Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Microvessels ; diagnostic imaging ; Neovascularization, Pathologic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To investigate the added value of CTAC for improving image quality and diagnostic efficiency of bone imaging in SPECT/CT.Methods Seventy-five patients (47 males,28 females,(56.6± 12.8) years) with abnormal uptake in planar whole-body bone scintigraphy underwent SPECT/CTfor differentiation of malignant from benign spinal lesions.NAC and CTAC SPECT images were classified based on 5-point scale (5:excellent,4:good,3:adequate,2:suboptimal,1:inadequate).The diagnostic confidence for both NAC and CTAC SPECT images were classified based on 4-point scale (4:definite,3:certain,2:equivocal,1:uninterpretable).The pathological results after surgery were used as gold standard to evaluate the added diagnostic value of CTAC for spinal lesions.Wilcoxon-signed rank sum test was used for data analysis.Results CTAC improved the image quality in 37.3％ (28/75) of patients,and downgraded in 2.7％ (2/75) of patients.The remaining 45 patients were unchanged (60.0％,45/75).SPECT with CTAC could significantly improve the image quality (z=-4.747,P＜0.001),but the overall diagnostic confidence was not increased (z=-1.000,P＞0.05).Conclusion CTAC can improve the image quality of spinal SPECT,especially useful in imaging with poorer quality,but it has no significant incremental value in diagnostic confidence.

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons

Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.

Objective To retrospectively evaluate the value of SPECT/CT imaging for follow-up of bone metastases.Methods A total of 178 patients with bone metastases (387 lesions) underwent 2 or more events of whole-body bone scintigraphy (WBS) and SPECT/CT imaging.Sequential images were analyzed by 2 experienced,nuclear medicine physicians.Each lesion was interpreted as progressive,remissive or stable in WBS or SPECT/CT independently.Reasons for the discordance between WBS and SPECT/CT results were analyzed.The results of clinical follow-up,including clinical symptoms,tumor markers,serum ALP,radiograph,CT and MRI,were likewise classified as progressive,remissive or stable.The x2 test was used to compare the differences between the two imaging methods.Results The follow-up results of the two imaging methods were consistent in 313 (80.88％,313/387) lesions,including 208 in progression and 105 in remission or stable condition.Among the 74(19.12％,74/387) lesions showing discordance,48 showed remission or stable conditions on WBS but progression on SPECT/CT (64.86％,48/74) ; while 26 showed progression on WBS but remission or stable condition on SPECT/CT (35.14％,26/74).There was a statistically significant difference of the follow-up results between WBS and SPECT/CT (x2 =6.54,P ＜0.05).Conclusion SPECT/CT is more valuable than WBS for follow-up of bone metastases.

Objective : To examine the diagnostic and prognostic value of long non-coding RNA (lncRNA) JPX in mesothelioma, so as to provide insights into diagnosis and prognosis of mesothelioma. Methods: Patients with clinically definitive diagnosis of mesothelioma from 2015 to 2019 that were sampled from asbestos processing plants in Zhejiang Province from 2015 to 2019 were recruited in the mesothelioma group, while healthy residents without asbestos exposure or asbestos-related diseases in the same area served as controls. Participants' demographics, pathologic diagnosis and imaging features were collected, and the expression of blood lncRNA JPX was detected using lncRNA microarrays. The diagnostic value of lncRNA JPX for mesothelioma was evaluated using the receiver operating characteristic (ROC) curve, and the correlation between lncRNA JPX expression and prognosis was examined among mesothelioma patients using survival analysis. Results: There were 17 subjects in the mesothelioma group, with a mean age of (65.71±8.36) years, and 34 subjects in the controls, with a mean age of (64.24±8.70) years. LncRNA microarray detected significantly high lncRNA JPX expression in mesothelioma patients, and higher blood lncRNA JPX expression was detected in the mesothelioma group than in the control group [median (interquartile range), 1.10 (1.31) vs. 0.89 (0.54); t'=-2.300, P=0.034]. The area under the ROC curve was 0.673 (95%CI: 0.507-0.839, P=0.046), and if the cutoff was 1.759, the sensitivity and specificity were 35.3% and 100.0%, respectively. Survival analysis showed no significant difference in the survival rate of mesothelioma patients between the high lncRNA JPX expression group and the low expression group (χ2=0.212, P=0.645). Conclusions LncRNA JPX overexpression is detected in the blood of patients with mesothelioma, and lncRNA JPX expression presents a diagnostic value for mesothelioma; however, it shows little prognostic value for mesothelioma.

Objective: To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods: The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results: The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice.

Objective:To explore the effect of the pharyngeal pressure feedback training on pharyngeal constriction in persons with swallowing disorders caused by brainstem lesions.Methods:Twenty patients with disordered swallowing caused by a brainstem lesion were randomly divided into a control group and an intervention group, each of 10. Both groups received routine swallowing training including oral sensorimotor training, neuromuscular stimulation and balloon catheter dilation, while the intervention group was additionally provided with two weeks of pharyngeal pressure feedback training. Before and after the treatment, both groups were evaluated in terms of the peak pressure of superior and inferior pharyngeal constriction, endoscopically and also using the functional oral intake scale.Results:There was no significant difference between the two groups in any measure before the intervention. Afterward, both groups had improved significantly by all of the measurements, but the average peak upper pharyngeal pressure, the average intake scale score and the endoscopy results of the intervention group were all significantly better than the control group′s averages.Conclusions:Pharyngeal pressure feedback training can significantly relieve swallowing disorders caused by brainstem lesions.

Objective:To explore the application of digital acoustic analysis in assessing the risk of aspiration among persons with dysphagia using the Praat speech analysis software.Methods:The swallowing of 46 stroke survivors with dysphagia was studied using video fluoroscopy. Each patient was required to pronounce " yi/i/" 3 times before and after taking each mouthful of food, and their voice samples were collected. The subjects were divided into a non-aspiration group of 16 and an aspiration group of 30 based on their penetration-aspiration scale scores. Fundamental frequency, relative average perturbation (RAP), jitter, shimmer, amplitude perturbation quotient and harmonic-to-noise ratio were compared between the two groups before and after taking food.Results:For the non-aspiration group, there was no significant difference in the acoustic data before and after eating. For the aspiration group there were significant differences in fundamental frequency, relative average perturbation and jitter before and after taking food. The average RAP and jitter of the non-aspiration group were significantly better than the aspiration group′s averages before eating. After eating, however, significant differences were observed only in average jitter.Conclusions:Analyzing perturbation and jitter can help to identify persons at risk of aspiration.

{L-End}Objective To analyze the effects of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry. {L-End}Methods A total of 1 004 workers of a chemical fiber factory were selected as the study subjects using convenient sampling method, and their blood pressure and body mass index were measured. Multiple linear regression model was used to analyze the relationship between night shift work and blood pressure, and multiple logistic regression was used to assess the independent impact and combined impact of night shifts and overweight/obesity on the risk of hypertension. {L-End}Results Compared with the non-night shift workers, the prevalence of hypertension in night shift workers was increased (5.3% vs 13.0%, P<0.05), with elevated systolic and diastolic blood pressure (both P<0.05). The results of multiple linear regression analysis showed that the systolic blood pressure and diastolic blood pressure of the night shift workers were higher than those of the non-night shift workers (both P<0.05), and the systolic blood pressure and diastolic blood pressure of overweight/obesity workers were higher than those of non-overweight/obesity workers (both P<0.01). The results of multiple logistic regression analysis showed that the risk of hypertension in night shift workers and overweight/obesity workers was higher than that in non-night shift workers and non-overweight/obesity workers [odds ratio (OR) and 95% confidence interval (CI) were 2.49 (1.04-5.99) and 2.65 (1.77-3.95), both P<0.05]. Night shift work and overweight/obesity showed a synergistic effect on blood pressure of workers. Compared to non-overweight/obesity non-night shift workers, overweight/obesity night shift workers had a higher risk of hypertension (OR=4.93, 95%CI: 1.70-14.29, P<0.01). {L-End}Conclusion Night shift work could lead to elevated blood pressure in workers in the chemical fiber industry, which is a potential risk factor for hypertension. The synergistic effect of night shift work and overweight/obesity may contribute to the increased risk of hypertension.