早期动态18F-FDG PET/CT成像在实体肿瘤评估中的应用

~(18)F-FDG PET/CT常规代谢成像反应肿瘤的葡萄糖代谢及乏氧情况,而~(18)F-FDG PET/CT早期动态成像能反映PET/CT成像早期肿瘤的灌注情况。由于肿瘤的异质性,在早期动态~(18)F-FDG PET/CT成像,即~(18)F-FDG PET/CT灌注成像中,存在独立于常规60 min~(18)F-FDG PET/CT代谢成像的SUVmax(最大标准摄取值)高摄取区。因此,在临床工作中应用~(18)F-FDG PET/CT早期动态成像,能够进一步对实体肿瘤的活性区域进行评估,能够更好评价患者预后、完善治疗方案。当前~(18)F-FDG早期动态成像已经应用在肝癌、肾癌以及膀胱癌等实体肿瘤诊断中。早期动态~(18)F-FDG PET/CT成像结合常规标准~(18)F-FDG PET/CT代谢成像,对实体肿块进行一站式成像方法,能够更好的对肿瘤进行评估。     

直径小于1 cm孤立性肺结节的18F-FDG PET/CT诊断研究进展

孤立性肺结节的鉴别诊断一直是胸部影像学的研究热点。早期且准确地鉴别肺内小结节的良恶性,对于患者治疗方案的确定以及随访情况的评估均具有重要的临床意义。~(18)F-FDG PET/CT在鉴别诊断恶性肿瘤方面具有明显优于其他传统检查的高特异性和高敏感性,其公认的恶性肿瘤的诊断阈值是最大化标准摄取值(maximum standard uptake value, SUVmax)为2.5,然而部分临床数据显示一些直径小于1 cm的恶性肺结节的SUVmax数值小于2.5。因此在早期研究中,~(18)F-FDG PET/CT在诊断直径较小的肺结节的其临床价值仍存在争议。为了尽量降低SUVmax的测量误差,提高~(18)F-FDG PET/CT诊断的准确率,衍生出了许多SUVmax辅助诊断方法以及优化的重建算法、放射性显像剂的联合应用等手段。本文将对~(18)F-FDG PET/CT鉴别诊断直径小于1 cm孤立性肺结节的研究进展进行综述。     

18F-FDG PET/CT 在宫颈癌诊断及分期中的临床价值

目的:探讨氟代脱氧葡萄糖(~(18)F-FDG)正电子发射断层显像/X线计算机体层成像仪(PET/CT)检查在局灶早期宫颈癌中的临床应用价值。方法:53例病理确诊为早期宫颈癌的患者行全身~(18)F-FDG PET/CT检查,并在检查结束10日内行广泛性全子宫切除术+双附件切除术+盆腔淋巴结清扫术,计算~(18)F-FDG PET/CT诊断宫颈原发部位肿瘤及盆腔淋巴结转移的敏感度,特异度与准确度。结果:~(18)F-FDG PET/CT检查诊断的宫颈原发部位肿瘤的敏感度为79.25%,特异度为86.79%,准确度为84.9%;以病人为单位诊断盆腔淋巴结转移的准确度为85.71%,特异度为97.87%;以淋巴结为单位诊断盆腔淋巴结转移的准确度为84.61%,特异度为99.00%。结论:PET/CT显像对宫颈癌诊断,分期诊断及盆腔淋巴结转移的检出具有重要临床意义。     

18F-FDG PET 和治疗量131I 全身扫描对分化型甲 状腺癌根治术后转移灶检测的临床价值评估

目的:探讨18F-FDG PET显像和131I-全身扫描(131I-WBS)SPECT显像对分化型甲状腺癌(DTC)术后转移灶的临床诊断价值。方法:对57例外科术后拟行131I治疗的DTC患者行18F-FDG PET全身显像和131I-WBS扫描,观察和记录在糖代谢和碘代谢中DTC转移灶的定位及数量变化,并同时测定甲状腺球蛋白(Tg),促甲状腺激素释放激素(TSH)等实验室检查项目。结果:57例DTC患者18F-FDG PET显像发现真阳性20例、假阳性3例、真阴性31例、假阴性3例,其灵敏度为87.0%,特异性为91.2%。而131I-WBS扫描发现真阳性13例、假阳性2例、真阴性34例、假阴性8例,其灵敏度为61.9%,特异性为94.4%。PET显像和131I-WBS扫描共检出阳性病灶73个,其中淋巴结32个,肺5个,纵隔6个,骨26个,其他部位4个。PET显像发现43个阳性病灶(58.9%),而131I-WBS检出30个(41.1%)。当Tg水平>10μg/L时,随着Tg在血清含量的增高,两种显像方法的对DTC转移灶的阳性检出率亦随之升高。结论:两种检查对DTC术后转移灶的监测和131I的治疗具有良好的互补性,18F-FDG PET显像在Tg阳性和131I-WBS阴性的患者的转移灶检出上更具有优势,有重要的临床指导意义。     

18F-FDG PET和治疗量131I全身扫描对分化型甲状腺癌根治术后转移灶检测的临床价值评估

目的：探讨18F-FDG PET显像和131I-全身扫描（131I-WBS）SPECT显像对分化型甲状腺癌（DTC）术后转移灶的临床诊断价值。方法：对57例外科术后拟行131I治疗的DTC患者行18F-FDG PET全身显像和131I-WBS扫描,观察和记录在糖代谢和碘代谢中DTC转移灶的定位及数量变化,并同时测定甲状腺球蛋白（Tg）,促甲状腺激素释放激素（TSH）等实验室检查项目。结果：57例DTC患者18F-FDG PET显像发现真阳性20例、假阳性3例、真阴性31例、假阴性3例,其灵敏度为87.0%,特异性为91.2%。而131I-WBS扫描发现真阳性13例、假阳性2例、真阴性34例、假阴性8例,其灵敏度为61.9%,特异性为94.4%。PET显像和131I-WBS扫描共检出阳性病灶73个,其中淋巴结32个,肺5个,纵隔6个,骨26个,其他部位4个。PET显像发现43个阳性病灶（58.9%）,而131I-WBS检出30个（41.1%）。当Tg水平〉10μg/L时,随着Tg在血清含量的增高,两种显像方法的对DTC转移灶的阳性检出率亦随之升高。结论：两种检查对DTC术后转移灶的监测和131I的治疗具有良好的互补性,18F-FDG PET显像在Tg阳性和131I-WBS阴性的患者的转移灶检出上更具有优势,有重要的临床指导意义。     

海南部分地区与省外非转移性浸润性乳腺癌患者临床病理参数的对比分析

目的:分析海南部分地区(省内)与省外非转移性浸润性乳腺癌患者临床病理参数的异同。方法:收集我院自2012年6月-2017年6月经病理和影像学确诊的非转移性浸润性乳腺癌患者214例,筛选有效病例159例,将患者年龄、肿瘤位置、ScarffBloom and Richardson(SBR)分级、肿瘤标记物(CEA、CA125、CA153)、TNM分期、阳性/活检淋巴结数、lunimal分型、初潮年龄、绝经状态、生育子女数、体重指数、体表面积等数据按省内、省外进行统计分析。结果:①省内患者确诊年龄明显早于省外(47.48±10.05 vs 51.33±10.03,p=0.02);②省内患者具有生育子女数较多(1.93±0.97 vs 1.38±0.64,p=0.00)和活检淋巴结数较多(20.67±9.56 vs 18.00±6.74,p=0.04)的特征;③省内患者绝经后体重指数(22.66±3.24 vs 25.56±3.67,p=0.00)和体表面积(1.60±0.12 vs1.68±0.16,p=0.00)较绝经前明显上升,而省外患者此现象不明显。结论:海南部分地区非转移性浸润性乳腺癌患者具有发病年龄早等特点,绝经后体质改变可能为该地区乳腺癌的促发因素。     

不同放射剂量CT在早期非小细胞肺癌中筛检价值对比

摘要 目的：探讨与对比不同放射剂量计算机断层扫描(Computed Tomography,CT)在早期非小细胞肺癌中筛检价值。方法：2020年1月到2020年12月选择在本院经病理确诊为肺内磨玻璃样结节患者98例作为研究对象,所有患者都给予常规剂量正电子发射计算机断层扫描(Positron emission tomography,PET)/CT检查与低剂量PET/CT检查,记录成像特征、辐射剂量并判定筛检价值。结果：低剂量PET/CT对肺部增厚、边界不规则、钙化、囊变的检出率高于常规剂量PET/CT(P<0.05)。低剂量PET/CT与常规剂量PET/CT的图像质量优良率为98.0 %和96.9 %,对比差异无统计学意义(P>0.05)。低剂量PET/CT的有效放射剂量、剂量长度乘积低于常规剂量PET/CT(P<0.05)。低剂量PET/CT的最大标准摄取值(maximum standardized uptake value,SUVmax)值低于常规剂量PET/CT(P<0.05)。低剂量PET/CT与常规剂量PET/CT分别筛检非小细胞肺癌51例与37例,筛检敏感性分别为98.1 %和69.2 %,特异性分别为100.0 %和97.8 %。结论：低放射剂量PET/CT在肺结节中的应用不会影响图像质量,且能降低辐射剂量,提高对早期非小细胞肺癌患者的筛检效果。     

经阿托伐他汀治疗的急性冠脉综合征患者CD4+T、CD4+CD28+T水平变化及与预后的关系

目的:探讨经阿托伐他汀治疗的急性冠脉综合征(ACS)的CD4~+T、CD4~+CD28~+T水平变化及与预后的关系。方法:选择128例ACS患者,随机分为对照组(64例)和观察组两组(64例),其中对照组患者给予常规治疗,观察组患者在上述基础上外加阿托伐他汀治疗。比较两组患者的细胞因子、CD4~+T及CD4~+CD28~+T水平变化,随访6个月,观察两组患者预后终点事件发生情况。并将观察组患者根据预后是否并发终点事件,将其分为预后良组(未并发终点事件)和预后不良组(并发终点事件)两组,分析不同预后ACS患者CD4~+T、CD4~+CD28~+T水平变化及与预后发生终点事件的相关性。结果:治疗后两组的高敏C反应蛋白(hs-CRP)、干扰素-γ(IFN-γ)水平均明显降低,白细胞介素-10(IL-10)、转化生长因子β1(TGF-β1)水平均明显升高,且观察组改善更为明显,差异均有统计学意义(P0.05)。两组患者治疗后CD4~+T明显升高,CD8~+T、CD4~+CD28~+T明显降低,且观察组上述指标改善更为明显,差异均有统计学意义(P0.05)。随访6月中,对照组患者预后有23例终点事件发生,观察组患者预后有26例终点事件发生,差异无统计学意义(P0.05)。与预后良好组相比,预后不良组患者的CD4~+T降低,CD4~+CD28~+T升高,差异均有统计学意义(P0.05)。经阿托伐他汀治疗的ACS患者预后发生终点事件与CD4~+T水平呈现负相关(r=-0.682,P=0.000),与CD4~+CD28~+T水平呈现正相关(r=0.733,P=0.000)。结论:经阿托伐他汀治疗的ACS患者预后发生终点事件与CD4~+T水平呈现负相关,与CD4~+CD28~+T水平呈现正相关,可为临床ACS患者预后的预测提供参考。     

Kallistatin在乳腺癌中表达的临床病理意义

目的:探讨Kallistatin在乳腺癌中表达的临床病理意义及预后价值。方法:收集乳腺癌档案蜡块及临床资料,分为无淋巴结转移的原发灶(NMBT),有淋巴结转移的原发灶(PBT)及配对的淋巴结转移灶(PMLN),应用免疫组化技术检测Kallistatin表达,统计学分析。结果:结果显示kallistatin在PBT组的表达高于NMBT组合和PMLN组。kallistatin的表达与组织学类型(P=0.003)、淋巴结状态(P0.001)、临床分期(P=0.002)、雌激素受体(ER)表达(P=0.046)有显著相关性。kallistatin在浸润性小叶癌中的阳性表达率高于浸润性导管癌,在PBT组的阳性表达率显著高于NMBT,临床分期越晚期阳性表达率越高,在ER阳性的病历中表达更高。Kaplan-Meier分析显示,kallistatin的阳性表达是乳腺癌患者无病生存时间短(P=0.008)和总生存时间短(P=0.006)的危险因素。在浸润性乳腺导管癌患者中,kallistatin的阳性表达与生存时间短有关(P=0.026)。还与ER阳性表达患者生存时间较短有关(P=0.010)。结论:Kallistatin在乳腺癌中的表达有较为复杂的临床病理意义,其表达提示预后不良。     

基于18F-FDG PET/CT参数评价不同EGFR基因状态晚期肺腺癌患者放化疗疗效预测价值

为评价18F-FDG PET/CT参数对不同表皮生长因子受体(epithelial growth factor receptor, EGFR)基因状态晚期肺腺癌患者同步放化疗的疗效预测价值,本研究选择2016年1月至2018年2月我院初诊的100例晚期肺腺癌患者,比较不同EGFR基因状态下晚期肺腺癌患者同步放化疗治疗的临床疗效,并对18F-FDG PET/CT显像中原发病灶的各项代谢参数,代谢肿瘤体积(MTV)、最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)和总肿瘤糖酵解(TLG)值,以预测不同EGFR基因状态晚期肺腺癌患者同步放化疗效果的受试者工作特征曲线(receiveroperatingcharacteristiccurve,ROC曲线),并进行分析。结果显示,SUVmax预测不考虑EGFR基因状态的晚期肺腺癌患者放化疗疗效的截断值为9.50 (AUC=0.715,敏感度=79.7%,特异性=61%,p=0.031),SUVmax预测EGFR野生型的晚期肺腺癌患者放化疗疗效的截断值为9.50 (敏感度=82.4%,特异性=64.3%, p=0.014)。MTV预测EGFR 19号及21号外显子突变的晚期肺腺癌患者放化疗疗效的截断值分别为93.50(敏感度=63.6%,特异性=92.3%, p=0.021),77.00 (敏感度=83.3%,特异性=69.2%, p=0.041)。综上所述,对于EGFR基因状态不明的肺腺癌患者,SUVmax值可较好的预测放化疗效果,尤其是对于EGFR野生型患者;当EGFR19号及21号外显子突变时,MTV值预测结果优于SUVmax值。     

Characterization of a murine thymic CD4+ T cell subset-TCRαβ+ 3G11-6C10- CD4+ CD8-thymocytes

The presence of a relatively mature CD4⁺ CD8⁻ (SP) T cell subset in mouse thymus has been demonstrated. Composing of 10% of total CD4SP thymocytes, this subset is defined by the absence of 3G11 and 6C10 expression with a phenotype of CD69^+/−, HSA^med/lo and heterogeneous for Qa-2 expression. The proliferation capability of TCRαβ⁺ 3Gl l⁻ 6C10⁻ CD4⁺ CD8⁻ thymocytes was high while using Con A stimulus. And Con A stimulation could result in secretion of IL4, IL-10, IL-6 and a little amount of IFNγ. IL-2 was barely detectable. This is distinct from typical Th0 type cytokines. The cells of this subset were NK1.1 negative, but strongly expressed GATA-3 mRNA. The results suggest that the CD4⁺ subset of 3G11⁻ 6C10⁻ NK1.1⁻ phenotype possesses immunocompetent cells with functions characteristic of Th2-like cytokines, which may indicate the cells at transitional status from Th0 to Th2, with a propensity to Th2. Project supported by the National Natural Science Foundation of China (Grant No. 39730410).     

The efficiency of (Na + K)-ATPase in tumorigenic cells

The efficiency of (Na⁺ + K⁺)-ATPase (i.e. the amount of K⁺ pumped per ATP hydrolyzed) in intact tumorigenic cells was estimated in this study. This was accomplished by simultaneously measuring the rate of ouabain-sensitive K⁺ uptake and oxygen consumption in tumorigenic cell suspensions during the reintroduction of K⁺ to K⁺-depleted cells. The ATP turnover was then estimated by assuming 5.6–6 ATP/O₂ as the stoichiometry of NADH-linked respiration in these cells. In the three cell lines tested (hamster and chick embryo cells transformed with Rous sarcoma virus and Ehrlich ascites cells), the K⁺/ATP ratio was approximately 2, the same value as that found in normal tissues. Furthermore, only 20% of the total ATP production of these cells was used by (Na⁺ + K⁺)-ATPase.     

应用15N示踪研究欧美杨对PM2.5无机成分NH4+和NO3-的吸收与分配

通过气溶胶发生系统模拟PM2.5颗粒的发生,运用15N示踪技术研究了欧美杨107(Populus euramericana Neva.)对PM2.5中水溶性无机成分NH+4和NO-3的吸收与分配规律。结果表明,欧美杨能够有效吸收PM2.5中的NH+4和NO-3。轻度和重度污染下,欧美杨叶片对NH+4和NO-3的吸收速率均于处理后第1天达到峰值,之后,轻度污染下对NH+4和NO-3的吸收速率迅速降低以后趋于稳定,而重度污染下对NH+4和NO-3的吸收速率缓慢下降至趋于稳定。轻度污染下的欧美杨叶片的15N含量在处理后第1天达到峰值,15N(NH+4)的含量为0.11 mg/g,干重,15N(NO-3)的为0.14 mg/g,干重,之后15N含量迅速下降至趋于稳定。重度污染下的叶片15N含量在处理第1天迅速增长,之后缓慢增长至处理后第7天达到最高值,15N(NH+4)的含量为0.11 mg/g,干重,15N(NO-3)的为0.13 mg/g,干重。处理7 d后,欧美杨不同组织器官吸收或通过再分配获取的15N含量存在差异。轻度污染下,细根对NH+4和NO-3的吸收量最高,树皮、叶柄、叶片次之,髓最低。而重度污染下,叶片对NH+4和NO-3的吸收量最高,细根、叶柄、树皮次之,髓最低。欧美杨各组织器官中NH+4和NO-3的含量均表现为重度污染大于轻度污染,且两种污染程度下的欧美杨各组织器官对NO-3的吸收均大于对NH+4的吸收。重度污染下,欧美杨茎木质部对15N(NH+4和NO-3)的吸收征调能力(Ndff,Nitrogen derived from fertilizer)最大,其次为髓,叶片最小;欧美杨各组织器官中的15N分配率表现为叶片细根叶柄树皮粗根茎木质部髓。研究结果对进一步揭示植物吸收PM2.5的机制及有效利用植物降低颗粒物污染、净化环境提供了重要的科学理论依据。     

血清IL-6、IL-8、IgM抗体及T细胞亚群水平对新生儿先天性梅毒的诊断价值

目的:探讨血清白介素-6(IL-6)、白介素-8(IL-8)、IgM抗体及T细胞亚群对先天性梅毒新生儿的诊断价值。方法:选择2015年5月至2017年5月在我院进行临床治疗的先天性梅毒新生儿81例为观察组,另选同期来我院进行健康体检81例新生儿为对照组。比较两组患者血清IL-6、IL-8、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)细胞及IgM抗体的阳性率。结果:治疗后,观察组血清IL-6、IL-8水平均明显高于对照组(P0.05),T细胞亚群中CD~(3+)、CD~(4+)、CD~(4+)/CD~(8+)明显低于对照组,而CD~(8+)T细胞比例高于对照组(P0.05)。19S-IgM-TP ELISA法检测出IgM的阳性率92.59%,明显高于TRUST法(74.07%)及TP-ELSA法(70.37%)(P0.05)。ROC曲线中,血清IL-8特异度为88.34%明显高于血清IL-6特异度81.48%、IgM抗体特异度60.13%、T细胞亚群特异度65.34%;IgM抗体的曲线面积88.91 cm~2明显大于IL-6的曲线面积45.09 cm~2、IL-8的曲线面积76.19 cm~2、T细胞亚群的曲线面积77.35 cm~2;T细胞亚群准备性67.89%明显高于IL-6准确性60.39%、IL-8准确性51.09%、IgM抗体准确性50.12;IgM抗体的灵敏度60.13%高于IL-6灵敏度59.19%、IL-8灵敏度42.35%、T细胞亚群灵敏度59.37%。具有比较意义(P0.05)。结论:血清IL-6、IL-8水平、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)及IgM抗体阳性率是诊断先天性梅毒新生儿的重要指标。     

(Na + K)-ATPase activity of crude homogenates of rat skeletal muscle as estimated from their K-dependent 3-O-methylfluorescein phosphatase activity

A highly sensitive fluorimetric assay using 3-O-methylfluorescein phosphate as substrate was used in the determination of K⁺-dependent phosphatase activity in preparations of rat skeletal muscle. The gastrocnemius muscle was chosen because of mixed fibre composition. Crude, detergent treated homogenate was used so as to avoid loss of activity during purification. K⁺-dependent phosphatase activities in the range 0.19–0.37 μmol · (g wet weight)⁻¹ · min⁻¹ were obtained, the value decreasing with age and K⁺-deficiency. Complete inhibition of the K⁺-dependent phosphatase was obtained with 10⁻³ M ouabain. Using a KSCN-extracted muscle enzyme the intimate relation between K⁺-dependent phosphatase activity and (Na⁺ + K⁺)-activated ATP hydrolysis could be demonstrated. A molecular activity of 620 min⁻¹ was estimated from simultaneous determination of K⁺-dependent phosphatase activity and [³H]ouabain binding capacity using the partially purified enzyme preparation. The corresponding enzyme concentration in the crude homogenates was calculated and corresponded well with the number of [³H]ouabain binding sites measured in intact muscles or biopsies hereof.     

A nhaD Na/Hantiporter and a pcd homologues are among the Rhodothermus marinus complex I genes

The NADH:menaquinone oxidoreductase (Nqo) is one of the enzymes present in the respiratory chain of the thermohalophilic bacterium Rhodothermus marinus. The genes coding for the R. marinus Nqo subunits were isolated and sequenced, clustering in two operons [nqo₁ to nqo₇ (nqo_A) and nqo₁₀ to nqo₁₄ (nqo_B)] and two independent genes (nqo₈ and nqo₉). Unexpectedly, two genes encoding homologues of a NhaD Na⁺/H⁺ antiporter (NhaD) and of a pterin-4α-carbinolamine dehydratase (PCD) were identified within nqo_B, flanked by nqo₁₃ and nqo₁₄. Eight conserved motives to harbour iron-sulphur centres are identified in the deduced primary structures, as well as two consensus sequences to bind nucleotides, in this case NADH and FMN. Moreover, the open-reading-frames of the putative NhaD and PCD were shown to be co-transcribed with the other complex I genes encoded by nqo_B. The possible role of these two genes in R. marinus complex I is discussed.     

川楝素对K+、Ca2+通道活动及细胞内Ca2+浓度的调控

川楝素是我国学者从驱蛔中药中分离、鉴定的一个三萜化合物，已证明具选择地影响神经递质释放，有效地对抗肉毒中毒，促进细胞分化、凋亡，抑制肿瘤增殖，抑制昆虫发育和取食，影响K⁺、Ca²⁺通道活动等多种生物效应. 综述了证明川楝素抑制多种K⁺通道，选择地易化L型Ca²⁺通道和进而升高胞内Ca⁺浓度的研究资料，并对川楝素产生这些生物效应的机制进行了讨论.     

13C and31P NMR spectroscopic studies on glucose metabolism inTribolium confusum

Nuclear magnetic resonance (NMR) technology was applied to study the glucose metabolism inTribolium confusum (Coleoptera).¹³C signals of D-(1-¹³C)glucose eaten by beetles were clearly detected in such metabolites of the glucose metabolism as glycogen, trehalose, triacylglycerol, alanine and proline by¹³C-NMR. After glucose feeding the³¹P-NMR spectra ofT. confusum showed the signal intensity increases in arginine-phosphate, sugar-phosphate and uridine diphosphoglucose. The results demonstrated the potential of NMR analysis for the study of glucose metabolism inT. confusum.     

Altered microRNAs in STHdh/Hdh cells: miR-146a targets TBP

We studied expression of 90 miRNAs in STHdh^Q111/Hdh^Q111 cells, a model for Huntington’s disease and compared with that obtained in STHdh^Q7/Hdh^Q7 cells. Fifteen miRNAs were down regulated and 12 miRNAs were up regulated more than 2-fold. Such changes were statistically significant. One hundred and forty-two genes are experimentally known targets of these altered miRNAs. It has been predicted that miR-146a may target Tata Binding Protein (TBP). Using luciferase reporter assays with 3′-UTRs of TBP, over-expression and inhibition of miR-146a, we showed that miR-146a targets TBP. Regulation of TBP by miR-146a may contribute to HD pathogenesis.