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BACKGROUND: Complex and high-risk surgical complications pose pressing challenges in the clinical implementation and advancement of endoscopic full-thickness resection (EFTR). Successful perforation repair under endoscopy, thereby avoiding surgical intervention and postoperative complications such as peritonitis, are pivotal for effective EFTR. AIM: To investigate the effectiveness and safety of EFTR assisted by distal serosal inversion under floss traction in gastric submucosal tumors. METHODS: A retrospective analysis of patients with gastric and duodenal submucosal tumors treated with EFTR assisted by the distal serosa inversion under dental floss traction from January 2023 to January 2024 was conducted. The total operation time, tumor dissection time, wound closure time, intraoperative bleeding volume, length of hospital stay and incidence of complications were analyzed. RESULTS: There were 93 patients, aged 55.1 ± 12.1 years. Complete tumor resection was achieved in all cases, resulting in a 100% success rate. The average total operation time was 67.4 ± 27.0 min, with tumor dissection taking 43.6 ± 20.4 min. Wound closure times varied, with gastric body closure time of 24.5 ± 14.1 min and gastric fundus closure time of 16.6 ± 8.7 min, showing a significant difference (P < 0.05). Intraoperative blood loss was 2.3 ± 4.0 mL, and average length of hospital stay was 5.7 ± 1.9 d. There was no secondary perforation after suturing in all cases. The incidence of delayed bleeding was 2.2%, and the incidence of abdominal infection was 3.2%. No patient required other surgical intervention during and after the operation. CONCLUSION: Distal serosal inversion under dental-floss-assisted EFTR significantly reduced wound closure time and intraoperative blood loss, making it a viable approach for gastric submucosal tumors.
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AIM: To evaluate the effects of intravitreal slow-release dexamethasone on traumatic proliferative vitreoretinopathy (PVR) and Müller cell gliosis and preliminarily explored the possible inflammatory mechanism in a rabbit model induced by penetrating ocular trauma. METHODS: Traumatic PVR was induced in the right eyes of pigmented rabbits by performing an 8-mm circumferential scleral incision placed 2.5 mm behind the limbus, followed by treatment with a slow-release dexamethasone implant (Ozurdex) or sham injection. Left eyes were used as normal controls. The intraocular pressure (IOP) was monitored using an iCare tonometer. PVR severity was evaluated via anatomical and histopathological examinations every week for 6wk; specific inflammatory cytokine and proliferative marker levels were measured by quantitative real-time polymerase chain reaction, Western blot, protein chip analysis, or immunofluorescence staining. RESULTS: During the observation period, PVR severity gradually increased. Intense Müller cell gliosis was observed in the peripheral retina near the wound and in the whole retina of PVR group. Ozurdex significantly alleviated PVR development and Müller cell gliosis. Post-traumatic inflammation fluctuated and was persistent. The interleukin-1ß (IL-1ß) mRNA level was significantly upregulated, peaking on day 3 and increasing again on day 21 after injury. The expression of nod-like receptor family pyrin domain containing 3 (NLRP3) showed a similar trend that began earlier than that of IL-1ß expression. Ozurdex suppressed the expression of IL-1ß, NLRP3, and phosphorylated nuclear factor-kappa B (NF-κB). The average IOP after treatment was within normal limits. CONCLUSION: The present study demonstrates chronic and fluctuating inflammation in a traumatic PVR rabbit model over 6wk. Ozurdex treatment significantly inhibites inflammatory cytokines expression and Müller cell gliosis, and thus alleviates PVR severity. This study highlights the important role of IL-1ß, and Ozurdex inhibites inflammation presumably via the NF-κB/NLRP3/IL-1ß inflammatory axis. In summary, Ozurdex provides a potential therapeutic option for traumatic PVR.
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This is a prospective, single center study aimed to evaluate the predictive power of peritumor and intratumor radiomics features assessed using T2 weight image (T2WI) of baseline magnetic resonance imaging (MRI) in evaluating pathological good response to NAC in patients with LARC (including Tany N+ or T3/4a Nany but not T4b). In total, 137 patients with LARC received NAC between April 2014 and August 2020. All patients were undergoing contrast-enhanced MRI and 129 patients contained small field of view (sFOV) sequence which were performed prior to treatment. The tumor regression grade standard was based on pathological response. The training and validation sets (n=91 vs. n=46) were established by random allocation of the patients. Receiver operating characteristic curve (ROC) analysis was applied to estimate the performance of different models based on clinical characteristics and radiomics features obtained from MRI, including peritumor and intratumor features, in predicting treatment response; these effects were calculated using the area under the curve (AUC). The performance and agreement of the nomogram were estimated using calibration plots. In total, 24 patients (17.52%) achieved a complete or near-complete response. For the individual radiomics model in the validation set, the performance of peritumor radiomics model in predicting treatment response yield an AUC of 0.838, while that of intratumor radiomics model is 0.805, which show no statically significant difference between then(P>0.05). The traditional and selective clinical features model shows a poor predictive ability in treatment response (AUC=0.596 and 0.521) in validation set. The AUC of combined radiomics model was improved compared to that of the individual radiomics models in the validation sets (AUC=0.844). The combined clinic-radiomics model yield the highest AUC (0.871) in the validation set, although it did not improve the performance of the radiomics model for predicting treatment response statically (P>0.05). Good agreement and discrimination were observed in the nomogram predictions. Both peritumor and intratumor radiomics features performed similarly in predicting a good response to NAC in patients with LARC. The clinic-radiomics model showed the best performance in predicting treatment response.
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BACKGROUND: The combination of transcatheter arterial chemoembolization (TACE) plus sorafenib prolonged progression-free survival (PFS) and overall survival (OS) than sorafenib or TACE monotherapy for patients with hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of radiotherapy (RT) plus monoclonal antibody against programmed cell death 1 (anti-PD1) versus TACE plus sorafenib for patients with advanced HCC. METHODS: Patients with advanced HCC who treated with RT plus anti-PD1 and TACE plus sorafenib were enrolled. Objective response rate (ORR), PFS, disease control rate (DCR) and OS were calculated to assess the antitumor response and the treatment-related adverse events to the safety. RESULTS: Between January 2018 to March 2021, 37 patients underwent RT plus anti-PD1 and 41 patients underwent TACE plus sorafenib. The baseline characteristics between the two groups were comparable. The ORR and DCR were significantly higher in the RT + PD1 group than the TACE plus sorafenib group according to RECIST 1.1 (54.05% vs. 12.20%, P < 0.001; 70.27% vs. 46.37%, P = 0.041; respectively) and according to mRECIST (56.76% vs. 31.71%, P = 0.039; 70.27% vs. 46.37%, P = 0.041; respectively). RT plus anti-PD1 provided significantly better PFS (HR, 0.51; 95% CI 0.30-0.86; P = 0.017) than TACE plus sorafenib. Moreover, patients with RT plus anti-PD1 had significantly higher 3-, 6-, and 9-month OS rates than those with TACE plus sorafenib(97.3% vs. 92.30%, P < 0.001; 91.89% vs. 68.60%, P < 0.001; 75.5% vs. 60.60%, P < 0.001; respectively). The median OS was more favorable 17.4 months for the RT + PD1 group and 11.9 months for the TACE plus sorafenib group. No treatment-related death was observed. Grade 3 or more treatment-related adverse events (TRAEs) occurred significantly less in patients in the RT + PD1 group than the TACE plus sorafenib group (29.7% vs. 75.6%, P < 0.001), and all TRAEs were manageable. CONCLUSIONS: In this real-world study, RT plus anti-PD1 showed significantly promising efficacy and manageable safety than TACE plus sorafenib in patients with advanced HCC. Toxicities were manageable, with no unexpected safety signals. The study provides evidence on a new therapeutic method in the treatment of advanced HCC.
Subject(s)
Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic/adverse effects , Combined Modality Therapy , Humans , Liver Neoplasms/pathology , Niacinamide/therapeutic use , Phenylurea Compounds/therapeutic use , Sorafenib/therapeutic useABSTRACT
BACKGROUND: Brain metastases (BM) are common in lung cancer. However, data on the status of immune biomarkers in BM lesions remain limited. METHODS: We retrospectively analyzed PD-L1 expression and infiltration levels of CD3+ , CD4+ , CD8+ T cells as biomarkers by immunohistochemistry in both BM lesions and primary lung cancer (PL) lesions of 29 lung cancer (LC) patients. In addition, the correlations between these biomarkers and the clinical outcome were analyzed using log-rank test. RESULTS: Intratumoral heterogeneous expression of PD-L1 was observed on tumor cells (TCs) in 11 cases and on immune cells (ICs) in 10 cases with BM samples from multiple regions. There was a disagreement in PD-L1 expression on TCs between paired BM and PL lesions in 15 cases and on ICs in seven cases. Intraepithelial CD3+ and CD8+ T cell infiltration levels in BM samples were lower than those in the paired PL samples. PD-L1 positivity on both TCs and ICs was associated with a better post-BM-surgery prognosis (p = 0.010; p = 0.041). Notably, PD-L1 positivity on TCs and a high level of intraepithelial CD8+ T cell infiltration could serve as an integrated biomarker that indicates longer survival time (p = 0.004) in LC patients. CONCLUSION: The heterogeneity in PD-L1 expression was common in both stromal and intraepithelial regions in BM lesions of LC patients, suggesting the need for multiregional PD-L1 testing in clinical practice. More importantly, a combination of PD-L1 expression on TCs with intraepithelial CD8+ T cell infiltration might predict better post-BM-surgery outcomes.
Subject(s)
B7-H1 Antigen/metabolism , Brain Neoplasms , Lung Neoplasms , Biomarkers, Tumor/metabolism , Brain Neoplasms/pathology , Brain Neoplasms/surgery , CD8-Positive T-Lymphocytes/metabolism , Humans , Lung Neoplasms/metabolism , Lymphocytes, Tumor-Infiltrating/metabolism , Prognosis , Retrospective StudiesABSTRACT
PURPOSE: This study aimed to evaluate the prognostic value of paranasal sinus involvement (PSI) in NPC and to explore its appropriate position in the current AJCC staging system. MATERIALS AND METHODS: Pretreatment MRI of 1317 patients with NPC treated with intensity-modulated radiotherapy (IMRT) between January 2010, and January 2013, were reviewed retrospectively. Survival was compared between patients with PSI-slight (sinus bone wall erosion only) and PSI-severe (tumor penetrated into sinus cavity). Multivariable analysis was performed to identify the independent predictors of survival. RESULTS: The study included 1317 patients (median age 46 years; range, 11-78 years). PSI-slight was present in 15.2% (200/1317) patients and PSI-severe in 20.0% (263/1317) patients. Overall survival (OS), distant metastasis-free survival (DMFS), loco-regional recurrence-free survival (LRFS), and progression-free survival (PFS) were significantly lower in patients with PSI-severe (all P < .05). In multivariable analysis, PSI-severe was an independent prognostic factor for OS, DMFS, LRFS, and PFS (all P < .05). 96 AJCC T3 category patients with PSI-severe were reclassified as T4 category. The revised T category had significantly better predictive value (higher C-index) than that the AJCC system for survival (OS, 0.661 vs. 0.652; DMFS, 0.655 vs. 0.650; and PFS, 0.625 vs. 0.625; P < .05 for all). CONCLUSION: PSI-severe is an independent negative prognostic factor in nasopharyngeal carcinoma, which is recommended to be classified as T4 category in the 8th AJCC staging system for NPC.
Subject(s)
Nasopharyngeal Neoplasms , Radiotherapy, Intensity-Modulated , Humans , Middle Aged , Nasopharyngeal Carcinoma/pathology , Nasopharyngeal Carcinoma/radiotherapy , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/radiotherapy , Neoplasm Staging , Prognosis , Retrospective StudiesABSTRACT
Electrocoagulation (EC) coupled with E-peroxone process (ECP) was a promising and cost-effective integrated technology for shale gas fracturing flowback water (SGFFW) treatment. In this study, the ECP process was comprehensively compared with two sequential processes (EC followed by E-peroxone (EC-E-peroxone) and E-peroxone followed by EC (E-peroxone-EC)) to elucidate the synergistic effect of this coupled process. In EC-E-peroxone process, COD decreased by 89.2%, while COD decreased by 82.5% for 180 min in E-peroxone-EC process. However, COD removal efficiency was 82.4% in ECP for only 90 min. Average current efficiency of the ECP process was 29.9%, which was twice than that of the sequential processes. The enhancement factor was calculated to be 1.63, demonstrating the substantial significant synergistic effects for ECP. Only low MW components could be observed for the EC-E-peroxone (average MW = 533 Da with PD ≈ 1) and ECP process (MW = 538 Da with PD ≈ 1). These results suggested that EC-E-peroxone and ECP process had much stronger oxidation ability, demonstrating the enhancement of OH production induced by the Al-based coagulants might be responsible for the significant enhancement of COD removal. These results indicated there could be a synergistic effect between EC and ozone in addition to EC and E-peroxone reactions. Compared to the two sequential processes, ECP was a high efficiency and space-saving electrochemical system with simultaneous coagulation and enhanced OH generation by the products of anode and the cathode.
Subject(s)
Electrochemical Techniques/methods , Hydrogen Peroxide/chemistry , Natural Gas/analysis , Ozone/chemistry , Water Pollutants, Chemical/analysis , Water Purification/methods , Biological Oxygen Demand Analysis , China , Electrodes , Flocculation , Hydraulic Fracking , Oxidation-Reduction , Wastewater/chemistryABSTRACT
To systematically evaluate the clinical efficacy and safety of Cheezheng Pain Relieving Plaster in the treatment of soft tissue injury. Four Chinese databases(namely CNKI, WanFang, VIP, CBM) and 2 English databases(namely PubMed, Cochrane Library) were retrieved from the establishment of each database to March 2019. The randomized controlled trials of Cheezheng Pain Relieving Plaster compared with routine therapy in treatment of soft tissue injury were included. The quality of the included studies was assessed using the Cochrane Risk Assessment Tool. Five studies were included, and 367 patients were enrolled. None of the included studies reported randomized concealment, blinding, follow-up and dropping off. The results showed that Cheezheng Pain Relieving Plaster may have advantages in alleviating joint pain, swelling, tenderness and dysfunction and other symptoms, with no serious adverse reaction. Compared with routine therapy, Cheezheng Pain Relieving Plaster may have advantages in the treatment of soft tissue injury. However, due to the quality of the included RCTs, the conclusions of this study were limited. In addition, to produce high-quality evidences for the clinical application of Cheezheng Pain Relieving Plaster, the conclusions of this study shall be further verified with large-sample, scientifically designed and strictly implemented clinical trials.
Subject(s)
Drugs, Chinese Herbal/therapeutic use , Pain/drug therapy , Soft Tissue Injuries/drug therapy , Arthralgia/drug therapy , Edema/drug therapy , Humans , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
PURPOSE: To analyze the imaging manifestations of mediastinal hemangioma (MH) by CT and MRI to aid in its successful diagnosis and preoperative evaluation. METHODS: Seventeen cases of MH diagnosed by histopathology combined with CT and MRI were retrospectively collected; and their CT and MRI features, including the lesions' site and range, shape, size, margin, density or signal, enhancement pattern, mass-cardiovascular interface, mass-pulmonary interface, and other characteristics were evaluated. RESULTS: The anterior, middle, and posterior mediastinum were involved in 13, 13, and 8 cases, respectively. The masses size varied from 20 to 233 mm. Irregular, dumbbell-like, and oval masses were found in 13, 2, and 2 cases, respectively, while with pampiniform growth in 16 cases and expansive growth in 1 case. Mixed density, homogeneous density solid masses, and heterogeneous density masses with dominant fat were found in 9, 5, and 3 cases, respectively, showing mild or significant enhancement in aortic phase while no or mild enhancement in pulmonary artery phase. Draining veins were found in 16 cases and feeding arteries in 10 cases. Phleboliths were detected in 10 cases, splenic hemangiomas in 6 cases, and left lateral-chest-wall hemangioma in 1 case. In MRI sequences, mixed signal was found on T1WI and heterogeneous hypersignal with nodular or linear hyposignal on T2WI in 5 cases, mild or significant enhancement in 4 cases, draining veins in 2 cases, and no feeding arteries or phleboliths were seen. CONCLUSION: Presence of phleboliths, pampiniform growth pattern, and aberrant draining veins are relatively specific characteristics in diagnosing MH.
Subject(s)
Hemangioma/diagnostic imaging , Magnetic Resonance Imaging/methods , Mediastinal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Child , Female , Hemangioma/pathology , Humans , Male , Mediastinal Neoplasms/pathology , Mediastinum/diagnostic imaging , Mediastinum/pathology , Middle Aged , Retrospective Studies , Young AdultABSTRACT
The aim of this study is to report and analyze the factors related with earlier occurrence of silicone oil (SO) emulsification in patients underwent pars plana vitrectomy and SO injection in our hospital. We retrospectively reviewed consecutive case series undergone both SO injection and removal in our hospital, and 182 ones were eligible. Possible related independent factors included: macula status (on/off), concomitant phacoemulsification with the surgery of SO tamponading, concomitant status of proliferative vitreoretinopathy, combined surgery of retinotomy, time to have emulsification (<6mo/≥6mo after primary SO injection), route of SO injection (anterior/posterior), lens status (aphakic/pseudophakic/phakic), anesthesia (local/general), brands and type of SO, with/without episcleral cryotherapy, with/without hypertension, with/without diabetes, with/without intraoperative use of triamcinolone acetonide. The study revealed that brand and type of SO was the significant factor related with earlier emulsification of SO. Further study was warranted to find out the underlying causes.
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Colloids and organics in shale gas fracturing flowback water (SGFFW) during shale gas extraction are of primary concerns. Coagulation combined with oxidation might be a promising process for SGFFW treatment. In this study, a novel electrocoagulation-peroxone (ECP) process was developed for SGFFW treatment by simultaneous coagulation and oxidation process with a Al plate as the anode and a carbon-PTFE gas diffusion electrode as the cathode, realizing the simultaneous processes of coagulation, H2O2 generation and activation by O3 at the cathode. Compared with electrocoagulation (EC) and peroxi-electrocoagulation (PEC), COD removal efficiency mainly followed the declining order of ECP, PEC and EC under the optimal current density of 50â¯mAâ¯cm-2. The appearance of medium MW fraction (1919â¯Da) during ozonation and PEC but disappearance in ECP indicated that these intermediate products couldn't be degraded by ozonation and PEC but could be further oxidized and mineralized by the hydroxyl radical produced by the cathode in ECP, demonstrating the hydroxyl radical might be responsible for the significant enhancement of COD removal. The pseudo-first order kinetic model can well fit ozonation and EC process but not the PEC and ECP process due to the synthetic effect of coagulation and oxidation. However, the proposed mechanism based model can generally fit ECP satisfactorily. The average current efficiency for PEC was 35.4% and 12% higher than that of ozonation and EC, respectively. This study demonstrated the feasibility of establishing a high efficiency and space-saving electrochemical system with integrated anodic coagulation and cathodic electro-peroxone for SGFFW treatment.
Subject(s)
Electrochemical Techniques/methods , Electrocoagulation/methods , Hydraulic Fracking/methods , Natural Gas , Organic Chemicals/isolation & purification , Water Purification/methods , Carbon , Electrodes , Hydroxyl Radical/chemistry , Kinetics , Oxidation-Reduction , Ozone , Sulfuric Acids/chemistry , Water Pollutants, Chemical/analysis , Water Pollutants, Chemical/isolation & purificationABSTRACT
Twisted light carrying orbital angular momentum (OAM) provides an additional degree of freedom for modern optics and an emerging resource for both classical and quantum information technologies. Its inherently infinite dimensions can potentially be exploited by using mode multiplexing to enhance data capacity for sustaining the unprecedented growth in big data and internet traffic and can be encoded to build large-scale quantum computing machines in high-dimensional Hilbert space. While the emission of twisted light from the surface of integrated devices to free space has been widely investigated, the transmission and processing inside a photonic chip remain to be addressed. Here, we present the first laser-direct-written waveguide being capable of supporting OAM modes and experimentally demonstrate a faithful mapping of twisted light into and out of a photonic chip. The states OAM_{0}, OAM_{-1}, OAM_{+1}, and their superpositions can transmit through the photonic chip with a total efficiency up to 60% with minimal crosstalk. In addition, we present the transmission of quantum twisted light states of single photons and measure the output states with single-photon imaging. Our results may add OAM as a new degree of freedom to be transmitted and manipulated in a photonic chip for high-capacity communication and high-dimensional quantum information processing.
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Quantum walks, in virtue of the coherent superposition and quantum interference, have exponential superiority over their classical counterpart in applications of quantum searching and quantum simulation. The quantum-enhanced power is highly related to the state space of quantum walks, which can be expanded by enlarging the photon number and/or the dimensions of the evolution network, but the former is considerably challenging due to probabilistic generation of single photons and multiplicative loss. We demonstrate a two-dimensional continuous-time quantum walk by using the external geometry of photonic waveguide arrays, rather than the inner degree of freedoms of photons. Using femtosecond laser direct writing, we construct a large-scale three-dimensional structure that forms a two-dimensional lattice with up to 49 × 49 nodes on a photonic chip. We demonstrate spatial two-dimensional quantum walks using heralded single photons and single photon-level imaging. We analyze the quantum transport properties via observing the ballistic evolution pattern and the variance profile, which agree well with simulation results. We further reveal the transient nature that is the unique feature for quantum walks of beyond one dimension. An architecture that allows a quantum walk to freely evolve in all directions and at a large scale, combining with defect and disorder control, may bring up powerful and versatile quantum walk machines for classically intractable problems.
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Oxytropis falcata has long been used to treat inflammation, sores, and bleeding in Tibet. However, the burn remedy and underlying molecular mechanisms are not well understood. This study is aimed at assessing the effect of Oxytropis falcate gel (OFG) on deep second-degree burn rats and exploring its mechanism. Wistar rats with second-degree burn were treated with OFG and silver sulfadiazine. Immunohistochemical detections for EGF and VEGF were performed, and ELISA detections for EGF, VEGF, p38, and IL-1ß in serum were determined. Rats treated with OFG (25, 50 g/kg) consisted of the major rhamnocitrin-3-O-ß-neohesperidoside significantly accelerated incrustation (P < 0.001) and decrustation (P < 0.001). According to HE staining, edema and infiltration of inflammatory cells decrease apparently with good hyperplasia and incrustation in administration groups (7 d). The expressions of EGF and CD34 in OFG (25, 50 g/kg) treatment increased obviously from immunohistochemical assessment (7 d). Serum EGF expression reached 321.27 ± 7.20 ng/mL by OFG treatment, while p38 (P < 0.05) and IL-1ß (P < 0.05) levels were significantly lower than the model and vehicle groups from day 1 to day 7. OFG possesses potential wound healing activities. The mechanism may be related to the increasing of biosynthesis and the releasing of EGF and CD34 and the decreasing p38 and IL-1ß levels.
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Long-distance quantum channels capable of transferring quantum states faithfully for unconditionally secure quantum communication have been so far confirmed to be feasible in both fiber and free-space air. However, it remains unclear whether seawater, which covers more than 70% of the earth, can also be utilized, leaving global quantum communication incomplete. Here we experimentally demonstrate that polarization quantum states including general qubits of single photon and entangled states can survive well after travelling through seawater. We perform experiments with seawater collected over a range of 36 kilometers in the Yellow Sea. For single photons at 405 nm in a blue-green window, we obtain an average process fidelity above 98%. For entangled photons at 810nm, albeit very high loss, we observe the violation of Bell inequality with 33 standard deviations. Our results confirm the feasibility of a seawater quantum channel, representing the first step towards underwater quantum communication.
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BACKGROUND: Cerebral arteriovenous malformation (cAVM) is a type of vascular malformation associated with vascular remodeling, hemodynamic imbalance, and inflammation. We detected four angioarchitecture-related cytokines to make a better understanding of the potential aberrant signaling in the pathogenesis of cAVM and found useful proteins in predicting the risk of cerebral hemorrhage. METHODS: Immunohistochemical analysis was conducted on specimens from twenty patients with cAVM diagnosed via magnetic resonance imaging and digital subtraction angiography and twenty primary epilepsy controls using antibodies against vascular endothelial growth factor receptor-2 (VEGFR-2), matrix metalloproteinase-9 (MMP-9), vascular cell adhesion molecule (VCAM-1), and endothelial nitric oxide synthase (eNOS). Western blotting and real-time fluorescent quantitative polymerase chain reaction (PCR) were performed to determine protein and mRNA expression levels. Student's t-test was used for statistical analysis. RESULTS: VEGFR-2, MMP-9, VCAM-1, and eNOS expression levels increased in patients with cAVM compared with those in normal cerebral vascular tissue, as determined by immunohistochemical analysis. In addition, Western blotting and real-time PCR showed that the protein and mRNA expression levels of VEGFR-2, MMP-9, VCAM-1, and eNOS were higher in the cAVM group than in the control group, all the differences mentioned were statistically significant (P < 0.05). CONCLUSIONS: VEGFR-2, MMP-9, VCAM-1, and eNOS are upregulated in patients with cAVM and might play important roles in angiogenesis, vascular remodeling, and migration in patients with cAVM. MMP-9, VEGFR-2, VCAM-1, and eNOS might be potential excellent group proteins in predicting the risk of cerebral hemorrhage at arteriovenous malformation.
Subject(s)
Intracranial Arteriovenous Malformations/metabolism , Adult , Blotting, Western , Female , Humans , Immunohistochemistry , Male , Matrix Metalloproteinase 9/metabolism , Middle Aged , Nitric Oxide Synthase Type III/metabolism , Real-Time Polymerase Chain Reaction , Vascular Cell Adhesion Molecule-1/metabolism , Vascular Endothelial Growth Factor A/metabolism , Vascular Endothelial Growth Factor Receptor-2/metabolism , Young AdultABSTRACT
PURPOSE: To determine the role of diffusion tensor imaging (DTI) metrics as biomarkers for the therapeutic effects of mesenchymal stem cells (MSCs) in acute peripheral nerve injury. MATERIALS AND METHODS: Forty-four adult rats received subepineurial microinjection of MSCs (n = 22) or phosphate buffered saline (PBS, n = 22) 1 week after the sciatic nerve trunk crush injury. Sequential fat-suppressed T2-weighted imaging, T2 measurement, DTI and sciatic nerve functional assessment were performed at a 3.0 Tesla MR unit over an 8-week follow-up, with histological assessments performed at regular intervals. The sciatic nerve function index, T2 value, and DTI metrics, including fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD), and mean diffusivity values of the distal stumps of crushed nerves were measured and compared between the two groups. RESULTS: Nerves treated with MSCs showed better functional recovery and exhibited more pronounced nerve regeneration compared with nerves treated with PBS. T2 values in nerves treated with MSCs or PBS showed a similar change pattern (P = 0.174), while FA and RD values in nerves treated with MSCs showed more rapid return (one week earlier) to baseline level than nerves treated with PBS (P = 0.045; 0.035). Nerves treated with MSCs had higher FA and lower RD values than nerves treated with PBS during the period from 2 to 3 weeks after surgery (P ≤ 0.0001, 0.004; P = 0.004, 0.006). CONCLUSION: FA and RD values derived from DTI might be used as sensitive biomarkers for detecting the therapeutic effect of stem cells in acute peripheral nerve crush injuries. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:855-862.
Subject(s)
Algorithms , Diffusion Tensor Imaging/methods , Image Interpretation, Computer-Assisted/methods , Peripheral Nerve Injuries/pathology , Peripheral Nerve Injuries/therapy , Stem Cell Transplantation/methods , Stem Cells/pathology , Animals , Male , Peripheral Nerve Injuries/diagnostic imaging , Rats , Rats, Sprague-Dawley , Reproducibility of Results , Sensitivity and Specificity , Treatment OutcomeABSTRACT
Purpose. To report the clinical features and CT manifestations of giant pancreatic serous cystadenoma (≥10 cm). Methods. We retrospectively reviewed the clinical features and CT findings of 6 cases of this entity. Results. All 6 patients were symptomatic. The tumors were 10.2 cm-16.5 cm (median value, 13.0 cm). CT imaging revealed that all 6 cases showed microcystic appearances (n = 5) or mixed microcystic and macrocystic appearances (n = 1). Five patients with tumors at the distal end of the pancreas received distal pancreatectomy. Among these 5 patients, 2 patients underwent partial transverse colon resection or omentum resection due to close adhesion. One patient whose tumor was located in the pancreatic head underwent pancreaticoduodenectomy; however, due to encasement of the portal and superior mesenteric veins, the tumor was incompletely resected. One patient had abundant draining veins on the tumor surface and suffered large blood loss (700 mL). After 6-49 months of follow-up the 6 patients showed no tumor recurrence or signs of malignant transformation. Conclusions. Giant pancreatic serous cystadenoma necessitates surgical resection due to large size, symptoms, uncertain diagnosis, and adjacent organ compression. The relationship between the tumors and the neighboring organs needs to be carefully assessed before operation on CT image.