Objective:To compare the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT, 18F-FDG PET/CT and multi-parameter MRI (mpMRI) in prostate cancer (PCa). Methods:Retrospective analysis was conducted on data from 22 patients ((72.6±6.2) years) with pathologically confirmed PCa in the Affiliated Taizhou People′s Hospital of Nanjing Medical University between April 2021 and September 2022. All patients underwent 18F-PSMA-1007 PET/CT, 18F-FDG PET/CT, and mpMRI examination within 30 d, and the imaging parameters were collected, including PSMA-SUV max, FDG-SUV max, minimum apparent diffusion coefficient (ADC min), mean apparent diffusion coefficient (ADC mean), PSMA-SUV max/ADC min, PSMA-SUV max/ADC mean, FDG-SUV max/ADC min, FDG-SUV max/ADC mean. Patients were divided into groups based on the International Society of Urological Pathology (ISUP) grading (≤3 vs >3) and serum total prostate specific antigen (TPSA; ≤20 μg/L vs >20 μg/L), and differences of imaging parameters between groups were compared (Mann-Whitney U test or independent-sample t test). ROC curves were generated to evaluate the diagnostic ability of each parameter for different levels of PCa. χ2 test and ROC curve analysis were used to compare the detection rate and diagnostic efficiency of three imaging methods for primary focus, lymph node metastasis, and bone metastasis in PCa. Results:Differences were found between ISUP≤3 ( n=6) and >3 ( n=16) groups in PSMA-SUV max/ADC min, PSMA-SUV max/ADC mean, PSMA-SUV max, and ADC min ( z values: from -2.65 to -2.36, t=3.60, P values: 0.002-0.018). But there was no significant difference found between TPSA≤20 μg/L ( n=5) and >20 μg/L ( n=17) groups in all indices ( z values: from -1.76 to -1.45, t values: -1.19 and 1.28, all P>0.05). The optimal cut-off value for PSMA-SUV max/ADC min in differentiating high-grade and low-grade PCa was determined to be 22.628×10 3. In the patient-based analysis, no statistical difference was found in the detection rate of PCa primary tumors among 18F-PSMA-1007 PET/CT, 18F-FDG PET/CT, and mpMRI ( χ2=1.91, P=0.767). However, the detection rates of lymph node and bone metastasis among three imaging methods were significantly different (72.73%(16/22), 59.09%(13/22), 36.36%(8/22) and 81.82%(18/22), 63.64%(14/22), 45.45%(10/22); χ2 values: 6.03, 6.29; P values: 0.049, 0.043). 18F-PSMA-1007 PET/CT resulted in a 36.36%(8/22) increase in N stage and the 40.91%(9/22) increase in M stage compared to mpMRI. Conclusions:PSMA-SUV max/ADC min is a valuable parameter for differentiating high-grade and low-grade PCa. 18F-PSMA-1007 PET/CT demonstrates superior detection rate of PCa lymph node and bone metastasis compared to 18F-FDG PET/CT and mpMRI, and exhibits higher diagnostic efficiency, so it can be recommended for NM staging in patients with PCa.

Dinitrogen tetroxide is often used as an oxidant in rocket propellant and has strong irritant and corrosive properties. This paper analyzes the clinical data of a patient with dinitrogen tetroxide poisoning admitted in the 63710 Army Hospital of Chinese People's Liberation Army, so as to further explore the poisoning mechanism, clinical characteristics and key points of acute inhaled dinitrogen tetroxide poisoning.

Dinitrogen tetroxide is often used as an oxidant in rocket propellant and has strong irritant and corrosive properties. This paper analyzes the clinical data of a patient with dinitrogen tetroxide poisoning admitted in the 63710 Army Hospital of Chinese People's Liberation Army, so as to further explore the poisoning mechanism, clinical characteristics and key points of acute inhaled dinitrogen tetroxide poisoning.

Objective:Using bioinformatics methods to study the immune infiltration mechanism of lupus nephritis(LN)and to explore potential target Chinese medicines,which can provide new directions for clinical treatment of LN.Methods:Gene expres-sion profile microarray dataset of LN was downloaded from GEO database,differential expressed genes(DEGs)were screened using R software,and GO and KEGG enrichment analysis were performed on these DEGs.Protein interaction network analysis of DEGs was performed by applying STRING database,key genes were screened by using Cytoscape,core gene expression was validated by Nephro-seq database,and the infiltration and correlation of 22 kinds of immune cells in LN were calculated by CIBERSORT deconvolution algorithm.Finally,herbal prediction of significantly enriched immune-related biological processes and key target genes were performed by Coremine Medical database.Results:A total of 367 LN-related DEGs were obtained,of which 253 were up-regulated and 114 were down-regulated.GO was mainly enriched in response to viruses,defense response to viruses,regulation of viral life cycle,regulation of viral processes,etc;KEGG was mainly enriched in S.aureus infection,COVID-19,influenza A,complement and coagulation cascade,pertussis,etc.Ten key genes were screened:IFIT3,OAS2,MX1,OAS1,RSAD2,XAF1,ISG15,IFIT1,ITGAM and PTPRC.Immune infiltration by CIBERSORT deconvolution algorithm showed that monocytes and initial B cells were highly expressed in LN,while memory B cells,naive CD4+T cells,follicular helper T cells and resting natural killer cells were lowly expressed in LN.Immune cell correlation analysis showed a positive correlation between initial B cells and plasma cells,a positive correlation between resting natural killer cells and resting dendritic cells,a negative correlation between monocytes and regulatory T cells,and a negative correlation between resting CD4+memory T cells and monocytes.Coremine Medical predicted that Salvia miltiorrhiza,Panax notogin-seng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony were found to be most closely related to immunity in LN.Conclusion:The development and progression of LN are results of the combined involvement of multiple genes and pathways.Mono-cytes,memory B cells,initial CD4+T cells and initial B cells are most closely associated with LN.The predicted Salvia miltiorrhiza,Panax notoginseng,Scutellaria baicalensis,ginseng,honey,monkey mushroom and peony may be used as target herbs for the poten-tial treatment of LN.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.

Objective:To investigate the related factors affecting the recovery of cholinesterase (ChE) activity in patients with acute chlorpyrifos poisoning.Methods:In February 2020, the clinical data of acute chlorpyrifos poisoning patients admitted in our hospital from January 2016 to December 2019 were retrospectively analyzed. The outcome variable was the time of ChE activity recovered to 50% lower limit of normal value, and multivariate linear regression analysis was performed to explore its influencing factors.Results:A total of 78 patients, 43 males and 35 females, with an average age (39.58±14.77) years were enrolled in this study. The average time of serum ChE activity recovered to 50% lower limit of normal value was (24.45±2.64) days. There was a correlation between hemoperfusion ( r=-0.644) , atropine dosage ( r=0.498) , chlorophosphorus dosage ( r=0.432) and the time of serum ChE activity recovered to 50% lower limit of normal value, in which hemoperfusion was significantly negatively correlated with the time of serum ChE activity recovered to 50% lower limit of normal value ( β=-4.222, P<0.05) . Conclusion:The recovery of serum ChE activity in patients with acute chlorpyrifos poisoning is very slow. Hemoperfusion can quickly remove chlorpyrifos, its metabolites and inflammatory mediators in the blood, thus effectively promoting the recovery of ChE activity.

Objective:To investigate the related factors affecting the recovery of cholinesterase (ChE) activity in patients with acute chlorpyrifos poisoning.Methods:In February 2020, the clinical data of acute chlorpyrifos poisoning patients admitted in our hospital from January 2016 to December 2019 were retrospectively analyzed. The outcome variable was the time of ChE activity recovered to 50% lower limit of normal value, and multivariate linear regression analysis was performed to explore its influencing factors.Results:A total of 78 patients, 43 males and 35 females, with an average age (39.58±14.77) years were enrolled in this study. The average time of serum ChE activity recovered to 50% lower limit of normal value was (24.45±2.64) days. There was a correlation between hemoperfusion ( r=-0.644) , atropine dosage ( r=0.498) , chlorophosphorus dosage ( r=0.432) and the time of serum ChE activity recovered to 50% lower limit of normal value, in which hemoperfusion was significantly negatively correlated with the time of serum ChE activity recovered to 50% lower limit of normal value ( β=-4.222, P<0.05) . Conclusion:The recovery of serum ChE activity in patients with acute chlorpyrifos poisoning is very slow. Hemoperfusion can quickly remove chlorpyrifos, its metabolites and inflammatory mediators in the blood, thus effectively promoting the recovery of ChE activity.

Objective:To investigate the clinical characteristics and prognosis of children with septic shock caused by invasive pneumococcal diseases (IPDs) in pediatric intensive care unit (PICU).Methods:The clinical data of children diagnosed as septic shock caused by IPDs and hospitalized in the intensive care unit (ICU) of Beijing Children′s Hospital, Capital Medical University and the PICU of Henan Children′s Hospital from January 2013 to August 2019 were retrospectively collected, and the clinical characteristics and prognosis of these patients were analyzed.Results:Twenty-one children were included, with a median age of 1.2 (0.75, 3.90) years old.The pediatric index of mortality 2 (PIM-2) at admitting was (23.3±29.6)%, and 6 cases had underlying diseases.Main sites of infection included blood flow (20 cases) and suppurative meningitis (15 cases). The drug sensitivity test was performed on 18 children, among who 9 cases were sensitive to Penicillin, 10 cases to Cefepime, 11 cases to Cefotaxime and 10 cases to Meropenem.All 18 patients were sensitive to Vancomycin and Linezolid.Seven cases and 13 cases were treated with sensitive antibiotics at the disease onset and before septic shock, respectively.In 21 cases whose lactic acid level was (6.1±4.6) mmol/L, the shock redress time of 10 cases was (10.9±10.1)h, and 13 cases (61.9%) died (14.6±12.2) hours after septic shock, among who 10 died of transforamed magna herniation.The PIM-2 score at admitting into PICU and the rate of intracranial hypertension crisis in the death group were significantly higher than those in the survival group [(37.1±30.3)% vs.(0.9±1.3)%, 69.9% (9/13 cases) vs.25.0% (2/8 cases)](all P<0.05). There was no significant difference in age and the utilization rate of effective antibiotics before septic shock between the two groups (all P<0.05). Four of the surviving 8 children had severe cerebral functional disability. Conclusions:Septic shock caused by IPD is more common in children under 5 years old, and the most common sites are blood flow and intracranial infection.It has high resistance rate against Cephalosporins and Carbopenem.Patients with purulent meningitis are easy to develop intracranial hypertension crisis, which has an extremely high mortality and morbidity, so it needs to be identified and treated early.

Objective:To understand the early clinical characteristics and drug sensitivity results of children died of invasive pneumococcal disease (IPD) in Pediatric Intensive Care Unit (PICU) so as to guide the early clinical identification and treatment.Methods:The early clinical data and drug sensitivity result of children died of IPD in PICU of the Children′s Hospital, Zhengzhou University and Beijing Children′s Hospital, Capital Medical University from May 2015 to May 2019 were retrospectively analyzed.Results:A total of 18 children meeting the criteria were enrolled, including 6 males and 12 females.The median age was 1 year and 9 months (ranged from 2 months and 20 days to 6 years and 7 months), there were 2 cases(11.1%) > 5 years old, and 16 cases(88.9%)≤ 5 years old.There were 17(94.4%) children related to community acquired infection.Among 18 cases, the first symptom was intracranial infection in 10 cases (55.6%), bloodstream infection in 4 cases (22.2%), and pulmonary infection in 3 cases (16.7%). There were 5 cases complicated with virus infection at the same time.Auxiliary examination: all of the 18 cases had anemia and hypoalbuminemia, and 15 cases(93.8%) had HCO 3- reduction.White blood cells(WBC), platelets(PLT) and natural killer (NK) cell decreased in 7 cases (7/18 cases), 12 cases (12/18 cases) and 6 cases (5/16 cases), respectively, but C-reactive protein(CRP), procalcitonin (PCT), lactic acid concentration(LAC), D-dimer (D-Di), international normalized ratio (INR) and B-type natriuretic peptide (BNP) were increased in 12 cases (12/18 cases), 14 cases (14/18 cases), 7 cases (7/17 cases), 14 cases (14/17 cases) and 9 cases (9/9 cases), respectively.Six children(33.3%) did not receive the treatment of sensitive antibiotics before admission.According to the drug sensitivity results: all the 18 strains had multiple-drug resistance(MDR), and the resistance rates of Penicillin, Erythromycin, Tetracycline, Clindamycin and Sulfamethoxazole were 22.2%, 100.0%, 100.0%, 100.0% and 94.4%, respectively, all the strains were sensitive to Vancomycin, Linezolid and Levofloxacin. Conclusions:Most of the children died of IPD in PICU are of community-acquired infection and less than 5 years old.Anemia and hypoalbuminemia are common in the dead children.The decreased in HCO 3- and increased PCT, LAC and D-Di in the early stage might be related to poor prognosis of patients.Most of the children died of IPD are infected with MDR strains.

Objective:To investigate the diagnosis and treatment of occupational acute methanol poisoning.Methods:Retrospective analysis of the clinical data of 5 cases of occupational acute me thanol poisoning admitted from October 11 to 12, 2018.Results:The first patient was diagnosed with severe acute methanol poisoning and died after treatment with mechanical ventilation, hemodialysis, and detoxification by ethanol and folic acid for 38 hours. The remaining four cases were all diagnosed with mild acute methanol poisoning and were discharged from hospital after active symptomatic support treatment for 63 to 69 hours. Fuhermore, all the four patients were followed up for one year and without sequelaes.Conclusion:Early evaluation of the disease, early combination with hemodialysis, and use of detoxification drugs are the key to rescue occupational acute methanol poisoning.