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.     

99 TcmN-NOEt门控心肌显像的临床应用

目的评价99Tcm-N-乙氧基,N-乙基氨荒酸钠(N-NOEt)门控心肌显像的临床应用价值,并与99Tcm-甲氧基异丁基异腈(MIBI)进行比较.方法 20例受检者分为2组,组1左室射血分数(LVEF)≥50%,共13例,平均年龄(49.9±14.7)岁;组2LVEF<50%,共7例,平均年龄(50.9±12.9)岁.受检者静脉注射99TcmN-NOEt 925 MBq后分别于30和120 min行静息门控心肌断层显像,并计算心/肺(H/L)比值.组2 6例、组1 1例在3 d内行99Tcm-MIBI门控心肌显像,将每例受检者的左室心肌分为9个节段,以常规4分法进行打分.结果组1 30及120 min H/L比值分别为1.47±0.47和1.59±0.53(t=0.31, P>0.05),2次显像的LVEF、舒张末期容积(EDV)和收缩末期容积(ESV)差异无显著性(P>0.05).组2 30和120 min H/L比值分别为0.72±0.11和0.89±0.11(t=2.93, P<0.05),2次显像的LVEF,EDV和ESV间差异无显著性(P>0.05).2组间的H/L比值和LVEF、EDV、ESV差异有显著性.NOEt与MIBI所得LVEF,EDV和ESV值基本一致(P>0.05),但NOEt的不正常节段数(21个)较MIBI(17个)为多,两者的一致性为93.65%, Kappa±s=0.87±0.12,得分分别为2.00±0.84(MIBI)和2.38±0.84(NOEt)(t=1.39, P>0.05).结论①左心功能受损时, 肺摄取99TcmN-NOEt增多.②99TcmN-NOEt与99Tcm-MIBI所测得的LVEF,EDV和ESV基本一致.③99TcmN-NOEt测得的心肌放射性缺损的范围及程度较MIBI广泛而严重.     

99Tcm-MIBI半定量显像对甲状腺癌的诊断价值

目的评价半定量99Tcm-甲氧基异丁基异腈(MIBI)显像法对甲状腺癌的诊断价值.方法对269例经病理检查或细胞学证实的甲状腺结节患者的99Tcm-MIBI显像结果进行分析,计算其5和60 min摄取比值(UR),并以甲状腺良性结节组UR值的+s为诊断阈值,分析假阳性和假阴性.结果甲状腺良性结节组5和60 min UR分别为0.806±0.192和0.847±0.189,而甲状腺癌组UR值分别为1.839±0.734和1.675±0.551,同组两时相比较P>0.05,而组间两时相比较P<0.001.以良性结节组+s为诊断阈值,99Tcm-MIBI对甲状腺癌诊断的灵敏度、特异性和准确性分别为89.24%、93.82%和87.36%,假阳性率和假阴性率分别为15.78%和12.09%,阳性预测值和阴性预测值分别为 77.57% 和93.83%.结论 99Tcm-MIBI半定量显像能较好地鉴别甲状腺结节的良恶性,但缺乏特异性,甲状腺腺瘤和结节性甲状腺肿易出现假阳性.     

99mTc标记抗心肌肌凝蛋白轻链单克隆抗体在体亲梗死心肌放射免疫显像研究

为探讨99mTc标记抗心肌肌凝蛋白轻链单克隆抗体(AMLCA)在体亲梗死心肌放射免疫显像的可行性,5只狗静脉注射99mTc-AMLCA后2、4、8、24h,对血液标本和各脏器进行放射性测量和γ像机显像.对2例心肌梗死狗进行在体99mTc-AMLCA心血池显像和99mTc-MIBI心肌灌注显像,并对其离体心脏进行γ显像和双感兴趣区双核素放射性测量.结果表明,注射后2、4、8、24h,血液99mTcAMLCA放射活性分别是(51.5±5.2)%、(27.3±3.1)%、(12.3±1.8)%和(5.6±0.6)%,心脏放射性分别是(11.2±1.2)%、(6.7±1.5)%、(5.5±0.9)%和(2.8±0.3)%,注射2h在体心脏γ显像最清晰,以后逐渐衰减,注射24h心脏不再显像.心梗狗在体99mTc-AML-CA心血池显像与99mTc-MIBI心肌灌注显像比较,前者放射浓聚区与后者放射缺损区吻合,其离体心脏γ显像放射性浓聚区TTC染色证实是梗死心肌,双感兴趣区双核素放射性测量表明,梗死心肌摄取99mTc-AMLCA具有特异性.本研究提示,99mTc-AMLCA在血中清除迅速且能被梗死心肌特异性摄取,在体99mTc-AMLCA心血池显像能显示梗死心肌,99mTc-AMLCA在体亲梗死心肌显像可行.     

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     

用99Tcm-HL91评价鼠心肌缺血模型

目的 探讨乏氧心肌显像剂99Tcm-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)用于诊断实验性缺血心肌的价值.方法 建立大鼠心肌在体缺血再灌注模型,采用体外放射自显影法检测正常对照组(6只)、缺血再灌注组(8只)及无再灌注组(8只)鼠心肌对99Tcm-HL91的摄取.结果 对照组和无再灌注组心肌未见局灶性放射性浓聚,再灌注组心肌非坏死区有较高放射性浓聚,与正常心肌组织的摄取比值为1.634±0.354.结论 99Tcm-HL91表现出较强的亲乏氧组织特性,能较好区分存活和梗死心肌.     

断指再植术后早期99Tcm-RBC显像的临床价值

目的探讨断指再植术后早期(<48h)动态99Tcm-RBC血池显像(BPI)的临床价值.方法 30例断指再植患者于术后48 h内进行5次BPI,计算并对比分析再植指和正常指的放射性比值(T/NT),根据再植指放射性聚集程度将显像结果分为0、Ⅰ、Ⅱ级.结果再植指通过4次高压氧(HBO)治疗后的T/NT(0.624±0.310)明显高于治疗前(0.413±0.274,t=2.79,P<0.01),4次治疗后的T/NT变化情况可作为终止HBO治疗的指征;治疗前显像为0、Ⅰ、Ⅱ级的T/NT分别为0.149±0.063、0.463±0.050、0.840±0.202(t=11.87、 9.30、5.77,P<0.01),血管危象发生率分别为100%、20%、0(χ2分别为28.8、20.0,P<0.01);48 h时显像为0、Ⅰ、Ⅱ级表现的再植指需再次手术和(或)坏死发生率分别为100%、8.3%、0(χ2分别为11.7、18.0,P<0.01).结论 BPI对断指再植术后早期动态监测疗效、预测血管危象发生和预后及进一步选择治疗方案均有重要的临床价值.     

早期放射性肝损伤的99Tcm-PHY显像研究

目的探讨肝脏放射性损伤早期效应的^99Tc^m-植酸盐(PHY)显像表现及病理组织学特征。方法12只家兔，在家兔左侧半肝40Gyx线照射前和照射后第3天，分别进行^99Tc^m-PHY肝脏显像，并行照射后注射显像剂24h后延迟显像，检查结束后进行肝脏病理组织学研究。结果半肝照射前^99Tc^m-PHY肝脏显像示肝脏对核素的摄取较均匀。半肝照射后第3天^99Tc^m-PHY显像，9只家兔(占75％)肝脏照射区的核素摄取能力明显降低，延迟显像还观察到照射区肝脏有核素滞留现象；余3只呈阴性。肝脏照射后第4天，家兔肝脏照射区与未照射区标本光镜下均未见明显异常；但随机抽查1只阳性家兔，电镜检查照射区肝脏可见细胞超微结构异常。结论^99Tc^m-PHY显像对早期检测肝脏放射性损伤效应有较重要的价值。     

应用18F-DOPA PET显像诊断路易小体性痴呆

目的评价测定纹状体突触前多巴胺代谢水平对路易小体性痴呆(DLB)诊断、鉴别诊断的价值.方法研究对象分为3组7例DLB患者,10例老年性痴呆(AD)患者及9例年龄相匹配的正常对照者.用18F-fluorodopa(DOPA)PET显像测定受检者纹状体突触前多巴胺的摄取(即脑内18F-DOPA放射性水平, 以流入速率常数Ki表示),然后对3组Ki值进行比较.结果①DLB组Ki值(壳核0.006 4±0.001 7,尾状核0.005 1±0.001 9)明显低于AD组(分别为0.011 9±0.002 1及0.009 2±0.001 4)及对照组(分别为0.013 1±0.002 8及0.012 2±0.003 5),差异均有显著性(P均<0.01);而AD组与对照组间的Ki值差异无显著性(P>0.05).②DLB的尾状核Ki值(正常值的42%)降低较壳核(正常值的49%)更为明显.③以Ki=0.006 2作为临界点(正常尾状核-2s),DLB与AD鉴别的灵敏度和特异性分别为86%和100%.结论用18F-DOPA PET显像检测多巴胺代谢功能有助于DLB的早期诊断和鉴别诊断.     

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±1.27,靶/非靶比值为5.23±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.     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.