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Preserving lacustrine ecosystems is vital for sustainable watershed development, and forecasting the environmental water availability of lakes would support policymakers in developing sound management strategies. This study proposed a methodology that merges the lake water level prediction and environmental water availability evaluation. The temporal fusion transformer (TFT) model forecasted the lake water levels for the next 7 days by inputting the streamflow and lake water level data for the past 30 days. The environmental water availability was assessed by comparing the forecasted lake water levels with the environmental water requirements, resulting in adequate, regular, scarce, and severely scarce environmental water availability. The methodology was tested in two case studies: Poyang Lake and Dongting Lake, the two largest freshwater lakes in the Yangtze River Basin, China. The TFT model performed well in forecasting the lake water levels, as shown by the high coefficient of determination and finite root mean square error. The coefficients of determination exceeded 0.98 during the model training, validation, and test for both Poyang Lake and Dongting Lake, and the root mean square errors ranged from 0.06 to 0.46 m. The accurate prediction of lake water level promoted the precise forecasting of the environmental water availability with the high Kappa coefficient exceeding 0.90. Results indicated the rationality and effectiveness of integrating the lake water level prediction and environmental water availability evaluation. Future research includes the applicability of the TFT model to other lakes worldwide to test the proposed approach and investigate strategies to cope with environmental water scarcity.
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Ecosistema , Lagos , Agua , Monitoreo del Ambiente/métodos , ChinaRESUMEN
The substantial impacts of exogenous pollutants on lake water quality have been extensively reported. Water-sediment factors, which are essential for regulating water quality in river-connected lakes, have not been studied in depth under different hydrological conditions. This study has combined a 31-year water environmental dataset (1991-2021) regarding Dongting Lake and a vector autoregression model (VAR) in order to investigate the impulse response characteristics and contributions of water quality caused by water-sediment factors across different periods. Our analysis suggests that total nitrogen (TN) exhibited a significant increasing trend, whereas total phosphorus (TP) increased to 0.17 mg/L, and then decreased to 0.07 mg/L from 1991 to 2021. The inflow of suspended sediment discharge (SSD) decreased significantly during the study period, mainly because of the decrease in SSD in the three channels (TC). In the pre-Three Gorges Dam (TGD) period, water discharge (WD) and SSD were the Granger causes of TN and TP. In the post-TGD periods this relationship disappeared because of the construction of the TGD, which reduced the inflow of SSD and WD into the lake. Water quality indicators showed an instant response to the shock from themselves with high values, whereas the impulse response of the water quality to water-sediment factors exhibited lagged variations. This meant that the water quality indicators displayed a high impact by themselves across the different periods, with values varying from 67 % to 95 %. Water level (WL) and SSD were the predominant water-sediment factors for TP in the pre-TGD period, with the impact on TP changes accounting for 11 % and 9 %, respectively, whereas the contribution of SSD decreased to 2 % in the post-TGD period. WL was the most crucial water-sediment factor for CODMn during the different periods, with contributions varying from 17 % to 20 %. To improve the water quality of Dongting Lake, in addition to the implementation of strict controls on excessive external nutrient loading, regulating water-sediment factors according to the hydrological features of Dongting Lake during different periods is vital.
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Background: Recurrent patellar dislocation (RPD) and habitual patellar dislocation (HPD) in flexion are frequently encountered in children and adolescents. Purpose: To compare the radiological features of RPD and HPD in children and adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Imaging data were collected from patients aged 9 to 15 years who received surgical treatment for HPD or RPD at a single institution between June 2015 and September 2020. The prevalence of trochlear dysplasia, tibial tubercle lateralization, and lower limb rotational deformity was assessed through hip/knee/ankle computed tomography (CT) using the following quantitative indicators: trochlear depth index, lateral trochlear inclination, sulcus angle, tibial tubercle-trochlear groove (TT-TG) distance, ratio of TT-TG distance to femoral width, TT-TG angle, femoral anteversion angle, and tibial external rotation angle. The morphology of trochlea and patella were graded on knee CT using the Dejour and Wiberg classification. The Insall-Salvati index and Caton-Deschamps index were used to evaluate the height of the patella on lateral view radiographs. To evaluate lower limbs malalignment, the mechanical lateral distal femoral angle and medial proximal tibial angle were measured on weightbearing full-length radiographs. The collected data were analyzed and compared between the HPD and RPD groups. Results: Enrolled were 15 patients (21 knees) diagnosed with HPD and 18 patients (22 knees) diagnosed with RPD. The age of first dislocation was significantly younger in the HPD group (7.6 ± 3.4 vs 11.2 ± 1.4 years; P = 0.003). Knees in the HPD group had a significantly higher proportion of Dejour type C dysplasia (57.1% vs 4.5%; P < .005) and Wiberg type 3 patella (66.7% vs 9.1%; P < .001). There were statistically significant differences between the groups in the trochlear depth index (HPD vs RPD: 1.1 ± 1.7 vs 2.2 ± 1.5 mm; P = .039), sulcus angle (170.3° ± 13.7° vs 157.3° ± 16.0°; P = .007), Insall-Salvati index (1.1 ± 0.2 vs 1.3 ± 0.2; P = .034), and tibial external rotation angle (31.3° ± 7.8° vs 38.4° ± 8.5°; P = .009). Conclusion: Patients in the HPD group presented with poorer trochlear and patellar development, lower patellar height, and less tibial external rotation compared with patients in the RPG group.
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OBJECTIVE: The present study was conducted to demonstrate the age-dependent changes in skeletal muscle mass and visceral fat area in a population of Chinese adults aged 30-92 years old. METHODS: A total of 6669 healthy Chinese men and 4494 healthy Chinese women aged 30-92 years old were assessed for their skeletal muscle mass and visceral fat area. RESULTS: The results showed age-dependent decreases in the total skeletal muscle mass indexes in both men and women aged 40-92 years old as well as age-dependent increases in the visceral fat area in men aged 30-92 years old and in women aged 30-80 years old. Multivariate regression models showed that the total skeletal muscle mass index was positively associated with the body mass index and negatively associated with the age and visceral fat area in both sexes. CONCLUSION: The loss of skeletal muscle mass becomes obvious at approximately 50 years of age, and the visceral fat area commences to increase at approximately 40 years of age in this Chinese population.
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Grasa Intraabdominal , Músculo Esquelético , Adulto , Masculino , Humanos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Músculo Esquelético/fisiología , Pueblos del Este de Asia , Índice de Masa CorporalRESUMEN
BACKGROUND: A20 is an anti-inflammatory molecule in nucleus pulposus (NP) cells. The anti-inflammatory properties of A20 are mainly attributed to its ability to suppress the NF-κB pathway. However, A20 can protect cells from death independently of NF-κB regulation. This study aimed to investigate the effects of A20 on pyroptosis and apoptosis of NP cells induced by lipopolysaccharide (LPS). METHODS: NP cells induced by LPS were used as an in vitro model of the inflammatory environment of the intervertebral disc. Pyroptosis, apoptosis, and mitophagy marker proteins were detected. Then, NP cells were transfected with A20 overexpressed lentivirus or A20-siRNA. Annexin V FITC/PI, Western blotting, and immunofluorescence assays were used to detect the apoptosis, pyroptosis, and mitophagy of NP cells. Furthermore, the expressions of A20, related proteins, and related inflammatory cytokines were detected by western blotting, and ELISA. RESULTS: Apoptosis and pyroptosis of NP cells increased gradually treated with LPS for 12 h, 24 h, and 48 h. Differently, the level of mitophagy increased first and then decreased, and was the highest at LPS treatment for 12 h. Overexpression or knockdown of A20 in NP cells revealed that A20 attenuated the pyroptosis, apoptosis, and production of inflammatory cytokines of NP cells induced by LPS, while A20 sponsored mitophagy, reduced ROS production and collapse of mitochondrial membrane potential (ΔΨm). Moreover, A20 also promoted mitochondrial dynamic homeostasis and attenuated LPS-induced excessive mitochondrial fission. Excitingly, inhibition of mitophagy attenuated the effect of A20 on the negative regulation of pyroptosis of NP cells induced by LPS. Pyroptosis was accompanied by a large release of inflammatory cytokines. Inhibition of pyroptosis also significantly reduced apoptosis of NP cells. Finally, The mitochondria-targeted active peptide SS-31 inhibited LPS-induced pyroptosis and ROS production in NP cells. CONCLUSIONS: To sum up, A20 attenuates pyroptosis and apoptosis of NP cells via promoting mitophagy and stabilizing mitochondrial dynamics. Besides, A20 reduces LPS-induced NP cell apoptosis by inhibiting NLRP3 inflammasome-mediated pyroptosis. It provides theoretical support for the reduction of functional NP cell loss in the intervertebral disc through the gene-targeted intervention of A20.
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Núcleo Pulposo , Antiinflamatorios/farmacología , Apoptosis , Citocinas/metabolismo , Lipopolisacáridos/farmacología , Dinámicas Mitocondriales , Mitofagia , FN-kappa B/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Piroptosis , Especies Reactivas de Oxígeno/metabolismoRESUMEN
To explore the molecular pathogenesis of primary hyperparathyroidism (PHPT), we investigated the proliferation and apoptosis of parathyroid cells in a rabbit model of diet-induced PHPT. A total of 120 adult Chinese rabbits were randomly divided into normal diet (Ca:P, 1:0.7) group (control group) or a high-phosphate diet (Ca:P, 1:7) group (experimental group). The thyroid and parathyroid complexes were harvested for 1-month interval from month 1 to month 6. The expression of proliferation markers, including proliferating cell nuclear antigen (PCNA) and cyclin-D1, and B cell lymphoma-2 (Bcl-2), were evaluated by immunohistochemistry in thyroid and parathyroid tissues. Apoptosis was quantified by DNA-fragment terminal labeling. Our results demonstrated that parathyroid cells in the experimental group started proliferating from the end of the 2nd month, the expression of PCNA, Bcl-2, and cyclin-D1 were significantly higher in the PHPT group than those of the control group (p<0.05). Furthermore, the apoptosis index (AI) was positively correlated with the glandular cell count and expression of PCNA in the 6th month in the PHPT group. Overall, our results suggested that excessive proliferation and apoptosis of parathyroid cells may contribute to the pathogenesis of PHPT through PCNA-related, Bcl-2-related, and cyclin-D1-related pathways.
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Hiperparatiroidismo Primario , Animales , Apoptosis , Proliferación Celular , Hiperparatiroidismo Primario/metabolismo , Antígeno Nuclear de Célula en Proliferación/metabolismo , Proteínas Proto-Oncogénicas c-bcl-2 , ConejosRESUMEN
Excessive inflammation post-traumatic spinal cord injury (SCI) induces microglial activation, which leads to prolonged neurological dysfunction. However, the mechanism underlying microglial activation-induced neuroinflammation remains poorly understood. Ruxolitinib (RUX), a selective inhibitor of JAK1/2, was recently reported to inhibit inflammatory storms caused by SARS-CoV-2 in the lung. However, its role in disrupting inflammation post-SCI has not been confirmed. In this study, microglia were treated with RUX for 24 hours and then activated with interferon-γ for 6 hours. The results showed that interferon-γ-induced phosphorylation of JAK and STAT in microglia was inhibited, and the mRNA expression levels of pro-inflammatory cytokines tumor necrosis factor-α, interleukin-1ß, interleukin-6, and cell proliferation marker Ki67 were reduced. In further in vivo experiments, a mouse model of spinal cord injury was treated intragastrically with RUX for 3 successive days, and the findings suggest that RUX can inhibit microglial proliferation by inhibiting the interferon-γ/JAK/STAT pathway. Moreover, microglia treated with RUX centripetally migrated toward injured foci, remaining limited and compacted within the glial scar, which resulted in axon preservation and less demyelination. Moreover, the protein expression levels of tumor necrosis factor-α, interleukin-1ß, and interleukin-6 were reduced. The neuromotor function of SCI mice also recovered. These findings suggest that RUX can inhibit neuroinflammation through inhibiting the interferon-γ/JAK/STAT pathway, thereby reducing secondary injury after SCI and producing neuroprotective effects.
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The hydrological conditions of river-connected lakes are complex primarily owing to their considerable water-level fluctuations (WLFs). Water quality in such lakes varies with hydrodynamic variations; however, their relationship is not clear. To identify the unique relationship between water level and water quality in river-connected lakes, we used the comprehensive pollution index (CPI) and regression analysis to analyze the spatiotemporal variation in water quality in Dongting Lake from 2015 to 2018 and the effects of water level on water quality. Four water quality parameters were selected: total nitrogen (TN), total phosphorus (TP), permanganate index (CODMn), and chlorophyll a (Chl-a). The results showed significant spatial variation in the lake water quality, with relatively high concentrations of TN, TP, CODMn, and Chl-a in East Dongting Lake. TN and TP decreased by 12.15% and 37.61%, respectively, from 2015 to 2018, whereas CODMn increased from 1.781 to 2.009 mg/L. Seasonally, TN and TP concentrations were low in the summer and autumn, with high concentrations in the winter and spring. In contrast, CODMn and Chl-a concentrations exhibited opposite trends. The pollution level in Dongting Lake ranged between slightly and moderately polluted, with a CPI ranging from 0.76 to 1.32 across all sampling sites during 2015-2018. The water level in Dongting Lake initially increased and, then, decreased in a year, with marked WLFs owing to seasonal shifts in precipitation and human activities. The water level had significant negative relationships with TN and TP concentrations and a significant positive relationship with CODMn concentration (p < 0.05). Based on the results, strict control of excessive external nutrient loading should be actively implemented in Dongting Lake, in addition to hydrological regulation for effective lake water quality management.
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Lagos , Contaminantes Químicos del Agua , China , Clorofila A , Monitoreo del Ambiente , Eutrofización , Humanos , Nitrógeno/análisis , Fósforo/análisis , Ríos , Contaminantes Químicos del Agua/análisis , Calidad del AguaRESUMEN
BACKGROUND: There are discrepancies in the understanding of the structure of the capsuloligamentous complex of the first metatarsophalangeal joint (MTPJ); this study aims to investigate the differences with previous anatomical reports of high-resolution 3T magnetic resonance imaging (MRI) and histological analysis in illustrating the structure of the capsuloligamentous complex of the first MTPJ. METHODS: Nine fresh frozen cadaveric feet specimens (from two women and three men; aged 32 to 58 years) were used in this study. All specimens underwent MR examination with T1-weighted imaging and T2-weighted spectral attenuated inversion recovery in three planes. Subsequently, all cadaveric feet specimens were sliced into 2-mm-thick sections. The MRI features of the capsuloligamentous complex of the first MTPJ were analyzed in these specimens. Hematoxylin-eosin and Masson's trichrome staining methods were used to explore the histologic features of the capsuloligamentous complex of the first MTPJ. RESULTS: Different from most previous studies, our results showed that the plantar plate could be divided into four portions including the central portion of the plantar plate, the intersesamoid, the sesamoid phalangeal and the metatarsosesamoid ligaments. The normal central portion of the plantar plate could be clearly visualized in the sagittal and coronal plane MR images. The intersesamoid ligament is a continuation of the central portion of the plantar plate on the sagittal plane on the gross specimen, the MR imaging, and the histological examination. On the coronal plane of the gross specimen and MR imaging, the sesamoid phalangeal ligaments and the central portion of the plantar plate can be seen as separate ligaments, but they appeared interwoven with the same continuous collagenous fibers on the histological analysis. CONCLUSION: High-resolution 3T MRI allows accurate demonstration of the different anatomical details of the capsuloligamentous complex of the first MTPJ from previous anatomical reports. The histological analysis provides further understanding of the structures of the capsuloligamentous complex of the first MTPJ from previous studies.
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Falanges de los Dedos de la Mano , Imagen por Resonancia Magnética , Articulación Metatarsofalángica , Cadáver , Femenino , Humanos , Ligamentos , Masculino , Articulación Metatarsofalángica/diagnóstico por imagen , Articulación Metatarsofalángica/patologíaRESUMEN
Water quality is essential for lake systems, which are not only influenced by climate change and human activities but are also controlled by high-frequency hydrological rhythms. However, the differences in water quality during different hydrological periods have not been addressed in detail. Here, a 15-year water quality dataset (2004-2018) was selected to explore the variation trends and their relationship with water level in different hydrological periods in Dongting Lake, a typical river-connected lake in China. The hydrological periods were classified into hydrological years and hydrological phases based on the characteristics of water level fluctuations. The results showed that annual variation in the water level in Dongting Lake fluctuated between 23.63 and 25.81 m from 2004 to 2018, and also displayed considerable water level differences ranging from 7.66 m (dry years) to 9.97 m (wet years) within a year. The water level of the lake phase showed significant differences among the different hydrological years. The concentration of TP, CODMn, and NH3-N showed significant decreasing trends, whereas that of TN showed a significant increasing trend from 2004 to 2018. The TN concentration in wet years was significantly higher than that in dry years, which could be attributed to sewage discharge and hydrological conditions. The contributions of the lake phase to the total sewage discharge successively decreased from 64.54% in wet years to 59.47% in dry years, while the river phase showed the opposite trends, ranging from 35.46% to 40.53%, reflecting the strong relationship between water regimes and pollutant fluxes. A regression analysis indicated the different responses of water quality to water level fluctuations over hydrological years, and water quality in different hydrological phases clearly separated the lake and river phases, highlighting the influence of water level fluctuations on water quality within a year. To maintain the water quality of Dongting Lake, the control of external load should not be relaxed, and hydrological regulation should be actively carried out within each year.
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Lagos , Ríos , Calidad del Agua , China , Clima , Monitoreo del Ambiente , HidrologíaRESUMEN
Excess inflammatory microglia activation deteriorates the pathological degree of spinal cord injury (SCI). We here employed microglia samples in vitro and murine model in vivo to trace the role of inhibition of Arhgef3 in inflammatory response post SCI. From the specimen analysis of lipopolysaccharide (LPS)-induced inflammatory microglia, we found that Arhgef3 expression was positively relative to microglia activation. In vitro, LPS caused the microglia inflammatory activation and induced upregulation of the Arhgef3 expression. Interestingly, presence of Arhgef3 could activate RhoA through promoting Rho GTPases, but silencing of Arhgef3 decreased RhoA activation and inhibited the microglia inflammation. Moreover, disruption of Arhgef3 inhibited the GTP-RhoA, resulted in a suppression of proinflammatory cytokines, and alleviated the LPS-elicited inflammatory genes expression. Moreover, artificially decreasing Arhgef3 expression remarkedly reduced ROS generation after LPS treatment. In vivo of a mouse mechanical contusion-induced SCI model, inhibition of Arhgef3 reduced the ratio of GTP-RhoA/Total-RhoA, and prevented SCI via mitigating the microglial inflammatory phenotype and decreased secondary neurological injury. Besides, inhibition of Arhgef3 prevented alleviated the degree of demyelination but did not affect neuronal regeneration. Meaningfully, absence of Arhgef3 improved mouse locomotor recovery post SCI. Taken together, Arhgef3 involves the microglial activation and inflammatory response following neural injury, and targeted disrupting of which may indicate a promising therapeutic direction in preventing SCI.
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Microglía/metabolismo , Factores de Intercambio de Guanina Nucleótido Rho/antagonistas & inhibidores , Factores de Intercambio de Guanina Nucleótido Rho/biosíntesis , Traumatismos de la Médula Espinal/metabolismo , Proteína de Unión al GTP rhoA/antagonistas & inhibidores , Proteína de Unión al GTP rhoA/metabolismo , Animales , Expresión Génica , Técnicas de Silenciamiento del Gen/métodos , Locomoción/fisiología , Masculino , Ratones , Ratones Endogámicos C57BL , Factores de Intercambio de Guanina Nucleótido Rho/genética , Traumatismos de la Médula Espinal/genéticaRESUMEN
Objective@#To improve the current understanding on the imaging features of pancreatic schwannoma.@*Methods@#Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.@*Results@#A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T1WI, and in partially low signal and partially high signal at T2WI, and completely opposite signal characteristics of T2WI area after T1 enhancement, referring to the finding that low T2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal.@*Conclusions@#Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.
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Objective@#To evaluate the imaging and clinicopathological characteristics of pancreas perivascular epithelioid cell tumors (PEComa).@*Methods@#The clinical data of patients with pancreatic PEComa admitted in Changhai Hospital of Navy Medical University from Nov 2013 to Nov 2017 were retrospectively analyzed. Related literature on PEComa were searched and the image and clinicopathological characteristics were investigated.@*Results@#Two pancreatic PEComa patients were admitted in Changhai Hospital. Twenty-nine PEComa patients were reported in previous literature. A total of 31 cases were detected, including 3 men and 27 women. The onset age of the patients ranged from 17-74 years old with a mean of 48 years old. The lesions were located at the pancreatic head and neck in 20 cases, and at the pancreatic body and tail in 11 cases. 27 cases had a single lesion, and 4 cases had multiple lesions. Tumor diameter ranged from 1.0-11.5 cm with a mean of 4.1 cm. The cystic solid of the lesions was recorded in 23 patients, and 18 cases had solid mass. Pancreatic duct dilation was reported in 21 patients and 14 of them did not have pancreatic duct dilation. Enhancement mode of the lesions was examined in 21 patients, and the enhancement degree of the lesions were higher than that of the pancreas in 16 cases.@*Conclusions@#PEComa has a certain imaging characteristic, which could help obtain a preoperative diagnosis.
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OBJECTIVE@#To investigate the clinical significance of minimal residual disease (MRD) monitoring by multiparameter flow cytometry (MFC) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute leukemia.@*METHODS@#81 cases of patients with AL treated with allo-HSCT in Department of Hematology, the First Affiliated Hospital of Chongqing Medical University form July 2015 to July 2018 was selected and retorspectively analyed. of which 79 patients were in CR and two patients were in non-CR. The CR group was further divided into two groups of MRD and MRD based on the MRD level prior to HSCT.@*RESULTS@#Among 81 patients, there were statistically significant differences in the three-year overall survival(OS) (CR 82.2%: NCR 0%), cumulative relapse incidence(RI) (CR 17.7%; NCR 100%) and leukemia-free survival rate(LFS) (CR 42.3%: NCR 0%) between CR and NCR group(P<0.05). Among 79 CR patients, MRD was negative in 30 patients while positive in 49 patients, there was significant differences in the three-year overall survival between MRD and MRD group. The results of univariate analysis showed that the MRD group showed lower LFS compared with that of MRD group (10.5% vs 36.2%)(P<0.001,95%CI).@*CONCLUSION@#MRD patients shows longer LFS as compared with that of MRD patients, therefore, MRD monitoring by MFC before allo-HSCT is very important for the prognosis of the AL patients.
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Objective To study the internal relationship between resting tremor and slow response in patients with Parkinson’s disease. Methods The movement characteristics of wrist joints in valgus direction was studied by dynamic modeling on wrist joints of the upper limbs. The system delay concept was introduced with human autonomous control and the sensory delay characteristics of Parkinson’s patients was simulated, to make stability analysis and dynamic response of the involuntary wrist movement. Results The stability analysis and numerical solution of this time-delayed control system showed that when the sensation was delayed to a certain extent, involuntary tremor of wrist joints in patients with Parkinson’s disease would happen, which conformed to resting tremor from Parkinson’s disease. Conclusions Resting tremor from Parkinson’s disease is caused by sensation and movement delay.
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Objective:To evaluate the imaging and clinicopathological characteristics of pancreas perivascular epithelioid cell tumors (PEComa).Methods:The clinical data of patients with pancreatic PEComa admitted in Changhai Hospital of Navy Medical University from Nov 2013 to Nov 2017 were retrospectively analyzed. Related literature on PEComa were searched and the image and clinicopathological characteristics were investigated.Results:Two pancreatic PEComa patients were admitted in Changhai Hospital. Twenty-nine PEComa patients were reported in previous literature. A total of 31 cases were detected, including 3 men and 27 women. The onset age of the patients ranged from 17-74 years old with a mean of 48 years old. The lesions were located at the pancreatic head and neck in 20 cases, and at the pancreatic body and tail in 11 cases. 27 cases had a single lesion, and 4 cases had multiple lesions. Tumor diameter ranged from 1.0-11.5 cm with a mean of 4.1 cm. The cystic solid of the lesions was recorded in 23 patients, and 18 cases had solid mass. Pancreatic duct dilation was reported in 21 patients and 14 of them did not have pancreatic duct dilation. Enhancement mode of the lesions was examined in 21 patients, and the enhancement degree of the lesions were higher than that of the pancreas in 16 cases.Conclusions:PEComa has a certain imaging characteristic, which could help obtain a preoperative diagnosis.
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Objective:To improve the current understanding on the imaging features of pancreatic schwannoma.Methods:Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed.Results:A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T 1WI, and in partially low signal and partially high signal at T 2WI, and completely opposite signal characteristics of T 2WI area after T 1 enhancement, referring to the finding that low T 2WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal. Conclusions:Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.
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Objective:To summarize the MRI features of intrapancreatic accessory spleen (IPAS) and G1 grade pancreatic neuroendocrine neoplasms (PNENs), and clarify the radiological features for differential diagnosis.Methods:The data of 11 patients with IPAS confirmed by surgical pathology or 99mTc thermal denatured red blood cell imaging and 9 patients with G1 grade PNENs confirmed by surgical pathology in the tail of pancreas from January 2013 to December 2019 admitted in First Affiliated Hospital of Navy Medical University were retrospectively analyzed. MRI features of IPAS group and PNENs group, including shape, size, whether it protruded beyond the contour of the pancreas, cystic degeneration, plain scan of T 2WI, DWI signal, multistage enhancement mode, false capsule, etc. were studied and compared. Results:There was significantly statistical difference between the two groups in the terms of contour protrusion, T 2WI and DWI signals, multistage enhancement, and pseudomembrane (all P< 0.05). Protruded lesion was more common in the PNENs group (9/9 cases) than in the IPAS group (3/11). The T 2WI and DWI signals of lesions in the PNENs group were slightly higher than those in the IPAS group, and the proportion of high T 2WI and DWI signal lesions in the PNENs group was 6/9 cases and 4/9 cases, respectively, while the proportion of high T 2WI and DWI signal lesions in the IPAS group was 0/11 cases. Multistage enhancement of lesions in the PNENs group was more likely to be consistent (6/9), while lesions in the IPAS group were more inconsistent (10/11). In the PNENs group, all lesions showed false envelope after enhancement (9/9), while in the IPAS group, no false envelope was observed after enhancement (0/11). Conclusions:The presence of protruded lesions, the characteristics of T 2WI and DWI signals, the mode of multiphase enhancement and the false envelope were essential signs for differentiating IPAS and G1 grade PNENs.
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Objective:To explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque.Methods:The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T 2WI, T 1WI and contrast-enhanced T 1WI of vessel wall, and T 2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. Results:A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen ( P=0.039), plaque enhancement degree ( P<0.001), plaque volume ( P=0.024) and plaque burden ( P=0.031) were all improved after the drug treatment, the NIHSS score of nervous system was also significantly improved, and the levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in 12 patients were significantly decreased. The mean follow-up time of patients with non-acute stroke was (695.35±555.90) days. The stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden were slightly improved, but without statistical significance ( P>0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C ( P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline ( P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ 2=0.229, P= 0.632). Conclusion:HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients.
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BACKGROUND: Hand injuries are very common in sports, such as skiing and ball sports. One of the major reasons causing hand and finger deformity is due to ligament and tendon injury. The aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging (MRI) can demonstrate the complex anatomy of the fingers and thumb, especially the tendons and ligaments, and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport activities. METHODS: Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers. A total of 20 healthy volunteers' hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this study. All subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression (PD FS) in axial, coronal, and sagittal plane, respectively. Subsequently, all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw (six in coronal plane, six in sagittal plane, and four in axial plane). The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament (UCL) at the metacarpal phalangeal joint (MCPJ) of thumb between 20 healthy volunteers and 44 patients (confirmed by surgery) were analyzed. RESULTS: The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers' hands showed uniform low-signal intensity on all the sequences of the MRI. Among 44 patients with tendinous and ligamentous injuries in the fingers or thumb, 12 cases with UCL injury at MCPJ of the thumb (Stener lesion = 8 and non-Stener lesion = 4), 6 cases with the central slip injury, 12 cases with terminal tendon injury, and 14 cases with flexor digitorum profundus injury. The ligaments and tendons disruption manifested as increased signal intensity and poor definition, discontinuity, and heterogeneous signal intensity of the involved ligaments and tendons. CONCLUSIONS: Sports injury-related fingers and thumb deformity are relatively common. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the fingers and thumb. It is a useful tool for accurate diagnosis of the sports-related ligaments and tendons injuries in hand.