1.Application value of cone beam CT in accurate diagnosis of submandibular gland calculi
Xiaofeng YANG ; Xiaojuan SUN ; Guangwei QIAO ; Zhongwei ZHOU ; Huixia LAN
Academic Journal of Naval Medical University 2024;45(8):1041-1045
Objective To compare the detection rates of X-ray,ultrasound,computed tomography(CT)and cone beam CT(CBCT)for submandibular gland calculi in different positions,and to explore the auxiliary value of 3-dimensional visualization technology in diagnosis and treatment of submandibular gland calculi.Methods The X-ray,ultrasound,CT and CBCT examination data of 113 patients with submandibular gland calculi at General Hospital of Ningxia Medical University from Nov.2014 to Mar.2021 were retrospectively analyzed.The detection rates and overall detection rates of the 4 imaging methods for calculi in different positions were compared.Mimics 19.0 software and CBCT data were used for 3D reconstruction imaging,visually displaying the location,size,morphology,and number of calculi from a visual perspective.Results There was no significant difference in the total detection rate of submandibular gland calculi between CBCT and CT(98.2%[111/113]vs 95.6%[108/113],P>0.05),but both were significantly higher than that of X-ray(65.5%,74/113)and ultrasound(73.5%,83/113).The detection rates of ultrasound for calculi in the anterior and middle ducts were the lowest(63.6%[21/33]and 72.2%[26/36],respectively),which were significantly different from those of CBCT(97.0%[32/33]and 100.0%[36/36],respectively)and CT(93.9%[31/33]and 97.2%[35/36],respectively)(all P<0.05).The detection rate of X-ray for calculi in the posterior duct was significantly lower than that of ultrasound,CBCT,and CT(40.9%[18/44]vs 81.8%[36/44],97.7%[43/44],and 95.5%[42/44],all P<0.01).After CBCT data were imported into Mimics 19.0 software,submandibular gland calculi with different sizes,shapes,or numbers were successfully visualized and reconstructed.The reconstructed image was clear,and anatomical position relationship between the calculi and the mandible was visualized.Conclusion CBCT has good application value in the diagnosis of submandibular gland calculi and can replace traditional CT for the diagnosis of sialolithiasis.Clinically,CBCT examination can be directly performed for accurate diagnosis of calculi in the posterior duct which are not detected by double coincidence diagnosis but are indicated by ultrasound.For calculi in the anterior and middle ducts,X-ray and CBCT are preferred.Visualization technology helps clinical patient education and the development of personalized preoperative treatment plans.
2.Application of 3D printed model combined with visual surgical simulation in clinical teaching of extremity bone defects
Bingchuan LIU ; Xingcai LI ; Zhongwei YANG ; Guojin HOU ; Fang ZHOU ; Yun TIAN
Chinese Journal of Medical Education Research 2024;23(9):1286-1291
Objective:To investigate the application effect of the comprehensive innovative teaching model with "3D printed model combined with visual surgical simulation" as the core in the clinical teaching of extremity bone defects.Methods:The physicians who participated in the clinical management of patients with extremity bone defects in Department of Orthopedics, Peking University Third Hospital, from March 2019 to December 2021 were selected as subjects and were divided into standardized training group with 52 physicians and refresher physician group with 58 physicians. Teaching and training was performed for the special disease of extremity bone defects, including basic knowledge teaching, dressing change for infected wounds, multidisciplinary discussion, digital surgical simulation, and practical surgical operation. The assessment indices for teaching quality included the assessment of theoretical knowledge and clinical skills, the objective evaluation of the clinical ability of patient management, and an investigation of the degree of satisfaction. SPSS 22.0 was used for the t-test and the chi-square test. Results:After training, both groups had significant increases in the assessment scores of theoretical knowledge [(32.4±6.7)and (42.2±3.8)] and clinical practice skills [(19.6±2.0), (20.8±2.2), (20.5±2.5), (21.5±2.3)]( P<0.05). After training, the standardized training group had significant increases in the scores of six objective evaluation indicators [(8.3±0.8) vs. (6.9±1.1), (7.4±0.7) vs. (6.3±1.5), (7.2±1.3) vs. (5.0±1.4), (7.9±1.2) vs. (4.0±1.5), (8.4±0.8) vs. (6.4±1.6), (40.3±2.6) vs. (28.6±2.4)]( P<0.01), while the refresher physician group had significant improvements in four aspects, i.e., the understanding of extremity bone defects [(8.1±0.9) vs. (7.2±1.1)], the self-confidence in facing complex extremity bone defects [(8.1±1.2) vs. (6.6±0.9)], spatial thinking ability in repair surgery for bone defects [(8.6±0.8) vs. (7.3±0.9)], and overall clinical performance in actual management of patients with bone defects [(41.4±2.3) vs. (37.3±1.8)] ( P<0.01). The satisfaction score for this comprehensive innovative teaching model was (95.3±3.2) points in the standardized training group and (94.8±2.8) points in the refresher physician group. Conclusions:The comprehensive innovative teaching model with "3D printed model combined with visual surgical simulation" as the core can significantly improve the basic knowledge and clinical skills of physicians in a short period of time and meet the needs for learning surgical techniques and advanced diagnosis and treatment concepts among refresher physicians.
3.Genetic background of idiopathic neurodevelopmental delay patients with significant brain deviation volume.
Xiang CHEN ; Yuxi CHEN ; Kai YAN ; Huiyao CHEN ; Qian QIN ; Lin YANG ; Bo LIU ; Guoqiang CHENG ; Yun CAO ; Bingbing WU ; Xinran DONG ; Zhongwei QIAO ; Wenhao ZHOU
Chinese Medical Journal 2023;136(7):807-814
BACKGROUND:
Significant brain volume deviation is an essential phenotype in children with neurodevelopmental delay (NDD), but its genetic basis has not been fully characterized. This study attempted to analyze the genetic factors associated with significant whole-brain deviation volume (WBDV).
METHODS:
We established a reference curve based on 4222 subjects ranging in age from the first postnatal day to 18 years. We recruited only NDD patients without acquired etiologies or positive genetic results. Cranial magnetic resonance imaging (MRI) and clinical exome sequencing (2742 genes) data were acquired. A genetic burden test was performed, and the results were compared between patients with and without significant WBDV. Literature review analyses and BrainSpan analysis based on the human brain developmental transcriptome were performed to detect the potential role of genetic risk factors in human brain development.
RESULTS:
We recruited a total of 253 NDD patients. Among them, 26 had significantly decreased WBDV (<-2 standard deviations [SDs]), and 14 had significantly increased WBDV (>+2 SDs). NDD patients with significant WBDV had higher rates of motor development delay (49.8% [106/213] vs . 75.0% [30/40], P = 0.003) than patients without significant WBDV. Genetic burden analyses found 30 genes with an increased allele frequency of rare variants in patients with significant WBDV. Analyses of the literature further demonstrated that these genes were not randomly identified: burden genes were more related to the brain development than background genes ( P = 1.656e -9 ). In seven human brain regions related to motor development, we observed burden genes had higher expression before 37-week gestational age than postnatal stages. Functional analyses found that burden genes were enriched in embryonic brain development, with positive regulation of synaptic growth at the neuromuscular junction, positive regulation of deoxyribonucleic acid templated transcription, and response to hormone, and these genes were shown to be expressed in neural progenitors. Based on single cell sequencing analyses, we found TUBB2B gene had elevated expression levels in neural progenitor cells, interneuron, and excitatory neuron and SOX15 had high expression in interneuron and excitatory neuron.
CONCLUSION
Idiopathic NDD patients with significant brain volume changes detected by MRI had an increased prevalence of motor development delay, which could be explained by the genetic differences characterized herein.
Child
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Humans
;
Neurodevelopmental Disorders/epidemiology*
;
Genetic Testing
;
Phenotype
;
Brain/pathology*
;
Genetic Background
;
SOX Transcription Factors/genetics*
4.Characteristics and treatment of snow sports injuries in Zhangjiakou Zone of the Olympic Winter Games Beijing 2022
Zhongwei YANG ; Ao SUN ; Shan GAO ; Fang ZHOU
Chinese Journal of Orthopaedic Trauma 2023;25(12):1017-1024
Objective:To characterize the injuries suffered by athletes in snow events other than alpine skiing in the Zhangjiakou Zone of the Olympic Winter Games Beijing 2022, in order to provide insights for prevention of sports injuries and preparation of large-scale winter sports events.Methods:The medical records were retrospectively collected of all athletes who had been treated at Beijing University Third Hospital Chongli within the closed loop of the Zhangjiakou Zone during the Winter Olympics and Paralympics (from November 21, 2021 to April 5, 2022). The incidence, severity and part of the injuries were analyzed, as well as the medical treatment process.Results:In the Zhangjiakou Zone, a total of 1,188 athletes participated in the Winter Olympic Games, with an injury incidence of 2.9% (34/1,188), while 420 ones participated in the Winter Paralympic Games, with an injury incidence of 1.7% (7/420). The average daily medical visits were the highest during the Winter Olympics phase (1.16 visits per day), and their emergency severity index (ESI) ranged from level 3 to level 4. The department of orthopedics was visited the most (92.7%, 38/41). Lower limb injuries accounted for the highest proportion (53.7%, 22/41), with the knee ones accounting for 36.6% (15/41) of all injuries. Most of the athletes with ESI level 3 received splint fixation (62.5%, 5/8), while those with ESI level 4 mostly received observation and follow-up (57.6%, 19/33). A total of 57 radiological examinations were performed in the 41 athletes. X-ray was used the most frequently on a single day (5.00 times) while magnetic resonance imaging was per day on average (0.16 times). The transfer time for the athletes injured was (27.4±8.8) min which was not influenced by the 4 weather conditions (cloudy, sunny, light snow, and cloudy) ( P=0.374). Conclusions:The incidence of injuries during the Beijing Winter Olympics in the Zhangjiakou Zone was lower than that in other areas of the Beijing Winter Olympics and in previous Winter Olympics. There were no serious life-threatening cases. The imaging examination resources and transfer speed in the Zhangjiakou Zone were able to meet the medical needs of athletes at all stages of the Beijing Winter Olympics and Paralympics. Athletes should pay attention to protection of their lower limbs during skiing competitions.
5.Effects and mechanism of water-soluble chitosan hydrogel on infected full-thickness skin defect wounds in diabetic mice.
Meng ZHU ; Yu Zhou CHEN ; Jin Zhao OU ; Zhao LI ; Sha HUANG ; Xiao Hua HU ; Xiao Yan JU ; Ye TIAN ; Zhongwei NIU
Chinese Journal of Burns 2022;38(10):923-931
Objective: To explore the effects and mechanism of water-soluble chitosan hydrogel on infected full-thickness skin defect wounds in diabetic mice. Methods: The experimental research method was adopted. The control hydrogel composed of polyvinyl alcohol and gelatin, and the water-soluble chitosan hydrogel composed of the aforementioned two materials and water-soluble chitosan were prepared by the cyclic freeze-thaw method. The fluidity of the two dressings in test tube before and after the first freeze-thawing was generally observed, and the difference in appearance of the final state of two dressings in 12-well plates were compared. According to random number table (the same grouping method below), the cell strains of L929 and HaCaT were both divided into water-soluble chitosan hydrogel group and control hydrogel group, respectively. After adding corresponding dressings and culturing for 24 h, the cell proliferation activity was measured using cell counting kit 8. Rabbit blood erythrocyte suspensions were divided into normal saline group, polyethylene glycol octyl phenyl ether (Triton X-100) group, water-soluble chitosan hydrogel group, and control hydrogel group, which were treated accordingly and incubated for 1 hour, and then the hemolysis degree of erythrocyte was detected by a microplate reader. Twenty-four female db/db mice aged 11-14 weeks were selected, and full-thickness skin defect wounds on their backs were inflicted and inoculated with the methicillin-resistant Staphylococcus aureus (MRSA), 72 h later, the mice were divided into blank control group, sulfadiazine silver hydrogel group, control hydrogel group, and water-soluble chitosan hydrogel group, which were treated accordingly. On post injury day (PID) 0 (immediately), 7, 14, and 21, the healing of the wound was observed. On PID 14 and 21, the wound healing rate was calculated. On PID 14, MRSA concentration in wounds was determined. On PID 21, the wounds were histologically analyzed by hematoxylin and eosin staining; the expression of CD31 in the wounds was detected by immunofluorescence method, and its positive percentage was calculated. Raw264.7 cells were taken and divided into interleukin-4 (IL-4) group, blank control group, control hydrogel group, and water-soluble chitosan hydrogel group, which were treated accordingly. At 48 h of culture, the percentages of CD206 positive cells were detected by flow cytometry. The number of samples was all 3. Data were statistically analyzed with independent sample t test, one-way analysis of variance, analysis of variance for repeated measurement, least significant difference test, and Dunnett T3 test. Results: Two dressings in test tube had certain fluidity before freeze-thawing and formed semi-solid gels after freeze-thawing for once. The final forms of two dressings in 12-well plates were basically stable and translucent sheets, with little difference in transparency. At 24 h of culture, the cell proliferation activities of L929 and HaCaT in water-soluble chitosan hydrogel group were significantly higher than those in control hydrogel group (with t values of 6.37 and 7.50, respectively, P<0.01). At 1 h of incubation, the hemolysis degree of erythrocyte in water-soluble chitosan hydrogel group was significantly lower than that in Triton X-100 group (P<0.01), but similar to that in normal saline group and control hydrogel group (P>0.05). On PID 0, the traumatic conditions of mice in the 4 groups were similar. On PID 7, more yellowish exudates were observed inside the wound in blank control group and control hydrogel group, while a small amount of exudates were observed in the wound in sulfadiazine silver hydrogel group and water-soluble chitosan hydrogel group. On PID 14, the wounds in blank control group and control hydrogel group were dry and crusted without obvious epithelial coverage; in sulfadiazine silver hydrogel group, the scabs fell off and purulent exudate was visible on the wound; in water-soluble chitosan hydrogel group, the base of wound was light red and obvious epithelial coverage could be observed on the wound. On PID 14, the wound healing rate in water-soluble chitosan hydrogel group was significantly higher than that in the other 3 groups (all P<0.01). On PID 21, the wound in water-soluble chitosan hydrogel group was completely closed, while the wounds in the other 3 groups were not completely healed; the wound healing rate in water-soluble chitosan hydrogel group was significantly higher than that in the other 3 groups (all P<0.01). On PID 14, the concentration of MRSA in the wound in water-soluble chitosan hydrogel group was significantly lower than that in blank control group (P<0.01), but similar to that in control hydrogel group and sulfadiazine silver hydrogel group (P>0.05). On PID 21, the new epidermis was severely damaged in blank control group; the epidermis on the wound in control hydrogel group also had a large area of defect; complete new epidermis had not yet being formed on the wound in sulfadiazine silver hydrogel group; the wound in water-soluble chitosan hydrogel group was not only completely covered by the new epidermis, the basal cells of the new epidermis were also regularly aligned. On PID 21, the percentage of CD31 positivity in the wound in water-soluble chitosan hydrogel group was (2.19±0.35)%, which was significantly higher than (0.18±0.05)% in blank control group, (0.23±0.06)% in control hydrogel group, and (0.62±0.25)% in sulfadiazine silver hydrogel group, all P<0.01. At 48 h of culture, the percentage of CD206 positive Raw264.7 cells in water-soluble chitosan hydrogel group was lower than that in IL-4 group (P>0.01) but significantly higher than that in blank control group and control hydrogel group (P<0.05 or P<0.01). Conclusions: The water-soluble chitosan hydrogel has good biosafety and can induce higher level of macrophage M2 polarization than control hydrogel without water-soluble chitosan, so it can enhance the repair effect of MRSA-infected full-thickness skin defect wounds in diabetic mice and promote rapid wound healing.
Mice
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Female
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Animals
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Rabbits
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Interleukin-4
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Hydrogels/pharmacology*
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Wound Healing
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Chitosan/pharmacology*
;
Diabetes Mellitus, Experimental
;
Water
;
Methicillin-Resistant Staphylococcus aureus
;
Gelatin
;
Polyvinyl Alcohol
;
Hemolysis
;
Saline Solution
;
Eosine Yellowish-(YS)
;
Hematoxylin
;
Octoxynol
;
Silver
;
Phenyl Ethers
;
Sulfadiazine
6.Analysis of variation trend in health workforce equity allocation in China.
Wu Ping ZHOU ; Shu Han YANG ; Nan MU ; Wei Yan JIAN
Journal of Peking University(Health Sciences) 2022;54(3):477-482
OBJECTIVE:
To analyze the long-term trends of the changes in the equity of China's health workforce allocation to provide a reference for the more balanced and orderly development of China's health system.
METHODS:
The Gini coefficient was used to evaluate the degree of equity in the allocation of health workforce between regions, and the Gini coefficients for the allocation of doctors and nurses based on population and regional gross domestic product (GDP) distribution were calculated respectively.
RESULTS:
In 2019, the number of licensed (assistant) physicians per 1 000 population in China was 2.77, and the number of registered nurses per 1 000 population was 3.18. The Gini coefficient for the distribution of licensed (assistant) physicians by population was 0.141 in 2002, decreasing to 0.081 by 2014 and then remained stable. The Gini coefficient for the distribution of registered nurses by population was 0.164 in 2002 and decreased to 0.066 in 2018. The Gini coefficient for the distribution of licensed (assistant) physicians by GDP was 0.236 in 2002, decreased to 0.169 in 2013, then increased to 0.183 and remained stable. The Gini coefficient for the distribution of registered nurses by GDP was 0.206 in 2002, decreased to 0.150 in 2013, and then increased each year to 0.180 in 2019. The equity of the allocation of registered nurses by population was worse than the equity of the allocation of licensed (assistant) physicians in 2002, and in 2016, for the first time, exceeded that of licensed (assistant) physicians.
CONCLUSION
Equity in the allocation of health workforce across China has improved, but the improvement in equity between regions has hit a bottleneck, with health workforce allocation in the western regions still relatively scarce. Although nursing workforce allocation equity caught up with licensed (assistant) physicians, the number of licensed (assistant) physicians is close to that of developed western countries, while there is a large gap in registered nurses. It is recommended that the relevant authorities make good long-term planning for health workforce, further increase the policy for the introduction of health workforce in the western region, and increase the supply of healthcare services in the western region with the help of digital transformation of healthcare and internet healthcare. At the same time, they should further increase investment in resources for higher nursing education and actively plan to cope with the ageing population.
China
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Health Equity
;
Health Services
;
Health Workforce
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Humans
;
Workforce
7.Biomechanical Study of New Biodegradable Esophageal Stent.
Wentao YAN ; Hongyi YU ; Biao DING ; Zhongwei ZHENG ; Hang YAN ; Shengli LIN ; Pinghong ZHOU
Chinese Journal of Medical Instrumentation 2022;46(2):126-131
The radial force of the degradable esophageal stent before and after degradation is one of the important indicators for effective treatment of esophageal stricture. Based on a combination of in vitro experiments and finite element analysis, this paper studies and verifies the biomechanical properties of a new type of degradable esophageal stent under different esophageal stricture conditions. Under radial extrusion conditions, the maximum stress at the port of the stent is 65.25 MPa, and the maximum strain is 1.98%; The peak values of stress and strain under local extrusion and plane extrusion conditions both appear in the extrusion area and the compression expansion area at both ends, which are respectively 48.68 MPa, 46.40 MPa, 0.49%, 1.13%. The maximum radial force of the undegraded stent was 11.22 N, and 97% and 51% of the maximum radial force were maintained after 3 months and 6 months of degradation, respectively. The research results verify the safety and effectiveness of the radial force of the new degradable esophageal stent, and provide a theoretical basis for the clinical treatment of esophageal stricture.
Esophageal Stenosis/surgery*
;
Finite Element Analysis
;
Humans
;
Mechanical Phenomena
;
Stents
8.Clinical effects of 3D printed porous titanium-alloy prosthesis in reconstruction of long bone defects of lower extremities
Bingchuan LIU ; Xingcai LI ; Weipeng QIU ; Yong XING ; Zhongwei YANG ; Guojin HOU ; Zhongjun LIU ; Fang ZHOU ; Yufeng ZHENG ; Peng WEN ; Yun TIAN
Chinese Journal of Orthopaedics 2022;42(10):626-634
Objective:To analyze and summarize the clinical effects of 3D printed porous titanium-alloy prosthesis implantation in the treatment of long bone defects of lower extremities.Methods:We retrospectively studied the clinical cases with lower extremity bone defect treated by 3D printed porous titanium prostheses from December 2017 to November 2021. 18 patients who were followed up for more than 12 months were included in this study. The enrolled patients included 12 males and 6 females, with an average of 48.9±22.5 years (range, 13-79 years), and an average body mass index of 23.1±4.3 kg/m 2 (range, 17.2-27.1 kg/m 2). There were 14 osteomyelitis-derived bone defects and 4 nonunion-derived bone defects. The bone defect locations included 10 cases of femur and 8 cases of tibia. The average bone defect distance was 13.9±9.7 cm (range, 5.8-31.2 cm), and the proportion of the defect length to the long bone (femur of tibia) was average 33.7%±16.8% (range, 15.0%-63.0%). The clinical efficacy was comprehensively evaluated through gross observation, imaging evaluation, changes in the total length of lower extremities and long bones, femorotibial angle (FTA) measurement, lower extremity functional scale (LEFS), satisfaction, complications and other indicators, focusing on the stabilization mechanism of the prosthesis and the regeneration of new bone. Results:All 18 patients were followed up for 12-35 months, with an average of 16.3 months. Postoperative X-rays at 1, 3, 12 and 24 months showed that new bone could gradually creep along the prosthesis surface. The preoperative bone defect length of long bone and total length of lower limb were respectively 39.4±4.0 cm and 80.5±5.7 cm, which were different from those of the healthy side by 1.6±1.0 cm and 1.5±1.1 cm. One week after implantation, the length of long bone and lower limb was 39.9±3.5 cm and 80.9±6.2 cm, respectively, and the average difference was 1.0±0.6 cm and 0.9±1.1 cm compared with the healthy side. At the last follow-up, the length of long bone and lower limb was 39.7±3.6 cm and 80.9±7.8 cm, with an average difference of 1.8±1.1 cm and 1.0±0.7 cm from the healthy side. There were no significant differences in the length of long bone and lower limbs at the three time points before surgery, one week after surgery and the last follow-up ( F=0.12, 0.04; P>0.05). The average FTA of the affected limb was 174.7° (173.9°, 175.5°), 175.2°(173.5°, 176.4°), and 175.0°(173.5°, 176.3°) at three time nodes, before surgery, one week after surgery and the last follow-up, respectively, and there was no significant statistical difference in pairwise comparison ( Z=0.01, P>0.05). Patients had a mean LEFS score of 50 (46, 51) at the last follow-up, significantly higher than the preoperative score of 20 (17, 21) ( Z=-5.56, P<0.001). The mean satisfaction score of the 18 patients at the last follow-up was 9.7. Two patients (11.1%) had screw fractures but all 3D printed porous titanium alloy prostheses remained stable without significant loosening or displacement. Two patients (11.1%) had nail channel infection of external fixator, all patients with channel infection were cured by intravenous antibiotics combined with local disinfection and dressing change. Conclusion:The implantation of 3D printed porous titanium-alloy prosthesis could efficiently and safely repair the long bone defects of the lower extremities. The prosthesis could maintain stable in the early and middle postoperative period. The length of the long bones and lower limbs did not change significantly with the weight-bearing and functional exercise of the limbs. The new bone could gradually crawl and grow from both ends of the defect, and the patient's limb function recovered significantly, and the patient's satisfaction was high.
9.Integrin alpha 3 expression in glioma and its prognostic value in glioma patients
Xiang ZHOU ; Zhongwei WANG ; Haigang CHANG ; Shupeng ZHAO ; Baozhe JIN
Chinese Journal of Neuromedicine 2022;21(3):232-241
Objective:To investigate the differences of integral alpha 3 (ITGA3) mRNA and protein expressions in gliomas of different grades and different cell lines, and gliomas tissues of different clinical and molecular characteristics, and evaluate their prognostic values in brain glioma patients.Methods:(1) ITGA3 mRNA expression data in the brain gliomas and clinical data of these glioma patients were obtained from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA). The differences of ITGA3 mRNA expressions in glioma patients with different gender, ages, WHO grading, isocitrate dehydrogenase 1 ( IDH) mutation statuses, and 1p/19q co-deletion statuses were compared. Kaplan-Meier method was used to plot and compare the survival curves of patients with ITGA3 mRNA high expression and ITGA3 mRNA low expression. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficiency of ITGA3 mRNA expression in survival rate of gliomas. Univariate and multivariate Cox regression analyses were used to explore the independent influencing factors for prognoses in glioma patients. The independent influencing factors for prognosis were used to construct nomograms and the calibration diagram was used to verify the reliability of nomograms in predicting the prognoses of these patients. (2) Intracellular localization of ITGA3 and ITGA3 protein expression in low- and high-grade gliomas were determined by on-line database of Human Protein Atlas (HPA). (3) Brain glioma cells U87, U118, U251 and human astrocytes SVG were cultured in vitro, and the ITGA3 mRNA and protein expressions in cells were detected by Western blotting and reverse transcription (RT)-PCR, respectively. Results:(1) In TCGA database, the ITGA3 mRNA expressions in gliomas of WHO grading II, III and IV increased successively, with significant differences (P<0.05). In CGGA database, the ITGA3 mRNA expression in glioma of WHO grading IV was statistically higher than that in glioma of WHO grading II and III ( P<0.05). In TCGA and CGGA databases, the ITGA3 mRNA expressions in glioma patients aged ≤40 years and >40 years, patients with IDH wild-type and IDH mutation, and patients with chromosome 1p/19q deletion and chromosome 1p/19q non-deletion were statistically different ( P<0.05). The survival rate of patients with low ITGA3 mRNA expression was significantly higher than that of patients with high ITGA3 mRNA expression, no matter in low-grade glioma, glioblastoma, or entire glioma samples ( P<0.05). ROC curve showed that, in TCGA database, the area under the curve (AUC) of ITGA3 mRNA in predicting 1, 3, and 5 years survival was 0.791, 0.786, and 0.708 in glioma patients; in CGGA database, the AUC of ITGA3 mRNA in predicting 1, 3, and 5 years survival was 0.661, 0.667, and 0.659. Multivariate Cox regression analysis showed that, in TCGA database, age, WHO grading, IDH mutation, chromosome 1p/19q deletion and ITGA3 mRNA expression ( HR=1.018, 95%CI: 1.006-1.030, P=0.0.003) were independent influencing factors for prognoses of glioma patients ( P<0.05); and in CGGA database, WHO grading, IDH mutation, chromosome 1p/19q deletion, and ITGA3 mRNA expression ( HR=1.445, 95%CI: 1.132-1.844, P=0.003) were independent influencing factors for prognoses of glioma patients ( P<0.05). Nomograms showed that age had the greatest influence in survival, followed by ITGA3 mRNA expression. Calibration plots showed that nomogram was reliable in predicting 1-, 3-, and 5-year survival in glioma patients. (2) Immunofluorescence localization showed that ITGA3 protein mainly aggregated in cell membrane and vesicles. Immunohistochemical staining showed that the ITGA3 protein expression in high-grade glioma tissues was obviously higher than that in low-grade glioma tissues. (3) The results of RT-PCR and Western blotting revealed that the ITGA3 mRNA and protein expressions in glioma cell lines U87, U118 and U251 were significantly higher than those in SVG cells ( P<0.05). Conclusion:The ITGA3 mRNA and protein expression levels are correlated with the malignant degrees of glioma; patients with ITGA3 mRNA low expression tend to have a high overall survival; ITGA3 mRNA expression can be used as an index to evaluate the prognoses of glioma patients.
10.Mid-term efficacy of prostatic artery embolization for benign prostatic hyperplasia
Zhongwei XU ; Chungao ZHOU ; Wei TIAN ; Bin LENG ; Haibin SHI ; Sheng LIU
Chinese Journal of Radiology 2021;55(11):1197-1201
Objective:To investigate the mid-term efficacy of prostatic artery embolization (PAE) for the treatment of lower urinary tract symptoms (LUTS), urinary retention (UR) or hematuria secondary to benign prostatic hyperplasia (BPH).Methods:This was a retrospective study conducted from February 2014 to December 2018 in 140 patients who underwent PAE for LUTS, UR or hematuria secondary to BPH, including 85 patients with LUTS (60 patients with LUTS and 25 LUTS combined with hematuria), 52 patients with UR (50 patients with UR and 2 UR combined with hematuria) and 3 patients with hematuria. All patients were followed up for 24 months. Clinical success rates were evaluated. Friedman test was performed to compare the differences in International Prostate Symptom Score (IPSS), quality of life (QoL) score, and prostatic volume (PV) between baseline and follow-up time points (3, 6, 12 and 24 months). A post hoc test was performed by the Bonferroni method.Results:Significant differences in IPSS, QoL score and PV between baseline and follow-up time points were observed in 85 patients with LUTS ( P<0.001 for all), and clinical success rates at 3, 6, 12, 24 months after PAE were 95.3% (81/85), 91.8% (78/85), 87.1%(74/85), 83.5%(71/85). The success rate of extubation in patients with UR within 1 month after PAE was 98.1% (51/52). The average interval from PAE to catheter-independence was (6.8±3.7) days, and clinical success rates were 94.1% (48/51), 92.2% (47/51), 88.2% (45/51), 84.3% (43/51), respectively. The interval from PAE to the resolution of hematuria was (3.4±2.5) days, and clinical success rates were 90.0%(27/30), 90.0%(27/30), 83.3%(25/30), 80.0%(24/30), respectively. Conclusions:PAE was an effective treatment option for symptoms secondary to BPH in mid-term follow up.

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