We report the synthesis and biological evaluation of 131I‐labeled antihuman tumor‐derived immunoglobulin G (IgG) light chain monoclonal antibody (4E9) ([131I]I‐4E9) as a promising probe for tumor imaging. [131I]I‐4E9 was synthesized in radiochemical yield of 89.9 ± 4.7% with radiochemical purity of more than 99%. [131I]I‐4E9 showed high stability in normal saline and human serum. In cell uptake studies, [131I]I‐4E9 exhibited favorable binding affinity and high specificity in HeLa MR cells. In biodistribution studies, [131I]I‐4E9 showed high tumor uptake, high tumor/non‐tumor ratios, and specific binding in BALB/c nu/nu mice bearing human HeLa MR xenografts. Single‐photon emission computerized tomography (SPECT) imaging of [131I]I‐4E9 in the HeLa MR xenograft model demonstrated clear visualization of tumor after 48 h and confirmed specific binding in tumor. These findings suggest that [131I]I‐4E9 possesses favorable biological characteristics and warrants further investigation as a prospective probe for imaging and treatment of cancers.

Radioimmunotherapy (RIT) has great potential in cancer therapy. However, its efficacy in numerous tumors is restricted due to myelotoxicity, thereby limiting the dose of radionuclide. To increase tumor radiosensitivity, we incorporated the recombinant lentivirus into the EJ cells (bladder cancer [BC] cells), and examined the combined anti-tumor effects of RIT with 131I-BDI-1(131I-monoclonal antibody against human BC-1) and gene therapy (GT). The recombinant lentivirus was constructed and packed. The animal xenograft model was built and when the tumor reached about 0.5 cm in diameter, the mice were randomly separated into four groups: (1) RIT + GT: the xenografts were continuously incorporated with the recombinant lentivirus for two days. And 7.4 MBq 131I-BDI-1 was IV-injected, and 10 mg prodrug 5-fluorocytosine (FC) was IV-injected for 7 days, (2) RIT: same dose of 131I-BDI-1 as the previous group mice, (3) GT: same as the first group, except no 131I-BDI-1, and (4) Untreated. Compute tumor volumes in all groups. After 28 days the mice were euthanized and the tumors were extracted and weighed, and the inhibition rate was computed. The RIT + GT mice, followed by the RIT mice, exhibited markedly slower tumor growth, compared to the control mice. The tumor size was comparable between the GT and control mice. The tumor inhibition rates after 28 days of incubation were 42.85 ± 0.23%, 27.92 ± 0.21% and 0.57 ± 0.11% for the four groups, respectively. In conclusion, RIT, combined with GT, suppressed tumor development more effectively than RIT or GT alone. This data highlights the potent additive effect of radioimmune and gene therapeutic interventions against cancer.

Objective:To develop a neural network model for the evaluation of glomerular filtration rate (GFR) based on multilayer perceptual neural network, and to compare with the improved Chinese based creatinine GFR evaluation formula (C-GFR cr) and the evaluation formula (EPI-GFR cr) of the American Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for the clinical applicability of multilayer perceptual neural network model in evaluating GFR. Methods:A total of 684 chronic kidney disease (CKD) patients used for developing a modified version of China′s based creatinine GFR evaluation formula were taken as the research object. The data of 454 patients were randomly selected as the development group and the data of the other 230 patients were as the verification group. The multilayer perceptual neural network GFR evaluation model (M-GFR cr) was established. With the double plasma GFR as the reference value (rGFR), the correlation, mean difference, mean absolute difference, precision and accuracy of C-GFR cr, EPI-GFR cr and M-GFR cr were compared. Results:Among the 684 CKD patients, there were 352 males and 332 females, with age of (49.9±15.8) years. The correlation between M-GFR cr and rGFR was the highest (Pearson correlation =0.93, P<0.001). The mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=9.929, P<0.001) and EPI-GFR cr ( Z=10.573, P<0.001). The mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=3.953, P<0.001) and EPI-GFR cr ( Z=4.210, P<0.001). The accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=26.068, P<0.001) and EPI-GFR cr ( χ2=23.154, P<0.001). The accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=8.264, P=0.001) and EPI-GFR cr ( χ2=11.963, P=0.001). The results of different stages of CKD showed that in the early stage of CKD (CKD 1-2), the mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=7.401, P<0.001) and EPI-GFR cr ( Z=8.096, P<0.001); the mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=4.723, P<0.001) and EPI-GFR cr ( Z=4.946, P<0.001); the accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=23.547, P<0.001) and EPI-GFR cr ( χ2=26.421, P<0.001); the accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=12.089, P=0.001) and EPI-GFR cr ( χ2=16.168, P<0.001). But there was no significant difference in the applicability among C-GFR cr, EPI-GFR cr and M-GFR cr in the advanced stages of CKD (CKD 3-5). Conclusion:Compared with the improved Chinese based creatinine GFR evaluation formula C-GFR cr and CKD-EPI evaluation formula EPI-GFR cr, the accuracy of multilayer perceptual neural network model to evaluate GFR in CKD patients has been significantly improved, especially in CKD 1-2 stage.

Mesoporous carbon nanotubes (mCNTs) hold great promise interests, owing to their superior nano-platform properties for biomedicine. To fully utilize this potential, the toxicity and biodistribution of pristine and surface-modified mCNTs (-OH/-COOH) should preferentially be addressed. The results of cell viability suggested that pristine mCNTs induced cell death in a concentration-dependent manner. As evidence of reactive oxygen species (ROS), malondialdehyde (MDA) and superoxide dismutase (SOD), pristine mCNTs induced noticeable redox imbalance. 99mTc tracing data suggested that the cellular uptake of pristine mCNTs posed a concentrate-dependent and energy-dependent manner via macropinocytotic and clathrin-dependent pathways, and the main accumulated organs were lung, liver and spleen. With OH modification, the ROS generation, MDA deposition and SOD consumption were evidently reduced compared with the pristine mCNTs at 24/48 h high-dose exposure. With COOH modification, the modified mCNTs only showed a significant difference in SOD consumption at 24/48 h exposure, but there was no significant difference in the measurement of ROS and MDA. The internalization mechanism and organ distribution of modified mCNTs were basically invariant. Together, our study provides evidence that mCNTs and the modified mCNTs all could induce oxidative damage and thereby impair cells. 99mTc-mCNTs can effectively trace the distribution of nanotubes in vivo.

Objective:To investigate the effect of electroporation-mediated local gene therapy on the expression of Wnt3a and β-catenin in callus of distraction gap during mandibular distraction osteogenesis of rabbits.Methods:The experiments were conducted in the laboratory of the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from September 2019 to December 2019. Forty eight New-Zealand rabbits were randomly divided into control group (group A), gene therapy group (group B) and normal saline group (group C), with 16 rabbits in each group. After bilateral mandible osteotomy and distractors were implanted, the distractors were activated at a speed of 0.8 mm/d on 4th day, postoperatively, and lasted for 7 days, followed by consolidation period. Group A distracted only, group B was subject to local injection of recombinant plasmid pIRES-hBMP2-hVEGF165 in the distraction gap and electroporation stimulation at the beginning of activation distractors; and group C local injection of the same dose of normal saline in the distraction gap and electroporation stimulation at the beginning of activation distractors. Four animals in each group were sacrificed on the day at the end of distraction, 7th, 14th, 28th days of consolidation period, respectively. The callus in the distraction gap was taken for immunohistochemical staining and RT-PCR to detect the expression of Wnt3a and β-catenin, and image analysis was performed. SPSS 22.0 statistical software was used for data analysis.Results:Immunohistochemical staining showed that Wnt3a and β-catenin were mainly located in the cytoplasm and nuclei of fibroblasts, chondrocytes and osteoblasts in callus tissue. Immunohistochemistry and RT-PCR showed that the expression of Wnt3a and β-catenin reached a peak at the end of distraction. With the disappearance of distraction tension, the expression of Wnt3a and β-catenin gradually decreased. After gene therapy intervention, the expression of Wnt3a and β-catenin was significantly increased, and the expression of Wnt3a and β-catenin in group B was the highest at each time point, with statistically significant difference compared with groups A and C ( F=96.3, P<0.01). Conclusions:Gene therapy promotes the expression of Wnt3a and β-catenin in the callus of distraction gap, regulating the balance of the bone reconstruction system and thus promoting the formation of new bone in the distraction gap.

Pep-1 (CGEMGWVRC) can potently bind to interleukin 13 receptor α 2 (IL-13Rα2), a tumor-restricted receptor found to be expressed in various malignancies. In this study, we intended to prepare a 99mTc-labeled probe and evaluate its in vivo tumor accumulation properties in a cervical cancer xenograft model. The Pep-1 was designed and radiolabeled with 99mTc by conjugation with mercaptoacetyl-triglycine (MAG3). The labeling yield, radiochemical purity and stability were characterized in vitro. Cell uptake assays and fluorescence imaging were conducted for qualitative and quantitative evaluation of the specificity and affinity of Pep-1. Flow cytometry and tissue immunofluorescence were used to confirm the IL-13Rα2 expression in cervical cancer. Biodistribution and in vivo imaging were performed periodically to evaluate the imaging value of 99mTc-MAG3-Pep-1 in cervical cancer xenograft model. 99mTc-MAG3-Pep-1 was successfully prepared with a high labeling yield and radiochemical purity (> 95%). Specific cell uptake was demonstrated by scramble control and unlabeled MAG3-Pep-1 blockade. Flow cytometry and tissue immunofluorescence also confirmed the mild IL-13Rα2 expression of HeLa. In the gamma imaging study and biodistribution, the tumors were imaged clearly at 2–6 h after injection of 99mTc-MAG3-Pep-1 and the accumulation of 99mTc-MAG3-Pep-1 in tumor was significantly higher than that in the blocking and scramble controls, demonstrating ligand–receptor binding specificity. This work demonstrated that 99mTc-MAG3-Pep-1 can bind to cervical cancer with high affinity and specificity. MAG3-Pep-1 may be a prospective precursor for IL-13Rα2-expressing cancer therapy.

目的 对131I-c(RGD)2在原位荷脑胶质瘤动物模型中的靶向定位作用进行研究,以探讨其应用于脑胶质瘤诊断与治疗的可能性.方法 采用U87-MG人脑胶质瘤细胞接种在裸鼠右脑尾状核内,建立了原位荷脑胶质瘤动物模型;采用氯氨T法将131I标记c(RGD)2,于原位荷脑胶质瘤裸鼠中进行生物分布研究,计算131I-c(RGD)2在脑胶质瘤中的摄取率及肿瘤与正常脑组织摄取率的比值(T/NT).结果 给药后3 h及6 h,肾的摄取均为所有器官中最高;给药后3 h肿瘤未累及的脑组织的摄取率为(0.16±0.10)％ID/g,胶质瘤组织的摄取率为(0.41±0.26)％ID/g,脑胶质瘤中的摄取率显著高于正常脑组织摄取率(P值为0.025);给药后6 h肿瘤未累及的脑组织的摄取率为(0.08±0.04)％ID/g,胶质瘤组织的摄取率为(0.44±0.23)％ID/g,脑胶质瘤中的摄取率亦显著高于正常脑组织摄取率(P值为0.011);给药后3 h T/NT比值为3.36±1.86,给药后6 h T/NT比值增高至5.55±1.75.结论 c(RGD)2具有靶向颅内胶质瘤的能力,在胶质瘤的靶向诊断与治疗中具有潜力,但其在脑胶质瘤中的摄取率相对较低,有待于进一步提高.

Arg-Arg-Leu (RRL) is a potent tumor-homing tripeptide. However, the binding target is unclear. In this study, we intended to identify the binding target of RRL and evaluate the tumor targeting of 99mTc-MAG3-RRL in vivo. Biotin-RRL, 5-TAMRA-RRL, and 99mTc-MAG3-RRL were designed to trace the binding target and tumor lesion. Immunoprecipitation-mass spectrometry was conducted to identify the candidate proteins and determination of the subcellular localization was also performed. A pull-down assay was performed to demonstrate the immunoprecipitate. Fluorescence colocalization and cell uptake assays were performed to elucidate the correlation between the selected binding protein and RRL, and the internalization mechanism of RRL. Biodistribution and in vivo imaging were performed to evaluate the tumor accumulation and targeting of 99mTc-MAG3-RRL. The target for RRL was screened to be heat shock protein 70 (HSP70). The prominent uptake distribution of RRL was concentrated in the membrane and cytoplasm. A pull-down assay demonstrated the existence of HSP70 in the biotin-RRL captured complex. Regarding fluorescence colocalization and cell uptake assays, RRL may interact with HSP70 at the nucleotide-binding domain (NBD). Clathrin-dependent endocytosis and macropinocytosis could be a vital internalization mechanism of RRL. In vivo imaging and biodistribution both demonstrated that 99mTc-MAG3-RRL can trace tumors with satisfactory accumulation in hepatoma xenograft mice. The radioactive signals accumulated in tumor lesions can be blocked by VER-155008, which can bind to the NBD of HSP70. Our findings revealed that RRL may interact with HSP70 and that 99mTc-MAG3-RRL could be a prospective probe for visualizing overexpressed HSP70 tumor sections.

合成了一种可特异性结合纤维蛋白-纤维连接蛋白的早期血栓显像剂131 I-YSSCREKA肽(酪氨酸-(D)丝氨酸-(D)丝氨酸-半胱氨酸-精氨酸-谷氨酸-赖氨酸-丙氨酸),对其标记、SPECT显像及初步生物学性能进行研究.结果表明:YSSCREKA八肽在室温下通过氯胺-T法反应5 min的标记率为(77.2±1.1)％(n=3),放射化学纯度为(90.0±3.1)％(n=3),体外稳定性较好.新西兰家兔SPECT显像显示在131 I-YSSCREKA肽注射后20 h血栓能较清晰地显像,血栓/血放射性比值为1.36.SD大鼠生物分布实验显示:20 h 131 I-YSSCREKA肽在血栓中的摄取率为(0.19±0.06)ID％/g(n=5),血栓/肌肉及血栓/血放射性比值分别为3.80和1.90.131 I-YSSCREKA肽有可能作为早期血栓的显像剂,但其在血栓中的摄取率有待于进一步提高.

Highly infiltrative and invasive glioma cells obscure the boundary between tumor and normal brain tissue, making it extremely difficult to precisely diagnose and completely remove. The combination of multimodal imaging with effective treatments to diagnose precisely and guide surgery and therapy accurately is desperately needed for glioma in the brain. Here, we report a biomimetic catalase-integrated-albumin phototheranostic nanoprobe (ICG/AuNR@BCNP) to realize multimodal imaging, amplify phototherapy, and guide surgery for glioma after penetrating the blood-brain barrier, accumulating into deep-seated glioma via albumin-binding protein mediated transportation. The phototheranostic nanoprobe enabled fluorescence, photoacoustic, and infrared thermal imaging with desirable detecting depth and high signal-to-background ratio for clearly differentiating brain tumors from surrounding tissues. Meanwhile, the nanoprobe could effectively induce local hyperthermia and promote the level of singlet oxygen based on alleviated hypoxic glioma microenvironment by decomposing endogenous hydrogen peroxide to oxygen to amplify phototherapy. Thus, significant inhibition of glioma growth, extended survival time, alleviated tumor hypoxia, improved apoptosis, and antiangiogenesis effects were exhibited in several animal models including the periphery and the brain through intravenous or intratumoral injection, meanwhile with low toxicity to normal tissue. The phototherapy was also guided by the assistance of external bioluminescence, magnetic resonance, and positron emission tomography imaging. Moreover, the nanoprobe could accurately guide the glioma resection. These results suggest that the phototheranostic nanoprobe is a promising nanoplatform specifically for glioma to achieve multimodal diagnosis, effective phototherapy, and accurate imaging-guided surgery.

目的 探讨微小RNA?301a(miR?301a)对非小细胞肺癌(NSCLC)细胞上皮间质转化(EMT)和SMAD家族成员4(Smad4)表达的影响.方法 采用实时定量PCR(QPCR)检测30对NSCLC组织和癌旁组织的miR?301a和Smad4水平;脂质体法向A549细胞转染miR?301a抑制剂(抑制组)或阴性对照(NC组),另以未行转染的细胞为对照组,采用QPCR、活细胞计数(CCK?8)、划痕实验、Transwell小室实验和Western blotting检测miR?301a水平、增殖活力、划痕愈合率、穿膜细胞数和Smad4水平,QPCR和Western blotting检测EMT相关标志物[上皮型钙黏蛋白(E?cad)、神经型钙黏蛋白(N?cad)和波形蛋白(Vim)]的水平,生物信息学预测和双荧光素酶报告验证miR?301a和Smad4间的靶向关系.结果 NSCLC组织的miR?301a水平为2.157±0.597,高于癌旁组织的1.023±0.229,癌组织的Smad4水平为0.648±0.162,低于癌旁组织的1.159±0.164,差异均有统计学意义(P<0.05).抑制组的miR?301a水平、划痕愈合率和穿膜细胞数分别为0.166±0.075、(31.518±4.306)％和(89.744±15.060)个,均低于对照组的1.032±0.097、(52.461±6.373)％和(139.339±17.871)个及NC组的0.981±0.089、(54.791±4.528)％和(145.243±19.782)个,而抑制组的Smad4水平为0.712±0.121,高于对照组的0.428±0.163和NC组的0.390±0.096,上述差异均有统计学意义(P<0.05).与其余两组相比,抑制组转染24、48 h的增殖活力及Vim和N?cad水平降低,而E?cad水平升高(P<0.05).Smad4野生型质粒与miR?301a模拟物共转染A549细胞后,荧光素酶活性下降(P<0.05),而Smad4突变型质粒和miR?301a模拟物共转染后,荧光素酶活性无明显变化(P>0.05).结论 NSCLC中miR?301a高表达且发挥类似癌基因的作用,下调该miRNA水平可抑制增殖和迁移侵袭能力并逆转EMT,可能通过靶向Smad4来发挥作用,有望成为NSCLC诊治的潜在新靶标.

OBJECTIVE:The objective of this study is to investigate the expression of Vascular cell adhesion molecule-1 (VCAM-1) and very late appearing antigen-4 (VLA-4) cytokines in MM (multiple Myeloma).METHOD:Forty patients with MM are selected as the experimental group and 30 healthy persons as the control group. Flow cytometry is used to detect the expression of VCAM-1 (CD106), VLA-4 (CD49d), CD38 and CD138 antigens in experimental group and control group. ELISA (Enzyme Linked Immunosorbent Assay) is used to detect the concentration of VCAM-1 in serum of experimental group and control group. RT-PCR is used to detect the expression of VCAM-1.RESULTS:The positive rate and antigen expression rate of VACM-1 antigen in the experimental group were significantly higher than those in the control group (P < 0.05). There were statistical differences of VLA-4 and VCAM-1 antigens between the initial diagnosis group and the relapse/refractory group, and between the relapse/refractory group and the platform stage group (P < 0.05). There were significant differences between VLA-4 antigen and VACM-1 antigen, phase I and phase II, and between phase I and phase III (P < 0.05). The concentration of VCAM-1 and the expression of VCAM-1 mRNA in the experimental group were significantly higher than (P < 0.01). In the different stages of ISS (International Staging System) and different disease groups in the experimental group, the concentration of VCAM-1 and the expression level of VCAM-1 mRNA are significantly different among the three groups of stage I, II and III (P < 0.01). There is a significant difference between the initial diagnosis group, the relapse/refractory group and the platform group (P < 0.05).CONCLUSION:There are abnormal expressions of adhesion molecules VCAM-1 and VLA-4 in multiple myeloma patients, which are related to ISS staging.

Therapeutic constructs with imaging modalities hold great promise for improving the treatment efficacy for cancer and many other diseases. We report here the design and synthesis of a self-assembling prodrug (SAPD) by the direct linkage of camptothecin (CPT), an anticancer drug, to a metal-chelating agent, DOTA. We found that under physiological conditions the DOTA-conjugated CPT prodrug can self-assemble into tubular supramolecular polymers (SPs) with a length of several micrometers. Our studies also suggest that the resultant assemblies were stable in biological environments and exhibited a fast drug release rate in the presence of intracellular glutathione. Furthermore, the SAPD exhibited remarkable in vitro efficacy against various cancer cell lines and effectively inhibited the growth of tumor spheroids. We believe that the design and optimization of self-assembling theranostic conjugates could provide a robust yet simple platform for the development of new imaging-guided drug delivery systems.

Objective To explore the role of β-catenin in distraction osteogenesis of new bone formation,the expression of β-catenin in the distraction gap callus was detected during rabbit mandibular distraction osteogenesis.Methods 26 New-Zealand rabbits were randomly divided into 3 groups.Group A is a normal control group with 2 rabbits,group B is the mandibular defect control group,and group C is the distraction group.Group B and C with 12 rabbits,respectively.The two rabbits in group A without surgery,their mandibles are normal control.In group B,vertical osteotomy was performed between the first molar and the mental foramen on the mandibles bilaterally,followed by rigid internal fixation with titanium plates and screw with 5 mm gap immediately.In group C,after the same osteotomy was performed,the fragments of mandibles were reduced and fixed with mandibular distractors bilaterally.On the fourth day postoperatively,the distraction started at a rate of 0.8 mm/d and lasted for 7 days,followed by consolidation period.Two rabbits of group B and C were sacrificed at 6th,10th,17th,24th,31st,38th day postoperatively,respectively.The newly formed callus in the distraction gap of mandibles was harvested for Western blotting and immunohistochemistry examination to detect the distribution and expression of β-catenin.The experimental data were analyzed by SPSS 22.0 statistical software using Spearman function.Results The result of Western blotting showed that the expression of β-catenin gradually increased at distraction period(6-10 days after surgery) and reached the peak at the end of the distraction period(10th day postoperatively),it gradually decreased during the consolidation period.However,the expression of β-catenin in group C was higher than that of group B.Immunohistochemistry stain showed that the expression of β-catenin mainly located in inflammatory cells(eg.monocyte),fibroblast of the granulation tissue,the osteoblasts,osteocyte on the surface of new formed trabecular,and the connective tissues surrounding the new bone in the new formed callus.Cytoplasmic and nuclear staining were positive.In group C,the expression of β-catenin was strong (3.245 8±0.132 3) after distraction (6th day postoperatively),and reached a peak (4.602 8± 0.021 9) on the 10th day postoperatively.With the disappearance of the distraction stress,the expression of β-catenin gradually decreased since17th day postoperatively(3.639 8± 0.125 5),but the staining was still positive.In group B,the strong positive staining of β-catenin on the 6th day after surgery (2.734 0±0.134 7),the strongest staining on the 10th day after surgery (3.101 3± 0.104 8),and the expression of β-catenin on the 17th day after surgery (2.542 8±0.211 1) was weaker than that on the 10th day after surgery.At each time point,the expression of β-catenin in group C was significantly higher than that in group B,and the difference was statistically significant (r =0.943,P =0.005 6).Conclusions During mandibular distraction osteogenesis,the distraction stress activates the Wnt signal pathway to enhance the expression of β-catenin,it suggests that β-catenin plays an important role in the transformation of the mechanical signal to chemical signals during the process of distraction osteogenesis,and participates in the regulation of new bone formation during distraction osteogenesis.

目的:报道5例原发肾上腺弥漫大B细胞淋巴瘤(DLBCL)的临床以及病理特点,提高对原发肾上腺DLBCL的认识及诊治水平.方法:回顾性分析在我院诊治的5例原发肾上腺DLBCL患者的临床及病理资料.结果:5例原发肾上腺DLBCL,其中4例为老年男性;临床多以腰痛或腹痛为首发表现,5例患者均伴有B症状,4例伴有乳酸脱氢酶升高,1PI积分多为中高危;3例患者伴有肾上腺皮质功能不全,其中2例需要糖皮质激素替代治疗;影像学均为双侧肾上腺肿块,超声或CT引导下穿刺病理确诊;病理4例呈现双表达DLBCL,活化B细胞来源;未见骨髓受累患者.原发肾上腺DLBCL采用包含利妥昔单抗的联合化疗疗效较理想,但停药易复发,应用来那度胺或沙利度胺维持治疗可能可以减少复发;治疗需要兼顾中枢神经系统淋巴瘤的预防,包括大剂量甲氨蝶呤或来那度胺预防.结论:本研究结果提示发现双侧肾上腺占位需要警惕原发肾上腺淋巴瘤,确诊需要活检病理证实;原发肾上腺DLBCL治疗建议含有利妥昔单抗的联合化疗,同时给予中枢淋巴瘤预防,联合化疗结束后建议维持治疗1～2年有助于减少复发.

由外伤或肿瘤骨转移造成的隐匿性骨折和愈合情况的准确诊断对制定合适的治疗方案具有非常重要的意义.为考查18F-NaF PET显像用于骨折诊断的诊断效能,本研究制备了18F-NaF注射液,并对其进行了质量控制和稳定性研究,然后建立新西兰兔骨折动物模型,模型建立约2周后进行了18F-NaFPET显像和99Tcm-亚甲基二磷酸盐(99Tcm-MDP) SPECT显像的自身对照实验,并对显像效果进行了比较.结果 表明:18F-NaF的产量大于37 GBq,各项检验结果均符合质控要求,40℃下放置8h和30℃下放置10 h所有检验结果均无明显变化;18F-NaF PET和99Tcm-MDP SPECT两种显像方式均可见全身骨骼,骨折部位呈明显放射性浓聚,但18F-NaF给药后30 min即可进行PET显像,骨折部位显示更为清晰,骨折部位与对侧正常骨骼的放射性摄取比(T/NT)明显高于99Tcm-MDP,而99Tcm-MDP需在给药后2h才能进行SPECT显像.本研究表明18F-NaF PET对骨折的显像性能优于99Tcm-MDP,可明显提高检查流通量和诊断效能.

目的 观察恶性肿瘤患者术中大量输血前后血栓弹力图(thromboelastography,TEG)与凝血功能各指标的变化,评估输血量对其的影响.方法 选择2015年6月至2017年12月北京大学肿瘤医院择期手术的大量输血患者51例,按输红细胞量分为3组,8～15 U组(22例)、16～25 U组(17例)、26U以上组(12例),检测各组输血前及输血后的TEG参数与常规凝血指标.结果 51例患者输血后的PT、INR、APTT较输血前明显延长,FIB与TEG参数中血细胞凝集块形成时间(K)、血细胞凝集块形成速率(Angle)、血凝块最大强度(MA)较输血前显著减少,差异均有统计学意义(P＜0.05).输血前,3组FIB比较,差异有统计学意义(P＜0.05);输血后,3组APTT、K、Angle、MA比较,差异均有统计学意义(P＜0.05).3组输血后的Angle、MA值与输血前比较差异均有统计学意义;8～15 U组与16～25 U组的K值输血前后差异有统计学意义(P＜0.05).结论 术中大量输血的恶性肿瘤患者常伴有凝血功能紊乱,应及时检测凝血指标,补充血液成分和血液制品.