number, total volume, and total iron burden of cerebral microbleeds (CMBs) and the relationship between CMBs with cognitive impairment in end-stage renal disease (ESRD) using semi-automatic quantitative susceptibility mapping (QSM).Methods:The study was a cross-sectional study. Clinical and imaging data of 46 ESRD patients with≥1 CMBs who attended Tianjin First Central Hospital from November 2018 to August 2022 were retrospectively analyzed. There were 26 males and 20 females, aged 42-75 years. All patients underwent susceptibility-weighted imaging (SWI) scanning, then SWI data was post-processed to obtain QSM. The semi-automatic dynamic programming algorithm was used to get the volume and mean susceptibility value of each CMB by sketching the boundary of CMBs. The CMBs iron load total volume were calculated. Stepwise linear regression analysis was used to explore independent influencing factors for the number, total volume, and total iron burden of CMBs in ESRD patients. Partial correlation analysis was used to explore the relationship between CMBs and cognitive impairment with the other signs of cerebral small vessel diseases as covariates.Results:In patients with ESRD, CMBs were located in the frontal lobe in 19 cases, parietal lobe in 9 cases, temporal lobe in 19 cases, occipital lobe in 14 cases, basal ganglia in 27 cases, dorsal thalamus in 15 cases, centrum semiovale in 14 cases, cerebellum in 14 cases, and brainstem in 13 cases. C-reactive protein levels (95% CI 101.81-157.85, r=0.96, P=0.001) and creatinine levels (95% CI 5.32-29.61, r=0.71, P=0.010) were influencing factors for the total iron burden of CMBs. C-reactive protein levels (95% CI 0.72-1.15, r=0.99, P=0.001) and creatinine levels (95% CI 0.03-0.22, r=0.89, P=0.014) were influencing factors for the total volume of CMBs. C-reactive protein levels (95% CI 0.10-0.12, r=0.96, P=0.001) and alkaline phosphatase levels (95% CI 0.16-0.38, r=0.59, P=0.001) were influencing factors for the number of CMBs. The total volume ( r=-0.61, P=0.009) and total iron burden ( r=-0.71, P=0.002) of CMBs in the frontal lobe were negatively correlated with cognitive function. However, although the number of CMBs in the frontal lobe was negatively correlated with cognitive function, the statistics analysis was insignificant ( r=-0.53, P=0.063). Conclusions:C-reactive protein and creatinine are influencing factors for CMBs′ total volume and total iron burden; C-reactive protein levels and alkaline phosphatase are influencing factors for the number of CMBs. The total iron burden and total volume of CMBs in the frontal lobe may be the biomarkers of cognitive impairment in patients with end-stage renal disease.

TSHR Variant Screening and Phenotype Analysis in 367 Chinese Patients With Congenital Hypothyroidism

Background@#Genetic defects in the human thyroid-stimulating hormone (TSH) receptor (TSHR) gene can cause congenital hypothyroidism (CH). However, the biological functions and comprehensive genotype–phenotype relationships for most TSHR variants associated with CH remain unexplored. We aimed to identify TSHR variants in Chinese patients with CH, analyze the functions of the variants, and explore the relationships between TSHR genotypes and clinical phenotypes. @*Methods@#In total, 367 patients with CH were recruited for TSHR variant screening using whole-exome sequencing. The effects of the variants were evaluated by in-silico programs such as SIFT and polyphen2. Furthermore, these variants were transfected into 293T cells to detect their Gs/cyclic AMP and Gq/11 signaling activity. @*Results@#Among the 367 patients with CH, 17 TSHR variants, including three novel variants, were identified in 45 patients, and 18 patients carried biallelic TSHR variants. In vitro experiments showed that 10 variants were associated with Gs/cyclic AMP and Gq/11 signaling pathway impairment to varying degrees. Patients with TSHR biallelic variants had lower serum TSH levels and higher free triiodothyronine and thyroxine levels at diagnosis than those with DUOX2 biallelic variants. @*Conclusions@#We found a high frequency of TSHR variants in Chinese patients with CH (12.3%), and 4.9% of cases were caused by TSHR biallelic variants. Ten variants were identified as loss-of-function variants. The data suggest that the clinical phenotype of CH patients caused by TSHR biallelic variants is relatively mild. Our study expands the TSHR variant spectrum and provides further evidence for the elucidation of the genetic etiology of CH.

The Risk Factors and Outcomes for Radiological Abnormalities in Early Convalescence of COVID-19 Patients Caused by the SARS-CoV-2 Omicron Variant: A Retrospective, Multicenter Follow-up Study

Background@#The emergence of the severe acute respiratory syndrome coronavirus 2 omicron variant has been triggering the new wave of coronavirus disease 2019 (COVID-19) globally. However, the risk factors and outcomes for radiological abnormalities in the early convalescent stage (1 month after diagnosis) of omicron infected patients are still unknown. @*Methods@#Patients were retrospectively enrolled if they were admitted to the hospital due to COVID-19. The chest computed tomography (CT) images and clinical data obtained at baseline (at the time of the first CT image that showed abnormalities after diagnosis) and 1 month after diagnosis were longitudinally analyzed. Uni-/multi-variable logistic regression tests were performed to explore independent risk factors for radiological abnormalities at baseline and residual pulmonary abnormalities after 1 month. @*Results@#We assessed 316 COVID-19 patients, including 47% with radiological abnormalities at baseline and 23% with residual pulmonary abnormalities at 1-month follow-up. In a multivariate regression analysis, age ≥ 50 years, body mass index ≥ 23.87, days after vaccination ≥ 81 days, lymphocyte count ≤ 1.21 × 10 -9 /L, interleukin-6 (IL-6) ≥ 10.05 pg/mL and IgG ≤ 14.140 S/CO were independent risk factors for CT abnormalities at baseline. The age ≥ 47 years, presence of interlobular septal thickening and IL-6 ≥ 5.85 pg/mL were the independent risk factors for residual pulmonary abnormalities at 1-month follow-up. For residual abnormalities group, the patients with less consolidations and more parenchymal bands at baseline could progress on CT score after 1 month. There were no significant changes in the number of involved lung lobes and total CT score during the early convalescent stage. @*Conclusion@#The higher IL-6 level was a common independent risk factor for CT abnormalities at baseline and residual pulmonary abnormalities at 1-month follow-up. There were no obvious radiographic changes during the early convalescent stage in patients with residual pulmonary abnormalities.

A study on the severity of brain tissue edema in acute anterior circulation ischemic stroke based on time to maximum of the residual function hemodynamic changes / 中华放射学杂志

Objective:To explore the value of the Wilcoxon-Mann-Whitney generalized dominance ratio (T max-weighted ratio) based on residual tissue time to peak (T max) delayed severity weighting in predicting the moderate to severe edema after acute anterior circulation ischemic stroke. Methods:The clinical and imaging features of patients with acute anterior circulation ischemic stroke from January 2019 to April 2022 in Yidu Central Hospital of Weifang were retrospectively analyzed. A total of 85 patients were enrolled, including 60 males and 25 females, with the age from 34 to 93 (67±11) years old. Patients underwent non-contrast CT, CT angiography of the head and neck, and CT perfusion imaging of the head, and ischemic core volume and the ratio of T max 4-6 s volume, T max 6-8 s volume, T max 8-10 s volume, and T max >10 s volume relative to the entire hypo-perfused area (T max>4 s volume) was measured, and the T max-weighted ratio was calculated, the collateral circulation were assessed. Patients were divided into mild edema group and moderate to severe edema group according to whether local swelling exceeded 1/3 of the unilateral cerebral hemisphere on non-contrast CT at 24-48 h. The indicators were compared between the two groups by independant t test, Mann-Whitney U and χ 2 test. The performance to predict moderate to severe edema was assessed using the receiver operating characteristic (ROC) curve. The univariate and multivariate logistic regression was used to analyze the risk factors for the moderate to severe edema. Differences in baseline National Institutes of Health Stroke Scale (NIHSS) score and infarct core volume were equalized by 1∶1 propensity score matching (PSM) and the differences of T max-weighted ratio between the two groups were further compared. Results:There were 52 cases in the mild edema group and 33 cases in the moderate to severe edema group. Baseline NIHSS score, T max>10 s volume, ischemic core volume, T max-weighted ratio and proportion of poor collateral circulation were higher in the moderate-severe edema group than those in the mild edema group ( P<0.001), T max 4-6 s volume was lower than in the mild edema group ( P<0.001). ROC analysis showed that the area under the curve (AUC) of T max-weighted ratio for predicting the incidence of moderate to severe edema was 0.885 (95%CI 0.798-0.944), with an optimal cut-off value of 1.17, sensitivity of 84.85% and specificity of 82.69% before PSM. The predictive ability based on T max-weighted ratio was similar to ischemic core volume( Z=0.64, P=0.520), T max 4-6 s volume ( Z=1.48, P=0.140) and superior to T max 6-8 s volume( Z=5.65, P<0.001), T max 8-10 s volume( Z=4.46, P<0.001), T max >10 s volume ( Z=2.91, P=0.004). Multivariate logistic regression analysis showed that T max-weighted ratio>1.17 was an independent predictor of the development of moderate to severe edema (OR=10.40,95%CI 2.65-40.83, P=0.001) through adjusted for baseline NIHSS score and ischemic core volume. After PSM, 14 patients in each group were included; the T max-weighted ratio was higher in the moderate-to-severe edema group than that in the mild edema group ( P<0.001), and the differences in other factors were not statistically significant (all P>0.05); ROC analysis showed that the AUC of T max-weighted ratio to predict the occurrence of moderate-to-severe edema was 0.852 (95%CI 0.667-0.957). Conclusion:The T max-weighted ratio can predict the occurrence of moderate-to-severe edema in brain tissue after acute anterior circulation ischemic stroke.

A nomogram based on dual-energy CT enhanced imaging for prediction of postoperative recurrence of early-stage glottic carcinoma / 中华放射学杂志

Objective:To explore the value of nomogram based on dual-energy CT (DECT) enhanced imaging in predicting postoperative recurrence-free survival (RFS) of early-stage glottic carcinoma (EGC).Methods:The clinicopathological and DECT data of patients with EGC confirmed by pathology in the Tianjin First Central Hospital from January 2015 to July 2018 were analyzed retrospectively. A total of 178 patients were enrolled, including 162 males and 16 females, with the age from 44 to 86 (62±9) years old. According to the follow-up data, the patients were divided into recurrent group ( n=32) and non-recurrent group ( n=146). The differences of clinicopathological data and DECT iodine maps parameters between the two groups were analyzed using χ 2 test, independent-sample t test and Mann-Whitney U test. The survival related cut-off values of the quantitative data between the two groups were selected by X-tile software. The survival curve was drawn using Kaplan-Meier method, and the difference of survival rate was tested with log-rank analysis. The variables with statistical differences were included in the Cox proportional hazard model for multivariate analysis to select the independent predictors of postoperative RFS. Based on the multivariate Cox analysis, the nomogram was drawn to predict the RFS at 1, 2 and 5 years. The prediction efficiency and clinical benefit of the nomogram were evaluated by C-index, calibration curve and decision curve analysis. Results:The median follow-up time was 24.3 months, ranging from 2 to 63 months. There was a significant difference in T-stage between recurrent and non-recurrent groups (χ2=9.21, P=0.002). The prognostic cutoff values obtained by X-tile software were arterial phase standardized iodine concentration (SIC AP)=0.28 and venous phase standardized iodine concentration (SIC VP)=0.87. The results of log-rank test showed that there were significant differences in RFS among patients with different T-stage, SIC AP and SIC VP (χ2=10.74, 15.50, 17.97, P=0.001,<0.001,<0.001). T-stage, SIC AP and SIC VP were identified as independent predictors of postoperative RFS (hazard ratio=2.271, 3.552, 3.266, P=0.026,<0.001, 0.003). The C-index of the nomogram combined with DECT parameter and T-stage was 0.785, which was higher than that of T-stage alone (0.622). The calibration curve showed that there was good consistency between the actual and predicted probability of the sample. The decision curve analysis showed that the clinical benefit of the nomogram was higher than that of the T-stage alone. Conclusion:The nomogram based on preoperative clinical factors (T-stage) and DECT iodine map factors (SIC AP and SIC vp) can predict the postoperative RFS of patients with EGC.

Evaluation of the effect of cerebral oxygen saturation on infarct progression in patients with acute ischemic stroke based on MR quantitative magnetic susceptibility mapping / 中华放射学杂志

Objective:To explore the effect of dynamic changes of cerebral oxygen saturation before and after treatment on the progression of infarction in patients with acute ischemic stroke (AIS).Methods:Totally 39 patients with first onset AIS within 24 hours in Tianjin First Central Hospital and Shanghai Fourth People′s Hospital Affiliated to Tongji University from May 2018 to July 2020 were enrolled retrospectively. All patients underwent multi-modal MR at admission (baseline) and within 2 weeks after standardized treatment, including diffusion weighted imaging (DWI), susceptibility weighted imaging (SWI), and dynamic magnetic sensitive contrast-enhanced magnetic resonance perfusion imaging (DSC-PWI). The degree of asymmetrically prominent cortical vein (APCV) at admission was observed on SWI, and the venous oxygen saturation (SvO 2) of APCV on the infarcted cerebral hemisphere was calculated in all patients before and after treatment. The original DWI and DSC-PWI images obtained from two MR scans were imported into the software to obtain the delayed perfusion volume [peak time (T max)>6 s] and the infarct core volume (apparent diffusion coeffivient value<620×10 -6 mm 2/s). According to the comparison of baseline infarct core (DWI-ASPECT) score and follow-up (FUP-ASPECT) score, all patients were divided into infarct progression group (27 cases) and non-infarct progression group (12 cases). Two independent sample t-test or Mann Whitney U-test were used to compare the differences of baseline infarct core volume, baseline SvO 2, SvO 2 change, baseline hypoperfusion volume and hypoperfusion volume change between the two groups. Univariate analysis and multivariate logistic regression analysis were used to obtain independent predictors of infarct progression. Pearson correlation analysis was used to evaluate the correlation between SvO 2 change, hypoperfusion volume change and infarct change score respectively. Results:Difference in baseline infarct core volume, baseline SvO 2, hypoperfusion volume and hypoperfusion volume change between infarct progression group and non-progression group had no statistical significance ( P>0.05). There was significant difference in the change of SvO 2 between the infarct progression group and non-infarct progression group after treatment [(27±11)%, (35±6)% respectively, t=-2.56, P=0.015]. Univariate logistic regression analysis showed that the change value of SvO 2 was the influencing factor of infarction progression of AIS (OR=0.872, 95%CI 0.773-0.984, P=0.026). Multivariate logistic regression analysis showed that the baseline NIHSS score (OR=1.248, 95%CI 1.042-1.494, P=0.016) was an independent predictor of infarction progression in AIS, and the change value of SvO 2 (OR=0.814, 95%CI 0.688-0.964, P=0.017) was an independent protective factor. The change of SvO 2 was positively correlated with the score of infarct change ( r=0.425, P=0.007). Conclusions:The change of SvO 2 after AIS treatment can independently predict the progress of acute infarction. Improvement of SvO 2 after treatment is conducive to delay the progress of infarction.

Predictive value of plasma TMAO combined with NT-proBNP on the prognosis and length of hospitalization of patients with ischemic heart failure / 中华心血管病杂志

Objective: To explore the value of the assessment of plasma trimethylamine N-oxide (TMAO) combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the all-cause mortality, length of hospitalization, and hospital cost in ischemic heart failure (IHF) patients. Methods: This prospective cohort study included 189 patients (157 males, mean age (64.0±10.5) years) with a left ventricular ejection fraction<45% caused by coronary artery disease, who hospitalized in our department from March 2016 to December 2020. Baseline data, including demographics, comorbid conditions and laboratory examination, were analyzed. The cumulative rate of all-cause mortality was evaluated using the Kaplan-Meier method and compared between the groups according to the log-rank test. Relative risks were reported as hazard ratios (HR) and 95% confidence interval (95%CI) calculated using the Cox proportional-hazards analysis, with stepwise adjustment for covariables. Spearman correlation analysis was then performed to determine the relationship between TMAO combined with NT-proBNP and length of hospitalization and hospital cost. Results: There were 50 patients in the low TMAO+low NT-proBNP group, 89 patients in high TMAO or high NT-proBNP group, 50 patients in high TMAO+high NT-proBNP group. The mean follow-up period was 3.0 years. Death occurred in 70 patients (37.0%), 27 patients (54.0%) in high TMAO+high NT-proBNP group, 29 patients (32.6%) in high TMAO or high NT-proBNP group and 14 patients (28.0%) in low TMAO+low NT-proBNP group. TMAO, in combination with NT-proBNP, improved all-cause mortality prediction in IHF patients when stratified as none, one or both biomarker(s) elevation, with the highest risk of all-cause mortality in high TMAO+high NT-proBNP group (HR=3.62, 95%CI 1.89-6.96, P<0.001). ROC curve analysis further confirmed that TMAO combined with NT-proBNP strengthened the prediction performance on the risk of all-cause death (AUC=0.727(95%CI 0.640-0.813), sensitivity 55.0%, characteristic 83.1%). Spearman correlation analysis showed that IHF patients with high TMAO and high NT-proBNP were positively associated with longer duration of hospitalization (r=0.191,P=0.009), but not associated with higher hospital cost (r=0.030, P=0.686). Conclusions: TMAO combined with NT-proBNP are valuable prediction tool on risk stratification of patients with IHF, and those with two biomarkers elevation face the highest risk of mortality during follow-up period, and are associated with the longer hospital stay.

A feasibility study of predictive values of lateral cervical lymph node metastasis from cN1-stage papillary thyroid carcinoma based on dual-energy CT nomogram / 中华放射学杂志

Objective:To investigate the feasibility of predicting lateral cervical lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC) based on the nomogram constructed by dual-energy CT data.Methods:In total 417 patients with PTC confirmed by pathology in Tianjin First Central Hospital from January 2015 to December 2018 were retrospectively analyzed as a training group. Internal validation was conducted, including 139 patients in the LLNM group and 278 patients in the non-LLNM group. A total of 169 PTC patients from January 2019 to June 2020 were included as an external validation group, including 58 patients in the LLNM group and 111 patients in the non-LLNM group. The morphological characteristics of the primary thyroid lesions on dual-energy CT iodine maps were analyzed, including tumor location, maximum diameter, calcification, and extrathyroidal extension (ETE). Iodine concentration (IC) of the PTC parenchyma and the internal carotid artery on the same level in the arterial and venous phases were measured, and normalized iodine concentration (NIC) was calculated. The independent risk factors for LLNM were obtained by univariate and multivariate logistic regression analysis. Base on the results, a prediction model was constructed and expressed in the form of a nomogram. The internal and external validation of the model was carried out using ROC curve.Results:Multivariate binary logistic regression analysis showed that the lesion location in the upper polar of the thyroid, the presence of ETE, IC in arterial phase>2.9 mg/ml, IC in the venous phase>3.2 mg/ml, and NIC in the arterial phase>0.21 were independent risk factors for LLNM prediction. The nomogram based on the above factors was constructed with an area under the ROC curve (AUC) of 0.895 (95%CI 0.862-0.923). With a cut-off value of 0.79, the sensitivity and specificity were 86.3% and 75.2%, respectively. As for the external validation group, the AUC of the model was 0.887 (95%CI 0.830-0.931), with the sensitivity of 82.8%, and the specificity of 81.1%.Conclusion:The application values of the nomogram model based on dual-energy CT data in preoperative evaluation of the possibility of LLNM of PTC patients has been verified. The model constructed in this study might be helpful with the individualized treatment in a certain degree.

Ultrasonographic differential diagnosis of intestinal involvement in Kawasaki disease and abdominal type allergic purpura / 中华超声影像学杂志

Objective:To compare and analyze the ultrasonic images between intestinal involvement in Kawasaki disease (IIKD) and abdominal type allergic purpura (ATAP), so as to improve the understanding of IIKD.Methods:From July 2014 to January 2020, the ultrasonographic images of 21 children with IIKD and 24 children with ATAP in Tianjin Children′s Hospital were collected and analyzed.Results:Univariate analysis showed that there were significant differences between IIKD group and ATAP group in non stratified thickening of intestinal wall, decreased echo of serosa and adjacent mesentery (irregular shape), thickening of peripheral fat tissue and abnormal shape of adjacent lymph nodes (all P<0.05); Multivariate analysis showed that decreased echo of serosa and adjacent mesentery (irregular shape) were independent influencing factors of IIKD. The area under ROC curve was 0.914(95% CI=0.819-1.000, P<0.001). The sensitivity and specificity of IIKD were 95.2% and 87.5%, respectively. Conclusions:The ultrasonographic images of intestinal involvement in IIKD and ATAP have certain specificity. Decreased echo of serosa and adjacent mesentery (irregular shape) can effectively distinguish IIKD and ATAP.

Prognostic nomogram incorporating radiological features for predicting overall survival in patients with AIDS-related non-Hodgkin lymphoma / 中华医学杂志(英文版)

BACKGROUND@#Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).@*METHODS@#A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.@*RESULTS@#In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.@*CONCLUSION@#A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.

Humulus lupulus L. Extract Prevents Ovariectomy-Induced Osteoporosis in Mice and Regulates Activities of Osteoblasts and Osteoclasts / 中国结合医学杂志

OBJECTIVE@#To systematically evaluate the protective effects of Humulus lupulus L. extract (HLE) on osteoporosis mice.@*METHODS@#In vivo experiment, a total of 35 12-week-old female ICR mice were equally divided into 5 groups: the sham control group (sham); the ovariectomy with vehicle group (OVX); the OVX with estradiol valerate [EV, 0.2 mg/(kg•d)] the OVX with low- or high-dose HLE groups [HLE, 1 g/(kg•d) and 3 g/(kg•d)], 7 in each group. Treatment began 1 week after the ovariectomized surgery and lasted for 12 weeks. Bone mass and trabecular bone mircoarchitecture were evaluated by micro computed tomography, and bone turnover markers in serum were evaluated using enzyme-linked immunosorbent assay (ELISA) kits. In vitro experiment, osteoblasts and osteoclasts were treated with HLE at doses of 0, 4, 20 and 100 µg/mL. Biomarkers for bone formation in osteoblasts and bone resorption in osteoclasts were analyzed.@*RESULTS@#Compared with the OVX group, HLE exerted bone protective effects by the increase of estradiol (P<0.05), the improvement of cancellous bone structure, bone mineral density (P<0.01) and the reduction of serum alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRAP), bone gla-protein, c-terminal telopeptides of type I collagen (CTX-I) and deoxypyridinoline levels (P<0.01 for all). In vitro experiment, compared with the control group, HLE at 20 µg/mL promoted the cell proliferation (P<0.01), and increased the expression of bone morphogenetic protein-2 and osteopontin levels in osteoblasts (both P<0.05). HLE at 100 µg/mL increased the osteoblastic ALP activities, and HLE at all dose enhanced the extracellular matrix mineralization (both P<0.01). Furthermore, compared with the control group, HLE at 20 µg/mL and 100 µg/mL inhibited osteoclastic TRAP activity (P<0.01), and reduced the expression of matrix metalloproteinase-9 and cathepsin K (both P<0.05).@*CONCLUSION@#HLE may protect against bone loss, and have potentials in the treatment of osteoporosis.

Intervening effects of lupulone and humulone in humulus lupulus l. On osteoblasts and osteoclasts of rats / 第二军医大学学报

Objective To explore the effects of lupulone (LUP) and humulone (HUM) in Humulus lupulus L. on osteoblasts and osteoclasts of rats. Methods Osteoblasts and osteoclasts isolated from 24-h-old Wistar rats were studied and divided into control group, LUP-treated low (10－15 mol/L)-, medium (10－14mol/L)-and high (10－13 mol/L)-dose groups, and HUM-treated low (10－15 mol/L)-, medium (10－14 mol/L)-and high (10－13mol/L)-dose groups. After drug treatment, the proliferation, differentiation and bone mineralization of osteoblasts were determined by MTT assay, alkaline phosphatase (ALP) activity assay and alizarin red staining, respectively. Osteoclasts were counted and tartrate-resistant acid phosphatase (TRAP) activity was measured to evaluate the effects of LUP and HUM on the activity of osteoclasts. Osteocalcin (OCN) levels were measured by kit assay, and the expression levels of bone formation related proteins osteopontin (OPN), bone sialoprotein (BSP), bone morphogenetic protein 2 (BMP-2), bone resorption related proteins cathepsin K (CK) and matrix metalloproteinase 9 (MMP-9) were measured by Western blotting analysis to evaluate the effects of LUP and HUM on bone metabolism. Results At the osteoblast level, LUP at dosages of 10－15 and 10－14 mol/L could significantly promote the cell proliferation (P0.05). LUP at dosages of 10－14 and 10－13 mol/L could significantly improve ALP activity and bone mineralization (P0.05, P0.01). LUP at dosage of 10－13 mol/L could significantly induce the expression of OCN (P0.01). Furthermore, LUP at dosages of 10－14 and 10－13 mol/L could significantly increase the expression of BSP and BMP-2 (P0.05). HUM at dosages of 10－15-10－13 mol/L could also significantly promote the osteoblastic proliferation, ALP activity and bone mineralization (P0.01), and could significantly increase the expression of OCN and OPN (P0.05, P0.01). Additionally, HUM at dosages of 10－14 and 10－13 mol/L could significantly increase the expression of BSP and BMP-2 (P0.05). At the osteoclast level, both LUP and HUM at dosages of 10－15-10－13 mol/L could significantly reduce the number of osteoclasts (P0.01) and could significantly inhibit the expression of CK (P0.05, P0.01). HUM at dosages of 10－15-10－13 mol/L could also significantly inhibit the expression of MMP-9 (P0.05, P0.01). Conclusion This study preliminarily clarifies that LUP and HUM can prevent bone loss by promoting bone formation and inhibiting bone resorption, which provides a new reference for the development of osteoporosis drugs.

Identification of three novel SRD5A2 mutations in Chinese patients with 5α-reductase 2 deficiency / 亚洲男科学杂志(英文版)

In this study, we investigated the genetics, clinical features, and therapeutic approach of 14 patients with 5α-reductase deficiency in China. Genotyping analysis was performed by direct sequencing of PCR products of the steroid 5α-reductase type 2 gene (SRD5A2). The 5α-reductase activities of three novel mutations were investigated by mutagenesis and an in vitro transfection assay. Most patients presented with a microphallus, variable degrees of hypospadias, and cryptorchidism. Eight of 14 patients (57.1%) were initially reared as females and changed their social gender from female to male after puberty. Nine mutations were identified in the 14 patients. p.G203S, p.Q6X, and p.R227Q were the most prevalent mutations. Three mutations (p.K35N, p.H162P, and p.Y136X) have not been reported previously. The nonsense mutation p.Y136X abolished enzymatic activity, whereas p.K35N and p.H162P retained partial enzymatic activity. Topical administration of dihydrotestosterone during infancy or early childhood combined with hypospadia repair surgery had good therapeutic results. In conclusion, we expand the mutation profile of SRD5A2 in the Chinese population. A rational clinical approach to this disorder requires early and accurate diagnosis, especially genetic diagnosis.

Thevalueofdynamicenhanced MRIimaginginthedifferentialdiagnosis betweenbenignIPandIP malignanttransformation / 实用放射学杂志

Objective ToinvestigatethevalueofDCEGMRIimagingindifferentiatingmalignanttransformationinvertedpapilloma (IP)frombenignIP.Methods 24casesofIPconfirmedbyoperationandpathologywerecollectedfromJanuary2012toJanuary 2018,including14caseswithbenignIPand10patientswithIP malignanttransformation.Thedynamicenhancementparametersof thetwogroups,theproductoftransferconstant(Ktrans),therefluxrateconstant(Kep),theextravascularextracellularspacevolume fraction (Ve)andthedifferenceoftheareaundertheinitialcurve(iAUC)wereanalyzed.Thesensitivityandspecificityofdifferent parametersintheidentificationofbenignIPandIP malignancytransformationwereevaluated.Results Thereweredifferencesno significantdifferenceinageandsexbetweenbenignIPgroupandIPmalignanttransformationgroup.Therewasasignificantdifference abouttheconvolutedcerebriformpatternbetweenthetwogroups(P＝0.004).Therewasnosignificantdifferenceofstagingbetween thetwogroups(P＝0.136).TheKtransvaluesofbenignIPgroupandIPmalignanttransformationgroupwere0.21±0.53 (min－1), 0.36±0.93 (min－1),andtherewasasignificantdifferencebetweenthetwogroups(P＝0.000).TheiAUCvaluesofbenignIPgroupand IP malignanttransformationgroupwere29.05±5.45,41.14±9.47,respectively,andthedifferenceofiAUCbetweentwogroupswas statisticallysignificant(P＝0.001).TherewasnosignificantdifferenceinKepandVebetweenbenignIPfromIPmalignanttransformation (P＞0.05).Conclusion BenignIPhasatypicalconvolutedcerebriG formpatternandtheabsenceofitindicatesmalignanttransformation. Thestagingoflesioncan’tdifferentiatethebenignIPfromIP malignanttransformation.DCEGMRIexaminationisworthyinthe evaluationbenignIPandIP malignanttransformation,especiallyKtransandiAUCvalues.

Interventional effects of prunella vulgaris sulfated polysaccharide on CCl4-induced hepatic fibrosis in rats / 天津医药

Objective To investigate the intervention effects of prunella vulgaris sulfated polysaccharide (PVSP) on carbon tetrachaloride(CCl4)-induced hepatic fibrosis in rat.Methods The 40% CCl4was used to induce hepatic fibrosis in rat model, then successful model rats were randomly divided into 3 groups, with 10 rats in each group, respectively, the model group(Model),the high dose PVSP group(PVSP-H:400 mg/kg)and the low dose PVSP group(PVSP-L:100 mg/kg). The blank group and solvent group were also established.The serum levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were determined by automatic biochemical analyzer.HE staining and Sirius red staining were used to examine the degree of hepatic fibrosis.The expression levels of collagen typeⅠ(Col-Ⅰ)and α-smooth muscle actin(α-SMA)mRNA were detected by qRT-PCR.Col-Ⅰand α-SMA in hepatic tissues were detected by immunohistochemistry staining.Results There were no significant changes in serum expressions of ALT and AST and mRNA proteins of Col-Ⅰand α-SMA in liver tissues between the blank group and Solvent group.Compared with the model group,the serum levels of ALT and AST were significantly decreased in the PVSP-H and PVSP-L groups (P<0.05). HE staining and Sirius red staining showed that PVSP could significantly reduce the degree of hepatic fibrosis.The expression of Col-Ⅰand α-SMA mRNA were decreased in the PVSP-H and PVSP-L groups(P<0.05).Immunohistochemistry showed that the expressions of Col-Ⅰ and α-SMA in hepatic tissues were decreased by PVSP (P<0.05), and the effect was dose-dependent. Conclusion PVSP has a protective effect on CCl4-induced hepatic fibrosis in rats, which may be related with the inhibiting expressions of Col-Ⅰand α-SMA,reducing secretion of collagen and promoting extracellular matrix degradation.

Comparison and Correlation of Magnetic Resonance Imaging and Clinical Severity in Nonhuman Immunodeficiency Virus Patients with Cryptococcal Infection of Central Nervous System / 中华医学杂志(英文版)

Background@#The incidence of cryptococcal meningitis among immunocompetent patients increases, especially in China and imaging plays an important role. The current study was to find the correlation between magnetic resonance imaging (MRI) manifestation and clinical severity in nonhuman immunodeficiency virus patients with cryptococcal infection of central nervous system (CNS).@*Methods@#A total of 65 patients with CNS cryptococcal infection from August 2014 to October 2016 were retrospectively included in this study. All the patients had MRI data and clinical data. The patients were divided into two groups according to whether the patients were confirmed with identifiable underlying disease. Comparison and correlation of MRI and clinical data in both groups were investigated using independent sample t- test, Chi-square test, Mann-Whitney test and Spearman rank correlation analysis.@*Results@#In all 65 patients, 41 cases (41/65, 63.1%; Group 1) had normal immunity and 24 cases (24/65, 36.9%; Group 2) had at least one identifiable underlying disease. Fever, higher percentage of neutrophil (NEUT) in white blood cell (WBC), and increased cell number of cerebral spinal fluid (CSF) were much common in patients with underlying disease (Group 1 vs. Group 2: Fever: 21/41 vs. 21/24, χ = 8.715, P = 0.003; NEUT in WBC: 73.15% vs. 79.60%, Z = -2.370, P = 0.018; cell number of CSF: 19 vs. 200, Z = -4.298, P < 0.001; respectively). Compared to the patients with normal immunity, the lesions are more common in the basal ganglia among patients with identifiable underlying disease (Group 1 vs. Group 2: 20/41 vs. 20/24, χ = 7.636, P = 0.006). The number of the involved brain areas in patients with identifiable underlying disease were well correlated with the number of cells and pressure of CSF (r = -0.472, P = 0.031; r = 0.779, P = 0.039; respectively).@*Conclusions@#With the increased number of the involved brain areas in patients with identifiable underlying disease, the body has lower immunity against the organism which might result in higher intracranial pressure and more severe clinical status.

Correlation research of renal perfusion and diffusion function using MRI in renal allograft early after renal transplantation / 中华放射学杂志

Objective To explore the correlationships between microperfusion diffusion indexes derived from intravoxel incoherent motion(IVIM)and perfusion values measured by arterial spin labeling (ASL)in renal allograft. Methods A total of 76 renal allograft recipients and 26 age-matched volunteers (group 0)were included in this prospective study. All subjects were underwent conventional MRI, IVIM and ASL MRI which were performed in the oblique-sagittal plane. Seventy-six recipients were divided into two groups based on the estimated glomerular filtration rate(eGFR):recipients with good allograft function(group 1, eGFR≥ 60 ml · min-1 · 1.73m-2,n=44)and recipients with impaired allograft function(group 2, eGFR0.05), but RBF value was significantly lower(P<0.05). The ADCslow, ADCfast, PF and RBF values of renal cortex were significantly lower in allografts with impaired function compared to allografts with good function(all P<0.01). In renal allografts, there were significant positive correlations between cortical ADCslow, ADCfast, PF, RBF value and eGFR(r values were 0.604, 0.552, 0.579 and 0.673, all P<0.01). Cortical ADCfast and PF value exhibited a significant correlation with RBF for recipients(r values were 0.501 and 0.423, all P<0.01). Conclusion Cortical ADCfast and PF values derived from IVIM and RBF measured by ASL show a significant positive correlation in renal allografts.

Effects of exogenous MeJA, SA and two kinds of endophytic fungi on physiology and total phenols content of seedlings of Bletilla striata / 中国中药杂志

Tissue culture seedlings of Bletilla striata were treated with MeJA, SA and two kinds of endophytic fungi in order to study the effects of those treatments on the physiology and total phenols content. The method of tissue culture was used to culture seeds into seedlings, and then different treatments were applied on them to observe and measure the changes of physiology and total phenols content. We find that the growth of seedlings treated with SA was poor, which treated with 40 μmol•L⁻¹ MeJA, 50 mL•L⁻¹ Hypocrea koningii and 10 mL•L⁻¹ Trichoderma koningiopsis showed better. The activity of SOD, POD and CAT was at a high level under SA treatment of each concentration. The activity of SOD and POD increased as the rise of MeJA concentration, while CAT was highest at 80 μmol•L⁻¹. The activity of SOD and POD increased with the increasing of the concentration of H. koningii treatment, while CAT reached the highest at 1 mL•L⁻¹. The activity of SOD, POD and CAT increased first and then declined with the concentration of T. koningiopsis increasing, and the highest activity was at 10 mL•L⁻¹. The contents of MDA, soluble protein and proline were increased more or less under the four treatments. The content of polysaccharide was at a high level under 60 μmol•L⁻¹ of MeJA. The total phenols content was at a high level under 40 μmol•L⁻¹ of MeJA, 60 μmol•L⁻¹ of SA, 1 mL•L⁻¹ of H. koningii and 10 mL•L⁻¹ of T. koningiopsis. The results indicated that the addition of exogenous MeJA, SA and endophytic fungi under certain concentrations could improve the resistance of B. striata and increase the content of total phenols at some degree and the trearment of MeJA, H. koningii and T. koningiopsis could promote the growth of seedlings under certain concentrations.

Preliminary study of cerebral venous oxygen saturation in healthy people using MR quantitative susceptibility mapping / 中华放射学杂志

of left and right side cerebral cortical veins was 159.16(154.88-164.13)ppb(× 10-9), 164.61(156.23-168.04) ppb, respectively. The median susceptibility (extent) of left and right side thalamostriate veins was 160.51 (152.14-170.06) ppb, 162.48(153.47-173.66)ppb, respectively. Left were less than the right, and the difference was statistically significant (Z=-3.14,-2.02, P<0.05). And the difference of two side of other cerebral venous susceptibility had no statistical significance. The median susceptibility (extent) of right cerebral cortical veins, left thalamostriate veins and right septal veins of 22 male was 166.22(159.21-169.99) ppb, 168.65(159.19-174.45)ppb and 153.42(148.10-161.78)ppb, respectively. The coresponding positions of median susceptibility (extent) of 38 female was 161.10(155.06-167.15)ppb, 157.70(151.53-164.41)ppb and 147.52(142.94- 154.16)ppb, respectively. The susceptibility of right cerebral cortical vein, left thalamostriate vein, right septal vein of male was significantly different from the females (Z=-2.03,-2.20,-2.33, P<0.05). Futhermore, we also found that there had positive correlation between age and right thalamostriate vein(r=0.28,P<0.05). Conclusion The magnetic sensitive of the right thalamostriate vein tends to increase along with the age, and some of peoples had difference with bilateral and age.

Analysis of articles published in Chin J Surg since founded in 1951 / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the characteristics of the articles published in Chin J Surg from 1951 to 2015.</p><p><b>METHODS</b>The journals and articles of Acad Surg from 1951 to 1952 and Chin J Surg from 1953 to 2015 were analyzed. The subjects, foundation, basic medical study, international cooperation of the articles were recorded.</p><p><b>RESULTS</b>In 65 years, there were 20 090 academic articles published in Chin J Surg. The proportions of general surgery, orthopedic surgery, thoracocardiac surgery, urology surgery and neurosurgery articles were 34.08%, 17.96%, 13.09%, 11.91% and 5.85%, respectively. There were 14.83% (1 728/11 653) articles receiving foundation, and 9.42% (1 817/19 290) articles reporting basic medical study. There were 14.8% articles from international authors and 119 articles with international cooperation. From 2000 to 2003, 29 articles in original English were published.</p><p><b>CONCLUSIONS</b>The coverage of Chin J Surg contains all the fields of surgery. It tends to publish the studies focus on clinical issues.Through reinforcing the content plan and optimizing the show form, the more Chinese surgical research achievements could be shared by the surgeons worldwide.</p>