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Objective:To assess the diagnostic value of ATP stress myocardial perfusion imaging(MPI) in detecting coronary heart disease (CAD) with quantitative coronary angiography (QCA) as the gold standard.Methods:A total of 95 consecutive patients (65 males, 30 females, age (56.2±8.5) years) who underwent ATP stress/rest MPI and coronary angiography (CAG) within one month in Fuwai Hospital, Chinese Academy of Medical Sciences from May 2018 to December 2018 were enrolled prospectively. The adverse reactions of ATP stress test were observed. Semi-quantitative analysis was performed on MPI results, and the summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) were obtained. Quantitative analysis was performed on CAG images, and the degree of QCA coronary artery stenosis was analyzed. Using QCA as the gold standard, the diagnostic efficiency of ATP stress MPI was calculated. Pearson correlation analysis was performed to analyzed the relationship between SSS and the degree of QCA coronary artery stenosis.Results:In 95 cases, the incidence of adverse reactions in ATP stress test was 73.7%(70/95), which could be relieved automatically after drug withdrawal. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ATP stress MPI in diagnosing coronary artery stenosis ≥50% were 45.3%(24/53), 81.0%(34/42), 75.0%(24/32), 54.0%(34/63) and 61.1%(58/95) respectively, which were 15/16, 78.5%(62/79), 46.9%(15/32), 98.4%(62/63), and 81.1%(77/95) respectively in diagnosing coronary artery stenosis ≥70%. There was moderate correlation between SSS and the degree of QCA coronary artery stenosis ( r=0.418, P=0.017). Conclusion:ATP stress MPI has a clinical value in the diagnosis of myocardial ischemia in CAD.
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@#In this study, different functional layer formulations and process parameters were used to prepare the levomilnacipran hydrochloride sustained-release capsules, the influence of functional layer formulation and process factors on dose dumping was studied by comparing their release curves in 40% ethanol; and the risk of dose dumping of the self-developed drug was evaluated by the similar factors of the release curve of the self-developed drug and the reference drug.The results showed that as the coating weight increased, the degree of dose dumping decreased; when the concentration of ethanol in the coating liquid solvent was less than 80%, the dose dumping increased; as the atomization pressure and maturation time increase, the dose dumping became more serious. In 0% ethanol (purified water), 5% ethanol, 20% ethanol and 40% ethanol media, the self-developed and reference preparations had the same degree of dose dumping within the specified time, and rotation speed had no significant effect on the release of metformin in vitro. In summary, formulation factors such as coating weight gain, ethanol concentration in the coating solution solvent, and process factors such as atomization pressure and curing time have a serious impact on the dose dumping of sustained-release capsules.Under the optimal functional layer formulation and process, special attention should be paid to the control of risk of self-developed dose dumping.
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Objective:To investigate differences in cardiac function and perfusion parameters measured by IQ-SPECT and low energy high-resolution (LEHR)-SPECT, as well as effects of scattering correction (SC) and CT attenuation correction (AC) on myocardial perfusion imaging.Methods:From May 2020 to September 2020, 80 patients (58 males, 22 females, age (57±10) years) who underwent SPECT myocardial perfusion imaging were retrospectively enrolled in Fuwai Hospital. According to the standardized left ventricular end-diastolic diameter of body surface measured by two-dimensional echocardiography, patients were divided into 2 groups: A group ( n=34) with significantly enlarged left ventricle and B group ( n=46) with no significant enlargement of left ventricle. LEHR-SPECT and IQ-SPECT gated myocardial perfusion imaging were performed in all patients. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), summed rest score (SRS) and total perfusion defect (TPD) were measured. Parameters measured by two methods and differences before and after SC and AC were compared by using paired t test and Wilcoxon signed rank test. The correlation was analyzed by Pearson correlation or Spearman rank correlation analyses, and the consistency was analyzed by Bland-Altman analysis. Results:In A group, EDV, EF and SRS measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC (EDV: (257±137) vs (276±154) ml, EF: (21±11)% vs (26±13)%, SRS: 17(6, 25) vs 18(8, 28); t values: -2.63, -7.46, z=-2.14, all P<0.05); all parameters measured by LEHR-SPECT and IQ-SPECT had well correlation ( r values: 0.965, 0.969, 0.967, rs values: 0.920, 0.960, all P<0.001) and consistency. In B group, EDV and EF measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC (EDV: (96±40) vs (107±39) ml, EF: (46±15)% vs (54±16)%; t values: -6.23, -10.71, both P=0.001); SRS and TPD measured by IQ-SPECT after SC and AC were significantly lower than non-SC and non-AC (SRS: 2(1, 4) vs 5(3, 11), TPD: (3%(1%, 5%) vs 7%(3%, 12%); z values: -4.11, -4.16, both P<0.001); all parameters measured by LEHR-SPECT and IQ-SPECT had well correlation ( r values: 0.956, 0.978, 0.958, rs values: 0.926, 0.944, all P<0.001) and consistency. Conclusions:There are good correlation and consistency of left ventricular function and myocardial perfusion parameters acquired by IQ-SPECT and LEHR-SPECT. Moreover, IQ-SPECT is able to shorten acquisition time, resulting in great potential in clinical application.
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Objective:To investigate the value of 18F-fluorodeoxyglucose (FDG) PET imaging in evaluating the 18F-FDG influx rate of lungs and its relationship with parameters of pulmonary hemodynamics in patients with pulmonary arterial hypertension related to congenital heart disease (PAH-CHD). Methods:From January 2018 to June 2019, a total of 16 PAH-CHD patients (6 males, 10 females, age (29.2±10.6) years) and 22 health controls who received physical examinations (8 males, 14 females, age (45.4±3.8) years) in Fuwai Hospital were respectively enrolled. All cases underwent dynamic 18F-FDG PET imaging for whole lung 18F-FDG influx rate (presented as Ki). Right heart catheterization was performed to evaluate pulmonary hemodynamic parameters such as pulmonary vascular resistance (PVR), mean pulmonary vascular pressure (mPAP) in PAH-CHD patients after imaging within one week. Independent-sample t test was used to compare Ki of 2 groups, and Pearson correlation analysis was used to analyze the relationship between Ki and PVR, mPAP in PAH-CHD patients. Results:Ki of the lungs was significantly higher in PAH-CHD patients than that in controls ((0.000 6±0.000 3) vs (0.000 4±0.000 3) ml·g -1·min -1; t=2.15, P=0.038). Ki was not correlated with PVR ((10.86±4.45) Wood units) or mPAP ((69.75±18.93) mmHg; 1 mmHg=0.133 kPa) in PAH-CHD patients ( r values: 0.202 and 0.006, both P>0.05). Conclusions:Pulmonary vascular remodeling can lead the increasing lung 18F-FDG uptake in patients with PAH-CHD. 18F-FDG PET may have the ability in monitoring and evaluating pulmonary vascular remodeling in PAH-CHD.
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Objective:To study the feasibility of cardiac 99Tc m-methoxyisobutylisonitrile (MIBI)/ 123I-metaiodobenzylguanidine (MIBG) dual-isotope imaging with cadmium-zinc-telluride (CZT) SPECT. Methods:Using a heart phantom, 99Tc m-MIBI single-isotope imaging and 99Tc m-MIBI/ 123I-MIBG dual-isotope imaging were acquired separately. Model A, B, C represented normal heart, 99Tc m/ 123I matched myocardium, 99Tc m/ 123I mismatched myocardium, respectively. Nineteen patients (9 males, 10 females; age (56±16) years) from September 2018 to June 2020 at Fuwai Hospital were enrolled to participate 99Tc m-MIBI myocardial perfusion imaging and myocardial perfusion/cardiac sympathetic imaging with 99Tc m-MIBI/ 123I-MIBG dual-isotope. Perfusion percent (PP%) and summed rest score (SRS) for all myocardial segments were obtained using quantitative perfusion SPECT (QPS) software by analyzing myocardial perfusion images. Difference and relationship between PP% and SRS were analyzed (Pearson and Spearman correlation analyses). No physical correction was applied for both acquisitions. Analysis of variance for repeated measurement data and Mann-Whitney U test were used. Results:There was no significant difference in myocardial perfusion images between 99Tc m single-isotope and 99Tc m/ 123I dual-isotope imaging with the heart phantom. 123I did not significantly impact on 99Tc m images. For patients, PP% did not differ between 99Tc m single-isotope ((69.2±14.5)%) and 99Tc m/ 123I dual-isotope imaging ((69.5±16.2)%; F=0.005, P=0.946) and correlated well ( r=0.845, P<0.01). SRS for 99Tc m single-isotope was 2(1, 13) and 2(2, 12) for 99Tc m/ 123I dual-isotope imaging ( z=-0.774, P=0.439) and the correlation between the two acquisitions was excellent ( rs=0.975, P<0.01). Conclusions:Even without physical correction, cardiac images interpretation won′t be significantly influenced by the interference of 123I with relatively higher energy on 99Tc m images. Cardiac 99Tc m-MIBI/ 123I-MIBG dual-isotope imaging is feasible.
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Objective:To analyze the relationships between baseline percentage of pulmonary perfusion defect scores (PPDs%) and residual pulmonary hypertension after pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH) patients.Methods:A total of 37 CTEPH patients (21 males, 16 females, age (50±12) years) who had pre- and post-pulmonary endarterectomy ventilation/perfusion (V/Q) scans from January 2016 to January 2019 at Fuwai Hospital were retrospectively collected. Residual pulmonary hypertension was defined as post-surgery mean pulmonary artery pressure (mPAP) higher than 30 mmHg (1 mmHg=0.133 kPa). Semi-quantitative index PPDs% was calculated to represent the extent of impaired perfusion in the whole lung. Pre- and post-surgery pulmonary hemodynamic parameters including pulmonary arterial pressure and resistance and lung perfusion were compared. Factors that may be related residual pulmonary hypertension were analyzed using logistic regression analysis. Paired t test and independent-sample t test were also used. Results:Pulmonary endarterectomy significantly decreased mPAP ((50.22±11.72) vs (26.41±10.61) mmHg; t=12.599, P<0.001) and pulmonary vascular resistance((10.06±5.48) vs (2.89±1.58) Wood unit; t=8.086, P<0.001). The number of defected lung segments (13.79±2.11 vs 5.52±2.82; t=11.593, P<0.001) was significantly reduced. Patients who had residual pulmonary hypertension ( n=11) exhibited significantly higher PPDs% before the surgery compared to those who were without residual pulmonary hypertension ( n=26; (57.48±5.88)% vs (47.77±11.09)%; t=-3.458, P=0.002). Baseline PPDs% was an independent factor for predicting residual pulmonary hypertension after pulmonary endarterectomy (odds ratio ( OR)=1.106, 95% CI: 1.006-1.216, P=0.036). Conclusions:Pulmonary V/Q scan can assess the therapeutic effects of pulmonary endarterectomy. Extent of impaired lung perfusion assessed by V/Q scan is the influencing factor for post-surgery residual pulmonary hypertension.
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Objective To compare difference in stability between two fixation modes in application of three-dimensional (3D) printed coronoid process prosthesis.Methods 3D coronoid process prosthesis was reconstructed from computed tomography (CT) scanning acquired from volunteers with normal bony architecture of elbow.The prosthesis fixation was simulated using screws with diameter of 2.0 mm and 2.5 mm separately.Finite element analysis (FEA) was conducted at elbow flexion with different angles and the parameters including the maximum equivalent stress and the maximum displacement were evaluated.Results Compared fixation using screw with the diameter of 2.0 mm and 2.5 mm,the maximum equivalent stress were 56.29 MPa and 39.96 MPa and the maximum displacement were 0.038 0 mm and 0.029 0 mm in 30° flexion of elbow;the maximum equivalent stress were 8.97 MPa and 8.12 MPa and the maximum displacement were 0.006 5 mm and 0.005 8 mm in 90° flexion of elbow;the maximum equivalent stress were 10.03 MPa and 9.32 MPa and the maximum displacement were 0.007 9 mm and 0.006 6 mm in 130° flexion of elbow.The maximum equivalent stress occurs at the junction of head and shaft with in both situations while the value from screw with diameter of 2.5 mm was lower.The displacement was smaller in the screw with diameter of 2.5 mm.Conclusion Compared to screws with the diameter of 2 mm,screw with the diameter of 2.5 mm shows superior stability in the fixation of 3D printed coronoid process prosthesis.
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ObjectiveTo investigate the characteristics of flora microbiota before and after transjugular intrahepatic portosystemic shunt (TIPS) in patients with liver cirrhosis. MethodsA total of 18 patients with liver cirrhosis who were hospitalized and underwent TIPS in Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, from July 2018 to July 2019 were enrolled. Fecal samples were collected from 18 patients before surgery, 6 fecal samples were collected at 1 month after surgery, and 9 were collected at 3 months after surgery. The results of liver function and coagulation were collected before and after surgery. Fecal samples were analyzed by the 16S rRNA high-throughput sequencing method, and the DADA2 method recommended by QIIME2 was used in the bioinformatics analysis. The intestinal flora was analyzed in terms of the generated amplified characteristic sequence, and the multiple hypothesis tests of LEfSe, SPSS (Alpha analysis), PERMANOVA (Beta analysis), and Pheatmap were used for analysis. For normally distributed continuous data, intergroup comparison of parameters at different time points was made by a repeated measures analysis of variance. For non-normally distributed continuous data, intergroup comparison of parameters at different time points was made using a generalized estimating equation, and further pairwise comparison was made using the Bonferroni method. ResultsThere were significant differences in total bilirubin and total bile acid between groups before TIPS and during the three periods of time after TIPS (F=8.201 and 39.482, P=0.001 and P＜0.001). At 1 month after surgery, Beta diversity changes were observed in fecal samples (F=2.603, P=002), while there was no significant difference in Alpha diversity of the fecal samples between the three periods of time (P＞0.05). At the genus level, portal venous pressure before TIPS was negatively correlated with Bifidobacterium, Collinsella, and Ruminococcus (r=-0.35, -0.38, and -0.34, P=0.04, 0.02, and 0.04) and was positively correlated with Boletus (r=0.41, P=0.015). Other indices were also correlated with different components of the intestinal flora (P＜0.05). ConclusionThere is a correlation between clinical indices and intestinal flora before TIPS. The composition of intestinal flora changes after TIPS, with a significant difference at the genus level.
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Objective@#To compare difference in stability between two fixation modes in application of three-dimensional (3D) printed coronoid process prosthesis.@*Methods@#3D coronoid process prosthesis was reconstructed from computed tomography (CT) scanning acquired from volunteers with normal bony architecture of elbow. The prosthesis fixation was simulated using screws with diameter of 2.0 mm and 2.5 mm separately. Finite element analysis (FEA) was conducted at elbow flexion with different angles and the parameters including the maximum equivalent stress and the maximum displacement were evaluated.@*Results@#Compared fixation using screw with the diameter of 2.0 mm and 2.5 mm, the maximum equivalent stress were 56.29 MPa and 39.96 MPa and the maximum displacement were 0.038 0 mm and 0.029 0 mm in 30° flexion of elbow; the maximum equivalent stress were 8.97 MPa and 8.12 MPa and the maximum displacement were 0.006 5 mm and 0.005 8 mm in 90° flexion of elbow; the maximum equivalent stress were 10.03 MPa and 9.32 MPa and the maximum displacement were 0.007 9 mm and 0.006 6 mm in 130° flexion of elbow. The maximum equivalent stress occurs at the junction of head and shaft with in both situations while the value from screw with diameter of 2.5 mm was lower. The displacement was smaller in the screw with diameter of 2.5 mm.@*Conclusion@#Compared to screws with the diameter of 2 mm, screw with the diameter of 2.5 mm shows superior stability in the fixation of 3D printed coronoid process prosthesis.
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Objective@#To investigate the epidemiological characteristics of norovirus outbreaks in Shenzhen during 2005 to 2017 in order to provide reference for disease control and prevention.@*Methods@#Monitoring data of norovirus outbreaks in Shenzhen from January 1, 2005 to December 31, 2017 were collected from Shenzhen Communicable Disease Information System and China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used for data analysis.@*Results@#From January 2005 to December 2017, 346 norovirus outbreaks (five or more cases in one community within one week) were reported in Shenzhen, of which 6.36% (22/346) were public health emergency events. Fewer outbreaks were reported during 2006 to 2013 and they were mainly caused by GⅡ.4 genotype, but the number increased sharply since 2014 with 57.80% (200/346) occurred in 2016—2017 and the epidemic genotype changed from GⅡ.4 to GⅡ.17 and GⅡ.2. The outbreaks peaked during November to March (76.88%, 266/346). There were 63.87% (221/346) reported in urban areas, 67.05% (232/346) in nurseries and 23.70% (82/346) in primary/middle schools. Among the 22 public health emergency events, 40.91% (10/22) were caused by person-to-person contacts, 40.91% (10/22) by foodborne transmission and 13.64% (3/22) by waterborne transmission. Moreover, 75.80% (238/314) of the outbreaks in nurseries and primary/middle schools were confined to one classroom and most were due to contact transmission.@*Conclusions@#Norovirus outbreaks increased obviously since 2014, which might be related to the changes of the predominant genotype from GⅡ.4 to GⅡ.17 and GⅡ.2. It is necessary to strengthen a comprehensive prevention and control in key units such as nurseries and primary/middle schools in winter and spring.
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Objective@#To investigate the genetic characteristics of VP1 genes carried by coxsackievirus A16 strains isolated from cases of hand foot and mouth disease (HFMD) in Shenzhen during 2016 to 2017.@*Methods@#Fecal and anal swab specimens were collected from patients with mild HFMD in four sentinel hospitals and the Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, China during 2016 to 2017. All specimens were tested for CVA16 viral RNA using real-time RT-PCR. The VP1 genes of 51 randomly selected CVA16 strains were amplified by RT-PCR and then sequenced using TaKaRa Biomedical Technology (Dalian). Bioinformatics software, including Mega6.02, BioEdit and DNAStar, was used for comparison and analysis of the VP1 genes.@*Results@#CVA16 strains in Shenzhen during 2016 to 2017 mainly belonged to B1a and B1b subtypes as well as an emerging subtype B3. The epidemic of B1b subtype was found in both 2016 (28 strains) and 2017 (19 strains), while the B1a subtype (two strains) was only detected in 2017. Two B3 subtype strains were detected in 2017. The strains of B1b subtype were closely related to the strains isolated in Shanghai (JQ314149), Wenzhou (KP289416) and Beijing (KU254598), while the B1a subtype strains were closely related to the strains isolated in Kunming (JQ316639) and Tailand (GQ184139). The B3 subtype strain was an emerging CVA16 epidemic strain in mainland China. Further comparison of the CVA16 epidemic strains in Shenzhen area during 2016 to 2017 with the CVA16 strains causing severe neurological symptoms showed that two amino acid mutations (S14N and M23L) were found in VP1 protein.@*Conclusions@#The epidemic strains of CVA16 were B1b subtype in Shenzhen area in 2016. However, B1a, B1b and the emerging B3 subtype strains were prevalent in 2017. Compared with the CVA16 strains causing severe neurological symptoms, the CVA16 strains circulating in Shenzhen during 2016 to 2017 carried two amino acid mutations inVP1 protein.
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Objective To investigate the epidemiological characteristics of norovirus outbreaks in Shenzhen during 2005 to 2017 in order to provide reference for disease control and prevention. Methods Monitoring data of norovirus outbreaks in Shenzhen from January 1, 2005 to December 31, 2017 were col-lected from Shenzhen Communicable Disease Information System and China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used for data analysis. Results From January 2005 to December 2017, 346 norovirus outbreaks (five or more cases in one community within one week) were reported in Shenzhen, of which 6. 36％ (22/346) were public health emergency events. Fewer outbreaks were reported during 2006 to 2013 and they were mainly caused by GⅡ. 4 genotype, but the num-ber increased sharply since 2014 with 57. 80％ (200/346) occurred in 2016—2017 and the epidemic geno-type changed from GⅡ. 4 to GⅡ. 17 and GⅡ. 2. The outbreaks peaked during November to March (76. 88％, 266/346). There were 63. 87％ (221/346) reported in urban areas, 67. 05％ (232/346) in nurseries and 23. 70％ ( 82/346 ) in primary/middle schools. Among the 22 public health emergency events, 40. 91％ (10/22) were caused by person-to-person contacts, 40. 91％ (10/22) by foodborne trans-mission and 13. 64％ (3/22) by waterborne transmission. Moreover, 75. 80％ (238/314) of the outbreaks in nurseries and primary/middle schools were confined to one classroom and most were due to contact trans-mission. Conclusions Norovirus outbreaks increased obviously since 2014, which might be related to the changes of the predominant genotype from GⅡ. 4 to GⅡ. 17 and GⅡ. 2. It is necessary to strengthen a com-prehensive prevention and control in key units such as nurseries and primary/middle schools in winter and spring.
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Objective To investigate the genetic characteristics of VP1 genes carried by coxsack-ievirus A16 strains isolated from cases of hand foot and mouth disease ( HFMD) in Shenzhen during 2016 to 2017. Methods Fecal and anal swab specimens were collected from patients with mild HFMD in four senti-nel hospitals and the Institute of Pathogen Biology, Shenzhen Center for Disease Control and Prevention, China during 2016 to 2017. All specimens were tested for CVA16 viral RNA using real-time RT-PCR. The VP1 genes of 51 randomly selected CVA16 strains were amplified by RT-PCR and then sequenced using TaKaRa Biomedical Technology ( Dalian). Bioinformatics software, including Mega6. 02, BioEdit and DNAStar, was used for comparison and analysis of the VP1 genes. Results CVA16 strains in Shenzhen during 2016 to 2017 mainly belonged to B1a and B1b subtypes as well as an emerging subtype B3. The epi-demic of B1b subtype was found in both 2016 (28 strains) and 2017 (19 strains), while the B1a subtype ( two strains) was only detected in 2017. Two B3 subtype strains were detected in 2017. The strains of B1b subtype were closely related to the strains isolated in Shanghai ( JQ314149 ) , Wenzhou ( KP289416 ) and Beijing (KU254598), while the B1a subtype strains were closely related to the strains isolated in Kunming (JQ316639) and Tailand (GQ184139). The B3 subtype strain was an emerging CVA16 epidemic strain in mainland China. Further comparison of the CVA16 epidemic strains in Shenzhen area during 2016 to 2017 with the CVA16 strains causing severe neurological symptoms showed that two amino acid mutations ( S14N and M23L) were found in VP1 protein. Conclusions The epidemic strains of CVA16 were B1b subtype in Shenzhen area in 2016. However, B1a, B1b and the emerging B3 subtype strains were prevalent in 2017. Compared with the CVA16 strains causing severe neurological symptoms, the CVA16 strains circulating in Shenzhen during 2016 to 2017 carried two amino acid mutations inVP1 protein.
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Objective To analyze the genetic characteristics of VP1-VP4 genes carried by cox-sackievirus A6 (CVA6) strains isolated from severe cases of hand, foot, and mouth disease (HFMD) in Shenzhen during 2012 to 2015. -ethods The VP1-VP4 genes of CVA6 strains isolated from severe HFMD cases in Shenzhen during 2012 to 2015 were amplified and sequenced. Phylogenetic analysis was performed to analyze the VP1-VP4 genes of CVA6 isolates and sequences downloaded from GenBank by using DNASTAR6. 0 and MEGA6. 02 software packages. Results Four cases of severe HFMD were caused by CVA6 in Shenzhen during 2012 to 2015. All of the patients had the symptom of fever, skin rash and aseptic encephalitis. The CVA6 strain causing severe HFMD in 2013 shared 98. 8％-98. 9％ homology in nucleotide sequences and 99. 3％-99. 8％ in amino acid sequences with the strains isolated in 2012. Two amino acid mutations were found in the CVA6 strain isolated in 2013, which were G73E in VP2 region and S13G in VP1 region. However, the CVA6 strain isolated in 2015 only shared 95. 0％ homology in nucleotide sequences and 99. 3％ homology in amino acid sequences with the strain isolated in 2013. Six amino acid mutations were identified including E73G in VP2 region and T5A, S27N, A30V, N137S and V242I in VP1 region. The phylogenetic analysis revealed that the four CVA6 strains belong to D3 sub-genotype. The CVA6 strains causing severe cases in 2012 had the nearest genetic relationship with the strain isolated in Changsha in 2012 (KJ156349). The CVA6 strain isolated in Shenzhen in 2013 had the nearest genetic relationship with the strain isolated in Shanghai in 2013 (KJ612513). The Shenzhen CVA6 isolate in 2015 showed high similarity to Weifang CVA6 isolate in 2014 (KX752785). Conclusions All CVA6 strains causing severe HFMD ca-ses in Shenzhen during 2012 to 2015 belongs to D3 sub-genotype. Mutations of S27N and A30V in the VP1 region of the CVA6 isolate in 2015 are located in the B cell epitopes. In addition, the VP1-V242I mutation in the CVA6 strain isolated in 2015 is located in the binding site of PSGL-1 receptor. These mutations may affect the binding of CVA6 strains to the cellular receptors and their infectivity to people.
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Objective To investigate the impact on myocardial blood flow (MBF) quantitation with multi-pinhole cadmium zinc telluride (CZT)-SPECT with or without partial physical corrections. Methods A total of 30 patients (18 males, 12 females; age: (63±9) years) with suspected or known coronary heart diseases who underwent dynamic SPECT from July 2018 to January 2019 in Fuwai Hospital were enrolled. Images were reconstructed using different corrections: no correction (NC), partial corrections ((noise re-duction ( NR) , NR+scatter correction ( SC) , NR+SC+resolution recovery ( RR) ) , NR+SC+RR+attenua-tion correction ( AC;total corrections, TC) . Kinetic modeling integrated one-tissue two-compartment model while using index of fitting quality ( R2 ) and fraction blood volume ( FBV) to assess the quality of modeling. Rest MBF ( RMBF) , stress MBF ( SMBF) and myocardial flow reserve ( MFR) quantified from no correc-tion ( NC) or partial corrections were compared with those of TC. Wilcoxon signed rank test and linear re-gression analysis were used to analyze the data. Results Compared to TC, NC showed the lowest R2( rest:0.69, stress:0.78;z values:4.78 and 4.78, both P<0.01) and highest FBV ( rest:0.37, stress:0.40;z values: -3.40 and -3.30, both P<0.01). The improvement of R2 and FBV was consistent with increased corrective terms. Compared with TC, NC overestimated SMBF and MFR ( z values:1.27 and-3.50, both P<0.01), all partial corrections overestimated RMBF and SBMF (z values:from -4.55 to 1.27, all P<0.01). NR and NR+SC underestimated MFR (both P<0.05). Linear regression analysis showed that the regressive coefficients of RMBF between NC, NR, NR+SC, NR+SC+RR and TC were 0.908-1.210, and Bland-Altman plots of RMBF demonstrated positive or negative biases (-0.07, 0.21, 0.26, 0.15 ml·min-1·g-1). The regression coefficients of SMBF were 1. 129-1. 308, and Bland-Altman plots demonstrated positive biases (0. 60, 0.25, 0.28, 0.24 ml·min-1·g-1). The regression coefficients of MFR were 0.907-1.318, and Bland-Altman plots demonstrated positive or negative biases (0.70,-0.11,-0.05, 0.01). Conclusion Full physical corrections can improve the index of fitting quality in the kinetic modeling and reduce left ventricle spillover, which help to warrant the accuracy of SPECT myocardial blood flow quantitation with multi-pin-hole CZR-SPECT.
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Objective@#To investigate the impact on myocardial blood flow (MBF) quantitation with multi-pinhole cadmium zinc telluride (CZT)-SPECT with or without partial physical corrections.@*Methods@#A total of 30 patients (18 males, 12 females; age: (63±9) years) with suspected or known coronary heart diseases who underwent dynamic SPECT from July 2018 to January 2019 in Fuwai Hospital were enrolled. Images were reconstructed using different corrections: no correction (NC), partial corrections ((noise reduction (NR), NR+ scatter correction (SC), NR+ SC+ resolution recovery (RR)), NR+ SC+ RR+ attenuation correction (AC; total corrections, TC). Kinetic modeling integrated one-tissue two-compartment model while using index of fitting quality (R2) and fraction blood volume (FBV) to assess the quality of modeling. Rest MBF (RMBF), stress MBF (SMBF) and myocardial flow reserve (MFR) quantified from no correction (NC) or partial corrections were compared with those of TC. Wilcoxon signed rank test and linear regression analysis were used to analyze the data.@*Results@#Compared to TC, NC showed the lowest R2 (rest: 0.69, stress: 0.78; z values: 4.78 and 4.78, both P<0.01) and highest FBV (rest: 0.37, stress: 0.40; z values: -3.40 and -3.30, both P<0.01). The improvement of R2 and FBV was consistent with increased corrective terms. Compared with TC, NC overestimated SMBF and MFR (z values: 1.27 and -3.50, both P<0.01), all partial corrections overestimated RMBF and SBMF (z values: from -4.55 to 1.27, all P<0.01). NR and NR+ SC underestimated MFR (both P<0.05). Linear regression analysis showed that the regressive coefficients of RMBF between NC, NR, NR+ SC, NR+ SC+ RR and TC were 0.908-1.210, and Bland-Altman plots of RMBF demonstrated positive or negative biases (-0.07, 0.21, 0.26, 0.15 ml·min-1·g-1). The regression coefficients of SMBF were 1.129-1.308, and Bland-Altman plots demonstrated positive biases (0.60, 0.25, 0.28, 0.24 ml·min-1·g-1). The regression coefficients of MFR were 0.907-1.318, and Bland-Altman plots demonstrated positive or negative biases (0.70, -0.11, -0.05, 0.01).@*Conclusion@#Full physical corrections can improve the index of fitting quality in the kinetic modeling and reduce left ventricle spillover, which help to warrant the accuracy of SPECT myocardial blood flow quantitation with multi-pinhole CZR-SPECT.
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Objective To compare the CT findings of poor-differentiated gastric neuroendocrine carcinomas (PD-NECs) and poordifferentiated gastric adenocarcinomas (PD-ADCs),and to increase the diagnostic accuracy rate.Methods In this retrospective study that enrolled 29 gastric PD-NECs and 29 gastric PD-ADCs,whose diagnoses were proven pathologically,we assessed their clinical characteristics and CT findings and then used univariate and multivariate analyses for statistical comparisons.Results The univariate analysis revealed that gastric PD-NECs were significantly smaller (P =0.002),more often showed well-defined margins (P＜0.001),and more frequently accompanied with intact overlying mucosa on CT when compared with gastric PD-ADCs (P ＜0.001).In the multivariate analysis,the presence of intact overlying mucosa (OR=0.028,95 ％ CI:0.001-0.863,P =0.041) and tumor-to-mucosa HU ratio on the arterial phase (OR=0.015,95 ％ CI:0.000-0.495,P =0.019) were two independent factors affecting the identification of gastric PD-NECs and gastric PD-ADCs.Receiver operating characteristic analysis (ROC) showed that the value of tumor-to-mucosa H U ratio on the arterial phase in differentiating them was moderate (AUC=0.72).Conclusion Gastric PD-NECs have better-defined margin,more intact overlying mucosa and higher tumor-to-mucosa HU ratio on the arterial phase than gastric PD-ADCs.
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Objective To evaluate the short-term results of arthroscopic treatment including micro-fractures and autologous osteochondralplasty for osteochondritis dissecans (OCD) of elbow.Methods Data of 30 OCD patients who were treated by arthroscopic micro-fracture or autologous osteochondralplasty from January 2012 to December 2014 were retrospectively analyzed.22 of them were followed-up for more than one year.Among them,there were 20 males and 2 females.All had OCD lesion on dominated side.The average age was 15 years old (range,12-19 years old).All patients suffered from pain and limitation on the range of motion at different level.Arthroscopic micro-fracture was performed if the diameter of the lesion was less than 1 cm,otherwise,autologous osteochondralplasty was performed.16 cases received arthroscopic micro-fracture and 6 cased received autologous osteochondralplasty.6 patients were athletes who received micro-fracture.16 patients were non-athletes and 10 of them received micro-fractures.The flexion-extension range of motion(ROM),Mayo elbow performance score (MEPS),visual analog scale for pain (VAS) were recorded preoperatively and at the final follow-up for comparison.Results Patients were followed up for 13 month on average (range,12-18 months) without any complications.All patients got improvement significantly with 100％ good or excellent rate.For patients receiving arthroscopic micro-fracture,the preoperative ROM,MEPS and VAS was 101.88°± 14.82°,64.38±4.79 and 5.13±1.09,which was improved to 114.38°±11.53°,88.75±8.06 and 0.88±1.02 respectively.There were significant differences between preoperative and postoperative ROM,MEPS and VAS.Among these 16 patients,13 were excellent and 3 were good.For 6 patients who received arthroscopic autologous osteochondralplasty,the preoperative ROM,MEPS and VAS was 105.00°± 11.83°,60.83±6.11 and 5.67±1.37,which was improved to 120.83°±6.11°,87.50±5.24 and 1.17±0.56 at the final follow up respectively.There were significant differences between preoperative and postoperative ROM,MEPS and VAS.Among these 6 patients,4 were excellent and 2 were good.Conclusion For elbow OCD,satisfied result can be expected by arthroscopic microfracture and autologous osteochondralplasty because both are effective procedures to improve the elbow function.
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Objective To detect the damage incidence rate of liver and myocardium in infantile rotavirus (RV) enteritis.And to provide the basis for prevention and cure of liver and myocardium damage in infantile RV enteritis.Methods The liver function and myocardial enzyme detection results of 395 patients with infantile RV enteritis were collected .These results were compared with those of 40 healthy kids from health examinations . Results The levels of alanine aminotransferase ( ALT ) , aspartate amino transferase ( AST ) , serum creatine kinase (CK) and serum creatine kinase isozyme(CK-MB) from infantile patients were (34.49 ±29.13)U/L,(52.44 ± 24.10)U/L,(141.75 ±132.22)U/L and (48.69 ±32.53)U/L,respectively,which were higher than those of the healthy control [(16.00 ±3.24)U/L,(29.90 ±3.76)U/L,(101.82 ±64.56)U/L and (22.32 ±8.98)U/L,t=4.008,5.901,3.982,5.64,all P<0.05].The abnormal occurrence rates of ALT ,AST,CK and CK-MB in infantile patients were 19.49％,73.16％,12.15％,73.16％,respectively,which were higher than those in healthy controls (2.50％,20.00％,0.00％,0.00％),the differences were statistically significant (χ2 =7.128,47.397,5.464, 300.239,all P<0.05).The incidence rates of liver and myocardium damage were 19.49％and 73.16％,respectively. Conclusion There are higher incidence rates of liver and myocardium damage in infantile RV enteritis .So for the infantile RV enteritis patients ,it is necessary to detect the liver function and myocardial enzyme level .The treatment for infantile RV enteritis should be included liver and myocardial protection except antivirus and correcting dehydration .
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Objective To investigate the feasibility of student standardized patient (SSP) in practice. Methods Undergraduates majoring in TCM clinic in grade 2011 in Heilongjiang University of Chinese Medicine were set as subjects and were under the cultivation of new SSP teaching model and traditional teaching model respectively. Objective theory paper examination, clinical skill score and student subjective evaluation were used for the research on teaching efficacy. Results Students in the experimental group were better than their peers in the control group in the aspects of objective theory paper examination and clinical skill score (P<0.05), with good student feedback. Conclusion SSP combining simulated wards in teaching of TCM surgery can provide great help for the transformation of clinical students to clinical doctor, which should be a new teaching model in TCM surgery with further digging and promotion.