Objective To explore the significance of 18fluorodeoxyglucose positron emission tomography(18F?FDG PET/CT)in the etiological diag?nosis of postoperative intestinal obstruction in patients with gastrointestinal cancer. Methods A total of 51 patients with postoperative intestinal ob?struction undergone 18F?FDG PET/CT were enrolled for the study. The images were interpreted by visual and semi?quantitative analysis(maximum standard uptake value,SUVmax). All the cases were confirmed by pathology and clinical follow?up for more than half a year. The sensitivity,specifici?ty and accuracy of 18F?FDG PET/CT for detecting malignant intestinal obstruction were calculated. Results Of the 51 patients,35 cases were con?firmed for malignant intestinal obstruction,and 16 cases were caused by other benign diseases. 18F?FDG PET/CT imaging was positive in 36 cases, and 33 cases were diagnosed as malignant and recurrent intestinal obstruction. Three cases of PET false?positive were peritonitis adhesion and anasto?motic inflammation. Two cases of PET false negative were peritoneal micrometastasis. The SUVmax of malignant lesions was 8.86±4.82,and the SUVmax of benign lesions was 2.05±1.95. The uptake of FDG was significantly higher in malignant intestinal obstruction than in benign intestinal obstruction (t=7.15,P<0.01). The sensitivity,specificity,and accuracy of 18F?FDG PET/CT diagnosis of malignant lesion were 94.3%,81.3%,and 90.2%, respectively. Conclusion The uptake of 18F?FDG in malignant intestinal obstruction was higher than that in benign intestinal obstruction. 18F?FDG PET/CT have a good diagnostic value for the intestinal obstruction of postoperative gastrointestinal cancer.

Objective To explore the changes in regional cerebral blood flow(rCBF)and cerebral hemodynamics in patients with CCVI.Methods Twenty patients diagnosed as CCVI were enrolled to undergo single photon emission computed tomography(SPECT)rCBF imaging or transcranial Doppler uhrasonography(TCD)examination.All the patients were free from cerebral structural abnormalities as demonstrated by X-CT or magnetic resonance imaging(MRI).Cranial arteries blood flow velocity,pulsating index(PI)were measured by TCD and compared with the mean of rCBF as measured by SPECT.Results On SPECT images, decreased rCBF lesions were found in 95 percent of patients(19/20).The areas of hypoperfusion were mainly located in frontal,temporal,parietal lobes and fondues nodus.Increased cranial arteries blood flow velocity was found in the anterior cerebral artery(ACA)and middle cerebral artery(MCA)in 80 percent of patients (16/20).There were no correlations among rCBF,the decreased percentage of rCBF,average velocity,and PI of cranial arteries.Conclusions By performing SPECT rCBF and TCD on CCVI patients,the degree of changes in rCBF and hemodynamics Can be evaluated easily,which is valuable for early clinical diagnosis and treatment of CCVI.

Objective To assess the predictive value of coronary angiography TIMI myocardial perfusion grade (TMPG), electrocardiogram (ECG) single-lend ST segment resolution (STR), ECG Max-ST-segment deviation (MaxSTE) on judging myocardial reperfusion after primary angioplasty in the patients with acute myocardial infarction (AMI). Methods Primary percutaneous coronary intervention(PCI) was performed in 42 patients within 12 hours after AMI onset. Coronary angiography and ECG was done before and after angioplasty. TMPG, ECG single-leed STR and MaxSTE were used to assess myocardial reperfusion immediately after PCI. Myocardial perfusion scan was examined in all the patients using99mTc-MIBI SPECT on day 7±2. Results Compared with the level of myocardial perfusion demonstrated in myocardial scan of 99mTc-MIBI SPECT, the sensitivity, specificity and accuracy of TMPG, single-lead STR and MaxSTE was calculated. The sensitivity of TMPG, single-lead STR and MaxSTE was 93.75%, 87.50% and 81.25%, respectively, the specificity of them was 20.00%, 80.00% and 80.00%, respectively, and the accuracy was 76.19%, 85.71% and 80.95%, respectively. The findings in single-lead STR and MaxSTE matched well with the results of myocardial scan of 99mTc-MIBI SPECT. Conclusion In the patients suffering from AMI treated with PCI, ECG is an effective method to assess myocardial tissue reperfusion.

Background and purpose:The proportion of incidental thyroid cancer in PET imaging was sig-niifcantly increased with the wide application of18F-FDG PET/CT. The correlation between the glucose metabolism of thyroid incidental thyroid cancer and pathological changes is unclear. The objective of this study is to analyze the relationship between the glucose metabolism by18F-FDG PET/CT and tumor differentiation or lymph node metastasis in patients with incidental thyroid cancer.Methods:A total of 195 patients with focal FDG-avid thyroid incidentaloma during cancer evaluation were enrolled. Fifty-three patients were diagnosed as having thyroid cancer by the pathology. The SUVmax of thyroid cancer foci, lesion size, lesion number, and SUVmax of normal thyroid tissue were quantiifed. The tumor pathological grades and lymph node metastasis were analyzed by the pathology. The patients were broken down into 4 groups (G1, G2, G3 and G4) according to the tumor pathological grades and lymph node metastasis (differentiated thyroid cancer, non-differentiated thyroid cancer, without lymph node metastasis and with lymph node metastasis). The differences of glucose metabolism between G1and G2groups, G3 and G4 groups were analyzed.Results:Fifty-three foci were found by PET imaging. Sixty-two foci were found by the pathology (37 papillary thyroid carcinoma, 4 follicular thyroid carcinoma, 9 medullary thyroid carcinoma, 3 poorly differentiated thyroid cancer). The SUVmax in the normal thyroid tissue, G1and G2were 1.51±0.30, 4.25±1.70 and 6.34±2.45, respectively. The SUVmax in the G1and G2were signiifcantly higher than in the normal thyroid tissue (t=11.0,t=7.10,P<0.01). The SUVmax of G3was 4.77±2.15, and the SUVmax of G4group was 4.67±2.02. The differences between G1and G2groups, G3 and G4groups were not statisti-cally signiifcant (t=3.61,P>0.05;t=0.33,P=0.56).Conclusion:The differentiated incidental thyroid carcinoma and non-differentiated incidental thyroid carcinoma had high glucose metabolism, and there was no signiifcant difference in the levels of glucose metabolism in different differentiation degree and metastasis ability cancer.

Objective To compare the imaging features of 18F-FDG PET/CT in malignant pleural effusion (MPE) and tuberculosis pleural effusion (TPE).Methods From January 2012 to December 2014,93 patients (52 males,41 females,and average age (66.7±12.7) years) with unexplained pleural effusion who underwent 18F-FDG PET/CT were retrospectively studied.MPE and TPE were confirmed by histology,cytology or clinical follow-up.Lesion SUVmax and T/NT were calculated.Both lesion size and density (in Hounsfield units) of pleural abnormalities on CT images were measured.The difference of images between MPE and TPE was analyzed.Diagnostic efficiency of 18F-FDG PET/CT for detecting MPE and TPE were estimated.Two-sample t test and x2 test were used to analyze the data.Results The lesion SUVmax of 66 patients with MPE and 27 patients with TPE was higher than that in normal tissues (7.72±6.50,8.43±4.92;t=7.81 and 7.15,both P＜0.01),but there was no statistical difference between the TPE and MPE (t=0.56,P＞0.05).T/NT was not significantly different between MPE and TPE (5.40±4.29,5.20±2.73 respectively,t=-0.22,P＞0.05) either.The uptake features of 18F-FDG were different between MPE and TPE (x2=29.3,P＜0.01).When the nodular 18F-FDG uptake increase in pleura was taken as the malignancy,diffuse 18F-FDG uptake increase in pleura as tuberculosis,the sensitivity,specificity,positive predictive value,and negative predictive value of 18F-FDG PET/CT were 78.8％ (52/66),81.5％ (22/27),91.2％ (52/57),61.1％ (22/36),respectively,for differentiation of MPE from TPE.Primary cancers were found in 43 patients.When the nodular uptake increase in pleura,or primary cancer associated with increased pleural uptake found by PET was taken as the malignancy,the above mentioned parameters were95.5％(63/66),81.5％(22/27),92.6％(63/68),88.0％(22/25),respectively.Conclusions The 18FFDG uptake in MPE and TPE is higher than that in normal tissues.18F-FDG PET/CT is helpful in the search for the primary tumor of MPE.Qualitative method of 18F-FDG PET/CT has a good value in the differentiation of MPE from TPE.

Objective To investigate the effects of dexmedetomidine (Dex) on the neuronal apoptosis in spinal dorsal horn in a rat model of chronic neuropathic pain.Methods Seventy-two adult male SD rats weighing 180-220 g were randomly divided into 3 groups ( n =24 each):sham operation group (group S) ; chronic constrictive injury (CCI) group; Dex + CCI group (group D).Two ligatures were placed on right sciatic nerve at 1 mm intervals with 4-0 silk thread in groups CCI and D.In group D Dex 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (PWT) and paw withdrawal latency to thermal stimulation (PWL) were measured at one day before (T0,baseline) and on the 3rd,7th and 14th day after operation (T1,2,3).Six animals were sacrificed at each time points (T1,2,3) after the measurement of PWT and PWL.Their lumbar segments (L4,5)were removed for examination with transmission electron microscope and detection of Bcl-2 and caspase-3 expression (by immune-histochemistry).Results CCI significantly decreased PWT and PWL,increased Bcl-2 and caspase-3 expression at T1,2,3 and induced apoptosis in spinal dorsal horn neurons in group CCI as compared with group S.Intraperitoneal Dex significantly attenuated CCI-induced mechanical and thermal hyperalgesia and neuronal apoptosis in group D as compared with group CCI.Dex injected intraperitoneally further increased Bcl-2 expression but decreased caspase-3 expression in group D as compared with group CCI.Conclusion Reduction in neuronal apoptosis in spinal dorsal horn is involved in the attenuation of neuropathic pain by Dex.

Objective To investigate the effect of dexmedetomidine on the expression of purinergic P2X4 receptor (P2X4R) mRNA and p38 mitogen-activated protein kinase (p38 MAPK) mRNA in spinal cord in a rat model of neuropathic pain (NP).Methods Seventy-two male SD rats weighing 180-220 g were randomly assigned into 3 groups ( n =24 each):sham operation group (group S),group NP and dexmedetomidine group ( group DEX).The animals were anesthetized with intraperitoneal 10％ choral hydrate 350 mg/kg.NP was induced by chronic constrictive injury (CCI).The right sciatic nerve was exposed and 4 ligatures were placed on sciatic nerve at 1 mm intervals with 4-0 silk thread in groups NP and DEX.In group S,the right sciatic nerve was only exposed but not ligated.Dexmedetomidine 50μg/kg was injected intraperitoneally daily staring from the end of operation,while the equal volume of normal saline was injected in groups S and NT.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured on day 1 before operation and on day 1,3,7 and 14 after operation.Six animals were sacrificed after MWT and TWL measurement on day 1,3,7 and 14 after operation in each group,the L4～6 segment of spinal cords was removed for determination of P2X4 R mRNA and p38 MAPK mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly up-regulated after operation in groups NP and DEX ( P ＜0.05).Compared with group NP,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly down-regulated after operation in group DEX ( P ＜ 0.05 ).TWL and MWT were significantly higher and the expression of P2X4 R mRNA and p38 MAPK mRNA was significantly lower on day 1,3 and 14 after operation than on day 7 after operation in groups NiP and DEX ( P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine attenuates NP is related to inhibition of the expression of P2X4 R mRNA and p38 MAPK in rats.

Objective To investigate the variance levels of plasma soluble leukocyte differentiation antigens CD40 (sCD40) and soluble CD40 ligand (sCD40L) in preeclamptic patients with renal damage and its relationship. Methods A total of 63 pregnant women attended the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College between August 2008 and June 2010. In the present study included 28 pregnant women with mild preeclampsia and 35 patients with severe preeclampsia. Thirty matched normotensive pregnant women were enrolled in the study as the control group. Expression of sCD40 and sCD40L were determined by ELISA. At the same time, the blood routine, C reaction protein ( CRP),urine routine, 24 hours urine protein excretion, and serum uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN) were measured. The correlation analysis was performed between the sCD40/sCD40L and the blood biochemical indexes in 3 groups. Results ( 1 ) The median levels of CRP in severe preeclampsia (10. 8 mg/L)and mild preeclampsia group(7. I mg/L)are significantly higher than that of control group (3. 3 mg/L,P ＜ 0. 05 ); The level of CRP in severe preeclampsia group was also higher than that of mild preeclampsia group ( P ＜ 0. 05 ). The median gestational age at delivery in severe preeclampsia ( 32. 5 weeks)was significantly less than that of mild preeclampsia group ( 37. 2 weeks) and normal group ( 38. 6 weeks,P ＜ 0. 05). However no significant differences were observed between mild preeclampsia group and normal group ( P ＞0. 05 ). The platelet count in severe preeclampsia ( 132 × 109/L) was significantly less than those of mild preeclampsia group (212 × 109/L) and normal group ( 216 × 109/L, P ＜ 0. 01 ), but no significant differences were observed in blood platelet amount between mild preeclampsia group and normal group ( P ＞0. 05 ). There was no significant difference in hemoglobin level and white blood cell in three groups ( P ＞0. 05). (2) The sCD40 plasma concentration in severe, mild preeclampsia and normal group was 133.6,126. 5 and 90. 7 ng/L, respectively. The sCD40 L plasma concentrations were 12. 5, 10. 4 and 4. 4 ng/L respectively in the 3 groups. 24 hours urinary protein quantitative was 4. 5 g/d,0. 8 g/d and 0 in the 3 groups respectively. And the UA level was 486 μ mol/L,289 μmol/L and 162 μmol/L. In the above three groups,the monitoring indicators were significantly higher in women with severe preeclampsia group compared with mild preeclampsia and control groups (P ＜ 0. 01 ), and there were also higher in mild preeclampsia group than that in control groups ( P ＜ 0. 01 ). The level of plasma Cr ( 89 μmol/L) and BUN ( 5. 32 mmol/L) in severe preeclampsia group were higher than those of mild preeclampsia group (66 μmol/L and 4. 49mmol/L) and control group ( 57 μmol/L and 3.32 mmol/L, P ＜ 0. 05 ). There was no significant difference between mild preeclampsia group and normal group (P ＞ 0. 05 ). (3) The correlation analysis indicated that the level of sCD40 has a positive correlation with 24 hours urinary protein quantitative( r = 0. 434, P ＜ 0. 05 ),also significant positive correlation( r =0. 536,0. 528 ,P ＜ 0. 01 ) between the level of sCD40 and UA or CRP in women with preeclampsia. There was no significant correlation between the level of sCD40 and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and platelet count(r =0. 135,0. 183, -0. 133,0. 190,0. 167, -0. 221 ,all P ＞0. 05 ). There were positive correlation between the level of sCD40L and 24 hours urine protein excretion, either UA or CRP( r =0. 591,0. 445,0. 539 ,all P ＜0. 01 ). No significant correlation was found between sCD40 L and systolic blood pressure, diastolic blood pressure,delivery gestational age, Cr, BUN, and platelet count( r =0. 178,0. 212, -0. 292,0. 144,0. 135, -0. 273,all P ＞0. 05). There was significant positive correlation between plasma sCD40 and sCD40L ( r =0. 707 ,P ＜0. 01 ). There was no relationship between the level of sCD40, sCD40L and the blood biochemical indexes in normotensive pregnant women ( P ＞ 0. 05 ). Conclusions The plasma concentrations of sCD40 and sCD40 L are significantly higher in pregnant women with preeclampsia compared with the control, which may be involved in the development of preeclampsia and contribute to the kidney damage. The variance levels of sCD40 and sCD40L may be also related to the severity of preeclampsia.

Objective To observe the effect of rehabilitation on unilateral spatial neglect(USN) in stroke patients with hemiplegia.Methods 42 stroke patients with hemiplegia and USN accepted several kinds of rehabilitation therapies for 8 weeks.Before and after the treatment,they were assessed with 4 kinds of USN assessments,Barthel Index and National Institutes of Health Stroke Scale(NIHSS).Results After the treatments,the scores of the Barthel Index and the NIHSS had obviously improved,while the abnormal ratio emerged through the 4 kinds of USN assessments obviously decreased.Conclusion Rehabilitation can improve the activity of daily living and promote the recovery of neural function of patients with USN after stroke.

Objective:To investigate the distribution of 99Tc m-methylene diphosphonate (MDP) at different stages of bone injury repair. Methods:A total of 30 rabbit models of femur injury were established by the method of electric drill and perforation of femur. According to the different stages of bone injury repair (at 1, 2 and 3 week), rabbits were divided into group A, B and C ( n=10 each group). Femoral SPECT/CT imaging was performed on the last day of different stages of bone injury repair to obtain radioactivity counts in the region of interest (ROI) on the test side and control side and to calculate target/background ratio (T/B). The light intensity of 3 groups was analyzed by phosphor screen imaging and the distribution of 99Tc m-MDP in bone cells was observed by autoradiography. One-way analysis of variance and paired t test were used to analyze the data. Results:The T/B values of group A, B and C were 1.16±0.14, 1.39±0.23 and 1.18±0.10, respectively ( F=5.83, P<0.01). There were significant differences of the maximum radiation count between the test side (50.00±12.45, 59.50±12.83 and 55.10±9.26) and the control side (43.20±9.57, 50.00±12.30 and 44.30± 6.50) in group A, B and C ( t values: 3.24, 2.28 and 5.77, all P<0.05). There were significant differences in the light intensity of bone specimens in group A, B and C by phosphor screen imaging (37 324.67±6 481.50, 60 950.33±9 781.72 and 43 905.00±4 957.92; F=8.25, P=0.02). 99Tc m-MDP were deposited in both intracellular and extracellular during different stages of bone repair in osteocytes and osteoblasts under autoradiography. Conclusion:At different stages of bone injury repair, the concentration of 99Tc m-MDP is significantly distributed, suggesting that there are other ways of concentration mechanism of 99Tc m-MDP in bone tissue besides the chemical adsorption with hydroxyapatite.