Atheriosclerosis mainly occurs in middle-aged and elderly people, as well as in obese individuals. It is closely associated with the occurrence and progression of coronary heart disease, peripheral vascular disease, and stroke, severely affecting human health. 18F-NaF is commonly used for PET/CT imaging and has excellent performance in plaque imaging in atheriosclerosis. It can image the plaque calcification during the early stage, thereby assessing the plaque and making reasonable predictions for the prognosis. This article provides a review of the application of 18F-NaF PET/CT in the imaging of calcified plaques in atheriosclerosis.

Primary liver cancer is a common digestive system malignant tumor. Positron emission tomography and computed tomography (PET/CT) is a new molecular imaging technique which can reflect the metabolic status of tumors and provide more biological information about tumors. Radiomics is used to extract and analyze quantitative features that can describe tumor features in medical images with a high throughput. This article reviews PET/CT radiomics and its application in the diagnosis and prognosis assessment of hepatocellular carcinoma.

Objective:To screen serum protein markers and evaluate their diagnostic application value in hepatitis B-related acute-on-chronic liver failure (HBV-ACLF).Methods:Serum samples of patients with HBV-ACLF, chronic hepatitis B (CHB) and normal healthy volunteers ( n = 5/group) were determined by cytokine antibody chip in line with the Chinese Diagnostic Standards Study for HBV-ACLF (COSSH-ACLF) cohort. The differentially expressed proteins significance were identified by microarray analysis and prediction. The preliminary serological markers of HBV-ACLF were screened for diagnosis. The potential markers were determined by enzyme-linked immunosorbent assay (ELISA), area under the receiver operating characteristic curve (AUROC) analysis and liver tissue immunohistochemistry for the diagnosis of HBV-ACLF. Student t-test or Mann-Whitney U test were used to compare the continuous measurement data between the two groups, and analysis of variance and Kruskal-Wallis test were used to compare the continuous measurement data between multiple groups. Results:Cytokine antibody chip preliminary screening results showed that the expression levels of these six cytokines, namely, macrophage inflammatory protein 3α (MIP-3α), hepatocyte growth factor, E-selectin, osteopontin, growth differentiation factor 15 and carcinoembryonic antigen-related cellular adhesion molecule 1 were significantly increased in the HBV-ACLF group. Among them, the expression level of MIP-3α was significantly higher in the HBV-ACLF group (99.6 times higher than CHB group and 146.9 times higher than healthy volunteers’ group, respectively, P < 0.0001) as validated by serum ELISA in 132 HBV-ACLF cases, 91 CHB cases and 72 healthy volunteers. AUROC analysis showed that the high expression of MIP-3α could be used as a marker to distinguish patients with HBV-ACLF from CHB. The AUROC was 0.995 (95% CI: 0.990 ~ 1.000), with sensitivity and specificity of 95.5% and. 98.9%, respectively. Immunohistochemistry showed that MIP-3α was positively expressed in HBV-ACLF-derived liver tissues, and negatively expressed in CHB-derived liver and normal liver tissues. Conclusion:Serum MIP-3α level is closely related to the pathological characteristics of HBV-ACLF. Therefore, it may be used as a potential serological marker for the diagnosis of HBV-ACLF.

Objective:The aim of this study was to analyze the relationship between the changes of pre- and post-operation PET/CT metabolic parameters and prognosis for liver cancer patients.Methods:A retrospective study was carried out among 92 patients with liver cancer who received liver transplantation and PET/CT examination in our hospital from October 2013 to May 2017.According to Deauville criteria, the lesions were classified into PET negative, weak positive, and strong positive. The metabolic parameters including SUV max, SUL, MTV, TMR, TLR, TLG, UVP of normal liver parenchyma, liver cancer lesions and mediastinum were measured or calculated. The relationship between metabolic parameters and recurrence was analyzed. The relationship of Deauville score and metabolic parameters and the changing characters of metabolic parameters between the PET/CT of pre and post transplantation were analyzed. Results:Thirty cases did not relapse after LT, among which 16, 7 and 7 cases had Deauville score of 3, 4 and 5 respectively in pre-operation PET/CT. The recurrence time of 62 patients in recurrence group was (10.90±10.30) months. MTV, TLG, UVP-M, UVP-LB in recurrence group were significant higher( P<0.05). Patients with low metabolic parameters show better prognosis than patients with high metabolic parameters. Metabolic parameters of 5 score group were higher than that of 4score. The metabolic parameters of recurrence group were higher than those in non-recurrence group. MTV, TLG, UVP-M, UVP-LB in post-operation PET/CT were lower than those in pre-operation PET/CT, however, SUV max, TMR, TLR, SUL had no significantly difference. Conclusions:PET/CT metabolic burden parameters should be evaluated before LT to select patients with better prognosis. For liver transplantation patients with high metabolic parameters, PET/CT examination should be performed early after surgery to improve the detection of recurrence and metastasis, and relevant treatment should be timely conducted.

Objective To provide reference for the adjustment of provincial health insurance directory by comparing the differences between 2017 and 2009 edition of National Health Insurance Directory(NHID) and exploring the characteristics of NHID adjustment. Methods The Excel 2016 was used to carry out a comparative analysis of the drugs included in the two editions of NHID from the 4 aspects such as classification,drug name,dosage form and payment range. Results The adjustments of NHID in 2017 include drug variety,payment range,drug classification and coding.A total of 339 drugs were added, of which 133 were chemical drugs with a growth rate of 11.4%,and 206 were Traditional Chinese Medicine with a growth rate of 20.0%.In addition,dosage form was added in 149 drug varieties.The adjustment mainly focuses on chronic diseases such as hypertension and diabetes,serious diseases such as cancer,innovative drugs,and pediatric drugs. Conclusion The adjustment of 2017 edition of NHID embodied the policy thinking of "filling,selecting,supporting innovation and encouraging competition". Moreover,the drug classification,name and coding are more scientific and reasonable.

Objective To investigate the value of 99Tcm-diethylene triamine pentoacetic acid (DTPA) renal dynamic imaging for detecting renal function before liver transplantation and predicting early acute kidney injury (AKI) postoperation.Methods A total of 40 patients (29 males,11 females,average age (45± 8) years) with end-stage liver diseases who underwent orthotopic liver transplantation from June 2015 to June 2016 were selected in this retrospective study.All patients underwent 99Tcm-DTPA renal dynamic imaging within one week before liver transplantation,the general glomerular filtration rate (GFR) and normalized GFR (NGFR) were calculated.The serum creatinine (SCr) and blood urea were detected during the perioperative period.Patients were divided into AKI group (n =15) and non-AKI group (n =25) according to whether the patients suffered from AKI 3 d after liver transplantation.The general GFR,NGFR,SCr and blood urea between two groups were compared using two-sample t test.The sensitivities and specificities of general GFR and NGFR for predicting AKI were evaluated by receiver operating characteristic (ROC) curve.Correlations between general GFR,NGFR and SCr,blood area before liver transplantation were investigated by Pearson correlation analysis.Results The general GFR,NGFR before operation in AKI group were significantly lower than those in non-AKI group:(58.6±7.7) ml/min vs (77.3±12.3) ml/min,(57.7±7.5) ml· min-1· 1.73 m-2 vs (76.8±12.6) ml · min-1 · 1.73 m-2(t values:-5.924,-5.981,both P＜0.05).The SCr,blood urea before operation in the 2 group were not significantly different:(93.5±13.0) μmol/L vs (85.8±15.7) μmol/L,(8.9±4.0) mmol/L vs (7.0±3.0) mmoL/L (t values:1.604,1.733,both P＞0.05).The area under curve (AUC) of general GFR and NGFR was 0.947 and 0.944,respectively.The early AKI was predicted by general GFR and NGFR under the cut-off＜60 ml/min and ＜60 ml · min-1 · 1.73 m-2 with sensitivities of 9/15,10/15 and specificities both of 96.0％ (24/25).There were negative correlations between the general GFR and SCr,general GFR and blood urea,NGFR and SCr,NGFR and blood urea (r values:-0.555,-0.391,-0.562,-0.390,all P＜0.05).Conclusions 99Tcm-DTPA renal dynamic imaging is helpful for the early detection of potential injury of the renal function.Both general GFR and NGFR could be the accurate indicators for predicting early AKI following orthotopic liver transplantation.

Objective To investigate the effects of acupuncture rehabilitation techniques combined with Xingnaojing injection on functional recovery and the plasam level of glial fibrillary acidic protein (GFAP) in patients with severe traumatic brain injury (STBI).Methods Eighty-four patients with STBI admitted to Department of Neurosurgery in Jiuquan People's Hospital from October 2013 to December 2015 were enrolled,they were divided into observation group (44 cases) and control group (40 cases) by random number table,all patients received the routine basic treatment,such as decreasing intracranial pressure,anti-infection,neural nutrition therapy,etc.In addition,the observation group was treated with acupuncture rehabilitation training (each training 50 minutes,1-2 times a day,10 times as a course of treatment,a total of 5 courses) and Xingnaojing injection (in 0.9％ normal saline or 5％ glucose injection 250 mL intravenous infusion,one time a day,10 days as a course of treatment,a total of 3 courses).The evaluation score of Montreal cognitive assessment (MoCA),Modified Barthel index (MBI),Fugl-Meyer assessment (FMA) of motor function score and the plasma levels of GFAP and myelin basic protein (MBP) were measured before and after treatment in the two groups.Results After treatment,the MoCA,MBI and FMA scores were significantly higher in two groups than those before treatment (all P ＜ 0.05),the contents of MBP and GFAP were significantly lower than those before treatment,and the changes in observation group were more significant than those in control group [visual space and execution capability (score):4.99 ± 0.67 vs.3.42 ± 0.73,denomination capability (score):2.98 ± 0.77 vs.2.84 ± 0.47,delayed memory (score):5.76± 0.33 vs.3.87± 2.08,attention (score):6.17± 0.65 vs.4.75 ± 0.81,speech capability (score):3.51 ± 0.46 vs.2.04 ± 0.13,abstract thinking capability (score):2.94 ± 0.27 vs.1.58 ± 0.96,orientation force (score):6.02±0.65 vs.4.88±0.62,FMA score:68.71 ±34.17 vs.41.13 ± 14.82,MBI score:69.12± 10.45vs.37.63±6.11,MBP (μg/L):1.32±0.23 vs.5.31±0.79,GFAP (μg/L):0.19±0.08 vs.0.39±0.04,all P ＜0.05].Conclusions Acupuncture rehabilitation training combined with Xingnaojing injection may obviously improve the cognitive and motor functions in patients suffered from STBI,and clinically the combined treatment is worthwhile to be used extensively.

ObjectiveTo investigate the effect of acup point injection and rehabilitation techniques on recovery of upper limb function and activities of daily life (ADL) in patients with shoulder-hand syndrome (SHS) after cerebral infarction.Methods Ninety-six patients with SHS after cerebral infarction admitted to Jiuquan City Traditional Chinese Medicine Hospital and Jiuquan City People's Hospital from January 2014 to February 2016 were enrolled, and they were randomly assigned to observation group (56 cases) and control group (40 cases). The patients in the two groups were given the same routine comprehensive cerebral infarction treatments and rehabilitation technological training. In the control group, additionally intermediate frequency physiotherapy was used, while in the observation group, acupuncture and acupoint injection of salvia miltiorrhiza and ligustrazine were added. The patients in two groups were treated consecutively for one month, afterwards, the upper limb motor function, ADL, shoulder joint pain, degree of swelling and range of motion were assessed, and the clinical effects were observed.Results After treatment, the modified Fugl-Meyer motor function score (FMA), modified barthel index (MBI) and the ranges of voluntary activities of shoulder abduction, adduction, flexion, extension, internal rotation and external rotation in patients of two groups were significantly increased than those before treatment; the pain visual analog scale (VAS) and the edema volume difference in observation group were lower than those in the control group, and after treatment, the changes of above indexes were more significant in the observation group than those in the control group [FMA: 70.10±6.38 vs. 41.76±18.69, VAS: 2.00±1.37 vs. 5.00±1.25, MBI: 75.17±3.51 vs. 51.56±2.12, edema volume difference (cm3): 2.13±2.05 vs. 5.75±1.17, flexion: (153.1±6.7)° vs. (56.0±10.9)°, extension: (39.6±5.8)° vs. (17.2±6.7)°, abduction:(168.1±9.6)° vs. (52.1±8.9)°, adduction: (52.1±3.6)° vs. (21.8±4.3)°, external rotation: (49.8±7.6)° vs. (23.2±5.2)°, internal rotation: (107.0±8.5)° vs. (51.2±6.1)°], the total effect in observation group was significantly higher than that in the control group [91.1% (52/56) vs. 70.0% (28/40),P < 0.05].Conclusions Acupuncture and acupoint injection combined with three-level therapeutic regimen of rehabilitation technological training for treatment of shoulder-hand syndrome after cerebral infarction can reduce the patient's pain and edema, and improve upper limb motor function and activities of daily living.

Objective To explore the effects of nurse-physician collaboration model on anxiety, depression and quality of life (QOL)of patients undergoing concurrent chemo-radiotherapy.Methods A total of 1 80 eligible patients from December 201 3 to December 201 4 were randomly divided into study group (n =96) and control group (n =84).The patients of study group received nurse-physician collaboration nursing,while the patients of control group received routine nursing.The self-rating anxiety scale (SAS ),self-rating depression scale (SDS ) and European organization for research and treatment of cancer quality of life questionnaire-3.0 (EORTC QLQ-C30)were used to investigate the differences between groups before and after intervention.Results Anxiety and depression in study group were better than those in control group after treatment,and the difference was statistically significant (P <0.05).Overall health,emotional function,social function,cognitive function,role function,pain,insomnia and breathing difficulties were better in study group than those in control group after treatment (P <0.05).Conclusions Nurse-physician collaboration model can improve the anxiety,depression and QOL of patients receiving chemoradiotherapy.

Objective To observe the treatment effect of Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection in treating deep venous thrombosis (DVT) in lower limb after cesarean section. Methods Seventy-six cases of DVT after cesarean were randomly divided into 2 groups. Thirty-six cases of control group were injected low molecular weight heparin calcium subcutaneously 100 AXaIU/kg twice daily, and forty cases of treatment group were treated with Buyang Huanwu Decoction additionally. After analysing the clinical symptoms and sign before and after treatment, HBV, LBV, PV, FIB, PLT, APTT, TT, PT and indexes of impedance plethysmography, CDFI were observed to evaluate the efficacy. Results After treatment, the total effective rate of treatment group was 97.5%(39/40), and the control group was 77.8%(28/36), the difference was statistically significant (P<0.05). The differences of hemorheological indexes (HBV, LBV, PV, FIB) and impedance plethysmography indexes between before and after treatment in treatment group were statistically significant (P<0.05), while the differences of blood coagulation indexes (APTT, TT, PT) were not significant (P>0.05). No adverse reaction was found during treatment. Conclusion The treatment of DVT after cesarean section with Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection is safe and effective.