Objective To evaluate the value of 18F-FDG PET/CT in assessing radiosensitivity enhancement by irisquinone (IR) on rabbit xenografted VX2 lung tumor models.Methods Twenty-four tumor-beating rabbits were randomly divided into 3 groups (8 rabbits/group):group A with radiotherapy alone,group B with combined radiotherapy and IR,and group C without radiotherapy (the control group).18F-FDG PET/CT imaging was performed before radiotherapy and 24 h and one week after radiotherapy.The tumor SUVmax on delayed imaging was calculated in all rabbits.Two rabbits in each group were sacrificed after PET/CT imaging.HE staining was used to assess the differences in cancer cells among groups.Paired t test,one-way analysis of variance and Kaplan-Meier analysis were performed to analyze the data using SPSS 13.0.Results Before radiotherapy,the tumor SUVmax of all the 24 rabbits on standard and delayed imaging were 2.200 ± 0.761 and 3.162 ± 0.833 (t =-5.582,P ＜ 0.01).At 24 h post-radiotherapy,the delayed SUVmax of groups A,B and C were 2.614 ± 0.654,2.349 ± 0.869 and 5.663 ± 1.144,respectively.The differences between pre-radiotherapy and 24 h post-radiotherapy were statistically significant in all three groups (t =2.527,3.620,11.011,all P ＜0.05).One week after radiotherapy,the delayed SUVmax of groups A,B and C were 3.625 ± 1.064,3.058 ±0.850 and 7.424 ± 1.751,respectively.The differences among groups A,B and C were statistically significant (tA∶ B =2.652,tA∶C =3.799,tB∶C =4.366,all P ＜0.05).The cancer cells of group B were fewer than those of groups A and C by pathological findings,which was consistent with 18F-FDG PET/CT results.The survival times of groups A,B and C were (62.375 ±4.534),(69.000 ±4.660) and (54.125 ±5.276) d,respectively.Kaplan-Meier survival curves revealed better survival of group B as compared to groups A and C,respectively (Log-rank,x2 =7.355,16.943,both P ＜ 0.01).Conclusion 18 F-FDG PET/CT is able to evaluate the effect of irisquinone on tumor radiosensitivity enhancement.

Purpose To investigate 1H-MRS in differentiating intracranial lymphoma from tumor-like demyelinating lesions. Materials and Methods Thirty-three cases of intracranial lymphoma confirmed by pathology and 18 cases of tumor-like demyelinating lesions confirmed by pathology or clinic were recruited in this study. Imaging data including single-voxel (TE=144 ms) 1H-MRS was retrospective analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and lactate peak was visually categorized into 5 grades based on the ratio of Lip-Lac peak to the height of the Cr peak. 1H-MRS findings of the intracranial lymphoma and the tumor-like demyelinating lesions were compared. The differentiation of the two diseases diagnosed by 1H-MRS and conventional MR were evaluated by use of receiver operating characteristic curves. Results There were significant difference of Cho/Cr, Cho/NAA ratio and Lip-Lac peak level between the intracranial lymphoma and tumor-like demyelinating lesions (P<0.001). It was more likely to be intracranial lymphoma when Cho/Cr ratio was>2.56, Cho/NAA ratio was>1.71, and Lip-Lac peak grade was>3. Cho/Cr, Cho/NAA ratio and Lip-Lac peak grade were found higher in atypical intracranial lymphomas when compared with those of tumor-like demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was increased from 0.827 to 0.870 when Cho/NAA ratio was added for analysis in the 28 uncertain cases. Conclusion 1H-MRS has great clinical significance for differentiating intracranial lymphoma from tumor-like demyelinating lesions. The values of Cho/Cr ratio>2.56, Cho/NAA ratio>1.71 and Lip-Lac grade >3 suggest intracranial lymphoma rather than TDLs. When the conventional MR imaging features can not do the differentiation, Cho/NAA ratio is a useful complement.

Objective To investigate the mechanism of bone morphogenetic protein 4(BMP4) in the genesis of Barrett′s esophagus.Methods Human esophageal epithelial cell (HEEC) and MRC-5 were cultured.The effects of different concentration of BMP4 and different pH value of hydrochloric acid or glycocholic acid on the expression of caudal-related homeobox transcription factor 2(CDX2) in HEEC were detected by real time polymerase chain reaction.The effects of different pH value of hydrochloric acid or glycocholic acid on BMP4 expression in MRC-5 were also investigated.Independent sample t test was performed for statistical analysis.Results After HEEC stimulated by BMP4 at 0.1, 1.0, 10.0 and 100.0 ng/mL, the relative quantity expressions of CDX2 were 1.617±0.246, 2.489±0.455, 5.629±0.449 and 13.670±1.689, respectively, which were higher than those of control group (1.000±0.043, 1.029±0.094, 1.001±0.002 and 1.049±0.051, respectively), and the differences were statistically significant (t=2.47, 3.14, 10.31, 7.47;all P<0.05).After MRC-5 stimulated by acid at pH four or five, or glycocholic acid at pH four or five, the relative quantity expressions of BMP4 were 2.430±0.105, 2.394±0.145, 125.900±12.620 and 2.128±0.215, respectively, which were higher than those of control group(1.025±0.095, 0.999±0.007, 1.060±0.138 and 0.893±0.110,respectively), and the differences were statistically significant (t=9.94, 9.59, 9.89, 5.11;all P<0.01).Conclusion BMP4 can increase the expression of CDX2 in HEEC, which promote the genesis of Barrett′s esophagus.

OBJECTIVE: To investigate the effect of pre-amputation pain block on the N-methyl-D-aspartate receptor activation in the central nervous system of amputated rats, and the association between pre-amputation pain block and chronic amputation-related pain. METHODS: Thirty-six adult male SD rats were randomly assigned to an NA group (n=12), a PA group (n=12) and a PAB group (n=12). Group NA was intraplantarly injected saline l00 μL while group PA and group PAB were intraplantarly injected complete Freund adjuvant (CFA) 100 μL. The sciatic nerve of group NA and group PA were freed from surrounding tissue, and that of group PAB was blocked by bupivacaine under pentobarbital sodium anesthesia 5 days after the injection. Thermal withdrawal latency (TWL) was measured before and after the injection. All rats were amputated at the scheduled survival time. The expression of N-methyl-D-aspartate receptor (NR2B) was measured by immunohistochemistry in L4-6 of the spinal cord and the anterior cingulated cortex 7 days after the amputation procedure. RESULTS: The TWL after intraplantar administration of CFA in group PA and group PAB decreased significantly compared with the baseline value (P<0.05), while the saline treated control group remained unchanged. Besides the basic value, the TWL of group PA was shorter than that of group NA at the above-mentioned time-points (P<0.05). Compared with the basic value and group NA, the TWL of group PAB after the block increased significantly (P<0.05). Compared with group NA and group PAB, group PA had a remarkably high expression of NR2B (P<0.05), while there was no difference between group PA and group PAB. CONCLUSION Pre-amputation pain may activate N-methyl-D-aspartate receptor of the central nervous system, which may lead acute postoperative pain to chronic pain. It is necessary to treat pre-amputation pain.
Amputation ; Animals ; Bupivacaine ; administration & dosage ; Freund's Adjuvant ; administration & dosage ; Gyrus Cinguli ; metabolism ; Male ; Nerve Block ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism ; Sciatic Nerve ; Spinal Cord ; metabolism

Objective To explore the clinical value of adaptive statistical iterative reconstruction(ASIR)combined with automatic tube current modulation in low dose scan of chest CT.Methods 80 patients who underwent chest CT scan were randomly divided into four groups,with a noise index(NI)of 14,16,18,and 20,respectively.Automatic tube current modulation technique for chest CT scan was adopted for all patients.The standard dose group,with a NI of 14,was reconstructed with FBP.While the low-dose groups,with a NI of 16,18 and 20,were reconstructed with four ASIR levels(20% ASIR,40% ASIR,60% ASIR and 80% ASIR) in each group.The volume CT dose index(CTDIvol),dose length product(DLP)and effective dose(ED)were recorded of the four groups.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated of the different reconstruction groups. Two radiologists with more than five years of work experience blindly scored the subjective image quality.Results Effective dose of the four groups with different NI were(3.29 ± 1.21)mSv,(3.10 ± 1.07)mSv,(2.20 ± 0.82)mSv and(1.97 ± 1.21)mSv,respectively. In all the reconstruction groups,when NI was constant,the greater the ASIR,the lower the SD.When ASIR percentage was constant, the SD was increased and the SNR was reduced along with NI rising up.When the parameters were set as NI 18 and ASIR 60%,the SD would be smaller and SNR would be higher than that of a standard dose group.In aspect of the scores from subjective image quality evaluation,there was no significant difference(P> 0.05).The average ED was decreased by about 33.2% when compared to the standard dose group.Conclusion Combining automatic tube current modulation with ASIR has a certain clinical practicality.When the NI is set at 18 and ASIR is 60%,the image quality can be optimal for not only satisfying the requirements of clinical diagnosis, but also reducing radiation dose in chest CT scanning.

Objective To re-evaluate the potential risk of small gastric stromal tumor ( diameter less than 2 cm), and to assess the safety and efficacy of endoscopic resection and further treatment strategy for small gastric stromal tumor. Methods Data of 584 patients undergoing endoscopic submucosal dissection ( ESD) and diagnosed as gastric submucosal tumor ( SMT) in Tianjin Medical University General Hospital from September 2008 to December 2015 were retrospectively analyzed. The clinical and pathological features and potential risk of small gastric stromal tumor were analyzed. The therapeutic outcomes, complications and follow-up results of ESD were summarized, and the follow-up results of patients undergoing ESD were compared with 45 patients who were suspected as small gastric stromal tumor and followed-up regularly by endoscopic ultrasonography ( EUS) in the same period. Results Among 584 cases of gastric SMT, stromal tumor ( 239 cases, 40. 9％) was the most common type, of which small gastric stromal tumor was found in 203 cases (84. 9％, 203/239). The mitotic index of all cases was no more than 5/50 high power field. However, adverse factors under EUS, mainly including strong echo and heterogeneity, were reported in 94 (46. 3％) out of 203 cases and were confirmed to be related to tumor size (P=0. 000). ESD was successfully performed in 203 patients with small gastric stromal tumor, and no serious complication or perioperative death occurred. Symptoms of 81. 4％ ( 144/177 ) patients were improved after ESD, and no stromal tumor recurrence or metastasis was observed during a follow-up of 12-84 months. Of the 45 patients followed-up regularly by EUS, 38 (84. 4％) patients had gastrointestinal symptoms and 84. 2％ (32/38) were not relieved during follow-up, and 12 (26. 7％) had a heavier psychological burden, seriously affecting the quality of life. Conclusion The incidence of adverse factors under EUS is high in patients with small gastric stromal tumor, and increased with tumor size. ESD is safe and effective for small gastric stromal tumor, which contributes to the diagnosis, further improves therapeutic effects and reduces psychological pressure.

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Objective:To explore the clinical, imaging manifestations, treatment methods and prognosis of primary angiosarcoma of longbone, with the aim of improving the diagnosis and treatment.Methods:During April 2014 to April 2018, 5 patients with histopathologically-proven primary angiosarcoma of longbone were enrolled in this retrospective study, clinicaland imagingcharacteristics wereanalysiaed. Thetreatment and follow-up results werediscussed.There were 3 males and 2 females; the age ranged from 27 to 79 years and an average age of 45.2±3.5 years. Theproximal humeruswas1case. Thedistal humeruswas1case.The proximalfemur was 2 cases.Thediatalfemur was 1case. Pathological fracturewas2case.According to the tumor site and the presence or absence of pathological fractures, lesion curettage and large-scale resection were taken separately. Adjuvant treatment was given according to the patient's condition after surgery. The length of the lesion wasmeasured and recorded. The X-ray, CT, MRI and nuclear medicine imaging features of the tumor and its characteristics were recorded and analyzed. The pathological characteristics of the tumor were recorded and analyzed. The treatment of the tumor and treatment effect and prognosis were analyzed.Results:The clinical manifestations of angiosarcoma of long bone are non-specific,local pain and swelling. The imaging manifestationsin X-ray, CT and MRI imaging have certain characteristics, such as osteolytic bone destruction in bone marrow cavity and/orcorti-calmostly,without scleroticrim, soft tissue mass, centripetal non-progressive filling and unevenenhancement or nodules gradual enhancement. The length of the tumor lesion is usually larger, the size is about 6.6±1.2 cm. The expression of CD31 and CD34 inosteoangio sarcoma lesions was higher, and the positiverate of ERG expression was about 100%. The survival time of 2 patients who underwent adjuvant chemotherapy after surgery was15 months, 37 months with median survival time was28 months. One patient who survived radiotherapy survived for 40 months. The survival time of 2 patients who underwent surgery alone was 8 months, 30 months, and the median survival time was19 months.Conclusion:Imaging finding scan beused as adjunctive diagnois of the primary angio sarcoma of bone. ERG is the most specific and sensitive marker in the pathological diagnosis of osteoangiosarcoma. Surgical resectionis still the first choice of treatment for long bone angiosarcoma. Surgical combined with radiotherapy can appropriately extend the survival time, and this program can be used as a treatment method chosen by doctors and patients.

Objective: To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R) injury in rats. Methods: Eighty clean-grade male Sprague-Dawley rats, aged 9-10 weeks, weighing 300-350 g, were divided into 4 groups (n=20 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R), dexmedetomidine group (group D), and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P). Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups, PD98059 2 mg/kg was given via the tail vein at the same time in group P, and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6, 8, 10 and 12 h of reperfusion, and the modified Basso, Beattie, Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion, and the L_3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot). The apoptosis index was calculated. Results: Compared with group S, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in the other three groups (P<0.05). Compared with I/R group, the BBB scores were significantly increased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in group D, and no significant change was found in the apoptosis index or p-ERK expression in group P (P>0.05). Compared with group D, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was down-regulated in group P (P<0.05). Conclusion The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

The purpose of this research was to study the effect of Xingxiong sodium chloride injection on cerebral ischemia-reperfusion injury in rats. Rats were divided into five groups, namely sham group, model group, ginkgolide injection group(3 mg/kg), Xingxiong sodium chloride injection high-dose group(14 mg/kg)and low dose group(7 mg/kg). Except for the sham group, animals in other groups were subjected to ischemia for 2h and reperfusion for 72 h by middle cerebral artery occlusion(MCAO)with thread technique, and then drugs were administered continuously by tail intravenous injection during reperfusion period for 3 days. The neurological deficit score and the histopathological score were evaluated; infarction ratio, brain water content and biochemical indexes of animals in each group were determined. Compared with model group, reduction of neurological deficit score, brain water content and infarction area were observed obviously at 7 mg/kg and 14 mg/kg of Xingxiong sodium chloride injection. Additionally, reduction of histopathological score, H2O2 and MDA content, increase of the level of GSH, GSH-Px, SOD and also the capacity of inhibition of superoxide anion radical(·O-2)and hydroxyl radial(·OH)were observed at 14 mg/kg. The results suggested that Xingxiong sodium chloride injection could effectively enhance the ability of anti-oxidation in the brain tissues, and protect brain from ischemia-reperfusion injury.