Objective: To explore the distribution of traditional Chinese medicine (TCM) syndromes in children with hepatolenticular degeneration (Wilson disease, WD) based on factor analysis and cluster analysis. Methods: From November 2018 to November 2023, general information (gender, age of admission, age of onset, course of disease, clinical staging, Western medicine clinical symptoms, and family history) and TCM four-examination informations (symptoms and signs) were retrospectively collected from 757 cases of children with WD at the First Affiliated Hospital of Anhui University of Chinese Medicine, and factor analysis and cluster analysis were used to investigate TCM syndromes in children with WD. Results: A total of 757 children with WD were included, of which 483 were male and 274 were female; the median age at admission was 12.58 years, the median age at onset was 8.33 years, and the median course of disease was 24.37 months; clinical typing result indicated 506 cases of hepatic type, 133 cases of brain type, 99 cases of mixed-type, and 19 cases of other type; 36.46% of the children had no clinical symptoms (elevated aminotransferases or abnormalities in copper biochemistry); a total of 177 cases had a definite family history, and 10 cases had a suspected family history. Forty-three TCM four-examination information were obtained, with the top 10 in descending order being feeling listless and weak, brown urine, slow action, inappetence, dim complexion, slurred speech, angular salivation, body weight loss, hand and foot tremors, and abdominal fullness. In children with WD, the syndrome element of disease location was primarily characterized by the liver, involving the spleen and kidney, and the syndrome elements of disease nature were characterized by dampness, heat, and yin deficiency. Based on factor analysis and cluster analysis, five TCM syndromes were derived, which were, in order, syndrome of dampness-heat accumulation (265 cases, 35.01%), syndrome of yin deficiency of the liver and kidney (202 cases, 26.68%), syndrome of liver hyperactivity with spleen deficiency (185 cases, 24.44%), syndrome of qi and blood deficiency (79 cases, 10.44%), and syndrome of yang deficiency of the spleen and kidney (26 cases, 3.43%). Conclusion The TCM syndromes of children with WD were primarily syndromes of dampness-heat accumulation, yin deficiency of the liver and kidney, and liver hyperactivity with spleen deficiency. The liver was the main disease location, and the disease nature was characterized by deficiency in origin and excess in superficiality, excess and deficiency mixed. These findings suggest that treating children with WD should be based on the liver while also considering the spleen and kidney.

ObjectiveTo study the correlations between traditional Chinese medicine （TCM） syndromes and lipid metabolism in children with Wilson disease （WD）. MethodsClinical data and lipid metabolism indicators ［total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， apolipoprotein A1 （ApoA1）， apolipoprotein B （ApoB）， and lipoprotein a （Lpa）］ were retrospectively collected from 341 children with WD. The clinical data were compared among WD children with different syndromes， and the correlations between TCM syndromes and lipid metabolism in children with WD were analyzed. Least absolute shrinkage and selection operator （LASSO） regression was used for variable screening， and unordered multinomial Logistic regression was employed to analyze the effects of lipid metabolism indicators on TCM syndromes. ResultsThe 341 children with WD included 121 （35.5%） children with the dampness-heat accumulation syndrome， 103 （30.2%） children with the liver-kidney Yin deficiency syndrome， 68 children with the combined phlegm and stasis syndrome， 29 children with the spleen-kidney Yang deficiency syndrome， and 20 children with the liver qi stagnation syndrome. The liver-kidney Yin deficiency syndrome， combined phlegm and stasis syndrome， and spleen-kidney Yang deficiency syndrome had correlations with the levels of lipid metabolism indicators （P<0.05）. Lipid metabolism abnormalities occurred in 232 （68.0%） children， including hypertriglyceridemia （108）， hypercholesterolemia （23）， mixed hyperlipidemia （67）， lipoprotein a-hyperlipoproteinemia （12）， and hypo-HDL-cholesterolemia （22）. The percentages of hypertriglyceridemia and hypo-HDL-cholesterolemia varied among children with different TCM syndromes （P<0.05）. Correlations existed for the liver-kidney Yin deficiency syndrome with TG， TC， and HDL-C， the combined phlegm and stasis syndrome with TG， the spleen-kidney Yang deficiency syndrome with TG， TC， and LDL-C， and the liver Qi stagnation syndrome with TC and LDL-C （P<0.05， P<0.01）. ConclusionThe TCM syndromes of children with WD are dominated by the dampness-heat accumulation syndrome and the liver-kidney Yin deficiency syndrome， and dyslipidemia in the children with WD is dominated by hypertriglyceridemia and mixed hyperlipidemia. There are different correlations between TCM syndromes and lipid metabolism indicators， among which TG， TC， LDL-C， and HDL-C could assist in identifying TCM syndromes in children with WD.

Hip surgery is often associated with moderate to severe postoperative pain due to exten-sive invasion.A safe and effective postoperative pain treatment can promote patients'recovering activities and facilitate the early functional recovery of the hip after the surgery.Although the routinely used intrave-nous self-controlled analgesia has an exquisite analgesic effect,it carries the risks of postoperative nausea and emesis,excessive sedation,intestinal paralysis,and even respiratory depression.As an alternative to transversus abdominis plane block(TAPB),lumbar quadratus block(QLB)has been gradually applied to the hip joint surgery.In this paper,we review the anatomical basis and characteristics of QLB and its clini-cal application in hip surgery,in order to provide the postoperative analgesia application of QLB.

Objective To investigate the effect of carbon dioxide pneumoperitoneum on the ox-ygen carrying capacity and electrolyte levels in the salvaged autologous blood undergoing laparoscopic surgery.To evaluate the clinical application value and to provide guidance for the salvage and transfu-sion of autologous blood in laparoscopic surgery.Methods Twenty cases who underwent laparoscopic surgery (group CP,laparoscopic hepatic hemangioma surgery)and twenty cases who underwent open surgery(group NCP,spinal surgery),including eighteen males and twenty-two females,aged 27-79, BMI 1.64-24.46 kg/m2,ASA Ⅰ-Ⅱ,were selected from Peking University People's Hospital from May 2016 to August 2017.Cases in both groups underwent general anesthesia.NBP,IBP,ECG, HR,SpO2,PETCO2,CVP,BIS and T were monitored and autologous blood salvage and transfusion were used during the operation.Arterial blood samples were collected from patients 10 min before and after autologous blood transfusion,salvaged blood samples were collected 1 min before and after fil-tration.Blood gas analysis,including the level of pH,PCO2,PO2,SO2,Hct,Hb,Lac and the con-centrations of Na+,K+,Ca2+,Cl-,Mg2+,were performed on all blood samples.Recording opera-tion time and blood in vitro time,blood loss volume intraoperative,total blood volume of salvage and transfusion.Results In group CP,pH,PO2and SO2of autologous blood 1 min before and after fil-tration were significantly lower than those of arterial blood 10 min before and after autologous blood transfusion (P<0.05).In group NCP,pH of autologous blood 1 min before and after filtration was significantly higher than that of arterial blood 10 min before and after autologous blood transfusion, while PCO2and PO2were significantly lower than the latter(P<0.05).PH,PO2and SO2of autolo-gous blood in group CP were significantly lower while PCO2was significantly higher than group NCP (P<0.05).PH of arterial blood 10 min after autologous blood transfusion was significantly lower while PCO2was significantly higher than group NCP (P<0.05).In group CP,the concentration of Na+and Cl- in autologous blood 1 min after filtration were significantly higher than those before fil-tration and the arterial blood 10 min before and after autologous blood transfusion.The concentration of K+,Ca2+and Mg2+in autologous blood 1 min after filtration were significantly lower than the lat-ter three blood samples (P<0.05).In group NCP,the concentrations of Na+and Cl- in autologous blood 1 min after filtration were significantly higher than those in arterial blood 10 min before and af-ter autologous blood transfusion.The concentrations of K+,Ca2+and Mg2+were significantly lower than those in the latter two blood samples (P<0.05).There were no significant differences in elec-trolyte concentration of all blood samples between two groups.Conclusion The salvaged blood in lap-aroscopic surgery is superacid and carrying less oxygen.After transfusion,may change patients'acid-base balance and increase the risk of acidosis.Its clinical application value need more further explora-tions.

OBJECTIVETo investigate the clinical value of dual-phase (18)F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer.

METHODSThe imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase (18)F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of (18)F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and (18)F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase (18)F-FDG PET/CT in preoperative staging.

RESULTSThe concordance rate of dual-phase FDG PET/CT-based bladder cancer staging with the histopathologic results was 63.0% in the 73 patients, and was 100% (7/7) for pT4 bladder cancers. With dual-phase FDG PET/CT, the detection rate was 75.0% (6/8) for lymph node metastases, 100% (4/4) for distant metastases, and 100% (4/4) for other concurrent primary malignancies.

CONCLUSIONThough with limited accuracy in T-staging of pTa, pT1, pT2, and pT3 bladder cancer, dual-phase FDG PET/CT has important clinical value in staging of pT4 bladder cancer and in N-staging, M-staging and detection of other concurrent primary malignancies.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; diagnostic imaging ; pathology ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Radiopharmaceuticals ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology

OBJECTIVETo investigate the tumor targeting efficacy of (18)F-AlF-NOTA-PRGD2, a novel radiotracer of Arginine-glycine-aspartic acid (RGD) peptides.

METHODS(18)F-AlF-NOTA-PRGD2 was synthesized in one-step by conjugating NOTA-PRGD2 with (18)F-AlF at 100 degrees celsius;. The tumor targeting efficacy and in vivo biodistribution profile of (18)F-AlF-NOTA-PRGD2, following intravenous injection via the tail vein, were evaluated in a nude mouse model bearing subcutaneous U87MG glioblastoma xenograft by radioactivity biodistribution assessment, PET/CT and microPET/CT.

RESULTSNOTA-PRGD2 was (18)F-fluorinated successfully in one-step with a yield of 17%-25% within 15-20 min. Radioactivity biodistribution study confirmed the tumor-targeting ability of (18)F-AlF-NOTA-PRGD2 in the tumor-bearing mice. At 1 and 2 h following injection, (18)F-AlF-NOTA-PRGD2 uptake in the tumor reached 4.14∓1.44 and 2.80∓1.18 % ID/g (t=1.910, P=0.070) with tumor/brain ratios of 2.95∓0.61 and 5.21∓2.62, respectively (t=-1.686, P=0.167). Both PET/CT and microPET/CT were capable of showing the radioactivity biodistribution of (18)F-AlF-NOTA-PRGD2 in the mouse model and clearly displayed the tumor, but microPET/CT showed a much better image quality.

CONCLUSION(18)F-AlF-NOTA-PRGD2 prepared by one-step radiosynthesis can selectively target to the tumor, demonstrating its potential as a good radiotracer for tumor imaging.

Animals ; Cell Line, Tumor ; Fluorine Radioisotopes ; Glioblastoma ; diagnostic imaging ; Humans ; Mice ; Mice, Nude ; Oligopeptides ; Positron-Emission Tomography ; methods ; Radioactive Tracers

Objective To investigate the clinical value of dual phase 18F-FDG PET/CT in the diagnosis of recurrent and metastatic bladder cancer after surgery. Methods The imaging data from 84 patients underwent the dual phase 18F-FDG PET/CT after surgery with known histories of bladder cancer were analyzed. Among the 84 patients, 16 had symptoms of recurrence, 24 had symptoms of metastasis and 44 didn′t have any symptom. The median interval time between the primary tumor resection and the PET/CT scan was 11.5 months (0.5 ~ 240 months). According to the PET/CT imaging procedures, all patients underwent whole body PET/CT scan at 60 minutes after IV injection of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis by using oral 40 mg furosemide. The 18F-FDG PET/CT findings were compared with histopathologic examination results and (or) the clinical follow-up. All patients were followed up for more than six months. Results Results of detecting recurrence and metastasis of bladder cancer showed that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the dual phase FDG PET/CT imaging protocol were 91.7%(22/24), 95.0%(57/60), 94.0%(79/84), 88.0%(22/25), 96.6%(57/59) and 90.0%(27/30), 96.3%(52/54), 94.0%(79/84), 93.1%(27/29), 94.5%(52/55), respectively. Conclusion Dual phase FDG PET/CT can be used to detect the recurrence and metastasis with high accuracy, contributing to the restaging and follow-up in bladder cancer after surgery.

Objective To estimate the curative effect of non-gastrointestinal decompression in laproscopic colorectal surgery. Methods By using the single-blind-random test and prospective study, 55 patients were divided into two groups, experimental group and matched group. The difference of operating time, gastrointestinal function recovery time, adverse effect, complication, average length of hospital stay between two groups were observed and evaluated. Results The difference of operating time, gastrointestinal function recovery time, adverse effect, complication, average length of hospital stay between two groups were not statistically significant(P>0.05). The incidence rate of sore throat and cough and expectoration difficulty after operation was significantly lower in the experimental group (the rate was respectively 16.0% vs 77.7% and 8.0% vs 50.0, P<0.05). However, The incidence rate of nausea and vomiting, abdom-inal distension was not statistically significant(P>0.05). Conclusion In the perioperative period of laproscopic colorectal surgery, non-gastrointestinal decompression appears to be security and feasible.

Objective To investigate the tumor targeting efficacy of 18F-AlF-NOTA-PRGD2, a novel radiotracer of Arginine-glycine-aspartic acid (RGD) peptides. Methods 18F-AlF-NOTA-PRGD2 was synthesized in one-step by conjugating NOTA-RGD2 with 18F-AlF at 100℃. The tumor targeting efficacy and in vivo biodistribution profile of 18F-AlF-NOTA-RGD2, following intravenous injection via the tail vein, were evaluated in a nude mouse model bearing subcutaneous U87MG glioblastoma xenograft by radioactivity biodistribution assessment, PET/CT and microPET/CT. Results NOTA-RGD2 was 18F-fluorinated successfully in one-step with a yield of 17%-25%within 15-20 min. Radioactivity biodistribution study confirmed the tumor-targeting ability of 18F-AlF-NOTA-PRGD2 in the tumor-bearing mice. At 1 and 2 h following injection, 18F-AlF-NOTA-PRGD2 uptake in the tumor reached 4.14 ± 1.44 and 2.80 ± 1.18%ID/g (t=1.910, P=0.070) with tumor/brain ratios of 2.95 ± 0.61 and 5.21 ± 2.62, respectively (t=-1.686, P=0.167). Both PET/CT and microPET/CT were capable of showing the radioactivity biodistribution of 18F-AlF-NOTA-PRGD2 in the mouse model and clearly displayed the tumor, but microPET/CT showed a much better image quality. Conclusion 18F- AlF- NOTA- PRGD2 prepared by one- step radiosynthesis can selectively target to the tumor, demonstrating its potential as a good radiotracer for tumor imaging.

Objective To investigate the clinical value of dual-phase 18F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer. Methods The imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase 18F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and 18F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase 18F-FDG PET/CT in preoperative staging. Results The concordance rate of dual-phase FDG PET/CT-based bladder cancer staging with the histopathologic results was 63.0%in the 73 patients, and was 100%(7/7) for pT4 bladder cancers. With dual-phase FDG PET/CT, the detection rate was 75.0%(6/8) for lymph node metastases, 100%(4/4) for distant metastases, and 100%(4/4) for other concurrent primary malignancies. Conclusion Though with limited accuracy in T-staging of pTa, pT1, pT2, and pT3 bladder cancer, dual-phase FDG PET/CT has important clinical value in staging of pT4 bladder cancer and in N-staging, M-staging and detection of other concurrent primary malignancies.