Volume 93  ·   Issue 11  ·  2013

To design a set of functional magnetic resonance imaging (fMRI) tasks to activate the major Chinese language functional areas.

Eight volunteers and 3 patients received fMRI studies with the tasks of semantic judgment, word reading and listening comprehension.Brain activation map of each task was obtained after standard fMRI data processing.

The fMRIexamination with 3 tasks activated middle frontal gyrus (BA 9), Broca area and Wernicke area respectively.

A set of fMRI examinations, including semantic judgment, word reading and listening comprehension, can activate the major Chinese language functional areas steadily and may be used as a preoperative localizer of language areas.

To evaluate the magnetic resonance (MR) imaging findings of breast cancer subtypes based on the profiles of ER/PR and Her2.

A retrospective study was conducted for 267 breast cancer subjects between February 2007 and January 2011.Clinicopathologic features and MR imaging findings of four subtypes were compared.The Chi-square (χ²) test, Fisher′s exact test and χ²section method were employed for categorical variables.

MR imaging findings:Patients with segment or linear enhancement type accounted for 25.6% in ER/PR⁺,Her2⁺subtype group and 36.1% in ER/PR^-,Her2⁺subtype, no significant difference existed between them (χ²=1.112, P=0.641).But they were significantly higher than ER/PR⁺,Her2^-subtype group and ER/PR^-,Her2^-subtype group (χ²=32.793, P<0.001|χ²=14.565, P<0.001).ER/PR^-, Her2^-subtype patients accounted for 14.6% of the total breast cancer patients (39/267).Subjects with ER/PR^-,Her2^-subtype were more likely to present unifocal (91.7%, 33/36) and mass type lesion (92.3%, 36/39).The mass type lesions in ER/PR^-,Her2^-subtype group were more likely to showed smooth margin[58.3% (21/36), P<0.001], very high intratumoral signal and peripheral hyperintense pattern on fat suppression T₂-weighted imaging (P<0.001) and early rim enhancement[81.5% (29/36), P<0.001].No significantly difference of four subtypes were found on number of mass, mass shape and pattern at dynamic enhancement imaging (χ²=1.413, P=0.713|χ²=8.423, P=0.204|χ²=4.657, P=0.540).

Segment or linear enhancement type is characterized by MR imaging.Early rim enhanced mass is ER/PR^-, Her2^-breast cancer.The most important characteristics of MR imaging include a smooth edge of breast mass, very high intratumoral signal on fat suppression T²-weighted imaging and peripheral hyperintense pattern.

To evaluate the onset of initial pneumatization of paranasal sinuses with magnetic resonance imaging (MRI) and provides references in the diagnosis and treatment of pediatric paranasal sinuses disease.

The MRI images of paranasal sinuses were retrospectively reviewed for 799 children of 0 month to 15 years old and the first pneumatization time of paranasal sinuses were analyzed.

The ethmoidal sinuse was the first pneumatized in 100% (46/46) of newborn children.And 45.7% (21/46) of maxillary sinuse showed penumatization during the first month of life and 97.8% (45/46) were penumatized at 7-12 months.The penumatized sphenoid sinuse was first identified as early as 4 months.And 86% (43/50) were penumatized from 1 to 2 years old.Frontal sinuse was the last pneumatized paranasal sinuse.And 8% (4/50) of frontal sinuse were penumatized at 1-2 years old and 97.8% (42/43) showed pneumatization at 14-15 years old.

MRI may be used to observe the pneumatization of paranasal sinuses.The initial pneumatization time of paranasal sinuses is earlier than previously described.

To evaluate the magnetic resonance diffusion-weighted imaging (DWI) in the detection of early ankylosing spondylitis and explore the manifestations of ankylosing spondylitis on whole body DWI (WB-DWI).

A total of 16 patients with early ankylosing spondylitis (AS) and 18 patients with low back pain (LBP) were recruited.Subchondral bone marrow apparent diffusion coefficient (ADC) in bilateral ilia and sacrum along sacroiliac joints were compared.An independent sample t-test (SPSS 16.0, SPSS, Chicago,Ⅲ) was utilized to analyze the ADC value differences between groups.P<0.05 denoted statistical significance.The mean ADC values of focal lesions in AS patients were also measured.Whole body diffusion weighted imaging was performed in additional 8 clinical confirmed AS patients and analyzed with the techniques of maximum intensity projection (MIP) and multiplanar reconstruction (MPR) in comparison with conventional MRI images to investigate the detectability of AS lesions with whole body DWI.

Mean ADC values in 16 AS patients were (0.51±0.13) ×10^-3mm²/s in ilia and (0.49±0.17) ×10^-3mm²/s in sacrum.Mean ADCvalues in 18 LBP patients were (0.32±0.06) ×10^-3mm²/s in ilia and (0.31±0.08) ×10^-3mm²/s in sacrum.The ADC value in AS patients were statistically significantly greater than those in ilia and sacrum of LBP patients.Whole body DWI detected abnormalities in 8 AS patients within bilateral sacroiliac joints and other sites corresponding to the clinical symptoms of patients.The mean ADC values of focal lesions of this patient cohort were (1.31±0.38) ×10^-3mm²/s in sacrum and (1.18±0.27) ×10^-3mm²/s in ilia.

Subchondral marrow ADC values along sacroiliac joints allow the differentiation of patients with early AS from LBP patients.In conjunctions with such post-processing techniques as MIP and MPR, WB-DWI allows a comprehensive assessment of AS patients to guide treatment, evaluate prognosis and follow therapeutic responses.

To explore the feasibility of in vivo labeling of adult rat neural progenitor cells (NPCs) in subventricular zone (SVZ) with superparamagnetic iron oxide particles (SPIOs) for tracking of magnetic resonance imaging (MRI).

A total of 7 SD rats were stereotactically injected with 3μl SPIOs (7 mg Fe/ml) into anterior horn of right lateral ventricle and then 5-bromo-2′-deoxyuridine (Brd U) was injected intraperitoneally once daily for 1 week.MRI was performed at 1, 3, 7 and 14 days post-injection.After the final MRI scan, all rats were transcardially perfused and their brains removed and fixed.The sections were processed for Prussian blue iron staining and Prussian blue plus BrdU immunohistochemical staining.

In all experimental animals, SPIOs were predominantly located in the anterior horn of right lateral ventricle and partial SPIOs entered the ventricular system.A needle path and a distribution of SPIOs along rostral migratory stream (RMS) towards olfactory bulb (OB) were depicted at the sagittal view of T₂WI, moderate MR artifact was visible and SPIOs tracking NPCs were successful (success rate of 100%).The result of staining showed SPIOs labeling NPCs were effective.And the labeling rates were 75.5%, 42.3%, 23.6% in SVZ, RMS and OB respectively.

Effective in vivo labeling of adult rat NPCs in SVZ with SPIOs is feasible.And dynamical migration of labeling NPCs along RMS towards OB may be visualized on MRI.

To conduct a preliminary study on the reliability of left ventricle volume filling curve through the commercial medical program Report-Card 4.0.

A total pf 22 normal volunteers underwent the examination.Images of standard 2-chamber view and short-axis view were acquired at endexpiration by electrocardiography-gated FIESTA CINE sequence.Then one experienced doctor manually contoured the endocardium during end-systole and end-diastole phases respectively, obtained the results of the volume of end-diastole (EDV) and end-systole (ESV),ejection fraction (EF), stroke volume (SV) and cardiac output (CO), processing time and mean processing time per phase.Papillary muscle was not included into left ventricle volume.Another two observers utilized LV ANALYSIS of Report-Card, generated the left ventricle volume filling curve and recorded the processing time and mean processing time per phase.From the curve, EDV, ESV, SV, EF, CO, peak ejecting rate (PER) and peak filling rate (PFR) were also acquired.One observer repeated the procedures a week later.

The difference of results from two Methods were insignificant (P>0.05) and the correlation was excellent (EDV 0.963, ESV 0.944).Intraobserver and inter-observer variability for measurements (EDV, ESV) were assessed by Bland-Altman analysis and interclass correlation coefficient (0.985,0.987,0.959 and 0.957 respectively).The mean processing time (179±51) s by means of manually contouring was significantly less than the mean processing time (331±99) s through REPORT-CARD 4.0 (P<0.001).However, the mean processing time per phase (17±5) s by means of REPORT-CARD 4.0 was significantly less than the mean processing time per phase (89±26) s through manually contouring (P<0.001).

The reliability of left ventricle volume filling curve generated through Report-Card is excellent.Left ventricle volume filling curve may be a reliable method of further studying the functions of left ventricle.

To explore the maternal and perinatal outcomes for different types of placenta previa (PP).

A total of 343 pregnancies with PP from January 2003 to December 2012 at our hospital were retrospectively reviewed.The general profiles, maternal and perinatal outcomes of different types of 325 singleton PP were evaluated.

Among them, 221 pregnancies were of complete PP.There were partial (n=22) and marginal (n=82) PP.Proportions of previous vaginal and cesarean deliveries in women with complete and partial PP were higher than those with marginal PP (P<0.05).Compared with marginal PP group, ratio of placenta in the uterus posterior wall prepartum hemorrhage and probability of blood transfusion and neonatal asphyxia were much higher in complete and partial PP.The gestational age at delivery and neonatal body weight with complete PP and partial PP marginal PP were higher than those of the other two groups (P<0.05).As for the placenta adhesion, placenta accrete or postpartum hemorrhage, no difference existed among three groups placenta location.

The gestational age at delivery, prepartum hemorrhage, probability of blood transfusion and perinatal outcome in women with PP are related with the type of PP.Both complete and partial PP have relatively worse outcomes.The type of PP has no effect on placenta adhesion, placenta accrete or postpartum hemorrhage.

To evaluate the effects of relieving pains and restoring vertebral heights of percutaneous balloon kyphoplasty by extrapedicular approach as a minimally invasive treatment in patients with painful osteoporotic vertebral compressive fractures (OVCF).

A retrospective analysis was conducted for 96 consecutive patients.There were 64 females and 32 males with a mean age 67 years (range: 55-82).Symptomatic levels were identified by correlating their clinical presentations with the findings of magnetic resonance imaging (MRI).The interval between onset of symptoms and surgical intervention ranged from 2 days to 4 months.A total of 118 levels(56 thoracic, 62 lumbar) were treated in this cohort.Immediate and postoperative 3-month follow-up visits were conducted.Visual analog scale(VAS)pain scores, preoperative and postoperative anterior, midline vertebral heights for fractured vertebrae were measured on lateral radiographs to evaluate the procedural outcomes.

There was swift pain relief associated with evident augmentation in weight-bearing resistance.Pain decreased from 8.1 to 2.1 points. Through kyphoplasty, the anterior, midline vertebral heights of 118 fractured vertebral bodies increased up to (75.83±19.84)% and(71.23±21.45)% respectively. None of them had worsening of fracture-induced narrowing of spinal canal.No device-related major complications occurred.

Percutaneous kyphoplasty through an extrapedicular approach results in immediate clinical improvement of mobility and pain relief.It safely increases vertebral body height and quickly returns geriatric patients to higher activity levels, increased independence and better quality-of-life.And its short-term outcomes are excellent.

To conduct pharmacoeconomic evaluations for the two therapies of rheumatoid arthritis (RA).

An expert survey was conducted on the cost and effectiveness of two RA therapies of methotrexate (MTX) alone and recombinant human tumor necrosis factor-α receptor Ⅱ: IgG Fc fusion protein (rh TNFR:Fc) plus MTX, followed by simulation estimates, and cost-effectiveness analysis on the basis of pharmacoeconomic Markov model.

MTX alone and rh TNFR∶Fc plus MTX cost RMB 1422 Yuan and RMB13000 Yuan respectively per treatment cycle (3 months).Five-year Markov model showed that the incremental cost-effectiveness ratio of rh TNFR:Fc plus MTX was RMB 99662 Yuan per QALY when compared with MTX alone.And it was lower than the threshold of willingness to pay.

The patients with RA on the combined treatment of rh TNFR:Fc and MTX may have potential long-run economic advantage over those on the treatment of MTX alone.

To explore the clinical characteristics, diagnosis, treatment and prognosis of perinuclear antineutrophil cytoplasmic antibody (p-ANCA) associated hypertrophic pachymeningitis.

A retrospective study was performed for 6 inpatients with p-ANCA associated hypertrophic pachymeningitis at our hospital from 2005 to 2012.

There were 3 males and 3 females with an age range of 52- 68 years.The main clinical manifestations included headache and multiple cranial neuropathies.Erythrocyte sedimentation rate, C-reactive protein, titer of myeloperoxidase (MPO)-ANCA and protein in cerebrospinal fluid were uniformly elevated in all 6 patients during active phase while cytoplasmic (c)-ANCA was all negative.Head magnetic resonance imaging (MRI) enhancement scan had a high diagnostic sensitivity.Different parts of dura were all thickened and obviously enhanced.Glucocorticoid was uniformly effective.During the follow-up period, 2 cases relapsed and received immunosuppressive agents.

The disease should be considered in elderly patients with headache, cranial nerve injury and positive p-ANCA.And head MRI enhancement scan is helpful for diagnosis.

To explore the effects of ketamine inhalation before one-lung ventilation (OLV) in patients undergoing transthoracic esophagectomy for esophageal cancer.

Upon the approval of hospital ethic committee,90 American Society of Anesthesiologists grade Ⅰ-Ⅱ patients scheduled for elective trans-left-thoracic esophagectomy for esophageal cancer were randomly and single-blindly divided into 3 groups.After intravenous anesthesia with double-lumen endobronchial intubation, the patients in each group received different therapies before OLV, i.e.inhaling ketamine 1 mg/kg in Group Ki, intravenous infusion of kemamine 1 mg/kg in Group Kv and inhaling normal saline 10 ml in Group C.Arterial blood gas analysis was performed.And (oxygen saturation) SpO₂, (partial pressure of end-tidal carbon dioxide) P_ETCO₂, (airway pressure) Paw and hemodynamic indicators were recorded at these points:before OLV (T1), OLV for 30 min (T2), OLV for 1 h (T3), OLV for 2 h (T4), OLV ended 5 min (T5) and end of surgery (T6).Central venous blood was sampled at T1, T2 and 2 h after surgery (T7) for the determination of interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) concentrations by enzyme-linked immunosorbent assay (ELISA).

Serum levels of IL-6, IL-8 and sICAM-1 in all groups increased significantly than those at previous timepoints.Serum levels of IL-6, IL-8 and sICAM-1 in Groups Ki and Kv were significantly lower than those in Group C at T7.PaO₂ in Groups Ki and Kv was significantly higher than that in Group Cat T4.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Group Kv were significantly higher than that in Groups Ki and C at T2-T4; HR in Group Kv was significantly higher than that in Group C at T2-T3.Paw in Group Kv was significantly higher than that in Group Cat T2-T6.

Inhalation and intravenous infusion of ketamine before OLV are equally effective in lowering the serum levels of IL-6, IL-8 and sICAM-1.And ultrasonic atomizing inhalation of ketamine can avoid adverse effects on airway pressure and circulatory system caused by an intravenous infusion of ketamine.

To explore the prevalence and risk factors of atherosclerotic renal artery stenosis (ARAS) in patients undergoing coronary angiography.

A total of 2506 patients with suspected and known coronary heart disease (CAD) at our hospital underwent simultaneous coronary and renal angiography.Renal artery stenosis was defined as at least one of renal artery stenosis≥50% narrowing of luminal diameter.The prevalence of ARAS was summarized from the results of angiography.And single- and multi-variable logistic regression analysis was used to assess the relationship between clinical characteristics and ARAS.

Among them, there were 1479 males and 1027 females with a mean age of 62.7±11.4 years.ARAS was detected in 409 patients (16.3%), including 214 (8.5%) with significant stenosis (≥75%) | Bilateral ARAS was detected in 98 patients (3.9%), including 27 (1.1%) with significant stenosis (≥75%).Left and right ARAS were detected in 162 patients (6.5%) and 148 patients (5.9%) respectively, including 84 patients (3.4%) with significant stenosis (≥75%) in left ARAS and 72 patients (2.9%) in right ARAS.Univariate analysis indicated that age, females, diabetes, hypertension, stroke, peripheral artery disease, coronary heart disease, renal insufficiency, dyslipidemia and hyperuricemia were the predictor for ARAS (P<0.05 or 0.01).Multivariate regression analysis demonstrated that age≥65 years (P=0.025, OR=1.358), females (P<0.01,OR=1.678), hypertension (P<0.01, OR=1.650), peripheral artery disease (P<0.01, OR=14.678), renal insufficiency (P<0.01,OR=1.835), coronary heart disease including 3-vessel (P<0.01, OR=1.746) and left main coronary (P<0.01, OR=3.416) disease were independent risk factors for ARAS.

Renal angiography should be routinely performed in female patients aged≥65 years with hypertension, peripheral artery disease,elevated creatinine and coronary heart disease,especially for 3-vessel and left main coronary disease to identify ARASin time.

To explore the neuroprotective mechanism of exogenous hydrogen sulfide after cerebral ischemia-reperfusion (I/R) in rats.

A total of 240 male Sprague-Dawley rats were randomly divided into 4 groups of sham-operation group (Ⅰ), I/R model group (Ⅱ), low-dose sodium hydrosulfide (NaHS) group (Ⅲ) and high-dose NaHS group (Ⅳ)(n=60 each).Reversible middle cerebral artery occlusion (MCAO) model was established by intraluminal suture.However, the rats of group Ⅰ were operated without a blockage of middle cerebral artery.The occlusions in other groups were removed after 2 h.And at 20 min pre-removal, normal saline, 50 μmol/kg NaHS, and 100μmol/kg NaHS were injected into the abdomens of rats in groups Ⅱ, Ⅲ and Ⅳ respectively.At 6 h, 24 h, 48 h and 7 d post-reperfusion, behavioral test was performed to evaluate the neurological deficiency. And triphenyltetrazolium chloride (TTC) staining was used to observe the volume of cerebral infarction.In addition, the protein expressions of tumor necrosis factor-alpha (TNF-α) and heat shock protein 20 (HSP20) in ischemic cortex were measured by immunohistochemistry and Western blot.

Compared with I/R group, the neurological deficiency scores and volume of cerebral infarction of groups Ⅲ and Ⅳ significantly decreased.Furthermore, the protein expression of HSP20 was markedly up-regulated in the groups Ⅲ and Ⅳ while there was a marked down-regulation of TNF-α after reperfusion.

NaHS may exert anti-necrotic and anti-inflammatory function by inducing the expression of HSP20, inhibiting the expression of TNF-α and reducing the size of cerebral infarction so as to protect neurons after I/R injury.

To explore the chronic effects of nicotinic antagonist and agonist on rat neurons injury induced by β-amyloid protein.

The rat model of neuron injury was established by the exposure to Aβ_25-35 and the intervention agent was either methyllycaconitine (MLA) or nicotine (Nic).And the experimental groups were control (distilled water), Aβ_25-35, MLA (MLA and Aβ25-35) and Nic (Nic and Aβ_25-35).Cellular viability was detected by methyl thiazalyl tetrazolium (MTT) chromatometry while apoptosis and necrosis were detected by flow cytometer.

Compared with control, cellular viability decreased while the apoptotic and necrotic rates increased in Aβ_25-35 group (P=0.00).The values of cellular viability at (0.75±0.02) and (0.75±0.09) in Aβ_25-35 and MLA groups respectively were significantly lower than that of Nic group (0.81±0.02, P=0.01) at Day 3 and 7.No significant differences existed in cellular viability between Aβ_25-35 and MLA groups.At Day 14, the differences of cellular viability were not obvious in all groups.At Day 21, cell viability of MLA group (0.64±0.10) was significantly higher than those of Aβ25-35 (0.57±0.04, P=0.019) and Nic groups (0.56±0.04, P=0.008).The apoptotic rate was lower than that of Aβ_25-35 group (3.70%±0.20% vs 4.70%±0.46%, P=0.008) while the necrotic rate lower than that of Aβ_25-35 group (7.73%±0.86% vs 16.30%±1.05%,P=0.00) and Nic group (16.03%±1.53%, P=0.00).However, no significant differences existed in cellular viability or apoptotic and necrotic rate between Aβ_25-35 and Nic groups.

With chronic treatment, the protective effect of α7 nicotinic antagonist methyllycaconitine increases whereas that of nicotinic agonist nicotine decreases.

To explore the memory consolidation related role of gene Arc in amygdala-kindled rats.

A total of 60 male amygdala-kindled rats were divided equally into 3 groups:0.9% sodium chloride injection, null vector lenvirus injection and silencing lentivirus injection.Quantitative polymerase chain reaction (qPCR) and Western blot were performed to confirm the silencing efficiency of Arc.And the passive avoidance test and Morris′water maze were used to test the memory consolidation ability of rats in three groups.

The memory consolidation ability became significantly impaired in the Arc silencing group in both of passive avoidance test and water maze comparing to the other groups.And no significant difference existed in memory consolidation ability between 0.9% sodium chloride and null vector lenvirus injection groups.

The ability of memory consolidation is impaired in Arc silencing amygdala-kindled rats and Arc may play a significant role in the consolidation of memory in amygdala-kindled rats.

To examine the effects of bone tissue from osteonecrosis of femoral head on the proliferation and differentiation of canine bone marrow mesenchymal stem cells in vitro culture.

A canine model of femoral head osteonecrosis was induced by liquid nitrogen freezing.BMSC were isolated from dog ilium bone marrow by a combination of gradient centrifugation and adherent wall culture.Different bone tissues and BMSC were cultivated indirectly in vitro by cocultured in Transwell plate.According to the culture media, 3 groups were established: blank group (10% FBS/DMEM), control group (10% FBS/DMEM+ bone tissue from natural femoral head) and experimental group (10% FBS/DMEM+ bone tissue from osteonecrosis of femoral head).Cell proliferation was measured by methylthiazol tetrazolium (MTT) method.Cell differentiation was examined by alkaline phosphatase (ALP) staining and its concentration examined.Alizarin red staining method was used to study the calcification effects and Oil red O staining method was used to detect if there was fat emergence.

As compared with the blank group, the proliferation in the control and experiment groups were significantly promoted after culturing for Days 1, 3 and 5 (P<0.05).The proliferation of the experiment group was higher than the control group at Day 5 and 7 day (P<0.05).After a 7-day co-culturing, ALP staining was positive in the control and experiment groups.At Day 7 and 9,the ALP activity in culture fluid was in this order:control group>experiment group>blank group (P<0.05).Alizarin red staining show control group had the most calcium nodules (12.17±2.48, P<0.05) and the number of calcium nodules in the experiment group was more than the blank group (P<0.05).Oil red O staining show there was no fat emergence after 21 days in every group.

Both natural and osteonecrotic bone tissue of femoral head could promoted the proliferation of canine BMSC and induces them osteogenic differentiation but not lipo differentiation, bone tissue from osteonecrosis of the femoral head had more competence in promoting proliferation but less capability in inducing osteogenic differentiation than natural bone tissue of the femoral head.

To reconstruct the 3-dimensional (3D) models of vertebral endplate and internal canal structure based upon the micro computed tomography (MicroCT) scanning data and clarify the structural characteristics and changes of bone, canals and lumbar vertebral endplates with advancing age in SD rats.

Lumbar spines from male SD rats aged 3, 9 and 16 months (n=15 each) were subjected to MicroCT scan.Mimics software was used to reconstruct the 3D models of lumbar vertebral endplate and internal canal structure.The bone volume fraction (BV/TV) of endplate was measured by CT An software.

The rebuilt 3D models of vertebral endplate showed that lumbar endplate was a thin layer of bone and the canals within vertebral endplate formed a ring-shaped canal network after reconstruction.Communicating branches existed between the adjacent canals.Every ring-shaped canal connected with trunk canals lying in the ventral and dorsal portions of endplate. The BV/TV of endplate in the ventral portion was lower than that in dorsal portion (ventral side:79.9%±7.3%| dorsal side:90.6%±6.2%, P<0.05) and BV/TV increased with advancing age.

The canals within rat lumbar vertebral endplate are not haphazard, but regularly arrayed to form a ring-shaped network of many circular canals, communicating branches and ventral and dorsal trunk canals.This canal network provides channels for blood vessels within endplate.The ratio of older rat canals decreases in endplate.