Objective To summarize the current status and trend of hypoglycemic agents of diabetic inpatients in different departments of Chinese PLA General Hospital.Methods The clinical data of diabetic patients admitted to Chinese PLA General Hospital from January 2000 to May 2014 were collected(those hospitalized in the department of endocrinology were excluded).A total of 10 041 patients were selected by stratified random sampling.The type of hypoglycemic agents in different departments and the variation on anti-hyperglycemic drugs with time were retrospectively analyzed.Results Of all the patients in non-endocrinological wards, 50.2% were treated with insulin, 36.9% with metformin, 21.3% with α-glycosidase inhibitor, and 18.9% with sulfonylureas.Metformin, α-glucosidase inhibitors, pre-mixed 30R, and insulin glargine were more commonly used than other anti-hyperglycemic agents, accounting for 36.9%, 21.0%, 14.0%, 8.7%, respectively.Metformin, sulfonylureas, α-glucosidase inhibitor, and different types of insulin were more widely applied in internal medicine while insulin therapy was more frequently used in surgical department.During the past 15 years, the proportions of insulin, glinides, α-glucosidase inhibitor, and thiazolidinediones application were gradually increased, while the proportions of sulfonylureas and metformin treatment were on the decline trend.Conclusion Most of the inpatients were treated with oral antidiabetic drugs.Metformin, α-glucosidase inhibitor, pre-mixed 30R, and insulin glargine were the most frequently prescribed agents for the inpatients.

Objective To assess the significance of insulin tolerance test(ITT) in clinical diagnosis of adult growth hormone deficiency(GHD).Methods Eighty-two patients with an established diagnosis of adult GHD [53males,29 females,mean age (30.9 ± 12.3) years (18-65 years)] were reviewed retrospectively for evaluating the GH response to ITT in the General Hospital of the People' s Liberation Army.Control data for peak GH after ITT were obtained in 15 healthy subjects [9 males,6 females,mean age (26.7 ± 5.6) years (22-41 years)].Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) were used to evaluate the diagnostic cut-off point of peak GH and GH increment response to ITT.Results (1) Mean peak GH response to ITT was significantly higher in 15 controls compared with 82 patients (the median 14 μg/L vs 0.62 μg/L,P =0.001).The cut-off point of the peak GH(chemiluminescent immunoassay,CLIA) response to ITT in adult GHD was 4.935 μg/L (AUC 0.993).(2) Mean GH increment was significantly higher in 15 controls compared with 82 patients (the median 13.17 μg/L vs 0.19 ug/L,P＜0.001).The cut-off point of the GH increment was 4.088 μg/L(AUC 0.937),with a 91.5％ sensitivity and 100％ specificity.(3) The peak GH showed even higher diagnostic value than the GH increment after ITT.(4)The above mentioned cut-off points (peak GH less than 4.935 μg/L and 5 μg/L) had a coincidence with a 95.1％ sensitivity and 100％ specificity,respectively.Conclusion The current guidelines for the diagnosis of adult GHD based on the optimal cut-off point of the peak GH(CLIA) response to ITT less than 5 μg/L turned to be of reliable diagnostic value in our country.

Objective To study the effect and mechanism of the thapsigargin combined with gefitinib on the proliferation of human lung adenocarcinoma gefitinib resistance cell line PC9/GR. Methods The cell viability of PC9/GR treated with gefitinib alone or gefitinib combined with thapsigargin was evaluated by CCK8 assay. The flow cytometry was used to analyze the PC9/GR cell apoptosis indued by the two group drugs. The ATF-6 and IRE1α protein expression of PC9/GR cells treated with the two group drugs were detected by Western blotting. Results The group of drug combination exhibited enhanced ability to inhibit cell proliferation, promote cell apoptosis and upregulate the ATF-6 and IRE1α protein expression of the PC9/GR compared with the group gefitinib used alone. Conclusion The sensitivity of PC9/GR to gefitinib was increased when the cells were treated by thapsigargin, which may be related with the state of endoplasmic reticulum stress（ERS） induced by thapsigargin.

Objective:To compare the value of 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) and 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the detection of bone metastasis in neuroendocrine neoplasm (NEN). Methods:From January 2014 to July 2019, 29 NEN patients (19 males, 10 females, age: 35-76 years) with bone metastasis who underwent 68Ga-DOTATATE and 18F-FDG PET/CT imaging within one month in Peking University Cancer Hospital & Institute were retrospectively enrolled. Patients were divided into Ki-67≤20% and Ki-67>20% groups according to the tumor proliferation activity, and osteolysis, osteogenesis and no change groups according to the CT findings of bone metastases. The differences of the number and radioactive uptake (maximum standardized uptake value (SUV max) ratio of bone lesion to normal bone (SUV T/B)) of detected bone metastases between 68Ga-DOTATATE and 18F-FDG PET/CT imaging were analyzed. χ2 and Mann-Whitney U tests were used to analyze the data. Results:The sensitivity of 68Ga-DOTATATE and 18F-FDG PET/CT imaging were 75.9%(22/29) and 82.8% (24/29) respectively, and there was no significant difference between the two modalities ( χ2=0.42, P>0.05). The numbers of cases with bone lesions detected by 68Ga-DOTATATE PET/CT imaging in pelvis, spine, ribs, proximal limbs, sternoclavicular scapula and skull were all higher than those of 18F-FDG PET/CT imaging (23, 22, 20, 14, 14, 10 vs 12, 19, 13, 11, 10, 6, respectively). The 68Ga-DOTATATE PET/CT imaging was significantly superior to 18F-FDG imaging in detecting bone metastases (9(3, 36) and 3(0, 18)) and SUV T/B(11.10(3.35, 22.30) and 1.60(1.05, 2.70); U values: 281.000, 77.000, both P<0.001). 68Ga-DOTATATE PET/CT imaging found more bone lesions in well differentiated NEN (Ki-67≤20%) group (11(2, 38) and 2(0, 13)) and osteogenic bone metastasis group (31(3, 100) and 3(0, 31); U values: 105.500, 69.500, both P<0.05). SUV T/B of 68Ga-DOTATATE PET/CT imaging was significantly higher than 18F-FDG PET/CT imaging in all subgroups ( U values: 3.000-22.000, all P<0.05). Conclusion:The 68Ga-DOTATATE PET/CT imaging is superior to 18F-FDG PET/CT imaging in the detection of bone metastasis in NEN.

Objective:To study the impact of different scattering correction algorithms in the reconstruction of PET/CT images on image artifacts and the precision of quantitative parameters.Methods:The phantom as described in the National Electrical Manufacturers Association (NEMA) NU2 standard was filled with 18F. The background activity was fixed, and the activity of the solution in the spheres was adjusted to obtain several configurations, including the normal ratio group (4.08∶1) and the extreme ratio group (200∶1). The surface contamination group with the same ratio as the extreme ratio group contained a small radioactive source with different doses of 18F (74, 37, 3.7 and 0.37 MBq) placed at the surface of the phantom. PET/CT images of 30 patients (21 males, 9 females, age: (44.5±10.2) years) from Peking University Cancer Hospital & Institute between July 2012 and December 2021 were retrospectively analyzed, including 10 with normal images ( 18F-FDG) and 20 with abnormal images (10 with dislocation during acquisition, 10 with surface contamination). The images were reconstructed with relative and absolute scattering correction. The phantom was evaluated using the target to background ratio (TBR) and the artifact classification. CV as well as the artifact classification were used to compare the clinical image quality. Mann-Whitney U test and χ2 test were used to analyze data. Results:In the normal ratio group and the extreme ratio group, the TBRs of phantom images reconstructed with relative correction were significantly higher than those with absolute correction (normal ratio group: 3.30(1.94, 4.53) vs 2.72(1.56, 3.56); z=-2.20, P=0.028; extreme ratio group: 105.47(45.62, 162.82) vs 101.36(43.96, 155.57); z=-1.99, P=0.046). In the surface contamination group, with the increase of the activity of the small source, the artifact became more obvious, and the artifact classification score of absolute correction was significantly better than that of relative correction (1.5(1.0, 2.0) vs 2.5(2.0, 3.0); z=-2.00, P=0.046). In the 10 normal 18F-FDG PET/CT patients, the CVliver of the relative correction (9.67%(8.00%, 11.00%)) was significantly lower than that of absolute correction (11.00%(9.00%, 12.00%); z=-2.57, P=0.010), indicating the higher image quality of images with relative correction. In abnormal images, the image quality of absolute correction was significantly higher than that of relative correction with fewer and less severe artifacts (dislocation cases: 9/10 vs 4/10; χ2=5.50, P=0.019; surface contamination cases: 9/10 vs 4/10; χ2=5.50, P=0.019). Conclusions:The relative scattering correction is suitable for normal situations in clinical PET acquisition. However, with dislocation or surface contamination, the absolute scattering correction helps to reduce the artifacts and improve the image quality.