Objective To investigate the value of dual-phase 18F-FDG PET/CT for differentiating pancreatic cancer from pancreatitis.Methods Dual-phase 18F-FDG PET/CT scanning was prospectively performed on patients with suspicious pancreatic lesions.Patients with solid focal pancreatic lesions proved by histopathology or clinical follow-up were enrolled and divided into 3 groups according to the maximum diameter of the focus: ≤2.0 cm (group A), >2.0 cm and ≤ 4.0 cm (group B), >4.0 cm (group C).SUVmax at (60±10) min and (120±15) min after FDG injection was defined as early and delayed SUVmax (SUVearly and SUVdelayed), respectively, and retention index (RI) was calculated.The differences of SUVearly, SUVdelayed and RI between pancreatic cancer and pancreatitis were analyzed with Mann-Whitney u test.ROC curve was used to determine the optimal cutoff values of the above three parameters and corresponding diagnostic efficiencies were obtained.The AUC was compared with MedCalc software.Results A total of 196 patients (152 pancreatic cancers and 44 pancreatic inflammatory lesions) with solid focal pancreatic lesions were enrolled.The AUC of SUVdelayed was significantly larger than that of SUVearly (0.83 vs 0.79, z=3.64, P<0.01).Numbers of patients in group A, B and C were 45, 96 and 55 respectively.There was no significant difference of the maximum diameter between pancreatic cancers and pancreatitis lesions in all three groups (z values:-0.39,-1.52,-1.41, all P>0.05).The SUVearly, SUVdelayed and RI of pancreatic cancers were all higher than those of pancreatitis in group A and B (z values: from-4.59 to-3.00, all P<0.01).The diagnostic sensitivity and accuracy of SUVearly > 3.6 combined with RI > 0 for diagnosing pancreatic cancer were higher than those of SUVearly > 3.6: 96.4%(27/28) vs 75.0%(21/28), 95.6%(43/45) vs 82.2%(37/45).The AUC of SUVdelayed was significantly larger than that of SUVearly in group B (0.81 vs 0.77, z=2.06, P<0.05).The optimal cutoff value of SUVdelayed in group B was 5.3, with the corresponding sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.4%(65/77), 13/19, 91.5%(65/71), 52.0%(13/25) and 81.2%(78/96), respectively.RI of pancreatic cancers was significantly higher than that of pancreatitis (25.0%(15.8%-35.7%) vs 14.4%(4.6%-18.7%), z=-2.39, P<0.05) in group C.The optimal cutoff value of RI in group C was 19.0%, with the corresponding sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 68.1%(32/47), 7/8, 97.0%(32/33), 31.8%(7/22) and 70.9%(39/55).Conclusions The SUVdelayed and RI of dual-phase 18F-FDG PET/CT might be useful for diagnosis of pancreatic tumors.SUVearly > 3.6 combined with RI >0 could be helpful to improve the diagnostic sensitivity and accuracy in patients with the maximum diameter of lesions ≤2.0 cm.The diagnostic value of SUVdelayed might be better than that of SUVearly in patients with the maximum tumor diameter of >2.0 cm and ≤4.0 cm.Only RI could be used for diagnosing pancreatic tumors in patients with the maximum tumor diameter > 4.0 cm.

Objective: To study correlation between heart rate variability (HRV) and arteriosclerosis in patients with essential hypertension (EH).Methods: A total of 139 EH patients from our hospital were enrolled as EH group.According to carotid-femoral pulse wave velocity (PWV), they were divided into normal subgroup (n=65, PWV<9 m/s) and abnormal subgroup (n=74, PWV≥9 m/s).Another 60 healthy adults undergoing physical examination in our hospital during the same period were selected as healthy control group.HRV indexes, PWV, carotid intima-media thickness (IMT) and number of carotid plaques were compared among all groups.Correlation among above indexes were analyzed in EH patients.Results: Compared with healthy control group, there was significant reduction in standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording[SDANN, (142.3±21.4)ms vs.(119.3±16.5)ms], significant rise in low frequency[LF, (341.7±37.9)Hz vs.(695.4±43.3) Hz], high frequency[HF, (519.1±33.6) Hz vs.(636.8±39.5)Hz], LF/HF[(0.6±0.3) vs.(1.0±0.2)], PWV[(7.44±0.82) m/s vs.(11.13±0.65) m/s]and IMT[(1.03±0.24)mm vs.(1.74±0.41)mm]in EH group, P<0.01 all;in EH group, compared with normal PWV subgroup, there was significant reduction in SDANN, and significant rise in LF, HF, LF/HF, IMT and mean number of carotid plaques in abnormal PWV subgroup, P<0.05 or <0.01;Pearson correlation analysis indicated that in EH patients, PWV and IMT were significant inversely correlated with SDANN (r=-0.713,-0.699, P<0.01 both), significant positively correlated with LF, HF, LF/HF and carotid plaques (r=0.506~0.935, P<0.01 all), and PWV was significant positively correlated with IMT (r=0.883, P=0.001).Conclusion: In EH patients, SDANN, LF, HF, LF/HF of HRV are significantly correlated with arteriosclerotic extent.Besides lowering blood pressure , HRV etc.related with artery pathological changs should also be treated.

Objective: To investigate the value of ¹⁸F-fluorodeoxyglucose (FDG) PET/CT in differentiation of noninvasive and malignant pancreatic cystic lesions (PCL). Methods: A total of 125 PCL patients (66 males, 59 females, age range: 13-83 years), who had pathology or typical imaging performance with ≥12 months follow-up between August 2010 and December 2015, were enrolled in this retrospective study. The diagnostic effects of ¹⁸F-FDG PET/CT were calculated. The size, maximum standardized uptake value (SUV_max), delayed SUV_max and retention index (RI) of noninvasive and malignant PCL were analyzed. The results of pathological examination and follow-up were used as the gold standard, and Mann-Whitney u test was used to analyze the data. Receiver operating characteristic (ROC) curves of SUV_max, delayed SUV_max and RI were drawn and compared. Results: A total of 132 PCL were found in 125 patients, including 71 malignant PCL and 61 noninvasive PCL. The size, SUV_max, delayed SUV_max, RI of noninvasive and malignant PLC were 2.2 (1.4, 3.8) cm vs 3.9 (3.0, 5.0) cm, 1.5 (1.2, 1.8) vs 6.4 (4.4, 9.3), 1.5 (1.2, 1.9) vs 6.4 (5.4, 11.7), -6.3%(-19.4%, 5.6%) vs 17.5%(7.6%, 29.4%), respectively. All parameters were significantly different between 2 groups (z values: from -9.267 to -4.904, all P<0.05). The area under curve (AUC) and cut-off value of SUV_max were 0.969 and 2.5, and the corresponding accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 92.4%(122/132), 93.0%(66/71), 91.8%(56/61), 93.0%(66/71), 91.8%(56/61), respectively. The AUC and cut-off value of delayed SUV_max were 0.969 and 2.7, and the accuracy, sensitivity, specificity, PPV, NPV were 94.3%(99/105), 96.7%(58/60), 91.1%(41/45), 93.5%(58/62), 95.3%(41/43), respectively. ROC curves of SUV_max and delayed SUV_max were not significantly different (z=1.799, P>0.05). Conclusion ¹⁸F-FDG PET/CT has good performance in differentiation of noninvasive and malignant PCL, but the delayed scan cannot further improve the efficacy of differential diagnosis.

Objective To explore the effect of forgiveness intervention on improving the happiness index and self-esteem of the elderly.Methods Totally 103 cases who had been offended and did not relieved were enrolled in this research.Two groups were assigned using digital random method.There were 49 cases in the experimental group and 50 cases in the control group that were counted in final statistics according to the inclusion and exclusion criteria.The experimental group received 8-week forgiveness therapy,control group re-ceived no special intervention.Results The scores of well-being,forgiving self,forgiving others and self-es-teem respectively were 3.06±0.97,3.23±0.62,3.01±0.63 and 2.71±0.35 respectively.Forgiving others was positively related with well-being and self-esteem(r=0.296,0.273,P<0.01),and there was no correlation between forgiving self and well-being(r=0.113,P>0.05). Forgiving others(t=5.309,P<0.01),self-esteem (t=2.732,P=0.008),well-being(t=2.732,P=0.008)in experimental group were improved after the inter-vention,but no difference was found in forgiving self(t=1.413,P=0.165). And there were significant differ-ence in both main effect and interaction effect in forgiving others(Fmain=39.05,Pmain<0.01; Finter=34.96, Pinter<0.01),self-esteem(Fmain=26.41,Pmain<0.01; Finter=35.83,Pinter<0.01),well-being(Fmain=20.96,Pmain<0.01;Finter=18.06,Pinter<0.01)at the pre-test,post-test and 1 month after intervention in experimen-tal group. In the control group,there was no significance in main effect(Fmain=1.98,Pmain=0.152),but the interaction effect was significantly different(Finter=10.98,Pinter<0.01).Conclusion Forgiveness interven-tion can improve forgiveness for elderly people.This intervention method has a positive effect on improving the overall happiness index and self-esteem of elderly people who have been subjected to other offenses,unfair treatment or interpersonal conflicts.

Objective:To evaluate the effect of goal-directed hemodynamic management of muscle oxygen saturation (SmO 2) on the postoperative renal function in hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors. Methods:Eighty-six essential hypertension patients, aged 18-64 yr, with body mass index ≤ 30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective laparoscopic radical gastrectomy for gastrointestinal tumors under general anesthesia, were divided into 2 groups ( n=43 each) using a random number table method: routine group (group C) and SmO 2 goal-directed group (group S). The fluctuation of mean arterial pressure (MAP) and heart rate (HR) were maintained < 20% of the preoperative baseline value by adjusting infusion speed and vasoactive drugs in group C. SmO 2 was maintained not less than 70% or not less than the baseline value by evaluating cardiac output (CO), HR, stroke volume, stroke volume variation, systemic vascular resistance index and MAP and by adjusting infusion rate and vasoactive drugs in group S. SmO 2, HR, MAP, CO, cardiac index (CI), stroke volume variation and systemic vascular resistance index were recorded before anesthesia induction (T 0, baseline value), at the beginning of surgery (T 1), at 40 min after the start of pneumoperitoneum (T 2), at 5 min after the end of pneumoperitoneum (T 3), and at the end of surgery (T 4). The glomerular filtration rate was measured before surgery and at 24 h after surgery, and the occurrence of decline in postoperative acute renal function was recorded.Intraoperative hypotension, fluid input and output, postoperative tracheal extubation time, length of hospital stay, occurrence of acute kidney injury and transfer to ICU, and the Quality of Recovery-15 scale score at 24 h after operation were recorded. Results:Compared with group C, SmO 2 at T 1-3 and CO and CI at T 3 were significantly increased, SVRI at T 2-4 was decreased, the intraoperative infusion volume and urine volume were increased, the glomerular filtration rate and Quality of Recovery-15 scale score were increased at 24 h after surgery, the incidence of decline in acute renal function was decreased ( P<0.05), and no significant change was found in the incidence of intraoperative hypotension, blood loss, postoperative extubation time, length of hospital stay, incidence of acute kidney injury and rate of transfer to ICU in group S ( P>0.05). Conclusions:SmO 2 goal-directed hemodynamic management can reduce the development of decline in postoperative acute renal function and improve the quality of postoperative recovery of hypertensive patients undergoing laparoscopic radical gastrectomy for gastrointestinal tumors.

Objective:To analyze the relationship between hematological and genotype characteristics of fetuses and patients with hemoglobin (Hb) H disease and their natural disease progression.Methods:From 2010 to 2022, a total of 1 252 blood samples from fetuses and patients with Hb H disease who visited the Guangxi Zhuang Autonomous Regional Maternal and Child Health Hospital were collected (including 174 umbilical cord blood samples, 1 062 peripheral blood samples from patients over 2 years old, and 16 peripheral blood samples from patients with rare cases of genotype Hb H). Additionally, 278 peripheral blood samples were collected from patients aged 0 - 2 years old with Hb H 3.7, Hb H 4.2, Hb H CS, and Hb H WS disease for the study of trends in red blood cell development. Multiple probe hybridization and microarray comparative genomic hybridization technology combined with first-generation Sanger sequencing were used for rare mutation detection.Results:Among the 1 062 Hb H disease patients over 2 years old, 62.34% (662/1 062) had gene deletion (--/-α), of which Hb H 3.7 (-- SEA/-α 3.7) and Hb H 4.2 (-- SEA/-α 4.2) were the most common, accounting for 42.28% (449/1 062) and 19.11% (203/1 062) of the total, respectively. Among the non-deletion genotypes (--/αα T or α Tα/αα T), Hb H CS (-- SEA/α CS), Hb H WS (-- SEA/α WS) and α CSα/α CSα accounted for 16.85% (179/1 062), 16.48% (175/1 062) and 1.98% (21/1 062), respectively. The 81.12% (537/662) of patients with deletional Hb H disease showed mild to moderate anemia, with Hb H detection rates ranging from 75% to 80%. Among non-deletional Hb H disease, Hb H WS disease showed the mild (blood Hb concentration > 95 g/L in 90% of patients) phenotype while Hb H CS and Hb H QS (-- SEA/αα QS) patients had moderate to severe anemia, with Hb H detected in peripheral blood at higher levels than in other types of Hb H disease patients. Except for Hb H CS and Hb H QS, which did not show a significant increase in Hb A2 levels when complicated with β-thalassemia, Hb A2 levels were increased (> 3.5%) in all other types of Hb H disease patients. When Hb H disease was complicated with β-thalassemia, Hb H peaks were not detected in either type of Hb H disease. The results of red blood cell development trend detection showed that erythrocyte counts were elevated in patients with Hb H disease compared to their normal counterparts; whereas, blood Hb, mean erythrocyte volume (MCV) and mean erythrocyte hemoglobin content (MCH) were lower than in their normal counterparts ( P < 0.05) and decreased to the minimum at 6 months to 1 year of age. Patients with Hb H CS disease, as the most severe form of anemia, had the highest MCV values ( P < 0.001). The results of fetal cord blood with Hb H disease showed that α CSα/α CSα caused severe intrauterine anemia, followed by Hb H QS and Hb H CS. The content of Hb Bart's in umbilical cord blood was negatively correlated with the severity of anemia ( rs = - 0.58, P < 0.001). When Hb H disease was complicated with β-thalassemia, there was no significant improvement in fetal anemia, and the Hb Bart's content did not change significantly ( P > 0.05). In addition, Hb H 21.9 (-α 21.9kb/-- SEA) and Hb H 2.4 (-α 2.4/-- SEA) were common in patients with deletion rare Hb H. In patients with non-deletion rare Hb H, αα Amsterdam-A1/-- SEA and αα Hb G-Georgia/-- SEA were both first reported. Conclusions:There is heterogeneity in clinical manifestations of patients with different types of Hb H disease or same type of Hb H disease at different developmental stages. When patients with Hb H are complicated with β-thalassemia, the phenotype of patients with the deletion type is improved, while that of patients with the non-deletion type is not. Compared to normal individuals, patients with Hb H disease have lower blood Hb concentration, MCV and MCH, and more rapid physiological changes in red blood cells.

OBJECTIVE: To investigate the effect of environmental estrogen bisphenol A (BPA) exposure on apoptosis of mouse ovarian preantral follicular granulosa cells and ovarian development and explore the underlying mechanism. METHODS: Mouse ovarian preantral follicular granulosa cells were isolated from female ICR mice at postnatal day (PND) 10 and cultured RESULTS: Compared with the control cells group, the isolated cells exposed to a low concentration of BPA (50 μmol/L) showed a significantly lowered apoptosis rate, increased mitochondrial membrane potential, and enhanced cellular proliferation ( CONCLUSIONS BPA can concentration-dependently regulate the function of ovarian preantral follicular granulosa cells in mice and potentially affects both the pregnant mice and the offspring female mice in light of early ovarian development.
Animals ; Apoptosis ; Benzhydryl Compounds ; Female ; Granulosa Cells ; Mice ; Mice, Inbred ICR ; Ovarian Follicle ; Phenols ; Pregnancy