Objective To investigate the feasibility of monitoring the tumor's hypoxic changes by 99Tcm-2-(2-methyl-5-nitro-1H-imidazol-1-yl) ethyl eihydrogen phosphate (MNLS) imaging after radiotherapy.Methods (1) H22 cells were cultured and mice model with liver cancer xenografte was made.The mice were imaged at 0.5,1,2,3,4,6 and 8 h (six mice in each group) after injected with 7.4 MBq 99TcmMNLS when the tumor size reach about 1 cm.Then the mice were sacrificed.The T/NT and ％ID/g of each time point was calculated.(2) The liver cancer bearing mice of radiotherapy group (25 Gy) and control group were imaged at 0,24,48 h,and then the technique of ROI was adopted to calculate the T/NT at each time point in the two groups.Immunohistochemical stain method was used to evaluate the expression level of HIF-1α in liver cancer.(3) One-way analysis of variance,the least significant difference t test,two-sample t test and Spearman correlation analysis were performed.Results (1) The uptake of 99TcmMNLS in the liver cancer bearing mice was significant at 2 h after injection and the ％ID/g was the highest.99Tcm-MNLS was excreted mainly through kidneys.(2) The T/NT and HIF-1α expression level in radiotherapy group at 24 h (2.65±0.27,(50.62±3.78)％) were lower than those at the instant (3.35±0.19,(85.32±0.94)％,t=5.640,6.701,both P＜0.05),but higher than those at 48 h (2.23±0.52,(21.69±0.75)％,t=7.674,4.911,both P＜0.05).The T/NT and HIF-1α expression in the radiotherapy group were significantly higher than those in the control group at the instant (2.74 ± 0.29,(28.26 ± 1.70) ％,t =4.235,3.473,both P＜0.05) but lower at 48 h (3.15±0.88,(67.64±3.55) ％,t =7.902,3.258,both P＜0.05).However,no significant difference was observed at 24 h between radiotherapy group and the control group (2.98±0.16,(58.45±0.98) ％,t =0.525,2.043,both P＞0.05).The change of T/NT closely correlated with the expression of HIF-1α in both the radiotherapy group and control group(r,=0.793,0.756,both P＜0.05).Conclusion 99Tcm-MNLS hypoxia imaging has potential to monitor changes of hypoxia in tumor after radiotherapy.

Purpose To explore the features of 99Tcm-AnnexinⅤscintigraphy of venous thrombus and its feasibility of discriminating fresh venous thrombus from old one. Materials and Methods The rabbits (n=15) were randomly divided into three groups (fresh thrombus group, old thrombus group and control group). The inferior vena cava thrombus models were developed in the rabbits of thrombus groups by inserting screw cooper wire into inferior vena cava. The rabbits of control group received sham operation. 99Tcm-AnnexinⅤwas injected in the rabbits of fresh thrombus group and control group one day after operation;the same was done in the rabbits of old thrombus group 14 days after operation. Planar anterior abdominal images were obtained at 30, 60, 90 and 120 min after 99Tcm-AnnexinⅤinjection in all groups respectively. The ratios of thrombus to background of the two thrombus groups and the ratios of the area correspondent to the thrombus groups to background of the control group were calculated by ROIs counts. Then rabbits were executed, and thrombus was used for pathology examination. Results 99Tcm-AnnexinⅤuptake in thrombi was clearly visualized in all rabbits of the fresh thrombus group;whilst negative images showed in all rabbits of the old thrombus group and control group. The thrombus to background ratios of the fresh thrombus group (4.06±0.49) were higher than that of the old thrombus group (2.46±0.38), and also higher than the inferior vena cava below inferior pole of right kidney level to background ratios (2.27±0.24) of the control group (t=5.746, 7.318;P<0.05). All the thrombi of the fresh thrombus group were confirmed as fresh mixed thrombi by HE staining, and those of the old thrombus group were confirmed as old mixed organized thrombi. Conclusion 99Tcm-AnnexinⅤmay become a new acute venous thrombus imaging tracer used to discriminate fresh venous thrombus from old one.

Objective To explore the influence of different injection techniques on the quality of bolus in 99mTc-DTPA renal dynamic imaging.Methods 395 patients accepted 99mTc-DTPA renal dynamic imaging were retrospectively analyzed.All patients were divided into three groups according to injection techniques:direct injection group (187 cases),intravenous route injection group (84 cases)and venous indwelling needle injection group (124 cases).The three groups were injected by each technique.Areas of interest (ROI) were drawn on abdominal aorta by Xeleris workstation in blood flow perfusion imaging.The time-radioactivity curves of ROI were got.The patients whose ROI curve formed a peak was successfully injected,and did not formed was unsuccessfully injected.The number of patients in three groups who were successfully or unsuccessfully injected was respectively calculated.The data of three groups was taken Chisquare test by SPSS17.0 software.Results 174 patients of the direct injection group,46 of the intravenous route injection group and 115 of the venous indwelling needle injection group were injected successfully.The successful rate respectively was 93.0％,54.8％ and 92.7％.The successful rate of the direct injection group and venous indwelling needle injection group were higher than intravenous route injection group.The difference had statistical significance.The successful rate of the direct injection group and venous indwelling needle injection group hadn't statistical significance.Conclusions The successful rates of the direct injection group and venous indwelling needle injection group were similar.The venous indwelling needle injection technique can be chosen.The successful rate of the intravenous route injection group was lower than the other two groups.The intravenous route injection technique should be chosen prudently.

Objective To evaluate the inhibition of urine 11-dH-TXB2 by dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin in Chinese cardiovascular patients after long-term therapy. Methods103 cardiovascular patients were treated with oral doses of dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin tablets (162 mg aspirin) daily for 24 weeks. The Urine 11-dH-TXB2 concentration were measured before and 6, 12, 24 weeks after administration. ResultsThe urine 11-dH-TXB2 concentration were （1840.41±1452.63） pg/ml, （820.01±610.55） pg/ml, （1011.19±1148.12） pg/ml, （1290.82±1425.51） pg/ml before and 6, 12, 24 weeks after administration. The urine 11-dh-TXB2 concentration was higher in 24th week than in 12th weeks and 6th week. ConclusionThe dihydroxyaluminum aminoacetate-heavy magnesium carbonate-aspirin can inhibit the platelet aggregation, which decreased after long-term administration.

Objective To review our experience in laparoscopic pancreaticoduodenectomy combined with major vascular resection and reconstruction.Methods Of 183 patients who underwent laparoscopic pancreaticoduodenectomy in our department from November 2013 to January 2017,major vascular resection and reconstruction using the SMA first approach for total mesopancreas excision was performed in 7 patients.The clinical data of these 7 patients were retrospectively analyzed.Results Total 3D laparoscopic surgery was performed in all these 7 patients.The mean operation time,mean blood loss and blood flow occlusion time were (551.4 ± 83.8) min,(671.3 ± 256.3) ml and (45.8 ± 6.7) min,respectively.Six out of 7 patients were pathologically diagnosed to have pancreatic adenocarcinoma with negative surgical margins.Two patients had lymphatic metastasis (the number of metastatic lymph node was 1 in each patient).The mean number of lymph nodes resected was (12.7 ± 5.8).The portal vein-superior mesenteric vein (PV-SMV) was segmentally resected and reconstructed using an end to end anastomosis following the preoperative plan in 4 patients.These included 2 patients who underwent total pancreatectomy.The portal vein was wedge-resected and reconstructed by venorrhaphy in 2 patients.The remaining 1 patient was histopathologically diagnosed to have a mass-type chronic pancreatitis.Only 1 patient was treated in the ICU for 1 day after surgery.Post-operative complications occurred in 2 patients and they were managed with nonsurgical treatment (PV-SMV thrombosis and gastric emptying disorder in 1 and a pancreatic leakage (level A) in 1).The mean length of post-operative hospital stay was (13.7 ± 3.2) days with no in-hospital mortality.Seven patients were alive by April 2017.The mean follow-up for the 6 patients with pancreatic adenocarcinoma was 4.5 (3.5 ～9) months.Conclusions Based on our experience in skillful and masterly major vascular resection and reconstruction in open surgery and on our experience in standard laparoscopic pancreaticoduodenectomy,laparoscopic pancreatieoduodenectomy combined with major vascular resection and reconstruction was feasible and safe.This surgery requires very mature skills in laparoscopic surgery.