1.CT diagnosis and differential diagnosis in Pulmonary hamartoma
Kezhen LI ; Rushan LIN ; Longjun PAN ; Yajun LI
Journal of Chinese Physician 2014;(z1):43-46
Objective Type around the HRCT manifestations of pulmonary hamartoma , in order to improve the level of diag-nosis of the disease .Methods Last 14 years retrospective analysis confirmed by surgery and biopsy of peripheral pulmonary hamar -toma 23 cases of CT performance.Results Nine cases of right lung (for 3 cases of the upper lobe of right lung middle in 2 cases, 4 cases were characterized by lower lobe ), 14 cases had left lung (6 cases left upper lobe, left lower lobe 8 cases), 12 cases round, round 8 cases, shallow points Ye Zheng 3 cases, border and clear, no deep lobulated, burr and satellite lesions.1.0~5.4 cm in di-ameter, the average is about 2.6 cm in diameter, less than 3 cm17 cases.5 cases of lesions containing fat , 7 cases there are both fat and calcification;8 cases of lesions with calcification , typical popcorn calcification in 3 cases;All 11 cases in 15 cases of calcified lesions located in the middle and lower lobe basal segment .3 cases of homogeneous soft tissue density with increase in mild to moderate strengthening , soft tissue density partial reinforcement degree about 5~16 HU.Conclusions HRCT can show pulmonary hamartoma characteristic calcification and fat density with help in the diagnosis of peripheral hamartoma lungs .Fat or there are both fat and calcifi-cation isolated pulmonary nodules or masses , can consider hamartoma;Instead of n/med tuberculosis good hair part containing calcium isolated pulmonary nodules , should think of hamartoma diagnosis .
2.Construction of mixed ability in eight-year program clinical teaching of obstetrics and gynecology
Kezhen LI ; Wenjun SUN ; Wei LIU ; Xwofeng HE ; Lijiang LIU
Chinese Journal of Medical Education Research 2012;11(3):302-305
Huazhong University of Science and Technology is one of the five schools that trial implementing eight-year program medical education of first batch.Eight-year program medical students in Tongji college came into obstetrics and gynecology clinical contact in 2010.According to the characteristics of students and discipline,obstetrics and gynecology department used multiple teaching methods and means as PBL teaching,integrated case management,typical clinical case conference,clinical diagnosis and treatment,academic lecture,research report,experimental design,scientific research and experi-ment,etc.Available practice mode was reformed.Those students accomplished clinical practice,and achieved expected effect.
3.The effect of irbesartan on the expression of angiopoietin-like protein 2 in the kidneys of type 2 diabetes rats
Yan WANG ; Kezhen LI ; Qi SONG ; Limin ZHOU ; Jian LUAN
Chinese Journal of Nephrology 2014;30(8):609-613
Objective To observe the effect of irbesartan on the expression of angiopoietinlike protein 2 (ANGPTL2) in the diabetic rats kidney and explore the underlying mechanism.Methods A total of sixty male SD rats were divided into normal control group (NC group,n=15) and experimental group (n=45) randomly.The experimental group was fed with high sugar-fat diet and given a low dose streptozocin (STZ 30 mg/kg)to establish type 2 diabetic model.Rats successfully induced diabetes were randomly divided into 2 groups:diabetes group (DM) and irbesartan group (DI).Weight,blood pressure,blood glucose,serum creatinine (Scr),blood urea nitrogen(BUN),24 hour urinary albumin(UAL) and renal histomorphology were observed after drug intervention at the 4th,8th and 12thweeks.The expression of ANGPTL2 in renal tissue were detected by immunohistochemistry,real-time PCR and Western blotting.Results The levels of Scr,BUN,TG,TC and UAL in group DM were higher than in group NC at the 4th,8th and 12th week (all P < 0.05).Compared with that in group DM,above indexes were lower in group DI at the 4th,8th and 12th week (all P < 0.05).The pathological changes of the kidney in group DM were more serious than that in group DI.The expression of ANGPTL2 in group DM was much higher than that in group NC at the 4th,8th and 12th week (all P <0.05),and irbesartan treatment inhibited the up-regulation of ANGPTL2 in group DI(all P < 0.05).Conclusion The expression of ANGPTL2 increases in T2DM rats kidney tissue with time and irbesartan can inhibit the up-regulation of ANGPTL2 in T2DM rats.
4.Preventing Effect of Different Dosages of Progynova in Intrauterine Adhesions After TCRS Under Laparoscope
Yunhong CHEN ; Yiling JIANG ; Li SU ; Yongqun YUAN ; Jihui AI ; Kezhen LI
Herald of Medicine 2016;35(6):604-607,608
Objective To explore the effect of different dosages of progynova in preventing intrauterine adhesions after transcervical resection of septum ( TCRS) under laparoscope. Methods Clinical data of 213 TCRS patients under laparoscope were retrospectively analyzed, and these cases were divided into four groups according to the dosages of progynova. Except for group A (n=26), group B, C, D were given 4,6,8 mg.d-1 of progynova.Endometrial thickness, menstrual blood volume, incidence rates of residual septal and intrauterine adhesions, rate of adverse effect, pregnancy rate after operation and rate of spontaneous abortion were compared among the four groups. Results The incidence rate of residual septal in group A, B, C, D was 11.5%, 6.9%, 6.0% and 6.3%, respectively.Incidence rate of intrauterine adhesions after operation was 46.2%, 12.5%, 9.0% and 4.2%, respectively.The pregnancy rate in group A, B, C and D was 30.8%, 59.7%, 58.2% and 60.4%, respectively. There were significant differences between group A and the other groups(all P<0.05).The high dose of progynova(8 mg.d-1) significantly increased endometrial thickness ( P<0. 05 ) and menstrual blood volume ( P<0. 05 ) . But the incidence rates of gastrointestinal tract reaction, hepatic damage and vaginal spotting in the high dose group of progynova increased obviously( P<0.05) . Conclusion Progynova is a safe and effective drug in preventing intrauterine adhesions after TCRS. It can effectively prevent intrauterine adhesions, increase pregnancy rate and improve pregnant outcome.
5.Experimental study of the effect of asiaticoside on preventing restenosis after percutaneous coronary intervention
Jianxie ZHOU ; Hongwei JIANG ; Lei YI ; Qiang LUO ; Wensheng LI ; Kezhen WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2004;0(05):-
Objective To investigate the feasibility of asiaticoside in preventing restenosis after percutaneous coronary intervention(PCI).Methods The rabbits' model of iliac arterial balloon injury was established and treated with asiaticoside for 4 weeks.The level of serum endothelin(ET),nitric oxide(NO) and C-reactive protein(CRP) was measured respectively and the pathological characteristics of iliac artery of rabbits were observed under light microscope.Results The serum ET and CRP obviously increased and the serum NO significantly decreased after the rabbits' iliac artery was peeled off by balloon injury(Compared~()with the control group,P
6.Correlation between physical status of human papilloma virus and cervical carcinogenesis.
Kezhen, LI ; Xin, JIN ; Yong, FANG ; Changyu, WANG ; Mei, GONG ; Pingbo, CHEN ; Jia, LIU ; Dongrui, DENG ; Jihui, AI
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(1):97-102
The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer, the physical status of HPV-16 in patients with cervical lesions, and the role of HPV-16 integration in cervical carcinogenesis were investigated. HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women. Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection, including 112 specimens with cervical cancer, 151 specimens with CIN I, 246 specimens with CIN and 120 specimens with CINIII. The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection. The frequency of HPV-16 pure integration was 65.18% (73/112), 56.57% (47/120), 23.58% (58/246) and 7.95% (12/151) in cervical cancer, CINIII, CINII and CINI patients respectively. In situ hybridization was performed on some paraffin-embedded sections of CINII, CINIII and cervical cancer to verify the physical status of HPV-16 infection. Significant difference was observed between cervical cancer and CIN I, CINII, CINIII in the frequency of HPV-16 integration (P<0.01). It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer. In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration. The application of testing HPV genotyping and physical status based on detection of HC-II HPV DNA would be in favor of predicting the prognosis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.
7.Suppression of EphB4 improves the inhibitory effect of mTOR shRNA on the biological behaviors of ovarian cancer cells by down-regulating Akt phosphorylation.
Xiangyi, MA ; Danfeng, LUO ; Kezhen, LI ; Ronghua, LIU ; Yan, LIU ; Tao, ZHU ; Dongrui, DENG ; Jianfeng, ZHOU ; Li, MENG ; Shixuan, WANG ; Ding, MA
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(3):358-63
The aim of the present study was to examine the effects of suppression of EphB4 and/or mTOR on the biological behaviors of ovarian cancer cells, and the potential regulatory pathways. Antisense EphB4 vectors and shRNA vectors targeting mammalian target of rapamycin (mTOR) were constructed and transfected into A2780 and SKOV3 cells (two ovarian cancer cell lines). The effects of the antisense EphB4 vectors and the shRNA vectors on the proliferation, apoptosis and invasion of ovarian cancer cells were measured, and the expression of EphB4, mTOR and Akt detected. The results showed that transfection with mTOR shRNA could inhibit growth, induce apoptosis, and reduce invasive ability of ovarian cancer cells, which was accompanied by downregulation of EphB4, mTOR and Akt. The inhibitory effects on cell growth caused by mTOR shRNA alone were weaker than those by antisense pEGFP-C1-EphB4. In the antisense pEGFP-C1-EphB4-transfected cells, it was found that EphB4 knockdown could decrease the mTOR expression and slightly reduce the Akt phosphorylation. Significant suppressive effects on cell growth were observed in cells co-transfected with antisense pEGFP-C1-EphB4 and mTOR shRNA. In co-transfection group, the expression levels of EphB4, mTOR and Akt were distinctly lower than those in other groups. It was concluded that suppression of EphB4 may inhibit the growth of ovarian cancer cells by downregulation of the PI3K/Akt/mTOR pathway, and reverse Akt phosphorylation induced by mTOR shRNA. Inhibition of EphB4 and mTOR combined may cooperatively suppress the biological behaviors of ovarian cancer cells.
8.Suppression of EphB4 improves the inhibitory effect of mTOR shRNA on the biological behaviors of ovarian cancer cells by down-regulating Akt phosphorylation.
Xiangyi MA ; Danfeng LUO ; Kezhen LI ; Ronghua LIU ; Yan LIU ; Tao ZHU ; Dongrui DENG ; Jianfeng ZHOU ; Li MENG ; Shixuan WANG ; Ding MA
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(3):358-363
The aim of the present study was to examine the effects of suppression of EphB4 and/or mTOR on the biological behaviors of ovarian cancer cells, and the potential regulatory pathways. Antisense EphB4 vectors and shRNA vectors targeting mammalian target of rapamycin (mTOR) were constructed and transfected into A2780 and SKOV3 cells (two ovarian cancer cell lines). The effects of the antisense EphB4 vectors and the shRNA vectors on the proliferation, apoptosis and invasion of ovarian cancer cells were measured, and the expression of EphB4, mTOR and Akt detected. The results showed that transfection with mTOR shRNA could inhibit growth, induce apoptosis, and reduce invasive ability of ovarian cancer cells, which was accompanied by downregulation of EphB4, mTOR and Akt. The inhibitory effects on cell growth caused by mTOR shRNA alone were weaker than those by antisense pEGFP-C1-EphB4. In the antisense pEGFP-C1-EphB4-transfected cells, it was found that EphB4 knockdown could decrease the mTOR expression and slightly reduce the Akt phosphorylation. Significant suppressive effects on cell growth were observed in cells co-transfected with antisense pEGFP-C1-EphB4 and mTOR shRNA. In co-transfection group, the expression levels of EphB4, mTOR and Akt were distinctly lower than those in other groups. It was concluded that suppression of EphB4 may inhibit the growth of ovarian cancer cells by downregulation of the PI3K/Akt/mTOR pathway, and reverse Akt phosphorylation induced by mTOR shRNA. Inhibition of EphB4 and mTOR combined may cooperatively suppress the biological behaviors of ovarian cancer cells.
Apoptosis
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genetics
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Cell Line, Tumor
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Cell Proliferation
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Down-Regulation
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genetics
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Female
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Humans
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Ovarian Neoplasms
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pathology
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physiopathology
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Proto-Oncogene Proteins c-akt
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genetics
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metabolism
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RNA, Small Interfering
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genetics
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Receptor, EphB4
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genetics
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metabolism
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Suppression, Genetic
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genetics
9.Establishment of a nomogram prediction model for the etiological type of large vessel occlusive stroke based on clinical and imaging parameters
Ling LI ; Ruoyao CAO ; Yao LU ; Yun JIANG ; Peng QI ; Guoxuan WANG ; Kezhen YU ; Juan CHEN
International Journal of Cerebrovascular Diseases 2023;31(6):409-417
Objective:To develop a nomogram model based on clinical and imaging parameters to predict the etiological type of acute ischemic stroke (AIS).Methods:Patients with AIS received endovascular treatment in Beijing Hospital from March 2016 to December 2021 were retrospectively included. According to the etiological type, they were divided into large artery atherosclerosis (LAA) and cardioembolism (CE). The clinical and imaging parameters mostly relevant to the etiological type were selected by LASSO regression, and a nomogram model for predicting the etiological type of AIS was established by multifactorial logistic regression to investigate the predictive value of relevant clinical imaging parameters. In addition, the diagnostic efficacy of the prediction model was assessed by receiver operator characteristic (ROC) curves, calibration curves, and clinical decision curves. Results:A total of 136 AIS patients with anterior circulation large vessel occlusion received endovascular treatment were included, including 62 patients with CE (45.6%) and 74 with LAA (54.4%). Variables with P<0.10 in the univariate analysis were included in LASSO regression to screen for relevant variables. The gender, baseline National Institute of Health Stroke Scale (NIHSS) score, penumbra to ischemic core ratio, brain natriuretic peptide (BNP), and platelet (PLT) count were included into the multivariate logistic regression model. The results revealed that gender (odds ratio [ OR] 2.632, 95% confidence interval [ CI] 1.048-6.607; P=0.039), baseline NIHSS score ( OR 1.078, 95% CI 1.002-1.160; P=0.043), BNP ( OR 1.004, 95% CI 1.002-1.007. P<0.001), PLT ( OR 0.991, 95% CI 0.982-0.999; P=0.031) as the predictors to distinguish LAA from CE. In addition, the penumbra to infarct core ratio ( OR 0.886, 95% CI 0.785-1.000; P=0.050) also played an important role in predicting the model. The diagnostic efficacy of this predictive model was analyzed by the ROC curves, with an area under the curve of 0.881 (95% CI 0.815-0.930, P<0.001). Bootstrap internal validation showed that the good compliance with a mean absolute error of 0.027 for true versus predicted value compliance. Calibration curves, clinical decision curves, and Hosmer-Lemeshow test ( P=0.562) showed good agreement between the predicted and actual values of the model. Conclusion:Patients with CE are more common in women, have higher NIHSS scores and BNP, and have lower PLT and penumbra to ischemic core ratio. The nomogram model combining the above indicators can better identify LAA and CE, and maybe helpful in clinical decision making.
10.Construction of a comprehensive nutritional index and relationship with quality of life and survival in patients with nasopharyngeal carcinoma undergoing intensity-modulated radiation therapy
Ping YU ; Jiayuan LI ; Kezhen XIAO
Chinese Journal of Practical Nursing 2023;39(24):1899-1906
Objective:To construct a comprehensive nutritional index after treatment of nasopharyngeal carcinoma patients with intensity-modulated radiation therapy (IMRT), and to analyze its relationship with quality of life and 3-year survival period, and aimed to provide some reference for the management of nasopharyngeal carcinoma patients.Methods:This was a prospective cohort study. The clinical data of 431 nasopharyngeal carcinoma patients who admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2017 to December 2021 were collected using convenience sampling method. To evaluate the nutritional status of the patients, the BMI, change in body weight, hemoglobin, lymphocyte count, and albumin level and other clinical data of the patients were collected before and after intensity-modulated radiation therapy. The comprehensive nutrition index after IMRT was constructed by principal component analysis. The Chinese version of European Organization for Reasearch and Treatment of Cancer quality of life questionnare-Core 30 (EORTC QLQ-C30) and Quality of life questionnaire head and neck cancer module(QLQ-H&N35) were used to evaluate the patients′ quality of life. The best diagnostic cutoff point for predicting patient death within 3 years using ROC, and based on the determined optimal diagnostic cutoff point, all patients were divided into a low comprehensive nutritional index group and a high comprehensive nutritional index group. And analyzed the Pearson correlation between comprehensive nutritional index and quality of life.Differences in 3-year survival between the two groups were compared using the Kaplan-Meier method and Log-rank test.Results:Using the diagnostic threshold of receiver operating characteristic, all patients were divided into low comprehensive nutrition index group ( n=280) and high comprehensive nutrition index group ( n=151).The BMI, percentage of weight change, albumin, hemoglobin, and lymphocyte count of nasopharyngeal carcinoma patients before intensity-modulated radiation therapy were (23.14 ± 2.87) kg/m 2, (1.08 ± 0.14)%, (44.02 ± 4.52) g/L, (147.28 ± 15.57)g/L, (1.76 ± 0.56)×10 9/L, and higher than after intensity-modulated radiation therapy (21.14 ± 4.07) kg/m 2, (0.97 ± 0.16)%, ( 38.99 ± 5.12) g/L, (113.87 ± 18.24)g/L, (0.50 ± 0.18)×10 9/L, respectively, the difference were statistically significant ( t values were 8.34 to 44.47, all P<0.05).The comprehensive nutritional index constructed using principal component analysis was correlated with multiple dimensions of EORTC QLQ-C30) and QLQ-H&N35, with statistically significant differences ( r values were -0.169 - 0.245, all P<0.05). Kaplan-Meier curves indicated that the 3-year survival rate of the high comprehensive nutritional index group was higher than that of the low comprehensive nutritional index group, with 87.42% and 79.29% respectively, and the difference was statistically significant ( χ2=4.53, P<0.05). Conclusions:The constructed comprehensive nutritional index could reflect the comprehensive nutritional status of nasopharyngeal carcinoma patients. Nasopharyngeal carcinoma patients with a low comprehensive nutritional index score had a worse quality of life and shorter 3-year survival. Active intervention and improvement of malnutrition in nasopharyngeal carcinoma patients should be undertaken to improve patient quality of life and improve survival.