1.Diffusion Weighted Imaging in Evaluating the Prognosis of Colorectal Cancer Patients with Regional Lymph Node Metastasis
Sen ZHANG ; Yu KANG ; Xiangke DU
Chinese Journal of Medical Imaging 2015;(7):513-516,522
PurposeDiffusion weighted imaging (DWI) can significantly improve the diagnosis of non-enlarged lymph node metastasis. This study aims to evaluate the correlation between the DWI findings and the prognosis, and to identify prognostic factors.Materials and Methods Forty-seven patients with colorectal cancer underwent MRI scan including DWI sequence before surgery. Imaging ifndings were compared with the pathologic results to determine the metastatic lymph nodes (DWI positive) or non-metastatic lymph nodes (DWI negative). Postoperative disease-free survival and overall survival for 5 years of the patients with DWI positive and DWI negative lymph nodes were compared. Correlation between the prognosis and the related factors were investigated including regional DWI-positive lymph nodes, short axis diameter and long axis diameter of the largest DWI-positive lymph node, and number of DWI-positive nodes.Results Of 47 patients,10 (21%) patients had regional DWI-positive lymph nodes showed high signal intensity on diffusion-weighted images. The patients with regional DWI negative lymph nodes had a signiifcant better ifve-year disease-free survival and overall survival (P<0.05). The short axis diameter of the largest DWI-positive lymph node was correlated with distant metastasis (AUC=0.77,P<0.05). The short axis diameter and long axis diameter of the maximum metastatic lymph nodes were correlated with overall survival (AUC=0.84 and 0.75,P<0.05). Five-year disease-free survival and overall survival of the patients with short axis diameter of the largest DWI-positive lymph node ≤9 mm were higher than the patients with lymph node short axis diameter >9 mm (P<0.05). Five-year disease-free survival and overall survival of the patients with long axis diameter of the largest DWI-positive lymph nodes ≤11 mm were higher than the patients with long axis diameter >11 mm (P<0.05). Five-year disease-free survival of the patients with all DWI positive lymph nodes resected was higher than the patient without DWI-positive lymph nodes resected (P<0.05).Conclusion The patients with regional DWI-negative lymph node had a better prognosis. Of the patients with DWI-positive lymph nodes, the patients with smaller lymph nodes have better prognosis than who have larger lymph nodes.
2.Surgical treatment for uncinate process carcinoma of the pancreas
Sen LI ; Yongquan PEI ; Futian DU
Chinese Journal of General Surgery 1993;0(03):-
Objective To summarize the clinical features of uncinate process carcinoma of the pancreas and improve the resection rate. Methods From Jan. 1990 to Jun.1999, Ten cases of pancreas uncinate process carcinoma received Whipple′s procedure. Portal vein resection and reanastomosis was performed in 5 cases, among them the resected length varied between 20~42 *!cm.Two cases underwent PV lateral wall partial resection. The longest time of PV blood occlusion was 40 *!minutes.Results Among 7 cases undergoing PV resection, 1 died with hepatic failure 3 days post-op. 1 case suffered postoperative chylous ascites.These 6 cases survived 13 to 29 months post-op. Among 3 cases not undergoing PV resection, 2 cases survived 13 months and 14 months, respectively. 1 case is still alive at the follow-up of 115 months post-op. Conclusion Pancreas uncinate process carcinoma has the tendency of invading adjacent PV and SMV, which should not be simply regarded as a contraindication of the radical resection.
3.Preparation of magnetic resonance molecular probe for breast cancer detection in vitro
Xubin LI ; Xiangke DU ; Tianlong HUO ; Xia LIU ; Sen ZHANG
Journal of Peking University(Health Sciences) 2004;0(02):-
0.05).There was remarkable low signal intensity on T2-weighed imaging and no evident artifacts for molecular probe when the concentration of Fe2+ was 20 mg/L.The least number of labeled cells detected by MR in vitro was 6?106 when the concentration of Fe2+ was 20 mg/L.Conclusion:Molecular probe,SPIO-OCT,can effectively label breast cells which express SSTR.The reasonable Fe2+ concentration of labeled cells and imaging was 20 mg/L.There is a correlation between MR signal intensity in vitro and the number of labeled cells.
4.Preliminary study of molecular imaging of human hepatoceilular carcinoma xenoggaft with Gd-based MR probe containiug arginine-glycine-aspartic acid chelate
Tianlong HUO ; Xiangke DU ; Sen ZHANG ; Xubin LI ; Xia LIU
Chinese Journal of Radiology 2008;42(10):1095-1100
Objective To develop a Gd-based MR probe containing arginine-glyeine-aspartic acid (RGD)motif to reveal integrin avβ3 receptor-expressed tumor.Methods Commercially available HYNICRGD conjugate with co-ligand EDDA was labeled with GdCl3,and the mixture was isolated and purified by solid phase extract(SPE)to get the entire probe Gd-EDDA-HYNIC-RGD.Human HCC cell line BEL-7402 was cultured and the cells harvested and suspended then subcutaneously inoculated into athymic nude mice for tumor growth.In vitro cell binding assay to integrin avβ3 receptor and cell viability experiments were conducted.Then in vivo,imaging of the three arms of xenografts were performed by MR scan with a dedicated animal coil at baseline and time points of 0.30,60,90 mninutes and 24 hour post-intravenous injection(P.i.) via the tail vein.Three arms of nude mice then were sacrificed for histological examination to confirm the imaging results.Results Gd-EDDA-HYNIC-RGD was successfully isolated by SPE and validity was verifled on signal enhancement througll in vitro and in vivo experiments.The T1 relaxation rate of the probe is 3.31 mmol/s:It is well tolerated to living cells when the concentration of the probe is below 0.1 μmol/ml;both BEL-7402 Hunlan Hepatocellular Carcinoma cell Iine and the tumor expressed avβ3receptor;The RGD-iigand was observed specificly binding with avβ3 receptor in vitro;The nude mice model bearing HHCC was well estabhshed.The signal intensity(SI)at the tumor site were 2247.6±39.0 at baseline and 2820.9±35.2 at 90 min p.i.respectively,the SI at 90min increased less than 25%of baseline,which is statistically different(t=-38.031,P<0.05);while the SI at muscle site were 1824.2±32.8 and 1845.8±27.2 respectively,which is not statistically different(t=-1.424,P>0.05);The signal to time curve for probe-administrated group is straightforward over time in the span of 0 to 90 minute p.i.while the control arms do not show such tendency.Conclusion Gd-EDDA-HYNIC-RGD has the potential to used as an MR probe detecting integrin avβ3 receptor-expressed tumor.This work may offer possibility of early detection and differentiation of specific tumors.
5.Effects of cognitive impairment in hippocampus on glucose and lipid metabolism and its relations with gastrointestinal motility in rats
Lin YE ; Sen DU ; Lin ZHU ; Chunbo XIA
The Journal of Practical Medicine 2015;(17):2789-2792
Objective To investigate the effects of cognitive impairment in hippocampus on glucose and lipid metabolism, and its relations with gastrointestinal motility. Methods The Aβ1-42 was injected into the hippocampus of rats. Levels of glucose and lipid were detected. The changes of gastrointestinal motility were detected by the type-B ultrasonic and the ink-pushing experiments. Hippocampal neurons apoptosis was detected by the TUNEL assay. Results In the experimental group, FPG, TG, TC, LDL were (7.92 ± 0.29) mmol/L, (2.24 ± 0.12) mmol/L, (4.67 ± 0.12) mmol/L, (2.41 ± 0.12) mmol/L, respectively, with significant differences among these three groups (P < 0.05). Compared with the sham group and the control group, the number of bowel movements per unit time (2.13 ± 0.83) times, gastric emptying rate (44.35 ± 7.53) % and the small intestinal propulsion rate (57.60 ± 7.82)%in the experimental group were significantly decreased (P<0.05). The experimental hippocampal neuronal apoptosis index was an average of (64.98 ± 3.70)%, which was significantly higher than that in the sham group and the control group (P < 0.05). Conclusion Hippocampal cognitive impairment can elevate the blood lipid level, which may be associated with the hippocampal neuronal apoptosis and the gastrointestinal motility disorders.
6.Evaluation on the influence of electrocardiograph modulated milliampere on image quality and exposure dosage of volume CT heart scan
Sen ZHANG ; Xiang-Ke DU ; Jian-Ying LI ;
Chinese Journal of Radiology 2001;0(09):-
0.05)between the images from the two groups.Conclusion When scanning the heart with volume CT(VCT),the application of ECG modulated mA can effectively reduce the exposure dosage without sacrificing the image quality.
8.Carbachol alleviates intestinal inflammation during enteral fluid resuscitation of rats with burn shock
Jinwei CHE ; Sen HU ; Shijia GENG ; Jing WU ; Lei WANG ; Ying DU ; Yiyun TIAN ; Zhiyong SHENG
Chinese Journal of Emergency Medicine 2008;17(9):917-920
Objective To investigate the effect of carbachol on local gut inflammation during entetal resuscitation of rats with bum shock. Method Thirty-eight Wistar rats were subjected to 35%TBSA full thickness scald injury, and enteral fluid was infused into animal intestines via duodenal stomas 30 minutes post bum. The animals were randomly divided into four groups: no resuscitation (Control, n = 8), enteral resuscitation using either a glucose electrolyte solution (GES, n = 10) or GES plus carbachol (60 μg·kg-1,GES/CAR, n = 10), or carbachol alone (CAR, n = 10) .The volumeof GES infusion was based on the Parkland formula (4 ml· 1% TB-SA-1·Kg-1) - All animals were sacrificed 4 hours post bum, and specimens of jejunal tissue were collected to determine the levels of tumor necrosis factor (TNF)-α, nitric oxide (NO), nitric oxide synthase (NOS) and myeloperoxidase (MPO). Serum assays for plasma diamine oxidase (DAO) activities were also performed. Results There were no statistical differences in the intestinal levels of NOS, NO, TNF-α and MPO, and plasma OAO activities, between the GES group and the control group. Compared to the GES group, the GES/CAR group showed significantly lowered levels of intestinal NOS (1.276 ±0.391 vs. 1.818 ±0.436, P<0.05), NO (0.925 ±0.402 vs. 1.561 ±0.190, P < 0.05, TNF-α (0.87±0.13 vs. 1.94±0.47, P <0.01) and MPO (0.465 ±0.092 vs. 0.832±0.214, P<0.05),and reduction in plasma DAO activites (0.732±0.192 vs. 1.381 ±0.564, P <0.05). The CAR group also showed significantly lowered levels of intestinal NOS, NO, TNF-α and MPO and reduced plasma DAO activites, compared to the GES group. Conclusions Theses results suggest that carbachol significantly inhibits the release of proinflammatory mediator and attenuates local inflammation in gut during enteral fluid resuscitation of rats in rats with bum shock. We postulate that carbachol may exert its and-inflammatory effects via the cholinergic anti-inflammatory pathway.
9.Development of animal model of early oral fluid resuscitation of burn shock
Jinwei CHE ; Sen HU ; Shijia GENG ; Jing WU ; Ying DU ; Guoqiang WANG ; Zhiyong SHENG
Chinese Journal of Trauma 2009;25(3):259-263
Objective To establish an animal model for study on early oral fluid resuscitation of burn shock so as to provide experimental basis for oral fluid resuscitation of burn shock in wars, accidents or disasters. Methods Male Beagle dogs weighing 11-13 kg were used in the study and the carotis, jugular and duodenum were cannulated respectively for measurement of homodynamics, tissue perfusion and gastrointestinal function. Dogs were subjected to a 35% TBSA full thickness flame injury with 10-mi-nute anesthesia by intravenous injection of propofol 24 hours later, and then randomly and equally divided into two groups(8 dogs in each group) : no fluid resuscitation group (NR group) undergoing no treatment in the first 24 hours post burn and oral fluid resuscitation group ( OR group) undergoing gastric infusion of glucose electrolyte solution (GES) according to Parkland formula. From the second 24 hours post burn, animals in two groups were given delayed Ⅳ fluid resuscitation, and then intravenous nutritional support was initiated at the 72nd hour. The mean arterial pressures (MAP), cardiac output (CO), dp/dt max of left ventricular contractility (dp/dtmax) and plasma volume (PV) were monitored continuously. The pa-rameters of gastrointestinal tissue peffusion, the rates of gastric emptying and intestinal absorption of GES were determined, the morbidity was also recorded at the end of 5-day experiment. Results After 35% TBSA burn injury, MAP, CO,dp/dt max and PV dropped markedly and gastrointestinal tissue perfusion reduced obviously. CO and PV in OR group were significantly higher than those in NG group at 4, 8 and 24 hours after burn. Homodynamic parameters and gastrointestinal tissue perfusion in OR group were pro-moted to pre-injury level at 48 and 72 hours respectively, while homodynamic parameters in NR group did not return to pre-injury level till 72 hours, and gastrointestinal tissue perfusion kept lower than pre-injury till 120 hours post burn. Rates of gastric emptying and intestinal absorption of GES significantly reduced to the lowest level (42% and 37% of pre-injury) at about 4 hours post bum, but did not return to pre-in-jury level till eight hours post bum. Over five days, two out of eight dogs (25%) died in NG group but none in OR group. Conclusions The animal model can exactly simulate the actual circumstance, where oral resuscitation is superior to Ⅳ resuscitation in some aspects in treating early bum shock in wars, accidents and disasters, and provide practical and reliable method for measurement of homodynamic parameters, tissue perfusion, gastric emptying and intestinal absorptive function.
10.Clinical selection of surgical methods for pure stenosis at the end of common bile duct: a report of 43 cases
Jiaqi LI ; Sen LI ; Futian DU ; Guanyi ZHUANG ; Chunyou LI ; Chengwei DONG ; Yulin GUO
Chinese Journal of Hepatobiliary Surgery 2010;16(11):820-822
Objective To explore the clinical selection of surgical methods for pure stenosis at the end of the common bile duct.Methods The clinical data of 43 cases of pure stenosis at the end of the common bile duct treated in this hospital from October 2003 to June 2009 were retrospectively analyzed.Of the 43 cases, 12 underwent endoscopic sphincterotomy(EST), 9 sphincteroplasty of Oddi, 5 pancreaticoduodenectomy,8 Roux-en-y choledochojejunostomy and 5 choledocoduodenostomy,4 underwent drainage of the T tube after exploration of the biliary passage.Results Among 37 patients did not undergo the radical pancreaticoduodenectomy,6 had space-occupying lesions 5-19 months postoperatively.Five of them received pancreaticoduodenectomy again.Conclusion Pure stenosis at the end of the common bile duct should be carefully managed.