目的 探讨肺内单发恶性肿瘤18F-FDG PET/CT显像时最大标准化摄取值(SUVmax)与肿瘤细胞生长指数(Ki-67)的相关性,为患者预后评估提供参考.方法 回顾性分析2016年4月至2018年7月安徽医科大学第二附属医院36例肺内单发恶性肿瘤患者资料,术前均行18 F-FDG PET/CT检查,测量病灶最大层面长径,病灶最大层面长径以3 cm为界,分为≤3 cm肺结节组和>3 cm肺肿块组.测定并计算肿瘤SUVmax早期值、SUVmax延迟期值、ΔSUVmax及滞留指数(RI),并采用Spearman秩相关分析与术后病理类型、Ki-67的相关性;采用非参数检验不同大小病灶的ΔSUVmax值及RI值差异、不同病理类型问ΔSUVmax值及RI值差异.结果 36例肺癌病灶SUVmax早期值为1.21～30.11,中位数为9.350(4.855,14.660).SUVmax延迟期值为1.53～31.71,中位数为10.450(6.938,17.233).原发灶最大层面长径为1.11～8.13 cm,中位数为2.700(2.075,3.668)cm.Ki-67为1％～90％.Spearman秩相关分析结果显示,SUVmax早期值与Ki-67的表达均呈低度相关(r=0.459,P<0.05);SUVmax延迟值、ΔSUVmax与Ki-67的表达均呈显著相关(r=0.584、0.506,P<0.05),RI与Ki-67问呈微弱相关(r=0.183,P=0.286).不同病理类型及不同大小病灶问ΔSUVmax值和RI值比较,差异无统计学意义(P>0.05).结论 肺内单发病灶行18F-FDG PET/CT显像时,不同肿瘤大小、病理类型对ΔSUVmax值和RI值影响不大.SUVmax越高,表明肿瘤增殖活性越大,可预估患者预后.

Objective:To investigate the application of brain pattern of the National Institutes of Health stroke scale (NIHSS) in the diagnosis and treatment of stroke.Methods:Sixty medical staff (30 doctors and 30 nurses) were included form the Second People's Hospital of Hefei. They were divided into experiment group (15 doctors and 15 nurses) and control groups (15 doctors and 15 nurses). The control group evaluated the condition of stroke patients according to the routine clinical data, while the experimental group evaluated it according to the conventional clinical data and NIHSS score brain chart. The efficiency of NIHSS brain pattern in the diagnosis and treatment of stroke patients was evaluated by questionnaire, and the differences of scores between two groups were compared by an independent sample t-test.Results:The doctors in the experiment group had a higher score of mastery of the patients' condition than those in the control group [(82.60±10.67) vs (72.27±8.65)], showing a statistically significant difference (t=2.911, P=0.007). The nurses in experiment group had a higher score of mastery of the patients' condition than those in the control group [(73.33±6.91) vs (51.07±6.88)], also showing a statistically significant difference (t=8.840, P＜0.001).Conclusion:The NIHSS brain pattern can assist medical staff in the diagnosis and treatment of stroke patients.

Objective:To screen differentially expressed genes (DEGs) between colorectal cancer and normal colorectal mucosa tissues by bioinformatics and analyze their relationship with prognosis.Methods:Colorectal cancer gene microarrays datasets GSE110224, GSE41328 and GSE22598 were downloaded from Gene Expression Omnibus (GEO) database. DEGs between colorectal cancer samples and normal tissue samples from those three datasets were screened by R software 4.0.3, and then GO and KEGG pathway analysis were carried out. The protein interaction network was constructed by STRING database, Cytoscape software v3.7.2 was used to screen the hub genes in the protein-protein interaction (PPI) network. Finally, the selected hub genes were validated and analyzed for the relationship with prognosis by the GEPIA database.Results:A total of 366 DEGs were screened, of which 128 were up-regulated and 238 were down-regulated. GO function enrichment showed hub genes were mainly involved in proteolysis, positive regulation of proliferation and other biological processes, and cellular component mainly enriched in extracellular space, extracellular region, mediating zinc ion binding, calcium ion binding and other molecular functions. KEGG analysis showed that the enriched pathways are mainly related to cytokine-cytokine receptor interaction, chemokine signaling pathway and other signal transduction pathway. Ten hub genes were selected from the PPI network, including nine up-regulated genes, which were CXCL8, CXCL1, SPP1, COL1A1, SOX9, MMP3, COL1A2, CD44, CXCL5, and one down-regulated gene CXCL12. Those ten genes were verified by using GEPIA showing that eight of them existed significant difference and all of them were consistent with the above analysis. Survival analysis results showed that genes CXCL8, SPP1 and COL1A2 were significantly associated with the survival rate of colorectal tumor patients.Conclusion:CXCL8 and SPP1 may be prognosis key genes of colorectal tumor patients and may serve as a potential biomarker providing basis on molecular level for screening and diagnosis of colorectal tumor.

目的 核素肾动态显像评估12种肾小球滤过率(GFR)计算公式在估算肾脏疾病患者GFR中适用性.方法 选择肾脏疾病患者137例,其中男性84例,女性53例;年龄16～85岁,中位年龄52.5岁;慢性肾脏病(CKD)84例,非CKD53例.行99m锝-二乙三胺五乙酸(99mTc-DTPA)肾动态单光子发射体层摄影术(SPECT)测定GFR.以SPECT所测得的GFR(iGFR)作为参考标准,以临床应用的12种方程(如MDRD公式、CKD-EPI、CG公式、Hojs公式、Filler公式)估算GFR(eGFR)为对照,分析各eGFR与iGFR的相关性、偏差、精确度、准确率、一致性及各公式预测早期CKD[或肾功能下降iGFR＜60mL/(min·1.73 m2)]诊断效能.结果 各eGFR与iGFR均显示相关性(P＜0.05).在数值估算上,CKD组中CKD-EPI糖尿病估算的eGFR与iGFR有较小偏差、较高精确度、较高符合率及一致性,非CKD组一致性超过预定的界限.12种公式预测早期CKD[或肾功能下降iGFR＜60 mL/(min·1.73m2)]诊断效能受试者工作特性(ROC)曲线下面积示CKD-EPI糖尿病测量的eGFR曲线下面积、Youden指数最大,非CKD组Hojs公式、Filler公式测量的eGFR曲线下面积、Youden指数最大.结论 12种公式预测的eGFR均存在不同程度偏差,CKD-EPI糖尿病在CKD、非 CKD两组中预测GFR值最适用;CKD-EPI糖尿病预测CKD组早期CKD发生诊断效能最大,Hojs公式、Filler公式预测非CKD组早期肾功能下降[GFR＜60 mL/(min·1.73 m2)]发生诊断效能最大.

目的 对比不同b值下前列腺影像报告与数据系统(PI-RADS)v2.1评分对前列腺病变的诊断效能,确定PI-RADS v2.1的最佳诊断b值.资料与方法 纳入病理证实的41例前列腺癌(PCa)和37例前列腺增生(BPH)患者,由2位医师分别对MRI T2WI、DWI(b值取800、1200、1500 s/mm2)及动态增强图像进行PI-RADS v2.1评分,并对评分结果进行一致性检验.比较不同b值下PI-RADSv2.1评分及病变表观扩散系数(ADC)值,并确定不同b值下前列腺外周带、移行带不同病理性质病变PI-RADS v2.1评分及ADC值的差异.根据受试者工作特征(ROC)曲线获得PI-RADSv2.1评分及ADC值的曲线下面积(AUC)及Delong检验,确定最大诊断效能对应的b值.结果 不同b值下,2位医师对所有病变PI-RADS v2.1评分一致性较强(Kappa=0.767、0.808、0.779,P<0.05).b值分别为800、1200、1500 s/mm2时,前列腺外周带PI-RADS v2.1分值AUC分别为0.838、0.838、0.905,前列腺移行带AUC分别为0.846、0.851、0.860;前列腺外周带ADC值的AUC分别为0.883、0.901、0.886,前列腺移行带AUC分别为0.828、0.838、0.808.前列腺外周带及移行带良、恶性病变的PI-RADSv2.1评分及ADC值比较,差异均有统计学意义(P<0.05).结论 不同b值下,PI-RADS v2.1评分对前列腺良、恶性病变均有较高的诊断效能.b值为1500 s/mm2时,对外周带良、恶性病变的诊断效能最高.ADC值可作为PI-RADS v2.1评分的补充.

Objective:To investigate the correlations among standardized uptake value (SUV), CT value, maximum transverse diameter of normal prostate, and patient age through 18F-fluorodeoxyglucose (FDG) PET/CT. Methods:Retrospective analysis of 181 male patients aged 19-94 (60.6±14.5) years who underwent 18F-FDG PET/CT in the Second Hospital of Anhui Medical University from June 2018 to February 2019 was performed. The patients were divided into four groups by age group (19-39 years, 16 cases; 40-59 years, 57 cases; 60-79 years, 94 cases; and 80-99 years, 14 cases). The maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), and mean CT value (CT mean) of prostate 18F-FDG were measured through a delineated region of interest method, and the maximum transverse diameter of the prostate was measured at the maximum transverse plane of the prostate. SPSS 16.0 statistical software was used in analyzing the correlations among the maximum transverse diameter of the prostate, SUV max, SUV mean, CT mean, and age on the basis of the Pearson correlation coefficient, scatter plot, and linear regression trend line. One-way ANOVA and LSD- t test were used for each parameter. Results:The maximum transverse diameter of the normal prostate was 3.4-6.5(4.66±0.59) cm, SUV max was 1.0-4.2 (2.44±0.49), SUV mean was 0.7-3.4(1.97±0.44), CT mean was 25-46(34.5±3.72) HU. The maximum transverse diameter of the prostate was positively correlated with age ( r=0.465, P<0.001). No significant correlation between prostate SUV max, SUV mean and age, the maximum transverse diameter of the prostate ( r=0.047, 0.071, 0.040, 0.035, all P>0.05). Prostate CT mean increased with age, and an extremely weak correlation or no correlation was observed between them ( r=0.126, P=0.091). The maximum transverse diameters of all the age groups (19-39, 40-59, 60-79, and 80-99 years) were (4.04±0.27), (4.52±0.53), (4.77±0.54), and (5.24±0.65) cm, respectively, the SUV max were 2.48±0.65, 2.38±0.50, 2.46±0.47, 2.48±0.42, respetively; the SUV mean were 2.03±0.51, 1.90±0.44, 2.00±0.42, and 2.05±0.41, respectively; and the CT mean were (33.25±3.59), (34.19±3.76), (34.76±3.80), and (35.29±2.97) HU, respectively. Significant differences were found among the maximum transverse diameters of the age groups ( F=16.278, P<0.001), whereas no significant difference was found among SUV max, SUV mean, and CT meanConclusion:The maximum transverse diameter of the prostate increases with age, but age does not significantly affect the glucose metabolism and CT density of the prostate.

目的 探讨核素甲状腺显像在131 I治疗甲状腺两叶不均等Graves病病人中的应用,为临床Graves病的131 I个性化治疗提供依据.方法 选择2010年1月至2015年12月间,在安徽医科大学第二附属医院核医学科首次接受131 I治疗的Graves病病人194例.131 I治疗前均行甲状腺核素显像,勾画甲状腺两叶ROI(region of interest),分别记录两叶放射性计数,根据两叶放射性计数比值差值绝对值分为两组:A组为比值差值≥20％,共40例;B组为差值<5％,共154例.参照131 I治疗格雷夫斯甲亢指南(2013版)又分为:治愈组(完全缓解和甲减)和未愈组(部分缓解、无效和复发).结果 (1)A、B组病人治愈率分别为75.00％、89.61％,两组治愈率间比较差异有统计学意义(χ2=5.84,P<0.05);(2)40例Graves病病人中甲状腺两叶长轴比值、短轴比值及面积比值的差值与放射性计数比值的差值均无相关性(均P>0.05);(3)A、B两组病人的治疗剂量分别为(474.00±310.80)MBq、(393.68±306.73)MBq,差异无统计学意义(均P>0.05);而A组中未愈组和治愈组与B组未愈组和治愈组比较均差异有统计学意义(均P<0.05).结论 (1)131I治疗甲状腺两叶大小不均等Graves病的效果明确,但较均等增大病人的重复治疗机率增大,可适当增加131 I治疗计划量;(2)甲状腺的长轴、短轴及面积等指标不能替代放射性计数来评估Graves病病人甲状腺两叶的不均等性.

脊髓震荡是脊髓损伤的一种类型,发病率相对较低可以导致短暂的神经系统紊乱、相关的运动和感觉丧失,并在受伤后48-72h内完全恢复 [1] 。脊髓震荡通常多发生在车祸、跌倒和各种运动过程中,最常发生部位为颈段 [2] 。相比急性脊髓损伤能够导致永久性肌力,感觉及自主功能的丧失,脊髓震荡预后良好 [3] 。影像学检查对于脊髓损伤的患者是必不可少的,常规MR检查对脊髓震荡的诊断有较大的局限性。磁共振扩散张量成像（DTI）作为近年来脊

目的 131I是核医学中使用量较大的人工放射性核素,挥发性强,在人体剂量学中,微粒碘与气态碘对内照射剂量的影响不同,因此研究应用过程中不同形态131I在环境中分布对内照射剂量估算具有重要的意义.方法 使用活性炭盒加滤膜分别采集某医院核医学科不同区域内空气中的气态131I和微粒态131I,利用HPGeγ谱仪对采集样品进行测量,获得了不同区域中气态碘和微粒碘的浓度分布.结果 给药量为400 mCi时核医学科区域中的气态131 I浓度范围为5.6×10-1～1.2×102Bq/m3,微粒态131I的浓度范围1.0 ×10-1 ～8.9 Bq/m3,给药室和病房中微粒与气态131I的比值在0.053～0.659之间,其比值都小于1.结论 气态131I相对微粒态131I来说浓度较高,且在核医学科不同区域,该比值差异较大.

目的 探讨全身骨扫描及MRI检查在诊断椎体终板炎中的应用价值.方法 收集安徽医科大学第二附属医院2014年6月至2016年12月行全身骨扫描,同时在骨扫描前后1个月内行脊柱或局部MRI检查并诊断为终板炎的38例患者的临床资料,由2位有经验的核医学科医师及放射科医师独立进行骨扫描及MRI图像的分析.结果 38例患者中,MRI共发现85个病灶,各部位占比为颈椎3.53％(3/85)、胸椎7.06％(6/85)、腰椎44.71％(38/85)、颈胸椎5.89％(5/85)、胸腰椎7.06％(6/85)、腰骶椎31.76％(27/85).Modic分型诊断为Ⅰ型者18例,Ⅱ型者18例,另2例介于Ⅰ型及Ⅱ型间,Ⅲ型0例.MRI诊断为椎体终板炎且骨扫描为阳性的病例中,共发现病灶数30个,各部位占比为腰椎60.0％(18/30)、腰骶椎20％(6/30)、胸椎10％(3/30)、胸腰椎6.67％(2/30)、骶椎3.33％(1/30).将全身骨扫描与MRI检查结果按符合程度进行讨论,包括阴性符合19例、完全符合6例、部分符合7例、不符合2例、部分不符合4例.绪论MRI在诊断椎体终板炎方面有明显的优势,骨扫描进行骨转移瘤诊断时,应充分结合MRI图像,可提高对椎体终板炎的诊断准确率.

Objective To investigate the application value of chronic kidney disease epidemiology collaboration (CKD-EPI) equations and amendatory equations for calculating glomerular filtration rate (GFR) in Chinese patients with diabetes,including CKD-EPI serum creatinine (Scr) equation (CKD-EPLcr),CKD-EPI serum cystatin C (ScysC) equation (CKD-EPLcysc),combination of CKD-EPLcr and CKD-EPIScrSCysC (CKD-EPISr SCysC),Asian modified CKD-EPI equation (CKD-EPIAsian),Chinese diabetes CKD-EPI equation (CKD-EPIDiabctes),refitted modification of diet in renal disease (MDRD) equation (rMDRD),Cockcroft-Gault equation (CG) and Simplified MDRD equation.Methods Serum creatinine (Scr) was detected using basic picric acid method,serum cystatin C (CysC) was measured by Latex enhanced turbidimetric,and the reference value of GFR was worked out by 99Tcm-DTPA renal dynamic imaging and standardization of body surface area.Relation of Scr,Scysc,GFR measured by every equations and rGFR were analyzed.The accuracy of 30％ of each equation,the consistency and deviation of the evaluation of renal function by each equation were compared.The diagnostic efficacy in GFR＜60 ml/(min · 1.73 m2) was compared using the receiver operating characteristic (ROC) curve.Results The rGFR had negative correlation with Scr、ScysC (both P＜0.001).The rGFR had positive correlation with GFR measured by CKD-EPIScr,CKD-EPIScysC,CKD-EPIS-SCysC,CKD-EPIAsian,CKD-EPIDiabetes rMDRD,CG and Simplified MDRD (all P＜0.001).The coincidence rate between 30％ of rGFR and GFR measured byCKD-EPIDiabetes and simplified MDRD were higher.There was no significant difference of rGFR and GFR measured by CKD-EPIscr,CKD-EPIScysC,CKD-EPIScr-SCysC,CKD-EPIAsian,CKD-EPIDiabetes,rMDRD,CG and Simplified MDRD.GFR measured by CKD-EPIDiabetes has the best consistent degree with rGFR.ROC curve showed that the area under curve of GFR measured by CKD-EPIDiabctes was largest and the Youden index was the highest.Conclusion There are different degrees of deviation in eGFR predicted by the eight kinds of equations.The accuracy and consistency of CKD-EPIDiabetes in Chinese 2-type diabetes is the best.

目的:观察综合保温措施对快速康复外科后腹腔镜下肾上腺切除术体温的影响.方法:选择ASAⅠ~Ⅲ级择期后腹腔镜下肾上腺切除术手术患者60例,随机分为常规对照组和综合保温处理组,每组30例.综合保温处理组全程应用综合保温措施,对照组术中常规保温护理.观察两组患者麻醉前、麻醉期间、麻醉复苏期各时段血流动力学、体温的变化.结果:综合保温处理组麻醉苏醒时间显著短于常规对照组,差异有统计学意义(P<0.05);在麻醉60、90、120 min及麻醉后30 min时,综合保温处理组体温均显著高于常规对照组,差异均有统计学意义(P<0.05),且其低体温发生率显著低于常规对照组,差异有统计学意义(P<0.05).结论:综合保温措施可有效预防快速康复外科后腹腔镜下肾上腺切除术低体温发生,有利于患者术后恢复.

Objective:To evaluate the applicability of the seven glomerular filtration rate estimation formulas in patients with renal malignancies.Method:Eighty patients with urinary system tumors treated in urology of our hospital between January 2015 and December 2016 were reviewed retrospectively.The glomerular filtration rate (GFR) measured by 99mTc-DTPA renal dynamic imaging was normalized by the surface area as reference standard rGFR,GFR of tumor patients was calculated by CKD-EPIscr,CKD-EPISCysC,CKD-EPIScr-SCysc,CKD-EPIAsis,CKD-EPIdiabetes modified MDRD and simplified MDRD were expressed as for eGFR-EPIscr,eGFR-EPIsCysC,eGFR-EPIscr-scysc,eGFR-EPIAsia,eGFR-EPIdiabetes,eGFRmodified MDRD,eGFRsimplified MDRD,respectively.The seven formulas were evaluated in terms of correlation,deviation,30％ accuracy,precision and 95％ consistency and diagnosis of renal function decline the receiver-operating characteristic curve (ROC) in patients with renal malignant tumor.Result:①There was a correlation between Scr and rGFR (r=-0.298,P =0.007),and SCysC had no correlation with rGFR (r=-0.154,P=0.173).(②)eGFR-EPIscr,eGFR-EPIsCysc,eGFR-EPIscr-SCscc,eGFR EPIAsia,eGFR-EPIdiabetes eGFRmodified MDRD,eGFRsimplified MDRD were correlated with rGFR (r=0.434,0.282,0.383,0.421,0.506,0.429,0.426,P=0.000,0.011,0.000,0.000,0.000,0.000,0.000,respectively).③The coincidence rate between 30％ of rGFR and eGFR EPIscr,eGFR-EPIAsia,eGFR-EPIdiabetes was the highest.④Paired t test showed there was no significant difference between eGFR-EPIscr,eGFR-EPIsCysC,eGFR-EPIscr-SCysc,eGFR-EPIAsia,eGFR simplified MDRDand rGFR (P＞0.05).⑤Bland-Altman plot showed that all formula conformance exceeded the predetermined limit,in comparison,eGFRdiab and rGFR consistency is better.With GFR＜60 ml · min-1 · 1.73m-2 for diagnostic point to kidney function decline,ROC curve showed that the area under the curve of eGFR-EPIscr,eGFR-EPISCysC,eGFR-EPIScr-sCysC,eGFR-EPIAsia,eGFR-EPIdiabetes,eGFRmodified MDRD,eGFRsimplified MDRD were 0.808,0.684,0.765,0.781,0.848,0.792,0.797,respectively.The eGFR estimated by eGFR-EPIScr-SCysc,eGFR EPIScr,eGFR EPIAsia,eGFRmodified MDRD,eGFRsimplmed MDRD,eGFR-EPIdiabetes showed the highest sensitivity,and eGFR-EPIdiabetes showed the best specificity.Conclusion:The eGFR estimated by the seven formulas were different.However,CKD-EPIdiabetes eGFR-EPIscr,eGFR-EPIAsia and eGrFRsimplmed MDRD have the better accuracy in estimating GFR,and the sensitivity and specificity of diagnosis of renal function are better.But it is necessary to further revise by increasing the sample size.

目的:探讨18F-脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)PET/CT联合血清糖类抗原125(carbohydrate antigen 125,CA125)及人附睾蛋白4(human epididymis protein 4,HE4)检测在卵巢癌术后复发和转移中的诊断价值.方法:回顾性分析63例卵巢癌患者术后PET/CT、CA125及HE4结果,与手术病理或临床随访资料相比较,判断三者对复发或转移性卵巢癌的诊断价值及相关性.结果:PET/CT诊断卵巢癌复发和转移的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为94.00%、84.62%、92.06%、95.92%、78.57%.CA125水平与复发和转移灶的最大标准摄取值(maximum standardized uptake value,SUVmax)呈正相关(r=0.428,P=0.002).PET/CT联合HE4诊断卵巢癌复发和转移的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为98.00%、84.62%、95.24%、96.08%、91.67%.结论:在诊断卵巢癌复发和转移中,18F-FDG PET/CT联合HE4具有最高的诊断效能.

目的 测量131I治疗甲癌过程中病人周围辐射场的空间分布和随治疗时间的变化趋势,为甲癌治疗病房的屏蔽设计和该类项目的辐射环境管理提供参考.方法 主动测量结合被动测量.结果 病人服药5 min后,其胸前1 m处剂量率达到393 μGy/h,随着治疗时间的增加,剂量率大幅衰减;整个治疗过程中,病人对距其最近的监测点处产生的累积剂量达到2.6 mSv;对于病房内各个累积剂量监测点,前24 h产生的剂量占整个治疗过程所产生总剂量的57％～ 80％,前48 h产生的剂量占整个治疗过程所产生总剂量的80％～95％,治疗后期对总剂量贡献很小.结论 测量结果较好地反映了131I治疗整个分化型甲状腺癌转移病灶过程中所产生辐射场的源强和分布.

目的 探讨99TcmO4- 甲状腺显像及融合显像在分化型甲状腺癌术后转移灶显影中的应用. 方法 回顾性分析2013年6月1日至2014年12月31日行甲状腺显像的分化型甲状腺癌术后患者共69例,观察残余甲状腺及转移灶的显示情况.结果 其中清除残余甲状腺治疗前34例显像者中,残余右叶显影9例(9/34),残余左叶显影5例(5/34),锥形叶显影6例(6/34),残余右叶及锥形叶显影3例(3/34),残余左叶及锥形叶显影3例(3/34),残余左叶、右叶显影5例(5/34),残余左叶、右叶及锥形叶显影3例(3/34). 颈部未见摄锝组织显影35例(35/69),且均为清甲治疗后患者. 其中有1例患者可见右侧髂骨翼放射性分布增高,1例患者可见全身多发放射性摄取增高,结合融合CT影像上述病灶均可见较明显骨质破坏;另1例患者可见左侧下颈部软组织包块,放射性分布增高,后经病理证实上述病灶均为转移灶. 结论 99TcmO4 -甲状腺显像简单、方便,不仅可以了解分化型甲状腺癌术后残余甲状腺情况,同时可以判断清甲治疗效果,亦可以用来明确部分分化型甲状腺癌术后转移情况.

Objective To discuss the diagnostic value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) in the tumor pa-tients with pathogens infection. Methods The clinical data of 43 tumor patients with pathogens infection ( the infection group) and 43 tumor patients without pathogens infection ( the non-infection group) ever treated in our hospital from Apr 2014 to Jan 2016 were retrospectively ana-lyzed. The variability and correlation of leukocyte count, neutrophils count, lymphocyte count, NLR, hemoglobin ( Hb) level and serum al-bumin ( ALB) level in the two groups were statistically analyzed and compared with the healthy controls. The risk factors of pathogens infec-tion in the tumor patients were analyzed by binary logistic regression, and the diagnostic value of NLR in the tumor patients with pathogens in-fection were evaluated by receiver-operating characteristic ( ROC) curves. Results NLR of the infection group was significantly higher than those of the non-infection group and healthy controls, and NLR of the non-infection group was also significantly higher than that of healthy controls (P=0. 000). Leukocyte count and neutrophils count of the infection group were significantly higher than those of the non-infection group and healthy controls (P =0. 000, P =0. 001), while no significant difference was found between the non-infection group and the healthy controls (P=0. 240, P=0. 666). Lymphocyte count, Hb and ALB levels of the infection group were significantly lower than those of the non-infection group and healthy controls (P=0. 000, P=0. 000, P=0. 003), and those of the non-infection group were also significant-ly lower than those of healthy controls (P=0. 000, P=0. 000, P=0. 000). NLR of the tumor patients was negatively associated with their serum ALB levels, Hb levels and lymphocyte count (r= -0. 530, r= -0. 216, r= -0. 740;P=0. 000, P=0. 046, P=0. 000), and was positively associated with their neutrophils count (r=0. 604, P=0. 000). Logistic regression analysis showed that the increase of NLR and the decrease of ALB were independent risk factors of the tumor patients with pathogens infection (P=0. 001, P=0. 023). ROC curves resul-ted that area under the curve (AUC) of NLR was 0. 864 (P=0. 000), and when the NLR value being 4. 19 and 4. 62, the NLR sensitivity of infection diagnosis were 88. 39% and 83. 7%, the NLR specificity were 69. 77% and 74. 4%, respectively, with the best diagnostic val-ue. The AUC of neutrophils count was 0. 647 (P=0. 018), and the leukocyte count showed no diagnostic value for infection (P=0. 237). Conclusion The peripheral blood NLR shows diagnositic value in the tumor patients with pathogens infection, and it also has correlation&nbsp;with the ALB and Hb levels.

Objective To explore the relationship among the different degrees of distress and quality of life scores in breast cancer patients after chemotherapy. Methods From March 2015 to March 2016, 60 breast cancer patients received 6 cycles of stand?ard chemotherapy in our hospital were evaluated by distress thermometer ( DT) and Functional Assessment of Cancer Therapy?Breast ( FACT?B) . Depending on whether the DT≥4, patients were divided into high and low groups. The scores of quality of life were com?pared between both groups. The correlation of distress and quality of life were analyzed. Results Sixty patients completed the question?naire. The average FACT?B score was 124?3±11?2 in DT low group, while 89?5±15?6 in DT high group, and the difference between the two groups was significant ( t=10?06, P<0?05) . There was a negative correlation between the DT score and FACT?B score signifi?cantly ( r=-0?949,P<0?05) . Conclusion Patients with breast cancer present different degree of psychological distress after chemo?therapy, and the distress scores is closely related to quality of life.

Objective To evaluate the clinical value of 99m Tc -MIBI SPECT/CT imaging for diagnosis of secondary hyperparathyroidism(SHPT),and to investigate the effect of possible factors on the parathyroid imaging.Methods A total of 35 patients were selected inthis study.Five minutes,thirty minutes (early phase)and two hours (delayed phase)after intravenous injection of 99m Tc-MIBI(740MBq),dual -phase planar imaging was performed,followed by SPECT/CT imaging over neck and chest.Thirty -five SHPT patientswere compared by both planar imaging and SPECT/CT imaging,while diagnosis of twenty -nine patients included was confirmed by pa-thology.χ2 -test was used to compare the results of planar and SPECT/CT imaging using SPSS 16.0 software.Results Compared to71.43%(25 /35)of the positive rate in planar imaging,the positive rate of the SPECT/CT imaging was 91.43%(32 /35).Difference inthe positive rates between planar and SPECT/CT imaging was statistically significant(χ2 =5.1429,P <0.05).Conclusions SPECT/CT imaging is more efficient than planar imaging for the fusion imaging and CT diagnosis of parathyroid glands with secondary hyperpar-athyroidism.SPECT/CT parathyroid imaging combined with CT scan can provide more information about localization of the lesions,which highly improve the positive rate of parathyroids.

Objective To assess the accuracy and feasibility of adenosine stress myocardial perfusion scintigraghy(MPS)for the di-agnosis ofcoronary artery disease(CAD).Methods A total of32 suspected coronary artery disease patients mean age (64.3 ±11.6)years, 22 men,10 women were recruited in this study.Adenosine was infused intravenously at a rate of o.14mg/kg/min for 6 minutes.At the end of 3 minute of adenosine infusion,925MBq of 99mTc-MIBI was injected intravenously.SPECT myocardial imaging acquisition was obtained 1 hour after adenosine infusion.If it was abnormal,the next day resting myocardial perfusion imaging was performed.Coronary angiography was performed in all patients.Results Fourteen patients had significant coronary artery stenosis and 18 had normal coronary angiography.Adeno-sine myocardial perfusion imaging was abnormal in 12 out of the 14 patients with significant coronary artery stenosis(sensitivity,85.71%). Fourteen out of the 18 patients with normal angiography had a normal adenosine myocardial perfusion imaging (specificity,77.78%).The positive predictive value and negative predictive value of adenosine 99mTc-MIBI myocardial perfusion imaging for detection of coronary ar-tery disease was 75%and 87.5%,respectively.Conclusion Adenosine myocardial perfusion imaging is probably an accurate method for de-tecting coronary artery disease and myocardial viability and is of value for patients with coronary disease to choose appropriate therapeutic strategies.