"弹丸"注射质量对肾动态显像的影响

目的 观察止血带直接静脉"弹丸"注射法和留置针"弹丸"注射法对肾动态显像图像的影响,并总结护理体会.方法 各类肾脏疾病患者共103例,其中实验组65例,止血带直接静脉"弹丸"注射法;对照组38例,留置针"弹丸"注射法,采用肾动态显影图像质量合格率作为观察指标,该指标在两组间的差异采用x2检验.结果 实验组59例显像清晰度合格,合格率90.77%;对照组8例显像清晰度合格,合格率21.05%.两组比较,实验组检查合格率显著高于对照组(P<0.05).结论 止血带直接静脉"弹丸"注射法比留置针"弹丸"法更合适肾动态显像.     

18F-FDG PET显像前行健康教育和清洁肠道对图像质量的影响

目的总结18F-FDG(氟代脱氧葡萄糖)正电子发射型计算机断层(PET)显像诊断肿瘤患者的护理体会,设法改善图像质量。方法94例肿瘤病人常规行18F-FDG显像。随机分为两组:有健康教育组49例患者检查前一天晚口服等渗溶液行清洁肠道,无健康教育组45例患者检查前未行清洁肠道,对两组图像质量进行对照比较。结果检查前有健康教育及有清洁肠道,肿瘤显像清晰度满意。检查前无健康教育及无清洁肠道肿瘤显像清晰度欠满意。结论设法放松患者情绪、控制血糖水平、检查前行清洁肠道对保障18F-FDG肿瘤代谢显像质量、实现影像分析并最终作出正确诊断具有重要作用。     

球后注射联合云克治疗Graves眼病的疗效观察及护理

目的探讨33例球后注射联合静脉注射云克治疗Graves眼病的疗效观察及护理。方法用甲泼尼龙琥珀酸钠20 mg+维生素B120.5ug球后注射,联合静脉注射云克11 mg(鍀[99TC]亚甲基二膦酸盐注射液),每日1次,5次为1个疗程,注射1个疗程休息2周,连续注射5个疗程,3个月后随访观察记录自觉症状、眼征情况。结果 33例(59眼)患者接受治疗,显效率30.51%(18/59),有效率62.71%(37/59),无效率6.78%(4/59),总有效率93.22%;大部分患者畏光、流泪、眼胀眼痛等症状及充血水肿、眼睑浮肿等体征得到明显改善或消失。结论球后注射联合静脉注射云克治疗甲状腺相关眼病效果显著,不良反应小,安全性高。     

Relationship between fluorodeoxyglucose uptake and overexpression of glucose transport protein 1 and hexokinase-Ⅱ in early-stage nasopharyngeal carcinoma

Objective To discuss the molecular mechanism of 18F-fluorodeoxyglucose (FDG) uptake in tumor and to assess its value to identify pathologic type and cancer staging in patients with earlystage nasopharyngeal carcinoma.Methods Forty patients with nasopharyngeal carcinoma of early-stage,including 12 cases with T1 stage and 28 cases with T2 stage, underwent FDG PET imaging.The maximum standardized uptake value ( SUVmax ) and mean standardized uptake value ( SUVmean ) of FDG uptake of each patient were measured and compared between T1 and T2 stage by t-test.The expression of glucose transport protein 1 ( Glut1 ) and hexokinase- Ⅱ ( HK- Ⅱ ) of each case was measured in paraffin sections by streptavidin-perosidase (SP) immunohistochemistry.The positive expression rate of Glut1 and HK- Ⅱ was calculated and compared between T1 and T2 by x2 test.Meanwhile, the correlation between the expression of Glut1 or HK-Ⅱ and the SUVmax was tested by Pearson analysis.Results The SUVmax and SUVmean in 40 patients were 9.45 ± 1.87 and 6.04 ± 1.09, respectively.The SUVmax of patients with T1 stage (8.95 ± 1.91 ) was significantly lower (t =4.46, P＜0.001 ) than that of patients with T2 stage (11.55 ± 1.70), and the SUVmean of patients with T1 stage (5.61 ± 1.08) was significantly lower ( t = 6.76, P ＜ 0.001 ) than that of patients with T2 stage (7.98 ± 1.10) too.Among 40 patients, all patients showed positive expression of Glut1 and HK-Ⅱ , and the positive expression rate of Glut1 and HK-Ⅱ was ( 45.2 ± 10.9 )% and ( 68.3 ±9.5)%, respectively.The positive expression rate of Glut1 was (38.4 ±8.1)% in T1 stage and (49.7 ±12.6)% in T2 stage, which displayed no difference (x2 =40.58, P＞0.05), but the HK-Ⅱ positive expression rate showed significant difference (x2 =58.71, P＜0.05) between T1 stage (60.1 ±11.1)% and T2 stage (77.9 ± 14.7 )%.The correlation analysis indicated that there was low-degree positive correlation (r =0.369, P=0.019) between the SUVmax and Glut1 expression, and there was medium-degree positive correlation (r = 0.549, P = 0.001 ) between the SUVmax and HK-Ⅱ expression.Conclusion Expression of Glut1 and HK-Ⅱ was positively correlated with FDG uptake in patients with early-stage nasopharyngeal carcinoma.     

骨显像骶椎放射性分布情况的临床研究

目的 通过分析全身骨显像时骶椎的放射性分布情况,探讨骶椎放射性分布浓聚及稀疏时的临床诊断.方法 收集212例全身骨显像未见明确骨转移灶的病例,对这些病例的骶椎的放射性分布按年龄、性别进行分组对比,分别统计每个年龄段骶椎的放射性分布情况.结果 骶椎放射性分布正常占57.6%,放射性分布略稀疏占31.1%,放射性分布略浓聚占11.3%.男女患者70岁以上骶椎放射性分布正常的比率明显降低,男/女患者70岁以上骶椎放射性分布稀疏的比率明显增高,女性70岁以上年龄段骶椎放射性分布浓聚比率明显高于男性.结论 男性患者与女性患者出现骶椎放射性分布情况相近,性别影响因素较小.70岁以上老年人由于骨质疏松的存在,导致骶椎放射性分布略稀疏,而且骨质疏松性骶椎隐性骨折,常导致骶椎放射性分布略浓聚.     

18F-FDG SPECT/CT棕色脂肪分布的护理干预

目的:分析18氟代脱氧葡萄糖(18F-FDG)符合线路正电子成像断层(SPECT/CT)显像在棕色脂肪组织(BAT)分布及护理方法,为合理有效避免BAT摄取18F-FDG提供参考依据。方法:选取2009年8月～2012年2月在我院行18F-FDG SPECT/CT全身检查的受检者共3580例,如患者出现BAT摄取18F-FDG,经提供特定护理后3～7 d进行第2次18F-FDG SPECT/CT显像,对其18F-FDG SPECT/CT显像结果进行分析。结果:共发现25例存在BAT摄取,以冬季多见。25例BAT摄取异常增高者在保暖和充分休息后,于检查后的3～7 d进行第2次18F-FDG SPECT/CT显像,其中20例BAT摄取基本消失,3例BAT摄取范围明显缩小,摄取18F-FDG程度减低,2例无明显改变。结论:在寒冷冬季,护理人员应针对特定的患者提供特定保暖可降低BAT摄取,减少18F-FDG SPECT/CT影像诊断的假阳性。     

89SrCl2治疗肿瘤骨转移所致疼痛的疗效观察及护理

目的观察放射性核素89锶(89SrCl2)对骨转移癌的止痛疗效,并总结护理体会.方法各类骨转移癌患者共58例均以同一剂量静脉注射给药,即4mci/人89SrCl2治疗,随访3个月-1年.结果经89SrCl2治疗后总有效率85.89%,未发现严重不良反应.结论89SrCl2治疗骨转移癌疼痛疗效明显,使多数患者的生活质量得以改善,部分患者病灶缩小或消失,起到了缓解病情延长生命的作用,是一种安全有效的方法.     

18F-FDG符合线路SPECT/CT显像中T/N比值对肺部病灶的诊断价值

目的 探讨18F-FDG 符合线路SPECT/CT显像中T/N比值在判断为肺部疾病良恶性鉴别的临床应用价值.方法 对65例进行18F-FDG代谢显像并病理活检证实为肺部疾病的患者进行回顾性分析.以靶组织和非靶组织比值(T/N)≥2.2为恶性,而T/N<2.2为良性作为判定标准,65例病例中T/N≥2.2为53例,T/N<2.2为12例.结果 18F-FDG符合线路SpECT/cT显像诊断肺部恶性病变的灵敏度96.08%(49/51),特异度71.43%(10/14),准确性90.77%(59/65).结论 18F-FOG符合线路SPECT/CT显像在肺部病灶诊断中有较高的临床应用价值.     

131I-Herceptin在荷人乳腺癌裸鼠模型中的生物分布及抗肿瘤活性研究

Objective Herceptin is a kind of anti-human epidermal growth factor receptor 2 (HER2)humanized monoclonal antibody and was largely applied in metastatic breast cancer with HER2 overexpressing.The clinical effective though better than concurrent chemoradiotherapy,but was still not satisfied due to cell transformed.131I-Herceptin may be of some help in elevation the control rate due to the cytotoxic effect from 131I.The aim of this study was to evaluate the radioimmunotherapy for HER2 overexpressing metastatic breast cancer using 131I-Hereeptin.Methods Herceptin was labelled to 131I with the lodogen method.The mice bearing with breast cancer were divided into three groups.One was 131I-Herceptin,another was Herceptin,and the other was control.The biodistribution of 131I-Herceptin in breast cancer xenogrit was measured by radioimmunoimaging on the 3rd,6th and 9th day after injection.The radioactivity of tumor to muscle(T/M)ratio was calculated and compared.From 1-d to 9-d,the inhibitory rate of tumor growth was calculated and compared.On the 9-d,the tumors of each group were desquamated and the per centage activity of injection dose per gram of tissue(%ID/g)was calculated and compared.Protein and geue expression of HER2 and carcinoembryonic antigen(CEA)were compared.One-way ANOVA was applied for statistical analyses.Results The radiochemical purity of 131I-Herceptin was 94%.The imaging manifestation indicated that the uptake of 131I-Herceptin in tumor was higher than that in other organs,the T/M ratio achieved to the highest level of 4.11 on 9-d(F=12.370,P＜0.05).On 9-d,tumor showed that highest%ID/g(F=166.150,P＜0.01)as(16.1±1.7)%.The inhibitory rate showed significant difference on 9-d[(42.0±6.9)%vs(23.2± 3.8)%,t=5.321,P＜0.001]between groups A and B.The protein expression(0.435±0.087 vs 0.557±0.043,t=2.811,P＜0.05)and gene expression (0.256 ±0.073 VS0.350±0.029.t=2.678,P＜0.05)of HER2 in 131I-Herceptin were significantly lower than that in Herceptin groups.Similarly,the protein expression(0.537± 0.048 VS 0.607±0.029,t=2.800,P＜0.05)and gene espression(0.362±0.048 vs 0.607±0.079,t=5.932,P＜0.001)of CEA in 131I-Herceptin group were significantly lower than that of Herceptin group.Conclusions 131I-Herceptin accumulates mainly in tumor and takes on remarkable targeting property to seek tumor with HER2 overexpression.It may inhibit the proliferation of breast cancer cells more effectively than Herceptin.