Objective In this study,we retrospectively analyzed the imaging characteristics of dual-tracer 68Ga-prostate specific membrane antigen(PSMA)and 18F-flurodeoxyglucose(FDG)positron emission tomography(PET)/computed tomography(CT)in metastatic prostate cancer(mPCa)patients.We analyzed the uptake modes of the dual tracers,explored clinical pathological parameters affecting the 18F-FDG uptake in the lesions,and evaluated their prognostic implications for prostate specific antigen progression-free survival(PSA-PFS).Methods A total of 41 mPCa patients who underwent dual-tracer PET/CT(68Ga-PSMA and 18F-FDG)scans between September 2021 and January 2024 were retrospectively enrolled.One patient had negative uptake of both PSMA and FDG.According to the uptake patterns of the 2 tracers,the other patients,40 in total,were categorized in 2 groups,including group A consisting of 33 cases who showed PSMA and FDG dual and those who showed FDG only avidity,and group B consisting of 7 cases who showed PSMA avidity only.Comparative analyses of clinical pathological characteristics between group A and group B were conducted.The relationship between various parameters and PSA-PFS was analyzed by the Kaplan-Meier method.Results A total of 26 patients(63.4％)were diagnosed with metastatic castration-resistant prostate cancer(mCRPC),and 38 cases(92.7％)had a Gleason score of 8-9.Bone metastasis,the predominant type of distant metastasis,occurred in 36 cases(87.8％).The skeletal and distant lymph node metastases mostly showed a dual positive uptake pattern for both PSMA and FDG(85.7％[24/28]and 81.8％[9/11]).37.5％(3/8)of the metastases to organs showed FDG only positive uptake pattern.The serum levels of prostate specific antigen(PSA)in group A were significantly higher than those in group B(P=0.013).A total of 13 patients of special pathological classification(intraductal carcinoma and neuroendocrine differentiation)were all found to be in group A.Among the 41 cases,16 were lost to follow-up.Of the 25 patients who completed follow-up,9 patients,with a median PSA value of 104 ng/mL,experienced PSA progression,while the 16 other patients,with a median PSA of 0.34 ng/mL,did not incur any PSA progression.There was significant difference in the median PSA between patients showing PSA progression and those who did not show PSA progression(P＜0.001).Kaplan-Meier survival analysis revealed that the median PSA-PFS of patients of specific pathological classifications was 7 months,which was shorter than the 16 months of the patients with typical prostate cancer,with the difference between the two groups being statistically meaningful(P=0.043).The median PSA-PFS for group A was 30 months.With more than half of the patients in the group not experiencing any PSA progression,group B did not reach the median PSA-PFS(P=0.645).Conclusion Dual-tracer PET/CT imaging with 68Ga-PSMA and 18F-FDG commonly exhibits avidity for both tracers in mPCa.Serum PSA level is a reliable biomarker for predicting FDG-positive lesions.mPCa presented with intraductal carcinoma and neuroendocrine differentiation tends to exhibit FDG avidity and is more susceptible to PSA progression.

Objective:To propose a monosegment thoracic and lumbar fracture dislocation (mTLFD) classification, and to evaluate its reliability and clinical application.Methods:All of 298 cases of thoracic and lumbar fracture dislocation who received surgical management in our hospital from January 2014 to December 2019 were retrospectively analyzed. 123 cases were included in the study according to inclusion and exclusion criteria. mTLFD classification was proposed based on the imaging characteristics: type I (intervertebral disc injury mainly) and type II (vertebral burst fracture mainly). The type II was classified based on distribution of injury segment: type IIa (T 11 and above) and Ttype IIb (below T 11). Six spinal surgeons (3 residents, 3 associate chief physicians) were selected to classify the 123 cases according to preoperative imaging data, and to perform reliability test of each type. The repeatability and reliability of the classification were evaluated by ICC index. Different management strategies were performedf or each type: type I was managed with posterior decompression interbody fusion and internal fixation; type IIa underwent posterior decompression and fixation, subtotal vertebral resection and fusion was performed if bony compromise was still present through intra-operative exploration. Type IIb underwent posterior decompression, posterolateral fusion and internal fixation on the first stage, while anterior subtotal vertebral resection and reconstruction was performed on the second stage if the bony compromise was still present based on post-operative CT examination. The American Spinal Injury Association (ASIA) grading of all patients was recorded, and the visual analogue scale (VAS), Oswetry disability Iindex (ODI) and local Cobb angle of each type was compared between pre-operation and final follow-up. Results:The average follow-up time of all patients was 10.4±1.8 months. The average repeatability and reliability ICC index of mTLFD of 3 residents and 3 deputy chief physicians were 0.926 and 0.964, respectively, and 0.746 and 0.907, respectively. The reliability ICC index of type I, type IIa and type IIb was 0.918, 0.947 and 0.962, respectively, and the repeatability ICC index was 0.930, 0.940 and 0.966, respectively. The neurological function recovery was obtained in 56 patients. The preoperative VAS of type I, type IIa and type IIb were 8.5±1.0, 8.4±1.0 and 8.3±0.9, and 2.0±1.1, 1.8±1.0 and 1.8±0.9 at the final follow-up (all P<0.001). The ODI of type I, type IIa and type IIb were 97.0%±2.1%, 97.1%±1.9% and 97.3%±2.1% before surgery, and 29.5%±6.8%, 27.0%±6.0% and 29.0%±6.7% at the final follow-up (all P<0.001). The local Cobb angles of type I, type IIa and type IIb were 20.9°±7.1°, 29.0°±9.1° and 26.4°±6.9° before surgery, and 12.5°±5.4°, 18.0°±9.1° and 13.1°±5.1° at the final follow-up (all P<0.001). Conclusion:The mTLFD classification proposed in this study has strong repeatability and reliability, and management strategy of each type have achieved satisfactory clinical efficacy, indicating that the classification has certain significance for management of thoracic and lumbar spine fracture dislocation.

AIM:Toinvestigatewhetherautophagyisup-regulatedwhenresveratrol(Res)inducesapoptosis in chondrosarcoma , and to study the effects of autophagy inhibitor combined with Res on chondrosarcoma .METHODS:SW1353 cells were divided into 4 groups: control group, Res group, 3-methyladenine (3MA) group, and Res +3MA group.Electron microscopy was used to observe the autophagyosomes in control group and Res group .At the same time, the viability of the cells in the 4 groups was detected by CCK-8 assay.TUNEL staining and Western blotting (for determi-ning the levels of cleaved caspase-3, Bax and Bcl-2) were used to reflect levels of apoptosis in all groups .The expression of autophagy-related proteins Beclin 1, LC3-Ⅱ and p62 was detected by Western blotting .RESULTS: Exposure of the cells to Res resulted in a decrease in cell viability and an increase in the level of apoptosis ( P<0.05 ) .Compared with control group, the level of apoptosis was increased but the autophagy was decreased (P <0.05).Compared with Res group, the cell viability and the level of autophagy were decreased and the level of apoptosis was increased ( P<0.05 ) . CONCLUSION:Resveratrol induces apoptosis and autophagy , and inhibition of autophgay enhances resveratrol-induced apoptosis in chondrosarcoma .

ObjectiveTo study the reasons and mechanism of cardiomyocyte apoptosis in chronic heart failure by using Losartan and to provide a theoretical basis for the treatment of chronic heart failure. Methods The models of chronic heart failure were produced by injecting Adriamycin and Losartan as intervention agents, the expression of apoptotic protein Bax, Bcl-2 and channel protein ERK1, JNK1 and P38MAPK were detected by immunohistochemistry and RT-PCR.Cardiomyocyte apoptosis and myocardial ultrastructure are detected by transmission electron microscopy and TUNEL staining.Results Compared with the model group of heart failure, after Losartan treatment, the ultra structure of myocardial cells were significantly improved, Apoptosis index was decreased significantly (P <0.01), The level of Bax and JNK1 decreased (Bax χ~2=6.6149, P=0.0078; JNK1 q=22.0156,P<0.01). However, the expressions of ERK1 and Bcl-2 were significantly increased (ERK1 q=15.3514,P<0.01;Bcl-2 χ~2=6.81,P=0.0074).Conclusion The effect of Losartan on chronic heart failure is related closely with the pathway of ERK1 and JNK1, and no p38 MAPK pathway.