1.Impact of 177Lu-DOTATATE therapy on radiation exposure of ward healthcare staff and accompanying persons
Xuesong SU ; Jinming ZHANG ; Jianhua GENG ; Yingmao CHEN ; Gaofeng LI ; Xuejuan WANG
Chinese Journal of Radiological Health 2024;33(5):510-516
Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during 177Lu-DOTATATE therapy. Methods A ward for 177Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of 177Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of 177Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during 177Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.
2.Impact of 177Lu-DOTATATE therapy on radiation exposure of ward healthcare staff and accompanying persons
Xuesong SU ; Jinming ZHANG ; Jianhua GENG ; Yingmao CHEN ; Gaofeng LI ; Xuejuan WANG
Chinese Journal of Radiological Health 2024;33(5):510-516
Objective To investigate air radioactivity contamination, surface contamination, ambient dose equivalent rates, and radiation doses to individuals in the treatment room during 177Lu-DOTATATE therapy. Methods A ward for 177Lu-DOTATATE therapy was selected in the nuclear medicine department of a general hospital. Air and surface radioactivity samples were collected before and after therapy for four patients. Ambient dose equivalent rates were measured around the four patients following the initiation of 177Lu-DOTATATE therapy. Measurements were taken at distances of 0.1, 0.3, 0.5, and 1−4 m (with 0.5 m intervals) from the right lateral midsection of the patient’s torso. The measurement time points included 5, 15, and 30 min after initiation of administration, as well as 0−4 h (with 1 h intervals), 24 h, and 48 h post-administration. Radiation exposure doses for personnel at different distances from the patients were calculated for each time interval. Results The results of radioactive aerosol detection for all four patients during and after the administration of 177Lu-DOTATATE were similar to those before administration. Surface contamination was not detected at the measurement locations except for patient number 2. The ambient dose equivalent rates increased with increasing injection dose during the administration. However, the ambient dose equivalent rates decreased significantly within one hour after administration. At the end of the administration, the average ambient dose equivalent rate at a distance of one meter for the four patients was 42.931 μSv/h. From the start of administration to four hours post-administration, personnel maintaining a distance of one meter from the patient received a total radiation dose of 167.64 μSv. Conclusion Air radioactivity contamination does not occur during 177Lu-DOTATATE therapy. However, measures should be taken before the commencement of therapy to address potential surface contamination. Both accompanying persons and healthcare staff receive radiation doses below the stipulated dose constraints throughout the treatment process. Therefore, it is necessary to implement appropriate measures to minimize the radiation exposure of healthcare staff.
3.Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study
Zuanjun SU ; Zhicong CHEN ; Jinming CAO ; Canye LI ; Jingjing DUAN ; Ting ZHOU ; Zhen YANG ; Yuanchi CHENG ; Zhijun XIAO ; Feng XU
Clinical Psychopharmacology and Neuroscience 2024;22(4):594-609
Objective:
Whether peripheral blood 5-hydroxytrptamine (5-HT) levels serve as biomarker for depression diagnosis/response evaluation has not been well determined. This work was explored to address this inconclusive issue.
Methods:
Animals were randomized into normal control group (NC, n = 10) and chronic unpredictable mild stress model group (CUMS-model, n = 20), respectively. Animals in CUMS-model group were subjected to chronic stress, then they were randomly subdivided into CUMS subgroup and CUMS + fluoxetine subgroup (CUMS + FLX). After FLX treatment, blood and tissues were collected. 5-HT and relevant protein expression were measured.
Results:
In mice model, there was a significant increase in serum and a significant reduction in plasma 5-HT levels in CUMS-model group versus NC group, while platelet 5-HT levels change little. After FLX treatment, serum and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup, while plasma 5-HT levels had not much change versus CUMS subgroup. Chronic stress enhanced colon and platelet serotonin transporter (SERT) expression and FLX treatment mitigated SERT expression. In rats’ model, there was a significant increase in serum 5-HT levels while plasma and platelet 5-HT levels showed little change in CUMS group versus NC group. After FLX treatment, serum, plasma and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup versus CUMS subgroup. The profile of relevant proteins expression changed by FLX were like those in mice.
Conclusion
Serum 5-HT levels might serve as a potential biomarker for depression diagnosis, meanwhile serum and platelet 5-HT levels might respond to antidepressant treatment.
4.Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study
Zuanjun SU ; Zhicong CHEN ; Jinming CAO ; Canye LI ; Jingjing DUAN ; Ting ZHOU ; Zhen YANG ; Yuanchi CHENG ; Zhijun XIAO ; Feng XU
Clinical Psychopharmacology and Neuroscience 2024;22(4):594-609
Objective:
Whether peripheral blood 5-hydroxytrptamine (5-HT) levels serve as biomarker for depression diagnosis/response evaluation has not been well determined. This work was explored to address this inconclusive issue.
Methods:
Animals were randomized into normal control group (NC, n = 10) and chronic unpredictable mild stress model group (CUMS-model, n = 20), respectively. Animals in CUMS-model group were subjected to chronic stress, then they were randomly subdivided into CUMS subgroup and CUMS + fluoxetine subgroup (CUMS + FLX). After FLX treatment, blood and tissues were collected. 5-HT and relevant protein expression were measured.
Results:
In mice model, there was a significant increase in serum and a significant reduction in plasma 5-HT levels in CUMS-model group versus NC group, while platelet 5-HT levels change little. After FLX treatment, serum and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup, while plasma 5-HT levels had not much change versus CUMS subgroup. Chronic stress enhanced colon and platelet serotonin transporter (SERT) expression and FLX treatment mitigated SERT expression. In rats’ model, there was a significant increase in serum 5-HT levels while plasma and platelet 5-HT levels showed little change in CUMS group versus NC group. After FLX treatment, serum, plasma and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup versus CUMS subgroup. The profile of relevant proteins expression changed by FLX were like those in mice.
Conclusion
Serum 5-HT levels might serve as a potential biomarker for depression diagnosis, meanwhile serum and platelet 5-HT levels might respond to antidepressant treatment.
5.Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study
Zuanjun SU ; Zhicong CHEN ; Jinming CAO ; Canye LI ; Jingjing DUAN ; Ting ZHOU ; Zhen YANG ; Yuanchi CHENG ; Zhijun XIAO ; Feng XU
Clinical Psychopharmacology and Neuroscience 2024;22(4):594-609
Objective:
Whether peripheral blood 5-hydroxytrptamine (5-HT) levels serve as biomarker for depression diagnosis/response evaluation has not been well determined. This work was explored to address this inconclusive issue.
Methods:
Animals were randomized into normal control group (NC, n = 10) and chronic unpredictable mild stress model group (CUMS-model, n = 20), respectively. Animals in CUMS-model group were subjected to chronic stress, then they were randomly subdivided into CUMS subgroup and CUMS + fluoxetine subgroup (CUMS + FLX). After FLX treatment, blood and tissues were collected. 5-HT and relevant protein expression were measured.
Results:
In mice model, there was a significant increase in serum and a significant reduction in plasma 5-HT levels in CUMS-model group versus NC group, while platelet 5-HT levels change little. After FLX treatment, serum and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup, while plasma 5-HT levels had not much change versus CUMS subgroup. Chronic stress enhanced colon and platelet serotonin transporter (SERT) expression and FLX treatment mitigated SERT expression. In rats’ model, there was a significant increase in serum 5-HT levels while plasma and platelet 5-HT levels showed little change in CUMS group versus NC group. After FLX treatment, serum, plasma and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup versus CUMS subgroup. The profile of relevant proteins expression changed by FLX were like those in mice.
Conclusion
Serum 5-HT levels might serve as a potential biomarker for depression diagnosis, meanwhile serum and platelet 5-HT levels might respond to antidepressant treatment.
6.Feasibility of Using Serum, Plasma, and Platelet 5-hydroxytryptamine as Peripheral Biomarker for the Depression Diagnosis and Response Evaluation to Antidepressants: Animal Experimental Study
Zuanjun SU ; Zhicong CHEN ; Jinming CAO ; Canye LI ; Jingjing DUAN ; Ting ZHOU ; Zhen YANG ; Yuanchi CHENG ; Zhijun XIAO ; Feng XU
Clinical Psychopharmacology and Neuroscience 2024;22(4):594-609
Objective:
Whether peripheral blood 5-hydroxytrptamine (5-HT) levels serve as biomarker for depression diagnosis/response evaluation has not been well determined. This work was explored to address this inconclusive issue.
Methods:
Animals were randomized into normal control group (NC, n = 10) and chronic unpredictable mild stress model group (CUMS-model, n = 20), respectively. Animals in CUMS-model group were subjected to chronic stress, then they were randomly subdivided into CUMS subgroup and CUMS + fluoxetine subgroup (CUMS + FLX). After FLX treatment, blood and tissues were collected. 5-HT and relevant protein expression were measured.
Results:
In mice model, there was a significant increase in serum and a significant reduction in plasma 5-HT levels in CUMS-model group versus NC group, while platelet 5-HT levels change little. After FLX treatment, serum and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup, while plasma 5-HT levels had not much change versus CUMS subgroup. Chronic stress enhanced colon and platelet serotonin transporter (SERT) expression and FLX treatment mitigated SERT expression. In rats’ model, there was a significant increase in serum 5-HT levels while plasma and platelet 5-HT levels showed little change in CUMS group versus NC group. After FLX treatment, serum, plasma and platelet 5-HT levels were significantly decreased in CUMS + FLX subgroup versus CUMS subgroup. The profile of relevant proteins expression changed by FLX were like those in mice.
Conclusion
Serum 5-HT levels might serve as a potential biomarker for depression diagnosis, meanwhile serum and platelet 5-HT levels might respond to antidepressant treatment.
7.Feasibility of early treatment of congenital giant melanocytic nevus
Jiaqi ZHANG ; Cheng CHEN ; Fen SHI ; Zheng SU ; Xiaolian XIAO ; Jian ZHANG ; Chen CHEN ; Yongzhen WANG ; Weiqiang LIANG ; Jinming ZHANG
Chinese Journal of Plastic Surgery 2022;38(11):1203-1209
Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.
8.Feasibility of early treatment of congenital giant melanocytic nevus
Jiaqi ZHANG ; Cheng CHEN ; Fen SHI ; Zheng SU ; Xiaolian XIAO ; Jian ZHANG ; Chen CHEN ; Yongzhen WANG ; Weiqiang LIANG ; Jinming ZHANG
Chinese Journal of Plastic Surgery 2022;38(11):1203-1209
Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.
9.Application of scrotal flap in the excision and repair of penoscrotal Paget disease
Jian ZHANG ; Weiqiang LIANG ; Jinming ZHANG ; Jiaqi ZHANG ; Xiaolian XIAO ; Zheng SU ; Meng LIU
Chinese Journal of Plastic Surgery 2021;37(3):281-288
Objective:To investigate the method, feasibility and clinical effect of scrotal flap in the immediate repair of penoscrotal Paget disease after excision.Methods:From January 2008 to September 2018, a total of 21 patients (age 42-74) diagnosed with penile scrotal Paget disease were admitted and treated in our department. All patients underwent local expanded resection, and intraoperative frozen section examination confirmed a negative margin. All patients used the scrotal flap or scrotal flap combined with other surgical methods to repair the defect.Results:Scrotal flaps were used in ten cases, scrotal flaps combined with other flaps in seven cases, and scrotal flaps combined with skin grafting in four cases. All the scrotal flaps had good blood supply, two cases had small partial skin graft necrosis, and one case had delayed healing of the flap donor area, and all the others had good wound healing. All patients were followed up for six months to 60 months, with an average follow-up time of 30.6 months. Most of the patients (95.2%, 20/21) were satisfied with the appearance of the penis and scrotum, and all the transferred flaps showed no edema. Local recurrence occurred in four patients within two years. Local recurrence and inguinal lymph node metastasis occurred in one patient within three years with a total local recurrence rate of 23.8% (5/21). Due to the small local recurrence lesion, the recurrence lesion was successfully repaired with the adjacent scrotal flap after expanding local excision, and the patients with inguinal lymph node metastasis received ipsilateral inguinal lymph node dissection.Conclusions:The scrotal flap has the characteristics of a large cutting area, flexible design, convenient transfer of flap, enough blood supply, simple, safe, and effective. Using this method can obtain a satisfactory shape of the penis and scrotum after the operation. Those defects that are difficult to use scrotal flap for a complete repair can be repaired with other flaps or skin grafts. A good therapeutic effect can be obtained as well. For the majority of recurrent lesions, scrotal skin flap can be reapplied.
10.Reconstruction of the middle and lower abdominal wall or the groin region defects following the resection of the dermatofibrosarcoma protuberan utilizing the ilioinguinal flap
Chen CHEN ; Xiangting RAO ; Fen SHI ; Meng LIU ; Zheng SU ; Jinming ZHANG ; Weiqiang LIANG
Chinese Journal of Plastic Surgery 2021;37(3):299-303
Objective:To summarize the methods and effects of utilizing the ilioinguinal flap in repairing the defect after the extended resection of the middle and lower abdominal wall or the groin region’s dermatofibrosarcoma protuberans.Methods:From November 2011 to October 2018, nine patients (including five males) with the middle and lower abdominal wall or groin region’s dermatofibrosarcoma protuberans received extended resection procedures in the Department of Plastic and Reconstructive Surgery of Sun Yat-sen Memorial Hospital, Sun Yat-sen University. The age distribution of patients was 27-60 years old with a mean age of 44.3 years old. The defect area following the extended resection of the tumor ranged from 9.5 cm × 10.5 cm to 15.0 cm × 18.0 cm, and the size of the ilioinguinal flap ranged from 6.0 cm × 11.0 cm to 8.0 cm × 15.0 cm. Either an axial flap or a V-Y advancement flap was used to repair the defect. Five patients were treated with the unilateral ilioinguinal flap, two with the bilateral ilioinguinal flap combination flap, one with the ilioinguinal flap combined with the tensor fascia lata myocutaneous flap, and one with the ilioinguinal flap combined with the anterolateral thigh flap.Results:All defects were covered by flaps completely, and all donor sites were closed directly. Eight flaps survived completely without necrosis, while one case of ilioinguinal flap faced the distal necrosis, which was debrided and repaired with full-thickness skin grafting in the second stage. The postoperative follow-up period ranged from 1.0 to 8.5 years. No local recurrence or other distant metastases occurred. All reconstructed regions had a good outline and ordinary sense function.Conclusions:Almost all defects after the extended resection of dermatofibrosarcoma protuberans in the middle and lower abdominal wall or the groin region could be repaired with a unilateral or bilateral ilioinguinal flap, whose blood supply is stable and reliable. Moreover, the operation presented is simple, less time-consuming, safe, reliable, and with a satisfactory postoperative appearance.

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