1.Risk factors and prognostic value of heart-type fatty acid binding protein in patients with heart failure
Yuyi CHEN ; Pengchao TIAN ; Changhong ZOU ; Jiayu FENG ; Yan HUANG ; Qiong ZHOU ; Mei ZHAI ; Xiaofeng ZHUANG ; Yihang WU ; Boping HUANG ; Jingyuan GUAN ; Jing WANG ; Xinqing LI ; Xuemei ZHAO ; Tianyu XU ; Yuhui ZHANG ; Jian ZHANG
Chinese Journal of Laboratory Medicine 2022;45(9):968-976
Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.
2.The CT findings and its pathological basis of gastrointestinal neuroendocrine tumors
Zaosong LIU ; Xinhua WEI ; Jin XU ; Xinqing JIANG
Journal of Practical Radiology 2017;33(3):412-414,421
Objective To investigate the CT findings and its pathological basis of gastrointestinal neuroendocrine tumors (GEP-NETs ). Methods The CT findings of 23 patients with GEP-NETs confirmed by pathology were analyzed retrospectively and compared with the pathological results.Results The GEP-NETs were found on CT in 20 patients,including focal gastrointestinal wall thickening in 4,mass formation in 6,and both in 10.The tumor diameter ranged from 0.9 cm to 5.2 cm with a mean value of (2.6±0.6)cm. Plain CT showed homogenous isodensity in 15 lesions,little necrosis with low density in 4,and hemorrhage with high density in 1. The dynamic contrast-enhanced CT showed the tumors with obvious enhancement in 16 cases and mild enhancement in 4 in arterial phase.In addition,serosa invasion was found in 7,enlargement of mesentery lymph node in 7,and liver metastases in 2.The pathol-ogy showed the location of submucosa and invasion of the tumors.Most small tumors had intact gastrointestinal mucosa,and some large ones had surface or infiltrated ulcer.Conclusion Some specific CT findings of GEP-NETs depend on its pathological character-istics.CT plays an important role in assessment of invasion extent and metastasis of the tumor.
3.Differentiation of glioblastomas and solitary metastatic brain tumors using texture analysis of conventional MRI
Xin CHEN ; Xinhua WEI ; Ruimeng YANG ; Lingling LIU ; Xiangdong XU ; Xinqing JIANG
Chinese Journal of Radiology 2016;50(3):186-190
Objective To investigate the diagnostic value of the texture analysis derived from conventional MR imaging in differentiating glioblastomas from solitary brain metastases. Methods Thirty-four patients with pathological diagnoses of glioblastomas and 34 patients with pathological diagnoses of solitary brain metastases were enrolled in our study. All patients underwent conventional MR imaging including axial T1WI, T2WI, fluid attenuated inversion recovery (FLAIR) and contrast-enhanced T1WI before surgery. Texture features were calculated from manually drawn ROIs by using MaZda software. The feature selection methods included mutual information (MI), Fishers coefficient, classification error probability combined with average correlation coefficients (POE+ACC) and the combination of the above three methods. These methods were used to identify the most significant texture features in discriminating glioblastomas from metastases. Then the statistical methods including raw data analysis (RDA), principal component analysis (PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were used to distinguish glioblastomas from metastases. The results were shown by misclassification rate. Meanwhile, two senior radiologists (who had 5 and 9 years of experience in neuroimaging diagnosis, respectively) analysed the data of the 68 patients. Chi-square test was used to compare the differences in the results between the radiologists' analysis and the texture analysis. Results In the four kinds of sequences, the texture features for differentiating glioblastomas from solitary brain metastases were mainly from T2WI which had the lowest misclassification rate, 8.82% (6/68). The misclassification rates of the feature selection methods were similar in MI, Fisher's coefficient and POE + ACC (10.29%-27.94% for MI;11.76%-44.12% for Fisher's coefficientand 8.82%-38.24% for POE+ACC). However, the misclassification rate of the combination of the three methods (8.82%-33.83% for FPM) was lower than that of any other kind of method. In the statistical methods, NDA (8.82%-11.76% ) had lower misclassification rate than RDA (26.47%-39.71% ), PCA (27.94%-39.71%) and LDA (13.24%-44.12%). Misclassification rate of the radiologists' analysis 14.71%(10/68) was higher than that of the texture analysis, but there was no statistically difference between them (χ2= 10.993, P=0.287). Conclusion Texture analysis of conventional MR imaging can provide reliably objective basis for differentiating glioblastoma from solitary brain metastasis.
4.Synthesis of a novel long-circulating dual-receptor targeting and dual-modal molecular probe:an in-vitro study
Ruimeng YANG ; Wenjie TANG ; Minyan WEI ; Shengsheng LAI ; Xiangdong XU ; Simin LIANG ; Xinhua WEI ; Xinqing JIANG
Chinese Journal of Radiology 2016;(1):41-46
Objective To explore a novel long-circulating dual-receptor targeting and dual-modal molecular probe and investigate its physicochemical properties and targeting effect on breast cancer cells in vitro. Methods Dual-receptor targeting and dual-modal molecular probe RGD@BBN-lipo(QDs)-SPIO was synthesized in the following steps: long-circulating liposome was prepared by film dispersion method;water-soluble superparamagnetic iron oxide (SPIO) nanoparticles and Quantum dots (QDs) were loaded in the hydrophilic and hydrophobic layer of liposome, respectively;RGD and BBN polypeptides were coupled on the former functional magnetic/fluorescent liposomes. Stability of the probe in different physiological solutions was investigated. Transmission electron microscopy (TEM) and particle size analyzer were used to measure nanoparticle sizes and the Zeta potential. Characterization of RGD and BBN was investigated through 1H-NMR and elemental analysis. The MRI T2 relaxivities (1/T2) of RGD@BBN-lipo(QDs)-SPIO was measured through T2 map scanning on 3.0 T MR system. HUV-EC-C cells were used for assessment of cells viability by MTS assay. Prussian blue staining and fluorescence imaging were carried out to determine the targeted breast cellular uptake of RGD@BBN-lipo(QDs)-SPIO nanoparticles. Results The targeting magnetic/fluorescent dual-model molecular probes appeared spherical or para-spherical,with a mean diameter of(118.2±3.9)nm,Zeta potential of (-24.78±1.68) mV,MR T2 magnetic relaxation rate of 0.498 1× 106 M-1 · s-1.RGD and BBN polypeptides were successfully coupled on the former functionally magnetic/fluorescent liposomes with the bind rates of 33.05%and 45.06%, respectively. There was low cytotoxity of the molecular probe on human umbilical vein endothelical cells(HUV-EC-C)by MTS study. Prussian blue staining and fluorescence imaging studies showed that the RGD@BBN-lipo(QDs)-SPIO nanoparticles could target any αvβ3 or gastrin releasing peptide receptor overexpression breast cancer. Conclusions RGD@BBN-lipo(QDs)-SPIO is a novel long-circulating dual-receptor targeting and dual-modal molecular probe and has excellent physicochemical properties and stability, high T2 relaxivities and strong targeting effect on cancer cells and has laid a solid foundation for early diagnosis of breast cancer.
5.Expression and clinical significance of Tim-3 in peripheral blood natural killer cells of patients with oral squamous cell carcinoma
Xiaojun GU ; Tengyong WANG ; Xinqing LIU ; Su XU ; Genxun ZHANG ; Ruiying LIU
Journal of Practical Stomatology 2016;32(5):692-695
Objective:To detect the expression levels of T cell immunoglobulin mucin-3 (Tim-3) in peripheral blood natural killer (NK) cells of patients with oral squamous cell carcinoma (OSCC) and to study their biological and clinical significance.Methods:The expression of Tim-3 in the CD3-CD56 + NK cells was examined in 72 patients with OSCC and 40 heathy controls (HC) by flow cytometry.The correlation of Tim-3 expression in NK cells with clinicopathological parameters was analyzed.Results:The proportion of CD3-CD56 + NK cells was significantly decreased in OSCC patients as compared with HC [(9.30 ± 2.52)% vs (17.36 ± 3.15)%,P < 0.001].The percentage of Tim-3 + CD3-CD56 + NK cells in OSCC patients was higher than that in HC [(14.35 ± 6.35) % vs (1.78 ± 0.86) %,P < 0.001].High percentage of Tim-3 + CD3-CD56 + NK cells was associated with cell differentiation,lymphatic metastasis and pathological stage of OSCC (P < 0.01).Conclusion:Lower proportion of NK cells and higher level of Tim-3 in peripheral blood NK cells may play a role in the development of OSCC.
6.Signal intensity-time curve and quantitative dynamic contrast-enhanced magnetic resonance imaging in differentiating neoplasms of uterus.
Yongmei GUO ; Xinqing JIANG ; Guoshun LIU ; Yunhai HUANG ; Xiangdong XU
Journal of Central South University(Medical Sciences) 2015;40(12):1357-1364
OBJECTIVE:
To evaluate signal intensity-time (SI-Time) curve and quantitative dynamic contrast-enhanced 3.0T magnetic resonance imaging in diagnosis and differentiating neoplasm of uterus.
METHODS:
A total of 42 cases of uterine neoplasm (20 were malignant and 22 were benign) were evaluated in our study. All cases received dynamic contrast-enhanced scanning on 3.0T MRI. The raw data was processed by Siemens Tissue 4D software and the SI-Time curve was obtained and analyzed. Pharmacokinetic modeling of Tofts with a modeled vascular input function was used for calculating volume parameters: volume transfer constant (Ktrans), reverse volume transfer constant (Kep), the extravascular extracellular space volume per unit volume of tissue (Ve). The correlation of these parameters at each groups were investigated. The SI-Time curve and the data of perfusion parameters between the 2 groups were compared by T test.
RESULTS:
Among 20 malignant tumors, 12 were cervical carcinoma and 8 were endometrial cancer. Among the benign tumors, 13 were leiomyomas, 3 were endometrial polyp, 3 were endometrial hyperplasia, and 3 were adenomyosis. 59.1% cases of benign tumors belong to Type I curve and 65% cases of malignant tumors belong to Type II curve. There was significant difference in SI-Time curve between benign and malignant tumors (P=0.011). If Type I curve was used as diagnostic criteria for benign tumors, and Type II and III curve were for malignant tumors, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value were 90.0%, 59.1%, 66.7%, and 86.7%, respectively. Ve was 0.477 ± 0.143 in malignant and 0.614 ± 0.146 in control group with significant difference (P=0.004). Ve was 0.477 ± 0.143 in malignant and 0.589 0.176 in benign group with significant difference (P=0.004). Ktrans was (0.178 ± 0.067) min⁻¹ in malignant and (0.263 ± 0.111) min⁻¹ in control group with significant difference (P=0.003). Ktrans was (0.182 ± 0.096) min⁻¹ in benign and (0.263 ± 0.111) min⁻¹ in control group with significant difference (P=0.011).
CONCLUSION
The type of SI-Time curve and perfusion parameters were important for differentiating benign and malignant uterine tumors in dynamic enhanced MRI. These parameters provide a supplement for conventional morphological MR diagnosis.
Contrast Media
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Female
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Humans
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Magnetic Resonance Imaging
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Sensitivity and Specificity
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Uterine Neoplasms
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diagnosis
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Uterus
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pathology
7.Value of 320-slice dynamic contrast enhanced spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations
Fan XU ; Yuan GUO ; Mei WU ; Hongzhen WU ; Xinqing JIANG ; Qingcong KONG
Chinese Journal of Hepatic Surgery(Electronic Edition) 2015;(2):100-104
ObjectiveTo investigate the clinical value of 320-slice spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations.MethodsClinical data of 62 patients with metastatic liver cancer with atypical CT manifestations who were conifrmed by the pathological examination and underwent 320-slice CT plain scan and enhanced scan in the First People's Hospital of Guangzhou from August 2010 to August 2014 were studied retrospectively. Of the 62 patients, 45 were males and 17 were females with the age ranging from 37 to 83 years old and the median of 63 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The imaging characteristics of the lesions by spiral CT plain scan and enhanced scan were observed, including density, number, boundary and enhancement pattern of the lesions.ResultsOn CT plain scan of the 62 cases, 94% (58/62) displayed low or slightly low density and 6% (4/62) displayed mixed high and low density, 77% (48/62) were with multiple lesions and 23% (14/62) were with single lesion; 79% (49/62) were with obscure boundary and 21%(13/62)were with well-deifned boundary. On CT enhanced scan, 50% (31/62) were with progressive enhancement, 21% (13/62) were without obvious enhancement, 11% (7/62) were with wreath-like edge enhancement, 5% (3/62) were with fast in fast out enhancement and 13% (8/62) were with multiple patterns enhancement.Conclusions320-slice dynamic contrast enhanced spiral CT may better relfect the histological and blood supply characteristics of metastatic liver cancer with atypical imaging manifestations and provide more accurate imaging evidences for the formulation of clinical therapeutic regimen.
8.Advances in functional genomics studies underlying acetic acid tolerance of Saccharomyces cerevisiae.
Xinqing ZHAO ; Mingming ZHANG ; Guihong XU ; Jianren XU ; Fengwu BAI
Chinese Journal of Biotechnology 2014;30(3):368-380
Industrial microorganisms are subject to various stress conditions, including products and substrates inhibitions. Therefore, improvement of stress tolerance is of great importance for industrial microbial production. Acetic acid is one of the major inhibitors in the cellulosic hydrolysates, which affects seriously on cell growth and metabolism of Saccharomyces cerevisiae. Studies on the molecular mechanisms underlying adaptive response and tolerance of acetic acid of S. cerevisiae benefit breeding of robust strains of industrial yeast for more efficient production. In recent years, more insights into the molecular mechanisms underlying acetic acid tolerance have been revealed through analysis of global gene expression and metabolomics analysis, as well as phenomics analysis by single gene deletion libraries. Novel genes related to response to acetic acid and improvement of acetic acid tolerance have been identified, and novel strains with improved acetic acid tolerance were constructed by modifying key genes. Metal ions including potassium and zinc play important roles in acetic acid tolerance in S. cerevisiae, and the effect of zinc was first discovered in our previous studies on flocculating yeast. Genes involved in cell wall remodeling, membrane transport, energy metabolism, amino acid biosynthesis and transport, as well as global transcription regulation were discussed. Exploration and modification of the molecular mechanisms of yeast acetic acid tolerance will be done further on levels such as post-translational modifications and synthetic biology and engineering; and the knowledge obtained will pave the way for breeding robust strains for more efficient bioconversion of cellulosic materials to produce biofuels and bio-based chemicals.
Acetic Acid
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pharmacology
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Genomics
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Industrial Microbiology
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Saccharomyces cerevisiae
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drug effects
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genetics
9.Relationship between the triglycerides to high-density lipoprotein ratio and coronary heart disease
Qingquan LIU ; Yaoguo WANG ; Zhaoxiang XU ; Xinqing DU
Chinese Journal of Geriatrics 2013;32(12):1281-1282
Objective To investigate the relationship of triglycerides/high-density lipoprotein (TG/HDL C) ratio with coronary heart disease (CHD) and its severity.Methods 158 patients with CHD were enrolled in this study.Patients were divided into 4 groups according to the selective coronary arteriography:the control group,single-vessel CHD group,double-vessel CHD group,multiple-vessel CHD group.The relationship between multiple risk factors and CHD was analyzed by stepwise multiple regression.The severity of coronary artery stenosis was analyzed by Gensini scoring system.Results TG/HDL-C ratio was elevated in patients with coronary artery stenosis as compared with the control group [(1.8±1.0) vs.(1.7±1.4),t=2.68,P<0.05].TG/HDL-C ratio was elevated along with the severity of CHD.TG/HDL-C ratio was elevated in multiple-vessel C HD group as compared with the control group by ANOVA analysis (P<0.05).Stepwise multiple regression showed that multiple-vessel CHD was positive related with total cholesterol (TC),LDL-C and TG/HDL-C ratio (β value:0.326,0.339,0.158,respectively,all P<0.05).Conclusions TG/HDL C ratio is related with multiple vessel CHD,but it does not have more clinical significances than other indicators.
10.Comparative study of MRI appearances in clear cell renal cell carcinoma,papillary renal cell carcinoma and chromophobe renal cell carcinoma
Lei MO ; Xinqing JIANG ; Yunhai HUANG ; Jing CHEN ; Jin XU
Chinese Journal of Radiology 2011;45(6):555-559
Objective To investigate the differential diagnostic features of subtypes of renal cell carcinoma(RCC) using dynamic contrast-enhanced MRI(DCE-MRI).Methods The MRI appearances of 77 RCCs, including 55 clear cell RCCs(CCRCC),14 papillary RCCs(PRCC) and 8 chromophobe RCCs(CRCC), were retrospectively analyzed and compared with findings of pathology. DCE-MRI was conducted in each case after intravenous administration of contrast agent. Region of interest measurements (cortical, nephrographic and delayed Phases) of signals within tumor and uninvolved renal cortex were used to calculate percentage signal intensity change and tumor-to-cortex enhancement index, and the data was analyzed by AVONA and t test. Results On unenhanced and enhanced MRI, most CRCCs showed homogeneous signal(7/8). CCRCC and PRCC often show inhomogenous signal with necrosis(36/55, 7/14). Hemorrhage and cystic degeneration were often found in PRCC (9/14). On the cortical, nephrographic and delayed phase images, CCRCCs showed greater signal intensity change[(296.15±60.27)%, (236.33±58.31)% and (216.83±46.72)%,respectively than PRCCs (79.70±18.84)%, (122.81±27.35)% and (117.55±20.63)%, respectively], and CRCCs showed intermediate change [(119.56±40.76)%, (163.06±33.91)% and (179.72±32.89)%, respectively].A phenomenon of quick staining and quick fainting was observed in CCRCCs. Both of CRCCs and PRCCs showed delayed enhancement. The tumor-to-cortex enhancement index at the cortical, nephrographic and delayed phases was highest for CCRCCs (1.26±0.34, 0.92±0.23 and 0.76±0.14, respectively), lowest for PRCCs (0.33±0.12, 0.41±0.23 and 0.35±0.11, respectively), and intermediate for CRCCs (0.54±0.10, 0.62±0.15 and 0.69±0.12, respectively,P<0.01). The degree of enhancement was significantly different among the 3 subtypes at the every contrast enhanced phase (F=940.931, 124.515 and 38.194, P<0.01), so was the tumor-to-cortex enhancement index(F=798.625,78.308 and 73.699, P<0.01). There was a good consistency between MR appearances of the 3 RCC subtypes and pathological characteristics. Conclusion DCE-MRI could distinctly show imaging features of CCRCC, PRCC and CRCC, which were related to their pathological characteristics, and these features were helpful in predicting a specific subtype of RCC.

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