Objective To investigate whether the perfusion of the solitary pulmonary nodules (SPNs) is homogeneous derived with 16-slice spiral CT and 64-sliee spiral CT. Methods Eight-five patients with. SPNs (diameter≤4 cm; 57 maliagnant;15 active inflammatory; 13 benign)underwent multi- location dynamic contrast material-enhanced serial CT. One scan was obtained every 1 seconds during 11- 41 seconds without scanning interval after injection, one scan was obtained at 90 seconds. TOSHIBA AquilionMerconi 16 : The section thickness was 8.0 mm for lesions 3.0-4.0 cm, 6. 0 mm for 2.0- 3.0 cm,4.0 mm for 1.5-2.0 cm,3.0 mm for 1.0-1.5 cm and 2.0 mm for lesions <1.0 cm. GE Lightspeed 64:The section thickness was 8.0 mm for lesions3.0-4.0 cm and 2.5 mm for <3.0 cm. Precontrast and posteontrast attenuation on every scan was recorded. The peak height , perfusion, ratio of peak height of the SPNs to that of the aorta and mean transit time of three central valid sections were calculated. The significance of the difference among groups was analyzed by means of ANOVA. Results The peak heights in three sections were ( 30.95±14.53 ), ( 25.10±13.32), (32.37±15.85) HU, respectively, the perfusions (33.01±21.35), (23.70±12.87), ( 29.00±15.47) ml·min-1·100 g-1, the ratios of peak height of the SPN to that of the aorta (13.58±6.41) %, (10.95±5.76) %, (13.64± 6.20)% and the mean transit times (11.61±5.74),(11.97±3.55), (13.44±3.74) s. Statistically significant differences were found among three sections in the peak height(F= 5.913,P=0.003), perfusion (F=6.464, P=0.002), ratio of peak height of the SPN to that of the aorta (F=5.333, P=0.005) and mean transit time (F= 3.837, P = 0.023). No statistically significant differences were found among three sections in precontrast attenuation ( F =0.032, P = 0.968). Conclusion The volume perfusion of the SPNs is inhomogeneous,it is suggested to evaluate blood flow patterns of the solitary pulmonary nodules with CT volume perfusion imaging.

Objective To explore the relationship between the extent of coronary artery lesions and plasma brain natriurefic peptide(BNP)levels in the patients with coronary artery disease(CAD)except for congestive heart failure(CHF).Method Seventy CAD patients without CHF evidenced by dinical manifestation and coronary arte- riography(CAG)from Cardiology Depamnent of the First Affiliated Hospital of Zhejiang University School of Medicine,China,were enrolled in the study.These patients were diagnozed under coronary arteriography(CAG) during March to May of 2007.They were divided into 3 groups:stable angina goup(24 patients),unstable angina group(25 patients),myocardial infarction group(21 patients).Twenty patients without coronary history and with normal CAG served as controls.Plasma BNP concentrations were measured with ELASA before CAG.The coronary lesion vessels and scores were estimated after CAG.The relationship between BNP levels and the coronary lesion vessels,as well as scores in CAD was analyzed.The data were expressed as(x±s)and was analyzed by using 2 independent samples test and spearman correlation with SPSS 13.0.A P value less than 0.01 indicated statistical significance.Results The plasma BNP concentrations in the patients,especially in the patients with myocardial infarction,were significantly higher than those in the controls.Spearman analysis showed that there was a positive correlation between the BNP levels and coronary lesion vessels(r1=0.309,P=0.01),also between BNP and coronary lesion score(r2=0.279,P=0.01).Conclusions In the patients without congestive heart failure,the more serious the coronary artery lesions,the higher the plasma BNP concentrations were.The degree of myocardial ischemia caused by coronary artery lesions was correlated with the plasma BNP level.Plasma BNP concentration could be valuable for the extent of coronary artery lesions in the patients of coronary artery disease.

[Objective]To investigate the clinical value of computed radiography(CR),computed tomography(CT)and magnetic resonance imaging(MRI)in spinal tuberculosis.[Method]Forty-one patients with histologically confirmed spinal tuberculosis underwant imaging examinations.Forty-one patients were performed CR,22 CT and 31 MRI.[Result]CR of 38 patients clearly revealed bone changes and narrowed or disappeared disk space.CR of 30 patients well showed the abnormal soft tissue.CT scan of 22 patients clearly depicted calcification and no abnormal was found in pedicles in all the 22 CT scans.CT scan of 21 patients revealed bone changes of vertebral bodies and CT scan of 20 patients showed abnormal soft tissue.The soft tissue was involved in all 31 patients with spinal tuberculosis.Diskspaces were involved in 29 cases and the pedicles were normal in all 31 case.The lesions showed hypointense in T1 scan primarily,hyperintense in T2 scan primarily.[Conclusion]CR is the first imaging approach for spinal tuberculosis.CT well reveal the extent and minute calcification.The extent,abnormal soft-tissue and abnormal disk space are more dramatically demonstrated on MRI imaging.CR,in addition to CT and MRI,is helpful in diagnosis of spinaltubereuinsis.

[Objective]To investigate the value of 16-slice spiral CT(MSCT)postprocessing in styloid process in vivo and provide the vivisection data for diagnosing and curing styloid process syndrome.[Method]Totally 100 volunteers with normal styloid processes underwent 16-slice spiral CT(MSCT). Based on the initial datum,4 kinds of postprocessing including multiple planar reconstruction(MPR), curve planar reconstruction(CPR),surface shaded display(SSD) and volume rendering (VR) were performed.The length and inclination angle of stytoid processes were measured. The distance of between styloid processes and carotid canal external aperture,jugular foramen, stylomastoid foramen ,mastoid process, internal carotid artery and internal jugular vein were surveyed. [Result]The average length of styloid processes was 24.51 mm?3.05 mm, left was 24.33 mm?3.15 mm and right was 24.69 mm?2.95 mm. The anterior inclination angle was 19.35??2.92? and medial was 24.00??4.07?.The distance of between styloid processes and carotid canal external aperture, jugular foramen,stylomastoid foramen ,mastoid process , internal carotid artery and internal jugular vein were 8.53 mm?2.45 mm, 2.87 mm?0.88 mm, 2.34 mm?0.74 mm, 17.23 mm?1.85 mm,6.49 mm?1.58 mm and 3.70 mm?1.46 mm respectively. [Conclusion]Sixteen-slice Spiral CT postprocessing demonstrate the stytoid processes in vivo accurately and fully, among which multiple planar reconstruction and surface shaded display are more valuable, because they can evaluate the length and inclination of the styloid processes and the distance between the processes and their surrounding structures in vivo more accurately.

To improve the stability and gene-carried capability of gene-attached microbubbles, the method for manufacture of albumin microbubbles was modified and new gene-loaded microbubbles were synthesized by incorporated gene-PEI complex into the shell of microbubbles. Agarose gel electrophoresis and bacteria transformation showed that PEI had the ability to provide the protection of plasmid DNA from ultrasonic degradation. The new gene-loaded microbubbles exhibited excellent acoustical and hemorheological properties. Moreover, they could carry more plasmid DNA than gene-attached microbubbles. beta-galactosidase plasmid transfection into cardiac myocytes was performed by using ultrasound targeted destruction of new gene-loaded microbubbles or gene-attached microbubbles. Gene expression in cardiac myocytes was detected by beta-galactosidase in situ staining and quantitive assay. It was shown that beta-galactosidase activity in cardiac myocytes was enhanced 107-fold by ultrasonic destruction of gene-loaded microbubbles compared with naked plasmid transfection and new gene-loaded microbubbles resulted in 6.85-fold increase in beta-galactosidase activity compared with optimal transfection mediated by gene-attached microbubbles. These results suggested that ultrasonic destruction of the gene-loaded microbubbles can enhance the cardiac myocytes exogenous gene transfer efficiency significantly and new gene-loaded microbubbles is an efficient and safe gene delivery vehicle.
Animals ; Cells, Cultured ; Genes, Reporter ; genetics ; Genetic Vectors ; Imines ; Microbubbles ; Myocytes, Cardiac ; metabolism ; Plasmids ; genetics ; Polyethylenes ; Rats ; Rats, Wistar ; Sonication ; Transfection ; methods ; beta-Galactosidase ; biosynthesis ; genetics

BACKGROUNDTo investigate the methods of dynamic enhanced multi-slice spiral CT in evaluation of blood flow patterns of solitary pulmonary nodules (SPNs) with enhancement.

METHODSSeventy-eight patients with SPNs (≤4 cm) with strong enhancement underwent dynamic multi-slice spiral CT (Marconi Mx8000) scan before and after contrast enhancement by injecting contrast material with a rate of 4 mL/s. For the 40 patients in protocol one, one scan was obtained every 2 seconds during 15-45 and 75-105 seconds after injection, while for the 38 patients in protocol two, one scan was obtained every 2 seconds during 11-41 and 71-101 seconds. For all the patients, one scan was obtained every 30 seconds during 2-9 minutes. The section thickness was 2.5 mm for lesions ≤3 cm and 5 mm for lesions > 3 cm. Standard algorithm was used in the image reconstruction. Precontrast and postcontrast attenuation on every scan was recorded. The perfusion, peak height, ratio of peak height of the SPN to that of the aorta and mean transit time were calculated.

RESULTSThe peak height, perfusion, ratio of peak height of the SPN to that of the aorta and mean transit time in malignant SPNs were 34.85 Hu±10.87 Hu, 30.37 ml/(min*100 g)±11.14 ml/(min*100 g), 13.78%± 3.96% , 14.19 s±6.19 s respectively in protocol one, while those in protocol two were 36.62 Hu±10.75 Hu, 30.01 ml/(min*100 g)±8.10 ml/(min*100 g), 14.70 %±4.71%, 13.91 s±4.82 s respectively. No statistically significant differences were found between the peak height (t= 0.673, P=0.503), perfusion (t= 0.152 , P=0.880), ratio of peak height of the SPN to that of the aorta (t= 0.861, P=0.393) and mean transit time (t= 0.199, P=0.843) in malignant SPNs measured in protocol one and those measured in protocol two. All mean transit time in protocol two (36/36) were obtained, but only part of them (25/32) were obtained in protocol one.

CONCLUSIONSDynamic enhanced multi-slice spiral CT is a non-invasive method for quantitative evaluation of blood flow patterns of SPNs with enhancement and scans beginning at 11 seconds after injection of contrast material is suggested.

OBJECTIVETo investigate the relationship between heart rate variability (HRV) and prostaglandin E2 (PGE2) in patients with renal insufficiencies.

METHODSHRV blood and 24-hour urine prostaglandin E2 (PGE2) detection were detected in the following 4 groups of people: group A was a control group comprised of 20 normal individuals; group B had 20 patients with renal disease but exhibiting normal renal function; group C contained 20 patients with renal disease and compensatory renal function; group D had 20 patients demonstrating renal insufficiencies. The indices standard deviation of all NN intervals (SDNN), index of standard deviation of the averages of NN intervals (SDANN), mean of the standard deviation of all NN intervals performed on all 5-minute segments of the entire recording (SDNNindex), square root of the mean of the sum of the squares of differences between adjacent NN intervals (rMSSD) and NN50 count divided by the total number of all NN intervals (PNN50) were used to evaluate HRV, blood and 24-hour urine were determined by specific radioimmunoassay (RIA).

RESULTSPGE2 in blood and urine and HRV exactly within 24 hours in patients with renal insufficiencies, negatively correlated with worsening damage to renal function. There was a slight or moderate correlation between blood and urine PGE2 and the SDNNindex, SDANNindex, SDNN, rMSSD and PNN50 indices (P < 0.05).

CONCLUSIONSHRV and cardiac autonomic regulatory functions are decreased in the patients with renal insufficiencies, while lower levels of PGE2 may be a related factor.

Adolescent ; Adult ; Aged ; Dinoprostone ; physiology ; Female ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; physiopathology

BACKGROUNDTo investigate the methods of dynamic enhanced multi-slice spiral CT in the evaluation of blood flow patterns of malignant solitary pulmonary nodules (SPNs).

METHODSFifty-seven patients with malignant SPNs (≤4 cm) underwent dynamic multi-slice spiral CT (Marconi Mx8000) scan before and after contrast enhancement by injecting 90 ml contrast material with a rate of 4 ml/s. Twenty-nine patients in protocol one were scanned every 2 seconds during 15-45 seconds and 75-105 seconds after injection, while 28 patients in protocol two were scanned every 2 seconds during 11-41 seconds and 71-101 seconds. All patients were then scanned every 30 seconds during 2-9 minutes. The collimation was 2.5 mm for lesions of ≤3 cm and 5 mm for lesions of 3-4 cm. Standard algorithm was used in the image reconstruction. The perfusion, peak height, ratio of peak height of the SPN to that of the aorta and mean transit time were calculated.

RESULTSThe enhancement value, perfusion, ratio of peak height of the SPN to that of the aorta and mean transit time were (34.61±11.37) HU, (31.17±11.18) ml/(min*100 g), 13.90%±4.15%, (13.96±5.86) s separately in protocol one, and (36.54±10.89) HU, (29.80±8.80) ml/(min*100 g), 15.01%±4.83%, (13.34±5.12) s respectively in protocol two. No statistically significant difference was found between the two groups. In addition, mean transit time from all 28 patients in protocol two were obtained, but only part of them were measured in protocol one (22/29).

CONCLUSIONSDynamic enhanced multi-slice spiral CT is a kind of non-invasive method for quantitative evaluation of blood flow patterns of malignant solitary pulmonary nodules. It might have potential significance in angiogenesis research for lung cancer.

BACKGROUNDTo improve the differential diagnosis accuracy for solitary pulmonary nodules (SPNs), and to study the basis and mechanisms of enhancement by comparing with the microvessel constructions (microvessel density and basement membrane of microvessels) in SPNs.

METHODSDynamic contrast enhancement CT scanning were performed in 38 peripheral lung cancer, 5 hamartoma and 10 inflammatory lesions which were less than 3 cm in diameter with Siemens Plus S or Marconi MX 8000 spiral CT scanner. The CT time-attenuation curves were interpreted. The microvessel density (MVD) and the basement membrane of microvessels of the resected specimens were observed with the ABC immuno-histochemical method in all patients.

RESULTSThe CT contrasted value of lung cancer [(49.05±16.08) HU] and inflammatory lesions [(49.59±21.30) HU] were significantly higher than that of hamartoma [(8.98±4.56) HU] (t=7.48, P < 0.05; t=8.35, P < 0.05), but the enhancement of lung cancer was similar to that of inflammatory lesions (t=0.76, P > 0.05). The time-attenuation curve of inflammatory lesions tended to increase faster and reach a higher peak value than that of lung cancer, and both of them maintained a high plateau after crossing. The hamartoma showed a slight increase and demonstrated a low plateau curve. The MVD of SPNs was positively related to CT enhancement (r=0.805 1). The microvessel counts of peripheral lung cancer (48.45±10.09) and inflammatory lesions (49.60±19.94) were significantly higher than that of hamartoma (8.70±7.30) (t=11.64, P < 0.001; t=6.09, P < 0.001), but no significant difference was found between lung cancer and inflammatory lesions (t=-0.26, P=0.799). There was no any difference in continuity of basement membrane between nodules with enhanced CT less than 30 HU and higher than 30 U (Chi-square=3.13, P > 0.05).

CONCLUSIONSThe microvessel counts mainly contribute to the enhancement of SPNs. The basement membrane is not related to nodule enhancement, but it might influence the pattern of time-attenuation curve.

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