Table of Content

21 March 2018, Volume 39 Issue 2

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Reproducibility of quantitative flow assessment of intracranial arteries of anterior cerebral circulation of healthy subjects using 4D flow imaging

Sui Binbin, Gao Peiyi, Lin Yan, Zhao Haiqing, Song Ligang

2018, 39(2):  157-162.  doi:10.3969/j.issn.1006-7795.2018.02.001

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Objective To investigate the reproducibility of quantitative flow assessment of healthy subjects using 4D flow imaging. Methods Four healthy volunteers were enrolled in this study. Four-dimensional flow magnetic resonance (MR) imaging were acquired and rescanned for circle of Willis using the same protocol and parameters. The flow data were post-processed with a prototype flow analysis software 4D Flow. The hemodynamic parameters at the biateral locations including the inlet of the intracranial portion of the internal carotid artery (ICA), the siphon of the ICA, the distal segment of the ICA, the beginning and the proximal segment of the middle cerebral artery (MCA), and the proximal segment of the anterior cerebral artery (ACA) were calculated. The average vessel area, average velocity, maximum flow velocity, and average net flow rate obtained from the first imaging and rescanned imaging were compared. Velocity vectors, streamlines, and particle traces maps were visualized. Results The comparison of hemodynamic parameters showed that significant difference was found in all parameters of right ICA (RICA) siphon, the maximum flow velocity of left ICA (LICA) siphon, bilateral ICA inlet segment, the beginning of bilateral MCA and ACA, and the proximal segment of right MCA, as well as the average area of the proximal segment of bilateral MCA and the beginning of left ACA, and the average velocity of the beginning of left ACA between two scanned images. In one subject, the heartbeats of two scans showed obvious change; and the maximum flow velocity was found to vary obviously. In the siphon segment of ICA, it was also found that there was intense variety in maximum flow velocity between two examinations. Conclusion The reproducibility of 4D flow imaging in quantitative flow assessment of intracranial arteries was acceptable. However, the reproducibility of 4D flow imaging will need further confirmation under different heartbeats conditions and for locations with complex hemodynamics status in future studies.

Amplitude of low-frequency fluctuation of functional magnetic resonance imaging in mild cognitive impairment

Fan Xiang, Yang Yanhui, Jia Xiuqin, Lu Jie, Li Kuncheng

2018, 39(2):  163-166.  doi:10.3969/j.issn.1006-7795.2018.02.002

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Objective To study the changes of amplitude of low-frequency fluctuation (ALFF) of resting-state functional magnetic resonance imaging (rs-fMRI) in patients with mild cognitive impairment (MCI). Methods Fifty patients with MCI and 50 normal controls (NC) were recruited. All subjects were examined by functional MRI (fMRI) to analyze the difference of resting-state brain function between MCI and normal controls based on the ALFF method. Results Compared with the normal controls, ALFF in the bilateral parahippocampal gyrus, bilateral caudate nucleus, left putamen and left insula decreased in MCI group. No increased region was found.Conclusion The activity of bilateral parahippocampal gyrus and some cognitive related subcortical structures decreased in the resting-state fMRI.

Graph theory-based analysis of brain functional networks in children with Gaucher disease

Zhang Miao, Wang Shengpei, Hu Di, Kang Huiying, He Huiguang, Peng Yun

2018, 39(2):  167-172.  doi:10.3969/j.issn.1006-7795.2018.02.003

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Objective To investigate the topological properties of brain functional networks in children with Gaucher disease (GD) and analyze their correlation with clinical parameters. Methods Sixteen children diagnosed as GD and sixteen age-and sex-matched healthy controls (HCs) were recruited. 3DT1-weighted anatomical images and resting state functional magnetic resonance imaging (MRI) data of all participants were obtained. A two sample t-test was used to analyze the differences between the children with type 1 GD and HCs. The Pearson test was used to analyze the correlation between the altered properties and the clinical parameters. Results Compared with HCs, no significant alterations of global topological properties were found in GD patients. Right middle frontal gyrus also showed decreased nodal degree, and right middle frontal gyrus, left inferior frontal gyrus/orbitofrontal gyrus, and left superior parietal gyrus/inferior parietal gyrus/precuneus/angular gyrus showed decreased efficiency. All the functional regions of interests (ROIs) were components of executive control network (ECN). Two brain hubs lost and they were left thalamus and precuneus. Three brain hubs appeared and they were right thalamus/caudate/putamen, right angular gyrus/middle occipital gyrus and right inferior parietal lobule. Conclusion The efficiency of global topological properties in children with GD is preserved. Only functional ROIs within ECN showed decreased performance and a few brain hubs reorganized. Our result provided neuroimaging evidence for brain functional impairment in children with GD.

Application of dual-energy CT in differentiating hemorrhage from contrast medium extravasation after endovascualr treatment of acute ischemic stroke

Guo Shuang, Li Qing, Wu Fang, Liu Jiabin, Li Yan, Du Xiangying, Lu Jie, Li Kuncheng

2018, 39(2):  173-177.  doi:10.3969/j.issn.1006-7795.2018.02.004

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Objective To explore the value of dual-energy CT (DE-CT) in differentiating intracerebral hemorrhage from extravasation of iodine contrast medium after endovascular treatment of acute ischemic stroke. Methods Patients with acute ischemic stroke who underwent endovascular treatment and follow-up dual-energy brain CT within 24 hours were included. Mixed energy images (MIX), virtual unenhanced non-contrast images(VNC)and iodine overlay maps (IOM) were reconstructed and evaluated. Follow-up conventional CT 72 hours after intervention was obtained to serve as the reference. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of dual-energy CT to differentiate hemorrhage from contrast extravasation were calculated. CT values of hemorrhage and contrast extravasation on MIX images were measured and ROC analysis was performed to obtain the cut-off value for differential diagnosis with MIX images alone and its accuracy. Results Dual-energy brain CT was performed on 60 patients after endovascular treatment, including 30 cases without intracerebral high density on CT. Among the 30 cases[22 male, 8 female, 40-80 years old, (62.4±10.1 years)] with high density on MIX images, 15 cases of hemorrhage, 14 cases of contrast extravasation and 1 case of hemorrhage with contrast extravasation were diagnosed with dual-energy CT. Compared with CT images 72 hours after intervention, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of diagnosing hemorrhage with dual-energy CT image analysis were 88%, 100%, 100%, 86% and 93%, respectively. The mean CT values of hemorrhage and contrast extravasation on MIX images were (56.6±11.7)Hu and (90.9±39.9)Hu, respectively. Based on ROC analysis, the best cutoff value was 74.0 Hu, the AUC value for differentiating hemorrhage and contrast extravasation with CT value was 0.781 (95% CI:0.661-0.950), (sensitivity 50%, specificity 92.9%). Conclusion DE-CT should be recommended for differentiation of hemorrhage from contrast extravasation after endovascular treatment of acute ischemic stroke. CT value can be used for differentiation in most occasions when DE-CT was not available.

Microstructural changes of white matter in obstructive sleep apnea syndrome on diffusional kurtosis imaging study

Li Wenfeng, Wen Hongwei, Liu Yue, Peng Yun, Cheng Hua, Li Hongbin, Tai Jun

2018, 39(2):  178-184.  doi:10.3969/j.issn.1006-7795.2018.02.005

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Objective To analyze the microstructural changes of white matter (WM) in obstructive sleep apnea syndrome (OSAS), and to explore neurophysiological mechanisms of cognitive impairment in patients with OSAS. Methods We used tract-based spatial statistics (TBSS) analysis to compare diffusion and kurtosis parameters in 19 OSAS children and 23 age and gender matched healthy children. Results Compared to healthy controls, the diffusion parameter fractional anisotropy (FA) decreased in WM regions (anterior limb of internal capsule, anterior thalamic radiation, fornix, inferior longitudinal fasciculus and corpus callosum) with coherent fiber arrangement, while the kurtosis parameter kurtosis fractional anisotropy (KFA) decreased in WM regions (superior longitudinal fasciculus and posterior corona radiata) with complex fiber arrangement. The two parameters were sensitive to reveal abnormality of WM in OSAS children. There are multiple abnormal brain lobes in OSAS patients. The KFA values in the right forelimb of internal capsule and the left parietal lobe were positively correlated with lowest oxygen saturation (LSaO₂). The values FA, KFA of DKI parameters in the corpus callosum, right posterior coronaries, left post central and left anterior parietal lobes were negatively correlated with SaO₂ <90% and hypoventilation index. Conclusion The abnormal KFA value existed in multiple brain lobes in OSAS patients, which showed significant positive correlations with hypoxia, which may be mechanism of cognitive impairment for OSAS children.

Value of multi-slice spiral CT low-dose scanning program in the argon-helium cryotherapy of lung cancer under the guidance of CT

Li Shengao, Li Qi, Cao Chunjie, Dong Hongyu, Li Jie, Zhang Qiuhuan, Wang Jingyuan, Hua Haiqin, Wang Zhiqun

2018, 39(2):  185-189.  doi:10.3969/j.issn.1006-7795.2018.02.006

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Objective To explore the feasibility of reducing radiation dose in argon-helium cryotherapy under multi-slice spiral CT guidance using low-dose scanning program. Methods Fifty-two patients with lung tumor, treated with argon-helium cryoprotective surgery, were divided into low dose group (group A) and conventional group (group B).The group A patients (22 patients) and group B (30 patients) were treated respectively by low dose scanning program with 120 kV, ATCM (15-60 mA) and 120 kV, ATCM (50-600 mA). The image quality (argon helium cryoides, the frozen ice hockey), radiation dose CTDI, image noise were observed and evaluated. Results The radiation dose index between two groups was significant difference (P<0.05). Compared with group B, the radiation dose index in group A was decreased by 80.90%. The difference of CT value and image noise between two groups has not significant difference (P > 0.05). There difference in the image quality score between group A and group B have statistically significant (P=0.020).The other score about image evaluating was not significant difference between two group (P > 0.05). Conclusion In the lung cancer under CT guidance of argon-helium cryotherapy, the low-dose scanning program not only reduced the radiation dose of patients effectively but also ensure the accuracy, safety of the treatment.

Multi-parameters quantitative analysis of breast infiltrating ductal carcinoma as measured by diffusion weighted imaging and dynamic enhancement

Peng Nan, Liu Huimin, Wang Weixin, Liu Ming, Wang Zhiqun

2018, 39(2):  190-194.  doi:10.3969/j.issn.1006-7795.2018.02.007

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Objective To analyze the imaging features of magnetic resonance diffusion weighted imaging (DWI) and dynamic enhanced scan in invasive ductal carcinoma of the breast. Methods Data of 32 cases of breast invasive ductal carcinoma confirmed by surgical operation or biopsy pathology were collected,the patients's age ranged from 31 to 77, average (56±11.60) years. All patients underwent routine breast magnetic resonance imaging (T1WI, T2WI), DWI and dynamic enhanced scanning. Images of the 32 patients were analyzed, including lesion location, DWI characteristics, apparent diffusion coefficient (ADC) values, morphological and characteristic of enhancement, and type of dynamic enhancement curve.The signal enhancement ratio(SER)was calculated. Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of SER. The statistically significant differences were set at P<0.05. Results The lesions mainly located in the external upper quadrant, a total of 16 cases (50%), followed by the inner and upper quadrant, 7 cases (21.9%), 5 cases (15.6%) posterior to the nipple, 3 cases (9.4%) in the inferior and outer quadrant, 1 case (3.1%) of multifocal lesions in different regions. DWI showed 23 cases of hyperintense signal, 7 cases of uneven or ring-shaped hyperintense signals, and 2 cases of mild hyperintense signals. The mean ADC was (0.910±0.231)×10^-3 mm²/s, which was significantly lower than that of the contralateral breast tissue (P<0.001). ROC analysis showed that the area under the curve(AUC) of ADC was 0.92, the best diagnostic value was 1.178×10^-3mm²/s, the sensitivity was 81.3%, and the specificity was 90.6%. Lump or nodular enhancement was found in 30 cases,with lobulation or speculation, and 2 cases showed non mass like enhancement. Edge centrality enhancement or multiple small ring enhancement was found in 30 cases; addtionally,1 case of center enhancement and 1 case of homogeneous enhancement were also found. The dynamic enhancement curve showed outflow type in 26 cases, platform type of 5 cases, and progressive type of 1 case, with significant difference. ROC analysis showed that the AUC of ADC was 0.912, the best diagnostic value was 0.857, the sensitivity was 96.8%, the specificity was 83.9%.Conclusion Breast infiltrating ductal carcinoma lesions mainly located in the two upper quadrant, with nodule or mass type, irregular edges with lobulation and spiky change. DWI signals were elevated to varying degrees and ADC values decreased.The early obvious enhancement were revealed on the lesions, strengthening on the edge or small annular enhancement.The most common type of enhancement curves were the outflow type. The SER significantly increased, which was helpful for the differential diagnosis.

Factors influencing social function in patients at ultra-high risk of psychosis

Zhu Hong, Jia Hongxiao

2018, 39(2):  195-198.  doi:10.3969/j.issn.1006-7795.2018.02.008

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Objective To study the relationship between the clinical features, cognitive function, duration of untreated psychosis (DUP), and social function of patients at ultra-high risk of psychosis. Methods The data about clinical information, cognitive function, DUP, and social function of 49 patients were collected and analyzed. Results There was no significant correlation between social function and age, age of onset, education years and DUP (P>0.05). The social function showed a significant negative correlation with total scores of Scale of Psychosis-risk Symptoms (SOPS) and negative symptoms scores (r=-0.357, P<0.05; r=-0.348, P<0.05); It also showed a significant negative correlation with trail making test A (r=-0.32, P<0.05), a positive correlation with the simple visual memory test, the Stroop test and the continuous performance test (CPT) (r=0.324, P<0.05; r=0.295, P<0.05; r=0.407, P=0.000). An optimal linear model was developed by using the stepwise regression (R²=0.231, F=13.491, P=0.001). The relationship between social function and CPT was linear (unstandardized coefficients B=6.046, 95%CI:-0.681-0.494, P=0.001), whereas other factors did not show significant linear relationship with social function (P>0.05). Conclusion The patients' clinical symptoms and cognitive function are closely related with social function, which could be as reference for intervention strategies for ultra-high risk group.

Evaluating the efficacy of ziprasidone in improving cognition,quality of life and clinical symptom in schizophrenia

Zhu Hong, Zhi Lihua, Jia Hongxiao

2018, 39(2):  199-203.  doi:10.3969/j.issn.1006-7795.2018.02.009

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Objective To investigate the efficacy of ziprasidone in improving cognitive function, quality of life and clinical symptom in schizophrenia. Methods Fifty-four patients were randomized to either ziprasidone or haloperidol treatment group. The clinical characters, cognition abilities and quality of their life were re-examined at follow-up intervals up to 16 weeks. Results Ziprasidone significantly improved the scores of Wisconsin card sorting test (WCST) error number at 12th week and 16th week, WCST persistent error number at 16th week, compared with baseline(P<0.05), but not in haloperidol group. Ziprasidone significantly improved the reaction time of continuous performance test(CPT) and the scores of digit span test at 12th and 16th week, compared with baseline(P<0.05), but not in haloperidol group. Both ziprasidone and haloperidol groups showed significant improvement in PANSS scores(F=77.10,P=0.000), with no significant difference between them. Ziprasidone significantly improved the scores of Quality of Life Enjoyment and Satisfaction Questionnaire(F=18.39,P=0.000) compared with baseline, but not in haloperidol group. Conclusion Ziprasidone can improve the attention, working memory,executive function and quality of life in schizophrenia patients. Same effect hasn't been observed in the group treated with haloperidol. Both ziprasidone and haloperidol showed similar clinical effects on psychiatric symptom in schizophrenia.

Relationship between Traditional Chinese Medicine constitution classifications and the side effects of antipsychotic drugs

Yu Ying, Zhuang Hongyan, Yin Dongqing, Du Jian, Yang Jing, Jia Hongxiao

2018, 39(2):  204-208.  doi:10.3969/j.issn.1006-7795.2018.02.010

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Objective To study the relationship between Traditional Chinese Medicine (TCM) constitution classifications and the side effects of antipsychotic drugs. Methods Totally 233 patients of Beijing Anding Hospital of Capital Medical University treated with equivalent doses of antipsychotics were divided into research group and control group,119 cases with severe side effects of antipsychotic drugs were set as research group and 114 cases with gentle ones were set as control group. The nine standardized TCM Constitution Questionnaire survey methods were used to carry out the TCM constitution identification. Treatment Emergent Symptom Scale (TESS) was used to assess the severity of the side effects of antipsychotic drugs. Results There were the difference between research group and control group in the distribution of constitution in TCM(χ²=16.68,P<0.05);The distribution ratios of the patients with the Blood-stasis constitution and the Qi-depression constitution in research group were greater than that in control group(χ²=4.56,4.24,P<0.05). There was positive correlation with the patients with the blood-stasis constitution and the qi-depression constitution and aggregate score of TESS with statistically significance (r=0.25,0.29,P<0.01). The patients with the blood-stasis constitution and the cardiovascular system subscale scores from TESS showed positive correlation,with statistically significance (r=0.31,P<0.01). The patients with the qi-depression constitution and the autonomic nerve subscale scores from TESS showed positive correlation,with statistically significance (r=0.214,P<0.05). Conclusion The patients with blood-stasis constitution and the qi-depression constitution were more likely to experience side effect:those with the blood-stasis constitution are more likely to have the side effects of cardiovascular system and those with the qi-depression constitution were more likely to have the side effects of autonomic nervous system.

Relationship between insight and unconscious self-face recognition in patients with schizophrenia

Xu Yuanyuan, Zhou Song, Zhu Hong, Geng Haiyan, Jia Hongxiao

2018, 39(2):  209-212.  doi:10.3969/j.issn.1006-7795.2018.02.011

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Objective Using the continuous flash suppression to explore the relationship between insight and unconscious self-face recognition in schizophrenia patients. Methods Totally 28 schizophrenia patients who met the diagnostic criteria of International Classification of Disease 10th Revision (ICD-10) were selected for a survey of unconscious self-face recognition and their insight was evaluated. Results The response time ratio of the self-face was positively correlated with the score of awareness of current illness, awareness of past illness, attribution of current illness, and attribution of past illness (r=0.439, 0.473, 0.393, 0.381, all P<0.05). Conclusion Schizophrenia patients who have more insight can recognize their own face more quickly in unconscious state.

The progress on clinical staging model in schizophrenia

Xu Yuanyuan, Jia Hongxiao

2018, 39(2):  213-216.  doi:10.3969/j.issn.1006-7795.2018.02.012

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This paper summarizes the research progress of clinical staging model in schizophrenia. The clinical staging model focuses on the course and progression of diseases and provides innovative assessment tools for psychiatrists and clinical psychologists. We reviewed the description of the different stages, clinical course, main features of each stage, and therapeutic schedule according to research team and clinical practice guidelines. The aim is to improve effective intervention measures and treatment methods of each stage, prevent the onset or the progress of schizophrenia, and improve the prognosis of schizophrenia.

Long lasting changes of motor function in MPTP-induced unilateral cynomolgus monkeys model

Luo Binbin, Hu Yasong, Yue Feng, Chen Biao

2018, 39(2):  217-222.  doi:10.3969/j.issn.1006-7795.2018.02.013

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Objective To establish long lasting changes of motor function in MPTP-induced non-human primate models for investigating neuroprotective therapy. We try to study the dynamic changes of motor function of MPTP-induced unilateral Parkinson's disease model in cynomolgus monkeys. Methods Total 5 healthy male cynomolgus monkeys (6~7 years old) were injected MPTP into the left internal carotid artery. The motor behavior changes were evaluated by clinical rating score and physical activity monitoring before and after MPTP injection at 3 and 6 months, 1, 3, and 6 years. Results The clinical rating score was significantly increased and reached the peak (14.65±8.41) at 3 months and partially recovered at 6 months (8.10±2.01, P=0.006), but maintained stable to 6 years after MPTP injection. The 24 h physical activity was significantly decreased and reached the peak at 3 months (16 597.79±12 488.87, P=0.014), 6 months (29 278.02±12 264.66, P=0.016) but recovered to the baseline level (50 084.20±30 170.89) after 1 year. Conclusion The results suggest that the motor deficit assessed by clinical rating score of MPTP-induced unilateral Parkinson's disease model in cynomolgus monkeys can last up to 6 years.

Effects of angiotensin converting enzyme 2 on apoptosis of hepatocytes

Song Lini, Cao Xi, Liu Wei, Yang Jinkui

2018, 39(2):  223-229.  doi:10.3969/j.issn.1006-7795.2018.02.014

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Objective To identify the role of angiotensin-converting enzyme 2 (ACE2) in apoptosis of hepatic cells and to characterize the related mechanisms. Methods 1 HepG2 cells were transfected with ACE2 over expression plasmid DNA; 2MTT assay was used to measure HepG2 cells viability which over expressed ACE2 gene and then exposed to palmitic acid; 3 TUNEL assay was used to detect the apoptosis of hepatocytes in age-matched male C57BL/6 and ACE2^-/y mice; 4The expression of apoptosis related genes were detected by RT-PCR; 5Western blotting was used to study the expression of Bcl2, Bax, CHOP, phosphorylation-JNK and caspase3. Results 1We determined that exposure to different concentration of PA for 24 h caused a decrease in cell viability. However, the cell viability in ACE2-overexpressing HepG2 cells was significantly higher than GFP group (when the concentration of PA was 0.4, 0.8 or 1.0 mmol/L, P<0.05). 2The TUNEL positive hepatocytes in age-matched male ACE2^-/y mice group were more than those of C57BL-6 mice in the control group. 3In ACE2-overexpressing HepG2 cells, the relative protein expressions of Bax, caspase-3, CHOP and phosphorylation-JNK were decreased. While, the expression of Bcl2 was increased significantly. At this stage, over-expression of ACE2 also down-regulated the expression of ER-stress related apoptosis pathway genes. Conclusion ACE2 could be involved in anti-apoptotic via resistance to endoplasmic reticulum stress.

miR-29s inhibit ACEA-induced J774A.1 cell migration by down regulation CB1 expression

Duan Xianghui, Chang Na, Li Liying

2018, 39(2):  230-235.  doi:10.3969/j.issn.1006-7795.2018.02.015

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Objective To investigate whether miR-29a-3p, miR-29b-3p and miR-29c-3p affect cannabinoid receptor 1(CB1)expression and cell migration in J774A.1 cells. Methods RT-qPCR was used to detect CB1 mRNA expression in J774A.1 cells. Boyden chamber assay was used for the detection of cell migration. Results In this study, we presented evidences that CB1 agonist Arachidonyl-2'-chloroethylamide (ACEA) upregulates the expression of CB1 mRNA in J774A.1 cells. Whereas miR-29a-3p or miR-29b-3p or miR-29c-3p mimics blocks the increase of CB1 mRNA level and ACEA-induced cell migration in J774A.1 cells. Conclusion miR-29s inhibit ACEA-induced J774A.1 cell migration via downregulating CB1 expression.

Relationship between the expression of heat shock factor 1 and mitochondrial damage in aging myocardium

Wu Linguo, Liu Dan, Wu Ye, Ma Xinliang, Liu Huirong

2018, 39(2):  236-242.  doi:10.3969/j.issn.1006-7795.2018.02.016

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Objective To explore the relationship between mitochondrial damage and the expression of heat shock factor 1 (HSF1) in aging myocardium.Methods Four-month-old and 24-month-old C57BL/6 mice were used as the young and aging mices. The changes of the morphology in mitochondria were observed by transmission electron microscopy in the myocardial tissue.The concentration of ATP and the production of reactive oxygen species (ROS) in aging myocardium and H9C2 cells were detected by related kits.JC-1 was used to detect the change of membrane potential in H9C2 cells.The expression of HSF1 was detected by Western blotting. Results In the aging myocardium, the morphology of mitochondria was changed and the concentration of ATP was decreased(1.253±0.059 vs 0.479±0.122, P=0.012), the production of ROS was increased(10.853±0.096 vs 1.550±0.233, P=0.025), and the expression of HSF1 was also increased in the aging myocardium (0.980±0.112 vs 1.979±0.175, P=0.013). The expression of HSF1 in aging myocardium was negatively correlated with the content of ATP (r=-0.977, P=0.005) and positively correlated with the content of ROS (r=0.934, P=0.020). After treated with H₂O₂, the mitochondrial membrane potential of cardiomyocytes decreased, the content of ATP decreased and the content of ROS increased,the expression of HSF1 was increased in the cardiomyocytes(P<0.05).Conclusion During the aging process,the mitochondria is damaged and the dysfunction of mitochondria was negatively correlated with the expression of HSF1 in aging myocardium.

Effects of Jiedu medicine combined with Liangxue medicine on mice psoriasis-like lesions induced by imiquimod

Zhai Chunyan, Di Tingting, Zhao Jingxia, Wang Yan, Xie Xinran, Li Xue, Meng Yujiao, Li Ningfei, Liu Zhengrong, Zhang Lu, Zhang Lei, Wang Ning, Li Ping

2018, 39(2):  243-251.  doi:10.3969/j.issn.1006-7795.2018.02.017

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Objective To observe the effects of Liangxue Jiedu (LXJD) decoction and Liangxue(LX)decoction on mice psoriasis-like lesions induced by imiquimod (IMQ), and further explore the the mechanism of compatibility of Jie Du medicine in psoriasis.Methods BALB/c mice (n=55) were randomly divided into 5 groups:control group, model group, LX groups, LXJD groups, and methotrexate (MTX) group. The model was induced by 5% IMQ daily. On day 7, to observe the psoriasis area and severity index(PASI) and score, observed lesions morphological changes and epidermal layer thickness under light microscope; The skin barrier function was evaluated by testing oil and water component in the skin. The histology and epidermal thicknesses were observed under high microscope. The expressions of proliferating cell nuclear antigen (PCNA) and CD3 were detected by immunohistochemical staining. And detecting interleukin-17 (IL-17) mRNA,IL-23 mRNA andIL-1β mRNA were detected by RT-PCR. Results The cutaneous symptoms were alleviated in LX and LXJD groups compared with those in model group accompanied with PASI scores decreased; the means of epidermis thickness in LX and LXJD groups were less than that in model group; compared with model group,the percentages of PCNA positive cells and the numbers of CD3 positive cells in LX and LXJD groups were reduced(P<0.05); meanwhile, the relative expressions of IL-1β mRNA in LX and LXJD groups were decreased compared with that in model group(P<0.05). In the above indexes, LXJD group was better than LX group(P<0.01). In addition the LXJD decoction can make the moisture content (16.980±2.739) and oil content (7.750±1.209) in the lesions of mice increased (P<0.05). The relative expression of IL-17 and IL-23 mRNA also decreased (P<0.05). In some indexes like PASI scores, epidermis thickness, the percentages of PCNA positive cells (5.66±0.057) and the numbers of CD3 positive cells (10.670±0.193), LXJD group was better than LX group (P<0.01). Conclusion LXJD decoction and LX decoction can inhibit the expression of IL-1 β, reduce inflammatory infiltration and thereby improving imiquimod-induced mice psoriasis-like lesions. Jiedu medicine may play a crucial role through the inflammatory axis of IL-17 and IL-23 on LXJD group which can better alleviate psoriasis like lesions and further improve the skin barrier function. It is suggested that the inhibitory effect of the Jie Du medicine on the related inflammatory factors may be a potential mechanism for the treatment of psoriasis.

Regulatory effect and mechanism of three kinds of dietary oils on human serum complement, inflammatory cytokines, chemokines and their associated protein levels

Wang Yifei, Ma Weiwei, Zhang Shuhua, He Dian, Yu Huanling, Xiao Rong

2018, 39(2):  252-257.  doi:10.3969/j.issn.1006-7795.2018.02.018

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Objective Healthy young college students as the research objects, based on the observation of dietary fat fluid of palm oil (PO), cocoa butter (CO), soybean oil (SO) of human serum complement component C3, C4 and tumor necrosis factor-α(TNF-α), interleukin-10 (IL-10) and the activity of normal T cell expressed and secreted regulatory proteins (RANTES) levels. Methods To meet inclusion and exclusion criteria of healthy young college students as subjects, according to body mass index (BMI), students can be divided into 3 groups at random, respectively is palm oil, cocoa butter, soybean oil group, each group of 31 people, a total of 93 people, intake with grease 12 weeks, respectively. Respectively, at the beginning of the experiment and the end of experiment detected objects composition of serum C3, C4 and cytokine TNF-α, IL-10, chemokine RANTES levels. Results Before and after the experiment of each group, the serum complement C3 and C4 levels were all decreased, and the difference was statistically significant (P<0.05). The serum TNF-α level was significantly decreased in palm oil group and soybean oil group (P<0.05). Serum IL-10 level was significantly increased in soybean oil group (P<0.05). There was no significant change in serum RANTES level in the three groups (P>0.05). Before and after the experiment, there was no significant difference in serum complement composition, cytoinflammatory cytokines and activity regulation protein levels in the three groups (P>0.05). Conclusion Palm oil, cocoa butter and soybean oil may reduce the inflammation of the body, especially the effect of soybean oil group is more significant.

Effects to obliterative bronchiolitis by blocking CD40-CD40L pathway in the mouse lung transplantation

Chen Rongjuan, Chen Qirui, Xu Jiangnan, Ding Yuezhong

2018, 39(2):  258-264.  doi:10.3969/j.issn.1006-7795.2018.02.019

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Objective Our research focus on the effects to obliterative bronchiolitis (OB) by blocking CD40-CD40L pathway with anti-mCD40L on allografts in mouse orthotopic lung transplantation model, and comparing with traditional immunosuppressive agents-cyclosporine/methylprednisolone (C/M) to explore new clinical treatment methods. Methods Murine orthotopic lung transplantation was performed in wild type C57BL/6 mice using Balb/c donors. At day 10, histopathologic characteristics were assessed by hematoxylin-eosin (HE) staining, Masson staining and neutrophil staining with antimyeloperoxidase; real-time polymerase chain reaction (RT-PCR) was performed for interleukin-17A (IL-17A) expressions. Results Donor lung of recipients were harvested at 10 days after transplantation. Groups with treatment of anti-mCD40L and cyclosporine/methylprednisolone showed an enlargement appearance compared with allograft group. Pathology results demonstrated that administration of anti-mCD40L can better improve rejection injury and OB compared with cyclosporine/methylprednisolone treatment group (P<0.05). Furthermore, administration of anti-mCD40L significantly reduced transcription levels of IL-17A in grafts(P<0.01). Conclusion This findings demonstrated that by blocking CD40-CD40L pathway with anti-mCD40L can better alleviate transplant rejection and OB mediated by IL-17A in mouse lung transplantation.

Efficacy comparison of methylprednisolone and dexamethasone treatment of sudden deafness: a system review and Meta-analysis

Gao Zhanmei, Song Yang, Liu Hua, Wen Changlong, Sun Haiyang

2018, 39(2):  265-271.  doi:10.3969/j.issn.1006-7795.2018.02.020

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Objective To analyze methylprednisolone and dexamethasone treatment the curative effect of sudden deafness by Meta analysis. Methods The retrieval of database was performed including CNKI, Wanfang, VIP, CBM, PubMed, Medline, Embase, Cochrane database, which were from Chinese and English database. The retrieval keywords including methylprednisolone, dexamethasone, and sudden deafness and the quality evaluation was used to follow the Newcastle-Ottawa Scale (NOS).Using the RevMan5.3 software for Meta analysis, the risk ratio (RR) value indicators and 95% CI as the study effects, the test of heterogeneity indexed choosing I² and P value. Then sensitivity of the inspection and subgroup analyses were done, Egger's test were used to evaluate the publication bias.If the study indicated publication bias, using trim and filling method would be used to make an evaluation. Result By comparison of the two groups for the treatment of curative effect of sudden deafness, Z=4.91(P<0.000 1), RR(95% CI):1.20(1.12-1.29), the difference was statistically significant (P< 0.05).Subgroup analysis in systemic medication group Z=5.23(P<0.000 01), RR(95% CI):1.28(1.17-1.41), the difference was statistically significant (P<0.05). Local drug group Z=5.99(P<0.000 01), RR(95% CI):1.30(1.19-1.42), the difference was statistically significant (P<0.05).Sensitivity analysis:Z=6.83(P<0.000 01), RR(95% CI):1.19(1.13-1.26), the difference was statistically significant too(P<0.05). Conclusion The efficacy of methylprednisolone for the treatment of sudden deafness is better than the dexamethasone for the treatment of sudden deafness.

Expression of PGRMC1 in breast cancer tissue and its correlation with clinicopathological features

Wang Lijuan, Ruan Xiangyan, Zhao Yue

2018, 39(2):  272-276.  doi:10.3969/j.issn.1006-7795.2018.02.021

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Objective To analyse the expression profile of immunohistochemical indicators progesterone receptor membrane component 1 (PGRMC1), estrogen receptor (ER), progestogen receptor (PR), Ki-67 and human epidermal growth factor receptor-2 (Her-2) in breast cancer tissues, benign breast tumor tissues and normal breast tissues, and evaluate the correlations between the expressions of PGRMC1 and other indicators in breast cancer tissues and benign breast tumor tissues. Methods Sixty cases of breast cancer tissue samples, 30 cases of benign breast tumor tissue and 30 cases of normal breast tissue samples (from the breast benign tumor mammotome minimally invasive rotary cutting around 1 cm of normal tissue, pathological assay revealed no abnormal breast tissue) were selected between September 2015 and January 2015. All the sources of the tissues were diagnosed by a hollow needle biopsy or postoperative histologic examination. Immunohistochemical method was used to detect breast cancer tissues, benign breast tumor tissues and normal breast tissues in the expression of PGRMC1, ER, PR, Ki-67 and Her-2, and analyze the correlations of PGRMC1 expression in breast cancer and benign breast tumor tissues with other indicators. Results Expression rate of PGRMC1:breast cancer group (68.3%) > benign breast tumor group (26.7%) > normal control group (6.7%), the difference between groups was statistically significant (P<0.01). Expression rate of ER:breast cancer group (58.3%) > benign breast tumor group (43.3%) > normal control group (23.3%), the difference between groups was statistically significant (P<0.01). Expression rate of ki-67:breast cancer group (66.7%) > benign breast tumor group (36.7%) > normal control group (13.3%), the difference between groups was statistically significant (P<0.01). The expression of PGRMC1 in breast cancer group was positively correlated with ER expression (OR=3.593,95%CI:1.131-11.418), and there was no correlation with the expressions of PR, ki-67 and Her-2. Conclusion The expression level of PGRMC1 in breast cancer group was significantly higher than that in benign breast tumor group and control. The expression of PGRMC1 in breast cancer tissue was positively correlated with ER expression, and there was no correlation with PR, ki-67 and Her-2 expression.

Clinical characteristic and prognostic analysis of elderly primary immune thrombocytopenia

Chen Yu, Wang Meifang, Cheng Fangfang, Shen Xing, Zhao Lidong, Yang Linhua

2018, 39(2):  277-281.  doi:10.3969/j.issn.1006-7795.2018.02.022

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Objective To explore the clinical features and prognostic factors of elderly-onset primary immune thrombocytopenia(ITP) and provide more evidence for the treatment of it.Methods Totally 177 cases of ITP were selected from the Second Hospital of Shanxi Medical University hospitalized patients (2013.06.01-2017.06.01) to summarize the clinical-data, including clinical manifestation,laboratory findings, treatment, therapeutic effect,prognosis of scheme.ITP of patients older than 60 years were defined as elderly-onset ITP. Results The data were collected from 177 ITP cases, and 48 of those were elderly-onset ITP.The ratio of male to female was 1:1, with an average age of (68.17±6.47)years. There were 30(62.5%) cases of newly diagnosed ITP,6(12.5%) cases of persistent ITP and 12(25%) cases of chronic ITP.After the treatment of rhTPO,rhTPO combined with dexamethasone,IVIG, IVIG combined with dexamethasone or high dose-dexamethasone, 40 patients got remission and the overall remission rate was 83%.The ANA was positive in 54.2% of elderly-onset ITPs,which was significantly higher than that in the no-elderly-onset ITP group(P<0.05);The proportion of cases with bleeding score above two was 77.1% in elderly-onset ITPs, which was significantly higher than that in the no-elderly-onset ITP group(P<0.05).With a median follow-up of 9.5 monthes(range from 0.5 to 40.0 monthes),there were 12 patients who finally replased.The replase rate was 30% and the median replase time was one month(range 0.5 to14 monthes).The lower percentage of NK cell was the risk factor for replase(P<0.05).Conclusion Elderly-onset ITP has higher bleeding scores and more underlying diseases such hypertensions and diabetes mellitus.Therefore, these patients need more attention in clinical practice and treatment for preventing complication should be started actively. Elderly-onset ITP was more likely to have positive ANA, suggesting that connective tissue diseases need to be excluded before making the diagnosis of ITP. The lower percentage of NK cell was the risk factor for replase in elderly-onset ITP,and further studies are needed to explore the underlying mechanism.

Association of overlap syndrome with pulmonary embolism in a cross-sectional study

Xie Jiang, Li Fei

2018, 39(2):  282-285.  doi:10.3969/j.issn.1006-7795.2018.02.023

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Objective To investigate the association between overlap syndrome and prevalence of pulmonary embolism (PE). Methods Totally 1 939 patients who completed sleep test from January 2011 to December 2014 in Beijing Anzhen Hospital, Capital Medical University were retrospectively studied. Overlap syndrome were defined as simultaneous diagnosis of chronic obstructive pulmonary diseases and obstructive sleep apnea[apnea-hypopnea index (AHI) ≥ 5/h]. Logistic analysis was used to evaluate the association of overlap syndrome with PE. Results Patients with versus those without overlap syndrome had higher odds of PE after adjusting for age, body mass index, AHI, meanSaO₂, hypertension, diabetes (OR 3.78, 95%CI 1.28-9.82, P=0.018). Overlap syndrome was associated with PE prevalence only among male subjects (OR 5.16, 95%CI 1.21-36.01, P=0.025). In multiple Logistic model, patients with meanSaO₂<93% (the median value of all subjects) had higher odds of PE than those with meanSaO₂ ≥ 93% (OR 2.82, 95%CI 1.27-6.61, P=0.011). Conclusion Overlap syndrome is associated with high prevalence of PE. Further study is needed to verify whether treatment toward overlap syndrome may reduce the risk of thrombotic diseases.

Analysis of etiology and clinical features of chronic pancreatitis in the elderly

Chi Tianyu, Zhang Mei

2018, 39(2):  286-291.  doi:10.3969/j.issn.1006-7795.2018.02.024

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Objective To investigate the etiology and clinical features of 106 elderly cases of chronic pancreatitis in Beijing. Methods Retrospective analysis of 106 elderly patients with diagnosis and treatment of chronic pancreatitis within 10 years in Xuanwu Hospital of Capital Medical University (January 2007 to January 2017), was compared with 132 cases of non-elderly patients with chronic pancreatitis in the same period. We compared the gender, etiology, clinical manifestations, complications and imaging diagnosis between two groups. Results The average age was (65.3±4.7) years old and male:female was 1.72:1 in 106 elderly patients. In the etiology analysis of elderly chronic pancreatitis, the biliary tract diseases accounted for 47.28%, followed by alcoholism 21.70%, which was the main cause in non-elderly people with chronic pancreatitis. The main clinical manifestations of chronic pancreatitis in the elderly were abdominal pain (64.15%) and abdominal distension (33.96%), which were significantly different from those of non-elderly patients with chronic pancreatitis. The complications of chronic pancreatitis in elderly patients were similar to those in non-elderly. The elderly group, image detection positive rate from high to low occurred in the order of endoscopic retrograde cholangiopancreatography (ERCP), endoscopicultrasound (EUS), magnetic resonance imaging (MRI)/magnetic resonancecholangiopancreatography (MRCP),computed tomography (CT) and ultrasound. Different image detection methods had significant difference both in the elderly group and non-elderly group. However there was no difference between the two groups for the same image method. Conclusion The main causes of chronic pancreatitis in the elderly were biliary diseases and alcohol abuse. The clinical manifestations were abdominal pain and abdominal distension, and the diagnosis should be based on the specific conditions of the elderly patients, and choose safe and high diagnostic imaging methods.

Relationship between RDW, neutrophil/lymphocyte ratio and endothelial function in essential hypertensive patients

Zhou Yaqun, Ding Cuntao, Sun Xipeng, Li Jing, Hua Qi

2018, 39(2):  292-298.  doi:10.3969/j.issn.1006-7795.2018.02.025

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Objective To investigate the relationship between red blood cell distribution width(RDW), neutrophil/lymphocyte ratio (NLR) and endothelial function in essential hypertensive patients. Methods We continuous enrolled 111 hypertensives patients from the Xuanwu hospital affiliated to Capital Medical University under the strict inclusion criteria. The Endo-PAT2000(Itamar Medical Inc.Caesarea) noninvasive testing equipment of vascular endothelial function measured reactive hyperemia index (RHI) which was used to evaluate vascular endothelial function and arterial stiffness in morning fasting adoption.Patients were divided into two groups:normal RHI group(RHI>1.67,n=63),abnormal RHI group (RHI ≤ 1.67,n=48).We also recorded age, blood pressure, history of smoking, fasting blood check. Results Systolic blood pressure (SBP) and pulse pressure (PP) in abnormal RHI group were significantly higher than those in normal RHI group.The Pearson correlation analysis indicated that, RHI was negatively associated with NLR(r=-0.358, P<0.01),SBP(r=-0.300, P=0.001)and PP(r=-0.311, P=0.001).Conclusion RHI gradually was declined with the elevation of NLR levels in hypertensives, and there was a linear correlation between them, which indicated that they may be associated with hyertensives endothelial injury. Further longitudinal studies are needed to better understand the causal relationship between endothelial function and NLR.

A prospective, randomized control study between titanium coating mesh and polypropylene mesh in laparoscopic inguinal hernia repair

Yang Shuo, Liu Yuchen, Wang Minggang, Shen Yingmo, Zhu Yilin, Cao Jinxin, Zou Zhenyu

2018, 39(2):  299-303.  doi:10.3969/j.issn.1006-7795.2018.02.026

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Objective To compare the effect between Titanium coating mesh and polypropylene mesh in laparoscopic inguinal hernia repair. Methods A total of 48 patients performed laparoscopic inguinal hernia repair from Jan. 2016 to Jun. 2016 were included into this study. All patients were divided into two groups randomly, including Titanium coating mesh group(observation group, n=24) and polypropylene mesh group(control group, n=24).The operation time, intraoperative bleeding, hospital stay, hospital cost, time return to work and complications were analyzed. Results All of the operations were performed successfully. No statistical difference was observed of operation time, intraoperative bleeding, hospital stay, time return to work between two groups(P>0.05). The difference of hospital cost, incidence of seroma and foreign body sensation were statistically(P<0.05). No recurrence, infection or chronic pain was observed at 1 year follow-up. In observation group, 1 seroma case and 6 foreign body sensation cases were observed. And in control group, 5 seroma cases and 8 foreign body sensation cases were observed, with lower hospital cost (P<0.05). Conclusion Use of Titanium coating mesh may decrease the incidence of seroma and foreign body sensation with same risk of recurrence and complications. It is worthy to be used for clinical practice although hospital cost may be higher than polypropylene mesh.