Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Objective:To investigate the clinical manifestations and 18F-FDG PET/CT imaging features of hilar tumor pulmonary infarction. Methods:From July 2016 to June 2021, 49 patients (40 males, 9 females; age 32-81 years) with hilar tumor pulmonary infarction who underwent PET/CT and enhanced CT in the second Hospital of Shandong University and Shandong Cancer Hospital and Institute, Shandong First Medical University were retrospectively enrolled. All patients were diagnosed by imaging follow-up or pathology. Clinical features and 18F-FDG PET/CT imaging features were analyzed. Results:A total of 108 infarcts were found in 49 patients by 18F-FDG PET/CT. Small cell carcinoma was the most common hilar tumor (67.35%, 33/49). The most common clinical manifestations of hilar tumor pulmonary infarction were cough (69.39%, 34/49) and hemoptysis (34.69%, 17/49). Pulmonary infarction was mainly multiple (69.39%, 34/49), and multiple lung lobes might be involved. The CT morphology of infarcts was wedge-shaped (46.30%, 50/108) or patchy (53.70%, 58/108), and the density was mainly bubble consolidation (61.11%, 66/108). There were 91 (84.26%, 91/108) infarcts showing FDG hypermetabolism, with the SUV max of 1.48-6.62, and the hypermetabolism mode was rim sign (36.11%, 39/108) or heterogeneous hypermetabolism (48.15%, 52/108). Nineteen patients (38.78%, 19/49) were complicated with pulmonary vein involvement, and 26 patients (53.06%, 26/49) had ipsilateral pleural effusion. Conclusions:Hilar tumor pulmonary infarction is characterized by cough. It is helpful for the diagnosis of hilar tumor pulmonary infarction in patients with hilar tumor when wedge-shaped, bubble consolidation, rim sign and heterogeneous hypermetabolism lesions are found in 18F-FDG PET/CT images.

Objective:To explore any changes with age in the center of plantar pressure among normal people after walking.Methods:Fifty healthy subjects were divided into a young group and an elderly group, each of 25. Gait descriptors were collected for each subject using a model AL-600 gait and balance training and evaluation apparatus. The gait descriptors were the center of pressure displacement (COPD), and the COPD in the medial-lateral (COPD-X) and anterior-posterior (COPD-Y) directions before and after 10 and 15 minutes of walking.Results:The average COPD, COPD-X and COPD-Y of the elderly group increased after both 10 and 15 minutes of walking, but among the young group increases were observed only after 15 minutes. The average COPD, COPD-X and COPD-Y of the elderly group were always significantly larger than the young group′s averages.Conclusions:Gait stability among the elderly decreases after as little as 10 minutes of walking, but among the young decreases are observed only after 15 minutes.

Multiple myeloma (MM) is a common malignant hematological tumor in adults, which is characterized by clonal malignant proliferation of plasma cells in the bone marrow and secretion of a large number of abnormal monoclonal immunoglobulins (M protein), leading to bone destruction, hypercalcemia, anemia, and renal insufficiency (Alexandrakis et al., 2015; Yang et al., 2018). Since a large number of new drugs, represented by proteasome inhibitors and immunomodulators, have been successfully used to treat MM, treatment efficacy and survival of patients have been significantly improved. However, due to the high heterogeneity of this disease, patients have responded differently to treatments with these new drugs (Palumbo and Anderson, 2011; Wang et al., 2016; Huang et al., 2020). Growth and survival of MM cells depend on the bone marrow microenvironment, especially numerous inflammatory cytokines secreted by myeloma cells and bone marrow stromal cells, such as vascular endothelial growth factor (VEGF), interleukin (IL)‍-6, transforming growth factor-‍β (TGF‍‍-‍‍β), and IL-10. These cytokines can promote the growth of myeloma cells, induce angiogenesis, and inhibit antitumor immunity, and are often linked to patient prognosis (Kumar et al., 2017). In this era of new drugs, the prognostic values of the serum levels of these cytokines in MM need further evaluation.
Adult ; Humans ; Cytokines ; Disease Progression ; Interleukin-10 ; Interleukin-6/metabolism* ; Multiple Myeloma/drug therapy* ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A

Objective:To document the blood indexes of middle-aged and elderly intracerebral hemorrhage (ICH) patients complicated with deep vein thrombosis (DVT).Methods:A retrospective analysis was conducted of 77 hospitalized ICH patients using venous color Doppler ultrasonography within 3 days of admission. According to the results, they were divided into a DVT group (18 cases) and a non-DVT group (59 cases). The blood routine, biochemistry, coagulation, and D-dimer examinations were conducted on the 2nd day after admission. T-tests and rank sum tests tested the significance of any differences between the groups in average white blood cell counts, neutrophil percentages, platelets, albumin, globulin, fasting blood glucose, urea nitrogen, creatinine, uric acid, electrolytes, fibrinogen or D-dimer.Results:The average levels of albumin, uric acid and calcium in the DVT group were significantly lower than in the non-DVT group. The average levels of fasting blood glucose and D-dimer were significantly higher.Conclusions:Decreased serum uric acid, calcium and albumin levels, together with increased fasting blood glucose and D-dimer are related to the occurrence of DVT in ICH patients. To reduce the risk of DVT it is important to maintain normal levels of serum uric acid, calcium and albumin and to limit D-dimer and fasting blood glucose.

Objective:To evaluate the effect of mechanical chest compression device in patients with cardiac arrest.Methods:The relevant literatures about mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation were systematically searched from China Knowledge Network (CNKI), VIP, Wanfang, PubMed, Web of Science and other databases. The effective data were extracted and analyzed by RevMan5.3 software.Results:A total of 20 clinical studies involving 29 727 patients were included, of which 11 104 patients received mechanical cardiopulmonary resuscitation and 18 623 patients received traditional manual cardiopulmonary resuscitation. The results of meta-analysis showed that mechanical cardiopulmonary resuscitation could not effectively improve the restoration of spontaneous circulation (ROSC) rate, admission survival rate, discharge survival rate and neurological prognosis in patients with cardiac arrest compared with manual cardiopulmonary resuscitation. ROSC occurrence rate ( RR=1.10, 95% CI: 0.99-1.23, P<0.01), admission survival rate ( RR=1.01, 95% CI: 0.95-1.08, P=0.67), discharge survival rate ( RR=1.00, 95% CI: 0.86-1.15, P=0.14), and good neurological function rate ( RR=0.81, 95% CI: 0.61-1.06, P=0.69) showed no significant differences between the mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation. Conclusions:Mechanical chest compression device has no advantage compared with manual cardiopulmonary resuscitation. Mechanical cardiopulmonary resuscitation is not recommended to completely replace manual chest compression in cardiopulmonary resuscitation.

Objective:To observe factors influencing the risk of urinary tract infection (UTI) after cerebral hemorrhage (ICH).Methods:A total of 77 ICH patients undergoing rehabilitation between August 2015 and August 2017 were studied. Among them, 24 were diagnosed with a UTI according to clinical manifestations and urine routine tests and urine culture. They formed the UTI group. The other 53 were the non-UTI group. Complete clinical evaluations were available for all 77, and those data were used to identify risk factors for UTI using univariate and multivariate logistic regression analysis.Results:The univariate analysis showed that age, side of paralysis, consciousness dysfunction, Brunnstrom staging of the lower extremity, tracheotomy, indwelling catheter, lung infection, white blood cell count, neutrophil percentage, serum natrium, uric acid, D-dimer level and fibrinogen were all significant predictors of UTI. The multivariate analysis identified age, right side hemiplegia and D-dimer level as useful predictors.Conclusions:Advanced age and a high D-dimer level are independent risk factors for UTI after ICH, while hemiplegia on the right side is a protective factor.

Objective:To observe risk factors for lung infection (LI) after cerebral hemorrhage (ICH).Methods:A total of 118 patients with ICH were retrospectively analyzed. Among them, 63 were diagnosed with an LI according to clinical manifestations and X-ray or CT on admission. They were selected into an LI group, while the rest formed the non-LI group. Gender, age, duration of disease, side of paralysis, position and type of ICH, complications, cognitive disorders, consciousness, dysphagia, motor function, and serum levels of albumin, sodium, potassium, calcium and magnesium were recorded on the second day after admission. The risk factors for LI were analyzed using univariate and multivariate logistic regression analysis.Results:Age, duration of disease, side of paralysis, position and type of ICH, tracheotomy, urinary tract infection, cognitive impairment, dysphagia, motor function, and serum levels of albumin, sodium, calcium, and magnesium were all significant predictors of LI after an ICH. Multivariate logistic regression analysis showed that right side hemiplegia, bilateral paralysis, subarachnoid hemorrhage, urinary tract infection, and serum magnesium are all significant predictors.Conclusions:Right or bilateral paralysis, subarachnoid hemorrhage and urinary tract infection are independent risk factors for LI after an ICH. High serum magnesium within the normal range can reduce the incidence of LI.

Objective:To explore the factors related to cognitive dysfunction after traumatic brain injury.Methods:A total of 55 patients with traumatic brain injury were analyzed retrospectively. The clinical information about the patients, including age, gender, paralyzed side, course of the disease, type of injury, degree of injury, treatment, speech function (grades of Boston aphasia severity), swallowing function (7-level evaluation method), limb motor function (Brunnstrom stages of the upper limb, hand and lower limb), complications (tracheotomy, lung infection, urinary tract infection, pressure sores, electrolyte imbalance and hypoproteinemia), whether the patient received rehabilitation therapy, and D-dimer and coagulation examination results were recorded. Univariate analysis and ordered multi-class logistic regression analysis were conducted to screen the related factors using Rancho Los Amigos cognitive function grades as the dependent variable.Results:The results of the univariate analysis showed that consciousness, aphasia severity, swallowing ability, Brunnstrom stages, having received a tracheotomy, urinary tract infection, hypoproteinemia, fibrinogen and D-dimer all significantly predicted Rancho Los Amigos cognitive function grades. The logistic regression analysis showed that disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection were significant predictors.Conclusions:Disordered consciousness, aphasia severity, Brunnstrom stage of the upper limbs, and urinary tract infection are factors related to cognitive dysfunction after traumatic brain injury.

Objective:This study aims to evaluate the prognostic effect of peripheral blood cells in multiple myeloma (MM) patients treated with bortezomib.Methods:The clinical data of 155 newly diagnosed MM patients in two blood disease treatment centers from January 2014 to December 2016 were retrospectively studied. All patients received bortezomib as the first-line treatment. The results of the peripheral blood cell counts, including absolute neutrophil count, absolute monocyte count (AMC) , hemoglobin level, mean corpuscular volume (MCV) , and platelet count, and other clinical features were analyzed.Results:AMC (>0.6×10 9/L) , MCV (>99.1 fl) , and platelet count (<150×10 9/L) significantly affected patients’ PFS and OS. The above three factors were assigned 1 point, respectively, to form the blood cell score. The analysis showed that 64 cases (41.3% ) had a score of 0, 57 cases (36.8% ) had 1, 32 cases (20.6% ) had 2, and 2 cases (1.3% ) had 3. The median PFS of the four groups were 42.8 m, 26.5 m, 15.8 m, and 6.4 m, respectively ( P<0.001) . The median OS were NR, 48.2 m, 31.1 m, and 31.4 m, respectively ( P=0.001) . Multivariate analysis suggested that the blood cell score (2-3 vs 0-1) and the proportion of marrow plasma cells (>30% ) were independent prognostic factors for PFS ( HR=1.95 and 1.76, respectively) , while age (>65y vs ≤65y) , R-ISS stage (3 vs 1-2) , and blood cell score (2-3 vs 0-1) were independent prognostic factors for OS ( HR=2.08, 2.13 and 2.12, respectively) . Conclusion:As an easy-to-access biomarker, the blood cell score can be used to evaluate the prognosis of newly diagnosed MM patients in the era of new drugs, but it is still necessary to expand the cases and make further confirmation in the prospective study.