Metabonomics Analysis of Brain Stem Tissue in Rats with Primary Brain Stem Injury Caused Death / 法医学杂志

OBJECTIVES@#To explore the potential biomarkers for the diagnosis of primary brain stem injury (PBSI) by using metabonomics method to observe the changes of metabolites in rats with PBSI caused death.@*METHODS@#PBSI, non-brain stem brain injury and decapitation rat models were established, and metabolic maps of brain stem were obtained by LC-MS metabonomics method and annotated to the HMDB database. Partial least square-discriminant analysis (PLS-DA) and random forest methods were used to screen potential biomarkers associated with PBSI diagnosis.@*RESULTS@#Eighty-six potential metabolic markers associated with PBSI were screened by PLS-DA. They were modeled and predicted by random forest algorithm with an accuracy rate of 83.3%. The 818 metabolic markers annotated to HMDB database were used for random forest modeling and prediction, and the accuracy rate was 88.9%. According to the importance in the identification of cause of death, the most important metabolic markers that were significantly up-regulated in PBSI group were HMDB0038126 (genipinic acid, GA), HMDB0013272 (N-lauroylglycine), HMDB0005199 [(R)-salsolinol] and HMDB0013645 (N,N-dimethylsphingosine).@*CONCLUSIONS@#GA, N-lauroylglycine, (R)-salsolinol and N,N-dimethylsphingosine are expected to be important metabolite indicators in the diagnosis of PBSI caused death, thus providing clues for forensic medicine practice.

Imaging features of pancreatic mucinous cystic neoplasms based on the European evidence-based guidelines on pancreatic cystic neoplasms and influencing factors of tumor preperty / 中华消化外科杂志

Objective:To investigate the imaging features of pancreatic mucinous cystic tumor (MCN) based on the European evidence-based guidelines on pancreatic cystic neoplasms and risk factors influencing tumor property.Methods:The retrospective case-control study was con-ducted. The clinicopathological data of 109 pancreatic MCN patients who were admitted to the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from March 2011 to April 2021 were collected. There were 5 males and 104 females, aged (49±15)years. There were 97 cases with benign tumors and 12 cases with malignant tumors. Observation indicators: (1) clinical characteristics of MCN patients with different tumor properties; (2) imaging features of MCN patients with different tumor properties; (3) multivariate analysis of factors affecting evaluating tumor pro-perties of MCN. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distri-bution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Statistically significant indicators in clinical and imaging characteristics were included in multivariate analysis. Multivariate analysis was performed by the Logistic regression model forward method. Results:(1) Clinical characteristics of MCN patients with different tumor properties. Gender(male, female), age, body mass index (BMI), cases with clinical symptoms (asymptomatically physical findings, abdominal pain and distension, emaciation, jaundice, pancreatitis, onset diabetes), cases with CA19-9 (<37 U/mL, ≥37 U/mL), cases with carcinoembryonic antigen (<5.0 μg/L, ≥5.0 μg/L), cases with surgical methods (pancreatoduo-denectomy, pancreatectomy of body and tail, segmental pancreatectomy), cases with tumor location (head of pancreas, tail of pancreas) were 4, 93, (47±14)years, (22±3)kg/m 2, 56, 35, 2, 1, 11, 5, 89, 8, 96, 1, 2, 90, 5, 4, 93 in the 97 cases with benign tumors, versus 1, 11, (59±17)years, (23±3)kg/m 2, 4, 4, 1, 0, 3, 2, 5, 7, 7, 5, 0, 12, 0, 0, 12 in the 12 cases with malignant tumors, showing significant differences in age, CA19-9 and carcinoembryonic antigen ( t=?2.69, χ2=22.57, 26.54, P<0.05) and showing no significant difference in gender, BMI, clinical symptoms, surgical methods and tumor location ( P>0.05) between them. (2) Imaging features of MCN patients with different tumor pro-perties. Of the 109 patients with pancreatic MCN, 85 cases underwent computed tomography (CT) plain and contrast-enhanced scan of pancreas, and 81 cases underwent magnetic resonance imaging (MRI) plain and contrast-enhanced scan of pancreas. There were 57 cases underwent both CT and MRI plain and contrast-enhanced scan of pancreas. Cases with tumor location (head of pancreas, tail of pancreas), cases with cyst morphology (circular, lobulated), cases with cyst diameter (<4 cm, ≥4 cm), diameter of cyst, cases with thickening of capsule wall, cases with calcification of capsule wall, cases with enhancing mural nodule of capsule wall, cases with pancreatic duct dilatation were 4, 93, 69, 28, 32, 65, 4.7(range, 3.3?6.8)cm, 38,20, 4, 13 in the 97 cases with benign tumors, versus 0, 12, 7, 5, 4, 8, 6.8(range, 3.3.?9.6)cm, 10, 2, 6, 4 in the 12 cases with malignant tumors, showing significant differences in thickening of capsule wall and enhancing mural nodule of capsule wall ( χ2=6.75, 21.75, P<0.05) and showing no significant difference in cyst morphology, cyst diameter, diameter of cyst, calcification of capsule wall and pancreatic duct dilatation ( P>0.05) between them. (3) Multivariate analysis of factors affecting evaluating tumor properties of pancreatic MCN. Result of multivariate analysis showed that age, carcinoembryonic antigen and mural nodule of capsule wall were independent factors affecting tumor properties of MCN ( odds Ratio=1.09, 19.67, 63.57, 95% confidence intervals as 1.01?1.18, 1.07?361.49, 4.07?993.49, P<0.05). Conclusions:Thickening of capsule wall and enhancing mural nodule of capsule wall are imaging features of patients with pancreatic MCN. Age, carcinoembryonic antigen and mural nodule of capsule wall are independent factors affecting tumor properties of pancreatic MCN.

Establishment and application of a method for the determination of plasma protein binding rate of imatinib and its metabolite / 中国药房

OBJECTIVE To establish a method for the determination of plasma protein binding rate of imatinib and its metabolite（N-desmethyl imatinib ）and apply it to patients with gastrointestinal stromal tumor （GIST）.METHODS Using imatinib - d8 as the internal standard ，after being deproteinized methanol ，the sample was determined by equilibrium dialysis combined with liquid chromatography -tandem mass spectrometry . The free concentrations of imatinib and its metabolites in plasma of GIST patients were detected by the same method . RESULTS The protein binding rates of imatinib with albumin ，α1-acid glycoprotein and globulin at 120 ng/mL and 4 000 ng/mL were （92.5±1.0）% and（91.7±0.4）%，（56.6±2.0）% and（62.6±2.6）%，（56.3±3.1）% and （68.0±8.6）% ，respectively. The protein binding rates of N-desmethyl imatinib with albumin ，α1-acid glycoprotein and globulin at 60 ng/mL and 2 000 ng/mL were （90.6±3.5）% and（91.3±1.5）%，（54.1±5.1）% and（63.7±1.3）%，（56.2±7.6）% and（67.5±7.3）%，respectively. Compared with the low concentration group of imatinib （120 ng/mL）and its metabolite （60 ng/mL），the plasma protein binding rate of high concentration of imatinib （4 000 ng/mL）and its metabolite （2 000 ng/mL）with α1-acid glycoprotein and globulin was significantly increased （P＜ Δ基金项目 国家自然科学基金资助项目（No.81503160）；江苏省 0.05），but there was no signifi -cant difference with albumin 卫生健康发展研究中心 2021年度开放课题（No.JSHD2021004）；江苏 （P＞0.05）. In blank plasma ，the protein binding rates of imatinib（4 000 ng/mL）at high concentration and its metabolites（2 000 ng/mL）were significantly lower than those of low （120， 60 ng/mL） and medium （750， 375 ng/mL）concentration （P＜0.01）. Average protein binding rates of imatinib and its metabolite in plasma of GIST patients were （99.0±0.3）% and（99.2±0.3）%，respectively；the correlation coefficients between the concentrations of imatinib and its metabolites and the protein binding rates were －0.298 5 and －3.332 3，respectively（all P＜0.05）. CONCLUSIONS The method for determining the plasma protein binding rates of imatinib and its metabolites is successfully established . The plasma protein binding rates of imatinib and its metabolites in patients with GIST are negatively correlated with drug concentration .

Internal Lower Incisor Morphology revealed by Computerized Microtomography / Morfologia interna de incisivos inferiores reveladas por microtomografía computadorizada

ABSTRACT This study evaluated the internal morphology of lower incisors using computerized microtomography (microCT) images. Eightynine lower incisors were scanned by microCT and reconstructed with NRecon software. 2D parameters (perimeter, root length, circularity and canal diameter) and 3D parameters (volume, surface area and structure model index) were evaluated with CTAn and CTVol software. The results are presented descriptively. It was found that 89.9% of the canals had a single main root canal (type I), followed by type II (6.7%) and III (3.4%), while 5.6% of the specimens presented lateral canals and 1.1% had an apical delta. Mean volume and surface area were 31.80mm³ and 90.58mm², respectively. The most prevalent shape of the root canal at CEJ level was circular (41.6%) and 1mm from the apex, 73% of the samples were classified as oval. Lower incisors with internal anatomical variations may offer a high degree of technical complexity and may result in treatment failure.

RESUMO Este estudo avaliou a morfologia interna dos dentes incisivos inferiores utilizando imagens de microtomografia computado rizada (microTC). 89 incisivos inferiores foram escaneados por microCT e reconstruídos com o programa NRecon. Parâmetros 2D perímetro, comprimento da raiz, circularidade e diâmetro do canal e parâmetros 3D volume, área superficial e índice de modelo de estrutura foram avaliados com os softwares CTAn e CTVol. Os resultados foram apresentados de forma descritiva. 89,9% dos canais apresentaram um único canal radicular principal (tipo I), seguido pelo tipo II (6,7%) e III (3,4%). 5,6% dos espécimes apresentavam canais laterais e 1,1% delta apical. O volume médio e a área de superfície foram 31,80mm³ e 90,58mm², respectivamente. A forma mais prevalente do canal radicular no nível da CEJ foi circular (41,6%) e a 1 mm do ápice, 73% das amostras foram classificadas como ovais. Incisivos inferiores com variações anatômicas internas podem oferecer um alto grau de complexidade técnica e resultar em falha do tratamento.

Study on optimizing rapid acquisition time of CZT-SPECT myocardial perfusion imaging using different injection doses / 中华核医学与分子影像杂志

Objective To explore the optimal and rapid imaging acquisition time and clinical ap-plicability when using high-and low-dose one day rest/stress myocardial perfusion imaging ( MPI) with cad-mium-zinc-telluride heart dedicated SPECT ( CZT-SPECT) . Methods The MPI data with high-dose rest/stress protocol in 51 patients (22 males, 29 females, age:(55.4±8.5) years) between November 2017 and December 2017 and those with low-dose protocol in 50 patients (27 males, 23 females, age:(59.1±12.8) years) between July 2018 and October 2018 were retrospectively analyzed. The MPI was performed with CZT-SPECT. Each patient received 296-370 MBq rest dose of 99Tcm-methoxyisobutylisonitrile (MIBI) for high-dose protocol, 111-222 MBq rest dose of 99 Tcm-MIBI for low-dose protocol. Stress dose was 3 times of the corresponding rest dose. Rest and stress scans were acquired 6 min and 4 min for high-dose protocol, while 8 min and 6 min for low-dose protocol in total. All rest or stress imaging data were reconstructed from list-mode raw data to obtain scan durations of 1 min, 2 min, etc, up to the maximum of acquisition time. Image quality at different acquisition times were evaluated, and myocardial perfusion and function parame-ters were compared. Paired t test, Wilcoxon signed rank test, Pearson correlation and Bland-Altman analyses were used for data analysis. Results The image quality was rated as excellent/good in all patients ( 100％, 51/51) when acquisition time≥3 min and ≥2 min respectively for rest and stress imaging with high-dose protocol, the similar results was obtained ( 100％, 50/50) when acquisition time≥4 min and≥3 min re-spectively for rest and stress imaging with low-dose protocol. The quantitative perfusion parameters(summed rest scores, summed stress scores, total perfusion deficit) and left ventricle ejection fraction ( LVEF) at shor-ter acquisition times (3 min/2 min, 4 min/3 min) were not significantly different from the results at the lon-ger acquisition times (6 min/4 min, 8 min/6 min;t values:from -1.196 to 1.597, z values:from -1.963 to 1. 945, all P>0. 05) . Those parameters at shorter and longer acquisition times showed strong correlations ( all r>0.700, all P<0.001) , and Bland-Altman analysis revealed good agreement between them. Conclusion The opti-mal acquisition time is 3 min/2 min for high-dose one-day rest/stress CZT-SPECT MPI, and 4 min/3 min for low-dose protocol, which can significantly shorten the MPI acquisition time, then reliable perfusion parameters and LVEF can be obtained under the premise of ensuring image quality, making it the better clinical applicability.

Síndrome de Wellens, equivalente clínico de estenosis coronaria crítica / Wellens' syndrome, clinical equivalent of critical coronary stenosis

Resumen El infarto agudo de miocardio con elevación del segmento ST es una indicación urgente de cateterismo cardiaco. El síndrome de Wellens es la inversión persistente de la onda T en las derivaciones V2 y V3 con datos clínicos compatibles con angina; la evidencia de este síndrome indica la oclusión crítica de la coronaria descendente anterior; el tratamiento de elección es el cateterismo cardiaco. Se comunica el caso clínico de un paciente con factores de riesgo cardiovascular, con evidencia de síndrome de Wellens tipo B; el reconocimiento y la adecuada toma de decisiones son críticas en estas circunstancias.

Abstract Acute myocardial infarction with ST elevation is an urgent indication for cardiac catheterization. Wellens' syndrome is a persistent reversal of the T wave in leads V2 and V3 with clinical presence compatible with angina; the evidence of this syndrome indicates the critical occlusion of the anterior descending coronary artery, with cardiac catheterization being the treatment of choice. We present the clinical case of a patient with cardiovascular risk factors, with evidence of Wellens' syndrome type B. Recognition and proper decision-making are critical in these circumstances.

Effect of Shuanglong formula on no-reflow in rats with myocardial ischemia/reperfusion / 中国药理学通报

Aim To explore the effect of Shuanglong formula(SLF) on no-reflow in rats with myocardial is-chemia/reperfusion (I/R). Methods The rats were divided into five groups, namely, sham group, I/R group,SLF(5,2.5,1.25 g·kg-1)group. Treatment group received SLF decoction by gavage once a day for five days,while other groups were offered drinking wa-ter by gavage once a day for five days. The rats in I/R group and SLF-pretreated group were induced by iga-tion of left anterior descending coronary artery,and the rats were subjected to ischemia for 4h followed by reperfusion. Sham operation group did not undergo oc-clusion of the coronary artery. After 4 hours' reperfu-sion, real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardi-ac functions. Blood was collected from the abdominal aorta and the serum was separated, and the levels of cTnT, CRP, CK and LDH were measured. The myo-cardial no-reflow area and infarction area were assessed by thioflavin S and nitrotetrazolium blue chloride, re-spectively. Results The SLF-pretreated group exhibi-ted significant reductions in the infarct area and no-re-flow area compared with I/R group(P <0.01 or P <0.05). In SLF-pretreated groups, β, A and A·β significantly increased as compared to those in I/R group. The LV anterior wall systolic and diastolic thicknesses (LVAW d/s) were significantly improved in SLF-pretreated group compared with those in I/R group. The LV internal diameter in systole (LVID s) and the LV volume in systole(LV s) were significantly reduced in SLF-pretreated group compared with those in I/R group. The EF, FS and SV were significantly improved in SLF-pretreated group compared with those in I/R group. The comparison between SLF-pretreated group and I/R group showed no significant difference in LDH, CK, cTnT, and CRP levels. Conclusion Shuanglong formula minimizes the sizes of myocardial infarct area and no-reflow area,improving regional my-ocardial blood flow and cardiac function.

Bilateral acute angle closure in a patient with dengue fever: a case report / Fechamento de ângulo agudo bilateral em paciente com dengue: relato de um caso

ABSTRACT We report the case of a 46-year-old female patient who presented with bilateral acute angle closure during the course of dengue infection. Dengue diagnosis was confirmed by serological tests. The patient had plateau iris configuration identified by ultrasound biomicroscopy. This is the second reported case with this condition during dengue fever and the first to describe the characteristics of the angle.

RESUMO Os autores relatam o caso de uma mulher de 46 anos que teve fechamento agudo de ângulo bilateral durante a infecção por dengue. O diagnóstico de dengue foi confirmado por testes sorológicos. A paciente teve configuração de íris em platô confirmada pela biomicroscopia ultrassônica. Esse é o segundo caso descrevendo essa condição durante um episódio de dengue e o primeiro a descrever as características do ângulo.

Rendimiento diagnóstico de la histerosalpingografía por resonancia magnética: resultados iniciales / Diagnostic performance of magnetic resonance hysterosalpingography: initial results Abstract

Objetivo: Determinar el rendimiento diagnóstico de la histerosalpingografía por resonancia magnética (HSG-RM), utilizando la laparoscopia como método de referencia. Materiales y métodos: Se incluyeron 22 pacientes. A todas se les realizó una HSG-RM con un resonador 1.5 Tesla y luego una laparoscopia con cromotubación. Dos radiólogos examinaron las RM, determinando la permeabilidad tubaria por consenso. Se realizaron análisis descriptivos y de rendimiento diagnóstico. Resultados: La HSG-RM tuvo una tasa de éxito del 91%. La duración del estudio fue 49ą15 minutos, el volumen inyectado 26 ą 16 cm³ y la escala de dolor 30ą 19 de 100. La sensibilidad y especificidad de la HSG-RM fueron del 100% para la prueba de Cotte global y a la izquierda, y del 25% y 93,3% para la prueba de Cotte a la derecha, respectivamente. Hubo 2 complicaciones menores y ninguna importante. Discusión: Nuestros resultados iniciales demostraron una alta sensibilidad y especificidad. Si bien otros estudios analizaron la capacidad de la HSG-RM para evaluar la permeabilidad tubaria con buenos resultados, el uso de un patrón de referencia defectuoso dejaba margen para una duda razonable, impidiendo una recomendación basada en pruebas sólidas. Sin embargo, al cotejar nuestros resultados con los publicados, observamos un alto grado de concordancia en tanto el derrame positivo se diagnostica correctamente con una especificidad de 100% o con un porcentaje cercano a esta cifra. Conclusión: La HSG-MR es una alternativa factible y segura de la HSG convencional o virtual, la histerosonografía y la cromotubación.

Objective: To determine the diagnostic performance of magnetic resonance hysterosalpingography (MRHSG) using laparoscopic chromotubation as a method of reference. Materials and methods: Twenty-two patients were included. The MRHSG was performed in a 1.5 Tesla MR scanner. Afterwards, patients underwent laparoscopic chromotubation. MR images were examined by two trained radiologists, and tubal patency was determined by consensus. A descriptive analysis was carried out, as well as an analysis of the diagnostic performance. Results: MRHSG had a 91% success rate. Exam duration of the examination was 49ą15min, with an injected volume 26ą 16cc, and pain scale 30ą 19 out of 100. Sensitivity and specificity of MRHSG was 100% for global and left Cotte, and 25% and 93.3% for right Cotte, respectively. Only 2 minor and no major complications were observed. Discussion: The initial results of MRHSG have shown high sensitivity and specificity. Even though other studies have analysed the potential of MRHSG with good results, the use of a flawed reference standard left a margin for a reasonable doubt as regards its true potential, thus preventing a solid evidence based recommendation. Nevertheless, if our results are compared to those published, a high level of agreement is observed in that positive spillage is correctly diagnosed with specificities near or at 100%. Conclusion: MRHSG is a feasible and safe alternative to conventional or virtual HSG, ultrasound-hysterography and chromotubation.

Analysis on nanobubbles for enhanced ultrasound imaging of small-cell lung cancer in nude mice / 肿瘤研究与临床

Objective To prepare nanobubbles and analysis its application for enhanced ultrasound imaging of small-cell lung cancer (SCLC). Methods Nanobubbles were prepared using a thin-film hydration-sonication method. MTT assay was used to evaluate the cytotoxicity of the nanobubbles for SCLC H446 cell line. The contrast-enhanced ultrasound (CEUS) of xenografted SCLC tumors in 10 nude mice was performed using nanobubbles and micro-scale microbubbles, and compared with livers. The time-intensity curve (TIC) was obtained using the Gamma variate and the following parameters were calculated, including area under the curve, time to peak, arrival time, peak intensity, and half-peak time. Results Nanobubbles with spherical shape distributed homogeneously, without obvious aggregation, the mean diameters was (392.1 ±48.6) nm and average zeta potential was (-16.8 ±2.9) mV. The MTT results indicated that the nanobubbles had no obvious cytotoxicity toward H446 cell line within the concentrations used for in vivo ultrasound imaging with nanobubbles (5 μg/ml). CEUS with the nanobubbles showed significantly higher peak intensity, and half-peak time [(18.14 ±0.62) s, (141.55 ±8.21) s] in comparison with the micro-scale microbubbles [(14.82 ±0.51) s, (120.43 ±8.73) s] (P= 0.033, 0.040). There was no significant difference in time to arrival, area under the curve and time to peak (all P>0.05). Compared with livers, the nanobubbles in xenografted SCLC tumors showed significantly shorter time to peak, lower peak intensity and area under the curve, and higher half-peak time (all P 0.05). Conclusion Nanobubbles ultrasound enhanced contrast agent shows good stability and contrast-enhancement effect in vitro, and provides an experimental basis for targeting ultrasound imaging and therapeutics of SCLC.

Clinical application of MDCTE score in evaluating Crohn's disease Activity / 安徽医科大学学报

Fifty activity small intestinal Crohn's disease patients were enrolled in this study.Every patient was confirmed multidetector CT enterography (MDCTE) scanning.The CT imaging and scored accoeding to the CT findings were retrospectively analyzed.Patients were divided into mild,moderate,severe activities according to patients'Crohn's disease activity index(CDAI).The correlation between CT score and the CDAI was compared.Results showed that CT score and CDAI had significant correlation (r =0.825,P ＜ 0.825).The MDCTE score can be used for clinical evaluation of Crohn's disease activity.

Application of PET/CT in targeted therapy of breast cancer / 中华核医学与分子影像杂志

Breast cancer is one of the most common malignant tumors in women, and its morbidity is increasing gradually in recent years. Precision treatment has been developed with individualized and standardized protocols according to the molecular classification of breast cancer. Targeted therapy is one of the most important methods. How to evaluate targeted therapy is the focus of attention. PET/CT plays an im-portant role in the diagnosis, staging, treatment plan and evaluation of therapeutic effect and prognosis, es-pecially in targeted therapy of breast cancer. This review summarizes the applications of PET/CT in targeted therapy of breast cancer.

Evaluation of relationship between myocardial injury and left ventricular mechanical dyssynchrony using 99 Tcm-MIBI myocardial perfusion SPECT and 18 F-FDG myocardial metabolic PET imaging / 中华核医学与分子影像杂志

Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.

Application of PET/CT in targeted therapy of breast cancer / 中华核医学与分子影像杂志

Breast cancer is one of the most common malignant tumors in women, and its morbidity is increasing gradually in recent years. Precision treatment has been developed with individualized and standardized protocols according to the molecular classification of breast cancer. Targeted therapy is one of the most important methods. How to evaluate targeted therapy is the focus of attention. PET/CT plays an im-portant role in the diagnosis, staging, treatment plan and evaluation of therapeutic effect and prognosis, es-pecially in targeted therapy of breast cancer. This review summarizes the applications of PET/CT in targeted therapy of breast cancer.

Evaluation of relationship between myocardial injury and left ventricular mechanical dyssynchrony using 99 Tcm-MIBI myocardial perfusion SPECT and 18 F-FDG myocardial metabolic PET imaging / 中华核医学与分子影像杂志

Objective To investigate the relationship between myocardial injury and damage of me-chanical synchrony in the left ventricle of patients with ischemic cardiomyopathy ( ICM) using 99 Tcm-MIBI MPI and gated 18 F-FDG myocardial metabolic PET imaging. Methods A total of 113 ICM patients ( 100 males, 13 females;average age (58±10) years) underwent 99Tcm-MIBI MPI and gated 18F-FDG myocardial metabolic PET imaging from July 2015 to December 2015 in Fu Wai Hospital were retrospectively analyzed. Three-point scoring system was used for quantitative assessment of myocardial ischemia and myocardial in-farction in each segment. Total ischemic score ( TIS) and total scar score ( TSS) of 17 segments were calcu-lated in each patient. The phase bandwidth ( BW) and phase SD were derived from phase analysis. Pearson correlation analysis and logistic regression analysis were used. Results TSS were correlated with BW and SD in all 93 patients with myocardial infarction ( r values:0. 517, 0.470, both P<0.01) and also in a sub-group of 34 patients with myocardial infarction and without myocardial ischemia ( r values: 0. 647, 0. 578, both P<0.01) . There were significant correlations between TIS and BW, SD in 79 patients with myocardial is-chemia ( r values:0.392, 0.378, both P<0.01) , but no significant correlation was found in a subgroup of 20 patients with myocardial ischemia and without myocardial infarction ( r values: 0. 002, -0. 003, both P>0. 05) . Logistic regression analysis showed that the number of myocardial infarction segments and TSS were as-sociated with mechanical dyssynchrony. Conclusion Myocardial infarction is the main factor of left ventricu-lar mechanical dyssynchrony in ICM patients, but chronic myocardial ischemia has no significant influence on mechanical dyssynchrony.

Estimation of femoral version based on broach geometry after femoral-neck osteotomy / 北京大学学报(医学版)

Objective:To find out whether it is accurate to estimate femoral version based on femoral broach after femoral neck osteotomy using computed tomography scans.Methods:In 32 total hip arthro-plasty (THA),we performed CT scans before and after operation.Four possible levels (lesser trochan-ter,5 mm above,10 mm above and 15 mm above the lesser trochanter)of broach version were calculated based on the pre-operative CT scan.Stem versions were measured on the post-operative CT scan.We de-termined the difference between the preoperative broach version and the postoperative stem version using the Student’s t-test for paired samples assuming equal variance.Results:For the operated hips,pre-operative hip version differed according to the level of measurement.Our findings showed that the average femoral version was 37.0°±11.0°at the level of the lesser trochanter (section 1),34.3°±10.6°at 5 mm above the lesser trochanter (section 2),28.1°±10.9°at 10 mm above the lesser trochanter (sec-tion 3),and 22.4°±13.7°at 15 mm above the lesser trochanter (section 4),and that the average ver-sion for the femoral neck (FNV)was 12.9°±13.8°.The postoperative hip version was the stem version (FSV),which we found to be an average of 26.1°±11.0°.The mean femoral version for section 1 and 2 was larger than the mean postoperative stem version (P0.05).The mean femoral neck version was less than the mean postoperative stem version (P<0.01);the difference was 13.2°±11.1°of the in-creased anteversion on average for the FSV compared with FNV.Conclusion:The accuracy of estimated femoral version after arthroplasty depends on broach level.When it is 10 mm above the lesser trochanter, stem version estimation is accurate,but below that level,there is a tendency to overestimate.

Evaluation of alveolar ridge reconstruction and esthetic result following immediate implant / 北京大学学报(医学版)

Objective:To evaluate the bone alteration subject to remodeling and analyze the esthetic result following immediate implant placement of incisors.Methods:In this study,20 patients (1 3 women,7 men)were involved,who needed implants for incisors of maxilla.The patients received 23 im-mediate implants totally.On the day of surgery and 6 months after the implants were placed,Cone beam CT (CBCT)was taken.The thickness of the alveolar ridge and the vertical change of marginal bone levels onthe mesial and distal aspects of theimplants were measured using the computer software (Planme-caRomexis Viewer 3.6.0.R).The evaluation of esthetic result by labial convexity score (LCS)and pa-pilla index score (PIS)were analyzed pre-operation and one year after the final crown was delivered.The statistics with paired-t test for the measurement data and Willcoxon test for rating data were done by SPSS 20.0.Results:The survival rate in the two-year follow-up was 1 00%.The measuring point 1 (MP1 ), MP2,MP3 and MP4 (0,2,4,6 mm apical to the implant platform,respectively)got significant altera-tions after 6 months of the follow-up.These differences were statistically significant (P<0.05 ).The major alteration happened at MP1 and MP4,which got (-0.89 ±2.06)mm and (-0.75 ±1 .28)mm reduction of the alveolar,respectively.The marginal alveolar ridge resorption was (-0.42 ±1 .24)mm and(-0.91 ±1 .96)mm for Ankylos System and Replace System,respectively,and the difference was not statistical significant .The esthetic results were quite acceptable.Before treatment,1 8 incisors rated 3 for LCS,and 2 incisors rated 4 for LCS;after final restoration,only 5 incisors rated 3 for LCS,and 1 4 incisors rated 2 for LCS.Before treatment,1 5 incisors rated 3 for PIS;after final restoration,1 3 incisors rated 3 for PIS.There was no statistically significant difference for the PIS pre-operation and 1 year after final restoration,while there was statistically significant negative change for LCS.Conclusion:Even fol-lowing the proper surgical technique,the alveolar ridge wall still can’t be maintained after immediate im-plant placed in fresh socket of incisors.The inter-dental papilla could be well maintained,while due to the remodeling of labial bone,labial convexity will inevitably collapse.Therefore immediate implant still has esthetic risk.

Cerebrovascular Reserve in Patients with Unilateral Internal Carotid Artery or Middle Cerebral Artery Stenosis: Study with 13N-Ammonia PET/CT Combined with Methazolamide / 中国康复理论与实践

@#Objective To evaluate the cerebrovascular reserve (CVR) with 13N-ammonia PET/CT and methazolamide in patients with cerebral ischemic disease. Methods From January, 2014 to December, 2015, basal and stress PET/CT were performed in ten healthy persons and 53 patients with unilateral internal carotid artery or middle cerebral artery stenosis. Radioactive counts were measured on mirror regions of bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe, basal ganglia and thalamus to calculate the blood flow change rate. Results For the healthy persons, the radioactive distribution of bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe, basal ganglia and thalamus were roughly symmetrical on both basal and stress PET/CT. The radioactive counts were more in basal ganglia and thalamus than in cortex, and the least in white matter. The radioactive counts were more on stress PET/CT than basal PET/CT, and there was no significant difference between both sides (t=1.552, P=0.132). For the patients, the blood flow perfusion decreased in 39 patients with 126 regions on basal PET/CT, and 49 patients with 183 regions on stress PET/CT. Within the 39 patients who found decreased blood flow perfusion regions, 16 patients were found new regions on stress PET/CT, and 29 regions of 13 patients improved in blood flow perfusion on stress PET/ CT. The blood flow change rate was significantly different between basal and stress PET/CT (t=2.466, P<0.05). Conclusion 13N-ammonia PET/CT cerebral blood flow perfusion imaging combined with methazolamide stress test can evaluate the cerebrovascular reserve in patients with unilateral internal carotid artery or middle cerebral artery stenosis, and is valuable for clinical assessment and early intervention for patients with cerebral ischemic disease.

Effect of refraction and axial length on retinal nerve fiber layer thickness and optic disc morphology in guinea pigs / 中国实验动物学报

Objective To observe the retinal nerve fiber layer ( RNFL) thickness and optic disc morphology in guinea pigs by optical coherence tomography ( OCT ) , and to investigate the correlation of spherical equivalent and axial length with those parameters .Methods Twenty healthy guinea pigs were used in this study .Spherical equivalent and axi-al length of nine guinea pigs were measured , and retinal nerve fiber layer thickness and optic disc morphology in the guinea pigs were analyzed by OCT .Results Spherical equivalent of the guinea pigs was positively correlated with average RNFL thickness, and with superior, temporal, inferior and nasal RNFL thicknesses;while ocular axial length was negatively cor-related with average RNFL thickness , and with superior , temporal , inferior and nasal RNFL thicknesses .Spherical equiva-lent and axial length did not correlate significantly with disc edge area , optic disc area , average cup disc ratio , or cup vol-ume .Vertical cup disc ratio significantly correlated with axial length , but did not with spherical equivalent .Conclusions The retinal nerve fiber layer thickness in guinea pigs is affected by both spherical equivalent and axial length .When guinea pigs are used as an animal model of glaucoma , the effect of refractive state and axial length should be considered .

Application of localization needles under ultrasound-guidance for the nonpalpable breast calcification / 国际外科学杂志

Breast calcification is a specific sign of nonpalpable early breast cancer,the accurate localization and biopsy can obviously improve the diagnosis rate of early breast cancer,and imaging-guided needle localization is the premise of accurate biopsy of breast calcification.As the recommended guidance,mammography-guided localization and biopsy has certain limitations in localizing and biopsying breast calcification,however,high-resolution uhrasound makes it possible to localize the nonpalpable calcification in breast,and which has a certain advantage.