OBJECTIVE:To investigate the utilization of aztreonam in perioperative patients in order to promote rational use of antimicrobial agents. METHODS: 215 discharged surgery cases were collected in Mar. 2009 and analyzed retrospectively to evaluate the rationality of drug use. RESULTS: Of 215 cases, preventive use accounted for 122 cases, among which rational use 29 cases and irrational use 93 cases; treatment use accounted for 93 cases, among which reasonable use 54 cases and unreasonable use 39 cases. CONCLUSION: Perioperative use of aztreonam was not in line with Guiding Principles for Clinical Use of Antibacterial Drugs, Notice for Further Strengthen Management of Clinical Use of Antibacterial Drugs Issued by General Office of the Ministry of Health. Unreasonable utilization require to arouse attention of medical personnel and strengthen management.

Objective To study the polymorphism of human platelet antigen HPA-1 to HPA-5,and HPA-15 system in Qingdao Han population.Methods A total of 918 samples from regular voluntary platelet donors in Qingdao were genotyped for HPA-1 to-5 and HPA-15 by PCR-SSP.Results The gene frequencies of HPA-1a,-1b;HPA-2a,-2b;HPA-3a,-3b;HPA-4a,-4b;HPA-5a,-5b;HPA-15a,-15b were 0.9940,0.0060;0.9319,0.0681;0.5822,0.4178;0.9897,0.0104;0.9804,0.0196;0.4913,0.5087,respectively.Both a and b alleles were found in each of the 6 HPA systems,and a/a homozygosity was more common in HPA-1,-2,-4 and-5 systems.The HPA genotype frequencies followed Hardy-Weinberg principle.HPA-1 frequency of Qingdao people was significantly different from that of North China(P

Objective To investigate the value of hepatobiliary scintigraphy combined with total bile acid (TBA) and γ-glutamyhransferase(γ-GT) detection in the differential diagnosis of persistent jaundice induced by infantile hepatitis syndrome(IHS) and congenital extrahepatic biliary atresia(EHBA).Methods A retrospective analysis of 60 infants with persistent jaundice undertaking 99Tcm-diethylacetanilide iminodiacetic acid (EHIDA) hepatobiliary scintigraphy was done in Nanfang Hospital by single photon emission computed tomography(SPECT).Meanwhile,these infants' sera were collected and separately detected by AU5431 automatic biochemical assay;the sensitivity,specificity and accuracy of hepatobiliary scintigraphy with TBA and γ-GT were evaluated.Results The sensitivity to 99Tcm-EHIDA hepatobiliary scintigraphy in the diagnosis of IHS and EHBA were 100.00％ (17/17 cases) and 67.57％ (25/37 cases),the specificity was 67.57％ (25/37 cases) and 100.00％ (17/17 cases),and the accuracy was 77.78％ (42/54cases) and 77.78％ (42/54 cases),respectively.The levels of TBA and γ-GT were higher in infants with EHBA than those with IHS(U =209.0,19.5,all P ＜0.05),and ROC curve analysis indicated that TBA in the IHS group and γ-GT in EHBA group had some diagnostic value[area under curve (AUC) =0.736,0.968,respectively].99Tcm-EHIDA hepatobiliary scintigraphy combined with TBA and γ-GT analysis suggested when intestinal non-radioactive imaging was shown,TBA was 98.5 μmol/L and γ-GT was 298 U/L,the sensitivity,specificity and accuracy of diagnosis of EHBA were 100.00.00％ (17/17 cases),100.00％ (37/37 cases) and 100.00％ (54/54 cases) in a serial test.Conclusions Hepatobiliary scintigraphy combined with TBA and γ-GT examination can effectively identify EHBA and IHS earlier,noninvasively and safely,which have important role in further treatment in infants with persistent jaundice.

Objective To establish rat models of extrahepatic biliary atresia,and to observe the characteristics of 99Tcm-MIBI hepatobiliary scintigraphy and evaluate its association with the expression Pglycoprotein (P-gp) in intestinal tissues.Methods A total of 12 SD rats were randomly divided into the normal control group (3 rats) and the group of common bile duct ligation (CBDL;9 rats).CBDL was used to establish the rat model of extrahepatic biliary atresia.99Tcm-MIBI hepatobiliary scintigraphy was performed at 2,3 and 4 weeks after ligation in the CBDL group and normal control group with continuous dynamic acquisition (3 min/frame) for 30 min and then delaying imaging at 30 min,1,2 and 3 h.After that,all rats were sacrificed,and the blood samples were taken out for the determination of serum ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA,and the tissues of duodenum,jejunum,ileum,colon and cecum were taken out for analyzing the expression level of P-gp by immunohistochemistry.Two-sample t test and one-way analysis of variance were used.Results Compared with the normal control group,the serum levels of ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA were significantly increasing at 2,3,4 weeks after ligation in CBDL group (t:-3.04 to-44.54,all P＜0.05).99Tcm-MIBI hepatobiliary imaging showed that there was radioactive accumulation in colon or cecum area,excluding the duodenum,jejunum and ileum area,at 3 h after intravenous injection of 99Tcm-MIBI in CBDL group.The results of immunohistochemistry showed that with the obstruction time prolonged,the expression levels of P-gp in duodenum,jejunum and ileum segments were gradually decreased (F=5.17,9.07,23.52;all P＜0.05),while the expression levels in the colon and cecum segments were not changed obviously (F=2.00,3.17;both P＞0.05).Conclusion 99Tcm-MIBI can be excreted through intestinal mucosa,and this process may be associated with P-gp expression.

Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.

OBJECTIVETo investigate the shielding effect of distance in radioactive iodine treatment in patients with differentiated thyroid cancer (DTC).

METHODSEighty-seven DTC patients underwent postoperative radioactive iodine treatment at the therapeutic doses ranging from 2.96 GBq to 7.4 GBq. The patients were divided into two groups to receive high-dose therapy (≥3.7 GBq, 48 patients) and low-dose therapy (<3.7 GBq, 39 patients). The radiation doses at 0.05 m, 1 m, and 3 m were recorded at different days; the doses at 1 m and 3 m on the third day, the dose of standard radioactivity source of 1.11GBq (131)I, and the natural background radioactivity were also recorded.

RESULTSThe radiation dose at a 1-meter distance was significantly higher in the high-dose group than in the low-dose group (P<0.05). The radiation doses in different dose groups at the other distances or at different time points showed no significant differences (P>0.05). On the third day after therapy, the radiation dose at 1 m was significantly lower than the reference radioactivity source of 1.11 GBq (131)I (P=0.000), but still higher than the natural background radioactivity at 3 m (P=0.000).

CONCLUSIONIn DTC patients who receive radioactive iodine therapy, the radioactive radiation dose decreases rapidly after 3 days. The radioactive radiation dose on the third day is significantly lower than the reference radioactive radiation dose, so that the patients can be discharged with safety for contact at a distance beyond one meter.

Adult ; Female ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Radiation Dosage ; Radiation Protection ; Thyroid Neoplasms ; radiotherapy

Objective:To explore the data of patients with inoperable stage Ⅲ non-small cell lung cancer (NSCLC) after radiotherapy from the Surveillance, Epidemiology, and End Results (SEER) database, and to evaluate the effect of age on prognosis.Methods:The data of patients with inoperable stage Ⅲ A and Ⅲ B NSCLC according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging standard who had been treated with radiotherapy from 2010 to 2016 were collected in the SEER database. A total of 17 117 cases were included in the analysis. According to the maximally selected test, the best cut-off value of age was 72 years old. According to the best cut-off value of age, patients were divided into the young group (< 72 years old, 11 008 cases) and the elderly group (≥ 72 years old, 6 109 cases). The basic clinical characteristics were compared between the two groups. Kaplan-Meier method was used to analyze the overall survival (OS) and log-rank test was performed. The multivariate Cox proportional hazards regression model was used to analyze the influencing factors for OS. The cumulative incidence function (CIF) was used to calculate the lung cancer-specific death rate and death rate from other causes in the different age groups, and the difference between the two groups was compared by Fine-Gray competing risk model, and the influencing factors of lung cancer-specific death were analyzed. Results:The proportion of squamous cell carcinoma in the elderly group was higher than that in the young group [51.1% (3 123/6 109) vs. 46.8% (5 154/11 008), P < 0.01], and the proportion of stage Ⅲ A was also higher than that in the young group [67.4% (4 120/6 109) vs. 60.1% (6 615/11 008), P < 0.01]; the proportion of patients receiving chemotherapy in the elderly group was lower than that in the young group [69.2% (4 226/6 109) vs. 88.6% (9 748/11 008), P < 0.01]. The 2-year and 5-year OS rates of the young group were 39.2% and 18.0%, and the elderly group were 32.4% and 12.5% (both P < 0.01). The multivariate Cox regression analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, reason for non-operation and chemotherapy were independent influencing factors for patients' OS after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.13 (95% CI 1.09-1.18) ( P <0.01). The 2-year and 5-year cumulative incidence rate of lung cancer-specific death in the elderly group were 60.3% and 75.7%, which were higher than the corresponding values of 55.9% and 74.0% in the young group, and the difference of cumulative incidence rate of lung cancer-specific death between the two groups was statistically significant ( P < 0.01). The 2-year and 5-year cumulative incidence rate of death from other causes in the elderly group were 7.3% and 11.8%, which were higher than the corresponding values of 4.9% and 8.0% in the young group, and the difference of death from other causes between the two groups was statistically significant ( P < 0.01). The competing risk model analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, and with or without chemotherapy were independent influencing factors for lung cancer-specific death in patients with inoperable stage Ⅲ NSCLC after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.07 (95% CI 1.02-1.12) ( P =0.002). Conclusions:Age is an independent prognostic factor for patients with inoperable stage Ⅲ NSCLC after radiotherapy. The prognosis of elderly patients is poor, and they have high risks of lung cancer-specific death and death from other causes.

Objective To investigate the shielding effect of distance in radioactive iodine treatment in patients with differentiated thyroid cancer (DTC). Methods Eighty- seven DTC patients underwent postoperative radioactive iodine treatment at the therapeutic doses ranging from 2.96 GBq to 7.4 GBq. The patients were divided into two groups to receive high-dose therapy (≥3.7 GBq, 48 patients) and low-dose therapy (<3.7 GBq, 39 patients). The radiation doses at 0.05 m, 1 m, and 3 m were recorded at different days;the doses at 1 m and 3 m on the third day, the dose of standard radioactivity source of 1.11GBq 131I, and the natural background radioactivity were also recorded. Results The radiation dose at a 1-meter distance was significantly higher in the high-dose group than in the low-dose group (P<0.05). The radiation doses in different dose groups at the other distances or at different time points showed no significant differences (P>0.05). On the third day after therapy, the radiation dose at 1 m was significantly lower than the reference radioactivity source of 1.11 GBq 131I (P=0.000), but still higher than the natural background radioactivity at 3 m (P=0.000). Conclusion In DTC patients who receive radioactive iodine therapy, the radioactive radiation dose decreases rapidly after 3 days. The radioactive radiation dose on the third day is significantly lower than the reference radioactive radiation dose, so that the patients can be discharged with safety for contact at a distance beyond one meter.

Objective To investigate the shielding effect of distance in radioactive iodine treatment in patients with differentiated thyroid cancer (DTC). Methods Eighty- seven DTC patients underwent postoperative radioactive iodine treatment at the therapeutic doses ranging from 2.96 GBq to 7.4 GBq. The patients were divided into two groups to receive high-dose therapy (≥3.7 GBq, 48 patients) and low-dose therapy (<3.7 GBq, 39 patients). The radiation doses at 0.05 m, 1 m, and 3 m were recorded at different days;the doses at 1 m and 3 m on the third day, the dose of standard radioactivity source of 1.11GBq 131I, and the natural background radioactivity were also recorded. Results The radiation dose at a 1-meter distance was significantly higher in the high-dose group than in the low-dose group (P<0.05). The radiation doses in different dose groups at the other distances or at different time points showed no significant differences (P>0.05). On the third day after therapy, the radiation dose at 1 m was significantly lower than the reference radioactivity source of 1.11 GBq 131I (P=0.000), but still higher than the natural background radioactivity at 3 m (P=0.000). Conclusion In DTC patients who receive radioactive iodine therapy, the radioactive radiation dose decreases rapidly after 3 days. The radioactive radiation dose on the third day is significantly lower than the reference radioactive radiation dose, so that the patients can be discharged with safety for contact at a distance beyond one meter.

Background and objective Hypoxia is an important biological characteristics of solid tumor, it is not sensitive to radiotherapy and chemotherapy for which is the presence of hypoxic cell, thus increasing their resistance to con-ventional radiotherapy and chemotherapy, therefore, the detection of hypoxia degree of tumor tissue is of great signiifcance. hTe hypoxia imaging of nuclear medicine can relfect the degree of tissue hypoxia, which can selectively retained on the hypoxic cells or tissues, including nitroimidazole and non nitroimidazole; the nitroimidazole is widely and deeply researched as hypoxic celles developer in China and abroad at present. hTe research about application of radionuclide labelled technique has clini-cal application value to develop the hypoxia imaging agent EDTA-MN complexes which was labeled. To study the feasibility of99mTc by direct labeling method, the radiochemical properties evaluation of99mTc-EDTA-MN, and observe the distribution characteristics of99mTc radiolabeled EDTA-MN in the xenogratf lung cancer nude mice bearing non-small cell lung cancer cell (A549), and provide experimental evidence for its further research and application.MethodshTe radiolabeling of EDTA-MN with99mTc was performed with direct labeling method, respectively, on the reaction dosage (10 mg, 5 mg, 2 mg), stannous chlo-ride dosage (8 mg/mL, 4 mg/mL, 2 mg/mL), mark system pH (2, 4, 5, 6) one by one test, using orthogonal design analysis, to ifnd the optimal labeling conditions. Labelling rate, radiochemical purity, lipid-water partition coeffcient and in vitro stability in normal saline (NS) were determined by TLC and HPLC, and the preliminary study on the distribution of99mTc-EDTA-MN in nude mice.Results hTe labeling rate of99mTc-EDTA-MN with the best labeling conditions was (84.11±2.83)%, and the ra-diochemical purity was higher than 90% by HPLC puriifcation, without any notable decomposition at room temperature over a period of 12 h. hTe partition coeffcient was lgP=-3.05, indicated that this complex was hydrophilic. At 3 h post-injection, the imaging of99mTc-EDTA-MN in nude mice bearing non-small cell lung cancer cell showed that more radioactive gathered in bladder at0.5 h, the transplanted tumor was clearly imaged at 1 h post-injection, during whole imaging radioactive in other tissues and organs was low. hTe radioactivity of tumor uptake by using of ROI technology were (88.14±11.59), (123.17±9.06), (98.08±14.40) and (79.87±10.57) at 0.5, 1, 2, 3 h post-injection, and the ratio of T/NT of tumor and liver area were (1.95± 0.19), (3.58±0.78), (3.95±0.39) and (5.01±0.28), respectively.99mTc-EDTA-MN could be quickly cleared from the blood in mice primarily through the kidneys, and the radioactivity in other tissues and organs remained low.Conclusion99mTc-EDTA-MN can be easily prepared and labeled compound with high labeling rate and stability, it appears to be suitable for further experiments requirementin vivo andin vitroapplication.