1.Diagnosis and management for peripancreatic pseudoaneurysms
Chengwu ZHANG ; Tingyang HU ; Jie LIU ; Yuhua ZHANG ; Zhiming HU ; Defei HONG ; Dongsheng HUANG
Chinese Journal of General Surgery 2017;32(3):207-210
Objective To summarize the experience of diagnosis and treatment for peripancreatic pseudoanemysms.Methods The clinical data of 12 patients with peripancreatic pseudoaneurysm were analyzed retrospectively.Out of 12 patients,6 presented with abdominal or alimentary tract bleeding because of pseudoaneurysm rupture.Possible etiology included chronic pancreatitis (6 cases),severe acute pancreatitis (3 cases),postpancreatoduedenectomy (3 cases),developed after transarterial chemoembolisition for hepatic carcinoma (1 case) and 1 without any definitive cause.Results Interventional radiology as first therapeutic procedure was carried out in 10 patients including 9 endovascular coil embolizations and 1 stent graft placement for pseudoaneurysm from branch of SMA,and bleeding was controlled successfully in 5 patients with pseudoaneurysm rupture.2 patients underwent laparotomy as initial therapy.Three patients underwent surgeries after a failed embolisation,another underwent laparotomy and peritoneal lavage and drainage for pancreaticoenteric anastomotic leak complicated with abdominal infection.2 SAP patients underwent ultrasound guided drainage for peripancreatic abscess.2 after PD patients died,with mortality of 16.7% (2/12).Conclusions Peripancreatic pseudoaneurysm carried a high and an unpredictable risk of rupture that warranted prompt interventional treatment or surgery.
2.Application of fast susceptibility weighted imaging based on deep learning in assessment of acute ischemic stroke
Qi DUAN ; Caohui DUAN ; Shiqing ZHOU ; Jinhao LYU ; Xiangbing BIAN ; Dekang ZHANG ; Kun CHENG ; Mingliang YANG ; Xueyang WANG ; Tingyang ZHANG ; Xinbo XING ; Chenglin TIAN ; Xin LOU
Chinese Journal of Radiology 2023;57(1):34-40
Objective:To explore the value of fast susceptibility weighted imaging (SWI) generated by a deep learning model in assessment of acute ischemic stroke (AIS).Methods:From January 2019 to January 2021, 118 AIS patients [75 males and 43 females, aged 23-100 (66±14) years] who underwent MR examination and SWI sequence scanning within 24 h of symptom onset in the First Medical Center of PLA General Hospital were retrospectively analyzed. MATLAB ′s randperm function was used to divide 118 patients into a training set of 96 cases and a test set of 22 cases at a ratio of 8∶2. Fourty-seven AIS patients [38 males and 9 females, aged 16-75 (58±12) years] from one center of a multicenter study were selected to build the external validation set. SWI image and filtered phase image were combined into complex value image as full sampling reference image. Undersampled SWI images were obtained by retrospective undersampling of reference fully sampled images, and the undersampling multiple was five times which could save 80% of the scanning time, then the complex-valued convolutional neural network (ComplexNet) was used to develop reconstruct fast SWI. Interclass correlation coefficient (ICC) or Kappa tests were used to compare the consistency of image quality and the diagnostic consistency for the presence of susceptibility vessel sign (SVS), cerebral microbleeds and asymmetry of cerebral deep medullary veins (DMVs) in AIS patient on fully sampled SWI and fast SWI based on ComplexNet.Results:In test set, score of image quality was 4.5±0.6 for fully sampled SWI image and 4.6±0.7 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.86, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.79, P<0.05), microbleeds (Kappa=0.86, P<0.05), and DMVs asymmetry (Kappa=0.82, P<0.05) in AIS patients. In the external validation set, score of image quality was 4.1±1.0 for fully sampled SWI image and 4.0±0.9 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.97, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.74, P<0.05), microbleeds (Kappa=0.83, P<0.05), and DMVs asymmetry (Kappa=0.74, P<0.05) in AIS patients. Conclusions:Deep learning techniques can significantly accelerate the speed of SWI, and the consistency of image quality and detected AIS signs between fast SWI based on ComplexNet and fully sampled SWI is good. The fast SWI based on ComplexNet can be applied to the radiographic assessment of clinical AIS patients
3.Preliminary study on the mechanism of infertility in female SD rats with spontaneous dwarfism
Hong LONG ; Chunmao HUO ; Kang LI ; Fengyun BAO ; Tingyang QIN ; Yujia ZHAO ; Shibin ZHANG
Acta Laboratorium Animalis Scientia Sinica 2023;31(11):1415-1422
Objective To investigate the causes of infertility and its pathological mechanism in female SD rats with spontaneous dwarfism(short stature rat,SSR).Methods Adult wildtype and SSR female SD rats were used in this study.A vaginal smear was used to observe changes in the motile cycle.Ovulation promotion was compared using the simultaneous estrus supernumerary ovulation method.Ovarian and uterine weight and body weight,and ovarian and uterine indices were measured.AMH,E2,FSH,LH,and FSH/LH levels in serum were measured.Transcriptome sequencing of ovarian tissues was performed to analyze gene expression differences.Results No abnormalities were observed in the estrous cycle of SSR female rats.The body weight of SSR female rats was significantly lower than that of wildtype rats,and their ovarian and uterine indices were significantly higher than that of wildtype rats.The mean number of ovulations was significantly higher in wildtype rats than in SSR female infertile rats(P<0.001).Serum AMH(P<0.01)and E2(P<0.05)levels were significantly higher in wildtype rats than in SSR female infertile rats,and serum levels of FSH,LH,and FSH/LH(P<0.05)were significantly lower in SSR infertile females than in SSR infertile rats,while PROG showed no significant difference.Transcriptome sequencing yielded 250 differentially expressed genes,including 190 upregulated and 60 downregulated genes.p53 signaling pathway and cytokine-cytokine receptor interaction.The MCC,MNC,EPC,and degree calculations of the CytoHubba plug-in were used to screen the top 10 significant nodes.The intersection was used to finally obtain nine hub genes,namely Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2.Conclusions Infertility in SSR female rats may be related to a decreased ovarian reserve function and poor ovarian response.Cxcl1,Cxcl2,IL1a,IL1b,Cd80,Mmp13,Mmp8,Fgf3,and Ptgs2 were associated with infertility,laying a theoretical foundation to further explore infertility mechanisms.
4.Clinical efficacy of atezolizumab plus bevacizumab in the first-line treatment of advanced hepatocellular carcinoma
Yi LU ; Junwei LIU ; Guoliang SHEN ; Junfa CHEN ; Tingyang HU ; Haijun HUANG ; Ran TAO ; Chengwu ZHANG
Chinese Journal of Digestive Surgery 2021;20(S2):25-28
Primary hepatic carcinoma has ranked as the sixth most commonly diagnosed cancer and the third leading cause of cancer death. China shares about 50% of new liver cancer cases, including 80% of hepatic carcinoma. Non-surgical therapy continues to make breakthroughs. The authors report a case of hepatic carcinoma with intrahepatic metastasis and tumor thrombus in the left portal vein, which has achieved continious partial response after the treatment of atezoli-zumab combined with bevacizumab, without adverse reactions such as liver and kidney function damage. The life quality of the patient was improved, showing safety and efficacy of the treatment.
5.MRI study of the relationship between the cerebral small vessel disease total burden and imaging markers and degree of middle cerebral artery stenosis
Xinbo XING ; Xueyang WANG ; Jinhao LYU ; Qi DUAN ; Caohui DUAN ; Xiangbing BIAN ; Kun CHENG ; Mingliang YANG ; Tingyang ZHANG ; Chenglin TIAN ; Xin LOU
Chinese Journal of Radiology 2024;58(1):34-40
Objective:To investigate the relationship between the cerebral small vascular disease (CSVD) total burden and the imaging markers and the degree of unilateral middle cerebral artery (MCA) stenosis.Methods:The study was a cross-sectional study. Clinical and imaging data of patients with chronic unilateral MCA stenosis who underwent multimodal MRI from October 2015 to January 2019 in the First Medical Center of PLA General Hospital were retrospectively analyzed. A total of 261 patients were included, 187 males and 74 females. According to the degree of MCA stenosis, the patients were divided into 102 cases in severe stenosis-occlusion group (stenosis degree ≥70%) and 159 cases in mild-moderate stenosis group (stenosis degree <70%). CSVD imaging marker scores (including white matter hyperintensity, perivascular space, cerebral microbleed, and lacune of presumed vascular origin) were assessed according to the ?standards for reporting vascular changes on neuroimaging 1 in the 2 groups, and the CSVD total burden score was calculated. Mann-Whitney U test was used to compare the indicators between the two groups, and the CSVD total burden score and imaging marker scores were ultimately included in a multifactorial binary logistic regression to assess the association of CSVD imaging markers with severe stenosis-occlusion of the MCA after adjusting for vascular risk factors (age, gender, drinking, smoking, hypertension, hyperlipidemia, atrial fibrillation and coronary heart disease). Results:There were significant differences in the CSVD total burden, centrum semiovale perivascular space and lacune of presumed vascular origin score between the mild-to-moderate stenosis group and the severe stenosis-occlusion group (all P<0.05), and none of the differences in the remaining imaging marker scores were statistically significant (all P>0.05). Multivariate binary logistics regression analysis showed CSVD total burden score ( OR=1.300, 95% CI 1.047-1.613, P=0.017), centrum semiovale perivascular space score ( OR=2.099, 95% CI 1.540-2.860, P<0.001) and lacune of presumed vascular origin score ( OR=2.609, 95% CI 1.294-5.261, P=0.007) were independent associated with severe stenosis-occlusion of MCA. Conclusion:The higher CSVD total burden score, centrum semiovale perivascular space score and lacune of presumed vascular origin score are associated with severe stenosis-occlusion of MCA.