Objective To investigate the added value of CTAC for improving image quality and diagnostic efficiency of bone imaging in SPECT/CT.Methods Seventy-five patients (47 males,28 females,(56.6± 12.8) years) with abnormal uptake in planar whole-body bone scintigraphy underwent SPECT/CTfor differentiation of malignant from benign spinal lesions.NAC and CTAC SPECT images were classified based on 5-point scale (5:excellent,4:good,3:adequate,2:suboptimal,1:inadequate).The diagnostic confidence for both NAC and CTAC SPECT images were classified based on 4-point scale (4:definite,3:certain,2:equivocal,1:uninterpretable).The pathological results after surgery were used as gold standard to evaluate the added diagnostic value of CTAC for spinal lesions.Wilcoxon-signed rank sum test was used for data analysis.Results CTAC improved the image quality in 37.3％ (28/75) of patients,and downgraded in 2.7％ (2/75) of patients.The remaining 45 patients were unchanged (60.0％,45/75).SPECT with CTAC could significantly improve the image quality (z=-4.747,P＜0.001),but the overall diagnostic confidence was not increased (z=-1.000,P＞0.05).Conclusion CTAC can improve the image quality of spinal SPECT,especially useful in imaging with poorer quality,but it has no significant incremental value in diagnostic confidence.

Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.

Objective To retrospectively evaluate the value of SPECT/CT imaging for follow-up of bone metastases.Methods A total of 178 patients with bone metastases (387 lesions) underwent 2 or more events of whole-body bone scintigraphy (WBS) and SPECT/CT imaging.Sequential images were analyzed by 2 experienced,nuclear medicine physicians.Each lesion was interpreted as progressive,remissive or stable in WBS or SPECT/CT independently.Reasons for the discordance between WBS and SPECT/CT results were analyzed.The results of clinical follow-up,including clinical symptoms,tumor markers,serum ALP,radiograph,CT and MRI,were likewise classified as progressive,remissive or stable.The x2 test was used to compare the differences between the two imaging methods.Results The follow-up results of the two imaging methods were consistent in 313 (80.88％,313/387) lesions,including 208 in progression and 105 in remission or stable condition.Among the 74(19.12％,74/387) lesions showing discordance,48 showed remission or stable conditions on WBS but progression on SPECT/CT (64.86％,48/74) ; while 26 showed progression on WBS but remission or stable condition on SPECT/CT (35.14％,26/74).There was a statistically significant difference of the follow-up results between WBS and SPECT/CT (x2 =6.54,P ＜0.05).Conclusion SPECT/CT is more valuable than WBS for follow-up of bone metastases.

Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Microvessels ; diagnostic imaging ; Neovascularization, Pathologic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons

Objective : To examine the diagnostic and prognostic value of long non-coding RNA (lncRNA) JPX in mesothelioma, so as to provide insights into diagnosis and prognosis of mesothelioma. Methods: Patients with clinically definitive diagnosis of mesothelioma from 2015 to 2019 that were sampled from asbestos processing plants in Zhejiang Province from 2015 to 2019 were recruited in the mesothelioma group, while healthy residents without asbestos exposure or asbestos-related diseases in the same area served as controls. Participants' demographics, pathologic diagnosis and imaging features were collected, and the expression of blood lncRNA JPX was detected using lncRNA microarrays. The diagnostic value of lncRNA JPX for mesothelioma was evaluated using the receiver operating characteristic (ROC) curve, and the correlation between lncRNA JPX expression and prognosis was examined among mesothelioma patients using survival analysis. Results: There were 17 subjects in the mesothelioma group, with a mean age of (65.71±8.36) years, and 34 subjects in the controls, with a mean age of (64.24±8.70) years. LncRNA microarray detected significantly high lncRNA JPX expression in mesothelioma patients, and higher blood lncRNA JPX expression was detected in the mesothelioma group than in the control group [median (interquartile range), 1.10 (1.31) vs. 0.89 (0.54); t'=-2.300, P=0.034]. The area under the ROC curve was 0.673 (95%CI: 0.507-0.839, P=0.046), and if the cutoff was 1.759, the sensitivity and specificity were 35.3% and 100.0%, respectively. Survival analysis showed no significant difference in the survival rate of mesothelioma patients between the high lncRNA JPX expression group and the low expression group (χ2=0.212, P=0.645). Conclusions LncRNA JPX overexpression is detected in the blood of patients with mesothelioma, and lncRNA JPX expression presents a diagnostic value for mesothelioma; however, it shows little prognostic value for mesothelioma.

Objective: To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods: The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results: The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice.

Objective:To analyze the 99 Tcm-methylene diphosphonate single photon emission computed tomography/spiral computed tomography (SPECT/CT)fusion imaging of bone metastases in patients with lung cancer and to evaluate the value of SPECT/CT in differentiating metastases from benign bone lesions.Methods:A total of 113 patients with bone metastases from lung cancer confirmed by pathology underwent bone scintigraphy and SPECT/CT imaging.Metastatic bone sites,quantity,up-take of radiotracer,and CT manifestations of each lesion were analyzed via bone scintigraphy imaging and SPECT/CT fusion imaging.Results:A total of 482 lesions from 113 patients were analyzed in this study.Among them,429 lesions were metasta-ses.Metastatic sites included spine(50.6%),thorax (29.1% ),pelvis (17.0%),extremities (2.1%),and skull(2.1%).CT manifestations were osteoblastic (41.0%),osteolytic (50.3%),mixed (4.0%),and normal (4.7%).Among these lesions, the proportion of hot spots displayed on SPECT/CT pictures was 90.7%(389/429),and the proportion of lesions with normal uptake of radiotracer was 9.3%(40/429).There were 53 benign lesions in 23 patients with bone metastasis.Conclusions:The most frequent metastatic sites in patients with lung cancer are spine and thorax.Bone metastasis from squamous carcinoma is more com-mon than from other types of lung cancer.The common CT manifestations are osteoblastic.The sensitivity and specificity of SPECT/CT fusion images for the diagnosis of bone metastatic lesions of lung cancer are high.

Objective:To investigate the relationship between family functioning and self-injurious behavior among primary school children, as well as the effects of teacher-student relationship and friendship quality.Methods:A questionnaire survey was conducted with 1 033 primary school children from grade four to six in Hunan province from March to April 2024, using the family APGAR index scale, the deliberate self-injury inventory, the teacher-student relationship subscale of the my class questionnaire, and the friendship quality questionnaire. Data were analyzed using SPSS 26.0 software for normality tests, descriptive statistics, chi-square tests, and Pearson correlation analyses. Confirmatory factor analysis was performed with AMOS 24.0, and moderated mediating effects were examined using the PROCESS 3.5 macro program.Results:(1) The prevalence of self-injurious behavior among the sampled children was 37.4% (359/958), with no significant gender difference ( χ2=0.01, P>0.05). However, the detection rate among grades was significantly different ( χ2=8.25, P<0.05, Cramer's V=0.09). (2) Self-injurious behavior was negatively correlated with family functioning, teacher-student relationship, and friendship quality ( r=-0.29, -0.25, -0.18, P<0.01). Among family functioning, teacher-student relationship and friendship quality, there was positive correlations between each other ( r=0.33-0.40, all P<0.01). (3) Teacher-student relationship partially mediated the relationship between family functioning and self-injurious behavior, with the mediating effect value accounting for 20%(-0.06/-0.30) of the total effect. (4) Friendship quality moderated the first stage of the mediating effect of teacher-student relationship on the relationship between family functioning and self-injurious behavior ( β=0.08, P<0.01). When children's friendship quality was higher, the predictive effect of family functioning on teacher-student relationship was significantly strengthened ( βsimple=0.30, P<0.001, 95% CI=0.21~0.38). Conclusion:Effective family functioning promotes positive teacher-student relationship in children, thereby reducing the risk of self-injurious behavior. This effect is notably stronger among children with higher-quality friendships.

Objective:To explore effect of IgG receptor FcγRⅡB on neuronal injury and imbalance of Th17/Treg in experi-mental autoimmune encephalomyelitis(EAE)model mice.Methods:C57BL/6 mice were randomly divided into control group,EAE group,FcγRⅡB group and EAE+FcγRⅡB group,with 15 mice in each group.EAE model was induced by subcutaneous injection of MOG35-55 peptide and treated with FcγRⅡB lentiviral solution.After modeling was established,body weight of mice was weighed every day,and neurological function was scored for 30 d;after 30 days,mice were sacrificed.HE staining was used to observe patho-logical changes of brain tissue,LFB staining was used to assess structural changes of spinal cord myelin,and immunofluorescence staining was used to detect spinal cord cerebral cortex neuron nuclear antigen(NeuN)and Caspase-3 expressions,TUNEL staining was used to detect apoptosis of neurons,ELISA was used to detect serum IL-6,IL-17,IL-10 and TGF-β levels,flow cytometry was used to analyze proportion of Th17 and Treg cells in spleen,Western blot was used to determine protein expressions of retinoic acid-related orphan receptor γt(RORγt)and Forkhead family transcription factor 3(Foxp3)in spinal cord tissue.Results:Compared with control group,mice in EAE group had decreased body weight,increased neurological function scores,obvious infiltration of inflamma-tory cells in brain tissue,and signs of demyelination in spinal cord,fluorescence expression intensity of NeuN was weakened and fluorescence expression intensity of Caspase-3 was enhanced,there were more TUNEL-positive stained cells,number of apoptotic cells was increased,levels of IL-6 and IL-17 in serum were increased,and levels of IL-10 and TGF-β were decreased,proportion of Th17 cells in spleen was increased,proportion of Treg was decreased,expression of RORγt protein in spinal cord tissue was up-regu-lated while relative expression of Foxp3 protein was down-regulated(P<0.05);compared with EAE group,weight of mice in EAE+FcγRⅡB group was increased,neurological function score was decreased,infiltration of inflammatory cells in brain tissue was reduced,demyelination of spinal cord was improved,fluorescence expression intensity of NeuN was enhanced,and fluorescence expression intensity of Caspase-3 was weakened,there were fewer TUNEL-positive stained cells,number of apoptotic cells was decreased,levels of IL-6 and IL-17 in serum were decreased,while levels of IL-10 and TGF-β were increased,at the same time,proportion of Th17 cells in spleen was decreased and proportion of Treg was increased,expression of RORγt protein in spinal cord tissue was down-regulated,while expression of Foxp3 protein was up-regulated(P<0.05).Conclusion:FcγRⅡB has neuroprotective effect on EAE mice,and can reduce infiltration of inflammatory cells and demyelination in brain tissue,whose mechanism may be related to regulation of cytokine levels and immune balance of Th17/Treg cells.