1.Evaluation of magnetic resonance imaging in autoimmune pancreatitis before and after treatment
Chinese Journal of Nuclear Medicine and Molecular Imaging 2018;38(4):252-256
Objective To evaluate the imaging features of MRI in autoimmune pancreatitis (AIP) and analyze the diagnostic value before and after treatment.Methods MRI data of 20 AIP patients (14 males,6 females;average age:(54.0±10.3) years) from January 2013 to December 2015 were retrospectively analyzed.The sequences of MRI included T1 weighted imaging (WI),T2WI,MR cholangiopancreatography (MRCP),diffusion weighted imaging (DWI) and dynamic enhancement images.Fifteen of the patients received DWI again after hormone therapy.The location and extent of lesions,signal,patterns of dynamic enhancement,"pseudocapsule" sign and other accompanying signs,the apparent diffusion coefficient (ADC) of the lesion and the DWI manifestations before and after treatment were observed,calculated and compared.x2 test and paired t test were used to analyze the data.Results Five patients were confirmed by pathology and 15 by clinical follow-up.In MRI,16 patients appeared diffusive swollen pancreases,and 4 patients were with focal enlargement.Lesions of pancreas showed low signal on T1WI and high signal on T2WI.Twelve patients presented "pseudocapsule" around the lesions and progressive enhance was shown in the delayed phase on dynamic contrast enhanced MRI.Ten patients showed stenotic choledoch in the head of pancreas and segmented stenotic pancreatic duct in MRCP.All pancreatic lesions in the 10 patients presented high signals on DWI.The pancreatic morphology,the signal of the lesion,the "pseudocapsule" sign and the enhancement degree on MRI were significantly improved compared with those before treatment in 15 patients (x2 values:5.000-22.941,all P<0.05).Mter hormone therapy,the signals on DWI were markedly weakened in pancreatic parenchyma,and ADC was significantly higher than that before treatment ((1.27± 0.14)×10-3 vs (1.05±0.16)×10-3 mm2/s;t=4.15,P<0.01).Conclusion DWI could reflect the pathological and biological characteristics of AIP and be used to evaluate the therapeutic efficacy of hormone treatment in AIP.
2.MRI and diffusion-weighted imaging in the diagnosis of autoimmune pancreatitis
Yuexi CHEN ; Guozhao LI ; Xiang ZHANG ; Xiaohui DUAN ; Fang ZHANG ; Liejing LU ; Meiwei CHEN ; Kun ZHAO ; Yueyao CHEN ; Jun SHEN
Chinese Journal of Hepatic Surgery(Electronic Edition) 2015;(1):42-45
Objective To investigate the value of magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in the diagnosis of autoimmune pancreatitis (AIP). Methods Clinical data of 11 patients pathologically diagnosed with AIP in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2013 to June 2014 were analyzed retrospectively. There were 7 males and 4 females with a mean age of (54±15) years old. The informed consents of all patients were obtained and local ethical committee approval had been received. Apparent diffusion coefifcient (ADC) of the pancreatic lesions was measured by MRI scan, multiphase dynamic enhanced scan and DWI. The imaging features of AIP by MRI and DWI were observed. Results The AIP lesions displayed iso-or slightly hypo-intense signal on T1WI and slightly hyper-intense signal on T2WI by MRI and continuous gradual enhancement by multiphase dynamic enhanced scan. The average ADC of the lesions by DWI was (1.09±0.09)×10-3 mm2/s and the pancreatic lesions displayed high signal. Diffusely swelling pancreas with plump shape, sausage-like appearance was observed in 7 cases. Local mass were observed at the pancreatic head in 3 cases. Mass in the pancreatic body and tail was observed in 1 case. Capsule-like ring-like shadow was observed around the pancreas in 6 cases by MRI and iso-or slightly hypo-intense signal on T1WI and slightly lower-or hyper-intense signal on T2WI were observed. No enhancement or hypo-enhancement was observed in arterial phase by multiphase dynamic enhanced scan. Delayed enhancement was observed in delayed phase. The enhancement degree was mildly lower than that of pancreatic parenchyma. Multiple enlarged lymph nodes were observed around the pancreas and at the retroperitoneum in 4 cases. Conclusions MRI is useful for the diagnosis of AIP. The dynamic enhanced scan and DWI ifndings can be used as the direct images for diagnosing AIP and have a high clinical reference value.
3.Graphical analysis of research hotspots about male nurses at home and abroad based on CiteSpace in recent 10 years
Jinhu MIAO ; Yuexi ZHU ; Shiyao YANG ; Jie CHEN ; Xie LIU ; Jingjing XU ; Feifei JIN ; Qunfen TAO
Modern Clinical Nursing 2024;23(8):62-70
Objective To investigate the research status and the research hotspots on male nurses at home and abroad in last decade,so as to provide references for further research in male nurses.Methods Literature between 2013 and 2024 on male nurses were retrieved from the Web of Science(WOS)and CNKI.CiteSpace 6.2.6 R7 software was used to analyse the volume of publication,keyword co-occurrence,keyword clustering and emergence.Results A total of 736 articles were included in the study.From 2013 to 2023,the number of published papers of male nurses in CNKI and WOS showed an increasing trend.The research was primarily affiliated with 263 institutions across 62 countries.The country with the highest volume of publication is China,followed by the United States,although there was a need to enhance collaboration with other nations.The institution with the most publications is the Hong Kong Polytechnic University.A comprehensive analysis of keyword co-occurrence,clustering,and emerging trends revealed that the research hotspots in the field of male nursing in CNKI mainly includes the advantages of male nurses,psychological capital,humanistic care,development,needs,professional identification.Whereas WOS focuses on the topics such as gender bias against male nurses,mental health,workplace violence,ambivalent sexism,motivational barriers,individual differences,societal prejudice and knowledge and attitucle.Both domestic and international research on male nurses primarily consist of cross-sectional surveys and qualitative studies,with fewer intervention studies.Currently,the researches regarding male nursing focus on the qualitative study of mental health of male nurses.Conclusion Focusing on the mental health and professional status of male nurses,domestic scholars need to increase the formulation and implementation of interventions in this field in order to address the practical issues faced by male nurses,therefore to promote the comprehensive development of the nursing profession,enhance the overall quality and service quality of the nursing team,and provide patients with higher quality in nursing services.
4.Professor 's experience of acupuncture and moxibustion of regulating spleen-stomach and differentiating meridians-collaterals.
Hai XU ; Liang-Liang CHEN ; Hong-Liang CHENG ; Nan LI ; Pei-Yang SUN ; Hao-Ran CHU
Chinese Acupuncture & Moxibustion 2019;39(11):1211-1213
Professor - successively followed famous doctors of acupuncture and spleen-stomach disease, such as -, inherited their academic thoughts and clinical experience, and studied the classics to summarize and propose the clinical academic proposition regulating spleen-stomach differentiating meridians-collaterals. In clinical practice, professor focuses on individual differences of patients, carefully examines syndrome and refines acupoint selection; he pays attention to regulating spleen-stomach, and actively uses Zusanli (ST 36); he simultaneously uses acupuncture-moxibustion and acupoints with efficacy; he inherits traditional reinforcing and reducing methods, and extends the scope of acupoint diagnosis and treatment, while he emphasizes keeping spirit and treating spirit, and the combination of mind and , in order to improve clinical diagnosis and treatment effect.
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Humans
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Male
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Meridians
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Moxibustion
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Spleen
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Stomach
5.Application value of 68Ga-DOTA-FAPI-04 PET/CT in evaluating renal fibrosis disease
Yue ZHOU ; Yuexi HUANG ; Yilin HUANG ; Yujie WANG ; Ying LI ; Wenbin LUO ; Lei LEI ; Lin LIU ; Santao OU ; Yue CHEN
Chinese Journal of Nuclear Medicine and Molecular Imaging 2021;41(12):727-731
Objective:To evaluate the value of 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)-fibroblast activating protein inhibitor (FAPI)-04 PET/CT on assessing different pathological grades in patients with renal fibrosis. Methods:A total of 25 patients (11 males, 14 females; age (39.3±13.9) years) diagnosed with renal fibrosis in the Affiliated Hospital of Southwest Medical University from September 2020 to August 2021 were retrospectively analyzed. All patients underwent renal puncture examination and 68Ga-DOTA-FAPI-04 PET/CT examination. The pathological results of kidney puncture were as the " gold standard" to divide the patients into mild fibrosis (Ⅰ), moderate fibrosis (Ⅱ), and severe fibrosis (Ⅲ). At the same time, 20 patients (10 males, 10 females; age (47.5±13.2) years) who underwent 68Ga-DOTA-FAPI-04 PET/CT examination showed no abnormal uptake of radioactivity in bilateral kidneys and no history of urinary system related diseases were enrolled as normal controls. Parameters including the maximum standardized uptake value (SUV max) of both kidneys, the mean standardized uptake value (SUV mean) of the liver, target/background ratio (TBR), glomerular filtration rate (GFR), and serum creatinine (Scr) were collected. Kruskal-Wallis rank sum test and Bonferroni correction method were used to compare the differences of SUV max, SUV mean, TBR and Scr among groups. One-way analysis of variance and least significant difference (LSD) t test were used to compare the difference of GFR among groups. The receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic efficacy of SUV max for the degree of renal fibrosis. Results:Of 25 patients, 22 had increased imaging agent uptake and the sensitivity of 68Ga-DOTA-FAPI-04 PET/CT in diagnosing renal fibrosis was 88%. The SUV max and TBR of patients with fibrosis grade Ⅰ, Ⅱ and Ⅲ were significantly higher than those of controls (SUV max: 4.40(3.30, 4.50), 5.90(4.28, 6.48), 8.50(7.50, 9.73) and 1.44(1.38, 1.68); TBR: 6.340±2.389, 8.097±1.420, 11.343±2.002 and 2.986±0.645; H values: 33.685, 32.368, all adjusted P<0.05 (Bonferroni correction method)). The Scr of patients with fibrosis grade Ⅰ and Ⅲ were significantly different (70.1(55.4, 92.5) and 174.1(161.4, 498.2) μmol/L; H=9.770, adjusted P<0.05 (Bonferroni correction method)). The liver SUV mean of patients with renal fibrosis grades Ⅱ and Ⅲ were significantly higher than that of controls (0.673±0.129, 0.751±0.170 and 0.514±0.142; H=15.609, both adjusted P<0.05 (Bonferroni correction method)). The GFR of patients with fibrosis grade Ⅲ had significant differences with grade Ⅰ and Ⅱ ((27.867±15.747), (87.756±31.657) and (63.160±29.556) ml/min; F=8.298, both P<0.05). ROC curve analysis showed that the area under curve was 0.946 7 (95% CI: 0.899 6-0.993 8, P<0.001). Conclusion:68Ga-DOTA-FAPI-04 PET/CT has a certain value in evaluating the degree of renal fibrosis, which can be used as a supplementary examination method for diagnosing renal fibrosis.
6.Modified Fixation of Levonorgestrel-releasing Intrauterine System for the Treatment of Adenomyosis
Jinbo LI ; Xueyun LI ; Fuli WU ; Shuqin CHEN
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(2):290-296
ObjectiveTo introduce a fixation technique with the modified levonorgestrel-releasing intrauterine system (LNG-IUS) and evaluate its efficacy in the treatment of adenomyosis patients with previous LNG-IUS expulsion. MethodsA retrospective analysis was done on 22 adenomyosis patients who underwent modified LNG-IUS fixation due to LNG-IUS expulsion at three hospitals from June 2022 to June 2023. The baseline clinical characteristics, operative and postoperative details were collected and analyzed. The Visual analogu scale (VAS) scores and pictorial blood loss assessment chart (PBAC) scores were measured and compared before, 3 and 6 months after the LNG-IUS fixation. ResultsThe mean operative time was (19.51±7.41) min and intraoperative bleeding was (6.71±5.30) mL. Of the patients, 13 were operated under local anaesthesia and the other 9 under intravenous anaesthesia. There were 4 operations performed by a resident doctor, 15 by an attending doctor and 3 by a senior doctor. No intraoperative or postoperative complication was found. The mean follow-up was 11.51 months and no patient had a recurrence of LNG-IUS expulsion during the follow-up period. The mean level of hemoglobin at 1 month after operation was significantly higher than that before (P<0.001). VAS scores and PBAC scores at 3 and 6 months postoperatively were all improved significantly than those preoperatively (P<0.001). ConclusionsEffectively preventing the recurrence of LNG-IUS expulsion, modified LNG-IUS fixation is a safe and efficient method for adenomyosis patients with previous LNG-IUS expulsion. Modified LNG-IUS fixation deserves the clinical application due to its easy operation and wide range of use on women.
7.Effects of Buzhong Yulin Decoction (补中愈淋汤) for Mice with Recurrent Urinary Tract Infectionon on Bladder Mucosal Barrier and Bacterial Load of Bladder Epithelial Cells
Hao YIN ; Yi XUE ; Biao ZHANG ; Zhuohui JIN ; Jiaoli ZHU ; Yi JIANG ; Xiaofang WANG ; Chen FENG ; Yunyun JIN ; Qingjiang JIN ; Qinglei JIN ; Xin WANG
Journal of Traditional Chinese Medicine 2024;65(22):2338-2346
ObjectiveTo investigate the possible mechanism of Buzhong Yulin Decoction (补中愈淋汤) in the prevention and treatment of recurrent urinary tract infection. MethodsThe mouse models of recurrent urinary tract infection were established by uropathogenic Escherichia coli (UPEC) strain UTI89 by bladder perfusion, and the successful mouse models were randomly divided into a model group, an antibiotic group, and a low- and high-dose Buzhong Yulin Decoction group, with six mice in each group. In addition, 5 C57BL/6 mice without modelling were taken as blank group. The low- and high-dose Buzhong Yulin Decoction groups received 0.1 ml/10 g of decoction by gavage, with concentrations of 1.3 g/ml and 5.2 g/ml, respectively; the antibiotic group received 0.1 ml/10 g of levofloxacin hydrochloride solution with 5 mg/ml by gavage; the blank and model groups received 0.1 ml/10 g of distilled water by gavage. Each group was gavaged once a day for 7 consecutive days. The total number of urine marks, the number of central urine marks, and the total urine volume of the urine marks were observed by the urine marking test; HE staining was used to observe the histopathological changes in the bladder of mice; serum levels of the inflammatory factors interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumour necrosis factor α (TNF-α) were detected by ELISA; the morphology of the epithelial cells of bladder was observed by scanning electron microscopy; immunofluorescence assay to detect bladder tissue anti-UroPlakin 3A protein level and UPEC bacterial load; the spread plate method to detect urinary bacterial load and bacterial load of bladder epithelial cells; RT-PCR method to detect Ras-related protein Rab-11A (RAB11A) and Ras-related protein Rab-27B (RAB27B) mRNA level in bladder tissue; immunoblotting to detect microtubule-associated protein 1 light chain3 (LC3) and P62 protein levels in bladder tissue. ResultsCompared with the blank group, the bladder epithelial cell layers were lost and showed abnormal morphology in mice of the model group; bladder tissue UroPlakin 3A protein and RAB11A and RAB27B mRNA levels reduced, the total number of urine marks, the number of central urine marks, bladder tissue UPEC bacterial load, urinary bacterial load, bacterial load in bladder epithelial cells, serum IL-1β, IL-6, and TNF-α levels, and LC3 and P62 protein levels in bladder tissue all elevated (P<0.05 or P<0.01). Compared with the model group, the bladder epithelial cell layers were intact and the morphology of epithelial cells were regular in the low- and high-dose Buzhong Yulin Decoction groups; the average surface area of bladder epithelial cells reduced, the levels of UroPlakin 3A protein and RAB11A and RAB27B mRNA in bladder tissues elevated, and total number of urine marks, the number of central urine marks, bladder tissue UPEC bacterial load, urinary bacterial load, bacterial load in bladder epithelial cells, serum IL-1β, IL-6, and TNF-α levels, and P62 protein levels in bladder tissue all reduced (P<0.05 or P<0.01), but LC3 protein levels showed no statistically significant (P>0.05). In the antibiotic group, the bladder epithelial cells were partially missing and the morphology of epithelial cells was abnormal. Compared with the antibiotic group, the average surface area of the bladder epithelial cells in the mice increased in the low- and high-dose Buzhong Yulin Decoction groups, the bacterial load of the bladder epithelial cells decreased, and the P62 protein level of the bladder tissue decreased (P<0.05). When comparing between the low- and high-dose Buzhong Yulin Decoction groups, the differences in each index were not statistically significant (P>0.05). ConclusionBuzhong Yulin Decoction may prevent and treat recurrent urinary tract infection by repairing the bladder mucosal barrier, increasing RAB11A and RAB27B level and enhancing autophagy in bladder tissues, thereby facilitating bacterial clearance from bladder epithelial cells and reducing the bacterial load of bladder epithelial cells.