Objective To evaluate the value of 68Ga-DOTATATE and 18F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms(GEP-NEN).Methods This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing 18F-FDG and 68Ga-DOTATATE PET/CT imaging at our hospital from August,2020 to March,2023,including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment.GEP-NEN were classified into G1,G2,and G3 neuroendocrine tumors(NET)and neuroendocrine carcinomas(NEC)based on pathological typing.The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers:68Ga-DOTATATE>18F-FDG(A);68Ga-DOTATATE=18F-FDG(B);68Ga-DOTATATE<18F-FDG(C);and complementation(D).The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis.Results In the 49 patients with GEP-NEN,68Ga-DOTATATE PET/CT was superior to 18F-FDG PET/CT for detecting systemic tumor lesions(P<0.001)and more sensitive for detecting primary/recurrent lesions,lymph node metastasis,liver metastasis,and bone metastasis(P<0.05),while 18F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis(P<0.05).In terms of the detection efficiency,Pattern A was found in 46.9%(23/49)patients,Pattern B in 38.8%(19/49),Pattern C in 12.2%(6/49),and Pattern D in 2.0%(1/49).The complementary value of 18F-FDG PET/CT to 68Ga-DOTATATE PET/CT was 0%in G1 NET patients(0/13),8.3%in G2 NET patients(2/24),50%in G3 NET patients(3/6),and 33.3%in NEC patients(2/6).12.2%(6/49)of the patients had their staging confirmed or changed due to additional lesions detected by 18F-FDG PET/CT imaging,resulting subsequently in establishment or adjustment of their treatment plans.Conclusion 68Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients.Additional 18F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2,G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.

OBJECTIVES: To evaluate the value of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). METHODS: This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET/CT imaging at our hospital from August, 2020 to March, 2023, including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment. GEP-NEN were classified into G1, G2, and G3 neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC) based on pathological typing. The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers: ⁶⁸Ga-DOTATATE>¹⁸F-FDG (A); ⁶⁸Ga-DOTATATE=¹⁸F-FDG (B); ⁶⁸Ga-DOTATATE<¹⁸F-FDG (C); and complementation (D). The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis. RESULTS: In the 49 patients with GEP-NEN, ⁶⁸Ga-DOTATATE PET/CT was superior to ¹⁸F-FDG PET/CT for detecting systemic tumor lesions (P<0.001) and more sensitive for detecting primary/recurrent lesions, lymph node metastasis, liver metastasis, and bone metastasis (P<0.05), while ¹⁸F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis (P<0.05). In terms of the detection efficiency, Pattern A was found in 46.9% (23/49) patients, Pattern B in 38.8% (19/49), Pattern C in 12.2% (6/49), and Pattern D in 2.0% (1/49). The complementary value of ¹⁸F-FDG PET/CT to ⁶⁸Ga-DOTATATE PET/CT was 0% in G1 NET patients (0/13), 8.3% in G2 NET patients (2/24), 50% in G3 NET patients (3/6), and 33.3% in NEC patients (2/6). 12.2% (6/49) of the patients had their staging confirmed or changed due to additional lesions detected by ¹⁸F-FDG PET/CT imaging, resulting subsequently in establishment or adjustment of their treatment plans. CONCLUSIONS ⁶⁸Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients. Additional ¹⁸F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2, G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.
Humans ; Positron Emission Tomography Computed Tomography/methods* ; Neuroendocrine Tumors/therapy* ; Pancreatic Neoplasms/therapy* ; Retrospective Studies ; Organometallic Compounds ; Stomach Neoplasms/therapy* ; Neoplasm Staging ; Fluorodeoxyglucose F18 ; Intestinal Neoplasms/therapy* ; Female ; Male ; Middle Aged ; Aged ; Adult

Objective To forecast the national nursing human resources situation and provide policy basis for promoting the development of the nurse team.Methods The registered nurse numbers,the total population,the registered(assistant)physician numbers,and the bed numbers in medical and health institutions(in thousands)were selected from 2013 to 2023,and the bed-to-nurse ratio,doctor-to-nurse ratio,and the number of nurses per thousand population were calculated and analyzed to study the changes in national nursing human resources over the past decade.A grey GM(1,1)model was established to predict the number of nurses per thousand population from 2024 to 2030.Results ① The number of nurses per thousand population has increased year by year in the past decade,with an average annual growth rate of 11.38％;② The precision of the grey GM(1,1)model for the number of nurses per thousand population is precise(α=-0.065 9,b=2.014 1,C value=0.003 3,P=1.000),with high fitting degree.And the predicted number of registered nurses per thousand population from 2024 to 2030 are 4.291,4.584,4.896,5.229,5.585,5.965,and 6.371 respectively.Conclusion The national nursing human resources allocation has been optimized in the past decade,and the GM(1,1)model predicts that the national nursing human resources change is also in an upward trend.However,relevant policies still need to be formulated to improve the bed-to-nurse ratio and doctor-to-nurse ratio.

Objective To forecast the national nursing human resources situation and provide policy basis for promoting the development of the nurse team.Methods The registered nurse numbers,the total population,the registered(assistant)physician numbers,and the bed numbers in medical and health institutions(in thousands)were selected from 2013 to 2023,and the bed-to-nurse ratio,doctor-to-nurse ratio,and the number of nurses per thousand population were calculated and analyzed to study the changes in national nursing human resources over the past decade.A grey GM(1,1)model was established to predict the number of nurses per thousand population from 2024 to 2030.Results ① The number of nurses per thousand population has increased year by year in the past decade,with an average annual growth rate of 11.38％;② The precision of the grey GM(1,1)model for the number of nurses per thousand population is precise(α=-0.065 9,b=2.014 1,C value=0.003 3,P=1.000),with high fitting degree.And the predicted number of registered nurses per thousand population from 2024 to 2030 are 4.291,4.584,4.896,5.229,5.585,5.965,and 6.371 respectively.Conclusion The national nursing human resources allocation has been optimized in the past decade,and the GM(1,1)model predicts that the national nursing human resources change is also in an upward trend.However,relevant policies still need to be formulated to improve the bed-to-nurse ratio and doctor-to-nurse ratio.

Objective To explore the influence of WeChat platform rehabilitation guidance mode on refracture of osteoporotic fracture patients.Methods Totally 100 osteoporotic fracture patients admitted to the Department of Orthopedics of the hospital from 2018 to 2019 were selected and randomly divided into control group and experimental group with 50 patients in each group.The control group adopted the conventional discharge rehabilitation guidance mode,and the experimental group implemented WeChat platform rehabilitation guidance mode on this basis,including WeChat platform construction and detailed intervention mode.The changes of bone mineral density and the recurrence rate of osteoporotic fracture were compared between the two groups at admission and after 3 years of follow-up.Results There were 7 cases of lost follow-up in the experimental group,and there were 6 cases of lost follow-up in the control group.After 3 years,the bone mineral density of the experimental group was significantly higher than that of the control group,and the recurrence fracture rate was significantly lower than that of the control group(P<0.05).Conclusion The application of WeChat platform rehabilitation guidance mode can effectively improve bone density and reduce the incidence of refracture in osteoporotic fracture patients.

Objective:To explore the application value and initial clinical experience of fluorescence-enhanced laparoscopy combined with indocyanine green in radical cystectomy with pelvic lymphadenectomy.Methods:A retrospective analysis was performed on the clinical data of a total of 8 patients admitted from May 2018 to August 2019 who underwent laparoscopic radical cystectomy with pelvic lymphadenectomy for muscle-invasive bladder cancer using the fluorescent laparoscopy system.There were 6 males and 2 females; aged 58 to 71 years, with an average of 65.8 years. The preoperative pathology was urothelial carcinoma, with 2 cases in T 2a stage, 4 cases in T 2b stage, and 2 cases in T 3a stage. The patient was injected a total of 2 ml of 2.5 mg/ml of indocyanine green through a rigid cystoscope using a 18 gauge cystoscope injection needle before surgery. The PINPOINT endoscopic fluorescence camera system performed surgery in real-time. A systematic examination of the surgical area under near-infrared fluorescence was performed every 5 minutes. Observation and recording of indocyanine green combined with fluorescence laparoscopy to mark the bladder tumor area and identify the sentinel drainage. Results:Eight cases were successfully completed under the fluorescence laparoscopic system.In terms of tumor markers, cystoscopy with indocyanine green allowed 7 of the 8 patients to successfully identify the tumor area under fluorescent laparoscopy. Six of the 8 patients with sentinel lymph nodes identified by indocyanine green lymphangiography were also successful, of which 3 were positive for lymph nodes. At the same time, intravenous indocyanine green was used to observe that the blood supply to the bladder and the end of the ureter was good. The operation time was 190-310 minutes, with an average of 235 minutes; the bleeding volume was 150-380 ml, with an average of 180 ml; the postoperative hospital stay was 10-22 days, with an average of 14.5 days. Postoperative pathological staging 2 cases in T 2a stage, 3 cases in T 2b stage, 3 cases in T 3a stage, with total number of lymph nodes 8-14, average 10. The 8 cases were followed-up for 4-12 months, average 5.5 months, without indocyanine green related complications. Conclusions:Indocyanine green fluorescent laparoscopy can accurately locate and identify the bladder tumor area and pelvic lymph nodes during radical cystectomy, which can reduce positive margins and unnecessary enlarged lymph node dissection.

Objective To evaluate the efficacy and safety of single flexible ureteroscope vs.flexible ureteroscope combined with intraoperative ultrasonography guided in the endogenous renal cyst incision and drainage.Methods Retrospective analysis of case data of 64 patients with endogenous renal cysts admitted from January 2015 to December 2017.All the patients undrwent contrast-enhanced CT,urinary tract imaging,ultrasound B to confirm bosniak classification Ⅰ and Ⅱ renal cyst.The patients (38 males,26 females) were divided into single flexible ureteroscope group [group A,32 cases of patients,average age (54.2 ±6.6) years,unilateral or bilateral cystic patients:19 cases/ 13cases,simple cyst of kidney or polycystic kidney:24 cases/8 cases,average maximum diameter of the renal cyst (5.4 ± 1.3) cm,combined with renal calculus:8 cases,combined with hydronephrosis:7 cases,1 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture] and flexible ureteroscope group combined with intraoperative ultrasonography guided [group B,32 cases of patients,average age (52.3 ± 9.3) years,unilateral or bilateral cystic patients:21 cases/11 cases,simple cyst of kidney or polycystic kidney:25 cases/7 cases.Average maximum diameter of the renal cyst (5.3 ±1.2) cm,combined with renal calculus:9 cases,combined with hydronephrosis:8 cases,2 case who had the history of laparoscopic renal cyst decapitation,1 case who had the history of percutaneous renal cyst puncture].The double J stent was placed two weeks before the surgery into the body of patients.During the operation,the surgical procedure were used by the electronic flexible ureteroscope and holmium laser (0.8 J,20 Hz),combined with ultrasound B in the monitoring,to find the suitable incision position.It would be defined as the successful result if we could put the head of flexible ureteroscope into the inside of renal cyst and see the image of mist in the screen of ultrasound B.According to the standard,the result of operation wound be defined compared to before operation (success:shrink more than 80％ or maximum diameter was smaller than 1 cm;improvement:shrink about 50％-79％;ordinary result:shrink about 30％-49％;failure:shrink smaller than 30％).Effective rate =(success cases + improvement cases)/total cases.We compared the differences of two groups in the time,efficacy,safety and complication of surgery.Results Compared the results of single flexible ureteroscope groups vs flexible ureteroscope group combined with intraoperative ultrasonography guided in the success cases of surgery,after 8-30 months following-up,total operative complication rate was [8 cases(25％)vs.1 case(3.1％)],success rate of operation in 6 month later [(20 cases (62.5％) vs.28 cases (87.5％)].Flexible ureteroscope group combined with intraoperative ultrasonography guided had advantages statistically (P ＜ 0.05).However,there was no statistical difference for the two groups in the time of operation [(33.4 ± 6.7) min vs.(35.1 ± 8.6) min],single operative complication (intraoperative wounding bleeding:3 cases vs.1 case,postoperative urinary infection:3 cases vs.0 case,perinephric space effusion:2 cases vs.0 case,renal function impairment:1 case vs.0 case)(P ＞0.05).Conclusions Flexible ureteroscope combined with intraoperative ultrasonography guided can help the urologist can improve the success rate of surgery and reduce the chance of surgical injury intraoperatively.

Wnt signaling pathway is one of the important signal transduction systems that involved in regulating nervous system devel-opment, which plays an important role in axonal regeneration, neural stem cell proliferation and differentiation into neurons and inhibition of differentiation into glial cells. After spinal cord injury, multiple Wnt protein expresses around the injury site, and some proteins of the Wnt family play an important role in spinal cord injury repair, in which the activation of Wnt/β-catenin signaling pathway is necessary for spinal cord regeneration after spinal cord injury.

The Notch signaling pathway plays a pivotal role in the process of neurogenesis in central nervous system. It not only maintains the appropriate number and proportion of neurons and glial cells in the growth and development of embryo, but also regulates the injured neural stem/progenitor cells to differentiate into neurons/glial cells of the adult nervous system, promoting the repair of the nervous system.

Objective To compare the clinical efficacy of herbal ion application and penetration therapy applied in the dog days, or in both of the dog days and coldest days for the treatment of recurrent respiratory tract infection (RRTI) in children. Methods This intervention was designed as a multi-center, randomized, single-blind, repeated-measurement design. A total of 240 RRTI children were randomly divided into Sanfu group (N=120, herbal ion application and penetration therapy applied in the dog days) and Fujiu group (N=120, herbal ion application and penetration therapy applied in both of the dog days and coldest days). Each group was treated for one year and then was followed up for one year. Before and after the treatment, we observed the frequency of respiratory tract infection, the period of onset, signs and symptoms of traditional Chinese medicine (TCM), and detected the salivary secretory immunoglobulin A (sIgA) at different time points. Results (1) The therapeutic effect of Fujiu group was better than that of Sanfu group, and the difference was significant (P<0.05). (2) The frequency of respiratory tract infection was reduced, the period of onset was shortened, and TCM signs and symptoms were improved in both groups, and the effect of Fujiu group was superior to that of Sanfu group (P<0.05). (3) Salivary sIgA showed a continuous upward trend in Fujiu group while a mild downward trend in Sanfu group at different time points (P<0.05). Conclusion Herbal ion application and penetration therapy applied in both of the dog days and coldest days shows better effect for the treatment of children RRTI than that applied only in the dog days.