重组质粒hTSHR转染低分化甲状腺癌细胞株后对摄碘能力及特异性基因表达的影响

Objective To investigate the changes of iodide uptake and the expression of thyroidspecific genes in poorly differentiated follicular thyroid carcinoma (FTC) cells after transfection of human TSH receptor (hTSHR) gene in vitro. Methods The recombinant eukaryotic expression plasmid PcDNA3. 1/hTSHR-cDNA was transformed into DH5a bacterial for amplification and then the recombinant plasmid was extracted. The recombinant was identified with PCR amplifying, restriction enzyme digestion analysis and DNA sequencing. The recombinant plasmid pcDNA3.1/hTSHR was transfected into FTC-133 cell line by lipofectin methodin vitro. Immunofluorescence, iodide uptake studies and real time-PCR were applied to detect target protein expression. Statistical analysis was performed with t-test using SPSS 13. 0 software. Results Kpn Ⅰ and Xba Ⅰ restriction enzyme digestion, PCR amplifying and DNA sequencing confirmed that pcDNA3. 1/hTSHR was successfully constructed. After transfection of the recombinant plasmid pcDNA3. 1/hTSHR-cDNA and the stimulation of hTSH, the tumor cells displayed the expression of hTSHR protein at cell surface and cytoplasm. The iodine uptake in pcDNA3. 1/hTSHR transfected cells was 2. 9 times higher than that of control(pcDNA3.1(+) transfected cells) group(t = 28.63, P ＜0. 01). The expression of TSHR,NIS, TPO and Tg (mRNA levels) in pcDNA3. 1/hTSHR transfected cells were also significantly elevated by 1.74 (t =5.959, P＜0.01), 7.2 (t =3.807,P＜0.05), 2.88 (t=4.769,P＜0. 01) and 2.67 times (t=6.388,P ＜0.01) respectively compared to those of the control group. Conclusion The study demonstrates that iodide uptake may be reactivated by hTSHR receptor gene transfection in poorly differentiated FTC cell.     

磁感应加热和HSV-tk自杀基因及核素内照射联合治疗乳腺癌的实验研究

Objective To investigate the antitumor therapeutic effect of combined therapy of magnetic induction heating by nano-magnetic particles, herpes simplex virus thymidine kinase gene(HSV-tk suicide gene) and internal radiation in mice bearing MCF-7 breast carcinoma. Methods The transfection reagents, plasmids heat shock protein-HSV-tk (pHSP-HSV-tk), ferroso-ferric oxide nano-magnetic fluid flow and 188Re-ganciclovir-bovine serum albumin-nanopaticles (GCV-BSA-NP) were prepared. The heating experiments in vivo were carried out using ferroso-ferric oxide nano-magnetic fluid flow. Sixty mice tumor models bearing MCF-7 breast carcinoma were established and randomly divided into six groups. Group A was the control group, B was gene transfection therapy group, C was hyperthermia group, D was gene transfection therapy combined with radionuclide brachytherapy group, E was gene therapy combined with hyperthermia group, and F was gene therapy, hyperthermia combined with radionuclide brachytherapy group. The tumor growth, tumor mass and histopathological changes were evaluated. The expression of HSV-tk in the groups of B, D, E and F was detected by RT-PCR. Poisson distribution and one-way analysis of variance (ANOVA) were used for statistical analysis by SPSS 10.0 software. Results In the animal heating experiments, the temperature of tumor increased up to 39.6 ℃, 43.2 ℃, and 48.1 ℃ quickly with different injected doses (2, 4 and 6 mg respectively) of nano-magnetic particles and maintained for 40 min. The temperature of tumor tissue reduced to 36.8 ℃, 37.5 ℃ and 37.8 ℃ in 10 min when alternating magnetic field (AMF) stopped. The tumor mass in Groups C ((452.50 ±30.29) mg), D ((240.98 ±35.32)mg), E((231.87 ±27.41) mg) and F ((141.55 ±23.78) mg) were much lower than that in Group A ((719.12±22.65) mg) (F=800.07, P＜0. 01), with the most significant treatment effect in Group F.The tumor mass in Group B((684.05 ±24.02) mg) was higher than that in Group D (t =32. 805, P ＜0. 05). Semi-quantitative RT-PCR analysis showed that the expression of HSV-tk in Groups B and D (0.33 ±0. 13 and 0. 46 ±0.12) was significantly different from that in Groups E and F (0.66 ±0.13 and 0.74 ±0. 11)(F = 21. 573, P ＜ 0.05). Conclusion Combined use of hyperthermia, gene therapy and radionuclide brachytherapy could effectively depress the growth of MCF-7 breast carcinoma, thus possessing treatment potential for this tumor.     

床旁纤维支气管镜引导经鼻气管插管抢救慢性阻塞性肺部疾病呼吸衰竭的临床应用

目的：探讨床边纤维支气管镜（简称纤支镜）引导下经鼻气管插管抢救慢性阻塞性肺部疾病（COPD）呼吸衰竭的临床价值。方法：总结48例喉镜经口插管和床旁纤维支气管镜引导经鼻气管插管所需时间、对生命体征影响、插管成功率、插管结束后并发症。结果：A组和B组插管所需时间差异无显著性（P〉0．05）。A组和B组插管结束后并发症（P〈0．01）。A组和B组插管成功率差异无显著性（P〉0．05）。A组和B组插管前后呼吸频率增加（P〈0．05）。A组和B组插管前后心率增加差异有非常显著性（P〈0．01）。A组和B组插管前后血压增加差异有显著性（P〈0．05）。A组和B组插管前后SPO2降低差异有非常显著性（P〈0．01）。结论：纤维支气管镜引导下经鼻气管插管抢救COPD呼吸衰竭，操作简单、快速、准确、安全，值得临床推广应用。     

Evaluation by ultrasound of traumatic rib fractures missed by radiography

Rib fractures are the most common (25%) injuries resulting from blunt chest trauma, and are usually revealed on radiographs. Radiography sometimes cannot show fractures, especially those in costal cartilages, except for densely calcified ones. Several authors have recently investigated the role of ultrasound in the detection of rib fractures. We conducted this study to investigate possible rib fractures with ultrasound, determine those overlooked on chest x-ray, and analyze the possible clinical predictors of these insidious rib fractures in minor or mild blunt chest trauma. A total of 20 patients with minor mild blunt chest trauma were enrolled into this study. All radiographs were reviewed by two radiologists who noted rib fractures or other complications. Ultrasonography was performed in the radiology department using a linear transducer by one radiologist. The costal cartilage normally appears relatively hypoechoic compared with the osseous rib. Fractures of the rib, costochondral junction, and costal cartilage were denoted by a clear disruption of the anterior echogenic margin. A total of 20 patients with normal radiological findings, but continuing symptoms were evaluated by ultrasound. The most common etiology of trauma was a fall, as seen in 60% of the patients. None of the rib fractures were identified radiographically. Sonography detected 26 rib fractures in 18 of 20 subjects at presentation. Sonography reveals more fractures than radiography and will reveal fractures in most patients presenting with suspected rib fracture.     

预处理对减少依托咪酯所致肌阵挛120例临床观察

目的：观察通过预处理对依托咪酯全麻诱导时肌阵挛的影响。方法：120例择期全麻患者随机分为3组：雷米芬太尼组、维库溴铵组和对照组,每组40例。观察各组全麻诱导时依托咪酯引起肌阵挛的例数,并记录肌阵挛的发生程度。结果：雷米芬太尼组出现3例肌阵挛（7.5%）,其中轻度1例,中度2例;维库溴铵组出现2例轻度肌阵挛（5.0%）;对照组出现30例肌阵挛（75.0%）,其中轻度15例、中度12例、重度3例。雷米芬太尼组和维库溴铵组肌阵挛发生率明显低于对照组（P〈0.01）,而雷米芬太尼组和维库溴铵组间比较差异无统计学意义。结论：通过雷米芬太尼和维库溴铵预处理均可减少依托咪酯全麻诱导所致的肌阵挛,而因二者对心血管系统的影响不同,使用维库溴铵预处理更利于心血管系统功能降低的患者。     

双神经弓式双端侧吻合治疗痛性指固有神经瘤

目的介绍一种治疗痛性指固有神经瘤的手术方法。方法2005年2月-2011年3月,巢湖紫晨手外科医院手外科中心采用双端侧吻合治疗指固有神经瘤11例11指。术中将神经瘤彻底切除直至正常神经束,对远、近端尺桡侧指固有神经分别进行远与远、近与近端一端吻合,形成远、近2条神经弓;测量两神经弓间距,取直径相近的前臂外侧皮神经,平分为两段,分别于神经弓的尺、桡侧开窗式端侧吻合。结果随访24．5—52个月,平均（38±2．5）个月。9例指疼痛完全消失,2年后未见复发;2例指自发性疼痛消失,但仍有轻度触痛,参照Burchiel疗效评定标准：优9指,良2指;优良率100％。感觉测定指标为s3～s4级,两点分辨觉为4．5—6．5mm。结论双神经弓式双端侧吻合的方法可有效治疗痛性指固有神经瘤,消除患指疼痛、恢复指腹灵敏性。     

Ilizarov外固定架分步延长法治疗儿童尺骨骨干续连症的疗效

 目的 探讨一种应用Ilizarov外固定架治疗儿童尺骨骨干续连症的方法及其疗效。方法 2009-02至2015-10,采用Ilizarov外固定架分步延长法,对29例尺骨骨干续连症患儿进行了矫治。通过定期门诊复查及拍摄患肢X线片,评估术后患肢畸形及功能改善情况。结果 患儿术后平均随访38个月,尺骨平均延长3.2 cm;1例延长过程中出现骨不连,通过调整延长速度后逐渐愈合;1例拆除外架后发生尺骨骨折,石膏固定后自行愈合。术后患儿腕关节、肘关节及前臂功能均得到改善。 结论 应用Ilizarov外固定架分步延长法治疗儿童尺骨骨干续连症效果明显,但术中要注意熟练操作,避免副损伤的发生,延长过程中要注意控制延长速度,做好各项并发症的预防。     

超声引导下注射凝血酶治疗医源性股动脉假性动脉瘤

目的:探讨超声引导下瘤腔内注射凝血酶治疗医源性股动脉假性动脉瘤的方法及其可行性和安全性.方法:6例患者因行股动脉穿刺于术后2～5 d发生6处股动脉假性动脉瘤,均在彩色多普勒超声定位下通过瘤腔内注射凝血酶进行治疗,治疗后即刻超声复查,并定期随访.结果:4例患者4处假性动脉瘤一次性注射凝血酶300～500 U后瘤腔即刻闭合,随访10～90 d,假性动脉瘤无复发.2例患者2处假性动脉瘤瘤体较大,第1次注射后于第3 d复发,行第2次注射后,假性动脉瘤无复发.其中1例患者出现一过性肢体栓塞临床表现,经观察后肢体栓塞临床表现消失,未特殊处理.6例患者均未出现过敏反应等并发症.结论:瘤腔内注射凝血酶治疗医源性股动脉假性动脉瘤是一种创伤小、有效、安全的方法,但操作时需注意瘤体的大小及凝血酶的用量.     

Comparison of SUVs Normalized by Lean Body Mass Determined by CT with Those Normalized by Lean Body Mass Estimated by Predictive Equations in Normal Tissues

Purpose

Standardized uptake values (SUVs) normalized by lean body mass (LBM) determined by CT were compared with those normalized by LBM estimated using predictive equations (PEs) in normal liver, spleen, and aorta using ¹⁸F-FDG PET/CT.

Methods

Fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) was conducted on 453 patients. LBM determined by CT was defined in 3 ways (LBM_CT1-3). Five PEs were used for comparison (LBM_PE1-5). Tissue SUV normalized by LBM (SUL) was calculated using LBM from each method (SUL_CT1-3, SUL_PE1-5). Agreement between methods was assessed by Bland-Altman analysis. Percentage difference and percentage error were also calculated.

Results

For all liver SUL_CTs vs. liver SUL_PEs except liver SUL_PE3, the range of biases, SDs of percentage difference and percentage errors were −0.17-0.24 SUL, 6.15-10.17 %, and 25.07- 38.91 %, respectively. For liver SUL_CTs vs. liver SUL_PE3, the corresponding figures were 0.47-0.69 SUL, 10.90-11.25 %, and 50.85-51.55 %, respectively, showing the largest percentage errors and positive biases. Irrespective of magnitudes of the biases, large percentage errors of 25.07-51.55 % were observed between liver SUL_CT1-3 and liver SUL_PE1-5. The results of spleen and aorta SUL_CTs and SUL_PEs comparison were almost identical to those for liver.

Conclusion

The present study demonstrated substantial errors in individual SUL_PEs compared with SUL_CTs as a reference value. Normalization of SUV by LBM determined by CT rather than PEs may be a useful approach to reduce errors in individual SUL_PEs.     

加强对CT检查患者辐射剂量的管理

目的 研究CT机普通扫描方式和单层螺旋扫描方式的患者体表X线吸收量，探讨CT检查时患者辐射剂量的推荐值。方法 前瞻性选取普通扫描方式10例固定管电压为130kV，变换管电流、层厚、层数进行不同部位的扫描。扫描前根据解剖结构，在扫描范围中心的前后分别布点，每个点置入3个探测元件TLF（Mg，Cu，P），用热释光方法（TLD）读出数值，进行处理;单层螺旋普通扫描方式30例，管电压、管电流等的组合与普通CT机相同，采用CT机自测值，记录之;再以不同的螺距和扫描持续时间进行扫描，记录剂量值，对照、处理。结果 普通扫描时，管电压、管电流一定，辐射剂量与层数成正比;螺旋扫描时，管电压、管电流和扫描长度一定，辐射剂量与扫描持续时间成正比，层厚、层数对辐射剂量的影响不大。结论 优化扫描方案，可控制CT检查患者的辐射剂量。