ABSTRACT
Primary liver cancer is a common digestive system malignant tumor. Positron emission tomography and computed tomography (PET/CT) is a new molecular imaging technique which can reflect the metabolic status of tumors and provide more biological information about tumors. Radiomics is used to extract and analyze quantitative features that can describe tumor features in medical images with a high throughput. This article reviews PET/CT radiomics and its application in the diagnosis and prognosis assessment of hepatocellular carcinoma.
ABSTRACT
Objective:The aim of this study was to analyze the relationship between the changes of pre- and post-operation PET/CT metabolic parameters and prognosis for liver cancer patients.Methods:A retrospective study was carried out among 92 patients with liver cancer who received liver transplantation and PET/CT examination in our hospital from October 2013 to May 2017.According to Deauville criteria, the lesions were classified into PET negative, weak positive, and strong positive. The metabolic parameters including SUV max, SUL, MTV, TMR, TLR, TLG, UVP of normal liver parenchyma, liver cancer lesions and mediastinum were measured or calculated. The relationship between metabolic parameters and recurrence was analyzed. The relationship of Deauville score and metabolic parameters and the changing characters of metabolic parameters between the PET/CT of pre and post transplantation were analyzed. Results:Thirty cases did not relapse after LT, among which 16, 7 and 7 cases had Deauville score of 3, 4 and 5 respectively in pre-operation PET/CT. The recurrence time of 62 patients in recurrence group was (10.90±10.30) months. MTV, TLG, UVP-M, UVP-LB in recurrence group were significant higher( P<0.05). Patients with low metabolic parameters show better prognosis than patients with high metabolic parameters. Metabolic parameters of 5 score group were higher than that of 4score. The metabolic parameters of recurrence group were higher than those in non-recurrence group. MTV, TLG, UVP-M, UVP-LB in post-operation PET/CT were lower than those in pre-operation PET/CT, however, SUV max, TMR, TLR, SUL had no significantly difference. Conclusions:PET/CT metabolic burden parameters should be evaluated before LT to select patients with better prognosis. For liver transplantation patients with high metabolic parameters, PET/CT examination should be performed early after surgery to improve the detection of recurrence and metastasis, and relevant treatment should be timely conducted.
ABSTRACT
Purpose@#The aim of this study was to develop a scale to measure nursing students' competence in managing violence from patients and relatives in the hospital where nursing students perform clinical practicum. @*Methods@#Literature review and Delphi expert consultation were utilized to develop the content of the management of workplace violence competence scale (MWVCS). A convenience sample of 797 nursing students responded to the questionnaire. Exploratory factor analysis of the scale was performed. Internal consistency and test–retest reliability were examined. @*Results@#The MWVCS consisted of 40 items with a five-point scale. Seven factors explained 63.2% of the total explained variance. The content validity index for the scale was .99. Cronbach's α of the scale was .96, and test–retest correlations were found to be ≥ .76. @*Conclusion@#The MWVCS is a reliable and valid scale for nursing educators to assess the level of students' competence in violence management and to evaluate the effectiveness of education to enhance their ability to manage workplace violence.
ABSTRACT
Purpose@#The aim of this study was to develop a scale to measure nursing students' competence in managing violence from patients and relatives in the hospital where nursing students perform clinical practicum. @*Methods@#Literature review and Delphi expert consultation were utilized to develop the content of the management of workplace violence competence scale (MWVCS). A convenience sample of 797 nursing students responded to the questionnaire. Exploratory factor analysis of the scale was performed. Internal consistency and test–retest reliability were examined. @*Results@#The MWVCS consisted of 40 items with a five-point scale. Seven factors explained 63.2% of the total explained variance. The content validity index for the scale was .99. Cronbach's α of the scale was .96, and test–retest correlations were found to be ≥ .76. @*Conclusion@#The MWVCS is a reliable and valid scale for nursing educators to assess the level of students' competence in violence management and to evaluate the effectiveness of education to enhance their ability to manage workplace violence.
ABSTRACT
Objective To explore the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT in assessing antineutrophil cytoplasmic antibody-associated vasculitis (AAV).Methods Fifteen patients (7 males,8 females,age (66±11) years) with AAV between January 2015 and June 2017 were retrospectively analyzed.There were 6 patients diagnosed as granulomatosis with polyangiitis (GPA),7 diagnosed as microscopic polyangiitis (MPA) and 2 diagnosed as eosinophilic granulomatosis with polyangiitis (EGPA).All patients underwent 18 F-FDG PET/CT and the image features were observed and analyzed.The maximum standardized uptake value (SUVmax) of the positive lesion was measured.The relationship between the SUVmax and C reactive protein (CRP) was analyzed with Pearson correlation.The SUVmax and the number of lesion sites were compared by two-sample t test between the CRP-elevated and CRP-normal patients.Results A total of 56 lesions in the 14 of 15 AAV patients were detected by PET/CT.The positive findings distributed in 15 tissues and organs,including the nasopharynxes (n =9),lungs (n =9),kidneys (n =8),spleen (n =6),lymph nodes (n =6),bone marrow (n =4),skin (n =3),prostate (n =2),aortas (n =2),vertebral soft tissues (n =2),orbita (n =1),parotid gland (n =1),thyroid gland (n =1),liver (n =1) and pancreas (n=1).The 60.7％ (34/56) of lesions were clinically unsuspected occult lesions.GPA lesions mainly invaded the nasopharynxes,lungs and kidneys;MPA lesions mainly invaded the kidneys and spleen;EGPA lesions mainly invaded the nasopharynxes,lymph nodes and bone marrow.There was no significant correlation between the level of CRP and the SUVmax of AAV lesions (r=0.462,P＞0.05).No differences in the SUVmax were observed between patients with elevated CRP levels and those with normal CRP levels (t=1.451,P＞0.05).But more lesion sites were observed in patients with elevated CRP (t=3.456,P＜0.05).Conclusions 18F-FDG PET/CT shows positive findings in multiple sites in AAV patients,including clinically unsuspected sites.This imaging technique may be a useful tool for diagnosis and evaluation of AAV.
ABSTRACT
Objective To investigate the value of 99Tcm-diethylene triamine pentoacetic acid (DTPA) renal dynamic imaging for detecting renal function before liver transplantation and predicting early acute kidney injury (AKI) postoperation.Methods A total of 40 patients (29 males,11 females,average age (45± 8) years) with end-stage liver diseases who underwent orthotopic liver transplantation from June 2015 to June 2016 were selected in this retrospective study.All patients underwent 99Tcm-DTPA renal dynamic imaging within one week before liver transplantation,the general glomerular filtration rate (GFR) and normalized GFR (NGFR) were calculated.The serum creatinine (SCr) and blood urea were detected during the perioperative period.Patients were divided into AKI group (n =15) and non-AKI group (n =25) according to whether the patients suffered from AKI 3 d after liver transplantation.The general GFR,NGFR,SCr and blood urea between two groups were compared using two-sample t test.The sensitivities and specificities of general GFR and NGFR for predicting AKI were evaluated by receiver operating characteristic (ROC) curve.Correlations between general GFR,NGFR and SCr,blood area before liver transplantation were investigated by Pearson correlation analysis.Results The general GFR,NGFR before operation in AKI group were significantly lower than those in non-AKI group:(58.6±7.7) ml/min vs (77.3±12.3) ml/min,(57.7±7.5) ml· min-1· 1.73 m-2 vs (76.8±12.6) ml · min-1 · 1.73 m-2(t values:-5.924,-5.981,both P＜0.05).The SCr,blood urea before operation in the 2 group were not significantly different:(93.5±13.0) μmol/L vs (85.8±15.7) μmol/L,(8.9±4.0) mmol/L vs (7.0±3.0) mmoL/L (t values:1.604,1.733,both P＞0.05).The area under curve (AUC) of general GFR and NGFR was 0.947 and 0.944,respectively.The early AKI was predicted by general GFR and NGFR under the cut-off＜60 ml/min and ＜60 ml · min-1 · 1.73 m-2 with sensitivities of 9/15,10/15 and specificities both of 96.0％ (24/25).There were negative correlations between the general GFR and SCr,general GFR and blood urea,NGFR and SCr,NGFR and blood urea (r values:-0.555,-0.391,-0.562,-0.390,all P＜0.05).Conclusions 99Tcm-DTPA renal dynamic imaging is helpful for the early detection of potential injury of the renal function.Both general GFR and NGFR could be the accurate indicators for predicting early AKI following orthotopic liver transplantation.
ABSTRACT
Objective To observe the effect of Jianpi Buxue Decoction on the protein expression of neurokinin 1 receptor (NK1R) and CD34 in C57BL/6 mice of lung cancer after chemotherapy, and to explore the improvement of chemotherapy-induced nausea and vomiting and myelosuppression treated with Jianpi Buxue Decoction. Methods Forty C57BL/6 mice were transplanted with Lewis lung cancer cells in the armpit of left anterior limb after being fed for 7 days, and then were randomly divided into lung cancer group, model group, and high-, middle- and low-dose Chinese medicine groups. Model group and Chinese medicine groups were injected intraperitoneally with cyclophosphamide (80 mg/kg) for one day. Lung cancer group and model group were given normal saline. Chinese medicine groups were administered with high-, middle- and low-dose of Jianpi Buxue Decoction (25, 12.6, 6.25 g/kg respectively) for 14 days. After the modeling, all of the mice were sacrificed, and then the brains and spleens were sampled. Western blotting method was used to detect the protein expression of NK1R and CD34. Results Compared with lung cancer group, the protein expression of cerebral NK1R and splenic CD34 in the model group was increased significantly ( P<0.01) . Compared with the model group, the protein expression of NK1R in mice brain tissues of high-, middle- and low- dose Jianpi Buxue Decoction groups was decreased significantly (P<0.01) , while the protein expression of CD34 in spleen tissues of middle-and low-dose Jiangpi Buxue Decoction groups was increased obviously ( P<0.05) . Conclusion Jianpi Buxue Decoction has an effect on down-regulating the protein expression of NK1R in brain tissues and on up-regulating the protein expression of CD34 in spleen tissues of C57BL/6 mice with lung cancer after chemotherapy, indicating that Jianpi Buxue Decoction probably can relieve chemotherapy-induced nausea and vomiting, and can improve the myelosuppression after chemotherapy.
ABSTRACT
BACKGROUND: The in vitro amplification is a primary method for harvesting endothelial progenitor cells (EPCs) due to its simple operation and low cost.OBJECTIVE: To isolate EPCs from rabbit bone marrow to further observe the effects of autologous EPCs on promoting vascular endothelial repair.DESIGN, TIME AND SETTING: An open experiment was performed at the laboratory of Department of Internal Medicine, Changzheng Hospital, Second Military Medical University of Chinese PLA between March 2005 and February 2006. MATERIALS: Eight New Zealand rabbits of either gender, aged 6-8 months, weighing (2.5:L-0.5) kg, were included in this study. Rabbit bone marrow was taken for isolation of bone marrow mononuclear cells by density centrifugation. METHODS: Bone marrow-derived mononuclear cells were inoculated at 1×106/cm2 and cultured for 7 days in M199 medium containing vascular endothelial growth factors and basic fibroblast growth factors. EPCs were identified by Dil-labeled acetylated low-density lipoprotein (Dil- Ac-LDL) and FITC-labeled lectin BS-1 staining. Cells that phagocytized Ac-LDL displayed red fluorescence, cells that combined with lectin BS-1 showed green fluorescence, and cells that were labeled with both exhibited orange fluorescence. Expression levels of CD133, CD134, and Flk-lwere detected using immunofluorescent staining and through the use of flow cytometer.MAIN OUTCOME MEASURES: ① Cellular morphology observation. ② Proliferative capacity of EPCs.③EPCs identified by Dil- Ac-LDL and FITC-labeled lectin BS-1. ④ lmmanohistocbemical identification of EPCs. ⑤Flow cytometry identification of EPC surface marker.RESULTS: ① Cellular morphological observation: the newly isolated bone marrow-derived mononuclear cells exhibited a round appearance. Following 72-hour culture, adherent cells grew in colony cluster, presenting with round or irregular appearance, and nuclear division was obvious. By day 7, flaky cell colonies mutually connected together, presenting with shuttle-shaped endothelioid cells.② Proliferative capability of EPCs: in the 2-4 days of culture, EPCs proliferated fast, and the proliferation slowed down thereafter, exhibiting a typical "S" -shaped appearance. By days 6 and 7, EPC proliferation accelerated again, with the absorbance values of 0.58±0.15 and 0.62±0.23, respectively. ③ Over 95% of EPC cytoplasm exhibited red fluorescence after stained with Ac-LDL, appropriately 100% of cytoplasm exhibited green fluorescence after stained with FITC-labeled lectin BS-1, and over 90% of cytoplasm exhibited orange fluorescence after double staining. ④ Immonohistochemistry and flow cytometry results revealed positive expression of EPC surface markers CD133, FIK-1, and CD34.CONCLUSION: Cell population with EPC characteristics can be successfully isolated from rabbit bone marrow by in vitro amplification.