乳腺癌新辅助化疗后残留肿瘤99Tcm-MIBI摄取与预后因素的关系

目的：探讨乳腺癌新辅助化疗后残留肿瘤^99Tc^m-MIBI显像估计患者预后因素的价值。方法：50例乳腺癌患者接受术前化疗（环磷酰胺＋氨甲喋呤＋5氟尿嘧啶3个疗程或环磷酰胺＋表阿毒素＋5氟尿嘧啶2个疗程），均进行^99Tc^m-MIBI早期和延迟乳腺显像，利用感兴趣区技术测定肿瘤部位（T）与对侧正常乳腺组织（N）早期、晚期放射性摄取比值（T／N（e）、T／N（d），计算滞留指数（RI）。手术切除乳腺癌组织和腋窝淋巴结做病理分析，尺量切除下肿瘤的最大长径。分析^99Tc^m-MIBI摄取与病理化疗反应程度、残留腋淋巴结转移数、残余肿瘤大小的关系。结果：残余乳腺癌^99Tc^m-MIBI的T／N（e）及RI在病理反应Ⅰ级组明显高于Ⅱ级和Ⅲ级组，T／N（e）在Ⅱ级组明显高于Ⅲ级组（P均〈O．05）。T／N（e）在残余肿块最大长径≤2cm组明显低于〉2～5．9cm组和≥6cm（P均〈0．05）．T／N（e）及RI存砖留转穆腑淋巴结数≥4个织明显高于1～3个组（P〈0．05）。^99Tc^m-MIBI早期摄取低且滞留少，提示患者预后良好，反之，预后不良。结论：新辅助化疗后残留肿瘤^99Tc^m-MIBI显像有助于评估患者预后因素，为术后制定化疗方案提供参考。     

乳腺癌99m Tc-MIBI显像与P-gp、Survivin表达的相关性研究

[目的]探讨乳腺癌中9m鍀-甲氧基异丁基异腈(99m Tc-MIBI)的摄取、滞留与多药耐药相关蛋白P-gp、survivin表达的相关性.[方法]对52例乳腺癌患者进行99m Tc-MIBI乳腺显像:静脉注射显像剂99m Tc-MIBI1110Mbq(30mci),30 min、120min后分别行99m Tc-MIBI乳腺显像,采用感性趣区(ROI)技术计算早期摄取比(Early uptake ratio,EUR)和延迟摄取比(Delay uptake ratio,DUR),计算肿瘤滞留指数(Retension index RI)、洗脱率(wash out ratio,WOR),采用免疫组化法检测乳腺癌组织P-gp、survivin表达水平,并与TUR、RI、WOR进行相关性分析.[结果]P-gp表达阳性率57.7％(30/52)与survivin 51.9％ (27/52)比较差异无显著性(x2=0.50,P＞0.05);P-gp的表达与WOR成正相关,与DUR、RI成负相关,而与EUR无相关性;survivin的表达与99m Tc-MIBI肿瘤显像无相关性.[结论]99m Tc-MIBI双时相显像(30 min和120 min)能较准确地预测乳腺癌多药耐药蛋白P-gp的功能状态,清除指数与P-gp表达呈正相关,99m Tc-MIBI显像具有检测乳腺癌患者肿瘤组织内P-gp表达的价值.     

双核素SPECT对甲状腺癌和亚急性甲状腺炎的诊断价值

目的评价99Tcm04-和99Tcm04-甲氧异腈(MIBI)双核素甲状腺显像对甲状腺癌和亚急性甲状腺炎的诊断价值。方法44例99Tcm04-甲状腺静态显像显示"冷"结节患者进行99Tcm04--MIBI显像和延迟显像,测定血清T3,T4,TSH水平。结果25例亚急性甲状腺炎患者和19例甲状腺癌患者99Tcm04-甲状腺显像显示"冷"结节,99Tcm04--MIBI甲状腺显像均表现出放射性填充,延迟显像甲状腺癌患者99Tcm04--MIBI清除减慢。亚急性甲状腺炎患者血清T3,T4水平升高,TSH反馈性降低。结论99Tcm04--MIBI甲状腺延迟显像对甲状腺癌和甲状腺炎鉴别有重要意义,血清T3,T4,TSH检测对甲状腺癌和亚急性甲状腺炎的诊断提供重要参考。     

原发性肺癌摄取99Tcm-MIBI与耐多药蛋白表达的关系

目的探讨原发性肺癌99Tcm-MIBI显像与P-糖蛋白(P-gp)、多药耐药相关蛋白(MRP)表达的关系。方法对25例原发性肺癌患者行30min、180min99Tcm-MIBI断层显像,应用免疫组化法检测手术标本中P-gp、MRP表达水平;将早期摄取比值(EUR)、晚期摄取比值(DUR)及储留指数(RI)与P-gp、MRP表达进行对比研究。结果①99Tcm-MIBI早期显像阳性率为92.00%,延迟显像为80.00%,EUR为1.46±0.42,DUR为1.45±0.39,RI<0者13例,RI>0者12例。②P-gp、MRP表达阳性率分别为52.00%(13/25)、16.00%(8/25);③在P-gp表达阴性组、阳性组RI有显著性差异;P-gp表达与RI有相关性(P<0.001);EUR、DUR及RI在MRP表达阴性组、阳性组均未见显著性差异;三者与MRP表达均未见相关性。④以99Tcm-MIBI的RI<0作为肺癌耐药阳性阈值时,RI对P-gp的灵敏度、特异性分别为84.62%、83.33%,阳性预测值、阴性预测值也分别为:84.62%、83.33%。⑤P-gp表达在RI<0和RI>0组间分别为(0.327±0.041)、(0.267±0.036)(P<0.01),MRP表达在两组间未见显著性差异。结论99Tcm-MIBI显像的RI可以作为检测原发性肺癌P-gp表达的指标,是判断肺癌MDR的最佳参数。而99Tcm-MIBI显像与MRP表达的关系尚需验证。     

定量~(99)Tc~m- MIBI心肌断层显像评估左室重构

目的：应用 99Tcm－甲氧基异丁基异腈 (MIBI)心肌断层显像方法对左室重构进行定量评估。材料和方法：对 18例正常人和 57例冠心病 (CHD)患者行 99Tcm－ MIBI心肌断层显像,分析两组间心尖部和中央部纵径比 (LR)和横径比 (TR)及二者之差 (LR－ TR)的差别。结果：病人组 LR和 TR值明显高于正常组,其中陈旧性心梗和心绞痛患者的 LR－ TR值明显高于正常组;病人组 LR和 TR值与缺损计分、缺血面积百分比以及异常节段数明显相关,与冠脉狭窄支数相关性较弱,与左冠状动脉前降支单支的狭窄程度无明显相关。结论：心肌 99Tcm－ MIBI断层显像通过 LR和 TR两种参数的选定,可对左室重构的发生进行定量的评估。     

甲状旁腺腺瘤99Tcm-MIBI摄取与生物化学指标的相关性研究

目的 探讨双时相甲状旁腺显像的99TCm-MIBI摄取与血清生化指标(iPTH、Ca2+、P、Mg2+)、瘤体大小的关系.方法 对23例甲状旁腺腺瘤患者的核素显像、血清生化指标、病理进行回顾性分析.图像采用腺瘤部位及对侧甲状腺的计数比值(P/T)进行半定量分析,求出早期及延迟显像的P/T值(P/T1、P/T2),并分组进行比较(A组:P/T2≥P/T1,B组:P/T2

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99mTc-MIBI肺肿瘤显像对肺癌化疗敏感性预测的研究

目的:探讨99mTc-MIBI肺肿瘤摄取与P-糖蛋白(Pgp)在肺癌多药耐药(MDR)表达之间的关系,以及99mTc-MIBI肺肿瘤显像在预测抗肿瘤药物化疗敏感性的价值。方法:回顾性分析38例肺癌的99mTc-MIBI肺肿瘤图像,计算T?Ne、T?Nd和RI,并根据Pgp的表达与否(阳性和阴性)及化疗方案的有效性与否(好转和加重)分组,对各组数据进行相关性分析。结果:32例患者的肿瘤组织进行了免疫组化分析,其中9例Pgp表达阳性(阳性组),23例表达阴性(阴性组),两组的T?Ne、T?Nd和RI值未见统计学差异。有完整化疗数据的20例中,病情好转与加重分别有10例,统计显示两组仅在T?Ne间有差异(P<0.05),分别是1.76±0.50和1.28±0.51。结论:99mTc-MIBI肺肿瘤显像可以预测肺癌对化疗的敏感性,但是确定其肺癌化疗敏感性的机制和标准化的方法,还有待于进一步的研究。     

脑膜瘤~(99)Tc~m-MIBI与~(99)Tc~m ECD SPECT脑显像的对照研究

目的　探讨脑膜瘤99Tcm MIBI和99Tcm ECDSPECT脑显像的影像特征 ,并评价其应用价值。方法　对 10例正常对照者及 18例脑膜瘤患者进行99Tcm MIBI和99Tcm ECDSPECT脑显像 ;分析病灶的影像特征。结果　正常对照者99Tcm MIBI显像脑实质内均无核素浓聚 ;99Tcm ECD显像脑实质内放射性核素分布大致均匀 ,左右侧基本对称。 18例脑膜瘤99Tcm MIBI显像见肿瘤处均表现为均匀的圆形或卵圆形放射性核素浓聚 ,其阳性率为 10 0 % ;而99Tcm ECD显像 18例中有 17例示肿瘤处表现为形态规整、边缘整齐的圆形或卵圆形内凹缺损 ,其形态与99Tcm MIBI显像所示的浓聚区相吻合 ,另1例为假阴性结果 ,其阳性率为 94.4%。结论　99Tcm MIBI结合99Tcm ECDSPECT脑显像可用于脑膜瘤的辅助诊断     

非小细胞肺癌放疗前后~(18)F-FDG符合线路正电子显像与~(99)Tc~m-HL91乏氧显像临床研究

目的观察非小细胞肺癌(non-small cell lung cancer,NSCLC)患者放疗前、后~(99)Tc~m-HL91乏氧显像与~(18)F-FDG符合线路正电子显像变化,探讨2种方法评价NSCLC放疗疗效的价值。方法 NSCLC患者20例,均行三维适形放疗,分别于放疗前1周、放疗结束后8周行18F-FDG符合线路正电子显像、静脉注射~(99)Tc~m-HL91后4h平面及SPECT/CT断层显像,采用半定量法测量肿瘤病灶和对侧正常肺组织摄取~(18)F-FDG及~(99)Tc~m-HL91比值(T/N);依据放疗疗效将20例患者分为放疗有效组和无效组,观察2组放疗前、后T/N比值变化,分析其与放疗疗效的关系。结果放疗后病灶和对侧正常肺组织摄取18F-FDG T/N比值(5.47±1.69)较放疗前(7.51±1.53)降低(P0.05);放疗后病灶和对侧正常肺组织摄取~(99)Tc~m-HL91的4h平面及SPECT/CT断层显像T/N比值(1.20±0.11、1.61±0.27)较放疗前(1.44±0.08、1.98±0.21)降低(P0.05);放疗前后摄取~(99)Tc~m-HL91的4h平面及SPECT/CT断层显像T/N比值明显低于摄取~(18)F-FDG T/N比值(P0.05);放疗结束后8周评价放疗疗效,有效13例,无效6例,死亡1例;放疗有效组、无效组放疗后病灶与对侧正常肺组织摄取~(99)Tc~m-HL91的4h断层显像T/N比值(1.34±0.13、1.82±0.35)低于放疗前(1.69±0.21、2.04±0.32)(P0.05),且2组放疗前后T/N比值比较差异有统计学意义(P0.05);有效组治疗前~(18)F-FDG显像T/N比值(7.34±1.25)与无效组(7.58±1.62)比较差异无统计学意义(P0.05),放疗后有效组T/N比值(4.61±1.32)较放疗前降低,且低于无效组放疗后(7.23±1.34)(P0.05);病灶摄取~(18)F-FDG和~(99)Tc~m-HL91 4h断层显像的T/N比值呈直线相关(r=0.641,P=0.034)。结论放疗可有效降低肿瘤的乏氧水平和肿瘤的葡萄糖代谢活性;~(99)Tc~m-HL91显像可反映病灶的乏氧状态及放疗前后乏氧水平改善程度,初步评价放疗疗效。     

乳腺癌99mTc-HL91乏氧显像和HIF-1α表达相关性的实验研究

目的:研究乳腺癌99mTc-HL91乏氧显像以及与乏氧诱导因子-1α(HIF-1α)表达水平的相关性。方法:31例乳腺癌患者行SPECT 99mTc-HL91乏氧显像,利用计算机感兴趣区(ROI)技术计算乳腺癌病灶计数/对侧计数(T/TN值),免疫组化方法检测肿瘤组织HIF-1α表达水平。结果:31个病灶对99mTc-HL91的摄取均高于对侧正常乳腺组织,99mTc-HL91摄取程度与肿瘤大小无相关关系(P>0.05);注射99mTc-HL91 4小时后SPECT显像浸润性导管癌T/NT值为2.16±0.38,浸润性小叶癌T/NT值为2.10±0.32,两者无显著性差异(P>0.05);病灶的T/NT值为1.36~6.43(中位值2.95),免疫组化结果显示表达HIF-1α的细胞数为25.6%~78.5%(中位数56.3%),两者之间呈正相关(P<0.01)。结论:乳腺癌组织对乏氧显像剂99mTc-HL91有显著的摄取,摄取值与病理类型及病灶大小无相关性,但与HIF-1α的表达存在正相关。     

二甲双胍联合西格列汀治疗老年糖尿病的meta分析

目的 通过系统评价的方式评估二甲双胍联合西格列汀治疗老年2型糖尿病(T2DM)的疗效和安全性。方法 通过检索中文数据库如万方、中国知网、维普数据库以及外文数据库如PubMed、Cochrane library等各个数据库,自建库以来至2023年2月1日期间所发表的二甲双胍联合西格列汀治疗老年T2DM的所有RCT研究,对纳入文献进行偏倚风险评价及 Meta 分析。结果 最终纳入10项研究,共927例患者;试验组均使用二甲双胍联合西格列汀,对照组均使用二甲双胍治疗。纳入的10项研究中,有5项研究进行了安全性评价即不良反应情况;发现二甲双胍联合西格列汀治疗具有良好的安全性。Meta分析的研究结果表明,试验组的空腹血糖、餐后血糖、糖化血红蛋白明显低于对照组。结论 西格列汀联合二甲双胍适用于老年糖尿病的治疗,降糖效果好,安全性高。     

The Rho Variant-Du

A simplified test for the D^u factor employing a reagent containing 25 per cent serum albumin, the "stick" technic to introduce cells and forceful cen-trifugation has been given an extensive trial in a routine blood bank operation. A routine preliminary test with anti-D gave 5,051 negative reactions among 26,753 bloods tested. The D^u tube test was then performed on the former with an anti-CDE reagent in parallel with the indirect antiglobulin test done with anti-D. All bloods positive by one or both tests were tested further for D antigens by an anti-D elution technic; they were also tested for Rh-Hr factors.
Among the 126 bloods positive by elution for the D^ufactor, 122 and 126 were positive respectively by the antiglobulin and the D^u tube tests. The two tests were in agreement on all eight of the type ccD^uee bloods found in the study. The D^utube test, as done with anti-CDE, gave no false negative reactions. It is, thus, concluded that bloods which are negative with this test will be type ccddee and can be labeled "Rh negative tested for D^u. Serological factors which might account for sensitivity of the D^u tube test's being the equal of the antiglobulin test are considered, as are the probabilities of the existence of D variants so weak that they could not be detected by either test.     

陇中损伤胶囊联合骨科机器人辅助下骶髂关节螺钉置入治疗骨盆后环骨折的疗效研究

目的：观察陇中损伤胶囊联合骨科机器人辅助下骶髂关节螺钉置入治疗骨盆后环骨折的疗效研究。方法：对 2021 年1 月至 2022 年 5 月采用外科治疗的 60例骨盆后环骨折病例进行回顾性分析,选取骨盆后环骨折患者60例,随机分为治疗组和对照组。对照组接受骨科机器人辅助下骶髂关节螺钉置入治疗,治疗组在该基础上,配合陇中损伤胶囊口服,1周作为一个疗程,2个疗程后从疼痛、肿胀程度、患者骨折愈合时间与住院时间4个指标评价临床疗效。结果：治疗组骨折愈合时间与住院时间均优于对照组(P<0.05);治疗组肿胀程度低于对照组(P<0.05);治疗组VAS评分低于对照(P<0.05)。结论：陇中损伤胶囊联合骨科机器人辅助下骶髂关节螺钉置入治疗骨盆后环骨折有很好的临床疗效,值得临床推广应用。     

Comparative Absorption of Ferri-Haemoglobin-59Fe/Ferro-Haemoglobin-59Fe and 59Fe3+/59Fe2+ in Humans with Normal and Depleted Iron Stores*

Abstract. The intestinal ⁵⁹Fe absorption from ferri- and ferro-haemogIobin-⁵⁹Fe and ⁵⁹Fe³⁺ and ⁵⁹Fe⁺ was calculated from whole body-⁵⁹Fe-retention measurements in subjects with normal and depleted iron stores. A ferri-haemoglobin-⁵⁹Fe/ferro-haemoglobin-⁵⁹Fe absorption ratio of 1.03 ±0.11 was observed for the absorption of ferri-haemoglobin-⁵⁹Fe (8.6± 0.77%) and ferro-haemogIobin-⁵⁹Fe (8.7±0.94%) in persons with normal iron stores. Depletion of iron stores caused a slight but significant higher rise of ferri-haemoglobin-⁵⁹Fe absorption (22 ± 1.7%) than the increase of ferro-haemoglobin-⁵⁹Fe absorption (18 ±0.9%) so that the absorption ratio was 1.24±0.073.—This remarkable iron valence independence of haemoglobin iron absorption is in considerable contrast to the well-established valence dependence of inorganic iron absorption which favours ferrous iron absorption especially with rising iron doses. The ⁵⁹Fe³⁺/⁵⁹Fe²⁺ absorption ratio for a diagnostic 0.56 mg Fe dose increased from 0.43 in subjects with normal iron stores to 0.74 in persons with depleted iron stores, whereas this absorption ratio was augmented only from 0.21 to 0.28 for the therapeutic 50 mg Fe-dose.—The different influence of iron valence on iron absorption from inorganic and haemoglobin iron supports other evidence for the existence of two separate mechanisms for ferrous iron and haem iron absorption in humans.     

Erythrocyte Li+/Na+ and Na+/H+ exchange, cardiac anatomy and function in insulin-dependent diabetics

It has been proposed that an increased activity of cell membrane Na+/H+ exchange, mirrored by increased erythrocyte Li+/Na+ exchange, may facilitate cell hypertrophy and hyperplasia. Patients with insulin-dependent diabetes mellitus may develop a specific cardiomyopathy with systolic and diastolic abnormalities and increased thickness of the left ventricle. Therefore, we have investigated the relationships between erythrocyte Li+/Na+ and Na+/H+ exchange and echocardiographic parameters in 31 male insulin-dependent diabetics (aged 17-68), in good metabolic control. Three had untreated mild hypertension. In all patients the urinary albumin excretion rate was less than 200 micrograms min-1. Ten patients had a Li+/Na+ countertransport higher than 0.37 mmol l-1 cell h-1, the upper normal limit for our laboratory (0.49 +/- 0.10, mean +/- SD). In comparison with the patients with normal countertransport, they had increased interventricular septum thickness and relative wall thickness (h/r). End diastolic volume and cardiac index were reduced while blood pressure and urinary albumin excretion rate were similar. In the whole study group, interventricular septum thickness was significantly correlated to Li+/Na+ exchange (r = 0.61, P less than 0.001) and Na+/H+ exchange (r = 0.35, P less than 0.05), independently of the effect of age and blood pressure. Posterior wall thickness was correlated to Li+/Na+ exchange (r = 0.38, P less than 0.05) and h/r to Li+/Na+ exchange (r = 0.41, P less than 0.05) and to Na+/H+ exchange (r = 0.44, P less than 0.05). Li+/Na+ exchange was negatively correlated to cardiac index (r = -0.37, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Further Observations on the Blood Factors RhA, RhB, RhC and RhD

The findings in 18 cases of individuals with Rh_o-positive blood who had antibodies in their serum resembling anti-Rh_o in specificity are briefly summarized. One interesting finding is the relatively high frequency of such individuals among Negroes, especially with the blood type Rh^d_o and Rh^abd_o. The significance of these findings is discussed.     

癌症患者未成年子女心理行为问题的研究进展

癌症患者未成年子女通常会存在各种生理、心理和行为问题,如焦虑、抑郁、社交恐惧、躯体疼痛、失眠和暴力倾向等,但我国研究者并未重视这一群体。本文对癌症患者未成年子女心理行为问题现状和相关影响因素进行综述,并介绍了国内外促进癌症患者未成年子女心理健康的干预措施,旨在为国内研究癌症患者未成年子女的心理行为问题的原因,并开发符合我国文化背景的理论模型和干预措施提供参考。