1.Clinical features of direct carotid cavernous fistulas: comparison with indirect carotid cavernous fistulas
Wenjing SONG ; Li LU ; Hao CHEN ; Wei ZHANG ; Jie ZU ; Lei BAO ; Kun ZAN ; Guiyun CUI
International Journal of Cerebrovascular Diseases 2021;29(1):18-23
Objective:To investigate the clinical features of direct and indirect carotid cavernous fistulas (CCFs).Methods:Patients with CCF treated in the Affiliated Hospital of Xuzhou Medical University from January 2010 to August 2020 were enrolled retrospectively. Relevant clinical data were collected, including the main clinical manifestations, neuroimaging features, and treatment methods. The clinical features of direct and indirect CCFs were compared.Results:A total of 31 patients were enrolled in the study, 29 (93.5%) had ocular symptoms, of which conjunctival hyperemia and edema ( n=24, 77.4%), exophthalmos ( n=19, 61.3%) and orbital murmur ( n=18, 58.1%) were most common. There were 23 patients (74.2%) in direct CCF group and 8 (25.8%) in indirect CCF group. The former had more history of head trauma (78.2% vs. 12.5%; P=0.002), more flow volume (high-flow CCFs: 100% vs. 37.5%; P<0.001) and more likely to cause orbital murmur (69.6% vs. 25.0%; P=0.043). Endovascular embolization was safe and effective. The common methods of endovascular embolization were EVAL glue combined with coil embolization ( n=18, 66.7%) and detachable balloon embolization alone ( n=6, 22.2%). Conclusion:Ocular manifestations are most prominent in patients with CCFs. Direct CCF is more common, usually with a history of head trauma, and the clinical and imaging features are more typical. Interventional embolization is the preferred treatment option for patients with CCF.
2.Clinical manifestations and MR imaging characteristics of hypertrophic olivary degeneration
Kun ZAN ; Xin LI ; Jie ZU ; Gui-Yun CUI
Chinese Journal of Neuromedicine 2013;12(9):953-955
Objective To analyze the clinical manifestations and MRI characteristics of hypertrophic olivary degeneration (HOD) to improve our knowledge for this disease and reduce misdiagnosis.Methods Twelve patients with HOD,admitted to our hospital from 2009 to 2012,were chosen in our study; their clinical data,including onset age,protopathy and other clinical manifestations,and imaging data,including SE sequence axial T1WI,T2WI and FLAIR fast spin-echo imaging,were analyzed.Results The protopathy in these 12 patients included pontine hemorrhage in 5,cerebellar infarction in 3,cerebral hemorrhage in 2,midbrain infarction in 1 and surgery for cerebellar tumor in 1.The main clinical symptoms included palatal myoclonus in 7,ataxia in 6,ocular myoclonus in 5,glossolalia in 3,diplopia in 2 and extremity tremor in 2.The region of inferior olivary nucleus (ION)presented high intensity on T2WI and iso-or mild hypointensity on T1WI in all 12 patients.Bilateral ION showed high signals in 5 in FLAIR; enlargement of the ION in 11 patients were noted.Conclusions HOD is a pathological phenomenon that occurs after injury to the dentato-olivary pathway.Its hallmarks include hypertrophy of the olive with increased T2 signal intensity on magnetic resonance imaging,and it often manifests with oculopalatal myoclonus clinically.
3.Expression and function of vascular endothelial growth factor and angiopoietins in rat brain after cerebral ischemia.
Li-kun ZAN ; Yue-jia SONG ; Guo-xin TENG ; Heng LI ; Wei LIU ; Ying JIA ; Min ZHOU ; Yu-lan SUN ; Ji-ping QI
Chinese Journal of Pathology 2011;40(12):834-839
OBJECTIVETo examine the temporal and spatial expression of vascular endothelial growth factor (VEGF) and angiopoietins (Ang) in rat brain after cerebral ischemia, and to elucidate the roles they played in angiogenesis and vascular permeability.
METHODSRats were subjected to either middle cerebral artery occlusion (MCAO) or sham operation. Reverse transcriptase-polymerase chain reaction, Western blotting, and immunohistochemistry were used to detect the expression of VEGF, Ang-1 and Ang-2 at different time points after ischemia. CD31 was used to label endothelial cells after MCAO. Vascular permeability was determined by Evans blue.
RESULTSVEGF was markedly increased at 2 h, had an initial peak at 12 h (0.7249 ± 0.1933, P < 0.01), and a second peak at 7 days (0.5264 ± 0.1519, P < 0.01). Ang-2 mRNA and protein significantly increased after MCAO, both of them peaked at 12 h (0.6747 ± 0.2416, P < 0.01; 1.1197 ± 0.1780, P < 0.01). In contrast, Ang-1 mRNA and protein gradually decreased after MCAO, respectively reaching a minimum at 3 d (0.3220 ± 0.1427, P < 0.01) and 1 d (0.1298 ± 0.0293, P < 0.01). Changes in the expression of these factors correlated with the progress of angiogenesis and vascular permeability. Evans blue test revealed that the vascular permeability gradually increased, and peaked at day 1 after ischemia [(6.219 ± 0.887) µg/g, P < 0.01].
CONCLUSIONDynamic temporal changes in VEGF, Ang-1 and Ang-2 expression stimulate the cerebral angiogenesis after focal cerebral ischemia.
Angiopoietin-1 ; genetics ; metabolism ; Angiopoietin-2 ; genetics ; metabolism ; Animals ; Blotting, Western ; Capillary Permeability ; Immunohistochemistry ; Infarction, Middle Cerebral Artery ; metabolism ; pathology ; physiopathology ; Male ; Neovascularization, Physiologic ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A ; genetics ; metabolism
4.Effect of mtrine on Fas expression in C6 glioma in rats
Ji-Ping QI ; Wei LIU ; Shu-Jun ZHANG ; Li-Kun ZAN ; Yu-Lan SUN ; Yue-Jia SONG
Chinese Journal of Neuromedicine 2009;8(4):355-358
Objective To investigate the effect of matrine on Fas expression in C6 glima in a tumor-bearing rat model. Methods Cultured cerebral glioma C6 cells wgre injected stereotactically into the lef tcaudate nucleus of the rats.The ratswere randomized into untreated group,bomeol-treated group,low-dose matrine group,high-dose maaine group,low-dose matrine+bomeol group,and high-dose matrine+borneol group.The effect of matrine on the quality of life of the rats and the glioma volume was evaluated according to the survival state of the rats and by gross observation,magnetic resonance imaging(MRJ)and HE smining of the brain tissue.Immunohistochemistry was performed to detect Fas expression in the glioma cells. Results The survival state ofthe rats,gross observation of the brain specimen. and results of MRI and HE staining all showed that matrine significantly improved the quality oflife of the glioma-bearing rats and inhibited the glioma cell proliferation.Fas expression Was significantly higher in low-dose matrine+bomeol group(98.16±11.82) and high-dose matrine+bomeol group(112.80±12.12)than in untreated group(39.09±7.79),bomeol group(46.87±7.43),low-dose matrinc group(42.41±7.83),and high-dose matrine group(44.20±7.47)(P<0.05).Fas expression Was obviously upregulated in the high-dose matrine+bomeol group aS compared with the low-dose matrine+bomeol group(P<0.05).Conclusion Matrine Can significantly upregulate Fas expression in glioma and inhibit glioma cell proliferation in the glioma-bearing rat model.
5.Effect of notoginseng radix on expression quantity of TGF-beta1/ Smads and CTGF mRNA in rats with alcoholic liver disease.
Zan-Ling ZHANG ; Zuo-Jun LI ; Shi-Kun LIU ; Yu-Lu ZHOU
China Journal of Chinese Materia Medica 2013;38(17):2859-2862
OBJECTIVETo evaluate the effect of Notoginseng Radix on hepatic expression of transforming growth factor beta1 (TGF-beta1) and connective tissue growth factor (CTGF) in rats with alcoholic liver disease (ALD), in order to discuss its protective effect on alcoholic cirrhosis.
METHODFifty SD male rats were divided into the normal control group, the model group, the high-dose and low-dose Notoginseng Radix groups (3.0, 12.0 g x kg(-1)) and the magnesium isoglycyrrhizinate group (24 mg x kg(-1)), with 10 rats in each group. Apart from the control group, other groups were administered with ethanol-cornoil-pyrazole for 14 weeks to establish the alcoholic liver disease model. During the establishment of the model, the high-dose and low-dose Notoginseng Radix groups were administered with 12 g x kg(-1) x d(-1) Notoginseng Radix for 14 weeks, once everyday. Efforts were made to detect liver function, pathology with Masson staining, and the expressions of TGF-beta1, Smad3, Smad7 and CTGF mRNA.
RESULTCompared with the rats in model group, rats in Notoginseng Radix groups showed significant reduction in liver ALT, AST, collagen fiber deposition, and TGF-beta1, Smad3 and CTGF mRNA expressions in liver tissues, with the increase in the expression quantity of Smad7 mRNA. There were differences between the Notoginseng Radix groups. No significant difference was observed between the high-dose Notoginseng Radix group and the magnesium isoglycyrrhizinate group.
CONCLUSIONNotoginseng Radix can affect TGF-beta1/Smads signaling pathway and reduce the expression of CTGF.
Animals ; Connective Tissue Growth Factor ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Gene Expression ; drug effects ; Humans ; Liver Diseases, Alcoholic ; drug therapy ; genetics ; metabolism ; Male ; Panax notoginseng ; chemistry ; Rats ; Rats, Sprague-Dawley ; Smad3 Protein ; genetics ; metabolism ; Smad7 Protein ; genetics ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism
6.Evaluation on the feasibility of total-body PET/CT imaging with short acquisition time in lungs and parenchymal organs
Minjie ZHAO ; Keyu ZAN ; Zhaoping CHENG ; Xiao CUI ; Leiying CHAI ; Kun LI ; Min GE ; Yanhua DUAN
Chinese Journal of Nuclear Medicine and Molecular Imaging 2022;42(12):713-718
Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.
7.Treatment of aseptic ulnar diaphyseal nonunion with locking compression plate and autogenous iliac bone graft.
Dong-Xu FENG ; Liang SUN ; Wei-Lou FENG ; Kun ZHANG ; Shu-Hao LI ; Wei HUANG ; Yang-Jun ZHU ; Zan-Dong ZHAO
China Journal of Orthopaedics and Traumatology 2019;32(12):1160-1164
OBJECTIVE:
To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion.
METHODS:
From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated.
RESULTS:
All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed.
CONCLUSIONS
LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.
Adolescent
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Adult
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Bone Plates
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Bone Transplantation
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Diaphyses
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Female
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Fracture Fixation, Internal
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Fractures, Ununited
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surgery
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Humans
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Ilium
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Male
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Middle Aged
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Retrospective Studies
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Treatment Outcome
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Ulna
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Young Adult