1.Effect of gravity and lung volume on MR perfusion imaging of human lung
Li FAN ; Shiyuan LIU ; Fei SUN ; Xiangsheng XIAO ; Xueyuan XU
Chinese Journal of Radiology 2008;42(4):377-381
Objective To investigate the effect of gravity and lung volume on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).MethodsMagnetic resonance imaging of lung perfusion was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner(GE medical system).Five sequentially coronal slices with the gap of 3cm from dorsal to ventral(labeled as P3,P6,P9,P12,P15,respeectivly)were obtained on end respiration and the relative pulmonary blood flow(rPBF)was measured.Another coronal perfusion-weighted image of P3 slice was obtained on end inspiration.Tagging efficiency of pulmonary parenchyma with IR(⊿SI%),the rPBF and area of the P3 slice were analyzed.respectively.Paired Student's t test was used for statistical analysis.Results(1)In the direction of gravity,an increase in rPBF of the gravity-dependent lung was found.rPBF of right lung from dorsal to ventral were 100.57±18.22,79.57±12.36,61.65±11.15,48.92±9.96,41.20±9.88,respectively;and that of left lung were 106.61±26.99,78.89±11.98,64.00±13.64,51.27±8.95,43.04±12.18.No statistical differences between P12 and P15,there were significant statistic differences of any other two coronal planes.But along an isogravitational plane,no statistical difference was observed.Regression coefficients of right and left lung were -4.98 and -5.16,respectively.This means the rPBF of right lung falls by 4.98 for each centimeter above the dorsal and that of left lung falls by 5.16.(2)For(⊿)SI%,rPBF and area,there were significant statistic differences at different respiratory phases(P<0.05).(⊿)SI%,rPBF,area at expiration phase vs.inspiration phase were 1.12±0.31 vs 0.71±0.18,90.78±17.35 vs 52.85±8.75,(12.59±3.23)×103mm2 vs (17.77±4.24)×103mm2 for right lung;and 1.01±0.24 vs 0.70±0.11,91.08±18.68 vs 54.58±10.70,(12.34±3.08)×103mm2 vs(17.34±4.98)×103mm2 for left lung.Greater (⊿)SI%and increased perfusion were observed on end expiration than on end inspiration.The area was larger on end inspiration than on end expiration.ConclusionsThe FAIR is sensitive to perfusion changes in the gravity-dependent lung.Pulmonary blood flow is less in a state of high lung inflation than in a low state(inspiration vs.expiration).Positioning the patient so that the area of interest is down-gravity and breath-hold on end expiration may improve visibility of perfusion defects.
2.Influence of lung inflation on arterial spin labeling signal in MR perfusion imaging of human lungs
Li FAN ; Shiyuan LIU ; Xiangsheng XIAO ; Xueyuan XU
Academic Journal of Second Military Medical University 2000;0(11):-
Objective:To investigate the influence of lung inflation on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).Methods:Coronal perfusion-weighted images were obtained at different respiratory phases from 10 healthy volunteers on a 1.5T whole body scanner(GE medical system)using FAIR sequence.The changes of tagging efficiency of pulmonary parenchyma(?SI %),pulmonary blood flow and area of the scanning slice of different respiratory phases were analyzed.Results:(1)Significant difference was found in ?SI% between different respiratory phases(right lung P=0.021 5,left lung P=0.008 4),with that at end expiration greater than that at end inspiration.(2)Significant difference was also found in pulmonary blood flow at different respiratory phases(right lung P=8.92?10-5,left lung P=0.000 2),with that at end expiration higher than that at end inspiration.(3)The areas of the scanning slice were also significantly different at different respiratory phases(right lung P=2.94?10-5,left lung P=0.000 5),with that at end inspiration larger than that at end expiration.Conclusion:Pulmonary blood flow during expiration is higher than that during inspiration,which might be due to the decreased lung volume and increased vascular density during expiration.
3.Comparative analysis of radiotherapy and 89Sr radionuclide therapy in the treatment of cervical metastatic cancer pain
Qi YANG ; Jianqiang WANG ; Fan ZHOU ; Xueyuan FAN ; Liqiang ZHONG ; Yuming JIA
Chinese Journal of Biochemical Pharmaceutics 2017;37(9):436-437
Objective To compare the effect of 89Sr radionuclide therapy and radiotherapy in the treatment of metastatic cancer pain of vertebral column. Methods 80 patients with cancer pain of vertebral metastasis in the second People's hospital of Yibin from April 2015 to April 2017, were randomly divided into the control group treated by radiotherapy treatment (n=40) and the the observation group treated by 89Sr radionuclide therapy(n=40), and the effect of treatment were compared between two groups. Results In the observation group, the total effective rate of pain response in patients with metastatic cancer pain of vertebral column was 85.0%, and the control group was 82.5%. There was no significant difference between two groups. The onset time of treatment in the observation group was (6.5±1.7)d, significantly shorter than that of the control group (12.9±2.6)d, and the difference was statistically significance (P<0.05). Conclusion The application of 89Sr radionuclide therapy in the treatment of vertebral metastatic pain is equivalent to the radiotherapy in improving the pain response, but the efficacy could be achieved in a short period of time, so it is worth popularizing widely in clinical practice.
4.Proton magnetic resonance spectroscopy of brain metabolism after traumatic axonal injury in rats
Xueyuan LI ; Jianqi LI ; Dongfu FENG ; Jia LI ; Mingxia FAN ; Mengchao PEI ; Lei GU ; Weiwei MEN
Chinese Journal of Trauma 2011;27(3):213-217
Objective To investigate the brain metabolic changes and evaluate their spatial distributions after traumatic axonal injury (TAI)in rats by using proton magnetic resonance spectroscopy(1H-MRS).Methods The TAI model was made by subjecting the head of the rats to the linear and angular accelerations.The multi-voxel MRS was employed to detect the tissue metabolic state at the levels of hippocampus-caudate and pons prior to injury and at 24 hours after injury.The alterations of NAA/Cr,NAA/Cho and Cho/Cr values as well as the spatial distribution of NAA/Cr reduction were accessed. Immunohistochemical staining for β-APP was used to observe the injured axons. Results A siguificantdecrease in NAA/Cr and NAA/Cho(P<0.05)and subtle increase in Cho/Cr(P>0.05)were observed in rats at 24 hours after TAI in comparison to the pre-injury levels.Notable decrease in NAA/Cr value was observed in the areas including the brain stem,hippocampus,internal capsule,corpus callosum and thalamus,where axonal injuries were confirmed by the histological examination. Conclusion Metabolic imbalances Occur in the brains of rats with TAI.with notable changes in the brain stem and the hippocampus.
5.Treatment of Eczema and Neurodermatitis with 0.1% Mometasone Furoate Cream: A Multi-Center Clinical Trial
Xueyuan YANG ; Zijia HU ; Zhigang BI ; Jun GU ; Weixin FAN ; Sefeng WANG ; Hao YU ; Donghua LOU
Chinese Journal of Dermatology 1995;0(01):-
Objective To observe the clinical efficacy and safety of 0.1% mometasone furoate cream in the topical treatment of eczematous dermatoses including neurodermatitis and eczema. Methods A randomized double-blind parallel controlled clinical trial was conducted. The home made mometasone furoate cream or imported Eloson cream was topically used in patients with such dermatoses once daily for 4 weeks, respectively. Symptom/sign scores were evaluated at the beginning of the treatment and at the 1st, 2nd, 3rd, 4th week after the initiation of the treatment. Results Two hundred and eighty-four patients were enrolled in the trial, including 143 patients with eczema and 141 patients with neurodermatitis. There are 142 patients each in test group and control group separately. All symptom/sign scores and total scores were significantly decreased 1, 2, 3, and 4 week after the treatment. No statistically significant difference was observed between the two groups. The cure rate and improvement rate in eczema patients were 78.87% and 97.18% in the test group; 84.51% and 92.96% in the control group; respectively. While the cure rate and improvement rate in neurodermatitis patients were 75.71% and 100% in the test group; 80.28% and 94.37% in the control group; respectively. The cure rate and improvement rate of total patients were 77.30% and 98.58% in the test group; 82.39% and 93.64% in the control group; respectively. No statistically significant difference in efficacy was observed between the two groups. There was no severe side effect in the two groups. One patient had mild contact dermatitis in the test group. Conclusions These results suggest that 0.1% mometasone furoate cream is an effective and safe drug in the treatment of neurodermatitis and eczema.
6.The influence of renal insufficiency on the prognosis of acute myocardial infarction patients with metabolic syndrome
Yuan GAO ; Liang GUO ; Xueyuan LI ; Haishan ZHANG ; Dandan FAN ; Guoxian QI ; Yingxian SUN
The Journal of Practical Medicine 2015;31(14):2303-2306
Objective To evaluate the influence of renal insufficiency (RI) on long-term major adverse cardiac events (MACE) of patients with acute myocardial infarction (AMI) plus metabolic syndrome (MetS) and received percutaneous coronary intervention (PCI). Methods This was a retrospective study. From February, 2011 to Octorber, 2013 , we consecutivly enrolled 223 AMI patients with MetS in the First Affiliated Hospital of China Medical University. There were 88 patients with RI in group A, and 135 patients as the control group (group B). Patients were followed up for major adverse cardiac events (MACE) for 1 year. Results Compared with group B, the incidence of 1-year MACE of patients in group A was increased (36.4% vs. 18.5%, P= 0.003). Result of Cox proportional hazard regression analysis showed that RI was a predictive factor for 1-year MACE (HR = 3.56,95%CI 1.004 ~ 4.170, P = 0.002). Conclusion The incidence of 1-year MACE for AMI patients with RI and MetS post-PCI was high. RI was a risk factor for poor prognosis of AMI patients with MetS.
7.Risk factors of hemodynamic instability after carotid artery stenting in elderly patients
Xueyuan YU ; Chunmei WANG ; Fan ZHANG ; Ying HUANG ; Bin YAN ; Yachan NING ; Jinming YANG ; Lianrui GUO
International Journal of Surgery 2021;48(9):622-626
Objective:To investigate the risk factors related to the hemodynamic instability occurring after carotid artery stenting(CAS) in elderly patients with carotid artery stenosis.Methods:The clinical data of 80 patients with carotid artery stenosis, who were treated with CAS at Xuanwu Hospital, Capital Medical University during the period from January 2018 to Decmber 2018, were retrospectively analyzed. Record demographic characteristics (age, gender, height, weight), history of underlying diseases (hypertension, diabetes, kidney disease, heart failure, etc.), history of medications, etc. Observe the clinical parameters such as creatinine, blood urea nitrogen (BUN), urine volume, input and output, albumin, hemoglobin, location of stenosis, and degree of stenosis. Measurement data conforming to the normal distribution were expressed as the mean ± standard deviation ( Mean± SD), and the t-test was used for comparison between groups; the measurement data that does not conform to the normal distribution were expressed as the median (interquartile range) [ M( P25, P75)] indicates that the rank sum test was used for comparison between groups; the Chi-square test was used for comparison of count data between groups. Relevant variables were subjected to single factor analysis, and statistically significant indicators were selected according to the results of single factor analysis to be included in the multivariate Logistic regression analysis. Results:After CAS, a total of 37 patients among the 80 patients developed hemodynamic instability, the incidence rate was 46.25%. Univariate analysis indicated that the factors associated with the occurrence of postoperative hemodynamic instability included height , platelet count, ulceration plaque and the fluid intake in the first 24 hours after surgery; Multivariate regression analysis revealed that the presence of ulceration plaque ( OR=11.559, 95% CI: 1.232-108.495) and the fluid intake in the first 24 hours after surgery( OR=1.001, 95% CI: 1.000-1.001) were the independent risk factors related to the hemodynamic instability after CAS. Conclusion:Elderly patients with the presence of ulceration plaque before surgery are more likely to develop hemodynamic instability after CAS, and within 24 hours after surgery is a high-risk time period for hemodynamic instability.
8.Risk factors of contrast-induced nephropathy after carotid artery stenting
Xueyuan YU ; Fan ZHANG ; Bin YAN ; Yachan NING ; Chunmei WANG ; Lianrui GUO
International Journal of Surgery 2023;50(3):180-184
Objective:To investigate the risk factors related to the contrast-induced nephropathy(CIN)occurring after carotid artery stenting(CAS)in patients with carotid artery stenosis.Methods:The clinical data of 137 patients with carotid artery stenosis, who were treated with CAS at Xuanwu Hospital, Capital Medical University during the period from January to Decmber 2021 were retrospectively analyzed. Record demographic characteristics (age, gender, height, weight), history of underlying diseases (hypertension, diabetes, kidney disease, etc.), history of medications, etc. Observe the clinical parameters such as creatinine, blood urea nitrogen, albumin, hemoglobin, hematocrit, degree of stenosis and estimated glomerular filtration rate (eGFR). Measurement data conforming to the normal distribution were expressed as the mean±standard deviation( ± s), and the t-test was used for comparison between groups; the measurement data that does not conform to the normal distribution were expressed as the median (interquartile range) [ M( Q1, Q3)], and the Rank-sum test was used for comparison between groups; the Chi-square test or Fisher exact test was used for comparison of count data between groups. Relevant variables were subjected to univariate analysis, and statistically significant indicators were selected according to the results of univariate analysis to be included in the multivariate Logistic regression analysis. Results:After CAS, a total of 29 patients (21.2%) among the 137 patients developed CIN. Univariate analysis indicated that bilateral carotid artery stenosis, uncontrolled hypertension before surgery, history of angiotensin converting enzyme inhibitor drugs, diabetes mellitus, history of insulin drugs, eGFR<45 mL/(min·1.73 m 2), body weight were the influencing factors associated with the occurrence of CIN after CAS in patients with carotid artery stenting; multivariate regression analysis revealed that the presence of bilateral carotid artery stenosis( OR=4.724, 95% CI: 1.455-15.338, P=0.010), diabetes mellitus( OR=3.451, 95% CI: 1.345-8.858, P=0.010) and eGFR <45 mL/(min·1.73 m 2)( OR=4.582, 95% CI: 1.001-20.971, P=0.050) were the independent risk factors related to the CIN after CAS. Conclusion:Patients with the presence of bilateral carotid artery stenosis, diabetes mellitus or eGFR <45 mL/(min·1.73 m 2) are more likely to develop CIN after CAS.