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Objective:To assess the imaging characteristics of muscle FDG metabolism, tumor incidence, and pulmonary interstitial changes in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody positivity in 18F-FDG PET/CT imaging, and the value of 18F-FDG PET/CT in differentiating anti-MDA5 antibody positive dermatomyositis. Methods:From June 2016 to July 2019, the PET/CT images of 75 patients with dermatomyositis (21 males, 54 females, age (52.3±14.3) years; 34 anti-MDA5 antibody positive and 41 anti-MDA5 antibody negative) and 30 healthy controls (10 males, 20 females; age (53.5±11.8) years) were retrospectively analyzed in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. The SUV max of muscle was measured and the mean of SUV max (mSUV max) was calculated. Statistics of patients with dermatomyositis complicated with neoplastic lesions and the SUV max of pneumonia lesions in patients with dermatomyositis complicated with interstitial pneumonia was determined. Independent sample t test, one-way analysis of variance, Student-Newman-Keuls (SNK) test and χ2 test were used to analyze data. The ROC curve analysis was used to analyze the diagnostic efficacy of mSUV max for the differential diagnosis of anti-MDA5 antibody positive dermatomyositis. Results:The muscle mSUV max of the control group, anti-MDA5 antibody positive and negative groups were 0.39±0.05, 0.66±0.21 and 0.87±0.29 ( F=39.93, P<0.001), respectively. The muscle mSUV max of dermatomyositis patients was increased compared with healthy controls ( q values: 6.76, 12.63, both P<0.001), and the muscle mSUV max of anti-MDA5 antibody negative was higher than positive ( q=5.79, P<0.001). The AUC was 0.74, and the cut-off value of muscle mSUV max was 0.75 with the accuracy of 74.7%(56/75). Of 41 patients with negative anti-MDA5 antibody, there were 6 (14.6%) had malignant tumor, while there was no malignant tumor in patients with positive anti-MDA5 antibody (0/34; χ2=5.41, P=0.020). There were 11 patients (26.8%, 11/41) with anti-MDA5 antibody negative dermatomyositis complicated with interstitial pneumonia and 33 patients (97.1%, 33/34) with anti-MDA5 antibody positive dermatomyositis complicated with interstitial pneumonia ( χ2=37.81, P<0.001). FDG metabolism in anti-MDA5 antibody positive patients was higher than that in anti-MDA5 antibody negative patients (lesion SUV max: 3.65±1.83 and 2.38±1.27; t=2.13, P=0.039). Conclusions:The muscle FDG metabolism of anti-MDA5 antibody positive dermatomyositis patients is higher than that of healthy controls, but lower than that of anti-MDA5 antibody negative patients. The incidence of neoplastic lesions in patients with positive anti-MDA5 antibody is lower than that in patients with negative anti-MDA5 antibody. The proportion and severity of interstitial pneumonia are higher in patients with positive anti-MDA5 antibody than in those with negative anti-MDA5 antibody. 18F-FDG PET/CT has certain value on identifying anti-MDA5 antibody positive dermatomyositis.
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Objective To survey the current status of human resources of the Anesthesiology in Chi-na and investigate the reform direction of human resources allocation of Chinese medical and health system. Methods Chinese Society of Anesthesiology organized the investigation from March 1, 2015 to June 30, 2015.All the hospitals in which clinical anesthesia was carried out were investigated only in mainland Chi-na.The questionnaires contained hospital general information, anesthesia-related information and surgery-re-lated information.Results A total of 16 280 questionnaires were released and 14 076 questionnaires (86.462%)were retrieved.There were 13 489 questionnaires(82.856%)identified as qualified anesthesia-related information ones and 7 026 questionnaires(43.157%)identified as qualified surgery-related informa-tion ones.Qualified anesthesia-related information questionnaires showed that there were 77 926 anesthesiolo-gists in total in China, 27 660 000 patients in whom anesthesia was completed inside operating room(OR)and 11 470 000 cases outside OR, one attending anesthesiologist completed anesthesia in 634 cases inside OR and in 263 cases outside OR on average; the number of per capita anesthesiologists was 5.7 per 100 000 pop-ulation in 2014.The number of per capita physicians per 10 000 population(r=0.735, P<0.05), the num-ber of anesthesiologists per 100 000 population(r=0.537, P<0.05)and the number of per capita patients requiring anesthesia per 100 000 population(r=0.571, P<0.05)were all positively correlated with GDP per capita in various provinces and cities nationwide and autonomous regions.The area having the highest num-ber of per capita anesthesiologists per 10 000 and per 100 000 population was Beijing, the area having the lowest number was Tibet; the area having the highest number of per capita patients requiring anesthesia per 100 000 population was Beijing, the area having the lowest number was Shanxi. The qualified surgery-related information questionnaires showed that the ratio of attending surgeons to attending anesthesiologists was 7.5:1.0 in China in 2014.Conclusion Although China has a huge number of anesthesiologists, the Anesthesiolo-gy is still shortage of anesthesiologists; the imbalanced distribution of human resources exists in different provinces and cities, in hospitals of different scales and between different medical specialties, and economics is one of the important influencing factors.