Objective To investigate the effect of 188Re-IGF-1 analogue (IGF-1A) in proliferation inhibition and apoptosis induction in human pancreatic carcinoma cell line Patu8988.Methods IGF-1A was labeled with 188Re.Patu8988 cells were divided into an un-treated control group,IGF-1A group (1,5,10,20 μg),188ReO4-group (0.37,1.85,3.70,7.40 MBq) and 188Re-IGF-1A group (0.37,0.74,1.85 MBq).The cell proliferation inhibition effects by the 188Re-IGF-1A and 188ReO4-were detected every day by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test from 1 d to 7 d after administration,while the IGF-1 A group was tested every day from 1 d to 6 d after treatment.Inhibition rates were calculated.At 3 d after treatment with 188ReO4-and 188Re-IGF-1A (1.85,3.70,7.40 MBq),cell apoptosis was detected by flow cytometry.For biodistribution studies of 188Re-IGF-1A,36 nude mice bearing Patu8988 cell xenografts were divided into6 groups.At different time points (15 min,1 h,4 h,1 d,3 d and5 d),36 mice (n =6 per time point) were sacrificed and organs of interest were removed,weighted and measured for radioactivity by a gamma counter.The absorbed doses of organs were calculated as ％ ID/g.One-way analysis of variance was used.Results After 4 d,inhibition rate of Patu8988 cell proliferation in the 188 Re-IGF-1A group (1.85 MBq) was (90.75 ±5.20) ％,higher than that in 188ReO4-group or IGF-1A group ((49.50±2.39)％,(23.00±4.21)％; F=554.724,P＜0.01).At 3 d after treatment with different doses of 188 Re-IGF-1A (1.85,3.70,7.40 MBq),floating cell ratios were (16.56 ± 0.95) ％,(33.39 ±5.93) ％ and (43.76 ± 1.38) ％,respectively.Apoptosisratios in the floating cells treated by 188 Re-IGF-1A (1.85,3.70,7.40 MBq) were (12.70±2.27)％,(17.80±1.51)％ and (23.23 ±1.22)％,respectively.Distribution in tumors was (39.30 ± 17.98),(10.59 ± 9.39),(5.32 ± 1.53) and (5.30 ±2.28) ％ ID/g at the 15 min,1 d,3 d,and 5 d timepoints after intratumoral injection,respectively.The absorbed dose of tumors was 5165.8 mGy/MBq.Conclusions Proliferation of human pancreatic carcinoma cell line Patu8988 can be inhibited and apoptosis can also be induced by 188Re-IGF-1A.The tumor region is the major distribution site in nude mice bearing human pancreatic cancer xenografts after intratumoral injection of 188 Re-IGF-1A.

Objective To evaluate the value of 18F-FDG PET/CT in histological grading and staging of follicular lymphoma (FL) and prediction of prognosis after first-line treatment.Methods From May 2007 to April 2013,24 patients (11 males,13 females; median age 55 years) with histopathological proof of FL were retrospectively studied.All patients were evaluated by 18F-FDG PET/CT before the first-line treatment and were divided into indolent FL and aggressive FL according to their histological grades and clinical stages.The sensitivity,specificity and SUVmax were calculated.Analysis of variance of factorial design was used to analyze the data.Within the same study period,18F-FDG PET/CT was also performed in 16 FL patients (9 males,7 females; median age 50.5 years) after first-line treatment (7/16 patients belonged to the aforementioned group with pretreatment PET/CT performed) ; and they were then divided into PET/CTpositive and PET/CT-negative groups.All 16 patients were followed for 6-49 months to evaluate the prognosis.The rates of overall survival (OS) and progression-free survival (PFS) were calculated.Results (1)The sensitivities of PET/CT in indolent and aggressive FL were 92.3％ (12/13) and 100％ (11/11),respectively.The SUVmax was 5.26± 1.70 vs 9.54±5.09 (F=5.196,P＜0.05).(2) According to PET/CT,3patients(12.5％,3/24) were upstaged from Ⅰ-Ⅱ to Ⅲ-Ⅳ,and 2 patients(8.3％,2/24) were downstaged from Ⅲ-Ⅳ to Ⅰ-Ⅱ.The SUVmax of stage Ⅰ-Ⅱ and Ⅲ-Ⅳ FL was 5.22±2.92 and 8.04±4.46(F=2.904,P＞0.05).(3)For the 16 FL patients with PET/CT after first-line treatment,the negative and positive groups had different OS and PFS.The 6-month OS,1-year OS and 3-year OS were 100％(13/13),9/9,4/5,respectively for the negative group,and 2/3,2/3,1/2,respectively for the positive group; while the corresponding 6-month PFS,1-year PFS and 3-year PFS were 92.3 ％ (12/13),8/9,3/5 and 2/3,0/3,0/2,respectively.Conclusions 18F-FDG PET/CT is valuable in the evaluation of histological grading and clinical staging of FL patients and in the prediction of prognosis after fist-line treatment.

Objective To observe the antioxidant effects of 99Tc-MDP on the brain of aged mice induced by D-galactose.Methods A total of 48 healthy female Kunming mice were divided into 6 groups by random number table method:normal control group,model group,vitamin E (Vit E) group,groups treated with low,middle and high dosages of 99Tc-MDP.Except the normal control group,mice of each group were injected with 10％ D-galactose saline subcutaneously in the neck for 42 d.At the same time,the 99Tc-MDP groups were given different dosages of 99Tc-MDP (1.75× 10-5,3.50× 10-5,0.70× 10-4 μg/g according to the body mass) respectively into abdominal cavity twice a day.Vit E group was given Vit E by intragastric administration from the first day.The model group was injected with saline every day.After behavioral testing,mice serum samples and brain tissue samples were collected for the determination of superoxide dismutase (SOD),malondialdehyde (MDA),glutathione peroxidase (GSH-Px) and monoamine oxidase (MAO)levels.Then the mice were sacrificed and the brain tissue was taken for HE staining.The independent-sample t test was used for data analysis.Results The mice model was established successfully.SOD levels in brain tissue of groups injected with low,middle,high dosages of 99Tc-MDP,Vit E group were (19.06± 6.44),(20.41±4.02),(22.24±3.76),(24.71±5.09) U/mgprot,respectively,all of which were higher than that of the model group((11.32±2.90) U/mgprot;t=3.099 6-6.504 6,P＜0.05 or ＜0.01).There were similar results for GSH-Px (t =2.214 1-4.145 7,P＜0.05 or ＜0.01).MDA and MAO levels in brain tissue of 99Tc-MDP groups were lower than those of the model group (t =2.140 3-3.057 8,all P＜0.05).Compared to normal control group,the hippocampus in model group showed reduced cell number and layers,disordered structure,with part of the cells in smaller volume and abnormal nuclear shape.In Vit E group and the three 99Tc-MDP groups,no significant change of neuron was observed compared with normal control group,the degeneration and necrosis of hippocampal cells were mild compared with model group,the cell number and morphology were normal,and the structures were clear.Conclusion 99Tc-MDP may increase the activities of SOD,GSH-Px and reduce the levels of MDA and MAO in brain tissue of aged mice,thus it may be helpful in delaying the brain aging.

Objective To evaluate the effect of P-gp inhibitors of verapamil (VER) and GF120918 on 18F-FDG uptake in Bcap37 and Bcap37/multidrug resistancce (MDR)1 cell lines in vitro,and to explore the relationship between 18F-FDG uptake and P-gp expression at cellular level.Methods Bcap37 and Bcap37/MDR1 cells were seeded into 6-well plates at a density of 1 × 106 per well.Three days later,37 kBq/ml 18F-FDG,or 37 kBq/ml 18F-FDG + 100 μmoL/L VER,or 37 kBq/ml 18F-FDG + 50 μmol/L GF120918 were added into each well.Mter incubated for 10,30,60 and 120 min at 37 ℃ and in 5％ CO2,the medium was removed and the cells were washed three times with 1 ml ice-cold PBS immediately.The radioactivity of 18 F-FDG was measured using a gamma counter.The uptake of 18F-FDG was expressed as the ratio of 18F-FDG radioactivity in Bcap37 or Bcap37/MDR1 cells and the overall radioactivity added to the cells in each well.The t test was used for statistical analysis.Results 18F-FDG uptake was higher in Bcap37/MDR1 cells than that in Bcap37 cells after incubated for 10 min.The uptake rate was (1.88 ±0.19) ％ in Bcap37/MDR1 cells and (1.37 ± 0.18) ％ in Bcap37 cells (t =7.832,P ＜ 0.05).On the contrary,18 F-FDG uptake was significantly higher in Bcap37 cells than that in Bcap37/MDR1 cells after incubated for 60 and 120 min.The uptake rates were (2.29 ±0.23)％ and (2.34 ±0.15)％ in Bcap37 cells,(1.47 ±0.14)％ and (1.53 ±0.22)％ in Bcap37/MDR1 cells (t =8.437,8.283,both P ＜ 0.05).18 F-FDG uptake was significantly higher with VER or GF120918 in Bcap37/MDR1 cells than that without VER or GF120918 after the incubation of 60 and 120 min (t =9.032,9.243 and 8.765,8.803,all P ＜ 0.05).The uptake rates with VER or GF120918 were (2.45 ±0.21)％ and (2.46 ±0.25)％,(2.50 ±0.24)％ and (2.48 ±0.27)％.There was no significant difference of 18F-FDG uptake in Bcap37 cells with or without VER or GF120918.Conclusions 18F-FDG is a substrate of P-gp at cellular level.P-gp may act as an efflux pump to reduce 18F-FDG uptake in Bcap37/MDR1 cells.The uptake of 18F-FDG can be used to evaluate the function of P-gp in tumor cells.

Objective To evaluate the relationship between 18F-FDG uptake and P-gp expression in Bcap37 or Bcap37/MDR1 tumor-bearing BALB/c nude mice.Methods Bcap37 or Bcap37/MDR1 cells were injected into BALB/c nude mice (1× 107cells/ml,0.2 ml/mouse) to construct mice models.Bcap37 (n=5) or Bcap37/MDR1 (n=5) tumor-bearing mice fasted for 6 h before imaging.After anesthesia,the mice were injected with 7.4 MBq of 18F-FDG via tail vein.The dynamic microPET scans were carried out for 90 min.On the microPET images,the ROI was drawn and the TAC was obtained.The next day,those 10 mice underwent dynamic microPET scans after injected with elacridar (GF120918) and 18F-FDG.Another 10 mice,5 with Bcap37 tumors and 5 with Bcap37/MDR1 tumors,were used.After 7.4 MBq 18F-FDG with or without 2.0 mg/kg GF120918 was administered via tail vein,microPET images were acquired at 60 min.ROI was drawn over the tumors and SUV was obtained.Two-sample t test was used to analyze the data.Results GF120918 did not significantly alter the 18F-FDG accumulation curve in Bcap37 tumors,but significantly enhanced the 18F-FDG accumulation in Bcap37/MDR1 tumors.GF120918 did not influence 18F-FDG uptake (SUV) in Bcap37 tumors (1.052±0.028,1.028±0.045,t =1.792,P＞0.05),but significantly increased the SUV in Bcap37/MDR1 tumors (1.015±0.043,0.712±0.031,t=3.365,P＜0.05);The SUV of 18 F-FDG in Bcap37 tumors was significantly higher than that in Bcap37/MDR1 tumors without injection of GF120918 (t =3.952,P＜0.05).The SUV was not significantly different when GF120118 was injected (t=1.835,P＞0.05).Conclusions 18F-FDG is a substrate of P-gp.18F-FDG imaging combined with GF120918 injection may be an effective noninvasive method for the detection of tumor's MDR.

Objective　To evaluate the clinical value of sequential subtraction scintigraphy (SSS) with 99m　Tc red blood cell (RBC) for the early detection of gastrointestinal (GI) bleeding. Methods　Ninety patients referred with clinical evidence of GI bleeding underwent 99m　Tc-RBC scintigraphy with digital gamma camera after labeling of 99m　 Tc-RBC in vivo. Sequential 12 conventional non-subtraction (CNS) images of abdomen were taken at 5?min intervals for 60?min. Then 5-min images were subsequently subtracted from each other using a computer and 11 subtracted images were obtained. Delayed images up to 24 hr were obtained when early results were negative and/or recurrent bleeding was suspected. Results　62 of 90 patients with suspected GI bleeding were conformed to have active hemorrhage up to 24?hr. The scintigrams were divided into the following three sets: within 30?min, 60?min, and 24?hr. The sensitivity of SSS was 87% (54/62, 30?min) and 91.9% (57/62, 60?min) respectively, which were significantly higher (P<0.05) than that of CNS (56.4%, 35/62 and 62.9%, 39/62). 24?hr delayed image of CNS increased the sensitivity to 85.4%. No significant difference in specificity between the two methods was noted. Of the 62 patients with definite active hemorrhage, the bleeding sites were identified by surgical operation in 42. The concordant rate with surgical operation in SSS was 92.8% (39/42), higher than that of CNS (73.8%, 31/42). Conclusions　Sequential subtraction scintigraphy with 99m　 Tc-RBC, compared with conventional non-subtraction scintigraphy, is an effective technique for the early detection of GI bleeding. It increases the diagnostic sensitivity, detecting a small amount of bleeding earlier than CNS; SSS reduces background activity, more accurately localizing bleeding sites. It also shortens the examination time, making this approach more suitable for pediatric, elderly and critically ill patients.

Objective:To assess the efficacy and the safety of the radiofrequency catheter ablation (RFCA) for the septal accessory pathway (AP) in children.Methods:From September 2013 to March 2019, 626 patients plan to underwent RFCA for paroxysmal supraventricular tachycardia (PSVT) in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine.Among them, 74 consecutive patients with right or left septal APs were included in the study and their clinical and RFCA data were analyzed.Results:The age of these 74 children (45 males, 29 female) was (7.8±3.5) years, ranging from 10 months to 13 years.The body weight (BW) was (27.7±14.4) kg, with 3 patients BW<15 kg.A discordant ventricular wall motion (DVWM) was found in 5 patients, and the combined congenital heart diseases were discovered in 2 patients.A three dimensional mapping system was applied in 69 ablations, and 3 ablations were performed only with the fluoroscopy monitor of 5 cases.According to the AP location, the number of cases located in the anteroseptal, the midseptal, the mouth of coronary sinus, the left posteroseptal and the right posteroseptal, were 28, 18, 10, 10 and 8, respectively.The ablation operations were applied in 72 patients.The initial acute success reached in 67 (93.1%) patients.The ablation energy was (18.0±1.8) W, the fluoroscopy time during the ablations was (4.7±2.7) minutes, and the procedure duration was (151.5±58.6) minutes.One inadvertent complete atrioventricular block (AVB) was noted as the ablation-related complication.All 5 children with the pre-DVWM were recovered after ablations.During a follow-up of (23.8±10.8) months, 4 patients experienced the recurrence of preexcitation syndrome atrioventricular reentrant tachycardia.Conclusions:With the 3D-mapping system, the RFCA of septal APs can be performed safely and effectively in pediatric patients of paroxysmal supraventri-cular tachycardia.However, as the ablation-related complication, AVB should not be ignored.

Objective To evaluate the safety and feasibility of simplified fast track surgery in gastric surgery.Methods The study enrolled consecutive cases of elective gastric surgery from March 2010 to December 2011.The patients were randomized into two groups:simplified fast track surgery group (n =149) and traditional clinical pathway group (n =154).Demographic,intra-operative and post-operative data between two groups were compared.Results The outcome of demographic and intra-operative data between simplified fast track surgery group and traditional clinical pathway group were not different statistically (P ＞ 0.05).The time of post-operative recovery and discharge of simplified fast track surgery group was significantly shorter than traditional clinical pathway group (P ＜ 0.05).Difference of post-operative complications of two groups was not significant (P ＞ 0.05).Conclusion The programme of simplified fast track surgery in gastric surgery is safe and feasible.

Achieving the millennium development goals and world peace and development are closely linked objectives, and WHO having been made great achievements and progress in the health sector through its related ob -jectives.All health-related millennium development goals such as maternal and child health , HIV/AIDS prevention and control , malaria and tuberculosis , safe drinking water and sanitation , and foreign medical assistance had been basically reached in China .This success was mainly due to the government attention and commitment , legal protec-tion, health information technology-informatization, effective projects and measures , but there are still differences in health status between regions and population groups , and increasing needs of health services quality improvement and chronic diseases control and prevention should be paid great attention in the future .

Objective To study the characteristics of the diseases spectrum in hospitalized children.Methods The items of main diagnosis,gender,age,etc.in the inpatients medical records home page data aged 0? 12 years old in second-level and above hospitals of Chongqing City during 2015 were performed the disease spectrum sequence and constituent ratio analysis for deeply digging the relation between the disease change trend with the age and sex.Results The top 5 main system diseases affecting children's health were respiratory system diseases (male 43.84％,female 45.74％),some conditions originated from prenatal period (male 12.01 ％,female 13.87 ％),infectious diseases and parasites diseases (male 9.48 ％,female 9.88 ％),digestive system diseases (male 9.09 ％,female 6.95 ％),injury,poisoning and some other consequences of external causes(male 6.86 ％,female 5.27 ％).Respiratory system diseases always ranked the first place,the sexual difference among various system disease was unobvious,the sequence of injury,poisoning and some other consequence of external causes was increased with the age increasing;in the ranking of respiratory system diseases,pneumonia(38.73 ％),acute bronchitis(17.29 ％) and acute tonsillitis(13.83％) were the top 3 diseases affecting children's health.Conclusion Respiratory system diseases are the concerned key point for children health promotion.The health and epidemic prevention departments should provide effective methods and measures for preventing respiratory system diseases in children.Furthermore,the targeted prevention and treatment measures should be proposed aiming at the difference of disease sequence in different age groups.