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25 August 2021, Volume 20 Issue 04 Previous IssueNext Issue

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Preliminary study of antifungal effect and mechanism of novel imidazoles 2-imidazole-2, 4-pentadienone 19 and 44 onCandida albicans CHEN Hua, LIU Jinyan, LI Wenjing, ZHAO Juntao, XIANG Mingjie 2021, 20 (04): 356-361. DOI:10.16150/j.1671-2870.2021.04.005 Abstract( 707) HTML( 3) PDF(964KB) ( 168) Objective:To detect the antifungal effect of the novel imidazoles 2-imidazole-2, 4-pentadienone 19 and 44 onCandida albicans, and explore the mechanism of the antifungal effect preliminarily.Methods:The inhibitory effects of 2-imidazole-2, 4-pentadienone 19 and 44 onCandida albicansstandard strains SC5314, ATCC90028 and clinical isolates were observed through susceptibility testin vitro(the concentration gradients of fluconazole, 2-imidazole-2, 4-pentadienone 19 and 44 were all set in 0.25-128.00 μg/mL), hyphal inhibition test (the concentration gradients of fluconazole, 2-imidazole-2, 4-pentadienone 19 and 44 were all set in 0, 2.00, 8.00, 16.00 μg/mL) and crystal violet staining cell coun-ting test (the concentration gradients of fluconazole, 2-imidazole-2, 4-pentadienone 19 and 44 were all set 2.00, 8.00, 16.00, 64.00 μg/mL). The morphological changes of membrane and organelles inCandida albicanswere observed by transmission electron microscopy when they were cultured with 2-imidazole-2, 4-pentadienone 19 (0.50 μg/mL) and 44 (2.00 μg/mL).Results:The susceptibility testin vitroshowed that the minimal inhibitory concentrations (MIC) of fluconazole, new drug 19, and new drug 44 onCandida albicansSC5314 were 1.00, 0.50, and 2.00 μg/mL, respectively. The clinical isolates ofCandida albicans21897, 210 and 141 were all fluconazole-resistant strains (MIC>128.00 μg/mL). The MICs of new drug 19 on three type isolates were 64.00 μg/mL,> 128.00 μg/mL and 64.00 μg/mL, and the MICs of new drug 44 on them were 8.00 μg/mL, 16.00 μg/mL and 16.00 μg/mL, respectively. The mycelial inhibition experiment showed that the mycelial growth ofCandida albicansSC5314 was significantly inhibited in the culture medium containing fluconazole and the novel drugs 19 and 44, and the higher the drug concentration (≤64.00 μg/mL). The inhibitory effects of new drugs 19 and 44 were better than fluconazole as the drug concentrations were 8.00 μg/ml or 64.00 μg/mL. Transmission electron microscopy showed that fluconazole and the novel drugs 19 and 44 led the cell membrane of SC5314 to become uneven and coarse in texture, which was obviously different from that of drug-free control.Conclusions:The new imidazoles 2-imidazole-2, 4-pentadienone 19 and 44 show strong inhibitory effects onCandida albicansby changing the structure of cell membrane. Figures and Tables|References|Related Articles|Metrics

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Evaluation of myocardial fibrosis by cardiac magnetic resonance imaging in patient with myotonic dystrophy type 1 HUANG Shaohua, LIANG Zonghui, TONG Huan, GUAN Xueni, GUO Ying, ZHANG Yan, CAO Bin, SUN Yumin 2021, 20 (04): 362-367. DOI:10.16150/j.1671-2870.2021.04.006 Abstract( 542) HTML( 1) PDF(510KB) ( 178) Objective:To evaluate myocardial fibrosis by cardiac magnetic resonance (CMR) in the patients with myo-tonic dystrophy type 1 (DM1), and compare the value of CMR and ECG.Methods:A total of 14 patients with genetically conformed DM1 were included, and were performed CMR, electrocardiogram and dynamic electrocardiogram. Myocardial fibrosis was defined as presence of late gadolinium enhancement (LGE) in CMR. According to the results of ECG and/or dynamic ECG, the patients with DM1 were divided into normal ECG and abnormal ECG groups, and the CMR results were compared between two groups.Results:CMR examination showed that the detection rate of myocardial fibrosis in DM1 patients was 35.7% (5 out of 14). Compared with those without myocardial fibrosis, the patients with myocardial fibrosis had higher left ventricular mass index [(47.1±5.4) g/m2vs. (40.2±3.4) g/m2,P=0.012)], left ventricular end-systolic volume index [(31.5±5.5) mL/m2vs. (25.8±2.8) mL/m2,P=0.024)], and left atrial volume index [(43.8±7.1) mL/m2vs. (34.3±7.4) mL/m2,P=0.037), while had lower left ventricular ejection fraction [(52.2±11.1)%vs. (63.9±5.3)%,P=0.019]. There was no correlation between the existence of myocardial fibrosis and the abnormal finding of ECG (44.4%vs. 20.0%,P=0.36) in the patients with DM1, while the other abnormal incidence detected by CMR was higher in abnormal ECG group than in normal ECG group (77.8%vs. 20.0%,P=0.036).Conclusions:Myocardial fibrosis occurs in some patients with DM1. For the patients with DM1, ECG screening fails to predict myocardial fibrosis, while CMR is valuable. Routine cardiac assessments for DM1 patients should include both CMR and ECG. Figures and Tables|References|Related Articles|Metrics

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Comparison of the diagnostic value of thyroglobulin measurement in needle washouts by FNAC and by FNCC for detecting node metastases in thyroid papillary carcinoma KUANG Lijun, TAO Lingling, ZHAN Weiwei, LI Weiwei, FAN Jinfang, ZHOU Wei 2021, 20 (04): 367-371. DOI:10.16150/j.1671-2870.2021.04.007 Abstract( 614) HTML( 2) PDF(525KB) ( 148) Objective:To compare the value of thyroglobulin(Tg) measurement by fine needle aspiration and by fine needle capillary techniques for diagnosing node metastases from thyroid papillary carcinoma(PTC).Methods:Fifty-four patients with suspicious metastatic lymph nodes from PTC were enrolled during January 2018 to December 2018. Ultrasound guided fine needle aspiration cytology(FNAC) and fine needle capillary cytology(FNCC) were performed for detecting suspicious lymph nodes, and the level of Tg in the eluent was measured. According to the post-operative pathologic results and clinical follow-up results, the difference of diagnostic efficacy between the two groups was compared.Results:A total of 76 suspicious lymph nodes were examined, and 48 of them were confirmed as metastasis by pathology. The mean level of Tg in needle washouts by FNAC and by FNCC were （4 588.02±1 042.09） ng/mL and (1 678.57±420.57) ng/mL (P=0.010 6), respectively. The area under receiver operating characteristic curve of Tg value in washouts by FNAC and by FNCC were 0.943 and 0.913, respectively. The difference was significant between methods (P=0.032). The cut-off value of Tg in FNAC group was 14.385 ng/mL, and the diagnostic sensitivity and specificity were 0.938 and 0.893, respectively. The cut-off value of Tg in FNCC group was 12.155 ng/mL, and the diagnostic sensitivity and specificity were 0.875 and 0.893, respectively.Conclusions:Both measurement of Tg in the eluent by FNCC and by FNAC are helpful to the diagnosis of metastatic lymph nodes from PTC. However, FNAC had more advantage over FNCC in diagnosing metastatic lymph nodes. Figures and Tables|References|Related Articles|Metrics

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Factors related to enlarged perivascular spaces and lacunes in patients with hypertension YANG Yang, WU Qinmi, FENG Yulan, ZHANG Bei, FU Yi 2021, 20 (04): 372-377. DOI:10.16150/j.1671-2870.2021.04.008 Abstract( 554) HTML( 2) PDF(562KB) ( 163) Objective:To explore the related factors of enlarged perivascular spaces (EPVS) and lacunes in the patients with hypertension, and to provide a basis for the prevention and treatment of cerebral small vessel disease.Methods:A total of 1 070 patients with essential hypertension without stroke history were enrolled, and the data was analyzed retrospectively. All patients received MRI scanning and ambulatory blood pressure monitoring. According to MRI images, they were divided into normal control, EPVS and lacunes groups, respectively. Univariate and multivariate logistic regression were performed among three groups to determine the factors related to EPVS and lacunes.Results:The indexes including age, gender, smoking, diabetes history, antiplatelet drugs, statins, hypertension duration, nocturnal blood pressure dip degree, mean systolic blood pressure, cholesterol, triglyceride, high-density lipoprotein, low density lipoprotein, urea nitrogen, creatinine, homocysteine and carotid plaque were significantly different among EPVS, lacunes and controls groups. Mean high systolic blood pressure and age were independent risk factors for EPVS, while the dipping degree of blood pressure, antiplatelet medicines and statins were independent protective factors for it. High mean systolic blood pressure, old age, smoking, and diabetes were independent risk factors for lacunes, while the dipping degree of nocturnal blood pressure, antiplatelet medicines and statins were independent protective factors for lacunes.Conclusions:For the patients with hypertension, the increase of mean systolic blood pressure and the decrease of nocturnal blood pressure dipping are the risk factors for EPVS and lacunes. Besides controlling mean systolic blood pressure level, the patients with hypertension should also receive chronotherapy to restore the normal nocturnal blood pressure dipping through changing the time of taking medicine. Figures and Tables|References|Related Articles|Metrics

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Application value of new accelerating technology based on constellation shuttling imaging in brain MRI ZHANG Xuekun, LI Yan, YAN Fuhua, ZHAO Hongfei, SONG Qi 2021, 20 (04): 378-383. DOI:10.16150/j.1671-2870.2021.04.009 Abstract( 675) HTML( 2) PDF(787KB) ( 144) Objective:To evaluate the image quality of brain MRI sequences accelerated by constellation shuttling imaging (uCS) to provide a basis for clinical application.Methods:Twenty volunteers underwent brain MRI scanning （TSE axial T1WI, T2-FLAIR, sagittal T1WI and GRE sagittal 3D-T1WI） twice using parallel imaging (routine scanning) and corresponding uCS accelerated acquisition. The evaluation of images in each sequence was conducted through combining the subjective (Likert five-point scale method, image artifact and overall quality) and objective (signal-to-noise ratio measurement) methods.Results:The scanning time of using uCS in each MRI sequence was shorter than that of conventional scanning. The total scanning time of uCS in each volunteer was 542 s, while that of conventional scanning was 735 s, which decreased 26.3%. The scanning time of 3D sequence was nearly reduced 39%. There is no statistically difference between uCS and conventional sequence in subjective evaluation (overall image quality and image artifact degree). The SNR of uCS axial T1WI and sagittal T1WI sequences was significantly higher than those of conventional axial T1WI and sagittal T1WI sequences(P<0.05). In addition, there was no difference between uCS and conventional scanning in SNR of FLAIR and 3D-T1WI sequences.Conclusions:Compared with conventional scanning, uCS can significantly accelerate the acquisition of brain MR images without loss of image quality. Figures and Tables|References|Related Articles|Metrics

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Comparative study on software DEEPVESSEL FFR and invasive FFR in assessing coronary ischemia XU Hao, ZHANG Zhi, XIE Xueqian, YANG Wenyi, LIU Shaowen 2021, 20 (04): 384-390. DOI:10.16150/j.1671-2870.2021.04.010 Abstract( 924) HTML( 6) PDF(1043KB) ( 304) Objective:To assess application value of artificial intelligence software DEEPVESSEL FFR(DV-FFR) in evaluating CTA (computed tomography angiography) of coronary ischemia.Methods:This was a prospective, single-center, and self-control study, and 21 vessels in 18 patients with coronary artery narrow (degree between 30%-90%) were included. Coronary ischemia was evaluated by DV-FFR and invasive FFR, and the efficiency of DV-FFR for diagnosing coronary ischemia was assessed by comparison with the results of golden criterion (invasive FFR). Based on data obtained from CTA DICOM, the blood vessel images were segmented and reconstructed by DV-FFR with deep learning technology, and vessel centerlines was obtained. FFR was calculated using3-D geometric auto-quantitative technology to assess ischemia in LAD (left anterior descending), LCX (left circumflex), RCA (right coronary artery).Results:When cut-off value of invasive FFR was taken as 0.8, DV-FFR≤0.8 was considered as functional coronary ischemia. On vessel level, the accuracy, specificity, sensitivity, positive predictive value, and negative predictive value of DV- FFR for diagnosing functional coronary ischemia were 90.5%, 88.9%, 91.7%, 91.7% and 88.9%, respectively. While on patient level, the above indexes were 88.9%, 87.5%, 90.0%, 90.0%and 87.5%, respectively. The results of the 2 methods were similar (P=0.787).Conclusions:The results of DV-FFR showed a good consistency with that of invasive FFR in evaluating coronary artery narrow degree between 30%-90%, which could be used as effective diagnostic approach. Figures and Tables|References|Related Articles|Metrics

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Relation of TCM syndrome type in traditional Chinese medicine with liver failure staging in Western medicine in patients with liver failure FENG Mingyang, DING Yezhou, ZHAO Qingqing, ZHAO Gangde, LOU Shike, ZHENG Chao, SUN Xuehua, LIU Kehui, LIN Lanyi, XIE Qing, ZHENG Lan, WANG HUI 2021, 20 (04): 391-395. DOI:10.16150/j.1671-2870.2021.04.011 Abstract( 589) HTML( 2) PDF(576KB) ( 295) Objective:To explore the relation of TCM(Triditional Chinese medicine syndrome) type in traditional Chinese medicine with liver failure staging in Western medicine in the patients with liver failure, and analyze the corresponding laboratory indicators and prognostic characteristics of the patients with different TCM syndrome type, and provide reference to treat liver failure through integrated traditional Chinese medicine and Western medicine.Methods:A total of 165 patients with liver failure were enrolled. Basic information of the patients was collected and the patients were divided into prophase, early stage, middle stage and late stage according to the severity of liver failure. The distribution of TCM syndrome types and their clinical manifestations, serological indicators and prognosis were analyzed.Results:In 165 inpatients with liver failure, there were four syndrome types, including liver depression and spleen deficiency, damp-heat accumulation, liver and kidney Yin deficiency, blood stasis and collateral obstruction. Among them, 81 cases belonged to the type of liver depression and spleen deficiency(49.09%). Hepatitis B virus(HBV) infection was the main cause for liver failure, accounting for 70% (65% combined with cirrhosis). In all patients with liver failure, there were 26 cases in the prophase, 87 cases in the early stage, 31 cases in the middle stage and 21 cases in the late stage. In the prophase stage of liver failure, 53.84% cases showed liver depression and spleen deficiency (14/26). 56.32% cases had liver depression and spleen deficiency (49/87) In the early stage of liver failure, and 38.71% cases in the middle stage of liver failure showed liver depression and spleen deficiency (12/31) and 38.71% cases had damp-heat accumulation (12/31). 52.38% patients with advanced liver failure belonged to in damp-heat accumulation type (11/21). The type of liver depression and spleen deficiency had the best prognosis, and the clinical improvement rate was more than 80%. While the type of liver and kidney Yin deficiency had the worst prognosis, and the proportion of clinical deterioration was 50%. Compared with the liver and kidney Yin deficiency type, the clinical improvement rate of damp-heat accumulation type blood stasis and collateral obstruction type were better and their improvement rate were over 50%, while alanine transaminase(ALT）[(655.0±143.4) IU/L] and aspartate transaminase（AST）[(504.0±117.7) IU/L] in the type of damp-heat accumulation were significantly higher than those in other syndrome types (P<0.05). In liver-kidney Yin deficiency type, prothrombin time[(PT)(21.57±0.95) s] was significantly prolonged (P<0.05), and total bilirubin (TBil)[(307.5±33.00) μmol/L] was significantly higher than that in other syndrome types (P<0.05).Conclusions:There was no difference in TCM syndrome type distribution among different stages of liver failure. Among the patients with liver failure, the proportion of liver depression and spleen deficiency was the highest, which had the best prognosis (clinical improvement rate over 80%). While the patients with liver and kidney Yin deficiency showed the worst prognosis (clinical deterioration rate accounted for 50%). However, the biochemical indexes of liver function of damp-heat accumulation type were worse than those of other syndromes,. Figures and Tables|References|Related Articles|Metrics