Object To study the effects of SINI TANG (SNT) on the rat aortic rings pre-contracted by high K + and phenylephrine (Phe). Methods The effects of SNT on the aortic rings in the presence of 60 mmol/L KCl and Phe (1?10 -9 -1?10 -4 mmol/L) were observed and t heir me chanisms were studied after treatment with Propranolol (Pro, 3?10 -6 mmol/ L) and Bay K8644 (BK, 1?10 -5 mmol/L) as tool drugs. Results SNT inhibited the contraction induced by cumulative Phe and decreased the maximum tension (T max ); Pro couldn't influe nce the effects of SNT. SNT attenuated the amplitude of contractile effect of hi gh K +; BK couldn't reverse the effects of SNT. Conclusion SNT can shift the dose-response curve to the right and decrease the T max . It shows that SNT is a kind of noncompe titive antagonism. SNT decreases the effect of high K + against contraction of the artery. BK, a L-type Ca 2+ channels activator, couldn't recover the inhibition induced by SNT. The results suggest that SNT inhibit ? 1 recep tor, while calcium channel may not be involved in attenuating the effect of SNT on high K +-induced contraction.

PurposeSmart neuro attenuation correlation (SNAC) is a new method of calculated attention correction. This paper aims to evaluate the impact of SNAC on the quality and standardized uptake value of brain imaging with PET/CT.Materials and Methods Fifty-eight patients who underwent systematic scan with18F-FDG PET/CT were analyzed retrospectively. CT attenuation correlation (CTAC) and SNAC brain PET images were reconstructed respectively. All images were analyzed by visual assessment and Scenium software and the results of the two methods were compared with regard to image contrast, homogeneity and mean SUV at different cerebral regions. Moreover, the correlation of the mean SUV of the two methods was further analyzed.Results There was no significant visual difference of contrast and uniformity between SNAC and CTAC. The Scenium analysis shows that the contrast of SNAC images were slightly higher than that of CTAC, but the difference were not statistically significant (4.19±1.11vs. 4.08±1.03,t=0.764,P>0.05). The uniformity of SNAC images were slightly lower than that of CTAC (1.00vs. 0.83). The mean SUV at various brain regions measured by SNAC was greater than that by CTAC, but both were significantly correlated (r=0.978,P<0.01), and the linear regression analysis also demonstrated that the results were consistent (R2=0.959). Compared with that measured by CTAC, the average percentage difference of SUV measured by SNAC was 8.45±4.71, but it varied greatly at 10 brain regions (-8.56-27.93). The analysis of variance presented significant differences in the average percentage difference of SUV at different brain regions (F=119.084,P<0.01), while the average percentage difference at the outer slices was greater than that at the central slices. Conclusion No significant difference exists in image quality between SNAC and CTAC. Although the mean SUV at different brain regions measured by SNAC may increase by various degrees, it is significantly associated with the results measured by CTAC. Moreover, SNAC simplifies the process of examination and reduces radiation dose, which is beneficial to patients as a qualitative method.

18F-FDG PET or PET/CT plays an important role in the differential diagnosis of rheumatic disease.By imaging evaluation of glucose metabolism,18F-FDG PET or PET/CT can identify disease activity and distribution.It can also evaluate treatment response of rheumatic disease based on the change of glucose metabolism between baseline and follow-up studies.This article reviews the clinical application of 18F-FDG PET or PET/CT in rheumatoid arthritis (RA),seronegative spondylarthropathy (SpA),large vessel vasculitis (LVV),polymyalgia rheumatica (PMR) and adult onset Still's disease (AOSD).

Objective To observe the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve that were combined to design a compound muscle flap.And to observe the effect of this flap clinical application.Methods Ten adult and fresh cadaver lower limbs were observed the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve,and were combined to design a compound muscle flap.Clinically applied in 5 cases,and the flap sizes ranged from 6 cm × 9 cm to 9 cm × 12 cm.Results After into the muscle,the lateral sural artery issued 3-5 perforating branches (OD:0.2-1.8 mm) along the way,which provided nutrition for the lateral head of the gastrocnemius and the surrounding skin and involved in the formation of shallow and deep fascia vascular network with the nutrient vessels of the lateral sural cutaneous nerve.From Feburary 2009 to November 2011,the compound pedicled muscle flap were clinically applied in 5 cases to repair the skin defects of the anterior knee and proximal tibia.Flaps in 4 cases completely survivedand 1 case had partial superficial necrosis on the distal part of the flap,which healed after dressing change.Conclusion The compound pedicled muscle flap has two sets of blood supply that could expand the area of the flap,which could guarantee its feeling.This kind of flap could repair the complicated skin and soft tissue defects around the knee joint.

Objective To investigate the characteristics of 18F-FDG PET/CT imaging in Takayasu arteritis (TA) and its clinical value.Methods Five male patients with TA in active phase (age range:65-82 years;mean age:(72.8±6.6) years) from November 2011 to August 2014 were retrospectively analyzed.All patients underwent 18F-FDG PET/CT imaging,and one of them who was in stable phase after one year's treatment underwent follow-up PET/CT imaging.The characteristics of the abnormal 18F-FDG uptake and SUVmax of lesions were analyzed.Another 5 age-and gender-matched patients with slightly elevated tumor markers and normal results of 18F-FDG PET/CT imaging in the same period were selected as the control group.Arteries were divided into 18 segments,including the ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right common carotid,the left/right subclavian,the left/right brachial,the superior mesenteric,the left/right common iliac,the left/right renal,and the left/right femoral,and their SUVmax were measured respectively.Paired t test was used to analyze the difference of SUVmax between TA group and the control group.Results (1) 18 F-FDG PET/CT imaging displayed diffused increase of radioactivity in the wall of aorta and its major branches in TA group,and CT showed multiple irregular thickening,punctate and banding calcification in arterial walls of those patients.The ascending aorta,the aortic arch,the descending aorta,the abdominal aorta,the brachiocephalic trunk,the left/right subclavian,the left/right common carotid,and the left/right common iliac artery were all involved in 5 patients;the left/right brachial and the left/right femoral artery were involved in 4 patients and the superior mesenteric artery was involved in 2 cases.The SUVmax range was 1.4-7.6,the highest SUVmax was in the left subclavian artery (n=2),the right subclavian artery (n=1) and the abdominal aorta artery (n=2).(2)The SUVmax of TA group and the control group were 3.96±1.35 and 2.13±0.53,respectively(t=10.40,P＜0.001).(3) As to the TA patient in stable phase after treatment,the FDG uptake of the wall of aorta and its major branches decreased obviously compared with that before treatment.The SUVmax of left subclavian artery decreased from 6.8 to 3.2.Conclusions 18F-FDG PET/CT is helpful in diagnosis of TA.It could accurately display the range of involved arteries,reflect the activity of the lesion and evaluate the therapeutic response.

Purpose To analyze the PET image of normal human brain by using Scenium software, so as to ifnd out the change of cerebral glucose metabolism with different age and gender. Materials and Methods Brain PET imaging data of 493 healthy males and 273 healthy females were collected in the study. The subjects were divided into 6 groups according to age:21-30 years group,31-40 years group, 41-50 years group, 51-60 years group, 61-70 years group and 71-82 years group. Each group was further subdivided according to gender. The brain areas were automatically outlined by Scenium and the mean standard uptake value (SUV) of each brain area was calculated and compared among groups. Results Most cerebral glucose metabolism of males at different age was significantly different (F=2.580-5.316, P<0.05), except temporal lobe in right side and cerebellum showed no difference (F=1.611-1.935, P>0.05); whilst difference in cerebral glucose metabolism of females at different age was not signiifcant (F=0.721-1.706, P>0.05). In male groups, cerebral glucose metabolism got peak at 31-40 years, and decreased signiifcantly at 51-60 years mainly involving areas like cinglulate gyrus, calcarine and surrounding cortex;and the groups after 61 years showed no signiifcant decrease. In female groups, cerebral glucose metabolism got peak at 31-40 years and showed no significant decrease along with age. Conclusion Cerebral glucose metabolism decreases unevenly after 40 years old. It drops significantly in males at 51-60 years whilst that in females is not obvious.

Objective To investigate the design and clinical result of the modified medial fasciocutaneous flap of lower leg in the different zonation. Methods The length of lower leg was divided into three zonations equally.According to the different zonation of the fasciocutaneous flap,the 45 patients were divided into three groups from Jan.2005 to Feb.2008.The defects of the patients were repaired with the flaps.The sizes of the flaps ranged from 5 cm×3 cm to 25 cm×10 cm.Results The flaps survived completely in 43 cases.The distal sides of flaps necrosed partially in 2 cases in the upper third of the lower leg.The necrosed part of the flap was repaired after the change dressings.The colour and texture of flaps were excellent,the appearance and function were satisfactory after a follow up of 4-20 months.Conclusion The modified medial fasciocutaneous flap of the lower leg is easy to design and dissect,blood supply is reliable without sacrifice of the major arteries.The flap can be used according to the different location of the fascia pedicel.It is the idea flap to repair the soft tissue defects of the front of knee joint,the leg,the ankle and the foot.

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.

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.