Objective:To investigate the value of 99Tc m-hydrazinonicotinamide (HYNIC)-prostate specific membrane antigen(PSMA) SPECT/CT imaging in biochemical recurrence of prostate cancer (PCa). Methods:From January 2018 to March 2023, 112 patients with biochemical recurrence of PCa (age (72.6±6.1) years) who underwent 99Tc m-HYNIC-PSMA SPECT/CT imaging in Henan Provincial People′s Hospital were retrospectively analyzed. According to the level of prostate specific antigen (PSA), patients were divided into 0.2 μg/L2 μg/L group. According to the Gleason score, patients were divided into Gleason score≥8 group and Gleason score <8 group. The detection rate between groups was analyzed by χ2 test, and the difference of the PSA level between groups was compared by Mann-Whitney U test. Results:PSMA imaging was positive in 77 cases and negative in 35 cases, with the detection rate of 68.8%(77/112). The detection rates of local recurrence, lymph node metastasis, bone metastasis and lung metastasis were 8.9%(10/112), 43.8%(49/112), 28.6%(32/112) and 0.9%(1/112), respectively. The detection rates of 0.2 μg/L2 μg/L groups were 44.7%(21/47), 8/12 and 90.6%(48/53), respectively ( χ2=24.44, P<0.001). The detection rates of Gleason score ≥8 group and <8 group were 76.4%(55/72) and 55.0%(22/40) ( χ2=5.47, P=0.032); the PSA level between the two groups was statistically different (3.11(0.75, 5.91) and 0.84(0.44, 2.92) μg/L; z=-2.99, P=0.003). Of the patients with PSMA positive imaging, 84.4%(65/77) changed their treatment regimen and 15.6%(12/77) continued to observe or maintain the original treatment plan. Of the patients with PSMA negative imaging, 40.0%(14/35) changed the treatment plan, 51.4%(18/35) continued to observe or maintain the original treatment plan, and 8.6%(3/35) discontinued the original treatment because no tumor metastasis was found. Conclusion:99Tc m-HYNIC-PSMA SPECT/CT imaging can provide reference for the lesion detection, treatment decision-making and follow-up observation of biochemical recurrence of PCa.

Objective The rapid growth of data exchange and information volume in hospital information systems has brought significant challenges to the operation,maintenance,and service performance of the system.In order to overcome the performance bottleneck of the software and improve the response performance of the hospital information system,our hospital has tentatively introduced the Exadata database machine.Methods The machine was launched through hardware parameter selec-tion,high availability testing,and data migration.The benefits were evaluated by comparing the I/O operation time,SQL state-ment execution time,and business system module loading time before and after the launch.Results After using this machine,the overall waiting time of I/O operations decreased by 83.47% ,the execution time of the same statement decreased by over 22% ,and the average loadingtime of the business system decreased by43.74% .Conclusion The database machine can effec-tively reduce query time,accelerate the running speed of business modules,and help improve the performance of hospital infor-mation systems.

Objective:To investigate the efficacy and influencing factors of initial 131I therapy in serum thyroglobulin (Tg) antibody (TgAb)-positive patients with papillary thyroid cancer (PTC). Methods:A retrospective analysis was performed on the clinical data of 1 624 patients with PTC who underwent 131I therapy in Henan Provincial People′s Hospital between January 2017 and January 2023. The patients were divided into TgAb-positive group (246 cases (36 males, 210 females), age: 43.5(31.0, 52.0) years) and TgAb-negative group (1 378 cases (439 males, 939 females), age: 44.0(34.0, 53.0) years). The efficacy was evaluated 6-12 months post 131I therapy based on serological tests (TgAb, Tg) and imaging results (ultrasonography, CT, 131I-whole body scan (WBS), SPECT/CT imaging), and the patients were divided into disease persistence/recurrence and non-persistence/recurrence groups. The χ2 test was used to analyze the difference in efficacy between the TgAb-positive group and the TgAb-negative group. Among TgAb-positive patients, the clinical characteristics of disease persistence/recurrence group were compared with those of non-persistence/recurrence ones by χ2 test or Mann-Whitney U test, and the independent risk factors affecting the efficacy of 131I therapy were analyzed by binary logistic regression. Results:The disease persistence/recurrence were found in 38 cases (15.4%, 38/246) of the TgAb-positive group and 143 cases (10.4%, 143/1 378) of the TgAb-negative group, with a statistically significant difference between the two groups ( χ2=5.42, P=0.020). Among the TgAb-positive patients, statistically significant differences were found in lymph node metastasis (35 vs 23 cases), the interval between surgery and 131I therapy (2.0(1.5, 3.0) vs 2.3(2.0, 3.0) months), stimulated Tg(sTg) level before the initial 131I therapy (0.18(0.04, 5.78) vs 0.04(0.04, 0.46) μg/L), and TgAb level before the initial 131I therapy (40.15(19.13, 156.15) vs 22.25(7.53, 76.20) kU/L) between disease persistence/recurrence group and non-persistence/recurrence group ( χ2=117.13, z values: -2.29, -2.41, -2.80, all P<0.05). Lymph node metastasis was an independent risk factor (odds ratio( OR)=89.326, 95% CI: 25.005-319.106, P<0.001) for the efficacy of 131I therapy in patients with TgAb-positive PTC. Conclusion:The overall efficacy of 131I therapy in patients with TgAb-positive PTC is relatively poor, and lymph node metastasis is an independent risk factor for the efficacy of 131I therapy, while the level of TgAb is not an independent risk factor for the efficacy of 131I therapy in these patients.

Objective:To summarize the clinical feature of functional distant metastasis (DM) of differentiated thyroid cancer (DTC) and observe the efficacy of 131I treatment. Methods:Between August 2008 and January 2021, a total of 13 DTC patients (4 males, 9 females; age 26-75 years) with functional DM from Henan Provincial People′s Hospital were retrospectively analyzed. Clinical data of patients were collected, including pathological type, metastasis size, metastasis location, and thyroid stimulating hormone (TSH) before the first 131I treatment. Efficacy of 131I treatment in patients with functional DM-DTC was evaluated by response evaluation criteria in solid tumors (RECIST) 1.1 and thyroglobulin (Tg). Complete remission (CR) and partial remission (PR) were considered as effective. Wilcoxon signed rank test was used to analyze the maximum diameter change of metastatic lesions before and after 131I treatment. Results:Among 13 DM-DTC patients, 8 were follicular thyroid cancer (FTC), 5 were papillary thyroid cancer (PTC). Metastasis lesions were mainly located in lungs ( n=12) and bones ( n=6). There were 12 patients with maximum metastasis diameter ≥1 cm, and 3 patients with TSH≥30 mU/L before the first 131I treatment. Nine patients were assessed as PR by RECIST 1.1, 3 patients were assessed as CR by RECIST 1.1 and the value of Tg, and 1 patient was assessed as PR by the changing of Tg. The effective rate of 131I treatment for patients with functional DM-DTC was 13/13. The maximum metastasis diameter was significantly decreased after 131I treatment (2.6(1.6, 3.3) vs 1.2(0.1, 2.2) cm; z=-3.06, P=0.002). Conclusion:Patients with functional DM-DTC are characterized by high proportion of FTC and the maximum metastasis diameter ≥1 cm, low proportion of TSH ≥30 mU/L before the first 131I treatment, and high effective rate of 131I treatment.

Objective:To explore the diagnostic value of quantitative 99Tc m-hydrazinonicotinamide(HYNIC)-prostate specific membrane antigen (PSMA) SPECT/CT in patients with prostate cancer. Methods:From November 2018 to March 2021, the data of 56 patients ((69.8±8.0) years) with clinically suspected prostate cancer, who had elevated radioactive uptake in prostate on 99Tc m-HYNIC-PSMA SPECT/CT images in Henan Provincial People′s Hospital, were retrospectively analyzed. According to the pathological results, patients were divided into prostate cancer group ( n=45) and non-prostate cancer group ( n=11). The xSPECT-QUANT software was used to quantitatively analyze the high uptake area of the prostate, and SUV max was measured. The independent-sample t test, Mann-Whitney U test, ROC curve and Spearman correlation analysis were used for data analysis. Results:The prostate cancer group had higher SUV max than non-prostate cancer group (10.79±5.96 vs 3.60±1.27; t=7.43, P<0.001). When SUV max≥6.46, the AUC of prostate cancer was 0.887, with the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 73.3%(33/45), 11/11, 100%(33/33), 47.8%(11/23), 78.6%(44/56), respectively. The SUV max of prostate cancer group was positively correlated with Gleason score ( rs=0.632, P<0.001). The SUV max of 29 patients with Gleason score≥8 was higher than that of 16 patients with Gleason score≤7 ( z=-3.89, P<0.001). There was no statistical difference in PSA level between patients with Gleason score≤ 7 and patients with non-prostate cancer ( z=-1.63, P=0.110), but the SUV max was significantly different ( z=-2.22, P=0.026). The SUV max of 23 patients with metastases was higher than that of 22 patients without metastasis (12.99±5.85 vs 8.50±5.28; t=2.69, P=0.010). ROC analysis showed that the AUC was 0.709; with SUV max≥13.02 as the threshold, the sensitivity for diagnosing prostate cancer metastases was 56.5%(13/23), the specificity was 86.4%(19/22), and the accuracy was 71.1%(32/45). Conclusions:The 99Tc m-HYNIC-PSMA SPECT/CT quantitative analysis is feasible in patients with prostate cancer. SUV max of 99Tc m-HYNIC-PSMA can be used in the diagnosis of prostate cancer, assessment of the malignancy and prediction of metastasis.

Objective:To prepare 68Ga-2-(4, 7-bis(carboxymethyl)-1, 4, 7-triazonan-1-yl)pentanedioic acid (NODAGA)-YHWYGYTPQNVI (GE11) and evaluate its feasibility of PET imaging for pancreatic cancer. Methods:GE11 peptide was conjugated with NODAGA and then labeled with 68Ga. The labeling yield, radiochemical purity, hydrophilicity, stability and specificity in vitro were determined. Human pancreatic cancer BxPC3 nude mice models ( n=9) were established. MicroPET imaging was then obtained after 30 and 90 min, and mice were sacrificed at 90 min to acquire the radioactivity distribution of main organs and tumors. Pair t test was used to analyze the data. Results:The labeling yield was (73.5±5.4)% and radiochemical purity was more than 98%. After incubation 120 min in mouse serum at 37 ℃, radiochemical purity was more than 92%. The uptake was specific in BxPC3 cell lines. MicroPET images showed that 68Ga-NODAGA-GE11 could accumulate quickly in tumor. Value of tumor uptake was significantly higher than that of normal pancreas at 90 min ((1.38±0.25) vs (0.49±0.07) %ID/g; t=12.67, P<0.05), and the radio-uptake of blood, muscle and bone was lower than that of tumor. Conclusions:68Ga-NODAGA-GE11 is easy to be prepared with high radiochemical purity and good stability, and can specifically target BxPC3 xenograft tumor. However, due to the high uptake in the kidneys and liver, the value of 68Ga-NODAGA-GE11 in PET imaging for pancreatic tumor needs further study.

Objective:To investigate the clinicopathological characteristics and 18F-fluorodeoxyglucose (FDG) PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs) with different pathological subtypes. Methods:From January 2013 to May 2018, 280 patients (196 males, 84 females, median age 58 years) with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed. Age, gender, smoking history, the location and size of tumor, Ki-67 positive index, thyroid transcription factor-1 (TTF-1), synaptophysin (Syn), chromogranin-A (CgA), CD56, maximum standardized uptake value (SUV max), lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs, including typical carcinoid (TC), atypical carcinoid (AC), small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). One-way analysis of variance, χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis. Results:There were significant differences in age, smoking history, tumor size and location, Ki-67 positive index, CgA, CD56, TTF-1, SUV max and TNM stage among TC( n=59), AC( n=21), SCLC( n=184) and LCNEC ( n=16) groups ( F values: 2.067, 3.358, H values: 17.749-22.351, all P<0.05). SCLC had the largest tumor size (5.5(3.0, 6.8) cm) and the highest proportion of central type (85.3%, 157/184), and were more prone to lymph node metastasis. LCNEC had the oldest age ((66±16) years), the largest proportion of smoking history (14/16) and peripheral type (12/16). CD56 in SCLC (95.7%, 176/184) and LCNEC(15/16) mostly showed positive expression, while the positive expression rates of CgA and TTF-1 were higher in TC and AC (96.6%(57/59), 93.2%(55/59) and 95.2%(20/21), 90.5%(19/21), respectively). The Ki-67 positive index and SUV max of the four subtypes were significantly different, with the highest in SCLC group and the lowest in TC group. Conclusion:Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on 18F-FDG PET/CT, which are useful for understanding their characteristics.

Objective: To study the effect of different wetness degrees in the root canal on the canal sealing. Methods: 160 root canal prepared single rooted teeth were divided into 4 groups (n = 40) by the root canal wetness degree (water content, V): (1) 0. 250 ～0. 299, (2) 0. 300 ～ 0. 599, (3) 0. 600 ～ 0. 899 and (4) 0. 900 ～ 1. 199 respectively. 80 teeth were divided into 4 groups (n = 20) for dye leakage test and another 80 for bacterial microleakage test. Zinc oxide paste (ZOP) and AH-Plus (AH-P) with vertical condensation of warm gutta-percha were respectively used to seal the canals in each group of the samples (n = 10) . The length of in vitro tooth dye penetration was measured by stereomicroscope; the time (days) of turbidity in the bacterial leakage model observed and compared. Results: Of all the canals sealed by ZOP or AH-P with the increase of the wetness the dye infiltration length increased significantly (P ＜0. 05) and the days in which the faecal intestine ball infiltrated into the lower chamber of the model was gradually decreased (P ＜0. 05) . Conclusion: The increase of root canal moisture may reduce the sealing of the root canal.

Objective: To investigate the regularity and clinical significance of abnormal bone uptake of ⁹⁹Tc^m-methylene bisphosphonate (MDP) in benign and malignant lesions. Methods: A retrospective analysis was performed on 266 patients (132 males, 134 females, age range: 8-85 years) with abnormal uptake of ⁹⁹Tc^m-MDP in extraosseous tissues from September 2015 to March 2018. The final diagnosis of abnormal uptake was made according to the histopathology, laboratory and related imaging examination (CT, MRI, ultrasound, SPECT/CT or PET/CT imaging) results within 2 weeks after ⁹⁹Tc^m-MDP imaging. Regularity of abnormal ⁹⁹Tc^m-MDP uptake was comprehensively analyzed. Differences between benign and malignant groups were compared by χ² test or Fisher exact test. Results: Abnormal ⁹⁹Tc^m-MDP uptake in extraosseous tissues in 232 patients (87.2%, 232/266) were confirmed as malignant lesions and those in 34 patients (12.8%, 34/266) were benign. There were no significant differences in gender (χ²=0.611, P>0.05), age (P=0.584), and location (P=0.118) between benign and malignant lesions, but the involvement was significantly different (χ²=19.515, P<0.05). There were significant differences between single focus and diffuse foci of single organ, diffuse foci of single organ and multiple foci groups (χ²=8.959, 19.325, both P<0.01). Conclusions The detection rate of malignancy among foci with abnormal ⁹⁹Tc^m-MDP uptake in extraosseous tissues is high, and the malignancy may relate with the involvement of foci. When extraosseous uptake is found, clinical information and related examination results should be comprehensively analyzed and the malignancy should be taken into account.

Objective To explore the association between serum amyloid A (SAA) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus(T2DM).Methods A total of 148 diabetic subjects were divided into three groups according to C1MT:normal IMT group,IMT incrassation group and arteriosclerosis group.Levels of SAA,25-hydroxyvitamin D [25 (OH) D],brachial-ankle artery pulse wave velocity (baPWV),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1 c),triglyceride (TG),total cholesterol (TC),body mass index (BMI) and blood presure were measured in all groups.The relationship between SAA,CIMT,25 (OH)D,baPWV and other factors was also analyzed.Results Compared to the normal IMT group,levels of FPG,HbA1 c,TC,BMI,SAA and ba-PWV were significantly higher in IMT incrassation group and arteriosclerosis group,while HDL-C and 25 (OH)D were lower.In arteriosclerosis group,levels of BMI,FPG,HbA1 c,SAA and ba-PWV were higher than those in IMT incrassation group,while 25 (OH) D was lower.Pearson correlation analysis showed that the level of SAA was positively correlated with baPWV,BMI,TC,course of disease and IMT,while it was negatively correlated with HDL-C and 25 (OH)D.Logistic regression analysis of IMT showed that smoking,obesity,high levels of HbAlc,FPG,TC,SAA,low levels of HDL-C and 25 (OH)D may contribute to higher levels of IMT.Conclusions SAA was closely related to carotid atherosclerosis.Further prospective studies will be helpful to explore the influence of SAA on diabetic macroangiopathy.