Willingness and influencing factors for cervical cancer screening among women in Chizhou / 公共卫生与预防医学

Objective To investigate the influencing factors of willingness to screen for cervical cancer in women in Chizhou. Methods A cross-sectional web-based survey of 3,058 migrant women living in Chizhou was conducted through a social media platform. The survey included questionnaires on socioeconomic characteristics, history of cervical cancer screening, knowledge of cervical cancer prevention and treatment, and attitude. The χ2 test and logistic regression were used to analyze the influencing factors of willingness to screen. Results Under 60 years of age, having a spouse or sexual partner (OR=1.368), having a junior high school education or above, living in urban areas (OR = 1.501), local household registration (OR=1.363), high monthly income, and high knowledge of cervical cancer prevention and control (OR=1.198) were positively associated with the rate of willingness to undergo cervical screening. Among attitude barriers, there were statistically significant differences in fear of seeing male doctors (38.23%), fear of seeing poor results (31.92%), belief that screening was painful (23.56%), shyness or embarrassment (20.18%), and belief that they did not need to participate in screening due to asymptomatic (17.56%), having received HPV vaccine (15.86%), or ages at which screening was not considered necessary (15.14%) between the groups (P<0.05). Conclusion Socioeconomic characteristics, knowledge of prevention and treatment, fear of screening experience, and lack of motivation are related factors affecting cervical cancer screening willingness. Achieving cervical cancer elimination requires action to improve screening coverage in socio-economic, health education and women's attitudes.

Correlation analysis between SUV index in 18F-FDG PET/CT imaging and invasiveness of early lung adenocarcinoma / 中华核医学与分子影像杂志

Objective:To investigate the correlation between the SUV index (SUV max of the lesion/SUV mean of the liver) in 18F-FDG PET/CT imaging and the invasiveness of early lung adenocarcinoma presenting as ground-glass nodule (GGN). Methods:From January 2012 to March 2020, 167 GGN patients (49 males, 118 females; age: (61.5±9.0) years) with early lung adenocarcinoma who underwent PET/CT imaging in Changzhou First People′s Hospital were retrospectively enrolled. The image parameters including the GGN number, location, type, edge, shape, abnormal bronchus sign, vacuole sign, pleural depression, vessel convergence sign, GGN diameter ( DGGN), solid component diameter ( Dsolid), consolidation to tumor ratio (CTR, Dsolid/ DGGN), CT values (CT value of ground-glass opacity (CT GGO), CT value of lung parenchyma (CT LP), ΔCT GGO-LP (CT GGO-CT LP)) and SUV index were analyzed. Single and multivariate logistic regressions were used to analyze the correlation between SUV index and infiltration. The generalized additive model was used for curve fitting, and the piece-wise regression model was used to further explain the nonlinearity. Results:In 189 GGNs, invasive adenocarcinoma accounted for 85.2% (161/189). Single logistic regression showed that the GGN number, type, shape, edge, abnormal bronchus sign, pleural depression, vessel convergence sign, DGGN, Dsolid, CTR, CT GGO, ΔCT GGO-LP and SUV index were related factors of infiltration (odds ratio ( OR) values: 0.396-224.083, P<0.001 or P<0.05). After fully adjusting for confounding factors, SUV index was significantly correlated with increased risk of invasion ( OR=2.162 (95% CI: 1.191-3.923), P=0.011). Curve fitting showed that the SUV index was non-linearly related to the risk of infiltration, and the risk of infiltration increased significantly only when the SUV index was greater than 0.43 ( OR=3.509 (95% CI: 1.429-8.620), P=0.006). The correlation between SUV index and infiltration had no interaction between age, vacuoles, pleural depression and CTR subgroups (all P>0.05). Conclusions:SUV index is an independent factor related to the invasiveness of early lung adenocarcinoma. The higher the SUV index, the greater the risk of invasion; but the two are not simply linearly correlated.

Construction and validation of the predictive models for the pathological invasion of early lung adenocarcinoma presenting as ground glass nodules based on 18F-FDG PET/CT / 中华核医学与分子影像杂志

Objective:To construct and verify of the predictive models for pathologic invasion of early lung adenocarcinoma with ground glass nodules (GGNs) based on 18F-FDG PET/CT. Methods:A retrospective analysis was conducted on 149 patients (44 males, 105 females; age (61.1±8.9) years) with pre-invasive lesions/minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) confirmed by pathology after surgery in the First People′s Hospital of Changzhou from October 2011 to October 2019. All patients underwent PET/CT for GGNs. GGNs were randomly divided into a modeling group and validation group with the proportion of 1∶1. Mann-Whitney U test or χ2 test was used to compare the qualitative morphological characteristics (shape, edge characteristics, etc.), quantitative parameters (consolidation-to-tumor ratio, attenuation value of the ground glass opacity (GGO) component on CT (CT GGO), etc.) and quantitative functional parameters (SUV max and SUV index(GGNs SUV max/liver SUV mean) of pre-invasive lesions/MIA and IAC. Logistic regression analysis was used to construct the models, and the ROC curve was used to verify the models′ robustness. Different AUCs were compared by Delong test. Results:A total of 170 GGNs were removed by surgery and confirmed pathologically. In the modeling group ( n=89), the proportion of mixed GGNs, irregular shape, edge characteristics, bronchiectasis/twist/truncation sign, GGNs maximum diameter and solid component maximum diameter, consolidation-to-tumor ratio, CT GGO, SUV max and SUV index in IAC group were significantly higher than those in pre-invasive/MIA group ( χ2 values: 5.00-23.40, z values: from -6.53 to -2.70, all P<0.05). Models 1-3 were constructed based on the qualitative parameters (GGNs type, edge characteristics), quantitative parameters (CT GGO, SUV index), combined qualitative and quantitative parameters (GGNs type, edge characteristics, SUV index) of PET/CT, respectively, and the AUCs of ROC were 0.896, 0.880 and 0.931 in the modeling group, respectively. And the AUC of model 2 was not decreased significantly in the validation group ( n=81; AUC=0.802; z=0.81, P=0.417). Conclusion:The model combined with morphological and functional quantitative parameters of 18F-FDG PET/CT can effectively predict the pathological invasion of early lung adenocarcinoma, and the constructed model is robust.

Correlation analysis between the maximum standard uptake value based on 18F-fluorodeoxyglucose PET-CT and the epidermal growth factor receptor mutation status of lung adenocarcinoma appearing as ground glass nodules / 中华放射学杂志

Objective:To explore the relationship between the maximum standard uptake value (SUV max) based on 18F-fluorodeoxyglucose (FDG) PET-CT and the epidermal growth factor receptor (EGFR) mutation status of lung adenocarcinoma appearing as ground glass nodules (GGN). Methods:A total of 103 patients with lung adenocarcinoma from October 2011 to December 2020 in the Third Affiliated Hospital of Soochow University were retrospectively enrolled. All patients underwent 18F-FDG PET-CT and high-resolution CT, and underwent surgical resection and EGFR detecting within one month. The patients were divided into EGFR mutation group and wild group according to the EGFR test results. The GGN number, type, location, shape, lobulation sign, spicule sign, abnormal bronchial sign, vacuole sign, pleural indentation, diameter of GGNs (D GGN), diameter of solid component (D solid) and nodule ground-glass opacity component CT mean (CT GGO) were analyzed on CT images. The maximum standard uptake value (SUV max) of nodules was measured on PET-CT images. The t test, Mann-Whitney U test or χ 2 test were used to compare the differences of clinical data, pathological data, CT imaging parameters and SUV max between the two groups. Hierarchical binary logistic regression model was used to assess whether there was any association between SUV max and EGFR mutation status in different subgroups. Generalized additive model and smooth curve fitting were applied to solve nonlinear problems, and piecewise binary logistic regression model was used to explain nonlinearity. Results:A total of 103 patients with 106 nodules were finally included. There were 75 patients (78 nodules) in the EGFR mutation group and 28 patients (28 nodules) in the EGFR wild group. Adenocarcinomas with EGFR mutation showed significantly higher spiculated edge, pleural depression sign and invasive adenocarcinoma proportions than those in EGFR wild group ( P<0.05). There were no significant differences in other indicators between groups ( P>0.05). After adjusting for age and fasting blood glucose, gender and the number of GGNs significantly affected the relationship between SUV max and EGFR mutation ( P<0.05), which suggested that there was an interaction. After adjusting for confounding factors, there was a non-linear relationship between SUV max and EGFR mutation status in female subgroup (degree of freedom was 1.817, P=0.026). When SUV max<2.4, the risk of EGFR mutation increased significantly with the increase of SUV max (OR=43.621, 95%CI 4.686-406.042), P<0.001]. When SUV max>2.4, the risk of EGFR mutation increased insignificantly ( P=0.392). Conclusions:Lung adenocarcinoma appearing as GGN has a higher risk of EGFR mutation. The risk of EGFR mutation in female patients increases with increasing SUV max, but there is saturation effect.

Value of 18F-FDG PET/CT metabolic parameters of primary lesions for predicting occult lymph node metastasis in non-small cell lung cancer / 中华核医学与分子影像杂志

Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters for occult lymph node metastasis (OLM) in non-small cell lung cancer (NSCLC). Methods:A total of 183 patients (72 males, 111 females; age (61.5±8.4) years) who underwent 18F-FDG PET/CT and preoperatively diagnosed with clinical N0 stage (cN0) in Third Affiliated Hospital of Soochow University from January 2013 to December 2018 were retrospectively enrolled. All patients underwent anatomical pulmonary resection with systematic lymph node dissections within 3 weeks after 18F-FDG PET/CT examinations. According to the presence or absence of lymph node metastasis, patients were divided into OLM positive (OLM+ ) group and OLM negative (OLM-) group. Parameters of primary lesions, such as the maximum diameter (D max), tumor sites, morphological features, maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic total volume (MTV), total lesion glycolysis (TLG), tumor SUV max to liver SUV mean (TLR max), tumor TLG to liver SUV mean (TLR TLG) were analyzed. Mann-Whitney U test and χ2 test were used to compare the parameters between groups. Multivariable logistic regression was used to analyze the independent risk factors for OLM. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different parameters. Results:Among 183 patients, 25 (13.7%, 25/183) of them were diagnosed as OLM. In OLM+ group, 46 lymph nodes were pathologically positive for metastasis, including 15 N1 disease and 31 N2 disease. D max (2.9(2.3, 3.7) vs 2.3(1.7, 2.8) cm), lobulation ((76.0%(19/25) vs 37.3%(59/158)), SUV max (11.1(7.9, 17.7) vs 4.7(2.3, 9.2)), TLG (41.5(10.2, 91.1) vs 15.6(6.5, 23.8) ml), TLR max (4.7(3.5, 7.6) vs 2.1(0.9, 4.0)) and TLR TLG (18.1(5.0, 44.3) vs 6.1(3.0, 11.4) ml) of the primary lesions in OLM+ group were significantly higher than those in OLM-group ( z values: from -4.709 to -3.247, χ2=13.190, all P<0.05). Multivariable logistic regression analysis showed that TLR max (odds ratio ( OR)=15.145, 95% CI: 3.381-67.830, P<0.001) and D max ( OR=3.220, 95% CI: 1.192-8.701, P=0.021) were independent risk factors for OLM. TLR max yielded the highest area under curve (AUC; AUC=0.794) with the threshold of 3.12, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for predicting OLM were 92.0%(23/25), 63.3%(100/158), 67.2%(123/183), 28.4%(23/81) and 98.0%(100/102), respectively. Conclusions:TLR max of tumor is the independent risk factor for OLM in NSCLC patients. TLR max can sensitively predict OLM preoperatively in patients with NSCLC.

Application of 18F-deoxyglucose PET and HRCT combined prediction model in the diagnosis of early invasive lung adenocarcinoma with consolidation-to-tumor ratio ≤ 0.5 / 中华放射学杂志

Objective:To explore the value of 18F-deoxyglucose (FDG) PET and high resolution CT (HRCT) combined prediction model in the identification of invasiveness of early lung adenocarcinoma with consolidation-to-tumor ratio (CTR)≤0.5. Methods:A retrospective analysis was performed on 91 patients with early lung adenocarcinoma with CTR≤0.5 who underwent PET/CT and HRCT before surgery in the Third Affiliated Hospital of Soochow University from October 2011 to October 2019, including 110 ground-glass nodules (GGNs). According to the pathological subtypes, they were divided into preinvasive-minimally invasive adenocarcinoma (MIA) group ( n=22) and invasive adenocarcinoma (IAC) group ( n=88). The image feature parameters of GGNs of the two groups were compared, and the HRCT model and PET-HRCT combined model were constructed using Logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficacy of different models. The Bootstrap resampling (times = 500) method was used for internal verification of the model, and we also performed interaction and hierarchical analysis on the model. Results:The proportions of mixed GGN, irregular shape, lobulation sign, dilated/distorted/cutoff bronchial sign, pleural indentation and vascular convergence in IAC group were significantly higher than those in preinvasive-MIA group (all P<0.05). Nodule diameter, solid component diameter, solid component ratio, CT value of ground glass attenuation component (CT GGO), and SUVindex of the IAC group were larger than those of the preinvasive-MIA group, and the differences were statistically significant ( P<0.001). Among the quantitative parameters of HRCT, CT GGO had the best diagnostic efficacy (AUC=0.775), with a sensitivity of 0.580 and a specificity of 0.909. The diagnostic efficacy of HRCT model and PET-HRCT combined model were better than CT GGO (AUC: 0.907 vs. 0.775, 0.931 vs. 0.775; P=0.027, 0.002, respectively), but the diagnostic efficacy of the former two was not statistically different ( P=0.210).When the specificity was 0.909, the sensitivity of the HRCT model and the PET-HRCT model (0.784 and 0.875, respectively) were significantly higher than that of the CT GGO (0.580), and the combined PET-HRCT model had a more significant increase in sensitivity. The PET-HRCT combined model showed no significant interaction between different nodule types, between groups with or without pleural indentation, and among nodule diameter subgroups (all P>0.05). Conclusion:PET-HRCT combined model has a good predictive value for the invasiveness of early lung adenocarcinoma with CTR≤0.5, and it can be used for GGN risk stratification to guide clinical decision-making.

Evolution of ARDS definition and establishment of diagnostic criteria for neonatal ARDS / 国际儿科学杂志

Acute respiratory distress syndrome (ARDS) is a common clinical critical illness and is one of the important causes of neonatal death.Since the first report of ARDS in 1967,its definition and diagnostic criteria have been controversial.The AECC diagnostic criteria proposed by American-European Consensus Conference in 1994 and the Berlin diagnostic criteria issued in 2012 are of great significance for the clinical diagnosis and scientific research of ARDS.In 2017,the first international diagnostic criteria for ARDS in neonates was released,which will play an active role in promoting basic research and clinical practice of neonatal ARDS.This article reviews the evolution of ARDS definitions and diagnostic criteria,as well as the establishment and clinical applications of diagnostic criteria for neonatal ARDS.

Clinical value of 18F-FDG PET/CT in assessing muscular inflammation of dermatomyositis / 中华核医学与分子影像杂志

Objective@#To analyze the imaging characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in muscular inflammation in dermatomyositis (DM), as well as the relationship between maximum standardized uptake value (SUVmax) and activity of muscular inflammation.@*Methods@#From July 2013 to November 2016, 17 hospitalized DM patients (8 males, 9 females, age range: 35-78 years) who underwent 18F-FDG PET/CT were retrospectively reviewed, including 13 typical DM (TDM) and 4 amyopathic DM (ADM). Seventeen healthy volunteers (8 males, 9 females, age range: 35-78 years) in the same period were enrolled as the control group. The proximal limb muscles of whole body were divided into 7 areas, and the SUVmax of each was measured and recorded. Two-sample t test, one-way analysis of variance, Dunnett-t test and Spearman correlation analysis were used to analyze data.@*Results@#Five TDM cases showed diffuse increased FDG uptake in global muscles; 8 TDM cases showed increased FDG uptake in local muscles, mainly in the shoulder and hip. The FDG uptake by muscles of 4 ADM patients was similar with that of controls. The SUVmax was lower and lower in the order of shoulder and back muscles, hip muscles, thoracic vertebra muscles, cervical vertebra muscles, biceps, proximal quadriceps and lumbar vertebra muscles in DM group. The muscle SUVmax of DM, TDM, ADM and the controls were 1.92±0.86, 2.14±0.85, 1.19±0.44 and 0.93±0.26, respectively (F=69.50, P<0.001). Muscle SUVmax of DM group was higher than that of controls, muscle SUVmax of TDM was higher than that of ADM, and muscle SUVmax of ADM was higher than that of controls (t values: 4.102-11.970, all P<0.05). Muscle SUVmax of 9 DM patients with interstitial lung disease (ILD) was lower than that of patients without ILD (1.73±0.09 vs 2.13±0.13; t=5.857, P<0.001). Muscle SUVmax of DM was positive correlated with serum levels of creatine kinase (CK) and creatine kinase isoenzyme composed by M and B subunits (CK-MB) (rs values: 0.814 and 0.751, both P<0.001).@*Conclusion@#18F-FDG PET/CT is helpful to detect muscular inflammation of DM and it can reflect the activity and severity with SUVmax, and meanwhile evaluate the condition of ILD associated with DM.

Clinical value of preoperative viable myocardium and postoperative left ventricular mechanical dyssynchrony for prognosis evaluation in patients undergoing coronary artery bypass graft / 中华核医学与分子影像杂志

Objective To investigate the predictive value of preoperative viable myocardium and postoperative left ventricular mechanical dyssynchrony (LVMD) for adverse cardiovascular events(ACE) after coronary artery bypass graft (CABG) in patients with coronary artery disease (CAD) using myocardial perfusion imaging (MPI).Methods From September 2012 to March 2016,49 patients (44 males,5 females,average age:(64±8) years) with CAD were prospectively recruited.All patients underwent 99Tcmmethoxyisobutylisonitrile (MIBI) SPECT gated MPI (GMPI) and 18F-fluorodeoxyglucose (FDG) PET myocardial metabolic imaging to assess myocardial viability preoperatively.GMPI was repeated 4-6 months after CABG to record postoperative LVMD.Phase analysis was used to measure bandwidth (BW) and standard deviation (SD).Regular follow-up was performed,and ACE were taken as the end point.Cox proportional hazard model,Kaplan-Meier method and log-rank test were used to analyze the data.Results The mean duration of follow-up was (3.82±0.80) years,and ACE were present after CABG in 17 CAD patients (34.7％,17/49).Cox multi-analysis revealed that the number of preoperative viable segments (hazard ratio (HR)=0.208,95％ CI:0.068-0.642) and postoperative BW (HR=1.245,95％ CI:1.099-1.411)were independent influencing factors of ACE in CAD patients after CABG (both P＜0.01).Kaplan-Meier survival analysis showed that the incidence of ACE in patients with ＜ 3 viable segments was significantly higher than those with ≥ 3 viable segments (57.1％ (12/21) vs 17.9％ (5/28);x2 =21.023,P＜0.01).The incidence of ACE was significantly higher in the postoperative BW≥98° group than that in the postoperative BW＜98° group (14/19 vs 10％ (3/30);x2 =38.395,P＜0.01).Conclusions Less preoperative viable segments and severe postoperative LVMD are independent risk factors of ACE after CABG in CAD patients.Postoperative LVMD in CAD patients undergoing CABG may have important clinical value in the riskrestratification and prognosis evaluation.

Temporal changes of left ventricular mechanical dyssynchrony early after acute myocardial infarction assessed by two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography: a comparison with single photo emission computed tomography gated myocardial perfusion imaging measurement / 中华超声影像学杂志

Objective To evaluate the dynamic changes of left ventricular mechanical synchrony in the early period after acute myocardial infarction (AMI) by two-dimensional speckle tracking imaging (2D-STI) and real time three-dimensional echocardiography (RT-3DE),and analyze the correlation with phase analysis of single photo emission computed tomography gated myocardial perfusion imaging (SPECT GMPI) in porcine models,and further to investigate the clinical significance of left ventricular mechanical dyssynchrony in patients with AMI.Methods Bama minipigs(n =11) were subjected to left anterior descending (LAD) occlusion by balloon to introduce AMI porcine models.All animals underwent 2D-STI and RT-3DE at the baseline (before AMI),1 day,1 week and 4 weeks after LAD occlusion,respectively.In addition,SPECT GMPI was measured at baseline and 1 day after AMI.Data was analyzed and compared the dynamic changes of left ventricular mechanical synchrony before and after AMI.Then the correlation between echocardiography and SPECT GMPI in evaluating left ventricular mechanical synchrony before and after AMI were calculated.Results Eight pigs were successfully established as AMI models and complete the study.SPECT GMPI,2D-STI and RT-3DE showed that the left ventricular mechanical synchrony indexes were significantly higher at 1 day after AMI than those before AMI,which means the appearance of left ventricular mechanical dyssynchrony.Compared with those 1 day after AMI,GLS,Time SD,Tmsv16-SD％ and Tmsv16-Dif％ did not change significantly at 1 week after AMI,but they significantly increased at4 weeks after AMI (all P ＜0.05).At baseline and 1 day after AMI,the GLS measured by 2D-STI and the SPECT GMPI parameter phase bandwidth (BW) showed good correlation(r =0.708-0.719,P ＜0.05),Time SD was significantly correlated with the SPECT GMPI parameter phase standard deviation (SD)(r =0.717-0.830,P ＜0.05),while Tmsv16-Dif％ derived from RT-3DE had a better positive correlation with BW (r =0.713-0.857,P ＜0.05),as similar as Tmsv16-SD％ with SD(r =0.803-0.957,P ＜0.05).Conclusions Left ventricular mechanical dyssynchrony is present 1 day after AMI.Compared with that 1 day after AMI,left ventricular mechanical dyssynchrony doesn't change significantly at 1week after AMI,but further aggravates at 4 weeks after AMI.The parameters of 2D-STI and RT-3DE have good correlation with the mechanical synchrony parameters measured by SPECT GMPI.2D-STI and RT-3DE can be used as reliable methods to evaluate left ventricle mechanical dyssynchrony early after AMI.

Enhancement with coronary artery calcification score in detection of coronary heart disease by myocardial perfusion SPECT imaging / 中华核医学与分子影像杂志

Objective To evaluate the additional value of CACS in detection of coronary artery disease (CAD) with MPI.Methods A total of 188 suspected CAD patients (128 males,60 females;average age (61.93±9.16) years) who underwent one-step examination of MPI combined with CACS from December 2012 to August 2014 were enrolled in this retrospective study.According to the gold standard of CAG,the diagnostic efficacy of MPI was calculated.ROC analysis was performed to determine the optimal CACS threshold for the detection of CAD.Mann-Whitney u test and x2 test were used for statistical analysis.Results (1) Seventy-three CAD cases were confirmed (≥ 50％ stenosis) among 188 patients.The sensitivity,specificity,accuracy for CAD diagnosis with MPI were 65.8％ (48/73),75.7％ (87/115),71.8％ (135/188),respectively.Twenty-five CAD patients had negative findings with MPI,including 2 with LM disease,4 with three-vessel disease (LAD±LCX±RCA,3-VD),3 with 2-VD,16 cases with 1-VD.Among them 13 cases (52.0％,13/25) had intermediate lesions of 1-VD (50％ ≤ stenosis＜70％).(2) The CACS of CAD group was significantly higher than that of non-CAD group (172.40(19.25,516.45) vs 0;z=-8.465,P＜0.001).According to the ROC analysis,95.1 was the optimal CACS cutoff to detect CAD patients.Combining MPI with CACS (at cutoff of 95.1) improved the sensitivity of MPI (80.8％,59/73;x2 =4.233,P＜0.05) for the detection of CAD,with no significant decrease in specificity and accuracy (71.3％,82/115;75.0％,141/188;x2 values:0.558 and 0.490,both P＞0.05).(3) Of the 25 CAD patients with negative MPI results,11(44.0％,11/25) showed abnormal CACS(CACS≥95.1),consisted of 2 cases of LM disease,4 cases of 3-VD,2 cases of 2-VD,3 cases of 1-VD.Diagnosis was corrected by CACS in 8/9 cases of severe CAD (LM CAD or multivessel disease) which were missed by MPI.Conclusion CACS could offer additional information for MPI in detection of suspected CAD patients,which can improve the sensitivity of MPI for diagnosing CAD,especially for severe CAD with LM lesions or multivessel CAD.

Influence of discontinuance of methimazole and propylthiouracil on 24 h radioactive iodine uptake in normal rats / 中华核医学与分子影像杂志

Objective To investigate the influence of discontinuance of methimazole (MMI) and propylthiouracil (PTU) on 24 h radioactive iodine uptake(RAIU) in normal rats.Methods A total of 66 female SD rats were randomly divided into 3 groups by simple random sampling method.MMI group (30 rats) received MMI with a dose of 0.6 mg·ml-1·d-1 orally for 2 weeks, PTU group (30 rats) received PTU with a dose of 6 mg·ml-1·d-1 orally for 2 weeks.At 1, 3, 5, 7 and 9 d after MMI or PTU was discontinued, 6 rats were sacrificed to measure 24 h RAIU respectively.The control group (6 rats) received normal saline with a dose of 1 ml/d orally for 2 weeks, and then they were sacrificed to measure 24 h RAIU too.Data were analyzed with two-sample t test or t′ test.Results Thyroid 24 h RAIU in normal rats was (14.6±4.3)%.The 24 h RAIU on 1, 3, 5, 7 and 9 d was (4.6±0.7)%, (24.2±7.2)%, (13.1±2.9)%, (14.1±2.6)%, (16.1±3.7)% respectively after MMI withdrawal.The 24 h RAIU was significantly lower than that in control group at day 1 (t′=5.55, P0.05).The 24 h RAIU on 1, 3, 5, 7 and 9 d was (1.9±0.8)%, (3.3±1.2)%, (7.7±2.4)%, (29.0±4.0)%, (17.1±4.8)% respectively after PTU withdrawal.It was lower than that in control group (t=7.01, 6.10, 3.40, all P0.05).Conclusions MMI and PTU can inhibit the iodine uptake of thyroid, the 24 h RAIU returns to normal level at day 5 after withdrawal of MMI and at day 9 after withdrawal of PTU in euthyroid rats.

Influence of discontinuance of methimazole and propylthiouracil on 24 h radioactive iodine uptake in normal rats / 中华核医学与分子影像杂志

Objective To investigate the influence of discontinuance of methimazole (MMI) and propylthiouracil (PTU) on 24 h radioactive iodine uptake(RAIU) in normal rats.Methods A total of 66 female SD rats were randomly divided into 3 groups by simple random sampling method.MMI group (30 rats) received MMI with a dose of 0.6 mg · ml-1 · d-1 orally for 2 weeks,PTU group (30 rats) received PTU with a dose of 6 mg · ml-1 · d-1 orally for 2 weeks.At 1,3,5,7 and 9 d after MMI or PTU was discontinued,6 rats were sacrificed to measure 24 h RAIU respectively.The control group (6 rats) received normal saline with a dose of 1 ml/d orally for 2 weeks,and then they were sacrificed to measure 24 h RAIU too.Data were analyzed with two-sample t test or t'test.Results Thyroid 24 h RAIU in normal rats was (14.6±4.3) ％.The 24 h RAIU on 1,3,5,7 and 9 d was (4.6±0.7) ％,(24.2±7.2) ％,(13.1 ±2.9) ％,(14.1±2.6) ％,(16.1 ±3.7)％ respectively after MMI withdrawal.The 24 h RAIU was significantly lower than that in control group at day 1 (t'=5.55,P＜0.01),higher at day 3 (t=-2.83,P＜0.05),and returned to the normal level at day 5,7,9 (t =0.68,0.24,-0.67,all P＞0.05).The 24 h RAIU on 1,3,5,7 and 9 d was (1.9±0.8)％,(3.3±1.2)％,(7.7±2.4)％,(29.0±4.0)％,(17.1±4.8)％ respectively after PTU withdrawal.It was lower than that in control group (t=7.01,6.10,3.40,all P＜0.05) at day 1,3,5,and higher at day 7 (t=-5.97,P＜0.01).The 24 h RAIU of 9 d showed no difference when compared with that in control group (t=-0.95,P＞0.05).Conclusions MMI and PTU can inhibit the iodine uptake of thyroid,the 24 h RAIU returns to normal level at day 5 after withdrawal of MMI and at day 9 after withdrawal of PTU in euthyroid rats.

Left ventricular systolic synchrony assessed by phase analysis of gated myocardial perfusion imaging in patients with old myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the left ventricular (LV) systolic synchrony by phase analysis of gated myocardial perfusion imaging (GMPI) with SPECT/CT in patients with old myocardial infarction (OMI) and further to identify independent predictors for LV dyssynchrony.</p><p><b>METHODS</b>Seventy-six OMI patients and seventy-four healthy volunteers (control group) underwent resting GMPI from October 2010 to September 2013 in our hospital were included in this study. The left ventricular systolic synchrony parameters including phase histogram bandwidth (BW) and phase standard deviation (SD) were obtained by Cedars-Sinai quantitative gated SPECT (QGS) phase analysis technique, and LV cardiac function was also measured. The extent of myocardial perfusion defect was analyzed by the Quantitative Perfusion SPECT (QPS) software. The value of BW and SD were compared between OMI and the control groups, between LVEF ≤ 35% and LVEF > 35% groups in OMI patients. Dyssynchrony was defined when the BW exceeded the abnormality threshold derived from a normal control group (threshold = x ± 2s for normal BW).</p><p><b>RESULTS</b>(1) The BW ((91.3 ± 58.6)° vs. (37.2 ± 11.7)°) and SD ((27.3 ± 20.8)° vs. (11.8 ± 5.4)°) were significantly higher and the LVEF was significantly lower in OMI group than in the normal control group (all P < 0.01). In addition, BW ((136.0 ± 52.9)° vs. (51.0 ± 24.0)°) and SD ((38.7 ± 21.3)° vs. (17.1 ± 14.0)°) were significantly higher in patients with LVEF ≤ 35% than in patients with LVEF > 35% (all P < 0.001). (2) Dyssynchrony (BW > 60.6°) prevalence was 57.9% (44/76) in OMI patients. Compared with the synchrony group, LVEF was significantly lower, while the left ventricular end-diastolic volume, end-systolic volume, summed motion score, summed thickening score and extent were significantly higher in dyssynchrony group (all P < 0.001). (3) Additionally, dyssynchrony prevalence was significantly higher in patients with LVEF ≤ 35% compared with patients with LVEF > 35% (91.7% (33/36) vs. 27.5% (11/40), P < 0.001). (4) Pearson correlation analysis showed that LVEF was negatively correlated with BW (r = -0.807, P < 0.001). (5) Multivariate logistic regression analysis revealed that the extent of myocardial perfusion defect was an independent predictor for dyssynchrony in OMI patients (OR = 1.076, 95% CI: 1.015-1.141, P = 0.015).</p><p><b>CONCLUSIONS</b>GMPI phase analysis can reliably reflect left ventricular systolic synchrony. The left ventricular systolic dyssynchrony in OMI patients is significantly increased. Left ventricular dyssynchrony is closely related to LVEF. The extent of myocardial perfusion defect (Extent) is an independent predictor for left ventricular systolic dyssynchrony in OMI patients.</p>

Human recombinant neutrophil inhibitory factor and hirulog hybrid (TNHH) protects against focal cerebral ischemia injury in rats / 中国药学杂志

OBJECTIVE: To investigate the protective effects of human recombinant neutrophil inhibitory factor and hirulog hybrid (TNHH) on focal cerebral ischemia in rats. METHODS: Middle cerebral artery occlusion model was prepared in rats to imitate the focal cerebral ischemia. Rats were divided into five groups: (1)blank, (2)sham, (3)focal cerebral ischemia, (4)ischemia + vehicle and (5)ischemia + TNHH(6.75 mg · kg-1). After persistent ischemia for 12 h, neurologic deficit score was assayed, and then scarified the animals to measure the brain infraction area by TTC staining, the brain pathological damage by HE staining, and the levels of inflammatory factor TNF-α and IL-1β in serum respectively by using ELISA and radio-immunity assay. RESULTS: TNHH could significantly improve the neurological outcome, decrease the infraction area, alleviate brain edema and pathological injury and reduce the levels of TNF-α and IL-1β in rats suffered persistent focal cerebral ischemia for 12 h. CONCLUSION: TNHH has significant anti-inflammatory and anti-edema effects, which could effectively alleviate focal cerebral ischemia injury in rats.

Gated Myocardial Perfusion Imaging Quantitative Analysis Technique in Evaluation of Left Ventricular Remodeling and Its Effect on Cardiac Function After Myocardial Infarction / 中国医学影像学杂志

Purpose To investigate the clinical value of gated myocardial perfusion imaging (GMPI) quantitative analysis technique in evaluating left ventricular remodeling and its effects on left ventricular function in patients with myocardial infarction (MI). Materials and Methods Seventy-six cases of MI patients were retrospectively analyzed, including pure left anterior descending artery (LAD) disease in 21 cases , left circumlfex artery (LCX) or right coronary branch (RCA) disease in 23 patients and multivessel disease in 32 cases. Seventy-four healthy people were additionally selected as control group. GMPI was performed on all subjects. Reconstruction images were automatically analyzed by using cardiac software QGS 2009 to obtain left ventricular remodeling index, including diastolic sphericity index (SIED) and end-systolic sphericity index (SIES). Cardiac function parameters were also obtained, including left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), left ventricular ejection fraction (LVEF), and peak iflling rate (PFR). Differences of the left ventricular remodeling index and cardiac function parameters between the MI group and the control group were compared to analyze the relationship between left ventricular remodeling after myocardial infarction and coronary artery lesions. Results SIED, SIES and EDV, ESV in MI group were signiifcantly higher than those in the normal group (P0.05). Linear regression analysis showed that LVEF and PFR in group of left ventricular remodeling was signiifcantly lower with the increase of SIED (F=43.231 and 15.642, P<0.01). SIED and SIES analysis resulted in high correlation for both intra-observer and inter-observer (r=0.881-0.926, P<0.01). Conclusion Left ventricular remodeling after myocardial infarction can be accurately evaluated by GMPI. Patients with myocardial infarction due to LAD or multi-vessel coronary artery diseases may have left ventricular remodeling easier and more severe. Left ventricular remodeling will seriously affect the myocardial contraction and diastolic function, resulting in the entire left ventricular dysfunction.

Change of Human Cerebral Glucose Metabolism with Age and Gender by Using Scenium Software / 中国医学影像学杂志

Purpose To analyze the PET image of normal human brain by using Scenium software, so as to ifnd out the change of cerebral glucose metabolism with different age and gender. Materials and Methods Brain PET imaging data of 493 healthy males and 273 healthy females were collected in the study. The subjects were divided into 6 groups according to age:21-30 years group,31-40 years group, 41-50 years group, 51-60 years group, 61-70 years group and 71-82 years group. Each group was further subdivided according to gender. The brain areas were automatically outlined by Scenium and the mean standard uptake value (SUV) of each brain area was calculated and compared among groups. Results Most cerebral glucose metabolism of males at different age was significantly different (F=2.580-5.316, P0.05); whilst difference in cerebral glucose metabolism of females at different age was not signiifcant (F=0.721-1.706, P>0.05). In male groups, cerebral glucose metabolism got peak at 31-40 years, and decreased signiifcantly at 51-60 years mainly involving areas like cinglulate gyrus, calcarine and surrounding cortex;and the groups after 61 years showed no signiifcant decrease. In female groups, cerebral glucose metabolism got peak at 31-40 years and showed no significant decrease along with age. Conclusion Cerebral glucose metabolism decreases unevenly after 40 years old. It drops significantly in males at 51-60 years whilst that in females is not obvious.

Left ventricular synchrony assessed by phase analysis of gated myocardial perfusion SPECT imaging in healthy subjects / 中华核医学与分子影像杂志

Objective To investigate the value of Cedars-Sinai quantitative gated SPECT (QGS) phase analysis for left ventricular synchrony assessment in healthy subjects.Methods Seventy-four healthy subjects (41 males,33 females,average age:(60±13) years) underwent both rest and exercise 99Tcm-MIBI G-MPI.QGS software was used to analyze the reconstructed rest gated SPECT images automatically,and then the parameters of left ventricular synchrony including phase bandwidth (BW) and phase standard deviation (SD) were obtained.The influences of gender and age (age＜60 years,n =36; age ≥ 60 years,n =38) on left ventricular systolic synchronicity were analyzed.The phase angle for original segmental contraction was measured to determine the onset of the ventricular contraction using 17-segment model.Forty healthy subjects were selected by simple random sampling method to evaluate the intra-observer and interobserver repeatability of QGS phase analysis software.Two-sample t test and linear correlation analysis were used to analyze the data.Results The BW and SD of left ventricular in healthy subjects were (37.22 ±11.71)°,(11.84±5.39)° respectively.Comparisons between male and female for BW and SD yielded no statistical significance (BW:(36.00±9.70)°,(38.73±13.84)°; SD:(11.88±5.56)°,(11.79±5.26)°; t=0.96 and-0.07,both P＞0.05) ; whereas the older subjects (age≥60 years) had larger BW than the others (age＜60 years ; (39.95± 12.65) °,(34.33± 10.00) ° ; t =-2.11,P＜0.05) and no statistical significance was shown for SD between the two age groups ((11.18±4.31) °,(12.54±6.33) ° ; t =1.08,P＞0.05).Of the 74 subjects,the mechanical activation started from the ventricular base to apex in 54 subjects (73％),and from apex to base in only 20 subjects (27％).High repeatability of phase analysis was observed for both intra-observer and inter-observer (r=0.867-0.906,all P＜0.001).Conclusions Good left ventricular segmental synchrony is shown in healthy subjects.No gender difference exists for ventricular synchrony assessment.Age (＜60 years) is important for better synchrony.Cedars-Sinai QGS cardiac phase analysis software is valuable in quantitative assessment of left ventricular synchrony with high repeatability.

A family-based association study of FXYD6 gene polymorphisms and schizophrenia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the association between the single nucleotide polymorphisms (SNPs) in FXYD6 gene and schizophrenia in a family-trios population.</p><p><b>METHODS</b>Six SNPs (rs10790212, rs11544201, rs555577, rs1815774, rs4938446 and rs497768) in the FXYD6 gene were genotyped by allele-specific PCR method in 101 nuclear families, and transmission disequilibrium test (TDT) was performed.</p><p><b>RESULTS</b>SNPs rs10790212 and rs11544201 showed significant association with schizophrenia (P<0.05). Furthermore, significant association of schizophrenia with the haplotype rs10790212-rs11544201 was found (P<0.05).</p><p><b>CONCLUSION</b>FXYD6 gene might play an important role in schizophrenia susceptibility and functional analysis of FXYD6 are needed.</p>