18F-DCFPyL PET/CT imaging characteristics of castration-resistant prostate cancer patients with different PSA levels / 中华泌尿外科杂志

Objective:To investigate the characteristics of 18F-DCFPyL PET/CT imaging in castration-resistant prostate cancer (CRPC) patients with different PSA levels. Methods:The imaging and clinical data of 50 patients with CRPC who underwent 18F-DCFPyL PET/CT examination in Chinese PLA General Hospital from January 2018 to December 2020 were analyzed retrospectively. The average age was 72 (54-95) years old. Serum total PSA was 92.28(0.36-2000.00) ng/ml. According to the total PSA level, the patients were divided into low PSA group(total PSA ≤ 1 ng/ml, n=9), medium PSA group (1 ng/ml<total PSA ≤ 10 ng/ml, n=18) and high PSA group(total PSA>10ng/ml, n=23). According to the standardized evaluation standard of molecular imaging, the suspicious tumor lesions on 18F-DCFPyL PET/CT imaging were scored by molecular imaging PSMA(miPSMA), and the miPSMA score ≥2 was defined as positive lesions. According to the number of lesions displayed by 18F-DCFPyL PET/CT, patients were divided into oligofocal group (the number of lesions ≤3) and multiple lesions group (the number of lesions >3). The imaging characteristics of patients in different groups were summarized. Results:The 18F-DCFPyL PET/CT imaging results of 50 cases in this study were all positive, including oligofocal group (n=27) and multiple lesions group (n=23). Of the 30 patients with unresected prostate, 18 had local recurrence of the prostate, while the other 12 patients with unresected prostate and 20 patients with resected prostate had no signs of local recurrence. The oligofocal group showed local recurrence, regional lymph node metastasis or bone metastasis. Patients with multiple lesions showed multiple lymph nodes and/or bone metastasis with or without local recurrence. There were 9, 18 and 4 patients with oligofoci in low, middle and high PSA groups, respectively.There were 27 patients in the oligonucleogenous group, and 21 of the 22 patients receiving local treatment were effective. All 3 patients treated with systemic treatments were effective. PSA progressed in 2 untreated patients. In the multi-foci group of 23 patients, 6 of 9 patients treated with abiraterone were effective. Two patients treated with enzalumide were ineffective. One of the 4 patients with chemotherapy was effective. One of the two patients treated with 177 Lu-PSMA nuclide was effective. One case did not respond to treatment with 89SrCl 2. Radiotherapy failed in 2 cases. PSA progressed in 3 untreated patients. Conclusions:18F-DCFPyLPET/CT imaging has a high detection rate of lesions in patients with CRPC and has potential guiding significance for follow-up treatment. The number of lesions in CRPC patients with different PSA levels was different, and the patients with low PSA levels were mainly oligofoci.

Clinical characteristics of patients with the de Winter electrocardiogram pattern / 中南大学学报(医学版)

OBJECTIVES@#To explore the electrocardiogram manifestations and clinical characteristics of patients with the de Winter electrocardiogram pattern.@*METHODS@#This retrospective study was performed on acute coronary syndrome (ACS), patients with culprit lesion in left anterior descending branch (LAD), who admitted to Yongchuan Hospital of Chongqing Medical University from August 2017 to October 2018. Patients were categorized into those with or without the de Winter electrocardiogram pattern. The characteristics of de Winter electrocardiogram were analyzed by the clinical data of the patients.@*RESULTS@#Among 230 patients with left anterior descending branch lesion, 14 (6%) had the de Winter electrocardiogram pattern. Compared with the control group, patients with de Winter electrocardiogram pattern were younger [(53.86±10.26) years old vs (67.20± 11.60) years old @*CONCLUSIONS@#The de Winter electrocardiogram pattern syndrome in patients with acute chest pain mostly indicates that the left anterior descending or the diagonal branch is subtotal or completely occluded, which is a special ST-segment elevation myocardial infarction equivalent and should attract the clinicians' extensive attention.

A new non-invasive liver disease model to judge the prognosis of patients with acute upper gastrointestinal hemorrhage due to cirrhosis / 中国医师杂志

Objective To evaluate the accuracy of the new non-invasive liver disease model platelet-albumin-bilirubin index (PALBI) in the diagnosis of patients with acute upper gastrointestinal hemorrhage (AUGIB) due to cirrhosis.Methods 277 patients with AUGIB due to cirrhosis were analyzed retrospectively.The data of platelet,total bilirubin,albumin,creatinine,international standardized ratio and etiology of cirrhosis were collected.Univariate and multivariate logistic regression analysis was used to identify independent risk factors for death in patients with cirrhosis complicated by AUGIB.Analysis of variance was used to compare the differences between the model for end-stage liver disease (MELD) and PALBI grades.Pearson correlation analysis was used to assess the association between MELD and PALBI.The operating characteristic curve (ROC) was used to compare the predictive power of both for short-term and long-term mortality in patients with cirrhosis complicated by AUGIB.Results The short-term and long-term mortality rates of patients with cirrhosis complicated by AUGIB were 13.7％ and 23.5％,respectively.The average hospital stay was (9.1 ± 3.9) days.The high MELD score and high PALBI index were confirmed as independent risk factors of death by single factor and multiple factors [odds ratio (OR) =1.17,4.43;P ＜0.05];the Pearson correlation analysis showed there was a positive correlation between MELD score and PALBI index (r =0.735,P ＜ 0.05).The PALBI score was scored in MELD-a patients,further subdivided into PALBI-1a and PALBI-1b.There were statistical difference in the 1-year mortality rate between the two groups (7.0％ vs 17.8％,x2 =4.033,P ＜ 0.05).The ROC curve was used to compare the predictive power of MELD and PALBI for short-term mortality.The area under curve (AUC) of PALBI was 0.767 (95％ CI:0.712-0.815),while the AUC of the MELD score was 0.651 (95％ CI:0.591-0.707),with statistically significant difference (Z =2.328,P ＜ 0.05).The predictive power of PALBI and MELD for long-term mortality were 0.731 (95％ CI:0.674-0.782),0.754 (95％ CI:0.699-0.804),but the difference was not statistically significant (Z =0.828,P ＞ 0.05).Conclusions PALBI has a better predictive effect on patients with cirrhosis complicated by AUGIB than MELD scores.PALBI can achieve a more precise prognosis classification for patients with MELD-a,and maintain a good prediction ability on the short-term (within 30 days of hospitalization and discharge) and long-term (within 1 year after discharge) mortality of patients.As a new liver disease model,PALBI can be used as an effective non-invasive means to judge the prognosis of patients with liver cirrhosis complicated by AUGIB.

A new non-invasive liver disease model to judge the prognosis of patients with acute upper gastrointestinal hemorrhage due to cirrhosis / 中国医师杂志

Objective@#To evaluate the accuracy of the new non-invasive liver disease model platelet-albumin-bilirubin index (PALBI) in the diagnosis of patients with acute upper gastrointestinal hemorrhage (AUGIB) due to cirrhosis.@*Methods@#277 patients with AUGIB due to cirrhosis were analyzed retrospectively. The data of platelet, total bilirubin, albumin, creatinine, international standardized ratio and etiology of cirrhosis were collected. Univariate and multivariate logistic regression analysis was used to identify independent risk factors for death in patients with cirrhosis complicated by AUGIB. Analysis of variance was used to compare the differences between the model for end-stage liver disease (MELD) and PALBI grades. Pearson correlation analysis was used to assess the association between MELD and PALBI. The operating characteristic curve (ROC) was used to compare the predictive power of both for short-term and long-term mortality in patients with cirrhosis complicated by AUGIB.@*Results@#The short-term and long-term mortality rates of patients with cirrhosis complicated by AUGIB were 13.7% and 23.5%, respectively. The average hospital stay was (9.1±3.9)days. The high MELD score and high PALBI index were confirmed as independent risk factors of death by single factor and multiple factors [odds ratio (OR)=1.17, 4.43; P<0.05]; the Pearson correlation analysis showed there was a positive correlation between MELD score and PALBI index (r=0.735, P<0.05). The PALBI score was scored in MELD-a patients, further subdivided into PALBI-1a and PALBI-1b. There were statistical difference in the 1-year mortality rate between the two groups (7.0% vs 17.8%, χ2=4.033, P<0.05). The ROC curve was used to compare the predictive power of MELD and PALBI for short-term mortality. The area under curve (AUC) of PALBI was 0.767 (95% CI: 0.712-0.815), while the AUC of the MELD score was 0.651 (95% CI: 0.591-0.707), with statistically significant difference (Z=2.328, P<0.05). The predictive power of PALBI and MELD for long-term mortality were 0.731(95% CI: 0.674-0.782), 0.754 (95% CI: 0.699-0.804), but the difference was not statistically significant (Z=0.828, P>0.05).@*Conclusions@#PALBI has a better predictive effect on patients with cirrhosis complicated by AUGIB than MELD scores. PALBI can achieve a more precise prognosis classification for patients with MELD-a, and maintain a good prediction ability on the short-term (within 30 days of hospitalization and discharge) and long-term (within 1 year after discharge) mortality of patients. As a new liver disease model, PALBI can be used as an effective non-invasive means to judge the prognosis of patients with liver cirrhosis complicated by AUGIB .

Characteristics of Cerebral Blood Flow in Brain CT Perfusion Imaging for Vascular Cognitive Impairment / 中国康复理论与实践

@#Objective To evaluate cerebral perfusion through brain computed tomography perfusion imaging (CTP) in order to investigate the relationship between cerebral perfusion and vascular cognitive impairment (VCI).Methods A total of 103 patients with ischemic stroke were recruited, who received thrombolytic therapy and CTP test in the Fourth Affiliated Hospital of China Medical University from December, 2016 to May, 2017. The patients were divided into normal cognitive function group (control group, n=43), vascular cognitive impairment-no dementia group (VCIND group, n=48), and vascular dementia group (VD group, n=12) according to the degree of impairment in cognitive function after the assessment of Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). The characteristics of cerebral blood flow perfusion in region of interest of brain CTP were analyzed.Results There was difference in incidence of diabetes among three groups (χ2=7.556, P<0.05). The rate of diabetes was higher in VCIND group and VD group than in the control group. Age and diabetes were the independent risk factors for VCI (OR>1, P<0.05). There was difference in cerebral blood volume (CBV) in frontal lobe, temporal lobe, and parietal lobe among three groups (F>3.216, P<0.05). CBV in frontal lobe, temporal lobe, and parietal lobe reduced in VD group than in the control group (P<0.05), while CBV in frontal lobe and temporal lobe reduced in VD group than in VCIND group (P<0.05). There was difference in mean transit time (MTT) in left temporal lobe, left parietal lobe, and centrum semiovale among three groups, while there was difference in left occipital lobe in time to peak (TTP) among three groups (F>3.116, P<0.05). MTT and TTP were higher in VD group than in the control group and VCIND group (P<0.05). There was no difference in cerebral blood flow (CBF) in both left and right brain, and MTT and TTP in right brain among three groups (P>0.05). CBV in frontal lobe, parietal lobe and right temporal lobe demonstrated positive relationship with the scores of MMSE (r>0.203, P<0.05). CBV in parietal lobe and left frontal lobe also demonstrated positive relationship with the scores of CDT (r>0.214, P<0.05).Conclusion The cerebral blood flow perfusion reduced in different levels of VCI, especially in frontal lobe, temporal lobe and parietal lobe. Cerebral blood flow perfusion reduced with the progress of cognitive impairment, and the left hemisphere injured earlier than the right one. Brain CTP may be applied in the early recognition of VCI.

Mechanism of Neural Stem and Progenitor Cells Mediated by Hypoxia Inducible Factor-1α in Ischemic Stroke Model (review) / 中国康复理论与实践

Hypoxia inducible factor-1αis a kind of hypoxia response factor. Acute cerebral ischemia and anoxia can induce up-regula-tion of hypoxia inducible factor-1α, and the downstream genes, which plays a role in both the energy metabolism and collateral circulation after cerebral ischemia. Neural stem and progenitor cells regeneration also benefit the functional outcome after ischemic stroke. Hypoxia in-ducible factor-1αmay induce proliferation and differentiation of neural stem and progenitor cells through Notch, Wnt/β-catenin pathways, etc., in the ischemic stroke model.

Study of ways itraconazole intravenous injection topatients with peripherally inserted central catheter / 中国实用护理杂志

Objective To study the pros and cons of two methods of infusing itraconazole injectionand prevent the blockage of peripherally inserted central catheter (PICC) and improve patients' satisfaction with nursing technology.Methods 172 patients infusing itraconazole were divided into two groups by random digital table method.86 cases established an independent infusion pathway as the control group,another 86 cases using PICC for itraconazole injection and withdrawing plunger of the syringe about 0.5 ml before and after the infusion and then pulsing-flushing it with 10 ml normal saline as the experimental group.Then compared the blockage rate of PICC and the patients' satisfaction with nursing technology.Results The blockage rate of the two groups had no significant difference (x2 =0.206,P ＞ 0.05) while patients' satisfaction with nursing skills was distinct,and the experimental group's was 96.51％ (83/86),much higher than 16.28％ (14/86) of the control group.Conclusions Withdrawing taken before and after the infusion of itraconazole injection could effectively prevent catheter blockage and improve patients' satisfaction with nursing technology.

Influencing factors of coexisting anxiety and depression in patients with NPC in Chaoshan region / 现代临床护理

Objective To explore depression and anxiety in nasopharyngeal carcinoma (NPC) patients in Chaoshan region and investigate their influencing factors. Methods Two hundred and one patients newly diagnosed with NPC were included in this study. The status of depression and anxiety during their hospital stay were evaluated using the self-rating depression scale (SDS) and the self-rating anxiety scale (SAS). Data including sex, age, education, history of smoking, course of disease, sleeping quality and oral pain were also collected and their relationships with depression and anxiety were analyzed as well. Results They had significantly higher mean SAS score (36.41 ± 7.41) and SDS score (48.42 ± 7.19), as compared with the healthy population. Single factor analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on the scores of SAS and SDS. Multivariate logistics regression analysis indicated that age, education, history of smoking, course of disease, sleeping quality, and oral pain had significant impact on their anxiety and depression. Conclusions Depression and anxiety are common psychological problems in NPC patients. Patients at the middle to elderly age and with low education, history of smoking, bad sleeping quality and oral pain are more susceptible to depression and anxiety.

Impacts of electroacupuncture combined with ultraviolet therapy on cytokines of herpes zoster at the acute stage in patients / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect of electroacupuncture (EA) combined with ultraviolet therapy on herpes zoster at the acute stage and the impacts on serum interleukin 2 (IL-2), interleukin 6 (IL-6) and interleukin 10 (IL-10) in the patients.</p><p><b>METHODS</b>Thirty-four patients of herpes zoster were randomized into a medicine group and a combined therapy group, 17 cases in each one. In the medicine group, the intravenous drops with acyclovir injection, muscular injection with cobamamide and the topical with acyclovir ointment were applied. Additionally, TDP was radiated locally. In the combined therapy group, on the basis of the treatment as the medicine group, EA and ultraviolet therapy were supplemented. The duration of treatment was 10 days in the two groups. Before and after treatment, blister relief, incrustation time and the visible analogue scale (VAS) were recorded in the two groups. The clinical efficacy was assessed in the two groups and the levels of serum IL-2, IL-6 and IL-10 were determined in the two groups.</p><p><b>RESULTS</b>In the combined therapy group, the time of blister relief and incrustation was earlier apparently than that in the medicine group (both P<0.05). VAS score after treatment were reduced as compared with that before treatment in the two groups (both P<0.01), and the reducing amplitude in the combined therapy group was larger than that in the medicine group (P<0.01). The total effective rate was 94. 1% (16/17) in the combined therapy group, higher than 76.4% (13/17) in the medicine group (P<0.05). After treatment, IL-2 levels were increased as compared with those before treatment in the two groups (both P<0.05), the levels of IL-6 and IL-10 were reduced obviously as compared with those before treatment in the two groups (all P<0.01). After treatment, the levels of IL-6, IL-10 were reduced much more apparently in the combined therapy group as compared with those in the medicine group (both P<0.05).</p><p><b>CONCLUSION</b>EA combined with ultraviolet irradiation more rapidly and effectively relief the symptoms of herpes zoster, significantly relief pain, shorten the duration of sickness, improve the body immunity and reduce nerve injury.</p>

The effect of drug dependence severity on the relationship between impulsivity construct and cue-elicited craving / 中华行为医学与脑科学杂志

Objective To investigate the effect of drug dependence severity on the relationship between impulsivity and craving.Methods 36 abstiuent drug-dependent individuals were recruited in the study.The participants were divided into the heavy depeudence group (HDG) or the low dependence group (LDG) according to the scores of Addiction Severity Index (ASI).The Barratt Impulsiveness Scale (BIS-11) and classical Stroop task were used to measure the trait impulsivity and state impulsivity.Block designed cue-induced craving paradigm was presented to measure cue-elicited craving.Results For the HDG,a significant positive correlation was found between trait impulsivity (the mean value of BIS-11-CI scale was (39.03± 16.50)) or state impulsivity (the difference of reaction time between congruent and incongruent situation was (87.77±36.95)ms)and cue-elicited craving (0.83± 1.91)(r=0.487,0.500,P＜0.05).However,for the LDG subjects,the impulsivity was not found significantly correlated with the cue-elicited craving(r=-0.261,0.081,P＞0.05).Conclusion The addiction severity influences the relationship between impulsivity and craving,and impulsivity can only be used as a predictor of relapse in HDG.The findings suggest that the drug may influence the shared brain mechanism between impulsivity and craving.

Research progress of percutaneous renal sympathetic radiofrequency ablation treating hypertension / 心血管康复医学杂志

Hypertension is a main risk factor for cardio-,cerebrovascular and renal diseases.Catheter-based renal sympathetic ablation provides a neW therapeutic method for hypertension, it shoWs effective antihypertensive and sympathetic denervation effects,and obtains additional benefits While treating hypertension.

Efficacy of rectally administered indomethacin for the prevention of post ERCP pancreatitis / 中华胰腺病杂志

Objectives To evaluate the efficacy of rectally administered indomethacin for the prevention of post-ERCP pancreatitis(PEP).Methods All eligible patients without high risk factors such as heart,lung,liver and kidney,coagulation dysfunction,without malignant disease and contraindication for NSAIDs,and pre-operative imaging study and lab test suggesting no pancreatitis,aged from 18 ～ 75 who underwent ERCP and EST were enrolled.In a randomized prospective trial,patients were randomized to receive a suppository containing indomethacin,100 mg,or an identical placebo 30 minutes after ERCP.PEP was diagnosed when there was pancreatitis related clinical symptoms,and serum amylase was higher than 3 times of the normal values,and when the patient needed more than 1 day hospitalization.Patients with PEP were evaluated with APACHE Ⅱ score 72 hours after ERCP.Results During 2004 ～ 2010,a total of 348 patients were enrolled,of which 182 received indomethacin and 166 received placebo.Six patients developed pancreatitis in the indomethacin group and 14 in the placebo group (3.3％ vs.8.4％,P ＜0.05),and the difference between the two group was statistically significant ( P ＜ 0.05 ).In those patients with PEP,the APACHE Ⅱ scores in indomethacin group (4.3 ± 1.3 ) were lower than that in the placebo group (7.4 ±1.7),and the difference between the two groups was statistically significant ( P ＜ 0.05 ).The incidence of hyperamylasemia in both groups was not statistically significant (9.3％ vs.10.8％,P ＞ 0.05 ).Conclusions This trial shows that rectally administered indomethacin after ERCP and EST can effectively reduce the incidence and severity of PEP.