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Objective@#To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM).@*Methods@#From January 2015 to July 2018, 14 FM patients (6 males, 8 females, average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied. The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (<20%), moderate (20%-50%) and severe (>50%) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (%). χ2 test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe.@*Results@#According to the results of Q SPECT imaging, all 14 patients had impaired blood perfusion in the superior lobe of left lung, and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung, superior lobe of right lung, middle lobe of right lung, inferior lobe of right lung were 11/3, 14/0, 13/1, 12/2, respectively. The incidence rates of impaired blood perfusion in different lobes were not significantly different (χ2=6.198, P=0.185). The range of lung perfusion defect was mild in 1, moderate in 7 and severe in 6 patients. The incidence rates of impaired blood ventilation in different lobes were not significantly different (χ2=1.587, P=0.811). The range of lung ventilation defeat was mild in 11, moderate in 2 and severe in 1 patients. The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41, respectively (χ2=28.42, P<0.05). There was more defect in Q SPECT imaging, but both methods showed segmental or subsegmental distribution.@*Conclusions@#The defect of V/Q SPECT imaging in FM patients is segmental in distribution, and more is observed in Q SPECT imaging. Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.
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Objective To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM).Methods From January 2015 to July 2018,14 FM patients (6 males,8 females,average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied.The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (＜20％),moderate (20％-50％) and severe (＞50％) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (％).x2 test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe.Results According to the results of Q SPECT imaging,all 14 patients had impaired blood perfusion in the superior lobe of left lung,and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung,superior lobe of right lung,middle lobe of right lung,inferior lobe of right lung were 11/3,14/0,13/1,12/2,respectively.The incidence rates of impaired blood perfusion in different lobes were not significantly different (x2=6.198,P=0.185).The range of lung perfusion defect was mild in 1,moderate in 7 and severe in 6 patients.The incidence rates of impaired blood ventilation in different lobes were not significantly different (x2 =1.587,P=0.811).The range of lung ventilation defeat was mild in 11,moderate in 2 and severe in 1 patients.The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41,respectively (x2=28.42,P＜0.05).There was more defect in Q SPECT imaging,but both methods showed segmental or subsegmental distribution.Conclusions The defect of V/Q SPECT imaging in FM patients is segmental in distribution,and more is observed in Q SPECT imaging.Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.
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Objective@#To investigate the value of ATP stress cerebral blood flow perfusion imaging (CBFPI) in diagnosis of ischemic cerebrovascular disease.@*Methods@#Thirty-two patients with cerebral ischemia and ischemic cerebral infarction (26 males, 6 females, average age: (63.0±8.7) years) in China-Japan Friendship Hospital from November 2016 to February 2017 were enrolled. All subjects underwent 99Tcm-ethylcysteinate dimer (ECD) rest and ATP stress CBFPI. Region of interest (ROI) was drawn in the symmetrical parts of the bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe and basal ganglia region, and the regional cerebral blood flow (rCBF) was automatically calculated. The images and rCBF of post- and pre-ATP stress CBFPI were analyzed and compared. Paired t test was used for statistical analysis.@*Results@#The positive rates of rest CBFPI, ATP stress CBFPI, and combination of both imaging were 53.1%(17/32), 65.6%(21/32), and 100%(32/32), respectively. In 16 cases with unilateral vascular stenosis, the average rCBF of diseased hemisphere was lower in stress imaging (62.7±13.3) ml·100 g-1·min-1 than that in rest imaging ((65.8±13.2) ml·100 g-1·min-1; t=3.07, P<0.05). While the average rCBF of the contralateral hemisphere in rest and stress imaging showed no significant difference ((67.4±13.3) vs (65.9±13.0) ml·100 g-1·min-1; t=1.90, P>0.05). In the other 16 patients with bilateral multivessel disease, the average rCBF of whole brain in rest imaging was higher than that in stress imaging: (62.5±13.9) vs (57.5±11.6) ml·100 g-1·min-1; t=3.50, P<0.05. There were 21 out of the 32 patients presented with a decreased cerebrovascular reserve.@*Conclusion@#ATP stress combined with rest CBFPI may improve positive rate remarkably and help to evaluate the cerebrovascular reserve.
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Objective To study the reliability of 99Tcm-(hydrazinonicotinamide (HYNIC)-BMS-200261) (tricine) (trisodium triphenylphosphine-3,3',3"-trisulfonate (TPPTS)) as a radiotracer for protease activated receptor-1 (PAR-1) expression in breast cancer.Methods Fifteen nude mice bearing MDA-MB-435,MDA-MB-231 and MCF-7 human breast cancer xenografts (5 mice for each cell line) with different PAR-1 expression were used for 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) γ imaging,and tumor/non-tumor (T/NT) ratios were obtained with region of interest (ROI) technique.Afterwards,the biodistribution of 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) was analyzed in tumor-bearing nude mice,and the radioactivity in tumor (percentage activity of injection dose per gram of tissue,％ID/g) was calculated.The immunostaining was performed to examine PAR-1 expression in tumor tissue and semi-quantitative analysis was used.One-way analysis of variance and Pearson correlation analysis were used to analyze data.Results At 2 h postinjection,the T/NT ratios were 3.03±0.32,2.27±0.25 and 1.51±0.13 respectively in nude mice bearing MDA-MB-435,MDA-MB-231 and MCF-7 xenografts;the tumor uptakes of 99Tcm-(HYNIC-BMS-200261)(tricine)(TPPTS) were (1.03±0.15),(0.56±0.14) and (0.30±0.06) ％ID/g;PAR-1 expression levels were (17.22±2.71) ％,(10.78± 1.95) ％ and (2.80± 1.18) ％,respectively (F values:47.66,46.36,62.35,all P＜0.05).The T/NT ratios and tumor uptake of 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) at 2 h post-injection were correlated with PAR-1 expression (r values:0.934 and 0.929,both P＜0.05).Conclusions 99Tcm-(HYNIC-BMS-200261) (tricine) (TPPTS) imaging could be a noninvasive and effective method for monitoring PAR-1 expression in human breast cancer.
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Objective To analyze the risk factors of blood vessel invasion in stage Ⅰ non-small cell lung cancer (NSCLC).Methods A retrospective analysis of 166 patients with stage Ⅰ NSCLC who underwent surgical resection and pathological diagnosis from January 2016 to March 2018 in China-Japan Friendship Hospital was conducted.The presence of blood vessel invasion in tumor tissue was detected by immunohistochemistry.Clinicopathological factors which may affect blood vessel invasion were evaluated by univariate analysis and multiple logistic regression analysis.For statistically significant factors revealed by multivariate analysis,the diagnostic efficiency and best cut-off point were calculated by the receiver operating characteristic curve.Results The univariate analysis identified that the smoking history (P =0.020),maximum standardized uptake value (SUVmax) (P =0.001),tumor diameter (P =0.001),TNM stage (P =0.002),and lymphatic invasion (P =0.023) were factors affecting blood vessel invasion status.Multivariate analysis showed that SUVmax was an independent risk factor for blood vessel invasion (OR =1.097,95 ％ CI 1.014-1.187,P =0.021).The preoperative SUVmax of primary tumor was a predictor for blood vessel invasion with the highest diagnostic accuracy at a cut-off value of 4.85,the sensitivity and specificity were 66.0 ％ and 71.7 ％,respectively.Conclusion The SUVmax is an independent predictor for blood vessel invasion in stage Ⅰ NSCLC,and the risk of blood vessel invasion rises with the increase of SUVmax.
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Objective:To evaluate the effect of humanistic care for medical care integration on quality of life in elder patients with mild cognitive impairment. Method:Seventy patients with mild cognitive impairment in our hos-pital were randomly divided into experimental group ( n=35 ) and control group ( n=35 ) using random number ta-ble. The patients in the control group were given routine care, while those in the experimental group were given hu-manistic care for medical care integration and home visiting once a month besides routine care. All the patients were evaluated by the Montreal Cognitive Assessment Scale ( MoCA) , Activities of Daily Living ( ADL) , and the MOS Item Short from Health Survey ( SF-36 ) during hospitalization, three months and six months after hospital discharge. Result:Three and six months after hospital discharge, the scores of these three scales of all subjects in two groups were significantly higher than those during hospitalization ( P<0 . 05 ) . The scores of the subjects in the experimental group also significantly higher than those of the control group, and the differences were statistically significant (P<0. 05). Conclusion: For the elder patients with mild cognitive impairment, humanistic care for medical care integration can significantly improve the cognitive function, self -care ability and quality of life. Therefore, it is worthy using in clinical treatment.
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Objective:To study the health equity and explore the influencing factors of health inequities among those insured in New Rural Cooperative Medical System and to provide theoretical and factual basis for improvement of medical insurance system through .Method:Using concentration index decomposition to explore the sources of inequity in health outcomes and the degree of horizontal inequity in health outcomes .Results:Economical level leads that the concentration indexes of two week prevalence favor the poor , i.e.the worse the health outcome of the rich is.Economical level leads that the concentration indexes of chronic disease prevalence and self -reported health defective rate favor the rich , i.e.the worse the health outcome of the poor is .Conclusion:Economic level is the primary factors affecting two weeks prevalence , age, culture level, the employment situation is the factors al-leviate health outcomes unfair .Increase people′s economic level and cultural level , improve the situation of em-ployment is important to the health equity .
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Objective To evaluate characteristics of CT and 18F-FDG PET/CT in pulmonary sclerosing hemangioma (PSH).Methods A retrospective study involving 12 patients (2 males,10 females;24-80 years old) confirmed as PSH by pathology from May 2012 to July 2014 was investigated.All patients underwent chest CT scan,including enhanced CT;and 5 cases underwent whole-body 18F-FDG PET/CT.All imaging data were collected and analyzed to find out a more effective diagnostic method.Results In 12 PSH patients,9 had single lesion,of which 4 involved left lung and 5 right lung.The rest 3 patients including 1 with two nodules located in the right lower lobe,and 2 with multiple nodules scattered in several lobes.Plain CT showed all lesions had uniformly isodensity,4 with calcification,3 with air meniscus sign.Contrast-enhanced CT examinations showed that the majority lesions were prominent enhancement and few moderate enhancement,all lesions showed vessel marginating sign and 6 with cystic and necrosis area.18F-FDG PET/CT examinations showed that the lesions displayed patchy pattern of mild to moderate uptake with SUVmax 2.2--4.0.Conclusions The characteristic CT features of PSH,especially the contrast-enhanced CT imaging,are important for diagnosis.18F-FDG PET/CT findings are extremely helpful in differentiating PSH from malignant lesions.
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<p><b>OBJECTIVE</b>To analyze the prognostic impact of preoperative (18)F-fluorodeoxyglucose (FDG) PET-CT on postoperative recurrence in patients with completely resected stage I non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The clinic data of 182 patients with stage I NSCLC who underwent (18)F-FDG PET-CT scan before surgical resection between June 2005 and June 2012 were reviewed retrospectively. There were 121 male and 61 female patients, with an average age of 68 years (range from 34 to 85 years). The pathological stage was I A in 98 patients, I B in 84 patients; the histology were adenocarcinoma in 137 patients, squamous cell carcinoma in 35 patients, and others in 10 patients. Clinicopathological factors including gender, age, smoking history, SUV(max), surgical procedure, pathological features and adjuvant chemotherapy were evaluated to identify the independent factors predicting postoperative recurrences by univariate and multivariate analysis. The survivals were calculated by the Kaplan-Meier method and differences in variables were analyzed by the Log-rank test.</p><p><b>RESULTS</b>The postoperative recurrence rate was 15.9%. The univariate analysis identified that the SUV(max) (t=3.278, P<0.001), p-stage (χ² =5.204, P=0.026), blood vessel invasion (χ² =5.333, P=0.027) and visceral pleural invasion (χ² =7.697, P=0.009) are factors for predicting postoperative recurrence. Only SUV(max) was found to be a significant independent factor according to multivariate analysis (HR=1.068, 95%CI: 1.015 to 1.123, P=0.001). The study population was stratified into three groups by SUV(max), patients with SUV(max) > 5.0 had significantly higher risk of recurrence (23.9%) than those with 2.5 < SUV(max) ≤ 5.0 (15.0%) and SUV(max) ≤ 2.5 (7.3%) (P=0.043); patients with SUV(max) ≤ 2.5 had significantly better 5-year recurrence-free survival rate (90.9%) than those with 2.5 < SUV(max) ≤ 5.0 (82.7%) and SUV(max) ≤ 2.5 (71.0%) (P=0.030). There was a trend toward higher probability of blood vessel invasion (χ² =20.267, P < 0.001), visceral pleural invasion (χ² =6.185, P=0.045) and pathological stage I B (χ² =13.589, P=0.001) with increased SUV(max).</p><p><b>CONCLUSIONS</b>Preoperative SUV(max) of primary tumor is a predictor of postoperative relapse for stage I NSCLC after surgical resection. Therefore, it can contribute to the risk stratification for patients with the same pathological stage and selecting the optimal postoperative follow-up and therapeutic strategy.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Diagnosis , General Surgery , Fluorodeoxyglucose F18 , Lung Neoplasms , Diagnosis , General Surgery , Neoplasm Recurrence, Local , Diagnosis , Neoplasm Staging , Positron-Emission Tomography , Postoperative Period , Prognosis , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
<p><b>BACKGROUND</b>In tumors the process of apoptosis occurs over an interval of time after chemotherapy. It is important to determine the best time for detecting apoptosis by in vivo imaging. In this study, we evaluated the dynamics and feasibility of imaging non-small cell lung cancer (NSCLC) apoptosis induced by paclitaxel treatment using a (99)Tc(m)-labeled Annexin V recombinant with ten consecutive histidines (His10-Annexin V) in a mouse model.</p><p><b>METHODS</b>(99)Tc(m)-His10-Annexin V was prepared by one step direct labeling; radio-chemical purity (RCP) and radio-stability was tested. The binding of (99)Tc(m)-His10-Annexin V to apoptotic cells was validated in vitro using camptothecin-induced Jurkat cells. In vivo bio-distribution was determined in mice by dissection. The human H460 NSCLC tumor cell line (H460) tumor-bearing mice were treated with intravenous paclitaxel 24, 48 and 72 hours later. (99)Tc(m)-His10-Annexin V was injected intravenously, and planar images were acquired at 2, 4 and 6 hours post-injection on a dual-head gamma camera fitted with a pinhole collimator. Tumor-to-normal tissue ratios (T/NT) were calculated by ROI analysis and they reflected specific binding of (99)Tc(m)-His10-Annexin V. Mice were sacrificed after imaging. Caspase-3, as the apoptosis detector, was determined by flow cytometry, and DNA fragmentation was analyzed by the terminal deoxynucleotidytransferase mediated dUTP nick-end labeling (TUNEL) assay. Nonspecific accumulation of protein was estimated using bovine serum albumin (BSA). The imaging data were correlated with TUNEL-positive nuclei and caspase-3 activity.</p><p><b>RESULTS</b>(99)Tc(m)-His10-Annexin V had a RCP > 98% and high stability 2 hours after radio-labeling, and it could bind to apoptotic cells with high affinity. Bio-distribution of (99)Tc(m)-His10-Annexin V showed predominant uptake in kidney, relatively low uptake in myocardium, liver and gastrointestinal tract, and rapid clearance from blood and kidney was observed. The T/NT was significantly increased after paclitaxel treatment, whereas it was low in untreated tumors (T/NT = 1.43 ± 0.18). The %ID/g activity in Group 2 (24 hours), Group 3 (48 hours) and Group 4 (72 hours) after treatment was 2.55 ± 0.73, 3.35 ± 1.10, and 3.4 ± 0.96, respectively. Whereas in the non-treated group, Group 1, %ID/g was 1.10 ± 0.18. The radiotracer uptake was positively correlated to the apoptotic index (r = 0.852, P < 0.01), as well as caspase-3 activity (r = 0.816, P < 0.01).</p><p><b>CONCLUSION</b>This study addresses the dynamics and feasibility of imaging non-small cell lung tumor apoptosis using (99)Tc(m)- His10-Annexin V.</p>
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Animals , Humans , Mice , Annexin A5 , Antineoplastic Agents, Phytogenic , Therapeutic Uses , Apoptosis , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Pathology , Cell Line, Tumor , Disease Models, Animal , Histidine , Lung Neoplasms , Drug Therapy , Pathology , Organotechnetium Compounds , Paclitaxel , Therapeutic Uses , RadiopharmaceuticalsABSTRACT
Objective: Analyze the impact of NCMS(new cooperative medical scheme) on rural medical institutions,and give suggestions for the sustainable development of medical institutions and the NCMS.Methods: Collect and analyze the efficiency and the account materials of the county-level healthcare departments and the town-level health centers of Zhen'an County in 2003 and 2006.Results: The implementation of NCMS produced an effect on the increase of the outpatient medical service;the service quality of the county-level medical institutions and the town-level health centers needs to be enhanced in spite of the increase of in-patient medical service;the medical institutions' income increased,and the medical service fees increased rapidly;the expenditure per person and time rose sharply.Conclusions: Management mechanism of NCMS should be further developed,construction and supervision of the county-level medical sectors and the town-level health centers,especially supervision of the quality of medical sectors be enhanced;the payment system be changed to control the growth rate of medical expenses.
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Objective: to measure anxiety status and explore integrated factors about anxiety of countrywomen in Shaanxi, then put forward to suggestions for improving women's mental health under the bio - psycho - social medical model. Methods: A cross - sectional survey was adopted. 592 married countrywomen volunteers were selected by cluster random sampling from Chang'an district of Xi'an in Shaanxi province. Self - rating anxiety scale, Self - rating depression scale and Life events scale were used for assessment of mental health of the subjects. Additional, gynecologic examinations were done to measure personal reproductive health status. Results: The facts of mental status of Shaanxi rural women brook no optimism. Among the 592 samples that were investigated in current study, 25. 3% have anxiety symptoms. For the study population, the average total index score of SAS was 34. 34. Further analysis revealed that dysmenorrhea, menarche age and depression are main risk factors influencing women's anxiety status. In addition, married countrywomen's anxiety is related to sexual intercourse satisfaction, uterus motion and per capita health care spending, etc.
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The World Health Organization points out that everyone has right to acquire basic health care service and social guarantee. The government should adopt proper and legal means to gradually realize everyone's health right with current resource.As the aggravation of poverty problem in the city,the problem of urban poor population will become one of the most important political events in the 21st century.Through analysing the problem of urban poor population in health care,this article discusses the mechanism of medical aid and the countermeasures to meet the basic medical demand of urban poor population,which will help to improve the health of poor population in the city,the medical service utilization and health fairness.