1.Analysis of the application value of 18F-FDG PET-CT in differentiating physiological uptake in the endometrium from stage IA endometrial carcinoma
Chunli GAO ; Guangjie YANG ; Lin AN ; Ben LI ; Yanjun LYU ; Zhonghang ZHENG ; Yi ZHANG ; Zhenguang WANG
Chinese Journal of Oncology 2025;47(4):356-362
Objective:To investigate the uptake patterns of 18F-fluorodeoxy glucose ( 18F-FDG) in the endometrium using positron emission tomography (PET) imaging and to differentiate these from stage IA endometrial cancer. Methods:From September 2022 to April 2024, a prospective inclusion of 354 women without gynecological diseases and no hormone usage who underwent 18F-FDG PET-CT examinations at the affiliated hospital of Qingdao University were set as the physiological group, while a group containing 42 cases of Stage IA endometrial carcinoma was also set. The physiological group was divided into five groups based on the menstrual cycle: menstrual period, proliferative phase, ovulatory phase, secretory phase, and menopausal phase. The images were analyzed using visual and quantitative measurements; quantitative analysis indicators were standardized uptake value maximum (SUVmax) and the region of interest/liver ratio (R/L value). Receiver operating characteristic (ROCs) curve was used to determine the optimal cutoff values for SUVmax and R/L value. A clinical model was established using binary logistic regression, and ROC curves were drawn to evaluate the predictive performance of the model. Results:The uptake of 18F-FDG in the endometrium exhibited cyclical variations throughout different physiological phases, with higher uptakes observed during the menstrual and ovulation phases (SUVmax values of 6.66±3.26 and 3.89±1.21, respectively), which are significantly higher than those in the proliferative phase [median SUVmax of 2.54 (2.02, 3.47)], secretory phase (SUVmax of 2.55±0.86), and menopausal phase [SUVmax median of 2.04 (1.69, 2.29)]. During the menstrual and ovulation phases, the radiotracer accumulation patterns were triangular in 105 cases, oval in 32 cases, and round-like in 2 cases. All 42 cases of endometrial cancer showed 18F-FDG uptake, with radiotracer accumulation patterns being round-like in 17 cases, oval in 10 cases, triangular in 9 cases, and irregular in 6 cases. There were statistically significant differences in the shapes of radiotracer concentration between the menstrual, ovulatory periods, and endometrial carcinoma (both P<0.001). The SUVmax and R/L values in menstrual period and ovulatory period were significantly lower than that in endometrial carcinoma group ( P<0.001). During the menstrual phase, the optimal cutoff values for SUVmax and R/L in distinguishing between endometrial and endometrial cancer were 12.59 and 3.81, respectively, with corresponding AUCs of 0.885 and 0.842. After incorporating endometrial uptake morphology into the model, the AUCs was improved to 0.969 and 0.948, respectively. During the ovulatory phase, the optimal cutoff values for SUVmax and R/L were 5.96 and 2.85, respectively, with AUCs of 0.984 and 0.968. After integrating endometrial uptake morphology into the model, the AUCs were increased to 0.999 and 0.998, respectively. Conclusions:The 18F-FDG PET imaging of the endometrium shows higher uptake during the menstrual and ovulatory periods, primarily triangular in shape; endometrial carcinoma uptake is significantly higher than the physiological uptake during the menstrual and ovulatory periods, mainly in circular, oval, and irregular shapes. When SUVmax≥5.96, R/L≥2.85, combined with the physiological cycle of the subjects and the morphological characteristics of the radiotracer concentration, it is possible to effectively differentiate between physiological uptake and Stage IA endometrial carcinoma.
2.The burden of noncommunicable chronic diseases attributable to metabolic factors in China from 1990 to 2021 and projections of mortality trends
Bowen ZHANG ; Yuhong HUANG ; Xi DU ; Hongrui CHEN ; Wei MU ; Yanjun SUN ; Shengwei GAO ; Zichen LYU ; Rongkun XUE ; Xiaohui YU
Chinese Journal of Endocrinology and Metabolism 2025;41(9):761-768
Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.
3.The burden of noncommunicable chronic diseases attributable to metabolic factors in China from 1990 to 2021 and projections of mortality trends
Bowen ZHANG ; Yuhong HUANG ; Xi DU ; Hongrui CHEN ; Wei MU ; Yanjun SUN ; Shengwei GAO ; Zichen LYU ; Rongkun XUE ; Xiaohui YU
Chinese Journal of Endocrinology and Metabolism 2025;41(9):761-768
Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.
4.Analysis of the application value of 18F-FDG PET-CT in differentiating physiological uptake in the endometrium from stage IA endometrial carcinoma
Chunli GAO ; Guangjie YANG ; Lin AN ; Ben LI ; Yanjun LYU ; Zhonghang ZHENG ; Yi ZHANG ; Zhenguang WANG
Chinese Journal of Oncology 2025;47(4):356-362
Objective:To investigate the uptake patterns of 18F-fluorodeoxy glucose ( 18F-FDG) in the endometrium using positron emission tomography (PET) imaging and to differentiate these from stage IA endometrial cancer. Methods:From September 2022 to April 2024, a prospective inclusion of 354 women without gynecological diseases and no hormone usage who underwent 18F-FDG PET-CT examinations at the affiliated hospital of Qingdao University were set as the physiological group, while a group containing 42 cases of Stage IA endometrial carcinoma was also set. The physiological group was divided into five groups based on the menstrual cycle: menstrual period, proliferative phase, ovulatory phase, secretory phase, and menopausal phase. The images were analyzed using visual and quantitative measurements; quantitative analysis indicators were standardized uptake value maximum (SUVmax) and the region of interest/liver ratio (R/L value). Receiver operating characteristic (ROCs) curve was used to determine the optimal cutoff values for SUVmax and R/L value. A clinical model was established using binary logistic regression, and ROC curves were drawn to evaluate the predictive performance of the model. Results:The uptake of 18F-FDG in the endometrium exhibited cyclical variations throughout different physiological phases, with higher uptakes observed during the menstrual and ovulation phases (SUVmax values of 6.66±3.26 and 3.89±1.21, respectively), which are significantly higher than those in the proliferative phase [median SUVmax of 2.54 (2.02, 3.47)], secretory phase (SUVmax of 2.55±0.86), and menopausal phase [SUVmax median of 2.04 (1.69, 2.29)]. During the menstrual and ovulation phases, the radiotracer accumulation patterns were triangular in 105 cases, oval in 32 cases, and round-like in 2 cases. All 42 cases of endometrial cancer showed 18F-FDG uptake, with radiotracer accumulation patterns being round-like in 17 cases, oval in 10 cases, triangular in 9 cases, and irregular in 6 cases. There were statistically significant differences in the shapes of radiotracer concentration between the menstrual, ovulatory periods, and endometrial carcinoma (both P<0.001). The SUVmax and R/L values in menstrual period and ovulatory period were significantly lower than that in endometrial carcinoma group ( P<0.001). During the menstrual phase, the optimal cutoff values for SUVmax and R/L in distinguishing between endometrial and endometrial cancer were 12.59 and 3.81, respectively, with corresponding AUCs of 0.885 and 0.842. After incorporating endometrial uptake morphology into the model, the AUCs was improved to 0.969 and 0.948, respectively. During the ovulatory phase, the optimal cutoff values for SUVmax and R/L were 5.96 and 2.85, respectively, with AUCs of 0.984 and 0.968. After integrating endometrial uptake morphology into the model, the AUCs were increased to 0.999 and 0.998, respectively. Conclusions:The 18F-FDG PET imaging of the endometrium shows higher uptake during the menstrual and ovulatory periods, primarily triangular in shape; endometrial carcinoma uptake is significantly higher than the physiological uptake during the menstrual and ovulatory periods, mainly in circular, oval, and irregular shapes. When SUVmax≥5.96, R/L≥2.85, combined with the physiological cycle of the subjects and the morphological characteristics of the radiotracer concentration, it is possible to effectively differentiate between physiological uptake and Stage IA endometrial carcinoma.
5.Surveillance and trend analysis of snails in Songjiang District of Shanghai from 2007 to 2023
Qi MAO ; Caiying SUN ; Anqi LI ; Weiwei LU ; Xihong LYU ; Xuehui LU ; Yanjun JIN ; Qing YU
Shanghai Journal of Preventive Medicine 2024;36(5):444-447
ObjectiveTo analyze the monitoring results and trends of Oncomelania in Songjiang District of Shanghai from 2007 to 2023, and to provide reference for future monitoring work. MethodsThe data of snail monitoring in Songjiang District from 2007 to 2023 were collected, including the location of snail spots, the number of survey frames, the area with snails, the number of frames with snails, the total number of snails, etc. The density of living snails and the occurrence rate of living snail frames were calculated. ResultsFrom 2007 to 2023, a total of 158 snail spots were found in 22 administrative villages in 4 towns in Songjiang District, including 131 emerging snail habitats (82.91%) and 27 reemerging snail habitats (17.09%). The total snail area was 175 980 m2, the number of snail frames was 10 061, and 33 302 snails were captured. The highest density was 260/0.11 m2, and 15 662 snails were dissected. No positive snails were found. The average density of living snails was 0.60/0.11 m2 and the average occurrence rate of living snail frames was 17.99%. The snail areas in different areas were Yexie Town 126 000 m2 (71.60%), Maogang Town 26 470 m2 (15.04%), Xinbang Town 17 040 m2 (9.68%), and Shihudang Town 6 470 m2 (3.68%). The average density of living snails in different areas was 0.89/0.11 m2 in Yexie Town, 0.65/0.11 m2 in Maogang Town, 0.26/0.11 m2 in Shihudang Town and 0.24/0.11 m2 in Xinbang Town. The snail areas of different snail habitats were as follows: woodland 151 250 m2(85.95%), river 13 810 m2(7.85%), ditch 6 910 m2(3.93%), farmland 4 010 m2(2.28%). The average density of living snails in different snail habitats: ditch 1.01/0.11 m2, beach 0.86/0.11 m2, woodland 0.57/0.11 m2, river 0.40/0.11 m2. The occurrence rate of living snail frames in different regions and different snail environment types showed a downward trend and the difference was statistically significant. ConclusionAlthough the snail monitoring indicators such as snail area, average living snail density and average living snail frame occurrence rate in Songjiang District are still at its historically low level, the average living snail density and average living snail frame occurrence rate are still high compared with other regions or the national average. We should focus on the upper reaches and tributaries of the Huangpu River, especially the key areas of seedling transplantation, and strengthen monitoring and supervision to reduce the risk of snail input.
6.Association between internet use and healthy lifestyles in urban adults in Hangzhou, China
Yanjun REN ; Hong XU ; Xiaohong ZHOU ; Xuefei SHENG ; Yuanyuan ZHAO ; Huami ZHANG ; Baohua HE ; Xing SU ; Jun LYU
Chinese Journal of Epidemiology 2023;44(9):1426-1433
Objective:To explore the association between internet use and healthy lifestyles in urban adults.Methods:From May to August, 2022, a face-to-face questionnaire survey was conducted in residents aged 18-64 years selected in the urban area of Hangzhou by integrated cluster stratified random sampling and Kish grid method. The information about internet use included the internet use time in the past 7 days and 12 kinds of internet use contents. Using factor analysis and K-means clustering, three types of internet use were summarized, i.e. general type, video game type and working/learning type. Healthy lifestyles were defined as active physical activity, healthy diet habit, non-smoking, non-drinking, healthy weight, and healthy waist circumference. The correlations between internet use and healthy lifestyles were evaluated by using binary logistic regression and multinomial logistic regression analyses.Results:A total of 1 624 participants were included. After adjusting for potential confounding factors, the longer internet use time group (≥8.5 h/d) was less likely to have healthy weight ( OR=0.59, 95% CI:0.41-0.85) and 5-6 healthy lifestyles ( OR=0.55, 95% CI: 0.32-0.96) compared with those with shorter internet use time group (<2.5 h/d). For different types of internet use, it was found that compared with working/learning type group, the general type group was less likely to have healthy diet habits ( OR=0.63, 95% CI: 0.46-0.86), non-drinking ( OR=0.68, 95% CI: 0.47-0.99), healthy waist circumference ( OR=0.59, 95% CI: 0.42-0.84) and 5-6 healthy lifestyles ( OR=0.40, 95% CI: 0.23-0.69), the video game type group was less likely to have active physical activity ( OR=0.73, 95% CI: 0.55-0.97) and healthy diet habits ( OR=0.79, 95% CI: 0.62-0.99). Conclusion:Too long internet use (≥8.5 h/d), general type and video game type of internet use were associated with unhealthy lifestyles.
7.Analysis on 12 cases of adrenal ganglioneuromas
Ping SUN ; Hui LYU ; Yanjun ZHAO ; Lianghua WU
Chinese Journal of Endocrine Surgery 2018;12(2):174-176
8.Risk factors of progressive motor deficit in patients with acute middle cerebral artery occlusion beyond thrombolysis time
Xuanjun LIU ; Guoshuai YANG ; Yanhui ZHOU ; Qihui CHENG ; Haili LIN ; Lyu ZHOU ; Yanjun ZHANG ; Yujie HU
Chinese Journal of Neuromedicine 2018;17(2):165-169
Objective To investigate the risk factors of progressive motor deficit (PMD) in patients with acute middle cerebral artery occlusion (MCAO) beyond thrombolysis time.Methods The clinical data of 123 patients with acute MCAO beyond thrombolysis time,admitted to our hospital from March 2015 to March 2017,were analyzed retrospectively.According to whether patients having National Institute of Health Stroke Scale (NIHSS) scores increased>2 within 5 d of admission and continued for 24 h,these patients were divided into two groups:PMD group and non-PMD group.Single factor analysis was performed on all clinical parameters that might influence PMD;in addition,the influencing factors of PMD were analyzed by multiple factor Logistic regression analysis.Results Fifty-one patients (41.5%) had PMD and 72 patients (58.5%) did not have PMD.Single factor analysis showed that the differences of randomized blood glucose level,ratio of patients with PH2 type hemorrhagic transformation,intracurricular infarct pattern,radiation crown infarct and collateral circulation pathway between the PMD group and the non-PMD group were statistically significant (P<0.05).Multiple factor Logistic regression analysis showed that ratio of patients with PH2 type hemorrhagic transformation,radiation infarct site,internal watershed infarct model and collateral circulation pathway were significantly correlated to PMD (OR=2.857,95%CI:1.037-7.869,P=0.042;OR=2.585,95%CI:1.219-5.481,P=0.013;OR=2.876,95%CI:1.327-6.232,P=0.007;OR=2.332,95%CI:1.120-4.867,P=).024).Conclusion PH2 type hemorrhagic transformation,corona radiate infarct,intemal watershed infarct model and insufficient collateral circulation pathway are the important risk factors of PMD in patients with acute MCAO beyond thrombolysis time.
9.Application value of Smart Mask technology in endovascular embolization of intracranial aneurysms
Kai ZHANG ; Qinghai HUANG ; Nan LYU ; Yanjun MAO ; Jun ZHANG ; Yongchun WANG ; Hui SHEN ; Hailing DING ; Lihe DAI
Chinese Journal of Cerebrovascular Diseases 2017;14(12):644-647
Objective To evaluate the application value of Smart Mask technology guiding micro-catheter in place for intracranial aneurysm embolization in endovascular interventional treatment. Methods The DSA data of 61 consecutive patients with unruptured intracranial aneurysm in the Department Neurosurgery,Changhai Hospital,the Second Military Medical University from August 5 to December 20,2016 were collected retrospectively. The conditions of the guildewire catheter reaching the aneurysms and the coil embolization in the Smart Mask technology group (n = 31)and conventional road map group (n = 30)were compared. The observation indexes included the differences in contrast agent dosage,exposure time,and operation time. Results The contrast agent dosage of the Smart Mask technology group and road map technology group were 192 ± 37 and 215 ± 40 ml respectively,the X-ray illumination quantity were 5913 ±1682 and 6975 ±2036 mGy respectively,and the operation time were 2. 62 ± 0. 29 h and 2. 94 ± 0. 35 h respectively. The differences were statistically significant (all P < 0. 05 ). Conclusion Using Smart Mask technology to assist endovascular embolization of intracranial aneurysms can effectively shorten the operation time,reduce the amount of X-ray radiation and contrast agent,and reduce the risk of operation.
10.The Relationship between the Development of Auditory and Speech in Children with Hearing Loss after Hearing Aid Fitting
Jing LYU ; Xueqing CHEN ; Hua ZHANG ; Jing LI ; Yanjun WU ; Shuo WANG ; Ying KONG
Journal of Audiology and Speech Pathology 2017;25(5):511-516
Objective To study the relationship between the development of auditory and speech in children with hearing loss after hearing aid fitting and discuss the development of speech with the ability of auditory in children at different stages of evaluation, with different degrees of hearing loss and different ages respectively.Methods A total of 19 children (14 boys and 5 girls) with hearing loss participated in this study.The age at hearing aid fitting ranged from 3 to 8 years old with a mean of 5.42±1.86 years old.According to their hearing levels, the children in this study were divided into two groups: the moderate hearing loss group (n=10) and the severe group (n=9).According to their ages at hearing aid fitting, all children in this study were divided into two groups: the less than or equal to six years old (n=11) and greater than six years old (n=8).MAIS and MUSS were used to evaluate their abilities of auditory and speech at pre-fitting, 1, 3, 6, 9 and 12 months after hearing aids were worn respectively.A linear and regression analysis was done in the statistic procedure.Results There was a significant correlation between the scores of MAIS and MUSS (R=0.774,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for the different evaluating stages respectively.The correlations were pre-fitting (R=0.710,P<0.05), 1 month after hearing aid fitting (R=0.774,P<0.05), 3 months after hearing aid fitting (R=0.814,P<0.05), 6 months after hearing aid fitting (R=0.819,P<0.05), 9 months after hearing aid fitting (R=0.707,P<0.05), 12 months after hearing aid fitting (R=0.649,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for MAIS (items 3~6) (Sound awareness) and MAIS (items 7~10) (Sound understanding).The correlations for MAIS (items 3~6) were (R=0.768,P<0.05), and for MAIS (items 7~10) (Sound understanding) (R=0.794,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different group of ages.The correlations for the group of <6years old were (R=0.808,P<0.05), and for the group of the ≥6 years old (R=0.775,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different groups of hearing loss levels.The correlation for the group of moderate hearing loss was (R=0.771,P<0.05), and the group of severe hearing loss (R=0.787,P<0.05).Conclusion The development of auditory ability is closely related to the speech ability.The speech abilities increase with the improvement of auditory abilities.The less severe the hearing loss is, the longer the use of hearing aids, the younger the children are, the better the speech ability improved with auditory ability development after hearing aid fitting.

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