Nuclear medicine molecular imaging has the characteristics of non-invasiveness,high sensitivity,spatiotemporal dynamic visualization,qualitative and quantitative analysis,and by virtue of the advantages of fusion imaging technology,it combines the features of functional metabolism and anatomical structure.Nuclear medicine molecular imaging evaluation is integrated throughout the management of radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC),including defining RAIR,exploring the lesions,guiding treatment decisions,evaluating efficacy,and assessing prognosis.131I-whole body scan(131I-WBS)is critical for determining RAIR-DTC.Diagnostic 131I-WBS can be used to explore postoperative residual thyroid and suspected iodine-avid metastases before 131I treatment,which is helpful for subsequent 131I treatment decisions.Post-treatment 131I-WBS can further clarify the iodine uptake characteristics of lesions and explore lesions not shown by diagnostic WBS,providing a reference for clarifying the clinical stage of patients and formulating follow-up management plans.The iodine uptake ability of lesions shown by post-treatment 131I-WBS can also predict the therapeutic efficacy of 131I treatment.131I-WBS combined with biochemical changes and other imaging examinations can also be used to evaluate the therapeutic efficacy of 131I treatment.18F-FDG positron emission tomography and computed tomography(PET/CT)is mainly used for high-risk DTC patients with persistently elevated serum thyroglobulin(Tg)or Tg antibody(TgAb)levels and negative 131I-WBS,and can explore and locate lesions.Combining 18F-FDG PET/CT with 131I-WBS provides a thorough evaluation of the overall tumor burden.The uptake of 18F-FDG by DTC metastases indicates poor 131I treatment response and poor prognosis for patients,and is a predictor of rapid disease progression and an increased risk of tumor-specific death.After local or systemic treatment of RAIR-DTC lesions,the early metabolic response to treatment can predict the clinical benefit of patients,allowing for timely adjustment of treatment strategies.In addition,various new radionuclide imaging techniques targeting angiogenesis(such as RGD peptides and prostate specific membrane antigen),fibroblast activation protein and somatostatin receptor can be used as supplementary means when 18F-FDG PET/CT is negative to detect RAIR-DTC lesions.They can also screen patients who qualify for targeted radionuclide therapy based on the uptake ability of imaging agents.These novel theranostics provide new options for progressive RAIR-DTC patients after multiline treatment.

Nuclear medicine molecular imaging has the characteristics of non-invasiveness,high sensitivity,spatiotemporal dynamic visualization,qualitative and quantitative analysis,and by virtue of the advantages of fusion imaging technology,it combines the features of functional metabolism and anatomical structure.Nuclear medicine molecular imaging evaluation is integrated throughout the management of radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC),including defining RAIR,exploring the lesions,guiding treatment decisions,evaluating efficacy,and assessing prognosis.131I-whole body scan(131I-WBS)is critical for determining RAIR-DTC.Diagnostic 131I-WBS can be used to explore postoperative residual thyroid and suspected iodine-avid metastases before 131I treatment,which is helpful for subsequent 131I treatment decisions.Post-treatment 131I-WBS can further clarify the iodine uptake characteristics of lesions and explore lesions not shown by diagnostic WBS,providing a reference for clarifying the clinical stage of patients and formulating follow-up management plans.The iodine uptake ability of lesions shown by post-treatment 131I-WBS can also predict the therapeutic efficacy of 131I treatment.131I-WBS combined with biochemical changes and other imaging examinations can also be used to evaluate the therapeutic efficacy of 131I treatment.18F-FDG positron emission tomography and computed tomography(PET/CT)is mainly used for high-risk DTC patients with persistently elevated serum thyroglobulin(Tg)or Tg antibody(TgAb)levels and negative 131I-WBS,and can explore and locate lesions.Combining 18F-FDG PET/CT with 131I-WBS provides a thorough evaluation of the overall tumor burden.The uptake of 18F-FDG by DTC metastases indicates poor 131I treatment response and poor prognosis for patients,and is a predictor of rapid disease progression and an increased risk of tumor-specific death.After local or systemic treatment of RAIR-DTC lesions,the early metabolic response to treatment can predict the clinical benefit of patients,allowing for timely adjustment of treatment strategies.In addition,various new radionuclide imaging techniques targeting angiogenesis(such as RGD peptides and prostate specific membrane antigen),fibroblast activation protein and somatostatin receptor can be used as supplementary means when 18F-FDG PET/CT is negative to detect RAIR-DTC lesions.They can also screen patients who qualify for targeted radionuclide therapy based on the uptake ability of imaging agents.These novel theranostics provide new options for progressive RAIR-DTC patients after multiline treatment.

Objective:To systematically analyze the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and treatment of SFTS.Methods:Relevant studies of SFTS from six databases, including China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, PubMed, Cochrane Library and Embase from January 2009 to May 2019 were systematically searched and identified. The literatures were screened and the data of patients′ epidemiology, clinical manifestations, laboratory examinations and prognosis were obtained. Revman 5.2 software was used for meta analysis.Results:Sixty-eight Chinese literatures and fourteen English literatures encompassing 6 780 patients with SFTS were included in the final analysis. Of these patients, 845 cases (12.46%) died. SFTS mostly occurred in mountainous and hilly areas, and farmers (3 637 cases) were the usual victims. The onset season was mostly in summer and the peak was from May to August each year. There were 1 434 patients had a clear history of tick bites, and 21 cases were human-to-human transmitted.There were 6 071 cases (89.54%) presented with fever, 5 407 cases (79.75%) presented with fatigue, 3 140 cases (46.31%) presented with muscle soreness, and 2 300 cases (33.92%) presented with chills.Using random effects model for meta analysis, the levels of creatine kinase (CK) (mean difference ( MD)=500.40, 95% confidence interval ( CI) 380.51-620.28, P<0.01) and lactic acid dehydrogenase (LDH)( MD=442.81, 95% CI 152.85-732.78, P=0.003) in severe patients were both higher than those in mild patients, and the difference were both statistically significant. The risk of death increased in patients aged>60 years( MD=8.19, 95% CI 4.03-12.36, P<0.01). The levels of CK( MD=530.92, 95% CI 29.27-1 032.56, P=0.040), LDH( MD=609.28, 95% CI 80.25-1 138.31, P=0.020), urea nitrogen ( MD=4.67, 95% CI 3.05-6.30, P<0.01) and creatinine ( MD=43.05, 95% CI 23.49-62.62, P<0.01) of patients in the death group were all higher than those in the survival group. The differences were all statistically significant. Conclusions:During the course of SFTS, the patients may show impaired blood system, heart, liver and kidney functions with high mortality. Clinicians should timely monitor the changes of blood routine, myocardial enzyme spectrum, liver and kidney functions and other indicators, so as to find cardiovascular and other system complications as early as possible. Timely treatment could not only reduce liver, heart and other organ injuries, but also reduce mortality.

Objective To studythe role of p16 and cyclin in the genesis and development of endometrial car-cinoma. Methods 12 cases of normal endometrium, 22 cases of proliferative endometrium and 41 cases of endome- trial carcinoma were detected for the expression of p16 and cyclin D1 by means of immunohistochemical S-P. Results In normal endometrium p16 was expressed while cyclm D1was almost negative in the proliferative phase, but both of them were negative in the secretory phase. Among the groups of the simple and compound hyperplasia, the atypical hyperplasia and the endometrial carcinoma,the expression of p16 showed a descending tendency, while the expression of cyclin showed an ascending tendency. In endometrial carcinomas the expression of p16 was significantly lower than that of normal endometrium and proliferative endometrium (P<0. 01 ,P<0.05). However, the expression of cy- clin in proliferate endometrium and endometrial carcinoma was significantly higher than that in normal endometri- un (P<0. 05,P<0. 01). The overexpression of cyclin D1 in the atypical hyperplasia group was obviously different from that in the simple and compound hyperplasia group (P＜0.01). In endometrial carcinoma,the expression of p16 was decreasing with the descending of cell differentiate degree, on the opposite, the expression of cyclin was in-creased and there existed a negative correlation between them. It was also observed that the overexpression of cyclin was significant different between and ( P ＜0. 01 ). Conclusionp1 6 is a negative regulating factor of cell cycle in endometrial carcinoma, while cyclin is a positive one. Both of them are important in the genesis and devel-opment of endometrial carcinoma. The Iow expression of p1 6 and the overexpression of cyclin are related with the malicious biological behaviors of endometrial carcinoma and maybe play an important role in the judgement of prog- nosis. Overexpression of cyclin may be an earlier molecular event in the genesis of endometrial carcinoma.