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Objective:To explore values and differences of multi-modality image registration and normalization methods in 18F-AV45 PET quantitative analysis of Alzheimer′s disease (AD). Methods:Twenty AD patients (10 males, 10 females; age (77.0±5.8) years) and 20 normal controls (NC; 8 males, 12 females; age (75.2±4.8) years) from the AD neuroimaging initiative (ADNI) open database of the National Institute on Aging were analyzed. β-amyloid (Aβ) deposition (positive/negative) was assessed by visual analysis. The SUV ratio (SUVr) in each brain region and individual average SUVr were calculated using template normalization method (M1), normalization after registration with 18F-FDG PET or MRI image (M2 or M3) respectively with the cerebellum as the reference area. The intra-class correlation coefficient (ICC) was used to complete the reliability between methods, and independent-sample t test and one-way repeated measures analysis of variance were used to compare the differences of quantitative indexes between different groups and different methods. ROC curve analysis was used to compare the diagnostic efficacy in distinguishing AD and NC, Aβ positive and negative cases. Results:There were 15 and 6 patients with positive Aβ deposition in AD group and in NC group respectively by visual analysis. The SUVrs of three methods were with good consistency (ICC=0.82, P<0.001), and the differences among individual average SUVrs (1.29±0.17, 1.36±0.23, 1.45±0.24) were significant ( F=68.78, P<0.001). There were significant differences between AD group (1.39±0.17, 1.48±0.24, 1.58±0.25) and NC group (1.20±0.10, 1.24±0.15, 1.33±0.16; t values: 3.55-4.33, all P<0.05), Aβ positive group (1.39±0.16, 1.50±0.21, 1.59±0.23) and negative group (1.19±0.11, 1.21±0.14, 1.31±0.15; t values: 4.58, 5.11, 4.41, all P<0.001), and the individual average SUVr of M3 was higher (both P<0.001). The AUCs of distinguishing Aβ positive and negative deposition of M1-M3 were 0.86, 0.88, 0.84 and the thresholds of SUVrs were 1.29, 1.37, 1.52, respectively. Conclusion:The three multi-modality registration and normalization methods are reliable methods for quantitation of 18F-AV45 PET imaging with certain differences, and should be selected carefully based on data conditions in practice.
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Objective:To explore the automatic synthesis method of 18F-AlF-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-octreotide and the imaging in neuroendocrine tumor (NET). Methods:Using the Trasis AllinOne synthesis module, 18F-AlF-NOTA-octreotide was automatically synthesized by chelating 18F-AlF and NOTA-octreotide at 100 ℃, and the quality of the product was analyzed. 18F-AlF-NOTA-octreotide and 18F-FDG PET/CT imaging were performed and compared in one patient with NET (male, 35 years old). Results:The total synthesis time of 18F-AlF-NOTA-octreotide was 35 min with a radiochemical yield of (55.8±1.8%)% (non-decay corrected, n=6), radiochemical purity more than 95% and good stability. The sterility and pyrogen-free of the product met the requirements. Compared with 18F-FDG (the lesion SUV max=3.8, target-to-background (T/B) ratio=1.03), 18F-AlF-NOTA-octreotide could be clearly imaged in the patient with NET with SUV max of 21.7 and T/B ratio of 4.09. Conclusions:The preparation of 18F-AlF-NOTA-octreotide with Trasis Allinone synthesis module is simple, rapid and stable. The product has high radiochemical purity and can meet the needs of clinical application. In vivo18F-ALF-NOTA-octreotide PET/CT imaging in the patient with NET shows higher T/B ratio, which has obvious advantages compared with 18F-FDG.
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Objective:To investigate the diagnostic value of conventional endoscopy (CE) and endoscopic ultrasonography (EUS) for invasion depth prediction of superficial gastric cancer.Methods:A total of 84 patients with superficial gastric cancer underwent both CE and EUS before treatment at Beijing Shijitan Hospital from January 2011 to December 2019. The patients were divided into CE affirmation group (47 cases) and CE non-affirmation group (37 cases) according to the endoscopist′s affirmation in the results of CE. Diagnostic accuracy of each method was compared with the histology of the resected specimen. And influential factors for the diagnosis were analyzed.Results:The overall accuracy in determining the invasion depth of superficial gastric cancer was 73.8% (62/84) for CE and 81.0% (68/84) for EUS respectively ( P=0.092). In CE affirmation group, the diagnostic accuracy of CE was significantly higher than that in the CE non-affirmation group [93.6% (44/47) VS 48.7% (18/37), χ2=21.656, P<0.001]. Twenty (23.8%) of 84 lesions were over-staged by CE, dignosed as surgical candidates, and 8 (40.0%) of the over-staged diagnosis were modified by additional EUS assessment. Multivariate logistic analysis showed that influential factors associated with observer affirmation included uneven surface of lesion ( OR=5.076, 95% CI: 1.628-15.821, P=0.005), margin elevation ( OR=3.831, 95% CI: 1.238-11.857, P=0.020) and undifferentiated carcinoma ( OR=6.887, 95% CI: 1.882-25.204, P=0.004). Conclusion:For patients of CE affirmation in the invasion depth, the diagnostic accuracy is high. For those of non-affirmation, additional EUS can improve the diagnostic accuracy and help to develop a more appropriate regime.
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Objective:To investigate the current situation of children′s awareness of disaster prevention and self-rescue ability in Mianyang area, provide reference for the development of scientific training programs on children′s disaster knowledge, and improve children′s survival ability during the disaster occurence.Methods:Through literature review and expert consultation, the questionnaire was designed by ourselves.Multi-stage sampling method was used to investigate 2 162 cases from county (city) high school, junior high school and primary school in Mianyang area.Results:8.3% of children had weak disaster awareness.Children had a good understanding of disaster related knowledge, with the highest alarm call awareness rate of 91.8%, fire, flood, earthquake escape and earthquake warning score of 86.5%, 84.2%, 84.2%, 83.0%.Cardiopulmonary resuscitation and fire hydrant operation awareness rate was very low (58.8%, 57.4%). Even some children still chose improper escape behavior.The scores of early warning knowledge and first aid skill were correlated with gender and age.In knowledge of disaster precursors, using of fire extinguishers and hydrants, and first aid skills, the scores of boys were significantly higher than those of girls ( P<0.001). Except for fire-related knowledge, gas leakage escape and shelter awareness rate, the older the children were, the higher the scores were ( P<0.05). The scores of early warning, escape knowledge and first aid skills were correlated with the location of home, and the differences were significant ( P>0.001). More than 80.0% of children chose flashlights, food and water, and emergency kits, while 65.0% to 75.0% children thought it was not necessary to prepare a radio, telephone directory, and cash. Conclusion:Children′s awareness of disaster reduction and self-rescue ability are generally good, but there are still insufficient first-aid skills and improper choice of escape behavior.The education of disaster awareness and self-rescue ability should be strengthened in children′s basic education so as to reduce the casualties of children caused by disasters.
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Objective@#To establish patient derived xenograft (PDX) model of malignant peritoneal mesothelioma (MPM), and to identify the key characteristics of tumor biology of the model, so as to provide an experiment platform for studying the pathologic mechanisms and new therapeutic strategies for MPM.@*Methods@#Surgically excised MPM tumor tissues were inoculated subcutaneously in BALB/c-nu/nu mice for 3 stable passages. In the 4th passage, the subcutaneous tumors were harvested under aseptic conditions, cleaned and made into MPM tumor cell homogenate. Four nude mice (two males and two females) were selected and one male and one female nude mouse were inoculated in the abdominal cavity at the dose of 100 μL, others were inoculated at a dose of 200 μL. The PDX model of MPM was established. The changes of body mass in nude mice were measured regularly, the extent of abdominal and pelvic tumors was judged by experimental peritoneal cancer index (ePCI) score, and the pathologic characteristics of tumors were analyzed.@*Results@#The subcutaneous and abdominal animal models of MPM were successfully established. The subcutaneous tumor model grew into tumor on the 20th day, followed by a slow growth stage between the 20th and 29th day, then a rapid growth stage between the 30th and 57th day. According to the dose of tumor cells (100, 200 μL) and timing (14th and 69th days after grafting), the abdominal tumor model successfully simulated the early and late clinical stages of MPM. The HE staining results of the MPM nude mice model showed that the tumor was epithelial mesothelioma and invaded most of the organs, including liver, spleen, pancreas, mesentery. Immunohistochemical staining for calretinin, cytokeratin 5/6, WT1 and Ki-67 were positive. Whole-genome exon sequencing identified 26 and 36 high frequency gene mutations in tumors derived from the PDX model and clinical sample from patients, including 21 common gene mutations.@*Conclusions@#The PDX model of MPM is established. The model is characterized by highly malignant tumor with rapid growth and high invasiveness.
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Objective To evaluate the clinical value of 18F-FDG PET/CT for detecting tumor on physical examination people with unexplained elevated serum carcinoembryonic antigen (CEA). Methods A total of 100 physical examination people with unexplained elevated serum levels of CEA in our hospital from June 2010 to December 2014 were involved in the study. All the people were detected with 18F-FDG PET/CT. The pathology, clinical follow ups and conventional medical imaging results were combined to evaluate the value of 18F-FDG PET/CT in diagnosing tumor. The doubling time (DT) of CEA was calculated in the patients who were received more than twice of serum CEA detection. The relationships between serum CEA levels, CEA DT and 18F-FDG PET/CT imaging were analyzed. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of serum CEA. Results Twenty-seven patients were confirmed with malignant tumor, and the rest of 73 cases were excluded. The 18F-FDG PET/CT reported one false positive and one false negative respectively. The sensitivity, specificity, accuracy, positive and negative predictive values of 18F-FDG PET/CT in diagnosing malignant tumors were 96.3%, 98.6%, 98.0%, 96.3% and 98.6% respectively. The median serum CEA levels were significantly higher in the positive 18F-FDG PET/CT patients than those in the negative patients (Z=5.796, P180 d and DT180 d and patients with DT0.05). The area under the curve (AUC) of serum CEA was 0.894, the optimal diagnostic cutoff value was 14.24μg/L. Conclusion 18F-FDG PET/CT is a useful image modality for detecting malignant tumors in patients with unexplained elevated serum CEA, especially for patients with CEA≥14.24μg/L and increase progressively.
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Objective To evaluate the clinical efficacy of cefotaxime combined with gamma globulin on neonatal septicemia. Methods The subjects of this study were selected from 88 cases of neonatal septicemia admitted in Jiangyou No.903 hospital from April 2014 to April 2017. They were randomly divided into two groups, each with 44 cases. The control group was given symptomatic treatment and cefotaxime, while the observation group symptomatic treatment, cefotaxime and gamma globulin as well. After 7days of treatment, the overall effective rates, case fatality rates, clinical symptoms (body temperature, resistance to milk, neurological symptoms), time for improvement and hospital stay were compared between the two groups. Results The overall effective rate of the observation group was 95.45％, much higher than 72.73％ of the control group (P<0.01). The observation group had much lower case fatality rate than the control group did (2.27％ vs 18.19％) (P<0.05). The time the observation group took for improvement in the condition of body temperature, resistance to milk, neurological symptoms, and hospital stay was (3.25±1.07) days, (4.93±1.96) days, (5.92±1.58) days, and (6.80±1.94) days respectively, all significantly shorter than the time the control group took (P<0.01). Conclusion The combination of cefotaxime and gamma globulin is effective in the treatment of neonatal septicemia. It can significantly reduce case fatality rate and shorten the time for clinical symptoms and hospital stay.
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Metastasis is the leading cause of death in breast cancer patients. However, the mechanisms underlying metastasis are not well understood and there is no effective treatment in the clinic. Here, we demonstrate that in MMTV-PyMT, a highly malignant spontaneous breast tumor model, IL-25 (also called IL-17E) was expressed by tumor-infiltrating CD4 T cells and macrophages. An IL-25 neutralization antibody, while not affecting primary tumor growth, substantially reduced lung metastasis. Inhibition of IL-25 resulted in decreased type 2 T cells and macrophages in the primary tumor microenvironments, both reported to enhance breast tumor invasion and subsequent metastasis to the lung. Taken together, our data suggest IL-25 blockade as a novel treatment for metastatic breast tumor.