Objective:To prepare ((2-(2-chlorophenyl)-3-(4-((2- 18F-fluoroethyl)oxy)phenyl)-5, 6, 7, 8-tetrahydrooxepino[3, 2-c]pyrazol-8-yl)amino)methanoic acid methyl ester ( 18F-JR-1001) and evaluate its binding affinity to the cannabinoid type 1 receptor (CB1R). Methods:18F-JR-1001 was synthesized using an integrated automated synthesis module, and its radiochemical yield (RCY) and molar activity were determined. Cell-specific uptake, lipid-water partition coefficient (log P), competitive binding assays, and in vitro stability tests were performed. Rimonabant-fed rat models (blocking group) with pre-occupied CB1R were established. Radioautography and microPET/CT imaging were conducted on both the blocking group and normal Sprague-Dawley (SD) rats to evaluate the brain uptake of 18F-JR-1001 and its blood-brain barrier (BBB) penetration capability. Results:The RCY of the synthetic 18F-JR-1001 after decay correction was (32.5±9.2)% ( n=10), with the molar activity of (194.6±67.3)GBq/μmol. Cell experiments demonstrated that 18F-JR-1001 exhibited specificity for CB1R, with log P of 3.40±0.11 ( n=3) and half-maximal inhibitory concentration of 0.975nmol/L. Within 3h at 37℃, the radiochemical purity of 18F-JR-1001 in physiological saline and blood remained above 92%, with no significant radioactive by-product peaks observed. Radioautography showed that the whole brain uptake of 18F-JR-1001 in the blocking group was 65.6% of that in normal SD rats. MicroPET/CT imaging showed that the mean whole brain uptake of 18F-JR-1001 in the blocking group was 0.4706, which was lower than that in normal SD rats (1.0561). Additionally, continuous scanning for 60min demonstrated that 18F-JR-1001 exhibited good BBB penetration capability. Conclusion:The synthesized 18F-JR-1001 meets the requirements of production and application, and is proved the potential as a CB1R-targeted tracer in the in vitro experiments, microPET/CT imaging and radioautography.

Objective To observe the value of ultrasound,CT and the combination for evaluating thyroid cancer(TC)involved peripheral structures.Methods Totally 102 patients with advanced TC were enrolled,and the value of ultrasound and CT for evaluating TC involved peripheral structures were analyzed taken post resection pathology as gold standards.Results The ultrasonic detection rate of TC involved laryngeal recurrent nerve and strap muscle was 47.37％(18/38)and 72.73％(24/33),while the CT detection rate was 15.79％(6/38)and 39.39％(13/33),respectively,the formers were better than the latters(both P＜0.05).Ultrasound had high sensitivity(88.24％),specificity(97.06％),and accuracy(94.12％)for diagnosing TC involved trachea,also had fair sensitivity(72.73％,72.73％),high specificity(96.70％,97.10％)and accuracy(94.12％,89.22％)for diagnosing TC involved thyroid cartilage and strap muscle.CT had high sensitivity(90.91％),specificity(92.31％)and accuracy(92.16％)for diagnosing TC involved thyroid cartilage,while had fair sensitivity(50.00％—76.47％)and high specificity(82.35％—88.46％)for diagnosing TC involved trachea,esophagus and blood vessels.The sensitivity and accuracy of combination of ultrasound and CT for evaluating TC involved peripheral structures were both higher than of each single method alone.Conclusion Combination of ultrasound and CT was valuable for evaluating TC involved peripheral structures.

Objective To observe the value of ultrasound,CT and the combination for evaluating thyroid cancer(TC)involved peripheral structures.Methods Totally 102 patients with advanced TC were enrolled,and the value of ultrasound and CT for evaluating TC involved peripheral structures were analyzed taken post resection pathology as gold standards.Results The ultrasonic detection rate of TC involved laryngeal recurrent nerve and strap muscle was 47.37％(18/38)and 72.73％(24/33),while the CT detection rate was 15.79％(6/38)and 39.39％(13/33),respectively,the formers were better than the latters(both P＜0.05).Ultrasound had high sensitivity(88.24％),specificity(97.06％),and accuracy(94.12％)for diagnosing TC involved trachea,also had fair sensitivity(72.73％,72.73％),high specificity(96.70％,97.10％)and accuracy(94.12％,89.22％)for diagnosing TC involved thyroid cartilage and strap muscle.CT had high sensitivity(90.91％),specificity(92.31％)and accuracy(92.16％)for diagnosing TC involved thyroid cartilage,while had fair sensitivity(50.00％—76.47％)and high specificity(82.35％—88.46％)for diagnosing TC involved trachea,esophagus and blood vessels.The sensitivity and accuracy of combination of ultrasound and CT for evaluating TC involved peripheral structures were both higher than of each single method alone.Conclusion Combination of ultrasound and CT was valuable for evaluating TC involved peripheral structures.

Objective:To prepare ((2-(2-chlorophenyl)-3-(4-((2- 18F-fluoroethyl)oxy)phenyl)-5, 6, 7, 8-tetrahydrooxepino[3, 2-c]pyrazol-8-yl)amino)methanoic acid methyl ester ( 18F-JR-1001) and evaluate its binding affinity to the cannabinoid type 1 receptor (CB1R). Methods:18F-JR-1001 was synthesized using an integrated automated synthesis module, and its radiochemical yield (RCY) and molar activity were determined. Cell-specific uptake, lipid-water partition coefficient (log P), competitive binding assays, and in vitro stability tests were performed. Rimonabant-fed rat models (blocking group) with pre-occupied CB1R were established. Radioautography and microPET/CT imaging were conducted on both the blocking group and normal Sprague-Dawley (SD) rats to evaluate the brain uptake of 18F-JR-1001 and its blood-brain barrier (BBB) penetration capability. Results:The RCY of the synthetic 18F-JR-1001 after decay correction was (32.5±9.2)% ( n=10), with the molar activity of (194.6±67.3)GBq/μmol. Cell experiments demonstrated that 18F-JR-1001 exhibited specificity for CB1R, with log P of 3.40±0.11 ( n=3) and half-maximal inhibitory concentration of 0.975nmol/L. Within 3h at 37℃, the radiochemical purity of 18F-JR-1001 in physiological saline and blood remained above 92%, with no significant radioactive by-product peaks observed. Radioautography showed that the whole brain uptake of 18F-JR-1001 in the blocking group was 65.6% of that in normal SD rats. MicroPET/CT imaging showed that the mean whole brain uptake of 18F-JR-1001 in the blocking group was 0.4706, which was lower than that in normal SD rats (1.0561). Additionally, continuous scanning for 60min demonstrated that 18F-JR-1001 exhibited good BBB penetration capability. Conclusion:The synthesized 18F-JR-1001 meets the requirements of production and application, and is proved the potential as a CB1R-targeted tracer in the in vitro experiments, microPET/CT imaging and radioautography.

OBJECTIVE To determine the prevalence of frontal recess cells variations in patients with frontal sinus associated headache according to the International Frontal Sinus Anatomy Classification(IFAC).METHODS A retrospective study was conducted on the CT scans of sinuses in patients with frontal sinus associated headache.We reviewed 46 patients with frontal sinus-related headache who had clinical symptoms and were relieved after nasal endoscopic surgery.The development of frontal recess cells in the frontal recess drainage area was analyzed,and the variation of middle meatus and sinus involvement were analyzed in the same time.The Anatomical variations and imaging characteristics of frontal recess cells development in patients with frontal sinus associated headache were analyzed.RESULTS A total of 92 sinus CT profiles were analyzed in 46 patients.The most common cells were agger nasi cell(ANC)(100%,92/92),followed by supra bulla cell(SBC)(78.3%,72/92),supra agger cell(SAC)(67.4%,62/92),supra bulla frontal cell(SBFC)(27.2%,25/92),supra agger frontal cell(SAFC)(20.7%,19/92),frontal septal cell(FSC)(8.7%,8/92)and supraorbital ethmoid cell(SOEC)(0%,0/92).In the conventional frontal sinus drainage area,SAFC(P=0.0108),SAC(P=0.0104)and SAFC(P=0.0088)in the IFAC classification were significantly associated with the occurrence of frontal sinus associated headache.At the same time,the middle concha bullosa also showed a significant correlation with the occurrence of frontal sinus associated headache in the lower segment of the frontal recess drainage channel(P=0.0390).CONCLUSION In the frontal recess drainage channel,the abnormal development of SAC,SAFC,SBFC and the middle concha bullosa are significantly correlated with frontal sinus associated headache.

The temporomandibular joint is the only joint structure within the craniofacial skeletal system,responsible for performing functions related to opening and closing mouth movements,such as chewing,speaking,and facial expression in daily life.The condyle of the mandible,as a vital component of the temporomandibular joint,originates from the mandibular process formed by the first gill arch and is the key growth center at the end of the mandibular ramus.Condyle is composed of a layer of cartilage as its surface and subchondral bone below,exhibiting unique biological processes during its growth and development.In the articular fossa,the functional movement of the condyle depends on its normal physiological and anatomical structure,which plays a crucial role in establishing occlusion and shaping facial features.Abnormal growth and development can lead to the occurrence of condylar deformities,which affect the vertical height of the patient's maxillofacial region and ultimately lead to secondary skeletal class Ⅱ or Ⅲ craniofacial deformities.During the process of growth and development,the condyle is subject to complex signal regulation.In recent years,with in-depth research on the temporomandibular joint,researchers have begun to discuss the regulatory mechanisms of condyle growth and development from the perspectives of gene expression and molecular level,in order to explain the causes of temporomandibular joint diseases and condylar deformities.This article provides a review on the growth process and structure of condyle,classification and pathological manifestations of condylar deformities,and related regulatory mechanisms of the growth and development of condyle,as well as pathogenesis of condylar deformities.The aim of this article is to provide research ideas for temporomandibular joint diseases and craniofacial malformations caused by abnormal development of the mandibular condyle in clinical practice.

Objective:To investigate the feasibility of simultaneous arteriovenous enhancement of neck CT with two-stage injection of contrast agent and its effect on image quality and radiation dose.Methods:A total of 30 patients undergoing neck CT enhancement scan due to space-occupying lesions in Beijing Tongren Hospital, Capital Medical University from February to April 2022 were prospectively included as the experimental group. The neck CT enhancement scan was performed with two-stage injection of contrast agent and arteriovenous simultaneous enhancement. The dosage of contrast agent was calculated according to the patient′s body weight, and the method of two-stage injection was adopted. The dosage of contrast agent in the first stage was 0.7 ml/kg, with normal saline in the middle stage, and the second stage (began at 35 s) was 0.3 ml/kg. A total of 30 patients with gender and age matching with the experimental group from December 2021 to January 2022 were retrospectively collected as the control group. The control group was treated with the traditional arterial phase and venous phase scanning method with the dosage of 1.0 ml/kg contrast agent. The arterial phase was scanned at the 30 s and the venous phase was scanned at the 60 s. The CT values of bilateral carotid arteries and jugular veins in the experimental group were measured, the CT values of bilateral carotid arteries in the arterial phase were measured in the control group, and the CT values of bilateral carotid arteries and jugular veins in the venous phase were measured. Carotid artery enhancement score was performed for images of experimental group and control group in arterial and venous phase, and jugular vein and lesion enhancement score was performed for images of experimental group and control group in venous phase. The effective dose was calculated for both groups. The difference of carotid artery CT values between images was compared by one-way analysis of variance, and LSD method was used for pairwise comparison. The CT values of jugular vein were compared using independent sample t test. Kruskal-Wallis test was used to compare carotid artery enhancement scores, and Nemenyi method was used for pairwise comparison. Jugular vein and lesion enhancement scores and effective dose were compared by Mann-Whitney U test. Results:The CT value of carotid artery of experimental group [left (276±24) HU, right (273±25) HU] was lower than that of control group in arterial phase [left (329±33) HU, right (327±32) HU], and higher than that in the venous phase [left (147±15) HU, right (148±16) HU]. All the differences were statistically significant ( P<0.001). The CT value of jugular vein of experimental group [left (206±18) HU, right (203±19)] was higher than that of control group in the venous phase [left (154±15) HU, right (151±15)], the difference was statistically significant ( t=11.88, 11.76, both P<0.001). There was no significant difference in carotid artery enhancement score between experimental group and control group in arterial phase ( P=0.624), but the carotid artery enhancement score of the experimental group was higher than that of the control group in the venous phase, and the difference was statistically significant ( P<0.001). The scores of jugular vein and lesion enhancement in experimental group were higher than those of control group in venous phase, and the difference was statistically significant ( Z=5.01, P<0.001). The effective dose of the experimental group [2.41(2.04, 2.72) mSv] was decreased by 52.2% compared with the control group [5.04(4.18, 5.44) mSv], and the difference was statistically significant ( Z=-6.24, P<0.001). Conclusions:The neck CT enhanced scan with two-stage injection of contrast agent and arteriovenous simultaneous enhancement method can obtain comprehensive images of arterial and venous phases, and realize simultaneous enhancement of carotid artery, jugular vein and lesions, and reduce radiation dose.

Objective:To investigate the feasibility of the application of low tube potential scanning in dacryocystography CT.Methods:The mixture of iohexol and saline with the ration of 1∶3 as the dacryocyst was set on the nose wing of the head-neck phantom. The phantom was scanned at 80, 100, 120, 140 kV with appropriate mAs to set the volume CT dose index(CTDI vol)at 10, 15, 20, 25, 30, 35 or 40 mGy. All the images were objectively evaluated to find out the optimal scanning parameters of 80 kV/240 mAs with the same contrast-to-noise ratio(CNR)of conventional scanning condition of 120 kV/180 mAs. A total of 62 patients who conducted dacryocystography CT in Beijing Tongren Hospital from November 2019 to July 2020 were prospectively selected. They were randomly divided equally into conventional scanning group with 120 kV/180 mAs and low tube potential group with 80 kV/240 mAs. The CT number, noise (SD) and contrast-to-noise ratio (CNR) of the two groups were measured as the objective evaluation indicators of image quality. The subjective evaluation was performed by two senior radiologists using a double-blind method and a 5-scale system evaluation. Results:For the phantom study, the CNR was positively correlated with CTDI vol under the same tube potential ( r=0.985, 0.965, 0.971, 0.972, P < 0.05). With the same CNR, the radiation dose decreased with lower tube potential. Under the conventional scanning parameters of 120 kV/180 mAs, the CNR was 27.8. At the same CNR, the optimal scanning parameters were 80 kV/240 mAs. For the clinical study, the CTDI vol of conventional scanning group and low tube potential group were 31.2 and 12.8 mGy respectively, 59% decreased in low tube potential group. There were statistically significant differences in CT number of dacryocyst area, CT number of orbital fat area and noise between the two groups ( t=-3.476, 2.601, -5.704, P < 0.05). There was no statistically significante difference in CNR between 2 groups( P>0.05). Two observers had a good consistency ( Kappa >0.75). There was no statistically significante difference in subjective rating between 2 groups( P>0.05). Conclusions:Low tube potential scanning could obtain satisfactory image quality in dacryocystography CT at much lower radiation dose.

We strive to explore a student-centered evaluation system focused on improving students' learning efficiency and learning effect. Through classroom questioning, discussion of difficult cases, new progress report, question bank test, writing of clerkship notes, simulated inquiry between students with bedside inquiry, physical examination between students with bedside physical examination, operation training of basic clinical skills, direct observation and evaluation of clinical skills, mini-clinical exercise evaluation, graduation examination and other measures, an evaluation system for promoting learning by class evaluation, clerkship evaluation and practice evaluation has been established to cultivate the connotation construction of medical moral quality and clinical practice ability of medical students, and further promote the mastery of basic theoretical knowledge and clinical operation skills. By comparing the results of the phased examination for medical practitioners, the passing rate of 2018 is significantly higher than that of 2017, with 23.31% increased passing rate of theoretical results, and 0.79% increased passing rate of skills operation results. It can be seen that the evaluation system for promoting learning has played a guiding role in the teaching practice of clinical courses in our hospital.

Objective To observe the clinical efficacy of hyperbaric oxygen (HBO) in the treatment of flat type sudden hearing loss (SHL).Methods A retrospective analysis was made on 71 cases of flat type SHL treated with HBO.The patients were treated with HBO once a day,10 days a treatment course.Pure-tone averages (PTAs) at 4 frequencies (500,1 000,2 000,4 000 Hz) were compared before and after HBO therapy,and therapeutic efficacy was analyzed.Results Forty-four patients (the invalid group) began HBO therapy,when conventional treatment was invalid.PTAs before and after HBO therapy were respectively (59.50 ± 10.58) dB HL and (39.18 ± 18.95) dB HL,and statistical significance could be noted,when comparisons were made between them (P ＜ 0.01).Twenty-seven patients (the initial group) received HBO therapy at the initial treatment stage.PTAs for the patients of this group before and after HBO therapy were respectively (60.81 ± 10.40) dB HL and (31.89 ± 16.24) dB HL,and there was statistical significance,when comparisons were made between them (P ＜ 0.01).Total efficacy rates for the 2 groups after treatment were respectively 61.36％ and 81.48％,and statistical significance could be seen,when comparisons were made between them(t =8.566,P ＜ 0.01).The treatment time from the onset to HBO therapy for the patients of the 2 groups was (16.32 ± 3.65) days and (9.07 ± 6.85) days respectively,and statistical significance could be noticed,when comparisons were made between the 2 groups (P ＜0.01).The treatment time from the onset to HBO therapy for the invalid group was ＞ 14 days,accounting for 53.33％ of the patients treated(30/44),while the treatment time from the onset to HBO therapy for the initial group was ≤ 14 days,accounting for 90.0％ (20/27),and statistical significance could also be noted,when comparisons were made between the 2 groups(P ＜ 0.01).When correlative analyses were made between HBO initiation time and effective rate,it could be seen that HBO initiation time was positively correlated with treatment efficacy (r =0.434,P ＜ 0.01).Conclusions HBO therapy could be used as one of the methods in the comprehensive treatment of flat type SHL,and the earlier HBO treatment was implemented,the better the results.