Objective To evaluate the clinical value of ulinastatin on the treatment of systemic inflammatory response syndrome in severe acute panereatitis. Method Eighty-four patients with severe a-cute pancreatitis were randomly divided into two groups. In the treatment group (42 cases),on the base of routine treatment, ulinastatin was administered intravenously for seven days after hospitalization, while in the control group only routine treatment was given (42 cases) to. Inflammatory factors in serum, the change of liver function and renal function were measured in two groups before and after the treatment, and the clinical efficacy were observed. Results There was significant difference, in the serum level of tumor necrosis factor-α, interleukin-1, interleukin-6, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and creatinine on the 7th day between two groups (P < 0.05 or < 0.01 ) ,there were significant differences in the incidence of complications, hospitalization time, incidence of multi-organ failure between two groups [14.3%(6/42) vs 38.1%(16/42), (29.4 ± 1.5)d vs (34.4 ± 1.8)d, 28.6%(12/42) vs 47.6%(20/42), P<0.01 or <0.05 ]. Conclusions Ulinastatin can suppress the secretion and release of some inflammatory factors, protect the important viscera functions and reduce the incidence of complications, and it has favorable clinical efficacy.

Objective To evaluate the value of whole body 18F-FDG PET/CT in the detection of recurrence/metastasis of cervical cancer.Methods A retrospective study was performed on 95 patients with cervical cancer who underwent 18F-FDG PET/CT after treatment.The lesion characteristics on 18F-FDG PET/CT were assessed visually and semi-quantitatively.A final diagnosis was confirmed by histopathology,diagnostic treatment and clinical follow-up imaging.The data were analyzed by Kappa test.Results 18 F-FDG PET/CT was positive in 54 patients,including 24 with local recurrence and 30 with distant metastases.The sensitivity,specificity and accuracy of 18F-FDG PET/CT for the detection of recurrence/metastasis of cervical cancer were 98.1％ (52/53),95.2％ (40/42) and 96.8％ (92/95),respectively.The positive predictive and negative predictive value were 96.3％ (52/54) and 97.6％ (40/41),respectively.18F-FDG PET/CT showed concordant results with pathological/clinical follow-up findings (Kappa =0.936,P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive and specific modality for the detection of recurrence/metastasis of cervical cancer and might be useful for further treatment plan.

Objective To analyze the relevant factors influencing 18F-FDG uptake in the primary lesion of breast invasive ductal carcinoma (BIDC).Methods A total of 160 female patients underwent 18 F-FDG PET/CT examination from 2010 to 2015 and breast lesions were revealed.Lesions were divided into benign group (n =118) and malignant group (n =49,BIDC) according to pathological results.KruskalWallis H test and Mann-Whitney u test were performed to compare SUVmax of the two groups,and to investigate the relationship between the SUVmax of breast malignant lesion and patients' age as well as clinical pathological parameters including T stage,lymphatic vessel invasion,nuclear grade,route of metastasis,ER,PR,HER2 and Ki-67 expression,and subtype of breast cancer.The diagnostic efficiency of 18F-FDG PET/ CT in differentiating benign and malignant breast lesions was analyzed using ROC curve analysis.Results The SUVmax of BIDC was 6.09(3.88,9.26),higher than that of breast benign lesion (1.35 (0.95,2.35);u=341.0,P＜0.05).The SUVmax of BIDC showed statistically significant difference between groups with different T stage,with or without lymphatic vessel invasion,with different nuclear grade,different routes of metastasis and different Ki-67 expression (u:117.5-209.5,H=7.70,P＜0.01 or 0.05).For all breast lesions,lesions with the maximum diameter ≤ 2.0 cm and lesions with the maximum diameter ＞2.0 cm,the optimum cutoff values of SUVmax were ＞2.60,＞ 1.71 and ＞3.97,respectively.When the optimum cutoff values of SUVmax for breast lesions with the maximum diameter ≤2.0 cm were selected as ＞ 1.71 and ＞2.60,the Youden indexes were 0.66 and 0.61(z=0.566,P＞0.05).When the optimum cutoff values of SUVmax for breast lesions with the maximum diamter ＞2.0 cm were selected as ＞3.97 and ＞2.60,the Youden indexes were 0.89 and 0.81(z=0.748,P＞0.05).Conclusions T stage,lymphatic vessel invasion,nuclear grade,route of metastasis and Ki-67 expression of BIDC influence the uptake of 18F-FDG by tumor tissues.The SUVmax of the primary lesion of BIDC is related to the size of lesion,and thus the diagnostic threshold of SUVmax should be decreased appropriately for small lesions.

Objective To explore the identification of the hypoxia regions within the primary foci and imaging time selection in 18F-fluoromisonidazole (FMISO) imaging on patients with nasopharyngeal carcinoma (NPC).Methods From July 2013 to July 2014,44 NPC patients (33 males,11 females,age range:18-74(53.45± 12.88) years) underwent 18 F-FMISO PET/CT imaging,including 3 cases with twice imaging (totally 47 case times).Inaging data were acquired and reconstructed 2 and 4 h after the injection of 18 F-FMISO.1s F-FMISO PET/CT images were merged with MRI images obtained 1 week before to construct fusion images.The boundary of primary tumor was determined based on MRI.Visual analysis was performed and SUVmax of posterior cervical muscles,NPC primary foci was measured by 2 observers respectively.The uptake ratio of primary tumor to muscle (TMR) was calculated.The identify consistency of hypoxic region between two observers were evaluated by Kappa test and intraclass correlation coefficient (ICC).The image contrast was evaluated by Wilcoxon paired rank sum test of TMR.Results PET images and MRI images of NPC primary foci were successfully fused.Positive non-NPC tissues were identified by MRI.The visual recognition of hypoxic regions of the two observers for 2 and 4 h imaging were highly consistent (Kappa =0.931 and 0.965,both P＜0.001).There was a high degree of consistency between the SUVmax of posterior cervicalmuscles and that of primary tumors.ICCs of posterior cervical muscles in 2 and 4 h were 0.896 (95％ CI:0.814-0.942) and 0.924 (95％ CI:0.865-0.958),respectively.ICCs of primary tumors in 2 and 4 h were 0.991 (95％ CI:0.985-0.995) and 0.998 (95％ CI:0.996-0.999),respectively.TMRs (M(P25,P75))in 2 and 4 h were 1.560 (1.341,3.015) and 1.675 (1.387,3.001) respectively in 24 positive case times,and the difference was statistically significant (z=-2.557,P＜0.05).Conclusions Using fusion images of 18F-FMISO PET and MRI,hypoxic tissues within NPC primary foci can be accurately identified.There is a high degree of consistency within the visual and quantitative analysis of two observers.The image contrast of 18F-FMISO PET at 4 h is superior to that at 2 h.

Objective To synthesize 18F-FMISO and analyze the quality of the product.Methods 1-(2'-nitro-l'-imidazolyl)-2-O-tetrahydropyranyl-O-trluendulfonylpropanediol (NITIT) was taken as the precursor and simple one pot method was used.CFN-MPS-100 fluorine multifunction radiopharmaceutical chemical synthesis module was adopted to complete the radioactive fluorination reaction in a closed flat flask,and the crude product was purified by semi-preparative HPLC,the solvent was removed by rotary evaporation.Then 15 ml saline was added into the product to get 18F-FMISO injection.Radio-HPLC and radio-TLC were applied for quality control.Results 18F-FMISO was obtained in 60 min with the radiochemical yield of (32±5.0)％ (no decay corrected,n=25).The radiochemical purity was above 99.0％ and still above 98.5％ after 6 h.The radioactive concentration was above 1.11 × 1012 Bq/L.The product was colorless solution,with pH value of 7.0.The radioactive nuclear purity was more than 99％.The K222 was less than 25 μg/ml.Conclusion 18 F-FMISO could be synthesized with automatic synthesis method based on the CFN-MPS-100 fluorine multifunction module.The labeling rate,stability and chemical purity are high.

Objective To systematically review the evidence for the effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism. Methods We searched databases including Pubmed, Elsevier, Web of Science, and WANFANG Database etc. for randomized controlled trials comparing vitamin D or analogues with placebo. We extracted data on insulin resistance and blood glucose, including homeostasis model assessment of insulin resistance( HOMA-IR), fasting blood glucose, HbA1C (% ). A1l data were analyzed using Review Manager 5. 0. Results Nine studies involving 867 participants were included. The results of meta-analysis showed that: ( 1 ) For people who are obese and with abnormal glucose metabolism, meta-analysis showed a small improvement in HOMA-IR(SMD -0. 34,95% CI -0. 61 to -0. 06, P<0. 05) and a small effect on fasting glucose (SMD -0. 41 mmol/ L, 95% CI -0. 68 to -0. 15, P<0. 05),while such effects were not seen in people who are obese but with normal blood glucose. (2) No serious adverse events were associated with the administration of vitamin D. Conclusion vitamin D supplementation may be benefit for improving insulin resistance and fasting blood glucose in people who are obese and with abnormal glucose metabolism, but has no effect on obese people with normal blood glucose.

Objective To investigate the value of gastrointestinal tract preparation with oral racean?isodamine tablets and isotonic mannitol in 18 F?FDG PET/CT imaging. Methods From July to September 2013, 129 patients with confirmed or suspected tumors who were referred for 18 F?FDG PET/CT imaging were divided into 2 groups. In the study group (30 males, 37 females, age (53.4±13.9) years), raceanisodam?ine tablets (10 mg) and 1 000-1 200 ml isotonic mannitol solution (2.5%) were orally taken at 10 min after in?jection of 18F?FDG;while in the control group (37 males, 25 females, age (60.0±12.8) years), 1 000-1 200 ml water was given. Mann?Whitney u test was used to compare the difference between the 2 groups in the filling degree of gastrointestinal lumen, delineation of tube wall, physiological uptake, matching degree of PET and CT images, delineation of mesentery, and the influence of gastrointestinal uptake on the identification of ab?dominal and pelvic lesions. χ2 test was used to compare the difference between the 2 groups in the uptake pattern of gastrointestinal tract and the incidence of side effects. Spearman correlation analysis was used to study the correlation between gastrointestinal lumen filling and PET/CT image matching. Results The gas?trointestinal lumen filling, delineation of tube wall, PET/CT image matching in the stomach, small intestine and colon (z: -5.096 to -2.665, all P<0.01),and delineation of mesentery (z=-2.781,P<0.01) were better in the study group than those in the control group. The filling degree of gastrointestinal lumen correla?ted with the corresponding PET/CT image matching (rs:0.521, 0.755, 0.239, all P<0.01). The physio?logical uptake of small intestine and colon was significantly higher in control group than that in the study group( z=-4.131, -3.095, both P<0.01) . But uptake in the stomach between the 2 groups was not signifi?cantly different(z=-0.776, P>0.05). There was statistically significant difference in the uptake pattern of small intestine between the two groups(χ2=12.884, P<0.01) , but not in the stomach and colon (χ2=0.559, 1.083,both P>0.05). The incidence of transient diarrhea (20?9%, 14/67) was higher in the study group than that in the control group (4.8%, 3/62;χ2=7.256,P<0.01). Conclusions The abdominal PET/CT image quality is improved by gastrointestinal preparation with oral raceanisodamine tablets (10 mg) and 1 000-1 200 ml isoton?ic mannitol solution (2.5%).

No abstract available.
Drug-Eluting Stents ; Stents ; Vertebral Artery ; Vertebrobasilar Insufficiency

Objective To investigate the role of Toll-like receptor 4 ( TLR4 ) and NOD-like receptor 3 (NLRP3)inflammasome in the liver injury of acute necrotizing pancreatitis (ANP) rat with obesity. Methods Twenty-four SD rats were randomly divided into normal group, ANP group, obesity group and obesity ANP group. The obesity rat model was established by continuously feeding high fat diet and the ANP model was induced by retrograde infusion of 5％ sodium taurocholate into the biliopancreatic duct. Rats were killed at 12 h after model establishment, and automatic biochemical immune analyzer were used for detecting serum AMY, LIP, ALT, AST, TG and TC. Pathological changes of pancreas and liver tissue samples were observed by miscroscopy and pathological score was recorded. The levels of MPO, CD68 , TLR4, NLRP3 and IL-1βin liver tissue were detected by immunofluorescence, and NF-κB and caspase-3 in liver tissue were detected by immunohistochemistry. Results The serum ALT and AST in obesity ANP group were significantly increased than those in ANP group (233. 00 ± 34. 44 U/L vs 102. 83 ± 8. 90 U/L,388. 00 ± 41. 60 U/L vs 282. 00 ± 21. 06 U/L);and liver pathologic score was also significantly higher than ANP group (6. 66 ± 1. 21 vs 3. 33 ± 1. 03);and CD68 + /TLR4 +, CD68 + /NLRP3 +, TLR4 + /NLRP3 +, MPO, NF-κB, IL-1β and caspase-3 level were all greatly higher in obesity ANP than those in ANP group, respectively (24. 16 ± 1. 47 vs 6. 66 ± 1. 21, 25. 00 ± 2. 60 vs 7. 00 ± 1. 41, 14. 16 ± 1. 47 vs 5. 50 ± 1. 04, 35. 33 ± 6. 88 vs 20. 83 ± 2. 48, 58. 80 ± 6. 75 vs 37. 63 ± 2. 96, 50. 00 ± 2. 36 vs 35. 00 ± 2. 82, 66. 00 ± 4. 04 vs 55. 00 ± 2. 60); and all the differences were statistically significant (all P<0. 05). Conclusions Liver injury was more severe in ANP rats with obesity, which may be related to the fact that obesity may enhance the activation of TLR4/NLRP3 signal pathway and result in the release of more inflammatory factors.

Objective To observe the value of spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis(LNM)of gastric cancer.Methods Totally 136 patients with gastric adenocarcinoma were retrospectively enrolled.The patients were further divided into LNM group(n=74)and non-LNM group(n=62)according to postoperative pathological findings of lymph nodes status.Clinical data,conventional CT findings and spectral CT parameters were compared between groups.Factors being significant different between groups were included in multivariate logistic regression analysis to screen independent predictors of gastric cancer LNM.Clinical+conventional CT model(model 1),spectrum CT model(model 2)and combined model(model 3)were constructed based on the above independent predictors,respectively.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for preoperative predicting LNM of gastric cancer.Results CT-N stage,CT-T stage,70,100 and 140 keV CT valuestumor at arterial phase(AP),arterial enhancement fraction(AEF)and normalized iodine concentration at venous phase(NICVP)were all independent predictors of gastric cancer LNM(all P＜0.05).AUC of model 3 was 0.846,higher than that of model 1 and model 2(AUC=0.767,0.774,Z=-0.368,-2.373,both P＜0.05)for preoperative predicting LNM of gastric cancer,while the latter two were not significantly different(Z=-0.152,P=0.879).Conclusion Spectral CT multi-parameter imaging could effectively predict LNM of gastric cancer preoperatively.