1.Uptake characteristics of 68Ga-FAPI-04 and 18F-FDG in surgical wounds after radical surgery for gastrointestinal adenocarcinoma
Yirong WANG ; Xiang LI ; Zhiyong QUAN ; Weidong YANG ; Fei KANG ; Mingru ZHANG ; Jiajun YE ; Guiyu LI ; Jing WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2023;43(6):349-354
Objective:To explore the uptake characteristics and temporal changes of 68Ga-fibroblast activation protein inhibitors (FAPIs) and 18F-FDG in the anastomotic site of reconstructed digestive tracts after radical surgery for gastrointestinal adenocarcinoma. Methods:A cohort of 43 patients (28 males, 15 females; age range 28-79 years) who underwent radical surgery for gastrointestinal adenocarcinoma and underwent 18F-FDG PET/CT follow-up between November 2020 and June 2022 in the First Affiliated Hospital of the Air Force Medical University was prospectively included. One week after the 18F-FDG PET/CT examination, 68Ga-FAPI-04 PET/CT imaging was performed. ROIs were drawn on the PET images at the highest uptake level of anastomotic sites of reconstructed digestive tract and abdominal wall incisions, and SUV max and target-to-background ratio (TBR) were determined. χ2 test, one-way analysis of variance, Kruskal-Wallis rank sum test (Bonferroni correction) and Wilcoxon signed-rank test were supplied. Results:There were 86 surgical wounds (13 gastric-intestinal anastomotic sites, 14 esophagus-intestinal anastomotic sites, 16 intestinal-intestinal anastomotic sites, and 43 abdominal wall incisions) included. In 68Ga-FAPI-04 PET imaging, SUV max of gastric-intestinal anastomotic sites was higher than that of abdominal wall incisions, with a statistically significant difference (adjusted P=0.014). The TBR did not show statistically significant differences among different types of surgical wounds ( H=3.88, P=0.275). In 18F-FDG PET imaging, SUV max of gastric-intestinal, esophagus-intestinal, and intestinal-intestinal anastomotic sites were all higher than that of abdominal wall incisions, with statistically significant differences (adjusted all P<0.001). There were no statistically significant differences in TBR among different types of surgical wounds ( H=3.02, P=0.388). In 68Ga-FAPI-04 PET imaging, the TBR of all types of anastomotic sites exhibited a decreasing trend with increasing postoperative time. Except for intestinal-intestinal anastomotic sites, the differences in TBR between < 0.5-year and ≥ 1.5-year groups were statistically significant for other types of surgical wounds (adjusted P<0.05). In 18F-FDG PET imaging, the TBR of abdominal wall incisions showed a decreasing trend with increasing postoperative time. However, the TBR of other types of surgical wounds did not show a decreasing trend, and the differences in TBR among different time groups were not statistically significant ( H values: 0.53-2.75, P values: 0.252-0.768). In comparing the two PET imaging agents, for all surgical wounds within the <0.5-year and 0.5-1.5-year groups, the 68Ga-FAPI-04 TBR was consistently higher than the 18F-FDG TBR ( z values: -3.17 and -2.55, P values: 0.002 and 0.011). However, in the ≥1.5-year group, the TBR values tended to be consistent, and the differences were not statistically significant ( z=-0.70, P=0.485). Conclusions:The 18F-FDG uptake in the anastomotic sites of reconstructed digestive tracts reaches a low level under half a year after surgery and does not significantly change over time, while the 68Ga-FAPIs uptake remains relatively high within the first 1.5 years after surgery but decreases over time. These patterns suggest that clinical attention should be paid to the differential diagnosis of anastomotic inflammation or fibrosis, which resulting in agent uptake and local tumor recurrence.
2.Application of improved nursing supports on children with hypospadias after operation
Guiyu XIANG ; Dan ZHU ; Fang HU
Chinese Journal of Modern Nursing 2016;22(23):3400-3402
Objective To summarize the experience and methods of improved nursing supports applied on children with hypospadias after operation and to assess the efficacy. Methods Eighty children with hypospadias were enrolled as control group applying unimproved nursing supports. Eighty four children with hypospadias were enrolled as experimental group applying improved nursing supports. Indicators such as hospital stay, complications and cost of treatment were compared between the two groups. The effect of improved nursing supports applied on children with hypospadias after operation were assessed. Results The hospital stay of experimental group was shorter than that of control group [(13.24±1.809) vs (13.69±1.650) d, t=2.025,P<0.05]. The cost of treatment of experimental group was lower than that of control group [(8 130.161±469.282) vs ( 8 277.538 ± 468. 089 ) Yuan;t = 2. 013, P<0. 05 ] . Twelve children suffered from complications in experimental group and so did 31 children in control group, but there was no statistical difference between the incidence of complications in the two groups (χ2=0.191,P>0.05).Conclusions Improved nursing support is a simple, economical, practical, convenient and reliable tool to apply on children with hypospadias after operation.
3.Design and Optimization of the Formulation and Technology of Theophylline Gel Matrix Sustained-release Tablets Based on QbD Concept
Xiwei JIANG ; Yunyang FEI ; Guiyu LIAN ; Rongwu XIANG ; Fei ZHAI ; Yukun JIANG ; Xin CHE
China Pharmacy 2019;30(18):2502-2507
OBJECTIVE: To design and optimize the formulation and technology of Theophylline hydrophilic gel matrix sustained-release tablets (self-made sustained-release tablets for short) based on the concept of “Quality by Design” (QbD). METHODS: Diluent type, tablet diameter, the property of adhesive (ratio of different adhesive types), the amount of adhesive were regarded as critical process parameters (CPPs). Similarity factor of dissolution curves of self-made Theophylline sustained-release tablets and reference preparation and its accumulative release rate at different time points were regarded as critical quality attributes (CQAs). L18(34) orthogonal tablet was adopted for design and trial, and secondary polynomial regression model was established. By using Modde 12.0 software, the design space and its acceptable range (PAR) were calculated through the optimal model. The optimal formulation and technology of Theophylline sustained-release tablets was determined, and validation test and Monte Carlo simulation verification were conducted. RESULTS: The optimal model with good coincidence, accuracy, validity and reproducibility was obtained, which could better fit the relationship between CQAs and CPPs. The design space and PAR value were obtained by further calculation (The optimum value of diluent was lactose; tablet diameter was 9.07-9.33 mm, and the optimal value was 9.20 mm; ratio of HPMC K4M to HPMC was 0.50-0.83, and the optimal value was 0.80; total amount of HPMC was 0.036 0-0.041 3 g per tablet, and the optimal value was 0.038 g per tablet). The optimal formulation and technology included that ratio of theophylline, HPMC K4M and HPMC K100M were 50%, 15.48% and 3.87%, respectively; the rest was filled with lactose and the diameter of the tablet was 9.20 mm. The results of validation confirmed that self-made Theophylline sustained-release tablets had similar in vitro release behavior compared with reference preparation. CONCLUSIONS: Based on the concept of QbD, the formulation and technology of Theophylline sustained-release tablets can meet the requirements of design, and the CPPs can be adjusted within the PAR range to meet the requirements of CQAs. This shows that the QbD concept is scientific and effective in the design and optimization of the formulation and technology of sustained and controlled release preparations.