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Fibroblast activation protein (FAP) is highly expressed in most epithelial tumors, and FAP inhibitors (FAPIs) have been used in tumor diagnosis and treatment. Taking FAP as the target, new kinds of tumor imaging and therapeutic radiopharmaceuticals can be developed. FAPIs have been used in the preclinical and clinical researches as the carrier of tumor imaging and treatment. This article reviews the research progress of FAPIs in nuclear medicine imaging and treatment.
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Objective To explore the efficiency of 6-18 F-fluoro-L-3,4-dihydroxyphenylalanine (18 F-FDOPA) PET/CT imaging in the diagnosis of pheochromocytoma/paraganglioma (PPGLs). Methods Twenty-six patients (15 males, 11 females;age:13-76 years) who were suspected of PPGLs with adrenal or retro-peritoneal mass were enrolled into this prospective study. All patients underwent 18 F-FDOPA PET/CT ima-ging. The clinical data, laboratory data and imaging results were collected. Region of interest ( ROI) was drawn on the liver and lesions, and the mean standardized uptake value ( SUVmean ) of the liver and the max-imum standardized uptake value ( SUVmax ) of lesions were calculated, as well as the ratio of tumor/lesion ratio ( T/L) . Based on the pathological results considered as the gold standard, the diagnostic efficiency of 18 F-FDOPA PET/CT imaging in PPGLs was calculated and compared with that of CT/MR. Besides, receiv-er operating characteristic ( ROC) curve analysis of T/L was used. Results Twenty-five patients were path-ologically confirmed, including 12 patients with PPGLs and 13 patients with non-PPGLs. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18 F-FDOPA PET/CT ima-ging was 11/12, 12/13, 92.00％(23/25), 11/12 and 12/13, respectively. The area under the ROC curve of T/L was 0.978, with the cut-off value of 1.55. 18 F-FDOPA PET/CT imaging totally detected 29 positive foci, including 12 of pheochromocytoma (PCC) and 17 of paraganglioma (PGL). Among those 18F-FDOPA positive PGL foci, 11 were detected by CT/MR, while 6 with diameter less than 1 cm were missed. Conclu-sion 18 F-FDOPA PET/CT imaging can detect more small PGL lesions than CT/MR, suggesting that it may be a proper imaging modality of PPGLs.
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Histone methyltransferase modulates heterochromatin formation,genomic imprinting and genetic transcription by regulating the combination of histones and DNA.As encoding genes of histone methyltransferase,mixed-lineage leukemia (MLL) genes are found to have close relationship with tumors.Recently,MLL2,a member of this family,has been found highly expressed anomalously in breast cancer,colorectal cancer and lymphoma.Whether MLL2 participates in the progression of cancer,the time phase of its participation and its specific role are still remained to further study.
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Objective Compared with haloperidol treatment,naloxone and naloxone combined haloperidol treatments were assessed in their efficacy and safety for excited type delirium in elderly.Methods The elderly patients with delirium were divided into haloperidol treatment (H),naloxone treatment (N) and combined treatment (C) in a prospective randomized controlled design.Delirium score scale (DSS) was used before and after treatments respectively.Clinical global impression scale-severity of illness (CGI-SI) score was evaluated daily to assess the onset time and improvement of delirium.Agitation-calmness evaluation scale (ACES) observed calmness effect in agitated patients before and after every medication intervention.Treatment emergent symptom scale (TESS) assessed side effects of all medications.Results The duration of three groups(H(4.0 ±2.9)d,N(4.2± 3.5) d,C (3.2 ± 3.2) d) had no significant difference (P ＞ 0.05) by multiple comparison.Compared the onset time of three groups (H (2.4 ± 1.6) d,N (2.4 ± 1.4) d,C (1.3 ± 0.9) d),the combined group was faster than the other two groups (all P ＜ 0.05),no significant difference between the two groups(P ＞ 0.05).DSS scores had no significant differences (P＞ 0.05) in three groups before treatment,so did CGI-SI scores.In the end,DSS scores were(H:18.8 ± 11.5,N:27.7 ± 7.2,C:29.5 ± 5.6) respectively.Statistically naloxone group and combined group with no significant difference (P ＞ 0.05),were better than the haloperidol group (all P ＜ 0.01) in recovery.At the same time CGI-SI scores were (H:3.3 ± 1.5,N:2.5 ± 1.5,C:1.8 ± 0.9) respectively.Statistically combined group was better than the haloperidol group (P ＜ 0.01),and no significant difference with naloxone group (P ＞ 0.05).Three groups had no significant difference in ACES scores (P ＞ 0.05) before and after medication interventions(H:5.9 ± 1.6,N:6.2 ± 1.8,C:6.4 ± 1.6) (P ＞ 0.05).Haloperidol group had 4 cases of extrapyramidal symptom evaluated by TESS and combined group had 2 cases.Two groups had no significant difference (Chisquare test P ＞ 0.05) in extrapyramidal symptom incidence.The naloxone group showed no side effects.Conclusion Naloxone combined haloperidol is slight better than naloxone,more than haloperidol in terms of efficacy.Haloperidol equally with combined medication showed more side effects than naloxone.
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Objective To set up the experimental animal model of the filial rats exposed clozapine in the pregnant clay and expect to know what is the effect on the offspring exposed the antipsychiatrie in gestation.Methods Female Wister rats were divided into both the control group (n=17)and elozapine group (n=2.5) which were intraperitoneally injected saline and clozapine respectively from pregnant day 6 to day 15,and their pup rats were examined development indexes such as the physical growth ,neural reflex,neural behavior and the expression of MAPK44/42 in brain in neonatal stage.Results it was shown that clozapine- exposed in pregnant day lead to the retardation of the weight of filial rats in earlier age such as postnatal day 4 (PND4) and PND7(F=12.56/7.51,P=0.001/0.008).As for neural reflex,the time of cliff avoidance of rats was significantly delayed in PND 3 and day 9 (F=4.969/4.348 ; P=0.03/0.041),and the ratio of positive response of air righting decreased compared with the control group in PND13 and PND15 (F=7.959/6.475,P=0.007/0.016).There was no difference between two groups on the behavior of the filial rats in the open field of filial rats.The expression of PhoMAPK44/42 in hippocampi of exposed-clozapine offspring in PND15 was significantly lower than the control' s(F=18.729/23.824,P=0.001) ,however,no difference was demonstrated on the expression of MAPK44/42 in hippocamaias well as the expression of both Pho-MAPK44/42 and MAPK44/42 in forehead cortex in two groups.Conclusion The resuits suggest the aberration of both physical and mental development of filial rats exposed clozapine in gestation.
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@#Objective To investigate the characteristics of delirium after cerebral infarction in elderly demented patients.Methods40 elderly demented patients with delirium after cerebral infarction were assessed with delirium score scale(DSS),mini-mental state examination (MMSE) during delirium and after delirium disappeared respectively.ResultsThe prominent symptoms from DSS as delirium were disturbance in sleep-awake cycle,speed of onset of behavior change,incoherent thought process,abnormalities of orientation,and misinterpretation of surroundings.The disturbance of sleep-awake cycle and speed of onset of behavior change recovered dramatically as delirium disappeared,however,the abnormalities of orientation and misinterpretation of surroundings mildly improved.The items with lower scores from MMSE as delirium were abilities of attention and calculation,abilities of recall,time disorientation,and three step language orders.The function of language from the items of MMSE improved very well as delirium disappeared,especially the three step language orders,however,the abilities of recall,abilities of attention and calculation,time disorientation mildly improved.ConclusionDetermination of the clinical features of delirium following dementia is helpful to distinguish the delirium from dementia.
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BACKGROUND: The pathway of cholinergic nerve also with rich opium receptor in the septum-hippocampus areas is an important part for spatial learning memory. There is study that naloxone, an antagonist of opium receptor, can relieve the inhibition of activity of cholinergic neuron caused by opioid peptides in the medial septum and hippocampus, promote the release of acetylcholine (Ach)into synaptic cleft, and improve the impairment of spatial memory.OBJECTIVE: To investigate the intervention effect of naloxone on impairment of spatial working memory of rats induced by scopolamine, a blocker of cholinergic muscarinic receptor.DESIGN: A randomized and controlled trial taking experimental animals as subjects.SETTING: Geriatric Department of Wuzhongpei Memorial Hospital at Shunde District of Foshan City.MATERIALS: The experiment was completed from 2003 to 2004 at the Experimental Animal Center of Medical School of Shantou University. A total of 21 SD rats of clean grade were at random divided into three groups:normal group, scopolamine group and naloxone group (scopolamine and naloxone), with 7 in each group. Build up of Morris water maze: A circular rubber pool, 2 m diameter and 55 cm height, with 30 cm depth of water at20℃-22℃, was built up. At the center of its southeast quadrant, a cylinder platform installed, which was 12 cm in diameter and 1.5 cm below the water surface, the only place for rats to escape death. The water of the pool was covered with bits of white polythene. In the house, there were light tubes, windows and tables in fixed place served as the outside cues of the pool. On the four walls of the pool, there were several randomly-hung and eye-catching markers as inside cues.METHODS: Medicines were intraperitoneally given 30 minutes before the experiment for rats in each group, scopolamine 0.4 mg/kg and naloxone 3mg/kg in two treatment groups, the equal volume saline in normal group.Then escape latencies of rats were recorded for two successive trials through a delayed-matching\task in self-made Morris water maze. After the Morris water maze examination, all rats were put to death, the tissue of left brain was selected, conventionally treated and sliced. The expression level of cholinacetyltranslase (ChAT) in areas of hippocampus and prefrontal lobe were quantitatively assayed by immunohistochemistry and the computerized image technique. At the same time, the tissue of right brain in two rats of each group was selected, the hippocampus was immediately freed, and the change of CAI region of the hippocampus observed with electron microscope.trastructure of CA1 region of hippocampus in rats.cies of two successive trials were very significantly different in normal group[(46.4±17.7)vs (13.4±8.2)s, t =7.32, P＜ 0.01], and significantly different in naloxone treatment group[ (27.9±14.3)vs (9.0±3.8)s, t=3.19, P＜ 0.05], but not pression of ChAT in pyramidal cells in CA1 and CA3 regions of hippocampus and in neurons of prefrontal cortex of three groups was not different statisticalhippocampus in all groups was normal; However, the ultrastructure of the neuron synapsis was abnormal obviously in scopolamine group: The synaptic vesicles were markedly different in size; the vesicles obviously gathered in the part of presynaptic membrane with an enhanced density, and large and sparse in the distal part. Both presynaptic and postsynaptic membranes were indistinct and fused, synaptic cleft not clear, and postsynaptic dense materials not homogeneous, indistinct and without clear borderline.CONCLUSION: Scopolamine could impair the power of spatial working memory in rats. Naloxone could promote great release of Achin neuron synaptic vesicles into synaptic clefts, and increase the density of postsynaptic dense materials, relieve the inhibition of opioid peptide to cholinergic neuron activity in the medial septum and hippocampus, and could improve space memory injury.
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Objective To find out about the current situation of mental health institutions in Guangdong. Methods An investigation via self-made questionnaires was made on the current situation of 62 mental health institutions in the province and a comparison was made of 22 mental hospitals between now and four years ago. Results Throughout the province, there were 9901 psychiatric beds, 1236 psychiatric doctors and 1909 psychiatric nurses, averaging respectively 1.16 beds, 0.15 doctors and 0.22 nurses per 10 thousand people. The bed utilization ratio was mostly 82.00% and only 12.00% of the mental health institutions adopted open management. A comparison of the 22 mental hospitals between now and 4 years ago showed that the numbers of hospital beds, doctors, doctors with associate senior professional tides and above, ECG machines, computers, hospital total income per year, and monthly charges for hospitalization had increased while the area of workplaces, the bed utilization ratio, the average number of daily outpatient visits, the average number of daily outpatient psychological consultations, and equipment other than ECG machines and computers remained unchanged and government funding had decreased. Couclusion The major problems with the mental health institutions in the province are shortage and lack of balance in the allocation of mental health resources, backwardness in the modes of management, difficulty in internal development, and reduction of government input.