Research progress on antiviral therapy in hepatitis C-negative recipients receiving kidney transplantation from infected donors / 中华临床感染病杂志

Kidney transplantation is the best option for end stage renal disease. Currently, shortage of donor kidneys become a global problem for kidney transplants, partly due to the abandonment of kidneys from donors infected with hepatitis C virus (HCV). With the advent of direct-acting antiviral drugs, the use of HCV infected donor kidneys has become an important measure to expand the donor pool. This article reviews the research progress on the safety, efficacy and timing of antiviral therapy for HCV-negative recipients receiving kidney transplantation from HCV-positive donors.

Clinicopathological features and survival prediction after radical resection of gastric cancer / 国际外科学杂志

Objective:To explore the prognostic factors that may affect the postoperative survival of gastric cancer by analyzing patients with radical gastrectomy.Methods:The data of 525 patients with radical gastrectomy, including 387 male and 138 female with average age (62.5±10.7) years old (ranged from 16 to 89 years), were analyzed retrospectively in Anqing Municipal Hospital between October 2010 to July 2015. The relationship between 33 variables and prognosis was analyzed by a Cox proportionalhazards regression model, meanwhile ROC curve was established in order to explore the risk factor of postopertive survival.Results:The over survival(OS) rate of all patients was 89.3% at 1 year, 68.4% at 3 years and 59.6% at 5 years. The 5-year OS rate was 81.9% at stage Ⅰ, 71.4% at stage Ⅱ and 44.1% at stage Ⅲ. In the multivariate analysis that included these factors, preoperative comorbidity ( HR=1.595, P=0.001), hemoglobin( HR=1.377, P=0.017), CA199( HR=1.618, P=0.004), tumor distribution( HR=1.943, P=0.032), pT stage( HR=1.731, P=0.012), pN stage( HR=2.118, P=0.000), signet ring cell( HR=1.642, P=0.038)and intravascular tumor thrombus( HR=1.391, P=0.039) were independent risk factors associating with postopertive survival.According to ROC curve, the following area (AUC value) could predict survival after radical gastrectomy, including CA199 (AUC=0.568), hemoglobin(AUC=0.586), preoperative comorbidity(AUC=0.554), pT stage(AUC=0.636), pN stage(AUC=0.670)and intravascular tumor thrombus(AUC=0.626)( P<0.05). Conclusion:According to ROC curve analysis, preoperative comorbidity, anemia, CA199, pN stage, pT stage and intravascular tumor thrombus played an role in predicting long-term survival after radical resection of gastric cancer.

Analysis of risk factors of lymph node metastasis in early gastric cancer patients undergo operation / 国际外科学杂志

Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI: 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI: 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.

Analysis of modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer / 国际外科学杂志

Objective To investigate the modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer.Methods The clinical data of 187 patients,including 99 male cases and 88 female cases with the average age (64.5 ± 10.8) years old (ranged from 37 to 87 years),with radical resection of rectal cancer were analyzed retrospectively in Anqing Hospital Affiliated of Anhui Medical University between August 2014 and October 2018,and the occurrence of early postoperative complications was analyzed according to the modified Clavien-Dindo grade system.The relationship between 32 variables and complications in the data was analyzed by single factor and multiple factors in order to explore the risk factors of early postoperative complications.Results One hundred and eighty seven patients with radical proctectomy,54 cases (28.9％,54/187) had early postoperative complications,including 15 cases of serious complications (8.0％,15/187),3 cases were performed second surgeries under general anesthesia (1.6％,3/187).Postoperative modified Clavien-Dindo Grade:12 cases with grade Ⅰ,27 cases with grade Ⅱ,11 cases with grade Ⅲ a,3 cases with grade Ⅲ b,1 case with grade Ⅳ a,no case with grade Ⅳ b and Ⅴ.The results of single factor analysis showed age (x2 =4.788,P =0.029),ASA grade (x2 =26.903,P =0.000),multiple organ resection (x2 =4.749,P =0.029),pT stage (x2 =8.080,P =0.044),pTNM stage (x2 =6.29,P =0.043),total harvested lymph node number (x2 =5.542,P =0.019).The occurrence of early complications after radical proctectomy,multi-factor analysis found that ASA grade (OR =3.539,P =0.000),pTNM stage (OR =1.846,P =0.034) was an independent risk factor for early postoperative complications of rectal cancer.The area (AUC value) under the curve of the prediction of early postoperative complications in patients with ASA grade and pTNM stage was 0.708 (95％ CI:0.625-0.791,P =0.000) and 0.555 (95％ CI:0.469-0.642,P =0.235).Conclusions Early complications after radical resection of rectal cancer are closely related to ASA grade and tumor pTNM staging.ASA grade can be used as a significant predictor of early complications after radical proctectomy in rectal cancer.

Application of Potassium Perchlorate in 99TCm-3PRGD2 SPECT/CT Gastric Image / 中国医学影像学杂志

Purpose To explore whether potassium perchlorate shall be taken orally to occlude gastric mucosa before taking 99Tcm-3PRGD2 SPECT/CT gastric image,and to provide theoretical evidence for clinical application.Material and Methods Eighteen adult male Wistar rats were divided into three groups randomly:low dose group of potassium perchlorate (36 mg/kg),high dose group (72 mg/kg) and normal saline control group,with six rats in each group.All rats were conducted with gavage of 1 ml/100 g respectively and,one hour later,injected with 99Tcm-3PRGD2 intravenously to rat tail.Then 99Tcm-3PRGD2 gastric image was taken two hours later.The same film reader carried out audio analysis of the image and then gastric and radioactivity ratio (T/N) on the lung of the same side were analyzed.Results Preparation of 99Tcm-3PRGD2 was simple and radiochemical purity of final products was (98.90±0.70)％.Rat weights in high dose group of potassium perchlorate,low dose group and control group were (479.7t21.5) g,(481.0± 17.6) g and (478.5± 16.5) g,respectively.The differences were of no statistical significance (F=0.027,P＞0.05).T/N values in rat stomach area were 1.2219±0.0165,1.2204±0.0167 and 1.2186±0.0175,respectively.The differences were of no statistical significance (F=0.055,P＞0.05).Conclusion Preparation of 99Tcm-3PRGD2 is simple and radiochemical purity is high.There is great possibility of no need to take potassium perchlorate orally to occlude gastric mucosa when taking 99Tcm-3PRGD2 SPECT/CT image (especially when the radiochemical purity of final products is over 98％),making it convenient in clinical promotion and utilization.

One-step Examination of Myocardial Perfusion Imaging Combined with Coronary Artery Calcium Score in Diagnosis of Coronary Artery Disease / 中国医学影像学杂志

Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used asgold standard, the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.

Comparison of the different reconstruction algorithms for Philips GEMINI PET/CT / 中国医学影像技术

Objective To evaluate the effects of different reconstruction algorithms on image quality for Philips GEMINI PET/CT. Methods Jaszczak phantom were scanned on the GEMINI PET/CT system, and the raw data were reconstructed using filtered-back projection with Hanning filter (FBP-Hanning), filtered-back projection with Butterworth filter (FBP-Butterworth), ordered subset expectation maximization (OSEM), row-action maximum likelihood algorithm (RAMLA) and three-dimensional row-action maximum likelihood algorithm (3D-RAMLA), respectively. The resolution, uniformity, contrast of images and the time of different reconstruction algorithms were compared. Results The reconstruction time was 180 s, 130 s, 120 s, 85 s and 80 s for 3D-RAMLA, RAMLA, OSEM, FBP-Hanning and FBP-Butterworth respectively in phantom studies. The smallest rods with diameter of 4.8 mm of the phantom could be observed for FBP- Butterworth and 6.4 mm for other algorithms in case of high counts. The image contrast of 3D-RAMLA were better than that other algorithms, and the image uniformity of 3D-RAMLA and RAMLA were better than those of other algorithms. The resolution, uniformity and contrast of images with all algorithms decreasd in case of low counts, and the image quality of FBP-Butterworth was not good enough for clinical studies. Conclusion Image quality is variable with different reconstruction algorithms. For clinical PET imaging, it is necessary to choose proper algorithms.