68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy.

To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.

Biphasic GA 68-labeled prostate specific membrane antigen-11 positron emission tomography/computed tomography scans in the differential diagnosis and risk stratification of initial primary prostate cancer.

BACKGROUND: This study aimed to assess the value of biphasic GA 68-labeled prostate-specific membrane antigen-11 (68Ga-PSMA-11) positron emission tomography/computed tomography (PET/CT) scan in the differential diagnosis and risk stratification of initial primary prostate cancer (PCa). METHODS: A total of 51 patients with PCa (8 low- and intermediate-risk PCa patients and 43 high-risk PCa patients) and 36 patients with benign prostate lesions, who underwent standard whole-body imaging and delayed pelvic imaging of 68Ga-PSMA-11 PET/CT, were enrolled in this prospective study. The PET parameters, such as maximum and mean standard uptake value (SUVmax and SUVmean), and maximum and mean standard retention index of PET images were calculated and compared in different prostate lesions. The diagnostic performances of the PET parameters were evaluated by receiver operating characteristic (ROC) curves. RESULTS: All the PET parameters of PCa participants were significantly higher than those of participants with benign prostate lesions (P<0.001). The SUVmean of delayed imaging had the best performance in the diagnosis of PCa with an area under the curve (AUC) of 0.918 (95% CI: 0.858 to 0.977), the sensitivity of 90.0%, and specificity of 83.3%. The SUVmax and SUVmean of high-risk PCa participants were significantly higher than those of low- and intermediate-risk PCa participants (P<0.005). The SUVmax of standard imaging had the best performance in predicting high-risk PCa with an AUC of 0.890 (95% CI: 0.799 to 0.980), a sensitivity of 76.7%, and a specificity of 100.0%. CONCLUSIONS: The biphasic 68Ga-PSMA-11 PET/CT scan had good performance in discriminating prostate cancer from benign prostate diseases. The SUVmean of the prostate lesion at delayed imaging of 68Ga-PSMA-11 PET/CT had the best value in the differential diagnosis of PCa, and the SUVmax at standard imaging was most valuable in predicting the risk stratification of PCa.

Semi-automatic evaluation of baseline whole-body tumor burden as an imaging biomarker of 68Ga-PSMA-11 PET/CT in newly diagnosed prostate cancer.

OBJECTIVES: The prognostic value of baseline tumor burden of prostate cancer was rarely studied. We aimed to evaluate the whole-body tumor burden of 68Ga- prostate specific membrane antigen-HBED-CC (68Ga-PSMA-11) PET/CT in newly diagnosed prostate cancer semi-automatically, and explore its preliminary application in predicting prognosis. METHODS: Similar to metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of 18F-FDG PET/CT, 68Ga-PSMA-11 PET/CT tumor burden parameters including whole-body PSMA tumor volume (wbPSMA-TV) and whole-body total lesions PSMA uptake (wbTL-PSMA) were acquired semi-automatically. The intra-observer and inter-observer reliability was analyzed. The relationship between tumor burden and prostate-specific antigen (PSA) value or Gleason score was investigated. The preliminary application of tumor burden in predicting progression-free survival (PFS) was explored. RESULTS: Fifty-nine newly diagnosed prostate cancer patients were retrospectively analyzed. Semi-automatic quantification of whole-body tumor burden had excellent intra-observer and inter-observer consistency [all intra-class correlation coefficient (ICC) > 0.990]. wbPSMA-TV and wbTL-PSMA were 32.6 (range 1.0-3968.2) cm3 and 161.9 (range 6.0-24971.7), respectively. wbPSMA-TV and wbTL-PSMA correlated with PSA (r = 0.858, p < 0.001; r = 0.879, p < 0.001) and Gleason score (r = 0.793, p < 0.001; r = 0.805, p < 0.001) significantly. In univariate analysis, wbPSMA-TV, wbTL-PSMA, SUVmax, SUVpeak, SUVmean, PSMA-TV, TL-PSMA of primary tumor, fPSA and Gleason score were independent significant predictors of PFS (all p < 0.05). Moreover, in multivariate analysis, wbTL-PSMA [hazard ratio (HR): 1.001, p = 0.014] and Gleason score (HR: 5.124, p = 0.031) can significantly predict progression-free prognosis. CONCLUSIONS: As imaging biomarkers, wbPSMA-TV and wbTL-PSMA correlated with clinical characteristics significantly. High wbTL-PSMA or Gleason score was associated with shorter PFS of newly diagnosed prostate cancer independently.

[The rate of morphologically normal sperm does not affect the clinical outcomes of conventional IVF in patients with one retrieved oocyte].

OBJECTIVE: To investigate the influence of the rate of morphologically normal sperm (MNS) on the clinical outcomes of conventional in vitro fertilization (IVF) in patients with one retrieved oocyte. METHODS: From January 2013 to January 2015, a total of 256 couples with one retrieved oocyte underwent conventional IVF in our center. According to the rate of MNS, the patients were divided into two groups: MNS < 4% (134 cycles) and MNS ≥ 4% (122 cycles). We compared the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo between the two groups. A total of 75 fresh embryo transfer cycles were performed, 43 in the MNS < 4% group and the other 32 in the MNS ≥ 4% group. We also compared the rates of implantation, clinical pregnancy and abortion between the two groups. RESULTS: There were no statistically significant differences between the two groups in the rates of no transferrable embryo cycles, fertilization, cleavage, normal fertilization, abnormal fertilization, high-quality embryo and transferrable embryo (P > 0.05). The rates of implantation, clinical pregnancy and abortion exhibited no remarkable differences either in the fresh embryo transfer cycles between the two groups (P > 0.05). CONCLUSION: The rate of MNS does not affect the clinical outcomes of conventional IVF in patients with one retrieved oocyte.

[Association of fertilization strategy and embryo transfer time with the incidence of ectopic pregnancy].

OBJECTIVE: To investigate the correlation of the fertilization strategy and embryo transfer (ET) time with the incidence of ectopic pregnancy. METHODS: We selected 3,331 fresh and 2,706 frozen-thawed ET cycles for the patients undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The fresh transfers included 2 546 IVF-ET and 785 ICSI-ET cycles and 2,220 day-3 embryo and 1,111 day-5 blastocyst transfers, while the frozen-thawed transfers included 2,080 IVF-ET and 626 ICSI-ET cycles and 741 day-3 embryo and 1 965 day-5 or -6 blastocyst transfers. We compared the incidence rate of ectopic pregnancy associated with different fertilization strategies and ET time. RESULTS: The incidence rate of ectopic pregnancy was 1. 41% (36/2 546) in the IVF-ET cycles and 3.44% (27/785) in the ICSI-ET cycles of the fresh transfers, significantly lower in the IVF-ET than in the ICSI-ET cycles (P < 0.01), and it was 1.01% (21/2,080) in the IVF-ET cycles and 0.80% (5/626) in the ICSI-ET cycles of the frozen-thawed transfers, with no remarkable difference between the two groups (P > 0.05). The IVF-ET and ICSI-ET cycles included 2,220 fresh day-3 (F-D3) embryos, 1,111 F-D5 blastocysts, 741 frozen-thawed day-3 (T-D3) embryos, and 1,965 T-D5/6 blastocysts. The incidence rate of ectopic pregnancy was 1.71% (n = 38) in the F-D3, 2.25% (n = 25) in the F-D5, 1.35% (n = 10) in the T-D3, and 0.81% (n = 16) in the T-D5/6 group, respectively, significantly lower in the T-D5/6 than in the other three groups (P < 0.05). CONCLUSION: The incidence rate of ectopic pregnancy is associated with fertilization strategies, which is significantly lower in frozen-thawed than in fresh embryo transfers.

[Intracytoplasmic sperm injection does not improve the clinical outcomes of the males with 100% teratozoospermia].

OBJECTIVE: To investigate whether intracytoplasmic sperm injection (ICSI) can improve the clinical outcomes of the male patients with 100% teratozoospermia. METHODS: We retrospectively analyzed the clinical data of 152 couples undergoing in vitro fertilization-embryo transfer (IVF-ET), including 75 cycles of IVF and 77 cycles of ICSI. We compared the rates of normal fertilization, high-quality embryos, transferrable embryos, implantation, clinical pregnancy, and abortion between the two groups. RESULTS: In the 100% teratozoospermia patients the number of transferrable embryos was significantly lower in the IVF than in the ICSI group (78.91% vs 84.92%, P < 0.05), while the rates of normal fertilization and implantation were higher in the former than in the latter (60.26% vs 57.87% and 48.00% vs 39.55%, both P > 0.05). There were no statistically significant differences between the two groups in the female age, Gn days, Gn dose, BMI, infertility duration, endometrial thickness, and basal serum FSH and E2. CONCLUSION: ICSI cannot improve the clinical outcomes of the male patients with 100% teratozoospermia.

Relationship between Resting Heart Rate and Coronary Syndrome / 中国康复理论与实践

@#Objective To investigate the relationship between resting heart rate (RHR) and coronary heart disease (CHD) and to explore the value of RHR in predicting the occurrence of acute coronary syndrome. Methods 445 patients with CHD were divided into stable angina group and acute coronary syndrome group. RHR, risk factors for coronary heart disease and their correlation were analyzed. Results RHR was higher in the acute coronary syndrome group than in the stable angina group (P<0.01). Logistic regression analysis showed that RHR (OR =1.052, 95% CI: 1.009~1.097, P=0.017), systolic blood pressure (OR=1.027, 95% CI: 1.003~1.053, P=0.031) and hyperglycemia (OR=2.743, 95% CI: 1.207~6.233, P=0.016) were independent risk factors for acute coronary syndrome. Conclusion RHR is an independent risk factor for incidence of acute coronary syndrome.

Effect of UbcHlO gene silencing on cell proliferation and cell cycle of lung cancer cell line NCI-H226 / 第二军医大学学报

Objective To use liposomal siRNA for silencing UbcHlO gene in human lung squamous carcinoma cell line NCI-H226 and to observe the changes of cell proliferation and cell cycle after silencing. Methods Three siRNA sequences targeting different sites of UbcHlO CDS were designed, and the shRNA recombinant plasmids were constructed. The recombinant plasmids were transfected into NCI-H226 cells via lipofectamine2000. UbcHlO mRNA and protein expression was examined by RT-PCR and Western blotting analysis 48 h after transfection, respectively. The viability of NCI-H226 cells was measured using CCK-8 at 24 and 48 h after transfection with the effective siRNA vector, and the cell cycle was detected by flow cytometry 48 h after transfection. Results The recombinant shRNA plasmids were successfully constructed and transfected into NCI-H226 cells. UbcHlO gene mRNA and protein were noticeably decreased in the three groups 48 h after transfection, with the inhibitory effect of No. 2 siRNA sequence (pshRNA2) being the strongest one (86%). The proliferative activity of NCI-H226 cells was significantly decreased 24 and 48 h after the transfection with the pshRNA2 compared with the control group (P<0. 05). Compared with the control group, NCI-H226 cells were blocked in G2 phase 48 h after the transfection with pshRNA2 (P<0. 05). Conclusion UbcHlO gene silencing can significantly inhibit the proliferative activity of NCI-H226 cells and block the cells in G2 phase.

Effect of continuous positive airway pressure on myocardial structure and plasma NO and ET in mini pigs with obstructive sleep apnea syndrome / 第二军医大学学报

Objective: To investigate the effect of continuous positive airway pressure (CPAP) on serum NO and plasma ET and myocardial structure in mini pigs with obstructive sleep apnea syndrome (OSAS). Methods: Twenty-four male mini pigs were evenly randomized into 4 groups: normal control group (group A), OSAS model group (group B), CPAP treated group (group C) and positive control group (group D). Animals in group A were not treated and those in the other 3 groups were treated with intermittent hypobaric hypoxia 6 h daily for 22 d. Animals in groups C was also given further CPAP treatment 6 h daily for 30 d. The animals in group D were raised for 30 d and were sacrificed together with those in group C; the animals in group A and group B were sacrificed simultaneously. Sleep monitoring and determination of serum NO and plasma ET were performed before execution and pathological examination of myocardial structure after execution. Results: The apnea-hypopnea index (AHI) of group C was significantly lower than those of group B and D and higher than that of group A (P<0.05); the SpO 2 of group C was significantly higher than those of group B and D (P<0.05), and was similar to that of group A. The levels of NO in group A, B, C, and D were (0.221±0.062), (0.115±0.061), (0.110±0.033), (0.077±0.043) μmol/L, respectively, and the levels of ET were (40.2±4.8), (99.8±22.4), (67.1±18.5), and (103.7±30.1) pg/ml, respectively. Group C had significantly higher NO level and lower ET level compared with group D (P<0.05). The ET level in group C was significantly lower than that in group B (P<0.05). Pathological examination showed that the myocardial structure in group B, C, and D all had hypoxia and ischemia damage compared with group A; the damage in group C was slighter than that in group B and D, but severer than that in group A. Conclusion: Thirty day-treatment with CPAP can improve the sleeping indices, plasma ET and serum NO level, and myocardial structure of OSAS mini pigs.

Analysis of TGFBI gene mutation in a Chinese family with atypical Reis-Buckler corneal dystrophy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the TGFBI gene mutation and the relationship between genotype and phenotype of a Chinese family with atypical Reis-Buckler corneal dystrophy (RBCD).</p><p><b>METHODS</b>Four patients, two non-carrier relatives of the family were enrolled in the present study. In addition to ophthalmologic examinations, PCR amplification and DNA sequencing of exons 4, 11, 12, and 14 of the TGFBI gene were carried out. Exon 14 was also sequenced in 100 healthy controls.</p><p><b>RESULTS</b>A G to A transition at codon 623 in all affected members was identified. This mutation resulted in a substitution of glycine (GGC) to aspartic acid (GAC) at the protein level.None of the healthy family members, or any of the 100 control subjects carried this mutation.</p><p><b>CONCLUSION</b>The G623D mutation of the TGFBI gene caused an atypical Reis-Buckler corneal dystrophy in this family. This mutation is reported in Chinese for the first time.</p>

Anxiety and Related Factors of Elderly Outpatients / 中国康复理论与实践

@#ObjectiveTo investigate the anxiety and its interrelated factors of elderly outpatients. MethodsZung self-rating anxiety scale was used to evaluate 971 elderly outpatients, the scores between different sex, age, degree of education, etc. were compared. ResultsThe scores may become significantly different with the patients' sex, age, degree of education, satisfaction in regards to medical service and recognition of the disease(P<0.05).ConclusionFactors such as sex, age, degree of education, satisfaction of medical service, etc, deeply affect the anxiety in elderly outpatients.

Review of Advances in Imaging Evaluation of Liver Fibrosis / 中国普外基础与临床杂志

Objective To review the study of noninvasive imaging methods for evaluating liver fibrosis.Meth- ods The current literatures on the use of the ultrasonography,CT and MRI for the evaluation of liver fibrosis were reviewed.The principles,applications and advancement of each imaging methods were described and summarized re- spectively.The features of the newly developed imaging techniques were also discussed.Results In addition to the morphologic information,the imaging examinations can also provide functional information about the circulation sta- tus,diffusion and metabolism features of liver.The potential diagnostic value of MR elastography for liver fibrosis has been addressed.Conclusion The imaging examinations,especially the functional MRI techniques,are reliable noninvasive alternatives for the evaluation of hepatic fibrosis,with bright potentiality for clinical application.