Fast and Accurate Semi-Automated Segmentation Method of Spinal Cord MR Images at 3T Applied to the Construction of a Cervical Spinal Cord Template

Objective

To design a fast and accurate semi-automated segmentation method for spinal cord 3T MR images and to construct a template of the cervical spinal cord.

Materials and Methods

A semi-automated double threshold-based method (DTbM) was proposed enabling both cross-sectional and volumetric measures from 3D T₂-weighted turbo spin echo MR scans of the spinal cord at 3T. Eighty-two healthy subjects, 10 patients with amyotrophic lateral sclerosis, 10 with spinal muscular atrophy and 10 with spinal cord injuries were studied. DTbM was compared with active surface method (ASM), threshold-based method (TbM) and manual outlining (ground truth). Accuracy of segmentations was scored visually by a radiologist in cervical and thoracic cord regions. Accuracy was also quantified at the cervical and thoracic levels as well as at C2 vertebral level. To construct a cervical template from healthy subjects’ images (n=59), a standardization pipeline was designed leading to well-centered straight spinal cord images and accurate probability tissue map.

Results

Visual scoring showed better performance for DTbM than for ASM. Mean Dice similarity coefficient (DSC) was 95.71% for DTbM and 90.78% for ASM at the cervical level and 94.27% for DTbM and 89.93% for ASM at the thoracic level. Finally, at C2 vertebral level, mean DSC was 97.98% for DTbM compared with 98.02% for TbM and 96.76% for ASM. DTbM showed similar accuracy compared with TbM, but with the advantage of limited manual interaction.

Conclusion

A semi-automated segmentation method with limited manual intervention was introduced and validated on 3T images, enabling the construction of a cervical spinal cord template.     

A pipeline to quantify spinal cord atrophy with deep learning: Application to differentiation of MS and NMOSD patients

PurposeQuantitative measurement of various anatomical regions of the brain and spinal cord (SC) in MRI images are used as unique biomarkers to consider progress and effects of demyelinating diseases of the central nervous system. This paper presents a fully-automated image processing pipeline which quantifies the SC volume of MRI images.MethodsIn the proposed pipeline, after conducting some pre-processing tasks, a deep convolutional network is utilized to segment the spinal cord cross-sectional area (SCCSA) of each slice. After full segmentation, certain extra slices interpolate between each two adjacent slices using the shape-based interpolation method. Then, a 3D model of the SC is reconstructed, and, by counting the voxels of it, the SC volume is calculated. The performance of the proposed method for the SCCSA segmentation is evaluated on 140 MRI images. Subsequently, to demonstrate the application of the proposed pipeline, we study the differentiations of SC atrophy between 38 Multiple Sclerosis (MS) and 25 Neuromyelitis Optica Spectrum Disorder (NMOSD) patients.ResultsThe experimental results of the SCCSA segmentation indicate that the proposed method, adapted by Mask R-CNN, presented the most satisfactory result with the average Dice coefficient of 0.96. For this method, statistical metrics including sensitivity, specificity, accuracy, and precision are 97.51%, 99.98%, 99.92%, and 98.04% respectively. Moreover, the t-test result (p-value = 0.00089) verified a significant difference between the SC atrophy of MS and NMOSD patients.ConclusionThe pipeline efficiently quantifies the SC volume of MRI images and can be utilized as an affordable computer-aided tool for diagnostic purposes.     

Comprehensive brain MRI segmentation in high risk preterm newborns

Most extremely preterm newborns exhibit cerebral atrophy/growth disturbances and white matter signal abnormalities on MRI at term-equivalent age. MRI brain volumes could serve as biomarkers for evaluating the effects of neonatal intensive care and predicting neurodevelopmental outcomes. This requires detailed, accurate, and reliable brain MRI segmentation methods. We describe our efforts to develop such methods in high risk newborns using a combination of manual and automated segmentation tools. After intensive efforts to accurately define structural boundaries, two trained raters independently performed manual segmentation of nine subcortical structures using axial T2-weighted MRI scans from 20 randomly selected extremely preterm infants. All scans were re-segmented by both raters to assess reliability. High intra-rater reliability was achieved, as assessed by repeatability and intra-class correlation coefficients (ICC range: 0.97 to 0.99) for all manually segmented regions. Inter-rater reliability was slightly lower (ICC range: 0.93 to 0.99). A semi-automated segmentation approach was developed that combined the parametric strengths of the Hidden Markov Random Field Expectation Maximization algorithm with non-parametric Parzen window classifier resulting in accurate white matter, gray matter, and CSF segmentation. Final manual correction of misclassification errors improved accuracy (similarity index range: 0.87 to 0.89) and facilitated objective quantification of white matter signal abnormalities. The semi-automated and manual methods were seamlessly integrated to generate full brain segmentation within two hours. This comprehensive approach can facilitate the evaluation of large cohorts to rigorously evaluate the utility of regional brain volumes as biomarkers of neonatal care and surrogate endpoints for neurodevelopmental outcomes.     

Application of a semi-automatic cartilage segmentation method for biomechanical modeling of the knee joint

Manual segmentation of articular cartilage from knee joint 3D magnetic resonance images (MRI) is a time consuming and laborious task. Thus, automatic methods are needed for faster and reproducible segmentations. In the present study, we developed a semi-automatic segmentation method based on radial intensity profiles to generate 3D geometries of knee joint cartilage which were then used in computational biomechanical models of the knee joint. Six healthy volunteers were imaged with a 3T MRI device and their knee cartilages were segmented both manually and semi-automatically. The values of cartilage thicknesses and volumes produced by these two methods were compared. Furthermore, the influences of possible geometrical differences on cartilage stresses and strains in the knee were evaluated with finite element modeling. The semi-automatic segmentation and 3D geometry construction of one knee joint (menisci, femoral and tibial cartilages) was approximately two times faster than with manual segmentation. Differences in cartilage thicknesses, volumes, contact pressures, stresses, and strains between segmentation methods in femoral and tibial cartilage were mostly insignificant (p > 0.05) and random, i.e. there were no systematic differences between the methods. In conclusion, the devised semi-automatic segmentation method is a quick and accurate way to determine cartilage geometries; it may become a valuable tool for biomechanical modeling applications with large patient groups.     

Age,Gender and Normalization Covariates for Spinal Cord Gray Matter and Total Cross-Sectional Areas at Cervical and Thoracic Levels: A 2D Phase Sensitive Inversion Recovery Imaging Study

The source of inter-subject variability and the influence of age and gender on morphometric characteristics of the spinal cord, such as the total cross-sectional area (TCA), the gray matter (GM) and white matter (WM) areas, currently remain under investigation. Understanding the effect of covariates such as age, gender, brain volumes, and skull- and vertebra-derived metrics on cervical and thoracic spinal cord TCA and GM areas in healthy subjects would be fundamental for exploring compartment specific changes in neurological diseases affecting the spinal cord. Using Magnetic Resonance Imaging at 3T we investigated 32 healthy subjects using a 2D phase sensitive inversion recovery sequence and we measured TCA, GM and WM areas at 4 cervical and thoracic levels of the spinal cord. We assessed age and gender relationships of cord measures and explored associations between cord measures and a) brain volumes and b) skull- and vertebra-derived metrics. Age and gender had a significant effect on TCA, WM and GM areas (with women and elderly having smaller values than men and younger people respectively), but not on the GM area/TCA ratio. The total intracranial volume and C3 vertebra dimensions showed the highest correlations with cord measures. When used in multi-regression models, they reduced cord areas group variability by approximately a third. Age and gender influences on cord measures and normalization strategies here presented might be of use in the study of compartment specific changes in various neurological diseases affecting the spinal cord.     

脊髓缺血损伤合并脓毒症后脊髓ZnT1表达的研究

目的：研究脊髓缺血损伤合并脓毒血症后大鼠脊髓的病理改变及脊髓组织中锌转运体1（zinc transporter1,ZnT1）的表达规律。方法：将32只wistar大鼠随机分为假手术组（s组,n=8）、腹主动脉阻断组（I／R组,n=8）、内毒素组（LPS组,n=8）和腹主动脉阻断＋内毒素组（I／R＋LPS组,n=8）。用HE染色的方法检测脊髓组织病理损害,用免疫组织化学的方法检测脊髓组织中ZnTl的表达规律。结果：1．病理结果改变：除S组外,I／R组、LPS组、UR＋LPS组三组大鼠HE染色切片中均可见脊髓组织损伤,各组脊髓损伤的严重程度有以下规律：S组〈I/R组〈LPS组〈I／R＋LPS组。2．免疫组化结果：脊髓损伤组ZnT1的表达较假手术组均增加（P〈0．05）。结论：1．脊髓缺血损伤合并内毒素攻击可导致严重的脊髓损伤。2．腹主动脉阻断合并内毒素攻击所致脊髓损伤早期脊髓组织中ZnT1表达上调,可能通过调节脊髓损伤早期脊髓组织中锌稳态平衡进而在脊髓损伤后脊髓神经元的病理生理活动中发挥重要作用,这一实验结果可为寻找早期脊髓损伤预防措施提供新的思路。     

Fully Automated Enhanced Tumor Compartmentalization: Man vs. Machine Reloaded

ObjectiveComparison of a fully-automated segmentation method that uses compartmental volume information to a semi-automatic user-guided and FDA-approved segmentation technique.MethodsNineteen patients with a recently diagnosed and histologically confirmed glioblastoma (GBM) were included and MR images were acquired with a 1.5 T MR scanner. Manual segmentation for volumetric analyses was performed using the open source software 3D Slicer version 4.2.2.3 (www.slicer.org). Semi-automatic segmentation was done by four independent neurosurgeons and neuroradiologists using the computer-assisted segmentation tool SmartBrush® (referred to as SB), a semi-automatic user-guided and FDA-approved tumor-outlining program that uses contour expansion. Fully automatic segmentations were performed with the Brain Tumor Image Analysis (BraTumIA, referred to as BT) software. We compared manual (ground truth, referred to as GT), computer-assisted (SB) and fully-automated (BT) segmentations with regard to: (1) products of two maximum diameters for 2D measurements, (2) the Dice coefficient, (3) the positive predictive value, (4) the sensitivity and (5) the volume error.ResultsSegmentations by the four expert raters resulted in a mean Dice coefficient between 0.72 and 0.77 using SB. BT achieved a mean Dice coefficient of 0.68. Significant differences were found for intermodal (BT vs. SB) and for intramodal (four SB expert raters) performances. The BT and SB segmentations of the contrast-enhancing volumes achieved a high correlation with the GT. Pearson correlation was 0.8 for BT; however, there were a few discrepancies between raters (BT and SB 1 only). Additional non-enhancing tumor tissue extending the SB volumes was found with BT in 16/19 cases. The clinically motivated sum of products of diameters measure (SPD) revealed neither significant intermodal nor intramodal variations. The analysis time for the four expert raters was faster (1 minute and 47 seconds to 3 minutes and 39 seconds) than with BT (5 minutes).ConclusionBT and SB provide comparable segmentation results in a clinical setting. SB provided similar SPD measures to BT and GT, but differed in the volume analysis in one of the four clinical raters. A major strength of BT may its independence from human interactions, it can thus be employed to handle large datasets and to associate tumor volumes with clinical and/or molecular datasets ("-omics") as well as for clinical analyses of brain tumor compartment volumes as baseline outcome parameters. Due to its multi-compartment segmentation it may provide information about GBM subcompartment compositions that may be subjected to clinical studies to investigate the delineation of the target volumes for adjuvant therapies in the future.     

Segmentation of organs-at-risk in cervical cancer CT images with a convolutional neural network

PurposeWe introduced and evaluated an end-to-end organs-at-risk (OARs) segmentation model that can provide accurate and consistent OARs segmentation results in much less time.MethodsWe collected 105 patients’ Computed Tomography (CT) scans that diagnosed locally advanced cervical cancer and treated with radiotherapy in one hospital. Seven organs, including the bladder, bone marrow, left femoral head, right femoral head, rectum, small intestine and spinal cord were defined as OARs. The annotated contours of the OARs previously delineated manually by the patient’s radiotherapy oncologist and confirmed by the professional committee consisted of eight experienced oncologists before the radiotherapy were used as the ground truth masks. A multi-class segmentation model based on U-Net was designed to fulfil the OARs segmentation task. The Dice Similarity Coefficient (DSC) and 95th Hausdorff Distance (HD) are used as quantitative evaluation metrics to evaluate the proposed method.ResultsThe mean DSC values of the proposed method are 0.924, 0.854, 0.906, 0.900, 0.791, 0.833 and 0.827 for the bladder, bone marrow, femoral head left, femoral head right, rectum, small intestine, and spinal cord, respectively. The mean HD values are 5.098, 1.993, 1.390, 1.435, 5.949, 5.281 and 3.269 for the above OARs respectively.ConclusionsOur proposed method can help reduce the inter-observer and intra-observer variability of manual OARs delineation and lessen oncologists’ efforts. The experimental results demonstrate that our model outperforms the benchmark U-Net model and the oncologists’ evaluations show that the segmentation results are highly acceptable to be used in radiation therapy planning.     

New bioimpedance model accurately predicts lower limb muscle volume: validation by magnetic resonance imaging

Conventional bioimpedance analysis (BIA) methods now simplify the representation of lower limb geometry and electrical properties for body composition estimation. In the present study, a three-dimensional model of the lower limb was assembled by segmentation of magnetic resonance cross-sectional images (MRI) for adipose tissue, skeletal muscle, and bone. An electrical network was then associated with this model. BIA and MRI measurements were made in six lean subjects (3 men and 3 women, age 32.2 +/- 6.9 yr). Assuming 0.85 S/m for the longitudinal conductivity of the muscle, the model predicted in the examined subjects an impedance profile that conformed well to the BIA impedance profile; predicted and measured resistances were similar (261.3 +/- 7.7 vs. 249 +/- 9 Omega; P = not significant). The resistance profile provided, through a simpler model, muscle area estimates along the lower limb and total leg muscle volume (mean 4,534 cm(3) for men and 4,071 cm(3) for women) with a mean of the absolute value of relative error with respect to MRI of 6.2 +/- 3.9. The new approach suggests that BIA can reasonably estimate the distribution and volume of muscles in the lower extremities of lean subjects.     

Altered levels of PGF in cat spinal cord tissue following traumatic injury.

Previous studies by others indicated that PGs were present in brain, spinal cord, and c.s.f. of several mammalian species. In the present study we compared levels of PGE and PGF by R.I.A. in spinal cord tissue from traumatized cats and cats pretreated with indomethacin prior to trauma to those of baseline and sham operated controls in order to assess for the first time, to our knowledge, whether meaningful changes in levels of PGE and PGF could be detected which might shed new light on the etiology of spinal cord trauma. Levels of PGF (nanograms/gram wet wt) in the cord segment immediately adjacent to the point of trauma were 8.05 +/- 1.50, and 13.13 +/- 1.38 for baseline and sham operated cats respectively. Spinal trauma led to more than a 100% increase in PGF levels to 29.26 +/- 3.58. Although pretreatment with indomethacin 30 min prior to trauma gave the expected blockade of the PGF response to trauma, a measurable level of PGF (2.55 +/- 0.17) was found in the cord after indomethacin. Cord levels of PGF declined after 3 hr in both sham operated and traumatized animals. PGF was maximally stimulated by trauma during the first 3 hr with little effect at 72 hr. Although carefully examined, PGE levels in cat spinal cord appeared to be virtually unaffected by trauma. These findings clearly demonstrate for the first time that traumatic injury to the spinal cord is accompanied by marked increases in PG levels at the site of trauma, and that the observed elevation in PGF in response to trauma can be blocked by indomethacin in vivo. Whether PGF changes are causally related to the etiology of spinal cord trauma, or merely represent a manifestation of PG release as a result of non-specific tissue injury, remains to be seen.     

Leukotriene B4 Release and Polymorphonuclear Cell Infiltration in Spinal Cord Injury

Activation of arachidonic acid occurs after spinal cord injury. Leukotriene B4 is a lipoxygenase metabolite of arachidonic acid. In a rat model of experimental spinal cord injury, we found that the leukotriene B4 content was less than the sensitivity of our assay (8 pg/mg of protein) in non-traumatized spinal cord. Leukotriene B4 was detectable in traumatized cord (mean +/- SE, 25 +/- 5 pg/mg of protein; n = 3). Release of leukotriene B4 from spinal cord slices into the incubation medium was also noted after trauma (9 +/- 1 pg/mg of protein; n = 12) and was enhanced by exposure of traumatized spinal cord slices to the calcium ionophore A23187 (375 +/- 43 pg/mg of protein; n = 12). The amount of leukotriene B4 released corresponded to the extent of post-traumatic polymorphonuclear cell infiltration determined by a myeloperoxidase assay. Results from this study suggest that the source of leukotriene B4 in spinal cord injury is infiltrating polymorphonuclear cells.     

Multimodal MRI-Based Study in Patients with SPG4 Mutations

Mutations in the SPG4 gene (SPG4-HSP) are the most frequent cause of hereditary spastic paraplegia, but the extent of the neurodegeneration related to the disease is not yet known. Therefore, our objective is to identify regions of the central nervous system damaged in patients with SPG4-HSP using a multi-modal neuroimaging approach. In addition, we aimed to identify possible clinical correlates of such damage. Eleven patients (mean age 46.0 ± 15.0 years, 8 men) with molecular confirmation of hereditary spastic paraplegia, and 23 matched healthy controls (mean age 51.4 ± 14.1years, 17 men) underwent MRI scans in a 3T scanner. We used 3D T1 images to perform volumetric measurements of the brain and spinal cord. We then performed tract-based spatial statistics and tractography analyses of diffusion tensor images to assess microstructural integrity of white matter tracts. Disease severity was quantified with the Spastic Paraplegia Rating Scale. Correlations were then carried out between MRI metrics and clinical data. Volumetric analyses did not identify macroscopic abnormalities in the brain of hereditary spastic paraplegia patients. In contrast, we found extensive fractional anisotropy reduction in the corticospinal tracts, cingulate gyri and splenium of the corpus callosum. Spinal cord morphometry identified atrophy without flattening in the group of patients with hereditary spastic paraplegia. Fractional anisotropy of the corpus callosum and pyramidal tracts did correlate with disease severity. Hereditary spastic paraplegia is characterized by relative sparing of the cortical mantle and remarkable damage to the distal portions of the corticospinal tracts, extending into the spinal cord.     

L'Inhibine B chez les blessés radiculo-médullaires. Résultats préliminaires

Spinal cord injuries in adult men sometimes results in semen alteration and in ejaculation missing. Testicular biopsies showed spinal cord injury is bound with testicular and germinal cells alterations. An endocrine profile for thirteen patients without semen at the time of the study is performed: total testosterone, bioavailable testosterone, FSH and inhibin B. Compared with seven normal controls, subjects with spinal cord injury had a significantly lower value of total testosterone, bioavailable testosterone and inhibin B. The FSH values higher in spinal cord injury are not significative. These results allowed to expect inhibin B like a good marker of testicular function and spermatogenesis. A longitudinal and on more subjects will answer to this question.     

Receptor activated bladder and spinal ATP release in neurally intact and chronic spinal cord injured rats

Neurally intact (NI) rats and chronic spinal cord injured (SCI) rats were studied to determine how activation of mechanosensory or cholinergic receptors in the bladder urothelium evokes ATP release from afferent terminals in the bladder as well as in the spinal cord. Spinal cord transection was performed at the T(9)-T(10) level 2-3 weeks prior to the experiment and a microdialysis fiber was inserted in the L(6)-S(1) lumbosacral spinal cord one day before the experiments. Mechanically evoked (i.e. 10 cm/W bladder pressure) ATP release into the bladder lumen was approximately 6.5-fold higher in SCI compared to NI rats (p<0.05). Intravesical carbachol (CCh) induced a significantly greater release of ATP in the bladder from SCI as compared to NI rats (3424.32+/-1255.57 pmol/ml versus 613.74+/-470.44 pmol/ml, respectively, p<0.05). However, ATP release in NI or SCI rats to intravesical CCh was not affected by the muscarinic antagonist atropine (Atr). Spinal release of ATP to bladder stimulation with 10 cm/W pressure was five-fold higher in SCI compared to NI rats (p<0.05). CCh also induced a significantly greater release of spinal ATP in SCI rats compared to controls (4.3+/-0.9 pmol versus 0.90+/-0.15 pmol, p<0.05). Surprisingly, the percent inhibitory effect of Atr on CCh-induced ATP release was less pronounced in SCI as compared to NI rats (49% versus 89%, respectively). SCI induces a dramatic increase in intravesical pressure and cholinergic receptor evoked bladder and spinal ATP release. Muscarinic receptors do not mediate intravesical CCh-induced ATP release into the bladder lumen in NI or SCI rats. In NI rats sensory muscarinic receptors are the predominant mechanism by which CCh induces ATP release from primary afferents within the lumbosacral spinal cord. Following SCI, however, nicotinic or purinergic receptor mechanisms become active, as evidenced by the fact that Atr was only partially effective in inhibiting CCh-induced spinal ATP release.     

Membrane lipids of human peripheral nerve and spinal cord.

Major membrane lipids were determined in specimens of human peripheral nerve (cauda equina) and spinal cord of 10 subjects aged 20-70 years. The same lipids were also assayed in myelin from the same tissues isolated with two different procedures and in myelin of cauda equina from 3 subjects aged 17-91 years isolated with a third method. The concentrations (mean and standard deviation) of phospholipids were 90 +/- 11 and 96 +/- 9 nmol/g fresh weight; of cholesterol 70 +/- 15 and 101 +/- 16; of cerebroside 19 +/- 3 and 41 +/- 7; of sulfatide 10 +/- 1 and 11 +/- l; and of gangliosides 0.80 +/- 0.08 and 0.40 +/- 0.05 N in cauda equina and spinal cord, respectively. The proportion of ethanolamine phosphoglyceride was lower and that of sphingomyelin higher in cauda equina than in spinal cord. The myelin of peripheral nerve and spinal cord contained almost the same proportions of lipids as the whole tissue. The protein-bound sialic acid content was 3-fold higher than the lipid-bound sialic acid content in cauda myelin. The fatty acid patterns of choline, ethanolamine, inositol and serine phosphoglycerides of spinal cord and its myelin, were very similar to those of cerebral white matter, while the phosphoglycerides of cauda equina had higher proportions of monoenoic acids and lower proportions of polyunsaturated fatty acids. The fatty acid patterns of sphingomyelin, cerebroside and sulfatide of spinal cord were similar to those of cerebral white matter, while those of cauda equina contained significantly more saturated fatty acids. This suggests that the lipid and fatty acid compositions of peripheral nerve are particularly suitable for the formation of a tightly packed myelin membrane which can be a powerful shield against infections and other injuries.     

MRI Characterization of Paranodal Junction Failure and Related Spinal Cord Changes in Mice

The paranodal junction is a specialized axon-glia contact zone that is important for normal neuronal activity and behavioral locomotor function in the central nervous system (CNS). Histological examination has been the only method for detecting pathological paranodal junction conditions. Recently, diffusion tensor MRI (DTI) has been used to detect microstructural changes in various CNS diseases. This study was conducted to determine whether MRI and DTI could detect structural changes in the paranodal junctions of the spinal cord in cerebroside sulfotransferase knock-out (CST-KO) mice. Here, we showed that high-resolution MRI and DTI characteristics can reflect paranodal junction failure in CST-KO mice. We found significantly lower T1 times and significantly higher T2 times in the spinal cord MRIs of CST-KO mice as compared to wild-type (WT) mice. Spinal cord DTI showed significantly lower axial diffusivity and significantly higher radial diffusivity in CST-KO mice as compared to WT mice. In contrast, the histological differences in the paranodal junctions of WT and CST-KO mice were so subtle that electron microscopy or immunohistological analyses were necessary to detect them. We also measured gait disturbance in the CST-KO mice, and determined the conduction latency by electrophysiology. These findings demonstrate the potential of using MRI and DTI to evaluate white matter disorders that involve paranodal junction failure.     

Approche hybride combinant champs de Markov et modèle statistique de forme pour l’extraction des contours de la prostate en IRM

Recent progress in magnetic resonance imaging (MRI) has enabled new prostate cancer diagnosis techniques. The newest challenges in this field are to enhance image-based tumours detection. In such a context, the extraction of prostate's contours is a crucial step in the interpretation of MR images, and is usually carried out by an expert radiologist. This is though a tedious time consuming task, especially in 3D images (like CT and MRI). In addition, manual delineation is not reproducible because of differences between observers. In this paper, we introduce a novel method for automatic segmentation of prostate MRI that could help physicians in extracting 3D outlines of the gland. First a deformable shape model is used to obtain a first segmentation. The latter is refined using intensity information and Markov Random Fields modelling of regions. We use the Iterative Conditional Mode for optimising voxels’ labelling according to a Maximum A Posteriori criterion. Results from evaluation on patients’ data show that the method is satisfyingly accurate, fast and robust which makes it suitable for use in a clinical context. A multicentric validation and transfer to the industry would bring the contributions of this method to clinical routine and help improving diagnosis of prostate cancer.     

miRNAs在脊髓损伤中作用的研究进展

脊髓损伤是一个重要的公共卫生难题,脊髓损伤可划分为三个病理生理阶段:原发性损伤期、继发性损伤期和慢性损伤期。基因表达的改变在脊髓损伤中起到了重要作用,miRNAs可以调控转录后所有基因的表达,所以miRNAs是脊髓损伤中一个很具有研究价值的研究对象。miRNAs是20-25碱基组成的非编码RNA,通过与靶mRNAs 3‘UTR结合下调其表达实现的对mRNA翻译进程的调控。miRNAs与中枢神经系统的发育、功能和疾病有密切关系。脊髓损伤后miRNAs通过调节中性粒细胞和炎性反应通路在炎性应答中起到了重要作用;miRNAs在细胞凋亡中表现出了复杂的功能,其表达的改变可能同时刺激和抑制凋亡;miRNAs可通过增强星形胶质细胞肥大和调节胶质瘢痕的进程;miRNAs的下调可能通过促进轴突靶向作用、神经元存活和轴突生长来促进损伤脊髓部位再生进程。目前脊髓损伤仍是现代医学的难题,对神经系统疾病中miRNAs作用的研究,为脊髓损伤治疗提供了一种新的治疗方案,也是将来研究中的热点。     

药物及靶向治疗在脊髓损伤中的治疗新进展

脊髓损伤(spinalcordinjury,SCI)是一种严重的损伤,它对患者的影响是相当持久的,SCI治疗的难点主要是由于损伤后脊髓中的微环境不利于神经细胞的再生、轴突的生长和新突触的形成,从而影响了脊髓组织的修复。现在SCI治疗的策略就是要改善损伤脊髓微环境,减少不利因素,从而促进脊髓结构修复和功能重建。本研究综述近年来逐渐发展起来的药物及靶向治疗方法,为SCI的新治疗提供参考依据,真正提高患者的生活质量。     

Cardiovascular responses of the bullfrog (Rana catesbeiana) to thermal stimulation of the spinal cord

Selective thermal stimulation of the spinal cord was performed in the bullfrog (Rana catesbeiana). Spinal cord warming caused an increase in systolic pressure of the truncus arteriosus, and cooling caused a decrease. Spinal cord warming caused an increase in systolic and pulse pressures of the conus arteriosus, and cooling caused a decrease. These results showed the temperature perceptibility of the spinal cord and a relationship between spinal cord temperature and autonomic functions in the frog as in other endothermic and ectothermic species.