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Objective To study the value of DSI Studio combined with diffusion tensor imaging(DTI)in evaluating the prognosis of postoperative motor function in patients with brain functional area tumors.Methods From January 2018 to August 2022,41 patients with brain functional area tumors who underwent surgical treatment and were pathologically diagnosed in our hospital were included in the study.All patients completed 3.0 T MRI routine sequence and DTI examination.DTI parameters of the corticospinal tract(CST)projection area of posterior limb of the internal capsule on the affected side and the healthy side were measured respectively,and the correlation with MRC muscle strength score and the CST grade was analyzed.Results The FA value of the affected side was significantly lower than that of the healthy side(P＜0.001),and the ADC value of the affected side was significantly higher than that of the healthy side(P＜0.001).The FA value of the affected side and the lateral rFA value were negatively correlated with the CST grade(P＜0.01).ADC value and rADC value were positively correlated with CST grade(P＜0.01).The FA value of the affected side and the partial rFA value were positively correlated with the degree of muscle strength score before and after surgery(P＜0.01).ADC value and rADC value were negatively corre-lated with CST grade(P＜0.01).Preoperative CST grading was negatively correlated with contralateral muscle strength.The area under the ROC curve of FA value,rFA value,ADC value,rADC value,and CST grade were 0.820(P＜0.01),0.796(P＜0.01),0.698(P＜0.05),0.638(P＞0.05)and 0.708(P＜0.05),respectively.Conclusion DTI parameters,muscle strength score and CST grade have certain value in the evaluation of postoperative motor function prognosis in patients with brain functional tumors.
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Objective:To investigate specificity of neurovascular compression in patients with primary trigeminal neuralgia (PTN) by three-dimension reconstruction and computational fluid dynamics.Methods:Clinical characteristics and preoperative magnetic resonance imaging (MRI) data of 20 patients with both PTN and single artery compression (PTN group) and 10 patients without PTN but having neurovascular contact in MRI images (control group) in the Second Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were collected and analyzed. After three-dimension reconstruction of the MRI images, curvature of the arterial loop, angle between the plane of arterial loop and the trigeminal nerve and location of the compression were observed. Then bidirectional structure-fluid coupling based on the optimized stereolithography models of arterial loop and nerve were processed by ANSYS 19.2 software. In the location of the compression of contact, equivalent stress (ES) of arterial loop on the nerve, shearing stress (SS) of the blood flow and local deformation of the nerve were iteratively computed. All parameters were analyzed and compared between the PTN group and the control group, and the correlation analysis was proceeded between the anatomical parameters and hemodynamical parameters.Results:The curvature of arterial loop [0.21(0.12) mm -1vs 0.13(0.07) mm -1, U=34.00, P<0.05], the angle between vascular loop and nerve [69.70(30.67)° vs 43.40(37.21)°, U=38.00, P<0.05] in the PTN group were significantly greater than those in the control group, and the location of compression was significantly closer to the root of nerve in the PTN group [PTN group: (4.23±1.29) mm vs control group: (5.54±1.85) mm, t=-2.26, P<0.05]. The average SS [15 952.48(5 365.56) Pa vs 12 501.97(6 355.26) Pa, U=53.00, P<0.05], ES [24 965.65(7 693.22) Pa vs 14 992.99(9 824.08) Pa, U=32.00, P<0.05] in the PTN group were significantly greater than those in the control group. The curvature of arterial loop was positively correlated with the SS ( r=0.931, P<0.05) and ES ( r=0.962, P<0.05), and the latter two ( r=0.787, P<0.05; r=0.853, P<0.05) were positively correlated with the local neural deformation. Conclusions:In patients with PTN, offending artery compresses the root of nerve by greater arterial curvature and angle between the arterial loop and nerve. These anatomical differences will cause significantly greater SS, ES and local neural deformation.
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Objective To systematically evaluate the efficacy and safety of craniotomy and decompressive craniectomy in the treatment of acute subdural hematoma.Methods A systematic search was performed in PubMed,EMbase,the Cochrane Library,Web of science,China National Knowledge Infrastructure (CNKI),WanFang Data,and CBM databases up to June 2018 for the studies that provided comparisons between craniotomy hematoma evacuation and decompressive craniectomy for acute subdural hematoma.For the two categorical variables,the Odds Ratio (OR) and its 95％ Confidence Interval (95％ CI) are used.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias of the included studies.The meta analysis was performed using Stata/SE 12.0 software.Results A total of 8 studies were included in the meta analysis,of which 828 patients underwent craniotomy,and 663 patients underwent decompressive craniectomy.Meta analysis results showed that patients receiving decompressive craniectomy had a significantly lower Glasgow Coma Scale (GCS) when they first had symptoms.The residual rate of acute subdural hematoma in the decompressive craniectomy group was significantly lower than that in the craniotomy group (P =0.015),but there was no significant difference in the rate of reoperation.The incidence of poor outcome at following was lower in the craniotomy group compared with decompressive craniectomy group (50.1％ vs 60.1％;P =0.003).Similarly,the mortality of the craniotomy group was lower than that of the decompressive craniectomy group (P =0.002).Conclusions Decompressive craniectomy may be the first choice for acute subdural hematoma,but the study is influenced by many factors and is not sufficient to provide definitive evidence.
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Objective To explore the value of dynamic contrast-enhanced (DCE).MRI in the early diagnosis of brucellosis spondylitis.Methods Fifty-six patients (24 female and 32 male) with Brucellosis with average age of (49± 3)years were retrospectively analyzed.Inclusion criteria:The patients with clinically diagnosed brinell coli spondylitis,drops of serum agglutination test degree 1:100＞(++),Hu＞red plate agglutination test (+ +),enzyme-linked immunosorbent assay to detect specific antibody IgG/IgM (+).Exclusion criteria:Pregnant and lactating women,patients with MRI examination contraindications and spinal tuberculosis,myeloma or other spinal disease,patients with the cervical,thoracic and lumbar 5 vertebral body involvement.The patients were classified into early lesion group and lesion group.Early lesion group was defined as low back pain less than a month,enzyme-linked immunosorbent assay positive IgM and negative IgG results,and no abnormality in conventional MR imaging,while lesion group was defined as low back pain for longer than 3 months,enzyme-linked immunosorbent assay positive IgG and negative IgM and marked lesion in conventional MR imaging.All the patients conducted with conventional MRI and DCE-MRI scan.The differences of the Ktrans,Kep,Ve and Vp between the vertebral lesions,early lesions of vertebral body and normal tissues were measured and compared.Results The values of Ktrans,Kep,Ve and Vp were significantly different between the vertebral lesions [(0.856±0.539) ml/min,(1.482±0.711) ml/min,0.542±0.267,0.034±0.017] and normal tissues [(0.315±0.298) ml/min,(0.713±0.548) ml/min,0.358±0.259,0.056±0.03](all P＜0.05).The values of Ktrans,Kep and Vp were significantly different between the early lesions of vertebral body and normal tissues (all P＜0.05),while no difference was found for Ve between the two groups (P＞0.05).Conclusion DCE-MRI quantitative analysis plays a role in the early diagnosis of the brucella spondylitis.
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Objective To quantitatively analyze brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors by dynamic contrast-enhanced (DCE)-MRI, and to evaluate the quantitative DCE-MRI in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors. Methods This was a retrospective study including 30 patients with brucellar spondylitis, 30 with tuberculous spondylitis, and 30 with spinal metastatic tumors. The clinical and demographic data were collected. All patients received routine MRI and DCE-MRI examinations. Volume transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve) and plasma volume fraction(Vp) of diseased vertebral bodies of the patients with brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors were measured on perfusion parameter maps. All indexes showed non-normal distribution. Differences of all indexes were compared and analyzed statistically with rank-sum test among the above diseases. Results For brucellosis spondylitis, spinal tuberculosis, and vertebrae metastasis, the values of Ktrans were(0.716 ± 0.017),(0.316 ± 0.004),(0.986 ± 0.012)min-1, the values of Kep were(1.326 ± 0.018), (0.747 ± 0.005),(2.899 ± 0.054)min-1, the values of Ve were 0.541 ± 0.011, 0.427 ± 0.017, 0.338 ± 0.007 and the values of Vp were 0.034 ± 0.003, 0.029 ± 0.003, 0.049 ± 0.007. The differences suggested statistical significance(H=50.24, 52.49, 48.31, 46.54, P<0.01) among the three diseases. Conclusion DCE-MRI quantitative analysis is helpful in the differential diagnosis of brucellar spondylitis, tuberculous spondylitis and spinal metastatic tumors.
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Objective To investigate the correlation of long term aspirin treatment and cerebral microbleeds(CMBs)incidence in non-hypertensive patients.Methods 56 non-hypertensive patients (the average age of 64.88±6.99)with long term aspirin adminis-tration (100 mg/d)were enrolled in the study from 2005 to 2010 in our hospital,with follow up to compare CMBs 5-10 years later. All patients underwent T2 WI,T1 WI,diffusion-weighted imaging (DWI)and susceptibility weighted imaging (SWI).The CMBs lesions were defined by senior radiologists.Patients’age,gender,total cholesterol level,aspirin,CMBs and CMBs location were taken into account in data analysis.Results CMBs incidence was 14.3% in all participants,lesions were located mostly in lobes.Aged,male and low total cholesterol level were the risk factors of CMBs (P0.05),the potential adverse effect of aspirin needs further investigation.
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Objective To clarify the inhibitory effect of Tripterine combined with Cisplatin on C6 glioma ceils and its apoptosis mechanism.Methods C6 glioma cells were treated with Tripterine,Cisplatin,or Tripterine combined with Cisplatin.CCK-8 assay was used to detect the growth inhibition rate in each group.Flow cytometry analysis was used to test the cell apoptosis rate.The expressions of apoptosis-related proteins including Bcl-2,Bax,XIAP,NF-kB were analyzed by ELISA.Results Compared with Tripterine-or Cisplatin-treated group,the inhibition ratio of cell growth in Tripterine and Cisplatin combination group was (69.76±7.28)％,which could significantly inhibit the growth of C6 glioma cells(t=23.78,P＜0.01).The apoptosis rate was significantly higher (47.75±5.63)％ in combination group than in Tripterine or Cisplatin treated group.The results of ELISA showed that the expression of Bax was significantly higher and Bcl-2,XIAP,NF-κB were obviously lower in the combination group than in Tripterine or Cisplatin treated group (t=35.27,P＜ 0.01).Conclusion The combination of Tripterine and Cisplatin significantly increases the inhibition rate on C6 glioma cells through upregulating Bax and inhibiting Bcl,XIAP and NF-kB to induce the apoptosis of C6 glioma cells.
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BACKGROUND:In the earliest stages of embryonic development and organ formation, fibroblast growth factor family members function as mediating the growth, differentiation, survival, and morphology of progenitor cels. Fibroblast growth factor mediates metabolic function, tissue repair and regeneration in mature tissues by reactivation of signal pathways. OBJECTIVE:To summarize and explore the role of the fibroblast growth factor signaling pathway in tissues and organs. METHODS:A computer-based online search was conducted in CNKI and PubMed databases by using the key words of “fibroblast growth factor, signaling pathway” from 2010 to 2016 and 2000 to 2016, respectively to screen the relevant literatures. The language was limited to both Chinese and English. Research progress in the fibroblast growth factor signaling pathway was summarized. RESULTS AND CONCLUSION:A total of 47 literatures were included. Mammalian fibroblast growth factor family is composed of 18 secreted signal proteins which interact with 4 tyrosine kinase signal fibroblast growth factor receptors. Interaction of fibroblast growth factor ligand with the receptor is regulated by a protein or cofactor binding proteoglycans and extracelular proteins. Activation of fibroblast growth factor receptor mediates interaction with cytoplasmic adapter protein, RAS-MAPK, and PI3K-AKT, phospholipase Cγand STAT signaling pathway by phosphorylation on a specific tyrosine residue. Four structuraly related intracelular non-signaling fibroblast growth factors regulate the voltage-gated sodium ion channels by their interactions. Fibroblast growth factors exist in almost al tissues and organs, and developmental defects and abnormal activity of this pathway (destruction of organogenesis) is associated with damage response to injury, metabolic disorders and cancer.
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Objective To study the application of microelectrode stereotactic functional nucleus lesioning operation in the treatment of Parkinson′s disease(PD) ,and to explore its clinical value .Methods The clinical data in 84 cases of PD treated with‐out using the microelectrode stereotactic functional nucleus lesioning operation(observation group) and 74 cases of PD treated by u‐sing microelectrode guided stereotactic functional nucleus lesioning in our hospital were retrospectively analyzed .At the same time the Unified Parkinson′s Disease Rating Scale (UPDRS) scores before the nucleus lesioning and at postoperative different medication states were obtained in the observation and the control group .Furthermore the difference of the UPDRS motor scores before and af‐ter operation were compared between the two groups .Results The UPDRS motor scores at postoperative 3 ,6 months and 1 year in the observation group were significantly improved compared with before operation(P0 .05) .Conclusion Stereotactic nucleus lesioning in treating PD has satisfactory effect and can significantly improve the UPRDS motor scores .Accurate positioning is the key to the operation success ,whether microelectrode recording can significantly improving the operation accuracy needs further discussion .
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Objective To investigate the applicative value of micro-surgery in the treatment of cerebral aneurysms.Methods During January 2011 to January 2013 in our hospital,90 patients with cerebral aneurysm were randomly divided into the endovascular group and the microsurgical clipping group (n =45 each).The endovascular group were treated with endovascular interventional treatment,and the patients of the microsurgical clipping group were treated with microsurgical clipping treatment.The aneurysm occlusion rate and recurrence,time of hospital stay,complications and prognosis were compared between the two groups.Results The complete occlusion rate was higher [97.8％ (44/45) vs.88.9％ (40/45) and the recurrence rate was lower 2.2％ (1/45) vs.13.3％(6/45) in microsurgical clipping group than in endovascular intervention group x2 =4.34 and 3.54,P=0.031 and 0.042),all P＜0.o5.The average time of hospital stay was longer in the endovascular intervention group than in the microsurgical clipping group [(19.3 4.4) days vs.(16.34.9) days,t 1.93,P=0.035].The good rate was higher in microsurgical clipping group than in endovascular intervention group [91.1％ (41/45) vs.77.8％ (35/45),x2=6.325,P=0.012].Conclusions Microsurgical clipping surgery can significantly raise the complete occlusion of cerebral aneurysms,reduce recurrence in patients with cerebral aneurysm,decrease the hospitalization time,and improve prognosis,which is worthy of clinical application.
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Objective To evaluate the predictive value of proton magnetic resonance spectroscopy (1H-MRS)and diffusion weighted imaging(DWI)in low-grade cerebral astrocytomas. Methods Twenty patients with histological proved low-grade astrocytomas treated with postoperative radiotherapy were evaluated with cMRIMRS, DWI before-and 3 months after radiotherapy respectively, then repeated every six months. rNAA,rCho,rCr,rADC was the ratio of NAA, Cho and Cr in the residual tumors region to the those of normal control region. The difference of rCho/rCr, rCho/rNAA, rADC between deteriorative group(group Ⅰ)and stable groups(group Ⅱ)were calculated both before-and 3months after radiotherapy. Results The value of rCho/rCr, rCho/rNAA were higher in group 1 than those in group Ⅱ 3 months after radiotherapy(t =3.65 and 4. 24,all P ＜ 0. 05), while the value of rADC was lower in group Ⅰ(t = 3.43, P ＜ 0. 05). The mean difference of rCho/rCr,rCho/rNAA, rADC in group Ⅰ were smaller than those in group Ⅱ(t = 2. 02,4. 21 and 3.00,all P ＜0. 05). The value of rCho/rCr,rCho/rNAA increased and rADC decreased gradually in group Ⅰ during follow up, and these patients were histologically proved recurrence within 11 - 16 months.While in group Ⅱ , the value of rCho/rCr, rCho/rNAA decreased and rADC increased gradually or steady.And also with a stable clinical performance and cMRI. Conclusions 1H-MRS and DWI own better predictive value of monitoring tumor metabolism change, growth potential and evaluation response to radiotherapy than conventional MRI in low-grade group astrocytomas.
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Objective To explore a simple and convenient method of small intestine double contrast examination:small intestine double contrast radiography with air-barium by non-tube fast.Methods 130 cases were randomly divided into study group(67) and control group(63).In study group,the enteric-coated capsules to be full of aerogenic powder,barium and cisapride were taken orally by the patients,while in control group,only barium was given orally,and metoclopramide injected by muscle,then the small intestinal air-barium double contrast examinations were performed.Results In the study group,the effect of examinations was satisfactory,ordinary and no effect in 53,12 and 2 cases respectively,and one patients fell because of swallowing difficulty,the total efficiency was 97.02% and the average examination time was(34.63?16.66) minute.In the control group,the effect of examinations was all ordinary and lasted time was(77.12?32.98) minute.These two methods were of remarkable difference in effect and lasted time in statistics(P
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Objective To study MRI feature in the lession and brain atrophy of cerebral multiple sclerosis (MS), and to analyze the relationship and the its correlated factors between cerebral MS and brain atrophy. Methods The MRI data from 80 patients with cerebral MS were collected and these patients were divided into two groups according to age. Each patient received T1-weighted and T2-weighted scanning. The number of lesion, characteristics of lesion and brain atrophy were evaluated and compared with control group. The correlated factors of brain atrophy were analyzed. Results (1)The most focal demyelinating lesions of cerebral MS were orbicular-ovate or similar round like with distinct boundary. Typical lesions presented with equal or long T1 and long T2 signals. The macroaxis of lesion was vertical to tangent line of lateral cerebral ventricle. (2)Compared with control group, the cerebroventricular anfractuosity was longer and lateral fissure was wider on MRI in cerebral MS group. The diameter of brain parenchyma was shorter. Statistic differences were found between two groups. (3)Among correlated factors, EDSS was the main predictive factor for cerebral atrophy. Conclusions The most lesions of cerebral MS are mainly located around lateral cerebral ventricles, orbicular-ovate or similar round like with distinct boundary, equal or slight long T1 and T2 signals on MRI.Brain atrophy is generally in cerebral MS and progress gradually, it is related to the course of disease, the number of lesion, the diameter of lesion and EDSS score. Measurement of brain atrophy may regard as an index about progression of MS.