Objective To construct the core competence index system of nursing postgraduates in TCM colleges and universities.Methods The Delphi method was used to investigate 30 nursing experts and consult about core competence that nursing postgraduates of TCM colleges and universities should have.Results The effective recovery rates of questionnaire were respectively 85.7％ and 86.7％.The authority coefficients were 0.86 and 0.84,and the consistency coefficients were 0.278 and 0.253 with statistical significance.Index system for core competence with 4 first-grade indexes and 20 second-grade indexes was formed.The full score ratio of first-class indexes was 0.96-1.00,coefficients variation was 0.10-0.13; for the second-class,the full score rate was 0.62-1.00,coefficient variation was 0.08-0.19.Conclusions For formation items of core competence index system of nursing postgraduates in TCM colleges and universities,the opinions of experts are centralized,which can provide reference for training program of nursing postgraduates in TCM colleges and universities.

Objective To explore the application effect of the experiential learning in the soft skills training of nursing students. Methods Using convenient sampling method to select one grade nursing students form a school in Guangzhou as the research objects, two classes were divided into the control group and the experimental group. The experimental group was trained by experiential learning, and the control group was trained by traditional teaching methods. After the training, the differences of nursing soft skills between the two groups were compared to evaluate the effectiveness and feasibility of experiential learning in improving nursing soft skills. Results After training, the total score of nursing soft skills in the experimental group was 156.94 ± 13.97 and the control group was 150.61 ± 12.58, the difference was statistically significant (t=-2.039,P<0.05). Nearly 91.4%(32/35) of nursing students were satisfied or very satisfied with the training methods of experiential learning and nursing students thought that ability or cognitive were promoted and the top three were: interpersonal communication ability, cognition of nursing soft skills, and nursing service etiquette. Nearly 82.9% (29/35) of nursing students expressed that they were willing to receive nursing soft skills training in experiential learning. Conclusions Experiential learning can effectively improve nursing soft skills of nursing students and it is suitable for promotion and application in nursing teaching.

Objective:To explore the experience of the postoperative adult patients with obstructive sleep apnea-hypopnea syndrome from the patients′ angle and to provide references for improving the postoperative comfort of the patients.Methods:The phenomenology research method was adopted in this study. Thirteen postoperative adult patients with obstructive sleep apnea-hypopnea syndrome from Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology participated in the in-depth interview with the interview outline. Data were analyzed by using Colaizzi′s phenomenological method.Results:Three level-1 themes and ten level-2 themes were extracted. The physical discomfort included throat discomfort, lacking of enough sleep at night, restricted diet, limitation in speaking. The negative emotion included the sense of worry, helplessness, fidget and regret. The wish of support included the wish of coping strategy and being understanded.Conclusions:The main uncomfortable experience of the patients is the throat discomfort which has the chain reaction and causes the other discomfort. So the nurses should inquire patients initiatively, cooperate with doctors and patients′ family members to relieve patients′ discomfort particularly at night, and then the patients′ quality of life, nurse-patient relationship and patients′ satisfaction may be improved.

Objective:To explore the diagnostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for the restaging of patients with colorectal cancer and its impact on treatment strategy. Methods:Patients with colorectal cancer who underwent 68Ga-FAPI PET imaging in the PET Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2020 to June 2021 were retrospectively analyzed. PET images were evaluated by 3 experienced imaging physicians. Biopsy or postoperative pathology, clinical and imaging follow-up results were as the gold standard. The diagnostic value of PET was compared with conventional imaging (CT/MR), and the impact of 68Ga-FAPI PET on guiding treatment was evaluated. χ2 test and Fisher exact test were used to compare the differences between groups. Results:A total of 33 patients were included (17 males, 16 females, age (52.8±12.3) years), of which 24 were finally diagnosed as recurrence/metastases/progression. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 68Ga-FAPI PET in detecting recurrence/metastases/progression of colorectal cancer were 93.9%(31/33), 100%(24/24), 7/9, 92.3%(24/26) and 7/7, respectively. Its accuracy, sensitivity and negative predictive value were significantly higher than those of conventional imaging (64.5%(20/31), 56.5%(13/23) and 7/17; χ2 values: 8.549 and 10.786, all P<0.05). Compared with the clinical or pathological stage before examination, 68Ga-FAPI PET led upstaging to stage Ⅳ in 12 patients (50.0%, 12/24). Of the 31 patients who were correctly diagnosed by 68Ga-FAPI PET, the treatment regimen of 22 patients (71.0%) was changed because of 68Ga-FAPI PET imaging. Conclusion:68Ga-FAPI PET has good diagnostic performance in the restaging of colorectal cancer, which is helpful to further guide clinical treatment strategy.

Objective:To explore the impact of different segmentation methods on differential diagnostic efficiency of 18F-FDG PET/MR radiomics to distinguish Parkinson′s disease (PD) from multiple system atrophy (MSA). Methods:From December 2017 to June 2019, 90 patients (60 with PD and 30 with MSA; 37 males, 53 females; age (55.8±9.5) years) who underwent 18F-FDG PET/MR in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively collected. Patients were randomized to training set and validation set in a ratio of 7∶3. The bilateral putamina and caudate nuclei, as the ROIs, were segmented by automatic segmentation of brain regions based on anatomical automatic labeling (AAL) template and manual segmentation using ITK-SNAP software. A total of 1 172 radiomics features were extracted from T 1 weighted imaging (WI) and 18F-FDG PET images. The minimal redundancy maximal relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) algorithm were used for features selection and radiomics signatures (Radscore) construction, with 10-fold cross-validation for preventing overfitting. The diagnostic performance of the models was assessed by ROC curve analysis, and the differences between models were calculated by Delong test. Results:There were 63 cases in training set (42 PD, 21 MSA) and 27 cases in validation set (18 PD, 9 MSA). The Radscore values were significantly different between the PD group and the MSA group in all training set and validation set of radiomics models ( 18F-FDG_Radscore and T 1WI_Radscore) based on automatic or manual segmentation methods ( z values: from -5.15 to -2.83, all P<0.05). ROC curve analysis showed that AUCs of 18F-FDG_Radscore and T 1WI_Radscore based on automatic segmentation in training and validation sets were 0.848, 0.840 and 0.892, 0.877, while AUCs were 0.900, 0.883 and 0.895, 0.870 based on manual segmentation. There were no significant differences in training and validation sets between Radiomics models based on different segmentation methods ( z values: 0.04-0.77, all P>0.05). Conclusions:The 18F-FDG PET/MR radiomics models based on different segmentation methods achieve promising diagnostic efficacy for distinguishing PD from MSA. The radiomics analysis based on automatic segmentation shows greater potential and practical value in the differential diagnosis of PD and MSA in view of the advantages including time-saving, labor-saving, and high repeatability.

Objective:To investigate the diagnostic and prognostic value of 68Ga-fibroblast activation protein inhibitor (FAPI) PET for hepatobiliary malignancies. Methods:From July 2020 to February 2023, 33 patients (23 males, 10 females; age (55.4±13.5) years) with suspected or confirmed liver or biliary tract malignancies who underwent 68Ga-FAPI PET in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. PET images were evaluated by 3 experienced nuclear medicine physicians, and the results of biopsy or postoperative pathology, clinical and imaging follow-up were used as the gold standard. One-way analysis of variance and least significant difference t test were used to compare the differences among groups. Survival analysis was performed using Kaplan-Meier curves and the log-rank test. Results:Of 33 patients, 14 performed PET for initial diagnosis and staging, and 19 for restaging. There were 14 patients with hepatocellular carcinoma (HCC), 13 patients with cholangiocarcinoma (CCA), and 6 patients with gallbladder carcinoma (GBC). The primary tumor of HCC, CCA and GBC all showed significant 68Ga-FAPI uptake, with no statistically significant difference in SUV max among groups ( F=1.58, P=0.250). The sensitivities of 68Ga-FAPI PET for initial diagnosis and restaging of hepatobiliary malignancies were 14/14 and 15/15, respectively. Compared with conventional imaging, 68Ga-FAPI PET changed the diagnosis and staging in 29.2%(7/24) patients. The treatment strategy was changed in 30.3%(10/33) patients with malignant tumors due to 68Ga-FAPI PET findings. Follow-up showed 22 cases survived and 11 cases died, with the overall survival of 355.56(80.00, 516.97) d, and 1- and 2-year survival rates were 68.2% and 57.9%, respectively. Semi-quantitative 68Ga-FAPI PET parameters such as SUV max, target-liver ratio (TLR), and target-blood ratio (TBR) had no significant prognostic value, but the prognosis of the group without distant metastases diagnosed by 68Ga-FAPI PET was significantly better than that of the group with distant metastasis ( P=0.032). Conclusion:68Ga-FAPI PET has high sensitivity for the diagnosis of hepatobiliary malignancies, which can help guide treatment decisions and prognosis evaluation.

The integrated PET/MR overcomes the problem of interferences between PET and the strong magnetic field of MRI, realizing the simultaneous acquisition of two modalities, which is a milestone in the field of medical imaging. The use of PET/MR requires the radiopharmaceutical as well as avoids interferences to the homogeneity of main magnetic field and stability of radio-frequency field from surrounding environment. Therefore, the site selection and layout design about integrated PET/MR are more complicated than the single mode system, and the results of installation and debugging should satisfy two imaging modalities (imaging quality and quantitative accuracy). In this paper, the room construction, installation and debugging of integrated PET/MR are discussed, which can supply a reference about key issues in the construction of similar projects.

Objective:To explore the feasibility of statistical parametric mapping (SPM) aided semi-quantitative analysis in 11C-Pittsburgh compound B (PIB) β-amyloid (Aβ) PET imaging acquired by hybrid PET/MR, and evaluate its possibility in assisting the diagnosis or differential diagnosis for cognitive impairment. Methods:From January 2018 to September 2019, 13 Alzheimer′s disease (AD) patients (4 males, 9 females; age (59.2±5.8) years) and 10 vascular cognitive disorders (VCD) patients (9 males, 1 female; age (59.5±11.5) years) who underwent 11C-PIB PET/MR in PET center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were retrospectively analyzed. The standardized uptake value ratio (SUVR) of eight key brain regions (cerebral white matter, striatum, thalamus, posterior cingulate gyrus, frontal cortex, posterior parietal cortex, lateral temporal cortex and occipital cortex) to cerebellum cortex were obtained by manual delineation and SPM-aided semi-automatic segmentation with the help of synchronous three-dimensional T 1 weighted imaging (3D T 1WI). Pearson correlation analysis was carried out on the SUVR obtained by the two methods. Independent-sample t test and paired t test were used to analyze the data. Results:There was no significant difference between AD group and VCD group in age and Mini-Mental State Examination (MMSE) score (19.7±4.7 vs 21.7±3.8; t values: 0.095 and 1.098, both P>0.05). Except thalamus( r=0.179, P=0.413), there were good correlations between SUVR obtained by segmentation and delineation in the other 7 key regions ( r values: 0.678-0.893, all P<0.05). The SUVR of 8 key regions obtained by the two methods in AD group was significantly higher than that in VCD group (1.519-2.055 vs 1.105-1.618; t values: 2.799-11.582, all P<0.01). The SUVR of striatum (1.942±0.205), posterior cingulate gyrus (1.915±0.249), frontal lobe (1.983±0.264), parietal lobe (2.008±0.296) and temporal cortex (1.931±0.254) in AD group was significantly higher than that of cerebral white matter (1.746±0.192; t values: 3.793-6.992, all P<0.01). But in VCD group, there was no region with the SUVR higher than that of cerebral white matter. Conclusions:Hybrid PET/MR can acquire the PET and MRI images synchronously, which can realize the accurate brain segmentation and obtain the semi-quantitative data of key brain regions aided by SPM. The method can analyze the characteristics and differences of amyloid imaging in AD and VCD, which is expected to provide an accurate imaging analysis method for the diagnosis and differential diagnosis of cognitive disorders.

Objective:To study whether Bayesian penalized likelihood (BPL) and its optimized reconstruction algorithm can improve the reconstructed image quality of low count total-body PET.Methods:Eight patients (5 males, 3 females, age (67.2±6.3) years) who underwent hybrid 18F-FDG PET/MR total-body scans at Department of Nuclear Medicine in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were collected retrospectively from January to June in 2023. Total-body PET/MR images of them were included and list-mode data were reconstructed with four methods, namely 25% counts conventional reconstruction (group 1), 100% counts conventional reconstruction (group 2), 25% counts BPL reconstruction (group 3), and 25% counts optimized BPL reconstruction (group 4). At last, 32 total-body PET images were obtained. SUV max and SUV mean in different ROIs and tumor metabolic volume (MTV) were measured. Total lesion glycolysis (TLG) and parameters of image quality including the ratio of lesion to background (L/B) and image signal-to-noise ratio (SNR) were calculated. Then the differences in all the parameters among the four groups were analyzed by repeated measures analysis of variance and Friedman test. Quantitative differences between BPL reconstruction and optimized BPL with the 100% counts conventional reconstruction were compared respectively by using the Bland-Altman (BA) plot. Results:For the inter-group comparison, except for SUV mean in the muscle ( F=0.38, P=0.767), SUV max and SUV mean in other ROIs were statistically different ( F values: 8.15-36.08, χ2=18.15, all P<0.01), as well as MTV and L/B ( χ2 values: 10.65, 13.35, P values: 0.014, 0.004), but not for TLG ( χ2=4.95, P=0.175) or SNR ( F=2.64, P=0.076). For the pairwise comparison, the differences between group 2 and group 3 were the most significant (all P<0.05). Compared with group 2, there were no significant differences for SUV max and SUV mean of the cerebellar cortex and lesions in group 4 (all P>0.05), as well as MTV and L/B (both P>0.05). In addition, compared with group 1, SUV max of liver and muscle in group 2 were decreased (both P<0.05), while there were no significant differences in group 4 (all P>0.05). BA plots showed that the differences of SUV, MTV, and TLG between group 4 and group 2 were smaller obviously than those between group 3 and group 2. Conclusion:BPL reconstruction can improve low focus detection sensitivity induced by low counts, but it will cause significant changes for PET quantification, which can be solved by optimized BPL reconstruction.

Objective: To discuss the correlation between ¹⁸F-fluorodeoxyglucose (FDG) imaging and arterial spin labeling perfusion weighted imaging (ASL-PWI) using synchronous PET/MR, and explore the feasibility of ¹⁸F-FDG PET and ASL for differential diagnosis in Parkinsonism (PS). Methods: A retrospective analysis was performed in 24 patients with Parkinson′s disease (PD), 10 patients with multiple system atrophy (MSA) and 6 patients with progressive supranuclear palsy (PSP) who all underwent ¹⁸F-FDG PET/MR imaging from October 2017 to December 2018 (15 males, 25 females, age: 34-77 years). Synchronously acquired data, including MRI T₁, ¹⁸F-FDG PET and three dimensional (3D) ASL-PWI were extracted. T₁ structure image was used to register with standard brain template, and the personalized brain template of each patient was obtained. Then, the templates were matched to the corresponding PET and ASL-PWI images, and the mean standardized uptake value (SUV_mean) and mean cerebral blood flow (CBF_mean) of each brain region could be extracted. Pearson correlation analysis was used to evaluate the correlation between SUV_mean and CBF_mean of the whole brain and the regions of interest (ROI; caudate nucleus, putamen, midbrain, pons and cerebellum). One-way analysis of variance and least significant difference t test were used to evaluate the characteristics of SUV_mean and CBF_mean in different diagnostic groups. The diagnostic values of SUV_mean and CBF_mean in different ROI were evaluated with receiver operating characteristic (ROC) curve analysis. Results: A total of 2 800 pairs of SUV_mean and CBF_mean were obtained from 40 cases in 3 groups. The overall correlation between them was good (r=0.468, P<0.01). There were also significant correlations between SUV_mean and CBF_mean in caudate nucleus, putamen, pons and cerebellum (r values: 0.346-0.492, all P<0.05). The CBF_mean of cerebellum in MSA group was significantly lower than that in PD group ((36.92±11.35) vs (47.92±10.75) ml·100 g^-1·min^-1; F=4.817, t=2.675, P<0.05). Compared to the PSP group, CBF_mean in caudate nucleus was higher in PD group ((30.02±3.51) vs (40.21±8.13) ml·100 g^-1·min^-1; F=5.393, t=2.969, P<0.05). The similar results were obtained for SUV_mean. To differentiate PD with MSA, CBF_mean of cerebellum possessed the highest diagnostic efficiency, with the area under ROC curve (AUC), sensitivity and specificity reaching 0.792, 83.3% and 70.0% respectively. To differentiate PSP with PD or MSA, CBF_mean in caudate nucleus had the highest diagnostic efficiency, and the AUC were 0.903 and 0.933 respectively. Conclusions In patients with PD, MSA and PSP, the level of ¹⁸F-FDG glucose metabolism is in good agreement with the ASL cerebral blood flow perfusion obtained by synchronous PET/MR. The distribution characteristics of specific ROI in both PET and MR imaging can be helpful to the differential diagnosis of PS.