Objective:To analyze the imaging features of hepatic metastases in gastrointestinal stromal tumors (GIST) on 18F-fluorodexyglucose (FDG) PET/CT in order to improve the accuracy of diagnosis. Methods:Clinical and imaging data of 33 patients (18 males, 15 females, age 34-70 years) with hepatic metastases in GIST who underwent PET/CT examination between May 2013 and July 2019 in Fujian Cancer Hospital were analyzed retrospectively. All patients underwent 18F-FDG PET/CT early imaging, and nine of them underwent delayed imaging. Visual analysis was performed on the PET/CT images by comparing FDG uptake of hepatic lesions and liver background, and all lesions were classified as significant hypermetabolism, slightly higher metabolism and equal or lower metabolism. Maximum standardized uptake value (SUV max) of primary GIST lesions and hepatic metastases were calculated and compared, and the relationship between them was analyzed. Wilcoxon rank sum test and Spearman rank correlation analysis were used to analyze the data. Results:Among 33 GIST patients, 9 patients had solitary hepatic metastasis, and 24 patients had multiple hepatic metastases (104 lesions). The diameter of metastases was 0.8-14.6(2.2(1.5, 3.9)) cm, and SUV max was 1.4-21.5(3.6(2.4, 5.7)). Of the 104 hepatic metastases, 94.2%(98/104) lesions had clear boundaries, 65.4%(68/104) lesions had uniform density (2 lesions with cystic density), 34.6%(36/104) lesions had uneven density in which hemorrhage, cystic change or necrosis could be found. On visual analysis of PET images, 38.5%(40/104) lesions were with significant hypermetabolism, 26.0%(27/104) were with slightly higher metabolism and 35.6%(37/104) were with equal or lower metabolism. In 24 patients with multiple hepatic metastases, 79.2%(19/24) showed different metabolic levels synchronously. Among 67 hypermetabolic metastases, 34.3%(23/67) were with homogeneous metabolism, of which 13 lesions with diameter<2.0 cm; 65.7%(44/67) were with heterogeneous metabolism, of which 36 lesions with diameter≥2.0 cm. There was a moderate correlation of SUV max between GIST primary tumors and hepatic metastases ( n=15; 9.2(6.8, 14.5) vs 3.8(2.1, 6.0), rs=0.556, P<0.01). The difference of SUV max between GIST primary tumors and hepatic metastases was statistically significant ( z=-5.098, P<0.01). In delayed imaging, 13/15 hepatic metastases with equal or lower metabolism changed to slightly higher metabolism. Conclusions:Hepatic metastases in GIST on 18F-FDG PET/CT imaging usually have clear boundary, and often associate with cystic degeneration, hemorrhage or necrosis. The metabolic patterns of hepatic metastases in GIST are varied. Delayed PET/CT imaging is helpful for the diagnosis of hypometabolic hepatic metastases in GIST.

BACKGROUND:The transplanted bone marrow stem cells (BMSCs) survive,migrate to the injury site and differentiate into neurons and astrocytes.Transplantation of BMSCs following spinal cord injury (SCI) may improve the recovery of spinal function and may be an effect way for treating spinal cord injury.The treatment of spinal cord injury by autologous BMSCs mobilization and surgical transplantation has a wide prospect of clinic application.However,it is still unclear whether outcomes and mechanisms of them are different.OBJECTIVE:To compare the efficacy of treating SCI in rats by mobilization and surgical transplantation of autologous BMSCs,and assess the two methods by qualitative indexes.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was conducted at the Henan Province People's Hospital from June 2007 to April 2008.MATERIALS:A total of 90 healthy Sprague Dawley rats aged 10 wees old,half male and half female,weighing (240±10) g,were subjected to make spinal cord injury models.MATHODS:After 3 days injection with bromodeoxyuridine 50 mg/kg per day,BMSCs were isolated from bone marrow of healthy rats.All the rats were underwent spinal cord injury by NYU impactor.All 90 rats were randomly divided into 3 groups,with 30 for each group.Rats in the mobilization group were subcutaneously injected with grenulocyte-colony stimulating factor for 7 days,20 mg/kg per day.In surgical transplantation group,a total of 0.3 mL (1×10~(10)/L) BMSCs were transplanted into injured area of spinal cord.Rats in control group were given the same volume of saline (0.3 mL) into injured area of spinal cord.All the rats were injected with 50 mg/kg bromodeoxyuridine daily at day 3 before surgery for 10 days in each group.MAIN OUTCOME MEASURES:The Basso-Beattie-Brasnahan (BBB) locomotor score was used to evaluate functional recovery in rat hindlima at 3 days,1,2,4 and 8 weeks after SCI.Motion evoked potential (MEP) and somatosensory evoked potential (SEP) tests were performed to defect the neural pathway so as to evaluate recovery of injured spinal cord.The cell structural changes and the expression and distribution of Brdu,glial fibrillary acidic protein (GFAP),and neuron specific enolase (NSE) were observed by pathological and immunohistochemical methods.and 8 weeks after injury (P ＜ 0.05),but there was no significant difference between the mobilization group and surgical was increased in the mobilization group and surgical transplantation group compared with the control group (P ＜ 0.05-0.01),but Histopathology showed that there were less empty,necrosis and GFAP-positive glial scar tissue,more Brdu-positive cells and NSE-positive cells in the mobilization group and surgical transplantation group than in the control group.CONCLUSION:Autologous BMSCs mobilization transplantation and surgery transplantation could significantly reduce the degree of SCI,and promote the recovery of the spinal cord function after injury for treating SCI.Compared between the two,mobilization of autologous BMSCs are more convenient,non-invasive,more likely to seize the opportunity to treatment.

Objective To observe the effect of ultrafine herb moxibustion on nasal mucosal remodeling in rats with allergic rhinitis. Methods Forty SD rats were randomly divided into control group (Group D) and modeling group. When successfully induced by intraperitoneal injection, aerosol inhalation and nasal spray of ovalbumin, the modeling group were randomly subdivided into modeling group (Group A), fluticasone propionate group (Group B) and ultrafine herb moxibustion group (Group C). Comparisons were made between the groups in respect of HE staining, transmission electron microscopy and counts of EOS. Results (1) Compared with Group D, Group A had significant elevation in counts of EOS (P<0.01);mucosal epithelium swelling, apparent angiotelectasis and eosinophilic infiltrated by HE staining; incomplete mucosal surface with deformity cilia, swelling mitochondria and partial loss of the mitochondria ridge by TEM . ( 2 ) Counts of EOS in Groups B and C were significantly decreased than in Group A (P<0.05, and P<0.01). Those in Group C were significantly decreased than in Group B (P<0.05), and there was insignificant difference in the counts between Group C and Group D (P=0.539). The HE staining Group B showed mild telangiectasia, with EOS scattered. The HE staining in Group C showed epithelial minor swelling and no telangiectasia. TEM showed mucosal surfaces in Groups B and C were complete, the quantity of cilia and microvillus increased apparently and cell junctions were normal. Normal endoplasmic reticulum and mitochondria were evident in Group C. Conclusion The ultrafine herb moxibustion can relieve the clinical symptoms, slow down and even reverse the nasal mucosal remodeling.

Objective To compare the diagnostic values of 18F-FDG and 18F-FLT PET/CT in patients with suspicious recurrence of glioma after multimodal treatment.Methods A total of 20 patients (13 males,7 females;age range:12-73 years) with glioma who underwent 18F-FDG and 18F-FLT PET/CT due to abnormal enhancement on MRI from January 2012 to June 2015 were enrolled in this retrospective study.According to the pathological or follow-up results,patients were divided into therapy-related benign changes (TRBC) group and recurrent glioma group,the later was subdivided into initial low-grade glioma (LGG) group and initial high-grade glioma(HGG) group.T/NT ratios of 18F-FDG and 18F-FLT between HGG (LGG) group and TRBC group were compared using one-way analysis of variance and the least significant difference t test.ROC curve analysis was conducted to calculate the differential diagnostic efficiency of 18F-FDG and 18F-FLT between TRBC and recurrent glioma.Results A total of 14 patients were proved as recurrent glioma and 6 patients as TRBC.The mean 18F-FDG T/NT ratios of HGG group,LGG group and TRBC group were 2.31±0.86,1.32±0.86 and 1.32±0.64,respectively.The 18F-FDG T/NT ratio of the HGG group was significantly higher than that of the TRBC group(F=3.671,t=-2.471,P＜0.05).The mean 18F-FLT T/NT ratios of HGG group,LGG group and TRBC group were 8.94±3.14,7.18±3.29 and 1.92±1.20,respectively (F=13.301,t values:-5.150 and-2.360,both P＜0.05).The optimal T/NT cutoff values for 18 F-FDG and 18F-FLT PET/CT were 1.62 and 4.58,respectively.The sensitivity,specificity and accuracy of detecting recurrent glioma with optimal T/NT cutoff value were 11/14,5/6 and 16/20 for 18F-FDG PET/CT,and those for 18F-FLT PET/CT were 13/14,6/6 and 19/20,respectively.No significant difference was observed between the diagnostic efficiencies of the two imaging modalities (x2 values:1.167,1.091 and 2.057;all P＞0.05).Conclusion There were no statistical significances between 18F-FDG and 18F-FLT PET/CT on the differential diagnosis of glioma recurrence.

Objective: To evaluate the value of ¹⁸F-FDG PET-CT in predicting the malignant potential of Gastrointestinal Stromal Tumors (GIST). Methods: The clinical and pathological features of 31 patients with GIST confirmed by surgery or biopsy were retrospectively analyzed. The malignant potential of GIST before treatment was assessed by ¹⁸F-FDG PET-CT. The GIST risk classification was graded according to the Standard revised by the National Institutes of Health (NIH) in 2008. The relationship between the maximal standard uptake value (SUVmax) and GIST risk classification, tumor diameter, Ki-67 index, and mitotic count were analyzed respectively. The cut-off level of SUVmax for the diagnosis of malignant GIST was calculated from the Receiver Operating Characteristic (ROC) curve. Results: Among the 31 cases of GIST patients, 14 cases were gastric primary (stomach group) and 17 cases were nongastric primary (outside stomach group). The SUVmax, tumor diameter, Ki-67 index and mitotic count of the 31 patients were 8.21±4.68, (7.82±5.12)cm, (10.03±11.07)% and (12.29±10.55)/50 HPF, respectively. SUVmax was significantly correlated with GIST risk classification (r=0.727, P<0.01), but not with tumor diameter, Ki-67 index and mitotic count (r=0.348, r=0.284, r=0.290, P=0.055, P=0.121, P=0.114). The SUVmax, tumor diameter, Ki-67 index and mitotic count in the stomach group were 4.36±2.36, (6.08±4.31)cm, (3.43±3.03)% and (5.71±2.20)/50 HPF, respectively. SUVmax was significantly correlated with tumor diameter, GIST risk classification and Ki-67 index (r=0.682, r=0.868, r=0.732, P<0.01) but not with mitotic count (r=0.510, P=0.063). The SUVmax of the GIST in the gastric group and the outside gastric group were 4.36±2.36 and 10.68±5.50, respectively. The difference was statistically significant (P=0.001). The SUVmax in the malignant group of GIST (middle or high risk grade) was 8.90±4.89, which was significantly higher than 2.22±0.86 in the benign group (low or very low risk grade). The difference was statistically significant between the two group (P<0.01). ROC curve analysis showed that a SUVmax cut-off of 3.75 was the most sensitive for predicting malignant GIST. When the area under the curve of 0.969, the sensitivity was 84.6% and the specificity was 100%. Conclusions The SUVmax was strongly correlated with the GIST risk category and also with the tumor diameter and Ki-67 index in the gastric primary GIST, so it can be used as an effective indicator in predicting malignant potential of GIST before treatment.