Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used asgold standard, the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P<0.05). According to the features of the ROC curve, the best threshold for the diagnosis of CAD with CACS was 96.45, with CACS≥96.45 as the positive standard in diagnosis of CAD, the sensitivity, specificity, accuracy, PPV and NPV for the diagnosis of CAD by CACS were 60.3%, 93.9%, 80.8%, 86.3%and 78.8%, respectively. ④ The sensitivity of MPI combined with CACS were significantly higher than MPI (80.8% vs. 65.8%, P<0.05), while the specificity (71.3% vs.75.7%, P>0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P<0.05), while the specificity was lower than CACS (71.3%vs. 93.9%, P<0.05) and the accuracy showed no statistically significant difference (75.0%vs. 80.8%, P>0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.

Aim To investigate the protective effect of catechin on cerebral ischemia-reperfusion injury in rats and its mechanism.Methods 40 rats were randomly divided into 5 groups:sham operation group,model group and 50,100 and 200 mg·kg~(-1) catechin groups,with 8 rats in each group.The model of focal cerebral ischemia-reperfusion in rats was established with modified sutured-occluded method.The rats in catechin groups were injected with catechin at the matched concentration.The rats in sham operation group and model group were injected with saline.And all rats were given more time in 2 hours after ischemia.Rats were sacrificed for histologic examination after the behavioral test,and their brains were taken to assay the activities of MPO and NOS.Results Catechin at different dosages(50,100 and 200 mg·kg~(-1))could obviously decrease neurological deficit score,repair histological injury,and reduce the activities of MPO and NOS in rats of focal cerebral ischemia-reperfusion injury.Conclusions Catechin can relieve the cerebral ischemia reperfusion injury,and its mechanism may be partly related to the effects of its antiinflammation and antioxidation.

Objective To evaluate the additional value of CACS in detection of coronary artery disease (CAD) with MPI.Methods A total of 188 suspected CAD patients (128 males,60 females;average age (61.93±9.16) years) who underwent one-step examination of MPI combined with CACS from December 2012 to August 2014 were enrolled in this retrospective study.According to the gold standard of CAG,the diagnostic efficacy of MPI was calculated.ROC analysis was performed to determine the optimal CACS threshold for the detection of CAD.Mann-Whitney u test and x2 test were used for statistical analysis.Results (1) Seventy-three CAD cases were confirmed (≥ 50％ stenosis) among 188 patients.The sensitivity,specificity,accuracy for CAD diagnosis with MPI were 65.8％ (48/73),75.7％ (87/115),71.8％ (135/188),respectively.Twenty-five CAD patients had negative findings with MPI,including 2 with LM disease,4 with three-vessel disease (LAD±LCX±RCA,3-VD),3 with 2-VD,16 cases with 1-VD.Among them 13 cases (52.0％,13/25) had intermediate lesions of 1-VD (50％ ≤ stenosis＜70％).(2) The CACS of CAD group was significantly higher than that of non-CAD group (172.40(19.25,516.45) vs 0;z=-8.465,P＜0.001).According to the ROC analysis,95.1 was the optimal CACS cutoff to detect CAD patients.Combining MPI with CACS (at cutoff of 95.1) improved the sensitivity of MPI (80.8％,59/73;x2 =4.233,P＜0.05) for the detection of CAD,with no significant decrease in specificity and accuracy (71.3％,82/115;75.0％,141/188;x2 values:0.558 and 0.490,both P＞0.05).(3) Of the 25 CAD patients with negative MPI results,11(44.0％,11/25) showed abnormal CACS(CACS≥95.1),consisted of 2 cases of LM disease,4 cases of 3-VD,2 cases of 2-VD,3 cases of 1-VD.Diagnosis was corrected by CACS in 8/9 cases of severe CAD (LM CAD or multivessel disease) which were missed by MPI.Conclusion CACS could offer additional information for MPI in detection of suspected CAD patients,which can improve the sensitivity of MPI for diagnosing CAD,especially for severe CAD with LM lesions or multivessel CAD.

Purpose To investigate the clinical value of gated myocardial perfusion imaging (GMPI) quantitative analysis technique in evaluating left ventricular remodeling and its effects on left ventricular function in patients with myocardial infarction (MI). Materials and Methods Seventy-six cases of MI patients were retrospectively analyzed, including pure left anterior descending artery (LAD) disease in 21 cases , left circumlfex artery (LCX) or right coronary branch (RCA) disease in 23 patients and multivessel disease in 32 cases. Seventy-four healthy people were additionally selected as control group. GMPI was performed on all subjects. Reconstruction images were automatically analyzed by using cardiac software QGS 2009 to obtain left ventricular remodeling index, including diastolic sphericity index (SIED) and end-systolic sphericity index (SIES). Cardiac function parameters were also obtained, including left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), left ventricular ejection fraction (LVEF), and peak iflling rate (PFR). Differences of the left ventricular remodeling index and cardiac function parameters between the MI group and the control group were compared to analyze the relationship between left ventricular remodeling after myocardial infarction and coronary artery lesions. Results SIED, SIES and EDV, ESV in MI group were signiifcantly higher than those in the normal group (P<0.01). The cardiac function parameters of LVEF and PFR were significantly lower than those of the normal group (P<0.01). SIED and SIES in the group of LAD lesions and multi-vessel disease were signiifcantly higher than those in the LCX/RCA lesion group (P<0.05). The left ventricular remodeling was occurred more often in LAD lesion group and multi-vessel disease group than in the LCX/RCA lesion group (χ2=6.502 and 10.166, P<0.05). There was no significant difference between the LAD lesions group and multi-vessel disease group (χ2=0.105, P>0.05). Linear regression analysis showed that LVEF and PFR in group of left ventricular remodeling was signiifcantly lower with the increase of SIED (F=43.231 and 15.642, P<0.01). SIED and SIES analysis resulted in high correlation for both intra-observer and inter-observer (r=0.881-0.926, P<0.01). Conclusion Left ventricular remodeling after myocardial infarction can be accurately evaluated by GMPI. Patients with myocardial infarction due to LAD or multi-vessel coronary artery diseases may have left ventricular remodeling easier and more severe. Left ventricular remodeling will seriously affect the myocardial contraction and diastolic function, resulting in the entire left ventricular dysfunction.

OBJECTIVETo assess the left ventricular (LV) systolic synchrony by phase analysis of gated myocardial perfusion imaging (GMPI) with SPECT/CT in patients with old myocardial infarction (OMI) and further to identify independent predictors for LV dyssynchrony.

METHODSSeventy-six OMI patients and seventy-four healthy volunteers (control group) underwent resting GMPI from October 2010 to September 2013 in our hospital were included in this study. The left ventricular systolic synchrony parameters including phase histogram bandwidth (BW) and phase standard deviation (SD) were obtained by Cedars-Sinai quantitative gated SPECT (QGS) phase analysis technique, and LV cardiac function was also measured. The extent of myocardial perfusion defect was analyzed by the Quantitative Perfusion SPECT (QPS) software. The value of BW and SD were compared between OMI and the control groups, between LVEF ≤ 35% and LVEF > 35% groups in OMI patients. Dyssynchrony was defined when the BW exceeded the abnormality threshold derived from a normal control group (threshold = x ± 2s for normal BW).

RESULTS(1) The BW ((91.3 ± 58.6)° vs. (37.2 ± 11.7)°) and SD ((27.3 ± 20.8)° vs. (11.8 ± 5.4)°) were significantly higher and the LVEF was significantly lower in OMI group than in the normal control group (all P < 0.01). In addition, BW ((136.0 ± 52.9)° vs. (51.0 ± 24.0)°) and SD ((38.7 ± 21.3)° vs. (17.1 ± 14.0)°) were significantly higher in patients with LVEF ≤ 35% than in patients with LVEF > 35% (all P < 0.001). (2) Dyssynchrony (BW > 60.6°) prevalence was 57.9% (44/76) in OMI patients. Compared with the synchrony group, LVEF was significantly lower, while the left ventricular end-diastolic volume, end-systolic volume, summed motion score, summed thickening score and extent were significantly higher in dyssynchrony group (all P < 0.001). (3) Additionally, dyssynchrony prevalence was significantly higher in patients with LVEF ≤ 35% compared with patients with LVEF > 35% (91.7% (33/36) vs. 27.5% (11/40), P < 0.001). (4) Pearson correlation analysis showed that LVEF was negatively correlated with BW (r = -0.807, P < 0.001). (5) Multivariate logistic regression analysis revealed that the extent of myocardial perfusion defect was an independent predictor for dyssynchrony in OMI patients (OR = 1.076, 95% CI: 1.015-1.141, P = 0.015).

CONCLUSIONSGMPI phase analysis can reliably reflect left ventricular systolic synchrony. The left ventricular systolic dyssynchrony in OMI patients is significantly increased. Left ventricular dyssynchrony is closely related to LVEF. The extent of myocardial perfusion defect (Extent) is an independent predictor for left ventricular systolic dyssynchrony in OMI patients.

Case-Control Studies ; Heart Ventricles ; Humans ; Myocardial Infarction ; physiopathology ; Myocardial Perfusion Imaging ; Stroke Volume ; Systole ; Tomography, Emission-Computed, Single-Photon ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Objective:To investigate the clinical characteristics of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) combined with anti- N-methyl- D-aspartate receptor (NMDAR) encephalitis. Methods:Sixty-five patients with MOGAD and 96 patients with anti-NMDAR encephalitis, admitted to our hospital from July 2018 to June 2021, were chosen in our study; 8 patients with MOGAD combined with anti-NMDAR encephalitis were selected as antibody double positive group; 21 patients with MOG antibody(+)/anti-NMDAR antibody(-) and 37 patients with anti-NMDAR antibody(+)/MOG antibody(-) were selected as controls. The differences of clinical characteristics of patients among these groups were compared.Results:(1) In these 8 patients from antibody double positive group, MOGAD and anti-NMDAR encephalitis occurred simultaneously in 6 patients, and anti-NMDAR encephalitis occurred prior to the episode of MOGAD in 2 patients. Autoimmune encephalitis was the dominant phenotype and demyelinating symptoms occurred in some patients. Both MOG antibody and anti-NMDAR antibody were detected in these 8 patients. MRI showed that lesions mostly involved in the cortex and subcortical white matter. Intravenous administration of high-dose methylprednisolone and immunoglobulin was given for patients at acute stage; two patients received mycophenolate mofetil treatment additionally during recurrence. After treatment, syndromes in these 8 patients got improvement. (2) There were no significant differences between patients from antibody double positive group and MOG antibody(+)/anti-NMDAR antibody(-) group in clinical manifestations, auxiliary examinations or treatments ( P>0.05). As compared with patients in antibody double positive group, patients in the anti-NMDAR antibody(+)/MOG antibody(-) group had significantly lower proportion of children and significantly higher modified Rankin scale (mRS) scores at the height of their illness ( P<0.05). As compared with patients in the MOG antibody(+)/anti-NMDAR antibody(-) group, patients in the anti-NMDAR antibody(+)/MOG antibody(-) group had significantly older onset age, significantly lower proportion of children, significantly higher proportion of patients with epilepsy and abnormal psychiatric behavior, significantly higher proportion of patients admitted to Intensive Care Unit, statistically higher mRS scores at the height of their illness, significantly lower proportion of patients with intracranial lesions, and significantly higher proportion of patients used immunoglobulin and plasma exchange ( P<0.05). Conclusion:MOG antibody and anti-NMDAR antibody can cause different clinical symptoms; when MOGAD patients have unusual symptoms, such as abnormal psychiatric behavior and epilepsy, or anti-NMDAR encephalitis patients develope demyelinating features, the possibility of MOGAD combined with anti-NMDAR encephalitis should be considered.

Objective:To summarize the clinical features of children with pneumonia caused by coinfection of human adenovirus type 7 and Mycoplasma pneumoniae.Methods:A total of 36 children with pneumonia caused by coinfection of human adenovirus type 7 and Mycoplasma pneumoniae (coinfection group) diagnosed in the Wuhan Children′s Hospital from December 1, 2018 to September 1, 2019 were enrolled.Their clinical manifestations, laboratory examinations, and imaging findings were retrospectively analyzed.In the same period, 94 children with single human adenovirus type 7 infection pneumonia were selected as the single infection group.Differences between 2 groups were compared using the Student′s t-test, rank sum test and Chi- square test. Results:In the coinfection group, 25 cases were males, 11 cases were females, their mean age was 3.11 years.The main clinical manifestations included fever (97.2%) and cough (100.0%). The mean body temperature was 40.0 ℃, with the thermal peak of 4 times per day, and the mean course of fever of 11 days.The incidence of severe pneumonia was significantly higher in coinfection group (86.1%) than that of single infection group (69.1%) ( χ2=3.878, P<0.05). The common complications included myocardial damage (55.5%), heart failure (16.7%), liver function damage (25.0%), gastrointestinal bleeding (5.5%), toxic encephalopathy (11.0%), hemophagocytic syndrome (16.7%), and bronchiolitis obliterans (50.0%). The levels of cytokines like interleukin (IL)-6 [237.84(108.59, 606.36) ng/L], IL-10[31.44(12.13, 69.60) ng/L]and interferon-γ [(102.85±92.23) ng/L] were obviously elevated, and among them, IL-6 and IL-10 elevations were significantly pronounced in coinfection group than that of single infection group[148.35(57.43, 390.82); 19.67(10.96, 35.35)] ( Z=-1.984, -2.077, all P<0.05). Lung consolidation (50.0%) and pleural effusion (38.9%) were common in coinfection group, and the incidence of pleural effusion in coinfection group was significantly higher than that of single infection group (19.1%)( χ2=5.594, P<0.05). Conclusions:Most of the pneumonia caused by human adenovirus type 7 mixed Mycoplasma pneumoniae in children is severe pneumonia, which may be related to the cytokine storm.

Objective To evaluate the dynamic changes of left ventricular mechanical synchrony in the early period after acute myocardial infarction (AMI) by two-dimensional speckle tracking imaging (2D-STI) and real time three-dimensional echocardiography (RT-3DE),and analyze the correlation with phase analysis of single photo emission computed tomography gated myocardial perfusion imaging (SPECT GMPI) in porcine models,and further to investigate the clinical significance of left ventricular mechanical dyssynchrony in patients with AMI.Methods Bama minipigs(n =11) were subjected to left anterior descending (LAD) occlusion by balloon to introduce AMI porcine models.All animals underwent 2D-STI and RT-3DE at the baseline (before AMI),1 day,1 week and 4 weeks after LAD occlusion,respectively.In addition,SPECT GMPI was measured at baseline and 1 day after AMI.Data was analyzed and compared the dynamic changes of left ventricular mechanical synchrony before and after AMI.Then the correlation between echocardiography and SPECT GMPI in evaluating left ventricular mechanical synchrony before and after AMI were calculated.Results Eight pigs were successfully established as AMI models and complete the study.SPECT GMPI,2D-STI and RT-3DE showed that the left ventricular mechanical synchrony indexes were significantly higher at 1 day after AMI than those before AMI,which means the appearance of left ventricular mechanical dyssynchrony.Compared with those 1 day after AMI,GLS,Time SD,Tmsv16-SD％ and Tmsv16-Dif％ did not change significantly at 1 week after AMI,but they significantly increased at4 weeks after AMI (all P ＜0.05).At baseline and 1 day after AMI,the GLS measured by 2D-STI and the SPECT GMPI parameter phase bandwidth (BW) showed good correlation(r =0.708-0.719,P ＜0.05),Time SD was significantly correlated with the SPECT GMPI parameter phase standard deviation (SD)(r =0.717-0.830,P ＜0.05),while Tmsv16-Dif％ derived from RT-3DE had a better positive correlation with BW (r =0.713-0.857,P ＜0.05),as similar as Tmsv16-SD％ with SD(r =0.803-0.957,P ＜0.05).Conclusions Left ventricular mechanical dyssynchrony is present 1 day after AMI.Compared with that 1 day after AMI,left ventricular mechanical dyssynchrony doesn't change significantly at 1week after AMI,but further aggravates at 4 weeks after AMI.The parameters of 2D-STI and RT-3DE have good correlation with the mechanical synchrony parameters measured by SPECT GMPI.2D-STI and RT-3DE can be used as reliable methods to evaluate left ventricle mechanical dyssynchrony early after AMI.

Objective:To investigate the correlation between the SUV index (SUV max of the lesion/SUV mean of the liver) in 18F-FDG PET/CT imaging and the invasiveness of early lung adenocarcinoma presenting as ground-glass nodule (GGN). Methods:From January 2012 to March 2020, 167 GGN patients (49 males, 118 females; age: (61.5±9.0) years) with early lung adenocarcinoma who underwent PET/CT imaging in Changzhou First People′s Hospital were retrospectively enrolled. The image parameters including the GGN number, location, type, edge, shape, abnormal bronchus sign, vacuole sign, pleural depression, vessel convergence sign, GGN diameter ( DGGN), solid component diameter ( Dsolid), consolidation to tumor ratio (CTR, Dsolid/ DGGN), CT values (CT value of ground-glass opacity (CT GGO), CT value of lung parenchyma (CT LP), ΔCT GGO-LP (CT GGO-CT LP)) and SUV index were analyzed. Single and multivariate logistic regressions were used to analyze the correlation between SUV index and infiltration. The generalized additive model was used for curve fitting, and the piece-wise regression model was used to further explain the nonlinearity. Results:In 189 GGNs, invasive adenocarcinoma accounted for 85.2% (161/189). Single logistic regression showed that the GGN number, type, shape, edge, abnormal bronchus sign, pleural depression, vessel convergence sign, DGGN, Dsolid, CTR, CT GGO, ΔCT GGO-LP and SUV index were related factors of infiltration (odds ratio ( OR) values: 0.396-224.083, P<0.001 or P<0.05). After fully adjusting for confounding factors, SUV index was significantly correlated with increased risk of invasion ( OR=2.162 (95% CI: 1.191-3.923), P=0.011). Curve fitting showed that the SUV index was non-linearly related to the risk of infiltration, and the risk of infiltration increased significantly only when the SUV index was greater than 0.43 ( OR=3.509 (95% CI: 1.429-8.620), P=0.006). The correlation between SUV index and infiltration had no interaction between age, vacuoles, pleural depression and CTR subgroups (all P>0.05). Conclusions:SUV index is an independent factor related to the invasiveness of early lung adenocarcinoma. The higher the SUV index, the greater the risk of invasion; but the two are not simply linearly correlated.

【Objective】 To observe the characteristics and correlation analysis of thromboelastogram (TEG) and platelet related indexes in patients with preeclampsia in late pregnancy. 【Methods】 88 patients with preeclampsia in late pregnancy treated in the Obstetrics Department of Shanghai Ninth People′s Hospital (Northern Hospital) from June 2017 to June 2020 were selected as observation group, and 288 normal pregnant women in late pregnancy with normal prenatal examination were selected as the control. The median elbow vein blood of the two groups were sampled. The TEG and coagulation related indexes of the two groups were compared, and the relationship between TEG and coagulation related indexes in patients with preeclampsia were analyzed. 【Results】 The K, MA, TT, INR and PLT value in the observation group, relative to controls, were significantly higher (P<0.01), but Angle, PT, and APTT value were significantly lower (P<0.01). The variance K and MA were negatively correlated with PT and APTT (P<0.05), but positively correlated with TT, INR and Plt (P<0.05). Angle was positively correlated with PT and APTT (P<0.05), but negatively correlated with TT, INR and Plt(P<0.05). 【Conclusion】 Routine TEG detection can effectively evaluate the coagulation state of patients with preeclampsia, who are often accompanied by coagulation dysfunction, help to guide clinical early prevention and intervention, and reduce the risk of perinatal hemorrhage and embolism diseases, which is worthy of popularizing in clinical.