Objective To evaluate the reproducibility of measuring renal oxygenation in rat using blood oxygen level-dependent MR imaging(BOLD MRI).Methods Five intact male Wistar rats were included in this study and their body weights were measured before MRI scans.BOLD MRI were performed ou day 1(d1),day 5(d5),day 10(d10),day 30(d30)and day 50(d50)on a 3.0 T MR scanner to measure the apparent spin-spin relaxation(R2*).On d30 and d50,the differences of R2*(△R2*)were calculated between before and 10 min after furosemide injection through the tail vein.The reproducibility of the baseline R2* of 5 times repeated scans were verified by the repeated-measure ANOVA test.The R2* and △R2* between pre-and post-furosemide iniection on d30 and d50 were measured on the codex and the medulla and a paired t test was run to analyze their responses to furosemide and the reproducibility of △R2*.Results The average body weight on d1,d5,d10,d3 and d50 was(150.4±3.7)g、(170.2±7.0)g、(201.0±5.8)g、(306.2±17.0)g and(352.0±12.2)g,respectively,with statistical difference(F=422.103.P＜0.01).The R2* showed no statistical difference in the cortex and medulla among the five scans(P＞0.05).On d30.the R2* of the cortex and medulla was(25.2±1.2)and(32.8±2.2)Hz before and significantly decreased to(21.1±2.2)and(25.9±3.0)Hz after furosemide administration,respectively(P＜0.01).On d50,the R2* of the cortex and medulla was(25.9±0.8)and(34.3±3.9)Hz before and significantly decreased to(20.2±1.5)and(27.0±3.2)Hz after furosemide administration.respectively(P＜0.01).The △R2* on the codex and medulla was(4.1±1.7)and(6.9 4-2.8)Hz on d30 and(5.8±1.1)and(7.3±2.8)Hz on d50,respectively,but there is no significant difference between eortex and medulla(P＞0.05).Conclusion The baseline R2* in the cortex and medulla were reproducible over 50 days and they were not body weighted.On 3.0 T MR scanners.R2* in the codex and medulla decreased significantly after administration of furosemide.

Objective To analyze the changes of renal apparent diffusion coefficient(ADC)value during development in intact rats.Methods Five intact male Wistar rats(1 month of age)were involved in this study.Using SE-echo planar imaging(EPI)sequence to acquire renal DWI at a 3.0 T MR on day 1,day 5,day 10,day 30,and day 50,respectively.The b value was 0 and 500 s/mm2.The ADCs of the cortex and the medulla were measured on the right kidney and the renal volume was calculated by manually renal outling on each slice.The difference of ADC between the cortex and the medulla was analyzed using a paired student t test,and the changes of renal volume and ADCs with rats development were evaluated with a repeated measurement ANOVA.Results The ADC of the cortex was higher than that of the medulla except on day 1(P＜0.01).when b value 0 and 500 s/mm2 were chosen.Renal volume increased with the rat development.from(0.86±0.02)ml to(1.47±0.21)ml.And the ADCs of both the cortex and medulla increased from(1.66±0.14)×10-3mm2/s to(1.96±0.08)×10-3mm2/s for the cortex and from (1.54±0.12)×10-3mm2/s to(1.91±0.09)×10-3mm2/s for the medulla.Conclusion Renal ADCs of both the cortex and medulla increase during the period from 1 to about 3 months of age in rats.The influence of age on renal ADC should be considered when choosing rats aged from 1 to 3 months for MR study.

Echocardiography ; methods ; Female ; Heart Neoplasms ; diagnosis ; surgery ; Humans ; Infant ; Myxoma ; diagnosis ; surgery ; Treatment Outcome ; Tricuspid Valve ; physiopathology ; surgery

AIM: To investigate whether a pathological micro-environmental culture system consisting of cholestatic sera induces embryonic stem cells (ESC) to differentiate into hepatocyte-like cells in vitro, and select hepatic stem cells from differentiating embryonic stem cells. METHODS: Mouse ESC, E14 cell line, were cultured in Dulbecco's modified Eagle's medium containing 106 U/L recombinant mouse leukemia inhibitory factor (rmLIF) and 10% FCS. After embryonic bodies formed by the hanging drop culture method, they were exposed to fibroblast growth factor-4 (FGF-4) and hepatocyte growth factor (HGF) for one week, and then placed to a pathological micro-environmental culture system consisting of 5% cholestatic sera and cultured for 2 weeks. Morphological examination, immunocytochemical staining of albumin and CK8/18 were carried out, and mRNA level of albumin and transthyretin were detected by RT-PCR. Glycogen storage and urea synthesis of the cells were tested with PAS staining and colorimetric assay, respectively. RESULTS: The proliferation of cells was inhibited at the early stage when cultured in a pathological micro-environmental culture system consisting of 5% cholestatic sera, but 2 weeks later, a large number of epithelial-like cell colonies were observed, which exhibited hepatocellular phenotype, expressing albumin and CK8/18, transcribing mRNA of albumin and transthyretin and synthesizing glycogen and urea. CONCLUSION: A pathological micro- environmental culture system consisting of 5% cholestatic sera could not only induce embryonic stem cells to differentiate into hepatocyte-like cells, but select hepatic stem cells from differentiating embryonic stem cells initially induced by FGF-4 and HGF in vitro as well.

Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.

AIM:To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN)and hepatocyte growth factor(HGF)in non-small-cell lung carcinoma(NSCLC)and their relationship with lymphoid metastasis and prognosis.METHODS:Expression of EMMPRIN and HGF in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of expression of EMMPRIN and HGF with tumor size,smoking,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis was analyzed.RESULTS:The expressive rates of EMMPRIN and HGF were 68% and 44%,respectively.The expressions of EMMPRIN and HGF were associated positively with lymphoid metastasis(r=0.371 and 0.339,P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC.CONCLUSION:The expression of EMMPRIN and HGF is associated with lymphoid metastasis and prognosis in NSCLC.Overexpression of EMMPRIN and HGF implies infavourable prognosis in NSCLC.

Objective To determine the effectiveness and safety of stereotactic body radiotherapy (SBRT)-CyberKnife for oligometastatic prostate cancer.Methods From May 2012 to February 2017,31 patients treated by CyberKnife were retrospectively reviewed,with a median age of 67 years(range 52 to 83 years),including 50 oligometastatic and 2 primary prostate cancer patients.The median PSA level was 8.4 ng/ml(range 0 to 300.0 ng/ml) and PSA test was performed every month.PSA progression-free survival (PSA-PFS),time to initiation of androgen deprivation therapy (ADT) and local control rate (LCR) were measured as the main outcomes.Results SBRT was well tolerated and were performed as planned in all patients.No SBRT related acute or late toxicities were observed.No bone fracture was observed in patients treated by bony targeted radiotherapy.The median follow-up after SBRT was 20.7.months (range 1.2-58.3 months).The median PSA-PFS was 5.3 months (range 0-58.3 months).1-year,2-year,and 4-year PSA-PFS was 52.0％,36.7％ and 36.7％ respe ctively.PSA level decrease was observed in 21 oligometastatic prostate cancer patients after SBRT,with median PSA-PFS of 12.3 months (range 1.2-58.3 months).PSA level increase was observed in 29 oligometastatic prostate cancer patients after SBRT.Six local recurrence were observed resulting in an actuarial 1-year,2-year and 3-year LCR of 90.4％,86.9％ and 82.6％,respectively.Twelve patients treated without ADT after SBRT,with median follow-up of 8.6 months (range 2.9-58.3 months) in this subgroup.Seven patients were added ADT after SBRT,with the median time from SBRT to initiation of ADT of 13.3 months (range 3.0-24.0 months) in this subgroup.Twelve patients were treated with ADT continuously after SBRT.Conclusions CyberKnife seems to be a safe and effective treatment with tolerated adverse events and good local control for patients with oligometastatic prostate cancer.

Objective To observe the effect of the clinical nursing pathway on the acute cerebral infarction patients.Methods Totals of 200 acute cerebral infarction patients were recruited and randomly divided into observation group and control group,with 100 cases each group.Control group received the routine nursing,while observation group received the clinical nursing pathway:the system,dynamic,continuous guidance and nursing care during hospital.Then,the length time of stay,hospitalization expenses,the incidence of complications,patients' satisfaction,the knowledge rates of disease of two groups were observed.Results The length time of stay and hospitalization expenses of observation group were respectively lower than that of the control group [ (25.2 ± 2.1 ) d vs (31.1 ± 3.2 ) d,(4 700 ± 105 ) yuan vs (5 030 ± 143 ) yuan; t =213.14,308.01 ; P ＜ 0.05 ].The incidence of complications,patients' satisfaction,the knowledge rates of disease of observation group were 2％,98.96％,96％ respectively,and that of control group were 9％,95.03％,75％ respectively,and the differences were statistically significant ( x2 =4.71,8.87,17.29,respectively ;P ＜0.05 or P ＜ 0.05).Conclusions Applying the clinical nursing pathway in the management of acute cerebral infarction patients can shorten the length time of stay,decrease hospitalization expenses,reduce the incidence of the complications,and improve the knowledge rates of disease of the patients.

OBJECTIVETo probe into the relationship between hypertension and hemodynamic score of cerebral vascular accumulative function by though studying the history of hypertension and level of blood pressure.

METHODSThe database of blood pressure and cerebral vascular hemodynamic indexes (CVHI) were from baseline data and measurement in a cohort. 18,512 participants who met the included criteria were enlisted in the study. The function scores were estimated using uniform methods according to CVHI. Participants were grouped by age, years of having hypertension and level of blood pressure. Differences of the function score between different groups were compared.

RESULTSThe function score in hypertension group was significantly lower than that of normal tension group, which decreased by 13.3 points. Within 5 years of hypertension history, the function score decreased as course of hypertension prolonged. The same trend was found between the score and level of both systolic and diastolic blood pressure. When systolic blood pressure elevated to 140 mmHg or diastolic blood pressure elevated to 95 mmHg, the function score was below 75 points.

CONCLUSIONThere were significant relationship between decrease of the function scores and medical history, course of hypertension as well as level of blood pressure.

Adult ; Age of Onset ; Aged ; Blood Pressure ; physiology ; Cerebrovascular Circulation ; physiology ; China ; epidemiology ; Cohort Studies ; Female ; Hemodynamics ; physiology ; Humans ; Hypertension ; epidemiology ; physiopathology ; Male ; Middle Aged

BACKGROUND: We investigated the influence of pre-analytical factors on the results of clinical tests and thereby analyzed approaches to improve quality management in clinical laboratories. METHODS: Unqualified clinical samples were selected from all the samples received at our clinical laboratory. The data were collected for 2009 and 2010, i.e., the years before and after the establishment of the laboratory quality management system. The rate and causes of generation of unqualified samples were analyzed, and measures to improve the laboratory practices were studied and implemented. RESULTS: A total of 1,051 unqualified samples were identified from among the 553,158 samples (the overall incidence rate of unqualified samples was 0.19%). The number of unqualified samples substantially varied according to the nature of the sample, and clinical samples collected for routine blood tests or coagulation tests were the predominant unqualified samples. The main causes of generation of unqualified samples were insufficient sample volumes and improper methods of mixing the samples. The rate of generation of unqualified samples decreased significantly after the implementation of improvement measures (0.26% in 2009 vs. 0.13% in 2010, P<0.001). CONCLUSIONS: The number of unqualified samples decreased significantly after the establishment of the laboratory quality management system, which promoted active communication among and training of the clinical staff to reduce the occurrence of pre-analytical errors. Comprehensive control of pre-analytical factors is an important approach in improving the clinical laboratory practices.
Clinical Laboratory Techniques/standards ; Diagnostic Errors/statistics & numerical data ; Humans ; Laboratories, Hospital/*standards ; Specimen Handling/standards