^99mTc—DTPA气溶胶吸入法测定糖尿病患者肺上皮细胞通透性改变

目的 探讨２型糖尿病患者肺泡通透性的变化。方法 采用吸入＾９９ｍＴｃ－ＤＮＰＡ气溶胶后，测定肺脏清除半衰期的方法。选择２型糖尿病２８例，１型糖尿病２例，伴有并发症的患者１６例（Ａ组），无并发症者１４例（Ｂ组），２０例健康志愿者作为对照组（Ｃ组）。结果①糖尿病患者肺脏＾９９ｃＴｃ－ＤＴＰＡ清除半衰期（Ｔ１／２）较正常人明显缩短，差别有显著性（Ｐ〈０．０５）。②Ａ组糖尿病患者肺脏对＾９９ｃＴｃ－ＤＴＰ     

ＣＤ４５单抗介导的淋巴瘤荷瘤裸鼠三步法预定位放免显像

摘 要： 【目的】 评价生物素化ＣＤ４５单抗介导的９９ｍＴｃ－生物素在人Ｒａｊｉ细胞移植瘤裸鼠模型中三步法预定位放免显像的价值。【方法】 ＣＤ４５单抗及ＤＴＰＡ－生物素的９９ｍＴｃ标记采用直接标记法。取人Ｒａｊｉ细胞移植瘤裸鼠１８只,随机分为２组,每组９只。实验组为三步法预定位放免显像组,静注生物素化ＣＤ４５单抗１００ μｇ,４８ ｈ后静注亲和素２００ μｇ,再过４８ ｈ静注９９ｍＴｃ－生物素７．４ ＭＢｑ（２０ μｇ）;对照组为９９ｍＴｃ－ＣＤ４５单抗放免显像组,静注９９ｍＴｃ－ＣＤ４５单抗１００ μｇ。上述两组裸鼠分别于注药后３、６、１２ ｈ分别进行ＳＰＥＣＴ显像,每个时间点各取３只裸鼠断颈处死后,取脏器组织及肿瘤,称重后在γ计数仪中测量放射性计数,经放射性衰变校正后计算各脏器的％ＩＤ／ｇ及肿瘤／非肿瘤（Ｔ／ＮＴ）比值。【结果】平均每分子ＣＤ４５单抗约结合１２分子生物素,ＣＤ４５单抗及ＤＴＰＡ－生物素的９９ｍＴｃ标记率分别＞７０％和＞８０％。三步法给药后荷瘤裸鼠ＳＰＥＣＴ显像及生物分布示：整个显像期间血池内放射性均较低,肝脾见较多放射性浓聚;注射标记物后３－６ｈ,肿瘤显影清晰,并持续到１２ ｈ;注药后３、６和１２ ｈ肿瘤的％ＩＤ／ｇ分别为１．７３ ± ０．２２、１．２４ ± ０．０３和０．９４ ± ０．０７;肿瘤／血液比值分别为３．５、４．９和７．８;肿瘤／肌肉比值分别为８．２、８．９和１０．４。而静注９９ｍＴｃ－ＣＤ４５单抗后则可见肝脾及肾脏明显放射性聚集,１２ｈ血池内见较多放射性分布,肿瘤部位见有少量放射性集聚,１２ ｈ肿瘤的％ＩＤ／ｇ为０．８９ ± ０．１３,肿瘤／血液及肿瘤／肌肉的比值分别为１．６和２．５。【结论】与９９ｍＴｃ－ＣＤ４５单抗相比较,９９ｍＴｃ－生物素三步法预定位放免显像明显改善肿瘤Ｔ／ＮＴ比值,标记物注射后３ ｈ即可使肿瘤显影。     

肝受体显象剂^99mTc—DTPA—AGA的研制

报道了肝受体显象剂＾９９ｍＴｃ－ＤＴＰＡ－ＮＧＡ的制备方法及其特性研究。该显象剂放化纯度〉９５％，在体外和人体血液中的稳定性均大于６小时，有良好的趋肝性和受体介导结合特性。＾９９ｍＴｃ－ＤＴＰＡ－ＮＧＡ和＾９９ｍＴｃ－ＮＧＡ对比研究表明，前者在体外和人血液中的稳定性均比后者好；家兔显象结果前者质量明显高于后者；尿中放射性代谢产物检测，前者在体内无脱落＾９９ｍＴｃ的现象，而后者较明显。临床１０例肝受     

新型心肌灌注显像剂^99mTc—Q3的临床前药理研究

为了给临床应用研究提供依据,作者对新型心肌灌注显像剂＾９９ｍＴｃ－Ｎ,Ｎ’－亚乙基－二（乙酰丙酮亚胺）二「三（３－甲氧基－１－丙基）膦」（＾９９ｍＴｃ－Ｑ３）进行了临床前药理研究。其内容包括：＾９９ｍＴｃ－Ｑ３在兔体内的血药清除动力学 浆蛋白结合率,小鼠体内分布,家犬显像及异常毒性试验等。     

^99mTc—RBC的X射线光电子能谱研究

＾９９ｍＴｃ－标记的红细胞（＾９９ｍＴｃ－ＲＢＣ）是目前最常用的血池显像剂。本工作用体内标记法制备了＾９９ｍＴｃ－ＲＢＣ，采用Ｘ－射线光电子能谱（ＸＰＳ）对＾９９ｍＴｃ－ＲＢＣ中Ｔｃ原子的化学状态及其变化进行了测定。＾９９ｍＴｃ－ＲＢＣ于标记后１ｈ与标记后２ｈ所测ＸＰＳ能谱显示，表明＾９９ｍＴｃ－ＲＢＣ的稳定性佳。从ＲＢＣ与＾９９ｍＴｃ成键的情况看，多肽键上带负电荷的羧酸根氧原子与＾９９ｍＴｃ配合     

应用^99mTc—DMSA判定骨转移癌治疗效果

对４例经＾１５３Ｓｍ－ＥＤＴＭＰ治疗２个疗程以上的骨转移癌病人同时进行＾９９ｍＴｃ－ＤＭＳＡ骨阳性显像及＾９９ｍＴｃ－ＭＤＰ全身骨显像。结果显示，如果＾９９ｍＴｃ－ＤＭＳＡ嘣一显像示骨转移癌原病灶处未见有放射性异常聚集，即使＾９９ｍＴｃ－ＭＤＰ骨显像显示病灶处有放射性异常聚集，仍应考虑骨转移癌经＾１５３Ｓｍ－ＥＤＴＭＰ治疗后病灶消失。如果＾９９ｍＴｃ－ＤＭＳＡ骨阳性显像显示病灶处有放射性异常聚合集     

~（99m）Tc－RBC的X射线光电子能谱研究

９９ｍＴｃ－标记的红细胞（９９ｍＴｃ－ＲＢＣ）是目前最常用的血池显象剂。木工作用体内标记法制备了９９ｍＴｃ－ＲＢＣ，采用Ｘ－射线光电子能谱（ＸＰＳ）对９９ｍＴｃ－ＲＢＣ中Ｔｃ原子的化学状态及其变化进行了测定。９０ｍＴｃ－ＲＢＣ于标记后１ｈ与标记后２ｈ所测ＸＰＳ能谱显示，表明９９ｍＴｃ－ＲＢＣ的稳定性佳。从ＲＢＣ与９９ｍＴｃ成键的情况看，多肽键上带负电荷的羧酸根氧原子与９９ｍＴｃ配合；半胱氨酸带负电荷的硫原子与９９ｍＴｃ配合。从９９ｍＴｃ－ＲＢＣ９９ｍＴｃ３ｄ５／２的Ｅｂ值（其中ｊ＝５／２，Ｅｂ为原子能级中电子的结合能），可以推测９９ｍＴｃ－ＲＢＣ中９９ｍＴｃ的价态低于３价。与此同时，对含、９９Ｔｃ（Ｖ）、９９Ｔｃ（ＩＶ）及９９Ｔｃ（Ⅲ）的化合物进行ＸＰＳ测定，其结果表明：化学位移随着９９Ｔｃ还原价态的降低而降低。实验结果与理论推测相符。     

双核素肾图的临床初步应用

在多功能仪上采用双核素示踪技术，一次静注小剂量双核素踪剂＾９９ｍＴｃ－ＤＴＰＡ和＾１３１Ｉ－ＯＩＨ，同时获得双核素肾图，测定３２例正常人和１０９例病人，建立了＾９９ｍＴｃ－ＤＴＰＡ肾图的７项常规定量分析指标，发现＾９９ｍＴｃ－ＤＴＰＡ肾图检出肾功能受损的灵敏度高于＾１３１－ＯＩＨ肾图，并评价了双核素肾图的协同诊断意义。     

马钱子碱的药代动力学

用荧光分光光度法测定马钱子碱在小鼠体内的血药肖度及其药代动力学参数。结果表明：小鼠尾静脉注射３种剂量１０，７．５和５ｍｇ．ｋｇ＾－１的Ｂ后时量曲线均符合二室开放模型。其主要动力学参数：Ｔ＾１／２ａ分别为０．１７，０．２２和０．１ｈ；Ｔ１／２β分别为１．９６，２．１１和２．０６ｈ；Ｖｃ分别为７．２３，７．５９和５６．６５Ｌ．ｋｇ＾－１ＡＵＣ分别为２．４８，１．９６和１．４５ｈ．ｍｇ。；＾－１；ＣＬｓ     

卵巢癌预定位放射免疫显像的实验研究

目的：提高放射免疫显像（ｒａｄｉｏｉｍｍｕｎｏｉｍａｇｉｎｇ,ＲＩＩ）质量,建立卵巢癌预定位放射显像技术。方法：将合成的环二乙基三胺五乙酸（ｃｙｃｌｉｃｄｉｅｔｈｙｌｅｎｅｔｒｉａｍｉｎｅｐｅｎｔａａｃｅｔｉｃａｃｉｄ,ｃＤＴＰＡ）与卵巢癌单抗ＣＯＣ１８３Ｂ２进行偶联,Ｓｅｐｈａｄｅｘ分离纯化后,采用免疫组织化学染色及细胞放射自显影对偶联物进行活性测定。将偶联的ＣＯＣ１８３Ｂ２ｃＤＴＰＡ或ＩｇＧ分别经腹腔注入荷人卵巢癌裸鼠腹水瘤模型体内,４８ｈ后,将还原９９ｍＴｃ淋洗液经腹腔注入体内,６ｈ后进行ＲＩＩ。显像后,体外称重并测量瘤及其他正常组织放射性活性,计算瘤与非瘤放射性比值（Ｔ／ＮＴ）。结果：（１）ＣＯＣ１８３Ｂ２ｃＤＴＰＡ与浆液性卵巢癌组织免疫组化染色呈阳性;细胞放射自显影结果可见卵巢癌ＳＫＯＶ３细胞膜周围呈环状显影,提示偶联后单抗仍保留了较好的免疫活性。（２）注射还原９９ｍＴｃ６ｈ后ＲＩＩ,可见实验组荷瘤裸鼠腹腔有特异放射性聚集;而对照荷瘤裸鼠腹腔无特异放射性聚集。实验组各器官Ｔ／ＮＴ值高于对照组,两者差异有显著性（Ｐ＜０．０５）。结论：ｃＤＴＰＡ偶联ＣＯＣ１８３Ｂ２单抗进行卵巢癌预定位放射免疫显像     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.