The clinical value of 18F-FDG PET/CT in tumor imaging has been widely recognized.However,the related cost is high.SPECT is used more widely.So 99Tcm-labeled radiopharmaceuticals can be easily accessed.The recent progress of glucose and its analogs labeled by 99Tcm in tumor imaging is focused.

Medullary thyroid cancer (MTC) is characterized hy the secretion of calcitonin that is derived from parafollicular cells.20％-25％ of MTC are hereditary.Compared with other types of thyroid cancer,MTC is prone to recurrence,metastasis,and younger onset age.RET gene germline mutation accounts for the hereditary MTC,and somatic mutation is responsible for part of sporadic cases.A good correlation between phenotype and genotype is reported.We present in this article a case of medullary thyroid cancer patient with genetic diagnosis and treatment as well as postoperative follow-up together with RET gene screening results in her family members in order to call attention to the diagnosis and treatment of MTC.

Objective: To study the role of miR-18a in regulating the proliferation, migration and invasion of ovarian cancer cells through IGF-2/Akt pathway. Methods: Ovarian cancer SKOV3 cells were cultured and grouped. The negative control group were not transfected with the plasmid, the blank plasmid group were transfected with the blank pcDNA3.1 plasmid, the IGF-2 plasmid group was transfected with the pcDNA3.1 plasmid expressing IGF-2, and the IGF-2 plasmid+L294002 group was transfected with pcDNA3.1 plasmid expressing IGF-2 and treated with Akt inhibitor LY294002. The upstream miRNA of IGF-2 was analyzed by bioinformatics method and verified by the double luciferase reporter gene method. The effect of overexpressing miR-18a on the expression of IGF-2 was observed. Results: Transfection of IGF-2 expression plasmid can increase the expression level of IGF-2 in cells and the content of IGF-2 in culture medium (P<0.05) . Cell proliferation in the IGF-2 plasmid group (0.93±0.22, F=9.629, P<0.05) , migration (80.22±13.28, F=12.689, P<0.05) , invasion (72.31±11.38, F=33.845, P<0.05) , the relative expression levels of p-PI3K (1.35±0.22, F=8.321, P<0.05) and p-Akt (0.94±0.18, F=9.612, P<0.05) . The proliferation, migration, invasion viability, in the viability and cells were significantly higher than those in the negative control group and the blank plasmid group. And relative expression levels of p-PI3K and p-Akt in the IGF-2 plasmid+L294002 group were significantly lower than those in the IGF-2 plasmid group (P<0.05) . IGF-2 is a target gene of miR-18a, and overexpression of miR-18a can down-regulate the expression level of IGF-2 (P<0.05) . Conclusion IGF-2 can promote the proliferation, migration, and invasion of ovarian cancer cells, and this promotion is related to the activation of the Akt pathway, and miR-18a may be an upstream regulatory molecule of IGF-2.

Objective To indentify the gene mutation of fibroblast growth factor receptor 3 (FGFR3) gene in a Chinese family with congenital achondroplasia (ACH). Methods The genomic DNA from 2 clinically diagnosed ACH patients and the other 4 members from the same family was prepared for PCR. The products of PCR were purified and then sequenced directly. Results Two patients with ACH in this family showed G-A transition mutation at nucleotide 1138 as heterozygotes. Conclusion The G-A transition mutation at nucleotide 1138 in transmembrane domain of FGFR3 gene seems to be the pathologic cause of this Chinese family with ACH.

Objective: To study the effect of different wetness degrees in the root canal on the canal sealing. Methods: 160 root canal prepared single rooted teeth were divided into 4 groups (n = 40) by the root canal wetness degree (water content, V): (1) 0. 250 ～0. 299, (2) 0. 300 ～ 0. 599, (3) 0. 600 ～ 0. 899 and (4) 0. 900 ～ 1. 199 respectively. 80 teeth were divided into 4 groups (n = 20) for dye leakage test and another 80 for bacterial microleakage test. Zinc oxide paste (ZOP) and AH-Plus (AH-P) with vertical condensation of warm gutta-percha were respectively used to seal the canals in each group of the samples (n = 10) . The length of in vitro tooth dye penetration was measured by stereomicroscope; the time (days) of turbidity in the bacterial leakage model observed and compared. Results: Of all the canals sealed by ZOP or AH-P with the increase of the wetness the dye infiltration length increased significantly (P ＜0. 05) and the days in which the faecal intestine ball infiltrated into the lower chamber of the model was gradually decreased (P ＜0. 05) . Conclusion: The increase of root canal moisture may reduce the sealing of the root canal.

Objective: To investigate the regularity and clinical significance of abnormal bone uptake of ⁹⁹Tc^m-methylene bisphosphonate (MDP) in benign and malignant lesions. Methods: A retrospective analysis was performed on 266 patients (132 males, 134 females, age range: 8-85 years) with abnormal uptake of ⁹⁹Tc^m-MDP in extraosseous tissues from September 2015 to March 2018. The final diagnosis of abnormal uptake was made according to the histopathology, laboratory and related imaging examination (CT, MRI, ultrasound, SPECT/CT or PET/CT imaging) results within 2 weeks after ⁹⁹Tc^m-MDP imaging. Regularity of abnormal ⁹⁹Tc^m-MDP uptake was comprehensively analyzed. Differences between benign and malignant groups were compared by χ² test or Fisher exact test. Results: Abnormal ⁹⁹Tc^m-MDP uptake in extraosseous tissues in 232 patients (87.2%, 232/266) were confirmed as malignant lesions and those in 34 patients (12.8%, 34/266) were benign. There were no significant differences in gender (χ²=0.611, P>0.05), age (P=0.584), and location (P=0.118) between benign and malignant lesions, but the involvement was significantly different (χ²=19.515, P<0.05). There were significant differences between single focus and diffuse foci of single organ, diffuse foci of single organ and multiple foci groups (χ²=8.959, 19.325, both P<0.01). Conclusions The detection rate of malignancy among foci with abnormal ⁹⁹Tc^m-MDP uptake in extraosseous tissues is high, and the malignancy may relate with the involvement of foci. When extraosseous uptake is found, clinical information and related examination results should be comprehensively analyzed and the malignancy should be taken into account.

Objective To analyze the differential gene expression between thymic carcinoids and normal thymic tissues and to study thepathogenesisofectopicACTH syndrome caused by thymic carcinoids. Methods Using gene chip technique, the gene differential expression of 2 tissues were observed following RNA labeled with different fluorescences (Cy3 and Cy5) hybridized to gene chip. Results Among 4224 genes on gene chip, 394 were up regulated more than 2 folds in thymic carcinoid tissues, 23 of which were associated with cell mitosis; 51 genes were upregulated more than 5 folds, 1 of which (PAK3) was associated with cell mitosis. Conclusion A group of differentially expressed genes were observed between the thymic carcinoids and normal thymic tissues.These overexpressed and cell mitosis-associated genes probably play a role in the pathogenesis of thymic carcinoid tumors.

Objective:To summarize the clinical feature of functional distant metastasis (DM) of differentiated thyroid cancer (DTC) and observe the efficacy of 131I treatment. Methods:Between August 2008 and January 2021, a total of 13 DTC patients (4 males, 9 females; age 26-75 years) with functional DM from Henan Provincial People′s Hospital were retrospectively analyzed. Clinical data of patients were collected, including pathological type, metastasis size, metastasis location, and thyroid stimulating hormone (TSH) before the first 131I treatment. Efficacy of 131I treatment in patients with functional DM-DTC was evaluated by response evaluation criteria in solid tumors (RECIST) 1.1 and thyroglobulin (Tg). Complete remission (CR) and partial remission (PR) were considered as effective. Wilcoxon signed rank test was used to analyze the maximum diameter change of metastatic lesions before and after 131I treatment. Results:Among 13 DM-DTC patients, 8 were follicular thyroid cancer (FTC), 5 were papillary thyroid cancer (PTC). Metastasis lesions were mainly located in lungs ( n=12) and bones ( n=6). There were 12 patients with maximum metastasis diameter ≥1 cm, and 3 patients with TSH≥30 mU/L before the first 131I treatment. Nine patients were assessed as PR by RECIST 1.1, 3 patients were assessed as CR by RECIST 1.1 and the value of Tg, and 1 patient was assessed as PR by the changing of Tg. The effective rate of 131I treatment for patients with functional DM-DTC was 13/13. The maximum metastasis diameter was significantly decreased after 131I treatment (2.6(1.6, 3.3) vs 1.2(0.1, 2.2) cm; z=-3.06, P=0.002). Conclusion:Patients with functional DM-DTC are characterized by high proportion of FTC and the maximum metastasis diameter ≥1 cm, low proportion of TSH ≥30 mU/L before the first 131I treatment, and high effective rate of 131I treatment.