1.Study of Hippocampal Perfusion in Temporal Lobe Epilepsy Patients with MRI Arterial Spin Labeling(ASL) Technique
Mingyuan HE ; Rui ZHAO ; Pengfei LIU
Journal of Medical Research 2017;46(3):82-86
Objective To perform the main application of MRI arterial spin labeling (ASL) in cerebral blood flow (CBF) on hippocampus of patients with temporal lobe epilepsy for quantitative measurement,to assess the relationship between temporal lobe epilepsy occurrence and hippocampal perfusion and to explore the critical value of hippocampal CBF predict the temporal lobe epilepsy early.Methods Forty-two subjects by video EEG (VEEG) and conventional MR sequences screend were divided into 3 groups eventually,namely group of healthy control,the group with one temporal lobe abnormal discharge,that conventional MRI in hippocampus is not abnormal and the last group with one side hippocampus sclerosis confirmed by conventional MRI in temporal lobe epilepsy patients,then for the hippocampal 3D ASL examination.We provided six same size regions of interest (ROI) in the hippocampal head,body,tail respectively with the best level display to measure and record bilateral hippocampal cerebral blood flow values (CBF values) of every subject,and to explore the relationship between the cerebral blood flow value in the hippocampus and temporal lobe epilepsy.Results Mean cerebral blood flow (CBF) value of each subject's unilateral hippocampus was calculated.The average CBF value of the hippocampus in the healthy control group was 53.82 ± 0.98ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral abnormal discharge group with the ipsilateral and contralateral were 49.12 ± 5.31ml/(100g · min) and 55.99 ± 1.65ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral hippocampal sclerosis group with the ipsilateral and contralateral were 39.57 ± 2.08ml/(100g · min) and 48.06 ± 1.74ml/(100g · min).Then pairwise comparison of the unilateral hippocampal average CBF value among the 3 groups of experimenters in different groups was performed.The results showed that in the eight times,the first six times had statistically significant differences.Comparing between the healthy control group and epilepsy unilateral temporal lobe abnormal discharge group,to calculates the best critical point by the ROC curve,the cut-off value was 46.76.Conclusion Magnetic resonance arterial spin labeling (ASL) technique can evaluate the cerebral blood flow in the hippocampus of patients with temporal lobe epilepsy by quantitative measurement of hippocampal CBF value.The changes of hippocampal perfusion in patients with temporal lobe epilepsy should be preceded by the changes of imaging.ASL quantitative measurement of hippocampal CBF value is helpful for early diagnosis and treatment of temporal lobe epilepsy.
2.The possible relationship between platelet membrane glycoprotein(GP)Ⅰ a gene polymorphism and change of platelet function after PCI.
Guangyuan YANG ; Mingyuan LIU ; Xiaohui ZHAO
Chinese Journal of Practical Internal Medicine 2001;0(03):-
0.05).(2)The plasma GMP-140 levels of both groups was remarkably increased immediately and a decreased trend 24 h after PCI,but did not return to normal(P
3.Effect of bladder volume change on normal tissue doses in 3D conformal brachytherapy for cervical cancer
Dan SHI ; Zhipeng ZHAO ; Mingyuan HE ; Hongfu ZHAO ; Guanghui CHENG
Chinese Journal of Radiation Oncology 2015;24(2):159-162
Objective To evaluate the effect of bladder volume change on the doses to normal tissues in cervical cancer patients undergoing external three-dimensional conformal radiotherapy (3DRT)plus 3D conformal brachytherapy (3DCBT).Methods The study included 56 patients with cervical cancer who were admitted to our hospital from 2012 to 2013 and received radical external 3DRT and 3DCBT.During 3DCBT,the doses to 0.1,1.0,and 2.0 cm3(D0.1 cm3,D1.0cm3,and D2.0cm3,respectively) for the rectum,small intestine,sigmoid colon,and bladder under different bladder filling status (empty,50,100,and 150 ml) were compared and analyzed by paired t-test.Results The rectum D0.1cm3 with bladder volumes of 50and 100 ml were significantly reduced compared with that with an empty bladder (P =0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the small intestine with bladder volumes of 50,100,and 150 ml were significantly reduced compared with those with an empty bladder (P =0.008,0.000,0.000 and 0.000,0.000,0.000 or 0.000,0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the bladder with bladder volumes of 100 and 150 ml were significantly increased compared with those with an empty bladder (P =0.000,0.000 and 0.000,0.000 or 0.000,0.000).Conclusions The doses to the bladder and small intestine are influenced by different bladder filling status,but the doses to the rectum and sigmoid colon show no significant variation.The increase in bladder volume is helpful in reducing the dose to the small intestine.Without any change in the bladder dose,the bladder volume of 50 ml is more beneficial to reduce the dose to the small intestine than those of 100 and 150 ml.
4.Effects of Trichinella spiralis infection on a murine model of OXZ-induced colitis
Ying ZHAO ; Haichuan DOU ; Xuelin WANG ; Mingyuan LIU
Chinese Journal of Microbiology and Immunology 2016;36(1):34-41
Objective To study the effects of Trichinella spiralis (T.spiralis) infection on mice with oxazolone (OXZ)-induced colitis and the possible immunologic mechanism.Methods Female BALB/c mice at age 6-8 weeks were randomly divided into four groups (A to D).Each mouse in groups B and D was infected with T.spiralis strains.Twenty-one days after T.spiralis infection,the mice in groups A and B were treated with 50% ethanol solution,while those in groups C and D were treated with OXZ to induce the murine model of colitis.Several parameters including survival rate,disease activity index (DAI),macroscopic damage and histological score,myeloperoxidase (MPO) activity and the expression of cytokines (IFN-γ,IL-4 and IL-10) in colonic and splenic tissues at mRNA and protein levels were measured 3 and 7 days after modeling.Results No significant differences in the survival rate,DAI score,macroscopic damage score,histological score,MPO activity were observed between mice from groups C and D (P>0.05).Pre-exposing the mice to T.spiralis strains neither alleviated the mucosal damages nor aggravated the condition of colitis.Compared with group C,the expression of IFN-γ on the third day and the expression of IFN-γ,IL-4 and IL-10 on the seventh day at mRNA and protein levels in colon and spleen tissues were significantly increased in mice treated with T.spiralis and OXZ (P<0.05).The expression of IL-10 at transcriptional level in spleen tissues on the third day was higher than that of group C (P<0.05).The expression of IL-4 and IL-10 at protein level in colon tissues on the third day were significantly up-regulated as compared with those of group C (P<0.05).Conclusion The severity of OXZ-induced colitis in the murine model was neither alleviated nor aggravated by pre-exposing the mice to T.spiralis strains.High doses of IL-10 not only weakened the regulatory effects on Th2 responses,but also induced the production of proinflammatory cytokines,resulting in a new drift of Th1/Th2 without aggravating Th2 responses.Further investigation on the mechanism of T.spiralis-induced over-expression of IL-10 should be conducted,which might increase the practicability of using T.spiralis strains against OXZ-induced colitis.
5.A comparative study of CT-and MRI-based three-dimensional conformal brachytherapy for locally advanced cervical cancer
Zhipeng ZHAO ; Yonggang ZHU ; Hongfu ZHAO ; Guanghui CHENG ; Mingyuan HE ; Dan SHI
Chinese Journal of Radiation Oncology 2015;(4):408-413
Objective To compare target volume and dosimetry between computed tomography (CT)?and magnetic resonance imaging (MRI)?guided three?dimensional (3D) conformal brachytherapy for locally advanced cervical cancer, and to provide evidence for optimization of the image?guided approach and improvement of treatment regimen. Methods Thirteen patients with locally advanced cervical cancer who were treated with radical radiotherapy in our hospital in 2014 were enrolled as subjects. All patients received MRI?guided 3D conformal intracavitary/ interstitial brachytherapy. All patients received MRI and CT scans for each brachytherapy fraction, based on which the target volume delineation, intracavitary/ interstitial regimen design, and intracavitary?only treatment regimen design were performed. Comparison of data between MRI and CT scans was performed using paired t test. Results The width and volume of the high?risk clinical target volume ( HR?CTV) were significantly smaller in the MRI simulation than in the CT simulation ((38.0±9?? 4) mm vs. (45.1±8?? 7) mm, P= 0?? 000;(34.2±15?? 3) cm3 vs. (42.9±20?? 4) cm3 , P= 0?? 002), and the width, thickness, and volume of the intermediate?risk clinical target volume (IR?CTV) were also significantly smaller in the MRI simulation than in the CT simulation ((58.8±9?? 4) mm vs. (65.4±10?? 3) mm, P= 0?? 000;(34.8±6?? 3) mm vs. (37.5±6?? 3) mm, P= 0?? 001;(90.9±28?? 5) cm3 vs. (109.0±36?? 4) cm3 , P= 0?? 000). The D90 values for HR?CTV and IR?CTV were significantly higher in the MRI simulation than in the CT simulation (87?? 6 Gy vs. 85?? 8 Gy, P= 0?? 013;67?? 7 Gy vs. 66?? 3 Gy, P= 0?? 005), while the average D2 cm3 values for the bladder and rectum were significantly lower in the MRI simulation than in the CT simulation ( 73?? 1 Gy vs . 75?? 5 Gy , P= 0?? 011 ; 61?? 0 Gy vs . 65?? 7 Gy , P= 0?? 000 ) . Conclusions Compared with the MRI simulation, the CT simulation overestimates the width of target volume. MRI has substantial advantages in dosimetry for target volume and normal tissues. The intracavitary/ interstitial treatment can make up the reduced dose for the target volume resulting from the CT simulation.
6.Dosimetric study of three-dimensional image-quided brachytherapy combined with intracavitary/ interstitial brachytherapy in locally advanced cervical cancer
Ning ZHANG ; Zhipeng ZHAO ; Guanghui CHENG ; Mingyuan HE ; Hongfu ZHAO ; Yuping GE
Chinese Journal of Radiation Oncology 2015;24(3):267-270
Objective To explore the dosimetric advantages of computed tomography-based and ultrasound-guided three-dimensional image-quided brachytherapy (3D-IGBT) combined with intracavitary/interstitial (IC/IS) brachytherapy for locally advanced cervical cancer.Methods A total of 45 patients with FIGO (2009) stage ⅠB2-ⅣA locally advanced cervical cancer who received radical external beam radiotherapy and 3D-IGBT combined with IC/IS brachytherapy in our hospital from 2013 to 2014 were analyzed.After the treatment with 192Ir-based IC/IS brachytherapy,patients had needles removed from the original images and received treatment only from IC radiation sources.Dosimetric differences in the planning D90 for high-risk clinical target volume (HR-CTV),D90 for intermediate-risk CTV (IR-CTV),and D2 cm3 for the bladder,rectum,sigmoid colon,and small intestines were determined and analyzed by paired t-test.Results A total of 260 after-loading treatment plans,including IC/IS treatment plans for 130 patients and IC treatment plans for 130 patients,were made.The D90 for HR-CTV and D90 for IR-CTV in the IC/IS brachytherapy group were significantly higher than those in the IC brachytherapy group (P =0.000;P =0.000).Moreover,the average D2cm3 values for the bladder and rectum were significantly reduced in the IC/IS brachytherapy group compared with those in the IC brachytherapy group (P =0.000;P =0.006).Conclusions The 3D-IGBT combined with IC/IS brachytherapy not only achieves a higher dose for the target volume,but also reduces the radiation dose to the bladder and rectum in the treatment of locally advanced cervical cancer.
7.Correlation between the dose measured in the rectum and reference dose in three-dimensional brachytherapy for cervical cancer
Liqiong LIU ; Zhipeng ZHAO ; Guanghui CHENG ; Mingyuan HE ; Hongfu ZHAO ; Yonggang ZHU ; Dan SHI
Chinese Journal of Radiation Oncology 2015;(6):649-652
Objective To explore the correlation between the dose measured in the rectum and reference dose in three?dimensional brachytherapy ( 3DBT ) for cervical cancer, and to evaluate the significance of the dose measured in the rectum. Methods Fifty patients receiving radiotherapy for cervical cancer were selected, and 3DBT was performed after pelvic external beam radiotherapy. According to the rectal monitoring method recommended in the report ICRU38, in vivo monitoring was applied to obtain the dose measured in the rectum, reference point dose ( DICRU ) , and D2 cm3 , and the planned dose was obtained from the planning system. The differences in these values were determined by the paired t?test and correlation analysis was performed with Pearson test. Results The dose measured in the rectum was higher than the planned dose (3. 48 vs. 3. 25,P=0. 000), and lower than DICRU(3. 48 vs. 3. 71,P=0. 000) and D2 cm3(3. 48 vs. 3. 87,P=0. 002). A linear relationship existed between the dose measured in the rectum and the planned dose, with a deviation percentage of-20% to 40% and an average deviation of 8. 16%;63%of the patients with cervical cancer had a deviation of<± 10%;the maximum deviation was 60%. The dose measured in the rectum had a strong correlation with DICRU(r=0. 722), but a weak correlation with D2 cm3 ( r=0. 284) . Conclusions During 3DBT for cervical cancer, the dose measured in the rectum has certain deviations, but has a linear correlation with the planned dose. Both the dose measured and the planned dose underestimate the dose at the reference point in the rectum, and in vivo rectal monitoring may be an effective method for quality control.
8.The clinical application research of Utrecht applicator in three-dimensional image guided brachytherapy (3D-IGBT) for cervical cancer
Zhipeng ZHAO ; Ning ZHANG ; Guanghui CHENG ; Mingyuan HE ; Dan SHI ; Hongfu ZHAO
Chinese Journal of Radiation Oncology 2016;25(9):950-954
Objective To investigate the clinical application of Utrecht applicator in three-dimensional image-guided brachytherapy (3D-IGBT) for locally advanced cervical cancer,as well as its application discipline in intracavitary/interstitial (IC/IS) therapy.Methods A retrospective analysis was performed for the clinical data of 45 patients with locally advanced cervical cancer who received radical radiotherapy,and the patients received external beam radiotherapy followed by 3D-IGBT.A total of 130 times (n =45) of IC/IS therapy were performed,and the patients who received such therapy were all enrolled.The patients who met the target dose fractionation defined in the plan were enrolled as group A (n=37,86 times),and the other patients were enrolled as group B (n=22,44 times).Two groups difference was analyzed with Group t-test.Results The frequencies of use of 15-,20-,and 25-mm ovoids by the applicator were 50.0%,20.0%,and 30.0%,respectively,and the 30-mm ovoid was not used.A total of 499 needles were used,and the frequencies of use of 6,7,10,and 11 insertion holes were 23.1%,21.2%,21.2%,and 24.1 %,respectively.Group A had a significantly lower mean number of the needles than group B (3.7 vs.4.2,P=0.008).Compared with group B,group A had a significantly lower mean high-risk clinical target volume (CTV)(40.71±18.43 cm3 vs.51.81±14.74 cm3,P=0.001),as well significantly lower width and height of high-risk CTV (P=0.011 and 0.006),but the thickness of high-risk CTV was similar between the two groups (P=0.595).The difference between height and insertion depth (DH) was similar between the two groups (P=0.366).Group A had a smaller difference between width and pinhole distance Dw than group B (P=0.007).Conclusions When IC/IS therapy is performed for locally advanced cervical cancer,the 15-,20-,and 25-mm ovoids of Utrecht applicator and 6,7,10,and 11 insertion holes are frequently used.When the number of needles is no less than 4 and the depth is no less than 3 cm,width is the major factor which affects the planned dose.
9.A comparative study of Utrecht interstitial applicator and ring interstitial applicator in three-dimensional conformal brachytherapy for cervical cancer
Hongfu ZHAO ; Dongmei HAN ; Guanghui CHENG ; Mingyuan HE ; Dan SHI ; Zhipeng ZHAO ; Yonggang ZHU
Chinese Journal of Radiation Oncology 2016;25(4):362-366
Objective To investigate the dosimetric differences between Utrecht applicator and ring applicator in three-dimensional (3D) conformal brachytherapy for locally advanced cervical cancer.Methods Twenty-five patients with locally advanced cervical cancer were treated with magnetic resonance imaging-guided 3D conformal brachytherapy.Utrecht applicator and ring applicator were used interchangeably for 96 cycles.Patients were divided into two groups according to the type of applicator.Each group received 48 cycles of treatment, in which ring applicator was first applied for 26 cycles and Utrecht applicator was first applied for 22 cycles.High-risk clinical target volume ( HR-CTV) , width, thickness, and D90 at the point A level, D2 cm3 of organs at risk (OARs), V7 Gy , W7 Gy,A, V7 Gy ,A, and W/T7 Gy were evaluated and analyzed using paired t-test.Results There were no significant differences in HR-CTV and the width, thickness, and D90 at the point A level between the Utrecht group and the ring group ( P=0.487;P=0.340;P=0.857;P=0.921);there were no significant differences in D2 cm3 values of bladder, rectum, sigmoid, and bowel between the two groups ( P=0.136;P=0.802;P=0.985;P=0.458);there were no significant differences in V7 Gy and T7 Gy,A between the two groups ( P=0.076;P=0.435) .The Utrecht group had a significantly larger W/T7 Gy,A than the ring group ( P=0.002 ) .Conclusions Utrecht applicator is appropriate for patients with relatively large width and width/thickness ratio of HR-CTV at the point A level.
10.Influence of statins on antiplatelet effects of clopidogrel
Hongsong ZHANG ; Mingyuan LIU ; Mei HAN ; Feng CHEN ; Jincheng ZHAO ; Xue BAI ; Yu YANG ; Guangyuan YANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):543-546
Objective:To observe influence of statins on antiplatelet activity of clopidogrel and provide basis for ra‐tionality of statins combined clopidogrel treatment .Methods :According to random number table ,a total of 90 pa‐tients diagnosed as acute coronary syndrome were equally divided into clopidogrel group ,clopidogrel + simvastatin group and clopidogrel + pravastatin group . Three groups received corresponding routine medication treatment . Plasma levels of platelet αgranule membrane protein (CD62P) ,lysosomal granule membrane glycoprotein (CD63) and maximum platelet aggregation rate (MPAR) were measured and compared among three groups before and 3d af‐ter treatment .Results:Compared with before treatment ,after treatment ,there were significant reductions in plas‐ma levels of CD62P and CD63 and MPAR in three groups , P<0.01 all .After treatment ,there were no significant difference in plasma levels of CD62P [ (14.63 ± 3.45) ng/ml vs .(14.14 ± 4.32) ng/ml vs .(14.59 ± 4.23) ng/ml] , CD63 [ (26.32 ± 10.43) ng/ml vs .(27.04 ± 10.75) ng/ml vs .(27.29 ± 9.27) ng/ml] and MPAR [ (28.62 ± 17.68)% vs .(28.38 ± 16.43)% vs .(29.13 ± 14.23)% ] among clopidogrel group ,clopidogrel + simvastatin group and clopidogrel + pravastatin group ,P>0.05 all .Conclusion:Short‐term and routine dose of statins combined clo‐pidogrel is feasible in treatment of acute coronary syndrome .The combined use of them will not affect antiplatelet function of clopidogrel .