OBJECTIVE To investigate nosocomial pulmonary infection in elderly patients receiving long-term(at least 30 day) mechanical ventilation. METHODS Retrospective survey was carried out in the aged patients with long-term mechanical ventilation,who admitted from Jan 2002 to Jun 2005.The risk factors of common pneumonia were studied by means of Logistic regression analysis. RESULTS In 69 cases with long-term mechanical ventilation,53 patients were caught common pneumonia(76.81%).Pulmonary tuberculosis and plural tuberculosis were(7(10.14%)) and(1(1.14%)),respectively.Nontuberculous mycobacterial infection was identified in 3 cases(4.35%).There were 8 cases suffered from Pneumocystis carinii pneumonia(11.59%).The length of mechanical ventilation and aspiration seemed to be the important risk factors for the development of common bacterial pneumonia. CONCLUSIONS The most significant preventive measures of common pneumonia include short mechanical ventilation and prevention of aspiration of gastric contents.Mycobacterium tuberculosis,nontuberculous mycobacteria and P.carinii induced pneumonia also should be considered in the elderly with(long-term) mechanical ventilation.

Objective To discuss the impact of an iterative reconstruction algorithm (True X) implemented with point spread function (PSF) on image quality and SUV in 18F-FDG PET, and compare with other reconstruction algorithms.Methods A total of 79 hypermetabolic lesions from 37 cancer patients (23 males, 14 females, age (63.38±15.25) years) were retrospectively studied.The PET images were reconstructed using the following six reconstruction algorithms, including FBP, FBP+TOF, iteration, iteration+TOF, True X, True X+TOF.Paired t test was used for statistical analysis.Results All six reconstruction algorithms showed significant difference in lesion SUVmax.The adoption of PSF increased SUVmax by 15%-16%, and decreased the dispersion of SUV in the liver parenchyma remarkably.Conclusions Lesion SUVmax calculated from different reconstruction algorithms has significant differences.Caution should be taken in using PSF, as it can improve image quality but may also increase lesion SUVmax.

OBJECTIVE: To study the radiation-sensitizing function and preliminary mechanism of paclitaxel in radiation-resistant nasopharyngeal carcinoma cells. METHOD: X-ray dose fractionated irradiation technology to build radiation-resistant subline of nasopharyngeal carcinoma; CNE-2S1 was treated with paclitaxel alone or combined with radiation therapy, while control group treated with radiation therapy; cell colony formation assay was used to observe sensitizing effect of paclitaxel on radiotherapy; flow cytometry analysis was used to analyze cell cycle distribution and apoptosis ratio of different treatment groups; immunoblotting was used to analyze SHP-1 expression levels of different treatment groups. RESULT: Nasopharyngeal carcinoma cells resistant to radiation was successfully established; cell colony formation assay showed that paclitaxel has obvious sensitizing effect on radiotherapy; FACS results showed that: CNE-2S1 treated by paclitaxel were arrested in G2M phase; paclitaxel and radiotherapy treatments significantly improved the CNE-2S1 apoptosis ratio; Western blot results showed that paclitaxel and combined radiotherapy can reduce the CNE-2S1 cells SHP-1 expression levels. CONCLUSION Paclitaxel enhanced radiation therapy for nasopharyngeal carcinoma cells resistant to radiation, and SHP-1 may be involved in this progress.
Apoptosis ; drug effects ; Carcinoma ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; pathology ; Paclitaxel ; pharmacology ; Protein Tyrosine Phosphatase, Non-Receptor Type 6 ; metabolism ; Radiation Tolerance ; drug effects

Objective To explore the effect of pulmonary rehabilitation under health guidance from clinic nurses on endurance capacity,quality of life, and lung function of the old patients with chronic obstructive pulmonary disease (COPD). Methods 54 old patients with stableCOPD were provided with health advice and rehabilitation training for 3 months. Their dyspnea and fatigue were evaluated with Borgrating scales, lung function were tested, 6-minute walking performance and quality of life were rated before and after the rehabilitation. ResultsThe dyspnea and fatigue decreased, 6-minute walking distance increased, and scores of quality of life improved (P<0.01) after rehabilitation,but lung function was not improved significantly (p0.05). Conclusion Health guidance from clinic nurses is able to improve the endurancecapacity and quality of life in old patients with chronic obstructive pulmonary disease.

ObjectiveTo investigate the social support and its related factors of elderly patients with chronic obstructive pulmonary disease (COPD).Methods60 outpatients with COPD over the age of 60 years were recruited in the study. Social support rating scale (SSRS) and demographic information were applied for investigation.ResultsScores of objective, subjective support, and availability of support were lower than the norm (P<0.05). Social support was significantly different among elderly patients with age, education levels and matital status (P<0.05). Patients aged over 70 years, low education level, divorced or widowed were vulnerable groups with low social support.ConclusionEfforts should be made to strengthen the social support system for elderly patients with COPD, especially for those aged over 70 years, low education, divorced or widowed.

Objective To investigate the feasibility of a novel molecular probe 99Tcm-3P4-RGD2 in evaluating arterial plaque stability after atorvastatin intervention in rabbits with SPECT/CT. Methods Eighteen male New Zealand rabbits were randomly divided into group A (stable plaque), group B (vulnerable plaque), and group C (vulnerable plaque with statin intervention). All rabbits were fed with high-fat food for 12 weeks. After high-fat feeding for two weeks, sham surgery was performed on group A. In the meantime, abdominal aorta injury was performed on group B and group C. After that, rabbits of group C were given oral atorvastatin (2.5 mg·kg-1·d-1). 99Tcm-3P4-RGD2 SPECT/CT imaging was performed on each group at the end of 4, 8 and 12 weeks. T/NT ratios were calculated. Animals were sacrificed at the end of 12 week after imaging studies. The abdominal aortas were collected, imaged with SPECT/CT, and evaluated by pathological HE staining and immunohistochemical analysis. MVD was calculated. Differences among 3 groups were analyzed using one-way analysis of variance. Results There was no significant radioactive uptake in the abdominal aortas of three groups on the 4th week′s imaging. The radioactive uptake in abdominal aortas increased slightly on the 8th week, with the highest radioactive uptake in group B. The radioactivity in abdominal aortas of the 3 groups maintained increasing on the 12th week, with T/NT ratios of 1.579±0.217, 1.873±0.226 and 1.524±0.237, respectively (F=8.984, P<0.05). In ex vivo abdominal aorta images, especially images of group B, radioactivity in lesion sites was higher than that in normal tissue. Accordingly, results of HE staining showed that artery plaques of group A and group C were grade Ⅱ and group B was grade Ⅳ. The MVD of group A, B and C was 8.17±1.17, 15.86±1.07 and 7.17±1.60, respectively (F=9036, P<0.05). Conclusion 99Tcm-3P4-RGD2 SPECT/CT imaging has a high sensitivity in the evaluation of arterial plaque stability after statin intervention in rabbits.

Objective To evaluate 18F-fluorodeoxyglucose (FDG) PET/CT in the rabbit model of vulnerable plaques by correlation with 99Tcm-Arg-Gly-Asp (RGD) SPECT/CT imaging,lipid levels,pathological and immunohistochemical results.Methods Sixteen male New Zealand white rabbits were randomly divided into normal diet group (group A,n =4),stable plaque group (group B,n =4) and vulnerable plaque group (group C,n =8) using completely random grouping method.The animals were given abdominal aorta sham operation (groups A and B) or balloon injury of the abdominal aorta (group C) 2 weeks after feeding.Animals were injected with 18F-FDG and 99Tcm-RGD respectively at the end of 4,8 and 12 weeks.PET/CT was performed at 1,2 and 3 h post-injection.SPECT/CT was performed at 30 min post-injection.One rabbit was sacrificed at the end of 4 and 8 weeks after imaging studies,respectively.The others were sacrificed at the end of 12 weeks after imaging studies.All abdominal aortas were harvested.Pathology and immunohistochemistry analysis were performed.The data were analyzed by one-way analysis of variance and Pearson correlation analysis.Results There was no uptake in any group at 4th week and no uptake in group A or group B at 8th week.There was mild uptake in group B at 12th week and group C at 8th week.There was intense uptake in group C at 12th week,whereas both mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax) were significantly higher than the other two groups (F values:7.952,14.279,both P＜0.05).In group C,SUVmax(0.43±0.08,0.68±0.06,1.74±0.63) and SUV (0.37±0.03,0.56±0.03,1.26+0.23) had significant difference at 3 h post-injection for imaging at 4th,8th and 12th week (F values:10.939,39.747,both P＜0.05).At 12th week,there was a strong correlation between the uptake of 18 F-FDG and target/non-target (T/NT) ratio of 99Tcm-RGD in all groups(r values:0.748,0.709,both P＜0.05).Histopathology results showed that the plaques had rich macrophages and a small amount of smooth muscle cells in group C,little macrophages in group B,while no macrophages in group A.Conclusion 18F-FDG PET/CT might be an effective noninvasive method for early assessment of aortic vulnerability to atherosclerotic plaque.

Objective:To establish the normal reference value of left ventricular function parameters by cadmium-zinc-tellurium (CZT) SPECT stress gated myocardial perfusion imaging (G-MPI) in low-likelihood of stable coronary artery disease (SCAD).Methods:From March 2022 to August 2022, 348 consecutive SCAD patients (146 males, 202 females, age (58±10) years) who underwent exercise or pharmacological stress G-MPI (CZT SPECT) in Beijing Anzhen Hospital, Capital Medical University were retrospectively recruited. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were acquired using quantitative gated SPECT (QGS) analysis. EDV and ESV were corrected by body surface area (BSA) to obtain EDV index (EDVI) and ESV index (ESVI), respectively. Independent-sample t test, one-way analysis of variance and Mann-Whitney U test were used for data analysis. The influences of EDV, ESV, EDVI, ESVI and LVEF were analyzed by multiple regressions for linear models. Results:There were 314 patients with low-likelihood of SCAD (128 males, 186 females, age (58±10) years) and 34 normal controls (18 males, 16 females, age (55±10) years). There were no significant differences of basic clinical characteristics and left ventricular function parameters in different genders between 2 groups ( z values: from -1.74 to -0.02, t values: from -1.16 to 1.17, all P>0.05). Using the 95% CI as the cut-off value for left ventricular function parameters in patients with a low-likelihood of SCAD, the upper limits of EDV, ESV, EDVI and ESVI in females and males were 84 and 111 ml, 30 and 44 ml, 47 and 54 ml/m 2, 17 and 21 ml/m 2, respectively, and the lower limit of LVEF in females and males were 58% and 55%, respectively. In the low-likelihood of SCAD group, the EDV ((58±13) vs (77±17) ml) and ESV ((16±7) vs (26±9) ml) of females were smaller than those of males ( t values: 10.65, 10.35, both P<0.001), while LVEF of females was higher than that of males ((72±7)% vs (67±6)%; t=-6.23, P<0.001). However, there were no significant differences in left ventricular function parameters among different age groups with the same gender ( F values: 0.12-2.19, all P>0.05). Based on multiple regression for linear models, the primary predictors of EDV, ESV and LVEF were gender and weight ( β values: from -0.380 to 0.358, all P<0.05). Conclusions:Normal reference values of left ventricular function parameters are established by CZT SPECT stress G-MPI in low-likelihood of SCAD patients. Left ventricular EDV and ESV of females are smaller than those of males, while LVEF of females is higher than that of males. The influence of gender on left ventricular function parameters should be considered in clinical practice.