Objective To investigate the value of 99Tcm-Duramycin SPCET/CT in the detection of vulnerable plaque (VP) in atherosclerotic (AS) rabbit models.Methods Sixteen New Zealand male rabbits were randomly divided into three groups:group A (sham-operated group,n =4),group B (stable plaque group,n =4) and group C (VP group,n =8).Group A was fed on normal diet,and the other 2groups were fed on cholesterol diet for 12 weeks.Femoral artery dissection sham-operation was done in group A and group B,while balloon-induced abdominal aorta wall injury was produced in group C after 2 weeks'feeding.Animals were injected with 99Tcm-Duramycin (74 MBq/kg) and then SPECT/CT imaging was performed at the end of 4,8,and 12 weeks,respectively.Abdominal aortas were explanted for ex vivo imaging and histological characterization of plaque.The apoptosis index (AI) was calculated.One-way analysis of variance was used to analyze data.Results There was no radioactive uptake by the abdominal aorta in each group at the end of 4 weeks and no uptake in group A and group B at the end of 8 weeks.There was slightly uptake radioactive uptake by the abdominal aorta in group B at the end of 12 weeks and in group C at the end of 8 weeks.There was intense uptake at the lesions of AS rabbits in group C at the end of 12 weeks,and the T/NT value significantly higher than that of the other two groups (3.40±0.22 vs 2.12±0.65,2.68±0.18,F=198.775,P＜0.05).The result was confirmed in the ex vivo imaging of the explanted aorta.The AI of group C was significantly higher than that of group A and B ((25.4±6.32) ％ vs (0±0.02)％,(5.3± 1.97)％,F=70.260,P＜0.05).Conclusions 99Tcm-Duramycin scimigraphy could identify the apoptosis of VP in the rabbit AS models.It is a promising non-invasive method to diagnose AS plaques.

Objective To investigate the potential of 99Tcm-Durarnycin and 99Tcm-RGD in detecting vulnerable plaque in rabbit models.Methods Fifteen healthy New Zealand male rabbits were randomly divided into group A (control group,n =5),group B (stable plaque group,n =5) and group C (vulnerable plaque group,n =5).Animals were injected with 99Tcm-Duramycin and 99Tcm-RGD at the end of 4,8 and 12 weeks.SPECT/CT scanning was performed at 0.5 h post injection.One rabbit was sacrificed at the end of 4 weeks and one at the end of 8 weeks after imaging.The others were sacrificed at the end of 12 weeks after imaging studies.All aortas were collected.Intravascular ultrasound (IVUS) was performed at the end of 8,12 weeks before SPECT/CT scanning.The data was analyzed with paired t test.Results In group A,the aortas had little uptake of the two probes.In group B,the aortas showed obvious radioactive uptake of 99Tcm-Duramycin and 99Tcm-RGD at the end of 8 weeks and 12 weeks,while 99Tcm-Durarnycin gave better display than 99Tcm-RGD.In group C,99Tcm-Duramycin uptake was higher than 99Tcm-RGD uptake in the aorta.The T/NT ratios of 99Tcm-Duramycin and 99Tcm-RGD in group C were 2.14±0.34 and 1.46±0.34 (t=4.072,P＜0.05) at the end of 4 weeks,2.93±0.41 and 1.66±0.22 (t=5.578,P＜0.05) at the end of 8 weeks,3.25±0.29 and 1.81±0.28 (t=19.692,P＜0.05) at the end of 12 weeks.In isolated specimen of group C,the yellow lipid plaque of the intima bulged on the lumen at the end of 12 weeks.IVUS indicated that,at the end of 8 weeks and 12 weeks,the endometrial thickness of group C was (450±104) mm and (767±52) mm (t=44.024,P ＜ 0.05) respectively,and the rates of luminal stenosis were (29.30± 2.81) ％ and (37.98 ±6.41)％ (t =9.226,P＜0.05).Conclusions Both 99Tcm-Duramycin and 99Tcm-RGD may be used to detect vulnerable plaque at early time.99Tcm-Duramycin may detect vulnerable atherosclerotic plaque earlier than 99Tcm-RGD and provide better diagnostic image.

Sialidosis is a rare lysosomal storage disease caused by NEU1 gene mutation at 6p21.33. It is characterized by myoclonic, ataxia, epilepsy, and decreased vision. A pair of twins with sialidosis type 1 are reported to enrich clinicians ′ understanding of the disease, so as to improve the diagnosis and treatment. The proband was a 16-year-old male. The main symptom was intermittent limb involuntary trembling for 2 years, with paroxysmal loss of consciousness. Fundus examination showed cherry-red spots. His twin brother had similar symptoms, but the overall performance was mild. Whole exome sequencing results showed that both patients carried compound heterozygous mutations of c.239C>T (p.P80L) and c.803A>G (p.Y268C) in NEU1 gene, which were from their normal phenotype mother and father.

Objective:To investigate the feasibility of early off-bed mobility in patients with mechanical ventilation and its effect on delirium and the duration of delirium in the intensive care unit (ICU).Methods:Adult patients who were admitted to ICU of the Affiliated Hospital of Zunyi Medical University from January 1st to December 31st 2020 for invasive mechanical ventilation and no early activity contraindication were selected. The patients were randomly divided into two groups. The experimental group conducted early off-bed mobility, such as using the shift machine off-bed sitting and walking aids to assist standing and walking, and the off-bed mobility is based on patient tolerance. The control group was given early bed activities, including conducting the joint range activity, limb movement, bed sitting, upper limb elastic belt movement, and lower limb cycling, once a day. Each joint moved 15-20 times, a total of 30 minutes. Both groups were treated with anti-infection, mechanical ventilation, analgesia and sedation, and nutrition therapy. After intervention, confusion assessment method for the ICU (CAM-ICU) was used to assess the onset and duration of delirium, physical restraint rate and duration of physical restraint, mechanical ventilation time, and the length of ICU stay.Results:After excluding patients who died or gave up treatment during the intervention period, 266 patients were included, with 133 patients in the experimental group and 133 patients in the control group. There were no significant differences in gender, age, diagnosis, degree of illness, sedative drugs between the two groups. The incidence of the delirium in intervention group was significantly lower than that in control group [26.3% (35/133) vs. 42.1% (56/133), χ 2 = 7.366, P = 0.007], the duration of delirium was shorter than that in control group (hours: 11.26±4.11 vs. 17.00±3.29, t = -4.157, P = 0.000), the rate of physical restraint was lower than that in control group [19.5% (26/133) vs. 45.1% (60/133), χ 2 = 19.864, P = 0.000], the duration of physical restraint was shorter than that in control group (hours: 9.71±4.07 vs. 13.55±7.40, t = -5.234, P = 0.000), the mechanical ventilation time and the length of ICU stay were shorter than those in control group [mechanical ventilation time (hours) : 106.23±42.25 vs. 133.10±41.88, t = -3.363, P = 0.001; length of ICU stay (days) : 8.35±6.21 vs. 13.25±9.98, t =-4.190, P = 0.000]. Conclusions:Early off-bed mobility can reduce physical restraint rate and the incidence of delirium, and thus can accelerate rehabilitation in critically ill patients. Early off-bed mobility is safe and effective for patients with mechanical ventilation in ICU.

Purpose To investigate the expression of fuma-rate hydratase(FH)and 2-succinocysteine(2SC)in leiomyoma with singular nuclear features,and to analyze the diagnostic val-ue of these two proteins in fumarase hydratase-deficient(FH-d)uterine leiomyomas.Methods Sixty-seven cases of leiomyoma with singular nuclear features were collected.The expression was detected by immunohistochemical EnVision method,and the relationship between the expression of FH,2SC and the morpho-logical characteristics of FH-d uterine leiomyomas was analyzed,and the relevant literature was reviewed.Results There were 67 patients of leiomyoma with singular nuclear features,among which 27 had FH-d leiomyoma.The positive rate of FH was(2/27,7.41％),significantly lower than that of leiomyomas without FH-d(31/40,77.50％).The positive rate of 2SC(26/27,96.30％)was significantly higher than that of leiomyo-mas without FH-d(11/40,27.50％).The statistical results showed that there was a correlation between the expression of FH and 2SC(P＜0.05);positive expression of FH and 2SC was associated with significant eosinophilic nucleoli,perinucleolar vacuoles,eosinophilic inclusions and antler vessels(P＜0.05).The sensitivity and specificity of FH immunohistochemi-cal identification of FH defective leiomyoma were 92.59％and 77.50％,respectively.The sensitivity and specificity of 2SC immunohistochemical were 96.30％and 72.50％for FH defec-tive leiomyomas,respectively.Conclusion In most leiomyomas with FH-d morphology,FH expression is negative and 2SC ex-pression is positive.The combined detection of FH and 2SC can significantly improve the diagnosis of FH defective leiomyoma.

Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.

Objective To determine the effect of trunk motion control on knee biomechanics during single-leg landing. Methods Twenty male healthy basketball players were recruited. The kinematics, kinetics parameters and surface electromyogram (EMG) of knee joints under trunk motion control during single-leg landing were studied by using Vicon motion Analysis system, Kistler force platform and Noraxon surface EMG system. Results Compared with natural landing, there were significant differences in flexion angle at initial contact moment, peak flexion angle and peak flexion moment during deeply inspiratory landing and landing with a stick, and a significantly larger flexion angle at initial contact moment, a larger peak flexion angle and smaller peak flexion moment were also found. Compared with natural landing, there was no statistical difference in peak valgus angle and peak valgus moment, as well as EMG activity of hamstrings, quadriceps muscles of the knee during deeply inspiratory landing and landing with a stick. Conclusions Deeply inspiratory landing or landing with a stick reduce the risk of anterior cruciate ligament (ACL) injury, and the results provide the theoretical basis for prevention of ACL injuries in basketball players during landing.