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Objective:To investigate the values of Ki-67 expression level and 4 molecular types for risk classification of prognosis in patients with medulloblastoma (MB).Methods:A retrospective study of 92 MB patients who underwent surgery and were confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from January 2009 to January 2018 was performed. The clinical data and survival data of the patients were collected and sorted out. The overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method, and the log-rank test was performed. Risk stratification of prognosis of patients was performed according to the Ki-67 expression level combined with molecular typing, the low-risk group had Ki-67 positive index ≤50% and WNT or SHH subtype, the medium-risk group had Ki-67 positive index ≤50% and GROUP 3 or GROUP 4 subtype, or Ki-67 positive index >50% and WNT or SHH subtype), and the high-risk group had Ki-67 positive index >50% and GROUP 3 or GROUP 4 subtype. The differences in OS and PFS among different risk groups were compared. A multivariate Cox proportional hazards model was used to assess factors affecting the survival of patients.Results:There were 50 cases (54.3%) with Ki-67 positive index ≤50% and 42 cases (45.7%) with Ki-67 positive index >50%. The 5-year PFS rate and OS rate of patients with Ki-67 positive index ≤50% were 46.9% and 63.1%, and patients with Ki-67 positive index >50% were 28.5% and 32.0%, there were statistical differences in PFS and OS between the two groups ( P values were 0.020 and 0.028). There were 16 cases (17.4%) of WNT subtype, 14 cases (15.2%) of SHH subtype, 40 cases (43.5%) of GROUP 3 subtype and 22 cases (23.9%) of GROUP 4 subtype, their 5-year PFS rates were 78.0%, 76.0%, 19.2% and 19.9%, respectively, and their 5-year OS rates were 82.1%, 76.0%, 40.2% and 0, respectively. MB patients with GROUP 3 or GROUP 4 subtype had poorer PFS and OS than patients with WNT or SHH subtype ( P values were 0.003 and 0.039). Ki-67 expression level and molecular typing were combined to carry out risk classification of prognosis. There were 12 cases (13.0%) in the low-risk group, 56 cases (60.9%) in the medium-risk group, and 24 cases (26.1%) in the high-risk group . There were statistical differences in PFS and OS among MB patients in low-, medium- and high-risk groups (both P < 0.001). Multivariate Cox regression analysis showed that radiotherapy and risk classification of prognosis as medium risk and low risk were independent protective factors for PFS (radiotherapy vs. no radiotherapy: OR = 0.263, 95% CI 0.124-0.556, P < 0.001; medium-risk group vs. high-risk group: OR = 0.069, 95% CI 0.008-0.581, P = 0.014; low-risk group vs. high-risk group: OR = 0.260, 95% CI 0.131-0.514, P < 0.001); radiotherapy and risk classification of prognosis as low risk were independent protective factors for OS (radiotherapy vs. no radiotherapy: OR = 0.221, 95% CI 0.097-0.503, P < 0.001; low-risk group vs. high-risk group: OR = 0.328, 95% CI 0.150-0.717, P = 0.005). Conclusions:The expression level of Ki-67 and 4 molecular types are related to the prognosis of MB patients. The combination of the two can be used to classify the prognosis risk of MB patients, which has reference significance for the prediction of prognosis of patients and the selection of individualized treatment plans.
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Objective:To explore the effect of different glucose concentrations on the uptake of 18F-FDG and the expression of glucose transport protein(Glut)-1 and Glut-3 in non-small cell lung cancer (NSCLC). Methods:NSCLC cell line A549 cells were cultured in DMEM medium with glucose concentrations of 3.9, 5.0, 6.1, 8.3 and 11.1 mmol/L respectively for 24 h. Then 3.7×10 4 Bq 18F-FDG was added into each group and γ counter was used to measure the radioactivity count 1 h later. Western blot was used to examine the expression of Glut-1 and Glut-3. One-way analysis of variance and Bonferroni test were used for data analysis. The correlation was analyzed by Pearson correlation analysis. Results:The 18F-FDG uptake rates in 3.9, 5.0, 6.1, 8.3 and 11.1 mmol/L groups were (4.89±0.83)%, (4.07±0.23)%, (3.66±0.29)%, (3.34±0.16)% and (3.29±0.24)%, respectively ( F=7.05, P=0.006). Compared with 3.9 mmol/L group, the 18F-FDG uptake rates in 8.3 and 11.1 mmol/L groups were reduced and differences were statistically significant ( P values: 0.013, 0.010), while there were no statistical differences between the other groups ( P values: 0.057-0.999). The relative expressions of Glut-1 and Glut-3 in each group were 1.17±0.10, 1.00±0.00, 0.84±0.07, 0.70±0.18, 0.61±0.16, and 1.14±0.05, 1.00±0.00, 0.86±0.12, 0.71±0.05, 0.40±0.06, respectively ( F values: 10.26 and 51.94, P values: 0.001, <0.001). Moreover, the 18F-FDG uptake rates were positively correlated with the expression of Glut-1 and Glut-3 ( r values: 0.775 and 0.744, both P=0.001). Conclusions:When the glucose concentration fluctuates within 3.9-11.1 mmol/L, the change of glucose will affect the 18F-FDG uptake rate and the expression of Glut-1 and Glut-3 in A549 cells. Moreover, the 18F-FDG uptake rate is related to the expressions of Glut-1 and Glut-3.
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Objective:To investigate the distribution of 99Tc m-methylene diphosphonate (MDP) at different stages of bone injury repair. Methods:A total of 30 rabbit models of femur injury were established by the method of electric drill and perforation of femur. According to the different stages of bone injury repair (at 1, 2 and 3 week), rabbits were divided into group A, B and C ( n=10 each group). Femoral SPECT/CT imaging was performed on the last day of different stages of bone injury repair to obtain radioactivity counts in the region of interest (ROI) on the test side and control side and to calculate target/background ratio (T/B). The light intensity of 3 groups was analyzed by phosphor screen imaging and the distribution of 99Tc m-MDP in bone cells was observed by autoradiography. One-way analysis of variance and paired t test were used to analyze the data. Results:The T/B values of group A, B and C were 1.16±0.14, 1.39±0.23 and 1.18±0.10, respectively ( F=5.83, P<0.01). There were significant differences of the maximum radiation count between the test side (50.00±12.45, 59.50±12.83 and 55.10±9.26) and the control side (43.20±9.57, 50.00±12.30 and 44.30± 6.50) in group A, B and C ( t values: 3.24, 2.28 and 5.77, all P<0.05). There were significant differences in the light intensity of bone specimens in group A, B and C by phosphor screen imaging (37 324.67±6 481.50, 60 950.33±9 781.72 and 43 905.00±4 957.92; F=8.25, P=0.02). 99Tc m-MDP were deposited in both intracellular and extracellular during different stages of bone repair in osteocytes and osteoblasts under autoradiography. Conclusion:At different stages of bone injury repair, the concentration of 99Tc m-MDP is significantly distributed, suggesting that there are other ways of concentration mechanism of 99Tc m-MDP in bone tissue besides the chemical adsorption with hydroxyapatite.
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During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.
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Since December 2019, corona virus disease 2019 (COVID-19) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of COVID-19. Based on the needs of emergency surgery for orthopedic trauma patients and review of the latest diagnosis and treatment strategy of COVID-19 and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of COVID-19 and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.
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Objective:To explore the correlation between TCM Syndromes of small pulmonary nodules (SPN) and the features of CT imaging and tumor markers in the chest.Methods:With retrospective study, the clinical data of 420 patients with small pulmonary nodules who were included from June 2016 to May 2018 from the East China Hospital Affiliated to Fudan University and Shanghai TCM Integrated Hospital were analized. The correlation between TCM syndromes and clinical high-risk indicators was analyzed by frequency analysis and Pearson correlation analysis.Results:The TCM syndromes were mainly lung qi and spleen qi deficiency syndrome (28.8%), followed by qi and yin deficiency syndrome (27.6%), lung yin deficiency syndrome (22.9%), qi deficiency and blood stasis syndrome (12.4%) and liver depression and spleen deficiency syndrome (8.3%). Compared with the patients with qi deficiency and blood stasis, the patients with liver depression and spleen deficiency had carcino embryonic antigen (CEA) level decreased significantly ( P<0.01); compared with the patients with qi and yin deficiency, CYFRA21-1 level in the patients with lung yin deficiency increased significantly ( P<0.001) and CYFRA21-1 level decreased in the patients with qi deficiency and blood stasis ( P=0.014); compared with the patients with lung yin deficiency, the level of neuron-specific- enolase (NSE) in the patients with lung qi and spleen qi deficiency. The level of NSE decreased ( P=0.044), and the level of NSE increased significantly in patients with liver depression and spleen deficiency ( P=0.005); there was no significant difference in the level of SCC between different syndromes ( F=0.825, P=0.551). The syndrome of deficiency of lung yin was moderately correlated with chronic bronchitis, smooth margin and burr ( r=0.613, -0.628, 0.755). The syndrome of qi and yin deficiency was lowly correlation to the solidity ( r=-0.421). The syndrome of lung qi and spleen qi deficiency was moderately correlation with the solidity ( r=0.540), and were low correlation with the chronic bronchitis history, ground glass, round, quasi round, and smooth edge ( r value was 0.303, -0.495, 0.376, -0.337, 0.319 respectively); liver depression and spleen deficiency syndrome were correlated with smoking history, chronic bronchitis history, left lower lobe of lung, isolated focus, multiple focus, quasi circle, NSE ( r value was -0.099, -0.150, 0.120, 0.113, -0.113, -0.107, 0.133 respectively); qi deficiency and blood stasis syndrome was moderately correlated with lobular shape ( r=0.682), and slightly correlated with irregular edge ( r=0.470). Conclusions:There is a certain correlation between TCM syndrome differentiation and clinical indexes in patients with pulmonary nodules. The level of tumor markers was different in different syndrome types. Among them, the lung yin deficiency syndrome and qi deficiency and blood stasis syndrome are at high risk of developing malignant tumors, but the lung qi and spleen qi deficiency syndrome, qi and yin deficiency syndrome and liver depression and spleen deficiency syndrome are at low risk of developing malignant tumors.
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Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.
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Objective To study the influence of excessive iodine intake on the 99Tcm-pertechnetate uptake function of thyroid and explore the related mechanism.Methods A total of 150 male Wistar rats were divided into normal iodine group (NI group) and 4 high iodine (HI) groups (10HI,50HI,100HI and 500HI group) with completely random method.Each group included 30 rats.Rats in HI groups were intragastrically administrated with different concentrations of KIO3,and rats in NI group were administrated with the same amount of distilled water.After a 7 d HI diet,each group was randomly divided into 3 subgroups:7 d group (HI diet for 7 d),10 d group (HI diet for 7 d + limiting iodine for 3 d) and 14 d group (HI diet for 7 d + limiting iodine for 7 d).All rats were given 1.85 MBq 99TcmO4-,then the thyroid glands were isolated and weighed 20 min post-injection.The radioactive counts were measured and the thyroid uptake percentage activity of injected dose per gram of tissue (％ID/g) of 99TcmO4-for each sample was calculated.Sodium-iodide symporter (NIS) expression level was analyzed by Western blot.One-way analysis of variance or Welch test was used to compare the differences among groups,and Spearman rank correlation analysis was also used.Results At the same observation time,the ％ID/g of 99TcmO4-and NIS expression among different HI groups were statistically significant (F values:48.825-119.219,all P＜0.01).In NI and 10 HI groups,％ID/g of 99TcmO4-and NIS expression were not significantly different among different time subgroups (F values:0.090-4.753,all P＞0.05).Significant differences of ％ ID/g of 99TcmO4-and NIS expression were found among different time subgroups in 50HI,100HI and 500HI groups (F values:10.442-90.408,all P＜0.01).Spearman correlation analysis showed that the concentration of iodine correlated negatively with ％ID/g of 99TcmO4-and NIS expression (rs values:-0.853 and-0.950,both P＜0.01),while the ％ID/g of 99TcmO4-and NIS expression was positively correlated (rs =0.925,P＜0.01).Conclusions Excessive iodine intake can inhibit thyroid uptake of 99TcmO4-in rats,which is associated with the down-regulation of NIS expression.The degree of inhibition correlates positively with iodine concentration,and correlates negatively with NIS expression.The degree of recovery of NIS and ％ID/g of 99TcmO4-may relate to the time of limiting the iodine intake.
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Objective A new type of double-tube standard source load model provides better simulation of the human thyroid than does a traditional single-tube standard source load model. The radioactive counts of these two models were compared, as were their impacts on thyroid iodine-131 (13lI) uptake rates. Methods A double-tube standard source load model was used to analyze its impact on the rates of 131I uptake by the subjects' thyroid glands, and to compare the results with those obtained using a single-tube standard source load model. Radioactive counts in different positions were measured by thyroid function instruments, and compared. Results The 131I uptake rates by the subjects' thyroid glands at 2, 4, and 24 hours obtained using a double-tube standard source load model were lower than those obtained using a single-tube standard source load model; the differences were statistically significant (P ＜ 0. 05). Radioactive counts obtained using the double-tube standard source load model in different positions were higher than those obtained with the single-tube standard source load model; the differences were statistically significant (P ＜ 0. 05). Radioactive counts decreased with increased displacement when models were placed at 10, 12, 14, 16, and 18 cm in the horizontal direction, and at 0, 1, 2, and 3 cm in the vertical direction. Conclusion The l31I uptake rates by the subjects' thyroid glands observed using a double-tube standard source load model were lower than those observed using a single-tube standard source load model.
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Objective To evaluate the damage of the salivary gland in Sjogren's syndrome (SS)patients with normal Young's modulus value (YMV) using salivary gland dynamic imaging (SGDI).Methods A total of 78 parotid glands and submandibular glands of SS patients and 100 parotid glands and submandibular glands of healthy people were collected in this retrospective study.The difference of YMV between 2 groups was analyzed with two-sample t test;receiver operating characteristic (ROC) curves of YMV were drawn to calculate the area under carve (AUC) and cut-off values.SGDI was used to observe the uptake ratio of 15 min (UR15) value in the SS salivary glands with normal YMV.Results The YMV of left parotid/submandibular glands and right parotid/submandibular glands were not statistically different in both SS patients and healthy people (t values:from-1.192 to-0.404,all P＞0.05).The YMV of parotid/submandibular glands in SS patients was higher than that in healthy people:(15.39±8.08) vs (9.33±2.21) kPa,(14.35±5.33) vs (9.18±2.36) kPa (t values:7.169 and 8.662,both P＜0.05).ROC curves showed that the AUC of parotid glands and submandibular glands were 0.78 and 0.83.As the cut-off values of YMV were 10.85 kPa and 10.95 kPa,the sensitivity were 69.23％ (54/78) and 73.08％ (57/78),the specificity were 77.00％ (77/100) and 83.00％ (83/100),the positive predictive value were 70.13％ (54/77) and 77.03％ (57/74),the negative predictive value were 76.24％ (77/101) and 79.81％ (83/104),respectively.There was no statistically difference between YMV and UR15 for evaluating the SS parotid glands and submandibular glands (x2 values:0.963 and 0.896,both P＞0.05).The UR15 value of 78 SS parotid glands and submandibular glands were 1.42±0.97 and 1.19±0.83,respectively.About 58.33％ (14/24) parotid glands with normal YMV (＜10.85 kPa) and 76.19％ (16/21) submandibular glands with normal YMV (＜10.95 kPa)had reduced cellular uptake in SS patients.Conclusions Parotid glands and submandibular glands in SS patients are damaged,and the tissue hardness is increased.SGDI can discover the cellular damage in SS salivary glands with normal YMV.
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Objective To evaluate the predictive value of posttreatment whole body scan (RxWBS) for radiation damage to the salivary glands in patients with differentiated thyroid carcinoma (DTC).Methods From April 2015 to June 2015,24 patients (8 males,16 females;age:26-64 years) with DTC,who accepted 131I therapy only one time and underwent Rx-WBS 2-4 d after 131I treatment,were recruited from the First Hospital of China Medical University.All patients had normal salivary glands function on salivary gland scintigraphy (SGS) performed on the day before 131I treatment,and 21 patients underwent SGS again 3 months after 131I treatment.The SGS results and clinical manifestations were used to evaluate the function of salivary glands after 131I therapy.Rx-WBS was analyzed by visual analysis and quantitative analysis (salivary gland to background uptake ratios,SUR).The SUR was compared between patient groups with different function of salivary glands.Mann-Whitney u test was used.Receiver operating characteristic (ROC) curve analysis was used to calculate the sensitivity of SUR for predicting the salivary gland damage.Results The SUR in dysfunctional parotid glands (n =12) was significantly higher than that in other glands with normal function (n=30;3.60(2.55,4.33) vs 2.75(2.33,3.29);z=-2.005,P＜0.05).The SUR was not different between submandibular glands with lower function (n =15) and those with normal function (n=27;z=-0.144,P＞0.05).The SUR of parotid glands (n =32) in patients with parotitis was significantly higher than that in others (n=16;3.16(2.53,4.01) vs 2.49(206,2 81);z=-3.073,P＜0.05).The SUR of submandibular glands (n=28) in patients with sialadenitis was significantly higher than that in others (n=20;4.43(2.67,7.61) vs 2.93(1.92,4.65);z=-2.740,P＜0.05).When 2.97 and 3.66 were selected as cutoff values,the sensitivities of SUR for predicting parotitis and sialadenitis were 59％(19/32) and 64％ (18/ 28),respectively.Conclusion Rx-WBS may play a role in predicting radiation damage to the salivary glands.
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Objective To explore the classical clinical features of mitochondrial encephalomyopathy with lactic acidosis and stroke like episodes (MELAS) syndrome.Methods The clinical data of 1 MELAS syndrome patient was analyzed retrospectively.Results This patient suffered from the symptoms of stroke such as speech disorder and abnormal behavior at the beginning.She had a medical history of maternal family.There were headache and seizure in the process of the disease.The result after a physical examination showed that the patient had hearing loss, visual field defect and decrease of muscle strength.The CT and MRI scan of head showed that the patient had a stroke like lesion which did not follow the distribution of blood vessels.The blood and cerebrospinal fluid examination has ruled out viral and autoimmune encephalitis.The final diagnosis of MELAS syndrome was confirmed by gene analysis.The gene mutation was the m.3243A>G mutation.The clinical symptoms of the patient were comprehensive and the imaging findings were typical.Conclusions Main clinical manifestations of MELAS syndrome are stroke like seizures, epilepsy, headache, dementia, hearing impairment, peripheral neuropathy, myopathy, lactic acidosis, diabetes and so on.Main imaging features of the disease are stroke like lesions, basal ganglia calcification and brain atrophy.
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The hybrid PET/MR has been gradually applied in clinical practice.However,the hybrid PET/MR is a com plex advanced technique,and it brings to the new challenges,especially regarding the workflow and scan protocols.The guidelines for hybrid PET/MR in brain imaging include information related to the indications and contraindications,preparation before examination,procedures of examination (PET imaging,conventional MRI brain imaging and special MRI imaging for brain disease),application of radiopharmaceutical and MRI contrast-enhanced agent.The purpose of the guidelines is to offer a framework that would be practical and helpful for clinical PET/MR brain imaging.In PET tracers,the guidelines only limit to the 18 F-FDG.
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The guidelines for standard nursing in the PET/MR imaging examination included preparation of examination,injecting drug,observing during scanning,post scanning care,management of adverse reaction of contrast agent and radiation protection.The purpose of these guidelines could were to provide the practical and effective management for nursing care in PET/MR imaging,and offer a framework for nurses that could provide useful and helpful in clinical practice and research.
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Objective To explore the significance of 18fluorodeoxyglucose positron emission tomography(18F?FDG PET/CT)in the etiological diag?nosis of postoperative intestinal obstruction in patients with gastrointestinal cancer. Methods A total of 51 patients with postoperative intestinal ob?struction undergone 18F?FDG PET/CT were enrolled for the study. The images were interpreted by visual and semi?quantitative analysis(maximum standard uptake value,SUVmax). All the cases were confirmed by pathology and clinical follow?up for more than half a year. The sensitivity,specifici?ty and accuracy of 18F?FDG PET/CT for detecting malignant intestinal obstruction were calculated. Results Of the 51 patients,35 cases were con?firmed for malignant intestinal obstruction,and 16 cases were caused by other benign diseases. 18F?FDG PET/CT imaging was positive in 36 cases, and 33 cases were diagnosed as malignant and recurrent intestinal obstruction. Three cases of PET false?positive were peritonitis adhesion and anasto?motic inflammation. Two cases of PET false negative were peritoneal micrometastasis. The SUVmax of malignant lesions was 8.86±4.82,and the SUVmax of benign lesions was 2.05±1.95. The uptake of FDG was significantly higher in malignant intestinal obstruction than in benign intestinal obstruction (t=7.15,P<0.01). The sensitivity,specificity,and accuracy of 18F?FDG PET/CT diagnosis of malignant lesion were 94.3%,81.3%,and 90.2%, respectively. Conclusion The uptake of 18F?FDG in malignant intestinal obstruction was higher than that in benign intestinal obstruction. 18F?FDG PET/CT have a good diagnostic value for the intestinal obstruction of postoperative gastrointestinal cancer.
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Information management system of nuclear medicine (IMSNM) is an important part of modem medical information system.It is used for the scientific management of clinical works,and classification and storage of patient data and examination data (words and images).With the help of IMSNM,standardization,automation and digitization of clinical operation protocols,the scientific and normalized management,the unification of image storage and viewing could be achieved.The IMSNM plays an important role in the health care,education and scientific research.This study mainly describes the design and application of IMSNM.
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Objective To compare the imaging features of 18F-FDG PET/CT in malignant pleural effusion (MPE) and tuberculosis pleural effusion (TPE).Methods From January 2012 to December 2014,93 patients (52 males,41 females,and average age (66.7±12.7) years) with unexplained pleural effusion who underwent 18F-FDG PET/CT were retrospectively studied.MPE and TPE were confirmed by histology,cytology or clinical follow-up.Lesion SUVmax and T/NT were calculated.Both lesion size and density (in Hounsfield units) of pleural abnormalities on CT images were measured.The difference of images between MPE and TPE was analyzed.Diagnostic efficiency of 18F-FDG PET/CT for detecting MPE and TPE were estimated.Two-sample t test and x2 test were used to analyze the data.Results The lesion SUVmax of 66 patients with MPE and 27 patients with TPE was higher than that in normal tissues (7.72±6.50,8.43±4.92;t=7.81 and 7.15,both P＜0.01),but there was no statistical difference between the TPE and MPE (t=0.56,P＞0.05).T/NT was not significantly different between MPE and TPE (5.40±4.29,5.20±2.73 respectively,t=-0.22,P＞0.05) either.The uptake features of 18F-FDG were different between MPE and TPE (x2=29.3,P＜0.01).When the nodular 18F-FDG uptake increase in pleura was taken as the malignancy,diffuse 18F-FDG uptake increase in pleura as tuberculosis,the sensitivity,specificity,positive predictive value,and negative predictive value of 18F-FDG PET/CT were 78.8％ (52/66),81.5％ (22/27),91.2％ (52/57),61.1％ (22/36),respectively,for differentiation of MPE from TPE.Primary cancers were found in 43 patients.When the nodular uptake increase in pleura,or primary cancer associated with increased pleural uptake found by PET was taken as the malignancy,the above mentioned parameters were95.5％(63/66),81.5％(22/27),92.6％(63/68),88.0％(22/25),respectively.Conclusions The 18FFDG uptake in MPE and TPE is higher than that in normal tissues.18F-FDG PET/CT is helpful in the search for the primary tumor of MPE.Qualitative method of 18F-FDG PET/CT has a good value in the differentiation of MPE from TPE.
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Background and purpose:The proportion of incidental thyroid cancer in PET imaging was sig-niifcantly increased with the wide application of18F-FDG PET/CT. The correlation between the glucose metabolism of thyroid incidental thyroid cancer and pathological changes is unclear. The objective of this study is to analyze the relationship between the glucose metabolism by18F-FDG PET/CT and tumor differentiation or lymph node metastasis in patients with incidental thyroid cancer.Methods:A total of 195 patients with focal FDG-avid thyroid incidentaloma during cancer evaluation were enrolled. Fifty-three patients were diagnosed as having thyroid cancer by the pathology. The SUVmax of thyroid cancer foci, lesion size, lesion number, and SUVmax of normal thyroid tissue were quantiifed. The tumor pathological grades and lymph node metastasis were analyzed by the pathology. The patients were broken down into 4 groups (G1, G2, G3 and G4) according to the tumor pathological grades and lymph node metastasis (differentiated thyroid cancer, non-differentiated thyroid cancer, without lymph node metastasis and with lymph node metastasis). The differences of glucose metabolism between G1and G2groups, G3 and G4 groups were analyzed.Results:Fifty-three foci were found by PET imaging. Sixty-two foci were found by the pathology (37 papillary thyroid carcinoma, 4 follicular thyroid carcinoma, 9 medullary thyroid carcinoma, 3 poorly differentiated thyroid cancer). The SUVmax in the normal thyroid tissue, G1and G2were 1.51±0.30, 4.25±1.70 and 6.34±2.45, respectively. The SUVmax in the G1and G2were signiifcantly higher than in the normal thyroid tissue (t=11.0,t=7.10,P0.05;t=0.33,P=0.56).Conclusion:The differentiated incidental thyroid carcinoma and non-differentiated incidental thyroid carcinoma had high glucose metabolism, and there was no signiifcant difference in the levels of glucose metabolism in different differentiation degree and metastasis ability cancer.
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Objective To evaluate the efficacy of 90Sr-90Y applicator treatment for hemangioma by superficial ultrasound.Methods A total of 94 infants with hemangioma were retrospectively analyzed,including 37 males and 57 females (age range:1-12 months,mean =4.5 months).Thickness of hemangioma was measured by superficial ultrasound on the day before 90Sr-90Y applicator treatment,10 d and 3 months after treatment.Paired t test and x2 test were used to analyze data.ROC curve was analyzed to determine the tumor thickness which could be cured by one-cycle of treatment.Results Sixty-two cases were cured,29 cases had partial response and 3 cases had treatment failure.Thickness of hemangioma was (0.38 ±0.28)cm before treatment and (0.16±0.35) cm 3 months post-treatment and the difference was statistically significant (t=7.377,P＜0.05).The treatment effect of 90Sr-90Y applicator was not influenced by gender.According to the site of hemangioma,the curative rates were 20/38 in head & neck,22/33 in chest,20/23 in limbs.Only the difference between the curative rates in head & neck and limbs was statistically significant (x2 =7.478,P＜0.05).The treatment effect of 90Sr-90Y applicator was evaluated by the thickness of hemangioma under the skin at 3 months post-treatment and the area under the ROC was 0.93.The threshold of the thickness of hemangioma which could be cured by one-cycle of treatment was 0.32 cm with the sensitivity of 93.8％ and specificity of 85.5％.Conclusions The 90Sr-90Y applicator had a good treatment effect on pure hemangioma in infants,especially for those located in limbs and torso.The lesion with thickness less than 0.32 cm had a higher chance to be cured by one-cycle of treatment.
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Objective To explore the characteristic of SPECT/CT imaging of osteolytic lesions with increased bone metabolism and its correlation with CT manifestation. Methods Twenty?one cancer patients with bone metastases underwent 99 Tcm?MDP SPECT/CT imaging ( 13 males, 8 females; age: ( 60. 52 ± 6?85) years) were retrospectively studied. The imaging characteristic of the lesion with high uptake of 99Tcm?MDP was observed and the correlation between the lesion/background ( L/B ) ratio and CT manifestation were analyzed. One?way analysis of variance, two?sample t test and linear correlation analysis were used. Results A total of 111 lesions were found in 21 patients by 99 Tcm?MDP whole?body bone scan, and 125 le?sions were found by SPECT/CT imaging, including 111 lesions with increased bone metabolism and abnor?mal CT manifestation and 14 osteolytic lesions with decreased bone metabolism. In 111 lesions with in?creased bone metabolism, there were 23(20.72%) osteolytic lesions, 54 (48.65%) osteoblastic lesions and 34 (30.63%) mixed lesions. The L/B ratio of osteolytic lesions with increased bone metabolism (11.82± 6?61) was lower than that of osteoblastic lesions (20.03±13.24) and that of mixed lesions (25.42±19.51;F=6.00, P<0?05) . The CT value of osteolytic lesions with increased bone metabolism was higher than that of osteolytic lesions with decreased bone metabolism :(167.53±79.21) HU vs (88.63±49.16) HU; t=3?345, P<0.05. The L/B ratio of lesions with increased bone metabolism was positively correlated to CT val?ue(r=0.404, P<0?05). Conclusions A part of lesions with increased bone metabolism on SPECT/CT im?ages are osteolytic lesions. The L/B ratio of them is positively correlated to CT value. SPECT/CT imaging can reduce missed diagnosis and misdiagnosis.