Objective:To investigate the ability of 18F-fibroblast activation protein inhibitor (FAPI) PET/CT imaging to identify involved myocardium in patients with hypertrophic cardiomyopathy (HCM) compared with cardiac MRI. Methods:A prospective study was conducted on 50 patients (32 males, 18 females, age (43±13) years) with HCM confirmed by ultrasound or cardiac MRI in Beijing Chaoyang Hospital from July 2021 to January 2022. All patients underwent both cardiac 18F-FAPI PET/CT and MRI. The SUV max and maximum target-to-background ratio (TBR max) of the left ventricular myocardium were obtained using post-processing software. Regions with 18F-FAPI uptake not less than predefined thresholds (SUV max 40%, 50%, 60%) were defined as myocardium with positive uptake. The FAPI amount was defined as the product of TBR max and the extent of FAPI-positive uptake (FAPI%). Cardiac MRI post-processing software was used to measure the extent of left ventricular myocardial late gadolinium enhancement (LGE) (expressed as LGE%), native T 1 value, extracellular volume fraction (ECV), and myocardial deformation characteristics. Spearman rank correlation analysis was employed to assess the correlation between 18F-FAPI imaging parameters and cardiac MRI parameters, as well as the correlation between FAPI amount and the 5-year risk score for sudden cardiac death (SCD). Linear regression analysis was utilized to identify factors associated with FAPI amount. Results:When the threshold for 18F-FAPI-positive uptake in the left ventricular myocardium was set at 60%, the correlations between FAPI amount, FAPI%, and MRI parameters were optimal ( rs values: from -0.465 to 0.460, all P<0.05). Multivariate linear regression analysis revealed that HCM duration ( β=0.128, 95% CI: 0.022-0.233, P=0.008), serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels ( β=0.190, 95% CI: 0.099-0.280, P<0.001), and left ventricular ejection fraction ( β=-0.005, 95% CI: -0.011 to 0.000, P=0.041) were independent predictors of FAPI amount. FAPI amount was positively correlated with the 5-year SCD risk score across different thresholds (40%: rs=0.32, P=0.026; 50%: rs=0.29, P=0.039; 60%: rs=0.29, P=0.040). Conclusions:When the threshold for 18F-FAPI-positive uptake is set at 60%, 18F-FAPI PET/CT imaging can more effectively identify the involved myocardium in HCM. FAPI amount is correlated with the 5-year SCD risk score in patients with HCM.

The article reports the diagnosis and treatment of a patient with congenital nephrogenic diabetes insipidus(NDI) caused by vasopressin V2 receptor(AVPR2) mutation. The proband presented with polyuria and polydipsia since early childhood. Urinary retention and bilateral hydronephrosis developed during the last year. The diagnosis of NDI was confirmed through an indirect water deprivation test and copeptin measurement. Genetic testing revealed a hemizygous truncating mutation in the AVPR2 gene. This article introduces the diagnostic approach for diabetes insipidus and elaborates the clinical value of copeptin in the differential diagnosis between NDI and central diabetes insipidus. A literature review was conducted to summarize the pathogenic mechanisms, clinical features, treatment, prognosis, and management of complications in NDI with AVPR2 mutation.

Objective:To investigate the ability of 18F-fibroblast activation protein inhibitor (FAPI) PET/CT imaging to identify involved myocardium in patients with hypertrophic cardiomyopathy (HCM) compared with cardiac MRI. Methods:A prospective study was conducted on 50 patients (32 males, 18 females, age (43±13) years) with HCM confirmed by ultrasound or cardiac MRI in Beijing Chaoyang Hospital from July 2021 to January 2022. All patients underwent both cardiac 18F-FAPI PET/CT and MRI. The SUV max and maximum target-to-background ratio (TBR max) of the left ventricular myocardium were obtained using post-processing software. Regions with 18F-FAPI uptake not less than predefined thresholds (SUV max 40%, 50%, 60%) were defined as myocardium with positive uptake. The FAPI amount was defined as the product of TBR max and the extent of FAPI-positive uptake (FAPI%). Cardiac MRI post-processing software was used to measure the extent of left ventricular myocardial late gadolinium enhancement (LGE) (expressed as LGE%), native T 1 value, extracellular volume fraction (ECV), and myocardial deformation characteristics. Spearman rank correlation analysis was employed to assess the correlation between 18F-FAPI imaging parameters and cardiac MRI parameters, as well as the correlation between FAPI amount and the 5-year risk score for sudden cardiac death (SCD). Linear regression analysis was utilized to identify factors associated with FAPI amount. Results:When the threshold for 18F-FAPI-positive uptake in the left ventricular myocardium was set at 60%, the correlations between FAPI amount, FAPI%, and MRI parameters were optimal ( rs values: from -0.465 to 0.460, all P<0.05). Multivariate linear regression analysis revealed that HCM duration ( β=0.128, 95% CI: 0.022-0.233, P=0.008), serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels ( β=0.190, 95% CI: 0.099-0.280, P<0.001), and left ventricular ejection fraction ( β=-0.005, 95% CI: -0.011 to 0.000, P=0.041) were independent predictors of FAPI amount. FAPI amount was positively correlated with the 5-year SCD risk score across different thresholds (40%: rs=0.32, P=0.026; 50%: rs=0.29, P=0.039; 60%: rs=0.29, P=0.040). Conclusions:When the threshold for 18F-FAPI-positive uptake is set at 60%, 18F-FAPI PET/CT imaging can more effectively identify the involved myocardium in HCM. FAPI amount is correlated with the 5-year SCD risk score in patients with HCM.

The article reports the diagnosis and treatment of a patient with congenital nephrogenic diabetes insipidus(NDI) caused by vasopressin V2 receptor(AVPR2) mutation. The proband presented with polyuria and polydipsia since early childhood. Urinary retention and bilateral hydronephrosis developed during the last year. The diagnosis of NDI was confirmed through an indirect water deprivation test and copeptin measurement. Genetic testing revealed a hemizygous truncating mutation in the AVPR2 gene. This article introduces the diagnostic approach for diabetes insipidus and elaborates the clinical value of copeptin in the differential diagnosis between NDI and central diabetes insipidus. A literature review was conducted to summarize the pathogenic mechanisms, clinical features, treatment, prognosis, and management of complications in NDI with AVPR2 mutation.

With the increasing incidence of diabetes in China, the related complications also show a trend of " spreading" , and diabetes foot (DF) is one of the most serious complications of diabetes. The arterial disease of lower limbs in patients with DF are relatively complex, and the recovery of arterial blood supply of lower limbs is the key to improve the quality of life and limb preservation rate of patients with DF. At present, endovascular therapy is the first choice for the treatment of diabetic foot ischemic lesions in China because of its minimally invasive and quick recovery. In order to treat DF in a better and more standardized way and make patients benefit more, this paper summarized the strategies of endovascular treatment for DF ischemia by combining the objectives of DF treatment and the principles of endovascular treatment.

Lung cancer despite advancement in the medical field continues to be a major threat to human lives and accounts for a high proportion of fatalities caused by cancers globally. The current study investigated vanillin oxime, a derivative of vanillin, against lung cancer cells for development of treatment and explored the mechanism. Cell viability changes by vanillin oxime were measured using MTT assay. Vanillin oxime-mediated apoptosis was detected in A549 and NCI-H2170 cells at 48 h of exposure by flow cytometry. The CEBP homologous protein (CHOP) and death receptor 5 (DR5) levels were analysed by RT-PCR and protein levels by Western blotting. Vanillin oxime in concentration-dependent way suppressed A549 and NCI-H2170 cell viabilities. On exposure to 12.5 and 15 μM concentrations of vanillin oxime elevated Bax, caspase-3, and -9 levels in A549 and NCI-H2170 cells were observed. Vanillin oxime exposure suppressed levels of Bcl-2, survivin, Bcl-xL, cFLIP, and IAPs proteins in A549 and NCI-H2170 cells. It stimulated significant elevation in DR4 and DR5 levels in A549 and NCI-H2170 cells. In A549 and NCI-H2170 cells vanillin oxime exposure caused significant (p < 0.05) enhancement in CHOP and DR5 mRNA expression. Vanillin oxime exposure of A549 and NCI-H2170 cells led to significant (p < 0.05) enhancement in levels of phosphorylated extracellular-signal-regulated kinase and c-Jun N-terminal kinase. Thus, vanillin oxime inhibits pulmonary cell proliferation via induction of apoptosis through tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) mediated pathway. Therefore, vanillin oxime may be studied further to develop a treatment for lung cancer.

Lung cancer despite advancement in the medical field continues to be a major threat to human lives and accounts for a high proportion of fatalities caused by cancers globally. The current study investigated vanillin oxime, a derivative of vanillin, against lung cancer cells for development of treatment and explored the mechanism. Cell viability changes by vanillin oxime were measured using MTT assay. Vanillin oxime-mediated apoptosis was detected in A549 and NCI-H2170 cells at 48 h of exposure by flow cytometry. The CEBP homologous protein (CHOP) and death receptor 5 (DR5) levels were analysed by RT-PCR and protein levels by Western blotting. Vanillin oxime in concentration-dependent way suppressed A549 and NCI-H2170 cell viabilities. On exposure to 12.5 and 15 μM concentrations of vanillin oxime elevated Bax, caspase-3, and -9 levels in A549 and NCI-H2170 cells were observed. Vanillin oxime exposure suppressed levels of Bcl-2, survivin, Bcl-xL, cFLIP, and IAPs proteins in A549 and NCI-H2170 cells. It stimulated significant elevation in DR4 and DR5 levels in A549 and NCI-H2170 cells. In A549 and NCI-H2170 cells vanillin oxime exposure caused significant (p < 0.05) enhancement in CHOP and DR5 mRNA expression. Vanillin oxime exposure of A549 and NCI-H2170 cells led to significant (p < 0.05) enhancement in levels of phosphorylated extracellular-signal-regulated kinase and c-Jun N-terminal kinase. Thus, vanillin oxime inhibits pulmonary cell proliferation via induction of apoptosis through tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) mediated pathway. Therefore, vanillin oxime may be studied further to develop a treatment for lung cancer.

Objective:To investigate the expression of glutathione peroxidases 4 (GPX4) in colon adenocarcinoma and its relationship with clinicopathological features and prognosis of patients.Methods:The data set of colon adenocarcinoma was obtained from The Cancer Genome Atlas (TCGA) database to analyze the expression of GPX4 in colon adenocarcinoma tissues and its predictive value for overall survival (OS). A total of 93 colon adenocarcinoma tissues and 87 adjacent mucosa tissues after operation from November 2009 to May 2010 provided by the National Human Genetic Resources Sharing Service Platform were selected. The expression of GPX4 protein was detected by using tissue chip immunohistochemistry. The relations between the expression of GPX4 protein and the clinicopathological features and OS of colon adenocarcinoma patients were analyzed. Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. The nomogram for predicting OS rate was established and drawn.Results:The analysis of data from TCGA database showed that in 380 cases of colon adenocarcinoma, the expression of GPX4 in colon adenocarcinoma tissues were higher than that in the normal colonic mucosa tissues [the value of fragments per kilobase of exon per million fragments mapped (FPKM): 85.654 (20.351-356.237) vs. 56.230 (48.783-63.931)], and the difference was statistically significant ( Z = -6.150, P<0.05). The OS in GPX4 high-expression group (FPKM ≥83.614) were poorer than that in GPX4 low-expression group (FPKM < 83.614) (median OS time: 84.40 months vs. 94.03 months, 5-year OS rate: 58.6% vs. 72.7%), and the difference was statistically significant ( P<0.05). Tissue chip immunohistochemical staining results show that the high-expression rate of GPX4 protein in colon adenocarcinoma tissues was higher than that in adjacent normal tissues [38.0% (35/92) vs. 7.3% (6/82)], and the difference was statistically significant ( χ2 = 22.727, P<0.01); the high-expression rate of GPX4 protein in left colon adenocarcinoma tissues was higher than that in right colon adenocarcinoma tissues [47.2% (25/53) vs. 25.6% (10/39), and the difference was statistically significant ( χ2 = 4.42, P = 0.036); the 5-year OS rate of patients in GPX4 high-expression group was lower than that in GPX4 low-expression group (25.7% vs. 57.9%), and the difference was statistically significant ( χ2 = 9.051, P<0.05). Multivariate Cox proportional hazards regression model analysis showed that lymph node metastasis (stage N 1-N 3) ( HR = 2.241, 95% CI 1.242-4.046, P = 0.007) and high expression of GPX4 ( HR = 2.783, 95% CI 1.598-4.848, P<0.01) were independent factors affecting the poor prognosis of colon adenocarcinoma patients. The above factors were used to establish a nomogram for predicting the prognosis of patients with colon adenocarcinoma, the C index was 0.739, indicating that the nomogram had good predictive performance. Conclusion:The expression of GPX4 is up-regulated in colon adenocarcinoma tissues, and its high expression is related to the malignant biological behavior of the tumor and poor prognosis.

Objective:To examine the safety and feasibility of using fusion indocyanine green fluorescence imaging (FIGFI) technique for intraoperative evaluation of colorectal perfusion in the totally laparoscopic left colectomy.Methods:A retrospective cohort study was conducted to collect the clinical data of 58 patients with left colon cancer who underwent totally laparoscopic surgery at the Colorectal Surgery Department, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2019. There were 39 males and 19 females, aging (57.0±10.1)years(range:28 to 75 years). According to whether the FIGFI was used during the operation, they were divided into 36 cases in the study group and 22 cases in the control group. The clinical pathological characteristics, operative and postoperative recovery of the two groups were compared by t test, χ 2 test, and Fisher exact test. Results:All the 58 patients underwent R0 resection with totally laparoscopic surgery. In the study group, due to poor bowel blood flow after cutting the mesentery (Sherwinter score = 1), 1 patient had to be expanded the resection range until the blood flow was rich(Sherwinter score≥3), and 1 patient in the control group had the complication of postoperative anastomotic leakage of grade A. Compared with the control group, the operation time in the study group was shorter ((156.3±43.5) minutes vs. (180.4±41.3) minutes, t=-2.083, P=0.042). However, there were no significant differences in the amount of blood loss, postoperative hospital stay, postoperative time of anal exhaust, length of bowel resection, number of lymph nodes dissected, and in the incidence of postoperative complications between the two groups. Median follow-up period was 23 months (range: 18 to 37 months). There were no long-term postoperative complications such as ischemic enteritis and anastomotic stenosis in both groups. Conclusions:The FIGFI is safe and feasible to assess the blood supply of intestinal segment and anastomosis during totally laparoscopic left hemicolectomy, and is easy to operate. It is expected to reduce the incidence of anastomotic leakage.

Objective:To examine the safety and feasibility of using fusion indocyanine green fluorescence imaging (FIGFI) technique for intraoperative evaluation of colorectal perfusion in the totally laparoscopic left colectomy.Methods:A retrospective cohort study was conducted to collect the clinical data of 58 patients with left colon cancer who underwent totally laparoscopic surgery at the Colorectal Surgery Department, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2019. There were 39 males and 19 females, aging (57.0±10.1)years(range:28 to 75 years). According to whether the FIGFI was used during the operation, they were divided into 36 cases in the study group and 22 cases in the control group. The clinical pathological characteristics, operative and postoperative recovery of the two groups were compared by t test, χ 2 test, and Fisher exact test. Results:All the 58 patients underwent R0 resection with totally laparoscopic surgery. In the study group, due to poor bowel blood flow after cutting the mesentery (Sherwinter score = 1), 1 patient had to be expanded the resection range until the blood flow was rich(Sherwinter score≥3), and 1 patient in the control group had the complication of postoperative anastomotic leakage of grade A. Compared with the control group, the operation time in the study group was shorter ((156.3±43.5) minutes vs. (180.4±41.3) minutes, t=-2.083, P=0.042). However, there were no significant differences in the amount of blood loss, postoperative hospital stay, postoperative time of anal exhaust, length of bowel resection, number of lymph nodes dissected, and in the incidence of postoperative complications between the two groups. Median follow-up period was 23 months (range: 18 to 37 months). There were no long-term postoperative complications such as ischemic enteritis and anastomotic stenosis in both groups. Conclusions:The FIGFI is safe and feasible to assess the blood supply of intestinal segment and anastomosis during totally laparoscopic left hemicolectomy, and is easy to operate. It is expected to reduce the incidence of anastomotic leakage.