177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To investigate the clinical value of serum monocyte/high-density lipoprotein ratio (MHR) level in the diagnosis of coronary heart disease(CHD).Methods:A total of 127 patients who underwent coronary angiography in the cardiology department of the Third Hospital of Changsha were enrolled as subjects. Patients with coronary artery stenosis ≥50% were included in the CHD group ( n=97), and patients with coronary artery stenosis <50% were included in the control group ( n=30). According to the clinical classification of CHD, the patients were divided into stable angina group ( n=31), unstable angina group ( n=35) and acute myocardial infarction group ( n=31). The general clinical data of the selected cases were collected, and the serum MHR, myeloperoxidase (MPO) and high sensitivity C-reactive protein (hs-CRP) were detected. The degree of coronary artery lesions was scored by Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) score system, and the number of coronary artery lesions was counted. The relationship between MHR level, MPO, hs-CRP and the degree of coronary artery stenosis in CHD group was analyzed. The MHR level of CHD was divided into three subgroups by triquartile: the differences of SYNTAX score and the number of coronary artery lesions were compared in the low MHR group (≤0.41, n=40), the middle MHR group (0.410.48, n=27). The value of serum MHR in diagnosing CHD was analyzed by receiver operating characteristic (ROC) curve. The risk factors of CHD were analyzed by multivariate logistic regression. Results:(1) The serum MHR level in CHD group was higher than that in non-CHD group ( P<0.001). In different clinical subgroups of CHD: the levels of serum MHR were significantly higher in acute myocardial infarction group than unstable angina group and stable angina group ( P<0.001). (2) There was a positive correlation between serum MHR, MPO level with SYNTAX score in CHD group ( r=0.878, 0.477, 0.285, all P<0.001). (3) The SYNTAX score in high MHR group was higher than those in middle MHR and low MHR group; the SYNTAX score in middle MHR group was higher than that of low MHR group ( P<0.001); There was no significant difference in the number of coronary artery lesions among the three MHR level subgroups ( P>0.05). (4) Multivariate logistic regression analysis showed that LDL-C ( OR=1.107, 95% CI: 0.974-1.259), MHR ( OR=1.873, 95% CI: 1.352-2.496) were independent risk factors for CHD (all P<0.05). (5) ROC curve showed that the area under the curve of MHR in diagnosing CHD was 0.987, and the sensitivity was 82.8%. Conclusions:Serum MHR level is higher in patients with CHD, which is closely related to the severity of coronary artery disease and is an independent risk factor of CHD.

Objective: To assess the effectiveness in optimizing resources and shortening critical children′s waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination. Results: A total of 375 985 patients were included, among whom males were 225 308 (59.9%) and females were 150 677 (40.1%), all younger than 14 years of age. The number of critical cases (level Ⅰ, level Ⅱ and level Ⅲ) was increased from 4 719 (3.7%) in 2015, 12 209 (10.2%) in 2016 to 16 188 (12.7%) in 2017. The number of non-critical patients (level Ⅴ) decreased year by year, as from 98 213 (76.8%) in 2015 to 75 210 (62.6%) in 2016 and 78 857 (61.7%) in 2017. The patients who classified as level Ⅰ or levelⅡaccording to the PETS were seen immediately by physician (n=1855, 0.5%). Overall, 119 738 patients (98.3%) who were classified as level Ⅲ or level Ⅳ could be seen by physician in a timely manner according to triage guidelines, while 2 112 patients (1.7%) could not. The mean waiting time was 9.09 min in level Ⅲ, 17.7 min in level Ⅳ, and 55.76 min in level Ⅴ patients, respectively. The critical cases admitted to the intensive care units were 175 (36.2%) in 2015, 350 (62.8%) in 2016 and 374 (66.2%) in 2017. The etiologies were respiratory diseases (73.3%), gastrointestinal diseases (15.8%) and infectious diseases (3.1%). Conclusion The application of PETS could optimize emergency resources and shorten the waiting time of critically ill children.

OBJECTIVE:To explore the effects of short-term application of atorvastatin combined with ezetimibe on efficacy and related indicators of patients with primary nephrotic syndrome with hyperlipidemia. METHODS:Data of 50 patients with prima-ry nephrotic syndrome with hyperlipidemia were retrospectively collected and divided into combination group and control group ac-cording different treatment,25 cases in each group. All patients received low-salt,low-fat ,high-quality protein,giving prednisone 1 mg/(kg·d),po,qd,combined with anticoagulation,diuretic,anti-infection,taking cytotoxic drugs if necessary. Based on it, control group received Atorvastatin calcium tablet 20 mg before going to bed,qd;combination group received Atorvastatin calcium tablet(the same dosage and usage with control group)+Ezetimibe tablet 10 mg,qd. They were treated for 2 weeks. Lipid-lowering efficacy and low-density lipoprotein(LDL-C),triglyceride(TG),cholesterol(TC),high-density lipoprotein(HDL-C),24 h uri-nary protein (M-TP),serum albumin,alanine aminotransferase (ALT),aspartate aminotransferase (AST),serum creatinine and blood urea nitrogen before and after treatment in 2 groups were observed and the incidence of adverse reaction was recorded. RE-SULTS:There was no significant differences in the total effective rate of Lipid-lowering in 2 groups(P>0.05). After treatment, LDL-C,TC and HDL-C in 2 groups were significantly lower than before,Alb in combination group and ALT in 2 groups were sig-nificantly higher than before,with statistical significance(P<0.05),while there were no significant difference in 2 groups(P>0.05). And there was no significant difference in the TG,M-TP,AST,serum creatinine and blood urea nitrogen before and after treatment(P>0.05). CONCLUSIONS:Atorvastatin combined with ezetimibe can improve the blood lipid of patients with primary nephrotic syndrome with hyperlipidemia,while showing similar efficacy and safety with atorvastatin alone in a short term.

Objective:To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in atrial fibrillation( AF) pa-tients after radiofrequency catheter ablation( RFCA) . Methods:A retrospective analysis was performed in the study. Totally 141 AF pa-tients with RFCA in our hospital were enrolled from January 2014 to October 2015. The patients were divided into rivaroxaban group(70 patients)and warfarin group (71 patients). In rivaroxaban group,rivaroxaban(10 mg, po,qd)was given for at least 3 months after RFCA. In warfarin group,low molecular heparin (100 IU·kg-1,ih) was given before RFCA, and standard dose of warfarin (3-5 mg,po,qd) was given for at least 3 months by adjusting the INR within the range of 2. 0-3. 0 after RFCA as bridging therapy. The death rate, throm-boem bolism events and bleeding events between the groups were evaluated and companed groups. Results: There were no significant differences in baseline characteristics between the groups except the diastolic pressure. There were no significant differences in the death and thromboembolism events(transient cerebral ischemia , ischemic encephalopathy, 2/70 vs 4/71,P>0. 05)between the groups. There were no TIMI major bleeding events in both groups. There were no significant differences in minor bleeding events between the groups (3/70 vs 4/71,P>0. 05). Conclusion: Compared with those of warfarin,the effectiveness and safety of rivaroxaban show the similar effect in AF patients after RFCA. Rivaroxaban can be safely and effectively used in AF patients with low or middle risk of thromboembo-lism after RFCA.

OBJECTIVE:To compare the efficacy and safety of dabigatran and warfarin respectively used in atrial fibrillation patients after radiofrequency ablation(RFCA). METHODS:Data of 141 nonvalvular atrial fibrillation patients,who scheduled for RFCA,were retrospectively analyzed and divided into warfarin group(71 cases)and dabigatran group(70 cases)by different med-ication. Patients in warfarin group should stop warfarin if they took before,then changed to Low molecular weight heparin calcium injection 100 U/kg,subcutaneous injection,taking RFCA when INR was lower than 1.5,stopping low molecular weight heparin 12 h before surgery;Low molecular weight heparin calcium injection 100 U/kg was intravenously injected when surgery;orally tak-ing Warfarin sodium tablet 4.5 mg after 4-6 h,once a day,meanwhile bridged overlapping treated at least 3-5 d with low molecu-lar weight heparin;monitoring once INR every 3 d after surgery,maintaining INR 2.0-3.0,taking warfalin at least 3 months. Pa-tients in dabigatran group stopped taking the anticoagulant drugs when admission,then changed to Dabigatran etexilate capsule 110 mg(age≥70 years old or body mass<60 kg)or 150 mg(age<70 years old or body mass≥60 mg),twice a day;stopping dabig-atran 24 h before surgery,the same medication as warfalin group when surgery;orally taking dabigatran after 6 h,taking at least 3 months. The total mortality rate,incidence of stroke(transient cerebral ischemia,ischemic encephalopathy),peripheral thrombosis rate and incidence of bleeding after 1 and 3 month(s)in 2 groups were observed. RESULTS:There were no significant differences in the total mortality rate,incidence of stroke,peripheral thrombosis rate and incidence of bleeding after 1 and 3 month(s) in 2 groups(P>0.05). CONCLUSIONS:Dabigatran has similar anticoagulant efficacy and safety with warfarin in atrial fibrillation pa-tients after RFCA.

Objective To investigate the capability of 99 Tcm?tricine?EDDA/HYNIC?SFSIIHTPILPL ( SP94) as a specific probe for HCC imaging. Methods HYNIC?SP94 peptide was prepared by solid phase synthesis, followed by 99 Tcm labeling with tricine?EDDA as the coligand. After determination of radiochemical purity and stability, cell binding study was carried out by incubating Huh?7 cells with 99 Tcm?tricine?EDDA/HYNIC?SP94 at different specific activities (2.5, 4.0 and 30.0 GBq/μmol). The biodistribution studies and microSPECT/CT imaging were performed in Huh?7 tumor?bearing mice ( study group) and Hela tumor?bear?ing mice ( control group ) . Statistical analysis was by two?sample t test. Results 99 Tcm?tricine?EDDA/HYNIC?SP94 was synthesized with over 95% of labeling yield, which remained stable in saline and FBS up to 12 h. With increasing concentrations of 99 Tcm?tricine?EDDA/HYNIC?SP94, Huh?7 cell binding increased but became gradually saturated. In biodistribution studies, (1.02±0.26) %ID/g of tracer was accumulated in Huh?7 tumors at 0.5 h after injection of 99 Tcm?tricine?EDDA/HYNIC?SP94, higher than that in the HYNIC?SP94 blocking group ((0.34±0.09) %ID/g;t=3.537, P<0.05). Compared to Hela tumors, Huh?7 tumors were clearly visualized by microSPECT/CT, with which better imaging quality could be achieved with higher specific radioactivity. Conclusion 99 Tcm?tricine?EDDA/HYNIC?SP94 could achieve a high labeling effi?ciency and good in vitro stability as a potential diagnostic tracer specifically targeted for HCC.

Objective To evaluate the combined impacts of blood glucose and its related metabolic factors on 18F-FDG uptake by liver.Methods A total of 544 subjects (384 males and 160 females, age range 24-73 years) undergoing 18F-FDG PET/CT were recruited in this retrospective study.SUVmean of the right lobe of liver was calculated.Two-sample t test and one-way analysis of variance were performed to compare SUVmean between patients with different genders and BMI levels.Linear correlation analysis, partial correlation analysis and multiple linear regression analysis were conducted to evaluate the relationship between age, injected 18F-FDG dose, blood glucose, serum T3, T4, FT3, FT4, BMR, BMI and liver SUVmean.Results The SUVmean of the liver in males and females were 1.89±0.42 and 1.92±0.38 (t=0.693, P>0.05), but it was significantly different among BMI groups (F=3.056, P<0.05).Age, blood glucose and FT3 were significantly associated with liver SUVmean (r′ values: 0.108, 0.140 and 0.105, all P<0.05) and were independent factors that indicated variation of liver SUVmean (β values: 0.006, 0.070 and 0.088, all P<0.05).Blood glucose was the strongest powerful predicting variable of liver SUVmean (β′=0.154, P<0.001).Conclusions Blood glucose and its related metabolic factors can affect the liver 18F-FDG uptake.Age, FT3, blood glucose are independent factors predicting variation of liver SUVmean.The impact of glucose metabolism status should be considered when assessing liver 18F-FDG uptake.

Objective To establish the quality standard for Yanyan syrup. Methods Thin layer chromatography ( TLC) was used for the qualitative identification of Puerariae Lobatae Radix and Scrophulariae Radix. High performance liquid chromatography (HPLC) was used to determine the content of puerarin on Diamonsil C18(200 mm×4.6 mm,5μm) column with mobile phase consisting of methanol-0.5% acetic acid (25:75) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 250 nm. Results TLC spots were clear and well-separated without negative interference.The linear range of puerarin was 3-120μg?mL-1( r=0.999 7) with an average recovery of 97.44% ( RSD=2.07%,n=6) . Conclusion The method for quality and quantity of Yanyan syrup is simple, specific, accurate and reliable.It can be used for the quality control of Yanyan syrup.

Objective To identify the effect of blood pool 18F-FDG activity on liver SUV and to investigate the optimal normalization method.Methods PET/CT and common serological examination items from 1 018 subjects were retrospectively collected.Mean SUV of liver and blood were recorded as SUVmean(L) and SUVmean (B),respectively.The difference and quotient of SUVmean(L) and SUV mean (B) were calculated as SUVmean (L-B) and SUVmean (L/B),respectively.CV of SUVmean (L),SUVmean (L-B) and SUVmean(L/B) were calculated to assess their inter-individual variations.Pearson correlation analysis was used to evaluate the relationship of SUVmean(L),SUVmean(L-B),SUVmean(L/B) with SUVmean(B).Multiple linear stepwise regression was performed to identify their vulnerability to common serological examination items.Results CV of SUVmean(L/B) (15.1％) was less than that of SUmean(L) (23.2％) and SUVmean(L-B) (40.6％).Correlation between SUVmean(L) and SUVmean(B) (r =0.820,P＜0.001) was more significant than that between SUVmean(L-B) and SUVmean(B) (r =0.205,P＜0.001) as well as between SUVmean (L/B) and SUVmean (B) (r=-0.376,P＜0.001).Blood glucose and BMI correlated with SUVmean(L) and SUVmean(L/B),but not with SUV (B).Age and HDL correlated with SUVmean(L) and SUVmean(B),but not with SUV (L/B).Fatty liver was significantly associated with SUV mean (L/B) (β =-0.047,P ＜0.001),but not with SUVmean(L) and SUVmean (B).Conclusions 18 F-FDG activity of blood pool affects liver SUV.SUV mean (L/B) is a simple and reliable normalization method since its inter-individual variation and vulnerability to common serological examination items are relatively lower than liver SUV.