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Objective:To explore the role of 18F-fluorodeoxyglucose (FDG) PET/CT in early detection of therapy-associated cardiotoxicity (TACT) in lymphoma patients and to analyze the diagnostic efficacy of different evaluation criteria. Methods:Consecutive patients between November 2009 to October 2018 in Peking University Cancer Hospital were retrospectively enrolled. All patients underwent standard chemotherapy. Myocardial uptake of 18F-FDG pre- and post-treatment were analyzed by visual interpretation and semi-quantitative (maximum standardized uptake value, SUV max) methods. The value of pre-treatment SUV max-heart -post-treatment SUV max-heart (ΔSUV max), %ΔSUV max, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background(left gluteal muscle) ratios were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cut-off values of those PET/CT imaging criteria for evaluating early TACT of lymphoma, taking electrocardiogram (ECG) positive as the end point. Independent-sample t test and χ2 test were performed. Results:A total of 274 patients (median age was 36-year old), with the male-to-female ratio of 1.85∶1, were included, and 78.1%(214/274) of them had non-Hodgkin′s lymphoma (NHL). After treatment, 55.1%(151/274)of the patients had high myocardial uptake of 18F-FDG (compared with liver uptake), 20.4%(56/274) of them had moderate myocardial uptake (between liver uptake and blood-pool uptake), and 24.5%(67/274) were with equal uptake (less than blood-pool uptake). There were significant differences in myocardial uptake between ECG-positive group ( n=71) and ECG-negative group ( n=203) ( SUV max: 7.77±4.06 vs 5.91±3.04; t=4.045, P<0.01). ROC curves showed that optimal thresholds of post-treatment SUV max-heart, Δ SUV max-heart, %ΔSUV max-heart, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background ratios were 9.4, 4.8, 1.4, 5.0, 2.3, 7.0 respectively. The corresponding areas under the curves (AUC) were 0.653, 0.637, 0.612, 0.655, 0.649 and 0.650, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of post-treatment SUV max-heart/SUV max-background ratio were 40.85%(29/71), 82.76%(168/203), 45.31%(29/64), 80.00%(168/210) and 71.90%(197/274). Conclusion:18F-FDG PET/CT can early detect TACT in patients with lymphoma, and if using 7.0 as the threshold of post-treatment SUV max-heart/SUV max- background ratio, the specificity and negative predictive value of 18F-FDG PET/CT for early prediction of TACT are up to 80%.
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Objective:To explore the effects of scenario simulation combined with case-based learning (CBL) teaching method on the operation skills, learning initiative and family satisfaction of pediatric nursing students.Methods:In the study, 51 nursing students who interned in Bengbu First People's Hospital from March to November in 2019 were selected as the control group, having the traditional teaching method; another 51 nursing students interned from March to November in 2020 were selected as the research group, taking the scenario simulation combined with CBL teaching method. The theoretical knowledge and operation skills of the two groups of nursing students were assessed, the learning initiative and various abilities were evaluated by using the relevant scales, and the nursing students' satisfaction with teaching was investigated. SPSS 22.0 was used for t test and chi-square test. Results:The theoretical knowledge and operation skill scores of nursing students in the study group were significantly higher than those in the control group ( P<0.05). The scores of each dimension and total score of learning initiative of nursing students in the study group were higher than those in the control group [(68.71±9.03) vs. (50.21±9.86)], including integrating theory with practice [(8.06±1.13) vs. (6.12±1.54)], learning ability practice [(8.15±1.18) vs. (6.53±1.37)], interpersonal communication ability [(8.13±1.07) vs. (6.28±1.39)], clinical thinking ability practice [(8.04±1.26) vs. (5.97±1.42)], ability to analyze and solve problems [(8.46±0.97) vs. (6.51±1.25)]. The scores of various abilities and overall satisfaction with teaching in the research group were significantly higher than those in the control group ( P<0.05). Conclusion:The implementation of scenario simulation combined with CBL teaching method for pediatric nursing students can improve their scores of theoretical knowledge and operational skills, enhance their learning initiative and abilities, and improve their satisfaction with teaching.
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Objective:To analyze the problems existing in the management mode of clinical research coordinator (CRC) in the new context, propose improvement measures and analyze the effectiveness of improvement.Methods:Four types of stakeholders related to CRC, including investigators, clinical research associates(CRA), institutional managers and human subjects were investigated in regular monthly questionnaire survey on the basis of CRC management comparasionat home and abroad. The new CRC management countermeasures implemented by our institution in July 2020 were taken as the time node, and the data from January to June 2020 were taken as the pre-implementation group, and the data from July to December 2020 were taken as the post-implementation group. Compare the monthly scores of CRCs′ work effect for 30 projects in the institution before and after the implementation of such countermeasures.Results:The scores of CRCs′ working effectiveness were improved after the implementation of CRC management countermeasures, whcih including standardizing the entry of CRC, updating of the training and assessment mechanisms, conducting regular communication meetings and developing reward and punishment measures. The scores from investigators increased by 20.17%, scores from CRAs increased by 11.54%, scores from institutional managers increased by 14.26%, scores from subjects increased by 10.64%, and the total scores increased by 14.13%( P<0.01). Conclusions:Countermeasures to optimize CRC management taken by drug clinical trial institutions can significantly improve CRCs′ working effectiveness in multiple dimensions.
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This study reported a case about a 30-year-old pregnant woman with placental teratoma. The presumptive diagnosis of placental teratoma was made based on the abnormal echo detected on the placental surface by ultrasound at 33 + gestational weeks. MRI examination also suggested the possibility. She had an otherwise uneventful pregnancy and puerperium and gave birth to a healthy newborn vaginally at 40 +4 gestational weeks. A smooth oval-shaped nodule covered by skin was visualized at the edge of the placenta, and pathological results suggested a mature cystic teratoma. The causes of placental teratoma remain unclear, and no obvious clinical symptoms are identified. Typically, it has no adverse effects on the mother and baby. A combination of ultrasound and MRI is critical to determine the nature of the tumor prenatally, but the gold standard for diagnosis relies on placental pathology.
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Objective To investigate the correlation between serum miR-320b and carotid atherosclerosis in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke visited the Department of Neurology,the Affiliated Hospital of Yangzhou University were enrolled.According to the findings of carotid artery ultrasonography,they were divided into plaque group and plaque-free group.The baseline clinical data such as demographic data,vascular risk factors,and blood biochemical indicators were collected.Reverse transcription quantitative polymerase chain reaction was used to detect the expression level of serum miR-320b.Multivariatelogistic regression analysis was used to determine the independent risk factors for carotid atherosclerosis.Results A total of 135 patients with acute ischemic stroke were enrolled in this study,including 58 females and 77 males,aged 58.4 ± 10.6 years.There were 85 patients in the plaque group and 50 in the plaque-free group.The total cholesterol (t =5.523,P =0.023) and low-density lipoprotein cholesterol (t =4.415,P =0.044) in the plaque group were significantly higher than those in the plaque-free group,while high-density lipoprotein cholesterol (t =5.849,P=0.017) and serum miR-320b (t =4.331,P=0.039) were significantly lower than those in the plaque-free group.Multivariate logistic regression analysis showed that referring to the highest quartile group,the low serum miR-320b level might be an independent risk factor for carotid atherosclerosis (the first quartile group:odds ratio 2.701,95％ confidence interval 1.154-6.321,P =0.022;the second quartile group:odds ratio 2.521,95％ confidence interval 1.249-5.091,P =0.010;and the third quartile group:odds ratio 1.849,95％ confidence interval 1.041-3.283,P=0.036).Conclusion The low serum miR-320b level might be an independent risk factor for carotid atherosclerosis in patients with acute ischemic stroke.
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To explore the effectiveness of positron emission tomography (PET) respiratory gating based on time and amplitude to improve the reconstructed image artifacts. It is necessary to appropriately select acquisition and processing methods which ensure the readability of myocardial imaging images in radionuclide medicine myocardial imaging. This summary mainly discusses the identification method and how to avoid adverse effect for images from myocardial imaging process, and includes similarities and differences of varieties methods: identification for image artifacts of myocardial imaging, image reconstruction algorithms and software processing and so on. It should be significant to choose the appropriate method to identify myocardial imaging artifacts in image collection. The pros and cons of myocardial imaging image reconstruction algorithm and various software processing methods still remain unknown. How to choose better appropriate acquisition, image reconstruction and software processing methods for myocardial imaging need further study.
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Objective To investigate the clinical significance of lipoprotein-associated phospholipase A2(LP-PLA2) measure-ment for type 2 diabetes mellitus(T2DM) patients combined with atherosclerosis .Methods The concentrations of LP-PLA2 ,cho-lesterol(CHO) ,triglyceride (TG) ,low density lipoprotein(LDL) ,high density lipoprotein(HDL) were measured for 47 T2DM pa-tients combined with atherosclerosis(patient group) and 94 healthy people who just underwent healthy examination and were proved to be healthy(control group) ,meanwhile the age and gender information of those people were collected .Then the tests results were compared between the two groups .Results There was no significant difference in age ,gender ,CHO ,HDL ,TG ,LDL between the two patient and control group(P>0 .05);Plasma LP-PLA2 level in patient group was higher than that in control group ,and the difference was statistically significant(P<0 .05) .Non-conditional Logistic regression analysis showed that the LP-PLA2 level was the risk factor with statistical significance(P<0 .05) .Conclusion LP-PLA2 concentration is an independent risk factor for athero-sclerosis in T2DM patients ,and its measurement has certain value for the diagnosis of atherosclerosis in T2DM patients .
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Objective To investigate the value of application of magnetic resonance imaging (MRI) in diagnosis and treatment of leptomeningeal metastases from malignant solid tumors.Methods A retrospective analysis was conducted depend on the radiological data of 63 patients who had been diagnosed as leptomeningcal metastasis of malignant solid tumors.Results All patients received brain MRI examination.26 patients underwent cervical or lumbar spine MRI examination.The MRI images showed nodular enhancement in the gyri and sulci,leptomeningeal linear enhancement,dura mater thickening and enhancement,ependymal enhancement,intraventricular metastasis,intraspinal metastatic nodules,communicating hydrocephalus,subdural hydroma and negative imaging.Ncuroimages of ependymal enhancenent,intraventricular metastasis and intraspinal implantation metastasis appeared in 5,7 and 9 patients with small cell carcinoma,respectively,which were higher than that of the other pathological types (P =0.002,P =0.009,P ＜ 0.000 1).Seizure occurred in 7 patients after intrathecal chemotherapy,of which 5 patients had pia mater linear enhancement.Among 33 patients treated with radiotherapy combined with intrathecal chemotherapy,3 patients had poor prognosis,of which 2 patients had negative imaging findings.The conditions of 25 patients were improved obviously after treatment,of which 21 patients showed different imaging remission in MRI re-examination.Conclusions The contrast MRI has an important assistant effect in diagnosis of leptomeningeal metastasis of malignant solid tumors.The MRI findings and clinical features are related with the pathological types.The pia mater linear enhancement indicates a high possibility of seizures after inthathecal chemotherapy,and it suggests that the preventive treatment should be given for such patients.MRI is not applicable to evaluate severity,prognosis and curative effect of the disease.
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Hannum and colleagues performed DNA methylation sequencing to examine the relationship between DNA methylome and aging rate. Notably, they succeeded in building a quantitative and reproducible model based on the epigenetic bio-markers to predict aging rate with high accuracy. This progress enlightens us in many aspects particularly in applying this novel set of bio-markers on studying the mechanism of aging rate using adult tissue-specific stem cells, building up a potential quantitative model to explore the mechanism for other epigenetic factors like non-coding RNA, and understanding the principle and mechanism of 3D chromatin structure in epigenetic modulation.
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Humans , Aging , Genetics , Pathology , Base Sequence , Chromatin , Genetics , DNA Methylation , Genetics , Epigenesis, Genetic , Genome, Human , RNA, Untranslated , Genetics , Sequence Analysis, DNAABSTRACT
ObjectiveTo observe Semaphorins-3A and synaptophysin P38 expression in hippocampus of developing rat induced by status epilepticus.Methods 320 SD rats were divided into four groups (P7,P14,P21 and P28) according to day -old after birth (7d,14d,21d and 28d).Rats in each group were randomly divided into model group (SE group) and saline control group (NS group).SE was induced by Pentylenetetrazol (PTZ).Semaphorins-3A and synaptophysin P38 expression were determined by immunohistochemical staining on 1d,7d,14d,21d and 28d after SE in hippocampal CA1 of rats.ResultsSemaphorins-3A-positive cells could be seen in the hippocampal granule cell layer in all rats.Semaphorins-3A expression tended to decrease with the increasing of day-age,especially in P7 group(91 552.68 ± 4664.69 ).No matter how day-age,Semaphorins-3A expression was similar to that in NS group and was obvious reduced in 7d after SE(56 938.84 ± 5688.47 ).Meanwhile P38 expression in P7-day-age rats had had been gradually increasing between 1 day and 14d (5413.18 ±48.77,6223.40±29.19,6902.94 ±78.51 ) and then stabilized gradually on 21d(7523.42 ± 62.94) after rats were tested.P38 expression in other day-age rat was relatively stable on the same level in physiological state.On the other hand P38 expression in the hippocampal CA1 region of P7,P14,P21 and P28 rats was significantly higher than that in normal rats between 1day and 28day after SE episode(P＜ 0.05 ),and reached a peak on 14 day(8408.35 ± 55.73 ).ConclusionSemaphorins-3A and synaptophysin P38 involved in hippocampal synaptic plasticity of rat in developing stage and epilepsy.
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Objective To study the distribution and expression of Semaphorins-3A protein in brain of postnatal rats.Methods Semaphorins-3A positive cells were observed by immunohistochemistry in the cerebral cortex,hippocampus,dentate gyms and entorhinal cortex in postnatal 0d,7d,14d,21 d and 28d of Sprague Dawley rats.Results Semaphorins-3A positive cells widely distributed in the granule cell layer ( Ⅱ ),external pyramidal cell layer ( Ⅲ ),internal granular cell layer ( Ⅳ ),pyramidal cell layer ( Ⅴ ) and layer of polymorphous cells ( Ⅵ ),in addition to the molecular layer ( Ⅰ ) of the parietal,occipital,frontal,temporal,insular,cingulate cortex,piriform cortex and entorhinal cortex with postnatal 0d,7d,14d,21d and 28d rats.The amount of semaphorins-3A positive cells(IOD) in the entorhinal cortex was 84916.23 ± 3266.34 in P0d,77711.41 ± 2634.26 in P7d,74124.25 ± 3989.09 in P14d,65887.63 ± 3406.57 in P21d and 57705.96 ± 3136.35 in P28d,meanwhile the region of semaphorins-3A positive cells narrowed in the part level with Ⅱ -Ⅵ levels of cortex.Similarly semaphorins-3A positive cells distributed mainly in granule cell layer of dentate gyrus,CA1,CA3 region and only a few of semaphorins-3A positive cells scattered in the multi-line layer in hippocampus.The expression level of semaphorins-3Awas significant difference among postnatal 0d,7d,14d,21d and 28d rats (P＜0.01).Conclusion Semaphorins-3A positive cells widely distribute in the various cortex and hippocampus in developing rat brain,and the region of semaphorins-3A is reduced with age growth of rats.
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Objective To observe neural stem cells proliferation,migration and differentiation in hippocampus in developing rats with status epileptictus.Methods 320 healthy SD rats at age 7,14,21,28 d (P7,P14,P21,P28) were randomly divided into status epilepticus (SE) and normal control group.In each group those rats at the same age were further randomly divided into 1,7,14,21,28 d five time points after PTZ-induced SE (n =8).New cell proliferation and migration were observed by immunohistochemistry studies in the dentate gyms.Double labeling with Brdu/NeuN and Brdu/GFAP was performed in the P14 rats.Results Nestin positive cells appeared in the dentate gyms on 1 d after SE in P7,P14,P21,P28 rats.The number of nestin positive cells gradually increased on 7 d and reached a peak on 14 d,then gradually reduced on 21 d,finally fell to a minimum on 28 d after SE.The numbers of nestin positive cells on 7 d(177.00 ± 3.22,t =16.033) and 14 d (195.00 ± 3.41,t =28.840) were significantly higher in the SE group than the NS group (147.50 ± 2.08,136.50 ± 2.65,both P ＜ 0.05).The smaller age of rats with SE onset,the greater the nestin intensity.But the number of nestin positive cells in the dentate gyrus of normal rats were gradually decreased with increasing age.Nestin positive cells were distributed in subgranular zone of dentate gyrus on 1 d and 7 d after SE,then gradually migrated to the granule cell layer on 14 d with morphological changes.Small part of nestin positive cells were ectopically migrated to the hilus of dentate gyrus in P14,P21,P28 age rats,and were also seen in the CA1,CA3 of hippocampus and cortex with various cell morphology.For differentiation of newly generated cells,most of Brdu positive cells coexpressed NeuN and about 4％-5％ cells co-expressed GFAP.Conclusions SE could induce neurogenesis in the hippocampal dentate gyrus area in developing rats which has age-related characteristics.Most new cells migrate from the subgranular zone to the granule cell layer of the dentate gyrus,and a small number of newly generated cells ectopically migrated to the hilus of dentate.The majority of newly generated cells differentiate into neurons,and the others differentiate into glial.