Analysis of age, month of onset and type of infection virus characteristics of 2 688 children with hand, foot and mouth disease of different traditional Chinese medicine syndromes in Heilongjiang province / 国际中医中药杂志

Objective To explore the distribution of sex, month of onset and type of infection virus in children with hand, foot and mouth disease of different TCM syndromes in Heilongjiang province. Methods A total of 2 688 hospitalized children who met the admission criteria in the Infectious Disease Department of Harbin Infectious Disease Hospital from September 1, 2014 to August 31, 2016 were selected. The TCM syndrome differentiation according to the clinical manifestations of children on the day of admission. The distribution of sex, month of onset and type of infection virus in children with different syndrome types were analyzed by SPSS 19.0 software. Results Hand, foot and mouth disease (HFMD) was more common in males than females in Heilongjiang, with a ratio of 1.58:1. Children of all sexes with hand, foot and mouth disease in Heilongjiang were predominantly with lung-defense syndrome. The incidence of lung-defense syndrome, lung-stomach heat syndrome, damp-heat syndrome and heart-spleen heat syndrome were the majority among the children aged 1-4 years, and the lung-defense syndrome was the highest proportion. From July to September, most of the cases occurred, especially in the case of lung-defense syndrome. Pathogenic tests showed that 1 456 cases were enterovirus universal RNA positive, 203 cases were enterovirus 71 positive and 108 cases were coxsackievirus A16 positive. The most common pathogens of the three pathogens were pathogenic lung-defense syndrome. Conclusions herewere some differences in age, time and virus infection among 2 688 children with hand, foot and mouth disease of different TCM syndromes in Heilongjiang, which may be related to region and climate.

Diagnostic value of 18F-FDG PET/CT for subsolid pulmonary nodules / 中华核医学与分子影像杂志

Objective To determine the value of 18F-FDG PET/CT in the detection of subsolid pulmonary nodules.Methods The 18F-FDG PET/CT imaging data of 44 patients (35 males,9 females,mean age (68.05±9.89) years) with 49 subsolid pulmonary nodules were retrospectively analyzed.There were 28 pure ground-glass nodules (pGGN) and 21 part-solid nodules (PSN),which were all confirmed by postsurgical pathology or imaging results during follow-up.The lesion size (dmax),ground-glass opacity (GGO) percentage,SUV retention index (RI),and the positive rates on PET images were accessed.The correlation between SUVmax and lesion size and GGO percentage was analyzed by Pearson correlation analysis.The SUVmax between benign and malignant pGGN,and that between malignant pGGN and PSN,were compared using two-sample t test.The diagnostic accuracy was compared using x2 test.Results (1) Six pGGN were benign while 43 nodules (including 22 pGGN and 21 PSN) were malignant among the 49 nodules.(2) SUVmax was positively correlated with lesion size (r=0.500,P＜0.05) and was negatively correlated with GGO percentage (r=-0.605,P＜0.05) for PSN,while SUVmax was positively correlated with lesion size (r=0.375,P＜0.05) for pGGN.(3) SUVmax was not significantly different (t =-0.813,P＞0.05) between 6 benign pGGN (0.78±0.25,range:0.50-1.20) and 22 malignant pGGN (0.91±0.34,range:0.40-1.70);SUVmax of 21 malignant PSN (2.10±1.16,range:0.60-5.60) was higher than that of 22 malignant pGGN (t=-4.645,P＜0.05).(4) When a nodule's activity being equal to or greater than that of mediastinal blood-pool was defined as malignancy,the accuracy rate of PSN (66.7％,14/21) was significantly higher than that of pGGN (9.1％,2/22; x2 =15.244,P ＜0.05).Based on the criteria for malignancy of RI＞10％,the accuracy rates for PSN and pGGN were 65.0％ (13/20) and 45.8％ (11/24),respectively (x2 =1.616,P＞0.05).Conclusion 18F-FDG PET/CT shows no clear advantage for diagnosis of pGGN,but is helpful for PSN.

18F-FDG PET/CT findings of autoimmune pancreatitis / 中华核医学与分子影像杂志

Objective To investigate the image characteristics and clinical application of 18F-FDG PET/CT in autoimmune pancreatitis (ALP).Methods The PET/CT images from six male patients (age ranging from 51 to 78(average 69) years) with AIP from 2005 to 2012 were studied retrospectively.Of the six patients,two had follow-up PET/CT images after steroid therapy.The morphologic abnormality was visually analyzed and SUV was calculated.Scores were obtained according to the SUV of pancreas compared with that of the liver (3 =SUV higher than liver,2=SUV similar to liver,1 =SUV lower than liver).The difference between the regular and delayed SUV was compared by paired t test using SPSS 17.0.Results All of the 6 patients showed diffuse FDG uptake in the entire pancreas with SUVmax of 3.2-6.0(5.2± 1.1).Five patients had score 3 and one had score 2.Five patients had delayed scan,of which 4 had increased uptake (SUVmax5.3-7.2),but the SUVmax was not significantly different compared to that before delay scan (4.8-6.0,t =-2.424,P＞0.05).Five patients showed extrapancreatic uptake,especially in the salivary glands.After the steroid therapy,the enlarged pancreas reduced and the intense uptake of the pancreas disappeared.The extrapancreatic uptake showed coinstantaneous remission.Conclusions Increasing FDG uptake at entire pancreas was observed in patients with AIP.18F-FDG PET/CT may be useful for detecting AIP and the associated extrapancreatic uptake,and monitoring the change after therapy,yet it needs further evaluation.

Analysis on variation tendency of serum thyroid hormone level in the healthy elderly aged over 80 years / 中华老年医学杂志

Objective To explore the variation tendency of serum thyroid hormone level in the elderly aged over 80 years.Methods The 602 healthy volunteers were divided into 3 groups by age:young group (20-59 years of age,n= 226),elderly group (60-79 years of age,n= 195),and advanced age group (80-102 years of age,n=181).Fasting blood of all persons was harvested,then the levels of serum total triiodothyroxine (TT3),total thyroxine (TT4),free tri-iodothyronine (FT3),free thyroxine (FT4),thyroid-stimulating hormone (TSH) and reverse tri-iodothyronine (rT3) were determined by chemistry luminescence technique and radioimmunoassay.Statistical analysis was made by the software SPSS 13.0.Results The levels of serum FT3 and TT3 were lower in elderly group than in young group (t=2.793,3.627,P=0.005,0.000).There were significant differences in the levels of serum TT3,TT4,FT3,TSH and rT3 between young group and advanced-age group (t =10.930,6.065,15.398,- 2.933,- 5.643,all P = 0.000),also between elderly group and advanced-age group (t= 8.382,4.298,11.573,-3.383,-5.148,all P＜0.001).The levels of serum FT3,TT3 and TT4 were negatively correlated with age (r=- 0.51,-0.39 and -0.25,respectively,all P＜0.01).And the levels of serum rT3 and TSH showed positive relationships with age (r=0.32,0.12,all P＜0.01).There were no relationships between the level of serum FT4 and age.The positive rate of serum TT3,TT4,FT3,FT4,TSH and rT3 concentration beyond the reference value was 0,0,13.8%,0,6.6% and 21% in advanced-age group,respectively.Conclusions The levels of serum thyroid hormone and thyroid-stimulating hormone change with age.The levels of FT3,rT3 and TSH change obviously in the elderly aged over 80 years.It could reduce the false positive rate in clinical practice if normal reference range for serum thyroid hormone levels in different aged elderly is established.

Evaluation of (99m)Tc-MIBI myocardial perfusion imaging with intravenous infusion of adenosine triphosphate in diagnosis of coronary artery disease / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the feasibility, safety and diagnostic accuracy of pharmacologic stress of (99m)Technetium-MIBI single-photon emission computed tomography (SPECT) with intravenous adenosine triphosphate (ATP) in patients with suspected coronary artery disease.</p><p><b>METHODS</b>The study group included 263 patients who were suspected of having coronary artery disease. All patients underwent (99m)Tc-MIBI myocardial perfusion imaging with ATP infusion (0.16 mg/kg body weight per min for 5 min). 20 mCi of (99m)Tc-MIBI were injected 3 minutes after the start of ATP infusion. Myocardial SPECT images were obtained 60 minutes later. Then, two days later, 20 mCi of (99m)Tc-MIBI were administered at rest and myocardial SPECT was repeated. 51 patients also underwent coronary angiography within two weeks for evaluation of sensitivity and specificity of ATP-myocardial perfusion imaging in detection of coronary artery disease. The occurrence of cardiac and non-cardiac adverse effects was carefully monitored during and after intravenous ATP infusion.</p><p><b>RESULTS</b>The ATP infusion protocol was completed in all patients. Although 59% of the patients had various kinds of adverse effects, most of them were mild. No patient required aminophyline. The most severe adverse effect was second degree type II atria-ventricular block (4/263), but all events were transient. The sensitivity and specificity of ATP-myocardial perfusion imaging were 97% and 82%, respectively.</p><p><b>CONCLUSIONS</b>It is shown that (99m)Technetium-MIBI SPECT with intravenous ATP is a safe and feasible technique for detecting coronary artery disease in patients unable to perform the exercise test.</p>

Analysis of misdiagnosis of bone metastatic tumor / 中华骨科杂志

Objective To promote more understanding of bone metastasis and reduce the misdiag-nostic rate of bone metastatic tumor.Methods The mechanism of skeletal metastasis,the spreading pathway of tumor to bone,its frequency and distribution of skeletal metastasis,as well as relative frequency of primary malignant tumor,clinical features,diagnosis and differential diagnosis with bone metastastic tumor were re-viewed.Five misdiagnosed cases as bone metastasis were presented.Results Five cases of patients were ob-tained post-longer time of follow-up examination,ranging from24to96months(average57.6months).Case1was carcinoma of lung,and case2carcinoma of prostatic gland,both were living and well.Case4and case5were tuberculosis of lumbar spine,their conditions were stable and satisfied.A lesion of lum-bo sacral disc in case3was found and diagnosed as infection and kept stable without any back and extremities pain since first attack of disease.The causes of misdiagnosis were analyzed.Conclusion Meticulous review of the history and clinical features as well as proper explanation of the supplemental data from plain X-ray,bone scintigraphy,CT and MRI findings are essential for diagnosis of majority of bone metastatic tumor.Al -though such new imaging devices(as bone scintigraphy,CT and MRI )possess a high sensitivity for early detection of bone metastasis,yet with a poor specificity,hence orthopaedic surgeon have to catch hold of proper understanding about new imaging techniques.In difficult and doubtful cases,the bone biopsy under CT guiding may be needed,the radioisotopic Hawkeye system and diffusion weighted MR imaging are rec-ommended for differential diagnosis of senile acute benign(e.g.osteoporosis)and malignant (e.g.metastasis)vertebral body com pressive fracture.

Evaluation of the clinical values of CT and positron emission tomography imaging in detection of bone metastases / 中华放射学杂志

Objective To assess the val ue of 18-fluorodeoxy glucose (~18F-FDG) positron emission tomography( PE T)-CT in the detection of malignant bone metastases. Methods Thirty-five out of 332 patients, 89 lesions were detected on ~18 F-FDG PET-CT and were interpreted separately on PET, combined CT, and fused PE T-CT images. Results Of the 89 lesions detected on PET- CT images, 68 were malignant and 21 were benign lesions. PET alone identified 62 malignant lesions and 17 benign lesions. The diagnostic sensitivity, specificit y, and accuracy of PET alone for diagnosis of bone metastases were 91.2% (62/68) , 81.0% (17/21), and 88.8% (79/89), respectively. The combined CT alone identifi ed 55 malignant lesions and 16 benign lesions. The diagnostic sensitivity, s pecificity, and accuracy of combined CT alone were 80.9% (55/68), 76.2% (16/21), and 79.8% (71/89), respectively. The fused PET-CT images identified 64 maligna nt and 19 benign lesions. The diagnostic sensitivity, specificity, and accuracy of the fused PET-CT were 94.1% (64/68), 90.5% (19/21), and 93.2% (83/89), respe ctively. Conclusion In the diagnosis of bone metastases, ~18F-FDG PET-CT imaging reduces the false positive rate and increases the specificity. ~18F-FDG PET-CT imaging is helpful in the differentiation o f bone metastases from benign lesions.