Objective To investigate the quality control and quality assurance of the SPECT/CT system.Methods The energy peak,energy resolution capacity and the intrinsic uniformity of the device's detector were regularly examined, and the quality control was performed. Results The daily hardware maintain could reduce the rate of system's trouble. The device's energy peak,energy resolution capacity were consistent during half year's observation period. The two detector's intrinsic uniformity were better after calibration than before. [ detector Ⅰ: ( 2.71 ± 0.28 ) vs (2.37±0.11)(t=2.489,P<0. 05);detector Ⅱ:(2.68 ±0.12)vs(2.38 ±0. 19)(t =6.421,P <0.01) ] .Conclusion Regular quality control and maintain could keep the function stabilization,enhance the availability rate of the SPECT/CT system.

Objective To explore the expressions of CK20, S100A7 and substance P (SP) in different stages of psoriatic lesions and their relationship. Methods A total of 19 patients, who had received irregular treatment for psoriasis and had both progressive and healed psoriatic lesions, were enrolled in this study. Skin tissue specimens were obtained from perilesional normal skin, progressive lesions and healed lesions of these patients and subjected to immunohistochemical analysis of expressions of CK20, S100A7 and SP. Results The relative expression level (absorbance value obtained from immunohistochemical analysis) was 7683.80 ± 6134.55,18305.04 ± 13171.30, 7257.53 ± 4417.75 for CK20, 8789.05 ± 6240.91, 18058.01 ± 16537.18, 9295.65 ±9310.02 for S100A7, 3242.51 ± 3775.41, 9364.98 ± 7596.64, 2910.85 ± 3349.46 for SP, respectively, in normal skin, progressive lesions and healed psoriatic lesions. A significant increase was observed in the expressions of CK20, S100A7 and SP in progressive lesions compared with normal skin and healed lesions, whereas no statistical difference was noted in those between normal skin and healed lesions (P ＞ 0.05 ). The expression of CK20 was positively correlated with that of S100A7 and SP (r = 0.779, 0.876, both P ＜ 0.05 ). Conclusion The pathogenesis of psoriasis seems to be associated with the changes in the number of Merkel cells.

Objective To explore the feasibility and safety of MCCE in gastrointestinal examination of elderly patients with malignant tumors.Methods Clinical data of 127 patients who underwent MCCE examination from April 2019 to September 2022 were retrospectively analyzed.According to age,the patients were divided into the elderly group(age≥65 year-old,n = 88)and the middle-aged group(40≤age<65 year-old,n = 39),and the clinical data of patients with malignant tumors were screened from the two groups for analysis and comparison.Results 131 patients received MCCE examination,and 4 elderly patients were excluded from this study due to swallowing failure,so 88 elderly patients were actually included in the study.In the elderly group,45.4%had serious cardiovascular diseases(40/88),27.3%had malignant tumors(24/88),8.0%had serious respiratory diseases(7/88),6.8%had anesthesia problems(6/88),and 9.1%had neurological diseases(8/88).Among the 24 elderly patients with malignant tumors,25.0%had severe cardiovascular disease,25.0%had poor general status,20.8%had brain metastases,and 12.5%had severe respiratory dysfunction.The positive diagnosis rate of gastric P2 lesions in the elderly group(52/88,59.1%)was significantly higher than that in the middle-aged group(13/39,33.3%)(P = 0.013).There was significant difference in positive rate of ulcer diagnosis between the two groups(29.5%and 10.2%)(P = 0.032).In patients with malignant tumors,the positive rate of ulcer diagnosis between the two groups(45.8%and 11.1%)was statistically significant(P = 0.038).The cleanliness and visualization scores of proximal stomach in the middle-aged group were higher than those in the elderly group,and the differences were statistically significant(P<0.05).Conclusion MCCE is generally effective and safe in elderly patients,especially those with malignant tumors,without missing any significant gastric lesions.

Objective:To investigate the management of patients with intravenous misplacement of nephrostomy tube following percutaneous renal surgery.Methods:The data of 6 patients with intravenous misplacement of nephrostomy tube during percutaneous nephrolithotomy (PCNL) treated in the two hospitals of Chenzhou from January 2006 to December 2020 were retrospectively analyzed. The median age was 41.0(38.5, 53.0) years old. There were 4 males and 2 females. Three patients had undergone contralateral upper urinary tract operation. One patient had undergone ipsilateral upper urinary tract operation. Two patients had not undergone upper urinary tract operation. Two of the 6 patients had a solitary kidney. Two patients were diagnosed with staghorn calculi (combined with mild hydronephrosis in 1 patient, moderate hydronephrosis in 1 patient). Four patients were diagnosed with ureteral calculus (combined with mild hydronephrosis in 2 patients, moderate hydronephrosis in 1 patient, severe hydronephrosis in 1 patient). In all 6 patients, the tract was dilated with fascial dilators. Immediately after dilator removal, brisk venous bleeding was noted. A nephrostomy tube was inserted promptly through the sheath to tamponade the tract and was immediately closed. Five cases were diagnosed by CT after operation, and 1 case was early diagnosed by intraoperative injection of contrast medium through nephrostomy tube. The nephrostomy tube was misplaced in 5 patients with left upper urinary tract calculi, and in 1 patient with right upper urinary tract calculi. The tip of nephrostomy tube was located in ipsilateral renal vein in 3 patients with left upper urinary tract calculus, inferior vena cava in 2 patients with left upper urinary tract calculus, and contralateral renal vein in 1 patient with right upper urinary tract calculus. No venous thrombosis of renal vein or inferior vena cava was founded in the 6 patients. All 6 patients were managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. One step method referred to total removal of nephrostomy tube under ultrasonic monitoring. Two step method referred to retracting the end of nephrostomy tube into the renal sinus under CT monitoring in the first step, then the nephrostomy tube was completely removed under ultrasound monitoring.Results:All 6 patients were successfully managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. The tube was withdrew by one-step method in 1 patient, by two-step method in 5 patients. The original operations were performed successfully under close observation in 4 patients during the same hospitalization and in 1 patient during the next hospitalization. Other type of operation in 1 patient was performed during the next hospitalization. The all 6 patients were discharged uneventfully. The stone was cleared.Conclusions:Intravenous misplacement of a nephrostomy tube is mainly diagnosed by CT. The nephrostomy tube should be sealed immediately after diagnosis. The intravenously misplaced nephrostomy tube can be successfully removed by one-step or two-step withdrawing under close monitoring. Upper urinary tract stones can be successfully treated at the same time or by stages.