Objective:To explore the significance of 99Tc m-sulfur colloid lymphoscintigraphy in the diagnosis of lower limb lymphedema after gynecological tumor surgery. Methods:The clinical data of patients with lower limb lymphedema after gynecological tumor surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2015 to October 2019 were retrospectively analyzed. 99Tc m-sulfur colloid lymphoscintigraphy was performed in all patients. The results of lymphatic vessel imaging, lymph node imaging and their combination in the diagnosis of lower limb lymphedema were analyzed. The diagnostic efficacy of lymphatic vessel imaging alone, lymph node imaging alone and their combination was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC), and the Youden index, sensitivity and specificity were calculated. Results:Among the 100 lower limbs of 50 patients, 56 limbs had lymphedema and 44 limbs had no obvious edema. When diagnosis was based on abnormal lymphatic vessel imaging alone, among 56 lower limbs with lymphedema, lower limbs lymphatic vessel imaging was positive in 38 (67.9%) and negative in 18 (32.1%); among 44 lower limbs without obvious edema, lower limbs lymphatic vessel imaging was positive in 6 (13.6%) and negative in 38 (86.4%); the sensitivity was 67.9%, the specificity was 86.4%, and the Youden index was 0.543. When diagnosis was based on abnormal lymph node imaging alone, among 56 lower limbs with lymphedema, lower limbs lymph node imaging was positive in 42 (75.0%) and negative in 14 (25.0%); among 44 lower limbs without obvious edema, lower limbs lymph node imaging was positive in 13 (29.5%) and negative in 31 (70.5%); the sensitivity was 75.0%, the specificity was 70.5%, and the Youden index was 0.455. When diagnosis was based on the combination of lymphatic vessel imaging and lymph node imaging, among 56 lower limbs with lymphedema, lymphatic vessel imaging and lymph node imaging were positive in 48 (85.7%) and negative in 8 (14.3%); among 44 lower limbs without obvious edema, lymphatic vessel imaging and lymph node imaging were positive in 14 (31.8%) and negative in 30 (68.2%); the sensitivity was 85.7%, the specificity was 68.2%, and the Youden index was 0.539. The AUC for the combined diagnosis of lymphatic vessel imaging and lymph node imaging was 0.781, the AUC for the diagnosis of abnormal lymphatic vessel imaging was 0.771, and the AUC for the diagnosis of abnormal lymph node imaging was 0.739 (all P < 0.01). Conclusions:99Tc m-sulfur colloid lymphoscintigraphy is of great help in the diagnosis of lower limb lymphedema after operation of gynecological tumors. The combination of lymph node imaging and lymphatic vessel imaging is more effective in the diagnosis of lower limb lymphedema.

This paper briefly described the application value of this imaging method in the evaluation of active thyroid-related ophthalmopathy (TAO) by analyzing the different results of 99Tc m-diethylene triaminepentaacetic acid (DTPA) SPECT/CT orbital imaging in 2 patients and combined with literature review. At present, the commonly used clinical assessment of TAO active phase is mainly based on the clinical activity score (CAS) of the patient's symptoms, but the clinical manifestations of mild and moderate patients partially overlap, and it is not easy to identify using the CAS score alone, and the diagnosis is subject to a certain degree. The results of this study show that 99Tc m-DTPA SPECT/CT orbital imaging has a higher negative predictive value for inactive TAO than CAS, indicating that this imaging can also be an option for TAO assessment.

This study aimed to assess prognosis of patients with newly diagnosed multiple myeloma (NDMM) by combining [18F]-FDG positron emission tomography (PET)/CT parameters and clinical indices. Clinical data and PET/CT parameters of 133 NDMM patients were retrospectively analyzed for associations between clinical indices and PET/CT parameters. Independent predictors of progression-free survival (PFS) and overall survival (OS) were determined. A new prognostic prediction system (NPPS) was constructed based on our findings. Prediction effectiveness was compared among the NPPS, International Staging System (ISS), Revised ISS (R-ISS), and R2-ISS. Prevalence of elevated β2-microglobulin, serum creatinine (sCr), serum calcium (sCa), and C-reactive protein concentrations was higher in patients with higher SUVmax (≥ 5.3). Prevalence of elevated sCa, sCr, and extramedullary disease (EMD) was higher in patients with a higher number of focal lesions (≥ 10). SUVmax, serum free-light chain (sFLC) ratio, and EMD were independent predictors of PFS and OS. The NPPS used SUVmax, sFLC ratio, and EMD could effectively predict OS and was more effective at prognostication than the ISS, R-ISS, and R2-ISS. [18F]-FDG PET/CT parameters play a significant role in predicting prognosis in NDMM patients. The NPPS based on SUVmax, sFLC ratio, and EMD outperformed the ISS, R-ISS, and R2-ISS in prognostication.

金纳米颗粒是一种由金构成的纳米材料,它具有生物相容性、导电性、抗氧化性等优点.在急性心肌梗死诊疗方面,基于金纳米颗粒的研究已获得显著进展,如可用作递送载体降低心肌梗死标志物水平、改善损伤的心肌结构及参与心脏组织工程支架材料的构建等.

>患者男,63岁,因"体格检查发现甲状腺结节3个月"入院。患者主诉无明显不适,于2015年7月体格检查时行甲状腺超声发现甲状腺结节,无局部红肿疼痛,无呼吸困难或吞咽梗阻感。体格检查:甲状腺无明显肿大,右叶可触及直径约15mm结节,质韧,边界尚清,活动度良好,颈部未及明显肿大淋巴结。外院甲状腺超声:甲状腺左叶中部1.9mm×1.4mm无回声结节;甲状腺右叶中部见17.4mm×12.7mm低回声结节,边界清,中下部3.2mm×2.7mm稍低回声结节,边界欠清,另见数个无回声结节及数个强回声斑,中下部多个强回声斑堆积成团。实验室检查:血钙3.62(括号中为正常参考值范围,下同;2.03～2.54)mmol/L;血磷0.70(0.96～1.62)mmol/L;PTH 815.62(15.00～65.00)ng/L;甲状腺激素

PURPOSE:The aim of this study was to determine an optimal threshold method for the segmentation of malignant lesions from (18)F-FDG PET/CT images and to evaluate the prognostic value of the total lesion glycolysis in post-surgical patients with epithelial ovarian cancer.METHODS:We retrospectively reviewed 47 patients with pathologically proven epithelial ovarian cancer who underwent (18)F-FDG PET/CT imaging after surgery. The follow-up time was 26.6 ± 19.8 months (ranged from 4 to 89 months). For each patient, every lesion was segmented by 2 thresholds with 3D-area growing algorithm, standard uptake value (SUV) 2.5, and background method. The detection rates were compared. The optimal threshold method was then used to calculate whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG). The prognostic significance of SUV(max), WBMTV, WBTLG, and other pathological variables for overall survival were assessed by Cox proportional hazards regression analysis and Kaplan-Meier survival analysis.RESULTS:A total of 142 metastatic lesions of 47 patients were confirmed by long-term clinical follow-up or pathological findings. The detection rates of the threshold SUV 2.5 and background methods were 37.32% (53/142) and 96.48% (137/142), respectively, which showed significant difference between the 2 methods (P < 0.005). In multivariate analysis, WBTLG, obtained from the background method, was an independent predictive factor associated with the prognosis (HR 1.043, 95% CI 1.01-1.078, P = 0.011), and none of the other factors had statistical association. Survival analysis also showed that the survival time was clearly shortened with WBTLG increasing (P < 0.001).CONCLUSIONS:In this group of post-surgery patients with epithelial ovarian cancer, the background method could segment much more malignant lesions than SUV = 2.5 method, and WBTLG, obtained from this method, could be used as an independent prognostic factor.

Objective: Angiogenic therapy is emerging as a potential strategy for the treatment of ischemic heart disease but is limited by a relatively short half-life of growth factors. Fibrin glue (FG) provides a reservoir for controlled- release of growth factors. The aim of this study was to evaluate the effects of basic fibroblast growth factor (bFGF) incorporating FG on angiogenesis and cardiac performance in a canine infarct model. Methods: Acute myocardial infarction was induced by ligation of the left anterior descending coronary artery (LAD). Group I ( n =6) underwent ligation of LAD alone. In Group II, transmural channels were created in the infarct area ( n =6). In Group III, non-transmural channels were created to locate FG cylinders containing bFGF ( n =6). Eight weeks after operation, myocardial perfusion was assessed by single photon emission computed tomography, cardiac function by echocardiography, and vascular development by immunohistochemical staining. Results: Total vascular density and the number of large vessels (internal diameter ≥50 μm) were dramatically higher in Group III than in Groups I and II at eight weeks. Only the controlled-release group exhibited an improvement in regional myocardial perfusion associated with lower defect score. Animals in Group III presented improved cardiac regional systolic and diastolic functions as well as global systolic function in comparison with the other two groups. Conclusions: Enhanced and sustained angiogenic response can be achieved by controlled-release bFGF incorporating FG within transmyocardial laser channels, thus enabling improvement in myocardial perfusion and cardiac function.

Objective To investigate the feasibility of rat sodium/iodide symporter (rNIS) as a reporter gene monitoring rat bone marrow mesenchymal cells (rBMSC) transplanted to rat myocardium in vivo.Methods Recombinated adenovirus vector was constructed by rNIS/enhanced green fluorescence protein (EGFP) (Ad-rNIS/EGFP).rBMSC transfected by Ad-rNIS/EGFP were studied using fluorescence microscope.Fifteen rats were transplanted with rBMSC and randomly divided into three groups:rNIS group (with rNIS transfection), blocked group (with rNIS transfection) by oral intake of perchloric sodium before planar imaging(GE Millennium MPR SPECT), and control group (without rNIS transfection).All rats underwent 99Tcm-pertechnetate planar imaging.The biological distribution of 99Tcm-pertechnetate was studied.The expressions of rNIS gene and protein in myocardium were measured by real time polymerase chain reaction (PCR) and western blot, respectively.The expressions of CD29, CD44, CD90, CD11b, CD34 and CD45 were measured by immunohistochemistry.Results rBMSC transfected by Ad-rNIS/EGFP showed EGFP expression under fluorescence microscope.The transplanted rat myocardium could be visualized on 99Tcm-pertechnetate planar imaging in rNIS group.The relative uptake ratio( Rheart/Rhmb, RUR) was 6.7 ±0.4.RUR in control group (3.0 ±0.2) was lower than that in rNIS group (t =2.78, P=0.03).The percentage injection dose per gram of tissue (% ID/g) of the transplanted myocardium was 60.2 ± 20.8 in rNIS group,which was higher than that (2.5 ± 0.4) % ID/g of control group ( t = 7.13, P＜0.001 ).rNIS gene and protein were highly expressed in transplanted myocardium in rNIS group but less expressed in control group.The expressions of CD29, CD44 and CD90 were positive, CD45 and CD45 negative CD11b mildly positive in the myocardium transplanted with infective rBMSC.Conclusion rNIS can efficiently monitor rBMSC transplanted to rat myocardium.

Objective Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131Ⅰ ablation therapy in PTC. Methods One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131Ⅰ ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT3, FT4), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 131Ⅰ ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation anaysis and t-test were used. Results Postoperative stimulated Tg lev-el had a significantly positive association with pestablation stimulated Tg level (r = 0. 960, P < 0.01). Postoperative stimulated Tg level in positive postablation Tg group was significantly higher than that in nega-tive pestablation Tg group [(199.8±327.7) μg/L vs (3.5±5.6) μg/L, t =5. 567, P <0.01]. About 76% (78/102) patients had evidence of metastatic cervical lymph nodes on routine histological testing. And 41% (446/1088) resected lymph nodes were histologically positive for metastatic disease. The number of metastatic lymph nodes resected had a significantly positive relationship with stimulated Tg at pestopera-tion and postablation (r = 0. 697, 0. 633, both P < 0.01). Conclusions Postoperative stimulated Tg level was of better prognostic value on stimulated Tg level after 131Ⅰ ablation therapy. Total or near-total thyroidec-tomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimu-lated Tg pesitivity in patients with PTC.

OBJECTIVE:To evaluate if 99mTc-HYNIC-annexin V may be used to detect the early chemotherapeutic effect and to determine the best timing for detecting apoptosis in vivo.METHODS:Annexin V was labeled with 99mTc using HYNIC as a bifunctional agent. Normal Kunming mice received inoculation of Ehrlich ascites cells into the right upper limb. After the tumor reached 1 cm in diameter, the mice were randomly divided into saline treatment group as control and cyclophosphamide (150 mg/kg injected intraperitoneally) treatment group. 99mTc-HYNIC-annexin V was injected intravenously at 1 h and 24 h after treatment. Region of interest technique (ROI) from the SPECT images taken at different time was used to get the ratio of tumor/limb in each group. TUNEL staining was used to detect apoptotic cells and the rates of positive stained cells were calculated.RESULTS:After treatment with saline, only little amount of the radiolabeled tracer could be seen in the tumor and showed weak image of the tumor. But after 24 h of treatment with cyclophosphamide, clear image on the tumor could be seen. 24 h after the treatment of cyclophosphamide, the ratio of tumor/limb was (6.27 +/- 0.24) which was much higher than that at 24 h after treatment with saline (2.36 +/- 0.18) and that at 1 h after cyclophosphamide treatment (4.00 +/- 0.38). At 24 h after cyclophosphamide treatment, TUNEL staining showed a significantly higher rate of apoptotic cells in the mice.CONCLUSION:99mTc-HYNIC-annexin V can be used as an apoptosis-imaging agent to detect and evaluate the early curative effect after chemotherapy. The effective detection of apoptotic response in tumor with 99mTc-HYNIC-annexin V requires a 24 h interval after chemotherapy. SPECT images can be obtained at 60 min after injection of the imaging agent. It suggests that 99mTc-HYNIC-annexin V may become a promising agent for apoptosis-imaging in clinical application.

Objective To compare the peptide fragments radiotracer 99mTc-YIGSR with 99mTc-MIBI in imaging Eldrich ascites tumor in mice.Methods By using S-Acetly-NHS-MAG3 as chelator,YIGSR was labeled with 99mTc at room temperature.The MIBI was boiled when labeled with 99mTc.The tumor-bearing mice model was prepared by inoculating 1×106 Ehrlich tumor cells in the right thigh.The tumor was allowed to grow for 7-10 days to a size of 1.0-1.5 cm in diameter.37-74 MBq of 99mTc-YIGSR or 99mTc-MIBI was injected in the tail vein of each mouse,which was then immobilized and imaged periodically under a gamma camera.Results The 99mTc-YIGSR accumulation at the tumor tissue was observed clearly at 30 min and reached the climax at 3 h with a tumor to normal ratio of 11.36.As the radiotracer was slowly cleared out,the tumor/normal ratio was decreased to 3.01 at 8 h.In the 99mTc-MIBI group,the tumor to normal ratio was 1.40 at 3 h and 0.55 at 8 h respectively.The difference between 99mTc-YIGSR and 99mTc-MIBI imaging was significant(P<0.01).Conclusion The high sensitivity and specificity of 99mTc-YIGSR suggested it was a new promising tumor receptor radiotracer.

Objective To investigate the feasibility of radiolabelled annexin V imaging for early diagnosis of Parkinson's disease.Methods Tc-99m-HYNIC-annexin V was prepared and its binding to apoptotic cell models of Parkinson's disease was studied in vitro. Cellular models of Parkinson's disease were produced by administering different concentrations of 1-methyl-4-phenylpyridinium to PC12 and SH-SY5Y cell lines. Cell apoptosis rates were analysed by flow cytometry. Annexin V was labelled with Tc-99m by hydrazinonicotinamide (HYNIC). Cell binding studies were carried out using cellular models of Parkinson's disease. Cell uptake studies were also performed after different levels of MPP+ treatment, and the correlation between the degree of apoptosis and Tc-99m-HYNIC-annexin V uptake was analysed.Results The specific activity of (TC)-T-99m-HYNIC-annexin V was 3.7-74 x 10(5) Bq center dot mg(-1) protein. In-vitro binding of Tc-99m-HYNIC-annexin V to model cells was specific, saturable and time dependent. Scatchard analysis gave a K-d of 7.16 +/- 1.78 nmol center dot l(-1), B-max values of 179 +/- 33 fmol per 10(6) cells (PC12) and 220 +/- 26 fmol per 10(6) cells (SHSY5Y). MPP+ at different concentrations can induce cell apoptosis in a dose-dependent manner; cellular uptake of 99mTc-HYNIC-annexin V as indicated by membrane-bound radiolabelled annexin V activity was linearly correlated with total fluorescence, as observed by FITC-annexin V flow cytometry (PC12: r = 0.924; SH-SY5Y: r = 0.937, P < 0.01).Conclusions Tc-99m-HYNIC-annexin V retains its receptor-binding activity and has a high affinity to cellular models of Parkinson's disease. The uptake of radioactivity correlated well with cell apoptosis rates; thus, Tc-99m-annexin V is a potential imaging agent with which to detect early neuron damage in Parkinson's disease.

Objective The aim of this study was to label 2'-fluoro-2'-deoxy-1-β-D-arabinofurano- syluracil(FAU)with ~(125)I,and to investigate the characteristics of the labeled compound as well as its bio- distribution in mice.Methods FAU was radiolabeled with Na~(125)I using the Iodogen method.The Sep-Pak C18 reverse phase column was used to purify the labeled product.The labeling efficiency,radiochemical purity,the in vitro stability and its biodistribution in mice were observed.Results FAU was successfully la- beled with Na~(125)I with the labeling efficiency of(63.12±5.01)%.The radiochemical purity was(98.60± 0.52)%.~(125)I-5-iodo-FAU(FIAU)was stable in PBS and fresh human serum under 37℃ and the radio- chemical purity remained more than 95.04% after 24 h.Mouse experiment showed that the radiolabeled product was washed out from blood quickly.The uptake expressed as percentage activity of injected dose per gram of tissue(%ID/g)was(4.33±1.00)%ID/g at 0.5 h and(0.71±0.06)%ID/g at 2 h after in- jection.The ~(125)I-FIAU was mainly excreted through'kidney.Conclusions ~(125)I-FIAU could be obtained by labeling FAU with the Iodogen method with satisfactory labeling efficiency,radiochemical purity and stabili- ty.Mouse biodistribution experiment showed it was mainly excreted through kidney.

目的 研究125I-氟-碘阿糖呋喃基尿嘧啶(FIAU)的性质及在小鼠体内的生物学分布.方法 利用Iodogen碘化标记法对氟脱氧呋喃糖尿嘧啶(FAU)进行标记,用Sep-Pak C18反相色谱柱进行纯化;观察125I-FIAU的标记率、放化纯、体外稳定性及其在小鼠体内的生物学分布.结果 以Iodogen固相氧化法标记FAU,得到125I-FIAU,标记率为(63.12±5.01)%;产物经Sep-Pak C18反相色谱柱纯化后放化纯为(98.60±O.52)%;125I-FIAU在PBS及人血清中37℃条件下稳定,24 h后放化纯＞95.04%.生物学分布实验表明:标记物从小鼠血液中清除迅速,用每克组织百分注射剂量率(%ID/g)表示,O.5 h为(4.33±1.00)%ID/g,2 h下降为(0.77±0.06)%ID/g,至24 h时基本清除完毕;肾脏是其主要排泄器官.结论 Iodogen固相氧化法可以进行FAU碘化标记,得到标记率、放化纯及稳定性较好的125I-FIAU,该标记物主要经肾脏排泄。

OBJECTIVE:To study the clinical value of thyroid imaging in differentiate the origin cervical mass.METHOD:Sixty-nine patients with cervical mass were subjected to 99mTc-pertechnetate imaging. 99Tc-MIBI hot spot imaging and perfusion imaging were performed in some of patients with cold or cool nodules. The findings of thyroid imaging were compared with follow up and histopathologic results.RESULT:Thirty-three of 69 patients were found with thyroid nodules, 36 patients mass were outside thyroid. Twelve of 33 thyroid nodules were found to be subacute thyroiditis. Two cases regarded as thyroglossal duct cyst were found to be ectopic thyroid glands. Twenty-seven of 36 masses out side thyroid were thyroglossal duct cysts.CONCLUSION:99m Tc-pertechnetate imaging, 99mTc-MIBI hot spot imaging and perfusion imaging are useful to differentiate the origin of cervical mass, and differentiate ectopic thyroid from thyroglossal duct cyst.

目的:以99mTc标记针对c-myc和bcl-2 mRNA的寡核苷酸并检测其在血管平滑肌细胞(VSMC)中的摄取情况,初步探讨其在粥样硬化病变中的诊断价值.方法:99mTc标记寡核苷酸后分别加入体外培养对数生长期及平台期猪冠状动脉VSMC,37℃条件下温育,检测不同时段摄取百分数.结果:增殖期或平台期VSMC对bcl-2探针的摄取均低于对c-myc探针的摄取.在c-myc探针组,增殖期细胞较平台期摄取高,反义探针较正义探针摄取高.结论:增殖期VSMC对c-myc反义探针的摄取增高和(或)对bcl-2反义探针的摄取减少,有望成为粥样病变的早期诊断指标.

目的构建人膜联蛋白Ⅴ(Annexin Ⅴ)表达载体并诱导其表达,应用双功能螯合剂联肼尼克酰胺(HYNIC)偶联后应用核素99mTc标记.方法 PCR扩增含Annexin Ⅴ编码基因序列,将扩增产物克隆至His融合表达载体pET-28a(+),以异丙基硫代-β-D-半乳糖苷(IPTG)诱导His融合Annexin Ⅴ的表达,应用Ni-NTA Superflow纯化并经测序、SDS-PAGE及Western blot确证.表达的蛋白通过HYNIC偶联后进行99mTc标记,考察标记物的特性.结果琼脂糖凝胶电泳示PCR扩增产物碱基数量与目的片段大小一致.对重组质粒的分析表明,插入片段的序列与发表的Annexin Ⅴ基因编码序列一致.在IPTG诱导下,经Western blot及SDS-PAGE证实,重组大肠埃希菌DH5α高效表达分子量约36 kD的目的产物.99mTc-HYNIC-Annexin Ⅴ标记率及放化纯均达到90%以上,稳定性在6 h以上,可以满足核素显像的要求.结论人Annexin Ⅴ编码序列已被克隆至His融合表达载体pET-28a(+)上,并在大肠埃希菌DH5α中高效、大量表达.经HYNIC偶联后99mTc标记,可以得到较高的标记率和放化纯.99mTc-HYNIC-Annexin Ⅴ有望成为一种有良好临床应用前景的凋亡显像剂.