Objective To evaluate the values of the quantitative parameters obtained from 18F-fluorodeoxyglucose (FDG) PET/CT imaging and MRI in prediction of lymph node metastasis (LNM) in patients with rectal cancer.Methods From May 2013 to October 2015,80 patients with rectal cancer (63 males,17 females,age range:37-85 years) that underwent preoperative MRI-diffusion weighted imaging (DWI) and 18 F-FDG PET/CT were enrolled.All patients had pathological results.Auto-segmentation methods of various thresholds were selected to determine the FDG metabolic parameters and whole volume region of interest (ROI) method was performed to measure apparent diffusion coefficient (ADC) in lymph node.Maximum standardized uptake value (SUVmax) =2.5,20％ SUVmax,30％ SUVmax,40％ SUVmax and 50％ SUVmax were selected as the cut-off values (COV),and named as COV1,COV2,COV3,COV4 and COV5,respectively.ROI was drawn automatically and the corresponding mean standardized uptake value (SUVmean) 1-SUVmean5,metabolic tumor volume (MTV) 1-MTV5 and total lesion glycolysis (TLG) 1-TLG5 were calculated.x2 test and logistic regression analysis were used to analyze the associations between the LNM and pathological factors,as well as 18F-FDG metabolic parameters and ADC.Results LNM was found in 55％ (44/80) of the patients.The metabolic parameters of primary tumor in patients with LNM were significantly higher than those in patients without LNM (u values:152.0-555.0,all P＜0.05);the ADC was significantly lower in LNM positive cases than that in LNM negative cases:0.96 (0.93,1.02) × 10-3 mm2/s vs 1.07(1.01,1.11) ×10-3 mm2/s,u=249.0,P＜0.05.Univariate analysis showed that T stage,SUVmax,SUVmean 1-SUVmean 5,MTV1-MTV5,TLG1-TLG5,ADC value were associated with pathologic lymph node involvement (x2 values:7.730-48.198,all P＜0.05).Multivariate analysis indicated that MTV1 (odds ratio (OR)=0.110,95％ CI:0.014-0.840),MTV2 (OR=0.075,95％ CI:0.007-0.852) and ADC (OR=0.034,95％ CI:0.003-0.381) of tumor were significant risk factors associated with LNM (all P＜0.05).The optimal COV of MTV1,MTV2 and ADC were 20.26 cm3,18.47 cm3 and 1.00× 10-3 mm2/s.Conclusion MTV1,MTV2 measured by 18F-FDG PET/CT and ADC measured by MRI-DWI of the primary tumor are risk factors of LNM from rectal cancer,and they may be useful to predict LNM in patients with rectal cancer.

Objective To explore the best time for indwelling gastric tube after tracheal stenosis in infants with congenital heart disease, so as to shorten the indwelling time and relieve the pain of children with tracheal tube. Methods A total of 50 infants with congenital heart disease combined with tracheal stenosis were divided into observation group (26 cases) and control group (24 cases) by the admission order. The observation group accepted swallowing function evaluation combined with physiological indicators to determine the timing of removal of indwelling gastric tube while the control group just conventionally evaluating swallowing function. Results The ICU retention time and total hospitalization days was (4.35 ± 0.94), (23.15 ± 4.92) d in the observation group, and (6.27 ± 1.42), (27.42 ± 6.43) d in the control group, and the difference between the two groups was statistically significant (Z=5.589, 2.621, P<0.05). The extubation time was (2.85 ± 0.23), (4.50 ± 0.27) days in the observation group and the control group, and the difference was statistically significant (χ2= 15.595, P<0.01). Conclusions Deglutition function assessment combined with physiological indicators for evaluating the time of retention of gastric tube after tracheal stenosis in infants with congenital heart disease could be more effective to reduce the occurrence of secondary intubation and postoperative complications,shorten the course of the disease, improve infants comfort level,promote postoperative recovery.