放射性核素骨显像在可注射性骨修复材料治疗犬股骨颈骨折实验中的应用价值

目的 探讨可注射性骨修复材料在犬股骨颈骨折中的修复能力及放射性核素骨显像技术在此过程中的应用价值.方法 健康成年杂种犬12只,每只犬左右两侧股骨头、颈分别作为对照侧与实验侧.实验侧应用中空加压螺钉复合可注射骨形态发生蛋白（BMP）缓释载体,对照侧单纯植入中空加压螺钉,术后4、8、12周分别通过放射性核素骨显像进行监测.结果 放射性核素骨显像中感兴趣区（ROI）计数和摄取比值显示实验组随着时间的延长再血管化的数量和成骨的质量呈现出上升的趋势.结论 可注射性骨修复材料具有良好的修复犬股骨颈骨折的能力,放射性核素骨显像在修复过程中有非常准确的预测效果.     

放射性核素骨显像时肝显影2例分析

放射性核素骨显像是诊断全身骨疾病的一种有效手段,是核医学的主要检查内容之一,特别是对于探查恶性肿瘤骨转移是一非常有用的工具.但骨显像时出现肝脏显影却很少见,我们遇到2例分析如下.     

放射性核素骨显像和血清前列腺特异抗原、碱性磷酸酶、骨特异性碱性磷酸酶测定在前列腺癌骨转移诊断中的应用价值

目的探讨放射性核素骨显像和血清前列腺特异抗原（PSA）,碱性磷酸酶（ALP）,骨特异性碱性磷酸酶（BAP）测定在前列腺癌骨转移诊断中的价值。方法回顾性分析2006年10月-2009年10月50例前列腺癌（PCa）患者骨显像结果及PSA、ALP、BAP测定结果。结果 50例Pca患者骨显像阳性率为70.0%。35例Pca骨转移患者分布在PSA〉20.0ng/mL时占97.1%,BAP〉20.1μg/L时占88.6%,ALP〉130.0μg/L时占94.3%。血清PSA、ALP、BAP水平随着放射性核素骨显像分级的增高而逐步增高,呈高度正相关。结论放射性核素骨显像仍然是目前诊断PCa骨转移的主要方法;PSA、ALP、BAP亦是重要的辅助诊断指标;PSA〉20.0ng/mL时,患者应常规行全身骨显像检查。     

放射性核素骨显像对原发性颌骨肿瘤范围预测价值

目的研究放射性核素骨显像在显示颌骨肿瘤侵润范围及指导临床手术切除肿瘤中的价值。方法收集原发性颌骨恶性肿瘤病人37例,术前均行放射性核素骨显像检查,并将显像显示的肿瘤侵犯范围与病理学结果进行对比。结果37例恶性颌骨肿瘤病人,放射性核素骨显像显示肿瘤大小和病理学证实的肿瘤侵润范围分别为（5.62±1.58）cm和（4.48±1.57）cm,二者比较差异有显著意义（t=2.98,P〈0.05）。其中的36例放射性核素骨显像显示的颌骨肿瘤范围,组织病理学检查证实35例手术切缘无肿瘤细胞浸润,1例手术切缘有肿瘤细胞浸润。结论放射性核素骨显像能较准确地评价颌骨内恶性肿瘤侵润范围,可为手术治疗原发性颌骨恶性肿瘤提供相对安全手术切缘。     

放射性核素骨显像在肺癌并肥大性骨关节病诊治中价值

目的探讨放射性核素骨显像在肺癌并肥大性骨关节病诊断及治疗中的应用价值。方法回顾性分析17例肺癌并肥大性骨关节病患者的放射性核素骨显像资料。结果治疗前,放射性核素骨显像示患者四肢长骨尤其是双下肢长骨均呈"双轨征"改变,关节周围为对称性核素浓聚;手术或化疗后,肥大性骨关节病特征性的"双轨征"表现消失。结论放射性核素骨显像显示"双轨征"是肺癌并肥大性骨关节病典型表现。     

风湿免疫疾病患者核素骨显像的意义

目的:了解放射性核素骨显像在风湿免疫疾病患者中的应用价值。方法:122例患者均行常规全身骨显像及局部骨关节静态及断层显像。结果:122例患者中骨显像阳性90例,阳性率73.7%,骨肿瘤16例,阳性率1.11%。结论:放射性核素骨显像在风湿免疫疾病的诊断及鉴别诊断中有一定的临床意义。     

X线骨骼摄片与核素骨显像在多发性骨髓瘤骨破坏的比较

目的 评价X线骨骼平片与放射性核素全身骨显像在多发性骨髓瘤(multiple myeloma，MM)患者骨损害的应用价值。方法 对20例初发MM患者X线骨骼平片和放射性核素(99MTC—MDP)全身骨显像对比研究。结果 X线骨骼平片穿凿样溶骨性骨破坏占90％(18／20例)，病理性骨折占80％(16／20例)，弥漫性骨质疏松占80％(16／20例)。放射性核素骨显像阳性率45％(9／20例)，其表现是放射性核素浓聚灶、稀疏区，分布不均。结论 放射性核素骨显像对MM骨损害检查不如x线骨骼平片敏感、特异性高。X线骨骼摄片检查仍是诊断MM骨骼损害的首选。     

核素示踪技术在神经母细胞瘤诊治中的应用进展

神经母细胞瘤是儿童最常见的颅外实体肿瘤.核素示踪技术在神经母细胞瘤的诊断、监测疗效、探测术后转移病灶、判断预后及治疗中有非常重要的作用.本文综述间碘苄胍(MIBG)显像、骨显像、生长抑素受体显像、放射性核素标记显像、PET、PET/CT显像等在神经母细胞中的应用以及MIBG和放射性核素标记抗体在治疗方面的最新进展.     

放射性核素骨显像骨代谢与骨密度的相关性分析

目的：探讨放射性核素骨显像骨代谢与骨密度的相关性,通过骨显像了解骨质疏松状况.方法：18例患者,男5例,女13例,年龄50～88岁,平均65岁.所有患者均通过骨密度扫描仪进行骨密度检查后,进行全身骨显像.骨显像与骨密度检查均取第L1～L4和股骨颈,并勾画感兴趣区（ROI）,然后分别测定各部位ROI放射性计数和骨密度值,计算骨显像各部位ROI值与同侧股骨中段ROI值的比值,观察各部位ROI比值与其骨密度值之间的相关性.结果：骨显像L1～L4各部位ROI比值与其骨密度值呈显著相关,而且,正常组与骨质疏松组的ROI比值与骨密度的相关性存在显著性差异.股骨颈的ROI比值与其骨密度无显著相关.骨显像L1～L4的ROI比值与其相应部位骨密度测定值之间变化趋势基本一致.结论：放射性核素SPECT骨显像腰椎ROI比值与其对应部位的骨密度值之间均呈显著相关,可通过其反映腰椎骨密度的变化.     

肺癌患者的核素骨显像应用分析

肺癌为我国多发肿瘤之一,较易产生骨转移,放射性核素骨显像较X线检测提早3～6个月发现骨转移灶,是发现骨转移较灵敏的方法.我科对我院门诊及住院57例经病理学诊断为肺癌病人的全身骨显像结果分析如下.     

儿童遗传性心律失常的诊治进展

回顾在遗传性心律失常领域最新发表的相关研究,主要关注与儿童心源性猝死关系密切的离子通道病,包括长QT综合征（LQTS）、短QT综合征（SQTS）、Brugada综合征（BrS）和儿茶酚胺敏感性多形性室性心动过速（CPVT）,总结它们在发病机制及诊治方面的进展。     

The acoustic characteristics of the skull

Many investigators have stated that the difficulties of imaging with acoustical energy through the skull result from the marked attenuation of the energy by the skull. In the literature measurements of total attenuation have been confused with those for absorption.Measurements made by us show that absorption by compact bone varies between 2–3 dB cm^?1 MHz^?1 and, in the low megaHertz region appears to be directly proportional to frequency.It has also between shown that the convoluted inner surface of the ivory bone of the inner table of the skull may degrade the collimation and directionality of the beam by refraction.Cancellous bone, such as is present in the dipole of the skull, greatly attenuates the energy. It is postulated that this largely results from scattering. It is also postulated that the energy propagates through cancellous bone as two components, one in the soft tissues and the other partly in the bony spicules. Observations suggest that attenuation due to scattering much more markedly affects the latter of these components and scatters more greatly the higher frequencies in a pulse of broad bandwidth.The energy in each component has varying propagation paths so that the later cycles in the pulse of each component are subject to increasing interference as a result of the variations in propagation times. The two components moreover may have different propagation times so that interference may occur between the pulses of each component as well.All of these phenomena degrade the collimation, coherence, directionality, beam width, pulse length, frequency and other properties of the ultrasonic energy upon which imaging through the skull depends.The interference effects described above are least for the first cycle in the pulse which usually is not the cycle of highest amplitude. Since, in the free field, most of the energy is concentrated around the beam axis, most of the energy in the field which is deflected from its normal propagation path is deflected away from the beam axis. Thus the directionality of the beam is least degraded in the beam axis. The effects of the skull in degrading the properties of the ultrasonic pulse would therefore be lessened if the amplitude of the first cycle of the pulse and the directionality of its energy could be used for imaging.     

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.     

2017年呼吸疾病主要进展

2017年,国内外学者在呼吸系统疾病的临床和基础领域均进行了深入研究,不仅对相关指南进行了更新,并且针对一些临床热点、难点问题达成专家共识,现就2017年呼吸疾病相关进展作一简单介绍。     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus,therapy, and the vaccination

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP

BackgroundWe aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.MethodsWe performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.ResultsFifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).ConclusionsTreatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.     

经颅黑质超声诊断帕金森病的临床评价

目的 通过对帕金森病患者及正常对照组进行经颅超声(transcranial sonography,TCS)检查,结合帕金森病患者的Hoehn Yahr（H Y）分级及帕金森病统一评分量表评分结果,了解我国大陆地区帕金森病患者有无黑质(substantia nigra, SN)回声增强表现。方法 对入选对象进行TCS检查,并对检查结果进行评价。结果 帕金森病患者 SN阳性率明显高于正常对照者（P＜0.05）。帕金森病SN异常组 H Y 分期明显高于帕金森病SN正常组(P＜0.05),表明帕金森病患者SN高回声面积与H Y分期相关。TCS检查对帕金森病的敏感性为80.5%,特异性为79.9%。结论 我国帕金森病患者SN强回声检出率显著高于对照组,说明我国帕金森病患者也存在SN回声增强这一现象,与国内外报道相一致。TCS检查对帕金森病的诊断具有一定的意义,敏感性及特异性较高。