1.Exploration on application value of 18F-PSMA-1007 PET/CT in diagnostic evaluation and treatment decision of prostate cancer
Jian CHEN ; Qiming CHEN ; Xiao CHEN ; Renxiang XIA ; Ze WANG ; Junhao JIN ; Xuzhi YAN ; Qiuli LIU ; Zehua SHU ; Yao ZHANG ; Jun ZHANG ; Luofu WANG ; Weihua LAN ; Jun JIANG
Chongqing Medicine 2024;53(22):3418-3428
Objective To investigate the value of 18F labeled prostate-specific membrane antigen(18F-PSMA)-1007 developing agent PET/CT(18F-PSMA-1007PET/CT)examination in the diagnostic evaluation and therapeutic decision of the newly diagnosed prostate cancer(PCa)and follow up after radical prostatecto-my(RP).Methods This study adopted the retrospective observational study method.A total of 68 patients receiving 18 F-PSMA-1007 PET/CT examination in this hospital from September 2022 to October 2023 were analyzed,including 36 cases of newly diagnosed PCa and 32 cases of biochemistry follow up failure after RP.A total of 30 items of clinical data were collected,including 8 items of basic clinical characteristics,7 items of pa-thology-related characteristics and 15 items of imaging characteristics.The patients clinical characteristics in the newly diagnosed PCa and biochemical failure after RP conducted the descriptive analysis.The Fisher exact probability method was used to analyze the differentiation of the SUVmax of primary lesions in different clini-cal subgroups[different tPSA levels at diagnosis,different mi-T stages,different Gleason scores at postopera-tive pathological puncture and different pathological types]in the newly diagnosed PCa group and the differ-entiation of recurrent lesion detection rates in different clinical subgroups(different tPSA in 18F-PSMA-1007 PET/CT examination,different pathological T stages,different lymph node invasion and different pathological Gleason scores in the biochemical failure after RP group.The Spearman correlation was adopted to test and analyze the correlation between the imaging features of positive lesions and tPSA.Results In the newly diag-nosed PCa group,there were 1 case of prostatic hyperplasia and 35 cases of PCa.SUVmax had no statistical differences among the primary lesions with different tPSA levels(P=0.81),different mi-T stages(P=0.70),different puncture Glleasonscores(P=0.20)and different pathological types(P=0.71).Moreover the tPSA value at diagnosis was positively correlated with the number of metastatic lesions(r=0.410,P=0.01).The clinical treatment decisions in 11 cases(31.43%)were changed according to the examination re-sults.In 9 cases of RP combined with lymph node dissection,the accuracy rate and concordance rate of 18F-PS-MA-1007 PET/CT and MRI in the lymph node detection rate all were 100%.I n the biochemical failure after RP group,the overall recurrent lesion detection rate was 71.88%(23/32),the operative area in situ recurrence(11 cases,34.38%)and bone metastasis(11 cases,34.38%)were most common.The differences of 18F-PS-MA-1007 PET/CT recurrent lesions detection rates had no statistical differences among the patients with dif-ferent tPSA levels(P=0.08),different pathological T stages(P=0.10),different postoperative pathological lymph node invasions(P=0.68)and different pathologic Gleason score in the 18F-PSMA-1007 PET/CT ex-amination.In the 18 F-PSMA-1007 PET/CT examination in the biochemical failure after RP,the tPSA value in the recurrent lesion was positively correlated with the number of recurrent lesions(r=0.48,P=0.01),SUVmax value in the recurrent lesion(r=0.46,P=0.01)and the SUVmean value(r=0.38,P=0.03).The clinical treatment decision in 18 cases(56.25%)was changed according to the examination results.Conclusion 18 F-PSMA-1007 PET/CT has good diagnostic value and efficiency for primary lesion and metastasis lesion of new-ly diagnosed PCa and recurrent foci of biochemical failure after RP.
2.Starting effect of highly active antiretroviral therapy on the incidence of anemia in HIV-infected patients
Jingjing LANG ; Panpan CHEN ; Lidan ZHU ; Xin XIN ; Qiuli XU ; Qianqian LIU ; Yan TANG ; Shaotan XIAO
Shanghai Journal of Preventive Medicine 2023;35(4):362-368
ObjectiveTo investigate the risk factors of anemia in HIV-infected patients receiving highly active antiretroviral therapy (HAART) in the Pudong New Area. MethodsA retrospective cohort study was conducted among HIV-infected patients who started HAART from 2005 to 2020 in Pudong New Area. Cox proportional hazards model was used to analyze the risk factors of anemia, moderate or severe anemia, and chronic anemia. The piecewise linear mixed-effect model was used to analyze the association between initial HAART classes and hemoglobin change in the follow-up. ResultsA total of 2 403 HIV-infected patients were included in the analysis. Among them, there were 357 cases of new onset anemia, 86 cases of chronic anemia and 102 cases of moderate or severe anemia, with the incidence density of 4.41/100 person years, 0.89/100 person years and 0.96/100 person years respectively. Multifactorial Cox regression analysis results showed that female, age >45 years, baseline CD4+ T lymphocyte count (CD4) <200 cells‧μL-1, opportunistic infections, glomerular filtration rate (eGFR) <60 mL‧min-1‧(1.73 m2)-1, and zidovudine (AZT) or protease inhibitor (PIs) based regimens were associated factors for the development of anemia. Female, age >45 years, CD4 <200 cells‧μL-1, opportunistic infections, and AZT-based regimens were associated with the development of chronic anemia. Mild anemia at baseline and AZT-based regimens were associated with the development of moderate or severe anemia. Linear mixed-effects model showed that the use of AZT (-7.87 g‧L-1, 95%CI: -9.42 to -6.32) or PIs (-3.43 g‧L-1, 95%CI: -5.57 to -1.30) was associated with lower Hb at follow-up. ConclusionInitial use of AZT and PIs is associated with progression to anemia and a lower follow-up hemoglobin level. Increased hemoglobin monitoring in users of AZT and PIs may be beneficial, especially during the first 6 months after initiation of HAART.
3.Preliminary study on the relationship between the contrast-enhanced ultrasonography of liver metastasis and the differentiation degree of neuroendocrine tumors
Shanshan YIN ; Binbin JIANG ; Qiuli CUI ; Zhihui FAN ; Wei WU ; Ying DAI ; Wei YANG ; Kun YAN
Chinese Journal of Ultrasonography 2019;28(2):108-113
Objective To retrospectively analyze contrast-enhanced ultrasound ( CEUS ) manifestations of neuroendocrine tumors ( NETs) liver metastases ,and explore the relationship between CEUS parameters and differentiation of NETs . Methods From January 2014 to June 2018 ,36 patients who had been performed CEUS due to liver metastasis of NETs with pathological diagnosis and immunohistochemical staining results were enrolled in this study . The CEUS findings of NETs liver metastases were summarized . According to the Ki-67 index ,CgA results ,and the stage G ,the patients were divided into Ki-67>20% group and Ki-67≤20% group ,CgA negative group and CgA positive group ,and group G1+G2 and group G3 ,respectively . The CEUS parameters of NETs liver metastases between the above groups were compared . Results In 36 lesions ,during the arterial phase of CEUS ,66 .7% (24/36) showed hyperenhancement ,16 .7% (6/36) isoenhancement ,13 .9% (5/36) rim-like enhancement ,and 5 .6% ( 2/36 ) hypoenhancement ; During the portal phase , 13 .9% ( 5/36 ) showed hyper or iso enhancement ,86 .1% (31/36) showed hypoenhancement . The average washout time was ( 67 .5 ± 56 .1)s ,of which 5 (13 .9% ) lesions were washed out after 120 s . The mean starting washout time was statistically different between the CgA negative group and the positive group[(91.6±81.5)svs(60.1±38.7)s,P =0 .001] . There was no statistically significant difference in all observations between the group of Ki-67≤20% and >20% ,group G1+G2 and group G3( P >0 .05) . Conclusions CEUS of NETs liver metastasis has certain characteristics ,among which hyperenhancement is its main enhancement mode ,and some lesions have a longer wash out time . The relationship with the degree of differentiation needs further investigation .
4.A preliminary study on prediction efficacy of multimodal MRI?based radiomics in combination with random forest model for preoperative glioma IDH1 gene type expression
Wenting LAN ; Zhan FENG ; Yan ZHANG ; Zhenya ZHAO ; Yi HUANG ; Qiuli HUANG ; Yuning PAN
Chinese Journal of Radiology 2019;53(10):864-870
Objective To preliminarily analyze the prediction efficiency of multimodal MRI?based radiomics model for preoperative glioma IDH1 gene expression type. Methods The MRI data of 108 surgery?proven glioma patients from May 2015 to January 2019 were retrospectively analyzed, and the MRI data included axial T1WI,T2WI,fluid attenuated inversion recovery (FLAIR),DWI imaging and enhanced T1WI sequence.Forty-seven cases were IDH1 mutant type, and 61 cases were IDH1 wild type. All patients were divided into training and validation groups according to the 7∶3 ratio of the random forest model. Seventy-three cases were in training group, and 35 cases were in validation group. Independent predictors of IDH1 mutation were screened by univariate analysis combined with multivariate logistic regression analysis (P<0.05) in order to construct a random forest diagnosis model of general clinical information and conventional MRI morphological features.General clinical information and conventional MRI morphological features included gender, age, umbers of cases of left and right hemispheres, location of tumors, maximum diameter of tumors, peritumoral edema, intratumoral cystic degeneration, enhancement and ADC value of tumors. The ROI was manually outlined by MaZda software in the most obvious level of 5 sequences of tumor mass and the radiomics features were extracted, including the gray?level co?occurrence matrix(GLCM), the run?length matrix(RUN), the absolute gradient(GRA),the auto?regressive model(ARM) and wavelets transform (WAV). The least absolute shrinkage and selection operator (LASSO)regression were used to select image radiomics features with a method of 10 fold cross?validation and to reduce the dimensions. The screened image radiomics labels were combined with the conventional morphological feature independent predictors to construct a multimodal MRI?based random forest model, and the validation data set was used to evaluate the accuracy and diagnostic efficiency of each model. The sensitivity and specificity of conventional MRI morphological feature model and multimodal MRI?based radiomics prediction model were evaluated dynamically by drawing ROC curves, and the prediction efficiency of the two models was quantified by using AUC statistical indicators. The model classification error rate under different outcomes and the classification error rate of out of bag(OOB)were used to evaluate the stability of the multimodal MRI?based random forest model. The contribution rate of each variable to the model was reflected by the characteristic variables importance assessment map. Results Univariate regression analysis of the conventional MRI morphological characteristics showed that peritumoral edema, cystic degeneration and enhancement were the three independent predictors of IDH1 gene expression (P<0.01). LASSO algorithm and 10?fold cross?validation identified six robust radiomic features including high frequency coefficients of wavelet transform (WavEnHH_s?4) of T2WI, S(4, 4) inverse difference of gray uniformity measurement (InvDfMom), S(5, 0) Entropy (entropy), WavEnHH_s?4 of T1WI enhancement, S(1, 1) InvDfMom, S(1, -1) Entropy Difference (DifEntrp)of Flair.The error rate of classification for different outcomes and classification error rate of random forest OOB data of multimodal MRI radiomics diagnosis model finally stabilized at 10%. The results of Characteristic Variable Importance Assessment Map: Mean Decrease Accuracy and Mean Decrease Gini index were consistent, which showed that besides three conventional MRI morphological predictors peritumoral edema, enhancement and cystic degeneration, the radiomics labels also played a key role in the model. The results of ROC curve showed that the accuracy, specificity,sensitivity and AUC of conventional MRI morphological feature model were 82.7%, 68.4%, 90.9% and 0.835, respectively, and those of multimodal MRI?based radiomics model were 88.5%, 89.5%, 87.8% and 0.956 respectively. Conclusion Multimodal MRI?based radiomics random forest model can improve the predictive efficiency of preoperative glioma IDH1 gene expression type more quantitatively.
5. A preliminary study on prediction efficacy of multimodal MRI-based radiomics in combination with random forest model for preoperative glioma IDH1 gene type expression
Wenting LAN ; Zhan FENG ; Yan ZHANG ; Zhenya ZHAO ; Yi HUANG ; Qiuli HUANG ; Yuning PAN
Chinese Journal of Radiology 2019;53(10):864-870
Objective:
To preliminarily analyze the prediction efficiency of multimodal MRI-based radiomics model for preoperative glioma IDH1 gene expression type.
Methods:
The MRI data of 108 surgery-proven glioma patients from May 2015 to January 2019 were retrospectively analyzed, and the MRI data included axial T1WI,T2WI,fluid attenuated inversion recovery (FLAIR),DWI imaging and enhanced T1WI sequence.Forty-seven cases were IDH1 mutant type, and 61 cases were IDH1 wild type. All patients were divided into training and validation groups according to the 7∶3 ratio of the random forest model. Seventy-three cases were in training group, and 35 cases were in validation group. Independent predictors of IDH1 mutation were screened by univariate analysis combined with multivariate logistic regression analysis (
6.A qualitative study on characteristics of eating behavior change in patients with type 2 diabetes
Jing ZHAO ; Qiuli ZHAO ; Limin WANG ; Saining HOU ; Yan LIANG
Chinese Journal of Nursing 2018;53(2):139-143
Objective To investigate characteristics of eating behavior change in patients with type 2 diabetes.Methods The grounded theory methodology was used.Nineteen patients with type 2 diabetes mellitus were interviewed.Then the records were transcribed and analyzed with open coding,axial coding and selective coding according to the grounded theory put forward by Strass and Corbin,to identify the categories and core category.Results The characteristics of eating behavior change in patients with type 2 diabetes included:searching information for diabetes diet,four types of diabetes diet,finding pleasure in a diabetes diet.Conclusion Patients with diabetes should pay attention to the source of dietary information and should not blindly try;patients who obtained the diet information had a choice between diet control and abandonment;the ability to enjoy a free diet in a diabetic diet will help improve patients' compliance with the diet.Medical staff should understand the characteristics of eating behavior change to promote early identification of behavior and the correct guidance for patients with diabetes.
7.Initial research for the diagnostic value of contrast-enhanced ultrasound parametric imaging in predicting extracapsular invasion and cervical lymph node metastasis of papillary thyroid cancer
Ke DING ; Kun YAN ; Qiuli CUI ; Wei YANG ; Wei WU ; Shanshan YIN ; Wenying LIU
Chinese Journal of Ultrasonography 2018;27(12):1054-1057
Objective To study the enhanced performance of contrast-enhanced ultrasouond( CEUS) parametric imaging , and to explore the diagnostic value of CEUS parametric imaging in predicting extracapsular invasion and cervical lymph node metastasis of papillary thyroid cancer( PTC) . Methods One hundred and fifty-eight PTCs in 136 patients pathologically proven papillary thyroid carcinoma between January 2016 and January 2017 were enrolled in this study . According to the pathological results of extracapsular invasion and cervical lymph node metastasis respectively ,the PTCs were grouped into the negative group and the positive group . The parametric imaging features of the two groups were summarized to explore the risk factors of extracapsular invasion and cervical lymph node metastasis of PTCs respectively . Results The parametric imaging suggested that centripetal enhancement had a significant effect on extracapsular invasion ( P =0 .001) . While there was no difference in the perfusion start time of extracapsular invasion between the negative and positive group ( P > 0 .05 ) . Besides , there was no statistical significance in the perfusion start time and perfusion pattern of cervical lymph node metastasis between the negative and positive group (all P >0 .05) .Conclusions The parametric imaging features help predicting extracapsular invasion in PTCs . And the ones with centripetal enhancement patterns are more often with extracapsular invasion .
8.Diagnostic value of conventional ultrasound and contrast enhanced ultrasound in predicting extrathyroidal extension of papillary thyroid cancer
Ke DING ; Qiuli CUI ; Kun YAN ; Wenying LIU ; Tianxiao WANG
Chinese Journal of Ultrasonography 2017;26(3):243-248
Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25%,25%-50%,≥50%),and the diagnostic efficiency in different degree of contact (>0 %,≥25 %,≥50%) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06%) based on pathologic results.When the degree of contact (> 0 %,< 25 %,25 %-50 %,≥ 50 %) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P <0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(>0%,≥25%,≥50%),it showed that the general diagnostic efficiency between two groups(>0%,≥25%) was similar by US and CEUS.However,the sensitivity and accuracy of >0% contact with the adjacent capsule were markedly higher than those of the other two groups(P <0.001).Selecting >0% contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0% contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.
9.Mechanism of fasudil combined Seretide in treating COPD complicated pulmonary artery hypertension
Kunqin LU ; Long CHEN ; Huajun ZHANG ; Qiuli YU ; Shixiang ZHU ; Zhiyun YANG ; Yan GE ; Haifeng KAN
Chinese Journal of cardiovascular Rehabilitation Medicine 2017;26(2):182-185
Objective: To explore mechanism of fasudil combined salmeterol and fluticasone propionate powder for inhalation (Seretide) in treating chronic obstructive pulmonary disease (COPD) complicated pulmonary artery hypertension (PAH).Methods: A total of 120 patients accorded with diagnostic standards of COPD and PAH, who hospitalized in our department from Jan 2013 to Oct 2014, were selected.According to random number table method, patients were randomly and equally divided into routine treatment group, fasudil group (received intravenous drip of fasudil based on routine treatment group) and combined treatment group (received additional Seretide therapy based on fasudil group).Levels of nitric oxide (NO), endothelin-1 (ET-1), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured and compared among three groups before and after treatment.Results: Compared with before treatment, after two-week treatment, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in three groups, P<0.05 or<0.01;compared with routine treatment group after treatment, there were significant reductions in levels of CRP[(14.8±3.3) mg/L vs.(12.9±3.6) mg/L vs.(11.4±3.4) mg/L], ESR[(37.3±8.9) mm/h vs.(32.9±8.8) mm/h vs.(29.3±5.6) mm/h]and ET-1[(63.1±11.2) ng/L vs.(57.5±8.1) ng/L vs.(53.1±8.9) ng/L], and significant rise in NO level[(70.2±10.7) μmol/L vs.(76.0±8.0) μmol/L vs.(80.5±11.3) μmol/L]in fasudil group and combined treatment group, P<0.05 or<0.01;compared with fasudil group, there were significant reductions in levels of CRP, ESR and ET-1, and significant rise in NO level in combined treatment, P<0.05 all.Conclusion: Fasudil hydrochloride combined Seretide can significantly reduce levels of ESR, CRP and ET-1, and increase NO level in COPD + PAH patients.It may improve prognosis in these patients, which is worth extending.
10.Dynamic Changes of Four Main Active Components in Wine-processed Cuscuta Chinensis with Different Processing Methods
Qiuli LI ; Yanfang LIU ; Mengxiao YAN ; Yanni SONG
China Pharmacist 2016;19(10):1882-1884
Objective:To study the dynamic changes of the main active components in wine-processed Cuscuta chinensis with dif-ferent rocessing methods. Methods: An HPLC method was adopted for the content determination of chlorogenic acids, hyperoside, quercetin and kaempferol in C. chinensis and wine-processed C. chinensis with different baking temperature, baking time and amount of yellow wine. The chromatographic conditions were as follows: the detection wavelength was 360 nm, and methanol-0. 1% phosphoric acid was used as the mobile phase with gradient elution. Results:The wine processing system could increase the content of quercetin and kaempferol, while decrease the content of chlorogenic acids and hyperin. Conclusion: Different processing methods have certain effects on the main active components, which provide basis for the further study on the processing mechanism and quality control of wine-processed C. chinensis.

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