Application advances of multiparametric PET/MR imaging in breast cancer / 中华核医学与分子影像杂志

Breast cancer has become the leading cause of cancer incidence worldwide, seriously endangering people′s physical and mental health. As an emerging multimodal molecular imaging technique, PET/MR contains multiple molecular probes as well as multiple parameters and sequences, providing much information for the diagnosis and treatment of breast cancer. This review summarizes the application of PET/MR in breast cancer, including the imaging protocol, early diagnosis, staging, monitoring of treatment response and prognosis assessment, also evaluates its strengths and weaknesses.

Clinical analysis of 137 cases of cardiac arrest treated with cardiopulmonary resuscitation machine / 中国中西医结合急救杂志

Objective To observe the clinical effect of cardiopulmonary resuscitation (CPR) in the treatment of cardiac arrest. Methods A retrospective analysis was coducted, 137 patients with cardiac arrest admitted to Department of Emergency of Fuyang People's Hospital from January 2017 to December 2018 were enrolled, emergency rescue with CPR machine. There were 116 cases of CPR in emergency room, including 44 cases of cardiac arrest before hospital and 72 cases of cardiac arrest in hospital. There were CPR was 21 cases of CPR in EICU. The difference of return of spontaneous circulation (ROSC) rate and rescue time between Emergency Room and Emergency Intensive Care Unit (EICU) and ROSC rate in patients with cardiac arrest before and after emergency rescue room were compared. Results There were 45 cases of ROSC in 137 patients, the success rate of rescue was 32.85%, rescue time was 30.00 (20.00-40.00) minutes, and the maximum duration of times was 180 minutes. The ROSC rate of EICU was significantly higher than that of emergency room [66.67% (14/21) vs. 26.72% (31/116), P < 0.05], and the rescue time was significantly shorter than that of emergency room [minutes: 25.00 (10.00-30.00) vs. 30.00 (25.00-40.00), P < 0.05]. The ROSC rate of patients with cardiac arrest in emergency room was significantly higher than that before hospitalization [33.33% (24/72) vs. 15.91% (7/44), P < 0.05], there was no significant difference in rescue time between patients with cardiac arrest in emergency room and that before hospitalization [minutes: 30.00 (20.00-40.00) vs. 30.00 (26.25-40.00), P > 0.05]. Conclusions The function of CPR provides high quality extrathoracic compression, which effectively saves the labor cost of cardiac compression, especially in the case of shortage of medical and nursing staff. In the face of patients who need continuous CPR for a long time, it is a feasible choice to use CPR machine instead of unarmed CPR, which is worth popularizing in clinic.

Comparison of uniaxial and polyaxial locking plate fixation for Sanders types Ⅳintra-articular calcaneal fractures / 中国医师进修杂志

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures. Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳintra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group, 38 cases) or polyaxial locking plates (B group, 34 cases) between January 2012 and December 2016. Operation time, intraoperative bleeding, union time, radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups. Results There were no significant differences between the two groups in operation time, intraoperative bleeding, or union time (P>0.05). The patients in A group were followed up for (23.2 ± 5.4) months, and those in B group were followed up for (22.5 ± 4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6 ± 4.5)° vs. (27.6 ± 6.1)°, (30.7 ± 4.2)° vs.(27.0 ± 5.4)°] and Gissane angles [(109.2 ± 10.8)° vs. (96.8 ± 9.5)°, (107.3 ± 10.1)° vs. (95.4 ± 10.2)°] at 3 and 12 months after operation , compared with A group (P<0.05). Evaluated by the Maryland foot score, the excellent and good rate for the B group was 91.2％(31/34) , which was insignificantly higher than that for the A group (84.2％, 32/38) (P > 0.05). Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures, but polyaxial locking plates may be superior in stability and functional recovery.

Treatment experience of large area cerebral infarction with portal vein pneumatosis / 中国中西医结合急救杂志

Acute cerebral infarction possesses the characteristics of high incidence, high disability rate and high mortality, especially in patients with large area cerebral infarction accompanied by a variety of chronic diseases,such as systemic hypertension, hyperglycemia, obesity, etc risk factors, their mortality will be much higher. Simultaneously, in the treatment of large area cerebral infarction, special attention should be paid on monitoring the disease situation changes of patients' electrolyte balance, digestive system and other systems; in this study, the experiences of treating a patient with large area cerebral infarction and occurrence of serious complications as portal vein pneumatosis, intestinal obstruction, etc in the course of disease were summarized.

Synthesis of istradefylline / 军事医学

Objective To optimize the synthesis process of istradefylline 1 for industrial production.Methods Istrade-fylline was synthesized from dimethyl carbonate and ethylamine through a series reactions including condensation,cycliza-tion,nitrosation,and reduction to produce 1,3-diethyl-5,6-diaminouracil(6),which was subjected to amidation with (E)-3,4-dimethoxycinnamic acid (8),followed by cyclization and methylation reaction.Compound 8 was prepared from veratr-aldehyde and propanedioic acid by Knoevenagel condensation.The structures of intermediate and target compounds were confirmed by MS and 1 H-NMR.Results and Conclusion The quality control points of each key process were optimized so that the total yield was 26.2% and the purity of the product was 99.76%.This improved synthesis method has some advan-tages,such as mild reaction conditions,simple operation,and applicability to industrial production.

Synthesis of phacolysin / 军事医学

Objectve To optimize the synthesis process of phacolysin 1 for industrial production.Methods Phacolysin as the target product was synthesized with a total yield of 40.7% by condensation reaction of O-phenylenediamine and sulfonation reaction.The yield reported in literature was 24.8%.Results Such factors as the ratio of the raw materials,the catalyst,and the reaction time were inveatigated and optimized to make the reaction conditions mild and easy to control with less side effect.Conclusion The structure is confirmed by 1HNMR and MS,and the optimized process is more suitable for industrial production.

Synthesis of ATP-competitive inhibitor Wye-125132 / 军事医学

Objective To synthesize Wye-125132,an inhibitor of mTOR,and to establish a synthetic route for industrial production.Methods Barbituric acid was used as the raw material to synthesize the intermediate 2, 4, 6-trichrolo-pyrimidine-5-carbaldehyde 2 via Vilsmeier-Haack and chlorination reaction, while intermediate 5 was prepared via 3-step reaction from 1,4-dioxaspiro-[4,5]decan-8-one.The condensation of 2 and 5 was followed by substitution reaction to obtain the key intermediate 7.The side chain 9 was prepared by 3-step reaction from bromine aniline.Then the title product 1 was obtained with the reaction of Suzuki cross-coupling of 7 and 9.The structures of intermediate and target compounds were confirmed by MS and 1 H-NMR.Results and Conclusion Compared with the method reported in the literature,this new synthesis method possesses some advantages, such as ready availablity of raw materials, simple operation, mild reaction conditions and easy disposal of products.The total yield is 13.2%,and the purity of the target compound is 99.77%.

Synthesis of iloperidone / 军事医学

Objective To optimize the synthesis process of iloperidone 1 for industrial production.Methods Piperi-dine-4-carboxylic acid, acetic acid and acetic anhydride were used as starting materials to generate 2 via amidation, Friedel-Crafts acylation, hydration, oximation, intramolecular cyclization and salification.Compound 2 was treated with 4-(3-chloropropoxy)-3-methoxyphenylethanone through condensation to afford iloperidone.The target compound 1 was prepared with an overall yield of 34.9%.Results and Conclusion Such factors as the ratio of the raw materials, the catalyst, reactive time were investigated and optimized to make the reaction conditions mild and easy to control with less side effects.The structure has been confirmed by IR, 1 H-NMR and MS.

The blood homocysteine level and distribution analysis of Ganzhou city people / 重庆医学

Objective We analysed the homocysteine level and distribution of ganzhou city crowd ,learned about its elevatory sit‐uation ,and provided theory basis for the intervention of high homocysteine level crowd and the prevention of heart and head blood vessel disease .Methods We detected the blood homocysteine level of 6419 adults who had physical examination in our hospital dur‐ing 2012 by enzymatic methods ,and analyzed the diagnose rate of HHcy and the distributions of Hcy in different age and gender . Results The total detection rate of high homocysteine level in 6419 adults was 39 .11% ,among which 47 .30% in male and 22 .49% in female ,the comparison was statistically significant (χ2 = 424 .28 ,P< 0 .05) ;the detection rate of male was higher than female .In different ages ,the detection rates were statistically significant comparatively (P< 0 .05) .The detection rate of homocys‐teine level in both gender rises with age .At the same time ,homocysteine levels in males of 25 - 34 years old age group and 35 - 44 years old age group ,45 - 54 years old age group and 55 - 64 yeas old age group were not statistically significant ;while there were statistical differences of Hcy level in the rest age groups of male ,different age groups of female and same age different gender groups (P< 0 .05) .Conclusion The HHcy detection rate and the blood Hcy distribution of Ganzhou city crowd has its regional characteristics compared with other regions ,and it may be associated with the main population distribution of hakka people and oth‐er geological factors .The detection rate of HHcy was relatively high ,and it′s advisable to take early prevention to lower the risk of heart and head blood vessel disease .

Expression of mice interlecukin-23 in pichia and preliminary studies on its biology function / 中国免疫学杂志

Objective:To clone the mice interleukin-23(mIL-23) and express it in Pichia efficiently.Methods:Two subunits of IL-23 were amplified by PCR from pcDNA3/mIL-23,and ligated together with adaptor by over-PCR.The IL-23 cDNA confirmed by sequencing was inserted into expressing vector pPICZαA and expressed in Pichia X-33 strain.IL-23 protein expression was induced by methanol and ammonia.The recombinant IL-23 was identified by immunoblot and its biological activity was analyzed.Results:DNA sequencing confirmed that cloned cDNA was identical to the published sequence of mIL-23.The recombinant plasmid pPICZαA/mIL-23 was electroprated into X-33.An expected 72 kD protein of mIL-23 was founded both in the induced pellets and supermatants by SDS-PAGE and coomassie blue staining.The 72 kD protein could be recognized in Western blot.While we could detect bands at 72 kD in cell pellets induced more than 24 h by Western blot.Detected by Western blot using anti-His antibody,we could see positive band at 72 kD from supernatants induced 24 and 36 h.While we could detect band at 72 kD in cell pellets induced between 24 h and 96 h.Meanwhile,we could see obviously proliferation of mice peripheral blood mononuclear cells(PBMC) treated with the induced pellets and supermanants.Conclusion:We have successfully expressed mIL-23 protein in Pichia and the expressed product has its bioactivity in promoting the proliferation on PBMC.

Safety and efficacy of interventional occlusion for patients with multiple outlets sac-type membranous ventricular septal defection / 中国组织工程研究

OBJECTIVE:To investigate the feasibility,safety and efficacy of domestic small waist big edge-type occluder for patients with multiple outlets sac-type membranous ventricular septal defection (VSD),and summarize its technical problems and the choice of treatment strategies.METHODS:A total of 20 patients with sac-type membranous VSD,underwent left ventricular angiography at left anterior oblique 45°-60° plus CAOD 20°-25°;the left ventricular entrance diameters were 7-21 (10.9±5.2) mm,more than 2 outlets in the right ventricular surfaces,and the largest outlet diameters were 3-10 (4.8±2.9) mm.According to the result from transthoracic echocardiography (TTE) and angiography,the sac-bag size,shape,location,extent of tissue adhesion,and stability were determined.Different types of small waist big edge-type occluder were implanted,and the occluder diameter was 5-14 (4.6±2.8) mm.Following 15 minutes of blocking,the immediate effects of occlusion were observed through repeating left ventricuiar angiography and TTE.All patients rechecked ultrasonic cardiography and electrocardiogram at 5-7 days of hospital stay,and 1,3,6 and 12 months following surgery.All patients took aspirin tablets for 6 months.RESULTS:Of 20 patients,17 cases underwent domestic small waist big edge occluder,blocked successfully through left ventricular entrance,2 cases were successful using symmetry block,and 1 case was failed.Intraoperative occlusion did not affect the aortic valve and tricuspid valve function.There were 1 case with left bundle branch block and 1 case with right bundle branch block during the operation,and all recovered within a week by using hormone therapy.After 6 months,the cardiac sizes were reduced to different degrees.CONCLUSION:It is safe and effective to treat multiple outlets sac-shaped membranous VSD with domestic small waist big edge-type occluder.The key technology,according to the sac size,shape,firmness,outlet orientation,import size,and the size of aortic stump,is to determine the block site and to select a suitable occluder.