Clinical application of gene chip technology in diagnosis and treatment of silicosis complicated with mycobacterial infection / 环境与职业医学

Background Gene chip technology has been increasingly used in the diagnosis and treatment of common tuberculosis. However, its role in the diagnosis and treatment of silicosis complicated with mycobacterial infection remains unclear. Objective To evaluate the application value of gene chip technology in the diagnosis and treatment of silicosis complicated with mycobacterial infection. Methods From January 2019 to June 2021, 197 silicosis patients suspected to be complicated with mycobacterial infection in Quanzhou First Hospital Affiliated to Fujian Medical University were enrolled in this study. The etiology evaluation for the 197 patients was conducted by acid-fast staining of sputum smear (sputum smear method), culture of Mycobacterium tuberculosis of sputum (sputum culture method), and gene chip technology of bronchoalveolar lavage fluid (BALF); and for 80 patients among them, acid-fast staining of BALF (BALF smear method) and culture of Mycobacterium tuberculosis of BALF (BALF culture method) were additionally performed. The positive rates and consistency were assessed using intraclass correlation coefficient (ICC). Test for Mycobacterium tuberculosis drug resistance mutation gene was added for patients with Mycobacterium tuberculosis complex by BALF gene chip technology. Results The average age of the 197 patients was (53.1±9.1) years, and the average dust exposure time was (21.1±9.4) years, including 192 males and 5 females. There were 8 cases with stage I silicosis, 17 cases with stage II silicosis, and 172 cases with stage III silicosis. Among them, 11.2% were positive for sputum smear; 24.4% were positive for sputum culture, and 36.0% were positive by gene chip of BALF. The difference between the three methods was statistically significant (P<0.05). The result of consistency test for the three methods showed that the ICC was 0.539 (P<0.001). Among the 80 patients, there was a significant difference in the positive rates of the five methods (χ2=25.23, P<0.001). The results of Bonferroni test showed statistically significant pair-wise differences between BALF culture method and sputum smear method, BALF culture method and BALF smear method, BALF gene chip method and sputum smear method, BALF gene chip method and BALF smear method (P<0.05), while there were no statistically significant differences between the other pairs (P>0.05). The result of consistency test for the five methods showed that the ICC was 0.586 (P<0.001). Among the 71 BALF gene chip positive cases, 59 cases reported positive Mycobacterium tuberculosis complex (17 cases were positive in the first-line anti-tuberculosis resistance test, and 2 cases were found positive quinolone resistance gene in the second-line anti-tuberculosis resistance test), and received regular anti-tuberculosis treatment, among them 45 cases improved and 14 cases were stable; 12 cases reported non-tuberculous mycobacteria cases, among them 5 cases received anti-non-tuberculous mycobacteria treatment (4 cases improved and 1 case was stable), and 7 cases with mild symptoms did not receive anti-non-tuberculous mycobacteria treatment. Conclusion Compared with sputum smear, sputum culture, and other traditional methods, gene chip technology of BALF can improve the positive rate of pathogenic diagnosis of silicosis complicated with mycobacterial infection, and can also quickly identify whether it is non-tuberculous mycobacteria infection or drug-resistant Mycobacterium tuberculosis infection, which is helpful to adjust treatment as soon as possible.

Preparation and microPET imaging of extradomain-B fibronectin specific probe 18F-AlF-NOTA-PEG 4-ZD2 / 中华核医学与分子影像杂志

Objective:To prepare specific molecular probe 18F-AlF-1, 4, 7-triazacylononane-1, 4, 7-triacetic acid-(polyethylene glycol) 4-ZD2 ( 18F-AlF-NOTA-PEG 4-ZD2) for targeting extradomain-B fibronectin (EDB-FN), and evaluate its properties in vitro and in vivo. Methods:18F-AlF-NOTA-PEG 4-ZD2 was prepared by one-step chelation labeling with Al 18F. The radiochemical purity and in vitro stability were determined by high performance liquid chromatography (HPLC). The partition coefficient (logP) of 18F-AlF-NOTA-PEG 4-ZD2 was evaluated, and the cell uptake experiment was carried out (triple-negative breast cancer (MDA-MB-231) cells (1×10 6/tube) were divided into 3 groups ( n=3 per group); positive group, inhibition group, control group). MicroPET imaging was performed on MDA-MB-231 bearing nude mice ( n=3) after 18F-AlF-NOTA-PEG 4-ZD2 injection (30, 60, 90, 120 min) and compared with blocking group ( n=3, NOTA-PEG 4-ZQ 2 was preinjected at 0.5 h before 18F-AIF-NOTA-PEG a-ZD2 injection). Independent-sample t test was used to analyze the data. Results:18F-AlF-NOTA-PEG 4-ZD2 was successfully prepared. The optimized radiochemical yield was (33.8±2.1)% (undecay corrected, n=8) and the radiochemical purity was >96%. After incubating 120 min at 37 ℃, the radiochemical purity of 18F-AlF-NOTA-PEG 4-ZD2 in human serum and PBS was >93%, indicating its good stability in vitro. The specific activity was (11.1±3.2) GBq/μmol, and logP was -1.43±0.05. The uptake value of tumor cells was (1.77±0.28) percentage applied activity (%AR)/10 6 cells at 120 min post-injection in positive group, and the total uptake value of the inhibition group was (0.76±0.07) %AR/10 6 cells ( t=4.30, P=0.032). MicroPET imaging in tumor bearing nude mice showed that 18F-AlF-NOTA-PEG 4-ZD2 was mainly metabolized by the liver and kidneys. The tumor uptake value was (1.94±0.21) percentage activity of injection dose per gram of tissue (%ID/g) at 60 min post-injection and the tumor/muscle ratio was 3.80±0.25 at 90 min post-injection in the experimental group, while the tumor uptake value of tumor bearing nude mice in the blocking group was (0.43±0.09) %ID/g at 60 min post-injection ( t=3.18, P=0.006). Conclusions:18F-AlF-NOTA-PEG 4-ZD2 can be prepared simply with high labeling rate and good stability in vitro, with high tumor uptake and tumor/muscle ratio in microPET imaging, and good specificity and long tumor residence time. The probe has good application prospect in breast cancer with high expression of fibronectin subtype EDB-FN.

Associated factors of screened myopia of junior middle school students in six provinces of China / 中国学校卫生

Objective@#To understand the current situation and associated factors of myopia in junior middle school students, and to provide scientific basis for prevention and control of myopia in junior middle school students.@*Methods@#A total of 5 393 junior middle school students were selected from middle schools in Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi provinces. The visual acuity of middle school students was examined, and the data of general population, economy, sociology and natural environment were obtained through statistical yearbook of each province. The influencing factors of myopia of middle school students were analyzed by univariate and multivariate Logistic regression.@*Results@#The results of single factor analysis showed that the myopia rate of junior high school students was different by gender, grades, parents average wage, sunshine duration, temperature, altitude, longitude and latitude(χ2=47.76，59.05，10.79，106.19，53.56，85.02，76.23，107.07，P<0.05). The results of multi factor analysis showed that gender, grade, average wage, temperature and latitude was positively associated with myopia vision; sunshine duration and longitude were negatively associated with the risk for myopia(OR=1.54，1.34，1.62，7.58，27.10，0.42，0.39，P<0.05).@*Conclusion@#The myopia of junior high school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening of sexual myopia in junior high school students. Economic and social factors and natural environmental factors should be taken into account in the formulation of myopia prevention and control measures.

Treatment strategies of complex lesions in patients with acute Stanford type A dissection of important branches involvement / 中华外科杂志

Acute Stanford type A aortic dissection with important branches involved is more complex, could lead to organ malperfusion syndrome even organ failure. The understanding of pathological anatomy, classification, staging, and the pathophysiological change has increasingly mature, but not complete. In addition, the treatment strategy for complex lesions is diversified, some questions may not reach consensus. Fully understanding of the anatomical and pathophysiology is very important for surgeons to choose reasonable treatment strategy. As the rapid development of the basic research, imaging techniques and the concept of surgery procedures, the manage technique of Stanfrod type A dissection and branch vessels at the same time is getting seriously, the related issues also need further discussions.

Comparative study of CT versus gross pathology in rabbit VX2 colorectal cancer model / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To establish rabbit VX2 colorectal cancer(CRC) model and to compare CT images with gross pathology in order to offer help for TNM staging in patients with CRC.</p><p><b>METHODS</b>VX2 tumor pieces were implanted into colonic wall in 9 New Zealand white rabbits and rectal wall in 2 New Zealand white rabbits. Four weeks after inoculation, Ultravist(370 mg/ml) was injected through ear marginal vein with high pressure injector for stage 3 scanning of chest, abdomen and pelvis, and enhanced CT (collimation 0.5 mm mm × 320, pitch factor 0.828, bulb rotation speed 0.5 s/cycle, 120 kV, automatic ma, range 80 to 100 mAs) was performed to determine the presence of CRC or metastasis once a week for 4-6 weeks. Once inoculated CRC or metastases occurred or 6 weeks after implantation, the rabbits were sacrificed regardless of the presence or absence of CRC or metastasis on the CT images. One rabbit was used for gross anatomy observation. Others were placed in wood boxes with -80centi-degree for 24 hours, then samples of 3 mm thickness were cut using a motorized saw to make macropathology. Each cutting surface of the specimens was photographed in serial number. If certain or suspected lesions were found on the slices, such part was labeled and then placed in 10% phosphate-buffered formaldehyde numbered box for subsequent pathological examination. CT image postprocessing was performed referring to the gross slice specimens and all findings were compared with the pathological reports.</p><p><b>RESULTS</b>Among 11 rabbits, tumor was successfully established in 8 rabbits. Pathology showed that single lung metastasis (7 to 10 mm) was found in 2 rabbits and liver metastasis (9 mm) in 1 rabbit. Number of lymph node located around the inoculated tumor was 22 and that around mesenteric vessels was 13 with diameter of 2 to 16 mm. Among these 35 lymph nodes from 8 successful rabbits, 9 nodes were positive, including 7 around inoculated tumor and 2 around mesenteric vessels. CT identified above 8 primary inoculated tumors, 2 lung metastatic lesions and 1 liver metastatic lesion, with detection rate of 100%. For the detection of lymph node in CT, 27 nodes were identified in the pericolorectal region (17 nodes) and perimesenteric vessels (10 nodes), in which 6 were positive metastasis (ring-shaped enrichment and central low density necrosis), resulting in a detection rate of 77.1%(27/35 nodes), and positive detection rate of 66.7% (6/9 nodes), respectively.</p><p><b>CONCLUSION</b>Living rabbit CT-gross pathological slice(3 mm-cut) of VX2 CRC model can be applied in image evaluation of small metastatic lesion.</p>

Myocardial glucose uptake and metabolic rate measurements in mice with microPET imaging / 中华核医学与分子影像杂志

Objective To establish a practical microPET imaging procedure for the measurement of myocardial metabolic rate of glucose (MRGlu) in mice.Methods Twenty wild-type BKS mice were divided into 4 groups by random number table method.The mice were anesthetized with different concentrations of isoflurane (1.3％,1.5％,1.8％,2.0％) at the temperature between 30 ℃ to 34 ℃.The respiratory rate and the physiologic condition were monitored for adjusting the most appropriate isoflurane concentration.Then,different volumes of saline were injected to the anesthetized mice and blood glucose concentrations were measured to test the optimal injection volume.Under the optimal operating condition,18 F-FDG were injected in a group of six mice and followed by microPET imaging.Left ventricular TAC was obtained by drawing ROI and myocardial glucose SUV was also calculated.Meanwhile,the TAC from venous sampling at different time points after 18F-FDG injection was generated.Kinetic Imaging System was used to estimate the coefficients and calculate the MRGlu(Ki ×Glu/LC; Ki =k1 ×k3/(k2+k3).One-way analysis of variance and q test were used to analyze the data.Results No movement was observed in non-fasted mice anesthetized with (1.5-1.8)％ isoflurane,and their respiratory rates were all over 80 per minute.The plasma glucose concentration showed no difference at each time point between the experimental group injected with 75 μl saline and the control group (F=1.215,P＞0.05).The plasma glucose concentration of mice injected with 150 μl saline exhibited statistically significant difference at 30 min (q =2.485,P=0.024),45 min (q =2.287,P=0.036) and 60 min (q =2.709,P =0.015).When the injection volume reached 300 μl,the blood glucose concentration increased remarkably at 45 min (q =2.435,P=0.027).Mice were maintained in good condition after injected with 18F-FDG ranging from 7.4 to 11.1 MBq within 75 μl volume,meanwhile clear and stable myocardial microPET images could also be obtained.The median myocardial SUV value was 11.88(9.71-14.93),Ki value was 0.19 (0.10-0.54) ml · min-1 · g-1and MRGlu value was 19.64 (5.55-23.28) mg · kg-1 · min-1at 45-55 min after 18F-FDG injection.Conclusion The microPET imaging may be a reliable,practical method to evaluate myocardial glucose uptake rate and metabolic rate in mice under the precondition of optimal isoflurane anesthetization (1.5％-1.8％)and small volume of 18F-FDG injection (≤＜75 μl).

Reconstruction of acetabular bone loss with porous tantalum acetabular components in total hip arthroplasty / 中华骨科杂志

Objective To explore the early-term efficacy of the reconstruction ot acetabular bone loss with porous tantalum acetabular components in total hip arthroplasty.Methods Twenty-one patients (21 hips) were included in this study,which had an acetabular replacement with tantalum acetabular components from August 2009 to April 2012.There were 6 males and 15 females,with the mean age of 55.7±16.2 years (range from 24 years to 78 years).The primary total hip arthroplasty in 5 cases,the revision in 16 cases.The acetabular bone defects were classified as Paprosky classification,which included,type Ⅰ in 9 cases,type Ⅱain 4,type Ⅱb in 5,type Ⅱcin 1,type Ⅲa in 1 and type Ⅲb in 1 case.Results The mean follow-up time was 20.1 months (range,6-40 months).In Paprosky Ⅰ,the Harris hip score was 87.2±7.4 postoperatively,which was significant higher than the preoperative score 41.1±6.3.In Paprosky Ⅱ,the Harris hip postoperative score (79.8±11.8) was significant higher than the preoperative score (38.4±12.5).In Paprosky Ⅲ,the Harris hip postoperative score (79) was significant higher than the preoperative score (24).21 Tantalum components were well fixed by the radiograph imaging.No cases suffered aseptic loosening and migration.Bone ingrowths was obviously performed in 21 hips.But 2 hips had a radiolucent line,1 case occurred in zone 3 and the line was filled 4 months later,the other case still existed at last follow-up without any more widen.No infections or mechanical failures.The survivorship of the tantalum acetabular components was 100％.Conclusion Our short-term results suggest this implants may enhance biological fixation in acetabular defect cases.Porous tantalum cup appears to be an ideal material to facilitate biologic ingrowths in these cases.Long-term follow-up still needs to be confirmed.

The risk factors of perioperative electrical storm in direct percutaneous coronary Intervention / 中国医师进修杂志

Objective To investigate the risk factors of electrical storm(ES) in patients with acute myocardial infarction (AMI) during perioperative period of direct percutaneous coronary intervention(PCI).Methods Forty-one AMI patients had been treated with direct PCI.The patients with perioperative ES were included in ES group and those without perioperative ES were included in conntrol group.ES was defined as the occurrence of spontaneous ventricular tachycardia or venicular fibrillation was twice or more within 24 h and unable to stop by itself and emergency treatment was needed.The difference of the clinical data between two groups were compared.Results There were 7 in 41 patients with direct PCI who had ES,the incidence was 17.07％,and 34 cases didn't have ES.Systolic pressure,diastolic pressure,white cell count,blood glucose,international normalized ratio and time duration from chest pain onset to direct PCI between two groups had no significant differences (P ＞0.05).Age,CK-MB,cardiac troponin I,the diameter of infarctrelated arleries(IRA ),incidence of reperfusion arrhythmia and mortality of ES group were all obviously higher than those of control group (P ＜ 0.05 or ＜ 0.01 ).The incidence of ES in patients whose IRA was left main artery or occlusion of middle section of two main coronary arteries,right coronary artery,left anterior descending branch and left circumflex artery was 66.67％(2/3),18.75％(3/16),11.76％(2/17) and O, respectively.Conclusions Perioperative ES during direct PCI most commonly occurrs in AMI patients with left main artery or occlusion of middle section of two main coronary artery.The diameter of IRA,TIMI flow classification after the patency of IRA and recanalization arrhythmia are the main risk factors of the occurrence of perioperative ES.

Noninvasive observation of atherosclerosis in mice with 7.0T MR and Micro-PET / 中国医学影像技术

Objective To explore the feasibility of detecting atherosclerosis with 7.0T MR and Micro-PET. Methods Ten 46-week-old ApoE-/- mice with high lipid diet for 6 months were selected to establish atherosclerosis models. Among them, 5 mice underwent MRI before and 12 h, 24 h, 36 h after injection of SPIO, respectively, and the other 5 mice were injected with ~(18)F-fluorodeoxyglucose (~(18)F-FDG) through tail vein and observed with Micro-PET after 1 h, 2 h and 3 h. The specimens of abdominal aorta were taken for pathologic examination. Results Atherosclerotic plaques were observed in all animals with 7.0T MRI after 6 months high lipid diet. Thirty-six hours after the injection of SPIO, the high signal rings were thinner and the lumen of blood vessels were wider than those before injection on T2WI. Radioactive concentration was observed in abdominal aorta and both sides of iliac artery 3 h after the injection of ~(18)F-fluorodeoxyglucose (~(18)F-FDG). Pathological examination showed the formation of atherosclerotic plaques and the aggregation of the macrophages. Conclusion 7.0T MRI and Micro-PET can be used to observe the macrophage-rich plaque and to judge the vulnerability of plaque, thus provide theoretical basis for early detection, diagnosis and treatment of atherosclerosis.