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Objective:To investigate the value of 18F-FDG PET/CT imaging in the diagnosis of suspected autoimmune encephalitis (AE) in children with epilepsy and negative MRI. Methods:From May 2019 to August 2022, 94 suspected AE children (49 males, 45 females; age 1-15 years) with epilepsy and negative MRI who underwent brain 18F-FDG PET/CT imaging at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. All patients were divided into AE and non-AE groups based on clinical final diagnosis. The effectiveness of visual diagnosis was evaluated. The cortical lesion extent score (S), and SUV max, SUV mean and minimum of SUV (SUV min) of cortical lesions (L), basal ganglia (B) and thalamus (T) were measured and SUV ratios (SUVR) of L/B or L/T were obtained. Independent-sample t test or Mann-Whitney U test was used to analyze data. Binary logistic regression analysis was used to screen the diagnostic factors of AE, and a diagnostic model was established. The diagnostic efficiency was evaluated by ROC curve analysis and Delong test. Results:There were 53 cases in AE group and 41 cases in non-AE group. Based on visual analysis, the sensitivity, specificity and accuracy of 18F-FDG PET/CT for AE were 100%(53/53), 43.9%(18/41) and 75.5%(71/94), respectively. Differences of LSUV max, LSUV mean, LSUV min, L/BSUVR max, L/BSUVR mean, L/BSUVR min, L/TSUVR max, L/TSUVR mean, L/TSUVR min and S between AE and non-AE groups were statistically significant ( z=-6.74, t values: from -8.51 to -3.97, all P<0.001). ROC curve analysis showed that the AUC of L/BSUVR max was the highest (0.914) among visual analysis and semi-quantitative parameters. Logistic regression analysis showed that S (odds ratio ( OR)=11.40, 95% CI: 2.18-59.52, P=0.004), L/BSUVR max( OR=13.19, 95% CI: 2.11-82.51, P=0.006) and L/TSUVR max( OR=9.66, 95% CI: 1.57-59.55, P=0.015) were independent diagnostic factors for AE. Regression model was established: P=1/(1+ e - x), x=2.433×S+ 2.580×L/BSUVR max+ 2.267×L/TSUVR max-3.802. The AUC of this model was 0.948, with the sensitivity, specificity and accuracy of 98.1%(52/53), 90.2%(37/41) and 94.7%(89/94), respectively. The diagnostic efficacy of the optimized scoring system was consistent with the pre-optimization model, and were both superior to L/BSUVR max(both z=2.01, both P=0.040). Conclusion:The diagnostic model and scoring system based on the semi-quantitative analysis of 18F-FDG PET/CT have better diagnostic efficacy for AE and are superior to semi-quantitative parameters alone.
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Objective:To investigate the clinical efficacy of arthroscopic limited incision of the articular capsule to repair the glenoid labrum in the treatment of borderline developmental dysplasia of the hip (BDDH) complicated with labral tear.Methods:A retrospective study was conducted to analyze the data of 18 patients with BDDH complicated with labral tear who had been admitted to Department of Orthopaedics, The Second Hospital Affiliated to Suzhou University from January 2016 to December 2019 (observation group). There were 12 males and 6 females with an age of (41.8 ± 8.5) years. Simultaneously, another 18 patients were selected as the control group whose hip development was normal but age and gender were matched with those in the observation group. There were 9 males and 9 females with an age of (43.5 ± 10.3) years. Both groups were treated by arthroscopic limited incision of the articular capsule to repair the glenoid labrum. The 2 groups were compared in terms of modified Harris hip score (MHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), and visual analogue scale (VAS).Results:There was no significant difference in the demographic data like age, gender ratio, body mass index, severity of labral tear or time from injury to operation between the 2 groups, indicating comparability between groups ( P>0.05). The observation and control groups were followed up for (38 ± 7) and (43 ± 6) months, respectively. For the observation and control groups, respectively, MHHS was (97.1 ± 3.3) points and (95.4 ± 4.2) points, HOS-ADL (92.6 ± 2.8) points and (91.4 ± 4.1) points, and VAS (0.6 ± 0.5) points and (1.0 ± 0.8) points, all showing no significant difference between groups ( P>0.05). Conclusion:In the treatment of BDDH patients complicated with labral tear, simple arthroscopic limited incision of the articular capsule to repair the glenoid labrum can lead to the same good medium-term efficacy as it can in those with normal hip development.
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Objective:To investigate the clinical significance of MAPT-IT1 in breast cancer and its biological effect in vitro.Methods:The expression of MAPT-IT1 in breast cancer was analyzed by TCGA database. 64 cases of breast cancer and normal adjacent tissues were collected. Human breast cancer MDA-MB-231 and MCF-7 cells were cultured and overexpressed MAPT-IT1 or rescue miR-181a-5p by cell transfection. MDA-MB-231 cells were divided into blank group A, overexpression group A and recovery group A; MCF-7 cells were divided into blank group B, overexpression group B and recovery group B. Real time quantitative PCR (RT-qPCR) was used to detect the expression of MAPT-IT1, miR-181a-5p and MAPT mRNA. Western blot was used to detect the expression of MAPT protein. CCK-8 assay was used to detect cell proliferation, and Transwell invasion assay was used to detect cell invasion.Results:The expression of MAPT-IT1 in normal paracancerous tissues and breast cancer tissues was 0.011±0.002 and 0.028±0.003 respectively. The expressions of MAPT-IT1 in breast cancer tissues were significantly higher than those in adjacent normal tissues, and high expression of MAPT-IT1 was correlated with early tumor progression, ER positive and prolonged prognosis ( P<0.05) . In blank group A, overexpression group A and recovery group A, the expressions of MAPT-IT1 were 1.000±0.078, 8.597±0.320 and 8.540±0.177, miR-181a-5p were 1.000±0.027, 0.263±0.024, 4.433±0.239, MAPT were 1.000±0.071, 3.297±0.243, 0.497±0.029. In blank group B, overexpression group B and recovery group B, the expressions of MAPT-IT1 were 1.000± 0.081, 5.716±0.309, 5.288±0.176, miR-181a-5p were 1.000±0.024, 0.291±0.022, 3.648±0.073, and MAPT were 1.000±0.054, 3.309±0.177, 0.883±0.075. After overexpression of MAPT-IT1, the expression of miR-181a-5p was down-regulated, while the expression of MAPT was significantly increased ( P<0.001) , and the proliferation and invasion ability of MDA-MB-231 and MCF-7 cells were significantly decreased ( P<0.05) . Re-expression of miR-181a-5p down-regulated MAPT and promoted cell proliferation and invasion ( P<0.05) . Conclusion:Overexpression of MAPT-IT1 can significantly down-regulate the expression of miR-181a-5p and enhance MAPT and inhibit the malignant phenotype of breast cancer cells in vitro.
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Objective To observe the effectiveness of the three-dimensional balanced chiropractic technique in the treatment of lumbar disc herniation (LDH) and analyze predictive factors for resorption of the herniated nucleus pulposus based on magnetic resonance imaging (MRI). Methods From June 2015 to June 2021, 95 patients with LDH treated with the three-dimensional balanced chiropractic techniquein our hospital were followed up for clinical and MRI data. They were divided into resorption group and non-resorption group based on the nucleus pulposus resorption rate. Multivariable binary logistic regression analysis was performed to determine the association of 12 factors (sex, age, course of disease, etc.)with nucleus pulposus resorption. Results Thirty-two cases (33.7%)were found at follow-up to have nucleus pulposus resorption (resorption rate≥30%). Resorption was most likely to occur in patients with a disease course of less than a year (P < 0.001), type 3 LDH accoding to the Michigan State University (MSU) classification (P = 0.014), leg numbness (P = 0.006), and a L4/5 or L5/S1 disc herniation (P < 0.001). Conclusion MRI can be used as an important tool to observe nucleus pulposus resorption in LDH. A disease course of less than a year, MSU type 3, leg numbness, a L4/5 or L5/S1 disc herniation are associated with a higher possibility of nucleus pulposus resorption, which can be used as indicators predicting the outcome of patients with LDH treated with the three-dimensional balanced chiropractic technique.
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Objective:To analyze changes in melanocyte density and epidermal thickness in vulvar lichen sclerosus (VLS) lesions.Methods:Vulvar skin tissues were collected from 15 adult female patients with VLS in Department of Dermatology, Beijing Hospital from June to December in 2018. According to pathological manifestations, 15 skin lesions were divided into early-stage VLS group ( n = 7) and late-stage VLS group ( n = 8) , and subjected to immunofluorescent staining. Then, density of melanocytes, and thickness of the whole epidermis and cell layers (from the bottom of the stratum corneum to the bottom of the basal layer) were calculated by using an image analysis software. Normal vulvar skin tissues were obtained from 15 healthy adult females after vulvar plastic surgery in Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and served as control group. Results:The density of melanocytes in the epidermis was significantly lower in the early-stage VLS group (0.170 ± 0.071) and late-stage VLS group (0.110 ± 0.035) than in the control group (0.275 ± 0.036; F = 36.426, P < 0.001) . There was no significant difference in the thickness of the whole epidermis among the early-stage VLS group (203.682 ± 137.997 μm) , late-stage VLS group (150.020 ± 70.914 μm) and control group (194.030 ± 82.996 μm; F = 0.738, P = 0.487) . The thickness of cell layers did not differ between the early-stage VLS group (154.603 ± 121.984 μm) and control group (176.974 ± 80.296 μm; P = 0.899) , but was significantly thinner in the late-stage VLS group (83.455 ± 37.129 μm) than in the control group ( P = 0.003) . Conclusions:The density of epidermal melanocytes decreased in the early-stage and late-stage VLS skin lesions. Compared with the normal skin tissues, the early-stage VLS lesions showed no significant changes in the thickness of the whole epidermis and cell layers, but the late-stage VLS lesions showed decreased thickness of cell layers.
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Objective:To investigate the imaging and pathology features of rosette-forming glioneuronal tumor (RGNT).Methods:From January 2010 to September 2019, 7 patients with pathologically conformed RGNT in our hospital were chosen, the imaging findings were analyzed retrospectively and compared with corresponding pathological features.Results:Six patients showed single lesion: 4 located in the vermis and its surrounding areas, in which 2 involved the pineal region and the tectum; the other 2 lesions located in the fourth ventricle. One patient had multiple lesions, which located in the third ventricle and the lateral ventricle respectively. Cystic-solid masses mainly with cystic changes were noted in these 7 patients, lesions in the vermis of cerebellum and its surrounding areas were polycystic while lesions in the ventricles were single cystic. The cystic areas of masses showed low density on plain CT scan and slightly long T 1 and long T 2 signal on MR imaging. The imaging findings were compared with the pathological findings: the density/signal changes were corresponded to the cystoid changes, hemorrhage and calcification, as seen in the postoperative specimens; the signal changes of the cystic areas were corresponded to the mucus matrix components and old hemorrhage; the characteristics of tumor enhancement were closely related to the distribution of solid components and degrees of blood supply. Conclusion:The imaging features of RGNT may partly reflect its pathological manifestations; combined with the specific location, imaging examinations may help make a correct preoperative diagnosis.
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Based on the Pharmaceutical Comprehensive Knowledge and Skills Outline in the year of 2003, 2007, 2011 and 2015,the changes and the trend in the chapters and contents of Pharmaceutical Comprehensive Knowledge and Skills were analyzed and discussed,the meaning of versions was elaborated,and the shortcomings were discussed as well. The catalog of the chapters and contents conformed to the economic and social development in China,which is moving toward the direction of clinical pharmacy service.
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Objective To explore the imaging characteristics of seminomas and nonseminomatous germ cell tumors (NSGCT) and its pathological foundation. Methods CT and MR imaging manifestations in 25 cases of testicular germ cell tumors proved by pathological examinations were analyzed retrospectively. All tumors were divided into seminomas group (12 cases) and NSGCT group (13 cases). In the seminomas group, 5 cases were examined by CT and 4 of those also had contrast enhanced CT. Seven cases had MRI and 4 of those had dynamic enhanced MRI. In the NSGCT group, 5 were examined by plain CT in which two were by contrast enhanced CT, eight were by MRI in which 4 were by dynamic enhanced MRI. CT or MRI characteristics (morphology, density or intensity, enhancement) in both groups were analyzed by Fisher test. Results Histological examination revealed 25 intratesticular lesions. In 12 seminomas, 10 showed a nodular/lobulated shape, 5 showed a mixed density or intensity. In 13 NSGCT, only one lesion showed a lobular shape, 11 showed a mixed density or intensity. Seven seminomas showed a low signal on T2WI on MRI while only two NSGCT showed this sign. In four lesions underwent dynamic MRI scanning, 3 showed fibrous septum enhancement while no lesions in NSGCT showed this sign. The occurrence rate of the above imaging characteristics in both group was significantly different (P<0.05). Conclusion Seminomas and NSGCT may have their own CT and MRI characteristics, which may be of great value for differential diagnosis .
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ObjectiveTo investigate the value of MR diffusion tensor imaging (DTI) of optic nerve in the estimation of optic nerve changes of primary chronic angle-closure glaucoma (PCACG).Methods Twenty-five patients with PCACG including monocular involvement in 4 patients and binocular involvement in 21 patients and involving 46 eyes in which 24 right eyes and 22 1eft eyes,and 20 normal volunteers were enrolled.Conventional MRI and DTI were performed on all subjects using Magnetom Tim 3.0 T MRI.Fractional anisotropy( FA),mean diffusivity ( MD),axial diffusivities ( λ ∥ ) and radial diffusivities ( λ ⊥ )were measured and then compared between patients group and control group and between left eyes and right eyes.Two independent samples t-test and paired t-test were used.ResultsOn conventional MRI,thinner optic nerve with vaginal cavity widened slightly was found in 8 optic nerves of 6 patients.The value of FA,λ∥,λ⊥ and MD of 24 right optic nerves in patient group was(0.27 ± 0.09) × 10-3,(2.30 ±0.26) × 10 - 3,( 1.55 ± 0.35 ) × 10 - 3,and ( 1.80 ± 0.31 ) × 10 - 3 mm2/s respectively and that of 22 left optic nerves was (0.24 ± 0.09) × 10-3,(2.25 ± 0.41) × 10-3,(1.61 ± 0.46) × 10-3,and (1.82 ±0.47) × 10-3mm2/s respectively.The FA of optic nerve in patient group was lower than that of control group (P ＜0.05 ),while the meanλ∥,λ ⊥ and MD values was obviously higher than control group (P ＜ 0.05).There was no significant difference between right and left optic nerves in patient gro up ( P ＞0.05).ConclusionsDTI could detect abnormality and provide information about the pathological process of optic nerve in patients with PCACG.