1.Methods of suppressing physiological myocardial uptake in 18F-FDG imaging
Chinese Journal of Nuclear Medicine and Molecular Imaging 2017;37(5):305-307
18F-FDG PET has been widely used in myocardial oncology and inflammatory imaging.Suppression of physiological uptake in heart is required for accurate diagnosis of some thoracic diseases,cardiac inflammatory diseases and coronary atherosclerosis.There is no unified criteria to reduce myocardial 18F-FDG uptake.This review summarizes the research progress of inhibiting physiological myocardial 18F-FDG uptake by controlling diet,mediating blood glucose and applying drugs.
2.Diagnosis of extreme lateral lumbar disc herniation with spiral CT multiplanar reformation
Xiaoxin HU ; Shihong CHEN ; Lan SUN
Chinese Journal of Radiology 2001;0(07):-
Objective To investigate the characteristics of extreme lateral lumbar disc herniation (ELLDH) with spiral CT multiplanar reformation (MPR), and to determine the effectiveness of MPR in the diagnosis of ELLDH. Method Twenty-five cases with ELLDH underwent conventional CT scans, thin slice spiral scan, and MPR on coronal and sagittal plane. Results Operative findings basically matched the MPR results in 25 ELLDH patients concerning the disc herniation position and compression of the nerve roots. The herniation involved the intervertebral foramina in 15 cases, external intervertebral foramina in 4, both intervertebral and external intervertebral foramina in 3, and intervertebral foramina and vertebral tubes of parity plane in 3. They were demonstrated on MPR as shapes of hillock, circular or trigonal soft-tissue density mass in intervertebral foramen, or outside and tread on the nerve root of parity plane. Among these 25 ELLDH cases, ELLDH was not found by conventional CT scans in 7 cases, but was found by MPR. ELLDH was suspected by conventional CT in 8, and was confirmed to be ELLDH by MPR. ELLDH was revealed by conventional CT scans in 10, but without indications of nerve root compression status, while MPR clearly indicated nerve root compression status. Conclusion MPR has important value in the diagnosis of ELLDH. It can properly identify the ELLDH site, shape, size, and its relation to nerve roots. It is very helpful for the surgeons in the selection of operation method.
3.Use of the Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis:study protocol for a retrospective non-randomized controlled trial
Zhigang MA ; Yuheng SUN ; Xiaoxin PENG ; Hongtao HU
Chinese Journal of Tissue Engineering Research 2016;20(30):4554-4560
BACKGROUND:The self-expanding Smart nitinol stent system is a popular treatment for carotid artery stenosis, because it is easy to manipulate and deploy, and endothelialization is rapid. OBJECTIVE:To assess the efficacy of Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis. METHODS:We conducted a retrospective, single-center, non-randomized, paral el control ed trial. A cohort of 103 patients with severe atherosclerotic carotid stenosis was included in the analysis after obtaining written informed consent from participants or their guardians. Treatment was undertaken according to each patient’s wishes after weighing the options:a Smart nitinol stent system (Cordis Corporation, Miami, FL, USA) was used in 40 patients, while 63 were managed conservatively with antiplatelet drugs. The primary outcome is the degree of disability of dependence 2 years after treatment, assessed by the modified Rankin Scale. The secondary outcomes are mRS scores 90 days and 1 year after treatment, recurrence of cerebrovascular events, and severity of neurologic deficit measured using the National Institutes of Health Stroke Scale 1 and 2 years after treatment. The study protocol was approved by the Ethics Committee of Beijing Jishuitan Hospital, China (approval number:201605-01) and conducted in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. This trial was registered at ClinicalTrial.gov (NCT02800174). DISCUSSION:Previous studies of the Smart nitinol stent system for the treatment of carotid stenosis are mostly self-control ed case series or smal cohort studies with short fol ow-up periods. Consequently, the long-term influence of Smart nitinol stent deployment on the risk of cerebrovascular events and long-term outcomes are not known. This trial il uminates the therapeutic benefits of the Smart nitinol stent system in a 2-year fol ow-up study involving a large cohort of patients with severe atherosclerotic carotid stenosis.
4.The research of obese patients examined with PSG in different sleeping positions.
Xiaoxin LIN ; Shuyan SUN ; Zhiming ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(7):379-381
Adult
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Female
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Humans
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Male
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Middle Aged
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Obesity
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physiopathology
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Polysomnography
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Posture
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Sleep
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Sleep Apnea, Obstructive
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physiopathology
5.Long-term effects of interventional therapy vs drug on severe carotid artery stenosis
Zhigang MA ; Yuheng SUN ; Qian GAO ; Xuman LI ; Xiaoxin PENG
Chinese Journal of Neurology 2008;41(1):20-24
Objective To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effect of different therapy prospectively.Methods A hundred and three patients with spoke or tansient ischemic attack(TIA)suffering from severe carotid artery stenosis were included into this study consectively.They were given intra-artery intervention or antiplatelet therapy based on clinical factors and the intension of the patients or their Legally Autllorized Representative (LAR)and thus divided into 2 groups.Forty patients were transplanted with stent,63 were given only with antiplatelet drugs.The major outcome of end-point was the 2-year functional prognosis evaluated by modified Rankin score(mRS),while the minor one was the cardiovascular events in 1 year.2 year or longer after the index stroke or TIA,which was defined as stroke,TIA,acute myocardic infarction(AMI)and sudden death in this study.Results There were no statistical significances of sex,years,medical histories,blood pressure, total cholesterol,triglyceide in two groups at baseline.For the major outcome,intra-artery intervention was an independent protective factor for impaired function(mRS 3-6)with the method of binary Logistic(RR= 0.13,P=0.001,95%CI 0.036-0.460).For the minor outcome,the incidence of the cardiovascular events in 1 year and 2 year after the index stroke or TIA was lower in the intra-artery intervention group than in the antiplatelet therapy(For 1 year follow up,intervention group:antiplatelet therapy group= 12.5%:42.9%,OR=0.19,95%CI 0.07-0.55,P=0.001;For 2 year follow up,17.5%:47.6%,OR =0.23,95%CI 0.09-0.60,P=0.002).The median time of cardiovascular events in the two groups was further investigated in 55 months and 54 months separately. Kaplan-Meier analysis showed no significant difference.Survival analysis with Cox-regression showed that neither therapy of intra-artery intervention nor antiplatelet therapy was an independent factor for the cardiovascular events(RR=1.063,95%CI 0.40- 2.83,P=0.900).Conclusions For the stroke or TIA patients suffering from high-degree carotid artery stenosis,intra-artery intervention is superior pure drug therapy in achieving better theapeutical effect and reducing the incidence of the cardiovascular events after the index stroke or TIA.However,its long term effect needs further study.
6.Effect of Traumatic Brain Injury on Expression of Vascular Endothelial Growth Factor in Femoral Fracture Callus in Rats
Zhikui LIU ; Liu ZHANG ; Xiaohua JIANG ; Shulin MU ; Xiaoxin SUN
Chinese Journal of Rehabilitation Theory and Practice 2009;15(3):233-235
Objective To explore the effect of the traumatic brain injury on the fracture healing and the related mechanism. Methods 64 12-week-old SD rats were randomly divided into 2 groups: The femoral fracture with a brain injury group and the femoral fracture group. The bone callus was obtained 1, 2, 3 and 4 week after operation respectively, and observed with the HE staining. The vascular endothelial growth factor (VEGF) and VEGF mRNA in the callus were detected with immunohistochemical staining and hybridization in situ. Results The formation and reforming of the callus in group with brain injury were ahead to only fracture. The percentages of the cells positive for VEGF and VEGF mRNA in the callus were more in group with brain injury than in pure fracture group at the same time point (P<0.05). Conclusion Traumatic brain injury can promote the healing of fracture, which is probably related to an increase in the expression of VEGF.
7.Application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroe-thylene vascular in right lobe living donor liver transplantation
Beicheng SUN ; Xiaoxin MU ; Guoqiang LI ; Chen WU ; Zhongming TAN
Chinese Journal of Digestive Surgery 2021;20(2):227-233
Objective:To investigate the application value of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver trans-plantation.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 4 donors and 4 recipients undergoing right lobe living donor liver transplantation in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School and 17 donors and 17 recipients undergoing right lobe living donor liver transplantation in the First Affiliated Hospital with Nanjing Medical University from June 2015 to August 2018 were collected. Of 21 donors, there were 10 males and 11 females, aged from 35 to 57 years, with a median age of 46 years. The median body mass of 21 donors were 64 kg, with a range from 56 to 72 kg. Of 21 recipients, there were 16 males and 5 females, aged from 21 to 68 years, with a median age of 42 years. The median body mass of 21 recipients were 63 kg, with a range from 47 to 77 kg. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect graft function, tumor recurrence, vascular graft complications, patency of vascular graft and survival of recipients up to August 2020. All recipients will be followed up for all their lives. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were represented as absolute numbers or percentages. The Kaplan-Meier method was used to calculate patency rates of hepatic vein outflow tract and survival rates to draw patency curve and survival curve. Results:(1) Surgical and postoperative situations: the operation time, the weight of donor graft, graft to recipient weight ratio and duration of hospital stay of 21 donors were (367±72)minutes, (557±68)g, 0.89%±0.16% and (10+2)days, respectively. No major complication requiring reoperation or intervention occurred in any of the 21 donors. One donor undergoing mild bile leakage preserved peritoneal drainage for one week. All 21 recipients underwent classic orthotopic liver transplantation successfully. The time of hepatic vein outflow tract reconstruction in donor graft, operation time and time of anhepatic phase of 21 recipients were (24±4)minutes, (326±66)minutes and (42±6)minutes, respectively. The number of reconstructed middle hepatic vein in hepatic segment 5 and 8 were 18 and 15, with the diameter of (6.1±1.3)mm and (7.2±1.2)mm, respectively. The number of reconstructed inferior right hepatic vein were 10, with the diameter of (6.3±1.3)mm. The postoperative treatment time at intensive care unit and duration of hospital stay of 21 recipients were (1.5±0.9)days and (22.6±6.7)days, respectively. Ten of 21 recipients underwent postoperative complications. Five recipients underwent graft dysfunction including the level of alanine aminotransferase and aspartate aminotransferase >1 000 IU/L and the level of bilirubin slightly increasing, combined with increased ascites. Enhanced computed tomography scan showed congestion in the right anterior of graft and thrombosis in the middle hepatic vein of hepatic segment 5 and segment 8. All 5 recipients undergoing graft dysfunction recovered with normal liver function and ascites decreasing after symptomatic treatment including liver protection therapy, anticoagulation and albumin infusion. Two recipients underwent inferior vena cava thrombosis and intractable pleural effusion one month after operation. Vena cava venography examination showed thrombosis in the graft vascular. Of the 2 recipients, one case with collateral circulation formation recovered undergoing balloon dilatation and stent placement combined with anticoagulation therapy of warfarin. The other one case recovered after anticoagulation therapy of warfarin. One recipient undergoing bile leakage and abdominal infection with klebsiella pneumoniae recovered after symptomatic treatment. Two recipients undergoing abdominal infection or pulmonary infection recovered after symptomatic treatment. There was no serious complication or death during perioperative period. (2) Follow-up: all 21 recipients were followed up for 10 to 57 months, with a median follow-up time of 38 months. During the follow-up, no recipient underwent graft dysfunction and 2 recipients had tumor recurrence at postoperative 6 months. Six of the 21 recipients died within 2 years after operation including 3 cases dying of tumor recurrence, 2 cases dying of acute hemorrhage and 1 case dying of liver failure. There was no death caused by vascular graft complica-tions. The postoperative 1, 3, 6-month, and 1-year and 2-year potency rates of hepatic vein outflow tract in 21 recipients were 88.4%, 88.4%, 82.4%, 68.0% and 42.1%, respectively. The 6-month, 1-year and 2-year overall survival rates in 21 recipients were 100%, 94.4%, 71.4%, respectively.Conclusion:Application of hepatic vein outflow tract reconstruction with ringed polytetrafluoroethylene vascular in right lobe living donor liver transplantation is safe and feasible.
8.Protection Mechanism ofZi-Bu Pi-Yin Recipe on Cortex Mitochondrial Dysfunction of Diabetes-associated Cognitive Dysfunction Rats
Zheng SUN ; Libin ZHAN ; Xiaoxin SUN ; Luping ZHENG ; Wei XIE ; Jian WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2015;(8):1639-1645
This study was aimed to observe the protection ofZi-Bu Pi-Yin recipe (ZBPYR) on the cortex mitochondrial dysfunction of diabetes-associated cognitive dysfunction rats. SD rats were randomly divided into four groups, which were the control (Con) group, the diabetes (DM) group, the ZBPYR treatment (ZBPYR1) group and the ZBPYR protection (ZBPYR2) group. Morris water maze test was taken to evaluate the learning and memory ability of rats. The transmission electron microscope (TEM) was used to detect the ultrastructure and quantity changes of cortex mitochondria. Western blot was used to detect the expression of Cyto C. The results showed that compared to Con group, the learning and memory ability were decreased in the DM group (P < 0.05); the learning and memory ability of the ZBPYR1 group was improved compared to the DM group (P < 0.05); compared to the DM group, the ZBPYR2 group was significantly improved (P < 0.01). Compared with the Con group, the number of cortex mitochondria in DM group was decreased (P< 0.05), and the structure was disordered, blurred, or even completely destroyed. After ZBPYR intervention, these pathological changes were reduced obviously. And the number of mitochondria in the ZBPYR2 group was increased than that of the DM group (P < 0.05). The expression of Cyto C in cytoplasm of the DM group was significantly higher than that of the Con group (P < 0.01). After ZBPYR intervention, the expression of Cyto C was decreased. It was concluded that ZBPYR regulated the mitochondrial morphology and changes of volume in the cortex, prevented the releasing of Cyto C from mitochondria to cytoplasm, and improved the cognitive function of diabetes rats.
9.Diagnosis of fetal complete atrioventricular block with echocardiography
Han, ZHANG ; Jinfeng, PEI ; Ya, YANG ; Ning, MA ; Rongjuan, LI ; Yijia, LI ; Qiwei, SUN ; Xiaoxin, ZHANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2014;(7):557-560
Objective To evaluate the application of M-mode echocardiography and Doppler echocardiography in diagnosing complete atrioventricular block (CAVB) in fetus. Methods M-mode and Doppler echocardiography were used to screen the fetuses and bradycadia was established as CAVB in 10 cases. Atrial and ventricular rhythm was measured by M-mode echocardiography. Flow of mitral valve, left ventricular in-flow and out-flow tract, venous duct was measured by Doppler echocardiography. The characteristics and prognoses of CAVB fetus were compared and analyzed. Results CAVB was established as independence in rhythm of atrium and ventricle. The rhythm of atrium could be in normal range, while the rhythm of ventricle should be slower than normal. Enlarged chambers were observed in 6 cases, cardiac dysfunction in 5 cases, and pericardial effusion in 7 cases. Tricuspid regurgitation and mitral regurgitation existed in 5 and 1 case, respectively. All of the CAVB fetus in this study underwent abortions. Conclusions Fetal echocardiography is proven to be a useful tool to diagnose CAVB, which greatly influenced the cardiac function in fetuses. Clear diagnosis as early as possible is crucial to the treatment of CAVB fetus.
10.Diagnostic value of 18F-FDG PET/CT in differentiating the cardiac benign from malignant lesions
Xiaoxin SUN ; Zuoxiang HE ; Xiaoli ZHANG ; Wei FANG ; Rui SHEN ; Daoyu WANG ; Yueqin TIAN
Chinese Journal of Nuclear Medicine and Molecular Imaging 2015;35(2):85-87
Objective To explore the clinical value of 18F-FDG PET/CT in differentiating between cardiac benign and malignant lesions.Methods From September 2009 to September 2012,a total of 9 (7males,2 females,average age (46± 22) years) patients with space-occupying lesions of the heart underwent whole body 18F-FDG PET/CT.18 F-FDG PET/CT diagnosis was made according to morphologic features and SUVmax of lesions.The final diagnoses were confirmed by either histopathology or clinical data and follow-up.Two-sample t test was used for data analysis.Results Among 9 cases of cardiac occupying lesions,4 cases were malignant tumors,4 cases were benign tumors (including 2 lipomas,1 myxoma,and 1 fibroma),1 case was thrombus.The average SUVmax of malignant tumors was 18.99±14.58,which was significantly higher than that of benign tumors (2.35±1.46,t=-2.58,P<0.05).With a cut-off SUVmax of 4.6,18F-FDG PET/CT could be used to noninvasively detect malignant tumors with a sensitivity of 4/4,specificity of 4/5,and accuracy of 8/9.Only 1 thrombus was misdiagnosed.Conclusion 18F-FDG PET/CT can aid the noninvasive differential diagnosis of cardiac malignant tumors from benign lesions.