Background and purpose:Internal mammary sentinel nodes (IMSNs) lymphoscintigraphy could guide in ?-detecting and removing the IMSNs for the purpose of biopsy during the operation,which is helpful to determine the necessity of postoperative radiotherapy. However,IMSNs imaging rate remains low if using axillary lymph nodes (ALNs) lymphoscintigraphy. This study was to investigate the tracer’s properties and try to improve the IMSNs imaging rate through changing the label procedure. Methods:The boiling time of 99mTC-sulphur colloidal particles was shortened from 3~5 minutes to 2 minutes during the label procedure, then the colloidal particles’ diameter, distribution and stability were observed by Transmission Electron Microscope (TEM), then the IMSNs lymphoscintigraphy was performed. Results:This colloidal tracer’s shape and distribution remained stable for 3 hours, and 90% of the particles had a diameter of 10 nm, the particles tended to aggregate afterwards. 4 hours after labeling, the diameter of particles exceeded 100 nm. IMSNs could be clearly imaged if the tracer was freshly used (within 3 hours after labeling). Conclusion:Within 3 hours after the labeling the unfiltered colloidal tracer with modified procedure, the particle could be used and internal mammary lymph nodes could be imaged more clearly.

Objective To study the time distribution of recurrence for postoperative breast cancer patients by hormone receptor status.Methods The characteristics of recurrence in 1099 breast cancer patients with different hormone receptor status undergoing surgery between December 1999 and April 2006 were analyzed retrospectively.Results For those 1099 patients the median follow-up time was 60.6 months.Recurrence was found in 171 patients.For hormone receptor-negative (HRN) patients the first peak of recurrence appeared at the 12th month and the second at about the 54th month.For hormone receptor-positive (HRP) patients the peak of recurrence appeared at the 36th month and a second peak at about the 54th month,and beyond 54 months the hazard was higher for hormone receptor-positive patients.The risk of recurrence was higher with more nodes involved.Node-positive HRP patients suffered two to three times higher risk of recurrence than node-negative HRP patients.Node-positive HRN patients had three to four times higher risk of recurrence than node-negative HRN patients.The recurrence-free survival in HRP patients was higher than that in HRN patients,also the recurrence-free survival in node-negative HRP patients was higher than that in node-positive patients (all P ＜ 0.01).Conclusions The recurrence risk for HRP breast cancer patients was higher than that in HRN patients after 54 months postoperatively.The risk of recurrence for node-positive breast cancer patients was higher than that for HRP node-negatives.

Purpose: To evaluate the clinical value of mammary sentinel lymphoscintigraphy in breast cancer. Methods: 91 patients with breast cancer in stage T1-2N0 were injected with 55. 5MBq/0. 5ml 99mTc- human serum albumin on the surface of the lesion subdermally or 92. 5MBq/4ml unfiltered 99mTc-sulfur colloid in four divided doses around the lesion. 63 patients underwent mammary lymphoscintigraphy and sentinel node biopsy using a hand-held r-ray detector probe were performed 2 - 16 hr postinjection in 70 patients during breast surgery . Results: The sentinel lymph node( s) (SLN) could quickly be shown by these two tracers in 81% (51/63) cases . A SLN with low activity could be seen in 13. 7% (7/5.1) cases , in which 85.7%(6/7) were proved to have a metastasis. Lymph drainage to the internal mammary nodes occurred in 38. 5% (5/13) of patients with an inner-lesion and in 26. 3% (10/38) of patients with an outer-lesion . The SLN was successfully identified in 95. 7% (67/70) of the patients and the number of the nodes ranged from 1 -5 with an average 1. 6 per person . The accuracy of the SLN with respect to the positive or negative status of the axillary nodes was 92.53% (62/67) . The sensitivity , specificity, PPV, NPV of the method was 82.75% (24/29), 100% (38/38), 100% (24/24) and 88. 37% (38/43), respectively . Conclusions: Mammary lymphoscintigraphy in breast cancer is helpful for localizing SLN correctly and identifying abnormal lymph drainage.

Background and purpose:Carcinoembryonic antigen(CEA) is mainly used in post-surveillance of colorectal cancer(CRC). Recently, bile CEA assay was reported to be of value in the diagnosis of OHM(occult hepatic metastasis) in CRC. We measured CEA levels in both peripheral vein and bile from patients with CRC to evaluate the change of bile CEA levels in patients with CRC and its relation to liver metastasis (LM). Methods:Three groups were enrolled in our study. Primary CRC Group: 27 patients with CRC but without LM; LM Group: 14 patients with LM from CRC; Control Group: 20 patients with benign biliary diseases (cholelithiasis or cholecystitis). Both serum and bile were collected to measure CEA levels in all groups but only bile CEA was measured in control group. Results:Bile CEA level in control group, primary CRC group and LM group were 1.73 ng/ml,13.7 ng/ml and314.27 ng/ml respectively, (P

Objective To evaluate the efficacy and safety of itraconazole injection in treatmeat of invasive fungal infections.Methods The clinical trial was conducted in 16 patients(17 times)with invasive fungal infection from August 2003 to August 2005,including 1 case confirmed,11 cases(12 times)suspected and 4 cases for empiric treatment.They were treated with iv itraconazole injection in a dose of 200 mg twice daily in the first and the second day,from the third day to 14th day they were given iv itraconazole injection in a dose of 200 mg once daily,and then treated with capsule in a dose of 200 mg twice daily for another 28 days.Two cases were treated with iv itraconazole injection in a dose of 200 mg twice daily for 9 days and 14 days;1 case in a dose of 200 mg once daily for 21 days.Results 62 strains were isolated from 16 patients with invasive fungal infection,including 40 strains in urine cultivate,and 21 strains of tropic candida were primacy.In confirmed and suspected patients,the cure rate was 6/13,the effective rate was 11/13 and the eradication rate was 6/13.The incidence of adverse reaction was 3/24.Conclusion Itraconazole injection is effective and safe in treatment of severe invasive fungal infections,especially in severe ill,old patients for long time use.

Objective To develop a polydimethylsiloxane (PDMS) microfluidic chip-based 18F microreactor for the preparation of 18F-labeled probes.Methods The 18F microreactor was composed of PDMS microfluidic chip and customized glass microvessel integrating with stainless capillary tube (D 0.6 mm) as heater/cooler.PDMS chips were fabricated by silk-screen printing technology,a traditional and easily accessible process.18F-FDG and 18F-fluoroacetate(FAC) were synthesized using the 18F microreactor.TLC was applied to measure the 18F-labeling yield and the radiochemical purity of 18F-FDG and 18F-FAC.Results The size of PDMS chip was 40.0 mm (l)×30.0 mm (w)×6.0 mm(h) and the liquid/gas inside channel was 0.3 mm (w)×50.0 μm (h).The customized glass microvessel was about 4.0 mm (D) ×30.0 mm (h) with 200 μl of reaction volume.The capillary tube which wrapped around the microvessel functioned as a heater when electric current was provided,while as a cooler when compressed air went through.The integrated 18F microreactor with a total size of 40.0 mm (l) ×30.0 mm (w) ×15.0 mm (h) was successfully used to prepare 18F-FDG and 18F-FAC,whose radiochemical purity were both higher than 96％ and 18F-labeling yield was 92.5％ and 90.0％ respectively in the first fluorination step.Conclusions A PDMS microfluidic chip-based 18F microreactor is developed and successfully applied to prepare 18F-FDG and 18F-FAC.It has the dual advantages of both microfluidc chip and traditional synthesis module and features of high integration,small total size and low consumption of labeling precursor.

Objective To investigate the pulmonary microvascular responsiveness of diabetic animals to sepsis and the potential mechanism of NO system.Methods Sixty-four Wistar rats of clean grade were randomly (random number) divided into 4 groups,namely normal control group (group A,n =16),diabetes group (group B,n =16),sepsis group (group C,n =16),diabetes and sepsis group (group D,n =16).Diabetic mellitus model was made in rats with injection of streptozotocin,STZ (65 mg/kg).Successful model was defined as the blood glucose value≥ 16.67 mmol/L 48 hours after injection of STZ.All animals were fed 4 weeks before initiation of next experiment.The sepsis model was established by intravenous injection of LPS (10 mg/kg) in rats.RT-PCR was used to determine the mRNA expression of Tie-2 in rats'blood.The ratio of dry/wet of lung tissue and the extravasation of Evans blue dye into the lung were detected.Quantitation of NO in lung tissue and serum was measured by using Griess method.RT-PCR was also used for determination of iNOS,eNOS,DDAH2 mRNA expressions in lung tissue.Data were analyzed with ANONA and LSD method for comparison between groups,and P ＜ 0.05 was considered statistically significant.Results Compared with septic group.,the diabetic rats with sepsis group demonstrated higher expression of Tie-2 mRNA in blood (19.72 ± 0.70) vs.(3.99 ± 0.92),P =0.00,lower ratio of dry/wet in lung tissue (0.19 ±0.01) vs.(0.22 ±0.01),P =0.000,higher permeability of Evans blue dye into lung tissue (3.76 ± 0.77) vs.(1.74 ± 0.24),P =0.000.Serum NO level was lower in group D than that in group C (123.13 ±4.24) vs.(188.30 ±5.18),P =0.000,however,NO levels in lung tissue of both group D and group C were higher than that in control group (53.62 ± 6.70),(23.63± 3.92) vs.(10.37 ± 1.29),P =0.00,and NO level in group D was higher in 2 times than that in group C (P =0.00).However,there were no differences in eNOS expression among groups A,B and C,but the difference in eNOS expression was present between group D with lower expression and group A,that lower in group D (0.07 ±0.02) vs.(0.38 ±0.05),P=0.017.Compared with group C,the expression of iNOS was higher in group D (80.23 ±2.49),(32.48±5.37) vs.(1.74±0.23),P=0.00),and the expression of DDAH2 was lower in group D (0.49 ±0.13),(7.26 ±0.50) vs.(11.96 ±0.55).Conclusions Diabetic rats with sepsis enhanced endothelial cell damages.Diabetes deteriorates the regulatory activity of NO system,suggesting the potential mechanism of the worsened damages of EC in diabetic sepsis host.

Objective To study the relationship between expression of multidrug resistant 1 ( MDR1) gene encoded P-glycoprotein ( P-gp) and multidrug resistance relation protein ( MRP) in ulcerative colitis and the disease behavior. Methods Sections of endoscopic biopsy samples from patients with ulcerative colitis were studied by immunohistochemistry with monoclonal antibody of MDR1 gene encoded P-gp and MRP. Results Expressions of MDR1 gene encoded P-gp and MRP in the 12th month and 18th month of ulcerative colitis were 40. 5% , 45.9% , 48. 6% and 51.4% , respectively, which were all significantly higher than those of early phase ( P < 0.05). P-gp and MRP expressions in active stage and remission stage of ulcerative colitis were 36.4% , 18. 6% , 46. 1% and 25.4% , respectively, which was significantly different between the two stages (P < 0.05 ). At active stage of ulcerative colitis there was no significant difference in expressions of P-gp and MRP among mild, moderate and severe patients (P > 0. 05 ). Conclusion Examination of P-gp and MRP expressions is feasible and dependable in presenting evidence of drug insistence. However, it is not suitable to be an indicator of severity because of its poor differentiation ability in active stage.

Objective To establish a rapid diagnostic method for the detection of marine vibrios,and then construct a new technology platform for the clinical diagnosis of marine vibrio infection.Methods A pair of PCR primers and a sequencing primer based on the whA gene of V.vulnificus and the toxR genes of V.parahemolyticus and V.alginolyticus were designed respectively,and then the specific DNA fragments were amplified.Next,the single-stranded DNA templates were prepared for pyrosequencing.The obtained base sequence was validated by NCBI alignment.In addition,the 16S rRNA genotyping of V.vulnificus was also performed.Results The PCR primers and sequencing primer of V.vulnificus showed good specificity,and a 167 bp DNA fragment was amplified from 4 strains of V.vulnificus.The pyrosequencing results completely matched with the whA gene sequence of V.vulnificus.Meanwhile,the control strains were negative.A 105 bp DNA fragment and a 134 bp DNA fragment were amplified from 11 strains of V.parahemolyticus and V.alginolyticus,respectively,and the pyrosequencing results were consistent with the expected sequence.In addition,one of 4 strains of V.vulnificus was identified as 16S rRNA-A type,and the other 3 as 16S rRNA-B type.Conclusion The PCR-pyrosequencing method established in this study is a new method for the real-time detection of short nucleotide sequences.It has some advantages such as high throughput,high precision and simple operation,and may be applied to the fast and accurate identification of marine and terrestrial pathogenic bacteria.

Objective To evaluate the prevalence and clinical significance of IgG,IgA and IgM isotypes of anti-peptidylarginine deiminase 4 (anti-PAD4) antibodies in early rheumatoid arthritis (RA).Methods IgG,IgA and IgM isotypes of anti-PAD4 antibodies were measured in the sera of 88 RA patients with disease duration less than 2 years,62 patients with other rheumatic diseases and 57 healthy subjects.The diagnostic performance of IgG,IgA and IgM isotypes of anti-PAD4 antibodies and their relationship with disease duration,DAS28,ESR,CRP,anti-CCP antibodies and rheumatoid factor (RF) were evaluated.Data analysis were performed using t test,U test and Spearman's association analysis.Results ① The sensitivities of IgG,IgA,and IgM isotypes for early RA were 28.41％,36.36％ and 9.09％ respectively.The specificities of IgG,IgA and IgM isotypes were 94.12％,93.28％ and 95.80％ respectively.② IgA isotype was positively correlated with age (r=0.234,P=0.028),DAS28 (r=0.309,P=0.007),ESR (r=0.382,P=0.000) and CRP (r=0.291,P=0.008),while negatively correlated with disease duration (r=-0.295,P=0.006).③ IgA isotype was positively correlated with IgG isotype (r=0.451,P＜0.01).In the IgG negative patients,the positivity of IgA isotype was 29％(18/63),which indicated that the IgA isotype might be helpful in diagnosing RA in IgG isotype negative patients.Conclusion Anti-PAD4 antibodies can be detected in early RA,primarily with IgA and IgG isotypes.IgA isotype has negative correlation with disease duration,indicating that IgA isotype of anti-PAD4 antibody may play a role in the very early stage RA.