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15 February 2017, Volume 45 Issue 2 Previous Issue    Next Issue
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Monograph-Minimally Invasive Endoscopic Spinal Surgery（Editor-in-Chief: XU Bao-shan）
Cell and Molecular Biology
Experimental Study
Clinical Study
Diagnostic Techniques


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Monograph-Minimally Invasive Endoscopic Spinal Surgery（Editor-in-Chief: XU Bao-shan）

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Treatment based on illness, steadily develop percutaneous transforaminal endoscopic surgery XU Bao-shan 2017, 45 (2):  113-115.  doi: 10.11958/20170017 Abstract ( 1433 )   PDF (352KB) ( 3635 )   At present, percutaneous transforaminal endoscopic discectomy (PTED) has been rapidly developed in our country, showing that spine surgery has entered the era of the minimally invasive spine surgery, but we must clearly recognize the learning curve and the difficulties in the operation. According to the specific needs of patients, safe and effective should be premised, and take the most convenient and effective measures, avoid the blind pursuit of new technology and high technical difficulty, avoid increasing the surgical indications and avoid exaggeration effect. We must have a solid foundation of spinal surgery and seriously standardized training. We must establish reasonable access and training system, which can avoid detours, shorten the learning curve, and let the transforaminal endoscopic minimally invasive techniques have a healthy and stable development. Related Articles | Metrics

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Combination of anterior debridement via small incision and posterior mini-invasive internal fixation for the treatment of single segment lumbar tuberculosis LIU Xin-yu, YUAN Suo-mao, TIAN Yong-hao, WANG Lian-lei, YAN Jun, ZHENG Yan-ping, GONG Liang-tai, LI Jian-min 2017, 45 (2):  116-120.  doi: 10.11958/20161549 Abstract ( 1018 )   PDF (2630KB) ( 3655 )   ObjectiveTo review and analyze the clinical effect of combined posterior mini-invasive fixation with anterior debridement via small incision for the treatment of single segment lumbar vertebral tuberculosis. MethodsTotal 31 cases with single segment lumbar tuberculosis(both borderline tuberculosis) without attachment involvement underwent one-stage anterior debridement, interbody fusion and posterior mini-invasive fixation from July 2010 to July 2015. Among them, 19 were male and 12 were female. The average age was 36.1±17.8 years old (ranged 21 ~ 61 years old). The average course of disease was 10 months (ranged from16 to 2 months). All were single segment involvement, and the involved segment was L2~3 in7 cases, L3 ~ 4 in 10 cases, L4 ~ 5 in 6 cases, and L5 ~ S1 in 8 cases. The clinical manifestations included lumbar back painin31 cases with an average pain visual analog score (VAS) of 6.6 ±1.4 points, lower limb numbness and weakness in 6 cases, and low fever in the afternoon in20 cases.ASIA grade was E in 25 cases and D in 6 cases. Paravertebral abscess occurred in 22 cases and iliac fossa gravity abscess appeared in 9 cases. Kyphosis was observed in 12 cases and the average Cobb angle was 21°±6 °. Quadruple anti-tuberculosis chemotherapy was used for at least 2 weeks preoperatively. Posterior mini-invasive fixation was fulfilled on prone position, including mini-invasive percutaneous screws in 18 cases and pedicle screw fixation viaWiltse approach in 13 cases. Posterior distraction and deformity correction was performed simultaneously for patients with kyphosis. Then the patients were changed to lateral position for anterior debridement, bone grafting and / or titanium mesh fusion. ResultsThe average operation time was 204min (ranged 160 ~ 240min) in 31 patients, and the mean blood loss was 168ml (ranged 100 ~ 300ml). Delayed healing of anterior incision occurred in 1 caseand the incision healed after 2 weeks’dressing of wound.The incision healed well in the rest30 cases.No complications such as nerve function, blood vessel injury and so on.The VAS scores of the 3 days after operation were 1.3±0.3 and 1.4±2.1 in percutaneous group and Wiltse approach group, respectively, and the difference was statistically significant (P<0.05). Low back pain VAS score was 1.4±1.5 points in all the 31patient three months after operation, was significantly lower than that before surgery (P<0.05). The patients with neurological symptoms recovered to E grade after operation. The average Cobb angle correction was 15±5°in the patients with kyphosis (P<0.05). All patients were followed up for an average of 36.8 months (ranged from 12 to 72 months). The clinical healing of tuberculosis was achieved at the final follow-up in all the 31 patients. No complications were observed, such as lumbar kyphosis, internal fixation loosening and breakage, dislocation, titanium mesh subsidence and so on. ConclusionsMini-invasive posterior internal fixation and anterior debridement via small incision was effective for the treatment of single segment lumbar vertebral tuberculosis in lesion debridement and spine stability reconstruction by short segment fixation.This technique can reduce fused segments, surgical trauma of anterior approach and related complications. Related Articles | Metrics

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Preliminary experience of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation LIU Yue, XU Bao-shan, JI Ning, JIANG Hong-feng, YANG Qiang 2017, 45 (2):  121-124.  doi: 10.11958/20170104 Abstract ( 888 )   PDF (601KB) ( 3673 )   Objective To investigate the feasibility of percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. Methods One patient with thoracic disc herniation involved the level of vertebral segment in T11/12 was treated with percutaneous transforaminal endoscopic spine system and followed up for 1 month. The targeted puncture was performed under local anesthesia and fluoroscopic guidance with patient in prone position. The foramen of T11/12 was enlarged gradually with four trephinations, and the working cannula was inserted transforaminal into the canal. Then the herniation was exposed and removed with full endoscopic technique, including the loosen nucleus pulposus. The dural sac was exposed and released adequately. Drainage was placed during operation. Results The procedure was successfully carried out and the dural sac was completely released. The drainage was removed in the second day of operation. The patient could walk in the third day after operation with obvious relief of back and leg pain. At the follow- up of one month postoperation, the visual analogue scale of leg pain decreased from 8 to 1, and the Oswestry disability index (ODI) decreased from 64 to 4. According to MacNab scale, excellent result was acquired. Conclusion There is the feasibility of the percutaneous transforaminal endoscopic spine system in thoracic discectomy for disc herniation. It is a good minimal invasive technique with good results and high technical requirements for surgeons. Related Articles | Metrics

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Clinical analysis of APECD and ODLP in the treatment of multisegmental cervical stenosis and giant disc herniation LI Ning, XU Bao-shan, LIU Yue, YANG Qiang, JIANG Hong-feng, JI Ning, ZHANG Chun-hong, YANG Tao 2017, 45 (2):  125-128.  doi: 10.11958/20170077 Abstract ( 1055 )   PDF (406KB) ( 3465 )   Objective To investigate the effect of anterior percutaneous endoscopic discectomy (APECD) and opendoor laminoplasty (ODLP) through hybrid surgery in the treatment of multisegmental cervical stenosis and giant disc herniation. Methods This study involved 3 patients with multisegmental cervical stenosis and giant disc herniation confirmed by MRI. Among them, there were 2 males and 1 female, with ages from 56-61. All patients showed significant paresthesia or weakness, and were treated between September and November 2016. The surgery was performed by first the ODLP that made spinal cord back shift, and then APECD for the second step. The visual analog scale (VAS) and neck disability index (NDI) were assessed before and after operation. Results The VAS and NDI scores were improved two weeks after operation. No adverse events like spinal cord injury and vascular injury were found during the operation. After operation, no patients were found incision infection, hematoma formation, cerebrospinal fluid leakage, dysphagia, trachyphonia and so on. Conclusion The hybrid surgery of APECD and ODLP for the treatment of the multisegmental cervical stenosis and giant disc herniation can not only decompress the nerve safely and improve the function, but also preserve cervical intervertebral disc and motion segments, therefore delaying the degeneration of adjacent segments with clinical significance. Related Articles | Metrics

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Update in the treatment of intervertebral disc disease by coblation nucleoplasty YAN Bing-shan, XU Bao-shan 2017, 45 (2):  129-133.  doi: 10.11958/20161491 Abstract ( 971 )   PDF (389KB) ( 3767 )   The intervertebral disc disease is a group of clinical diseases with complex etiology, various clinical symptoms and poor conservative treatment effect. The traditional treatment methods include conservative treatment, local injection and open surgery. In recent years, minimally invasive spine surgery has made great progress and development, and its clinical effect has been fully affirmed. Coblation nucleoplasty (CN) has been mainly used in the treatment of contained disc herniation since it has been used in clinical treatment. Its application is not favorable because of narrow indications, uncertain clinical efficacy and other reasons. At present, the application of CN in the intervertebral disc diseases has been reported in many literatures, and its working principle, operation safety, indications and efficacy have been analyzed and extended. Those literatures play an important role in its clinical application. Therefore, in this paper, the application status of CN in the intervertebral disc diseases is reviewed. Related Articles | Metrics

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Clinical research progress of posterior cervical expansive open-door laminoplasty ZHAO Huan-rong，XU Bao-shan 2017, 45 (2):  133-138.  doi: 10.11958/20161560 Abstract ( 1282 )   PDF (454KB) ( 3628 )   Compressive cervical myelopathy (CCM) is a common disease of spinal surgery. Various kinds of reasons such as herniation of cervical disc and ossification of the posterior longitudinal ligament (OPLL) lead to spinal canal stenosis, thereby compressing the spinal cord, and a series of neurological symptoms are caused. Currently, posterior cervical expansive open-door laminoplasty (PCEOLP) is widely used for cervical decompression in patients with CCM involving three or more levels. This operation can expand the spinal canal while preserving the posterior structures of the cervical spine, and non-neurological complications are relatively rare. However, there are characteristic complications to this procedure such as nerve root palsy, axial neck pain, and loss of range of motion (ROM). Various modified techniques of PCEOLP have been developed to reduce postoperative complications. In this review, clinical research progress of PCEOLP in recent years is summarized, mainly focusing on internal fixation of materials and methods, operative approach, cervical decompression level, combined application of different surgical procedures, opening size and application of new technologies. Related Articles | Metrics

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Study of characteristics of three dimensional motion of cervical spine during maximal axial rotation LIANG Wei1, LI Hong-da2, LIU Jia-nan3, WEI Dong2, XIA Qun2△ 2017, 45 (2):  139-142.  doi: 10.11958/20161523 Abstract ( 904 )   PDF (648KB) ( 3792 )   Objective To determine the three dimensional motion data of each segment of cervical vertebrae and analyze the characteristics of the intervertebral coupled motion during cervical axial rotation under physiological weight bearing. Methods A total of 16 healthy volunteers (ranging from 22 to 29, median age, 23 years) were recruited to our study. Any cervical spine disorder history, pain or other discomfort and malformations were excluded so as to avoid abnormal neck motion. These subjects underwent CT scans of their cervical segments in a supine position, and 3D models of C1-C7 were constructed. Next, each subject was asked to sit up straight and was positioned in the following sequence: maximal left and right twisting, while double oblique images by DFIS were taken simultaneously at each of the positions. Then, the CT models were matched to the osseous outlines of the images from the two oblique views to quantify the position of cervical vertebraes in 3D at each position. Through local coordinate systems at the center of vertebral bodies, changes of position and angle of each cephalad vertebrae relative to the cauddal one were calculated before and after the axial rotation. Results (1) In the axial rotation of the cervical spine, the contribution of C1/2 accounted for the most of the total cervical rotation range. For the lower levels, axial rotation was found to be maximal at C3/4 and C5/6, minimal at C2/3. (2) In cervical axial motion, C1/2 demonstrated a coupled lateral bending opposite to the axial rotation direction, while each segment of C2- 7 demonstrated coupled lateral bending towards the same side of the axial rotation. Among these segments the lateral bending angle of C2/3 was smaller than angles of C3/4, C4/5 and C5/6. Conclusion This study investigated the cervical coupling behavior using the noninvasive 2D-3D matching technique and obtained the motion data at each cervical spinal segment. These findings will help to improve the understanding on physiological cervical spine movement and potential biomechanical mechanism and treatment of cervical spondylosis. Also our data may provide useful reference for the prosthesis design. Related Articles | Metrics

Cell and Molecular Biology

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The effect and mechanism of resveratrol on autophagy regulation in nasopharyngeal carcinoma CNE-2 cells WANG Min, ZHAO Hong, ZHENG Jia-fa, XIE Yuan-jie, YAO Ping-bo 2017, 45 (2):  143-145.  doi: 10.11958/20160975 Abstract ( 897 )   PDF (359KB) ( 3562 )   Objective To investigate the effect of resveratrol on autophagic flux of nasopharyngeal carcinoma CNE-2 cells, and to explore the underlying mechanism. Methods Nasopharyngeal carcinoma CNE- 2 cells were divided into control group and resveratrol group. Cells in control group were normally cultured at 37 ℃ and received no further treatment. Resveratrol group was added 40 μmol/L resveratrol 2 h before cells were culture at 37 ℃ . Western blot analysis was performed to detect protein expressions of LC3B, p62, Beclin-1, phospho-mTOR (p-mTOR) and phospho-S6 (p-S6). The autophagic flux was detected under the confocal laser scanning microscopy through different color spots, after cells were transfected with adenovirus encoding GFP- mRFP- LC3. Results (1) The protein expression of LC3B was significantly increased and the protein expression of p62 was significantly decreased in resveratrol group compared with those of control group (P＜0.05). There was no significant difference in Beclin- 1 expression between two groups. (2) Compared to control group, expressions of p- mTOR and p- S6 were significantly decreased in resveratrol group (P＜0.05). (3) Compared to control group, the red mRFP puncta were significantly increased, and the yellow GFP puncta were significantly decreased in resveratrol group (P＜0.05). Conclusion Resveratrol promotes the autophagic flux of nasopharyngeal carcinoma CNE- 2 cells, and the effects are possibly dependent on the activation of mTOR pathway-related proteins. Related Articles | Metrics

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Optimization of prokaryotic expression condition and purification of soluble GST-CRH protein YU Shuo1, CHEN Feng2, LIU Ying-fu3, HUO Jing-rui2, LI Guang-zong2, ZHANG Yi2, DING Hui2, FAN Hao-jun1△ 2017, 45 (2):  146-150.  doi: 10.11958/20161302 Abstract ( 843 )   PDF (819KB) ( 3566 )   Objective To obtain the recombinant corticotropin releasing hormone (CRH) protein with soluble, high purity protein through optimizing prokaryotic expression condition and purifying glutathione thiol transferase (GST)-CRH protein. Methods To detect the expression of soluble CRH protein through grope of the host strain GST-CRH temperature of induction expression, the host strain concentration (OD600), IPTG concentration and induction time, the purification of GST-CRH was performed by GST-CRH agarose gel. Western Blot assay was used for the expression identification of the target protein. Results The optimal conditions for the induction of CRH protein were determined: temperature of 30 ℃, IPTG induced concentration 0.1 mmol/L, bacteria density (OD600) 0.8, the induction time of 8 hours, purified GST-CRH > 95% fusion protein was obtained. Conclusion The optimal expression conditions of GST- CRH are obtained, and the soluble protein of high purity GST-CRH is also obtained. Related Articles | Metrics

Experimental Study

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The different gene methylation levels of rat Schwann cells detected by MeDIP-Seq LIN Wei, FAN Bao-you, FENG Shi-qing△, REN Yi-ming, ZHOU Xian-hu 2017, 45 (2):  151-154.  doi: 10.11958/20161211 Abstract ( 868 )   PDF (799KB) ( 3494 )   Objective To explore the difference of DNA methylation levels between normal Schwann cells (NSCs) and activated Schwann cells (ASCs) in rats. Methods The adult Wistar rats were received sciatic nerve ligation and fed for 7 days. The ASCs and NSCs were separated from ligated sciatic nerves and brachial plexus respectively. Immunocytochemical staining of S- 100 antibody was used to identify the cells. The growth condition of cells was detected by CCK- 8 method. Methylated DNA immunoprecipitation sequencing (MeDIP-Seq) was applied to filter the differentially methylated regions in ASCs and NSCs. The distribution of differentially methylated genes related with axonal regeneration in chromosome was analyzed, and Gene ontology（GO） and PATHWAY analysis were also conducted. Results High purity of ASCs and NSCs were obtained successfully, which were both positive for S- 100 antibody. In the same culture condition, ASCs showed a faster proliferation than that of NSCs. A total of 177 176 differentially methylated regions were found by MeDIP-Seq. Among them, 1 097 were located in the promoter (≤1 kb), 1 136 in the promoter (1-2 kb) and 567 on the CpG. After functional annotation of differentially methylated genes, 214 differentially methylated genes related with axonal regeneration were found in ASCs and NSCs. Compared with NSCs, 191 genes were up-regulated and 23 genes were down -regulated in ASCs. These genes were located on different chromosomes, most of which on chromosome 12 (22 genes) and the least on chromosomes M (2 genes). GO analysis indicated that the differential methylated genes were involved in axon growth, axon formation, axon elongation and axon guidance. The MAPK, cell adhesion molecules, Ras signaling pathway may be related with the differential methylated genes. Conclusion The methylation levels between ASCs and NSCs are significantly different, which are probably related with axon regeneration. Related Articles | Metrics

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The effect and mechanism of indole-3-carbinol on alleviating the radiation-induced bone marrow hematopoietic cell injury in mice LU Lu, DONG Jia-li, FAN Sai-jun△ 2017, 45 (2):  155-159.  doi: 10.11958/20161281 Abstract ( 970 )   PDF (502KB) ( 3919 )   Objective To investigate the protective effect of indole- 3- carbinol (I3C) on radiation- induced mouse bone marrow hematopoietic cell injury and the involved mechanisms. Methods (1) The bone marrow nuclear cells (BMNCs) from CD45.1 subtype of C57BL/6J mice were collected by a density gradient centrifugation method. The BMNCs were pretreated with a series doses of I3C (0 mol/L, 10- 8 mol/L-10- 3 mol/L) and then exposed with radiation of 137Cs γ-ray (doses of irradiation were 0 Gy, 1 Gy and 4 Gy). After 18-hour culturing, the bioluminescence method was used to detect the cell viability. (2) These cells were divided into control group and 10- 6 mol/L I3C group. Both groups were received the irradiation (0 Gy, 1 Gy and 4 Gy) and inoculated into the methylcellulose semi-solid culture medium to incubate 7 days, the colony forming unit-granulocyte monocytes (CFU-GM) were observed. (3) Twenty-four CD45.2 subtype mice used as the receptor were exposed with 8 Gy radiation. The CD45.1 BMNCs were divided into control group, 4 Gy irradiation group, 4 Gy irradiation and 10- 6 mol/L I3C group. Donor cells were harvested from C57BL/6J (CD45.1) mice after they received various treatments, and were then mixed with competitive BMNCs from C57BL/6J (CD45.2) mice. The mixed cells were transplanted into recipient mice (8 mice/group). Flow cytometry was used to analyze the proportion of donor cells in peripheral blood of receptor. (4) The cells were divided into control group, 10- 6 mol/L I3C group, 1 Gy irradiation group, 1 Gy irradiation with 10-6 mol/L I3C group. After 24-hour culturing, Western blot assay was used to detect the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and hemeoxygenase-1 (HO-1). Results (1) I3C showed a significant cytotoxic effect on the BMNCs when its concentration was above 10- 4 mol/L. 10- 7-10- 6 mol/L I3C could reduce the radiation injury of BMNCs under the same dose of irradiation. Therefore, 10-6 mol/L I3C was chosen for subsequent experiments. (2) The CFU-GM was significantly higher in 10-6 mol/L I3C group than that of control group (P < 0.05). (3) Results of flow cytometry showed that the proportion of donor cells in receptor was significantly higher in 4 Gy irradiation group than that of control group, which decreased the engraftment capability of irradiated HSCs (P < 0.05), although the engraftment capability of irradiated HSCs improved after 10-6 mol/L I3C treatment. (4) I3C significantly enhanced the increased protein expression of Nrf2 and HO-1 caused by radiation (P < 0.05). Conclusion I3C has a protective effect on hematopoietic cells following radiation-induced injury, which may be related with activating the Nrf2/HO-1 signal pathway. Related Articles | Metrics

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Studies of the mechanism of endothelial dysfunction in rats under intermittent hypoxia WANG Xin1, SUN Bei2, LIU Fang1, FENG Jing1△，CAO Jie1△ 2017, 45 (2):  160-163.  doi: 10.11958/20161305 Abstract ( 859 )   PDF (380KB) ( 4019 )   Objective To explore the mechanism of vessel endothelial dysfunction in rats under intermittent hypoxia (IH). Methods The respiratory simulation system was used to simulate IH. Sixty C57BL/6J rats (male) were randomized into control group and IH group. The rats of IH group were exposed to IH 8 hours per day for 6 weeks. The serum levels of hypoxia inducible factor (HIF)-1a and stromal cell derived factor (SDF)-1a were assessed by ELISA. The serum levels of reactive oxygen species (ROS) were detected in two groups. The serum expression of miR- 199a-5p was detected by realtime fluorescent quantitative PCR in two groups. The dual luciferase report system and point mutation test were used to verify target gene for HIF-1a. Results The serum levels of HIF-1a and SDF-1a were significantly higher in IH group than those of control group (μg/L: 1.60±0.02 vs. 1.19±0.02, 1 823.00±8.97 vs. 1 444.00±17.90, P＜0.01). The serum level of ROS was significantly higher in IH group than that of control group (U/mL: 487.66±35.73 vs. 211.57±23.82, P＜0.01). The serum level of miR-199a-5p expression was significantly lower in IH group compared to that of control group (1.31±0.07 vs. 3.47± 0.17, P＜0.01). The result of dual luciferase reporter gene detection confirmed that target gene of miR-199a-5p was HIF- 1a. Conclusion The serum level of miR- 199a- 5p is decreased first due to IH, and then its target gene (HIF- 1a) is increased. HIF-1a can induce the increased level of SDF-1a, and its receptor (CXCR-4 ) is also increased. Finally, HIF- 1a can increase the serum level of ROS, resulting in the endothelial dysfunction. Related Articles | Metrics

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Artesunate supresses NF-κB and MCP-1 expressions in high glucose-induced rat mesangial cell proliferation model HUANG Xue-juan, SU Ke△, LONG Yan, XUN Jing-qiong, WANG Hai-xu 2017, 45 (2):  164-167.  doi: 10.11958/20160973 Abstract ( 889 )   PDF (820KB) ( 4284 )   Objective To investigate the effects of artesunate (Art) on cell proliferation, apoptosis, nuclear factor (NF)- κB and monocyte chemotactic protein 1 (MCP-1) expressions induced by high glucose in rat renal mesangial cells (HBZY- 1), and the mechanism thereof. Methods HBZY-1 cells were cultured and divided into normal glucose group (5.6 mmol/L), high glucose group (25 mmol/L) and high glucose with different concentrations of Art (10 mg/L, 20 mg/L, 30 mg/L) groups. MTT assay was used to detect the cell proliferation after 48 h. The apoptotic rate was evaluated by flow cytometry with Annexin V-FITC/PI double stains. The protein levels of NF-κB and MCP-1 in the cell culture supernatant were determined using ELISA. Results High glucose induced apoptosis and proliferation in HBZY-1 cells, and the expressions of NF-κB and MCP- 1 in the supernatant were also increased (P＜0.05). After treatment with Art, the proliferation was obviously abolished, and the apoptosis was increased, and the expressions of NF-κB and MCP-1 in the supernatant were decreased in HBZY- 1 cells. The effects of Art showed a dose- dependent manner (P＜0.05). Conclusion Artesunate treatment can reverse the effect of high glucose in HBZY- 1 cells in a dose- dependent manner, which may provide a new therapeutic strategy for diabetic nephropathy. Related Articles | Metrics

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Patch clamp study of ultra-rapid delayed rectifier-potassium channel and the effect of Ibulitide on rat isolated atrial myocytes LI Qiong1, LI Jian2, WU Dong-yan1, REN Jing1, LU Feng-min1, XU Jing1 2017, 45 (2):  168-171.  doi: 10.11958/20161263 Abstract ( 864 )   PDF (466KB) ( 3516 )   Objective To study the characteristic of ultra-rapid delayed rectifier- potassium channel K current (IKur) in rat isolated atrial myocytes using whole- cell patch clamp technique, and the effect of Ibulitide on rat isolated atrial myocytes. Methods Atrial myocytes of rats on an in vitro Langendorf perfusion system were obtained by double digestion (collagenase type Ⅱ) method. Whole-cell patch-clamp recording technique was used to record IKur currents. The currentvoltage (I-V) curves of K + currents of atrial myocytes were fitted. With filled Ibulitide (2 μg/L, filled 3 minutes), IKur was recorded. Results The Results showed that IKur was activated rapidly, almost no lag， and deactivation slowly. This current was activated at about -20 mV, the peak current was present apparent voltage dependence. The peak current density was (2.01±0.27) pA/pF. After filled with Ibulite, this current was no any changed activation. Ibulite decreased the peak current density from +30 mV to +50 mV， but no statistical significance. Conclusion The IKur of rats can activate rapidly with no delays and inactivate slowly. This current is ultra- rapid delayed rectify outside current，and obvious displays the characteristic of outward rectification of whole action potential duration. The 2 µg/L Ibulitide shows no statistical significance for this current. Related Articles | Metrics

Clinical Study

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Changes of serum Th1/Th2 cytokines in peripheral blood pre- and post-liver transplantation LI Ya-guang1, WANG Kai1,2△, LIU Kai1, ZHOU Chun-lei1, WU Bin1,2, GAO Wei1,2 2017, 45 (2):  172-175.  doi: 10.11958/20161259 Abstract ( 1080 )   PDF (326KB) ( 3707 )   Objective To explore the trend of changes of Th1 and Th2 cytokines within 6 months after adult liver transplantation (LT). Methods Twenty-three patients from Tianjin First Center Hospital were chosen as the patient group with an average age of (52.7±7.6), range from 37 to 63 years old, including 21 males and 2 females. Twenty healthy staffs from Tianjin First Center Hospital formed the control group (C) with 15 males and 2 females whose average age was (31.0 ± 6.1) ranged from 22 to 24 years old. The patient group was treated with tacrolimus after LT as main immunosuppressive drug. The peripheral blood at time points before (T0) and 1 month (T1), 3 months (T3), 6 months (T6) after LT at 9:00 AM were collected. The blood sample was also collected form control group but only one time. Levels of IL-2, IFN-γ, IL-10 and TGF- β were detected by ELISA. Results (1) The concentration of IL-2 showed a continuous up-going trend, which was not such obvious between T1 and T0, and until T3 reached a higher concentration than T0. The concentration at T6 was higher than T0 and T1. There were no significant differences in concentrations of T0 to T3 between patient group and control group, while T6 reached a higher concentration in patient group than that of the control group. (2) The concentration of IFN- γ experienced a shortly down-going trend from T0 to T3, and started rising, reached the peak at 3 months after the operation, then started its down-going trend. There were no significant differences in the concentrations of IFN-γ from T1 to T6, and T3 reached a higher concentration than T1 while T6 was lower than T3. Only at T3, the concentration of IFN-γ was higher in patient group than that of control group. (3) There were no significant differences in the concentrations of IL-10 at various time points in patient group, and there were no significant differences in the concentrations of IL-10 at different time points between two groups (P＞0.05). (4) The concentration of TGF-β showed a gradual decline after the operation, and reached its bottom at T6, and which was lower than T0 to T3. Compared with the control group, the down- going trend was not such obviously at T0 and T1, and the concentration was down at T3 and T6（P＜0.05） . Conclusion Our results suggest that there is a tendency of an increasing Th1 cytokine expression at early stage in post-transplantation, while the TGF-β of Th2 cytokine is a decreasing trend. This tendency may associate with the autoimmunity response caused by LT and the immunosuppressive drugs. Related Articles | Metrics

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Analysis of delayed cerebral ischemia after coiling and clipping of intracranial aneurysms LIU Peng-ran, JIN Zhang-ning, CAI Xin-wang, ZHANG Zhen, GAO Nan-nan, WANG Zhe, YANG Xin-yu△ 2017, 45 (2):  176-179.  doi: 10.11958/20160053 Abstract ( 906 )   PDF (338KB) ( 3682 )   Objective To compare and analyze the occurrence of delayed cerebral ischemia（DCI）after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P <0.01). The patients were followed up for 6 months. The poor prognosis rates were 17.0% and 25.7% in clipping group and coiling group, respectively (P > 0.01). The overall mortality was 11.0% , the former had a lower mortality rate (5.9% vs. 17.8% , P <0.01). According to Logistic regression analysis, Fisher Grade 3- 4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P＜0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly. Related Articles | Metrics

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Non-invasive prenatal test in 2 949 intermediate risk women after traditional Down syndrome screening TU Xin-zhi1, DUAN Chun2, LI Yu-zhe1, YANG Xiao-min1, XIE Jian-sheng3△ 2017, 45 (2):  180-183.  doi: 10.11958/20161125 Abstract ( 1502 )   PDF (342KB) ( 4638 )   Objective To explore the value of non-invasive prenatal test (NIPT) in pregnant women with intermediate risk after traditional Down syndrome screening. Methods From March 1 2015 to March 31 2016, a total of 2 949 pregnant women with intermediate risk after traditional Down syndrome screening who received NIPT as the second-line screening method at Shenzhen Maternity and Child Healthcare Hospital after informed consent were recruited for this study. Retrospective data analysis including the results of traditional Down syndrome screening, ultrasound, NIPT and invasive amniocentesis to fetal karyotype analysis were conducted, and pregnant outcomes were followed up. Results NIPT results were all obtained in 2 949 pregnant women with intermediate risk after traditional Down syndrome screening. Of 25 NIPTpositive cases, 24 cases received invasive amniocentesis to fetal karyotype analysis. Thirteen cases were confirmed with fetal chromosomal abnormalities including 5 cases of trisomy 21, 2 cases of trisomy 13, 4 cases of sex chromosomal abnormalities and 2 cases of other chromosomal abnormalities. In addition, 1 NIPT-positive case refused prenatal diagnosis was confirmed normal result after birth. The postnatal follow- up in NIPT- negative women did not find any newborn with chromosomal abnormality. The incidence of fetal chromosomal abnormalities in women with intermediate risk was 0.44% (13/2 949). Conclusion NIPT can be used as second-line screening method in pregnant women with intermediate risk after Down syndrome screening, which could lead to the prenatal detection of a higher proportion of fetal chromosomal abnormalities and a lower invasive-testing rate. Related Articles | Metrics

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The gene polymorphisms of MTHFR C677T and the susceptibility of chronic pulmonary heart disease MA Wu-lin*, YANG Fang*△, YANG Na, YUN Li-na, WANG Chuan-chuan, ZHAO Shuang-feng, LI Xia 2017, 45 (2):  184-186.  doi: 10.11958/20161052 Abstract ( 777 )   PDF (334KB) ( 3783 )   Objective To investigate the relationship between gene polymorphisms of homocysteine (Hcy), metabolic enzymes methylenetetrahydrofolate reductase MTHFR C677T and chronic pulmonary heart disease (CPHD). Methods The gene polymorphisms of MTHFR C677T were determined by the polymerase chain reaction- restriction fragment length polymorphism（PCR-RFLP） in CPHD patients (n=120) and healthy control (HC, n=120), and genotyping was carried on. The automatic biochemistry analyzer was used to detect the level of Hcy and other related biochemical indicators. Results There was significant difference in Hcy level between the CPHD group and HC group (P＜0.05). The mutation frequencies of CC, CT and TT were 24.17%, 43.33% and 32.50%, 35.00%, 47.50% and 17.50% in the CPHD group and HC group. The mutation frequencies of allele C /T were 45.83% and 54.17% in HC group, and 58.75% and 41.25% in control group. There was significant difference in the overall frequency distribution between the three genotypes (χ2 =8.010, P＜0.05). The frequency of T allele was significantly higher in CPHD group than that in control group (χ2=8.025， P＜0.05). Conclusion The increased Hcy and its metabolic enzyme MTHFR C677T may be involved in the occurrence and development of CPHD. Related Articles | Metrics

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The relationship between microalbuminuria and cardiac diastolic function in patients with type II diabetes mellitus and nonalcoholic fatty liver disease WANG De-man1, DI Fu-sheng2△ 2017, 45 (2):  187-191.  doi: 10.11958/20161034 Abstract ( 1155 )   PDF (405KB) ( 3652 )   Objective To study the relationship between microalbuminuria and cardiac diastolic function in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 262 patients with T2DM and NAFLD were included in this study. Patients were divided into normal group (n=106) and abnormal group (n= 156) according to their cardiac diastolic function. Data of waist circumference (WC), low density lipoprotein cholesterol (LDL-C), triglyceride(TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), fasting insulin level (FINS), insulin resistance index (HOMA- IR), glycosylated hemoglobin (HbA1c), glomerular filtration rate (GFR), C reactive protein (CRP), urinary microalbuminuria excretion rate (UAER), left ventricular myocardial quality index (LVWI) and liver fat content (LFC) were compared between two groups. All patients were divided into four groups according to data of UAER and GFR: group A[UAER<20 μg/min and GFR≥90 mL/(min·1.73 m2)], group B [UAER<20 μg/min and GFR<90 mL/(min·1.73 m2)], group C [UAER≥20 μg/min and GFR≥90 mL/(min·1.73 m2)], and group D [UAER≥20 μg/min and GFR<90 mL/(min·1.73 m2)]. The differences between the relevant indicators were analyzed between groups. Logistic regression analysis was used to compare UAER between normal group and abnormal group. Also the relationship between the related factors and cardiac diastolic function was compared between these two groups. Results For abnormal group, TG, SBP, HOMA- IR, CRP, UAER, LVWI and LFC were significantly higher, and GFR was significantly lower, than those of normal group (P＜0.05). There were no significant differences in other indicators between two groups. Values of peak early/ late diastolic filling velocity (E/A) showed a reduction trend in order in A, B， C and D groups (P＜0.05). Values of LVWI showed a increasing trend in order in four groups (P＜0.05). Values of LFC were significantly higher in C and D groups compared with those of A and B groups (P＜0.05). There was no significant difference in LFC between A group and B group. The GFR <90 mL/ （min·1.73 m2） was an independent risk factor for cardiac diastolic function in normal group of UAER, and higher UAER was an independent risk factor for cardiac diastolic function in the abnormal group of UAER. Conclusion There is obviously reduced cardiac diastolic function in patients with T2DM and NAFLD and microalbuminuria. When UAER≥20 µg/min, the higher UAER is an independent risk factor for reducing diastolic cardiac dysfunction. Related Articles | Metrics

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The relation between blood routine test indicators and advanced saphenous vein graft disease in patients with coronary artery bypass grafting SUN Bo1， LIU Yin2△, GAO Jing2， SUN Gen-yi2 2017, 45 (2):  191-196.  doi: 10.11958/20160750 Abstract ( 1351 )   PDF (409KB) ( 3887 )   Objective To investigate the correlation between blood routine test indicators and advanced saphenous vein graft disease (SVGD) in patients with coronary artery bypass grafting (CABG). Methods By defining SVGD as an occlusion of 50% or more of the saphenous vein graft (SVG) excluding distal anastomotic occlusion, patients were divided into SVGD group and non- SVGD group, who suffered CABG over 1 year with recurrent angina and underwent coronary angiography (CAG) operation from March 2015 to January 2016 in Tianjin Chest Hospital. Results of blood routine test data were compared between two groups. The multivariable Logistic regression was analyzed for the relationship between blood routine test indicators and advanced SVGD. Results There were 148 patients in the study, 109 patients in SVGD group and 39 patients in non-SVGD group. There were significant differences in level of red blood cell distribution width (RDW: 0.123 2±0.008 9 vs. 0.120 2±0.005 2, P<0.05), neutrophil/lymphocyte ratio (NLR: 3.40±2.11 vs. 2.75±0.82, P＜0.05) and platelet and lymphocyte ratio (PLR: 143.10±54.70 vs. 124.57±34.40, P<0.05) between SVGD group and non-SVGD group. Multivariable Logistic regression analysis showed that RDW>0.127 5［OR (95%CI): 4.905 (1.058-22.747), P=0.042］ , NLR> 3.34［OR(95%CI): 4.013(1.466-10.987), P=0.007］ were independent risk factors for advanced SVGD, as well as PCT>0.185 ［OR(95%CI): 2.636(1.098-6.324), P=0.030］might be risk factor for advanced SVGD. Conclusion RDW>0.127 5, NLR> 3.34 could indicate advanced SVGD. We need more samples to support that PCT>0.185 is used to be risk indicators for advanced SVGD. Related Articles | Metrics

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The efficacy of metformin combined with insulin in the treatment of T1DM in children DONG Jin, HUANG Le, ZHAO Yan 2017, 45 (2):  197-199.  doi: 10.11958/20160568 Abstract ( 1028 )   PDF (324KB) ( 3701 )   Objective To investigate metformin combined with insulin aspart 30 injection (NovoMix 30) in the treatment of type 1 diabetes mellitus (T1DM) in children and adolescents. Methods A total of 126 T1DM children over 10 years of age were randomly divided into insulin group (A) and insulin + metformin group (B). A group (n=60) was given insulin aspart 30 injection (insulin aspart 30), and B group (n=66) was given the metformin and insulin aspart 30 injection (NovoMix 30). Results The two groups can effectively control blood glucose, but the B group in the blood glucose control time, insulin dosage, the incidence of hypoglycemia, fasting blood glucose and hospitalization time were better than those of A group. There was no significant difference in liver and kidney function before and after oral administration of metformin in B group (P＞0.05). Conclusion Metformin combined with insulin is effective and safe in the treatment of children with T1DM. Related Articles | Metrics

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Study on the relationship of chronic pharyngitis and unhealthy lifestyle and obesity MIAO Zhuang 2017, 45 (2):  200-204.  doi: 10.11958/20161199 Abstract ( 1400 )   PDF (345KB) ( 4163 )   Objective To investigate the relationship between chronic pharyngitis and lifestyle and obesity. Methods A total of 7 655 participants who underwent a health examination in the Navy General Hospital were recruited. These participants came from the same region and had similar occupations. Their lifestyle information data including smoking status, drinking status, and physical activity were collected. Differences of lifestyle and the prevalence of chronic pharyngitis were compared between men and women. Single- factor analysis and multivariate Logistic regression analysis were performed to identify the relationship of chronic pharyngitis and lifestyle and obesity. Results The proportion of smoking and drinking, the prevalence of chronic pharyngitis, levels of systolic blood pressure, diastolic blood pressure, triglycerides, and fasting blood glucose were significantly higher, and the ratio of lack of exercise and normal body weight significantly decreased, in men than those in women (P＜0.01). There were no significant differences in age and LDL-C between different gender groups. The prevalence of chronic pharyngitis increased with the frequency of drinking and the increase of obesity in man and women. The prevalence of chronic pharyngitis was not statistically significant in man with smoking than that in man without smoking. There was no significant difference in the prevalence of chronic pharyngitis between females with or without smoking. The prevalence of chronic pharyngitis decreased with the increase of physical activity in both men and women (P＜0.01). Higher levels of systolic blood pressure and fasting blood pressure and regular physical activity were protective factors, and obesity was a harmful factor of chronic pharyngitis in men and women. Currently, smoking and regular drinking were harmful factors of chronic pharyngitis in men but not in women. Old age and occasional alcohol consumption were risk factors for women. Conclusion There is a significant value of strengthening physical activity and maintaining normal body weight in the prevention and treatment of chronic pharyngitis. It is also important for men to quit smoking and limit drinking in the prevention and treatment of chronic pharyngitis. Related Articles | Metrics

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Selection of surgical approach for posterior malleolar fracture YANG Guo-yue1, JIANG Han1, LIU Zhi1, CHEN Zhi-qing1, HOU Xiao-bin1, ZHANG Hong2△ 2017, 45 (2):  205-209.  doi: 10.11958/20161082 Abstract ( 1991 )   PDF (974KB) ( 3720 )   Objective To investigate the clinical characteristics of posterior malleolar ankle fracture, and the selection of the surgical approach. Methods From January 2013 to September 2015, 83 cases of posterior malleolar fractures were retrospectively analyzed. Haraguchi typing was performed based on the three- dimensional CT. There were 54 cases with HaraguchiⅠ type, 16 cases with HaraguchiⅡ type, and 13 cases with HaraguchiⅢ type. The patients who were HaraguchiⅠ and Haraguchi Ⅲ types accepted the operation with posterolateral approach. The patients who were Haraguchi Ⅱtype and combined medial malleolus fracture accepted the operation with medial approach. The Haraguchi Ⅱ patients who were not combined medial malleolus fracture were used the medial paraachilles approach. Images of the ankle joint were filmed 2 weeks, 4 weeks, 12 weeks, 6 months and 12 months after the surgery. The healing time, complications and corresponding record outcome were determined by X-ray and clinical examination. At the last follow-up, ankle function and quality of life of patients were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and SF-36. Results Eighty-three patients were follow-up for 6-24 (mean 15.4± 6.2) months. The fractures healed on Xray. The average X-ray healing time was from 12 to 24 (mean 18.6±4.2) weeks. AOFAS score was 71 to 100 (mean 88.4±8.4) points. Sixty-seven cases were excellent, 14 cases were good, 2 cases were moderate, and good rate was 97.59%. SF-36 physiological score was 31.6-69.2 points(mean 48.4±4.8 points); SF-36 psychological score 28.6-64.5 points(mean 45.8± 3.5 points). Chronic ankle pain was complained by one patient. He was diagnosed traumatic arthritis, oral non- steroidal drugs was used to relief his ankle pain. One patient wound infected, and healed after treatment. No instrument failure and fracture displacement were found. Conclusion According to fracture morphology and clinical features after posterior malleolar ankle fracture, different surgical approaches are selected, which will be satisfied with the outcome. Related Articles | Metrics

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Comparison and evaluation of different assays in the diagnosis of severe fever with thrombocytopenia syndrome CHENG Ning-ning1, DU Yan-hua2, HUANG Xue-yong2,3, LI Yi2, ZHAO Yi-ke1, MA Hong-xia2, XU Bian-li1△ 2017, 45 (2):  210-214.  doi: 10.11958/20161421 Abstract ( 864 )   PDF (355KB) ( 4157 )   Objective To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P < 0.05). For 109 cases with acute and convalescent paired serum samples, there was no significant difference in the positive rates between ELISA-IgG (75.23%) and real-time PCR (72.48%) detections (χ2=0.18, P > 0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P < 0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased (Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA- IgM can be used as an assistant method to guide clinical diagnosis. Related Articles | Metrics

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The clinical value of 18F-FDG PET/CT for diagnosing tumor in physical examination people with unexplained elevated serum CEA ZHENG Hong-na, LI Jing, XIE Jing-hui, DU Xue-mei, CHEN Bo, ZHANG Yan-jun△ 2017, 45 (2):  215-219.  doi: 10.11958/20160954 Abstract ( 974 )   PDF (548KB) ( 3804 )   Objective To evaluate the clinical value of 18F-FDG PET/CT for detecting tumor on physical examination people with unexplained elevated serum carcinoembryonic antigen (CEA). Methods A total of 100 physical examination people with unexplained elevated serum levels of CEA in our hospital from June 2010 to December 2014 were involved in the study. All the people were detected with 18F-FDG PET/CT. The pathology, clinical follow ups and conventional medical imaging results were combined to evaluate the value of 18F-FDG PET/CT in diagnosing tumor. The doubling time (DT) of CEA was calculated in the patients who were received more than twice of serum CEA detection. The relationships between serum CEA levels, CEA DT and 18F-FDG PET/CT imaging were analyzed. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of serum CEA. Results Twenty-seven patients were confirmed with malignant tumor, and the rest of 73 cases were excluded. The 18F- FDG PET/CT reported one false positive and one false negative respectively. The sensitivity, specificity, accuracy, positive and negative predictive values of 18F-FDG PET/CT in diagnosing malignant tumors were 96.3% , 98.6% , 98.0% , 96.3% and 98.6% respectively. The median serum CEA levels were significantly higher in the positive 18F-FDG PET/CT patients than those in the negative patients (Z=5.796, P＜0.05). The prevalence of 18F-FDG PET/CT positive patients was higher with an increase in absolute CEA levels (χ2=37.823, P＜0.05). The median DT of serum CEA levels was shorter in the positive 18F-FDG PET/CT patients than that in the negative patients (Z=4.301， P＜0.05). The positive rates of 18F-FDG PET/CT in patients with 0 d＜DT＜180 d were significantly higher than patients with DT＞180 d and DT＜0 d (χ2=17.472 and 17.325, both P＜0.05). There was no significant difference in the positive rate of 18F-FDG PET/CT between patients with DT＞180 d and patients with DT＜0 d (χ2=0.255， P＞0.05). The area under the curve (AUC) of serum CEA was 0.894, the optimal diagnostic cutoff value was 14.24 μg/L. Conclusion 18FFDG PET/CT is a useful image modality for detecting malignant tumors in patients with unexplained elevated serum CEA, especially for patients with CEA≥14.24 μg/L and increase progressively. Related Articles | Metrics

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Value of 18F-FDG PET/CT in differentiating tuberculous and cancerous diffuse peritoneal lesions ZHANG Wen-yan, CAI Li, WANG Ying, YU Hao-nan, GAO Shuo△ 2017, 45 (2):  220-224.  doi: 10.11958/20161088 Abstract ( 1191 )   PDF (558KB) ( 4394 )   Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18FFDG PET/CT features of 72 patients with tuberculous peritonitis， 28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F- FDG. The degree of 18F- FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P＞0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65， T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69， T/NT=0.57±0.27, t=2.243 and 5.045， both P＜0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases. Related Articles | Metrics