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Objective At present, the clinical significance and biological function of Msi1 (Musashi1) in colon cancer are still not very clear. So, a comprehensive understanding of the expression and role of Msi1 in colon cancer has important clinical and theoretical significance. This study is to investigate the clinical significance of Msi1 gene and its biological role in colon cancer by lentiviral vector to interfere with Msi1 gene expression in colon cancer SW480 cells. Methods 20 colon cancer specimens were collected from the Second Surgery Department of the Fourth Hospital of Hebei Medical University from October 2013 to May 2014. Each specimen was collected from the cancer tissue and the adjacent intestinal wall tissue. Western blot was performed to determine the protein expression of Msi1 in tumor tissues and adjacent normal tissues from colon cancer patients. The relationship between Msi1 protein expression and clinical characteristics was further analyzed. The lentiviral vector was used to construct a stable SW480 cell line with low expression of Msi1. The lentivirus containing two different interference sequences (shmsi1-1 and shmsi1-2) was transfected into the target cells, and the colon cancer cells were divided into control group (without any treatment), shMsi1-1 group (transfected shMsi1-1) and shMsi1-2 group (transfected shMsi1-2). The two lentivirus silencing effects were detected by Western blot. Cell proliferation was detected by CCK-8 assay, Clone formation assay was conducted to detect the colony forming ability, and Flow cytometry analysis was used to examine the apoptosis rate. Results The protein expression of Msi1 in colon cancer tissue(0.863±0.208) was significantly higher than that in adjacent normal tissues(0.272±0.078), and the difference was statistically significant(P<0.001). The relative expression of Msi1 protein in shMsi1-1 and shMsi1-2 groups (0.299±0.111 and 0.207±0.087) was significantly lower than that in the control group (1.000±0.149) (P<0.001). The proliferation rate of shMsi1-1 and shMsi1-2 at 48 h and 72 h was significantly lower than that of the control group (P<0.01). Compared with the control group (296.33±64.04), shMsi1-1 group (92.00±43.31) and shMsi1-2 group (78.67±32.87) were significantly decreased (P<0.01). Compared with the control group [(4.01±0.26) %], the apoptosis rate of shMsi1-1 group, shMsi1-2 group [(10.22±1.04) %, (10.87±1.27) %] was significantly increased (P<0.001). Conclusion Interference with Msi1 gene expression inhibits proliferation of colon cancer SW480 cells and promotes tumor cell apoptosis. This finding provides a new intervention target for the clinical treatment of colon cancer.
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OBJECTIVE@#To evaluate the clinical application of indocyanine green (ICG) visualization by near infrared fluorescence laparoscopy (NIFL) in complex upper urinary tract reconstructions surgery.@*METHODS@#This was a retrospective study of 7 patients who underwent complex surgeries of ureteral reconstruction between May 2019 and October 2019. There were 6 males and 1 female with the age ranging from 24 to 57 years (median age was 47 years). There were 5 cases of right ureteral strictures, of which 3 were proximal ureteral strictures and 2 were multiple and long ureteral strictures caused by radiotherapy. There were 2 cases of left ureteral strictures, of which 1 was ureteropelvic junction stricture and 1 was proximal ureteral stricture. There were 4 cases of secondary repair operations and 3 cases of primary operations. All the patients underwent laparoscopic surgery via the abdominal approach. ICG was injected into the ureter via nephrostomy tube during the operations, and the diseased ureter was identified by NIFL. Among the patients, 2 cases underwent IUPU (Institute of Urology, Peking University) modified ileal ureter replacement, 2 cases underwent ureteroureterostomy, 2 cases underwent appendiceal onlay flap ureteroplasty, and 1 case underwent lingual mucosa onlay flap ureteroplasty.@*RESULTS@#All the operations were successfully completed without open conversion. The localization and separation of ureteral lesions were completed under NIFL. The mean operative time was 187 (135-300) min. The duration of ureteral separation was 15-27 min, and the mean time was 18 min. The estimated blood loss was 15-200 mL, the mean estimated blood loss was 50 mL. There was one patient with ileal ureter replacement who had fever after surgery and responded well to antibiotics. The mean (range) length of postoperative hospital stay was 7 (6-10) days and no postoperative complications of a high grade (Clavien-Dindo Ⅲ and Ⅳ) occurred. Up to now, the mean follow-up duration was 9 (6-11) months, and no indocyanine green toxicity occurred. All D-J stents and nephrostomy were removed successfully 2 months after the operation. Ultrasound showed no obvious hydronephrosis, and CTU (computed tomography urography) showed that the urinary tract was unobstructed and the kidney function was normal.@*CONCLUSION@#The application of ICG in the complex upper urinary tract reconstructive surgery is a safe and easy method to help surgeon to identify the ureter which may reduce the risk of iatrogenic damage and protect the ureteral blood supply.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Indocyanine Green , Laparoscopy , Retrospective Studies , Ureter/surgery , Ureteral Obstruction , Urologic Surgical ProceduresABSTRACT
Objective@#To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery.@*Methods@#A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom, and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0.@*Results@#Compared with the control group, the experimental group had significantly higher scores in theoretical examinations (34.79±2.20 vs. 31.73±3.12, t=4.676, P=0.000) and clinical skill examination (50.06±2.98 vs. 45.82±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2%) thought that the new teaching method could increase their learning interest, 33(97.0%) believed it could improve learning efficiency, 25(73.5%) believed the models obtained by 3D printing had good quality, 32(94.1%) felt that it could improve clinical skills, 28 (82.4%) thought it could enhance the interaction between students and teachers, and 29(85.3%) thought it did not bring extra burden.@*Conclusion@#The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.
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Objective To investigate the application of 3D printing in the flipped classroom in the practice teaching of otolaryngology-head and neck surgery. Methods A total of 68 medical undergraduates of the Grade 2013 in Air Force Medical University were divided into experimental group and control group, with 34 undergraduates in each group. The undergraduates in the experimental group received the teaching method of 3D printing in the with flipped classroom , and those in the control group received traditional teaching. The teaching effect was evaluated by questionnaire and examinations of basic knowledge and clinical skills, Independent-samples t test was used for between-group comparison with SPSS 20.0. Results Compared with the control group , the experimental group had significantly higher scores in theoretical examinations (34.79 ±2.20 vs. 31.73 ±3.12, t=4.676, P=0.000) and clinical skill examination (50.06 ±2.98 vs. 45.82 ±4.68, t=4.449, P=0.000). The questionnaire survey showed that among the 34 undergraduates in the experimental group, 31(91.2％) thought that the new teaching method could increase their learning interest, 33 (97.0％) believed it could improve learning efficiency, 25 (73.5％) believed the models obtained by 3D printing had good quality, 32 (94.1％) felt that it could improve clinical skills, 28 (82.4％) thought it could enhance the interaction between students and teachers, and 29(85.3％) thought it did not bring extra burden. Conclusion The teaching method of 3D printing combined with flipped classroom in the practice teaching of otolaryngology-head and neck surgery can improve students' learning interest, academic scores, and clinical skills, and therefore, it holds promise for application in teaching.
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OBJECTIVE Non-alcoholic fatty liver disease(NAFLD) encompasses a series of patho-logic changes ranging from steatosis to steatohepatitis,which may progress to cirrhosis and hepatocel-lular carcinoma.The purpose of this study was to determine whether Ganoderma lucidum polysaccha-ride peptide (GLPP) has therapeutic effect on NAFLD. METHODS ob/ob mouse model and ApoC3 transgenic mouse model were used for exploring the effect of GLPP on NAFLD. Key metabolic path-ways and enzymes were identified by metabolomics combining with KEGG and PIUmet analyses and key enzymes were detected by Western blotting. Hepatosteatosis models of HepG2 cells and primary hepatocytes were used to further confirm the therapeutic effect of GLPP on NAFLD. RESULTS GLPP administrated for a month alleviated hepatosteatosis, dyslipidemia, liver dysfunction and liver insulin resistance. Pathways of glycerophospholipid metabolism, fatty acid metabolism and primary bile acid biosynthesis were involved in the therapeutic effect of GLPP on NAFLD. Detection of key enzymes revealed that GLPP reversed low expression of CYP7A1,CYP8B1,FXR,SHP and high expression of FGFR4 in ob/ob mice and ApoC3 mice. Besides, GLPP inhibited fatty acid synthesis by reducing the expression of SREBP1c, FAS and ACC via a FXR-SHP dependent mechanism. Additionally, GLPP reduced the accumulation of lipid droplets and the content of TG in HepG2 cells and primary hepato-cytes induced by oleic acid and palmitic acid. CONCLUSION GLPP significantly improves NAFLD via regulating bile acid synthesis dependent on FXR-SHP/FGF pathway, which finally inhibits fatty acid synthesis,indicating that GLPP might be developed as a therapeutic drug for NAFLD.
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Objective To establish and verify the fluctuation of reference intervals for biochestry parameters in routine physical exami-nation. Methods The results of biochemistry parameters,i.e., total protein (TP), albumin (Alb), total bilirubin (T-Bil), alanine aminotransferase (ALT), glucose (Glu), urea (Urea), creatinine (Cr), uric acid (UA), triacylglycerol (TG) and total cholesterol ( TC) from 2 089 healthy subjects in routine physical examination during consecutive 2014, 2015 and 2016 were randomly collected, in which all the results were within the reference range. The ratio (λ1) of the results of 2015 to those of 2014, and ratio (λ2) of the re-sults of 2016 to those of 2015 were calculated. λ1was analyzed statistically to establish the fluctuation of reference interval (CIλ). CIλ was verified by λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and the upper and low-er limits of CIλ. The CIpwas verified by the results of 2016. The ratios of CIpto the upper and lower limits of conventional reference in-terval were calculated. Results The values of CIλwere as follows: TP: 0.91 to 1.08, Alb: 0.91 to 1.08, T-Bil: 0.58 to 1.74, ALT:0.49 to 1.99, Glu: 0.84 to 1.20, Urea: 0.67 to 1.50, Cr: 0.82 to 1.22, UA: 0.77 to 1.32, TG: 0.51 to 1.98 and TC: 0.80 to 1.26. Compared with conventional reference interval, the ratio of the upper and lower limits of CIp was lessened. Conclusion The personal-ized reference interval (CIp) which may increase the sensitivity of conventional reference intervals was established and verified.
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Interstitial lung diseases (ILDs) are a diverse group of pulmonary disorders characterized by various patterns of inflammation and fibrosis in the interstitium of the lung.The underlying pathogene sis of ILDs is complex and associated with multiple rheumatologic conditions,such as systemic sclerosis,rheumatoid arthritis,pollymyositis and dermatomyositis,Sjt(o)gren's syndrome,and systemic lupus erythematosus.As the disease progresses,excessive pulmonary fibrosis impairs alveolar gas exchange and damages pulmonary function.The common methods to diagnose ILDs,such as clinical manifestations,pulmonary function test,and radiological examinations are not specific for ILDs and not able to diagnose ILDs at the early stage due to their low sensitivity.So,the easy way is important to diagnose ILDs.One important biomarker for ILDs is the high-molecular-weight glycoprotein,Krebs von den Lungen-6 (KL-6).KL-6 encoded by the MUC1 gene is a mucin-like glycoprotein with high molecular weight and expressed predominantly on the cell surface of type Ⅱ alveolar epithelial cells,and is detectable in the serum of patients with ILDs.We here report a case of ILDs associated with dermatomyositis and secondary Sj(o)gren's syndrome.A 60-year-old woman was admitted to our hospital with the chief complaints of debilitation,dry mouth,dyspnea and astasia.ILDs associated with dermatomyositis and secondary Sj(o)gren's syndrome was diagnosed clinically when the following criteria were satisfied:(1) development of dyspnea within 2 months of presentation,(2) pulmonary dispersion dysfunction,(3) bilateral infiltrative shadows on chest high resolution computed tomography (HRCT).She was treated with prednisone 50 mg/d prior to admission,but the result of therapy was not good.In our hospital she was treated with intravenous methylprednisolone and cyclophosphamide and oral hydroxychloroquine sulfate.Subsequently,her serum KL-6 levels gradually decreased after treatment,pulmonary diffuse function improved,and the improvement in the clinical manifestation and HRCT findings were observed.Nevertheless,the combination treatment of glucocorticoid and cyclophosphamide had contributed to the favourable outcomes.In conclusion,detection of serum KL-6 levels in ILDs associated with connective tissue diseases may be beneficial to making a definitive diagnosis,predicting the prognosis and monitoring the disease activity,which would be of great help in clinical practice.However,a well-designed clinical study with more patients and a longer follow-up period are required to arrive at a more conclusive judgment on the role of serum KL-6 in patients with ILDs.
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Objective To establish and verify the personalized reference interval of blood cells.Methods The results of blood cells from 2 089 health subjects in 2014,2015 and 2016 were collected.The ratio of the later results to the previous results was defined as the fluctuation (λ).The ratio (λ1) of the results of 2015 to the results of 2014 was calculated and λ1 was analyzed statistically to establish the fluctuation reference interval (CIλ).The ratio (λ2) of the results of 2016 to the results of 2015 was calculated.λ2 was used to verify λ2.The personalized reference interval (CIp) was established by multiplying each result of 2015 and CIλ.CIp was verified by results of 2016.The ratio of the upper and lower limits of CIp was calculated.The ratio of the upper and lower limits of the reference interval (WS/T 405) was calculated.Results The values of CIλ were as follows:WBC (0.66 to 1.53),L(0.67 to 1.51),M (0.50 to 2.00),N(0.56 to 1.78),E(0.4 to 2.51),PLT(0.76 to 1.32),RBC(0.92 to 1.12),Hb(0.92 to 1.11),Hct(0.91 to 1.12),MCV(0.95 to 1.07),MCH(0.95 to 1.05)and MCHC(0.94 to 1.06).The validation tests of CIλ and CIp showed that both CIλ and CIp were suitable for this laboratory.Compared with the reference interval of professional criteria,the ratio of the upper and lower limits of the CIp was smaller than that of traditional criteria.Conclusion CIp for this laboratory was established and verified.Compared with traditional criteria,CIp should be more personalized and highly sensitive.
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With widely application of bronchoavleolar lavage , a lot of cases on L.Blattarum infections in respiratory system have emerged in recent years .However , after closely lucubrating pictures of these reported cases and analyzing the results of our animal experiments.It was doubted the reported morphology of L.Blattarum belongs to respiratory ciliated columnar epithelium .This article aimed at guiding our colleagues to distinguish the morphology of Lophomonas blattarum in respiratory system, and,avoid the misdiagnosis.
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<p><b>BACKGROUND</b>Multimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.</p><p><b>METHODS</b>This is a prospective, double-blinded, randomized and control study. Seventy-two patients with osteoarthritis that met clinical criteria for total knee arthroplasty were recruited into the study, and were randomized to receive either multimodal cocktail periarticular injection with steroid or without steroid. Pain was assessed by visual analogue scale (VAS) at preoperative and postoperative at rest, and during activity. The range of motion was recorded preoperatively and postoperatively. The amount of daily and cumulative morphine consumption were measured by patient-controlled analgesia in the first 72 hours postoperatively. The duration of celecoxib usage was also recorded at the last follow-up.</p><p><b>RESULTS</b>There were no differences between the non-steroid and steroid groups with regard to VAS at rest and during activity, or range of motion, at any postoperative observation time. The postoperative Knee Society Knee Score in the steroid group improved significantly as compared with that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; P < 0.0045), three-month follow-up (90.2±16.3 and 72.5±16.6; P < 0.0027), but after postoperative six-month the Knee Society Knee Score showed no significant difference between the groups. There was no significant difference in consumption of the morphine about daily or total consumption within 72 hours between the two groups. The duration of celecoxib usage in patients in the steroid group was significantly shorter than that in the non-steroid group ((7.2±0.7) compared with (10.5±1.9) weeks; P = 0.012).</p><p><b>CONCLUSION</b>The patients who received the steroid injection had faster rehabilitation and less non-steroidal antiinflammatory drugs consumption.</p>
Subject(s)
Aged , Female , Humans , Male , Arthroplasty, Replacement, Knee , Methods , Celecoxib , Cyclooxygenase 2 Inhibitors , Therapeutic Uses , Injections, Intra-Articular , Pain Measurement , Pyrazoles , Therapeutic Uses , Steroids , Therapeutic Uses , Sulfonamides , Therapeutic UsesABSTRACT
Objective To investigate the operative technique and outcome of the expanded flap to repair the full thickness defects of nose and upper lip simultaneously.Methods Three kinds of ex panded flaps were chosen to reconstruct the full thickness defects of nose and upper lip.They were designed according to the location and the size of the defects,and also the circumstances of the donor site.Treatment effectiveness were observed by long-term follow-up.Results 7 patients were treated with the expanded flap.All cases received satisfactory results with no complications such as flap necrosis.And for male patients,the frontal expanded flap could reconstruct upper lip and beard simultaneously that reached better shape.Conclusions It is an ideal approach of repairing nasal-lip defects by the tissue expanded flap.
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Objective To investigate the long-term excessive drinking semen nitric oxide (NO) content in their sperm quality and spermatogenic cell apoptosis and infertility. Methods Nitrate reductase method was used to specific reduce the NO metabolites nitrate (NO3-) to nitrite (NO2-), which was used on behalf of the total NO level. Terminal deoxynucleotidyl transferase (TdT) and mediated nick end labeling (TUNEL) method and binocular optical microscope were used to detect and observe the rate of apoptosis of spermatogenic cells and the morphological structure. The SQA-V sperm quality automatic analyzer was used to measure sperm quality. Results In not drinking semen fertility group, NO content was (54.81±11.45)μmol / L, the rate of spermatogenic cell apoptosis was (4.52±1.23)%, sperm motility was (80.24±0.17)%, energy a+b (78.32±0.12)%, deformity rate (5.30±0.13)%, and long-term excessive alcohol infertility C group was [(128.83±22.73)μmol/L,(17.34±2.53)%,(51.18±0.58)%,(21.45±0.26)%,(21.12±3.24)%] respectively. Compared to a very significant difference (t＝10.04,17.38,6.69,15.59,17.02,P＜0.01) . In long-term excessive drinking group, the levels of NO and spermatogenesis cell apoptosis rate was significantly positive correlated (r＝0.93,P＜0.01).Apoptosis of spermatogenic cell nucleus chromatin was condensed in the formation of crescent-shaped perinuclear, nuclear was cleavaged to form apoptotic bodies. Conclusions In the long-term excessive drinking semen, NO content and spermatogenic cell apoptosis rate was increased, the sperm had poor quality. The results showed that the long-term excessive drinking can cause germ cell apoptosis in male infertility and promote the body to overproduce NO, whichmay be one of the reasons for male infertility.
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<p><b>OBJECTIVE</b>To investigate an effective method for the correction of the narrow nostril secondary to cleft lip.</p><p><b>METHODS</b>A "bird wing shape" incision was made on the nasal tip to form a "W-shape" flap for repairing the nasal deformities secondary to cleft lip, especially for the cases with narrow nostril.</p><p><b>RESULTS</b>Twenty-eight patients were treated with this method. All the cases achieved a symmetry shape of nasal ala, nostril, nasal columella and a normal height of nasal tip except for 2 cases with malformation at nasal tip who achieved improvement after reoperation. 21 cases were followed up for 6-12 months with good cosmetic result and no recurrence.</p><p><b>CONCLUSIONS</b>"W-shape" flap at the nasal tip is an ideal way for the correction of mild to moderate narrow nostril deformity secondary to cleft lip.</p>
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Adolescent , Adult , Female , Humans , Male , Young Adult , Cleft Lip , General Surgery , Nose , Congenital Abnormalities , General Surgery , Nose Deformities, Acquired , General Surgery , Rhinoplasty , Methods , Skin Transplantation , Surgical FlapsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of (18)F-FDG PET-CT for assessment of therapeutic response and prediction of patient outcome after concurrent chemoradiotherapy (CCRT) of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Forty six patients with histologically proven stage III NSCLC had two repeated (18)F-FDG PET-CT scans either one week before therapy and at the dose of 40 ∼ 50 Gy. The SUV(max) and changes of the two groups were compared with (1) the therapeutic response and (2) treatment results and long-term survival.</p><p><b>RESULTS</b>Of the 46 eligible cases, the pretreatment SUV(max) of the responding and non-responding groups was 7.59 ± 3.14 and 14.72 ± 4.67, respectively. The midtreatment SUV(max) of the two groups was 2.89 ± 1.39 and 9.82 ± 3.31, respectively. Significant difference(t = 4.74, P = 0.001;t = 7.23, P = 0.001) in SUV(max) was observed both before and during treatment. Furthermore, the percentage change of pretreatment and midtreatment SUV(max) was ΔSUV(max) = 61.9% ± 8.7% and ΔSUV(max) = 33.6% ± 9.0%, also with a significant difference between the two groups (t = 2.83, P = 0.007). In addition, the 1-year survival rate of the the responding and non-responding groups was 68.0% and 38.1%, respectively. The 2-year survival rate of the two groups was 64.0% and 33.3%, respectively, with a significant difference between the two groups (P = 0.043, P = 0.038).</p><p><b>CONCLUSION</b>(18)F-FDG PET-CT is highly effective in detecting therapeutic response in stage III NSCLC patients. The analysis of percentage change of SUV(max) provides incremental value in early prediction of therapeutic response and patient outcome.</p>
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Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinoma, Non-Small-Cell Lung , Diagnostic Imaging , Metabolism , Pathology , Therapeutics , Cisplatin , Combined Modality Therapy , Fluorodeoxyglucose F18 , Pharmacokinetics , Lung Neoplasms , Diagnostic Imaging , Metabolism , Pathology , Therapeutics , Neoplasm Staging , Paclitaxel , Positron-Emission Tomography , Prognosis , Radiopharmaceuticals , Pharmacokinetics , Radiotherapy, Conformal , Tomography, X-Ray Computed , VinblastineABSTRACT
<p><b>OBJECTIVE</b>To evaluate the rule of the rebuilding of binocular vision after surgery in strabismus for thyroid-associated ophthalmopathy.</p><p><b>METHOD</b>The binocular vision was examined and compared in 30 patients before and after strabismus surgeries.</p><p><b>RESULTS</b>The strabismus degrees were 20-80(delta) before surgeries and 2-12(delta) after surgeries. As shown by synoptophores examinations, 19 patients (63.3%) had degree one before strabismus surgeries and the number increased to 28 (93.3%) after the surgeries. Synoptophore fusion area was 0-12(0) [mean (6.1 +/- 4.7)0] before strabismus surgeries and was 0-30(0) [mean (14.4 +/- 5.1)0] after the surgeries (P < 0.001). Nine patients (30%) had stereovision before strabismus surgeries, and the number increased to 22 (73.3%) after the surgeries. Pre-surgery stereoacuity was as follows: none < or = 60", 2 patients 80-200", and 4 patients 300-800"; while the post-surgery stereoacuity was as follows: 4 patients < or = 60", 6 patients 80-200", and 10 patients 300-800" (P < 0.05).</p><p><b>CONCLUSION</b>Strabismus surgeries for thyroid-associated ophthalmopathy can effectively improve ocular movement and rebuilt binocular vision.</p>
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Humans , Eye Movements , Graves Ophthalmopathy , General Surgery , Strabismus , General Surgery , Vision Disparity , Vision, Binocular , Visual AcuityABSTRACT
<p><b>OBJECTIVE</b>Tumor hypoxia can influence response to radiotherapy and other treatment modalities. Oxygenation status is proved to be an independent prognostic factor. 99mTc-HL91 (99mTc labeled 4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime) is a potential noninvasive marker of tumor hypoxia. It has been reported that 99mTc-HL91 has certain validity for hypoxia imaging. But its clinical study had not been reported widely. This study was carried out to evaluate the relationship between the T/N ratio of HL91 SPECT hypoxia imaging and the radiotherapeutic outcome.</p><p><b>METHODS</b>32 patients with pathologically proven non-small cell lung cancer received three-dimensional conformal radiotherapy were enrolled into the study. 99mTc-HL91 SPECT scanning was performed in all patients at one or two days before radiotherapy. It was also performed in 18 patients at one or two days after the onset of radiotherapy, when they received a dose of 30 - 40 Gy already. Anterior, posterior and lateral planar images were collected at 2, 4 and 6 hours, respectively, after intravenous injection of approximately 740 MBq 99mTc-HL91. Regions of interest (ROIs) were drawn in the tumor and the contralateral normal lung tissue, and the radioactivity ratio of tumor to normal tissue (T/N) was calculated. To assess whether the tumor uptake of 99mTc-HL91 is predictive of treatment response, the SPECT results were correlated with the results of clinical follow-up.</p><p><b>RESULTS</b>The relationship between T/N ratios at 4 h images after injection was shown to be the best of three acquired images before radiotherapy. The response and overall survival to radiotherapy were analyzed for all 32 patients. The results of 9mTc-HL91 correlated well with radiotherapy response (P = 0. 002) and also patients' survival (P = 0.043). The average T/N values of 18 patients who received serial scanning were 1.57 +/- 0.18, 1.44 +/- 0.19 and 1.30 +/- 0.14, respectively. There was a significant difference between those three groups (P = 0. 000). The T/N changes during radiotherapy were not associated with the treatment outcome.</p><p><b>CONCLUSION</b>HL91 SPECT imaging can identify the hypoxia status and changes during radiotherapy in lung cancer. Hypoxia SPECT imaging with HL91 before treatment may predict radiotherapy response and patients' survival. Longer follow up in more patients is planned to confirm this result.</p>