99Tcm-枸橼酸盐和99Tcm(Ⅴ)-DMSA显像诊断急性化脓性骨关节炎

目的　探讨99Tcm 枸橼酸盐和99Tcm(Ⅴ ) 二巯基丁二酸 (DMSA)显像对急性化脓性骨关节炎的诊断价值。方法　 17例急性化脓性骨关节炎患者和 19例非化脓性骨关节病患者分别行99Tcm 亚甲基二膦酸盐 (MDP)、99Tcm 枸橼酸盐和99Tcm(Ⅴ ) DMSA显像 ,行半定量分析。结果　 3种显像剂在急性化脓性骨关节炎病灶处均有明显趋骨性浓集 ;非化脓性骨关节病病灶处99Tcm MDP和99Tcm(Ⅴ ) DMSA有明显趋骨性浓集 ,99Tcm 枸橼酸盐仅有轻度趋骨性浓集 ,后者还可见周围软组织放射性浓集。半定量分析示 ,急性化脓性骨关节炎99Tcm 枸橼酸盐显像靶与非靶组织 (L N)比值 (2 30 0± 0 0 94 )明显高于非化脓性骨关节病 (1 2 98± 0 0 5 4 ,P <0 0 1) ;99Tcm(Ⅴ ) DMSA显像L N比值分别为 3 4 95±0 180和 3 0 91± 0 0 91,差异无显著性 (P >0 0 5 )。结论　联合应用99Tcm 枸橼酸盐和99Tcm(Ⅴ ) DMSA或99Tcm MDP显像能无创地评估骨组织炎症的病理生理状态。99Tcm 枸橼酸盐显像可显示骨组织炎症累及范围 ,而后两者可显示炎症所致骨组织代谢增高范围。     

葡萄糖负荷对细菌性兔骨关节炎动物模型摄取99Tcm(Ⅴ)-DMSA及其生物分布的影响

目的　探讨葡萄糖负荷影响99Tcm(Ⅴ ) 二巯基丁二酸 (DMSA)在细菌性骨关节炎症处浓集的可能机制。方法　自制细菌性兔骨关节炎动物模型 ,葡萄糖负荷下分别用感兴趣区技术和百分注射量分析法 ,分析葡萄糖负荷对99Tcm(Ⅴ ) DMSA生物分布及骨关节炎症处摄取和滞留99Tcm(Ⅴ ) DMSA的影响。结果　葡萄糖负荷对99Tcm(Ⅴ) DMSA全身生物分布没有明显影响 ,明显提高细菌性骨关节炎症区99Tcm(Ⅴ ) DMSA摄取水平 ,其 6h患侧与健侧比值 :显像分析法为对照组 2 882± 0 52 5,实验组 3 487± 0 53 5(P <0 0 5) ;百分注射量分析法为对照组 3 153± 0 3 3 4 ,实验组 5 0 71± 1 780 (P <0 0 5)。结论　葡萄糖负荷可提高骨组织炎症区99Tcm(Ⅴ ) DMSA摄取水平     

99 Tcm-MIBI与99Tcm-MDP骨显像诊断 骨良恶性病变的比较

目的　对比分析99Tcm 甲氧基异丁基异腈 (MIBI)和99Tcm 亚甲基二膦酸盐 (MDP)对骨良恶性病变的诊断价值和疗效评估。方法　 6 1例临床拟诊骨良恶性病变患者分别进行 2项骨显像 ,其中 6例恶性肿瘤患者分别进行化疗前后显像。显像后均经手术、病理检查对比分析。结果　99Tcm MIBI显像 :73 %恶性肿瘤病灶肉眼见中、高度MIBI浓聚 ,6 0 %良性病灶肉眼未见MIBI聚集。恶性病灶部位与对侧正常组织放射性计数比值 (L C)即99Tcm MIBI摄取比值 (3 0 8± 1 6 7)明显高于良性病灶(1 36± 0 6 4) ,P <0 0 1。99Tcm MDP显像 :大多数恶性或良性病灶肉眼见中、高度MDP浓聚 ,但恶性病灶99Tcm MDPL C(3 76± 1 37)与良性病灶L C(3 10± 1 0 5 )比较差异无显著性 (P >0 0 5 )。化疗可以抑制99Tcm MIBI摄取 ,99Tcm MIBI摄取程度与99Tcm MDP比较能较好反应治疗效果。结论　99Tcm MIBI对鉴别诊断良恶性骨病和评估疗效有较好的应用价值 ,与99Tcm MDP显像联合应用可更全面地提供信息     

99Tcm-Ap4A显像探测动脉粥样硬化斑块的动物实验研究

目的　探讨应用二磷酸腺苷 (ADP)的类似物99Tcm 四磷酸二腺苷 (Ap4A)显像探测动脉粥样硬化斑块的可行性。方法　采用酒石酸亚锡还原99TcmO- 4 标记Ap4A ,柱层析纯化 ,纸层析鉴定放射化学纯度。观察99Tcm Ap4A在昆明小鼠体内的生物分布并测定动脉粥样硬化模型家兔病灶斑块 血液、病灶斑块 无斑块动脉壁的放射性比值 ,进行腹主动脉宏观放射自显影及正常家兔及动脉粥样硬化家兔体外体内显像。结果　99Tcm Ap4A的放射化学纯度为 85 %～ 91%。99Tcm Ap4A在小鼠血液内清除迅速。注射99Tcm Ap4A后 30min粥样硬化组靶 血比值达 3.17± 1.2 7,靶 非靶比值为 5 2 3± 1.87。粥样硬化组自显影胶片上的曝光黑影与肉眼可见的动脉粥样硬化斑块有良好的一致性。体外显像 :正常家兔组腹主动脉未显影 ,粥样硬化组腹主动脉放射性浓聚清晰可见。体内显像 :粥样硬化组家兔的腹主动脉在注射99Tcm Ap4A后 15～ 30min与正常家兔组相比放射性浓聚明显增强 ,并持续到注药后 3h。结论　99Tcm Ap4A是一种有潜力的可快速显示动脉粥样硬化斑块形成的显像剂。     

~(99)Tc~m-HL91与~(99)Tc~m-MIBI在Lewis肺癌小鼠模型中的实验研究

目的　进行99Tcm 4,9 二氮 3,3,10 ,10 四甲基十二烷 2 ,11 二酮肟 (HL91)和99Tcm 甲氧基异丁基异腈 (MIBI)肿瘤显像对比研究 ,探讨99Tcm HL91诊断肿瘤的可能性。方法　各取 4只移植性Lewis肺癌小鼠分别注射99Tcm HL91或99Tcm MIBI,2、4h后进行全身后位静态显像 ,利用感兴趣区技术 ,分别计算不同时相肿瘤与头 (T/H)、胸 (T/C)、对侧部位 (T/L)的放射性比值。 4h后处死99Tcm HL91显像小鼠 4只 ,取血并剥离脏器及肿瘤组织 ,称重 ,测量放射性计数 ,计算肿瘤与各脏器放射性比值。结果　99Tcm MIBI显像组的肿瘤部位显影均不清晰 ,其中 2和 4h的T/C为 0 2 0± 0 0 8和 0 14± 0 0 7,两时相之间无明显差异。99Tcm HL91显像组各时相肿瘤显影均较清晰 ,其中 2和 4h的T/C为3 2 5± 1 2 5和 2 44± 1 0 7,两时相间无明显差异 ,而与99Tcm MIBI显像组各时相比较差异有显著性 (t=4 8～ 7 5 ,P <0 0 1)。体外测量肿瘤与脑、胸等脏器的单位重量放射性比值较高 ,肿瘤与肝、肾等腹部脏器的单位重量放射性比值较低。结论　在移植性Lewis肺癌小鼠组织中 ,99Tcm MIBI显像效果不佳 ,而99Tcm HL91吸收良好且清除缓慢。     

99Tcm-HYNIC-fMLFK用于小鼠炎症显像

目的　研究99Tcm 标记的趋化肽类似物fMLFK在小鼠体内的分布特征以及用于炎症显像的可能性。方法　以固相方法合成趋化肽类似物fMLFK ,经HYNIC衍生化后以99Tcm 标记。经小鼠尾静脉给药 ,观察99Tcm HYNIC fMLFK在正常和炎症小鼠体内的生物学分布。炎症小鼠于给药后6 ,12及 2 0h进行显像。结果　99Tcm HYNIC fMLFK在小鼠心脏、甲状腺、肌肉和胃肠道中每克组织百分注射剂量率 (%ID g)较低 ,且随时间延长清除较快 ;炎症病灶 %ID g相对较高 ,随时间延长清除较慢。同时 ,其在血液中清除迅速 ,给药后 3h %ID g降低为 0 5h的 2 4 %。给药后 2 ,3和 2 0h的炎症病灶肌肉 正常肌肉比值 (T NT)分别为 2 8± 0 4 ,3 1± 0 3和 14 3± 2 0。给药后 12h显像可见炎症病灶 ,2 0h延迟显像病灶更加清晰。结论　99Tcm HYNIC fMLFK能够选择性浓聚于炎症病灶 ,可用于急性炎症的临床诊断。     

放射性核素显像在骨肉瘤诊断中的应用

目的　评价骨肉瘤的核素显像特征,以利于骨肉瘤的诊断和疗效评估。方法　133例骨肉瘤患者做了174次99Tcm-亚甲基二膦酸(MDP)全身骨显像和33次201Tl三时相局部显像,观察骨肉瘤的显像特征和对显像剂的摄取情况。结果　108例骨肉瘤单发病灶的99Tcm-MDP显像特征为病灶部位的高摄取,在放射性浓集的热区病灶中可见大小不等的减低区,伴或不伴有软组织浓集,半定量分析摄取比值为5.40±3.42(n=33);33例骨肉瘤201Tl三时相显像血流曲线明显升高,15min比值为3.38±2.12,3h为2.03±0.87。报告了放射性核素显像在骨肉瘤多发病灶、肺转移灶及术后复发和骨转移诊断中的应用。结论　放射性核素显像可示踪骨肉瘤成骨的生物学行为,在骨肉瘤的基础和临床研究中有重要意义。     

99Tcm-sandostatin生长抑素受体显像用于诊断肺癌

目的　探讨99Tcm sandostatin生长抑素受体显像对肺癌的诊断价值。方法　 35例肺部肿瘤患者静脉注射99Tcm sandostatin (991 6± 187 5 9)MBq后行平面及胸部断层SPECT显像 ,重建后获得发射 透射图像及融合图像。勾画感兴趣区 ,计算肿瘤和对侧正常肺组织的放射性比值 (T N)。所有病灶均经病理检查及 (或 )其他检查证实。 5例孤立性肺结节 (SPN)行1 8F 脱氧葡萄糖 (FDG)符合线路显像 ,1例小细胞肺癌 (SCLC)治疗前后均行99Tcm sandostatin显像。 15例受检者于99Tcm sandostatin显像后 1周内行全身骨显像。结果　99Tcm sandostatin显像诊断肺癌的灵敏度、特异性和准确性分别为 93 3%、5 5例和 94 3%。 2例鳞癌99Tcm sandostatin显像假阴性。 4例SCLC99Tcm sandostatin显像发现胸膜异常放射性浓聚区 ,病理检查证实为胸膜转移。15例骨显像中 12例发现骨转移 ,99Tcm san dostatin仅发现 5例骨转移。SCLC、非小细胞肺癌 (NSCLC)T N分别为 3 4 3± 0 6 6、2 2 4± 0 31,差异有显著性 (t=4 0 72 ,P <0 0 0 1)。SCLC对99Tcm sandostatin的摄取明显高于NSCLC。结论　99Tcm san dostatin生长抑素受体显像无创、安全、经济 ,对肺癌有较好的诊断价值。     

99Tcm-octreotide显像在乳腺癌诊断中的应用

目的　探讨99Tcm 奥曲肽 (octreotide)显像对乳腺癌诊断的临床价值。方法　 36例乳腺肿块患者 ,据手术及病理检查结果分为乳腺癌组 (19例 )和乳腺良性病变组 (17例 )。术前分次进行乳腺99Tcm octreotide及99Tcm 甲氧基异丁基异腈 (MIBI)显像 ,行定性及半定量 [放射性摄取比值 (UR)测定 ]分析。结果　99Tcm octreotide显像对乳腺癌诊断的灵敏度 (6 8 4 %)低于99Tcm MIBI (94 7%,P <0 0 5 ) ,特异性 (10 0 %)明显高于99Tcm MIBI(76 5 %,P <0 0 5 ) ,准确性 (83 3%)与99Tcm MIBI (86 1%)差异无显著性 (P >0 0 5 )。联合99Tcm octreotide与99Tcm MIBI显像特异性高 (10 0 %) ,但准确性(80 6 %)无明显变化 (P >0 0 5 )。结论　99Tcm octreotide显像对乳腺癌诊断特异性高 ,准确性与99Tcm MIBI显像无明显差别。     

99 Tcm-抗人粒细胞单克隆抗体对兔炎症的放射免疫显像

目的评价99Tcm-抗人粒细胞单克隆抗体(McAb) SZ-102在实验性炎症家兔放射免疫显像中的价值.方法以2-亚氨基噻吩盐酸盐(2-IT)修饰SZ-102,99Tcm-葡庚糖酸钠(GH)配体交换法标记SZ-102.兔左下肢炎症模型经耳缘静脉注入99Tcm-SZ-102,行SPECT显像,99Tcm标记非特异性鼠IgG作阴性对照.显像完毕处死动物,测定99Tcm-SZ-102离体炎症肌肉/血液和对侧正常肌肉/血液放射性比值.结果 99Tcm-SZ-102对家兔炎症部位显影清晰,其最佳显像时间为注射后2～4 h,而99Tcm标记非特异性鼠IgG对家兔炎症部位未能显影.血液半清除时间99Tcm-SZ-102 T1/2α为(0.10±0.04) h,T1/2β为(3.19±0.41) h.99Tcm-SZ-102显像离体炎症肌肉/血液和对侧正常肌肉/血液放射性比值分别为0.22±0.02和0.02±0.01.结论 99Tcm-SZ-102具有活体内炎症定位导向能力,显像时间短,对隐匿性炎症或肿瘤感染病灶的诊断有潜在的临床价值.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.