Objective To investigate the change and its related risk factors of cognitive function of patients with Parkinson's disease(PD).Methods The cognitive function of 70 idiopathic PD patients were assessed with Montreal cognitive assessment scale (MoCA),and other PD related neuropsychological test batteries were used to evaluate their movement symptoms and non-movement symptoms such as depression and anxiety.Patients' personal information were collected at the same time.They were reassessed after 2 years.Results As the disease progressed,the MoCA score of the PD patients significantly reduced from (24.79±4.07) points to (21.69±5.22) points (P＜0.01).Seven subdomains of MoCA were attenuated,and 5 of them reached statistical significance.Motor subtype was a main predictor of the outcome of the cognitive impairment in PD.Scores of MoCA total score,naming,language,abstract and directional domains reduced more notably in patients with postural instability gait difficulty(PIGD) than those in the tremor dominant(TD) patients.Conclusion Cognitive function of PD patients decreases obviously after 2 years.The patients' cognitive impairment should be identified and intervened as soon as possible,especially the patients with PIGD.

Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.

Ureteral stricture, urine leakage and other urinary complications are likely to occur after kidney transplantation, which severely affect the function of renal allograft and even lead to renal allograft loss. Ureteral stent plays a critical role in kidney transplantation, which could promote the urine flow from kidney to bladder after kidney transplantation, lower the pressure within the ureter and reduce the risk of early urinary complications. However, it may also cause urinary tract infection, stent-related complications and BK virus infection, etc. Therefore, clinicians should flexibly grasp the indications for ureteral stent removal. In this article, the application, potential adverse reactions and the timing of removal of ureteral stent in the field of kidney transplantation were reviewed, aiming to provide reference for clinical decision-making related to ureteral stent after kidney transplantation.

Objective To investigate the correlation of DCEGMRI findings with pathologic tumor response to neoadjuvant chemotherapy for patients with tripleGnegative breast cancer (TNBC).Methods SixtyGnine patients with TNBC were enrolled,who underwent DCEG MRI before neoadj uvant chemotherapy,then completed neoadjuvant chemotherapy and surgery.Patterns of tumor volume reduction were divided into two types.Univariate and multivariate Logistic regression analyses were performed to detect the independent predictors of pathological tumor response.Results 30.4% (21/69)patients achieved a pathologic complete response.Multivariate Logistic regression analysis showed that homogenous enhancement on preGneoadj uvant chemotherapy MRI (OR＝1 0.87 ,9 5%CI＝2.94－48.3 1 ,P＜0.00 1 )and concentric shrinkage pattern on postGneoadj uvant chemotherapy (OR＝1 3.04,9 5%CI＝2.0 1－54.1 1 ,P＜0.00 1 )were the independent predictors of pathologic complete response.Conclusion Homogeneous enhancement on preGneoadj uvant chemotherapy MRI and the presence of concentric shrinkage pattern are correlated with pathologically complete response in patients with TNBC.

OBJECTIVETo study the early X-ray and CT findings of patients with severe acute respiratory syndrome (SARS).

METHODSChest radiography and CT were performed in 28 patients with SARS within one to three days after onset of the disease. CT examinations included conventional spiral CT and high-resolution CT (HRCT). The radiographic and CT findings of these patients were analyzed retrospectively.

RESULTSAbnormal CT findings were noted in all the patients, but abnormal chest radiographic findings in 17 cases (60.7%, 17/28). CT showed single small focal patchy opacities in 23 patients (82.1%, 23/28), including oval ground-glass opacities in 20 patients, lobular distribution ground-glass opacities in 2 and small patchy consolidation in one. Multi-focal ground-glass opacities were found in 2 patients and extensive opacities in three. In the 28 patients, a total of 31 lesions were found in the upper (7, 22.6%), middle (3, 9.7%), and lower lobes (21, 67.7%). The diameter of the lesions ranged from 20 to 35 mm.

CONCLUSIONThe dominant feature of early SARS patients is focal patchy opacity in the lung, and oval small ground-glass opacities are the common morphological findings on CT.

Adult ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Previous studies proposed that the synergistic effect of fibroblast growth factor-21 (FGF-21) and insulin may be due to the improvement of insulin sensitivity by FGF-21. However, there is no experimental evidence to support this. This study was designed to elucidate the mechanism of synergistic effect of FGF-21 and insulin in the regulation of glucose metabolism. The synergistic effect of FGF-21 and insulin on regulating glucose metabolism was demonstrated by investigating the glucose absorption rate by insulin resistance HepG2 cell model and the blood glucose chances in type 2 diabetic db/db mice after treatments with different concentrations of FGF-21 or/and insulin; The synergistic metabolism was revealed through detecting GLUT1 and GLUT4 transcription levels in the liver by real-time PCR method. The experimental results showed that FGF-21 and insulin have a synergistic effect on the regulation of glucose metabolism. The results of real-time PCR showed that the effective dose of FGF-21 could up-regulate the transcription level of GLUT1 in a dose-dependent manner, but had no effect on the transcription level of GLUT4. Insulin (4 u) alone could up-regulate the transcription level of GLUT4, yet had no effect on that of GLUT1. Ineffective dose 0.1 mg kg(-1) FGF-21 alone could not change the transcription level of GLUT1 or GLUT4. However, when the ineffective dose 0.1 mg x kg(-1) FGF-21 was used in combination with insulin (4 u) significantly increased the transcription levels of both GLUT1 and GLUT4, the transcription level of GLUT1 was similar to that treated with 5 time concentration of FGF-21 alone; the transcription level of GLUT4 is higher than that treated with insulin (4 u) alone. In summary, in the presence of FGF-21, insulin increases the sensitivity of FGF-21 through enhancing GLUT1 transcription. Vice versa, FGF-21 increases the sensitivity of insulin by stimulating GLUT4 transcription in the presence of insulin. FGF-21 and insulin exert a synergistic effect on glucose metabolism through mutual sensitization.

Objective:To explore the value of 18F-fluorodexyglucose (FDG) PET/CT combined with integrated contrast-enhanced CT on the diagnosis of hepatic epithelioid hemangioendothelioma(HEH). Methods:Six patients (2 males, 4 females, age: (41.0±5.6) years) histopathologically confirmed to be HEH in Qingdao Central Hospital between November 2013 and November 2018 were retrospectively analyzed. All patients underwent 18F-FDG PET/CT dual-phase imaging and three-phase dynamic enhanced scanning with integrated CT. Characteristics of 18F-FDG PET/CT and contrast-enhanced CT images were classified and analyzed. Results:All 6 patients had multi-lesions (30 lesions in total). The capsule retraction sign was found in 16.7% (5/30) lesions, target sign was found in 33.3% (10/30) lesions, and " lollipop sign" was found in 13.3% (4/30) lesions. There were three ways of enhancement showed by CT: mild progressive enhancement, delayed enhancement, and black target sign/white target sign in the portal phase. Among the 30 lesions, 66.7% (20/30) had higher 18F-FDG uptake than liver parenchyma, with maximum standardized uptake value (SUV max) of 4.18±0.64 during routine imaging and 4.23±0.70 during delayed imaging, and the retention index was 0.65(-1.88, 4.60). The rest 33.3% (10/30) showed similar 18F-FDG uptake to liver parenchyma, with SUV max of 2.75±0.52 during routine imaging, and 2.78±0.55 during delayed imaging. The uptake of 18F-FDG increased with time in 22 lesions and decreased in 8 lesions. In the metabolically heterogeneous lesions, the relatively high-metabolization site was also the site with higher peak enhancement; in the lesions with uniform metabolism, the CT enhancement was also uniform. Bilateral pulmonary metastases were found in 2/6 patients. Conclusion:18F-FDG PET/CT dual-phase imaging combined with CT three-phase dynamic enhanced scanning is helpful in accurate diagnosis of HEH and could show extrahepatic metastases.

To explore the characteristics and gender differences of non-motor symptoms（NMS） in De Novo Parkinson’s diseases （PD）. Methods 203 newly diagnosed PD patients （102 males，101 females） and 255 healthy controls （110 males，145 females） were selected. The clinical data were collected and evaluated by mini-mental State Examination （MMSE），Montreal Cognitive Assessment （MoCA），Hamilton Depression Scale （HAMD），Hamilton Anxiety Scale （HAMA），Parkinson’s disease Sleep Scale （PDSS），Unified PD Rating Scale Part III （UPDRS-III） and Hoehn Yahr （H-Y） stage. Non-motor questionnaire screening scale （NMSQ） was used to assess their non-motor symptoms，and compared the characteristics of NMS in different genders. Multivariate linear regression was used to analyze the influencing factors of NMDQ score in PD patients. Results 98.5% of PD patients had at least one NMS，among which forgetfulness （ 67.5%），depression （49.8%） were the most common. The total score and nine domains of NMS in PD group were significantly higher than those in healthy controls （all P<0.05）. The rates of interest decline，depression，anxiety and excessive sweating in female in PD group were significantly higher than those in male，while the rate of dysphagia was significantly lower （all P<0.05）. The rates of hallucination and sweating increase in female in healthy controls were significantly higher than those inmale，the rate of memory decline was significantly lower （all P<0.05）. The total scores of NMS in male and female patients with PD were affected by HAMD and PDSS （all P<0.05），while male patients were more likely to be affected by the disease duration （β= 0.181，P=0.032）. Conclusion The incidence of non motor symptoms in newly diagnosed PD patients is significantly higher than that in healthy controls and different in gender.

Objective:To explore the value of 18F-FDG PET/CT combined with pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) in diagnosis and differential diagnosis of stageⅠA small cell lung cancer (SCLC). Methods:From June 2017 to October 2021, 113 patients (75 males, 38 females; age 32-79 years) with stageⅠA lung cancer (70 with adenocarcinoma, 25 with squamous cell carcinoma, 18 with SCLC; patients with adenocarcinoma and squamous cell carcinoma were combined into non-SCLC (NSCLC) group) and 30 patients with benign pulmonary nodule (21 males, 9 females; age 37-77 years) from the Affiliated Qingdao Central Hospital of Qingdao University were retrospectively analyzed. All patients were examined by 18F-FDG PET/CT and serum tumor markers associated with lung cancer. Differences of the clinical, imaging and tumor markers data among different groups were analyzed by χ2 test, Fisher exact test and Kruskal-Wallis rank sum test. Independent risk factors were analyzed by logistic regression analysis and ROC curve analysis was used to analyze the value of different predictive factors in diagnosis and differential diagnosis of SCLC. Results:There were significant differences in SUV max, lobulation sign, spiculation sign, calcification, pleural traction sign, ProGRP, NSE and carcinoembryonic antigen (CEA) among SCLC, NSCLC and benign nodules groups ( H values: 14.06-20.54, χ2 values: 8.16-14.95, all P<0.05), in which lobulation sign of SCLC was more than that of benign nodules (12/18 vs 26.7%(8/30); χ2=7.41, P=0.007), spiculation sign (2/18 vs 51.6%(49/95); χ2=10.01, P=0.002) and pleural traction sign (1/18 vs 35.8%(34/95); χ2=6.47, P=0.011) were less than those of NSCLC, SUV max was higher than that of benign nodules (7.4(5.8, 9.0) vs 2.3(1.4, 5.1); H=51.82, P<0.001), ProGRP was higher than that of NSCLC and benign nodules (64.0(40.1, 84.8) vs 38.7(26.9, 47.6), 36.7(29.1, 40.5) ng/L; H values: 36.13, 43.96, P values: 0.002, 0.001) and NSE was higher than that of benign nodules (12.4(10.9, 14.5) vs 7.4(5.4, 11.8) μg/L; H=40.53, P=0.001). When differentiated SCLC from NSCLC, spiculation sign (odds ratio ( OR)=0.043, 95% CI: 0.004-0.450, P=0.009) and ProGRP ( OR=1.083, 95% CI: 1.035-1.133, P<0.001) were independent risk factors for SCLC, and the AUC of the two factors combination was 0.875, with the sensitivity and specificity of 14/18 and 84.2%(80/95). When differentiated SCLC from benign nodules, SUV max( OR=2.706, 95% CI: 1.099-6.662, P=0.030), ProGRP ( OR=1.165, 95% CI: 1.009-1.344, P=0.038) and NSE ( OR=1.639, 95% CI: 1.016-2.645, P=0.043) were independent risk factors for SCLC, and the AUC of the three factors combination was 0.985, with the sensitivity and specificity of 17/18 and 96.7%(29/30). Conclusion:18F-FDG PET/CT combined with tumor markers ProGRP and NSE is helpful to improve the diagnosis and differential diagnosis of stage ⅠA SCLC.

Objective To observe the value of 18F-FDG PET/CT combined with tumor markers for diagnosis of non stageⅠ A limited-stage small cell lung cancer(LS-SCLC).Methods Totally 87 cases of non stage Ⅰ A LS-SCLC(LS-SCLC group),137 of non stage Ⅰ A non-small cell lung cancer(NSCLC,NSCLC group)and 48 cases of pulmonary inflammatory lesions(inflammatory group)were enrolled.Patients'general data,tumor marker levels and PET/CT findings were comparatively analyzed.Logistic regression analysis was performed to evaluate the efficacy of parameters for diagnosing non stage Ⅰ A LS-SCLC.Results There were significant differences of patients'age,neuron-specific enolase(NSE),pro-gastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCCA)and cytokeratin-19-fragment(CYFRA21-1),as well as of the maximum lesion diameter,maximum standard uptake value(SUVmax),morphology,spiculation sign,relationship between long axis and bronchus,lymph node fusion and proportion of lymph node with higher SUVmax than primary lesion among 3 groups(all P＜0.05).The area under the curve(AUC)of the combination of spiculation sign,NSE＞23.5 μg/L,ProGRP＞111.8 ng/L,SCCA≤2.5 μg/L and CYFRA21-1≤7.4 μg/L for differentiating LS-SCLC and NSCLC was 0.91,higher than that of each single parameter(all P＜0.05).AUC of the combination of SUVmax＞8.1,NSE＞19.4 μg/L,ProGRP＞72.5 ng/L and lymph node fusion for differentiating LS-SCLC and pulmonary inflammatory lesions was 0.99,higher than each single parameter(all P＜0.05).Conclusion 18F-FDG PET/CT combined with tumor markers ProGRP and NSE was helpful for diagnosing non stage ⅠA LS-SCLC.