1.Clinical value of different imaging techniques in the diagnosis of periampullary carcinoma
Chunlin TANG ; Rui LI ; Anli GUO ; Xiaohang ZHANG ; Zhaohui CHEN ; Yonglin CHEN ; Ping BIE
Chinese Journal of Digestive Surgery 2012;11(5):452-454
Periampullary carcinoma is a rare malignant tumor of digestive system,and its accurate diagnosis is still difficult.From January 2007 to July 2012,12 patients with periampullary carcinoma had been admitted to the Southwest Hospital of Third Military Medical University,and the imaging data were retrospectively analyzed.The results of ultrasonography revealed that all tumors were hypoechoic.The tumor displayed hyperenhancement in 3 patients,isoenhancement in 1 patient,hypoenhancement in 8 patients during the arterial phase on contrastenhanced ultrasonography (CEUS),while the tumor displayed hypoenhancement in all patients during the venous phase.Magnetic resonance imaging (MRI) plain scanning showed duodenal papilla enlargement in 1 patient,ampullary tissue mass signal in 2 patients,tissue mass signal at distal common bile duct in 2 patients,the rest 7 patients did not show tissue mass signal.Lower biliary obstruction was the common manifestation of the 12 patients on magnetic resonance cholangiopancreatography (MRCP),intrahepatic and extrahepatic bile vine-like expansion in 4 patients,double duct sign in 2 patients,the bottom of common bile duct with filling defect in 2 patients and it revealed beak-like narrow in 1 patient.CEUS,MRI and MRCP could both play an important role as conventional methods in diagnosing periampullary carcinoma.
2.Imaging features of renal myomatous angiomyolipoma on CT
Bingni ZHOU ; Xiaohang LIU ; Wei TANG ; Hualei GAN ; Can LI ; Liangping ZHOU
China Oncology 2017;27(3):207-211
Background and purpose: Since the detection of renal neoplasm is increasing, it's important to distinguish myomatous angiomyolipoma (mAML) from malignant tumors. This study aimed to investigate the imaging features of renal mAML on computer tomography (CT) and improve the accuracy of diagnosis and differential diagnosis. Methods: Ten patients were diagnosed with mAML. The cases were composed of 4 men and 6 women, with a mean age of 53.2 years (range 38-64). Among all of the cases, the percentage of spindle cell is more than 70%. Two radiologists reviewed all of the images to evaluate general characteristics, imaging features on unenhanced CT and enhanced CT. The mean attenuation on the unenhanced CT of mAML, normal renal parenchyma and skeletal muscle was compared by the paired-sample t test. Results: Among all of the tumors, nine lesions were solitary, and the other one was accompanied with typical AML. Six lesions were at the left kidney while four lesions were at the right side. Five lesions located intracapsularly. All the lesions were well-defined, nine of them were regular. The tumor sizes ranged from 15 to 80 mm with mean (43±19) cm. Intratumoral macroscopic fat, cystic degeneration and vessels were found in two lesions, two lesions and three lesions, respectively. Calcification or hemorrhage was not detected in any cases. On unenhanced CT, 70% cases were hyperattenuating. Eight cases were homogeneous or slightly heterogeneous. The mean attenuation of the tumor lesions on unenhanced CT was (48.60±5.50) HU, which was higher than that of normal renal parenchyma (39.70±6.67) HU (P<0.05), and similar to that of skeletal muscle (48.9±2.28) HU (P>0.05). After intravenous injection of contrast media, seven cases were categorized as the slightly heterogeneous or heterogeneous enhancement type. Four cases showed a weak enhancement whereas five cases were with a moderate enhancement. The gradual, prolonged and early washout enhancement patterns were observed in 40%, 40%, and 20% of the cases, respectively. Conclusion: The radiological appearance of mAML had a tendency to be hyperattenuating on unenhanced CT images without macroscopic fat; it could be homogeneous or slightly heterogeneous on unenhanced scans. After the injection of contrast agent, mAML tended to have a weak or moderate, lightly heterogeneous to heterogeneous enhancement, and it could demonstrate gradual and prolonged enhancement patterns.
3.MRI characteristics of ductal carcinoma in situ of the breast
Linghui XU ; Weijun PENG ; Yajia GU ; Ruimin LI ; Xiaohang LIU ; Xiaohong WANG ; Jian MAO ; Feng TANG ; Jianhui DING
Chinese Journal of Radiology 2011;45(2):159-163
Objective To evaluate and recognize the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast and provide imaging information for the early detection and treatment planning Methods All MRI data in 71 patients with histollogically proved DCIS were analyzed retrospectively. The 71 patients were divided into two groups, NI ( pure DCIS, 44 patients) and N2 ( DCIS with microinvasion, 27 patients). According to the BI-RADS descriptors, all lesions were defined as a focus (smaller than 5 mm in diameter), mass and no-mass-like three enhancement types. The morphological features (M1 = focus, M2 = linear or linear-branched, M3 = branching-ductal, M4 = segmental, M5 = focal,M6 = regional, M7 = diffuse, M8 = mass) and the time-intensity curve (TIC) pattern [type l ( persistent enhancement curves), type Ⅱ( plateau), type Ⅲ(washout) and type Ⅳ (the same enhancement as glandular tissue)] were described. Chi-square test was used for the morphological characteristics of lesions.Results The 73 DCIS lesions were found in 71 patients, and 5.5% (n =4) were stippled lesions, 87.7%( n =64) were no-mass-like lesions, 6.8%(n=5) were mass-like lesions. In no-mass-like lesions (n=64), M3 was found in 15 cases, M4 in 34 cases, M5 in 9 cases and M6 in 6 cases, respectively, M3 and M4 were the most common distribution patterns. In N1 group(n =45) and N2 group (n =28), M3, M4,M5, M6 were found in 7 and 8, 21 and 13, 7 and 2, 3 and 3 cases, respectively. There were no statistic differences between two groups (P>0.05). In 31 showed heterogeneous enhancement, both M3 and M4 were observed in 35.5% (11/31). In 26 clustered ring enhancement lesions, M4 was observed in 88.5% (23/26). Four lesions showed reticular enhancement,2 lesions showed a clumped enhancement and 1 lesion showed homogeneous enhancement. In 5 mass-like lesions, N1 group had 3 cases, N2 group had 2 cases.Four lesions showed lobulated margin, 4 lesions showed speculated margin, 1 mass showed smooth margin.Five mass showed heterogeneous enhancement. Type Ⅰ , type Ⅱ , type Ⅲ and type Ⅳ TIC ( n = 25) were demonstrated in 8, 11, 3 and 3 lesions, respectively. Conclusions M3, M4, especially segmental clustered ring enhancement, are the most common morphological characteristics of DCIS. Type Ⅰ and type Ⅱ TIC are the most common types.
4.Determination of non-steroidal anti-inflammatory drugs in the environmental water samples by a polyvinylimide-modified magnetic nanoparticles-based solid phase extraction coupled with high-performance liquid chromatography
Xiaohang TANG ; Huilin SONG ; Liying YAO ; Guowen QIN ; Xingchen WANG ; Wenyuan LIU ; Shunli JI
Journal of China Pharmaceutical University 2024;55(4):485-492
The long-term presence of non-steroidal anti-inflammatory drugs (NSAIDs) in the environmental water samples not only affects the life safety of aquatic organisms and disturbs the ecoenvironment, but also poses a serious threat to human health. In this study, amino-functionalized Fe3O4 nanoparticles (Fe3O4-NH2) were firstly prepared by solvothermal method. Subsequently, polyethyleneimine (PEI) with a branched chain structure was successfully grafted onto Fe3O4 nanoparticles by Schiff base reaction in aqueous solution at room temperature using glutaraldehyde as a cross-linking agent, and a recyclable PEI-grafted magnetic nano-sorbent (Fe3O4@PEI) was synthesized and applied for the detection of NSAIDs in the environmental water samples. The compositional properties of Fe3O4@PEI were investigated by different characterization methods and the parameters affecting the extraction of NSAIDs were optimized. Due to high adsorption of Fe3O4@PEI for NSAIDs, the quantitative analysis of four NSAIDs in the environmental water samples, ketoprofen, naproxen, diclofenac and tolfenamic acid, was performed in combination with high-performance liquid chromatography. A good linear relationship between the chromatographic peak area and concentration was observed in the range of 1−500 µg/mL. The recoveries of the samples at three different spiked levels ranged from 85.6% to 107.8%; the intra-day precision was less than 7.8% (n=6); and the inter-day precision was less than 9.5% (n=3). The method is simple, rapid, accurate and reliable, and can be used for the analysis of NSAIDs in the environmental water samples.
5.Application of short-term training path for prenatal ultrasound diagnostician in primary hospitals
Suzhen RAN ; Peng TU ; Yiling ZUO ; Song CHEN ; Yun LIN ; Jing TANG ; Jun WEI ; Zhengchun YANG ; Xiaohang ZHANG ; Jian WANG
Chinese Journal of Medical Education Research 2022;21(5):572-576
Objective:To explore the establishment and effect of short-term training path for prenatal ultrasound diagnosticians in primary hospitals.Methods:A total of 105 trainees from in total 5 batches of the "prenatal ultrasound screening training base" in Chongqing were selected as the research objects, and a combination of multiple teaching methods was used to carry out specialized training for primary prenatal ultrasound screening doctors before and after training. Theoretical examinations and practical operation assessments were performed, and after training, remote image quality control and continuous improvement methods were established for trainees to assess training effectiveness. SPSS 21.0 was used for t test, Wilcoxon test and chi-square test. Results:After training, the results of the theoretical examinations and practical operation examinations of the trainees were higher than those before the training ( P<0.05), and after the completion of the training, the number of trainees who returned to their original units to carry out prenatal ultrasound examination, the average number of prenatal ultrasound examinations per month and the number of referrals to higher prenatal diagnosis centers of each trainee increased significantly ( P<0.05). Conclusion:The establishment of short-term training path for prenatal ultrasound diagnosis can effectively improve the professional theoretical knowledge and practical operation level of prenatal ultrasound doctors in primary hospitals, and greatly solve the problem of technical promotion under the shortage of grassroots hospitals.
6.An improved 4-vessel intermittent occlusion method for establishing rat models of global cerebral ischemia-reperfusion injury.
Wei SUN ; Ping CHEN ; Xiaohang TANG ; Yingmin GU ; Xuesong TIAN
Journal of Southern Medical University 2023;43(7):1194-1203
OBJECTIVE:
To improve the classical 4-vessel occlusion (4VO) model established by Pulsinelli and Brierley.
METHODS:
Thirty-two male SD rats were randomized into sham operation group, I4VO-Con10 group, I4VO-Int10 group and I4VO-Int15 group. The sham surgery group underwent exposure of the bilateral vertebral arteries and carotid arteries without occlusion to block blood flow. The I4VO-Con10 group experienced continuous ischemia by occluding the bilateral vertebral arteries and carotid arteries for 10 minutes followed by reperfusion for 24 hours. The I4VO-Int10 and I4VO-Int15 groups were subjected to intermittent ischemia. The I4VO- Int10 group underwent 5 minutes of ischemia, followed by 5 minutes of reperfusion and another 5 minutes of ischemia, and then reperfusion for 24 hours. The I4VO-Int15 group experienced 5 minutes of ischemia followed by two cycles of 5 minutes of reperfusion and 5 minutes of ischemia, and then reperfusion for 24 hours. The regional cerebral blood flow (rCBF) was monitored with laser Doppler scanning, and survival of the rats was observed. HE staining was used to observe hippocampal pathologies to determine the optimal method for modeling. Another 48 rats were randomized into 6 groups, including a sham operation group and 5 model groups established using the optimal method. The 5 I4VO model groups were further divided based on the reperfusion time points (1, 3, 7, 14, and 28 days) into I4VO-D1, I4VO-D3, I4VO-D7, I4VO- D14, and I4VO- D28 groups. Body weight changes and survival of the rats were recorded. HE staining was used to observe morphological changes in the hippocampal, retinal and optic tract tissues. The Y-maze test and light/dark box test were used to evaluate cognitive and visual functions of the rats in I4VO-D28 group.
RESULTS:
Occlusion for 5 min for 3 times at the interval of 5 min was the optimal method for 4VO modeling. In the latter 48 rats, the body weight was significantly lower than that of the sham-operated rats at 1, 3, 7, 14 and 28 days after modeling without significant difference in survival rate among the groups. The rats with intermittent vessel occlusion exhibited progressive deterioration of hippocampal neuronal injury and neuronal loss. Cognitive impairment was observed in the rats in I4VO-D28 group, but no obvious ischemic injury of the retina or the optic tract was detected.
CONCLUSION
The improved 4VO model can successfully mimic the main pathological processes of global cerebral ischemia-reperfusion injury without causing visual impairment in rats.
Rats
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Male
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Animals
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Rats, Sprague-Dawley
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Brain Ischemia
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Cerebral Infarction
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Reperfusion Injury
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Body Weight
7.The phenotypic and genetic spectrum of colony-stimulating factor 1 receptor gene-related leukoencephalopathy in China
Jingying WU ; Zaiqiang ZHANG ; Qing LIU ; Jun XU ; Weihai XU ; Liyong WU ; Zhiying WU ; Kang WANG ; Jianjun WU ; Zhangyu ZOU ; Haishan JIANG ; Wei ZHANG ; Wei GE ; Yuhu ZHANG ; Tongxia ZHANG ; Lixia ZHANG ; Zhanhang WANG ; Li LING ; Chang ZHOU ; Yun LI ; Beisha TANG ; Jianguang TANG ; Ping ZHONG ; Liang SHANG ; Yimin SUN ; Guixian ZHAO ; Xiuhe ZHAO ; Hongfu LI ; Jiong HU ; Jieling JIANG ; Chao ZHANG ; Xinghua LUAN ; Yuwu ZHAO ; Wotu TIAN ; Feixia ZHAN ; Xiaohang QIAN ; Huidong TANG ; Yuyan TAN ; Chunkang CHANG ; Youshan ZHAO ; Li CAO
Chinese Journal of Neurology 2021;54(11):1109-1118
Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.