Optimization of 18F-FDG PET/CT semi-quantitative diagnostic model for children with autoimmune encephalitis with epilepsy and negative MRI / 中华核医学与分子影像杂志

Objective:To investigate the value of 18F-FDG PET/CT imaging in the diagnosis of suspected autoimmune encephalitis (AE) in children with epilepsy and negative MRI. Methods:From May 2019 to August 2022, 94 suspected AE children (49 males, 45 females; age 1-15 years) with epilepsy and negative MRI who underwent brain 18F-FDG PET/CT imaging at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. All patients were divided into AE and non-AE groups based on clinical final diagnosis. The effectiveness of visual diagnosis was evaluated. The cortical lesion extent score (S), and SUV max, SUV mean and minimum of SUV (SUV min) of cortical lesions (L), basal ganglia (B) and thalamus (T) were measured and SUV ratios (SUVR) of L/B or L/T were obtained. Independent-sample t test or Mann-Whitney U test was used to analyze data. Binary logistic regression analysis was used to screen the diagnostic factors of AE, and a diagnostic model was established. The diagnostic efficiency was evaluated by ROC curve analysis and Delong test. Results:There were 53 cases in AE group and 41 cases in non-AE group. Based on visual analysis, the sensitivity, specificity and accuracy of 18F-FDG PET/CT for AE were 100%(53/53), 43.9%(18/41) and 75.5%(71/94), respectively. Differences of LSUV max, LSUV mean, LSUV min, L/BSUVR max, L/BSUVR mean, L/BSUVR min, L/TSUVR max, L/TSUVR mean, L/TSUVR min and S between AE and non-AE groups were statistically significant ( z=-6.74, t values: from -8.51 to -3.97, all P<0.001). ROC curve analysis showed that the AUC of L/BSUVR max was the highest (0.914) among visual analysis and semi-quantitative parameters. Logistic regression analysis showed that S (odds ratio ( OR)=11.40, 95% CI: 2.18-59.52, P=0.004), L/BSUVR max( OR=13.19, 95% CI: 2.11-82.51, P=0.006) and L/TSUVR max( OR=9.66, 95% CI: 1.57-59.55, P=0.015) were independent diagnostic factors for AE. Regression model was established: P=1/(1+ e - x), x=2.433×S+ 2.580×L/BSUVR max+ 2.267×L/TSUVR max-3.802. The AUC of this model was 0.948, with the sensitivity, specificity and accuracy of 98.1%(52/53), 90.2%(37/41) and 94.7%(89/94), respectively. The diagnostic efficacy of the optimized scoring system was consistent with the pre-optimization model, and were both superior to L/BSUVR max(both z=2.01, both P=0.040). Conclusion:The diagnostic model and scoring system based on the semi-quantitative analysis of 18F-FDG PET/CT have better diagnostic efficacy for AE and are superior to semi-quantitative parameters alone.

Value of 18F-FDG PET/CT SUVmax for preoperative assessment of primary tumor infiltration and metastases in patients with endometrial cancer / 中华核医学与分子影像杂志

Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer.Methods A retrospective study was performed in 51 patients (average age (59± 12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015.Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging.With SUVmax as the statistical variable,comparison was made between the pathologically confirmed benign and malignant groups,and in case of the latter,the extent of infiltration,histologic grade and subtype of primary tumor,lymph node and distant metastases were also analyzed.Two-sample t test was used to analyze the data,and diagnostic efficacy of PET/CT for metastasis was calculated.Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor.SUVmax was found to significantly correlate with histopathology classification (benign:3.4 ± 1.2,malignant:12.8 ± 6.5) and depth of myometrial invasion (≥1/2:17.7±5.4,＜1/2:10.9±5.9;t=-8.7 and 3.2,both P＜0.05),but not with cervical stromal invasion,histologic grade or histologic subtype(t =1.8,-1.9,1.5,all P＞0.05).The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7％ (18/21),98.2％ (271/276),97.3％ (289/ 297),78.3％(18/23),98.9％ (271/274),respectively,and on a patient basis were 6/6,97.3％ (36/ 37),97.7％ (42/43),6/7,100％ (36/36),respectively.The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12.Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion,lymph node metastases and other metastases in patients with endometrial cancer,particularly in specificity and NPV.

PET/CT findings of Langerhans cell histiocytosis in children / 中华核医学与分子影像杂志

Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.

Evaluation of mouse acute liver damage by breath test with domestically synthesized ~(13)C-methacetin / 上海交通大学学报（医学版）

Objective To establish a convenient ~(13)C-breath test system in live mice,and investigate the value of ~(13)C-methacetin breath test(~(13)C-MBT) in the diagnosis of acute liver damage of mice with domestically synthesized ~(13)C-methacetin. Methods Domestically synthesized ~(13)C.methacetin was prepared from aeamol by methylation. Abdominal injection of CCl_4 was adopted to duplicate acute liver damage of mice,then the mice were housed under normal laboratory condition for a whole month to gain recovery,which were indentified by hepatic pathological examinations and biochemical teats of liver function.After fasting, the mice were orally administered ~(13)C-methacetin,and the expired air was collected at various time points. Infrared spectrometer was employed, and delm over baseline(DOB) curves of ~(13)C-exhalation were drawn. Results Six to eight min after administration of ~(13)C-methacetin,the rate of ~(13)C-exhalation peaked in control group(51.9±2.04), and decreased thereafter. Sixteen min after administration of ~(13)C-methacetin,the rate of ~(13)JC-exhalation peaked in model group(26.37±5.74), and decreased thereafter.There were significant differences between these two groups(P<0.05).There was no significant difference in peak value and time to reach the peak on DOB curves of ~(13)C-methacetin breath test after the two groups of mice were housed under the same condition for a month(P>0.05).Conclution ~(13)C-MBT facilitates the collection and evaluation of ~(13)CO_2 in the expired air of live mice,and yields precise reflection of alterations of liver function in acute liver injury and functional recovery.

Eukaryotic expression and bioactivity determination of the fusion protein sTNFRII-gAD consisting of soluble tumor necrosis factor receptor II and globular domain of adiponectin / 生物工程学报

In order to get soluble TNF receptor (sTNFR) II with good neutralizing activity against TNFalpha, we constructed the fusion gene sTNFRII-gAD, which encoded human sTNFR II and the globular domain of adiponectin (gAD), and then expressed it in mammalian cells and analyzed its anti-TNFalpha activity. First, sTNFRII cDNA was obtained by RT-PCR from the total RNA of human peripheral blood lymphocytes, and fused in frame with gAD gene. Then, the fusion gene sTNFRII-gAD was cloned into the expression vector pAAV2neo to result in the plasmid pAAV2neo-sTNFRII-gAD. By immunofluorescent staining with monoclonal antibody either against TNFRII or against adiponectin, we demonstrated that the pAAV2neo-s7NFRII-gAD-transiently-transfected BHK-21S cells were positive. To obtain G418-resistant BHK-21S/pAAV2neo-sTNFRII-gAD cells, we cultured the transfected BHK-21S cells above in 10% FBS containing DMEM media with 800 microg/mL G418 for 15 days, and changed the serum-containing culture media to a serum-free chemically defined media so as to change the cells culturing style from adhesion to suspension. 24 hours later, we harvested the supernatant of the culture for sTNFRII-gAD fusion protein characterization and anti-TNFalpha activity analysis. With monoclonal antibody either against TNFRII or against adiponectin, the Western blotting analysis showed that the sTNFRII-gAD fusion protein was expressed and existed as monomer, trimer and multimer forms in the supernatant. The bioactivity assay demonstrated that the sTNFRII-gAD fusion protein had the ability to neutralize TNFalpha so as to inhibit the cytotoxicity of TNFalpha on L929 cells. Put together, this study has laid the groundwork for large-scale preparation of sTNFRII-gAD fusion protein.

X-ray evaluation of intestinal malrotafion in adults / 中国医师进修杂志

Objective To evaluate the X-ray diagnosis value of intestinal malrotation in adults.Methods The X-ray findings of 16 cases with intestinal malrotation confirmed by surgery were analyzed retrospectively. All of them were taken X-ray plain films, 11 cases were taken alimentary tract barium meal,and 5 cases were taken barium enema. Results Eight cases were found incomplete obstruction of the duodenum, and 2 cases were found low small intestine obstruction on the X-ray plain films. The alimentary tract barium meal showed 4 cases with dilatation and incomplete obstruction of the duodenal bulb to horizontal segment,and the distal end of narrowing intestine appeared as a rat tail,7 cases showed the abnormal duodenal location and shape,called "strip" sign. Four cases were found abnormal duodenojejunal flexure by barium enema examination. Conclusion The alimentary tract barium meal and barium enema examination has great diagnosis value for intestinal malrotation in adults.

Prolonged-releasing performance of drug loaded polyelectrolyte nanocapsules effected by acid phosphatease: in vitro analysis / 生物工程学报

The aims of the study were to prepare polyelectrolyte nanocapsules effected by acid phosphatease (ACP) and to study prolonged-releasing performance of the nanocapsules in vitro. Using the layer by layer (LbL) self-assembly technique, polyelectrolyte-beta-glycerophosphoric acid nanocapsules were prepared. The morphologies of the nanocapsules were characterized by transmission electron microscopy (TEM) and biocompatibility was well examined by cell-culture method. The drug adriamycin would be loaded in nanocapsules for concentration gradient, the encapsulation efficiency could be calculated. Nanocapsules were reacted with acid phosphatease standard and HepG2 cells that express the ACP, respectively. The prolonged-releasing of adriamycin was verified and tumor cells apoptosis were measured. TEM images showed that the nanocapsule sizes were between 200-300 nm. The material biocompatibility was good until the concentration of nanacapsule was up to 250 microg/mL. The drug encapsulation efficiency reached 68.12%. The release rate of polyelectrolyte (PAH/PSS-beta-glycerophosphoric acid)s nanocapsules was higher than in the control nanocapsules at 48 h (38% Vs 15%) after its reaction to the ACP standard (P < 0.05). Compared with the control, nanocapsules could significantly inhibit the growth of HepG2 cells that expressed the ACP, and the efficiency of cell apoptosis was 7.59% higher at 24 h (13.73 Vs 6.14, P < 0.05). Polyelectrolytes (PAH/PSS-beta-glycerophosphoric acid) nanocapsules in vitro have response to acid phosphatease by which prolonged-releasing can be affected. This property can be used for treatment of some malignant and benign diseases with elevated acid phosphatease level.

The Impact of Internet Media on the Politics Socialization of Medical Students / 中国医学伦理学

As a special media of politics and culture spreading,internet has a unique influence on politics socialization due to its characteristics of openness,reciprocity,and anonymity.Combined with the features of medical students,this paper analyzes the positive and negative impacts of internet media on the politics socialization of medical students,and comes up with feasible countermeasures for promoting the politics socialization of medical students in current information era.

Comparative Study on the Mechanism of Formation of Pulse Manifestations in Patients of Coronary Heart Disease and Hematopathy / 中医杂志

Most of the CHD patients reveal string pulse, mainly due to damage of heart function, lowering of arterial compliance and increase of total peripheral resistance. The common pulse in patients of blood diseases reveal frequent, tiny, string and slippery characteristic, mostly due to the increase of compensatory pumping action of the heart, shortening of ejection time of the left heart, with better vessel compliance and hemorheology, low total peripheral resistance.

RESEARCH ON BATCH QUANTITIVE DETERMINATION OF L-MALIC ACID IN FERMENTATION LIQUOR / 微生物学通报

A simple and rapid method was established for the determination of the content of L-malic acid in fermentation liquor. This procedure includes six steps: (1) Use a microi- njector to inject the fermentation liquor quantitively on the filter paper, then use the chromatography solution (n-butanol: formic acid: water=8:1.5:1) for paper chromatography. (2) Atomize the display reagent (10ml 0.02?10~(-2) bromocresol green: 0.2ml 10?10~(-2) sodium hydroxide) on the chromatography paper. (3) Scissor off L-malic acid spots from the paper and put in into 5 ml distilled water for three hours. (4) In 1ml eluent, add 6 ml 96?10~(-2) sulphuric acid and 0.1ml 1.0?10~(-2) ?-naphthol.(5) Heat the reaction system in 100℃ water for sixty minutes. (6) After cooling determine the optical density at the wavelength 476 am in the colorimeter.