Objective The purpose of this study was to compare the image quality of readout-segmented EPI (RS-EPI) and that of standard single-shot echo-planar imaging (SS-EPI) in patients with scrotal diseases. Methods Initial diagnosis of scrotal diseases were included in the prospective study, all patients underwent scrotum routine MRI and RS-EPI, SS-EPI sequence at 3.0 T. A total of 38 patients were recruited qualitative assessment ,and 29 patients proved by operation and pathology (malignant 21 cases and benign 8 cases) were included quantitative analysis.For qualitative comparison of image quality, two readers independently assessed the two sets of DWI, which consisted of identification of structure and geometric distortion of scrotum (epididymis,testes, lesion) using a 5-point Likert scale. For assessment of image parameters, signal-to-noise ratio (SNR), contrast, contrast-to-noise ratio (CNR),apparent diffusion coefficient value of normal testis and testis distortion ratio of anatomical(T2WI)/DWI fusion image were calculated. Inter-observer agreement was assessed with the Kappa statistics, the differences of scores of
RS-EPI and SS-EPI were compared by using Wilcoxon rank-sum test, and image parameters were compared by using paired sample t test. Results There was good reader agreement in the scores, the Kappa value were 0.77, 0.74, 0.80, 0.87. The difference of identification of structure and geometric distortion on RS-EPI and SS-EPI had statistic significance, the RS-EPI was superior to SS-EPI in image quality (all P<0.05).The SNR, contrast of benign lesion for two sequences had no statistic significance(P values were 0.352, 0.124, respectively), but the difference of CNR had statistic significance(P<0.05). The SNR,contrast and CNR of malignant lesion for two sequences had statistic significance (all P<0.05). The mean size of the testis was (35.61 ± 9.78)mm, the mean distance in fusion image of RS-EPI or SS-EPI with T2WI were (3.80 ± 1.32)mm and (7.54 ± 2.62)mm, and the mean distortion ratios of the two set were (11.1 ± 0.6)% and (22.4 ± 19.2)%, respectively, the difference of two sets had statistic significance(P<0.05). There was no significant difference in the ADC obtained by using either DWI method(t=0.396,P=0.796), the mean ADC values of normal testes for RS-EPI and SS-EPI, respectively, were (1.18 ± 0.06) × 10-3mm2/s, (1.24 ± 0.11) × 10-3mm2/s.Conclusion RS-EPI DWI images is a feasible technique in the scrotum for producing high-resolution DWI with reduced geometric distortion and offers potentially superior image quality compared to SS-EPI at 3.0 T.

The clinical manifestations of anti- N-methyl-daspartate (NMDA) receptor encephalitis and viral encephalitis are similar but the treatments and prognoses are different, so the early differentiation of the two diseases is very important. Early diagnosis is affected by delayed antibody detection and false negative detection, while routine auxiliary tests lack specificity; therefore, they have limited value in identification. The 18F-fulorodeoxyglucose (FDG) marked positron emission computed tomography (PETCT) is highly sensitive to abnormal cerebral metabolism in the early stage of anti-NMDA receptor encephalitis, showing a characteristic metabolic pattern of frontal or temporal lobe increase metabolism and occipital decrease metabolism. The number of patients who underwent 18F FDG PETCT examination for viral encephalitis was small; different kinds of viral encephalitis show different brain metabolism, but there was no characteristic hypometabolism of the occipital lobe. This paper reviews the cerebral metabolic characteristics of 18F-FDG PETCT in anti-NMDA receptor encephalitis and viral encephalitis.

Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis. Most patients have a good prognosis, but a small number of patients have memory impairment and other sequelaes. Early immunotherapy is a key factor for good prognosis of patients with this disease. However, a key problem in the treatment of this disease is the lack of biomarkers for disease monitoring and prognosis assessment. Therefore, it is positive for guiding the diagnosis and treatment and evaluating the prognosis to find biomarkers that can reflect the disease. Here, biological factors abnormally elevated in cerebrospinal fluid of patients with anti-NMDA receptor encephalitis are reviewed, and biological factors with potential as biomarkers are summarized.

Objective:To analyze the relationship between serum antibody titers, clinical characteristics, and prognosis in patients with encephalitis induced by anti leucine-rich glioma inactivated 1 (LGI1) antibody.Methods:Clinical data of 20 patients diagnosed with encephalitis in the Department of Neurology, First Hospital of Shanxi Medical University from February 2015 to February 2021 were collected and retrospectively analyzed. Patients were divided into 2 groups based on their serum anti LGI1 antibody titers, namely the high titer group (1∶100, 1∶320) and the low titer group (1∶10, 1∶32). The clinical characteristics, laboratory test results, and prognosis of the 2 groups of patients were compared. Relusts The age of the 20 patients with anti LGI1 antibody encephalitis ranged from 27 to 69 (53.5±11.2) years, with a male to female ratio of 1∶1. There were 9 patients in the low titer group and 11 patients in the high titer group. There was no statistically significant difference in the types and quantities of clinical symptoms between the 2 groups. Patients in the high titer group were more prone to abnormal lesions on cranial magnetic resonance imaging (10/11 vs 3/9, P=0.014). There was no statistically significant difference between the 2 groups in the presence or absence of cerebrospinal fluid anti LGI1 antibodies (9/11 vs 4/9, P=0.160). During the follow-up, it was found that 1/20 patient died of pulmonary embolism, 7/20 of patients were able to recover to their predisease state, and 9/20 of patients had residual memory impairment. In the high titer group, 3/11 of patients experienced recurrence, while there was no recurrence in the low titer group. There was no statistically significant difference in the neurological prognosis between the 2 groups at 3 months of discharge and follow-up (the number of patients whose modified Rankin Scale score≤2: 10/10 vs 8/9, P=0.474). Conclusions:Patients with high serum anti LGI1 antibody titers are more likely to develop intracerebral lesions. Higher antibody titers may be associated with a higher risk of disease recurrence. There was no significant correlation between serum antibody titers and neurological outcomes.

Autoimmune encephalitis (AE) is a novel form of encephalitis associated with antibodies to cell-surface or synaptic proteins. Epileptic seizures act as the predominant manifestation of AE which are triggered by interaction between kinds of antibodies and antigens on cell-surface or intracellular. Patients with AE-related epilepsy are insensitive to antiepileptic drugs but sensitive to immunotherapy. Early initiation of immunotherapy can significantly improve the prognosis. To date, there are few reports on the treatment plan of antiepileptic drug to the patients with AE-related epilepsy. In this review we report the most relevant data about the morbidity, pathogenesis and treatment of AE-related epilepsy with aim of providing better treatment options.

Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis mediated by anti-NMDA receptor antibody. At present, the diagnosis of the disease depends mainly on typical clinical symptoms and detection of specific antibodies in cerebrospinal fluid. Early and timely treatment can curb the disease progression and improve the prognosis of the disease. However, because of the atypical clinical manifestations of patients and long waiting time for antibody detection, early identification is difficult. Imaging equipment is more popular in primary hospitals in China, and it is easier to perform imaging examination for suspected patients in the early stage; therefore, this article aims to review the imaging characteristics and current imaging research progress of anti-NMDA receptor encephalitis in recent years, so as to improve clinicians' understanding and early recognition of this disease.

OBJECTIVETo study the management of acute superior mesenteric artery (SMA) ischemia and to improve its prognosis.

METHODThe clinical data of 37 patients treated from January 1996 to August 2007 was retrospectively reviewed.

RESULTSOf the cases, 19 (51.4%) patients were diagnosed with acute SMA embolism, 15 (40.5%) with acute SMA thrombosis, 2 (5.4%) with spontaneous isolated dissection of SMA and 1 (2.7%) with SMA aneurysm. Nineteen (51.4%) patients were misdiagnosed in emergency. Eighteen (48.6%) patients died in the hospital, and most of them died of severe infection and multiple organ failure. Three cases of the survived 19 patients experienced severe complications (2 with short gut syndrome, 1 with cerebral hemorrhage). Nine cases were followed-up for a mean period of 15 months, and 5 died during that term.

CONCLUSIONSAcute SMA ischemia has multiple etiological factors. Early intervention can improve the prognosis.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion ; diagnosis ; therapy ; Middle Aged ; Prognosis ; Retrospective Studies

BACKGROUNDParaquat (PQ), an effective and widely used herbicide, has been proven to be safe when appropriately applied to eliminate weeds. However, PQ poisoning is an extremely frustrating clinical condition with a high mortality and with a lack of effective treatments in humans. PQ mainly accumulates in the lung, and the main molecular mechanism of PQ toxicity is based on redox cycling and intracellular oxidative stress generation. The aim of this study was to evaluate whether lysine acetylsalicylate (LAS) could protect the lung from the damage of PQ poisoning and to study the mechanisms of protection.

METHODSA model of PQ poisoning was established in 75 Sprague-Dawley rats by intragastric administration of 50 mg/kg PQ, followed by treatment with 200 mg/kg of LAS. The rats were randomly divided into sham, PQ, and PQ + LAS groups, with 25 in each group. We assessed and compared the malonaldehyde (MDA) content, superoxide dismutase activity (SOD), glutathion peroxidase (GSH-Px), and catalase (CAT) in serum and lung and the hydroxyproline (HYP) content, pathological changes, apoptosis and expression of Bcl-2/Bax protein in lung of rats on days 1, 3, 7, 14 and 21 after PQ poisoning and LAS treatment.

RESULTSCompared to the PQ group rats, early treatment with LAS reduced the MDA and HYP contents, and increased the SOD, GSH-Px, and CAT activities in the serum and lung on days 1, 3, 7, 14, and 21 after PQ poisoning (all P < 0.05). After early LAS treatment, the apoptotic rate and Bax expression of lung decreased, the Bcl-2 expression increased, and the Bcl-2/Bax ratio increased, compared to the PQ group rats. Furthermore, the pathological results of lungs revealed that after LAS treatment, early manifestations of PQ poisoning, such as hemorrhage, edema and inflammatory-cell infiltration, were improved to some degree, and collagen fibers in the pulmonary interstitium were also obviously reduced.

CONCLUSIONIn this rat model of PQ poisoning, LAS effectively ameliorated the lung injury induced by PQ, possibly through antioxidation, anti-fibrosis, anti-apoptosis, and anticoagulation.

Animals ; Antioxidants ; metabolism ; Aspirin ; analogs & derivatives ; standards ; therapeutic use ; Catalase ; metabolism ; Glutathione Peroxidase ; metabolism ; Lung ; drug effects ; metabolism ; Lung Injury ; chemically induced ; drug therapy ; metabolism ; Lysine ; analogs & derivatives ; standards ; therapeutic use ; Male ; Malondialdehyde ; metabolism ; Paraquat ; toxicity ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

Aim To investigate the effect of baicalein on the reversal of multidrug resistance ( MDR) media-ted by breast cancer resistance protein ( BCRP) in hu-man breast cancer MCF-7/MX cells, and explore the possible mechanisms. Methods MTT assay was per-formed to determine the cytotoxicity of baicalein and susceptibility of chemotherapeutic drugs. The protein expression levels of BCRP, p-p38 MAPK and NF-κB p65 were determined by Western blot. Results MCF-7/MX cells were not only resistant to MX but cross-re-sistant to 5-FU and DDP, and the resistance index was 70. 45, 6. 68 and 21. 47, respectively. 2. 5, 5μmol· L-1 of baicalein could increase the sensitivity to above chemotherapeutic agents and decrease the expression levels of BCRP, p-p38 MAPK and NF-κB p65 in MCF-7/MX cells. Conclusion Baicalein can effec-tively reverse MDR of MCF-7/MX by down-regulating BCRP expression through p38/MAPK and NF-κB path-ways.

AIM:To investigate the effects of baicalein on pulmonary arterial hypertension(PAH)induced by monocrotaline(MCT)in rats,and its molecular mechanism was further explored.METHODS: Male SD rats(n=28) were randomly divided into 4 groups: control group, MCT group, MCT+baicalein 50 mg/kg group and MCT +baicalein 100 mg/kg group.The PAH model was established by subcutaneous injection of MCT.After 2 weeks of modeling,the rats in baicalein treatment groups were gavaged baicalein 50 and 100 mg· kg -1· d-1for 14 d,the rats in control group were administered with saline.After 4 weeks of modeling,right ventricular systolic pressure(RVSP),right ventricular hypertro-phy index(RVHI)and right ventricular mass index(RVMI)were detected.Masson staining was used to detect the degree of lung fibrosis.The pathomorphological changes of the pulmonary vessels were observed by HE staining.Western blot was used to detect the expression of α-smooth muscle actin(α-SMA)in the lung tissue and the phosphorylation p 38,ERK and JNK in the artery.RESULTS:Compared with the control group,RVSP, RVHI and RVMI increased significantly in the MCT group(P<0.01).Pulmonary fibrosis and the thickening of pulmonary artery wall were observed.α-SMA was up-regulated and p38,ERK and JNK was activated significantly(P<0.01).Compared with the MCT group,baicalein(50 and 100 mg/kg)significantly decreased the RVSP,RVHI and RVMI(P<0.01).Lung fibrosis was reduced and the vas-cular wall thickening was decreased in baicalein-treated groups.Baicalein(50 and 100 mg/kg)inhibited the phosphoryla-tion of p38,ERK and JNK compared with the MCT group(P<0.01).CONCLUSION:Baicalein ameliorates MCT-in-duced PAH by the inhibition of pulmonary artery wall thickening at least partially via MAPK signaling pathway.