Nonunion remains a major complication after skeletal trauma. In the last decade, extracorporeal shock wave therapy has become a common tool for the treatment of delayed unions or non-unions. With the help of a review of the literature, the current author gave an overview of indications, choices of devices, success rates and complications for ESWT in the treatment of non-unions. The conceivable mechanism was also outlined.

Objective To summarize the extra-bone joint characteristics of 18F-FDG PET/CT images in patients with adult-onset Still's disease. Methods Twelve patients with adult-onset Still's disease as confirmed by clinical and laboratory tests were enrolled in this study. The characteristics of 18F-FDG PET/CT images were retrospectively analyzed. Results Among the 12 patients, no patients were found with solid malignant tumors. Various degrees of high uptake were found in liver, spleen, bone marrow or lymph node. The hepatic SUV was 2.74 ± 0.89, the spleen SUV was 3.68 ± 1.24, and the SUV of thoracic spine was 4.36 ± 1.35. For the lumbar vertebral, the value of SUV was 4.26 ± 1.25. Lymph node high uptakes were found in 8 patients at different sites , including retroperitoneal , pelvic cavity and pelvic wall , inguinal bilateral neck , hepatic portal , axillary lymph nodes. The value of SUV was 3.76 ± 1.41. Conclusions 18F-FDG of AOSD has certain characteristics, such as diffusely uptake of liver, spleen, bone marrow, or lymph node, with or without pleural effusion.

Objective To evaluate the role of 11C-methionine positron emission tomographv(MET PET-CT)in differentiating tumor recurrence from radiation necrosis in brain slioma patients.Methods From June 2008 to September 2009,30 brain glioma patients with suspected tumor recurvence or radiation necrosis after radiotherapy were evaluated by MET PET-CT.The median time between initial radiotherapy and PET examination was 13.5 months.Tumor recurrence were confirmed by histological analysis while necrosis was based on histological analysis or the subsequent clinical follow-up.Results Eighteen out of 19 patients were histologically confirmed tumor recurrence among those tumor recurrence shown by MET PET-CT after surgery or stereotactic biopsy.11 patients were considered to have radiation necrosis because of stable neurological sympotoms and without massive enlargement of the lesion during the after follow-up.The sensitivity,specificity and accuracy of MET PET-CT for detecting tumor recurrence were 100%,91.7%and 96.7%respectively.Conclusion MET PET-CT is a powerful tool in differentiating brain tumor recurrence from radiation necrosis after radiotherapy.

Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Due to the availability of 18F-FDG in PET centers, this article aims to advocate and promote the standardization of 18F-FDG PET brain imaging in dementia in order to improve the reliability, repeatability and comparison of the imaging process and results. It is also provided to guide the PET imaging operation standard and to give suggestions on image interpretation.

ObjectiveTo analyze the changes in CD4⁺T lymphocyte (CD4 cells) levels and influencing factors in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) before and after highly active anti-retroviral therapy (HAART) in Xining City, Qinghai Province, so as to provide a scientific basis for formulating corresponding follow-up intervention strategies. MethodsFrom February to July, 2023, 468 HIV/AIDS patients who received HAART in Xining, Qinghai Province were selected using a convenient sampling method for a questionnaire survey. Venous blood was collected and CD4 cell levels were detected by flow cytometry. SPSS 22.0 was used for t-test, analysis of variance and χ²⁃test, and multiple linear regression analysis was used to explore the level of CD4 cells and its main influencing factors in HIV/AIDS population after HAART. ResultsUnivariate analysis showed significant differences in baseline CD4 cell levels among people of different ages, nationalities, residential types and annual income (P<0.05). There were statistically significant differences in the most recent CD4 cell levels among people of different nationalities, different marital statuses, with or without regular physical exercise, with or without hypertension, different baseline CD4 cell count, different years since HIV diagnosis, different years of HAART treatment, and different treatment programs (P<0.05). Multiple linear regression analysis showed that the baseline CD4 cell count was 350‒499 (t=7.40) and ≥500 (t=6.69), the number of years of HAART treatment was 5‒9 (t=3.59) and ≥10 (t=4.54), the number of years of HIV diagnosis was ≥10 (t=-2.58), the number of people receiving second-line treatment (t=-2.49) and the latest CD4 cell levels after HAART were statistically correlated (P<0.05). ConclusionThe CD4 cell levels of HIV/AIDS population in Xining city of Qinghai Province are affected by many factors. Comprehensive health intervention should be carried out for this population, the implementation of early detection and treatment strategy should be strengthened, relevant physiological and biochemical indicators should be monitored regularly, and health education should be carried out, so as to encourage this population group to choose a healthy lifestyle, improving their quality of life from multiple dimensions.