2.Prognosis of Patients with Acute Internal Carotid Artery or Middle Cerebral Artery Occlusion
Xiaoling LIAO ; Yilong WANG ; Yongjun WANG ; Jing XUE ; Peiyi GAO
Chinese Journal of Rehabilitation Theory and Practice 2007;13(8):714-715
Objective To investigate prognosis of acute ischemic patients with internal carotid artery or middle cerebral artery occlusion and define predictors of clinical outcome.MethodsThe clinical and radiological data of 48 stroke patients who underwent magnetic resonance angiography (MRA) within 6 hours of symptom onset and visualized internal carotid artery or middle cerebral artery occlusion on early MRA were analyzed. 90 days after onset, modified Ranking Scale (mRS) scores were obtained and factors related with prognosis were defined by logistic regression analysis.ResultsOf 48 patients, 17 cases (35.4%) got good clinical outcome (mRS 0~2), 31 cases (64.6%) got poor clinical outcome (mRS 3~6) with 7 cases (14.6%) died. In multivariate logistic regression analysis, only large infarction ( OR=21.1, 95%CI 1.4~314.2, P=0.027) and hyperglycaemia ( OR=5.1, 95%CI 1.3~19.8, P=0.019) were independent predictors of poor outcome.ConclusionClinical outcomes of most acute stroke patients with internal carotid artery or middle cerebral artery occlusion are poor. Large infarction and hyperglycaemia are independent predictors of clinical outcome.
3.Clinical Features and Prognosis of Acute Ischemic Stroke Patients with Different Infarction Patterns
Xiaoling LIAO ; Yilong WANG ; Yongjun WANG ; Jing XUE ; Peiyi GAO
Chinese Journal of Rehabilitation Theory and Practice 2007;13(3):212-214
Objective To investigate the clinical features and prognosis of acute ischemic stroke patients with different infarction patterns.Methods87 patients who underwent diffusion weighted imaging (DWI) within 6 h after symptom onset and visualized acute cerebral infarcts within the middle cerebral artery territory were prospectively studied.According to DWI lesion patterns,the patients were divided into 6 groups.Before MR was performed and 24 h after onset,scores of National Institutes of Health Stroke Scale (NIHSS) were recorded.3 months after onset,scores of modified Ranking scale(mRS) were obtained.ResultsThe baseline NIHSS,infarction volume,occlusion of relevant internal carotid artery or middle cerebral artery and clinical outcome were significantly different among 6 groups(P<0.05).ConclusionDifferent infarction patterns of acute ischemic stroke were associated with clinical symptoms,vascular status,and clinical outcome,that may help to guide treatment and judge prognosis.
4.Imaging and pathological features of atypical teratoid/rhabdoid tumors in the central nervous system
Huachen ZHU ; Jian ZHOU ; Zhiping WANG ; Nan ZHOU ; Peiyi GAO
Journal of Practical Radiology 2014;(8):1263-1266
Objective To investigate the imaging and pathological features of atypical teratoid/rhab doid tumor (AT/RT)occur-ring in the central nervous system (CNS).Methods The CT and MRI findings of 1 6 patients with CNS AT/RT were retrospectively analyzed,and their pathological and immunohistochemical results were studied.Results There were 12 males and 4 females. Tumors located is at supratentorial in 10 and infratentorial in 6.Cystic changes in tumors were noted in 12 cases.The solid portion of tumors was isointense on T2-weighted images relative to normal brain grey matter in 9 patients.Extensive peritumoral edema was observed in 1 1 lesions.The tumors showed bandlike rim of significant enhancement in 10 cases.The incidence of hemorrhage and calcification in tumors were 43.8% and 41.7% respectively.Histopathologically,AT/RT was characterized by the presence of rhab-doid cells associated with variable components of epithelial,primitive neuroectodermal and mesenchymal differentiation.Conclusion Atypical teratoid/rhabdoid tumor is several imaging findings which are relatively specific on CT and MR images.CT and MRI may provide valuable information for pre-operation diagnosis and prognostic evaluation in patients with CNS AT/RT.
5.Possibility of three-dimensional time-of-flight magnetic resonance angiography as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease prior to stent implantation
Mingyong LIU ; Lichun ZHOU ; Yongjun WANG ; Jing LEI ; Peiyi GAO
Chinese Journal of Tissue Engineering Research 2008;12(48):9597-9600
AIM: To investigate whether three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) can be used as a reliable screening tool for evaluation of intracranial vascular stenosis and occlusive disease before stent implantation. METHODS: Thirty-three patients with suspected intracranial arterial stenosis received 3D TOF MRA and digital subtraction angiography (DSA) examinations in Chaoyang Hospital Affiliated to Capital Medical University between March 2007 and April 2008,and were included for this study. Two physicians blindly estimated stenosis,patient history,and clinical information of 363 vascular segments from 33 patients,including bilateral internal carotid artery (ICA),anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery,and basilar artery (BA). Stenosis was categorized as 30%-49%,50%-69%,70%-99%,and 100%. For each kind of stenosis,sensitivity,specificity,positive predictive value,negative predictive value,K and P values of MRA were calculated,respectively,as compared to DSA. RESULTS: A total of 42 diseased vascular segments were identified. Compared to DSA,for intracranial stenosis 50%-69%,3D TOF MRA showed sensitivity 100%,specificity 96.8%,positive predictive value 62.1%,negative predictive value 100%,K value 0.751,and P value 0.000; For intracranial stenosis 70%-99%,the corresponding value was 100%,98.6%,70.6%,100%,0.821,and 0.000,respectively; For intracranial stenosis 30%-49%,it was 25.0%,99.7%,66.7%,98.3%,0.356,and 0.000,respectively.CONCLUSION: For high sensitivity and specificity to intracranial stenosis 100%,70%-99%,or 50%-69%,compared to DSA,3D TOF MRA is a reliable screening tool for preoperational evaluation of intracranial vascular stenosis and occlusive disease.
6.Expression of MPO and TGF-β1 in Ulcerative colitis
Yanying WANG ; Lifang SUN ; Jing YU ; Yanfeng WANG ; Zhiwei YANG ; Xiaoguang MIAO ; Peiyi ZHANG ; Yindong WANG
Journal of Chinese Physician 2009;11(1):31-33
Objective To explore the expression and effect of MP0 and TGF-β1 in ulcerative colitis tissues.Methods The expressions of MPO and TGF-Bl in colonal tissue specimens were determined by immunohistochemistry(two step method)in 37 cases of ulcerative colitis,10 crohng disease and 20 normal mucosa.Results The positive rates of MPO and TGF.B1 were 10%and 20.0%in the normal mucosa,55.0%and 35.O%in crohn's disease,and 89.2%and 86.5%in ulcerative colitis.Expression of MPO and TGF-β1 in the ulcerative colitis were higIIer than that in crohn's disease and normal mucosa(P<0.05),there was correlation between MPO and TGF-β1(r=O.51,P<0.05).Conclusion MPO and FGF-β1 are involved in the pathology of UC,and detection of MPO and TGFβ1 can provide some value to evaluate the conditions of UC.
7.The clinical application of chromoendoscopy with acetic acid and indigo carmine dye in the diagnosis of early gastric neoplasia and precancerous lesion
Lihua HU ; Peng CHEN ; Jiye ZHANG ; Yanying WANG ; Wenduo WANG ; Peiyi ZHANG
Clinical Medicine of China 2014;30(3):288-290
Objective To investigate the significance of chromoendoscopy with acetic acid and indigo carmine dye in the diagnosis of early gastric neoplasia and precancerous lesion.Methods After conventional electronic endoscopic diagnosis,From 2011 fanuay to 300 patients of suspicious lesions were randomly divided into endoscopic dye group and control group,each was 150 cases.Patients of endoscopic dye group were directly performed biopsy after acetic acid and indigo carmine dye,while in control group were performed biopsy after only indigo carmine dye.Results In the endoscopic dye group,16 early neoplasia (10.7%),15 severe atypical hyperplasia (10.0%),79 moderate atypical hyperplasia or Intestinal metaplasia (52.7%) and 40 chronic gastritis were found.In the control group,5 early neoplasia (3.3%),10 severe atypical hyperplasia (6.7%),42 moderate atypical hyperplasia or Intestinal metaplasia(28.0%) and 93 chronic gastritis were found.Early gastric cancer and precancerous lesion detection rate of endoscopic dye was significantly higher than that of the control group,and the difference was statistically significant (P < 0.001).After samples were stained with acetic acid and indigo carmine dye,the image of the mucosa of early cancer and severe atypical hyperplasia were faded mucosa,and the image of moderate atypical hyperplasia and Intestinal metaplasia was dyed asymmetrical.Chronic gastritis and normal mucosa was showed dyed equality.Conclusion Chromoendoscopy with acetic acid and indigo carmine dye improve the detection rate of early gastric cancer and precancerous lesion,thereby of high application value.
8.Application of a new mismatch model on evaluating infarct core and penumbra in acute ischemic stroke using CT perfusion source images
Xiaochun WANG ; Peiyi GAO ; Jing XUE ; Guangrui LIU ; Li MA ; Chen WANG
Chinese Journal of Radiology 2009;43(3):231-234
Objective To assess the diagnostic value of determining infarct core and penumbra using CT perfusion source images (CTP-SI) mismatch model in hemispheric stroke less than 9 hours.Methods "one-stop shop" CT examination including non-contrast enhanced CT (NCCT), CTP, CT angiography (CTA) were performed in 24 patients with symptoms of stroke less than 9 hours.The Alberta Stroke Program Early CT Score (ASPECTS) were analyzed on arterial phase CTP-SI and venous phase CTP SI using Wilcoxon rank-sum test, then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median (min-max) scores of ASPECTS on arterial phase CTP-SI, venous phase CTP-SI and follow-up imaging were 9.0 ( 2.0-10.0 ), 9.3 ( 6.5-10.0 ) and 9.0 ( 7.0-10.0 ),respectively. ASPECTS measured on arterial phase CTP-SI significantly differed from the ASPECTS on venous phase CTP-SI ( Z =-2.812, P = 0.005 ).Moreover, the linear regression analysis showed significant correlation between the ASPECTS on venous phase CTP-SI and follow up imaging ASPECTS ( Beta =0.715,P = 0.003 ).Conclusion CTP-SI mismatch model provides a method of choice in predicting penumbra and infarct core in hemispheric stroke.
9.The effect of erythropoietin on myocardial cytoskeletal proteins after hypoxia/reoxygenation injury
Huilin JIANG ; Huajun WANG ; Bingliu LI ; Xiaohui CHEN ; Yongcheng ZHU ; Peiyi LIN
Chinese Journal of Emergency Medicine 2014;23(3):294-298
Objective To observe the impact of hypoxia/reoxygenation on myocardial cytoskeletal proteins (α-actinin protein,tubulin protein,desmin protein) and to investigate EPO lessening the damage of myocardial cytoskeleton proteins in rats proved by culturing hypoxia/reoxygenation injured myocardial cells in presence of EPO.Methods The rat model of asphyxia-induced cardiac arrest was performed by turning-off the ventilator and clamping the endotracheal tube.After asphyxia for 8 minutes,CPR was carried out.A total of 24 rats were divided into normal group,ischemia/resuscitation (I/R) group and the EPO group (n =8).The model of myocardial dysfunction was determined 2 hours after restoration of spontaneous circulation (ROSC).The rats of EPO group were given EPO 5000 U/kg after ROSC.The rat heart specimens were collected.Actinin,Tubulin and Desmin protein were observed by SABC immunohistochemistry.The cultured cardiomyocytes were taken from neonatal rats and were divided into three groups:the normal group,the hypoxia/reoxygenation (H/R) group (hypoxia 10 h/reoxygenate 4h),the EPO group (hypoxia 10 h/reoxygenate 4 h,plus 10 U/mL EPO).The changes of tubulin and actinin in cultured cardiomyocytes were observe by Immunofluorescence.Results From immunohistochemistry,there were no significant difference in the optical density of actinin,tubulin and desmin among the normal,I/Rand EPO groups.After H/R injury,the structures of the actinin,tubulin protein were destroyed,the network structure of both protein were unclear in cultured myocardial cells.The grades of fluorescence intensity of actinin and tubulin in H/R group were significant lower than those in normal group,but there was no significant difference between H/R group and EPO group.Conclusions The damage of cytoskeleton during ischemia/reperfusion may be time-dependent.EPO has no beneficial effect on the cytoskeleton after I/R injury.
10.Therapeatic effects of two different dosage of rosuvastatin on endothelial dysfunction in diabetic rats
Peiyi XIE ; Zhijie ZHANG ; Yousu SU ; Wen AI ; Fei CHEN ; Lei WANG ; Shaoyuan CHEN
Chinese Journal of Geriatrics 2011;30(8):687-689
Objective To evaluate the effects of two different dosage of rosuvastatin on endothelial dysfunction in diabetic rats. Methods The 24 diabetic rats were randomly divided into three groups (n=8,each): diabetic control group, 20 mg rosuvastatin daily (RV 20 mg group) and 10mg rosuvastatin daily for 8 weeks (RV 10 mg group) and normal control group (SD group). The levels of blood glucose, lipid, nitric oxide(NO) and endothelin-1 (ET-1) were measured before and 8 weeks after treatment. Results The levels of blood glucose were higher in all diabetic rats groups than in SD group before experiment (P<0. 01). Compared with diabetic rats control group, blood glucose was slightly lower in RV 10 mg group and RV 20 mg group at 8 weeks (P>0. 05). The plasma NO level was significantly lower in diabetic rats control group than in SD group (P<0. 05).After 8 weeks, plasma NO levels were significantly higher in RV 20 mg and RV 10 mg groups than in diabetic rats control group (P<0. 01 or P<0. 05). The plasma levels of ET-1 was significantly higher in diabetic rats control group than in SD group (P<0. 01). After 8 weeks, plasma ET-1 levels were significantly lower in RV 20 mg and RV 10 mg group than in diabetic rats control group (P<0. 01).Meanwhile, the plasma lipids were lower in RV 20 mg and RV 10 mg group than in diabetic control group (P<0. 05 or P<0. 01). Conclusions Rosuvastatin can adjust blood lipids and significantly improve endothelial function in diabetic rats by increasing plasma NO level and decreasing plasma ET-1 level.