18F-氟代脱氧葡萄糖应用于肺癌术中导向的实验研究

目的研究放射导向手术(RGS)在肺肿瘤外科中的应用价值.方法根据有无肺转移,40只荷肺腺癌小鼠被随机配对分成两组,并经尾静脉注入200μl(100μCi)18F-氟代脱氧葡萄糖(18F-FDG).注药后进行体外放免显像、手持型γ探测仪(GDP)体内探测及井型探测仪分析.结果注药后2h肿瘤显像最清晰.井型探测仪显示心脏与肿瘤的放射性分布(%ID/g)高于其他脏器.GDP显示肿瘤/正常组织放射性比值(T/NT)为3.71～13.57(除肿瘤/心脏以外).肺转移组肺组织的%ID/g及T/NT比值与对照组肺组织相比存在显著性差异(P<0.01).肺转移癌的T/NT为2.91±0.45.结论肺癌组织能够大量摄取18F-FDG,利用GDP可准确区分肿瘤及正常组织并探测出转移病灶.     

~(99m)Tc-培普利欧霉素诊断肺肿瘤的价值~(99m)Tc-MIBI比较

目的 :评价99mTc -PPM平面显像诊断肺癌的临床价值。材料与方法 :2 8例经X线、CT证实肺肿瘤患者 ,其中 2 0例恶性 ,8例良性。注射99mTc -PPM后 5min、15min、30min、1h行平面显像 ,选延迟相图像以ROI法处理 ,计算T/NT ;并与99mTc -MIBI比较。结果 :8例良性肿瘤的99mTc -PPMT/NT值为 1.0 4± 0 .0 8;2 0例恶性肿瘤的T/NT值为 1.41± 0 .16。以T/NT值 1.2为标准 ,99mTc -PPM对肺癌诊断的灵敏度、特异性和准确度分别为 90 % (18/2 0 )、87.5 % (7/8)、89.3 % (2 5 /2 8) ;该结果与99mTc -MIBI相比无明显的差异。结论 :99mTc -PPM可用于鉴别肺肿瘤显像 ,以区别肿瘤的良恶性     

肺肿瘤99Tcm-MDP血流灌注与微血管密度的关系

目的 探讨肺肿瘤99Tcm-亚甲基二膦酸盐(MDP)血流灌注与微血管密度(MVD)的关系.方法 对26例肺癌和9例肺良性病变患者进行早期(5 min)99Tcm-MDP SPECT显像,用感兴趣区(ROI)法计算病灶与健侧相应部位正常肺组织的放射性比值(T/NT),用Spearman等级相关分析比较手术切除标本MVD与T/NT的关系.结果 肺癌的T/NT(2.36±0.56)明显高于肺炎性假瘤(1.67±0.21)和结核球(1.42±0.48),差异均有统计学意义(t=2.68,3.29,4.01;P＜0.01),肺癌的MVD[(14.6±2.9)支]明显高于肺炎性假瘤[(11.2±2.1)支]和结核球[(3.2±0.9)支],差异均有统计学意义(t=2.46,7.67,4.06;P均＜0.01),肺肿瘤的T/NT与MVD呈明显正相关(r=0.884,P＜0.01).结论 肺癌99Tcm-MDP血流灌注水平增高与MVD增加密切相关.     

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-PPM及99Tcm-MIBI肺显像诊断原发性肺癌

目的 探讨99Tcm－培普利欧霉素（PPM）及99Tcm-甲氧基异丁基异腈（MIBI）肺显像诊断原发性肺癌的临床价值。方法 对28例临床诊断肺肿瘤患者进行99Tcm-PPM ey 99T0-MIBI肺肿瘤显像并进行比较。结果 肺癌与良性病变对99T -PPMey 99T-MIBI观的摄取差异有显著性（P＜0．01）,以肺癌晚期显像摄取比值（T／NT,X－S）作为判断良恶性阈值,99Tcm-PPM及99Tcm-MIBI对肺癌诊断的灵敏度,准确性分别为90％,89．3％,和80％,82．1％,两者结合显像阳性率为95％,病灶对放射性药物的摄取与肿瘤大小无明显相关（P＞0．05）,结论 99Tcm-PPM ey 99T-MIBI肺显像对肺癌的诊断,鉴别诊断有一定的临床价值。两者联合应用可提高肺癌的阳性检出率,单独使用99Tcm-PPM优于99Tcm-MIBI。     

99Tcm-DTPA-生物素-亲和素预定位技术用于肿瘤放免显像

目的评价用99Tcm替代111In标记生物素-亲和素系统(BAS)在肿瘤放免显像预定位中的价值.方法 DTPA-生物素溶液中加入99Tcm淋洗液,室温放置10 min.荷LA-795肺癌鼠分成荷瘤7 d肺无转移组和荷瘤15 d肿瘤肺转移组.采用三步法预定位技术给药,先注射生物素化C50抗体,1 d后注射亲和素,再过2 d注射99Tcm-DTPA-生物素,设对照和空白组;并与常规99Tcm直接法标记C50抗体放免显像比较.结果 99Tcm-DTPA-生物素的标记率大于90%,亚锡量是影响标记率的重要因素.注射后2 h,三步法组肿瘤摄取量为(1.35±0.45)%ID/g,瘤/血比值(T/B)为5.86,瘤/肌肉比值(T/M)为8.43.而对照直接注射99Tcm-DTPA-生物素组的T/B为0.85,T/M为1.1.99Tcm直接法标记C50放免显像组在注射后8 h的T/B为1.65,T/M为2.0.注射后2 h平面显像,三步法组肿瘤显影清晰,余各组肿瘤均未显影.结论 99Tcm-DTPA-生物素可用于三步法肿瘤放射免疫显像,并优于直接标记法.     

~(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-神经紧张肽结肠癌显像的实验研究

目的　探讨99Tcm 神经紧张肽 (NT)显像早期诊断结肠癌的价值。方法　用99Tcm 标记NT进行裸鼠结肠癌模型体内生物分布和显像研究 ,观察受体阻断后99Tcm NT在裸鼠肿瘤模型体内的组织分布和显像特点。测定99Tcm NT与结肠癌细胞的亲和力常数 (Kd)。结果　99Tcm NT对结肠癌细胞Kd为 0 91nmol/L ;标记率 (>94 % )高且稳定。体内生物分布 :99Tcm NT主要经肾脏排泄 ,3和 12h肿瘤 /肌肉比值分别为 3 2 5± 1 0 2和 4 15± 1 4 6 ;受体阻断后 3h肿瘤 /肌肉比值 (1 2 1± 0 6 2 )明显降低 ,与受体未阻断结果相比差异有显著性 (P <0 0 1)。裸鼠肿瘤模型显像时间早 (0 5h开始显影 ) ,3h肿瘤 /对侧肢体比值为 2 6 8± 0 4 4 ;受体阻断后 3h肿瘤 /对侧肢体比值为 1 14± 0 36 ,与受体未阻断结果相比差异有显著性 (P <0 0 1)。结论　99Tcm NT制备方法简单 ,为结肠癌的早期特异性诊断提供了一种可能的新方法。     

99Tcm-抗人膀胱癌人-鼠嵌合抗体在荷人膀胱癌裸鼠的放射免疫显像

目的　研究99Tcm 抗人膀胱癌人 鼠嵌合抗体ch BDI对膀胱癌细胞的体外结合性能、在荷人膀胱癌裸鼠中的体内分布及对肿瘤的靶向定位性能。方法　用改进的Schwarz方法进行99Tcm 标记 ,经SephadexG 5 0柱分离纯化。用纸层析法测定标记率与放化纯 ;用Lindmo的方法测定免疫活性分数 ;用Scatchard作图法求得亲和常数。荷人膀胱癌裸鼠静脉注射99Tcm ch BDI 11.1MBq(30 μg) ,分别于 2、6、2 0及 2 4h行放射免疫显像。用感兴趣区 (ROI)技术获得全身和肿瘤放射性计数及肿瘤与对侧正常组织 (T NT)的放射性比值。 2 4h显像后处死裸鼠 ,测定体内放射性分布 ,计算每克组织百分注射剂量率 (%ID g)及T NT比值。结果　99Tcm ch BDI标记率为 (6 6 .5± 7.3) % ,放化纯 >90 % ,免疫活性分数为 76 % ,亲和常数为 3.5 6× 10 9L mol。荷人膀胱癌裸鼠放射免疫显像结果示 ,静脉注射后 6h肿瘤显影清晰 ,随时间延长更清晰。全身放射性计数随时间延长迅速降低 ,肿瘤放射性计数下降缓慢 ,T NT比值随时间增高。荷瘤裸鼠体内分布结果示 ,静脉注射后 2 4h肿瘤 %ID g为 17.4 ,除肾脏外 ,肿瘤与其他正常组织有很高的T NT比值 ,与脑、肌肉、小肠壁、骨骼及心壁的T NT比值分别为 136 .0、5 5 .1、39.3、2 9.7及 2 7 9。结论　ch BDI具有良     

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。     

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.     

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).     

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.     

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.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）