Table of Content

21 February 2021, Volume 42 Issue 1

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Basic and Clinical Research in Nuclear Medicine

Characteristics of myocardial metabolism on PET/CT in patients with newly diagnosed lung adenocarcinoma and factors associated with high left ventricular metabolism

Wang Li, Wu Jiaoyan, Yang Minfu

2021, 42(1):  1-7.  doi:10.3969/j.issn.1006-7795.2021.01.001

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Objective To explore whether myocardial glucose metabolism is altered and its related factors in newly diagnosed patients with lung adenocarcinoma (LAD) who underwent fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT). Methods From our ¹⁸F-FDG PET/CT imaging database, 182 patients with newly diagnosed LAD and 45 non-oncologic subjects with matched age and sex were retrospectively analyzed. The uptake of ¹⁸F-FDG in left ventricular (LV) myocardium, arterial wall, epicardial adipose tissue (EAT), spleen, and bone marrow were compared between the two groups. Multiple Logistic regression analysis was used to identify significant factors related with the high uptake of ¹⁸F-FDG in left ventricle of LAD. Results LAD patients had higher uptake of ¹⁸F-FDG in left ventricle than that of non-oncologic patients (P=0.05), whereas no significant difference of ¹⁸F-FDG uptake was found in the arterial wall, EAT, spleen, or bone marrow between the two groups. The activity of EAT was independently related to the high LV ¹⁸F-FDG uptake in LAD before antineoplastic therapy. Conclusion Myocardial glucose metabolism was increased in patients with LAD before antineoplastic therapy. The activity of EAT was an independent factor for prediction of the high LV ¹⁸F-FDG uptake in LAD.

The value of ¹²³I-MIBG SPECT/CT tomography imaging in Curie score of pediatric neuroblastoma

Wang Wei, Lu Xia, Liu Jun, Kan Ying, Liu Jie, Yang Jigang

2021, 42(1):  8-14.  doi:10.3969/j.issn.1006-7795.2021.01.002

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Objective To explore the value of ¹²³I-metaiodobenzylguanidine(¹²³I-MIBG ) plane imaging and single-photon emission computed tomography (SPECT)/ computed tomography (CT) in Curie score of pediatric neuroblastoma. Methods Retrospective analysis of ¹²³I-MIBG plane imaging and SPECT/CT tomography images of 211 pediatric neuroblastoma patients was performed. All patients were ranked into high-risk patients with stage 3 or 4. All scores of ¹²³I-MIBG SPECT/CT planar and tomography imaging were collected. Pathological results, other related imaging examinations and clinical follow-up results were used as gold standard of diagnosis. The differences between two imaging methods were compared, and also the diagnostic accuracy and consistency of two imaging methods were compared with gold standard of diagnosis. Results Based on planar imaging and SPECT/CT tomography, 48.82% (103/211) patients had same Curie scores while 51.18% (108/211) patients had different scores. Curie score of planar imaging and tomography were 0 (0,1) and 0 (0,2), respectively, with significant difference (Z=-3.46, P<0.001). According to the results of Curie score, patients were divided into high score group (≥2) and low score group (<2). There was significant difference between two imaging methods in grouping (P=0.001). The diagnostic accuracy rates of planar imaging and tomographic imaging were 51.66% and 93.84%, respectively, with significant difference (P＜0.001). The diagnostic consistency of two imaging with the gold standard of diagnosis was 0.44(0.34-0.54) and 0.90 (0.85-0.96) respectively. Compared with planar imaging, tomography imaging showed excellent consistency with gold standard of diagnosis. Conclusion Compared with planar imaging, tomography imaging had better diagnostic accuracy and consistency. The Curie score based on ¹²³I-MIBG SPECT/CT tomography imaging had an important significance for semi-quantitative evaluation of pediatric neuroblastoma.

Research on glycine cell uptake mechanisms

Li Zhu, Li Nan, Liu Zhibo, Yang Zhi

2021, 42(1):  15-20.  doi:10.3969/j.issn.1006-7795.2021.01.003

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Objective To study the quantitative relationship between the uptake of ¹⁸F-BF₃-Phe and the expression of large-neutral amino acid transporter-1(LAT-1), and to elucidate the uptake mechanism of ¹⁸F-BF₃-Phe in cancer cells. Methods ¹⁸F-BF₃-Phe uptake experiments was performed with different levels of LAT-1 transfected cells. The ¹⁸F-BF₃-Phe uptake by PC9, BXPC3, PC3, HEPG2 cells was assayed at different time points. Results The uptake of ¹⁸F-BF₃-Phe in LAT-1 transfected cells was linearly correlated with the increase in the proportion of LAT-1 transfection. The uptake of ¹⁸F-BF₃-Phe in PC9, BXPC3, PC3, and HepG2 tumor cells showed an increasing trend over time. The uptake of ¹⁸F-BF₃-Phe by PC9 and BXPC3 cells was significantly higher than the other two cell lines. Conclusion The uptake of ¹⁸F-BF₃-Phe by LAT-1 transfected cells was positively correlated with the expression of LAT-1 transporter, which provided an important theoretical basis for further in vivo experiments. ¹⁸F-BF₃-Phe was highly uptaken by a variety of tumor cells, showing potential in clinical translation of this probe in tumor imaging.

Correlation between metabolic characteristics of ocular adnexal lymphoma manifested by ¹⁸F-FDG PET/CT and its clinical stage

Wang Guanyun, Yang Hui, Chen Jiaxin, Xiao Wentian, Li Can, Yao Shulin, Wang Ruimin, Xu Baixuan

2021, 42(1):  21-25.  doi:10.3969/j.issn.1006-7795.2021.01.004

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Objective To analyze the relationship between the metabolic parameters of ocular adnexal lymphoma (OAL) by ¹⁸F-fluorodeoxyglucose(¹⁸F-FDG) positron emission tomography/computed tomography(PET/CT) and its clinical stage, and compare the differences of metabolic parameters between different pathological types of OAL.Methods A total of 37 patients who underwent ¹⁸F-FDG PET/CT in the Department of Nuclear Medicine of the First Medical Center of PLA General Hospital from April 2012 to April 2020 and was diagnosed as OAL by pathology were enrolled. The maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis lesion (TLG) were retrospectively analyzed, respectively. Ann Arbor classification was based on PET/CT results and clinical data. The patients were grouped according to main pathological types, and the differences in the metabolic parameters between the groups were compared to each other to explore the correlations between the metabolic parameters and different stages. Results The pathological classification was mainly B-cell lymphoma in the extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT, n=13), diffuse large B-cell lymphoma (DLBCL, n=12) and extranodal natural killer/T-cell lymphoma, nasal type (ENK-TCL, n=7). By comparing the metabolic parameters of the above three groups, the differences of metabolic parameters between DLBCL, ENK-TCL and MALT were statistically significant (P<0.01). In all 37 patients, there were significant differences in SUVmax and TLG among different stages (P<0.05), and the metabolic parameters were positively correlated with disease stages, and the correlation between TLG and MTV were stronger than that between SUVmax and SUVmean. Conclusion The metabolic parameters manifested by ¹⁸F-FDG PET/CT were correlated with clinical stage, especially TLG and MTV.

Diagnostic value of ischemia severity at myocardial perfusion imaging in elderly persons with suspected coronary disease

Gu Shanshan, Lu Jie, Chen Gang

2021, 42(1):  26-30.  doi:10.3969/j.issn.1006-7795.2021.01.005

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Objective To evaluate the value of different thresholds of myocardial perfusion and ischemia scores obtained from myocardial perfusion imaging (MPI) in diagnosing in elderly persons with suspected coronary artery disease. Methods A total of 99 patients [mean age (67.24±5.18) years, 53 male and 46 female] who underwent two-day rest-stress MPI in Department of Nuclear Medicine, Civil Aviation General Hospital from August 2017 to June 2020 were enrolled, and the data were analyzed retrospectively. According to coronary angiography (CAG) results, the patients undergoing CAG within 6 months were divided into coronary artery disease (CAD) group(patients group, 52 cases) and non-CAD group (control group, 47 cases). The general clinical information, summed rest score (SRS), summed stress score (SSS) and summed difference score (SDS) were collected. t test and χ² test were used to compare the data between the different groups. Multivariate Logistic regressions were used to establish the independent diagnostic value and accuracy of MPI parameters. Results In multivariate analysis accounting for clinical variables associated with CAD, both SSS (7.425, 95%CI: 2.873-19.192, P＜0.001) and SDS (8.020, 95%CI: 2.980-21.984, P＜0.001) were independently related with CAD. The consistency of SSS＞3 in the diagnosis of CAD is better than the different threshold of myocardial perfusion combined with ischemia. Conclusion The myocardial perfusion and ischemia scores from MPI are independent risk factors for predicting CAD in the elderly persons, but SSS combined with different SDS thresholds could not improve the diagnostic efficiency of elderly persons with suspected coronary disease.

Research progresses in evaluating the stability of carotid atherosclerotic plaque with positron emission tomography/computed tomography

Zhang Yue, Lu Jie

2021, 42(1):  31-36.  doi:10.3969/j.issn.1006-7795.2021.01.006

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Rupture of carotid atherosclerotic plaque is the primary cause of cerebral infarction. It is a cutting edge in atherosclerosis to investigate the pathophysiological mechanism of vulnerable plaque progression for early detection. Recent studies have revealed that inflammation may cause the occurrence, development, and rupture of atherosclerotic plaque, however, its physiological mechanism and relationship with the outcome of atherosclerotic plaque are poorly understood. High-resolution magnetic resonance imaging(HR-MRI)and positron emission tomography(PET)are the non-invasive imaging technology and increasingly applied to evaluate atherosclerotic plaque. As HR-MRI is used for imaging morphology of carotid plaque with high spatial resolution, PET can be used for quantitative imaging macrophages metabolism of response to inflammation with high sensitivity and specificity. In this work, we reviewed the research progresses in the evaluation of carotid atherosclerotic plaque stability with HR-MRI, PET and simultaneous PET/MR imaging to reveal the physiological mechanism of inflammation and plaque stability and provide early imaging warning of vulnerable plaques, and develop more effective treatment strategies. It may play an important role in effectively preventing the occurrence of cerebral infarction.

Basic Research

Morphological study on different animal models of titanium particles inducing osteolysis

Zhang Chen, Liu Zige, Song Guorui, Li Yan, Chen Desheng, Cheng Mengqi

2021, 42(1):  37-42.  doi:10.3969/j.issn.1006-7795.2021.01.007

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Objective To establish three different osteolysis models induced by titanium particles, and to compare their morphological differences, inflammatory level, osteolysis and osteoclast count, so as to provide a better basis for the selection of osteolysis animal models. Methods Forty five female BALB/c mice were divided into three groups randomly: Titanium particles stimulate the skull osteolysis model (group A), titanium particles stimulate the balloon model group (group B) and titanium particles stimulate the balloon bone graft model group (group C).Morphologically observe three groups of models by gross observation and histopathology. The transmission electron microscope was used to observe and compare the osteolytic area of the group A and group B, and the ultrastructure of soft tissue changes in the group C. The similarities between them and the pathophysiological changes of human specimens were discussed. Results In general, there was infiltration of titanium particles on the surface of skull in group A, and the surface of bone was not smooth; there was infiltration of titanium particles, thickening of the wall of airbag, and inflammatory edema in the group B; there were infiltration of inflammatory cells between the skull block and the surrounding airbag tissue, wrapped by titanium particles, and the inflammatory reaction was obvious in group C. HE staining results: there were some inflammatory reactions around the titanium particles on the skull surface, and the bone surface was not smooth in group A; there were many kinds of inflammatory cells infiltrated in the cyst wall, and titanium particles could gather in group B; there were inflammatory cells infiltrated around the titanium particles, and osteolysis on the bone surface was seen in group C. By transmission electron microscope: titanium particles were found in the cytoplasm of osteoclasts in group A, and some lamellar osteolysis was found under the titanium particles; titanium particles were infiltrated in the cytoplasm of cells in group B, matrix tissue was scattered around the cells, and the water content in the matrix tissue was reduced; osteoclast precursor cells were proliferative and active around the bone tissue in group C, loss of bone surface. Conclusion Three kinds of animal models of osteolysis stimulated by titanium particles have different morphological manifestations, which can provide an effective experimental platform for the basic research of osteolysis around prosthesis.

A network pharmacology approach to uncover the molecular mechanisms of Houshiheisan for treatment of ischemic stroke

Wang Xuan, Ma Chongyang, Zhang Yawen, Cheng Hongfa, Zhang Qiuxia

2021, 42(1):  43-52.  doi:10.3969/j.issn.1006-7795.2021.01.008

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Objective To analyze the core components and possible molecular mechanisms of Houshiheisan in the treatment of cerebral ischemia by network pharmacological method. Methods Through active components screening, components targets and disease targets prediction of Houshiheisan, the “component-target” network was established and analyzed to obtain the effective components and targets. Protein-protein interaction(PPI) network was constructed for Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis to identify potential signal pathways. Results Five effective components of Houshiheisan against cerebral ischemia, including β-Sitosterol, cryptopine, fumarine, stigmasterol, and (2R)-7-hydroxy-5-methoxy-2-phenylchroman-4-one, and 22 important anti-cerebral ischemia targets, including estrogen receptor(ESR1), androgen receptor(AR), prostaglandin G/H synthase 2(PTGS2), prothrombin(F2), nitric oxide synthase, endothelial(NOS3), etc. were found. Based on the PPI results, pharmacological targets of Houshiheisan treating cerebral ischemia might have a close relationship with the fluid shear stress pathway, advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) pathway, and hypoxia inducible factor1-α/vascular endothelial growth factor(HIF1-α/VEGF) pathway, etc. Conclusion Houshiheisan for treatment of ischemic stroke mainly plays a role in regulating inflammation, angiogenesis, and oxidative stress. It holds direct or indirect relationships with multiple signal pathways and has the characteristics of multi-components, multi-targets, and multi-pathways.

Regulating role of has-miR-1291 on gene ARHGAP29 verified by dual luciferase reporter system

Xu Qian, Wang Sha, Liu Qiwei, Lyu Chengxiao, Gan Lu, Liu Xin

2021, 42(1):  53-57.  doi:10.3969/j.issn.1006-7795.2021.01.009

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Objective To verify the targeted-regulating effect of hsa-miR-1291 on ARHGAP29 gene. Methods PCR was used to amplify the 3'UTR sequence of the target gene ARHGAP29, using the genome DNA of 293T cells as template and the amplification primer designed based on the 3'UTR sequence information of the gene. After cloning the amplification of ARHGAP29-WT 3'UTR or ARHGAP29-MUT 3'UTR into the pmiR-RB-Report vector, dual-luciferase reporter system was conducted. For further detection of relative fluorescence values, hsa-miR-1291 mimic or Non-target Control were respectively co-transfected into 293T cells with ARHGAP29-WT 3'UTR pmiR-RB-Report(wild-type vector) or ARHGAP29-MUT 3'UTR pmiR-RB-Report(mutant vector). Results ARHGAP29-WT 3'UTR pmiR-RB-Report vector (wild-type vector) and ARHGAP29-MUT 3'UTR pmiR-RB-Report vector (mutant vector) were successfully constructed. Fluorescence test showed that after transfection with wild-type vector, fluorescence expression decreased significantly in hsa-miR-1291 mimic group compared with non-target control (NC) group (0.67±0.04 vs 1.00±0.08, P=0.014). After transfection with hsa-miR-1291 mimic, the fluorescence expression of the mutant vector increased compared with that of the wild-type vector (1.20±0.05 vs 0.67±0.04, P<0.001). Conclusion These data suggested that has-miR-1291 may have a targeted regulatory effect on ARHGAP29.

Preparation of a novel iridium(Ⅲ) complex probe for sensing of copper ion and hydrogen sulfide in sequence

Pang Qidan, Wang Tianran, Xiao Nao

2021, 42(1):  58-65.  doi:10.3969/j.issn.1006-7795.2021.01.010

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Objective To synthesis a new water-soluble iridium complex Ir-cyc and explore the sensing properties of Ir-cyc towards Cu²⁺ and H₂S in sequence with fluorescence spectra. Methods Iridium complex [Ir(ppy)₂Cl]₂ was prepared from 2-phenylpyridine (ppy) and iridium trichloride (IrCl₃); the ligand Phen-Br was synthesized from 5-amino-o-phenanthroline and 2-bromoacetyl bromide by nucleophilic substitution; the bromine-functionalized iridium complex Ir-Br was obtained by chelation reaction of [Ir(ppy)₂Cl]₂ and Phen-Br; Ir-Br was further nucleophilically substituted with cyc to prepare the probe molecule Ir-cyc. Results The structures of the synthesized intermediates and final iridium complex were determined by mass spectrometry. The basic photophysical properties of the probe Ir-cyc were characterized by fluorescence spectroscopy and UV-Vis spectroscopy. The fluorescence spectral changes revealed that the probe Ir-cyc could detect Cu²⁺ and H₂S in sequence. Conclusion A novel iridium complex of probe Ir-cyc was prepared by classical chelation and nucleophilic substitution reactions, which could recognize Cu²⁺ and H₂S sequentially in aqueous solution and has potential application in environmental monitoring and biological sample analysis.

Construction of B7-H3 knockdown ES-2 cell line and its effect on cell proliferation

Deng Mengqi, Zhang Yanqin, Chang Xiangyu, Wu Di, Xu Chunyu, Miao Jinwei

2021, 42(1):  66-70.  doi:10.3969/j.issn.1006-7795.2021.01.011

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Objective To construct a B7-H3 knockdown ES-2 cell line and determine the effect of B7-H3 gene on the proliferation of ES-2 cell line. Methods Lentivirus mediated shRNA interference was used to establish ES-2 cell line with B7-H3 knockdown. Fluorescence microscopy,real-time fluorescent quantitative PCR(qRT-PCR) and flow cytometry were used to verify the effect of B7-H3 knockdown, and cell counting kit-8 (CCK-8) was used to test its effect on proliferation. Results The results of CCK-8 showed that the proliferation rate of the experimental group was significantly lower than that of the control group, with statistical significance(P<0.05). Conclusion B7-H3 knockdown ES-2 cell line is successfully constructed, and it is found that B7-H3 knockdown can significantly reduce the proliferation rate of ES-2 cells.

Identification of protein-coding genes regulated by aberrant methylation in glioblastoma

Ji Jianghuai, Zhao Xiaoxiao, Li Qianpeng, An Yi, Zhao Lei, Li Dongguo

2021, 42(1):  71-76.  doi:10.3969/j.issn.1006-7795.2021.01.012

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Objective By integrating multi-omics data, we identified protein-coding genes (PCGs) regulated by DNA methylation in glioblastoma (GBM), evaluated the biological functions of PCGs under different methylation patterns, and explored the risk markers associated with GBM prognosis. Methods Based on multi-omics data, we constructed the DNA methylation profiles of PCGs in GBM, screened PCGs whose expression was regulated by aberrant methylation and functional enrichment analysis. Meanwhile, we performed survival analysis of the selected PCGs by combining with GBM clinical data. Results 630 PCGs whose expression was regulated by aberrant methylation were identified, and 51 PCGs associated with GBM prognosis were excavated. Conclusions The potential PCGs whose expression were regulated by aberrant methylation were identified systematically, and we provide a novel insight for identifying GBM risk markers and potential therapeutic targets.

Clinical significance of kininogen 1 expression in non-small cell lung cancer biofluids and tissues

Wang Weiwei, Wang Shanshan, Zhang Man

2021, 42(1):  77-82.  doi:10.3969/j.issn.1006-7795.2021.01.013

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Objective To evaluate the clinical significance in the diagnosis and prognosis of non-small cell lung cancer (NSCLC) by detecting the expression of kininogen-1 (KNG1) in plasma, alveolar lavage fluid, urine and tissues of patients with NSCLC. Methods The plasma, alveolar lavage fluid and urine samples were collected from 40 patients with NSCLC and 20 patients with benign lung disease (as control group). Enzyme-linked immunosorbent assay was used to detect the content of KNG1 in plasma, bronchoalveolar lavage fluid (BALF) and urine. The expression of KNG1 in 40 NSCLC and its paracancerous control samples was detected by immunohistochemistry. Results The levels of KNG1 in plasma, BALF and urine of patients with NSCLC were significantly higher than those of the control group. Receiver operating characteristic (ROC) curve analysis showed that KNG1 had an area under curve (AUC) of 0.79, 0.89 and 0.87 in plasma, BALF, and urine respectively. All had statistical significance (P<0.05), indicating that KNG1 of each specimen had certain ability to diagnose NSCLC. The diagnostic cut-off values were 1 653.6 mg/L for plasma, 52.1 mg/L for BALF and 2.3 mg/L for urine. The results showed that the consistency of urine was the highest (Kappa=0.59), indicating that the diagnostic effect was better than plasma and BALF. Immunohistochemical staining of 40 NSCLC and adjacent normal tissues showed that KNG1 was higher in NSCLC tissues than in adjacent normal tissues. Conclusions KNG1 was highly expressed in plasma, alveolar lavage fluid, urine and tissues of NSCLC, and had a certain ability to diagnose NSCLC in body fluids, especially urine.

The study on the current situation of life style of villager with chronic diseasesand influence by interpersonal communication——based on case study in H district of Beijing

Dong Yi, Cao Wenjun, Wang Chen

2021, 42(1):  83-88.  doi:10.3969/j.issn.1006-7795.2021.01.014

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Objective To investigate the current situation of life style of chronic diseases villagers, analyze the influence of interpersonal interaction, interpersonal identity, and interpersonal symbiosis among villagers on the life style of middle aged and elderly villagers with chronic diseases, and discuss the problems and put forward countermeasures. Methods Based on the social and historical research method, supported by the field study of sociology, the purpose sampling method was adopted to conduct observation and interview of 60 villagers with chronic diseases in 14 administrative villages in 3 towns of H district, and questionnaire survey was taken on 768 people from 48 administrative villages in 6 towns of H district. Results The interpersonal communication mode and the life styles based on kinship and geography in villages had a positive effect on prevention of chronic disease, but the influence of traditional culture and small living space made the rural residents' habits hard to change through interpersonal communication, which had a negative effect on eliminating chronic diseases. Conclusion The interpersonal communication mode in villages was an important part of the way of life. The way of preventing chronic diseases should base on its environment and take advantage of the situation to improve the health literacy and dietary habit and take exercise scientifically, so that the villagers could truly gain more sense of contentment on their health.

Antioxidant activity of lycopene-curcumin combination in mice with acute ethanol oxidative damage

Gao Lifang, Gao Wen

2021, 42(1):  89-93.  doi:10.3969/j.issn.1006-7795.2021.01.015

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Objective To evaluate the antioxidant effect of lycopene combined with curcumin on mice with acute alcoholism. Methods Healthy male Kunming mice were divided into 5 groups according to the weight, respectively for the blank control group, model control group, the low, medium and high three level doses subjects’ intervention group (100, 200, 600 mg/kg). The mice were given subjects through gavage administration for 30 consecutive days. On the 31st day of the experiment, the model control group and three level groups were administrated 50% anhydrous ethanol (12 mL/kg) by gavage after a 16 h overnight fasting, and the blank group was not processed. Blood was collected from the inner canthus of mice after 6 h. Those indexes were determined including the total superoxide dismutase (T-SOD) activity, protein carbonyl (PC), reduced glutathione (GSH), glutathione peroxidase activities (GSH-Px), malondialdehyde (MDA) and in blood samples of mice. Results The activities of SOD and GSH-Px, content of GSH in the high-dose group mice were higher than those in the model control group (P<0.05), and the PC content of mice in the high-dose group was lower than that in the model control group (P<0.05). Conclusion The combined application of lycopene and curcumin has potential antioxidant effects. Pretreatment with the combinations of lycopene and curcumin effectively attenuated the oxidative damage caused by acute alcoholic injury mice.

Clinical Research

Natural modification of uterine fibroids during pregnancy

Zhao Jing, Luo Mei, Wang Shuzhen, Ding Ling, Zheng Jing

2021, 42(1):  94-100.  doi:10.3969/j.issn.1006-7795.2021.01.016

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Objective To explore the natural modification of uterine fibroids during pregnancy. Methods This longitudinal study enrolled a total of 499 cases of uterine fibroids during pregnancy in Beijing Chaoyang Hospital, Capital Medical University from January 1st 2011 to December 31st 2017. The fibroids' maximum diameter determined with ultrasound in different trimesters of pregnancy was extracted from medical record and analyzed respectively. Results A significant increase of uterine fibroids in diameter was observed from the first trimester to the second trimester of pregnancy [(3.94±2.02) cm vs (3.05±1.69)cm,t=13.94, P＜0.001)],and from the second trimester to early third trimester [(4.18±2.22) cm vs (4.02±2.23) cm,t=2.96,P=0.003)], while no significant change in size of fibroids was seen between the early and the late third trimester [(3.93±2.17) cm vs (3.91±2.15) cm,t=-0.81,P=0.417]. A progressive increase in the diameter of fibroids was detected from the first trimester to the late third trimesters [(2.94±1.70) cm vs (3.86±2.01) cm, t=-13.43,P<0.001]. However this kind of growth trend had proved to have no relation to the initial maximum diameter detected in the first trimester, patient age, obstetric history (gravidity, parity),location or number of fibroids (P＞0.05). In 175 cases with complete data (ultrasound results in 4 periods of pregnancy respectively), 38.3% of the maximum diameter of fibroids throughout pregnancy occurred in the second trimester, while 33.1% in the early third trimester, 21.1% in the late third trimester, and only 7.4% occurred in the first trimester. Taking both sensitivity and specificity into consideration, the maximum diameter of fibroid in the first trimester larger than 4 cm showed the most predictive value that the fibroids would be significantly enlarged during pregnancy (>3 cm), with a sensitivity of 83.33% and specificity of 76.07%. Conclusions There was a significant increase, also the largest increment in uterine fibroids during pregnancy from the first to the second trimester. The increase slowed down progressively in the early third trimester, followed by a subsequent decrease in the late third trimester. The growing trend of uterine fibroids with different initial sizes were similar to one another.

Observation on effect of rotational atherectomy followed by drug-eluting stents implantation in patients age ≥65 years with severe calcified coronary lesions

Hu Bin, Zhou Yujie, Jia Dean, Qin Zheng, Xu Xiaohan, Yang Shiwei, Zhou Zhimin

2021, 42(1):  101-104.  doi:10.3969/j.issn.1006-7795.2021.01.017

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Objective To assess the effect of coronary rotational atherectomy followed by drug-eluting stents implantation in patients age ≥65 years with complex calcified coronary lesions. Methods A total of 198 consecutive patients with coronary artery disease receiving rotational atherectomy from January 2016 to December 2017 were retrospectively analyzed.Patients were divided into an ≥65 years group(n=116) and a <65 years group (n=82). We compared the characteristics of rotational atherectomy, peri-procedural complications and 1-year major adverse cardiac events (MACE), comprised of cardiac death, miocardial infarction, target vessel revascularization. Results The incidence of peri-procedural complications had no significant difference between the≥65 years group and the<65 years group(18.9％ vs 13.3％, P=0.202).And the rate of MACE was similar in the ≥65 years and <65 years groups (10.3% vs 7.3％, P=0.320). Conclusion Coronary rotational atherectomy followed by drug-eluting stents implantation is a safe and effective treatment strategy in patients age ≥65 years with complex calcified coronary lesions.

Measurement of sagittal parameters of spine and pelvis in asymptomatic Han population

Liu Miaomiao, Lyu Rui, Cheng Weiwei

2021, 42(1):  105-110.  doi:10.3969/j.issn.1006-7795.2021.01.018

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Objective To analysis the morphology and orientation characteristics of pelvis in normal Chinese adults and study the correlations among all the spinopelvic parameters and the correlations between these parameters and body properties like sex, age and body mass index (BMI). Methods A total of 85 asymptomatic Chinese adult volunteers from Beijing City with the age ranged from 21 to 65 years were enrolled in this study. The average age of the male were (46.0±14.1) years and the female were (41.8±13.6) years, respectively. Ten most important pelvic and spinal parameters were evaluated, which included pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), cervical lordosis(CL), thoracic kyphosis (TK), sagittal vertical axis (SVA), lumbopelvic lordosis angle (PR-T12), Spino-sacral angle (SSA), and sacral pelvic angle (SPA). Both the relationship among these parameters one another and the relationships between these parameters and age, sex, and BMI were assessed using the Pearson correlation analysis. Results The mean values of PI, PT, SS, LL, TK, CL, SVA, PR-T12, SSA, and SPA were51.1°±8.2°, 18.5°±8.0°, 32.8°±6.3°, 36.7°±11.8°, 20.8°±11.3°, 11.2°±9.7°,(14.9±39.6) mm, 75.6°± 9.8°, 122.9°±7.8°, 54.3°±7.1°, respectively. The results showed that the age is positively correlated with PI and PT, while negatively correlated with LL and TK. SS was correlated with ethnicity. Besides, TK, CL, and SVA were very different between the male and female groups. While LL and TK were slightly correlated with BMI. Conclusions The normal values of spinopelvic parameters were related with the age, ethnicity, sex, and BMI of the individuals. These results offered a significant reference for clinical work.

The intrinsic connection and predictive value of monocytes for disease courses in adult mycoplasma pneumonia

He Jingyu, Wang Jing

2021, 42(1):  111-116.  doi:10.3969/j.issn.1006-7795.2021.01.019

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Objective To explore the intrinsic connection and the clinical value of monocytes for disease courses in adult mycoplasma pneumonia. Methods A retrospective analysis of 95 patients with mycoplasma pneumonia from January 2016 to December 2018 was conducted in Department of Emergency, Xuanwu Hospital, Capital Medical University. Patients were divided into long-course group (n=71) and short-course group(n=24) based on whether disease courses were longer than 14 days. The absolute value of monocytes(MO) and thepercentage of monocytes(MO%) in blood routine were collected within 24 hours of admission. Furthermore, their correlations with disease courses were discussed. Results Baseline analysis displays that the MO, MO%, C-reactive protein (CRP),procalcitonin, red blood cell, platelet volume distribution width (PDW), average platelet volume and heart rates were lower, and the oxygen partial pressure was higher in the long-course group (P<0.05).Logistic regression showed that MO% was an independent predictor of disease duration over 14 days (P=0.003). Receiver operating characteristic (ROC) curve analysis showed that MO% had moderate predictive value for disease courses. Area under ROC curve, MO%: 0.708±0.062(P=0.002), cut-off value: 7.414 7%,sensitivity (Se) 63.38%,specificity(Sp)79.17%,positive predictive value (PV+) 90.0%, negative predictive value, (PV-) 42.22%. The area under the combined predictive ROC curve of MO% with CRP and PDW: 0.793±0.053(P=0.000), cut-off value: 7.441 4,Se 78.87%,Sp 70.83%, PV+88.89%,PV-53.13%. Conclusions MO% has clinical application value in disease-course prediction and evaluation of mycoplasma pneumonia in adults:especially combined with CRP and PDW.The smaller the MO% value, the longer the course of disease.

Correlation between alpha activity and cognitive in resting electroencephalogram of schizophrenia

Sha Sha, Zhao Xixi, Han Chuanliang, Peng Xing, Zhang Pei, Dong Wen, Yin Jingjing, Wang Changming

2021, 42(1):  117-124.  doi:10.3969/j.issn.1006-7795.2021.01.020

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Objective To explore the correlation between alpha oscillation and cognitive in resting electroencephalogram (EEG) of schizophrenia. Methods Participants are 22 schizophrenia patients (SCH) and 23 matched healthy controls (HC). All participants were required to perform the MATRICS Consensus Cognitive Battery (MCCB) for cognitive evaluation, and electrophysiology indexes were recorded by EEG recording system. Comparisons were made between two groups in alpha relative power on the left frontal area (F3, F7), the right side of the frontal area (F4, F8), the left side of the central region (T3, C3), the right side of the central (T4, C4), left posterior brain areas (T5, P3, O1), right posterior brain areas (T6, P4, O2), and the Fz, CPz, Pz, Oz sites. Results In addition to the social cognitive dimension, scores of the schizophrenia group in all other dimensions of MCCB test were significantly lower than the HC group (All P<0.001). Compared to HC, the SCH group exhibited significantly lower global alpha activity (P<0.05) under closed eyes and exhibited significantly lower global alpha activity on posterior brain areas and CPz, Pz and Oz electrodes (P<0.05) under open eyes. In SCH group, the MCCB scores, information processing speed scores, speech learning and memory scores, and reasoning and problem solving scores positively related to the global relative alpha activity under closed eyes, except the first three dimensions under open eyes. Conclusions There're multidimensional damages of the cognitive level in schizophrenic. Under the resting-state alpha oscillation is positively related with the information processing speed, verbal learning and memory, reasoning and problem solving. Therefore, the resting-state alpha oscillation could be a biological indicator of the cognitive level in schizophrenic.

Assessment of urinary microalbumin and oxygenation in diabetic patients using blood oxygenation level-dependent MRI

Zheng Shuangshuang, Gao Zhiyuan, Song Shuangshuang, He Yueming, Lu Jie

2021, 42(1):  125-130.  doi:10.3969/j.issn.1006-7795.2021.01.021

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Objective To explore the relationship between the ratio of urine albumin to creatinine(ACR) and renal oxygenation in patients with type 2 diabetes by blood oxygen level-dependent magnetic resonance imaging(BOLD MRI). Methods Totally 44 patients with type 2 diabetes and 14 healthy volunteers were recruited. Diabetic patients were divided into ACR normal diabetic group, early diabetic nephropathy group and clinical diabetic nephropathy group based on ACR. Bilateral renal cortical R2^*(CR2^*) and medullary R2^*(MR2^*) values were extracted and quantified on BOLD MRI. CR2^* and MR2^* were compared among the groups separately. The relationships were analyzed between R2^* values and clinical index of renal function. Results Compared with controls, MR2^* in ACR normal diabetic group(P=0.015) and clinical diabetic nephropathy group(P=0.023) were significantly increased. MR2^* in the early diabetic nephropathy group was higher than that in normal control group, but the difference was not statistically significant. CR2^* in each diabetes group was higher than that in the normal control group, but there was no statistical difference. The positive correlation was found between MR2^* and ACR(r=0.409, P=0.006). Conclusion BOLD MRI could non-invasively evaluate the renal oxygenation level in different stages of ACR in diabetic patients and monitor functional hypoxia changes in renal medulla in early diabetic patients.

A comparative study on the consistency of 3D MEDIC and 3D SPACEmagnetic resonance neurography imaging in lumbosacral plexus nerve roots

Sun Zheng, Kong Chao, Lu Shibao, Chen Hai, Da Yuwei, Zhang Miao, Lu Jie

2021, 42(1):  131-137.  doi:10.3969/j.issn.1006-7795.2021.01.022

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Objective To validate the feasibility and reproducibility of three dimensional multi-echo data imagine combination with selective water excitation (3D MEDIC WE)and three-dimensional sampling perfection with application optimized contrasts by using different flip angle evolution(3D SPACE STIR)sequence in lumbosacral plexus nerve root imaging. Methods Fifty-five subjects were undergone with two magnetic resonance neurography(MRN)sequences of lumbosacral plexus nerve roots to evaluate the signal to noise ratio(SNR),contrast to noise ratio(CNR)and contrast ratio(CR) of image quality parameters, and to validate the consistency of measurement of nerve root diameter in normal control (NC) group,chronic inflammatory demyelinating polyradiculoneuropathy(CIDP)group and lumbar disc herniation(LDH) group, respectively. Results The consistency of nerve root diameter measured by the two MRN sequences was higher (r=0.95 in NC group, r=0.99 in CIDP group, r=0.97 in LDH group, P<0.001). The image quality evaluation index showed that 3D space sequence was superior in the three indexes of SNR, CNR and CR, and the image quality score of 3D medic qualitative evaluation was higher. Both the two sequences can clearly show the normal lumbosacral plexus nerve root, the diffuse morphological thickening nerve root and the compressed nerve root caused by the disc herniation. Conclusion 3DMEDIC and 3D SPACE sequences can be used in the assessment of lumbosacral plexus nerve root imaging. The two sequences have high feasibility and reproducibility in the evaluation of normal and abnormal shape and course of nerve root. Considering the all-round evaluation of clinical images, we can choose the best sequence to provide image support.

Local infiltration anesthesia for early analgesic effect after total knee arthroplasty

Zhao Xiaoxiong, Zhang Bo, Ren Shixiang, Ma Desi, Chen Tong, Lin Yuan

2021, 42(1):  138-142.  doi:10.3969/j.issn.1006-7795.2021.01.023

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Objective To evaluate the efficacy of local infiltration anesthesia(LIA) in different injection regions after total knee arthroplasty(TKA). Methods In our hospital, from March 2017 to June 2018, 100 patients underwent unilateral primary TKA due to knee osteoarthritis were prospectively studied. Random number grouping method was used to randomly divide into 2 groups:posterior and lateral infiltration anesthesia group (Group A) and anterior infiltration anesthesia group (group B). Group A received analgesic drugs inposterior and lateral area [interspace between the popliteal artery and posterior capsule of the knee (IPACK) and attachment of medial collateral ligament(MCL) and lateral collateral ligament(LCL)] and received normal saline(NS) 20 mL in anterior area (synovium of suprapatellar bursa, quadriceps tendon and incision). On the contrary, group B received 20 mL NS in posterior and lateral area, and received analgesic drugs in anterior area. The baseline information, preoperative and postoperative Visual Analogue Scale(VAS), American Knee Society Score(KSS) and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were recorded. In addition, the postoperative dosage of tramadol was also recorded. Results There was no significant difference and preoperative VAS between two groups. There was significant difference in postoperative VAS score between two groups at rest (P<0.05), but not at dynamic state (P>0.05). There was no significant difference in preoperative and postoperative KSS and WOMAC between the two groups (P>0.05). The average dose of tramadol used in group A was lower than that in group B, but there was no statistically significant difference (P>0.05). Conclusion Posterior and lateral local infiltration anesthesia was obviously effective after TKA than the anterior LIA at rest and can reduce the dosage of oral analgesics. We recommend to strengthen the infiltration analgesia in the posterior and lateral area of the knee joint rather than simplely anterior analgesia, such as wounds. Posterior and lateral LIA can effectively control early postoperative pain of TKA patients at rest.

Cognitive function, emotion management and its influencing factors in stable schizophrenia

Zhang Ying, Wang Ruomei, Li Gang

2021, 42(1):  143-147.  doi:10.3969/j.issn.1006-7795.2021.01.024

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Objective To explore the level of emotion management in social cognitive function and cognitive function of patients with stable schizophrenia, and analyze the related influencing factors. Methods A total of 100 patients with stable schizophrenia, 50 patients with unstable schizophrenia and 50 healthy controls were tested with MATRICS consensus cognitive battery test (MCCB). The severity of psychotic symptoms in patients with schizophrenia was assessed by Brief Psychiatric Rating Scale (BPRS). The cognitive function of the three groups was compared, and the related factors affecting cognitive function and emotional management level of stable schizophrenia patients were analyzed. Results The total score of MCCB and the scores of each subtest in the control group were higher than those in the stable schizophrenic patients. The emotional management, symbol coding, Hopkins word learning test, brief visuospatial memory, spatial span and maze test of stable schizophrenia patients in the case group were higher than those of unstable schizophrenia patients (P<0.05); Multivariate linear regression analysis showed that age, course of disease and total score of BPRS were the influencing factors of cognitive function in stable schizophrenia patients (P<0.05). The factors influencing emotion management of stable schizophrenic patients included total score of BPRS, connection test a, symbol coding and short visual spatial memory (P<0.05). Conclusions Even in the stable stage, the overall cognitive function and emotional management level of schizophrenic patients are still significantly lower than that of healthy people. Early onset, long course of disease and unstable mental symptoms are important risk factors for cognitive impairment of schizophrenia patients. The severity of mental symptoms, information processing speed and visual learning ability will affect their emotional management level.

The predictive effect of serum intact parathyroid hormone (iPTH) levels on permanent hypoparathyroidism in patients after total thyroidectomy

Cai Shuyan, Zheng Jianwei

2021, 42(1):  148-152.  doi:10.3969/j.issn.1006-7795.2021.01.025

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Objective To determine intact parathyroid hormone (iPTH) levels at 24 hours after total thyroidectomy, to predict the occurrence of permanent hypoparathyroidism (pHPP), and to analyze the clinical value of parathyroid hormone as an independent risk factor for predicting hypoparathyroidism. Methods Totally 622 patients with thyroid cancer and benign thyroid lesions who underwent total thyroidectomy at Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University from December 2008 to December 2019 were studied retrospectively. Independent sample t test and Chi-square test were used to analyze and compare serum iPTH levels, and multivariate Logistic regression analysis was applied to evaluate the correlation between each data and the occurrence of permanent hypoparathyroidism after surgery. The area under the receiver operating characteristic (ROC) curve (AUC) was used to calculate iPTH levels to predict the accuracy of permanent hypoparathyroidism. Results Among the 622 cases of total thyroidectomy, 25 cases of permanent hypoparathyroidism occurred, with an incidence of 4.02% (25/622). Multivariate analysis showed that iPTH level on postoperative day 1(OR=2.815, 95% CI:1.169-6.781,P=0.021) was independent risk factor for postoperative permanent hypoparathyroidism. The concentration of iPTH threshold value was 5.45 pg/mL (AUC 0.974, 95%CI: 0.958-0.985,P<0.001) at 24 hours after total thyroidectomy. Conclusions Serum iPTH level measured on the first day after total thyroidectomy was closely related to the occurrence of permanent hypoparathyroidism postoperatively, It was an independent predictor of risk factors.

The clinical characteristics and risk factors of acute exacerbations of chronic obstructive pulmonary disease combined with deep venous thrombosis

Yue Xiaoyan, Li Fengjie, Jiang Zhifeng, Zhu Yanan

2021, 42(1):  153-157.  doi:10.3969/j.issn.1006-7795.2021.01.026

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Objective To investigate the risk factors of deep venous thrombosis (DVT) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 51 patients with AECOPD admitted to the emergency ward of our hospital from October 2018 to April 2019 were collected and divided into the thrombotic group and the non-thrombotic group according to the results of lower extremity vein color Doppler ultrasound report after admission, and the basic data, clinical characteristics and examination results of the two groups were compared. Results In the presence of lower extremity edema, pulmonary hypertension, average pressure, D-dimer of significant differences between the two groups of patients (P< 0.05), the results of single factor analysis of meaningful factors multivariable Logistic regression analysis, the results show lower extremity edema and pulmonary hypertension are AECOPD combined independent risk factors for DVT (P<0.05, OR=5.215, 3.741), but mean arterial pressure and D-dimer are not AECOPD combined independent risk factors for DVT (P>0.05).There was no significant difference in C-reactive protein, interleukin-6, interleukin-8, tumor necrosis factor, and arterial partial oxygen pressure between the two groups (P>0.05). Conclusion For AECOPD patients, the possibility of deep venous thrombosis can be inferred from the lower limb edema, pulmonary hypertension, and then the diagnosis and prevention of lower limb deep vein thrombosis can be achieved through targeted examination and treatment.

Experimental study of anti miRNA-181a induces apoptosis via Mitophagy enhancing on Multiple Myeloma cells

Cui Xing, Zhong Ping

2021, 42(1):  167-169.  doi:10.3969/j.issn.1006-7795.2021.01.029

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Objective To investigate the role and possible molecular mechanism of anti miRNA 181a in the regulation of mitophagy and apoptosis on Multiple Myeloma(MM) cells. Methods The expression of miRNA 181a in human normal peripheral blood CD138+ cells,MM patients' bone marrow CD138+ cells and human myeloma cell lines MM1S was detected by fluorescence quantitative PCR (QPCR) . MiR 181a inhibitor(miR-181a inhibitor group) and negative control group (NC group) were transfected into MM1S cells, mitochondrial membrane potential(MMP) was examined by flow cytometry, autophagy and mitochondrial structure were observed by transmission electron microscope, and Western blotting was used to detect the expression of mitophagy related protein (Cleaved-caspase-3, Bcl-2/Bax, LC3 Ⅱ/LC3-Ⅰ, P62 and parkin) in three groups. overexpression Parkin of miR-181a inhibitor group as rescue test and Western blotting was used to detect mitophagy related protein expression after overexpress Parkin. Results The relative expression levels of miR-181a in MM patients' bone marrow and MM1S cell lines were 1.57±0.09 and 1.64±0.06, which significantly higher than normal peripheral blood cell (P<0.05). After transfection of miR-181a inhibitor,the apoptosis rate of miR-181a inhibitor group is significantly higher than the other two groups, the number of autophagic vesicles decreased with mitochondrial structure badly damaged were also observed in miR-181a inhibitor group. In miR-181a inhibitor group, relative expression of autophagy related protein Cleaved-caspase-3, the ratio of Bcl-2/Bax and LC3 Ⅱ/LC3-Ⅰincreased significantly, P62 decreased remarkable (P<0.01) . After the Parkin expression was rescued, MM1S cells' viability recovered. Conclusion Anti miRNA-181a could induce apoptosis on multiple myeloma cells via enhancing the level of mitophagy.