Analysis of 134Cs, 137Cs, and 60Co in aerosol samples: An intercomparison among laboratories / 中国辐射卫生

Objective To improve the analysis of 134Cs, 137Cs, and 60Co in aerosol samples by the national key radiation environment laboratories. Methods Intercomparison of analysis results of 134Cs, 137Cs, and 60Co in standard aerosol samples was performed among the national key radiation environment laboratories according to Gamma spectrometry method of analyzing radionuclides in biological samples (GB/T 16145-1995 ), and the intercomparison results were evaluated by the standard deviation. Results Six laboratories were involved in the intercomparison. For 134Cs, 50% of the laboratories showed a relative deviation less than 10%, and 50% showed a relative deviation of 10%-20%. For 137Cs, 33.3% of the laboratories showed a relative deviation less than 10%, and 76.7% showed a relative deviation of 10%-20%. For 60Cs, all laboratories showed a relative deviation less than 10%. The overall intercomparison results were acceptable. Conclusion The laboratories in this intercomparison show generally good results.

Simple bone grafting versus dynamization of locking compression plate combined with autologous bone grafting for femoral aseptic nonunion / 中华创伤骨科杂志

Objective:To compare the clinical effects between simple bone grafting and dynamization of locking compression plate (LCP) combined with autologous bone grafting in the treatment of femoral aseptic nonunion.Methods:In this retrospective study, 30 patients with femoral aseptic nonunion were included who had been treated from January 2010 to January 2020 at Department of Orthopaedics, General Hospital of Central Theater Command of Chinese People’s Liberation Army. They were 19 males and 11 females, with an age from 25 to 55 years. Of them, 12 were subjected to LCP dynamization combined with autologous bone grafting (group A) and 18 to simple bone grafting (group B). The 2 groups were compared in terms of surgical indicators, fracture healing time, Hospital for Special Surgery (HSS) knee scores at preoperation and 12 months postoperation and Lane-Sandhu radiographic scores at 1, 3, 6 and 12 months postoperation.Results:As there was no statistically significant difference in general information between the 2 groups, they were comparable ( P>0.05). The fracture healing time in group A [(8.2±1.7) months] was significantly shorter than that in group B [(9.8±2.2) months] ( P<0.05). There was no significant difference between the 2 groups in Lane-Sandhu radiographic score at 1 month postoperation ( P>0.05). The Lane-Sandhu radiological scores in group A at 3, 6, and 12 months postoperation (4.2±1.2, 8.4±0.7 and 10.8±0.9) were significantly higher than those in group B (3.3±0.9, 7.1±1.3 and 9.8±1.2) ( P<0.05). There was no statistically significant difference between the 2 groups in preoperative HSS knee score ( P>0.05). The HSS knee score at 12 months postoperation in group A (83.3±4.3) was significantly higher than that in group B (76.2±4.1) ( P<0.05). Conclusion:In the treatment of femoral aseptic nonunion, compared with simple bone grafting, LCP dynamization combined with autologous bone grafting may shorten fracture healing time, improve bone formation, and thus lead to better therapeutic efficacy.

Miniplates combined with reconstruction plate for the treatment of comminuted posterior wall acetabular fractures / 中华创伤杂志

Objective:To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods:A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019. There were 18 males and 9 females, at age of 23-61 years［（45.9±10.9）years］. All patients were treated by using miniplates combined with the reconstruction plate. The operation time, intraoperative blood loss, intraoperative blood transfusion, length of hospital stay and time of fracture healing were recorded. The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively. The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3, 6 months postoperatively and the final follow-up. Postoperative complications were observed, and heterotopic ossification was assessed by Brooker grading standard.Results:All patients were followed up for 12-48 months［36（24, 36）months］. The operation time was 123-242 minutes［（165.4±29.8）minutes］; the intraoperative blood loss was 170-550 ml［（358.3±111.3）ml］; nine patients required intraoperative blood transfusion of 300-500 ml［（377.8±66.7）ml］. The length of hospital stay was 12-29 days［（21.4±4.7）days］. The fracture healing time was 12-24 weeks［（16.3±3.0）weeks］. According to Matta radiographic standard, the reduction quality was excellent in 21 patients, good in 3 and poor in 3 at 2 days postoperatively, with the excellent rate of 89%. The modified Merle D'Aubigné-Postel score was 9-16 points［（13.1±1.9）points］at 3 months postoperatively, was 10-18 points［（15.4±2.0）points］at 6 months postoperatively, and was 12-18 points［（16.9±1.8）points］at last follow-up（ P<0.01）. The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different（ P<0.01）, and the difference between 6 months and the follow-up was statistically significant（ P<0.01）. The modified Merle D'Aubigné-Postel score was graded as excellent in 0 patient, good in 7, fair in 11 and poor in 9 at 3 months postoperatively, with the excellent rate of 26%; graded as excellent in 3 patients, good in 19, fair in 2 and poor in 3 at 6 months postoperatively, with the excellent rate of 81%; graded as excellent in 18 patients, good in 5, fair in 3 and poor in 1 at the last follow-up, with the excellent rate of 85%（ P<0.01）. No iatrogenic sciatic nerve injury, deep vein thrombosis or wound infection occurred after operation. No hardware loosening or loss of reduction occurred during the follow-up. The post-traumatic arthritis was identified in 2 patients. The avascular necrosis of femoral head was observed in 1 patient and thereafter underwent total hip replacement. The heterotopic ossification occurred in 3 patients, among which 2 patients were graded as Brooker class I and 1 as class II, but there was no adverse effect on hip function. Conclusions:Miniplates combined with reconstruction plate in the treatment of comminuted posterior wall acetabular fractures have reliable fixation effect and attain good reduction, high fracture healing rate, less complications and satisfactory functional recovery.

Efficacy of thoracic endovascular aortic repair for treatment of Stanford type B traumatic aortic dissection / 中华创伤杂志

Objective:To investigate the clinical efficacy of thoracic endovascular aortic repair (TEVAR) in treating Stanford type B traumatic aortic dissection (TAD).Methods:A retrospective case series study was conducted to analyze the clinical date of 26 patients with Stanford type B TAD admitted to Nantong First People's Hospital from June 2011 to December 2019. There were 21 males and 5 females, aged 35-83 years [(56.2±12.9)years]. All patients mainly suffered from chest and back trauma and were treated with TEVAR. The operation time, intraoperative blood loss, intraoperative heparin dosage, duration of ICU stay and postoperative organ complications were collected. The changes of brain natriuretic peptide, urea nitrogen and creatinine were compared before operation and at one day after operation. The CT angiography (CTA) was performed to mainly detect the location of stent, reverse tearing, paraplegia and internal leakage at 6 months after TEVAR. The aortic CTA was used to measure the maximum diameter of aortic dissecting aneurysm and true lumen diameter of distal aorta before operation and at 6 months after operation, and the diameter changes were compared to determine the aortic remodeling after TEVAR.Results:All patients were followed up for 6-36 months [(25.9±6.3)months]. The operation time was 60-200 minutes [(96.7±30.7)minutes], the intraoperative blood loss was 20-45 ml [(31.1±6.8)ml], the dosage of heparin was 0-0.53 mg/kg [(0.4±0.1)mg/kg], the postoperative ICU stay was 1-7 days [(4.7±1.3)days]. Seven patients developed pulmonary infections after operation and showed significant improvement after closed thoracic drainage, airway management and anti-infection treatment. Two patients had abnormal renal function after operation and received medical therapy for improvement. There was no significant difference in brain natriuretic peptide, urea nitrogen and creatinine between before operation and one day after operation ( P>0.05). At 6 months after operation, the CTA showed that the stent position was satisfactory and there were no serious complications such as reverse tearing and paraplegia. Of one patient with type I endoleak, the tumor did not further expand and his condition was stable. At 6 months after operation, the diameter of dissecting aneurysm [(34.4±5.0)mm] was smaller than that before operation [(38.2±5.6)mm], the true lumen of distal stent [(26.8±4.6)mm] was larger than that before operation [(22.6±6.0)mm] ( P<0.05 or 0.01). Conclusion:For Stanford type B TAD, TEVAR has no significant effect on cardiac function and renal function, with no severe complications and good aortic remodeling.

Application of OTSU-based self-attenuation correction PET reconstruction technology in 18F-AV45 imaging / 中华核医学与分子影像杂志

Objective:To explore the application of OTSU-based self-attenuation correction PET (sacPET) reconstruction technology in 18F-florbetapir (AV45) imaging. Methods:From November 2018 to December 2019, 7 confirmed Alzheimer′s disease (AD) patients (4 males, 3 females, age (69.6±4.5)years) and 3 healthy controls (HC; 1 male, 2 females, age (68.0±4.6) years) were recruited prospectively for 18F-AV45 PET imaging in the First Affiliated Hospital of Sun Yat-Sen University. Original data collected by PET acquisition was processed with sacPET reconstruction and then compared with standard PET images by visual analysis and semi-quantitative analysis. Fisher exact test, Kappa test and Pearson correlation analysis were used to analyze data. Results:In HC group and AD group, the radioactive distribution showed by sacPET images and that by standard PET images were similar, and the contrast of gray-white matter in sacPET images was weaker than that in standard PET images. Moreover, the positive uptake area of the cortex in the AD group was smaller than that in standard PET images. Visual analysis showed 19 positive regions in sacPET images and 22 in standard PET images, with no statistical difference of positive rates of the sub-regions in the cortex between the two PET images (all P>0.05), and the overall consistency of 88.00% (44/50; Kappa=0.75 (95% CI: 0.57-0.94), P<0.05). Semi-quantitative analysis showed that the standardized uptake value ratio (SUVR) of frontal lobe and cingulate gyrus measured by sacPET was lower than that measured by standard PET (0.93±0.06 vs 0.96±0.06 and 0.99±0.04 vs 1.01±0.04; t values: 5.30 and 5.10, both P<0.01), while SUVR of parietal lobe, temporal lobe and occipital lobe measured by sacPET was higher than that measured by standard PET (0.78±0.08 vs 0.68±0.07, 0.97±0.07 vs 0.91±0.08 and 0.94±0.11 vs 0.71±0.12; t values: 6.27, 7.36 and 16.90, all P<0.01). The overall SUVR of sacPET images was significantly correlated with the standard PET images ( r=0.75, P<0.001). Conclusion:For 18F-AV45 imaging, sacPET reconstruction technology can obtain reliable and effective PET images without CT data, but its accuracy and precision still need to be improved.

3D navigation versus C-arm fluoroscopy for placement of percutaneous double-segment long sacroiliac screws in treatment of injury to posterior pelvic ring / 中华创伤骨科杂志

Objective:To compare the efficacy of 3D navigation versus C-arm fluoroscopy for placement of percutaneous double-segment long sacroiliac screws in the treatment of injury to the posterior pelvic ring.Methods:A retrospective study was conducted in the 48 patients with pelvic fracture who had been treated surgically from February 2015 to October 2020 at Department of Orthopaedics, General Hospital of Central Command of PLA. The patients were divided into a navigation group and a fluoroscopy group according to their different auxiliary ways to assist screw placement. In the navigation group of 27 patients, there were 19 males and 8 females, with an age of (45.5±7.4) years; in the fluoroscopy group of 21 patients, there were 14 males and 7 females, with an age of (44.1±10.1) years. The 2 groups were compared in terms of placement time for each screw, fluoroscopy time for each screw, adjustments of guide wire, accuracy of screw position, quality of fracture reduction, fracture union time, pelvic function, and postoperative complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). The placement time for each screw [(12.7±2.2) min], fluoroscopy time for each screw [(40.7±9.3) s] and adjustments of guide wire [1 (0,1) time] in the navigation group were significantly less than those in the fluoroscopy group [(23.7±3.6) min, (71.4±14.1)s and 5 (4,6) times] (all P<0.05); the assessment of screw placement in the former (49 excellent, 4 good and one poor cases) was significantly better than that in the latter (29 excellent, 8 good and 5 poor cases) ( P<0.05). The 48 patients were followed up for 8 to 25 months (mean, 13.1 months). There were no significant differences between the 2 groups in fracture union time, quality of fracture reduction or Majeed scores for the pelvic function (all P>0.05).Symptoms of injury to the L5 nerve root were observed in one patient in the fluoroscopy group; none of the patients reported postoperative complications like wound infection, screw loosening or breaking. Conclusions:Compared with C-arm fluoroscopy, 3D navigation may better assist placement of percutaneous double-segment long sacroiliac screws in the treatment of injury to the posterior pelvic ring, because 3D navigation can significantly shorten the time for screw placement and the fluoroscopy time for screw placement, reduce adjustments of guide wire, and improve accuracy of screw placement.

Clinical Analysis of 18 cases with orbital apex syndrome / 中国神经精神疾病杂志

Objective To explore the clinical characteristics, etiology and prognosis of orbit apex syndrome. Methods Clinical data of 18 patients with orbit syndrome was summarized and analyzed. Results All patients developed vision loss, ptosis and diplopia, such as a headache or sore eyes forehead performance. However, the onset symptoms varied including vision decline or loss in 8 cases, headache in 7 cases, eye pain in 1 case, toothache in 1 case, stuffy nose and runny nose in 1 case and exophthalmos in 1 cases. The Causes included trauma in 6 cases (33％), mass lesion in 5 cases (28％), nonspecific inflammation in 1 cases (22％), infection in 3 cases (17％). Vision and eye movements disorder were improved in 5 cases of 6 patients with trauma in which 3 mild cases recovered better and one severe case did not recovered. Of 5 patients with mass lesion, the vision and eye movement were improved in one patients with sphenoid sinus mucocele receiving surgical operation. but not in the rest 4 cases with orbital adenoid cystic carcinoma or osteosarcoma patients receiving either surgical operation or radiotherapy. Of 4 patients with nonspecific inflammatory disease, eye movements were improved in 2 mild cases but not in 2 severe cases. Of 3 infectious diseases, eye movements were improved in 1 mild case. Conclusion Orbital apex syndrome is a heterogeneous disorder with multiple etiologies, presenting with a variety of initial symptoms. The prognosis depends on causes, timely diagnosis, early diagnosis and early treatment.

Application of [11C] CFT dopamine transporter PET imaging in the diagnosis and severity assessment of Parkinson disease / 中国神经精神疾病杂志

Objective To investigate the clinical value of [11C]CFT PET in the diagnosis and severity assessment of Parkinson disease (PD). Methods Thirty-eight patients with PD at various Hoehn & Yahr (H&Y) stages were included and underwent a [11C]CFT PET scan. The correlation between [11C]CFT uptake and unified Parkinson disease rating scale part III (UPDRS III) of PD patients was evaluated by calculating Pearson’s regression coefficient. Statistical parametric mapping (SPM) analysis was performed to compare the difference of dopamine transporter (DAT) distribution between ear-ly and advanced PD patients. Results There was a significant reduction of [11C]CFT uptake in the bilateral striatum of PD patients. There was a significant negative correlation between clinical scores of UPDRS III, rigidity, bradykinesia, pos-ture, gait and [11C]CFT uptake in the striatum. The SPM analysis revealed a significant and asymmetric decrease of [11C] CFT uptake in the striatum, predominantly on the putamen and caudate nucleus contralateral to the onset limb, in the posterior area of ipsilateral putamen in early PD (H&Y 1-2) patients compared with the normal controls. There was a sig-nificant symmetric decrease of [11C]CFT uptake in both putamen and caudate nucleus in advanced PD (H&Y 3-5) pa- tients, compared with normal controls. Compared with early PD patients, the reduction of DAT was more severe in bilater-al caudate nucleus and the ipsilateral putamen in the advanced PD patients. Conclusions [11C]CFT PET is a sensitive biomarker in the diagnosis and assessment of disease severity of PD patients.

A clinical study on mild cognitive impairment in amyotrophic lateral sclerosis / 中华神经科杂志

Objective To explore the cognitive status of amyotrophic lateral sclerosis (ALS) patients, and to explore the involved cognitive domains, subtypes and risk factors of mild cognitive impairment in ALS ( ALS-MCI).Methods Twenty-nine cases of ALS and 58 healthy volunteers were included.The severity of the bulbar and spinal functions of the patients was evaluated by the Improved Norris Scale.According to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition-Revised( DSM-Ⅳ-R) criteria of dementia, ALS cases were classified as demented and non-demented.For non-demented ALS cases, the common cognitive batteries evaluating mental state, verbal memory, executive, attentional and visuospatial abilities were performed.Hamilton Anxiety Scale ( HAMA) and Hamilton Depression Scale (HAMD) were evaluated too.They were further classified into ALS-cognitively normal (ALS-CogNL) and ALS-MCI groups according to Petersen criteria of MCI.Risk factors possibly correlated with ALS-MCI were analyzed by comparing the differences in age, age of onset, duration of the disease, sites of onset, symptoms of bulbar and limb function between ALS-CogNL and ALS-MCI groups.Results Among 29 ALS cases, 14 (48.3% ) cases with cognitively normal( ALS-CogNL), 15 cases (51.7% ) with ALS-MCI,and none with dementia were identified.Among 15 ALS-MCI cases, 12 cases with executive dysfunction, 8 cases with memory deficits,9 cases with attention impairment and none with visuospatial impairment were found.ALSMCI cases could be further classified into three subtypes; 1 case with amnestic MCI (aMCI) ,6 cases with single domain non-memory MCI ( sdMCI), and 8 cases with multiple domains slightly impaired MCI (mdMCI).Between ALS-MCI and ALS-CogNL groups, there were significant differences (t = -2.435,- 2.576, both P ＜ 0.05) in education ((8.7 ± 2.8) years vs (11.3 ± 3.0) years) and Improved Norrisscale (bulbar score: (28.4 ± 7.7) scores vs ( 34.0 ± 3.4) scores) , however, no significant differences in sex, age, age of onset, duration,site of onset,HAMA or HAMD scores,and Improved Norris scale( spinal score) were found.Conclusions Cognitive deficits commonly exist in ALS patients.For the involved domains, executive dysfunction is the most common, deficits of attention and memory are also common, and deficit in visuospatial function is not found.The most common subtype of ALS-MCI is mdMCI.Severe bulbar symptoms and lower education may be the risk factors of ALS-MCI.

Human pregnane X receptor-mediated transcriptional regulation of CYP3A4 by extracts of 7 traditional Chinese medicines / 中国中药杂志

<p><b>OBJECTIVE</b>To test whether 7 herbs stimulate human pregnane X receptor (PXR)-mediated CYP3A4 transcription.</p><p><b>METHOD</b>Transient cotransfection reporter gene assays were performed with human PXR expression plasmids and a reporter plasmid containing the XRES in the CYP3A4 gene promoter in HepG2 cells.</p><p><b>RESULT</b>The aqueous extracts of Chrysanthemi Flos, Lycii Fructus, and Salviae Miltiorrhizae Radix et Rhizoma, and the methanol extracts of Chrysanthemi Flos, Crataegi Fructus, Lycii Fructus, Lonicerae Japonicae Flos, Dioscoreae Rhizoma,and Salviae Miltiorrhizae Radix et Rhizoma, activated human PXR-mediated transcription.</p><p><b>CONCLUSION</b>The aqueous extracts of Chrysanthemi Flos, Lycii Fructus, and Salviae Miltiorrhizae Radix et Rhizoma, and the methanol extracts of Chrysanthemi Flos, Crataegi Fructus, Lycii Fructus, Lonicerae Japonicae Flos, Dioscoreae Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma are inducers of CYP3A4 by activating PXR, and thus may influence the metabolism of other substrates on CYP3A4.</p>

Study on the Protective Devices of Microwaves Radiated From Mobile Telephones / 环境与健康杂志

Objective To research the effective protection from microwaves radiated from mobile telephones. Methods The observed mobile telephone was covered with a compound membrane developed by us and made from metal foil, metal silk screen, graphite and binder with a thickness of 0.5 mm. The electromagnetic field intensities were determined at 2.6 cm far from the front of the speaker, screen and keyboard of the observed mobile telephones covered with protective membrane or not. Results The electromagnetic field intensities of those three monitored locations mentioned above were 0.145, 0.095 and 0.085 mW/cm 2 for the mobile telephone without the protective membrane respectively, and were all