Objective:To investigate the application value of dual-phase 18F-fluorocholine (FCH) PET/CT imaging in uremic hyperparathyroidism (uHPT). Methods:Twenty patients (10 males, 10 females, age: (46.8±12.3) years) who were diagnosed with uHPT and underwent neck ultrasound and dual-phase (5, 45 min) 18F-FCH PET/CT imaging at Affiliated Hospital of Southwest Medical University between December 2019 and March 2022 were retrospectively analyzed. Patients underwent parathyroidectomy within 1 month after PET/CT imaging. The sensitivity of neck ultrasound and dual-phase 18F-FCH PET/CT imaging for the diagnosis of hyperfunctioning parathyroid glands were compared based on the surgical results. The early- and late-phase 18F-FCH PET/CT images were compared visually and quantitatively, and the difference of SUV max between parathyroid hyperplasia and parathyroid adenoma was compared. The correlations between SUV max and important laboratory parameters and the volume of lesions measured on CT were tested. Fisher exact test, paired t test, independent-sample t test and Spearman rank correlation analysis were used for statistical analysis. Results:A total of 69 masses were removed in 20 patients with uHPT, and 55 parathyroid hyperplasia and 10 parathyroid adenomas were identified by pathology. Dual-phase 18F-FCH PET/CT imaging (87.69%, 57/65) was more sensitive than neck ultrasound (56.92%, 37/65) for the diagnosis of hyperfunction of the parathyroid gland ( P=0.001). The early imaging detected more lesions than late imaging (57 vs 49) respectively, which showing higher sensitivity (87.69%(57/65) vs 75.38%(49/65); P<0.001). The SUV max(5.75±2.21 vs 4.08±1.51) and the corresponding parathyroid-to-thyroid ratio (2.99±0.99 vs 3.57±1.30) were both significantly different between early and late imaging ( t values: 8.28, 4.33, both P<0.001). There were no significant differences between parathyroid hyperplasia and parathyroid adenoma in SUV max(early imaging: 5.08±2.27 vs 6.58±2.24; t=-1.90, P=0.063; late imaging: 3.89±1.54 vs 4.93±1.04; t=-1.94, P=0.059). The sum of SUV max of all lesions in early imaging was not correlated with preoperative serum parathyroid hormone (PTH) or Ca or P or lesion size ( rs values: from -0.22 to 0.06, all P>0.05). Conclusions:Dual-phase 18F-FCH PET/CT imaging has high sensitivity in the diagnosis of uHPT, and early and late imaging shows advantages in different aspects, with good preoperative localization ability. Therefore, for patients with uHPT, it is recommended to complete the dual-phase 18F-FCH PET/CT examination before surgery.

Objective: To analyze the clinical risk factors of bronchopulmonary dysplasia(BPD) in very premature infants and provide reference for the prevention and treatment of BPD in order to improve the prognosis of premature infants. Methods: From January 2015 to December 2017, 263 very premature infants(referring to premature infants with gestational age between 28 weeks and 32 weeks) in the neonatology department of the Maternal and Child Health Care Hospital Affiliated to Anhui Medical University were selected.They were divided into BPD group(108 cases) and non-BPD group(155 cases) according to the diagnostic criteria of BPD.The clinical data of the patients and the hospitalized patients were retrospectively investigated.The general conditions of the very premature infants in the two groups were compared.The clinical risk factors for BPD in very premature infants were analyzed. Results: There were 263 very preterm infants included in the study, 108 cases in the BPD group, the incidence was 41.1%.The data analysis showed that BPD occurred in premature infants with sex(χ²=4.311), gestational age(Z=-6.544), birth weight(t=-5.382), maternal chorioamnionitis(χ²=4.946), neonatal respiratory distress syndrome(χ²=25.424), anemia(χ²=22.443), multiple blood transfusion(Z=-8.101), mechanical ventilation time greater than 7 days(χ²=10.946), high oxygen concentration(χ²=25.028), the differences were statistically significant(all P<0.05). The multivariate logistic regression analysis suggested that gestational age(OR=1.478, 95% CI: 1.140-1.914), maternal pregnancy with chorioamnionitis (OR=0.152, 95% CI: 0.029-0.797), maximum oxygen concentration>40%(OR=0.261, 95% CI: 0.136-0.502), number of blood transfusions(OR=0.582, 95% CI: 0.456-0.742) were independent risk factors for BPD in preterm infants. Conclusion There are many factors leading to BPD in premature infants, including maternal comorbidities and neonatal factors, and its pathogenesis is complex and diverse.It is necessary to further study these related factors, timely intervention, strengthen maternal health care, and minimize risk factors, thus to reduce the incidence of BPD, improve the prognosis of premature infants.