【Objective】 To explore the application value of ¹⁸F-PSMA PET/CT on the detection of metastatic lesions of prostate cancer with serum total prostate specific antigen (tPSA) ≤20 ng/mL and the predictive variables affecting the imaging results, and to establish a predictive nomogram for the metastasis of prostate cancer. 【Methods】 The imaging, pathological, serum and clinical data of 175 pathologically confirmed prostate cancer patients who underwent ¹⁸F-PSMA PET/CT examination during Jan.2020 and Oct.2021 were retrospectively collected.The patients were divided into metastatic group and non-metastatic group according to PET/CT imaging results, and the positive detection rate of metastatic lesions was calculated.The independent influencing factors of ¹⁸F-PSMA PET/CT in the positive detection of metastatic lesions were determined with univariate and multivariate logistic regression analyses.The predictive nomogram was established. 【Results】 Of the 175 patients, metastatic lesions were detected in 78 cases and not detected in 97 cases, with a detection rate of 44.6% (78/175).There were statistically significant differences between the metastatic group and the non-metastatic group in urinary tract symptoms, androgen deprivation treatment (ADT) at the time of PET/CT examination and the risk level of Gleason score (GS) (P<0.05).Univariate logistic regression showed that urinary tract symptoms(OR=3.64, P<0.001), GS risk (OR=3.96, P<0.001) and concurrent ADT treatment (OR=3.71, P<0.001) were associated with the positive detection rate of metastatic lesions.Multivariate Logistic regression showed that urinary tract symptoms (OR=3.19, P=0.002), GS high-risk group (OR=2.95, P=0.005) and concurrent ADT treatment (OR=3.27, P=0.001) were independent predictors of positive detection rate. 【Conclusion】 The probability of metastasis in newly diagnosed prostate cancer patients with tPSA≤20 ng/mL is high.¹⁸F-PSMA PET/CT is of high value for the early detection of metastasis.Urinary tract symptoms, GS high-risk group and concurrent ADT treatment are independent predictors of metastatic lesions.The predictive nomogram can help assist clinical optimization of imaging examination path.

Objective:To explore the impact of home enteral nutrition (HEN) on the treatment strategy of patients with high position intestinal fistula.Methods:The clinical and follow-up data of 36 patients with high position intestinal fistula requiring HEN treated in Beijing Tsinghua Changgung Hospital from Jan 2021 to Sep 2023 was retrospectively analyzed.Results:Among the 36 cases, 2 had indwelling nasogastric tubes, 12 had indwelling nasojejunal nutritional tubes, and 22 had percutaneous jejunostomy. The incidence of HEN-related complications in patients was 13.9%, and there were no serious catheter complications.During HEN, high position intestinal fistula healed in 19 cases (52.8%), returned to the hospital for the next stage of intestinal fistula treatment in 11 cases (30.6%), needed to return to the hospital for nutritional support in 1 case (2.8%), and intestinal fistula aggravated to terminate HEN in 2 cases (5.6%).Conclusion:Under the management of professional team, HEN via nasogastric/jejunal nutritional tube or percutaneous jejunostomy is safe and feasible in patients with high intestinal fistula.

Objective:To evaluate the diagnostic value of the 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in seminal vesicle invasion (SVI) of prostate cancer. Methods:Clinical and pathological materials of 88 patients (age: 51-84 years) who underwent radical prostatectomy (RP) between May 2019 and December 2021 in the First Affiliated Hospital of Xi′an Jiaotong University were analyzed retrospectively. All patients underwent 18F-PSMA-1007 PET/CT examination for primary staging before surgery. The diagnostic efficiency of 18F-PSMA-1007 PET/CT in SVI was obtained using postoperative pathological results as the " gold standard" and ROC curve was drawn. Furthermore, univariate and multivariate logistic regression analyses were used to screen the influencing factors for 18F-PSMA-1007 PET/CT prediction of SVI. Results:The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing SVI were 79.55%(70/88), 72.73%(16/22), 81.82%(54/66), 57.14%(16/28) and 90.00%(54/60), respectively. The ROC AUC was 0.77. Results of univariate logistic regression showed that total prostate specific antigen (tPSA), primary SUV max, Gleason score, International Society of Urological Pathology (ISUP) grade group were associated with 18F-PSMA-1007 PET/CT prediction of SVI. Results of multivariate logistic regression showed that Gleason score (odds ratio ( OR)=2.04, 95% CI: 1.19-3.50, P=0.009) was a predictor of SVI in prostate cancer. Conclusion:18F-PSMA-1007 PET/CT has certain diagnostic value in SVI of prostate cancer, and combining with Gleason score can improve the diagnostic efficiency.

【Objective】 To analyze the correlation of whole body tumor burden of ¹⁸F-prostate specific membrane antigen positron emission computed tomography （¹⁸F-PSMA PET/CT） with prostate specific antigen （PSA） and Gleason score so as to evaluate the value of ¹⁸F-PSMA PET/CT whole body tumor burden for predicting serum PSA progression in prostate cancer. 【Methods】 We retrospectively recruited 213 patients with prostate cancer who underwent ¹⁸F-PSMA PET/CT scanning from March 2019 to April 2021. The serum PSA and Gleason score were collected. Whole body tumor burden was measured by a semi-automatic method. The correlation of tumor burden with serum PSA and Gleason score was analyzed. After radical prostatectomy， the patients were divided into groups according to negative or positive ¹⁸F-PSMA PET/CT. PSA differences between groups were compared， and the receiver operating characteristic curve （ROC） of the subjects was drawn so as to obtain the threshold value of PSA to predict the positive rate of ¹⁸F-PSMA PET/CT. The patients were followed up for PSA after radical surgery， divided into groups according to the progress of PSA， and the differences in tumor burden between groups were compared. 【Results】 In Gleason score ≤7， =8， and ≥9 groups， whole body tumor burden was correlated with PSA in each group （P=0.001）， and tumor burden significantly differed between the groups （P<0.001）. In initial diagnosis and treatment group， biochemical recurrence group， and medication group， the correlation between tumor burden and PSA was statistically significant （P=0.001）. The Gleason score of primary prostate lesion was significantly correlated with systemic tumor burden （P<0.001）. The area under ROC curve of PSA predicting the positive rate of ¹⁸F-PSMA PET/CT after radical prostatectomy was 0.821； when PSA>0.577 ng/mL， the sensitivity and the specificity were 66.7% and 96.8%， respectively. The mean whole body tumor burden in ¹⁸F-PSMA PET/CT positive patients with PSA progression was higher than that in patients without PSA progression. 【Conclusion】 The whole body tumor burden of ¹⁸F-PSMA PET/CT is significantly correlated with PSA， which is helpful in predicting the serum PSA progression in prostate cancer. PSA can predict the positive rate of ¹⁸F-PSMA PET/CT to a certain extent. At the same time， PSA can also predict positive results of ¹⁸F-PSMA PET/CT to a certain extent， and guide clinical rational selection of this examination.

【Objective】 To investigate the value of prostate-specific antigen （PSA） level， Gleason score， and PSMA PET/CT maximum standardized uptake value （SUVmax） in predicting prostate cancer （PCa） metastasis and the treatment option of oligometastatic PCa. 【Methods】 We retrospectively recruited 170 patients with PCa confirmed by pathology， 97 of whom were untreated， and divided them into nonmetastatic group， oligometastatic group （metastasis≤5）， and polymetastatic group. In addition， 28 patients with oligometastatic PCa underwent radical prostatectomy and 45 patients underwent androgen-deprivation therapy. We compared the differences in SUVmax， PSA， and Gleason scores between the three sub-groups of untreated patients， and also analyzed the correlation between SUVmax of local cancer lesions， Gleason score and PSA level. We further compared the differences in SUVmax and PSA levels between radical prostatectomy and androgen-deprivation therapy of oligometastatic PCa patients. According to Gleason score， patients with oligometastatic PCa were divided into two groups （low-intermediate risk group with Gleason score ≤7 and high-risk group with Gleason score ≥8）， and the levels of SUVmax and PSA between the groups were compared. 【Results】 With the increasing number of metastases， SUVmax， PSA levels and Gleason scores all showed an upward trend， and there were significant differences among the three groups （P=0.029， P=0.001， P=0.046）. The post-hoc test found significant difference in Gleason score between the oligometastatic group and the other two groups （P=0.043， P=0.002） as well as correlation of SUVmax level of the primary tumor with Gleason score and PSA （P=0.002， r=0.315； P<0.001， r=0.430）. There was significant difference in PSA level between the two groups after radical prostatectomy and androgen-deprivation therapy （P=0.017）. The difference in PSA between the two treatments persisted in the low-intermediate risk groups （P=0.021）. 【Conclusion】 PSA level， Gleason score and SUVmax have some value in predicting PCa metastasis. Radical prostatectomy is an effective treatment strategy for patients with oligometastatic PCa， especially those with low-intermediate Gleason score.

【Objective】 To investigate the value of prostate cancer prevention trial risk calculator （PCPT-RC） combined with biopsy Gleason score for predicting the risk of metastasis in newly diagnosed prostate cancer patients. 【Methods】 We retrospectively collected the data of 74 patients with newly diagnosed prostate cancer confirmed by biopsy from April 2019 to August 2021， concurrent with ¹⁸F-PSMA-1007 PET/CT whole body imaging in the same period. Based on this， a binary logistic regression model was established to obtain the high risk probability of PCPT. We calculated the receiver operating characteristic curve （ROC） was drawn and the area under the curve， Yuden index， sensitivity， specificity， positive predictive value and negative predictive value. We compared the predictive value of the prostate cancer prevention trial risk calculator and Gleason score alone or in combination in predicting the risk of prostate cancer metastasis. 【Results】 Based on the PSMA PET/CT results， 74 patients were divided into non-metastatic group （46/74） and metastatic group （28/74）. PCPT high risk probability ［41.14% （16%-67%）］ vs. ［30.89% （5%-65%）］， Gleason score ［8.5（6-10） score］ vs. ［7.7（6-9） score］， tPSA ［26.24（5.70-42.32） ng/mL］ vs. ［19.58（2.47-49.35） ng/mL］， and fPSA ［3.94（0.82-12.00） ng/mL］ vs. ［2.33（0.35-10.20） ng/mL］ were significantly higher in metastatic group than in non-metastatic group. Binary Logistic regression analysis showed that Gleason score and PCPT low risk probability may be independent predictors of prostate cancer metastasis. PCPT low risk probability alone did not predict the risk of prostate cancer metastasis （P=0.172）. The predictive accuracy of Gleason score and high probability of PCPT in predicting prostate cancer metastasis were 0.715 and 0.679， respectively， and the accuracy of the combined prediction was 0.809. 【Conclusion】 PCPT-RC combined with Gleason score is valuable for predicting the metastasis risk of newly diagnosed prostate cancer patients， which has certain guiding significance for clinical individualized treatment.

BACKGROUND: The pulmonary microbiome is closely related to the occurrence of pulmonary diseases. The morbidity and mortality of lung cancer are relatively high in the world. It has been confirmed that lung microecology changes in lung cancer patients compared with healthy individuals. Furthermore, the abundance of some bacterial species shows obvious changes, suggesting their potential use as a microbial marker for the detection of lung cancer. The composition of the pulmonary microbiome in patients with different histological types of lung cancer has not been determined. We aim to study the correlation and difference of microbiome between different histological types of lung cancer. METHODS: Illumina HiSeq high-throughput sequencing technology was used to sequenced the 16S rDNA V3-V4 region of bacterial in sputum samples of patients with advanced lung cancer. RESULTS: It was found that Streptococcus, Neisseria and Prevotella were the main bacteria of lung cancer patients. Advantage bacterium group differ between different histological types of lung cancer. Adenocarcinoma (AD) group was dominated by Streptococcus and Neisseria, followed by Veillonella. Small cell lung cancer (SCLC) group was dominated by Neisseria, followed by Streptococcus. Squamous carcinoma (SCC) group was dominated by Streptococcus, followed by Veillonella. Combined small cell lung cancer (C-SCLC) group was dominated by Streptococcus, followed by Prevotella. CONCLUSIONS The pulmonary bacterial microbiome of lung cancer of different histological types is different. This experiment enrichs the pulmonary bacterial microbiome data of lung cancer and fills the gap of pulmonary microbiome of small cell lung cancer.

Recently, unsupervised deep learning methods have shown great potential in image processing. Compared with a large-amount demand for paired training data of supervised methods with a specific task, unsupervised methods can learn a universal and explicit prior information on data distribution and integrate it into the reconstruction process. Therefore, it can be used in various image reconstruction environments without showing degraded performance. The importance of unsupervised learning in MRI reconstruction appears to be growing. Nevertheless, the establishment of prior formulation in unsupervised deep learning varies a lot depending on mathematical approximation and network architectures. In this work, we summarized basic concepts of unsupervised deep learning comprehensively and compared performances of several state-of-the-art unsupervised learning methods for MRI reconstruction.

BACKGROUND:There are a lot of adipose-derived stem cel s in the vascular stroma. These cel s are shown to play a very important role in the fat granule transplantation.
OBJECTIVE:To explore the role of adipose-derived stem cel s in the fat granule transplantation.
METHODS:Normal adipose tissues were obtained from 10 male BALB/C mice, SPF grade. Adipose-derived stem cel s and fat granules were extracted from the abdominal fat tissues. Another 24 nude mice acted as recipients and were assigned into control, fat granule transplantation or mixed transplantation (adipose-derived stem cel s+fat granules) groups. In the latter two groups, fat granule suspension and suspension of fat granules and adipose-derived stem cel s were injected into the shoulder of rats, respectively. In the control group, the same volume of cel medium was injected. Four weeks later, separated plasma and grafts were taken out for indicator measurement.
RESULTS AND CONCLUSION:Compared with the fat granule transplantation group, the mixed transplantation could remarkably increase the weight of grafts, while reduce the absorption of grafted fat tissues (P<0.01). After transplantation, the highest level of vascular endothelial growth factor in the plasma was obtained in the mixed transplantation group fol owed by fat granule transplantation group and control group (P<0.01). Level of basic fibroblast growth factor and microvessel density were significantly higher in the mixed transplantation group than the fat granule transplantation group (P<0.01). Better cel morphology and higher number of fat droplets were found in the mixed transplantation group compared with the fat granule transplantation group. Al these results indicate that adipose-derived stem cel transplantation can remarkably promote the expression of basic fibroblast growth factor, improve graft microcirculation, and improve morphology and function of fat granules.

Objective To compare the value of apparent diffusion coefficient (ADC) value and the standardized apparent dif‐fusion coefficient (ADC) value in diagnosing malignancy degree of prostate cancer .Methods Diffusion weighted imaging (DWI) results of 34 patients with prostate cancer proved pathologically were retrospectively analyzed .The ADC values in 49 lesions and normal peripheral zones of the prostates of the patients were measured .Then ,ADC values of the lesions were calculated .According to the results of Gleason score ,the lesions were divided into 3 groups:Gleason score≤6 (low‐risk group) ,Gleason score=7 (inter‐mediate‐risk group) and Gleason score≥8 (high‐risk group) .Statistical analysis was performed to evaluate the differences of the ADC values and sADC values in three groups ,and to evaluate the correlation between Gleason score and ADC value or sADC value . Results There were statistically differences overall in ADC values and sADC values of the three groups (P<0 .01) .There was no difference between the intermediate‐risk and high‐risk group in ADC values (P> 0 .05) ,however ,there were difference between sADC values of three groups each other (P< 0 .05) .ADC values (r= -0 .546 ,P=0 .000) and sADC values (r= -0 .575 ,P=0 .000) showed all negative correlation with Gleason score .There were no differences between sADC values and ADC values of three groups in areas under the receiver operating characteristic curve (AUCs) (P>0 .05) .However ,when change the specificity to 100% ,sADC had higher sensitivity than ADC values (47 .5% vs .5 .6% ,78 .2% vs .50 .9% ) in differentiating low‐risk from inter‐mediate‐risk group ,and low‐risk from high‐risk group .Conclusion ADC value and sADC value showed all negative correlation with Gleason score ,but sADC value may be of higher performance in diagnosing malignancy degree of prostate cancer .