Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.

Objective To construct radiomics-semantic models to predict the treatment resistance of chemoradiotherapy in brain gliomas based on MRI and clinical data of multicenter patients.Methods Among 2 108 brain gliomas patients from five medical institutions,132 patients had residual gliomas after surgery.The clinical risk factors and multimodal MRI were collected.All patients were divided into training set(n=95)and validation set(n=37).The treatment response of gliomas after standardized chemoradiotherapy were divided into resistant and non-resistant types.The semantic features of MRI were evaluated by two radiologists.Three different segmentation regions of interest(ROI)were delineated to extract radiomics features.And that three groups of radiomics models were con-structed based on different sequence MRIs.The radiomics model with the best predictive efficacy in each group was selected and combined with MRI semantic features,three radiomics-semantic models(combined models)were established.Finally,a MRI semantic model,three groups of radiomics models and three combined models were developed.Results Comparisons between the different models showed that the radiomics-semantic model based on pre-operative T2-fluid attenuated inversion recovery(FLAIR)sequence,had the best predictive efficacy,the area under the curve(AUC)in the training and validation sets were 0.866[95％confidence interval(CI)0.790-0.942]and 0.810(95％CI 0.667-0.952),respectively.The radiomics-semantic model based on postoperative T1 WI sequence performed the second best,with the AUC of the training and validation sets being 0.812(95％CI 0.726-0.898)and 0.711(95％CI 0.541-0.881),respectively.Conclusion The combined models based on MRI radiomics and semantic features are able to predict the treatment resistance of chemoradiotherapy in brain gliomas patients,and may be used as an important basis for optimizing treatment.

Objective To construct radiomics-semantic models to predict the treatment resistance of chemoradiotherapy in brain gliomas based on MRI and clinical data of multicenter patients.Methods Among 2 108 brain gliomas patients from five medical institutions,132 patients had residual gliomas after surgery.The clinical risk factors and multimodal MRI were collected.All patients were divided into training set(n=95)and validation set(n=37).The treatment response of gliomas after standardized chemoradiotherapy were divided into resistant and non-resistant types.The semantic features of MRI were evaluated by two radiologists.Three different segmentation regions of interest(ROI)were delineated to extract radiomics features.And that three groups of radiomics models were con-structed based on different sequence MRIs.The radiomics model with the best predictive efficacy in each group was selected and combined with MRI semantic features,three radiomics-semantic models(combined models)were established.Finally,a MRI semantic model,three groups of radiomics models and three combined models were developed.Results Comparisons between the different models showed that the radiomics-semantic model based on pre-operative T2-fluid attenuated inversion recovery(FLAIR)sequence,had the best predictive efficacy,the area under the curve(AUC)in the training and validation sets were 0.866[95％confidence interval(CI)0.790-0.942]and 0.810(95％CI 0.667-0.952),respectively.The radiomics-semantic model based on postoperative T1 WI sequence performed the second best,with the AUC of the training and validation sets being 0.812(95％CI 0.726-0.898)and 0.711(95％CI 0.541-0.881),respectively.Conclusion The combined models based on MRI radiomics and semantic features are able to predict the treatment resistance of chemoradiotherapy in brain gliomas patients,and may be used as an important basis for optimizing treatment.

Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.

Objective To explore the application of diffusion tensor imaging (DTI)in crossed cerebellar diaschisis (CCD)of cerebral gliomas. Methods MR images of 17 patients with high grade gliomas and 20 patients with low grade gliomas confirmed by postoperative pathology and 18 normal controls were analyzed retrospectively.The fractional anisotropy (FA)of cerebellar hemisphere was quantitatively measured with DTI technique.The asymmetry index (AI)of cerebellar hemispheric was calculated and compared in patients.The correlation between CCD phenomenon and histological grade of cerebral gliomas was also analyzed.Results Compared with ipsilateral cerebellar hemisphere of cerebral high grade gliomas,the FA value of contralateral cerebellar hemisphere significantly reduced (t=3.42,P<0.05).But there were no significant differences of FA values between contralateral cerebellar hemisphere and ipsilateral cerebellar hemisphere in cerebral low grade gliomas patients (t=0.80,P>0.05).The AI values of cerebellar hemisphere in high grade gliomas increased compared with low grade gliomas and normal controls (t=4.15,P<0.05;t=4.68,P<0.05),but there were no significant differences in the AI values of cerebellar hemisphere between low grade gliomas patients and normal controls (t=0.79,P>0.05).Conclusion CCD phenomenon is associated with the histological grade of cerebral gliomas.High grade gliomas can cause CCD phenomenon,but there is no evident CCD phenomenon in low grade gliomas.DTI technique is able to quantitatively assess CCD noninvasively by FA parameter.

Objective To investigate the applicative value of enhanced 3D multi-echo GRE T2*-weighted angiography(ESWAN) sequence phase values in evaluating brain gray nuclei iron content in idiopathic restless legs syndrome(RLS) patients, providing imaging basis in diagnosis and treatment of idiopathic RLS. Methods In our institute from June 2012 to September 2016,forty-five RLS patients were selected as the RLS group, and 45 healthy volunteers as the control group. ESWAN sequence was performed and serum ferritin values were obtained in all patients and volunteers. The raw data of ESWAN was postprocessed , where the phase maps were obtained. Phase analysis was performed on localized brain gray nuclei regions of interest (substantia nigra, red nucleus, dentate nucleus, thalamus, pallidum, putamen and caudate nucleus ) selected on phase maps. Differences between the 2 subject groups were evaluated using ANCOVA including age as a covariate. Results The phase values of the substantia nigra, thalamus, pallidum and putamen in the RLS group were (-0.087 ± 0.021), (-0.053 ± 0.012), (-0.161 ± 0.008), (-0.125 ± 0.019) radians , respectively. The phase values of the substantia nigra, thalamus, pallidum and putamen in the control group were (-0.127 ± 0.007), (-0.066 ± 0.007), (-0.166 ± 0.007), (-0.150 ± 0.010) radians, respectively. There were significant differences between the two groups (F=142.492, 37.988, 10.558, 60.725;P<0.05). Indicating reduced iron content in several regions of brain gray nuclei of the patients with RLS. Serum ferritin concentration between the RLS patients (157.02±95.78)μg/L and healthy controls (175.49 ± 38.65)μg/L was not significant (F=1.353,P>0.05). Conclusions Phase values can make a quantitative assessment of brain gray nuclei iron content in RLS patients, our results supported the hypothesis of reduced brain iron content in RLS patents , which may have an important role in the pathogenesis of the disorder. However, iron content change in some brain regions was not correlated with serum ferritin concentration changes.

ABSTRACT:Objective To observe the influence of saikosaponin-d (SSd)on the proliferation and the function of autophagy of human hepatocellular carcinoma (HCC)cell line SMMC-7721 to explore the possible mechanisms. Methods SMMC-7721 was cultured invitro and then treated with SSd of various concentrations (5.0,7.5,10.0, 12.5,15.0 and 17.5 mg/L)for 24,48 and 72 h.We used MTT to detect cell proliferation,selected the optimal concentration and time,and detected the expressions of BECN1 at mRNA and protein levels by PCR and Western blot.Results The inhibition rate of the proliferation of SMMC-7721 cell line increased with the increase of the concentration of SSd,and the highest inhibition rate (60%)appeared when the concentration reached 12.5 mg/L. The expression of BECN1 in the group with SSd was obviously higher than that in the control group (P<0.05). 3-MA decreased not only the expressions of BECN1 at mRNA and protein levels but also the expression of BECN1 when used in conjunction with SSd.Conclusion The inhibiting function of SSd on SMMC-7721 presents a dependency between drug concentration and function time,basically in line with the drug dose-effect relationship. SSd induces the occurrence of autophagic cell death through up-regulating the expression of BECN1 ,thus inhibiting the proliferation of SMMC-7 7 2 1 .

Objective To evaluate the value of 3D-PCASL in the pre-operation brain gliomas-grading.Methods 3D-PCASL images of 41 cases of gliomas comfirmed by pathology,including 20 cases of low-grade and 21 cases of high-grade were retrospectively analyzed. The cerebral blood flows of the solid region of tumor (TBF),1cm and 1 cm-2 cm brain tissue around the tumor,and contralateral normal brain CBF were obtained based on the region of interest (ROI),respectively.Results According to independent sample t-test,all had statisti-cally significant differences (P <0.001)between high and low-grade gliomas except the 1-2 cm region around the tumor.One-way ANO-VA displayed that all of them had its statistically significant between differences region (P <0.001)in high-grade gliomas,which had statisti-cally significant differences (P <0.001)except 1 cm and 1 -2 cm of peri-tumor in low-grade gliomas.ROC curve analysis of TBF/contralateral gray matter showed that the area under the curve was 0.96.When 2 was chosen as threshold of rCBF,there was the highest sensitivity (85.7%)and specificity (100%).The accurate rate of conventional MRI for gliomas dianosis was 76% and the ac-curate rate of conventional MRI with ASL was 93%,which was statistically significant difference (χ2 =6.61,P =0.01)between two methodson the chi-square test.Conclusion 3D-PCASL can improve the accuracy of diagnosis of different grade brain gliomas.Com-pared with others parameters,rCBF have a higher sensitivity and specificity.

Objective To investigate the relationship of the serum levels of high sensitivity C-reactive protein(hs-CRP) and homocysteine with middle cerebral artery(MCA) intraplaque hemorrhage.Methods A total of 63 patients who met the inclusion criteria showed high-grade(≥ 70％)MCA stenosis.The levels of serum hs-CRP and Hcy were detected.All patients were divided into symptomatic group and asymptomatic group,intraplaque hemorrhage group and non-intraplaque hemorrhage group.All patients performed conventional MRI and high-resolution MRI(HR-MRI).The correlation of the serum levels of hs-CRP and homocysteine with middle cerebral artery intraplaque hemorrhage was analyzed.Results Totally 37 symptomatic and 26 asymptomatic MCA stenoses were analyzed.The occurrence rate of intraplaque hemorrhage was significantly higher in symptomatic MCA stenosis group than in asymptomatic MCA stenosis group (40.5 ％ vs.11.5 ％,x2 =6.29,P＜ 0.05).Symptomatic group displayed a higher hs-CRP and Hey levels (8.97 ± 3.36 mg/L and 20.00 ± 3.16 μmol/L,respectively) than did asymptomatic group [(5.26 ± 3.12) mg/L and (12.22 ± 1.88) μmol/L,t =4.43 and 11.23,respectively,each P ＜ 0.001].The hs-CRP and Hcy levels were higher in intraplaque hemorrhage group [(10.53 ± 3.59) mg/L and (21.70 ± 2.40) μmol/L,respectively] than in non-intraplaque hemorrhage group[(6.20 ± 3.02) mg/L and(11.77±1.69) μmol/L,t=4.87 and 18.58,respectively,each P＜0.001].The hs-CRP and Hcy levels were positively correlated with the risk for middle cerebral artery intraplaque hemorrhage(r=0.461 and 0.519,each P＜0.001).Conclusions The serum levels of hs-CRP and Hcy are closely associated with middle cerebral artery intraplaque hemorrhage,which can be used to evaluate the stability of plaque.The MCA intraplaque hemorrhage is associated with ipsilateral stroke.

BACKGROUNDAs an X-linked recessive way, arginine vasopressin receptor 2 (AVPR2) gene mutation resulted in a hereditary disease - congenital nephrogenic diabetes insipidus (CNDI). We found a suspect clinical CNDI pedigree. In order to identify the genetic etiology, we performed the genetic analysis.

METHODSThe clinical features of the proband and his family members were recorded. The laboratory tests and imaging inspections were analyzed. The water deprivation and pituitrin loading test were performed in the proband and his brother. The genomic DNA of all the members of the pedigree was extracted and then PCR amplification on AVPR2 gene was carried out. Sequencing in both directions was performed to identify mutation on AVPR2 gene.

RESULTSBoth the proband and his brother were diagnosed as CNDI, meanwhile the other members of this pedigree were normal. No severe biochemical abnormality was found in the two CNDI patients. Both the patients had moderate urinary retention, severe megaloureter and hydronephrosis, and mild renal insufficiency. Two mutations of AVPR2 gene were discovered in the 3rd exon in the patients, a silent mutation L309L and a nonsense mutation R337X. The AVPR2 gene R337X mutation was co-segregated with CNDI. R337X mutation was not a reported mutation in the mainland of China.

CONCLUSIONThe AVPR2 gene R337X mutation was also a genetic etiology of CNDI patients in the mainland of China.

Adult ; Diabetes Insipidus, Nephrogenic ; genetics ; Female ; Humans ; Male ; Mutation ; Pedigree ; Receptors, Vasopressin ; genetics ; Vasopressins ; genetics