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To explore the value of magnetic resonance diffusion-weighted imaging (MR-DWI) for evaluating inflammatory activity of perianal Crohn's fistula. Methods: A total of 55 patients, who were diagnosed as perianal Crohn's fistula by surgery and/or endoscopy, were assessed retrospectively. All patients, underwent pelvic magnetic resonance imaging (MRI) before and 32 weeks after the treatment, were divided into 2 groups according to their response to treatment: an effective group (34 cases) and an ineffective group (21 cases). The MRI images of patients in the 2 groups were analyzed. The changes of apparent diffusion coefficient (ADC) values before and after treatment in the 2 groups were measured and compared by a paired t-test. An MRI-based score of perianal Crohn's disease severity was calculated as a reference standard, and the correlation between the ADC value and the MRI-based score was analyzed by using a Pearson correlation coefficient method. Results: In the effective group, the ADC values after therapy were significantly greater than those before therapy (P0.05). There was a strong negative correlation between the ADC values (after and before therapy) and the MRI-based scores in all the patients [in the effective group alone (r=-0.672, P<0.01) or in the effective group + the ineffective group (r=-0.638, P<0.01)]. Conclusion: Changes in the ADC values of perianal fistula are related to the fistula activity. MR-DWI and ADC value can accurately evaluate the inflammatory activity of perianal Crohn's fistula.
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Humanos , Doença de Crohn , Imagem de Difusão por Ressonância Magnética , Fístula , Estudos RetrospectivosRESUMO
Cell-penetrating peptides (CPPs) are short peptides that can penetrate the cell membrane or tissue barrier. CPPs can deliver a variety of biomacromolecules, such as proteins, RNA and DNA, into cells to produce intracellular functional effects. Endocytosis and direct penetration have been suggested as the two major uptake mechanisms for CPPs-mediated cargo delivery. Compared with other non-natural chemical molecules-based delivery reagents, the CPPs have better biocompatibility, lower cytotoxicity, are easily degraded after cargo delivery, and can be fused and recombined expressed with bioactive proteins. Because of these advantages, the CPPs have become an important potential tool for delivery of developing drugs which targets intracellular factors. As a novel delivery tool, the CPPs also show promising application prospects in biomedical researches. This review summarized recent advances regarding the classification characteristics, the cellular uptake mechanisms and therapeutic application potentials of CPPs.
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Transporte Biológico , Membrana Celular , Peptídeos Penetradores de Células , Metabolismo , EndocitoseRESUMO
Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.
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Objective To explore the clinical value of the combined dual-source CT venography(CTV)for the diagnosis of iliac vein compression syndrome(IVCS).Methods 43 patients with clinically suspected IVCS underwent CTV examination.Among them,22 cases were assessed with combined CTV while 21 cases were given conventionally indirect CTV.The lower extremity deep vein was scanned from foot to head.The dual-energy technology was applied for data acquisition.Results Two kinds of CTV methods could be used directly for diagnosing IVCS and checking the asymptomatic mild iliac vein compression.32 IVCS patients were diagnosed by CTV.In 27 cases with deep venous thrombosis(DVT),the average diameter of the left iliac vein was(3.23 ± 1.45)mm and the average compression rate was 67%.The differences were statistically significant in comparisons of the average diameter of left iliac vein between IVCS patients with or without DVT and patients without IVCS.The image quality scores of bidirectional CTV were higher than indirect CTV with statistically significant difference.Conclusion Combined CTV is a feasible technique for lower extremity venography.The image quality of combined CTV is better than conventional indirect CTV with greater clinical value.
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Objective To evaluate non-enhancement magnetic resonance venography (MRV) of iliac vein in diagnosing Cockett syndrome.Methods Magnetic resonance iliac venography was performed with Ingenia 3.0 T superconducting type MRI system.Abdominal surface coil was employed.The scanning sequences included M2DIPEAR (TR/TE=45/5.8 ms,flip angle=60°),THRIVE (TR/TE=6.8/3.5 ms,flip angle=10°),BTFESPAIR (TR/TE=3.4/1.7 ms,flip angle=80°) and FLAIR (TR/TE=9 000/120 ms,flip angle 90°).The layer thickness of 3 mm was used in all scanning,and the average number of acquisition was 3 times.Results On MRV imaging,Cockett syndrome was characterized by narrowed anteroposterior diameter and broadened transverse diameter of the compressed iliac vein,and curved impression could be seen on its anterior border,and collateral vessel formation could be observed.The mean diameters of the left iliac veins in the light,mnedium and severe patients with Cockett syndrome were 7.52,4.83 and 2.76 mm respectively,with the average compression ratios being 37%,69% and 83% respectively.Conclusion Non-enhanced MRV is a feasible method for the diagnosis of iliac vein stenosis,this examination is especially suitable for the checking needs of specific population.
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Objective To evaluate the characteristics and the value of dual-source CT single-energy high pitch scanning technology in postoperative follow-up of endovascular graft exclusion to DeBakey Ⅲ aortic dissection.Methods All of 58 patients with endovas-cular graft exclusion to Debakey Ⅲ aortic dissection underwent dual-source CT checkup.30 patients (group A)were scanned with single-energy high pitch technology,voltage 120 kV,pitch 3.2;28 patients (group B)were scanned with dual-energy standard pitch technology,voltage 100 kV and 140 kV,pitch 1.0;both groups were used CareDose4D technology to automatically track the cur-rent.Image post-processing was completed at the workstation.The stent condition,endoleak and residual dissection were observed and analyzed.The differences of image quality and radiation dose between two scanning modes were compared.Results All of 58 cases,postoperative conditions to 9 cases were perfect,the proportion was 1 5.52%;43 cases were with distal residual dissection,the proportion is 74.14%;and 12 cases were accompanied with endoleaks,the proportion was 20.69%.The endoleaks manifestation in-cluded punctuate,band-like,and patchy high density around the stent in enhanced images.The difference of scan length between group A and group B was not statistically significant,the image quality of both groups met excellent standard .The acquisition time and effective radiation dose to group A were 1/4 and 56% of group B respectively.the differences of both groups were statistically significant.Conclusion Dual-source CT with single-energy high pitch scanning technology can ensure image quality and significantly reduce the effective radiation dose,it is a more advantageous scanning mode.
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Objective To quantitatively study the features of cerebromspinal fluid(CSF)flow dynamies in normal sella region in MRI with phase-contrast method.Methods Seventeen healthy volunteers were studied.The CSF flow image in sella region was positioned at the middle sagittal T1WI or T2WI image.This pulse sequence used a encoding velocity of 20 cm/s.The waveforms were analyzed for the maximum flow velocity,flow volume rate and the change of the figures.From the velocity and area measurements on the cine images,mean CSF flow was calculated in millimeters per second and milliliters per cardiac cycle.Results The normal CSF flow of the sella region had two directions which was downward(caudal)flow during thesystolic period and upward(cranial)flow during the diastolic period of the cardiac cycle.The downward and upward peak flow velocity,mean downward and upward flow velocity and mean flow velocity was(1.44±0.99)cm/s,(302.71±248.15)ms,(1.16±0.64)cm/s,(331.00±225.38)ms,(0.49±0.39)cm/s.(0.67±0.44)cm/s,(0.54±O.30)cm/s,respectively.The downward and upward peak flow volume rate.mean downward and upward flow volume rate and mean flow volume rate was (0.014±0.009)ml/s.(0.012±0.006)ml/s,(0.047±0.041)ml/s,(0.053±0.003)ml/s,(0.005±0.003)ml/s,(0.034±0.031)ml/s,respectively.The mean cycle was(775.25±173.06)ms.Conclusion Phase-contrast method in MRI cine is a noninvasive method to study the CSF flow in physiological and pathological conditions for determining the pattern,direction,speed and quantity of the CSF flow.Therefore it is better than other invasive research modalities and has an important value in clinical application.
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Objective To evaluate the capacity of reverse dot blot(RDB)technique in screening Human papillomavirus infection in cervix.Methods 49 cases examined by hybrid capture 2(HC2)were collected for RDB technique testing.Results In the 49 cases,the positive of HR-HPV examined by HC2 was 89.8%(44/49),53.1%(26/49)by RDB,respectively.Sensitivity,specificity of RDB technique was 59.1%,100(5/5),conordance rate was 63.3%(31/49),positive predictive value and negative predictive value of RDB was 100%,21.7%,respectivdy.Kappa=0.23.Conclusion It is superior in the economy for screening human papillomavirus infection in cervix that RDB technique is developed and optimized,cheap RDB technique should be substituted for expensive HC2.
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Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.