Table of Content

21 December 2022, Volume 43 Issue 6

Previous Issue    Next Issue

Nuclear Medicine and Molecular Imaging Assists Clinical Diagnosis and Treatment

Application of ¹¹C-MET PET/CT in screening isocitric dehydrogenase and 1p/19q status in supratentorial lower-grade gliomas

Zhang Shu, Wang Kai, Yang Zihao, Qiao Zhen, Li Xiaotong, Yuan Leilei, Ai Lin

2022, 43(6):  826-833.  doi:10.3969/j.issn.1006-7795.2022.06.002

Asbtract ( 391 )   PDF (3623KB) ( 39 )  

References | Related Articles | Metrics

Objective To evaluate the value of ¹¹C-methionine (¹¹C-MET ) positron emission tomography/computed tomography (PET/CT) in screeningisocitric dehydrogenase (IDH) mutation and 1p/19q co-deletion status in supratentorial lower-grade glioma (LrGG). Methods The preoperative ¹¹C-MET PET/CT images and pathological data of 37 patients with lower-grade supratentorial glioma were retrospectively analyzed. The maximum tumor/normal tissue ratio (TNR_max), mean tumor/normal tissue ratio (TNR_mean) and peak tumor/normal tissue ratio (TNR_peak) of lesions on were measured. According to IDH gene mutation and 1p/19q co-deletion status, patients were divided into three groups: IDH wild type (IDH^wt); IDH mutation-1p/19q co-deletion type (IDH^mut1p/19q^del) and IDH mutation-1p/19q intact type (IDH^mut1p/19q^int). TNR values of different molecular subtypes of LrGG were compared with each other. The differential diagnostic efficacy of semi-quantitative parameters for different molecular subtypes of LrGG was analyzed using receiver operating characteristic (ROC)curve. Logistic regression was used to establish a joint diagnostic model, and the ROC analysis was conducted to evaluate the predictive efficiency of joint diagnostic model. Results There were significant differences in TNR_max, TNR_mean and TNR_peak among the three groups of LrGG (P<0.05). TNR_max, TNR_mean and TNR_peak were the highest in the IDH^wt group, followed by the IDH^mut1p/19q^del group. Semiquantitative values were the lowest in the IDH^mut1p/19q^int group. The TNR_max, TNR_mean and TNR_peak of IDH^wt LrGG were higher than those of IDH^mut LrGG, and the difference was statistically significant(P<0.05). The results of ROC analysis showed that the area under the curves (AUCs) of TNR_max, TNR_mean, and TNR_peak for screening IDH mutations were 0.827, 0.847, and 0.807, with thresholds of 3.09, 1.84, and 2.58, respectively, and the accuracy rates were 70.3%、75.7% and 75.7%, respectively. The screening model based on Logistic regression analysis can improve diagnostic accuracy, with an AUC value of 0.943, sensitivity, specificity, and accuracy of 100%, 83.3%, and 94.6%, respectively. The TNR_max, TNR_mean and TNR_peak of IDH^mut1p/19q^del LrGG were significantly higher than those of IDH^mut1p/19q^int LrGG (P<0.05). The AUCs of TNR_max, TNR_mean, and TNR_peak for predicting 1p/19q co-deletion of IDH^mut LrGG were 0.766, 0.792, and 0.812, with thresholds of 3.35, 1.44, and 2.02, respectively, and the accuracies were 76.0%, 80.0%, and 80.0%, respectively. Joint diagnostic model cannot improve diagnostic efficiency. Conclusion ¹¹C-MET PET/CT is helpful for screening IDH mutation and 1p/19q co-deletion status in supratentorial lower-grade gliomas. The combination of multiple parameters can improve the efficiency of screening IDH gene mutation.

Prediction of tumor histopathological grade using a modified peritoneal cancer index by ¹⁸F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei

Zhang Li, Li Bing, Tong Guansheng

2022, 43(6):  834-839.  doi:10.3969/j.issn.1006-7795.2022.06.003

Asbtract ( 156 )   PDF (2084KB) ( 33 )  

References | Related Articles | Metrics

Objective The aim of this study was to investigate the ability of the modified peritoneal cancer index (PCI) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT), maximum standardized uptake value (SUVmax) and SUVmax/liver mean standardized uptake value(SUVmean_liver) to predict the histopathological grade in patients with pseudomyxoma peritonei(PMP). Methods The pathological data of 31 patients with PMP of appendiceal origin and 34 ¹⁸F-FDG PET/CT results (3 patients underwent twice examinations) from January 2017 to June 2022 were analyzed retrospectively. PET-PCI was the sum of the SUVmax scores of PMP lesions in 13 specific abdominal-pelvic regions. The SUVmax and SUVmax/SUVmean_liver of the lesion were also measured. Results There were 14 cases of low grade PMP, 12 cases of high grade PMP, and 5 cases of high grade with signet ring cells PMP. The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade were higher than those of the low grade (PET-PCI:23.08 ± 7.47 vs 15.81 ± 10.59, P=0.047; SUVmax:7.91 ± 4.67 vs 6.73 ± 3.99, P=0.470; SUVmax/SUVmean_liver:3.63 ± 1.89 vs 3.17 ± 2.70, P=0.614). The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade with signet ring cells were higher than those of the high grade (PET-PCI:25.20 ± 8.84 vs 23.08 ± 7.47, P=0.614; SUVmax:9.29 ± 8.46 vs 7.91 ± 4.67, P=0.660;SUVmax/SUVmean_liver:3.73±1.83 vs 3.63±1.89,P=0.917)。The values of PET-PCI, SUVmax, and SUVmax/SUVmean_liver were consistent with the PMP histopathological grade, while there was only a significant different between the PET-PCI of the high-and low-grade PMP. Conclusion Compared with SUVmax and SUVmax/SUVmean_liver, PET-PCI can better reflect the histopathological grade of PMP.

Evaluation of the effect of NEMA NU 2-2018 Standards in performance test of PET/CT system

Geng Yiqiang, Liu Jiajin, Wu Shina, Sun Shuwei, Zhao Dong, Song Jingbin, Sun Yabing, Wang Ruimin

2022, 43(6):  840-844.  doi:10.3969/j.issn.1006-7795.2022.06.004

Asbtract ( 303 )   PDF (1767KB) ( 71 )  

References | Related Articles | Metrics

Objective To explore the application of National Electrical Manufactures Association(NEMA) NU-2 2018 Standards in equipment performance testing of positron emission tomography/computed tomography (PET/CT) system. Methods According to NEMA NU 2-2018 Standards, the performance indexes were tested, including the spatial resolution, sensitivity, scatter fraction, count loss, random measurement, timing resolution, count loss rate, random measurement correction accuracy, image quality, accuracy of attenuation and scatter correction, and image co-registration accuracy of Siemens Biograph Vision 600 PET/CT. Results The transverse and axial spatial resolution were 3.75 mm and 3.76 mm at a 1 cm offset, The sensitivity was 16.8 kcps/MBq at the center of the field of view and 16.7 kcps/MBq at a 10 cm offset from the axial of the field of view. The scatter fraction was measured at 38.58% while noise equivalent count rate peaked at 258.26 kcps corresponding to 27.37 kBq/mL.The result of timing resolution is 209.82ps. The contrast recovery of the image quality phantom ranged from 88.9% to 96.2%, and the background variability ranged from 2.05% to 6.80%, the average lung residual error was 2.43%. The maximum error of counting loss and random coincidence correction was 3.9%. At 5 cm and 100 cm from the end of the bed plate,Co-registration accuracy between PET and CT were 0.46 mm and 1.07 mm at a 1 cm offset from the Y of the center field of view, 1.06 mm and 1.45 mm at a 20 cm offset from the X of the center field of view, and 0.85 mm and 1.15 mm at a 20 cm offset from the Y of the center field of view. Conclusion The conditions of NEMA NU 2-2018 standards are closer to clinical examination and can better reflect the system performance of PET/CT equipment.

Preliminary study of ¹⁸F-FAPI PET/CT in hypertrophic cardiomyopathy: comparison with cardiac magnetic resonance imaging

Zhang Yu, Dong Zhixiang, Li Changcheng, Wang Li, Yang Minfu

2022, 43(6):  845-853.  doi:10.3969/j.issn.1006-7795.2022.06.005

Asbtract ( 500 )   PDF (3491KB) ( 49 )  

References | Related Articles | Metrics

Objective To explore the characteristics of ¹⁸F-labeled fibroblast activation protein inhibitor (FAPI) positron emission tomography/computed tomography (PET/CT) in the patients with hypertrophic cardiomyopathy (HCM), as well as the correlation between ¹⁸F-FAPI activity and cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) technique. Methods Twenty-two HCM patients were prospectively recruited in this study with ¹⁸F-FAPI PET/CT examination, CMR examination and blood tests. A control group of twenty-two healthy participants with the same age and sex as the HCM group was also recruited and only underwent ¹⁸F-FAPI PET/CT examination. The maximum standardized uptake value (SUV_max) and maximum target-to-background ratio (TBR_max) of left ventricular (LV) myocardium were then obtained by post-processing software. The region grow algorithm with a threshold of 40% of the SUV_max was set to determine the ¹⁸F-FAPI volume. The ¹⁸F-FAPI volume was further expressed as a percentage of LV volume derived from CMR, which was defined as the ¹⁸F-FAPI extent (FAPI%). CMR examination was performed on a 3.0 Tesla scanner. The maximum thickness and LGE extent (LGE%) of LV myocardium were then obtained by post-processing software. The independent-sample t test or Mann Whitney U test was used to evaluate the differences of ¹⁸F-FAPI uptake between the patients with HCM and healthy participants. The correlation of ¹⁸F-FAPI activity and CMR parameters were assessed by Pearson/Spearman's correlation test. Results The myocardial ¹⁸F-FAPI uptake of LV in patients with HCM was significantly higher than that in the healthy participants (TBR_max, median: 8.96 vs 1.19, P<0.001). In patients with HCM, the ¹⁸F-FAPI extent was larger than LGE extent (FAPI% vs LGE%, median: 73.77 vs 6.69, P<0.001), and moderate correlation was observed between ¹⁸F-FAPI extent, LGE extent and LVEF (FAPI, LGE% and LVEF, r = 0.67,-0.49, P<0.05).Moreover, moderate correlation was observed between ¹⁸F-FAPI extent with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatine kinase-MB (CK-MB) (FAPI% , NT-proBNP and CK-MB, r = 0.58,0.54, P<0.05). No correlation was observed between CMR parameters and blood tests. Conclusion The measurement of ¹⁸F-FAPI was moderately correlated with the CMR, and ¹⁸F-FAPI PET/CT could detect a wider range of myocardium than CMR.

Comparison of continuous-bed-motion and step-and-shoot acquisition modes on ¹⁸F-FDG PET/CT imaging

Yang Sen, Wang Ling, Liu Peng, Jin Chaoling, Li Honglei, Fu Liping

2022, 43(6):  854-860.  doi:10.3969/j.issn.1006-7795.2022.06.006

Asbtract ( 306 )   PDF (5450KB) ( 34 )  

References | Related Articles | Metrics

Objective To investigate the effects of continuous-bed-motion (CBM) and step-and-shoot (SS) acquisition modes on image quality and quantitative analysis in ¹⁸F-FDG(fluorodeoxyglucose) PET/CT (positron emission tomography/computed tomography) . Methods A total of 50 patients were prospectively selected and undertake PET image acquisition in Siemens Biograph Vision 600 PET/CT equipment with CBM and SS modes. Mean standardized uptake value (SUV_mean) and standard deviation (SD) of mediastinal blood pool, lung, liver, muscle, and bone were measured, and evaluate image noise with SD. Paired t test, Paired rank sum testPearson correlation analysis and Bland-Altman Figure were used to evaluate the difference and relationship between the data of two groups. Results In different acquisition sequences, the SUV_mean of mediastinal bloodPool and liver were decreased significantly (t= 5.630 and 4.993, all P<0.05), the SUV_mean of lumbar vertebra was increased significantly (t=-3.320, P<0.05), while the SUV_mean of lung and muscle was not significantly different (all P>0.05). In different acquisition modes, there were no significant difference in SUV_mean of all tissues (t values:from-1.626 to-0.311, P>0.05), and there were high correlation with them (r values: from 0.903 to 0.985),the Bland-Altman Figure shows that the mean difference of each tissues are-0.02(95%CI:-0.27 to 0.24), -0.01(95%CI:-0.05 to 0.03), 0.00(95%CI:-0.19 to 0.18), -0.01(95%CI:-0.08 to 0.06), -0.03(95%CI:-0.28 to 0.22),and 0.00(95%CI:-0.07 to 0.08). Except for the SD of thigh muscle (Z= -1.163, P>0.05), the SS_SD of other tissues was lower than that of CBM_SD (Z=-4.406, -2.856, -5.556, -2.954 and -3.104, all P<0.05). Conclusion CBM is a flexible acquisition method, which can provide the same quantitative information as SS. It is an effective supplement to PET/CT image acquisition method.

Value of ^99mTc-MIBI SPECT/CT in pre-operative diagnosis of primary hyperparathyroidism

Wang Man, Hou Yaqin, Cui Bixiao, Bi Sheng, Wang Bojun, Zhang Chun, Lu Jie

2022, 43(6):  861-866.  doi:10.3969/j.issn.1006-7795.2022.06.007

Asbtract ( 218 )   PDF (1451KB) ( 33 )  

References | Related Articles | Metrics

Objective To evaluate the clinical value of ^99mTc-sestamibi (^99mTc-MIBI) single photon emission computed tomography (SPECT)/computed tomography (CT) in preoperative diagnosis of primary hyperparathyroidism (PHPT) by comparing with ^99mTc-MIBI dualphase planar imaging and ultrasonography. Methods　A total of 101 patients (23 males, 78 females, 14-74 yearsold) who had received parathyroidectomy from Xuanwu Hospital, Capital Medical University were enrolled into this retrospective study. The pathological results were considered as the gold standard. The diagnostic efficiencies (sensitivity, specificity, accuracy, positive predictive value, and negative predictive value) of ^99mTc-MIBI SPECT/CT were compared with ^99mTc-MIBI dual-phase planar imaging and ultrasound examination using χ2 test. The size of positive lesions was compared with negative lesions in ^99mTc-MIBI SPECT/CT and 99mTc-MIBI dual-phase planar imaging usingt test respectively. Results　A total of 120 PHPT lesions were found in 101 patients, of which 93 cases had single lesion and 8 cases had multiple lesions, and 120 lesions included 89 parathyroid adenomas (8 ectopic adenomas), 5 atypical adenomas, 24 hyperplastic lesions (3 ectopic lesions), and 2 parathyroid carcinomas. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ^99mTc-MIBI SPECT/ CT for PHPT were 90.00%,99.64%,96.78%,99.08%, and 95.93% respectively. The corresponding results of dual-phase planar imaging were 76.67%,99.30%,92.57%,97.87%, and 90.97% respectively. The corresponding results of ultrasound examination were 82.50%,99.64%,94.55%,99.00%, and 93.09% respectively. The sensitivity (χ2 =14.062, P<0.001), accuracy (χ2=15.059, P<0.001), and negative predictive value (χ2=6.034, P<0.05) of ^99mTc-MIBI SPECT/CT for PHPT were higher than those of planar imaging. In contrast there were no significant differences in sensitivity and accuracy between ^99mTc-MIBI SPECT/CT and ultrasound examination (P>0.05). The maximum diameters of positive lesions of SPECT/CT and planar imaging were (1.90±0.98)cm and (2.01±0.99)cm, respectively, which were significantly larger than those of negative lesions (1.36±0.54) cm and (1.25±0.67) cm (t=2.311,3.827, both P<0.05), respectively. Conclusion There were higher sensitivity, accuracy, and negative predictive value of ^99mTc-MIBI SPECT/CT in the diagnosis of PHPT, which has important clinical application value in preoperative localization and qualitative diagnosis of PHPT.

Application value of ¹⁸F-FDG PET/CT in differential diagnosis of choroidal melanoma and choroidal metastatic carcinoma

Luo Shiyu, Li Mei, Luo Sha, Wang Shuang, Zhang Juan, Li Meng, Nan Xiao, Xian Junfang

2022, 43(6):  867-872.  doi:10.3969/j.issn.1006-7795.2022.06.008

Asbtract ( 173 )   PDF (6739KB) ( 24 )  

References | Related Articles | Metrics

Objective To analyze the imaging characteristics and metabolic parameters of fluoro-18-deoxyglucose(¹⁸F-FDG) positron emission tomography/computed tomography(PET/CT) in patients with choroidal melanoma and choroidal metastatic carcinoma, and to explore its clinical application value in the diagnosis and differentiation of the two diseases. Methods The patients that underwent ¹⁸F-FDG PET/CT examination in the Department of Nuclear Medicine, Beijing Tongren Hospital, Capital Medical University from May 2020 to March 2022 and finally diagnosed as choroidal melanoma or choroidal metastatic carcinoma were enrolled. The CT imaging features and ¹⁸F-FDG PET metabolic parameters of the two diseases were compared with each other, the latter including maximum standardized uptake value (SUV_max), peak standardized uptake value (SUV_peak), and total lesion glycolysis (TLG). Chi-square test, Fisher exact test, two independent samples t-test and rank sum test were used to compare the differences of the above mentioned between the two group. Spearman correlation analysis was used to evaluate the correlation between metabolic parameters and lesion size. Results A total of 76 patients were enrolled, including 58 cases of choroidal melanoma and 18 cases of choroidal metastatic carcinoma. There were no significant differences in gender, age, and affected side between the two groups (all P> 0.05). There were statistically significant differences in the location(χ²=9.263, P=0.041)and shape(χ²=21.735, P<0.001)of lesions between the two groups. The thickness of the choroidal melanoma group was significantly higher than that of the choroidal metastatic carcinoma group (t=2.539, P=0.013). There was no significant difference in the largest basal diameter between the two groups (P>0.05). The SUV_max of the choroidal melanoma group was lower than that of the choroidal metastatic carcinoma group (P<0.05). There was no significant difference in SUV_peak and TLG between the two groups (all P>0.05). In the choroidal melanoma group, SUV_max, SUV_peak, and TLG were positively correlated with the largest basal diameter (r=0.528, 0.613, 0.732, all P<0.001) and thickness (r=0.521, 0.605, 0.730, all P<0.001). In the choroidal metastatic carcinoma group, SUV_peak and TLG were positively correlated with the largest basal diameter (r=0.528, 0.661, P=0.024, 0.003) and thickness (r=0.591, 0.688, P=0.010, 0.002). However, there was no significant correlation between SUV_max and the largest basal diameter and thickness (all P>0.05). Conclusion ¹⁸F-FDG PET/CT imaging findings and metabolic parameter SUV_max have certain value in the differential diagnosis of choroidal melanoma and metastatic carcinoma.

Value of ^{99 m}Tc-MIBI SPECT planar imaging and tomographic imaging in diagnosis of primary hyperparathyroidism

Guo Yuehong, Huang Jingwei, Chang Yuting, Yang Minfu

2022, 43(6):  873-879.  doi:10.3969/j.issn.1006-7795.2022.06.009

Asbtract ( 208 )   PDF (4837KB) ( 33 )  

References | Related Articles | Metrics

Objective To assess the diagnostic values of ^{99 m}Tc-MIBI SPECT/CT planar imaging and tomographic imaging in preoperative primary hyperparathyroidism (PHPT). Methods A total of 78 patients in Beijing Chaoyang Hospital from 2019 to 2021 with suspected PHPT who underwent pre-operative^99mTc-MIBI SPECT/CT from January 2019 to January 2021 were retrospectively reviewed.The diagnostic efficacy of early planar imaging, late planar imaging, and tomographic imaging were calculated respectively.The results were compared by χ² test. Results Of all the 78 patients, 20 males (25.64%) and 58 females (74.36%) were included, aged 14-78 (49.36±14.21) years old.Postoperative pathology confirmed 75 patients with PHPT.At patient level, the sensitivity, specificity, and accuracy of early planar imaging were 60.00%, 66.67%, and 60.26%, respectively.The sensitivity, specificity, and accuracy of late planar imaging were 81.33%, 0%, and 78.21%, respectively.The sensitivity, specificity, and accuracy of tomographic imaging were 89.33%, 66.67%, and 88.46%, respectively.The sensitivity and accuracy were significantly higher in late planar imaging and tomographic imaging than that in early planar imaging (χ ²=8.233,P=0.004 and χ ²=17.058,P ＜ 0.001, χ² =5.898,P=0.015 and χ²=16.272,P＜0.001, respectively).At lesion level, the sensitivity, specificity, and accuracy of early planar imaging were 55.42%, 83.33%, and 57.30%, respectively.The sensitivity, specificity, and accuracy of late planar imaging were 73.49%, 16.67%, and 69.66%, respectively.The sensitivity, specificity, and accuracy of tomographic imaging were 90.36%, 66.67%, and 88.76%, respectively.The sensitivity was significantly higher in late planar imaging than that in early planar imaging (χ²=5.916, P=0.015).The sensitivity and accuracy were significantly higher in tomographic imaging than that in early planar imaging and late planar imaging (χ²=25.639, P ＜ 0.001;χ²=22.364, P ＜ 0.001 and χ²=7.975,P=0.005 and χ ² =9.860,P=0.002, respectively). Conclusion The diagnostic values of ^{99 m}Tc-MIBI late imaging in preoperative primary hyperparathyroidism is more significant than that of early imaging.The late tomographic imaging can improve the sensitivity and accuracy.

Advances about molecular imaging of nuclear medicine in diagnosis and treatment of glioma

Xu Yang, Wang Kai, Chen Qiang, Ai Lin

2022, 43(6):  880-885.  doi:10.3969/j.issn.1006-7795.2022.06.010

Asbtract ( 144 )   PDF (1040KB) ( 35 )  

References | Related Articles | Metrics

Glioma is one of the most common intracranial tumors, and the prognosis of patients is usually poor.Conventional structural imaging offers insufficient information, by contrast the rapid development of molecular imaging, especially molecular imaging of nuclear medicine, provides a unique perspective to understand the biological characteristics of glioma, and further enhances physicians' understanding of glioma.This paper reviewed the advances of molecular imaging of nuclear medicine in the diagnosis, preoperative grading, judgment of molecular events, efficacy evaluation and prediction of prognosis of glioma in recent years.

New Progress of Rhinology Research

Effect of baicalin on lipopolysaccharide-stimulated inflammatory response in human monocytes THP-1

Wang Ping, Yang Jun, Wang Xiangdong, Zhang Luo

2022, 43(6):  893-898.  doi:10.3969/j.issn.1006-7795.2022.06.012

Asbtract ( 174 )   PDF (3761KB) ( 44 )  

References | Related Articles | Metrics

Objective To observe the effect of baicalin on the lipopolysaccharide (LPS)-stimulated inflammatory response in human monocytes THP-1. Methods LPS was used to induce the inflammatory response of human monocyte THP-1, and the relative expression levels of interleukin-1β (IL-1β), IL-6, IL-8, granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumor necrosis factor-α (TNF-α) were detected by real-time quantitative polymerase chain reaction (RT-qPCR) method to optimize the stimulation concentration of LPS.The cytotoxic effects of baicalein were also detected using the lactate dehydrogenase assay kit to optimize the bacailin concentration. The LPS-induced inflammation model of human monocyte THP-1 was pretreated with baicalin at different concentrations, and the inhibition effect of baicalin on the increasing expression of IL-1β, IL-6, IL-8, GM-CSF and TNF-α induced by LPS was examined by RT-qPCR. Results Compared to the control, the LPS treatment of human monocytes THP-1 at 1 μg/mL for 24 h could significantly increase the expression of IL-1β, IL-6, IL-8, GM-CSF and TNF-α (P<0.05).Treatment with baicalin at 10, 30 and 100 μmol/L on human monocytes THP-1 for 24 h and 48 h showed no significant cell cytotoxicity. The baicalein at 30 μmol/L and 100 μmol/L could significantly inhibit the LPS-induced increasing expression of IL-1β, IL-6, IL-8, GM-CSF and TNF-α in human monocytes THP-1. Conclusion The baicalin could significantly inhibit LPS-induced inflammatory response in human monocytes THP-1.

Clinical characteristics of chronic rhinosinusitis with nasal polyps with different body mass index

Li Yan, Wang Qiqi, Zhang Yuling, Duan Su, Zhang Haibo, Wang Xiangdong, Lan Feng

2022, 43(6):  899-904.  doi:10.3969/j.issn.1006-7795.2022.06.013

Asbtract ( 211 )   PDF (1047KB) ( 35 )  

References | Related Articles | Metrics

Objective To analysis the clinical characteristics in chronic rhinosinusitis with nasal polyps (CRSwNP) patients with different level of body mass index (BMI). Methods A total of 448 CRSwNP patients and 308 controls with septal deviation in Beijing Tongren Hospital from 2013 to 2019 were recruited retrospectively. According to BMI levels, CRSwNP patients were divided into 2 groups: underweight & normal weight (BMI<25 kg/m²) or overweight & obese (BMI≥25 kg/m²), and the rate of asthma comorbidity and revision surgery were analyzed. Results The percentage of eosinophilis in peripheral blood and the allergy comorbidity rate in CRSwNP patients were significantly higher than those in control group (P<0.05). Further classified the patients by genders, the female patients had higher rate of asthma comorbidity (31.6% vs 20.7%), and male overweight & obese CRSwNP patients were more than female overweight & obese patients. Classified the patients by BMI levels and gender, revision surgery rate of female overweight & obese CRSwNP patients was 43.6%, which was significantly higher than that of female underweight and normal weight patients. The percentage of eosinophil in peripheral blood in female overweight & obese patients was significantly lower than that in underweight and normal weight patients. The percentage of eosinophil in peripheral blood of male overweight & obese patients was significantly lower than that of underweight and normal weight patients. Conclusions The overweight and obesity female CRSwNP patients were susceptible to be with comorbid asthma and recurrence after surgery, and controlling the weight of female patients with CRSwNP may prevent nasal polyps recurrence in the females.

Study on immunohistochemical staining techniques of human inner ear frozen sections

Li Ying, Chen Biao, Wang Naili, Hao Xinping

2022, 43(6):  905-910.  doi:10.3969/j.issn.1006-7795.2022.06.014

Asbtract ( 167 )   PDF (2535KB) ( 52 )  

References | Related Articles | Metrics

Objective To study the methods of anti-slice escaping treatment and antigenic retrieval in the process of immunohistochemical staining of frozen sections of human inner ear for an improved staining. Methods Temporal bone specimens without ear diseases were taken. After sampling, fixation, decalcification, dehydration, and embedding, frozen sections were performed and frozen at -20 ℃. According to the anti-slice escaping treatment, the sample was divided into three groups: post-fixation group (group I), baked slice group (group Ⅱ), and post-fixation combined with baked slice group (group Ⅲ). Then each group underwent antigen retrieval and was divided into group A (heat repair group), group B (enzymatic digestion group) and group C (Triton group).The expression of four antibodies of WARP, NF200, CD68 and IBA1 in each group was detected by indirect fluorescence immunohistochemistry, observed under laser confocal microscope, and the results of dissection were analyzed. Results Compared to group Ⅰ and group Ⅱ, group Ⅲ had the best effect on preventing slices escape from glass slid. The antigen retrieval effect of group A and group C was relatively satisfactory. While the repair effect of group B was not good with a destructive effect on the cellular structure of the tissue. Conclusion The application of post-fixation combined with baked slice method to anti-slice escaping and the application of heat repair or Triton treatment for antigen repair have achieved good results in this study. Appropriate anti-slice escaping treatment and antigen retrieval methods play a crucial role in improving the sensitivity of immunohistochemical staining and preparation quality of inner ear frozen sections.

Analysis of radiological results of residual frontal recess cells and the efficacy of revision surgery in patients with recurrent frontal sinusitis after sinusotomy

Shi Muhan, Wang Chong, Wang Min, Yuan Fei, Xing Zhimin, Yuan Xiaopei, Wu Yuxiao

2022, 43(6):  911-918.  doi:10.3969/j.issn.1006-7795.2022.06.015

Asbtract ( 243 )   PDF (9950KB) ( 37 )  

References | Related Articles | Metrics

Objective To investigate the situation of residual frontal recess cells and efficacy of revision surgery by analyzing the computed tomographic (CT) results of the patients with recurrent frontal sinusitis after endoscopic sinus surgery. Methods A retrospective analysis of 64 chronic rhinosinusitis patients with recurrent frontal sinusitis after surgery who were prepared for surgery in Department of Otorhinolaryngology Head and Neck Surgery of Peking University People's Hospital from January 2017 to December 2019 was performed. The results of Visual Analog Scales (VAS) of nasal symptoms of the patients before and after surgery were collected. The patients' CT were analyzed according to The International Frontal Sinus Anatomy Classification (IFAC) to record the prevalence of every type of the residual frontal recess cells. The Lund-Mackay (LM) scores of all frontal sinuses were also recorded. The relationship of the patient's general information and the situation of residual frontal recess cells between the frontal sinus LM sores was analyzed statistically by using SPSS 27.0. The VAS scores of patients before and after surgery were analyzed. Results In this study 121 sides frontal sinuses were evolved. All kinds of frontal recess cells were found in the patients: agger nasi cell in 108 sides (89.3%), supra agger cell in 11 sides (9.1%), supra agger cell in 19 sides (15.7%), supra bulla cell in 20 sides (16.5%), supra bulla frontal cell in 13 sides (10.7%), supraorbital ethmoid cell in 40 sides (33.1%), frontal septal cell in 49 sides (40.5%), type 1 frontal septal cell in 15 sides (12.4%), and type 2 frontal septal cell in 34 sided (28.1%). Besides, the frontal septal cells and the supraorbital ethmoid cells were more prone to remaining. There were 54 patients followed up 1 year after surgery. The average VAS scores of the patients before and 1 year after surgery were 6.6±1.4 and 2.8±1.4, respectively. A total of 7 patients underwent Draf Ⅲ surgery. The mean VAS scores of total symptoms before and 1 year after surgery were 7.6±1.1 and 3.9±0.9, respectively. In statistical analysis, t the number of previous surgery (P=0.016, OR=2.639) was correlated with the increase of the frontal sinus LM sores. There were statistical differences between the VAS scores of the patients before and after surgery (t=19.656, P<0.01). Conclusions The proportion of some residual frontal recess cells were high in chronic rhinosinusitis patients after surgery. It may increase the risk of recurrence of frontal sinusitis. For the patients with recurrent frontal sinusitis, appropriate surgical skills should be measured. During the surgery, the frontal recess cells should be completely removed and ensure the drainage pathway smoothly to prevent recurrence.

Research advances in the anti-inflammatory effects and mechanisms of baicalin in chronic inflammatory diseases of respiratory mucosa

Yang Jingxing, Cai Chao, Zhao Yan, Wang Xiangdong, Zhang Luo

2022, 43(6):  919-923.  doi:10.3969/j.issn.1006-7795.2022.06.016

Asbtract ( 210 )   PDF (2344KB) ( 39 )  

References | Related Articles | Metrics

Baicalin is a kind of flavonoid component derived from the root of Scutellaria baicalensis, the main active ingredient of the plant. It has a wide range of pharmacological effects such as anti-inflammatory, anti-cancer, antiviral and antioxidant effects.Chronic inflammatory diseases of the respiratory mucosa, mainly chronic rhinosinusitis, allergic rhinitis and asthma, are among the serious chronic diseases affecting human daily life. The pathogenesis is complex and the current therapeutic methods have certain limitations and adverse effects.The traditional Chinese medicine baicalin has the potential to be developed as a drug for the treatment of chronic inflammatory diseases of the respiratory mucosa because of its good anti-inflammatory effect and low toxic side effects.In this review, we summarize the anti-inflammatory mechanism of baicalin in chronic inflammatory diseases of the respiratory mucosa and provide theoretical basis for its clinical application in related diseases.

Clinical Research

Correlation study between thyrotropin receptor antibodies (TRAb) and intestinal flora and short-chain fatty acids in patients with Graves disease

Wang Hua, Shi Tingting, Xin Zhong, Hua Lin, Li Cong, Cao Qiumei

2022, 43(6):  931-939.  doi:10.3969/j.issn.1006-7795.2022.06.018

Asbtract ( 165 )   PDF (2845KB) ( 43 )  

References | Related Articles | Metrics

Objective To investigate the differences in intestinal microbiota and short-chain fatty acids between patients suffering from Graves disease (GD) with normal thyroid function and healthy controls, and to analyze the correlation between thyrotropin receptor auto-antibodies (TRAb) and different intestinal microbiota. Methods Totally 30 Graves patients with normal thyroid function (GD group) and 32 healthy controls (Control) were enrolled in our study.Feces were collected, and 16S rRNA sequencing was used to analyze the structure of intestinal bacteria, and gas chromatography-mass spectrometry (GC-MS) was used to determine the content of short-chain fatty acids, the relationship between TRAb and intestinal microbiota was analyzed. Results Compared with the control group, α-diversity indexes of intestinal flora in GD patients were significantly decreased statistically.At the family level, the abundance of Bacteroidaceae and Ruminococcaceae decreased in GD patients, while the abundance of Prevotellaceae and Erysipelotrichaceae increased.At the species level, Eubacterium _hallii, Ruminococcus and Eubacterium_ventriosum were increased in GD patients, whileRuminococcus-bicirculans and Bacteroide_vulgatus decreased, and the differences were statistically significant.LEfSe analysis showed that Prevotellaceae (f_prevotellaceae and g_unidentified_prevotellaceae) and anaerobic bacteria (s_Prevotella copri) were enriched in GD group.The levels of propionic acid and butyric acid in GD patients were significantly decreased.The level of propionic acid was positively correlated with the abundance of Ruminococcaceae. Our analysis showed that serum TRAb antibody was inversely correlated with Ruminococcus abundance. Conclusion Even if the thyroid function of patients with Graves disease was normal, the intestinal flora and levels of propionic acid in patients were still significantly changed, and this change may be related to the serum TRAb antibody.

Analysis of characteristics of lung function trajectory in long-term treatment and management of children with asthma

Li Ang, Huang Huijie, Yang Shiqing, Hou Xiaoling, Xiang Li

2022, 43(6):  940-947.  doi:10.3969/j.issn.1006-7795.2022.06.019

Asbtract ( 187 )   PDF (1876KB) ( 10 )  

References | Related Articles | Metrics

Objective To analyze the trajectory characteristics of pulmonary function in 5 to 17 years old children with asthma after long-term treatment management in a single center and explore the factors influencing pulmonary function trajectories and to identify early persistent pulmonary function impairment phenotypes. Methods This is a retrospective cohort study. We enrolled 5 to 17 years old children with bronchial asthma who were diagnosed in the Department of Allergy, Beijing Children's Hospital from November 1,2018 to November 30,2020, and have been treated for 3 years or more. The clinical information was collected, which included demographic characteristics, medical history, steps of control treatment drugs, assessment of asthma control level and allergen results. The result of pulmonary function tests with maximum expiratory flow-volume curve (MEFV) was retrospectively analyzed. The parameters contain the percentage of the forced expiratory volume in the first second to the predicted value (FEV1%pred), forced vital capacity as a percentage of predicted value (FVC%pred), forced expiratory volume in one second to forced vital capacity (FEV1/FVC), the percentage of the maximum expiratory flow to the predicted value (PEF%pred), and the percentage of the maximum mid-expiratory flow to the predicted value (MMEF%pred). The pulmonary function data after 2-year managment were sorted out for trajectory analysis with univariate analysis and multivariate Logistics regression analysis. Results Out of 157 children, a total of 471 cases of pulmonary function data were used for trajectory analysis. FVC%pred, FEV1%pred and FEV1/FVC were divided into 2 types of trajectories: low trajectory and high trajectory. The trajectories fitted by PEF%pred and MMEF%pred were not statistically significant (P>0.05). Multivariate Logistic regression analysis showed that the risk factor for the low trajectory of FVC%pred is control instability (OR=4.878; 95%CI: 1.714-13.882). The risk factor for the low trajectory of FEV1%pred was the first abnormal lung function (OR=4.911; 95%CI: 2.137-11.287), and those for the low trajectory of FEV1/FVC was first-time abnormal lung function(OR=18.472;95%CI:5.182-65.850)and males (OR=3.774; 95%CI: 1.125-12.658). Conclusions The males, the first analyzable abnormal lung function and unstable control was risk factors that was prone to result in low trajectories.

Analysis of clinical features of primary angle closure glaucoma with retinitis pigmentosa

Duan Xiaoming, Kang Mengtian, Tang Xin, Wang Tao

2022, 43(6):  948-952.  doi:10.3969/j.issn.1006-7795.2022.06.020

Asbtract ( 187 )   PDF (1020KB) ( 28 )  

References | Related Articles | Metrics

Objective To investigate the clinical features of primary angle closure glaucoma (PACG) patients with retinitis pigmentosa (RP). Methods This study included 32 patients suffering from PACG combined with RP hospitalized in Beijing Tongren Hospital, Capital Medical University from April 2013 to April 2017, and 229 PACG patients without RP hospitalized in the same period.According to the type of glaucoma, patients were divided into 4 groups, 12 patients in acute angle closure glaucoma with RP group (AACG-RP), 20 patients in chronic angle closure glaucoma with RP group (CACG-RP), 94 patients in AACG-non RP group and 135 patients in CACG-non RP group.The age of onset and axial length (AL) were compared among these four groups. Results Mean age of onset was (39.00±12.07) years in AACG-RP group, (43.85±12.79) years in CACG-RP group, (66.44±9.40) years in AACG-non RP group and (63.95±10.42) years in CACG-non RP group.The difference between the four groups was statistically significant (F=47.70,P<0.05).The mean AL was (21.31±1.37) mm in AACG-RP group, (22.33±1.09) mm in CACG-RP group, (22.31±1.03) mm in AACG-non RP group and (22.47±1.01) mm in CACG-non RP group.The difference between the four groups was statistically significant (F=19.09,P<0.05). Conclusions In PACG patients combined with RP, AACG patients had earlier age of onset and shorter AL than CACG patients. PACG patients combined with RP had earlier age of onset and shorter AL than those without RP, especially those with AACG combined with RP.

Risk factors for incomplete resection and prolonged operative duration of endoscopic submucosal dissection for colorectal tumors

Gu Feng, Jiang Wei, Liu Yuhang, Zhai Huihong

2022, 43(6):  959-965.  doi:10.3969/j.issn.1006-7795.2022.06.022

Asbtract ( 297 )   PDF (1976KB) ( 16 )  

References | Related Articles | Metrics

Objective To investigate risk factors for incomplete resection and prolonged operative duration of endoscopic submucosal dissection (ESD) for colorectal tumors. Methods Patients who received ESD procedures for colorectal tumors at Beijing Friendship Hospital, Capital Medical University between February 2014 and November 2021 were included in the study. The Chi-square test and logistic regression model were applied to analyze risk factors for incomplete resection and prolonged operative duration of ESD. Results A total of 433 patients were included in the final analysis. 98.8% of ESD procedures were completed successfully (428/433) and the mean operative time was (67.91±64.28) minutes. Incomplete resection rate was 20.56% (88/428), and risk factors for incomplete resection were tumor size over 4 cm (P=0.001,OR=3.017, 95%CI: 1.536-5.924), severe submucosal fibrosis(P<0.001, OR=5.825, 95%CI: 2.540-13.355)and the non-lifting sign(P=0.025,OR=2.831,95%CI:1.141-7.025). 15.7% of patients (67/428) underwent prolonged ESD which last more than 120 minutes. Female (P=0.044,OR=1.832,95%CI: 1.017-3.300), tumor size over 4cm (P<0.001,OR=10.276,95%CI: 5.340-19.774)were significantly associated with prolonged operative duration. Conclusion Risk factors for incomplete resection included tumor size larger than 4cm, tumor with ulcerative colitis, severe submucosal fibrosis, and the non-lifting sign. Risk factors for prolonged operative time included female patients and larger tumor size.