Rapid detection of aflatoxin B_1 in Chinese herbal medicines by indirect and direct competitive enzyme-linked immunosorbent assays: a comparative analysis / 中国中药杂志

The indirect competitive enzyme-linked immunosorbent assay(ic-ELISA) and direct competitive enzyme-linked immunosorbent assay(dc-ELISA) were performed for the rapid detection of aflatoxin B_1(AFB_1) in Astragali Radix, Zingiberis Rhizoma Recens, Jujubae Fructus, and Nelumbinis Semen with self-made antigens and antibodies. Different extraction methods were investigated to reduce the matrix effects of different medicinal parts in Chinese herbal medicines. The sensitivity of dc-ELISA method was improved by optimizing the molar ratio of AFB_1 to horseradish peroxidase(HRP). In this study, the sensitivity(IC_(50)) of ic-ELISA and dc-ELISA was 0.046 and 0.023 ng·mL~(-1), with the limit of detection(LOD) of 0.007 and 0.004 ng·mL~(-1), respectively. The detection time was 3 h and 50 min for ic-ELISA and dc-ELISA, respectively. The recovery rates were within the range of 62.96%-104.4%, with RSDs of less than 10%. Confirmed by LC-MS/MS, three positive samples of Nelumbinis Semen were detected from 53 samples. Two ELISA methods established in this study were accurate, rapid and sensitive, and can be used for rapid screening of AFB_1 in Chinese herbal medicines such as Astragali Radix, Zingiberis Rhizoma Recens, Jujubae Fructus, and Nelumbinis Semen. In addition, the advantages and limitations of the two methods were compared and discussed, which can provide a reference for the testing institutions to choose the proper method.

Preparation of highly sensitive monoclonal antibody against aflatoxin B_1 and its application in rapid detection of contamination in Ziziphi Spinosae Semen / 中国中药杂志

A highly sensitive monoclonal antibody against aflatoxin B_1(AFB_1) was prepared and an indirect competition enzyme-linked immunosorbent assay(ic-ELISA) was established based on the antibody which was used for high-throughput and rapid screening of AFB_1 contamination in Chinese herbal medicines to ensure the safety of medication. In this study, the structure of AFB_1 was modified by improved oxime method, and the carrier protein was coupled by EDC-NHS method to obtain the complete antigen of AFB_1, which was more convenient and environmental friendly. The Balb/c female mice were immunized using increasing the immunization dose and various ways of injection, and finally the AFB_1 monoclonal antibody was prepared. The AFB_1 monoclonal antibody belongs to IgG_(2 b) immunoglobulin by identifying its immunological characteristics, and its sensitivity(IC_(50)) can reach 0.15 μg·L~(-1), and the affi-nity is 2.81×10~8 L·mol~(-1). The cross-reaction rates of AFB_2, AFG_1, and AFG_2 were 35.07%, 8.75%, and 1.15%, respectively, and there was almost no cross-reactivity with other mycotoxins. Based on the high sensitivity and specificity of the antibody, an ic-ELISA method was established and applied to the determination of AFB_1 contamination in Ziziphi Spinosae Semen. According to the matrix matching standard curve, the linear concentration range for AFB_1 was 0.05-0.58 μg·L~(-1)(R~2=0.992), the recoveries were 88.00%-119.0%, and the detection limit was 1.69 μg·kg~(-1). The AFB_1 in 33 batches of Ziziphi Spinosae Semen samples was determined by ic-ELISA, and the contamination level was 3.62-206.58 μg·kg~(-1). The linear correlation coefficient between the detection results of ic-ELISA and UHPLC-MS/MS was 0.996, and there were no false positive and false negative cases. It indicates that the established ic-ELISA is accurate and reliable, and could provide a simple and effective technique for fast screening of AFB_1 contamination in Ziziphi Spinosae Semen, and also could be considered as the reference for the detection and monitoring of AFB_1 contamination in other Chinese herbal medicines.

Research progress of sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer / 国际外科学杂志

The feasibility and safety of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for breast cancer are still controversial in clinical practice.SLNB after NAC is feasible and safe for patients with clinically node-negative (cN0) breast cancer,while those with clinically node-positive (cN +) should be carefully considered.In addition to methylene blue and 99mTc-sulfur colloid tracing,some other tracing methods have been proposed in clinical studies,such as carbon nanoparticles and indocyanine green fluorescence tracing.The axillary lymph node (ALN) state of SLNB patients after NAC was associated with molecular subtyping,response to chemotherapy,residual breast tumor size,etc.Therefore,a number of factors should be considered to determine whether ALN dissection is needed.The false negative rate of SLNB after NAC can be reduced by some measures such as placing clips prior to surgery and preoperative tattooing with sterile black carbon suspension.Besides ALN,internal mammary lymph nodes is another route for breast cancer metastasis.As a low-invasive diagnostic technique,internal mammary sentinel lymph node biopsy can complete lymph node staging and pathological staging to guide treatment.This review attempts to introduce the research progress of SLNB after NAC from multiple aspects such as feasibility and safety,tracer methods,assessment of ALN status and methods to reduce false negative rate.

Research progress of sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer / 国际外科学杂志

The feasibility and safety of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NAC) for breast cancer are still controversial in clinical practice. SLNB after NAC is feasible and safe for patients with clinically node-negative (cN0) breast cancer, while those with clinically node-positive (cN+ ) should be carefully considered. In addition to methylene blue and 99mTc-sulfur colloid tracing, some other tracing methods have been proposed in clinical studies, such as carbon nanoparticles and indocyanine green fluorescence tracing. The axillary lymph node (ALN) state of SLNB patients after NAC was associated with molecular subtyping, response to chemotherapy, residual breast tumor size, etc. Therefore, a number of factors should be considered to determine whether ALN dissection is needed. The false negative rate of SLNB after NAC can be reduced by some measures such as placing clips prior to surgery and preoperative tattooing with sterile black carbon suspension. Besides ALN, internal mammary lymph nodes is another route for breast cancer metastasis. As a low-invasive diagnostic technique, internal mammary sentinel lymph node biopsy can complete lymph node staging and pathological staging to guide treatment. This review attempts to introduce the research progress of SLNB after NAC from multiple aspects such as feasibility and safety, tracer methods, assessment of ALN status and methods to reduce false negative rate.

Clinical analysis of esophageal submucosal hematoma caused by endoscopic injection sclerotherapy: 5-cases-report and literature review / 中国内镜杂志

Objective To study the etiology clinical features, treatment outcomes and prevention of esophageal submucosal hematoma caused by endoscopic injection sclerotherapy (EIS) of esophageal varices. Methods We retrospectively reviewed the clinical data of patients who were diagnosed with esophageal submucosal hematoma caused by EIS and treated in our hospital from Jan 2014 to July 2016. Five patients were analyzed including one patient receiving endoscopic gastrointestinal catheterization combined with medication, and the remaining four received medication therapy only. Results All five patients were discharged with clinical improvement. However the patients treated only with medication therapy recovered more slowly than the ones who treated with combined therapy. No treatment related side-effects were observed among two treatment groups. Conclusion Endoscopic gastrointestinal catheterization combined with medication may be an effective treatment for esophageal submocasal hematoma caused by EIS. However, the actual clinical efficacy and safety remain to be proven by future large sample randomized clinical studies.

Effects of Remind-to-move Treatment on Functional Recovery after Stroke / 中国康复理论与实践

Objective To explore the effect of remind-to-move treatment on upper limb motor function,activities of daily living and participation in patients with subacute stroke. Methods From February,2016 to October,2017,45 patients with mild to medium upper limbs dysfunction after stroke were randomly assigned to control group(n=23)and experimental group(n=22).The control group accepted rou-tine occupational therapy,while the experimental group wore a wristwatch on the hemiplegic forearm to encour-age the predetermined training programs,for three weeks.They were measured with Fugl-Meyer Assessment-Up-per Extremity(FMA-UE),Function Independence Measurement(FIM),Motor Activity Log(MAL),and Stroke Impact Scale(SIS)before and after treatment. Results Both groups improved in part of the scores of three scales after treatment(P<0.05),and improved more in the experimental group than in the control group in scores of FMA-UE and FIM,and some sub-scores of MAL and SIS(t>1.183,P<0.05),with no significant difference in other indexes(P>0.05). Conclusion Remind-to-move treatment can promote the recovery of upper limb motor function,activities of daily living and participation in the patients with subacute stroke.

Determination of salvianolic acid B and borneol in compound Danshen tablet by near-infrared spectroscopy and establishment of dependency model / 中国中药杂志

To determine the contents of salvianolic acid B and borneol in compound Danshen tablet (composed of Salviae Miltiorrhizae Radix et Rhizome, Notoginseng Radix et Rhizome and Borneolum Syntheticum) by near-infrared spectroscopy (NIR) and to establish a dependency model for rapid quantitative analysis. NIR data of 74 batches of compound Danshen tablet from different companies were collected; the contents of salvianolic acid B and borneol were determined by using high performanceliquid chromatography (HPLC) and gas chromatography (GC) respectively to establish the dependency model for salvianolic acid B and borneol. The results showed that the best waveband for salvianolic acid B was 10 846.2-10 013, 9 195.3-8 362.2, 6 719.1-4 242.8 cm⁻¹; root-mean-squares error of cross-validation (RMSECV), coefficient of determination ² and regression point displacement (RPD) of salvianolic acid B were 1.72 mg·g⁻¹, 91.05% and 7.93 mg·g⁻¹, respectively. While the best wavebands, RMSECV, ² and RPD of borneol were 10 846.2-5 060.5 cm⁻¹, 1.2 mg·g⁻¹, 96.11% and 6.71 mg·g⁻¹，respectively. The relative error of the established model as validation results for validation set samples was 2.67% and 4.64%， respectively.With the good predictability, the models can be applied to the real time monitoring and quality control of compound Danshen tablet.

Etiological analysis, preventional and therapeutical strategies for the unsatisfied cervical posterior decompression surgery / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the causes of unsatisfied cervical posterior decompression surgery and describe the overhauling strategies and precaution.</p><p><b>METHODS</b>The clinical data of 14 patients required revision surgery were retrospectively analyzed, and these patients with unsatisfied effects were due to cervical posterior decompression surgery from January 2012 to December 2014. Overhauling reasons were analyzed and then different revision procedures were performed. The functions of cervical cord and ambulation were evaluated respectively by modified Japanese Orthopedic Association(mJOA) score and Nurick grade according to the course order:preoperative for the first time, pre-revision and at final follow-up. Improvement rate of nerves function were calculated before and after operation for the first time, before and after revision. Above data were statistically analyzed by SPSS16.0 software.</p><p><b>RESULTS</b>Reoperation reasons including 2 patients with the insufficiency width of laminectomy, 2 patients with the inadequate length of decompression, 2 patients with nerve root and spinal cord compression caused by fractured collapse, 4 patients with closed the door of vertebral lamina, 1 patient with less open-door angle, 2 patiens with ossification of posterior longitudinal ligament (1 case complicated with close the door), 2 patients with cervical spine kyphotic deformity aggravating (1 case complicated with close the door), 1 patient with nerve root canal stenosis caused by uncovertebral joint hyperplasia. Preoperative for the first time, pre-revision and at final follow-up, mJOA scores were 11.89±1.67, 13.11±1.09, 15.61±0.59, and Nurick grades were 4.21±0.58, 3.57±0.51, 1.71±0.47, respectively. There was significant difference between final follow-up and preoperative for the first time, pre-revision(<0.05). Improvement rate of nerve function was (22.33±9.49)% with bad before and after operation for the first time, and (64.60±9.88)% with good before and after revision, with statistical significance(<0.05).</p><p><b>CONCLUSIONS</b>Individualized revision surgery based on different causes for unsatisfied cervical posterior decompression can improve the function of spinal cord. Preoperative carefully analyzing the etiological factors, thoroughly decompression can reduce the revision rate.</p>

Prophylactic central lymph node dissection for patients of cN0 thyroid papillary carcinoma / 中华普通外科杂志

Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.

Clinical significance of recognizing Zuckerkandl tubercle during thyroid surgery / 中国医师进修杂志

Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.

Curative effect analysis on proximal frmoral nail antirotation for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical efficacy and key matters for the treatment of femoral intertrochanteric fracture and integrity of lateral trochanteric wall by proximal frmoral nail antirotation (PFNA).</p><p><b>METHODS</b>From June 2010 to December 2012,210 femoral intertrochanteric fracture patients treated with PFNA were retrospectively analyzed, including 76 males and 134 females aged from 46 to 96 years old with an average of 71 years old. All fracture were caused by injury and classified to type I (5 cases) type II (16 cases), type III (73 cases) and type IV (116 cases) according to Evans classification. The time of getting out of bed, postoperative complications and displacement of screw blade and fracture healing were observed, Baumgaertner criteria were used to evaluate quality of fracture reduction, Harris criteria were used to evaulate hip joint function.</p><p><b>RESULTS</b>All incisions were healed at stage I, no complications occurred except incomplete of lateral trochanteric wall patients without reconstruction, other patients could get out of bed with crutches at one week and all patients discharged from hospital at 10 days after operation. One hundred and seventy-eight patients were followed up from 3 to 17 months with an average of 10 months. One case occurred unhealed fracture displacement caused by screw blade cutting, 2 cases occurred screw blade transfomed to proximal and out femoral head, other patients obtained fracture healing at 12 to 16 weeks after operation. According to Baumgaertner criteria, 130 cases obtained good results, 45 cases acceptable, and 3 poor; while 107 cases obtained excellent results, 65 good, 3 good and 3 poor according to Harris score.</p><p><b>CONCLUSION</b>PFNA with mechanical advantage of intramedullary fixation has advantsges of stable fixation, shorter operation time, minimally invasive. Satisfied clinical effects could obtained by grasping fixation principle, dealing with negative factors in operation. Intraoperative reconstruction for integrity of lateral trochanteric wall could assure stable fixation and earlier get out of bed.</p>

Analysis of the reason of secondary fracture after percutaneous vertebroplasty for osteoporotic vertebral compression fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the reasons of secondary fracture after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs) and discuss the measure of prevention and cure.</p><p><b>METHODS</b>From January 2011 to January 2013, the clinical data of 180 patients with primary OVCFs treated by PVP were retrospectively analyzed. There were 75 males and 105 females, aged from 68 to 95 years old with an average of (79.50 ± 5.45) years. The involved vertebrae were identified according to the clinical symptoms and imaging data. PVP were performed in 362 vertebrae and the patients were followed up with an average of 12 months. Subsequent vertebral fractures were found through the pain's reappearance and MRI or bone scan. The patients were divided into secondary fracture group and no-secondary fracture group according to the subsequent fractures or no. Secondary fracture group was divided into two groups according to gender, and the patients with secondary fracture were also categorized into the original surgical vertebral fractures, adjacent vertebral fracture and remote vertebral fractures. The age, gender, the cement volume, the cement leakage, secondary fracture site, the incidence and type of secondary fracture were observed and compared among different groups.</p><p><b>RESULTS</b>Among the 362 vertebrae of PVP, there were 109 vertebrae in male and 253 vertebrae in female. And 27 vertebrae (10 in male and 17 in female) of 22 cases (9 males and 13 females) occurred secondary fracture. The second PVP were performed in 13 cases (16 vertebrae) and the third PVP in 2 cases (4 vertebrae); 7 cases (7 vertebrae) were treated with conservative therapy. There was no statistically significant difference on age, gender, cement volume and leakage between secondary fracture group and no-secondary fracture group (P > 0.05). There was no statistically significant difference on the incidence and type of secondary fracture between male and female (P > 0.05). No significant difference was found on the adjacent and remote vertebral fractures (P > 0.05). Most of secondary fracture occurred in 6 months, and whether the single and double side injection, cement leakage had no obvious relation.</p><p><b>CONCLUSION</b>There is no significant difference in the subsequent fracture after PVP for the OVCFs different gender and fractured site, and also no significant difference in the adjacent and remote vertebral fractures. The report didn't support the biomechanical viewpoint that vertebral body stiffness increasing after PVP would lead to adjacent vertebral stress increasing and result easily in adjacent vertebral fracture. Secondary fracture occurs always in 6 months after operation, which is the natural course of osteoporosis.</p>

Overexpression of eIF4E gene in acute myeloid leukemia and its relation with disease progression / 中国实验血液学杂志

The aim of this study was to detect the expression level of eIF4E gene in patients with non-treated, remission and non-remission/relapse acute myeloid leukemia (AML), and other non-malignant haematologic diseases so as to analyze and reveal the relationship of eIF4E gene expression with AML progression. SYBR Green I RT-PCR was used to assay the expression level of eIF4E mRNA extracted from bone marrow mononuclear cells in 30 patients with AML (6 in M2, 5 in M3, 8 in M4, 10 in M5, 1 in M6) and 20 patients with non-malignant hematologic diseases. The β2-microglubin(β2M) was used as internal reference and the formula 2(-ΔCt)×100% was applied to calculate the expression level of eIF4E gene. The results showed that the eIF4E expression level (7.098 ± 5.544)% in patients with non-treated and non-remitted/relapsed AML was significantly higher than that in patients with remission (0.964 ± 0.312)% (P < 0.01) and non-malignant hematologic diseases (0.248 ± 0.163)% (P < 0.01). There was no difference between latter two group patients, even though the expression level of eIF4E gene in patients with M4 and M5 was higher. As compared with non-malignant hematologic diseases, the expression level of eIF4E gene of patients with remission patients showed no significant difference. It is concluded that the over-expression of eIF4E gene has been found in patients with AML, and its level obviously decreases along with remission of disease, thus the eIF4E gene may be a surveillance parameter for disease progression.

Anti-mycobacteria drugs therapy for periductal mastitis with fistula / 中华外科杂志

<p><b>OBJECTIVES</b>To study the etiology, clinical and pathologic characteristics of periductal mastitis with fistula and estimate the effect of anti-mycobacterial agents for periductal mastitis with fistula.</p><p><b>METHODS</b>Totally 27 patients of periductal mastitis with fistula received anti-mycobacteria drugs therapy from December 2008 to September 2011 were analyzed retrospectively. All of the patients were female. The mean age at onset was 28 years (range 15 to 40 years old). The main clinical manifestation of the 27 patients was breast fistula, including 21 patients with single fistula and 6 patients with multiple fistula. Three patients manifested with pure fistula, 14 patients with both fistula and lump, 10 patients with fistula, lump and abscess. The samples including pus or tissues of all patients were underwent bacteria culture and all patients core needle biopsy. All patients were given primary anti-mycobacteria drugs therapy, parts of patients received surgery based on the evaluation of medical treatment.</p><p><b>RESULTS</b>The common bacteria culture of all patients failed to demonstrate any causative microorganism. Four cases were selected randomly to undergo PCR of mycobacteria, only one case was identified as Massiliense in bacteria culture of mycobacteria. Twenty-seven patients with periductal mastitis with fistula were treated with anti-mycobacterial agents (isoniazid, rifampicin and ethambutol or pyrazinamide of triple oral drugs) for 1 to 3 months, the fistula of all 27 patients were closed well. Sixteen patients were treated with the agents only and cured. Eleven patients received surgical treatment after treated with the medical agents. None of the patients were given mastectomy. All patients had no reccurence until now.</p><p><b>CONCLUSIONS</b>The periductal mastitis with fistula has a closely relationship with the infection of nontuberculosis mycobacteria. Those patients could be treated with triple anti-mycobacterial agents and could also avoided mastectomy.</p>

The clinical study of high-frequency ultrasound-guided vacuum-assisted biopsy for breast microcalcifications / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical application of high-frequency ultrasound-guided vacuum-assisted biopsy for breast microcalcifications.</p><p><b>METHODS</b>Sixty-six patients with 70 lesions of microcalcifications detected at mammography underwent high-frequency ultrasound-guided vacuum-assisted biopsy from July 2009 to October 2010. All patients were female, aged 24 to 61 years (median age 40 years). Among 70 lesions of microcalcifications, unilateral lesions were 62 cases and bilateral lesions were 4 cases. The clinical factors that affected the success of biopsy were investigated by χ(2) test and Logistic regression analysis.</p><p><b>RESULTS</b>Among 70 lesions of microcalcifications, the successful rate of biopsy was 72.9% (51/70). The biopsy successful rate of microcalcifications without and with masses were 65.2% (30/46) and 87.5% (21/34) respectively (χ(2) = 3.960, P = 0.047). The biopsy successful rate of microcalcifications of maximal diameter more than 5 mm was higher than that of maximal diameter less than 5 mm (88.9% vs. 55.9%, χ(2) = 9.633, P = 0.002). The Logistic regression analysis showed that the types and maximal diameter of microcalcifications were the main factors that affected the success of biopsy.</p><p><b>CONCLUSION</b>The clinical application of high-frequency ultrasound-guided vacuum-assisted biopsy was an effective option for the diagnosis of breast microcalcifications, especially for the type of microcalcifications with masses and the maximal diameter more than 5 mm.</p>

Value of 18F-FETNIM PET-CT for detection of tumor hypoxia in non-small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the feasibility of [(18)F]fluoroerythronitroimidazole ((18)F-FETNIM) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>Forty-two patients with newly diagnosed NSCLC underwent (18)F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT, 23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection (18)F-FETNIM. (18)F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated.</p><p><b>RESULTS</b>SUVmax-T (2.43 +/- 1.34) was significantly higher than SUVmax-N (0.87 +/- 0.46, P < 0.001) at 120 min. SUVmax-T (2.80 +/- 1.09) and SUVmax-N (1.16 +/- 0.56) at 60 min were significantly higher than SUVmax-T (2.61 +/- 1.10) and SUVmax-N (P < 0.01) at 120 min. T/N (2.56 +/- 0.71) at 60 min was higher than that at 120 min (2.48 +/- 0.60), but the difference between them was not significant (P = 0.324).</p><p><b>CONCLUSION</b>Our results indicate that (18)F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.</p>

Real-time volume rendering based on gradient adaptive shading / 南方医科大学学报

For medical image volume rendering, it is very difficult to simultaneously visualize interior and exterior structures while preserving clear shape cues. Highly transparent transfer functions produce cluttered images with many overlapping structures, while clipping techniques completely remove possibly important contextual information. To address this issue, A gradient adaptive shading based illumination model is proposed and implemented in CUDA architecture. The coefficients of ambient, diffuse and specular lighting are tuned adaptively according to gradient. The experiments show that our method is capable of preserving 3-D contextual information in medical image dataset while still show clear boundaries with real-time interactive speed.

Hypoparathyroidism following total thyroidectomy / 中华普通外科杂志

Objective To predict the occurrence of hypoparathyroidism following total thyroidectomy. Methods In this study, 124 patients underwent total thyroidectomy, 46 for thyroid cancer and 78 for multinodular goiter, additional neck dissection was performed on cancer patients. Serum calcium and parathyroid hormone (PTH) levels were examined preoperatively and at 1 h, 1 d and 2 d postoperatively. The occurrence of postoperative hypoparathyroidism was observed. Receiver operating characteristic curve analysis was employed to identify the best indicator to early predict the occurrence of clinical hypocalcemic symptoms. Results Fifty-eight (46.8%) patients suffered from postoperative transient hypoparathyroidism, with 22 ( 47. 8% ) cases in thyroid cancer group and 36 ( 46. 2% ) in multinodular goiter group ( λ2 = 0. 033, P = 0. 857). One (0.8%) patient in cancer group had permanent hypoparathyroidism. 90 patients (72.6%) had postoperative hypocalcaemia, 58 (46. 8% ) had subnormal serum PTH levels, 40 (32. 3% ) had hypocalcaemia symptoms. Postoperative serum calcium (F=21. 358,P =0. 000) and PTH ( F = 18.253, P =0.000) levels decreased more in cancer group than in goiter group.Receiver operating characteristic curve analysis demonstrated that the percentage of serum PTH level decline at 1 h postoperatively was most predictive and 76. 6% decline was the best cut-off value for the occurrence of clinical hypocalcaemia symptoms ( area under the curve being 0.933 ) with a sensitivity of 89. 7% and a specificity of 87.9%. Conclusions Neck dissection added to total thyroidectomy can decrease the postoperative serum calcium and PTH levels more seriously, but may not increase the incidence of postoperative transient hyperparathyroidism. The percentage of serum PTH level decline at 1 h postoperatively predicts the occurrence of clinical hypocalcaemia symptoms.

2D/3D registration system based on single X ray image and CT data / 医用生物力学

Objective To build a 2D/3D registration system based on the compute unified device architecture(CUDA) frame with single X-ray image and CT data of knee joints and apply it in the research of knee motion and stability of implanted prosthesis. Method The digital radiography(DR) equipment used in the study was calibrated by the Zhang zhengyou Calibration Method, and then digitally rendered radiographs(DRR) images were generated in the CUDA frame with light tracing algorithm, and the best 2D/3D registration parameters were calculated with a similarity operator of cross correlation; finally, the results were evaluated by using the method of 3D/3D registration with data obtained from a 3D laser scanner. Results With knee specimen X-ray images and CT data, in 6 degrees of freedom, the average errors of transform were below 1 mm, and those of rotation were below 1°. Conclusions The 2D/3D registration system can meet the precision requirement of motion detection and be used to study the knee motion and prosthesis location.

2D, 3D Rigid Registration Algorithm Base on CUDA / 中国医学物理学杂志

Objective: Real time medical image registration technique is one of the key techniques in image based surgery navi-gation system. While in medical image analysis, image registration is usually a very time-cousuming operation, and this is not conducive to clinical real-time requirements. This paper studies and realizes the acceleration of the process of image registra-tion. Methods: In order to improve the regisWation rate, in this paper, we propose a new technology which is based on CUDA (Compute Unified Device Architecture) programming model to accelerate the process of registration in hardware, using paral-lel methods to achieve pixel coordinate transformation, linear interpolation, and calculate the corresponding pixel gray value residuals. Results: The registration is up to the sub-pixel level and the GPU-based registration is dozens or even hundreds of times faster than CPU-based registration. Conclusions: This method greatly enhances the speed of rigid registration without changing the alignment accuracy.