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To explore the relationship between low-density lipoprotein cholesterol (LDL-C) level and infection risk in elderly stage 5 kidney disease (CKD) patients. This study retrospectively analyzed all 378 patients with grade 5 CKD over 60 years old treated in the Nephrology Department of our hospital from February 2014 to July 2019, including 286 cases with infection and 92 cases without. According to LDL-C levels, the patients were divided into three groups (Tertile 1-Tertile 3). Basic patient data and laboratory test results were collected for all three groups for analysis. The incidence of infection showed a gradually decreasing trend in the three groups (from 80.2, 78.6 to 68.3%), along with increasing LDL-C levels from Tertile 1 to Tertile 3, although the differences were not statistically significant (p = 0.075). After fully adjusting for confounding factors, the risk of infection was significantly reduced (OR = 0.646, 95% CI 0.420–0.993, p = 0.046) with increasing LDL-C levels. For the LDL-C levels of the three groups, the rising trend of LDL-C was significantly associated with the reduction in infection risk (OR = 0.545, 95% CI 0.317–0.937, p = 0.028). Curve fitting revealed that LDL-C levels were linearly negatively associated with the risk of infection, and the relationship between the two was not affected by the other factors (p for interaction: 0.567–1.000). LDL-C level is linearly negatively associated with the risk of infection in elderly patients with stage 5 CKD.

BACKGROUND: To explore the association between the glucose metabolism level of lung ground-glass nodules (GGNs), as revealed by (18)F-flurodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) imaging, and the invasive pathological growth pattern of early lung adenocarcinoma. METHODS: We retrospectively analyzed patients who underwent PET/CT examination and surgical resection due to persistent GGNs, which were confirmed to be early lung adenocarcinoma by postoperative pathology examination. After adjusting for confounding factors and performing stratified analysis, we explored the association between the maximum standard uptake value of PET (SUVmax) and the invasive pathological growth pattern of early stage lung adenocarcinoma. RESULTS: The proportions of invasive adenocarcinoma (INV) in the SUVmax of Tertile 1, Tertile 2, and Tertile 3 were 52.7%, 73.3%, and 87.1%, respectively. After adjusting for potential confounding factors, the risk of INV gradually increased as the GGN SUVmax increased [odds ratio (OR): 1.520, 95% confidence interval (CI): 1.044–2.213, P=0.029]. This trend was statistically significant (OR: 1.678, 95% CI: 1.064–2.647, P=0.026), especially in Tertile 3 vs. Tertile 1 (OR: 4.879, 95% CI: 1.349–17.648, P=0.016). Curve fitting showed that the SUVmax and INV risk were linearly and positively associated. The association was consistent in different subgroups based on GGN number, type, shape, edge, bronchial sign, vacuole sign, pleural depression sign, diameters, and consolidation-to-tumor ratio, suggesting that there was no significant interaction between different grouping parameters and the association (P for interaction range = 0.129–0.909). CONCLUSIONS: In FDG PET, the glucose metabolism level (SUVmax) of lung GGNs is independently associated with INV risk, and this association is linear and positive.

Background Sublobar resection is suitable for peripheral cT1N0M0 non-small-cell lung cancer (NSCLC). The traditional PET-CT criterion (lymph node size ≥1.0 cm or SUVmax ≥2.5) for predicting lymph nodes metastasis (LNM) has unsatisfactory performance. Objective We explore the clinical role of preoperative SUVmax and the size of the primary lesions for predicting peripheral cT1 NSCLC LNM. Methods We retrospectively analyzed 174 peripheral cT1 NSCLC patients underwent preoperative 18F-FDG PET-CT and divided into the LNM and non-LNM group by pathology. We compared the differences of primary lesions' baseline characteristics between the two groups. The risk factors of LNM were determined by univariate and multivariate analysis, and we assessed the diagnostic efficacy with the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value (NPV). Results Of the enrolled cases, the incidence of LNM was 24.7%. The preoperative SUVmax >6.3 or size >2.3 cm of the primary lesions were independent risk factors of peripheral cT1 NSCLC LNM (ORs, 95% CIs were 6.18 (2.40-15.92) and 3.03 (1.35-6.81). The sensitivity, NPV of SUVmax >6.3 or size >2.3 cm of the primary lesions were higher than the traditional PET-CT criterion for predicting LNM (100.0 vs. 86.0%, 100.0 vs. 89.7%). A Hosmer-Lemeshow test showed a goodness-of-fit (P = 0.479). Conclusions The excellent sensitivity and NPV of preoperative of the SUVmax >6.3 or size >2.3 cm of the primary lesions based on 18F-FDG PET-CT might identify the patients at low-risk LNM in peripheral cT1 NSCLC.

BACKGROUND: Sublobar resection is not suitable for patients with pathological invasiveness [including lymph node metastasis (LNM), visceral pleural invasion (VPI), and lymphovascular invasion (LVI)] of peripheral clinical T1 (cT1) non-small cell lung cancer (NSCLC), while primary tumor maximum standardized uptake value (SUV(max)) on (18)F-FDG PET-CT is related to pathological invasiveness, the significance differed among different institutions is still challenging. This study explored the relationship between the tumor-to-blood standardized uptake ratio (SUR) of (18)F-FDG PET-CT and primary tumor pathological invasiveness in peripheral cT1 NSCLC patients. METHODS: This retrospective study included 174 patients with suspected lung neoplasms who underwent preoperative (18)F-FDG PET-CT. We compared the differences of the clinicopathological variables, metabolic and morphological parameters in the pathological invasiveness and less-invasiveness group. We performed a trend test for these parameters based on the tertiles of SUR. The relationship between SUR and pathological invasiveness was evaluated by univariate and multivariate logistics regression models (included unadjusted, simple adjusted, and fully adjusted models), odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. A smooth fitting curve between SUR and pathological invasiveness was produced by the generalized additive model (GAM). RESULTS: Thirty-eight point five percent of patients had pathological invasiveness and tended to have a higher SUR value than the less-invasiveness group [6.50 (4.82–11.16) vs. 4.12 (2.04–6.61), P

Background To establish and validate 18F-fluorodeoxyglucose (18F-FDG) PET/CT-based radiomics model and use it to predict the intermediate-high risk growth patterns in early invasive adenocarcinoma (IAC). Methods Ninety-three ground-glass nodules (GGNs) from 91 patients with stage I who underwent a preoperative 18F-FDG PET/CT scan and histopathological examination were included in this study. The LIFEx software was used to extract 52 PET and 49 CT radiomic features. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select radiomic features and develop radiomics signatures. We used the receiver operating characteristics curve (ROC) to compare the predictive performance of conventional CT parameters, radiomics signatures, and the combination of these two. Also, a nomogram based on conventional CT indicators and radiomics signature score (rad-score) was developed. Results GGNs were divided into lepidic group (n = 18) and acinar-papillary group (n = 75). Four radiomic features (2 for PET and 2 for CT) were selected to calculate the rad-score, and the area under the curve (AUC) of rad-score was 0.790, which was not significantly different as the attenuation value of the ground-glass opacity component on CT (CTGGO) (0.675). When rad-score was combined with edge (joint model), the AUC increased to 0.804 (95% CI [0.699–0.895]), but which was not significantly higher than CTGGO (P = 0.109). Furthermore, the decision curve of joint model showed higher clinical value than rad-score and CTGGO, especially under the purpose of screening for intermediate-high risk growth patterns. Conclusion PET/CT-based radiomics model shows good performance in predicting intermediate-high risk growth patterns in early IAC. This model provides a useful method for risk stratification, clinical management, and personalized treatment.

Background Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease that affects the liver and a variety of extra-hepatic organ systems. This study aimed to investigate the relationship between hepatic steatosis and glucose metabolism in liver and extra-hepatic tissues and organs. Methods The whole body 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) images of 191 asymptomatic tumor screening patients were retrospectively analyzed. Patients with the ratio of spleen/liver CT densities > 1.1 were defined to have NAFLD, and their clinical symptoms, laboratory markers, FDG uptake in a variety of tissues and organs including heart, mediastinal blood pool, liver, spleen, pancreas, and skeletal muscle, as well as abdominal adipose tissue volumes including visceral adipose tissue (VAT) volume and subcutaneous adipose tissue (SAT) volume were compared with those of the non-NAFLD patients and used to analyze the independent correlation factors of NAFLD. Results Among the 191 patients, 33 (17.3%) were NAFLD, and 158 (82.7%) were non-NAFLD. There was no significant correlation between the mean standardized uptake value (SUVmean) and CT density of liver as well as the ratio of spleen/liver CT densities. Hepatic steatosis, but not FDG intake, was more significant in NAFLD patients with abnormal liver function than those with normal liver function. Compared with the non-NAFLD patients, NAFLD patients had significantly reduced myocardial glucose metabolism, but significantly increased mediastinal blood pool, spleen SUVmean and abdominal adipose tissue volumes (including VAT and SAT volumes) (P r = 0.366 with hepatic CT density and − 0.236 with the ratio of spleen/liver CT densities, P Conclusions NAFLD is a systemic disease that can lead to the change of glucose metabolism in some extra-hepatic tissues and organs, especially the myocardium.

Objectives We aimed to investigate predictive factors of occult lymph node metastasis and to explore the diagnostic value of various standardized uptake value (SUV) parameters using fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography computed tomography (PET/CT) in predicting occult lymph node metastasis of clinical N0 non-small cell lung cancer patients. Methods We retrospectively analyzed PET/computed tomography parameters of tumor and clinical data of 124 clinical N0 non-small cell lung cancer patients who underwent both preoperative F-FDG PET/computed tomography and anatomical pulmonary resection with systematic lymph node dissections. The SUVmax, SUVmean, metabolic total volume, and total lesion glycolysis of the primary tumor was automatically measured on the PET/computed tomography workstation. Standardized uptake ratio (SUR) were derived from tumor standardized uptake value divided by blood SUVmean (B-SUR) or liver SUVmean (L-SUR), respectively. Results According to postoperative pathology, 19 (15%) were diagnosed as occult lymph node metastasis among 124 clinical N0 non-small cell lung cancer patients. On univariate analysis, carcinoembryonic antigen, cytokeratin 19 fragment, lobulation, and all PET parameters were associated with occult lymph node metastasis. The area under the receiver operating characteristic curve, sensitivity, and negative predictive value of L-SURmax were the highest among all PET parameters (0.778, 94.7%, and 98.4%, respectively). On multivariate analysis, carcinoembryonic antigen, cytokeratin 19 fragment, and L-SURmax were independent risk factors for predicting occult lymph node metastasis. Compared to L-SURmax alone and the combination of carcinoembryonic antigen and cytokeratin 19 fragment, the model consisting of three independent risk factors achieved a greater area under the receiver operating characteristic curve (0.901 vs. 0.778 vs. 0.780, P = 0.021 and 0.0141). Conclusions L-SURmax showed the most powerful predictive performance than the other PET parameters in predicting occult lymph node metastasis. The combination of three independent risk factors (carcinoembryonic antigen, cytokeratin 19 fragment, and L-SURmax) can effectively predict occult lymph node metastasis in clinical N0 non-small cell lung cancer patients.

Objective Insulin resistance can increase the risk of cognitive dysfunction and dementia. Our purpose is to use 18F-FDG PET imaging to explore the effect of insulin resistance on brain glucose metabolism in cognitively normal subjects. Methods A total of 189 cognitively normal subjects who underwent PET examinations were enrolled. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to evaluate the presence of insulin resistance. Multivariate linear regression and generalized additive models were used to analyze the association between HOMA-IR and glucose metabolism in the whole brain and evaluate the effects of various covariates. The SPM12 software was used to evaluate the regional effect of insulin resistance on brain glucose metabolism. Results After being fully adjusted for confounding factors, HOMA-IR showed an approximately linear negative correlation with brain glucose metabolism (β = -0.219, T = -3.331, P = 0.021). Compared with normal subjects, insulin-resistant subjects had reduced glucose metabolism in bilateral middle temporal gyrus, bilateral middle frontal gyrus, right precentral gyrus, right inferior frontal gyrus, right cuneiform lobe and bilateral cerebellar regions. In cognitively normal subjects, systemic insulin resistance has a significant effect on brain glucose metabolism. Conclusions 18F-FDG brain PET imaging could be helpful for the early diagnosis and treatment of changes in brain glucose metabolism caused by insulin resistance.

Purpose This work aims to train, validate, and test a dual-stream three-dimensional convolutional neural network (3D-CNN) based on fluorine 18 (18F)-fluorodeoxyglucose (FDG) PET/CT to distinguish benign lesions and invasive adenocarcinoma (IAC) in ground-glass nodules (GGNs). Methods We retrospectively analyzed patients with suspicious GGNs who underwent 18F-FDG PET/CT in our hospital from November 2011 to November 2020. The patients with benign lesions or IAC were selected for this study. According to the ratio of 7:3, the data were randomly divided into training data and testing data. Partial image feature extraction software was used to segment PET and CT images, and the training data after using the data augmentation were used for the training and validation (fivefold cross-validation) of the three CNNs (PET, CT, and PET/CT networks). Results A total of 23 benign nodules and 92 IAC nodules from 106 patients were included in this study. In the training set, the performance of PET network (accuracy, sensitivity, and specificity of 0.92 ± 0.02, 0.97 ± 0.03, and 0.76 ± 0.15) was better than the CT network (accuracy, sensitivity, and specificity of 0.84 ± 0.03, 0.90 ± 0.07, and 0.62 ± 0.16) (especially accuracy was significant, P-value was 0.001); in the testing set, the performance of both networks declined. However, the accuracy and sensitivity of PET network were still higher than that of CT network (0.76 vs. 0.67; 0.85 vs. 0.70). For dual-stream PET/CT network, its performance was almost the same as PET network in the training set (P-value was 0.372–1.000), while in the testing set, although its performance decreased, the accuracy and sensitivity (0.85 and 0.96) were still higher than both CT and PET networks. Moreover, the accuracy of PET/CT network was higher than two nuclear medicine physicians [physician 1 (3-year experience): 0.70 and physician 2 (10-year experience): 0.73]. Conclusion The 3D-CNN based on 18F-FDG PET/CT can be used to distinguish benign lesions and IAC in GGNs, and the performance is better when both CT and PET images are used together.

Xinshui Wang,1 Lijuan Jiang,2 Xiaonan Shao3 1Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China; 2Department of Clinical Laboratory, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of China; 3Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of ChinaCorrespondence: Lijuan JiangDepartment of Clinical Laboratory, the Third Affiliated Hospital of Soochow University, Changzhou, 213003, People’s Republic of ChinaTel +86-0-13776885831Fax +86-0519-86621235Email czyyjlj@126.comBackground: To explore the relationship between insulin resistance and osteoporosis risk in Chinese patients with type 2 diabetes mellitus (T2DM).Methods: A total of 234 T2DM patients were retrospectively analyzed, and their lumbar bone mineral density (BMD) and insulin resistance using C-peptide-based homeostasis model of insulin resistance [HOMA-IR (CP)] were assessed. Univariate and multivariable logistic regression methods were used to evaluate the association between HOMA-IR (CP) and osteoporosis, and subgroup analysis was performed on female and male patients.Results: After fully adjusting the covariates, the association between HOMA-IR (CP) and osteoporosis was only significant in female patients (P = 0.022); the interaction effect with gender was significant (P for interaction < 0.05). Curve fitting showed that the relationship between HOMA-IR (CP) and osteoporosis in women was nonlinear. When HOMA-IR (CP) is < 4.00, its effect on osteoporosis was not significant (P = 0.474); when HOMA-IR (CP) is > 4.00, the risk of osteoporosis increased significantly, with OR = 26.88 (95% CI: 2.75– 262.69, P = 0.005). The relationship between insulin resistance and osteoporosis risk in T2DM patients is significantly affected by gender.Conclusion: The higher the degree of insulin resistance in female patients, the greater the risk of osteoporosis, but the two are not linearly associated.Keywords: type 2 diabetes mellitus, insulin resistance, osteoporosis, bone mineral density, homeostasis model assessment for insulin resistance

AIM To establish reference intervals (RIs) for maternal blood and umbilical cord blood procalcitonin (PCT) in healthy Chinese women in late pregnancy. METHODS One hundred and twenty-seven healthy Chinese women in late pregnancy, including 70 vaginal deliveries and 57 cesarean section deliveries, were retrospectively analyzed. These pregnant women gave birth to 58 male infants and 69 female infants. Another 127 age-matched healthy women who were not pregnant were enrolled as the control group. PCT levels in maternal blood, umbilical cord blood and control blood were determined using electrochemiluminescence immunoassay. The RIs of PCT were defined using an intermediate 95% interval. RESULTS The RIs for maternal blood and umbilical cord blood PCT were 0.020-0.075 ng/mL and 0.020-0.159 ng/mL, respectively. The cord blood PCT level was not significantly different between different delivery methods (P > 0.05). In contrast, the umbilical cord blood PCT in female newborns was higher than that in male newborns (0.088 ± 0.046 ng/mL vs 0.072 ± 0.030 ng/mL, P

Background: The early diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) in patients with chronic kidney disease (CKD) remains a challenge. Methods: The study consecutively enrolled patients who had suffered from chest pain within 3 h whose electrocardiogram had no elevation in the ST segment. CKD was defined as an estimated glomerular filtration rate (eGFR) 2, and the diagnostic criteria for NSTEMI were defined according to the recommended guideline. Circulating microRNA-1 was collected and determined by quantitative real-time reverse transcription polymerase chain reaction. Results: A total of 456 patients with suspected NSTEMI were included. There were 115 patients in the CKD group, including 67 with NSTEMI, 20 with stable angina, 7 with unstable angina, 18 with heart failure, and 3 with other disorders. Compared with the NSTEMI group, the non-NSTEMI group just had significant differences in microRNA-1 and high-sensitivity cardiac troponin I (hs-cTnI) (both p < 0.05). The relative expression of microRNA-1 was significantly increased in the NSTEMI group as compared with that in the other disease groups (all p < 0.05). A receiver operating characteristic (ROC) curve analysis suggested that microRNA-1 and hs-cTnI had advantages in the early diagnosis of NSTEMI with CKD (AUC [area under the ROC curve] 0.879 and 0.812, respectively, both p < 0.05). Compared with that in the non-CKD group, the accuracy of microRNA-1 was almost as good in the CKD group (84.3 vs. 89.4%, p > 0.05). However, the diagnostic accuracy of hs-cTnI was significantly decreased (79.1 vs. 91.5%, p < 0.05), as was its specificity (75.0 vs. 95.5%, p < 0.05). There was no significant difference in the correlation between microRNA-1 and eGFR (p > 0.05), but a statistically significantly negative correlation between hs-cTnI and eGFR (p < 0.05). Conclusion: Circulating microRNA-1 is capable of early diagnosis of NSTEMI in patients with CKD suffering from chest pain.

Background Severe burn sepsis can lead to high mortality. We explored the valuable prognostic indicators for severe burn sepsis with inhalation lesion. Methods Thirty-eight severe burn patients with sepsis who were admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2017 were retrospectively analyzed. Among them, 22 patients were assigned to the death group and 16 patients to the survival group. Their general information, vital signs, and blood index including serum procalcitonin (PCT) and C-reactive protein (CRP) levels at admission, diagnosis of sepsis, and 1-week post-diagnosis of sepsis were compared. Results Patients in the death group were older and had lower platelet count (PLT) at diagnosis of sepsis and 1-week post-diagnosis as well as higher PCT level at 1-week post-diagnosis than patients in the survival group (all p Conclusion Age, PLT at diagnosis of sepsis, and 1-week post-diagnosis as well as PCT level at 1-week post-diagnosis are indicators for the evaluation of prognosis of severe burn sepsis with inhalation lesion. Among them, PLT at diagnosis has the greatest prognostic value. In addition, age can predict the patients’ mortality and survival time after sepsis.

OBJECTIVE. The purpose of this study was to explore the value of FDG PET combined with high-resolution CT (HRCT) in predicting the pathologic subtypes and growth patterns of early lung adenocarcinoma. MATERIALS AND METHODS. A retrospective analysis was conducted on the PET/CT data on ground-glass nodules (GGNs) resected from patients with stage IA lung adenocarcinoma. The efficacy of PET maximum standardized uptake value (SUVmax) combined with HRCT signs in prediction of histopathologic subtype and growth pattern of lung adeno-carcinoma was evaluated. RESULTS. SUVmax was significantly higher in GGNs with invasive HRCT signs. The diameter of GGN (odds ratio, 1.660; p = 0.000) and the difference in attenuation value (odds ratio, 1.012; p = 0.011) between ground-glass components and adjacent lung tissues were independent predictors of FDG uptake by GGNs. SUVmax was higher in invasive adenocarcinoma than in adenocarcinoma in situ (AIS)-minimally invasive adenocarcinoma (MIA) (median SUVmax, 2.0 vs 1.1; p = 0.008). An SUVmax of 2.0 was the optimal cutoff value for differentiating invasive adenocarcinoma from AIS-MIA. Acinar-papillary adenocarcinoma had a higher SUVmax than lepidic adenocarcinoma (median SUVmax, 2.1 vs 1.3; p = 0.037). An SUVmax of 1.4 was the optimal cutoff value for differentiating the growth pattern of adenocarcinoma. Use of PET/CT with HRCT significantly improved efficacy for differentiating invasive adeno-carcinoma from AIS-MIA. However, use of HRCT cannot significantly improve the diagnostic efficacy of FDG PET in the evaluation of tumors with different growth patterns. CONCLUSION. FDG PET can be used to predict the histopathologic subtypes and growth patterns of early lung adenocarcinoma. Combined with HRCT, it has value for predicting invasive histopathologic subtypes but no significance for predicting invasive growth patterns.

Objective To analyze the FDG-PET and high-resolution computed tomography (HRCT) features of early lung adenocarcinoma manifesting as solitary ground-glass opacity nodules (GGNs), and to establish a new risk model for predicting the invasiveness of early lung adenocarcinoma. Methods We retrospectively analyzed the data of clinical stage IA lung adenocarcinoma patients who received preoperative PET/CT and HRCT examination. Patients were divided into invasive adenocarcinoma (IVA) group and preinvasive minimally invasive adenocarcinoma (MIA) group. The correlations between FDG-PET parameters, HRCT parameters and histopathological invasiveness, and their predictive efficacy were analyzed. A mathematical model for predicting histopathological invasiveness of early lung adenocarcinoma was established and assessed. Results This study enrolled 56 patients, 48 were in IVA group and 8 were in preinvasive MIA group. Compared with those in preinvasive MIA group, GGNs in IVA group showed larger diameter, higher ground-glass opacity (GGO) density and more pleural indentation signs (70.8%) on HRCT; they also showed higher maximum standardized uptake value (SUV) and SUV index on FDG-PET (P = 0.001-0.037). Logistic regression analysis found a risk model for predicting IVA of solitary GGNs that were established by CTGGO and SUV index. Receiver operating characteristic curves showed that this model had the highest area under the curve (AUC), sensitivity, specificity and accuracy (AUC, 0.948; sensitivity, 95.8%; specificity, 87.5%; accuracy, 94.6%). Conclusion Using HRCT combined with FDG-PET to establish the corresponding mathematical prediction model has the potential to identify IVA in early lung adenocarcinoma preoperatively.

Left ventricular (LV) remodeling has adverse effects on the prognosis of patients with myocardial infarction (MI). The aim of this study is to identify the risk factors of LV remodeling in MI patients by radionuclide myocardial imaging. This retrospective study consisted of 92 patients who had a history of definite prior MI on ECG and underwent both resting gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) and positron emission tomography (PET) myocardial metabolism imaging. LV remodeling was defined as > mean + 2SD of LV end-diastolic volume index (LVEDVi) in the normal database. LV enlargement, cardiac dysfunction, wall thickening abnormalities expressed as summed thickening score (STS) were more severe in the old MI patients as compared to those with subacute MI. STS (Odds ratio, 1.296; P = .004) and the proportion of segments with reduced wall thickening in segments with normal perfusion (Odds ratio, 1.110; P = .001) were identified as the independent factors of LV remodeling in subacute and old MI patients in the multivariate binary regression model. Total perfusion deficit (TPD), viable myocardium, scar, and the proportion of segments with reduced wall thickening in segments with decreased perfusion showed strong correlation with LV remodeling in the univariate regression model as well. LV remodeling in old MI patients is more extensive and severe than that in subacute MI patients. LV wall thickening abnormalities as expressed by STS and the proportion of segments with reduced wall thickening in segments with normal perfusion are the independent risk factors of LV remodeling in MI patients.

To investigate the predictive value of procalcitonin (PCT) in patients with stage 1–4 and stage 5 chronic kidney disease (CKD). Five hundred and forty-one CKD inpatients were retrospectively analyzed and divided into CKD stage 1–4 (CKD1–4) and CKD stage 5 (CKD5) groups. Each group was further divided into non-infection, local infection, and sepsis subgroups. The clinical characteristics and inflammatory indexes of each subgroup including PCT, C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (N%) were compared, and the receiver operating characteristic curves to predict local infection and sepsis were plotted. Our research showed that the incidence and severity of infection in CKD5 group were significantly higher than those of CKD1–4 group; the baseline PCT level in CKD patients increased as renal function decreased and strongly correlated with CKD staging (r = 0.749); for CKD1–4 group, PCT, WBC, and N% could predict sepsis with the area under the curve (AUC) of 0.956, 0.854, and 0.917, respectively, but only CRP could predict local infection with AUC of 0.729, and for CKD5 group, only PCT and CRP could predict local infection with AUC of 0.715 and 0.780, respectively, and only PCT and N% could predict sepsis with AUC of 0.823 and 0.683, respectively. The baseline PCT level of CKD patients is negatively correlated with renal function. In both CKD1–4 and CKD5 patients, the predictive value of PCT for local infection is not as good as that of CRP, while it has a significant advantage in predicting sepsis.

OBJECTIVE To investigate the high metabolic characteristics of uterine fibroids in fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomographic imaging and the underlying mechanisms. MATERIALS AND METHODS A total of 47 patients with uterine fibroids who underwent PET/computed tomographic imaging and ultrasound examination from November 2011 to May 2015 were retrospectively analyzed. The characteristics of F-FDG uptake by uterine fibroids were analyzed and their correlations with age, menopause, menstrual cycle, hormone indexes, tumor markers as well as the number and maximum diameter of fibroids in ultrasound images were explored using univariate analysis and multivariate logistic regression analysis. RESULTS (a) The total positive F-FDG uptake rate and maximum standardized uptake value (SUVmax) were 40.4% (19/47) and 4.38±2.57 (1.74-10.81), respectively, in patients with uterine fibroids; (b) univariate analysis showed that age, menopause, estrogen, follicle-stimulating hormone, luteinizing hormone as well as the number of fibroids were correlated positively with F-FDG uptake in uterine fibroids (P

To explore the values of C-reactive protein (CRP) and procalcitonin (PCT) in identifying infection and disease activity in systemic lupus erythematosus (SLE) patients. Patients with SLE and infection from April 2015 to January 2018 were included in this study. We compared the clinical characteristics and biomarkers between different groups and calculated the receiver operating characteristic curve, sensitivity, and specificity of the corresponding biomarkers. Logistic regression analysis was performed on the variables exhibiting significant differences in univariate analysis. A total of 177 SLE patients were retrospectively analyzed. The patients were divided into noninfected-inactive group, noninfected-active group, infected-inactive group, and infected-active group. CRP level of infected-inactive group was significantly higher than noninfected-inactive group (P .05). Multivariate analysis showed that CRP (>24.0 mg/L) was the only independent risk factor for SLE infection (odds ratio, OR = 2.896, P = .032). PCT level of infected-active group was significantly higher than infected-inactive group (P .05). SLE active group had shorter disease course, lower infection rate, higher PCT level, and lower platelet count (PLT). Multivariate logistic analysis showed that PCT (>0.048 ng/mL) and PLT (96 months) was independent protective factor (OR = 0.169, P

To explore the significance of circulating miRNA-1 (miR-1) released within 3 h after the onset of acute chest pain in the diagnosis and prognosis of acute myocardial infarction (AMI).A total of 337 patients with acute chest pain within 3 h were enrolled in this study and divided into AMI group and non-AMI group. The AMI diagnostic efficacy of miR-1 was determined and compared with that of cardiac troponin I (cTnI). The patients were followed up for 720 d after treatment. The significance of circulating miR-1 in AMI prognosis was assessed using univariate and COX regression analysis.There were 174 patients in AMI group, 163 in non-AMI group. Circulating miR-1 level was significantly higher in AMI group than in non-AMI group (P 0.001). The AMI diagnostic efficacy of miR-1 and cTnI were similar (P 0.05). We established two AMI diagnostic models, the AUC values of which were larger than that of cTnI or miR-1 (P 0.05). When miR-1 combined with CK-MB, cTnI, and other clinical and laboratory parameters (model 2), the AUC was the largest (AUC: 0.961) and had the highest diagnostic efficiency. Circulating miR-1, Killip classification, and treatment method were influencing factors for AMI prognosis (P 0.05).Circulating miR-1 within 3 h of acute chest pain has the potential diagnostic value for AMI, and which is an independent risk factor for the prognosis of AMI and can be used to predict AMI prognosis.

The aim of the present study was to investigate the predictive value of procalcitonin (PCT) for infection in patients with type 2 diabetes mellitus (T2DM). A retrospective analysis of 178 patients with T2DM who were divided into non-infection, local infection and sepsis groups was conducted; in conjunction with 33 healthy control patients. Clinicopathological characteristics and inflammatory indicators were compared between the four groups. Patients in the non-infection group exhibited significantly higher PCT levels compared with healthy controls (P=0.002). In addition, PCT, C-reactive protein (CRP), white blood cell count and neutrophil percent were significantly different amongst patients with T2MD across different infection groups (all P local infection group > non-infection group (all P

Background To investigate the early diagnostic and prognostic value of microRNA-1 in patients with acute chest pain. Methods This study enrolled 341 patients attacked by chest pain within 3 h, and another 100 volunteers as control group. Circulating microRNA-1 was collected and determined by real-time quantitative reverse transcription-polymerase chain reaction. The clinical follow-up period was 720 days. Results There were 174 patients in acute myocardial infarction (AMI) group, 167 in non-AMI group. The relative expression of microRNA-1 was significantly increased within 3 h in AMI group, and it continued rising within 12 h, lower at 24 h than that 12 h in AMI group without reperfusion therapy. Otherwise, microRNA-1 concentration was markedly low at 12 h after primary percutaneous coronary intervention in AMI group. The 95% reference range of circulating microRNA-1 was 0.171–0.653. It was significantly available for microRNA-1 to early diagnose AMI with an optimal cutoff value of 2.215 and diagnostic accuracy could be improved when combined with cardiac troponin I. It was not statistically significant for microRNA-1 to forecast future AMI but might prognose mortality of 720 days in chest pain patients. In patients with chest pain, microRNA-1 concentration was high with major adverse cardiac events within 30 days, low with high overall survival within 720 days. Conclusions Circulating microRNA-1 might diagnose early AMI and predict the prognosis of patients with chest pain.

(18)F-FDG PET/CT has been widely applied for tumor imaging. However, it is reported that many normal tissues, e.g., brown adipose tissue, can also uptake (18)F-FDG. The purpose of this study was to determine the imaging characteristics of (18)F-FDG uptake in brown adipose tissue (BAT) in PET/CT. A total of 2,944 patients who underwent PET/CT from September 2011 to March 2013 were analyzed retrospectively. Imaging features of (18)F-FDG uptake in BAT were analyzed. Univariate analysis and logistic regression analysis were performed to evaluate the effect of age, gender, cancer status, body mass index (BMI), average daily maximum temperature of imaging month and fasting plasma glucose (Glu) on the positive rate of (18)F-FDG uptake in BAT. The results showed that 1.9% (57/2944) patients had (18)F-FDG uptake in BAT. (18)F-FDG, manifested as flaky, nodular and beaded shape, was symmetrically distributed in the adipose tissues of cervical and supraclavicular, mediastinal, paravertebral, and perirenal areas. Uptake of (18)F-FDG within cervical/supraclavicular area was most common (89.5%, 51/57) with an SUVmax ranging from 2.8 to 31.4. Univariate analysis showed that gender and cancer status were not significantly correlated with the BAT (18)F-FDG uptake rate. In contrast, age, BMI, Glu and average daily maximum temperature in the imaging month were significantly correlated with the BAT (18)F-FDG uptake rate (P

To assess the predictive value of procalcitonin (PCT) in the risk of sepsis in patients with stage 5 chronic kidney disease (CKD).A total of 373 inpatients with stage 5 CKD were retrospectively analyzed. The patients were divided into non-infection group, local infection group, and sepsis group. The clinical characteristics and inflammatory parameters including PCT, C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NEU%) were compared and the receiver operating characteristic (ROC) curves to predict sepsis were plotted. Related risk factors of sepsis were analyzed by logistic regression analysis.(1) The hemodialysis ratio of sepsis group was the highest at 92.3%. PCT, CRP, and NEU% were significantly different among the three subgroups (P 0.05 for all). Total cholesterol and low density lipoprotein (LDL) levels in sepsis group were significantly lower than that in local infection group (P 0.05 for both). (2) CRP and WBC were unable to predict sepsis (P 0.05 for all), while PCT and NEU% could predict sepsis with areas under the curve (AUC) of 0.838 and 0.691, respectively (P 0.05 for all). (3) Multivariate logistic regression analysis showed that PCT 1.650 ng/mL was a risk factor (OR = 6.926, P = 0.002) while LDL was probably a protective factor (OR = 0.336, P = 0.040) of sepsis in patients with stage 5 CKD.At stage 5 CKD, the predictive value of PCT for sepsis is best among inflammatory markers, and PCT and LDL levels are independent factors of sepsis.

Diabetes is a highly prevalent chronic disease among US adults, and its prevalence among US veterans is even higher. This study aimed to examine the prevalence of and trends in diabetes in US veterans by using data from the US National Health and Nutrition Examination Survey from 2005 through 2014. The overall prevalence of diabetes and undiagnosed diabetes was 20.5% and 3.4%, respectively, and increased from 15.5% in 2005-2006 to 20.5% in 2013-2014 (P = .04). Effective prevention and intervention approaches are needed to lower diabetes prevalence among US veterans and ultimately improve their health status.

The current commonly used treatments for cesarean scar pregnancy (CSP) include multiple treatments such as medication, uterine artery embolization, curettage and surgery, and their combinations. However, every treatment option has risks of excessive hemorrhage from uterus. In this study, we retrospectively analyzed the risk factors for intraoperative hemorrhage of different treatments for CSP patients, with the hope to provide the guidance for CSP treatment. Fifty-eight cases of CSP patients who were treated with curettage after medication, curettage after uterine artery embolization, or surgery were retrospectively analyzed and compared for the clinical efficacy, length of hospital stay, and hemorrhage rate. Further, they were divided into the bleeding group (≥200 mL, 15 cases) and the control group ( .05). Univariate analysis found that patients in the bleeding group had significantly longer menolipsis time and greater maximum diameter than patients in the control group (P

Chest X-ray is a “golden standard” for the diagnosis and severity assessment of community-acquired pneumonia (CAP). However, it cannot be used as routine examination of CAP in children. The present study aims to investigate the roles of prealbumin (PA) in CAP in children and further determine the usefulness of PA in diagnosis and severity assessment of CAP in children. This was a retrospective analysis of 174 cases of hospitalized children with CAP. The following indicators were recorded: vital sign, inflammatory indexes, PA, and respiratory pathogens immunoglobulin M antibody test results. A total of 33 healthy children were selected as the control group. The results of laboratory tests between CAP and control groups were compared. CAP group was further divided into mild CAP and severe CAP groups, and vital signs and laboratory examination results of 2 groups were compared. The total positive rate of Mycoplasma pneumoniae in this study was 27.4%, and there was no significant difference in different seasons (P = 0.356). Compared with controls, there was no significant difference between procalcitonin and C-reactive protein in CAP group (P = 0.355, 0.061). The white blood cell count, percentage of neutrophils, neutrophil count, and erythrocyte sedimentation rate in the CAP group were significantly higher than those in control group, and PA was significantly lower than that in the control group (all P

Background The prevalence of dyslipidemia in China was increased over the last several years. Studies have shown that the activity of aBAT is related to the lipid metabolism. In this study, we analyzed blood lipid level in tumor-free healthy Chinese adults in order to determine the role of aBAT in lipid metabolism. Methods We retrospectively analyzed the factors that affect the blood lipid level in 717 tumor-free healthy adults who received blood lipid measurement and PET/CT scan by multivariate regression analysis. We also determined the role of aBAT on lipid profile by case–control study. Results (1) Our results showed that 411 (57.3 %) subjects had dyslipidemia. The prevalence of the subjects with hypercholesteremia, hypertriglyceridemia, low high-density lipoprotein cholesterol and high low-density lipoprotein cholesterol was 9.5 %, 44.4 %, 30.8 % and 1.4 %, respectively. Multivariate logistic regression analysis with dyslipidemia as the dependent variable showed that body mass index (BMI) and smoking are independent risk factors for dyslipidemia (OR > 1, P

Rationale: Multiple primary malignant tumors (MPMTs) are defined as 2 or more independent primary malignancies of different histologies/origins in the same individual. Although the incidence of MPMTs is being increasing, second primary cancer (SPC) is still rare and difficult to distinguish from metastasis. Here, we present a case of thyroid carcinoma with lung metastasis and primary lung cancer. Patients concerns: The patient was a 66-year-old man diagnosed of papillary thyroid carcinoma (PTC) with lymph nodes, lung, and skeletons metastases. One of the pulmonary nodules had contrary manifestations, such as, noniodine avid, high uptake of 18F-fluorodexyglucose (18F-FDG) and progress after iodine-131 radioiodine therapy. Interventions: CT guided biopsy and I-125 seed brachytherapy of nodule in right upper lobe were performed. Diagnosis: The patient was diagnosed of PTC with lymph nodes, lung, and skeletons metastases, accompanied by primary lung adenocarcinoma. Outcomes: After 2 years of follow-up, nodules of inferior lobes almost disappeared and the nodule of right upper lobe shrank to only 0.7 cm. Lessons: Physicians should be aware of SPC in clinical work, and improve the early diagnosis rate with a variety of examination methods and select the best treatment to improve the prognosis of patients.

Rationale: Uterine fibroids are the most common pelvic solid tumors and common to 25% of women. 18F-fluorodexyglucose (18F-FDG) is an energy metabolism tracer. Although FDG is generally concentrated in malignant lesions with high glucose metabolism, it can also accumulate in normal tissues, benign lesions, and inflammatory sites. The exact mechanism of FDG uptake by uterine fibroids is not clear. Here, we report a case of uterine fibroids with positive 18F-FDG positron emission tomography/computed tomography (PET/CT) imaging and significantly increased CA19-9. Patients concerns: The patient was a 43-year-old woman and admitted to our hospital because of “1-year-extended menstrual periods.” At admission, she had normal CA125, AFP, and CEA level and CA19-9>1000.00 U/mL. Gynecological transvaginal ultrasound found enlarged uterus with an anterior hypoechoic area of 3.9 × 4.2 cm. CT and contrast-enhanced CT showed significantly enhanced mass shadow on the left anterior wall of uterus. 18F-FDG PET/CT showed increased FDG metabolism of tumor in the anterior wall of the uterus. Interventions: Laparoscopic hysterectomy was performed. Diagnosis: Pathological examination demonstrated subserosal leiomyoma. Outcomes: Her CA19-9 level dropped to 91.50 U/mL 1 day after surgery. Lessons: Significantly elevated CA19-9 was positioned in the uterus by PET/CT imaging, which not only avoided unnecessary gastrointestinal endoscopy and reduced the suffering of patients, but also strengthened the operation confidence in gynecologists.