Objective To investigate the clinical application of radionuclide pulmonary V/Q scan in the diagnosis,evaluation of the severity and prognosis of pediatric patients with bronchiolitis obliterans (BO).Methods From February 2005 to April 2011,30 BO pediatric patients (18 males,12 females,age range:7 months-14 years) were prospectively recruited for radionuclide pulmonary V/Q scan.The relationship between the radionuclide pulmonary V/Q scan and clinical presentations was analyzed.Results Perfusion defects were seen in 25 cases (83.3％) and ventilation defects in 27 cases(90.0％).Among the 27patients with abnormal V/Q scan,matched abnormalities were seen in 13 cases (48.1％),mismatched in 1 case (3.7％) and reverse mismatched in 13 cases (48.1％).Of the 3 patients with mild disease,1 had normal V/Q scan while 2 showed V/Q defect in 1 segment.In the 10 patients with moderate disease,the mean number of segments having perfusion and ventilation defects was 3.7 and 5.6,respectively.In the 17 patients with severe disease,the mean number of segments having perfusion and ventilation defects was 6.0 and 8.2,respectively.During follow-up,all 8 patients with progressive disease presented with severe impairment of pulmonary perfusion and ventilation;while the 16 patients with improvement had mild impairment of pulmonary perfusion and ventilation or normal V/Q scan.Conclusion Radionuclide pulmonary V/Q scan is valuable for diagnosis,evaluation of the disease severity,and prognosis in pediatric patients with BO.

Objective To derive reference limits of cardiac functional parameters (CFP) determined by gated myocardial SPECT imaging, and to analyze the influence of gender, age and weight on CFP. Methods One hundred and seventy-five consecutive outpatients (89 males with age of (48.3±10.7) years and 86 females with age of (49.8±10.4) years) were defined as patients with low-likelihood coronary heart disease (LCHD). All patients underwent adenosine or exercise stress 99Tcm-MIBI G-MPI from February 2008 to April 2011. The EF, EDV and ESV of the left ventricle were measured by quantitative gated SPECT (QGS) software. The reference limits were derived by means of Gaussian distribution or percentiles. The influence of gender, age and weight on CFP was analyzed by multiple regressions for linear models. Two-sample t test was used to analyze data of 2 groups. Parameters between different age groups were compared by one-way analysis of variance. Results The lower reference limit of EF for males was 50%, the upper limit of EDV and ESV was 112 ml and 49 ml respectively. For females, the corresponding reference limits were 54%, 77 ml and 30 ml. Men had higher EDV, ESV (EDV: (75.8±18.3) ml vs (53.3±11.7) ml, t=9.35, P<001; ESV: (27.1±10.9) ml vs (14.3±7.9) ml, t=8.59, P<0.01) and lower EF than women ((65.1±76)% vs (74.7±10.0)%, t=-6.92, P<0.01). The incidence of small hearts in women was 76%(65/86). The gender and age was the primary and secondary predictors of both of EF and ESV, while the body weight was a significantly third predictor for cardiac volume. Patients were dived into different age (≤40 years, 41-49 years, ≥50 years) groups. For males, EDV, ESV and EF were not significantly different among the different age groups (F values: 1.106, 0.954, 1.029, all P>0.05). For females, EDV was not different (F=2408, P>005), while ESV and EF were significantly different among 3 groups (F values: 5.010, 6.229, both P<0.05). Conclusions The CFP determined by G-MPI in LCHD patients are significantly affected by gender and age. The age-related changes of CFP in males are different from those in females.

Objective: To assess the effect of coronary collateral circulation (CCC) on myocardial viabilityin patients with chronic total occlusion of left anterior descending (LAD) artery. Methods: A total of 101 consecutive patients with confirmed diagnosis of total LAD occlusion in our hospital were enrolled. Rest 99mTc-MIBISPECT myocardial perfusion and 18F-FDG PET were performed, in addition all patients received coronary angiography (CAG) at 3 months front and back. Both images were reconstructed in the same machine and QPS software was used to obtain the summed rest score (SRS), abnormal resting total perfusion defect (TPD), viable and non-viable myocardium, LVEDV, LVESV and LVEF in relevant patients. Based on CAG result, the patients were divided into 2 groups: CCC group, n=39 and No CCC group, n=62; according to existing old myocardial infarctionand location of LAD occlusion, the patients were further divided into 4 subgroups. The above parameters were compared among different groups. Results: There were 86 male and 15 female patients with the mean age at (59.92±11.43) years. Relevant parameters in CCC group and No CCC groupwere as in SRS: (21.23±9.68) vs (28.56±8.76), TPD: (30.03±13.69) %vs (40.37±12.50) %, viable myocardium: (21.77±13.12) % vs (13.66±9.23) %, non-viable myocardium (8.28±8.58) %vs (27.40±12.97) %, all P<0.05; in LVEDV: (109.82±30.01) ml vs (173.71±57.69) ml, LVESV: (62.82±22.39) ml vs (122.53±51.66) ml, LVEF: (43.85±8.46) % vs (31.03±8.30) %, all P<0.05. Conclusion: Our preliminary study found that CCC could maintain left ventricular rest perfusion, myocardial viability and protect cardiac function in patients with chronic total LAD occlusion.

Objective To develop a candidate reference method for the determination of sodium in serum by inductively coupled plasma mass spectrometry method (ICP-MS). Methods Aluminum, as internal standard of sodium, was added into serum samples and sodium standard solutions by gravimetric analysis. The samples were digested by HNO3 and diluted, and its 23Na/27Al isotope ratios were obtained by ICP-MS. The sodium concentrations were calculated with the standard curve method in serum. Results The analytical recoveries of sodium were 100.67% and 100.15% respectively, and the precisions were 0.08% and 0.04% respectively for 2 different serum samples. The results of measuring sodium in serum of Standard Reference Material (SRM) gave the coefficients of variation (CVs) of 0.18% and 0.22% for 2 levels of standard reference material(SRM) 909b and 0.41%, 0.41% and 0.66% for 3 levels of SRM 956b. The relative deviations between the results and median of the certified value were 0.17% and 0.14% for 909b and -0.09%, -1.05%, -0.48% for 956b respectively. Conclusions The ICP-MS and aluminum internal standard method is proved to be not only precise and accurate, but also quick and convenient for measuring sodium in serum. It is promising to be a candidate reference method for determination of sodium in serum.

Objective To explore the relationship between the index of SPECT myocardial viability teat of the left ventricle and long-term cardiovascular adverse events following the coronary artery bypass graft.Methods Clinical data were selected from the coronary-heart-disease patients with CABG and the isotopic SPECT test of myocardial viability prior to the operation in the Fuwai Cardiovascular Hospital,the Chinese Academy of Medical Science from January 1,1999 to December 31,2005.Total 709 patients were included in this study.Regular follow-up in patients was performed following operation.Investigate the nuclear medicine documents of the patients above;make the semi-quantitative scores of myocardial viability prior to operation by the 17-segment method of ventricle.Through the COX multi-factor analysis of the statistical methods to explore the relationship between the index of the myocardial viability and the long-term cardiac adverse events selected in advance.Results The mean duration of follow-up was(3.43±2.42)years.The COX multi-analysis revealed that the total score of left ventricular myocardial viability is the independent impact factors for long term cardiac death,long terrm re-hospitalization rate and long term composite end points events.The cut off values of total score of left ventricular myocardial viability for long term cardiac death,long term re-hospitalization rate and long term composite end points events is 15,9,13 respectively.Conclusion The total score of left ventricular myocardial viability of SPECT is independently associated with long-term events,and the cut values of myocardial viability total score for long-term cardiac death,re-hospitalization and composite MACE events are 15,9,and 13 respectively.For the groups with total scores above and below the cut off values,there is significant difference of long term cardiac events risk between groups.

Objective To explore the clinical value of 18F-FDG PET/CT in differentiating between cardiac benign and malignant lesions.Methods From September 2009 to September 2012,a total of 9 (7males,2 females,average age (46± 22) years) patients with space-occupying lesions of the heart underwent whole body 18F-FDG PET/CT.18 F-FDG PET/CT diagnosis was made according to morphologic features and SUVmax of lesions.The final diagnoses were confirmed by either histopathology or clinical data and follow-up.Two-sample t test was used for data analysis.Results Among 9 cases of cardiac occupying lesions,4 cases were malignant tumors,4 cases were benign tumors (including 2 lipomas,1 myxoma,and 1 fibroma),1 case was thrombus.The average SUVmax of malignant tumors was 18.99±14.58,which was significantly higher than that of benign tumors (2.35±1.46,t=-2.58,P＜0.05).With a cut-off SUVmax of 4.6,18F-FDG PET/CT could be used to noninvasively detect malignant tumors with a sensitivity of 4/4,specificity of 4/5,and accuracy of 8/9.Only 1 thrombus was misdiagnosed.Conclusion 18F-FDG PET/CT can aid the noninvasive differential diagnosis of cardiac malignant tumors from benign lesions.

1.The external features and arterial supply of the papillary muscles of the leftventricle were studied in 54 human,52 dogs' and 110 rabbits' hearts.Radiopaquemedium or Chinese ink were injected into coronary arteries.After injection,arter-iography of some hearts were taken,and serial celloidin sections of the papillarymuscles of other hearts were made.The diameters of the papillary arteries and thedensity of the vessels were measured.2.The papillary muscles could be divided into three patterns,depending on theextent of their attachment to the ventricular wall and the relative length of theirfree part protruding into the ventricular cavity.The three patterns were as follows:(1)The attached type,the papillary muscle was largely adherent to the sucbjacentventricular myocardium,with only one third or less of its length protruding into theventricular cavity(34% in human hearts,100% in dogs' and 38% in rabbits').(2)The free type,the free end of the papillary muscle was one half of its length ormore(28% in human hearts,10% in rabbits').(3)The intermediate type,thelength of the free protruding part of the papillary muscle was intermediate between(1)and(2)(38% in human hearts,52% in rabbits').3.In the human and the dogs' hearts the anterolateral papillary muscle receivedbranches from the anterior descending artery and the diagonal left ventricularbranches or the left circumflex artery;while in the rabbits' it received branchesmainly from the anterior branches of the left ventricular artery.The posteromedialpapillary muscle received a variable supply from the left circumflex artery and orthe branches of the right coronary artery in the dogs' hearts and in the human hearts,while in the rabbits' hearts,it mainly received branches from the posteriorbranches of the left ventricular artery.4.The arrangement of the arterial vasculature of the papillary muscle seemedto be related to the different patterns of the papillary muscles.The free typereceived a large central artery which coursed through the entire papillary muscle toits apex(87.5%).The attached type had a segmental supply of 3～9 long penetrat-ing intramyocardial vessels(94.29%).The intermediate type had a combination ofboth types of vascular arrangement(98.5%).5.The average diameter of the central arteries was 617.50 ? in human hearts atits entry into the base of the papillary muscle,and 236.05 ? in rabbits.The dia-meters of the segmental arteries were 323.60 ? in human hearts,300.05 ? in dogs',121.78 ? in rabbits' respectively.The diameters of the capillary vessels were 5～8 ?in human hearts,3～6 ? in dogs',2.5～6 ? in rabbits' respectively.The numbersof capillaries that observed in a length of 200? were 15.45 in human hearts,16.2in dogs',19.3 in rabbits'.The specific values of the density of vessels per unitarea were 34.4% in human hearts,34.1% in dogs',56% in rabbits'.

(0.05)). The sensitivity and the agreement rate were best at dose of Dob 10 ?g?kg~(-1)?min~(-1) with (86.5)% and (86.5)% (Kappa(0.71)), respectively. When Isoket combined with Dob 3,5 ?g?kg~(-1)?min~(-1), the sensitivities and the agreement rates were both significantly improved than either one used (both P

Objective: To describe the clinical characteristics with long-term prognosis in patients with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM).
Methods: A total of 66 MVOHCM patients treated in our hospital were retrospectively studied for their morbidity, clinical characteristics and mortality. The cumulative survival rate was calculated by Kaplan-Meier method; the risk factors for cardiac death and cardiovascular events were analyzed by uni- and multivariate Cox proportional hazard model.
Results: There were 66 (2.74%) patients suffering from MVOHCM among 2413 patients of hypertrophic cardiomyopathy and the average diagnostic age was (40.16 ± 14.64) years. With (7.30 ± 6.25) years of follow-up study, the cardiovascular mortality was 13.6% and unexplained syncope (HR=13.37, 95% CI: 1.65-114.46, P=0.015) was the independent predictor for cardiovascular death. There were 45.45% (30/66) patients experienced at least 1 time of cardiovascular event and the most frequent one was non-sustained ventricular tachycardia (NSVT); 19.70% (13/66) of patients combined with apical aneurysms, and they were more inclined to experience NSVT.
Conclusion: MVOHCM patients usually have unfavorable prognosis with the higher incidence of cardiovascular events, some patients may develop apical aneurysm. The early diagnosis of MVOHCM is important for appropriate treatment.

Objective: To assess the feasibility of coronary lfow reserve (CFR) detection by SPECT myocardial perfusion imaging using a self developed software with preliminary clinical veriifcation. Methods: CFR calculation software was developed according to Mat lab guide. A total of 16 patients were enrolled including 13 male and 3 female at the mean age of (58±11) years . CAG conifrmed that 25 coronary branches were with stenosis>50% and 23 branches were without stenosis. 2-day ATP/rest99mTc-sestamibi dynamic SPECT myocardial perfusion imaging was conducted to detect CFR. First transit counts were used to sketch the interested pulmonary artery segments and to obtain the arterial input curve of contrast agent as total PAC reached to heart. Reconstructed short-axis images were divided into 3 sections to sketch interested territories (ROI) and to obtain RMC at each territory. Estimated CFR was expressed by the ratio of MBF=RMC/PAC followed by calculating the ratio of MFR=MBFstress/MBFrest. Results: The difference between simulated value and true value could be ignored which conifrmed that our program may accurately measure CFR. The reproducibility by different operators (r=0.986) and the same operator (r=0.983) was good. CFR value in non-stenosis branches were higher than stenosis branches (1.28 ± 0.19) vs (1.10 ± 0.27),P=0.008 and CFR value in stenosis branches was negatively related to stenosis degree (r=-0.5,P=0.02). Conclusion: Our self developed software is reliable for CFR detection by SPECT myocardial perfusion imaging; preliminary study showed good application prospect in clinical practice.