1.Progress in neuroimaging related to suicide in depression
Chinese Journal of Behavioral Medicine and Brain Science 2021;30(4):373-378
Depression is an emotional disorder characterized by significant and persistent depression, and it is a serious mental disorder with high incidence rate, high disability rate and high suicide rate. Suicide is the most dangerous clinical symptom of depression, causing great harm to individuals, families and society. At present, the prevention of suicidal behavior in patients with depression mainly depends on the experience of clinicians, but there is a lack of an accurate predictive model. Understanding the neurobiological basis of suicidal behavior in patients with depression will help to effectively prevent suicidal behavior in patients with depression and reduce the social burden. In recent years, structural and functional magnetic resonance imaging (fMRI) technology has been used to explore the neuroimaging charictristics for the depression patient with or without suicidal ideation or suicidal behavior. It mainly involves the abnormal changes of orbitofrontal lobe, temporal parietal lobe, cingulate gyrus, hippocampus, striatum and other brain regions, and brain core cognitive network, especially prefrontal limbic system.It is clear that abnormal changes of brain structure or function were significantly associated with suicidal severity in depression patients. More studies are needed to explore the changes of brain structure and function in depression patients with suicidal ideation or suicidal behavior, and look for thepotentially neuroimaging markers that can be used to identify whether depression is accompanied by suicidal ideation/behavior in the early clinical stage.
2.Observation of therapeutic effect after chemoembolization and blood supply in liver metastases cancers
Runqing DUAN ; Chunming XIE ; Dongfeng SHEN
Cancer Research and Clinic 2001;0(04):-
Objective To evaluate DSA feature, the value, efficacy and side effect, survival time of microcathereter superselective catherization intervenetional treatment on liver metastases cancer. Methods 60 cases with liver metastases cancers were cannulated through common femoral artery by seldinger technique. If the artery was lack, second radiography was given through superselective hepatic artery. On the base of DSA feature of liver metastases, all the patients were divided into two groups: superselective- catherization group and nonsuperselective-catherization group. There were 30 patients in each group respectively. Microcathereter was used in the former to "embed" the tumor vessel and "siphonal" technique was used in the later. Compared the changes of the two groups in volume, the deposit of iodized oil in liver matastases after treating one month and the changes of ALT, ALB, TBIL in blood. The efficacy and side effect were compared in two groups. The survival time and DSA feature of using microcathereter were also analyzed. Results The DSA feature and efficacy of superselective-catherization group was better than that of non-superselective-catherization group, the side effect was mild and the survival time was longer than the former. Conclusion Microcathereter superselective catherization to treat liver metastases cancer has better efficacy, artery radiography, lighter side effect and can prolong the survival time.
3.Comparative study on digital substraction angiography and CT diagnosis for the residual and new lesions of primary hepatocelluar carcinoma after transcatheter arterial chemoembolization
Minling YANG ; Zhiyong YANG ; Chunming XIE
Cancer Research and Clinic 2014;26(3):145-147,152
Objective To comparative analyze the CT enhanced scan and digital substraction angiography (DSA) in showing the residual and new lesions after treatment of transcatheter arterial chemoembolization (TACE).Methods 60 cases of patients with complete clinical information and imaging data from June 2010 to February 2013 were collected,these patients were diagnosed of primary hepatocelluar carcinoma and underwent TACE treatment.The sensitivity and specificity of CT and DSA to detect the residual and new lesions after TACE treatment were analyzed.By analysis of the main factors affecting the low detection rate to seek a method that can improve PHC residual new lesions detection rate after TACE.Results There were 86 lesions in 60 cases,CT enhanced scan clearly determined the diagnosis of 49 lesions (42 residues,7 new lesions).37 lesions did not prompted to tumor recurrence (residual and new lesions).DSA as the gold standard,the sensitivity of CT enhanced scan to check out the lesions was 84.5 % (49/58),specificity was 100.0 % (28/28),the false negative rate was 15.5 % (9/58),the accuracy was 89.5 % (77/86).Enhanced CT detection rate of tumor recurrence was 57.0 % (49/86),the DSA detection rate of tumor recurrence was 67.4 % (58/86).The difference of determining tumor recurrence between the CT enhanced scan and DSA was significant (x2 =7.11,P < 0.05).Conclusions Three dynamic contrast-enhanced CT scan is the first choice for follow-up examination methods after TACE for hepatocellular carcinoma,but many factors will affect the detection rate of the residual and new lesions.Compared with CT examination,DSA examination has more advantages.DSA examination should be performed when the clinical suspicion of tumor recurrence is negative after enhanced CT scan.
4.Prevalence and Risk Factors of Renal Artery Stenosis in Patients with Refractory Hypertension
Ningdong PANG ; Chunming XIE ; Minling YANG ; Duiping FENG ; Yi CHEN
Chinese Journal of Medical Imaging 2015;(7):510-512
PurposeTo investigate the independent risk factors of refractory hypertension for effective screening and treatment.Materials and Methods 142 patients with refractory hypertension underwent renal angiography, morbidity of renal artery stenosis (RAS) and angiography results were analyzed using univariate and multivariate Logistic regression.Results Thirty-eight cases of RAS were identiifed with incidence of 26.8%. Univariate analysis indicated that diabetes, peripheral artery disease and coronary heart disease were the predictor for RAS (P<0.05 orP<0.01). Multivariate regression analysis demonstrated that peripheral artery disease (OR 5.011, 95%CI 2.17-8.93,P<0.001) was independent risk factors for RAS. Diabetes and coronary heart disease were not independent risk factors.Conclusion Peripheral artery disease is independent risk factor for RAS among patients with refractory hypertension, which can serve as a screening index of renal angiography or renal angioplasty and stenting for RAS.
6.The clinical efficacy of transcatheter super-selective hepatic artery embolization for the treatment of symptomatic polycystic liver disease
Zhiyu NAN ; Chunming XIE ; Duiping FENG ; Minling YANG ; Ningdong PANG ; Yi CHEN ; Chao ZHAO
Journal of Interventional Radiology 2015;(5):388-391
Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.
7.Relationship between aspartate aminotransferase to alanine aminotransferase ratio and metabolic syndrome in college students
Xiaoli LIU ; Qiang LU ; Junfeng JIAO ; Xiaoming WANG ; Chunming MA ; Changshun XIE ; Fuzai YIN
Chinese Journal of Health Management 2012;(6):409-412
Objeetive To evaluate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and metabolic syndrome in college students.Methods Anthropometric and metabolic measurements including fasting plasma glucose (FPG),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),true insulin (TI),(AST and ALT) were assessed in a crosssectional study of 425 college students aged 19 to 24 years old (male 216,female 209) in 2009.The participants were then assigned to the AST/ALT ratio < 1 group or the AST/ALT ratio ≥ 1 group.Metabolic syndrome was defined as Adult Treatment Panel Ⅲ criteria.Results AST/ALT ratio < 1 was found in 146 subjects (34.4%).After adjustment for age and sex,AST/ALT ratio showed a positive correlation with HDLC (r=0.125) and negative correlations with body mass index (BMI,r=-0.281),waist circumtance (WC,r =-0.264),TG (r =-0.134),TI (r =-0.118) and HOMA-insulin resistance (HOMA-IR,r =-0.121) (all P <0.05).The prevalence of metabolic syndrome was 2.1% and was similar in males and females (2.3% vs.1.9%,P =0.774).Those with AST/ALT ratio < 1 had a significantly higher prevalence of metabolic syndrome (4.8% vs.0.7%,P =0.016).After adjustment for age,gender and BMI,the prevalence of metabolic syndrome of subjects with AST/ALT ratio < 1 was nearly 7 (95% CI:1.430 to 34.019,P =0.016) times of those with AST/ALT ratio ≥ 1.Conclusion AST/ALT ratio may be related with metabolic syndrome in college students.
8.White matter change in diffusion tensor imaging of amnestic mild cognitive impairment
Duan LIU ; Hao SHU ; Zan WANG ; Chunxian YUE ; Yongmei SHI ; Chunming XIE ; Zhijun ZHANG
Chinese Journal of Neurology 2014;47(5):315-319
Objective To investigate the features of white matter impairment and its relationship with cognition in patients with amnestic mild cognitive impairment (aMCI).Methods Eighty-three cases of aMCI and 85 normal aging volunteers were scanned with diffusion tensor imaging (DTI) using MR system.All subjects completed the neuropsychological battery.We analyzed the differences between two groups using tract-based spatial statistics and the association between regions in difference and cognition using correlation analysis.Results There were significant differences between aMCI and normal control in the neuropsychological battery including the Mini-Mental State Examination(26.2 ± 2.6 vs 28.3 ± 1.3,F =43.224,P =0.000),Mattis Dementia Rating Scale-2 (131.4 ± 6.9 vs 138.0 ± 3.5,F =62.308,P =0.000),Auditory Verbal Learning Test-delayed recall(2.4 ± 1.6 vs 7.5 ± 2.0,F =324.018,P =0.000),Boston Naming Test(8.7 ± 1.4 vs 9.2 ± 1.0,F =6.821,P =0.010),Rey-Osterrich Complex Figure Test (12.1 ± 7.3 vs 18.5 ± 6.1,F =40.674,P =0.000),Symbol Digit Modulation Test (30.0 ± 10.1 vs 38.6 ± 9.8,F =30.786,P =0.000),Trail-Making Test Part B ((256.8 ± 124.5) s vs (178.1 ± 59.0) s,F =27.601,P =0.000).Significantly higher diffusivity indexes and radial diffusivity were also found in aMCI subjects compared to healthy elders in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract,corpus callosum,cingulum,corona radiate.We also found that axial diffusivity was significantly increased in the parahippocampal,superior longitudinal fasciculus,inferior longitudinal fasciculus,superior fronto-occipital fasciculus,inferior fronto-occipital fasciculus,unciform fasciculus,corticospinal tract and corpus callosum,whereas fractional anisotropy changes were not observed in aMCI.Diffusivity indexes values in bilateral frontal lobe (left r =0.67 ; right r =0.70),left cingulum (r =0.63),parietal white matter (r =0.69) and radial diffusivity values in left parietal (r =0.68) were significantly related to Trail Making Test A among aMCI (all P < 0.05).Conclusions In aMCI patients,there was a wide range of white matter damage,with no brain region-specific.Executive function deficit was related to the white matter impairment in bilateral frontal lobe,left cingulate and parietal lobe.The specificity and sensitivity of four DTI parameters fordetecting white matter lesions are variant.Trial registration Clinical Research Center of Jiangsu Province (BL2013025)
9.Interpretation of the new consensus on classification and diagnosis of posterior cortical atrophy
Yuting SU ; Chunming XIE ; Chang TAN
Chinese Journal of Neurology 2020;53(9):736-740
Posterior cortical atrophy (PCA) is a kind of neurodegenerative dementia. The core feature of the PCA includes progressive decline in visual processing and other posterior parietal-occipital cortex-related cognitive functions. Recently, neuroimaging features of PCA from magnetic resonance imaging/single photon emission computed tomography/ 18F-deoxyglucose positron emission tomography-computer tomography studies represent the typical characteristics of cortical atrophy, hypoperfusion, and hypometabolism in the posterior parietal-occipital cortex. The most common neuropathological changes of PCA are amyloid plaques deposition and neurofibrillary tangles in posterior cortex, while the molecular biomarkers are decreased amyloid β-protein 1-42 together with increased T-tau and/or P-tau in cerebral spinal fluid. From this point, PCA is also considered as an atypical form of Alzheimer′s disease (AD). However, individuals fulfilling the criteria for the core clinico-radiological PCA syndrome, can also fulfill the core clinical criteria for any other neurodegenerative syndrome, and represent negative AD-related pathophysiological biomarkers. Heterogeneity within the PCA syndrome and pathophysiological biomarkers prompt the PCA working group to establish a new consensus on PCA classification and diagnostic criteria, which is proposed for use in a number of different research contexts and the research of AD, atypical AD and related syndromes. This paper gives a brief introduction and interpretation of the newly proposed classification and diagnostic criteria of PCA.
10.Recent advance in assessment of collateral circulation in patients with ischemic stroke based on arterial spin labeling magnetic resonance imaging
Chinese Journal of Neuromedicine 2020;19(9):909-915
Arterial spin labeling (ASL) is a magnetic resonance perfusion imaging method for visualizing whole-brain perfusion by using autologous arterial blood as an endogenous tracer. Recently, it has been widely used in studies about ischemic stroke, especially in evaluating ischemic penumbra and cerebral collateral circulation, and is found to have good consistency with golden standard digital subtraction angiography (DSA). Due to its noninvasive and reproducible advantages, ASL is an ideal technique for assessing collateral circulation in patients with acute ischemic stroke (AIS) and has a good application prospect. We briefly review the progress of ASL in evaluating collateral circulation of AIS patients, to provide some references for the effective development of collateral circulation assessment in clinic.