Risk factors analysis of achilles tendon rupture in male by propensity score / 中国医师杂志

Objective:To investigate the risk factors of achilles tendon rupture in male patients and to verify them.Methods:Retrospective analysis was made on the medical records of male inpatients with achilles tendon rupture (242 cases in achilles tendon rupture group) and simple ankle joint injury (825 cases in control group) admitted to Qilu Hospital of Shandong University from May 2013 to June 2020. The tendency score matching method was used to balance the confounding factors at a ratio of 1∶1. After matching, 147 cases were in achilles tendon rupture group and 147 cases in control group. The baseline data and related indicators were compared before and after matching, and the risk factors of achilles tendon rupture were analyzed by constructing a multivariate logistic regression model.Results:The age, smoking rate, drinking rate, family history of hypertension and diabetes, previous history of hypertension, diabetes and coronary heart disease, and BMI of the achilles tendon rupture group before matching were significantly lower than those of the control group (all P<0.05). After matching, there was no significant difference in age, smoking proportion, drinking proportion, family history of hypertension, diabetes and coronary heart disease, previous history of hypertension, diabetes and coronary heart disease, and BMI between the two groups (all P>0.05). After matching, the levels of fasting uric acid (UA), cholesterol (TG) and triglyceride (TC) in achilles tendon rupture group were significantly higher than those in control group, and the differences were statistically significant (all P<0.05). Multivariate binary logistic regression analysis showed UA ( OR=1.006, 95% CI: 1.003-1.010, P<0.001), TC ( OR=2.462, 95% CI: 1.194-5.076, P=0.015) was an independent risk factor for achilles tendon rupture in male. Conclusions:Dyslipidemia and UA may be an independent risk factor for achilles tendon rupture in male.

Medium-term clinical effects of minimally invasive percutaneous plate osteosynthesis for type sander Ⅲ, Ⅳ calcaneal fractures / 中国医师杂志

Objective:To compare minimally invasive percutaneous plate osteosynthesis (MIPPO) and open reduction and internal fixation via traditional lateral L-type approach (ORIF-LA) in the therapeutic effects concerning reduction and calcaneal alignment for Sanders Ⅲ/Ⅳ calcaneal fractures.Methods:A retrospective analysis was conducted of the 105 patients with calcaneal fracture who had been treated at Department of Foot and Ankle Surgery, Qilu Hospital from 2014.1 to 2018.2. Of them, 50 were treated with MIPPO (group A) and the other 55 with ORIF-LA (group B). The X-ray lateral and axial films, three-dimensional computed tomography (CT) of the calcaneal were taken pre-operatively and post-operatively to evaluate the reduction and calcaneal alignment. The American Orthopedic Foot Ankle (AOFAS) Ankle-Hind Foot Scale and Foot Function Index-Verbal Rating Scales (FFI-5pt) were adopted to assess the therapeutic effects. The postoperative complications of the two groups were compared.Results:All patients were followed up for 20-36 months (mean 24 months). The length of hospital stay and incision in group A was shorter than that in group B ( t=-11.276, -25.965, P<0.001). In group A and group B, the correction degrees of B?hler angle and Gissane angle were (34.49±3.81)°, (35.12±3.77)° and (-20.62±9.86)°, (-20.94±8.38)°, respectively ( P>0.05). Posterior calcaneal articular surface defects or steps in group A and group B were 1.55(1.12, 2.00)mm and 1.20(1.03, 1.60)mm, indicating that there was no significant difference in the reconstruction ability between the two groups ( P>0.05). There was no significant difference in VAS pain score between the two groups at 3 months after operation ( P>0.05), but group A was significantly lower than group B at 3 days after operation ( P<0.001). There was no significant difference in AOFAS and FFI-5pt scores between the two groups at 18 months after operation ( P>0.05). The complications of group A (6.0% incision infection, 2.0% incision area sensory disturbance, 2.0% foot stiffness) were lower than those of group B (16.36% incision infection, 14.55% incision area sensory disturbance, 10.9% foot stiffness) ( P<0.05). Conclusions:Compared with ORIF-LA, the MIPPO shows promising results in terms of reduction capacity and safety. Use of the MIPPO technique minimized the risk of postoperative wound complications and achieved superior functional outcomes compared with standard locking plate fixation via the extended lateral approach. MIPPO can be used as a choice for the treatment of calcaneal fracture.

Research progress of PET metabolic radiomics / 中华核医学与分子影像杂志

In recent years, the development of artificial intelligence technology has promoted the rise of radiomics, which makes image analysis tools, especially texture analysis, extensively concerned in image analysis of PET. In the study of radiomics, tools for image feature analysis such as texture analysis can extract rich information about pathological tissues from the imaging data to describe the characteristics of tumors, judge the prognosis, and evaluate the curative effect of tumors. This review mainly summarizes the research status, progress, challenges and foreground of texture analysis in PET metabolic radiomics.

Elastic fixation with Tightrope system for inferior tibiofibular syndesmosis diastasis: a cadaveric study / 中华创伤骨科杂志

Objective:To study the performance of the elastic fixation with our self-designed Tightrope system for inferior tibiofibular syndesmosis (ITFS) diastasis.Methods:In this self-control study, 6 specimens of normal cadaveric ankle were used as a normal ITFS group while the models of the ITFS diastasis were constructed as a group of ITFS diastasis. On the models of ITFS diastasis, elastic fixation with transverse Tightrope system (transverse fixation group) or binding Tightrope system (binding fixation group) was applied. The reduction and stability of ITFS were compared between transverse fixation and binding fixation for ITFS diastasis in terms of ITFS parameters on X-Ray[tibiofibular clear space (TFCS) and medial clear space (MCS)] and on CT[inferior tibiofibular anterior clear space (ITFACS), inferior tibiofibular middle clear space (ITFMCS), inferior tibiofibular posterior clear space (ITFPCS), anterior inferior tibiofibular interval (AITFI) and fibular rotation (θfib)].Results:The transverse fixation with Tightrope system for ITFS diastasis on the models led to iatrogenic injury to the fibular and the ITFS interosseous ligaments and to the perforating peroneal artery, and malreduction as well while the binding fixation with Tightrope system caused no injury to the anterior or the posterior ITFS ligament or the superior peroneal retinaculum but fine reduction as well. In comparisons of TFCS, ankle MCS, ITFACS, ITFMCS and AITFI between the 4 groups, normal ITFS group<binding fixation group<transverse fixation group<ITFS diastasis group; in comparison of ITFPCS between the 4 groups, transverse fixation group<binding fixation group<normal ITFS group< ITFS diastasis group; in comparison of θfib between the 4 groups, normal ITFS group<binding fixation group< ITFS diastasis group< transverse fixation group. Significant differences were shown in all the pairwise comparisons ( P<0.05). Conclusion:The binding fixation with our self-designed Tightrope system may be superior to the transverse fixation in surgical approach and reduction and stability of ITFS.

One case of papillary carcinoma of thyroid following successful liver transplantation / 中华内分泌外科杂志

The incidence of papillary thyroid cancer after liver transplantation is relatively low. This article introduces the treatment and prognosis of a case of papillary thyroid cancer after liver transplantation, and discusses the occurrence and development of thyroid cancer after liver transplantation and perioperative management and the prognosis, in order to further enhance the comprehensive management of such patients, extend the survival period and improve the quality of life.

Single-stage reconstruction of achilles tendon and overlying skin defect with peroneus brevis tendon transfer and peroneal tendofascial flap / 中华显微外科杂志

Objective To explore the efficacy of peroneus brevis tendon transfer and peroneal tendofascial flap for repairing achilles tendon and overlying skin defect.Methods From April,2004 to May,2015,5 cases of achilles tendon and overlying skin defect were treated with peroneus brevis tendon transfer and peroneal tendofascial flap.In these cases,the length of the achilles tendon defect was from 3.0 cm to 8.0 cm,and the size of skin defect ranged from 2.0 cm × 3.0 cm to 3.0 cm × 5.0 cm.Using peroneus brevis tendon to reconstruct achilles tendon defect,and covered with peroneal tendofascial flap,and then skin graft.One of them combined with the gastrocnemius tendon V-Y advancement to promote the reconstruction of achilles tendon longer defect.The patients were followed-up regularly,and evaluated by the American Society of Ankle Arrhythmia (AOFAS) ankle-hindfoot scoring system.ResultsAll operations were successful and the grafted skin survived.All cases were followed-up from 6 months to 10 years with an average of 5.2 years.At the time of last followed-up,all wounds healed well without re-infection and ulceration.Not foot varus deformity and the strongth was back to the level before the injury.AOFAS ankle-hindfoot score was increased from (50.44 ± 12.05)(preoperative) to (90.02 ± 6.55)(the last follow-up) (P＜0.05).Conclusion There were some advantages in the method of the treatment of achilles tendon and overlying skin defect by using peroneus brevis tendon transfer and peroneal tendofascial flap,such as easy to cut,small damage to the donor area,and no significant deformity to the receptor area,etc.It is a good way to repair achilles tendon and overlying skin defects.

Implementation and management of clinical research training / 中华医学科研管理杂志

Clinical research design is the beginning and the cornerstone for clinical research,and it functions as the preliminary step of translational research.In order to improve clinical research ability,foster quality research talents team,and to promote the development of translational research,Peking Union Medical College Hospital (PUMCH) started to provide the online course Designing Clinical Research (DCR),which has greatly contributed to enhancing clinical research capacity.The management of DCR online course serves as a great exploration on training junior medical professionals and international research collaboration.This study aims at sharing the management experiences of clinical research design and junior talents training.

Comparison of ultrasound and position emission tomography/computerized tomography in diagnosis and lymph node staging of breast cancer / 中华医学超声杂志（电子版）

Objective To compare the application of ultrasound and positron emission tomography/computed tomography (PET/CT) in diagnosis and lymph node staging of breast cancer. Methods Using automated breast volume scanner (ABVS) and PET/CT examination of 40 lesions in 38 patients, and for comparison with the pathological findings, the diagnostic accuracy of PET/CT and ABVS in breast cancer was comparatively analyzed. Results The sensitivity of ABVS in the diagnosis of breast cancer was 95.65%, the specificity was 70.59%, and the accuracy rate was 85.00%; the sensitivity of PET/CT in the diagnosis of breast cancer was 86.96%, the specificity was 82.35%, and the accuracy rate was 85.00%;the diagnostic sensitivity of their combined application was 86.96%, the specificity was 94.12%, and the accuracy rate was 90.00%. In 10 cases of breast cancer patients with lymph node metastasis, the sensitivity、specificity and accuracy rate of PET/CT in the diagnosis of metastatic lymph nodes were 90.0%, 92.8%, and 92.1% respectively; the sensitivity, specificity and accuracy rate of ultrasound in the diagnosis of metastatic lymph nodes were 70.0%, 96.4% and 89.5%, respectively. Conclusions The ABVS and PET/CT are both effective approaches in the diagnosis of breast cancer. Their combined application may significantly improve the specificity and accuracy of diagnosis. For patients with lymph node metastases, the sensitivity of PET/CT for lymph node metastases was high and conducive to clinical staging, which is an important implication in guiding the choice of clinical treatment and prognosis of patients.

Preparation of HER2 radioligand 99Tcm-ABH2 and its in vivo imaging in breast cancer-xenografted mice / 中华核医学与分子影像杂志

Objective To prepare 99Tcm-human epidermal growth factor receptor 2 (HER2) affibody (ABH2) and explore its feasibility as an imaging agent in HER2-positive breast cancer.Methods Sodium glucoheptonate and SnCl2 · 2H2O were used to label ABH2 with 99Tcm.The labeling yield and radiochemical purity of 99Tcm-ABH2 were determined.The stability of 99Tcm-ABH2 was tested in PBS and serum.The equilibrium disassociation constant (Kd) of 99Tcm-ABH2 was measured with MBA-MD-361 breast cancer cells.SPECT/CT imaging was carried out at 1.0 h and 4.5 h after injection of 37 MBq 99Tcm-ABH2 in nude mice (n=4) xenografted with MBA-MD-361 breast cancer.The T/NT (liver,brain,lung,heart,bone and muscle) ratios were deduced from SPECT/CT acquired data.For the blocking experiment,200 μg ABH2 was injected intravenously before 99Tcm-ABH2 injection.SPECT/CT imaging was performed in the same way.The T/NT ratios were compared between non-blocked and blocked groups by one-way analysis of variance.Results Fhe labeling yield of 99Tcm-ABH2 was above 99％.99Tcm-ABH2 was substantially stable in PBS and serum;the radiochemical purity was (95.0± 1.0)％ after incubation with serum at 37 ℃ for 6.0 h.The Kd of 99Tcm-ABH2 was 1.7 nmol/L.The radioactive uptake in cancer was visualized at 1.0 h and 4.5 h after injection of 99Tcm-ABH2 in HER2 positive MDA-MB-361 breast cancer.99Tcm-ABH2 was cleared out mainly through urinary system.The ratios of tumor to liver,lung,brain,heart,muscle and bone were 1.81± 0.60,8.95±1.13,20.08±6.12,7.61±0.56,10.62±1.78,11.42±2.07,respectively at 4.5 h after 99Tcm-ABH2 injection.After ABH2 blocking,the corresponding T/NT ratios were 0.60±0.23,3.05± 1.38,5.24±2.17,2.42±1.02,8.16±2.66,2.76±0.48 (F=29.38,P＜0.05) respectively.Conclusion 99Tcm-ABH2 could be synthesized with high purity,and this new agent could be used to image HER2-positive breast cancer specifically.

Diagnostic value of three evaluation methods of ¹⁸F-FDG PET/CT in detecting bone marrow infiltration in patients with newly diagnosed diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate three methods of ¹⁸F-FDG PET/CT in detecting bone marrow infiltration in patients with newly diagnosed diffuse large B-cell lymphoma.</p><p><b>METHODS</b>Seventy-seven patients with newly diagnosed diffuse large B-cell lymphoma from July 2012 to June 2014 were retrospectively analyzed. All patients received both ¹⁸F-FDG PET/CT scan and bone marrow biopsy in the region of the posterior iliac crests. There were three evaluation methods of ¹⁸F-FDG PET/CT to detect bone marrow infiltration, including visual comparison (the FDG uptake in bone marrow of iliac crests was higher than the normal liver tissue), the maximal standardized uptake values (SUV(max)) in bone marrow of iliac crests (more than or equal to 2.5), the ratio of maximal standardized uptake values of iliac crests bone marrow to liver parenchyma intensity (more than 1). All results were compared with the bone marrow biopsy.</p><p><b>RESULTS</b>Visual comparison of ¹⁸F-FDG PET/CT could be used to diagnose bone marrow infiltration, with the sensitivity of 100.00%, specificity of 80.00%, positive predictive value of 48.00%, and negative predictive value of 100.00%. When the SUV(max) of iliac crests was used as the diagnostic threshold, the sensitivity was 75.00%, with 92.31% specificity, 64.29% positive predictive value, and 95.24% negative predictive value. The ratio of SUV(max) had the best diagnostic efficiency, with sensitivity of 100.00%, specificity of 90.77%, positive predictive value of 66.67%, and negative predictive value of 100.00%.</p><p><b>CONCLUSION</b>The ratio of SUV(max) is a valuable diagnostic method in detecting diffuse large B-cell lymphoatic bone marrow involvement.</p>

Utility of [99m]Tc-PEG[4]-E[PEG[4]-c[RGDFK]][2] in posttherapy surveillance of patients with reelevated carcinoembryonic antigen levels

To evaluate the efficacy of [99m]Tc-PEG[4]-E[PEG[4]-c [RGDfK]][2][[99m]Tc-3PRGD2] single photon emission computed tomography [SPECT] in monitoring the recurrence of malignancies. Materials and [99m]Tc-3PRGD2 SPECT was performed on 28 patients [10 females and 18 males; median age 49.2 years] suspected of recurrent malignancies due to an asymptomatically reelevated carcinoembryonic antigen level. The SPECT was performed 0.5 h after an intravenous injection of 11.1 MBq/kg [0.3 mCi/kg] of [99m]Tc-3PRGD2. The SPECT and concurrent contrast-enhanced computed tomography [ceCT] findings were analyzed with reference to the histopathological findings and/or clinical follow-up data. Recurrences were identified in 20 out of the 28 patients [prevalence 71.4%] with altogether 26 lesions. Fifteen lesions were confirmed by histopathological findings, and the other 11 lesions were confirmed by serial radiological or clinical follow-up. Of the 20 patients with recurrent malignancies, 12 [60%] were correctly identified by [99m]Tc-3PRGD2 SPECT. In the patient-based analysis, the sensitivity and specificity of [99m]Tc-3PRGD2 SPECT were 60 and 100%, respectively, and the positive and negative predictive values were 100 and 50%, respectively. In the lesion-based evaluation, the sensitivity and specificity were 62 and 100%, respectively. The sensitivity and specificity of the ceCT in the patient-based evaluation were 60 and 75%, respectively, and the positive and negative predictive values were 86 and 40%, respectively. In the lesion-based evaluation, the sensitivity and specificity of the ceCT were 70 and 84%, respectively. [99m]Tc-3PRGD2, as a new SPECT tracer targeting the integrin alpha[v]beta[3] receptor, was more useful in distinguishing recurrences as compared to ceCT

Clinical value of 68Ga-DOTATATE PET/CT in pituitary adenoma: a pilot study / 中华核医学与分子影像杂志

Objective To investigate the correlation between the uptake of 68Ga-DOTATATE in pituitary adenoma and clinical parameters such as hormonal hypersecretion,and to evaluate the curative effect with 68Ga-DOTATATE imaging after octreotide therapy in patients with growth hormone-secreting adenoma (GH adenoma).Methods A total of 34 patients (15 males,19 females) with pituitary adenoma were recruited,including 5 adrenocorticotropic hormone-secreting adenoma (ACTH adenoma),17 GH adenoma,and 12 non-functioning adenoma (NF adenoma).In the 17 patients with GH adenoma,there were 13 patients treated by octreotide intramuscular injection 3 times with a total dose of 60 mg for 3 months.The finial diagnosis was based on histology.68Ga-DOTATATE imaging was performed,and SUV tumor volume and density index (DI) were recorded in all patients.The DI was the ratio of tumor SUVmean to tumor volume.The effective therapy was defined as more than 50％ of hormonal suppression or more than 20％ of tumor shrinkage.Non-parametric Mann-Whitney u test was used.Results NF adenoma showed greater tumor volume than secretory adenoma,((9.10±7.00) cm3 vs (2.92±1.60) cm3,u=43.0,P＜0.05),whereas DI of secretory adenoma was higher than that of NF adenoma (7.16±4.52 vs 1.08±1.40,u=48.5,P＜0.05).Additionally,DI was significantly higher(3.55±0.91 vs 1.38±0.69,u =2.0,P＜0.05) in patients (n =8) with effective treatment than that in patients without effective treatment (n =5).Conclusion 68 Ga-DOTATATE may be a useful probe for PET imaging in patients with pituitary adenoma,and may be valuable for predicting the therapeutic effect of somatostatin analog treatment.

Synthesis and in vivo evaluation of 68Ga-DOTATATE in mice / 中华核医学与分子影像杂志

Objective To synthesize 68 Ga-1,4,7,10-tetraazacyclododecane-N,N',N,N()-tetraacetic acid-D-Phe1-Tyr3-Thr8-octreotide (68Ga-DOTATATE) manually and automatically,validate its qualities in vitro,and evaluate its biodistribution in ICR mice and the microPET imaging in nude mice bearing pancreatic AR42J tumor.Methods 68Ga-DOTATATE was synthesized by automatic method using commercial metal isotope multifunctional module with strong cation exchange (SCX) column and by manual method.Both the products were measured for quality control.For the biodistribution study 5 groups of ICR mice were injected with 68Ga-DOTATATE(1.11 MBq) and executed at 10,30,60,120 and 240 min postinjection,respectively.The organs were weighted,and ％ ID/g was calculated.Nude mice bearing pancreatic AR42J tumor were intravenously injected with 3.7 MBq 68Ga-DOTATATE,and then microPET imaging was acquired at 10,30,60,120,18 and 240 min.Results 68Ga-DOTATATE could be successfully synthesized by the automatic and manual methods.Both the product injections were colorless and clear.The pH value was 6.5±0.1.For the products obtained from the two methods,the radiochemical purities were over 99％,and the products were stable for 4 h at room temperature.For the automatic method,68Ga-DOTATATE was synthesized within 30 min and with the radiochemical yield of (51.8±3.2)％ (time decay corrected).For the manual method,the time used for the synthesis was 20 min,and the labeling yield was over 99％.Three batches of the products were aseptic and pyrogen-free.In ICR mice,68Ga-DOTATATE was excreted by the kidney,and showed relatively high accumulation in the liver,spleen,pancreas and adrenal glands,while lower in the bone and soft tissue.The clearance from blood was fast with (4.41±0.81) ％ID/g at 10 min postinjection and (0.78 ± 0.32) ％ ID/g at 1 h.MicroPET imaging showed increased uptake of 68GaDOTATATE in the tumor tissues,and T/NT were 2.01±0.29(10 min),6.74±2.90(30 min) and 4.46±2.05 (60 min),respectively.Conclusions 68 Ga-DOTATATE could be successfully synthesized manually and automatically.The products reach to the specification of radioactive drugs and could be used as an attractive positron emitting radiotracer for detection of the somatostatin receptor-positive tumors.

The value of 18F-FDG PET/CT in diagnosing giant cell arteritis presenting as fever of unknown origin / 中华内科杂志

Objective To evaluate the clinical diagnostic contribution of 18 F-FDG PET/CT in giant cell arteritis with initial presentation as fever of unknown origin (FUO).Methods Eight cases with initial presentation as FUO diagnosed with the contribution of PET/CT were retrospectively studied in Peking Union Medical College Hospital.The radiologic manifestations of PET/CT were analyzed.Results Eight patients (4 men and 4 women) with average (63 ± 7) years (range from 55-75 years) were included in our study based on the criteria.Non-specific clinical symptoms were common in these patients,including fatigue,night sweat and weight loss.They all suffered from anemia of chronic disease.Not surprisingly,the inflammatory parameters were elevated significantly in all patients.The medical history,physical examination and routine lab and radiologic examinations couldn't reveal the causes of fever.PET/CT was performed in all of them,which demonstrated intense 18F-FDG uptake in the area of aorta and its major branches with maximal standard uptake value (SUVmax) 2.1-4.6 (3.6 ± 0.9).Immunosuppressive agents were effective to control the inflammation activity.The SUV decreased significantly after treatment in the follow-up PET/CT.Conclusions PET/CT has demonstrated high yield of diagnostic contribution in giant cell arteritis with initial presentation as fever of unknown origin.As to elderly FUO patients presenting with prominent inflammatory reaction,PET/CT may provide potential value to differentiate diagnosis from maligancies.

Application of health education in family care for elderly patients / 现代临床护理

Objective To investigate the effect of health education on the family care for elderly patients.Methods Health education were done during family care for 65 elderly patients.A comparison was done between pre-intervention and post-intervention effect in terms of mastery of disease knowledge,health behavior,curative compliance and emotion management.Result The effect after intervention was significantly better than that before intervention (χ2=28.770,P<0.01).Conclusion During family care for elderly patients,health education is effective for the improvements of mastery of disease knowledge,health behavior,curative compliance,emotion management and ultimately the quality of life.

Integrated positron emission tomography and computed tomography in preoperative lymph node staging of non-small cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Integrated positron emission tomography and computed tomography (PET/CT) is increasingly used for the preoperative nodal staging of non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the accuracy of PET/CT in comparison with CT in detection of nodal metastasis and preoperative nodal staging in patients with NSCLC, and to analyze the causes of the PET/CT false-negative and false-positive results.</p><p><b>METHODS</b>Consecutive patients with pathologically proven NSCLC who underwent staging using PET/CT from July 2008 to February 2012 were evaluated retrospectively. Nodal staging was pathologically confirmed on tissue specimens obtained at thoracotomy. The accuracy of PET/CT and CT in the assessment of intrathoracic nodal involvement was determined using histological results as the reference standard. Logistic regression was used to define the causes of the false-negative and false-positive results.</p><p><b>RESULTS</b>A total of 528 lymph node stations were evaluated in 101 patients. Lymph nodes were positive for malignancy in 43 out of 101 patients (42.6%), and 101 out of 528 nodal stations (19.2%). PET/CT was significantly more accurate for nodal staging than CT. The sensitivity, specificity, positive and negative predictive values, and accuracy of PET/CT for detecting nodal metastasis were 51.5%, 95.8%, 74.3%, 89.3%, and 87.3% and the corresponding data by CT were 45.5%, 87.1%, 45.5%, 87.1%, and 79.2%, respectively. PET/CT confers significantly higher specificity, positive predictive value, and accuracy than CT in detecting nodal metastasis. False-negative results by PET/CT are significantly associated with smaller lymph node size, whereas false-positive results are related to a combination of inflammatory disorders and larger lymph node size.</p><p><b>CONCLUSION</b>PET/CT confers significantly higher accuracy than CT in nodal staging, and is more specific and accurate than CT in detecting nodal metastasis but has a low sensitivity and high false-negative rate.</p>

68Ga-labeled HER2 affibody with C-terminal cysteine and its PET imaging / 中华核医学与分子影像杂志

Objective To label the modified human epidermal growth factor receptor 2 (HER2) affibody with 68Ga at cysteine position of carboxyl-terminal Gly-Gly-Gly-Cys (GGGC) sequence,and to image the mice model bearing HER2-expressed breast cancer with microPET.Methods The HER2 affibody with carboxyl-terminal cysteine was produced by gene engineering.The 1,4,7,10-tetraazacyclododecane-1,4,7-tris-aceticacid (DOTA) was conjugated to the thiol (SH)-group of cysteine by DOTA-10-maleimidoethylacetamide (MMA-DOTA).The newly eluted 68Ga was labeled to DOTA-HER2 affibody at 90 ℃.The labeled mixture was purified by C18 cartridge and eluted with anhydrous alcohol.The purified 68Ga-labeled affibody was prepared for cell binding analysis and microPET imaging.The HER2-expressed breast cancer cells MBA-MD-361 were used to analyze cell binding and establish cancer model with BALB/c nude mice.68Ga-labeled affibody (3.7 MBq) was administered to 4 nude mice with breast cancer via tail vein for microPET imaging at 20 and 60 min post injection.The mice were sacrificed immediately after imaging in unconscious state and their tissue/organs (tumor,muscle,bone and heart) were removed for weighing and radioactivity counting by γ counter.The tumor to normal organ ratios of radioactivity (tumor to liver,muscle,bone and heart)were calculated.Results The purity of HER2 affibody was more than 95％.The radiochemical purity of 68Ga-labeled HER2 affibody was 97％.The KD value (affinity) of 68Ga-labeled HER2 affibody was 1.5 nmol/L in HER2positive cells.MicroPET imaging showed that 68Ga-labeled HER2 affibody could bind HER2-positive cancer rapidly and excreted mainly through urinary system.The radioactivity ratios of tumor to liver,muscle,bone and heart were 17.4±1.0,35.1±10.9,20.7±6.2 and 20.9±4.0,respectively.Conclusions 68Ga could be labeled to HER2 affibody.The 68Ga-labeled HER2 affibody may be useful for PET imaging of HER2-positive tumor.

Advances in radionuclide molecular imaging of pancreatic β-cells / 中华核医学与分子影像杂志

In both type 1 and type 2 diabetes mellitus,β-cell mass (BCM) is lost.Various treatments are developed to restore or reconstruct BCM.The development of non-invasive methods to quantify BCM in vivo offers the potential for early detection of β-cell dysfunction prior to the clinical onset of diabetes.PET imaging with radioligands that directly target the pancreatic β-cells appears promising.The ability to determine the BCM has been investigated in several targets and their corresponding radiotracers,including radiolabeled receptor ligands,antibodies,metabolites and reporter genes.Therefore,we summarize the recent progress in radionuclide molecular imaging of pancreatic β-cells.

Evaluation of hyperacute cerebral ischemia in rats using micro SPECT/CT / 中华核医学与分子影像杂志

Objective To assess the diagnostic value of 99Tcm-ECD SPECT for hyperacute cerebral ischemia using rats models.Methods A stable and permanent acute cerebral ischemia model using unilateral middle cerebral occlusion was tested in 24 healthy SD rats.The rats were randomly divided into 6 groups according to the time duration between imaging and induced-ischemia (1,2,3,4,5 and 6 h,respectively).The rats were sacrificed immediately after 99Tcm-ECD SPECT/CT imaging and then the brain tissue was dissected for triphenyl tetrazolium chloride (TTC) and HE staining.The count ratio of affected cortex to the contralateral cortex of ＜ 50％ was defined as ischemia on micro SPECT/CT.The volume of the ischemic area was calculated on both SPECT/CT and TTC images.Paired t test was used to determine the statistical difference between the volumes on SPECT/CT and TTC staining.Results The ischemia volume evaluated by TTC staining at 1,2,3,4,5 and 6 h after occlusion was (73.98 ± 27.76),(90.75 ±29.00),(135.00±40.83),(136.25±22.51),(158.50±32.72) and (168.00±32.75) mm3,respectively.The corresponding ischemia volume evaluated by micro SPECT/CT was (98.50 ± 27.77),(110.40±26.80),(157.00±36.82),(165.50±26.54),(175.75±31.16) and (177.25 ±34.33) mm3,respectively,which was concordant with that by TTC staining at each time point (t:-1.681 to-0.390,all P ＞0.05).The ischemic area on micro SPECT/CT imaging was consistent with the pink area by TTC staining.The volume evaluated by micro SPECT/CT tended to be constant 3 h after the occlusion.The ischemia volume showed no significant difference among 3,4,5 and 6 h (all P ＞ 0.05).Conclusions Micro SPECT/CT may have an haemodynamic value for evaluating in vivo cerebral ischemia applied in a rat model.It might have clinical value for the evaluation and decision-making of ultra acute cerebral infarctions.

Effect of anti-syphilis treatment on perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis / 中华临床感染病杂志

Objective To investigate the effect of anti-syphilis treatment on the perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis.Methods One hundred and ninety eight pregnant women complicated with syphilis were collected from Chengdu Hospital of Infectious Diseases during January 2010 and January 2012,including 98 cases received standard treatment,59 cases received nonstandard treatment and 41 cases did not receive treatment.Pearson x2 and partition of chi-square were used for the comparison of pregnant outcomes,neonatal prognosis and negative rates of rapid plasma circle card test (RPR) among 3 groups.Results The incidence of adverse pregnancy outcomes,including miscarriage,prematurity,still birth and congenital malformation were 4.08％,27.12％ and 63.41％ in three groups,respectively.The incidence of congenital syphilis,low birth weight,asphyxia in infants and neonatal death raised in from standard-treatment group,nonstandard-treatment group to untreated group.Congenital syphilis rates were 2.04％,18.75％ and 35.29％ in three groups,respectively.RPR titers in newborns from mothers with high RPR titer (≥ 1 ∶ 8) in standard-treatment group were significantly lower than those in nonstandard-treatment group and untreated group (x2 =37.122,P ＜ 0.01).RPR negative rates were 100.00％,59.26％ and 25.00％ in three groups,respectively (x2 =18.839,P ＜ 0.01).Conclusion Standard anti-syphilis treatment can improve pregnant outcome,neonatal prognosis and reduce the incidence of congenital syphilis.