Predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for medium-term outcome in patients with primary gastrointestinal diffuse large B cell lymphoma / 中华核医学与分子影像杂志

Objective:To explore the predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for the medium-term efficacy of chemotherapy in patients with primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL). Methods:From April 2011 to May 2020, 67 patients (37 males, 30 females, age: 28-85 years) with PGI-DLBCL examined by 18F-FDG PET/CT before chemotherapy in Changhai Hospital, Navy Medical University were retrospectively analyzed. All patients were treated with cyclophosphamide+ doxorubicin+ vincristine+ prednisone (CHOP) or rituximab+ CHOP (R-CHOP) regimens, and the medium-term efficacy was evaluated after 2-4 cycles of chemotherapy. The effect outcome was divided into complete remission (CR) group and non-CR (NCR) group based on the Lugano lymphoma response evaluation criteria. Mann-Whitney U test was used to compare the differences of SUV max, peak of SUV (SUV peak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) between two groups. The independent risk factors of NCR were analyzed by multivariate logistic regression and the binary logistic regression model was established according to the results. The model was tested with external validation data ( n=15). Results:Of 67 PGI-DLBCL patients, 28(41.8%) were CR and 39(58.2%) were NCR. SUV peak, MTV, TLG, PLR and NLR in NCR group (17.3(12.3, 28.1), 73.8(42.9, 141.7) cm 3, 887.5(300.9, 2 075.3) g, 203.9(155.7, 297.1), 3.9(3.0, 4.9)) were significantly higher than those in CR group (9.5(6.2, 15.2), 11.3(4.7, 23.2) cm 3, 85.2(35.5, 214.6) g, 149.3(102.8, 173.1), 2.2(1.8, 4.6); z values: from -6.41 to -2.33, all P<0.05). The logistic regression model was as follows: P=1/(1+ e - x), x=0.100×MTV+ 0.024×PLR-8.064. The prediction accuracy for NCR risk was 86.57%(58/67), with the accuracy of 13/15 tested by external validation data. Conclusion:MTV combined with PLR has a good predictive value for medium-term efficacy of CHOP/R-CHOP chemotherapy in patients with PGI-DLBCL.

Extent of lymphadenectomy for esophageal cancer / 中华胃肠外科杂志

Esophageal cancer is a common malignant tumor in China. For resectable ones, surgery is still the primary treatment. At present, the extent of lymph node dissection remains controversial. Extended lymphadenectomy makes metastatic lymph nodes more likely to be resected, which contributed to pathological staging and postoperative treatment. However,it may also increase the risk of postoperative complications and affect prognosis. Therefore, it is controversial how to balance the optimal extent/number of dissected lymph nodes for radical resection with the lower risk of severe complications. In addition, whether the lymph node dissection strategy should be modified after neoadjuvant therapy needs to be investigated, especially for patients who have a complete response to neoadjuvant therapy. Herein, we summarize the clinical experience on the extent of lymph node dissection in China and worldwide, aiming to provide guidence for the extent of lymph node dissection in esophageal cancer.

Preliminary analysis of the effect of individualized voice therapy on pediatric voice disorders / 临床耳鼻咽喉头颈外科杂志

Objective:To determine the effectiveness of individualized voice therapy in persistent pediatric voice disorders. Methods:Thirty-eight children who were admitted to the Department of Pediatric Otolaryngology Shenzhen Hospital, Southern Medical University due to persistent voice disorder from November 2021 to October 2022 were included. All children were evaluated by dynamic laryngoscopy before voice therapy. Two voice doctors performed GRBAS score and acoustic analysis on the children's voice samples to obtain the relevant parameters including F0, Jitter, Shimmer, and MPT; All children were given personalized voice therapy for 8 weeks. Results:Among 38 children with voice disorders, 75.8%（29 cases） were diagnosed with vocal nodules, 20.6%（8 cases） were vocal polyps, and 3.4%（1 case） were vocal cysts. And in all children. And 51.7%（20 cases） had the sign of supraglottic extrusion under dynamic laryngoscopy. GRBAS scores decreased from 1.93 ± 0.62, 1.82 ± 0.55, 0.98 ± 0.54, 0.65 ± 0.48, 1.05 ± 0.52 to 0.62 ± 0.60, 0.58 ± 0.53, 0.32 ± 0.40, 0.22 ± 0.36, 0.37 ± 0.36. F0, Jitter, Shimmer decreased from（243.11±39.73） Hz, （0.85±0.99）%, （9.96±3.78）% to（225.43±43.20） Hz, （0.33±0.57）%, （7.72±4.32）%, respectively MPT was prolonged from（5.82±2.30） s to（7.87±3.21） s after treatment. All parameters changes had statistical significance. Conclusion:Voice therapy can solve children's voice problems, improve their voice quality and effectively treat children's voice disorders.

Current status of minimally invasive techniques in the field of esophageal surgery / 中华消化外科杂志

Esophageal cancer is a common malignant tumor of the digestive system in China. Currently, surgical resection is the main treatment for localized and resectable esophageal cancer. Minimally invasive treatment of esophageal cancer has the advantages of small trauma, neat incision, less pain, quick postoperative recovery, low postoperative complication incidence and mortality, and the treatment effect is comparable to traditional open surgery. Therefore, minimally invasive surgery for esophageal cancer has gradually become the mainstream choice for esophageal surgery. Various minimally invasive treatment approaches for esophageal cancer have correspon-dingly different indications, advantages and disadvantages. With the continuous development of minimally invasive technology, the shortcomings of various minimally invasive surgical approaches have been continuously overcome, which has brought about the diversification of minimally invasive treatment options. The authors comb the latest research progress at home and abroad, discuss and summarize the current application of minimally invasive techniques in esophageal surgery, hoping to provide references for the clinical minimally invasive treatment of esophageal cancer.

Preparation of Al 18F-PSMA-11 and its preliminary PET/CT imaging / 中华核医学与分子影像杂志

Objective:To optimize the preparation conditions and methods of Al 18F-prostate specific membrane antigen (PSMA)-11 and evaluate the feasibility of clinical transformation. Methods:PSMA- N, N′-bis(2-hydroxy-5-(carboxyethy)benzyl)ethylenediamine- N, N′-diacetic acid (HBED-CC) dissolved in CH 3COONH 4 buffer (pH=4.8) was reacted with AlCl 3·3H 2O dissolved in pure water at a molar ratio of 1∶1 (60 ℃, 10 min), and then purified by tC18 column and freeze-dried to obtain [Al]-PSMA-11. [Al]-PSMA-11 was labeled by 18F - and the effects of reaction temperature and pH value on the labeling rate were investigated. The labeled products were purified by tC18 column and filtered through sterile filter to obtain Al 18F-PSMA-11. The comparison of biodistribution between Al 18F-PSMA-11 and 68Ga-PSMA-11 was analyzed on 5 healthy volunteers (age (56±8) years). The differences of SUV max between two groups were analyzed by independent-sample t test. Besides, the early and delayed imaging of Al 18F-PSMA-11 PET/CT were performed on a patient (70 years old) with recurrent prostate cancer for assessment of its potential for prostate cancer recurrence monitoring. Results:The labeling rate was (42.3±3.2)% reacting in aqueous phase (60 ℃, pH=4.8) for 15 min. After being purified with tC18 cartridge, the radiochemical purity of the product was still more than 95% after placement at room temperature for 3 h. Preliminary application demonstrated that there was no significant difference in the biodistribution of Al 18F-PSMA-11 and 68Ga-PSMA-11 among lacrimal gland, parotid gland, submandibular gland, liver, spleen, kidney, bladder and part of intestine and SUV max of targeted organs were also not different ( t values: 0.19-1.95, all P>0.05) between two groups. Multiple bone metastases were observed by Al 18F-PSMA-11 PET/CT delayed imaging (3 h) in a patient with recurrent prostate cancer. Conclusion:Al 18F-PSMA-11 produced with pre-conjugated [Al]-PSMA-11 meets the requirement of the PET imaging application, and it has good potential of localization and imaging for prostate cancer metastatic lesions.

Diagnosis and treatment value of bedside severe ultrasound in children with shock / 中国小儿急救医学

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.

Disease spectrum and prognosis of children in pediatric intensive care unit in non-epidemic areas during Corona Virus Disease 2019 epidemic period / 中国小儿急救医学

Objective:To analyze the influence of Corona Virus Disease 2019(COVID-19) epidemic on inpatient disease spectrum, treatment methods and outcomes in pediatric intensive care unit(PICU)in non-epidemic areas.Methods:The clinical data of children admitted to PICU at Shengjing Hospital of China Medical University from February 1, 2019 to May 30, 2019(group Ⅰ)and from February 1, 2020 to May 30, 2020(group Ⅱ)were collected retrospectively.We analyzed the spectrum changes of infectious and non-infectious diseases, visiting time, as well as compared the diseases of various systems and accidental injuries, and the use of important treatment methods, all-cause mortality.Results:There were 339 cases in group Ⅰ and 208 cases in group Ⅱ.The total number of patients in group Ⅱ decreased by 38.6% compared with group Ⅰ.There was no significant difference in pediatric multiple organ dysfunction score (P-MODS)( P=0.894)between two groups within 24 hours after admission, but pediatric logistic organ dysfunction score (PELOD)-2 in group Ⅱ[1(0, 3)] was higher than that in group Ⅰ[1(0, 2)] within 24 hours after admission, with statistical difference( P=0.012). The length of hospital stay in group Ⅱ was longer than that in group Ⅰ, but there was no statistical difference.The length of hospital stay in shock group, accidental injury and poisoning group were 6(5.25, 8.25)days and 9(6, 16)days, respectively, with statistical differences( P=0.048, P=0.001). Compared with group Ⅰ, the number and ratio of infectious diseases(pneumonia, aseptic encephalitis and sepsis)in group Ⅱ decreased significantly[176(52.1%)to 93(44.5%), P=0.095]. Neuromuscular diseases: aseptic encephalitis decreased from 13.2% to 7.2%; non-traumatic intracranial hemorrhage increased from 0.9% to 3.8%, with statistical difference( P=0.028, P=0.017). Compared with group Ⅰ, the number of invasive interventional therapy cases in group Ⅱ decreased significantly, among which non-invasive ventilator, plasma exchange and fiberoptic bronchoscope decreased by at least 50%, but there was no significant difference between two groups.The average time from onset to visit was 7(4, 12)days in group Ⅰ and 3(1, 6)days in group Ⅱ, with statistical difference( P=0.002). There were 16 hospital deaths in group Ⅰ, with a mortality rate of 4.7%, and 7 hospital deaths in group Ⅱ, with a mortality rate of 3.4%.There was no significant difference in the total mortality and the mortality of the main diseases causing death. Conclusion:The epidemic situation of Corona Virus Disease 2019 led to characteristic changes in disease spectrum of children admitted to PICU, and infectious diseases were obviously reduced.Non-infectious diseases such as trauma and poisoning were still the main causes of critically ill children.During the epidemic period, there was no obvious change in treatment, PICU admission time and all-cause mortality rate of critically ill children in non-epidemic areas, thus it could be seen that the epidemic did not have adverse effects on treatment, referral, and prognosis of critically ill children.

Effect of Qiyu Sanlong Decoction in Inducing Autophagy of A549 Cells by Regulating Molecular Expression Related to Signal Axis of mTOR-Beclin1-LC3 / 中国实验方剂学杂志

Objective:To observe the effect of Qiyu Sanlong decoction （QYSL） on the expressions of key molecules in signal axis of mammalian rapamycin target protein （mTOR）/yeast Atg6 homologous （Beclin1）/ microtubule-associated protein1 light chain3 （LC3） in A549 cells. Method:With A549 cells as the research object， the effect of QYSL medicated serum on cell viability of A549 cells were detected by cell counting kit-8 （CCK-8） method. The effect of QYSL decoction on A549 cell apoptosis， autophagosome formation and the expression of autophagy markers were detected by Terminal-deoxynucleoitidyl transferase mediated nick end labeling （TUNEL） method， transmission electron microscope （TEM）， Real-time polymerase chain reaction （Real-time PCR） and Western blot. Result:QYSL medicated serum could inhibit the viability of A549 cells in a concentration-dependent manner. Compared with the blank serum group， the number of apoptotic A549 cells in the QYSL medicated serum group was significantly increased （P<0.01）， and the formation of autophagosome was significantly increased. Compared with the blank serum group， the mRNA and protein expressions of mTOR in A549 cells in the QYSL serum group were significantly decreased （P<0.01）， while mRNA and protein expressions of Beclin-1， autophagy related genes 5 （ATG5）， autophagy related genes 13 （ATG13） were significantly increased （P<0.01）. Conclusion:QYSL decoction can induce autophagy in A549 cells， and its specific mechanism may be related to the down-regulation of mTOR expression， the up-regulation of Beclin1， ATG5， ATG13 and LC3 expression， and the promotion of LC3Ⅰ conversion to LC3Ⅱ.

The Role of Wound Swab Microbial Cultures and Antibiotic Sensitivity Results in the Management of Sacrococcygeal Pilonidal Abscess

Purpose@#Current practice for patients who present to hospitals with acute sacrococcygeal pilonidal abscess is operative management. Wound swabs are routinely taken peri-operatively and antibiotics are initiated empirically pending culture and sensitivity results. The aim of our study was to evaluate whether the results of wound swabs change post-operative antibiotic therapy for these patients, and to identify the common microorganisms. @*Methods@#This was a retrospective analysis which included patients who presented to the Northern Hospital, Victoria, with acute sacrococcygeal pilonidal abscess between 1st January 2013 to 30th June 2016. Data was collected using hospital electronic medical records. Patients who had wound swabs taken were identified and their post-operative management analyzed. @*Results@#There were 297 presentations identified within the study period, of which, 224 cases (224/297, 75.4%) had wound swabs taken, out of which 130 (130/297, 43.8%) cases were followed up in outpatient clinic and 1 case (1/130, 0.8%) had a subsequent change in antibiotics based on the wound swab result. Common microorganisms grown were mixed anaerobes (138/224, 61.6%) and skin flora (45/224, 20.1%). @*Conclusion@#Wound swabs could be omitted during peri-operative care for patients with acute sacrococcygeal pilonidal abscess. The because the results of wound swabs did not change the management of these patients. Additionally, omitting wound swabs could save money for the health care. Pre-operative antibiotic therapy should have anaerobic coverage as it is the most common type of micro-organism cultured from pilonidal abscesses.

Effect of Qiyu Sanlong Decoction in Inhibiting Growth of Lung Cancer by Regulating Expressions of Beclin1, Atg5 and LC3B / 中国实验方剂学杂志

Objective::To study the effect of Qiyu Sanlong decoction on the growth of subcutaneous tumor in lung cancer mice and the expressions of key autophagy molecule, yeast Atg6 homologous (Beclin1), autophagy related genes5 (Atg5), and microtubule-associated protein1 light chain3 (LC3B). Method::Lewis lung carcinoma cells (LLC) were used to reproduce the lung cancer mice transplanted model. After the modeling, the mice were randomly divided into model group, Qiyu Sanlong decoction group, chemotherapy group and combination group, with 18 transplanted mice in each group. In model group, mice were fed with 0.9% saline 20 mL·kg-1 daily. In Qiyu Sanlong decoction group, mice were fed with Qiyu Sanlong decoction 80.48 g·kg-1 daily. The chemotherapy group was intraperitoneally injected with 0.4 mL cisplatin solution (DDP) at the 1st, 3rd and 5th day. The combination group was orally given the drugs at the concentration of 80.48 g·kg-1, and 0.4 mL DDP solution was intraperitoneally injected at the 1st, 3rd and 5th day. After 21 days of continuous treatment, tumor tissue was exfoliated and weighed, and the tumor inhibition rate was calculated. Hematoxylin-eosin (HE) staining was used to observe the histological changes of tumor. The expressions and localizations of Beclin1 and LC3B in tumor tissues were detected by immunohistochemical staining. Protein expressions of Beclin1, Atg5, LC3B-Ⅰand LC3B-Ⅱ were determined by Western blot, and the ratio of LC3B-Ⅱ/LC3B-Ⅰ was calculated. The transcription levels of Beclin1, Atg5 mRNA in tumor tissues were detected by Real-time PCR. Result::Qiyu Sanlong decoction had a mild inhibitory effect on transplanted tumor, with an inhibitory rate of 31.2%. Under microscope, patchy necrotic tumor cells were observed in the tumor tissues of Qiyu Sanlong decoction group. Immunohistochemical staining and Western blot analysis showed that Qiyu Sanlong decoction could up-regulate the expressions of Beclin1, Atg5 and LC3B protein (P<0.01), and promote the conversion from LC3B-Ⅰ into LC3-Ⅱ compared with the model group. Real-time PCR results showed that Qiyu Sanlong decoction could promote the transcription of Beclin1 mRNA and Atg5 mRNA compared with the model group (P<0.01). Conclusion::Qiyu Sanlong decoction has a mild inhibitory effect on lung tumors, and its mechanism may be related to up-regulating the expressions of autophagy key proteins Beclin1, Atg5 and LC3B, and promoting the conversion from LC3B-Ⅰ to LC3B-Ⅱ.

The clinical value of combined 68Ga-SSA/18F-FDG PET/CT imaging in neuroendocrine neoplasms / 中华核医学与分子影像杂志

Neuroendocrine neoplasms (NEN) are tumors that originate from neuroendocrine cells or peptidergic neurons.NEN can be found in a variety of organs with high heterogeneity in pathology and large difference in prognosis.Conventional imaging methods and pathological biopsy have important roles in the diagnosis of NEN,while both of them have limitations.Most NEN cells highly express several peptide receptors,especially somatostatin receptors (SSTR).Moreover,some of them have high glycolysis activity because of high proliferative activity.68Ga-somatostatin analogs (68Ga-SSA) combined with 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging can comprehensively evaluate both the expression of SSTR and the activity of glycolysis in NEN,providing effective information for diagnosis,treatment,monitoring and prognosis.This review summarizes the current studies of combined 68Ga-SSA/18F-FDG PET/CT imaging in patients with NEN.

Expression of serum eosinophil cationic protein in children with respiratory syncytial viruses pneumonia and its clinical significance / 中国医师进修杂志

Objective:To investigate the expression of serum eosinophil cationic protein (ECP) in children with respiratory syncytial viruses (RSV) pneumonia and its clinical significance.Method:One hundred and six children with RSV pneumonia (RSV pneumonia group) and 70 healthy children (control group) from January 2017 to October 2019 in the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University were selected. Among children with RSV pneumonia, low risk was in 68 cases, intermediate risk was in 25 cases and high risk was in 13 cases. The serum ECP level was measured by enzyme-linked immunosorbent assay. The lung function indexes were measured, including the forced expiratory volume in one second as a percentage of predicted value (FEV 1%), forced expiratory volume in one second (FEV 1)/forced vital capacity (FVC) and fractional exhaled nitric oxide (FeNO). Risk factors of severity in children with RSV pneumonia were analyzed by multivariate Logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of serum ECP for RSV pneumonia. Results:The FEV 1% and FEV 1/FVC in RSV pneumonia group were significantly lower than those in control group: (81.47 ± 14.08)% vs. (96.80 ± 17.10)% vs. (72.17 ± 21.63)% and (93.46 ± 26.57)%, the FeNO and ECP were significantly higher than those in control group: (17.88 ± 2.55) ppb vs. (9.79 ± 2.35) ppb and (64.00 ± 20.05) μg/L vs. (41.59 ± 16.99) μg/L, and there were statistical differences ( P<0.01). The serum ECP in RSV pneumonia children with intermediate risk and high risk were significantly higher than that in RSV pneumonia children with low risk: (70.82 ± 20.84), (90.71 ± 19.75) μg/L vs. (58.05 ± 14.72) μg/L, the serum ECP in high risk children was significantly higher than that in intermediate risk children, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that FEV 1%, FEV 1/FVC, FeNO and ECP were independent risk factors of severity in children with RSV pneumonia ( OR=12.913, 17.845, 0.002 and 0.126; 95% CI 2.641 to 63.139, 2.972 to 107.139, 0.000 to 0.017 and 0.028 to 0.566; P<0.01). ROC curve analysis result showed that the optimal cut-off value of serum ECP for the diagnosis of RSV pneumonia was 51.84 μg/L, AUC was 0.809, and the sensitivity and specificity were 78.57% and 75.47%; the optimal cut-off value of serum ECP for early diagnosis of RSV pneumonia was 43.17 μg/L, AUC was 0.714, and the sensitivity and specificity were 58.57% and 82.35%. Pearson correlation analysis result showed that serum ECP was negatively correlated with FEV 1% and FEV 1/FVC ( r=-0.632 and-0.604, P<0.01), and it was positively correlated with FeNO ( r=0.707, P<0.01). Conclusions:Serum ECP level in children with RSV pneumonia is significantly increased, which is negatively correlated with FEV 1% and FEV 1/FVC, and positively correlated with FeNO. Serum ECP can be used as one of the reference indicators for the diagnosis and severity assessment of children with RSV pneumonia.

The clinical value of combined 68Ga-SSA/18F-FDG PET/CT imaging in neuroendocrine neoplasms / 中华核医学与分子影像杂志

Neuroendocrine neoplasms (NEN) are tumors that originate from neuroendocrine cells or peptidergic neurons. NEN can be found in a variety of organs with high heterogeneity in pathology and large difference in prognosis. Conventional imaging methods and pathological biopsy have important roles in the diagnosis of NEN, while both of them have limitations. Most NEN cells highly express several peptide receptors, especially somatostatin receptors (SSTR). Moreover, some of them have high glycolysis activity because of high proliferative activity. 68Ga-somatostatin analogs (68Ga-SSA) combined with 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging can comprehensively evaluate both the expression of SSTR and the activity of glycolysis in NEN, providing effective information for diagnosis, treatment, monitoring and prognosis. This review summarizes the current studies of combined 68Ga-SSA/18F-FDG PET/CT imaging in patients with NEN.

The Role of Wound Swab Microbial Cultures and Antibiotic Sensitivity Results in the Management of Sacrococcygeal Pilonidal Abscess

Purpose@#Current practice for patients who present to hospitals with acute sacrococcygeal pilonidal abscess is operative management. Wound swabs are routinely taken peri-operatively and antibiotics are initiated empirically pending culture and sensitivity results. The aim of our study was to evaluate whether the results of wound swabs change post-operative antibiotic therapy for these patients, and to identify the common microorganisms. @*Methods@#This was a retrospective analysis which included patients who presented to the Northern Hospital, Victoria, with acute sacrococcygeal pilonidal abscess between 1st January 2013 to 30th June 2016. Data was collected using hospital electronic medical records. Patients who had wound swabs taken were identified and their post-operative management analyzed. @*Results@#There were 297 presentations identified within the study period, of which, 224 cases (224/297, 75.4%) had wound swabs taken, out of which 130 (130/297, 43.8%) cases were followed up in outpatient clinic and 1 case (1/130, 0.8%) had a subsequent change in antibiotics based on the wound swab result. Common microorganisms grown were mixed anaerobes (138/224, 61.6%) and skin flora (45/224, 20.1%). @*Conclusion@#Wound swabs could be omitted during peri-operative care for patients with acute sacrococcygeal pilonidal abscess. The because the results of wound swabs did not change the management of these patients. Additionally, omitting wound swabs could save money for the health care. Pre-operative antibiotic therapy should have anaerobic coverage as it is the most common type of micro-organism cultured from pilonidal abscesses.

Impact of different admission ways on treatment efficiency in patients with acute ST-segment elevation myocardial infarction / 中华心血管病杂志

Objective: To analyze the impact of different admission ways on the timeliness of percutaneous coronary intervention and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 1 044 patients with STEMI, who received primary percutaneous coronary intervention (PPCI) in 9 hospitals in Chengdu from January 2017 to June 2019, were retrospectively enrolled. According to the admission ways, patients were divided into ambulance group (n=100), self-transport group (n=584) and transferred group (n=360). Timeliness and in-hospital mortality were compared among the groups. Indicators of timeliness included the time from symptoms onset to arrive at the hospital, the time from arrive at the hospital to balloon and the total myocardial ischemia time (the time from symptoms to balloon). Multivariate logistic regression analysis was used to verify whether the admission ways was the determinant for in-hospital death in STEMI patients receiving PPCI. Results: The median total myocardial ischemic time in the ambulance group was significantly shorter than that in the self-transport group (180.0 (135.0, 282.0) minutes vs. 278.0 (177.8, 478.5) minutes, P<0.05) and the transferred group (180.0 (135.0, 282.0) minutes vs. 301.0 (204.3, 520.8) minutes, P<0.05). The median time from symptoms to door was as follows: ambulance group<self-transport group<transferred group (100.0 (56.3, 198.0) minutes vs. 149.0 (72.0, 313.5) minutes vs. 238.0 (135.0, 545.0) minutes, all P<0.05). The median door-to-balloon time was significantly shorter in the ambulance group and transferred group than in the self-transport group (75.0 (44.3, 101.8) minutes vs. 97.0 (71.0, 140.5) minutes, 67.0 (40.0, 91.8) minutes vs. 97.0 (71.0, 140.5) minutes, both P<0.05). There was no significant difference in all-cause mortality among the three groups (P>0.05). Multivariate logistic regression analysis showed that admission way was not significantly associated with in-hospital death (P>0.05). Conclusions: STEMI patients, who are admitted through the medical emergency system, are more likely to receive timely interventional therapy.Different admission ways have no impact on in-hospital mortality.

Value of 18F-FDG PET/CT in diagnosis of prosthetic vascular graft infection after endovascular aortic repair / 中华核医学与分子影像杂志

Objective To study the features and clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT in prosthetic vascular graft infections (PVGIs) after endovascular aortic repair (EVAR).Methods Data of 27 patients (22 males and 5 females,age range:21-77 years,average age:42 years) who underwent PET/CT imaging after EVAR from October 2011 to January 2017 were studied retrospectively.A total of 11 cases were finally diagnosed as PVGIs (PVGIs group),and the remaining 16 cases were defined as the negative group.PET/CT imaging features were compared between two groups.The detection rates of PET/CT and aortic CT angiography (CTA) for PVGIs were calculated and compared.Two-sample t test and Fisher exact test were used for data analysis.Results Significant uptake of FDG around the stents was detected by PET/CT in all patients in PVGIs group.The maximum standardized uptake value (SUVmax) of 11 patients in early imaging was 14.9±3.3 (10.8-21.8) and that of 9 patients in delayed imaging was 13.8±3.4 (10.6-19.1).Six patients of the negative group underwent the delayed imaging.No uptake or mild uptake of FDG around the stents was observed in negative group,with the SUVmax of 1.7±0.8(1.0--2.9) in early imaging and 1.6±0.7(1.1-2.5) in delayed imaging.SUVmax in negative group was significantly lower than that in PVGIs group (t values:12.6 and 11.8,both P＜0.001).Five patients in PVGIs group were diagnosed as graft infections by the aortic CTA,while the remaining 6 cases showed no definitive infection signs on aortic CTA.The detection rate of aortic CTA was 5/11,which was significantly lower than that of PET/CT (P＜0.05).In negative group,6 patients had abnormal FDG uptakes in other areas and were finally confirmed as infectious lesions (n=3) or malignant tumors (n=3).Conclusion Compared with aortic CTA,18F-FDG PET/CT is more sensitive and accurate in detection and diagnosis of PVGIs after EVAR.

Neuroprotective effect of surround needling combined with acupoint injection on acute herpetic neuralgia / 中国针灸

OBJECTIVE@#To explore the effect and mechanism of surround needling combined with acupoint injection on acute herpetic neuralgia (AHN).@*METHODS@#Ninety-nine patients with T-T segment AHN were randomly divided into 3 groups, 33 cases in each group, including 2 cases dropped off in the surround needling group, 4 cases dropped off in the acupoint injection group, and 3 cases dropped off in the combined group. Oral valacyclovir was given in each group, 0.3 g each time, 2 times a day for 10 days. Oblique insertion of needle used at points around the herpes in the surround needling group, and continuous wave was stimulated to tolerance for 20 min; the same acupoints were selected as the surround needling group, stimulated with the mixture injection of mecobalamin and lidocaine in the acupoint injection group; After the surround needling, acupoint injection was performed in the combined group. The treatment was given once a day, 14 times for a course, and one course was needed in all groups. The skin healing conditions (blistering, crusting, and dislocation time) of each group were compared after treatment. The pain scores, pain area and quality of life scores in each group were observed before and after treatment. The levels of neuron specific enolase (NSE), substance P (SP) and calcitonin gene-related peptide (CGRP) in the local blister fluid were measured before and after treatment in all groups.@*RESULTS@#The blistering, crusting and dislocation time in the combined group were earlier than the other two groups (all <0.05). The pain score and pain area in the each group were significantly lower than those before treatment, and the quality of life score was significantly higher than that before treatment (all <0.05). The improvements of pain score and quality of life score in the combined group were more obvious than the other two groups (all <0.05). After treatment, the levels of NSE, SP and CGRP in the local blister fluid in each groups were significantly lower than those before treatment (all <0.05). The indexes in the combined group were significantly lower than those in the other two groups (all <0.05).@*CONCLUSION@#Both surround needling and acupoint injection have an adjuvant effect on AHN. The combination of the two is better, the skin is healed quickly, the analgesia is significant, and the contents of local NSE, SP and CGRP are significantly decreased. The mechanism of action is to exert neuroprotective effects.

Differentiation of autoimmune pancreatitis and pancreatic ductal adenocarcinoma based on multi-modality texture features in F-FDG PET/CT / 生物医学工程学杂志

Autoimmune pancreatitis (AIP) is a unique subtype of chronic pancreatitis, which shares many clinical presentations with pancreatic ductal adenocarcinoma (PDA). The misdiagnosis of AIP often leads to unnecessary pancreatic resection. F-FDG positron emission tomography/ computed tomography (PET/CT) could provide comprehensive information on the morphology, density, and functional metabolism of the pancreas at the same time. It has been proved to be a promising modality for noninvasive differentiation between AIP and PDA. However, there is a lack of clinical analysis of PET/CT image texture features. Difficulty still remains in differentiating AIP and PDA based on commonly used diagnostic methods. Therefore, this paper studied the differentiation of AIP and PDA based on multi-modality texture features. We utilized multiple feature extraction algorithms to extract the texture features from CT and PET images at first. Then, the Fisher criterion and sequence forward floating selection algorithm (SFFS) combined with support vector machine (SVM) was employed to select the optimal multi-modality feature subset. Finally, the SVM classifier was used to differentiate AIP from PDA. The results prove that texture analysis of lesions helps to achieve accurate differentiation of AIP and PDA.

Predictive value of 18F-FDG PET/CT related metabolic parameters for Kras mutation in colorectal cancer patients / 中华核医学与分子影像杂志

Objective To explore the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT related metabolic parameters for Kras mutation in colorectal cancer (CRC) patients.Methods Retrospective analysis was conducted in 150 patients (105 males,45 females,median age:63 years) with CRC who underwent 18F-FDG PET/CT in Changhai Hospital of Navy Medical University between November 2011 and August 2017.The primary tumors were removed by surgery and patients received genetic testing within 1 month after PET/CT.18F-FDG PET/CT related metabolic parameters were measured,including maximum standardized uptake value (SUVmax),metabolic tumor volume (MTV;including MTV2.5,MTV20％,MTV30％,MTV40％,MTV50％),total lesion glycolysis (TLG;including TLG2.5,TLG20％,TLG30％,TLG40％,TLG50％).Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to analyze the data.Results There were 78 Kras-mutated type patients and 72 wild-type patients.Logistic regression analysis showed that SUVmax (odds ratio (OR) =1.176,95％ CI:1.043-1.327) and MTV2.5 (OR =1.125,95 ％ CI:1.002-1.263) were predictors of Kras mutation.With SUVmax =15.5 and MTV2.5 =23.79 cm3 as the cut-off value,the prediction accuracies of Kras mutation were 67.33％(101/150) and 65.33％(98/150),respectively.The accuracies of SUVmax and MTV2.5 for predicting Kras mutation were higher in recta or sigmoid colon cancers (70.79％(63/89) and 68.54％(61/89)).Conclusion SUVmax and MTV2.5 can predict Kras mutation in CRC patients,but there is a significant gap of predictive efficiency between PET/CT and gene detection.

Práticas corporais, comportamento desviante e consumo de álcool e drogas: uma revisão sistemática / Body practices, deviant behavior and alcohol and drug consumption: a systematic review / Prácticas corporales, el comportamiento desviado y consumo de alcohol y drogas: una revisión sistemática

O estudo objetiva revisar na literatura científica acerca das práticas corporais e o consumo de álcool e drogas a partir do comportamento desviante. Trata-se de uma revisão sistemática nas bases de dados MEDLINE, Scielo, Scopus, Web of Science e SportDiscus, utilizando os descritores e palavras-chave "lazer desviante", "sociologia do desvio", "práticas corporais", "álcool" e "drogas". Os critérios de inclusão foram artigos originais, estudos publicados em periódicos nacionais e internacionais. Vinte estudos publicados em periódicos foram analisados minuciosamente. Os estudos encontrados foram organizados em categorias de acordo com a temática trabalhada: i) lazer, práticas corporais e comportamento desviante em adolescentes e adultos; ii) práticas corporais e comportamento desviante no âmbito do trabalho, e iii) práticas corporais e comportamento desviante em diferentes grupos. As práticas corporais foram vistas como aspecto que podem auxiliar na prevenção de uso de álcool e drogas, mas que sejam direcionadas as formas de prevenção.

The study aims to review in the scientific literature about the corporal practices and the consumption of alcohol and drugs from the deviant behavior. It is a systematic review in the MEDLINE, Scielo, Scopus, Web of Science and SportDiscus databases, using the descriptors and keywords "deviant leisure", "deviant sociology", "corporal practices", "alcohol" and "drugs". The inclusion criteria were original articles, studies published in national and international journals. Twenty studies published in journals were analyzed in detail. The studies were organized in categories according to the theme: i) leisure, body practices and deviant behavior in adolescents and adults; ii) body practices and deviant behavior in the work area; and iii) corporal practices and deviant behavior in different groups. The body practices were seen as aspect that can aid in the prevention of alcohol and drug use, but that are directed the forms of prevention.

El estudio del objetivo es revisar la literatura científica sobre las prácticas corporales y el consumo de alcohol y drogas de la conducta desviada. Se trata de una revisión sistemática en MEDLINE, SciELO, Scopus, Web of Science y SportDiscus utilizando descriptores y palabras clave "ocio desviada", "sociología de la desviación", "prácticas corporales", "alcohol" y "drogas". Los criterios de inclusión fueron artículos originales, estudios publicados en revistas nacionales e internacionales. Se analizaron veinte estudios publicados en revistas. Los estudios encontrados fueron organizados en categorías de acuerdo con la temática trabajado: i) el ocio, las prácticas corporales y la conducta desviada en adolescentes y adultos; ii) el cuerpo y prácticas desviadas en el trabajo, y iii) las prácticas corporales y la conducta desviada en diferentes grupos. Las prácticas corporales fueron vistos como un aspecto que puede ayudar en la prevención de alcohol y drogas, pero que las formas de prevención se dirigen.