In vitro evaluation of a manganese chloride phantom-based MRI technique for quantitative determination of lumbar intervertebral disc composition and condition

The application of MRI as a non-invasive, quantitative tool for diagnosing lumbar intervertebral disc degeneration is currently an area of active research. The objective of this study was to examine, in vitro, the efficacy of a manganese chloride phantom-based MRI technique for quantitatively assessing lumbar disc composition and degenerative condition. Sixteen human lumbar discs were imaged ex vivo using T2-weighted MRI, and assigned a quantitative grade based on the relative signal intensities of nine phantoms containing serial concentrations of manganese chloride. Discs were then graded macroscopically for degenerative condition, and water and uronic acid (glycosaminoglycan) contents were determined. MRI ranking exhibited significant and strong negative correlation with nucleus pulposus uronic acid content (r = −0.78). MRI grades were significantly higher for degenerate discs. The technique described presents immediate potential for in vitro studies requiring robust, minimally invasive and quantitative determination of lumbar disc composition and condition. Additionally, the technique may have potential as a clinical tool for diagnosing lumbar disc degeneration as it provides a standardised series of reference phantoms facilitating cross-platform consistency, requires short scan times and simple T2-weighted signal intensity measurements.     

静脉补钾局部疼痛缓解方法的研究

目的 :寻找缓解静脉补钾局部疼痛的方法。方法 :连续入院病人 30 0例 ,入院后第 1、2、3天分别静脉输入 10 %葡萄糖溶液 5 0 0ml加入 10 %氯化钾 15ml(A组 )、5 %葡萄糖氯化钠溶液 5 0 0ml加入 10 %氯化钾 15ml (B组 )以及生理盐水 5 0 0ml加入 10 %氯化钾 15ml(C组 ) ,同时观察局部疼痛的发生情况。对A组中出现疼痛的病例立即在输液中加入 10 %氯化钠 10ml,观察对局部疼痛的影响。结果 :A组中疼痛发生率为 80 .33 % ,B、C组分别为 11.6 7%及 10 .0 0 % ,与A组相比 ,差异有统计学意义 (P≤0 .0 0 1) ,而B、C组之间差别无统计学意义 (P >0 .0 5 )。A组中疼痛病例加入 10 %氯化钠后 94.19%病人疼痛消失 ,与加入前相比 ,差异有统计学意义 (P <0 .0 1)。结论 :采用糖盐水或生理盐水做溶剂补钾可显著减少疼痛的发生 ,在 10 %葡萄糖溶液中加入适量氯化钠可消除或减轻补钾时的疼痛。     

氯化三乙基锡抑制大鼠C6胶质瘤细胞增殖并诱导凋亡

目的探讨氯化三乙基锡对体外培养大鼠C6胶质瘤细胞的抑瘤作用。方法采用四甲基偶氮唑盐（MTT）比色法检测氯化三乙基锡对C6胶质瘤细胞的增殖抑制作用，采用普通倒置显微镜和HE染色形态学方法观察氯化三乙基锡对C6细胞增殖抑制作用。结果不同浓度的氯化三乙基锡在体外可抑制C6胶质瘤细胞的增殖，药物浓度为0．5μM、1．0μM和2．0μM时，抑制率分别为15．62％、36．16％和41．92％，存在着剂量依赖关系。氯化三乙基锡对C6胶质瘤细胞的增殖抑制率在不同浓度组与对照组之间具有显著性差异（P〈0．05），以及不同浓度组之间具有显著性差异（P〈0．01）。HE染色观察到2．0μM氯化三乙基锡作用于C6胶质瘤细胞48h后，出现细胞凋亡特有的形态学改变。结论氯化三乙基锡可抑制体外培养C6胶质瘤细胞增殖并诱导细胞凋亡。     

Advances in the diagnosis and management of cystic fibrosis

Cystic fibrosis (CF), the most common lethal genetic disease affecting Caucasians, is a multi-system illness, most frequently characterized by childhood chronic obstructive pulmonary disease, pancreatic exocrine insufficiency, and abnormal sweat electrolyte concentrations. The diagnosis of CF is based on a combination of the above clinical findings and/or a positive family history of the illness in conjunction with an abnormal sweat test. The quantitative pilocarpine iontophoresis test is the sole acceptable method for diagnostic confirmation of the clinical suspicion of CF. A recent advance in the diagnosis of CF has been in the development of methods for neonatal detection. The immunoreactive trypsinogen (IRT) detection test is practical, adaptable to large scale screening of dried neonatal blood spots, relatively inexpensive, and promising for the detection of newborns with CF who have pancreatic insufficiency. However, the reliability and validity of this method have not yet been adequately established. Major advances in the treatment of patients with CF have emerged in the last decades, particularly in supportive pulmonary and nutritional care.     

大鼠局灶性脑缺血再灌注TTC染色与MRI弥散加权成像的相关性研究

目的 研究大鼠局灶性脑缺血再灌注MRI弥散加权成像(DWI)的变化,探讨其与TIC染色变化的关系. 方法 44只雄性SD大鼠按随机数字表法分为假手术组和脑缺血2h、脑缺血6h再灌注不同时间组(0 h、0.5h、2h、6h、24 h),每组各4只.脑缺血2h组、脑缺血6h组采用线栓法制作成大脑中动脉栓塞模型.各组大鼠于不同再灌注时间点行MRI DWI扫描,结束后立即处死,取相应部位脑组织行TTC染色,观察分析其与DWI成像的关系. 结果 脑缺血2h组、脑缺血6h组再灌注0h均可见部分右侧大脑半球DWI呈高信号,表观扩散系数(ADC)值降低,TTC染色可见部分右侧大脑半球失染呈白色.缺血2h组再灌注24 h后DWI异常信号区相对面积明显变小,ADC值增大,TTC失染相对面积变小,较再灌注0h差异有统计学意义(P＜0.05),而脑缺血6h组则差异无统计学意义(P＞0.05).脑缺血6h组再灌注不同时间点较脑缺血2h组再灌注相应时间点DWI异常信号区相对面积大,ADC值低,TTC失染相对面积大,差异有统计学意义(P＜0.05).脑缺血2h组、脑缺血6h组再灌注相对应时间点DWI异常信号区面积与TTC染色失染区面积比较差异无统计学意义(P＞0.05). 结论 脑缺血再灌注后可用MRI DWI成像评价脑缺血面积.     

A Randomized,Double-Blind,Dose-Finding,Multicenter, Phase 2 Study of Radium Chloride (Ra 223) in Patients with Bone Metastases and Castration-Resistant Prostate Cancer

Background

Patients with castration-resistant prostate cancer (CRPC) and bone metastases have an unmet clinical need for effective treatments that improve quality of life and survival with a favorable safety profile.

Objective

To prospectively evaluate the efficacy and safety of three different doses of radium chloride (Ra 223) in patients with CRPC and bone metastases.

Design, setting, and participants

In this phase 2 double-blind multicenter study, 122 patients were randomized to receive three injections of Ra 223 at 6-wk intervals, at doses of 25 kBq/kg (n = 41), 50 kBq/kg (n = 39), or 80 kBq/kg (n = 42). The study compared the proportion of patients in each dose group who had a confirmed decrease of ≥50% in baseline prostate-specific antigen (PSA) levels.

Outcome measurements and statistical analysis

Efficacy was evaluated using blood samples to measure PSA and other tumor markers, recorded skeletal-related events, and pain assessments. Safety was evaluated using adverse events (AEs), physical examination, and clinical laboratory tests. The Jonckheere-Terpstra test assessed trends between groups.

Results and limitations

The study met its primary end point with a statistically significant dose–response relationship in confirmed ≥50% PSA declines for no patients (0%) in the 25-kBq/kg dose group, two patients (6%) in the 50-kBq/kg dose group, and five patients (13%) in the 80-kBq/kg dose group (p = 0.0297). A ≥50% decrease in bone alkaline phosphatase levels was identified in six patients (16%), 24 patients (67%), and 25 patients (66%) in the 25-, 50-, and 80-kBq/kg dose groups, respectively (p < 0.0001). The most common treatment-related AEs (≥10%) occurring up to week 24 across all dose groups were diarrhea (21%), nausea (16%), and anemia (14%). No difference in incidence of hematologic events was seen among dose groups. Potential limitations include small patient numbers and differences among dose groups at baseline.

Conclusions

Ra 223 had a dose-dependent effect on serum markers of CRPC activity, suggesting that control of bone disease with Ra 223 may affect cancer-related outcomes. Ra 223 was well tolerated at all doses.

Trial registration

ClinicalTrials.gov: NCT00337155.     

输液用连通管在冷盐水灌注导管消融术中的应用

冷盐水灌注导管射频消融术已广泛用于快速心律失常的治疗中，冷盐水灌注大头电极导管可维持较低的组织界面温度，增加热传导作用，使消融的传输能量明显增加，故它能在消融部位产生更大更深的组织损伤，从而有效应用于快速心律失常的治疗。消融前，灌注电极导管尾端的输液孔与灌注泵及稀释肝素盐水（1：1）相连，灌注泵设置高低两种流速，消融时以高速17ml／min灌注，标测时以低速2ml／min灌注，以维持管路的通畅。     

4种大鼠肾草酸钙结石模型的比较

目的筛选简便、快捷、成石效果好的SD大鼠肾草酸钙结石的造模方法。方法分别采用目前普遍使用的2种大鼠肾草酸钙结石的模型复制方法和2种改良的造模方法进行造模,并设立空白对照组,造模结束后采集每组大鼠24h尿量及血清,比较大鼠24h尿量、尿Ca2＋、尿Mg2＋、尿pH、尿草酸（0x）及血尿素氮（BUN）、肌酐（cr）、P、Ca2＋、Mg2＋,肾脏病理切片HE染色后光学显微镜下观察和比较各组大鼠肾脏病理改变及草酸钙结晶的沉积情况。结果E组[1％乙二醇＋2％氯化铵＋10％葡萄糖（48d）]在光学显微镜下草酸钙结晶沉积较传统组C组明显增多（P〈0．05）,但有30％大鼠死亡,血肌酐在5组大鼠中最高。D组[1％乙二醇＋2％氯化铵＋10％葡萄糖（28d）]较传统组C组草酸钙结晶沉积明显增多（P〈0．05）,并且造模时间短,大鼠存活率高（80％）,E组与D组相比结晶形成量无统计学意义（P〉0．05）,B组[1％乙二醇（28d）3肾脏中无肾结晶形成,仅有轻微的肾脏病理学改变,大鼠无死亡,肌酐不高。空白对照组无结晶形成,无病理改变。结论用1％乙二醇＋2％氯化铵＋10％葡萄糖诱导28天复制肾草酸钙结石模型的效果好,并且花费时间短,大鼠存活率高,建议选用。     

10%氯化钠在充血性心力衰竭低钠血症时的应用

目的　探讨 10 %高渗氯化钠在治疗充血性心力衰竭 (CHF)伴有低钠血症时的安全性和有效性。方法　选择 110例CHF伴有低钠血症的患者 ,在常规综合治疗 (休息、吸氧、强心、利尿、扩血管 )及治疗原发病等综合治疗的基础上 ,对治疗组 6 0例和对照组 5 0例进行对比分析。治疗组在限水的同时给予 10 %氯化钠治疗。对照组限水但不补钠。观察治疗前后两组血钠浓度、血钠与心功能改善时间。结果　治疗组和对照组治疗前血钠浓度分别为 (12 7.13± 4 .99)mmol/L、(12 6 .0 2± 5 .98)mmol/L(P >0 .0 5 ) ;治疗后分别为(137.38± 4 .5 4 )mmol/L、(12 4 .36± 8.72 )mmol/L(P <0 .0 1)。治疗组和对照组治疗后血钠改善时间分别为 (3.72± 2 .0 5 )天与 (10 .72± 5 .2 8)天 (P <0 .0 1)。心功能改善时间分别为 (6 .4 0± 3.10 )天、(10 .5 8± 4 .2 1)天 (P <0 .0 1)。结论　 10 %氯化钠在CHF低钠血症时的应用安全有效 ,可使低钠血症和心功能在短期内得到改善。