1.Quantitative evaluation of liver function by liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI
Shuangshuang XIE ; Qian JI ; Wen SHEN
Chinese Journal of Hepatobiliary Surgery 2014;20(8):553-556
Objective To investigate the utilization of liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for liver function evaluation.Methods Fifty-five patients who received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed.Images were obtained before injection and in hepatobiliary phase (5,10,and 20 minutes after Gd-EOB-DTPA injection).The patients were assigned into two subgroups according to individual liver function (n =35 in Group 1:normal liver and Child-Pugh class A; n =20 in Group 2:Child-Pugh class B and C).The relative liver enhancement (RE) was calculated at different time point.The general data (age,sex) and relevant laboratory results were recorded.Independent sample t-test was conducted to compare the RE between two groups at different time point.ROC curve was used to determine the best time point and RE threshold that can reflect the differences between two groups.Univariate analyses was performed to analyze the relationship between RE at the best time point and laboratory results.Multivariate analyses was performed to screen the independent influencing factor for RE at the best time point.Results The differences of RE between two groups were statistically significant at all time points (P < 0.0001).10 minutes was the best time point for detecting the differences of liver function between two groups.When an RE cutoff value (> 1.52) was applied,normal or Child-Pugh class A could be predicted with sensitivity of 74.3% and specificity of 90%.RE at the best time point was significantly related with total serum bilirubin level (TBil),serum albumin level (Alb) and prothrombin time (PT).And TBil was an independent influencing factor.Conclusion RE can be used to evaluate the liver function,and 10 minutes is the best time point that can be used to differentiate patients with normal or mild liver damage from those with moderate or severe liver damage.
2.Relationship between liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI and liver function
Shuangshuang XIE ; Qian JI ; Jiancun HOU ; Yamin ZHANG ; Wen SHEN
Chinese Journal of Radiology 2014;48(8):655-658
Objective To evaluate the effect of liver function on liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI.Methods Sixty-seven patients who suffered from cirrhosis and received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed,and divided into three subgroups according to ChildPugh score(45 patients in group A,20 in group B,5 in group C).All the individuals of both groups had MRI before injection,and hepatobiliary phase images were obtained at 5,10,and 20 minutes after bolus administration of Gd-EOB-DTPA.The relative enhancement(RE) was calculated by dividing the signal intensity of liver(SI) at t min after injection(SIt) by precontrast SI(SI0).The total serum bilirubin level(TB),serum albumin level(Alb) and prothrombin time(PT) were recorded.The one-way ANOVA was used to compare the RE among three groups at 5,10 and 20 minutes.SNK was used for further pairwise comparison.The effect of liver function on RE was assessed with the generalized linear model.Pearson correlation coefficients were measured between each biochemical test result(TB,Alb,PT) and RE at different time points.Results The RE at 5,10 and 20 minutes were 1.59±0.20,1.65±0.22,1.69±0.25 of group A; 1.47± 0.14,1.48±0.18,1.50±0.22 of group B,1.35±0.07,1.27±0.06,1.26±0.06 of group C.There were statistically significant differences of RE among groups at 5,10 and 20 minutes(F=5.854,11.207,9.666,P<0.01).Statistically pairwise comparison differences of RE were found between group A and C at 5,10 and 20 minutes(P<0.01),between B and C at 10 and 20 minutes(P<0.05),between A and B at 10 minutes(P< 0.05).There were statistically significant differences of TB,Alb and PT among groups(P<0.01).RE at 10 and 20 minutes had moderate negative correlation with TB(r=-0.483,-0.500; P<0.01),low negative correlation with PT(r=-0.326,-0.351;P<0.01) and weak positive correlation with Alb(r=0.290,0.292;P<0.05).Conclusions There are differences of RE among patients with different liver function,and the RE is associated with TB,Alb and PT.Thus,it may allow us to estimate the liver function.
3.Practice and experiences on clinical pharmacy of TCM
Tanjun WEI ; Xiaoqun XIE ; Shuangshuang WANG ; Ping ZHOU ; Yi WANG
International Journal of Traditional Chinese Medicine 2014;(8):741-743
By retrospective analysis method, the paper was summarized experience of clinical pharmacy of TCM. The purpose of the paper was given location of clinical pharmacists in Traditional Chinese Medicine(TCM), to clear their main status and functions, seek methods and ways to solve the problems in the process of work. The work was proceeding orderly. Good results have been achieved. The clinical pharmacists of TCM participate in clinical rational use of drugs to change the service mode ofindirect service for the patients in the past with the patients, doctors and nurses so as to make better service for people's life and health of Chinese medicine.
4.The impact of nucleos(t)ide analogue antiviral therapy on anxiety and depression of patients with chronic hepatitis B
Shuangshuang XIE ; Qiang LI ; Xia YANG ; Wenbo FAN ; Jinhong YU ; Li LIU ; Wenwen LI ; Shijun CHEN
Chinese Journal of Infectious Diseases 2011;29(12):723-728
Objective To explore the impact of nucleos(t)ide analogue antiviral therapy on anxiety and depression of patients with chronic hepatitis B (CHB),and analyze the related factors.Methods Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,120 CHB patients were investigated with self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The demography data of patients were collected.Serum levels of alanine transaminase (ALT) and hepatitis B virus (HBV) DNA and other biochemical indicators were measured regularly.Results Before nucleos(t)ide analogue antiviral therapy,1 year and 2 years after antiviral therapy,both the mean scores of SAS and SDS became lower gradually (F=12.661 and 22.395,respectively;both P<0.01).The percentage of patients with SAS and SDS scores more than 50 were 5.8%,4.2%,1.7% and 13.3%,7.5%,5.0%,respectively.After 2 years of therapy,the anxiety improvement rate of the patients obtained HBV DNA<1000 copy/mL was 69.0%,while those with HBV DNA≥1000 copy/mL was 22.2% (x2 =22.325,P<0.01).Meanwhile,after 2 years of therapy,the depression improvement rate of the patients obtained HBV DNA<1000 copy/mL was 77.4%,while those with HBV DNA≥1000 copy/mL was 22.2% (x2 =32.179,P<0.01).Multiple factors Logistic regression analysis indicated that the odds ratios (OR) of improvement of anxiety and depression in patients with HBV DNA<1000 copy/mL were 7.751 (95% CI:3.026-19.853) and 15.069(95% CI:5.309-42.770),respectively,compared with those with HBV DNA≥1000 copy/mL; and OR of improvement of depression in patients with ALT≤40 U/L waa 4.103 (95% CI: 1.376 - 12.238).Conclusions Nucleos(t) ide analogue antiviral therapy could improve the anxiety and depression of CHB patients.The HBV DNA negativity is the independent impact factor of improvement of anxiety and depression in CHB the patients.
5.The value of arterial spin labeling MRI for evaluating early renal allograft function
Tao REN ; Chenglong WEN ; Lihua CHEN ; Shuangshuang XIE ; Lixiang HUANG ; Zhen WANG ; Jianzhong YIN ; Wen SHEN
Chinese Journal of Radiology 2016;50(3):165-169
Objective To assess the value of arterial spin labeling(ASL) MRI in the staging of early renal allograft function. Methods Sixty two renal allograft recipients (2 to 4 weeks after kidney transplantation) and 20 age match volunteers were included in this study. All subjects underwent conventional MRI and ASL MRI which was performed in the oblique-sagittal plane. Recipients were divided into two groups according to the estimated glomerular filtration rate (eGFR), recipients with good allograft function (eGFR≥60 ml · min-1 · 1.73 m-2,n=37) and recipients with impaired allograft function (eGFR<60 ml · min - 1 · 1.73 m - 2,n=25). Renal blood flow (RBF) was measured and an intra-class correlation coefficient (ICC) was calculated to confirm the reproducibility of the measured results from two doctors. One-way analysis of variance (ANOVA) and Bonferroni were used to compare the different cortical RBF among three groups. Correlation of RBF with eGFR was evaluated using Pearson correlation coefficients. The receiver operating characteristic (ROC) curve was performed to assess the diagnostic efficacy of using cortical RBF to discriminate allografts with impaired function from good function. Results RBF values showed good reproducibility between doctors with an ICC larger than 0.90 in different group. Mean cortical RBF were (390 ± 61),(290 ± 69),(201 ± 86) ml · 100 g-1 · min-1 for healthy controls, recipients with good and impaired allograft function, respectively(F=37.313,P<0.01). RBF exhibited a significant correlation with renal function as determined by eGFR for recipients (r=0.60,P<0.01). Mean cortical RBF showed a high area under the ROC curve (0.773) to discriminate renal allografts with different function, with a sensitivity of 56.0% (14/25) and a specificity of 89.2% (33/37). Conclusion ASL MRI can assess the early renal allografts perfusion, and provide valuable information in the staging of renal function. It could be a useful method for evaluating renal function noninvasively.
6.Relationship between neurogenesis in the brains of adult organisms and the neurodegenerative disease
Tan ZHANG ; Ruogu PAN ; Chengyi ZHANG ; Yangyang ZHOU ; Mingqi XIE ; Shuangshuang QI ; Chenyou SUN
Basic & Clinical Medicine 2015;(10):1401-1405
It is very common that the number of neurons in the brain is progressively decreasing in the neurodegen-erative diseases such as Alzheimer’s disease, Parkinson’s disease and Huntington’s disease, etc.Moreover, it is much more important that there is a decline in the neurogenesis of adult brain in such neurodegenerative diseases. In treating neurodegenerative diseases, it is a potential therapeutic modality to promote endogenous neurogenesis in the brain.
7.Applied value of 3.0T blood oxygen level dependent (BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury (WIRI) in rabbits
Shichao XU ; Zhiqiang CHU ; Tao REN ; Shuangshuang XIE ; Zhijun TAN ; Qian JI
Chinese Journal of Organ Transplantation 2016;37(2):112-116
Objective To investigate the applied value of 3.0T blood oxygen level dependent(BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury (WIRI) in rabbits.Method Twenty healthy adult New Zealand white rabbits were randomly divided into two groups by using the stochastic indicator method.In 10 rabbits enrolled in the treatment group,the model of hepatic WIRI after ischemia for 30 min followed by 6-h reperfusion was established,and the remaining 10 rabbits were chosen as the normal control group and were not subjected to any surgery.All the experimental rabbits were scanned by 3.0T MRI and BOLD MRI.T2* values were separatelymeasured by 2 considered radiologists and the R2* values were calculated (R2* =1/T2*).Thereafter,the intra-class correlation coefficient (ICC) was used to check the consistency.All rabbits were killed after MR examination and routine assays were performed for testing the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and lactate dehydrogenase (LDH) in the ear vein blood serum.The contents of total superoxide dismutase (SOD),malondialdehyde (MDA) and myeloperoxidase (MPO) in liver tissues were determined,and histopathological changes were examined.The correlation between R2 * value and clinical test index was evaluated by Spearman correlation analysis.The R2* value was evaluated by ROC curve.Result ICC =0.87 > 0.75,suggesting that the repeatability of the outcome is good.Compared to the normal control group,R2*value of the warm ischemia-reperfusion injury group was increased (P =0.000).The differences in ALT,AST,LDH,total SOD,MDA and MPO between the two groups were statistically significant (P<0.01).R2* values were significantly positively correlated with ALT,AST,LDH,MDA and MPO (r>0.6,P<0.05),and there was a significantly negative correlation between R2* and total SOD (r=-0.663,P=0.001).The R2* value could efficiently diagnose rabbit hepatic WIRI (AUC =0.99) with the best diagnostic threshold being 116.40 Hz.Conclusion 3.0T BOLD MRI can accurately and non-invasively assess the pathophysiologic changes caused by WIRI.It is of great importance for 3.0T BOLD MRI in dynamically monitoring and evaluating hepatic WIRI.
8.Quality of life in patients with obstructive hypertrophic cardiomyopathy after percutaneous transluminal septal tunnel myocardial ablation and its influencing factors in a short time
He WANG ; Huaimin GUAN ; Jinhong XIE ; Yushan CHEN ; Minghua LUO ; Shuangshuang CHAI
The Journal of Practical Medicine 2014;(9):1398-1400
Objective To observe the short-term quality of life in patients with obstructive hypertrophic cardiomyopathy (OHCM) after percutaneous transluminal septal tunnel myocardial ablation (PTSTMA). Methods The quality of life in patients with OHCM were assessed by the SF-36 before and three months after PTSTMA. Results Three months after the procedure , quality of life was markedly improved at different variances in patients with OHCM as compared with the baseline. The linear regression analysis showed the factors influencing quality of life were character, coexistence with other diseases, and 6-minute walk test. Conclusions Percutaneous transluminal septal tunnel myocardial ablation can improve the short-term quality of life in patients with OHCM. Postoperative psychological counseling and rehabilitation guidance can practically enhance quality of life.
9.Aterial Spin Labeling Evaluation of Residual Renal Function After Partial Nephrectomy on Renal Cell Carcinoma
Chenglong WEN ; Tao REN ; Lihua CHEN ; Lixiang HUANG ; Shuangshuang XIE ; Chao CHAI ; Qian LIU ; Wen SHEN
Chinese Journal of Medical Imaging 2017;25(7):555-558
Purpose To investigate the value of arterial spin labeling (ASL) in evaluating renal function in patients with renal cell carcinoma (RCC) after laparoscopic partial nephrectomy.Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively.The patients were performed ASL scan one week before and three months after operation.The correlation between renal blood flow (RBF) value measured by ASL and the glomerular filtration rate (GFR) measured by radionuclide method in the renal cortex of healthy side was analyzed.The RBF values in the kidney of affected side or healthy side were measured,the difference of which between before operation and three months after operation was compared.Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation (r=0.638,P<0.05).In the affected side of kidney,the RBF value of remaining renal tissue [(291.5 ± 37.3) ml/(100g·min)] compared with that of preoperative renal tissue [(237.8 ± 46.2) ml/(100g·min)]increased about 53.7 ml/(100g · min) (P<0.05).In the healthy side of kidney,the RBF value of renal tissue [(241.1 ± 50.3) ml/(100 g · min)] compared with that of preoperative renal tissue [(290.4 ± 51.8) ml/(100 g·min)] decreased about 49.3 ml/(100 g·min) (P<0.05).Conclusion ASL can be used to evaluate renal function,and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.
10.Assessment of early renal allograft function after transplantation using renal intravoxel incoherent motion imaging and T1 mapping
Lihua CHEN ; Tao REN ; Chenglong WEN ; Shuangshuang XIE ; Lixiang HUANG ; Yingxin FU ; Zhen WANG ; Jianzhong YIN ; Wen SHEN
Chinese Journal of Radiology 2016;50(10):762-767
Objectives To investigate the ability of T1 mapping and intravoxel incoherent motion imaging (IVIM) parameters for evaluating renal allografts at the early stage after renal transplantation. Methods This prospective study protocol was approved by the local ethics committee, and written informed consent was obtained from all subjects. Sixty two recipients 2 to 4 weeks after kidney transplantation and 20 healthy volunteers (control group) underwent routine MRI, T1 mapping, and IVIM imaging (11 b values, 0 to 700 s/mm2). Recipients were divided into two groups base on their estimated glomerular filtration rate (eGFR):37 recipients with good allograft function (eGFR≥60 ml·min-1·1.73 m-2) and 25 recipients with impaired allograft function (eGFR<60 ml·min-1·1.73 m-2). The ADC, true diffusion coefficient (ADCslow), pseudo-diffusion coefficient (ADCfast), perfusion fraction (f) and T1 values were measured on both cortex and medulla. Differences among groups were compared using the one-way analysis of variance. Correlations between eGFR and the parameters in renal allografts were assessed by using Pearson correlation analysis. ROC was performed to assess the diagnostic utilities of using these parameters to discriminate allografts with impaired function from good function. Results Excepting for cortical T1, ADCfast and medullary T1, f values, allografts with good function showed no differences in other parameters compared with healthy control. Excepting for medullary T1 and ADCfast,the other values showed significantly differences in allografts with impaired function compared to allografts with good function (all P<0.05). Excepting for medullary f and ADCfast values, allografts with impaired function showed significantly differences in the parameters compared with good function group(all P<0.05). In renal allografts, excepting for medullary T1, ADCfast, and f values, cortical T1 exhibited a negative correlation with renal function, and there was a significant positive correlation between eGFR and other parameters. Cortical T1 value showed high sensitivity(91.9%) to discriminate renal allografts with different function, with the threshold of 17.36 × 102 ms, and ADC value showed high specificity(96.0%)with the threshold of 1.98 × 10-3 mm2/s. Conclusion T1 mapping and IVIM technique may be useful for detecting renal allograft dysfunction, and be a reliable imaging for evaluating and monitoring allograft function.