Objective:To determine the prevalence of sarcopenia and explore related influencing factors of sarcopenia in maintenance hemodialysis (MHD) patients.Methods:MHD patients aged ≥18 years old and receiving therapies of ≥3 months from March 2019 to December 2019 in Blood Purification Centre of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively enrolled in this study. General data of the patients were collected. Grip strength was measured by the Jamar dynamometer and the chair stand was measured by a chair of standard height to assess skeletal muscle strength and appendicular skeletal muscle mass was measured by dual energy X-ray absorptiometry. Baseline data between MHD patients with and without myasthenia were compared. Logistic regression analysis method was used to analyze the influencing factors for sarcopenia in MHD patients.Results:A total of 125 MHD patients were enrolled, with 68 males (54.4%), age of (59.4±14.9) years and median dialysis age of 51.0(23.5, 101.0) months. Sarcopenia was diagnosed in 39 cases (31.2%). Compared with MHD patients without sarcopenia, age, tumor necrosis factor-α, von Willebrand factor (vWF) and proportion of using α ketones were higher, and serum carbondioxide combining power (CO 2CP), prealbumin, albumin and proportion of regular exercise were lower in MHD patients with sarcopenia (all P<0.05). Multivariable logistic regression analysis results showed that low CO 2CP ( OR=0.717, 95% CI 0.576-0.892, P=0.003), high vWF ( OR=1.037, 95% CI 1.016-1.058, P<0.001) and no regular exercise ( OR=0.309, 95% CI 0.118-0.810, P=0.017) were independent influencing factors of sarcopenia in MHD patients. Conclusions:The prevalence of sarcopenia in MHD patients is high. Low CO 2CP, high vWF and no regular exercise are independent influencing factors for sarcopenia in MHD patients.

目的 研究18F-FDG PET/CT对腹部增强CT术前评估胰腺癌远处转移的增益价值.方法 回顾分析51例胰腺癌患者的腹部增强CT和18F-FDG PET/CT资料.通过增强CT、增强CT结合18F-FDG PET/CT评估胰腺癌是否发生远处转移,以病理或随访结果为金标准,分析18F-FDG PET/CT的增益价值.结果 增强CT结合18F-FDG PET/CT诊断胰腺癌远处转移的灵敏度、特异度和准确度分别为94.2％(33/35)、100％(16/16)、96.1％ (49/51),与单独增强CT的71.4％ (25/35)、100％ (16/16)、76.5％ (41/51)相比,灵敏度和准确度的差异有统计学意义(x2=6.43,P=0.011;x2=6.04,P=0.014).共有26例患者增强CT未检出远处转移,结合18F-FDG PET/CT后,其中6例接近肝包膜直径6.7～9.8 mm的肝转移和2例肺转移被检出.另25例增强CT检出远处转移的患者,结合18F-FDG PET/CT后,评估结果未发生改变.结论 18F-FDG PET/CT对于腹部增强CT未检出远处转移的胰腺癌患者有增益价值,尤其是肝内有直径＜1 cm且接近肝包膜的微小病灶患者.

目的 观察99 Tcm-甲氧基异丁基异腈(99 Tcm-MIBI)双时相平面显像和SPECT/CT断层显像诊断原发性甲状旁腺功能亢进症(PHPT)的价值.方法 收集术前接受99Tcm-MIBI双时相平面显像和SPECT/CT断层显像的疑似PHPT患者40例,所有患者均接受手术治疗.以术后病理诊断为金标准,计算并比较99Tcm-MIBI双时相平面显像和SPECT/CT断层显像诊断PHPT的灵敏度.结果 40例中,38例经病理确诊为PHPT,99Tcm-MIBI双时相平面显像灵敏度为89.47％ (34/38),99Tcm-MIBI SPECT/CT断层显像灵敏度为94.74％(36/38),差异无统计学意义(P＞0.05).对不同病灶大小及不同甲状旁腺素水平PHPT,99 Tcm-MIBI双时相平面显像与SPECT/CT断层显像诊断灵敏度差异均无统计学意义(P均＞0.05).结论 99Tcm-MIBI双时相平面显像和SPECT/CT断层显像诊断PHPT灵敏度高.

肝癌是消化系统中常见的恶性肿瘤之一,在我国其发病率在男性肿瘤中位居第3位,仅次于胃癌及食管癌,在女性为第4位。肝癌按其来源分为原发性肝癌和转移性肝癌。统计显示,目前转移性肝癌是最常见的肝脏恶性肿瘤,但是近20年来，原发性肝癌呈现明显的上升趋势。