1.Diagnosis,Treatment and Prognosis of Sinonasal Neuroendocrine Carcinoma
Chaowu JIANG ; Yuping NA ; Min GUO ; Jinya WEN ; Ben LIU
Journal of Kunming Medical University 2013;(8):125-128
Objective To study the diagnosis and treatment of neuroendocrine carcinoma of the nasal cavity and paranasal sinuses, and analyse the influencing factors of suvival and prognosis. Methods We retrospectively analyzed the diagnosis and treatment process of 14 patients with sinonasal neuroendocrine carcinoma (SNEC) admitted in The First Affiliated Hospital of Kunming Medical University from 2007 to 2011. All patients were followed up to learn the survival status of them.Results All patients were followed up for one year up to six years except 2 patients who gave up treatment. Five patients died and six survived with good tumor control in the followed up period. Two patients received only endoscopy surgery, and one of them died from lung metastasis in 21 months after operation, and the other one survived with good tumor control, the disease free survival (DFS) was 9 months . Eight patients were treated by endscopy surgery and /or chemo-radiotherapy, three cases died in following-up period, and five of them survivied with good tumor control, and the disease free survival was 20.25 months.Two patients with transcatheter arterial infusion chemotherapy survivied with good tumor control within the follow up period,and the DFS was 25.5 months.Five patients had moderately differentiated SNEC and DFS was 25.5 months. Seven patients had poorly differentiated SNEC with DFS 14.6 months. Six patients were T4N0M0, four patients were T3N0M0, two patients T2N0M0, and their DFS were 19 months, 12.8 months and 33 month, respectively. Conclusions Surgery with radiotherapy and/or chemotherapy is the current treatment method for sinonasal neuroendocrine carcinoma. Small cell neuroendocrine carcinoma with poor differiation displays highly aggressive and poor prognosis. Diagnosis and treatment in early stage is important for good prognosis.
2.MRI assessment of acute myocardial infarction with transplantation of autologous mesenchymal stem cells in swine:an experimental study
Minjie LU ; Shihua ZHAO ; Haiyan QIAN ; Shiliang JIANG ; Yunqing WEI ; Chaowu YAN ; Yuejin YANG ; Yuqing LIU
Chinese Journal of Radiology 2008;42(2):201-205
ObjectiveTo investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs)transplantation on acute myocardial infarction in swine models using MRI. MethodsFourteen Chinese mini-pigs(27±3 kg)were divided into control group(n=7)and transplantation group(n=7).Acute myocardial infarction(AMI)model was made by occlusion of the left anterior descending coronary artery for 90 minutes,and then 10 ml autologous MSCs(3 × 106 cell/ml)were injected into LAD by over-wire-balloon catheter after one week. MRl was performed to assess the cardiac function and myocardial perfusion 1 week after AMI and 6 weeks after transplantation.The implanted cells in vitro were analyzed by immunofluorescence.ResuitsThe left ventricular ejection fraction(LVEF)in transplantation group was increased from(42.7 ±7.5)%to(50.1±10.1)%,which was significantly different from that in control group(P<0.01).In addition,the dyskinetic segments in infarcted region and the infareted area were decreased by 4 and 3.2 cm2 respectively(P<0.01),and the left ventricular weight index was increased by 4.1 g/m2 in transplantation group(P<0.05)compared with control group.The DAPI-labeled cells in infarcted and peri-infarcted region indicated the survived MSCs.Immunofluoreseence also confirmed that those cells expressed cardiomyocyte-specific troponin T,connexin 43 and vessel-specific smooth muscle actin.Capillary density in both infarcted and peri-infarcted region were higher in transplantation group than the control group(P<0.01).Conclusion MRI is a reliable imaging method for assessing the effects of stem cell transplantation in acute myocardial infartion of swine models.
3.Imaging of cardiovascular malformations in Williams syndrome
Shiguo LI ; Shihua ZHAO ; Shiliang JIANG ; Lianjun HUANG ; Zhongying XU ; Jian LING ; Hong ZHENG ; Chaowu YAN ; Jinguo LU
Chinese Journal of Radiology 2008;42(9):916-918
Objective To evaluate the imaging methods for cardiovascular malformations in Williams syndrome(WS).Methods Thirteen cases of WS(7 males and 6 females)aged 10 months to 13 years were involved in this study.All patients underwent chest X-ray radiography,electrocardiography.echocardiography and physical examination.3 cases underwent electronic beam computed tomography (EBCT),cardiac catheterization and angiography were performed in 8 cases.Results Twelve patients were referred to our hespital for cardiac murmur and 1 cnse for cyanosis after birth.7 patients were found with "elfin-like"facial features.6 patients with pulmonary arterial stenosis.2 Cases with patent ductus arteriosus.2 case8 with 8evere pulmonary hypertension and 1 case with total endocardial cushion defect.Sudden death occurred in 2 patients during and after catlleterization.respectively. Conclusions Conventional angiography is the golden standard for the diagnosis of cardiovascular malformations in WS.Noninvnsive methods such as MSCT and MRI should be suggested because of the risk of sudden death in conventional angiography.
4.Clinical features and MRI characteristics in patients with cardiac amyloidosis
Junyi WAN ; Shihua ZHAO ; Shiliang JIANG ; Yan ZHANG ; Chaowu YAN ; Minjie LU ; Yang ZHOU ; Jie HUANG ; Hong ZHAO
Chinese Journal of Radiology 2010;44(12):1297-1299
Objective To observe the clinical features and cardiac magnetic resonance (CMR)imaging characteristics in patients with cardiac amyloidosis. Methods A total of 5 patients (4 males and 1 female) with the diagnosis of cardiac amyloidosis (3 were proven by heart transplantation, 2 by endomyocardial biopsy) were evaluated by electrocardiogram, echocardiogram, chest X-ray and CMR with delayed Gadolinium enhancement. Results Echocardiograms were abnormal in all five patients; chest X-ray showed pulmonary hemorrhage ( 3 ), cardiomegaly (5), pleural effusion (3); echocardiogram showed atrial enlargement, left ventricular wall thickening, limited ventricular wall motion, etc. CMR exhibited increased thickness of the left ventricular wall, mild to moderate depression of systolic function ( mean ejection fraction: 32.5% ± 15.0% ) and bilateral atrial enlargement with restriction of diastolic ventricular filling. In all patients, there were widespread enhancement of the thickened myocardium on delayed postcontrast studies. In 4 patients, global subendocardial delayed gadolinium enhancement was found, in papillary muscles, and interventricular septa with" zebra-like" sign in 3 patients. Left ventricular transmural delayed gadolinium enhancement was found in 1 patient. Conclusions CMR shows a characteristic pattern of global subendocardial delayed gadolinium enhancement in cardiac amyloidosis. The findings may be valuable in the diagnosis of cardiac amyloidosis.
5.Characteristics of hypertrophic cardiomyopathy on delayed contrast-enhanced MRI
Chaowu YAN ; Shihua ZHAO ; Hua LI ; Shiliang JIANG ; Minjie LU ; Yan ZHANG ; Yunqing WEI ; Jian LING ; Wei FANG
Chinese Journal of Radiology 2010;44(9):903-906
Objective To analyze the characteristics of hypertrophic cardiomyopathy (HCM) on delayed contrast-enhanced cardiac magnetic resonance imaging (CMRI). Methods All patients underwent delayed contrast-enhanced CMRI. The left ventricle was divided into 9 segments to assess the location,extent and function of the hypertrophic segments. The t test was applied for the statistics. Results Of 154 patients, delayed enhancement of hypertrophic segment was found in 95 cases and non-delayed enhancement in 59 cases. The thickness and number of hypertrophic segment in patients with delayed enhancement were larger than those with non-delayed enhancement [ (24. 8 ± 5. 5 ) mm vs (20. 4 ±3.8) mm, t = 3.82, P < 0.05; (3.3 ± 1.9) vs (2.4 ± 1.7), t = 2. 26, P < 0.05 ], and the age was younger [ (46. 0 ± 15.2) years vs (55.0 ± 11.9) years, t = - 3. 67, P <0. 05 ]. The diffuse enhancement was found in 62 patients, and confluent enhancement in 33 patients. Confluent enhancement was found in all 14 patients after the alcohol ablation procedure. Conclusion The age, thickness and number of hypertrophic segments in patients with delayed enhancement are different from those with non-delayed enhancement.
6.The Pubmed Bibliometric Analysis of Trend in the Research on Age-related Hearing Loss
Min GUO ; Tao WEI ; Yuping NA ; Chaowu JIANG ; Congjun YE ; Jingyu GAO ; Lizhu YANG ; Jing NA ; Biao RUAN
Journal of Audiology and Speech Pathology 2015;(5):527-533
Objective This study aimed to define research status of age -related hearing loss ,and provide the basis and direction for future research .Methods We have retrieved all relevant literatures on age -related hearing loss from Pubmed ,and conduct an objective analysis of the existing literatures by Bibliometric analytics and co -word analysis method using co -occurrence bibliographic information mining system and SPSS22 .0 software for data analysis .Results There were a large number of articles and journals about presbycusis and age -related hearing loss .Many countries were involved in the research .Literatures and core authors were mainly from developed coun‐tries such as Europe and the United States .The quantity and quality of Chinese literatures were in a leading position in Asia .The researches focused on the common characteristics of patients ,the epidemiology ,characteristics of hear‐ing ,treatment and laboratory studies .There were some new research directions in recent 5 years ,such as factors as‐sociated with the younger ages before developing presbycusis ,standard design and use of questionnaires ,prevention and control .Conclusion Age-related hearing loss will continue to be a hot topic with growing focus on micro and macro development of multi -disciplinary cooperation .The penetration will be the trend for the future research while the prevention will become a new focus of research .
7.MRI of restrictive cardiomyopathy
Shihua ZHAO ; Shiliang JIANG ; Huaibing CHENG ; Minjie LU ; Chaowu YAN ; Jian LING ; Yan ZHANG ; Bo HOU ; Huan XU ; Qiong LIU ; Shiguo LI ; Gansheng FENG
Chinese Journal of Radiology 2009;43(9):903-907
marked hi-atrial dilation, near-normal ventricular chambers and near-normal ventricular thickness were presented. Conclusion MRI is an excellent imaging modality for the diagnosis of restrictive cardiomyopathy.
8.Dynamic MRI of ferumoxide-labeled bone mesenchymal stem cells after transplantation in infarcted myocardium
Qiong LIU ; Shihua ZHAO ; Minjie LU ; Shiliang JIANG ; Chaowu YAN ; Yan ZHANG ; Liang MENG ; Yue TANG ; Xianmin MENG ; Yingjie WEI ; Qingzhi WANG
Chinese Journal of Radiology 2009;43(3):305-310
Objective To investigate the ability of magnetic resonance imaging (MRI) in tracking magnetically labeled mesenchymal stem cells (MR-MSCs) in a swine myocardial infarction (MI) model.Methods Adult Chinese mini-pigs (n = 6) were subjected to open-chest experimental MI operation.Their antegeneic bone marrow-derived mesenchymal stem cells ( MSCs ) was cultured and doubly labeled with ferumoxides and DAPL On the 14 th day after MSCs transplantation, the size and location of the myocardial infarction were assessed by using delayed-enhancement MRI (DE-MRI). Then the labeled MSCs were injected intramyocardially into peri-infarct zone and normal myocardium. At 24 hrs and 3 weeks after injection, the contrast and the volume of the MR-MSCs hypointense lesion from the MR images were acquired, and the contrast was determined using the difference in signal intensity between the hypointense and normal myocardium divided by signal intensity of the normal region.After humane euthanasia, the heart was excised and histology corresponding to MRI slices that demonstrated MR-MSCs lesions was performed.Repeated-measures ANOVA and a paired t test were used for comparison of the contrast and the volume of the MR-MSCs hypointense lesion at different time points. Comparisons between independent groups were performed with the standard Student t test.Results The labeling efficiency of ferumoxides and DAPI was 100% . On the 14 th day after the MI operation, the average percentage of infracted myocardial area was (33.6±8.9)% .Twenty- four hours after MSCs transplantation, MSCs injection sites appeared as ovoid hypointensive lesions with sharp border on T2 * images. At 24 h after injection, the signal contrast [(67.00±5.48)% vs (61.92 ±7.76)%,t = 1.65,P =0.1158] and the size [(0.56 ±0.24) cm2 vs (0.52 ± 0.25 ) cm2, t = 0.39, P = 0.7044 ] of the lesions showed no statistical difference between the peri infarct zone and the normal myocardium.At 3 weeks after injection, the signal contrast decreased and the size diminished both in the peri-infarct zone and in the normal myocardium. Moreover, the contrast of the lesions in peri-infarct zone decreased more significantly than that in normal myocardium [(26.88 +7.27)%vs (15.00 :t:4.51)%, F =20.08, P =0.0003].Post mortem analysis found the fluorescontly labeled MSCs demonstrated on histological sections.There were much more dense fluorescently labled MSCs per high power fields at injection sites of normal myocardium than at injection sites of peri-infarct zone [ (106 ±25 )/HPF vs ( 143 ± 31 )/HPF, t = - 2.47, P = 0.0293 ].In MSCs injection sites of the peri-infarct zone,the capillary density was significantly higher than that in control sites [ (13.4 ± 4.0 )/HPF vs (9.4 ±3.1 )/HPF, t = 2.49, P = 0.0229].At 3 weeks after injection, ferumoxide was contained within partial original MSCs.Conclusion Magnetic resonance imaging of MSCs is a feasible method for the in vivo tracking of transplanted stem cells and could reflect the tendency of the local stem cell quantity, but there still has limitation for the semi-quantitation of the transplanted stem cells.
9.Diagnosing left ventricular noncompaction by cardiac MRI and its differential diagnosis on left ventricular hypertrabeculation
Shihua ZHAO ; Jinchao YU ; Shiliang JIANG ; Liming WANG ; Minjie LU ; Jian LING ; Yan ZHANG ; Chaowu YAN ; Qiong LIU ; Huaibing CHENG ; Shiguo LI
Chinese Journal of Radiology 2010;44(7):711-715
Objective To define the diagnostic criteria of cardiovascular magnetic resonance imaging in distinguishing isolated left ventricular noncompaction (LVNC) from lesser degrees of hypertrabeculation. Methods Twenty-five patients with LVNC, 39 with dilated cardiomyopathy ( DCM), 16 with aortic stenosis(AS), 15 with aortic regurgitation(AR) , 19 with hypertension (HT) and 22 normal subjects were enrolled in this study. Cardiac magnetic resonance imaging was performed to evaluate the left chamber diameter, functional parameters and noncompaction or hypertrabeculation of the left ventricle in diastole with one-way ANOVA. The left ventricle was divided into 17 segments for localizing all involved segments in this present study. Results The LVNC patients had the commonest myocardial segments involved (10±2)in all subjects. Each patient with LVNC was unexceptionally associated with apical noncompaction (17th segment) , which was seldom found in the other subjects. The lateral walls including 16th, 12th and 11th segments were the most vulnerable segments in all subjects, but nobody was found to involve the basal and mid septum including 2nd, 3rd, 8th and 9th segments. The end-diastolic NC/C (noncompaction/compaction) ratio was, on average, the greatest in patients with LVNC (3.3±0.6), compared with all other subjects(AS:1.0 ±0.3, AR:1.0 ±0.3,HT:0.8 ±0.1,healthy volunteers:0.9 ±0. 2) (F = 169. 62,P <0.05). Receiver operating characteristics analysis identified the end-diastolic NC/C ratio of>2.5 as a valuable parameter to distinguish LVNC from DCM.with values for sensitivity of 96.O%(24/25)and specificity of 94.9%(37/39),respectively.The mean number of NC/C ratio>2.5 segments in the LVNC patients was 4.0 ±2.0.while 8 of 39 patients with DCM had only one segment of NC/C ratio >2.5.Conclusions MRI is all exceUent imaging modality to diagnose LVNC and distinguish LIVNC from hypertrabeeulation.The criteria of LVNC is the NC/C ratio>2.5 in two or more than two segments of free ventricular walls associated with the left ventrieular apex involved.
10.The manufacturing and clinical application of heterogenous acellular dermal matrix.
Duyin JIANG ; Bi CHEN ; Mingda XU ; Dahai HU ; Chaowu TANG ; Xiongxiang ZHU
Chinese Journal of Burns 2002;18(1):15-18
OBJECTIVETo lower down the antigenicity of heterogenous swine acellular dermal tissue, and to explore the feasibility of clinical using it as a composite graft for human patients.
METHODSSplit-thickness skin was harvested from healthy swines and then processed by two methods. The swine acellular dermal matrix (sADM) was prepared by removing cells from the skin with trypsin and Triton X-100. Then the cross-linked sADM (sADM(1)) and non-cross-linked sADM (sADM(0)) were embedded subcutaneously in rabbits and also transplanted onto the burn wounds of patients. The histological changes and also transplantation results were observed.
RESULTS(1) In animals with sADM(0) embedded subcutaneously, the grafted tissue was invaded immediately by host cells with obvious inflammatory reaction and tissue degradation. But there was less inflammatory reaction, and with no obvious skin degradation and contraction with sADM(1). (2) In ten burn patients with III degree burn wounds and one patient with wound in chest after scar removal, sADM and ultra-thin skin (UTS) composite graft were grafted on the wounds with autologous thin skin (ATS) and autologous razor-thin or UTS as the control. Nineteen pieces of composite skin of sADM with UTS were grafted on the wounds with survival rate of 78.9%, exhibiting no evident difference with that of ATS. When sADM(0) and UTS were grafed, there exhibited remarkable early inflammatory reaction and wound contraction with similar external appearance with that of UTS. Whereas when sADM(1) and UTS were grafted, there appeared less early inflammatory reaction and wound contraction, resulting in an even appearance and soft to touch similar to that with ATS. But ulceration occurred, with exposure of sADM(1), exposure and severe macrophage reaction to foreign body in 6 wounds of 3 cases 12.8 +/- 6.9 weeks after sADM(1) and UTS grafting.
CONCLUSIONGrafting of sADM as a dermal substitute of composite skin could alleviate early post-grafting immune reaction and improve UTS grafting results. But the delayed graft rejection couldn't be avoided.
Animals ; Burns ; surgery ; Dermatologic Surgical Procedures ; Dermis ; immunology ; transplantation ; Humans ; Rabbits ; Skin ; immunology ; injuries ; Skin Transplantation ; methods ; Skin, Artificial ; Swine ; Time Factors ; Transplantation, Heterologous ; Wound Healing