We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within ...We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an- giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start- ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a ＇rule-out＇ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.展开更多
Pulmonary embolism （PE） is a common cardiovascular and cardiopulmonary illness and the incidence increases exponentially with age. Because the clinical signs and symptoms are non-specific, its diagnosis is always di...Pulmonary embolism （PE） is a common cardiovascular and cardiopulmonary illness and the incidence increases exponentially with age. Because the clinical signs and symptoms are non-specific, its diagnosis is always difficult.展开更多
BACKGROUND Large-scale functional connectivity(LSFC)patterns in the brain have unique intrinsic characteristics.Abnormal LSFC patterns have been found in patients with dementia,as well as in those with mild cognitive ...BACKGROUND Large-scale functional connectivity(LSFC)patterns in the brain have unique intrinsic characteristics.Abnormal LSFC patterns have been found in patients with dementia,as well as in those with mild cognitive impairment(MCI),and these patterns predicted their cognitive performance.It has been reported that patients with type 2 diabetes mellitus(T2DM)may develop MCI that could progress to dementia.We investigated whether we could adopt LSFC patterns as discriminative features to predict the cognitive function of patients with T2DM,using connectome-based predictive modeling(CPM)and a support vector machine.AIM To investigate the utility of LSFC for predicting cognitive impairment related to T2DM more accurately and reliably.METHODS Resting-state functional magnetic resonance images were derived from 42 patients with T2DM and 24 healthy controls.Cognitive function was assessed using the Montreal Cognitive Assessment(MoCA).Patients with T2DM were divided into two groups,according to the presence(T2DM-C;n=16)or absence(T2DM-NC;n=26)of MCI.Brain regions were marked using Harvard Oxford(HOA-112),automated anatomical labeling(AAL-116),and 264-region functional(Power-264)atlases.LSFC biomarkers for predicting MoCA scores were identified using a new CPM technique.Subsequently,we used a support vector machine based on LSFC patterns for among-group differentiation.The area under the receiver operating characteristic curve determined the appearance of the classification.RESULTS CPM could predict the MoCA scores in patients with T2DM(Pearson’s correlation coefficient between predicted and actual MoCA scores,r=0.32,P=0.0066[HOA-112 atlas];r=0.32,P=0.0078[AAL-116 atlas];r=0.42,P=0.0038[Power-264 atlas]),indicating that LSFC patterns represent cognition-level measures in these patients.Positive(anti-correlated)LSFC networks based on the Power-264 atlas showed the best predictive performance;moreover,we observed new brain regions of interest associated with T2DM-related cognition.The area under the receiver operating characteristic curve values(T2DM-NC group vs.T2DM-C group)were 0.65-0.70,with LSFC matrices based on HOA-112 and Power-264 atlases having the highest value(0.70).Most discriminative and attractive LSFCs were related to the default mode network,limbic system,and basal ganglia.CONCLUSION LSFC provides neuroimaging-based information that may be useful in detecting MCI early and accurately in patients with T2DM.展开更多
Objective:To investigate the manifestations of pulmonary sclerosing pneumocytoma by multi-slice spiral CT (MSCT) and ^18F-FDG PET/CT in order to improve the accuracy of preoperative diagnosis. Methods:42 cases of PSP ...Objective:To investigate the manifestations of pulmonary sclerosing pneumocytoma by multi-slice spiral CT (MSCT) and ^18F-FDG PET/CT in order to improve the accuracy of preoperative diagnosis. Methods:42 cases of PSP confirmed by pathology after operation were retrospectively analyzed. The distribution, size, shape, special signs and metabolic characteristics of lesions were observed. The relationship between the maximum diameter of lesions and clinical symptoms and the correlation between the maximum diameter of lesions and the maximum standardized uptake value (SUVmax) were analyzed. Results:MSCT plain scan was performed in 36 cases, enhanced in 29 cases, MSCT observed vessel marginal sign in 21 cases, air crescent sign in 9 cases, halo sign in 7 cases, calcification in 20 cases, transfissure sign in 6 cases, pleural plain scan in 23 cases;mean value of CT plain scan (36.50±21.65) HU, mean arterial phase of enhanced CT (73.13±37.22) HU, venous phase (74.78±18.36) HU;There was no significant difference in the maximum diameter of lesions between the symptomatic group and the asymptomatic group (P=0.283);^18F-FDG PET/CT in 16 cases, showed 1 case of low uptake (6.25%), 6 cases of moderate uptake (37.50%), 9 cases of high uptake (56.25%) and 3 cases of hilar and mediastinal lymph node hypermetabolism. There was no significant difference between the size of typical lesions and SUVmax(P=0.212);There was no significant correlation between the size of atypical lesions and SUVmax (P=0.253), and between the size of typical and atypical lesions and SUVmax (P=0.066). There were 8 cases of PSP diagnosed correctly before operation, with an accuracy of 19.05%, 2 cases of hamartoma, 3 cases of inflammatory pseudotumors, 3 cases of tuberculoma, 3 cases of metastasis and 10 cases of malignant tumors. Conclusion:The metabolic characteristics of PSP lesions in MSCT such as "blood vessel marginal sign", "air crescent sign", "halo sign", "transfissure sign", "calcification", "pleura sticking" and 18F-FDG PET/CT can show malignant tumors, which provide important basis for the diagnosis of PSP.展开更多
文摘We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an- giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start- ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a ＇rule-out＇ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.
文摘Pulmonary embolism （PE） is a common cardiovascular and cardiopulmonary illness and the incidence increases exponentially with age. Because the clinical signs and symptoms are non-specific, its diagnosis is always difficult.
基金Supported by the National Natural Science Foundation of China,No.81771815.
文摘BACKGROUND Large-scale functional connectivity(LSFC)patterns in the brain have unique intrinsic characteristics.Abnormal LSFC patterns have been found in patients with dementia,as well as in those with mild cognitive impairment(MCI),and these patterns predicted their cognitive performance.It has been reported that patients with type 2 diabetes mellitus(T2DM)may develop MCI that could progress to dementia.We investigated whether we could adopt LSFC patterns as discriminative features to predict the cognitive function of patients with T2DM,using connectome-based predictive modeling(CPM)and a support vector machine.AIM To investigate the utility of LSFC for predicting cognitive impairment related to T2DM more accurately and reliably.METHODS Resting-state functional magnetic resonance images were derived from 42 patients with T2DM and 24 healthy controls.Cognitive function was assessed using the Montreal Cognitive Assessment(MoCA).Patients with T2DM were divided into two groups,according to the presence(T2DM-C;n=16)or absence(T2DM-NC;n=26)of MCI.Brain regions were marked using Harvard Oxford(HOA-112),automated anatomical labeling(AAL-116),and 264-region functional(Power-264)atlases.LSFC biomarkers for predicting MoCA scores were identified using a new CPM technique.Subsequently,we used a support vector machine based on LSFC patterns for among-group differentiation.The area under the receiver operating characteristic curve determined the appearance of the classification.RESULTS CPM could predict the MoCA scores in patients with T2DM(Pearson’s correlation coefficient between predicted and actual MoCA scores,r=0.32,P=0.0066[HOA-112 atlas];r=0.32,P=0.0078[AAL-116 atlas];r=0.42,P=0.0038[Power-264 atlas]),indicating that LSFC patterns represent cognition-level measures in these patients.Positive(anti-correlated)LSFC networks based on the Power-264 atlas showed the best predictive performance;moreover,we observed new brain regions of interest associated with T2DM-related cognition.The area under the receiver operating characteristic curve values(T2DM-NC group vs.T2DM-C group)were 0.65-0.70,with LSFC matrices based on HOA-112 and Power-264 atlases having the highest value(0.70).Most discriminative and attractive LSFCs were related to the default mode network,limbic system,and basal ganglia.CONCLUSION LSFC provides neuroimaging-based information that may be useful in detecting MCI early and accurately in patients with T2DM.
基金Shaanxi provincial health and family planning research fund project(No.2016D010).
文摘Objective:To investigate the manifestations of pulmonary sclerosing pneumocytoma by multi-slice spiral CT (MSCT) and ^18F-FDG PET/CT in order to improve the accuracy of preoperative diagnosis. Methods:42 cases of PSP confirmed by pathology after operation were retrospectively analyzed. The distribution, size, shape, special signs and metabolic characteristics of lesions were observed. The relationship between the maximum diameter of lesions and clinical symptoms and the correlation between the maximum diameter of lesions and the maximum standardized uptake value (SUVmax) were analyzed. Results:MSCT plain scan was performed in 36 cases, enhanced in 29 cases, MSCT observed vessel marginal sign in 21 cases, air crescent sign in 9 cases, halo sign in 7 cases, calcification in 20 cases, transfissure sign in 6 cases, pleural plain scan in 23 cases;mean value of CT plain scan (36.50±21.65) HU, mean arterial phase of enhanced CT (73.13±37.22) HU, venous phase (74.78±18.36) HU;There was no significant difference in the maximum diameter of lesions between the symptomatic group and the asymptomatic group (P=0.283);^18F-FDG PET/CT in 16 cases, showed 1 case of low uptake (6.25%), 6 cases of moderate uptake (37.50%), 9 cases of high uptake (56.25%) and 3 cases of hilar and mediastinal lymph node hypermetabolism. There was no significant difference between the size of typical lesions and SUVmax(P=0.212);There was no significant correlation between the size of atypical lesions and SUVmax (P=0.253), and between the size of typical and atypical lesions and SUVmax (P=0.066). There were 8 cases of PSP diagnosed correctly before operation, with an accuracy of 19.05%, 2 cases of hamartoma, 3 cases of inflammatory pseudotumors, 3 cases of tuberculoma, 3 cases of metastasis and 10 cases of malignant tumors. Conclusion:The metabolic characteristics of PSP lesions in MSCT such as "blood vessel marginal sign", "air crescent sign", "halo sign", "transfissure sign", "calcification", "pleura sticking" and 18F-FDG PET/CT can show malignant tumors, which provide important basis for the diagnosis of PSP.
