Objective To evaluate the clinical value of 9 9 Tc m-HL91 as a tumor positive imaging agent in diagnosis of pulmonary neopl asms. Methods We performed 2 h,4 h planar and 4 h tomogr aphy fusion imaging after injection of HL91 on 42 patients with high probability of pulmonary cancer. Tumor-to-normal tissue background (T/N) ratios were meas ured for all scans. Results T/N ratios at 2 h,4 h planar and 4 h transectional imaging in malignant group were 1.50? 0.17 ,1.71?0.22 and 2.72?0.75, respectively; while in benign group, they were 1.21?0.10,1.25 ?0.22 and 1.49?0.36, respectively. 4 h delay T/N ratios in malignant group we re obviously higher than 2 h ( P 0.05). There were no remarkable differences of T/N ra tios in different phases and histological types of lung carcinoma. Using maligna nt transection ratio ( -1s ) as diagnostic threshold, the sensitivity , specificity and accuracy were 84.85% , 88.89% and 85.71% , respectiv ely. Using transection ratio( +1s ) of benign group as diagnostic th reshold , the sensitivity, specificity and accuracy were 90.91%, 88.89% and 95.2 4%,respectively. Conclusion The results indicate that as a tumor positive imaging agent 99 Tc m-HL91 is useful in diagosising pulmon ary neoplasms.

Objective To certify whether 99mTc-HL91 can be trapped in ischemic myocardium prominently for clinical imaging. Methods The model of myocardial ischemia in rabbits was prepared and the distribution of 99mTc-HL91 was observed. The distribution of 99mTc-HL91 in the whole body was also observed. Results The myocardium of the left ventricle supplied by LCX was ischemic according to the change of electrical physiology and the results of NBT dying. The radioactivity in the myocardium of left ventricle supplied by LCX was higher than that supplied by LAD. LCX/LAD: 120 min, 2.57; 180 min, 3.45. 99mTc-HL91 was mostly distributed in the liver and kidney, next, the stomach and intestine. It was excreted through urination and defecation. There was little radioactivity in the heart and lungs and it eliminated quickly. 99mTc-HL91 was eliminated quickly from blood, too. Conclusion Ischemic myocardium can trap 99mTc-HL91 more significantly and relatively prominently at 180 minutes of post-injection. 99mTc-HL91 can be used in myocardial hypoxia imaging.

Objective To know the current situation of core competency of midwives in Guangzhou, and analyze the influencing factors.Methods A cross sectional survey was conducted among 256 midwives from 13 hospitals in Guangzhou to investigate their core competency.Results The total average score of core competency of midwives was (4.09±0.49). The scores of intrapartum care and antenatal care were higher,while the scores of progestational care and public health care were lower. Multivariate regression analysis showed that the core competency of midwives was influenced by several aspects,and they were work experience,work experience in midwifery,age,title,job and marital status (β′=0.771, 0.549,0.409,0.390,0.250,0.137;P<0.05).Conclusions The overall level of midwifery competency of midwives in Guangzhou is good,but their professional scope and role function need to be deepen and expanded,so as to satisfy the growing health care demand from pregnant women and their families. Managers should develop individualized and specific training and management strategies to improve midwives′ competency based on the condition of hospitals.

Objective:To explore the prognostic factors of primary plasma cell leukemia (pPCL) in the era of novel agents.Methods:The clinical data of 66 patients with pPCL treated at the Department of Haematology, Beijing Chao-Yang Hospital, Capital Medical University from 2011 to 2022 were retrospectively collected to analyze their prognostic factors.Results:Among the 66 patients with pPCL, the median age was 59 (range: 29-79) years. The median overall survival (OS) duration was 19.0 (95% CI 10.4-27.6) months, and the median progression-free survival (PFS) duration was 11.0 (95% CI 6.5-15.6) months. The median OS and PFS were significantly longer in patients with the best post-treatment response of very good partial remission (VGPR) or better than in patients with a response of partial remission (PR) or worse (median OS: 33.0 months vs 6.0 months, P<0.001; median PFS: 16.0 months vs 3.0 months, P<0.001). OS was significantly longer in patients who underwent autologous hematopoietic stem cell transplantation than in those who did not undergo transplantation (49.0 months vs 6.0 months, P=0.002), and there was a trend toward a longer PFS in patients who underwent transplantation than in those who did not undergo transplantation (19.0 months vs 8.0 months, P=0.299). The median OS and PFS were significantly longer in patients who received maintenance therapy than in those who did not receive maintenance therapy (median OS: 56.0 months vs 4.0 months, P<0.001; median PFS: 20.0 months vs 2.0 months, P<0.001). Multivariate analysis showed that hypercalcemia was an independent risk factor ( HR=3.204, 95% CI 1.068-9.610, P=0.038) for patients with pPCL, while receiving maintenance therapy ( HR=0.075, 95% CI 0.022-0.253, P<0.001) and post-treatment response of VGPR or better ( HR=0.175, 95% CI 0.048-0.638, P=0.008) were independent protective factors for patients with pPCL. Conclusions:In the era of novel agents, hypercalcemia, receiving maintenance therapy, and post-treatment response of VGPR or better are independent prognostic factors for pPCL.

Objective:To investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space(DTI-ALPS)in bipolar disorder Ⅰ(BD-Ⅰ).Methods:A total of 44 BD-Ⅰ patients(BD-Ⅰ group) admitted to the Affiliated Brain Hospital of Guangzhou Medical University from January 2012 to December 2017 were selected.In addition, totally 30 healthy controls (HC group) were recruited. The diffusion tensor image data were analyzed retrospectively, and along the perivascular space (ALPS) index was calculated. Hamilton anxiety scale (HAMA), 17-item Hamilton depression rating scale (HAMD-17), Young mania rating scale (YMRS) and global assessment function (GAF) were used to evaluate the severity of anxiety, depression, mania and social function respectively. SPSS 25.0 software was used for t-test, Z-test and chi-square test, and the differences in clinical data and DTI-ALPS index between the two groups were compared. The partial correlation test was used to analyze the correlations between DTI-ALPS index and the clinical indicators such as HAMA, HAMD-17, YMRS and GAF. Results:The DTI-ALPS indexes in left(1.69±0.17), right(1.44±0.15) and bilateral cerebral hemispheres(1.56±0.15) of BD-Ⅰ group were lower than those in HC group ((1.71±0.15), (1.46±0.13) and (1.58±0.12)), but the differences were not statistically significant ( t=-0.441, -0.545, -0.556, all P>0.05). After controlling for gender, age, years of education and course of disease, there were significant negative correlations between bilateral average DTI-ALPS index and somatic anxiety ( r=-0.334, P=0.038), as well as between right DTI-ALPS index and somatic anxiety( r=-0.349, P=0.030) in BD-Ⅰ group. Conclusion:The dysfunction of cerebral glymphatic system is not obvious in BD-Ⅰ patients, but their anxiety may be related to dysfunction cerebral glymphatic system.