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Wu L.,First Peoples Hospital of Changzhou | Qiu Y.,Nanjing University | Wang B.,Nanjing University | Zhu Z.Z.,Nanjing University | Ma W.W.,Nanjing University
Spine | Year: 2010

Study Design: A prospective trial of MRI study in patients with "idiopathic" left thoracic scoliosis. Objective: To investigate the prevalence of neural axis abnormalities in asymptomatic patients with "idiopathic" left thoracic scoliosis. Summary of Background Data: Some patients with neural axis abnormalities have scoliosis as the only presenting sign, and they might be given a diagnosis of "idiopathic" scoliosis. These neural axis abnormalities are risk factors for neurologic injury during spine correction. With the development of MRI, neural axis abnormalities are increasingly being found in patients with "idiopathic" scoliosis. However, there are few reports on the prevalence of neural axis abnormalities in asymptomatic patients with "idiopathic" left thoracic scoliosis. Methods: A total of 68 patients with presumed "idiopathic" left thoracic scoliosis were examined for neural axis abnormalities, using MRI. Results: Neural axis abnormalities were detected in 37 (54%) patients, including Chiari 1 malformation in 15 patients, Chiari 1 malformation with syringomyelia in 10, Chiari 1 malformation with syringomyelia and tethered cord in 1, Chiari 1 malformation with syringomyelia and diastematomyelia in 1, syringomyelia in 8, syringomyelia with tethered cord in 1, and arachnoidal cyst in cerebel-lomedullary cistern in 1 patient. There were statistically significant differences between patients with and without neural axis abnormalities regarding gender and curve severity (P < 0.05). Conclusion: When a left thoracic curve pattern is present in patients with "idiopathic" scoliosis, especially in male patients or patients with severe curve, strong consideration should be given to the possibility of the presence of neural axis abnormalities, and acquisition of an MRI scan considered. © 2010, Lippincott Williams & Wilkins. Source

Zhang J.,Shanghai JiaoTong University | Wang L.,Shanghai JiaoTong University | Qiu M.,First Peoples Hospital of Changzhou | Liu Z.,University of Texas M. D. Anderson Cancer Center | And 4 more authors.
International Journal of Gynecological Cancer | Year: 2013

The objective of this study was to analyze the relationship among the protein levels of MCM7, p63, and human papillomavirus (HPV) in different cervical lesion tissues and appraise their predictive value in evaluating severity of cervical disease. Methods: Twelve normal cervix or chronic cervicitis, 42 squamous intraepithelial lesions, and 53 cervical carcinoma tissues were enrolled, and the protein levels of MCM7, p63, and HPV were detected by immunohistochemistry. Results: The positive examination rates of all the MCM7, p63, and HPV proteins increased gradually and significantly from normal cervix and chronic cervicitis tissues, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions to cervical carcinomas, respectively. As to predict high-grade squamous intraepithelial lesions and carcinogenesis is concerned, theMCM7protein had a sensitivity of 94.0%, a specificity of 56.5%, a positive predictive value of 88.8%, and a negative predictive value of 72.2%. The p63 protein had a sensitivity of 78.6%, a specificity of 81.8%, a positive predictive value of 94.3%, and a negative predictive value of 50.0%. Protein level ofMCM7 was positively correlated with that of p63 in cervical tissues (r = 0.806, P G 0.01), and the p63 was also positively correlated with histopathologic type (P G 0.05). Conclusions: Protein levels ofMCM7and p63were associated significantly with high-grade cervical lesion, and aberrant p63 protein level may distinguish different histopathologic types of cervical carcinoma. They may act as coYpredictive index in both HPV-dependent and HPVindependent high-grade cervical lesion with high sensitivity and specificity. © 2013 by IGCS and ESGO. Source

Qiu W.Q.,Boston University | Mwamburi M.,Tufts University | Besser L.M.,University of Washington | Zhu H.,Boston University | And 7 more authors.
Journal of Alzheimer's Disease | Year: 2013

Our cross-sectional study showed that the interaction between apolipoprotein E4 (ApoE4) and angiotensin converting enzyme (ACE) inhibitors was associated with Alzheimer's disease (AD). The aim of this longitudinal study was to differentiate whether ACE inhibitors accelerate or reduce the risk of AD in the context of ApoE alleles. Using the longitudinal data from the National Alzheimer's Coordinating Center (NACC) with ApoE genotyping and documentation of ACE inhibitors use, we found that in the absence of ApoE4, subjects who had been taking central ACE inhibitor use (χ2 test: 21% versus 27%, p = 0.0002) or peripheral ACE inhibitor use (χ2 test: 13% versus 27%, p < 0.0001) had lower incidence of AD compared with those who had not been taking an ACE inhibitor. In contrast, in the presence of ApoE4, there was no such association between ACE inhibitor use and the risk of AD. After adjusting for the confounders, central ACE inhibitor use (OR = 0.68, 95% CI = 0.55, 0.83, p = 0.0002) or peripheral ACE inhibitor use (OR = 0.33, 95% CI = 0.33, 0.68, p < 0.0001) still remained inversely associated with a risk of developing AD in ApoE4 non-carriers. In conclusion, ACE inhibitors, especially peripherally acting ones, were associated with a reduced risk of AD in the absence of ApoE4, but had no such effect in those carrying the ApoE4 allele. A double-blind clinical trial should be considered to determine the effect of ACE inhibitors on prevention of AD in the context of ApoE genotype. © 2013 - IOS Press and the authors. All rights reserved. Source

Yuan J.-W.,Guangdong Pharmaceutical University | Wang Y.-T.,First Peoples Hospital of Changzhou | Lu C.-Z.,Xuzhou Central Hospital
Hellenic Journal of Nuclear Medicine | Year: 2015

Objective: Anatomic coronary artery disease (CAD) can be determined by coronary angiography (CAG) in patients with normal stress single photon emission tomography (SPET) myocardial perfusion imaging (MPI). Coronary angiography results of patients with negative exercise MPI and the prognosis of these patients (CAG-diagnosed CAD vs. non-CAD) were investigated in the current study. Subjects and Methods: Suspected CAD patients who had SPET-MPI and subsequent CAG studies were retrospectively reviewed from May 2002 to November 2006. Siemens Diacam SPET and Siemens Ecam SPET γ-cameras were used for the examination of rest/exercise technetium-99m methoxy isobutyl isonitrile (99mTc-MIBI) myocardial imaging. Coronary angiography was performed with Philips arura angiography machine by the standard Judkins method. Results: In all, 6598 patients underwent clinically indicated rest/exercise 99mTc-MIBI SPET-MPI, and 133 patients underwent CAG despite negative MPI. Thirty one patients were diagnosed with CAD by CAG. Most of these lesions (66%) were located in distal vessels and most of these patients (68%) had 1 vessel disease. Age (P<0.01), hypertension (P<0.01), typical angina pectoris (P<0.01), high pretest likelihood of CAD (P<0.001), exercise induced angina (P<0.05), positive exercise ECG (P<0.01), and transient enlargement of scintigraphic left ventricular size (P<0.05) were significantly different between non-CAD and CAD groups. After median follow-up time of 53±18 months, annualized cardiac event rate was 0.9 % and 0.2 % in CAD and non-CAD group, respectively (χ2=1.22, P=0.27). Conclusions: In all, 23% of 133 patients in our study we confirmed anatomic CAD by CAG, despite negative findings in SPET-MPI. Several clinical, stress, and MPI findings could be potential predictors. However, similar to non-CAD group, the CAG diagnosed CAD patients who had negative 99mTc-MIBI SPET-MPI exercise test had a good pro-gnosis with annualized cardiac event rate less than 1.0%. Source

Zhou H.,Nanjing Medical University | Tan Q.,Nanjing Medical University | Liu S.,Nanjing Medical University | Wang S.,Nanjing Medical University | And 3 more authors.
Journal of Reconstructive Microsurgery | Year: 2013

Background The anterolateral thigh (ALT) flap has been widely used in reconstruction of soft tissue defects. The anatomic variations of perforators increase the difficulties of flap elevation. The ABC system has been described for locating the most common three perforators in Western populations. Less evidence has been found regarding whether it is suitable for Chinese population. The purpose of this study is to explore the improvement of preoperative location technology and flap design for Chinese people. Methods Detection for perforator signals on the bilateral thigh surface was perfromed on 50 Chinese adults using handheld Doppler. Define the A-P line as the line between the anterior superior iliac spin (ASIS) and the superolateral corner of the patella (P). We defined a coordinate system on the thigh surface to record the data of each signal point. The A-P line was y-axis in this coordinate system, and the midpoint of the line was the zero point. The data of these signals were recorded in the form of coordinates. Statistics and mathematic methods were used to analyze the regularity of signal distribution and the correlation between body mass index (BMI) and signal distribution. The findings were applied in five patients who underwent the ALT flap transplantation to confirm its clinical value. Results The results showed that most of the signals appeared near the A-P line. Most signals were located 1 cm lateral (mean 0.5 cm lateral) to the A-P line. The mean vertical distance between perforator B and perforators A and C was 4 cm. More perforator signals were detected at the two horizontal level (as shown in the picture above) than other horizontal levels. The rate of accurate preoperative detection was 40% (6 of 15 perforators) and the error rate was 20% (3 of 15 perforators). The mean deviation was 1.34 cm, which is acceptable for clinical application. The mean vertical distance between perforator B and perforators A and C in clinical study (4.81 cm) corresponded to the finding of the Doppler study (4.2 cm), whereas the mean distance between perforators and the A-P line (1.57 cm) was more than the Doppler finding (0.48 cm). Conclusion The A-P line is still a reliable guiding line for Doppler detection and flap design. The ABC system is suitable for the Chinese population but must be adjusted: perforator B is marked first at the midpoint and 0.5 cm lateral to the A-P line and perforators A and C are marked 4 cm distal and proximal to perforator B, respectively. In designing the flap, the region 3 cm around point B and the region between the two horizontal planes at point B and 4 cm lower should both be contained into the flap, no matter what the finding of Doppler detection is. © 2013 by Thieme Medical Publishers, Inc. Source

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