Metaiodobenzylguanidine (MIBG) is an analog of norepinephrine that accumulates in sympathetic nerve endings soon after intravenous administration. The degree of accumulation reflects the uptake, storage and release of transmitters by noradrenergic neurons. Myocardial imaging with ¹²³I labeled MIBG ( ¹²³I-MIBG) can be used to estimate the extent of local myocardial sympathetic nerve damage, which has been widely used in the diagnosis and treatment of various heart diseases. In recent years, numerous studies have been carried out on the application of ¹²³I-MIBG in the diagnosis of degenerative diseases of the nervous system (such as Parkinson's disease and dementia of Lewy body), and have made some achievements. The purpose of this review is to summarize the current clinical application of ¹²³I-MIBG myocardial imaging in the diagnosis of dementia with Lewy bodies, the problems in imaging technology and the possible research directions in the future, so as to provide valuable reference information for clinicians to reasonably and accurately apply this technology in the early diagnosis and discrimination of dementia.
Humans ; Lewy Bodies ; 3-Iodobenzylguanidine ; Lewy Body Disease/diagnostic imaging* ; Iodine Radioisotopes

Carney complex(CNC) is a rare disease in endocrinology, with osteochondromyxoma accounting for only 1% of it. This article details the diagnosis and treatment of a young female patient with recurrent fracture, full moon face and perioral spotted pigmentation. Combined with clinical manifestations, auxiliary examination and pathology, Carney complex with osteochondromyxoma was diagnosed. Multiple bone deformities in this case should be differentiated from McCune-Albright syndrome and ectopic ACTH secreting tumor with multiple bone metastases. The report of this case is helpful to improve the understanding of osteochondromyxoma in endocrinology, radiology, orthopedics and other disciplines, so as to avoid missed diagnosis and misdiagnosis.

With the reform of medical insurance payment mode and the promotion of medical insurance policy, medical insurance management has become the core of public hospital operation and management. According to the business scenario of medical insurance management in public hospitals, medical insurance intelligent management can be divided into three levels: automatic medical insurance intelligent management engine based on rules, digital medical insurance management assistance based on dialogue user interface and hospital medical insurance management brain based on deep learning. In August 2020, under the requirements of hospital intelligent management standards, a tertiary hospital broke through the traditional medical insurance management mode to launch the practice of digital enabled panoramic scene intelligent management of medical insurance, which included medical insurance intelligent business audit, medical insurance intelligent reconciliation, medical insurance intelligent cost control and medical insurance intelligent management cockpit. These measures had realized the intellectualization and standardization of medical insurance management and improved the overall operation efficiency of the hospital.

2-［ F］-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ( F-FDG PET/CT) combining positron emission tomography with computed tomography is used to evaluate the body's glucose metabolic changes under different conditions. In addition to its established role in oncological imaging, F-FDG PET/CT has clinical utility in suspected inflammation and infection. The technique can identify the source of infection in a timely fashion ahead of morphological changes, map the extent and severity of inflammation, guide the site for tissue biopsy and assess therapy response. This article reviewed the use of F-FDG PET/CT in infection and inflammation, such as fever of unknown origin, sarcoidosis, vessel vasculitis, osteomyelitis, joint prosthesis or implant-related complications, human immunodeficiency virus-related infections, and other indications, such as inflammatory bowel disease, so as to provide reference for clinicians to select F-FDG PET/CT to help them in the diagnosis and treatment of inflammatory diseases.
Fluorodeoxyglucose F18 ; Humans ; Inflammation ; Positron Emission Tomography Computed Tomography ; Radiopharmaceuticals

Objective To observe the effect of acute normovolemic hemodilution(ANH)combined with enhanced recovery after surgery(ERAS)on immune function in patients undergoing hepatic lobectomy. Methods 80 patients were divided into two groups:ERAS group(group E),ANH combined with ERAS group(group AE). bleeding volume,blood transfusion,infused fluid volume,urine output during operation and clinical index after surgery were recorded. Exhaust and defecation time ,fluid intake time and hospitalization duration were also record-ed. Blood samples were obtained from the patients at 30 min before anesthesia induction(T1),immediately(T2), 24 h(T3),3 d(T4)and 7 d(T5)after the end of operation for determination of the expression of CD3+,CD4+, CD8+ on T cells and natural killer cell. Results In group E ,CD3+,CD4+ T-lymphocytes and NK cells at T2-3 decreased as compared with T0. Compared with group E ,no allogeneic blood transfusion cases were found and clinical index duration was shorter in group AE. CD3+,CD4+T-lymphocytes and NK cells at T2-3 increased in group AE as compared with those in Group E. The difference is significant (P < 0.05). Conclusion ANH combined with ERAS can decrease allogenic blood transfusion and increase post-operation immunologic function ,shorten the postoperative hospitalization time.

Objective To evaluate the value of pre-operative 99Tcm-MIBI SPECT/CT in patients with HPT by comparing with planar 99Tcm-MIBI and ultrasound imaging. Methods A total of 57 patients (9 males, 48 females; average age: (52.9±15.5) years) were enrolled into this retrospective study. They all underwent 99Tcm-MIBI planar scintigraphy, 99Tcm-MIBI SPECT/CT and ultrasound during March to October in 2016. All patients received parathyroidectomy and the surgical pathology was considered as the gold standard. The diagnostic efficiencies were compared using χ2 test. Results A total of 86 HPT lesions were confirmed, including 47 lesions in 46 PHPT patients and 39 lesions in 11 SHPT patients. The sensitivities of SPECT/CT, planar, ultrasound and combined imaging (planar plus ultrasound) were 87.21%(75/86), 69.77%(60/86), 65.12%(56/86) and 84.88%(73/86), respectively. The overall sensitivity of SPECT/CT was significantly higher than that of individual planar imaging and that of ultrasound (χ2 values: 4.691 and 7.818, both P<0.05), but similar to that of the combined imaging (χ2=0.044, P>0.05). No significant difference was observed among the specificities of all these modalities (χ2=2.219, P>0.05). For PHPT lesions, the sensitivities of SPECT/CT, planar imaging, combined imaging and ultrasound were 9574%(45/47), 93.62%(44/47), 97.87%(46/47) and 76.60%(36/47), respectively. No statistically significant difference was found in the sensitivity of the former 3 modalities (χ2=1.044, P>0.05), but the sensitivity of ultrasound was the lowest(χ2=16.223, P<0.05). For SHPT, the sensitivities of the corresponding 4 modalities were 76.92%(30/39), 41.03%(16/39), 51.28%(20/39) and 69.23%(27/39), respectively. SPECT/CT was significantly superior to planar imaging and ultrasound(χ2 values: 10.386 and 5.571, both P<0.05), but comparable to the combined imaging(χ2=0.586, P>0.05). Only SPECT/CT could accurately localize 5 ectopic HPT lesions. Conclusion Compared to planar imaging and ultrasound, SPECT/CT has higher sensitivity for SHPT patients, and could provide precise localization for ectopic lesions, thus facilitating patient planning for minimally invasive surgery.

Norepinephrine transporter (NET) transfection leads to significant uptake of iodine-131-1abeled metaiodobenzylguanidine (131I-MIBG) in non-neuroendocrine tumors.However,the use of 131I-MIBG is limited by its short retention time in target cells.To prolong the retention of 131I-MIBG in target cells,we infected hepatocarcinoma (HepG2) cells with Lentivirus-encoding human NET and vesicular monoamine transporter 2 (VMAT2) genes to obtain NET-expressing,NET-VMAT2-coexpressing,and negative-control cell lines.We evaluated the uptake and efflux of 131I-MIBG both in vitro and in vivo in mice bearing transfected tumors.NET-expressing and NET-VMAT2-coexpressing cells respectively showed 2.24 and 2.22 times higher 131I-MIBG uptake than controls.Two hours after removal of 131I-MIBG-containing medium,25.4％ efflux was observed in NET-VMAT2-coexpressing cells and 38.6％ in NET-expressing cells.In vivo experiments were performed in nude mice bearing transfected tumors;results revealed that NET-VMAT2-coexpressing tumors had longer 131I-MIBG retention time than NET-expressing tumors.Meanwhile,NET-VMAT2-coexpressing and NET-expressing tumors displayed 0.54％ and 0.19％,respectively,of the injected dose per gram of tissue 24 h after 131I-MIBG administration.Cotransfection of HepG2 cells with NET and VMAT2 resulted in increased 131I-MIBG uptake and retention.However,the degree of increase was insufficient to be therapeutically effective in target cells.

Objective To investigate the biokinetics of 131 I and its absorbed dose in patients with metastatic DTC. Methods Forty?one patients with metastatic DTC who were referred to 131 I therapy were prospectively recruited from September 2009 to September 2011. Scintigraphic images were serially acquired after the ingestion of 131I (3.70-9.25 GBq) to assess the biokinetics. CT was used to measure the masses of the DTC lesions. Calculation of absorbed doses to DTC lesions was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine and Molecular Imaging. Kruskal?Wallis rank sum test was used to compare the differences of absorbed dose among different tumor deposits. Results In total, 59 io?dine?avid metastatic lesions (35 in cervical lymph node, 17 in lung and 7 in bone) in 41 patients were evalu?ated and the mean absorbed dose of DTC lesions was (10.4±6.5) Gy/GBq, with range of 0.1 to 136.2 Gy/GBq. The median absorbed dose was 11.3 Gy/GBq for lymph node metastase, 10.1 Gy/GBq for lung metastases and 9.6 Gy/GBq for bone metastases. There were no statistically significant differences in absorbed doses a?mong the metastases of lymph node, lung and bone ( Z=0.907, P>0.05) . Conclusion A wide inter?lesion variation of absorbed dose to metastatic DTC is observed.

Objective To clone and identify the heat shock factors(HSFs)of Schistosoma japonicum and analyze its molec?ular structure and alternative splicing pattern. Methods The New Zealand rabbits were infected with the cercariae of Schistoso?ma japonicum and were killed and dissected 42 days post?infection,and the adult worms of S. japonicum and the livers of the rabbits were harvested. Then,the total RNA was extracted by using Trizol reagent. The Sj?hsf open reading frame(ORF)and the alternative splicing fragments were amplified by RT?PCR from the female,male and egg samples,then cloned and verified by enzyme digestion and sequencing. DNAMAN 8.0,InterPro,Mega 6 combined with the Internet databases were utilized to clarify the gene structure,functional domains,alternative splicing pattern,and the homology and phylogenetic tree of HSFs. Re?sults Sj?hsf ORF and the alternative splicing fragments were amplified from the female,male and egg samples of S. japonicum by RT?PCR. After cloning,the positive recombinant plasmids pBSjHSFf?F,pBSjHSFf?M,pBSjHSFf?E containing Sj?hsf ORF, pBSjHSFs?F,pBSjHSFs?M,pBSjHSFs?E with Sj?hsf alternative splicing fragments were identified by enzyme digestion and se?quencing. Three alternative splicing Sj?hsf isoforms were observed through sequence analysis:Sj?hsf?isoform1(2 050 bp),Sj?hsf ?isoform2(2 086 bp)and Sj?hsf?isoform3(2 111 bp);the GenBank accession numbers were KU954546,KX119143 and KX119144,respectively. All the three isoforms located in the same Contig SJC_S000780 of S. japonicum genome and all ex?pressed at female,male and egg stages,but Sj?hsf?isoform1 with a high?level expression. Sj?HSF?isoform1(671 aa)and Sj?HSF?isoform2(683 aa)had DBD(DNA binding domain),HR?A/B and HR?C domains,while Sj?HSF?isoform3(282 aa)stopped in advance without HR?C domain. Phylogenetic tree analysis of HSFs illustrated that Sj?HSFs belonged to HSF1 family,with a close phylogenetic relationship to Sm?HSFs. Conclusions There are three alternative splicing isoforms of Sj?HSF existing in the female,male and egg stages of S. japonicum,but Sj?HSF?isoform1 expresses in a high?level. This study lays the foundation for further study on molecular mechanisms of Sj?HSFs in regulating the heat shock response system.

OBJECTIVETo examine the expression profile and immunofluorescence localization of the major egg antigen p40 of Schistosoma japonicum (Sjp40) during granuloma formation in the liver of infected New Zealand white rabbits.

METHODSNew Zealand white rabbits were infected with S. japonicum cercariae, and the livers were harvested at 29 and 45 days post-infection (dpi). The total RNA of the liver tissues was extracted for expression profiling of Sjp40 by quantitative reverse transcription-PCR (qRT-PCR) with GAPDH of S. japonicum as the endogenous reference gene. The expression of Sjp40 in the liver were detected by Western blotting using anti-Sjp40 monoclonal antibody (mAb) 9G7 or anti-Toxoplasma gondii tSAG1 mAb Y3A8 (control) as the primary antibody. Paraffin sections of the liver were prepared for observing egg granuloma formation using HE staining and for indirect immunofluorescence assay of Sjp40 location in the trapped eggs and egg granulomas.

RESULTSThe level of Sjp40 mRNA in the eggs trapped in rabbit livers was significantly higher at 45 dpi than that at 29 dpi (P<0.05), and Western blotting confirmed the presence of Sjp40 protein in the rabbit livers at both 29 and 45 dpi. Immunofluorescence assay demonstrated localized expression of Sjp40 in the immature eggs in the rabbit liver at 29 dpi, but at 45 dpi fluorescence was detected in clusters of mature eggs containing miracidium and in the surrounding egg granulomas.

CONCLUSIONSThe transcriptional levels of Sjp40 significantly increased with the maturation of eggs trapped in the rabbit livers. Sjp40 protein spread from the eggs to the surrounding egg granuloma at 45 dpi when acute liver granulomatous lesions occur, suggesting that Sjp40 plays a key role in egg granulomas formation in the livers of infected New Zealand white rabbits.

Animals ; Antibodies, Monoclonal ; Antigens, Helminth ; metabolism ; Fluorescent Antibody Technique ; Gene Expression Profiling ; Granuloma ; parasitology ; Helminth Proteins ; metabolism ; Liver ; parasitology ; RNA, Messenger ; Rabbits ; Schistosoma japonicum ; Schistosomiasis japonica