Simple Synthesis of [18F] AV-45 and its Clinical Application in the Diagnosis of Alzheimer's Disease.

OBJECTIVE: [18F] AV-45 can be produced in a simple, stable, and repeatable manner on the Tracerlab FXF-N platform using a self-editing synthetic procedure and solid-phase extraction purification method. This technique is applied to positron emission tomography (PET) imaging of Alzheimer's disease (AD) to observe its distribution and characteristics in various brain regions and its diagnostic efficiency for the disease. METHODS: The precursor was subjected to nucleophilic radiofluorination at 120°C in anhydrous dimethyl sulfoxide, followed by acid hydrolysis of the protecting groups. The neutralized reaction mixture was purified by solid phase extraction to obtain a relatively pure [18F] AV-45 product with a high specific activity. A total of 10 participants who were diagnosed with Alzheimer's disease (AD group) and 10 healthy controls (HC group) were included retrospectively. All of them underwent [18F] AV-45 brain PET/CT imaging. The distribution of [18F] AV-45 in the AD group was analyzed visually and semi-quantitatively. RESULTS: Six consecutive radiochemical syntheses were performed in this experiment. The average production time of [18F] AV-45 was 52 minutes, the radiochemical yield was 14.2 % ± 2.7% (n = 6), and the radiochemical purity was greater than 95%. When used with PET/CT imaging, the results of the visual analysis indicated increased [18F] AV-45 radioactivity uptake in the frontal, temporal, and parietal lobes in AD patients. Semiquantitative analysis showed the highest diagnostic efficacy in the posterior cingulate gyrus compared with other brain regions (P < 0.001). CONCLUSION: Intravenous [18F] AV-45 was successfully prepared on the Tracerlab FXF-N platform by solid-phase extraction of crude product and automated radiochemical synthesis. PET/CT imaging can be used to diagnose and evaluate AD patients and provide a more robust basis for clinicians to diagnose AD.

Antegrade versus Retrograde Approach for Recanalization of Ostial or Stumpless Coronary Chronic Total Occlusion.

Purpose: This research aimed to evaluate the procedural and in-hospital clinical outcomes of percutaneous coronary intervention (PCI) for ostial or stumpless chronic total occlusion (CTO) utilizing both the antegrade-only and retrograde approaches. Methods: A comprehensive retrospective examination was conducted on the procedural and in-hospital clinical outcomes of 89 consecutive patients subjected to ostial or stumpless CTO PCI at our institution between April 2015 and October 2022. Results: The antegrade-only technique demonstrated a superior technical success rate (92.0% vs 71.9%, p = 0.041) and procedural success rate (92.0% vs 68.8%, p = 0.022) in comparison to the retrograde approach (RA). The RA group presented a notably elevated Japanese-CTO (J-CTO) score relative to the antegrade-only approach group (2.45±0.73 vs 1.64±0.70, p < 0.001). The antegrade-only approach group manifested an increased frequency of microchannels at the proximal stump relative to the RA group (56.0% vs 10.9%, p < 0.001). In-hospital major adverse cardiac events (MACE) and in-hospital myocardial infarction (MI) were observed more prevalently in the RA group (18.8% vs 0, p = 0.003; 15.6% vs 0, p = 0.008; respectively). A J-CTO score below 2 and the manifestation of microchannels at the proximal stump were identified as predictors for successful antegrade-only approach PCI for ostial or stumpless CTO (OR: 2.79 [95% CI: 1.92-5.03, P =0.003]; OR: 2.89 [95% CI: 1.32-6.03, P =0.001]; respectively). Conclusion: Relative to RA PCI for ostial or stumpless CTO, the antegrade-only approach is utilized for less complex CTO lesions and is associated with a diminished probability of in-hospital MACE.

Assessing the Clinical Influence of Chronic Total Occlusions (CTOs) Revascularization and the Impact of Vascularization Completeness on Patients with Left Ventricular (LV) Systolic Dysfunction.

Objectives: This paper intends to assess the clinical influence of chronic total occlusions (CTOs), revascularization, and the impact of vascularization completeness on patients with left ventricular (LV) systolic dysfunction. Background: The roles of CTO vascularization in clinical benefits remain conflicting. In addition, data concerning the different results of CTO vascularization and vascularization completeness according to LV systole function were assessed. Methods: From an overall 918 consecutive patients with at least one CTO, 281 patients with ejection fraction (EF) ≤40% accepted coronary angiographic analysis between Jan 1, 2012, and Dec 31, 2020, and 29 patients were excluded. Subsequently, 261 patients were grouped into the successful CTO-PCI revascularization group (SCR, n = 135) and the optimal medical therapy group (OMT, n = 126). The prognosis influence of successfully finished CTO-PCI and complete revascularization on survival was evaluated. The primary endpoint was cardiac mortality, and the secondary endpoints were major adverse cardiac and cerebrovascular events (MACCE). Results: After a median follow-up time of 38.02 months, the cardiac mortality (p=0.037) and MACCE (p=0.001) were more remarkable in the OMT group than in the SCR group. Moreover, patients with CTO-PCI had survival benefits from complete revascularization for MACCE (p=0.025) and cardiac mortality (p=0.041). Based on multivariable Cox proportional hazards regression analysis, age ≧ 75 years (HR: 3.443, 95% CI 1.719-6.897, p < 0.001) predicted a worse probability of cardiac mortality. Additionally, previous PCI (HR: 1.592, 95% CI 1.034-2.449, p=0.035) and previous MI (HR: 1.971, 95% CI 1.258-3.088, p=0.003) predicted a worse probability of MACCE, and SCR (HR: 0.499, 95% CI 0.320-0.776, p=0.002) was a protection predictor of MACCE. Conclusion: In patients with LV systole dysfunction (EF ≤ 40%), successfully finished CTO-PCI is related to long-term survival benefits. The benefits were more remarkable in patients with complete coronary revascularization (CCR).

Optimization of Automatic Synthesis and Separation of [18F] AV-45 and Quality Control.

Objective: Based on the Tracerlab FXF-N platform, a synthesis program and preparative high-performance liquid chromatography (HPLC) purification program edited by us can stably and repeatedly produce [18F] AV-45 without changing the process. The [18F] AV-45 produced meets the main indexes of radiopharmaceutical intravenous preparations. Methods: The O-toluene sulfonated precursor (1 mg) was subjected to nucleophilic radiofluorination at 115°C in anhydrous dimethyl sulfoxide (DMSO), then the protective group was hydrolyzed by acid. The neutralized reaction mixture was purified through a preparative HPLC then formulated for injection using a C18 purification cartridge. This method yielded a relatively pure [18F] AV-45 product with high specific activity. Results: Four consecutive radiochemical synthesis operations were carried out in this experiment; the average production time of [18F] AV-45 preparation was 60 min, the radiochemical yield was 14.8 ± 2.1% (n = 4), the radiochemical purity was greater than 95%, and the other important quality control indexes met the requirements of radioactive drugs for intravenous administration. Conclusion: This experiment was based on the Tracerlab FXF-N platform with the synthesis program and preparative HPLC purification program edited by us. Through screening and optimization of the separation and purification system and the separation and analysis system, as well as automatic radiochemical synthesis and preparation quality control, intravenous [18F] AV-45 was successfully prepared.

Clinical study of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen in the treatment of advanced esophageal cancer.

OBJECTIVE: this study aimed to investigate the clinical efficacy and feasibility of the treatment of advanced esophageal cancer with a combination of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen. METHODS: forty-five patients with advanced esophageal cancer were enrolled and were randomly divided into two groups: a treatment group and a control group. Patients in the treatment group were treated with a 125I particle-integrated esophageal covered stent and hyperbaric oxygen, while patients in the control group were treated with a 125I particle-integrated esophageal covered stent. The clinical effects and long-term survival time of the two groups were observed. RESULTS: in the treatment group, the complete remission (CR) rate and partial remission (PR) rate of local lesions were 19.2 % and 61.5 %, respectively, and the total effective rate was 80.7 %. In the control group, the CR rate and PR rate of local lesions were 10.5 % and 52.6 %, respectively, and the total effective rate was 63.1 %. The total effective rate was higher in the treatment group than in the control group, which was statistically significant (p < 0.05). CONCLUSION: the combination of a 125I particle-integrated esophageal covered stent and hyperbaric oxygen shows a good short- and long-term efficacy in the treatment of advanced esophageal cancer.

Positron emission tomography/computed tomography dual imaging using 18-fluorine flurodeoxyglucose and 11C-labeled 2-ß-carbomethoxy-3-ß-(4-fluorophenyl) tropane for the severity assessment of Parkinson disease.

The value of dual imaging mode for the severity assessment of Parkinson disease (PD) is explored by conducting positron emission tomography computed tomography (PET/CT) double imaging using combined 18-fluorine flurodeoxyglucose (F-FDG) brain metabolism and 11C-2ß-carbomethoxy-3ß-(4-fluorophenyl) tropane (C-CFT) brain dopamine transporter (DAT).A total of 102 patients with PD and 50 healthy people in the control group are enrolled for the PET/CT dual imaging of F-FDG brain metabolism and C-CFT brain DAT. The characteristics of F-FDG PET/CT and C-CFT PET/CT imaging are analyzed by delineating the region of interest. Differences in the glucose metabolism and DAT distribution in the basal ganglia of patients with PD and healthy control group in the PET/CT imaging and the radioactive distribution characteristics of cerebral cortex in glucose metabolism imaging are compared. The characteristics of PET/CT imaging of C-CFT brain DAT in the ganglion region in absorbing C-CFT in different PD groups are analyzed.Compared with the healthy control group, changes in the cerebral glucose metabolism in the PD group mainly occur due to the increased symmetry metabolism of the nucleus of bilateral basal ganglia and the decreased metabolism of the cerebral cortex as shown in the F-FDG PET/CT images. With disease progression, the bilateral parietal, frontal, temporal, and occipital leaves showed different degrees of FDG metabolism. Statistically significant difference is observed for theC-CFT absorption among the caudate nucleus and the anterior, middle, and posterior nuclei of the bilateral basal ganglia of the PD and healthy control groups. In the PD group, the bilateral caudate nucleus and the anterior, middle, and posterior parts of the putamen show decreased DAT distribution. Regardless of unilateral or bilateral symptoms, the DAT distribution in the nucleus of the contralateral basal ganglia and in the posterior part of the nucleus is substantially reduced.PET/CT dual imaging by F-FDG PET/CT combined with C-CFT PET/CT features high application value for the severity assessment of PD.

Biological characteristics of 18F-FDG PET/CT imaging of cerebral alveolar echinococcosis.

This study aims to analyze the characteristics of F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) for cerebral alveolar echinococcosis (CAE).Twenty-five CAE patients underwent F-FDG PET/CT, and the diagnosis was confirmed by clinical and surgical pathology. The F-FDG PET/CT results were subject to visual and semiquantitative analysis, and the difference in F-FDG SUVmax for lesions among the 3 types of CAE was evaluated.In the 25 CAE patients, 62 lesions were detected by F-FDG PET/CT, and these lesions were classified into 3 types, according to the characteristics of the lesion's uptake of F-FDG on PET images: type I, 17 lesions, FDG was concentrated into a mass radioactive distribution in the CAE foci; type II, 28 lesions, FDG presented a annular concentrated radioactive distribution around the CAE foci; type III, 17 lesions, FDG in the CAE foci presented a radioactive distribution with defects and sparse areas. The difference in F-FDG SUVmax between type I and type II CAE was not statistically significant (P > .05), the difference in F-FDG SUVmax between type I and type III CAE was statistically significant (P < .001), and the difference in F-FDG SUVmax between type II and type III CAE was statistically significant (P < .001);The F-FDG PET manifestations of CAE are classified into 3 types. Both type I and type II may have invasive activity, while the lesions of type III CAE show that the focus is relatively stable or at a stationary phase. If there are no definite alveolar echinococcus focus in other sites, these patients can temporarily delay the treatment. It is recommended that the patient should undergo whole body PET/CT once a year to dynamically observe the bioactivity and size of type III CAE lesions and assess the presence of new echinococcus lesions in the rest of the body.

Analysis of curative effect of I125 implantation combined with radiofrequency ablation in treating bone metastases.

The aims of this study were to investigate the clinical effects of I125 implantation combined with radiofrequency ablation in treating bone metastases (BM) and analyze its clinical application so as to provide better treatment protocols for the treatment of BM. A total of 63 BM patients were randomly divided into the I125 implantation group (CON, treated with I125 seeds alone, 33 patients) and the combination group (I125-MA, 30 patients) to compare the clinical efficacy and adverse effects. After treatment, the clinical efficacy of Group I125-MA was significantly better than Group CON, and the quality of life was improved significantly (P< 0.05). I125-MA has relatively better clinical efficacy in treating BM, which can not only significantly improve patients' life quality but also cause no serious adverse reaction. The therapy of I125 implantation combined with radiofrequency ablation provides a new idea for treating bone metastases. Compare Group I125-MA and Group CON, remission rates of bone pain were 76.7% vs 42.4% (P< 0.05); movement ability: 73.3% vs 39.4% (P< 0.05); quality of life: improvement rates: 70% vs 42.4% (P< 0.05), the median initial time of relieve pain: 3.5 days vs 7.6 days (P< 0.05).

First detection of equatorial dark dust lane in a protostellar disk at submillimeter wavelength.

In the earliest (so-called "Class 0") phase of Sun-like (low-mass) star formation, circumstellar disks are expected to form, feeding the protostars. However, these disks are difficult to resolve spatially because of their small sizes. Moreover, there are theoretical difficulties in producing these disks in the earliest phase because of the retarding effects of magnetic fields on the rotating, collapsing material (so-called "magnetic braking"). With the Atacama Large Millimeter/submillimeter Array (ALMA), it becomes possible to uncover these disks and study them in detail. HH 212 is a very young protostellar system. With ALMA, we not only detect but also spatially resolve its disk in dust emission at submillimeter wavelength. The disk is nearly edge-on and has a radius of ~60 astronomical unit. It shows a prominent equatorial dark lane sandwiched between two brighter features due to relatively low temperature and high optical depth near the disk midplane. For the first time, this dark lane is seen at submillimeter wavelength, producing a "hamburger"-shaped appearance that is reminiscent of the scattered-light image of an edge-on disk in optical and near infrared light. Our observations open up an exciting possibility of directly detecting and characterizing small disks around the youngest protostars through high-resolution imaging with ALMA, which provides strong constraints on theories of disk formation.

Analysis of the clinical value of 18F-FDG PET/CT in hepatic alveolar echinococcosis before and after autologous liver transplantation.

The aim of this study was to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in advanced liver alveolar echinococcosis (LAE) prior to and following autologous liver transplantation (ALT). The biodistribution of lesions in 8 patients was recorded using 18F-FDG PET/CT prior to and following surgery. The maximum standardized uptake value (SUVmax) of the lesions was also measured and compared with the pathological results. The overall hepatic peri-lesion SUVmax of the patients was 3.57±1.21, and the delayed SUVmax was 4.19±1.70. The diagnostic sensitivity of 18F-FDG PET/CT in LAE was 91.67%, with a specificity of 60.00% and accuracy of 82.35%. The positive predictive value was 84.62%, and the negative predictive value was 75.00%. SUVmax values of the surviving liver were 1.23±0.78 after 1 month, 1.15±0.67 after 3 months and 0.85±0.35 after 6 months. Compared with normal liver values (0.95±0.19), the 1-month SUVmax was significantly different. The SUVmax in 3 patients with high-lividity lesions was 2.05±0.72, and the delayed SUVmax was 3.15±0.83; 3 months after transplantation, the SUVmax was 1.85±0.62, and the delayed SUVmax was 2.95±0.79, revealing no significant difference. In conclusion, 18F-FDG PET/CT is effective for determining the biological boundary of LAE and shows important clinical value in determining the metabolic activities of the surviving liver following ALT.

Self-similar fragmentation regulated by magnetic fields in a region forming massive stars.

Most molecular clouds are filamentary or elongated. For those forming low-mass stars (<8 solar masses), the competition between self-gravity and turbulent pressure along the dynamically dominant intercloud magnetic field (10 to 100 parsecs) shapes the clouds to be elongated either perpendicularly or parallel to the fields. A recent study also suggested that on the scales of 0.1 to 0.01 parsecs, such fields are dynamically important within cloud cores forming massive stars (>8 solar masses). But whether the core field morphologies are inherited from the intercloud medium or governed by cloud turbulence is unknown, as is the effect of magnetic fields on cloud fragmentation at scales of 10 to 0.1 parsecs. Here we report magnetic-field maps inferred from polarimetric observations of NGC 6334, a region forming massive stars, on the 100 to 0.01 parsec scale. NGC 6334 hosts young star-forming sites where fields are not severely affected by stellar feedback, and their directions do not change much over the entire scale range. This means that the fields are dynamically important. The ordered fields lead to a self-similar gas fragmentation: at all scales, there exist elongated gas structures nearly perpendicular to the fields. Many gas elongations have density peaks near the ends, which symmetrically pinch the fields. The field strength is proportional to the 0.4th power of the density, which is an indication of anisotropic gas contractions along the field. We conclude that magnetic fields have a crucial role in the fragmentation of NGC 6334.

Effects of temperature and wavelength choice on in-situ dissolution test of Cimetidine tablets.

The effects of temperature and wavelength choice on in-situ dissolution test instrument of Cimetidine were studied. Absorbance (A)<1.0 is required when using a fiber-optic dissolution test system. The detection wavelength of λmax (218 nm) was replaced by 244 nm to carry out this test. The absorbance of Cimetidine solution at different temperature showed an obvious change. Calibration of Cimetidine solution should be tested at the same temperature (37° C) with the test solution. A suitable wavelength with smaller tangent slope could be chosen for in-situ dissolution test of Cimetidine tablets.

Magnetic fields in the formation of massive stars.

Massive stars play a crucial role in the production of heavy elements and in the evolution of the interstellar medium, yet how they form is still a matter of debate. We report high-angular-resolution submillimeter observations toward the massive hot molecular core (HMC) in the high-mass star-forming region G31.41+0.31. We find that the evolution of the gravitational collapse of the HMC is controlled by the magnetic field. The HMC is simultaneously contracting and rotating, and the magnetic field lines threading the HMC are deformed along its major axis, acquiring an hourglass shape. The magnetic energy dominates over the centrifugal and turbulence energies, and there is evidence of magnetic braking in the contracting core.

The critical role of disks in the formation of high-mass stars.

Although massive stars (commonly defined as those in excess of about eight solar masses, or with initial luminosities of a thousand times the solar luminosity or more) have an enormous impact on the galactic environment, how they form has been a mystery. The solution probably involves the existence of accretion disks. Rotational motions have been found in the gas surrounding young high-mass stars, which suggests that non-spherical accretion could be the fundamental ingredient of the massive-star formation recipe.

A disk of dust and molecular gas around a high-mass protostar.

The processes leading to the birth of low-mass stars such as our Sun have been well studied, but the formation of high-mass (over eight times the Sun's mass, M(o)) stars remains poorly understood. Recent studies suggest that high-mass stars may form through accretion of material from a circumstellar disk, in essentially the same way as low-mass stars form, rather than through the merging of several low-mass stars. There is as yet, however, no conclusive evidence. Here we report the presence of a flattened disk-like structure around a massive 15M(o) protostar in the Cepheus A region, based on observations of continuum emission from the dust and line emission from the molecular gas. The disk has a radius of about 330 astronomical units (Au) and a mass of 1 to 8 M(o). It is oriented perpendicular to, and spatially coincident with, the central embedded powerful bipolar radio jet, just as is the case with low-mass stars, from which we conclude that high-mass stars can form through accretion.