新型放射性骨治疗剂117Snm-TTHMP生物学性能的研究

目的 探讨^117Sn^m-三乙撑四胺六甲撑膦酸(TTHMP)的生物学性能，以期开发新型放射性骨治疗剂。方法 以^117Sn^m-DTPA作对照，进行^117Sn^m-TTHMP新西兰兔平面骨显像和昆明种小白鼠体内分布实验。收集小鼠48h尿液，计算^117Sn^m-TTHMP、^117Sn^m-DTPA在骨摄取高峰时相各重要脏器及全身放射性滞留量。结果 ①^117Sn^m-TTHMP兔骨显像提示骨摄取较高，颅骨、脊柱、四肢显示清晰，与^117Sn^m-DTPA骨显像效果相似。②^117Sn^m-TTHMP血液清除与骨摄取迅速，注射后1h骨摄取每克组织百分注射剂量率(％ID／g)为15．82，4h为18．89，24h为25．23，14d后仍高达15．39。肾脏为主要排泄器官，非靶脏器放射性残留低。③^117Sn^m-TTHMP骨摄取率高于^117Sn^m-DTPA，差异明显。结论 ^117Sn^m-TTHMP有良好的生物学性能，是一种新型极具发展潜力的放射性骨治疗剂，值得进一步研究。     

99Tcm-MIDP的制备及其生物学分布

目的探讨^99Tc^m标记2-（2-甲基咪唑-1-基）-1-羟基乙烷-1，1-二膦酸（MIDP）用于骨显像的可能性。方法以2-甲基咪唑为原料，经3步反应制得MIDP。以SnCl2为还原剂，加入5mg MIDP，在pH值7．0下加入^99Tc^mO4^-溶液，室温放置8min即得^99Tc^m-MIDP。于正常小鼠尾静脉注射1．0MBq（0．2m1）^99Tc^m-MIDP，在不同时间断头处死小鼠。取心、肝、脾、肺、肾，肌肉、骨和血等，称重后测量放射性，计算每克组织百分注射剂量率（％ID／g）及骨中放射性与各组织中放射性的比值，并计算血药清除动力学方程和各参数。新西兰兔静脉注射^99Tc^m-MIDP后于不同时间显像。结果MIDP的制备总收率为34．3％。^99Tc^m-MIDP的标记率和放化纯均〉90％。在3h时小鼠骨摄取^99Tc^m-MIDP的量（Am.骨）为14．19％ID／g，Am.骨／Am.血为94．60，血药动力学方程为C=18．849e^-0.254＋3．568e^-0.0194。兔显像结果表明，3h时即可获得清晰的骨显像图。结论^99Tc^m-MIDP制备方便，骨显像清晰，是一种较有希望的新型骨显像剂：     

153Sm-EDTMP-纳米羟基磷灰石的生物学性能

目的研究^153Sm-乙二胺四甲撑膦酸(EDTMP)-纳米羟基磷灰石(HA)的体内外生物学性能。方法采用溶胶-凝胶法合成纳米HA并用电镜和X线衍射进行鉴定，采用独立变数法研究^153Sm-EDTMP-纳米HA的最佳标记条件并对产物进行体外稳定性分析，进行^153Sm-EDTMP-纳米HA新西兰兔显像，比较纳米HA、^153Sm-EDTMP和^153Sm-EDTMP-纳米HA对肝癌SMMC-7721和乳腺癌MCF-7细胞的体外抑制作用。结果①纳米HA为针状结晶，结晶度较好，径向10～30nm，轴向70～100nm，X线衍射证明产物为HA。②^153Sm-EDTMP-纳米HA的标记率均在95％以上。体外稳定性好，在生理盐水中放置48h后放化纯仍大于95％。③正常新西兰兔^153Sm-EDTMP-纳米HA显像对比度较好，骨骼系统显示清晰，肾脏显影，血清中放射性下降较快。④^153Sm-EDTMP-纳米HA对肝癌SMMC-7721和乳腺癌MCF-7细胞的半抑制率质量浓度分别为1．98mg／L和0．075mg／L，而纳米HA分别为3．31mg／L和0．52mg／L，^153Sm-EDTMP分别为4．32mg／L和0．67mg／L，^153Sm-EDTMP-纳米HA对肿瘤生长的抑制率明显高于纳米HA和^153Sm-EDTMP。结论^153Sm-EDTMP-纳米HA的骨组织摄取好，有明显的体外抑制肿瘤生长的作用。     

^153Sm—EDTMP显像测定骨摄取率在个体化治疗剂量计算中的应用

目的 探讨^153Sm-乙二胺四甲撑膦酸（EDTMP）全身显像法在个体化给药剂量计算中的价值。方法 对20例骨转移癌患者进行^153Sm-EDTMP显像,计算骨摄取率,并与尿液收集法进行比较。结果 显像法与尿液收集法所测得的骨摄取率之间具有很好的相关性（r=0.93)。根据显像法计算的骨摄取率,给药剂量为1．40－2．27GBq(平均1．90GBq),骨髓吸收剂量为1．37－1．43Gy(平均1．40Gy)。按标准体重计算,则应给予的剂量为1．75－2．41GBq（平均2．18GBq),骨髓吸收剂量为1．37－2．27Gy(平均1．63Gy)。两种方法给药剂量之间差异有显著性（t=4.075,P=0.001),同髓吸收剂量差异也有显著性（t=4.030,P=0.001)。结论 骨转移癌患者治疗剂量按^153Sm-EDTMP显像法测定的骨摄取率进行个体化给药,在达到治疗目的同时,还可避免发生骨髓毒性反应,具有重要的临床价值。     

抗癌胚抗原单链抗体与核心链霉亲和素融合蛋白在荷瘤裸鼠体内的预定位显像

目的：研究^153Sm-生物素和抗癌胚抗原单链抗体与核心链霉亲和素融合蛋白（CEA ScFv-core-streptavidin）在荷人直肠癌裸鼠体内的两步法预定位显像和体内分布。方法：对23只荷人结直肠癌裸鼠腹腔注射CEA ScFv-core-streptavidin进行预定位，24h后腹腔注射^153Sm-生物素，其中20只于1、4、8和24h进行体内分布研究，余3只于8和24h进行定位显像。结果：在荷人结直肠癌裸鼠腹腔注射CEA ScFv-core-streptavidin预定位后24h，注射^153Sm-生物素后1h，肿瘤/血比值为0.49，4和8h达1.21和1.56，24h达最高，为3.09。裸鼠定位显像示，8h肿瘤部位放射性明显浓聚，24h本底明显降低，肿瘤呈放射性“热“区。结论：^153Sm-生物素和CEA ScFv-core-streptavidin预定位显像能提高靶/非靶比值，缩短显像时间，改善图像质量。     

99Tc-亚甲基二膦酸盐与153Sm-乙二胺四亚甲基膦酸对骨侵袭和骨质溶解抑制作用的对比研究

目的 对比观察99c-亚甲基二膦酸盐(99Tc-MDP)与153Sm-乙二胺四亚甲基膦酸(153Sm-EDTMP)对Walker256癌细胞引起的大鼠骨侵袭和骨质溶解的抑制作用及二者对移植瘤细胞的影响.方法 建立Walker 256癌大鼠骨侵袭和骨质溶解模型.设空白对照组、99Tc-MDP治疗组、153Sm-EDTMP治疗组、99Tc-MDP+153Sm-EDTMP治疗组,采用99Tcm-MDP全身骨显像、骨骼X线片及胫骨病理切片方法观察两种药物单独或联合应用对荷瘤大鼠骨侵袭和骨质溶解的抑制作用,并通过流式细胞仪分析两种药物对移植瘤细胞的影响.结果 与对照组相比,99Tc-MDP治疗组、153Sm-EDTMP治疗组、99Tc-MDP+153Sm-EDTMP治疗组均能明显抑制荷瘤大鼠骨侵袭和骨质溶解(确切概率法:P<0.05).两种药物联合应用与单独应用相比未见明显差异.各治疗组移植瘤细胞的凋亡率明显高于对照组,S期的细胞比例明显下降,二者联合应用的作用更明显.结论 ①99Tc-MDP及153Sm-EDTMP对荷Walker 256癌大鼠均有抑制骨侵袭和骨质溶解的作用;②两种药物在诱导移植瘤细胞凋亡、抑制移植瘤细胞增殖方面均有一定作用,二者联合应用的作用更明显.     

153Sm-EDTMP治疗多发性骨转移癌的临床观察

目的 评价放射性核素^153Sm-2乙二胺四甲基膦酸（^153Sm-EDTMP）治疗骨转移癌的疗效及其对造血功能的影响。方法 静脉注射^153Sm-EDTMP，每次0．5-1．5mCi／kg体重。观察治疗前、后患者的生活质量、病灶及血细胞的变化。结果 患者疼痛完全缓解率（CR）32．5％（13／40）；部分缓解率（PR）50％（20／40）；疾病进展（PD）17．5％（7／40）；总有效率82．5％。单一应用^153Sm-EDTMP，剂量≤1mCi的患者。对造血功能影响较小，一般于治疗后4周基本恢复。剂量〉1mCi或与化疗联合应用的患者，对造血功能影响较大，需用G-CSF或输血（包括脐血）治疗，约治疗后6周才能恢复。结论 ①^153Sm-EDTMP是比较理想的治疗多发性骨转移癌的放射性核素之一，具有控制病情发展、消除骨转移灶，改善患者生活质量的作用；②^153Sm-EDTMP治疗后可使患者血象一过性降低。剂量〉1mCi，连续治疗2次以上者可诱发全血减少；③脐血有恢复射线所致的造血功能损伤的作用。     

^99Tc^m-精氨酸-谷氨酸-苏氨酸在荷人肺癌H1299裸鼠体内分布和显像

目的通过研究^99Tc^m-精氨酸-谷氨酸-苏氨酸（RET）在荷人肺癌H1299裸鼠体内的分布及显像,探讨其用于肺癌显像的可行性。方法采用^99Tc^m-直接法标记RET,再行^99Tc^m-RET与NSCLC细胞H1299的结合实验。荷人肺癌H1299裸鼠尾静脉注射^99Tc^m-RET后,行不同时间（15、30min,1、2．4、8、24、48h组各4只鼠）体内分布实验,分别测定组织放射性摄取（％ID／g）;另取荷瘤鼠3只,注射4．81MBq^99Tc^m-RET后于0．5、1、2、4．5、5、6h行γ显像。结果^99Tc^m-直接标记RET的标记率为（93．15±2．02）％,与H1299细胞的最高结合率为（3．56±0．37）％。荷瘤裸鼠尾静脉注射^99Tc^m-RET后4h肿瘤放射性摄取达（4．96±1．05）％ID／g,肝脏、脾脏有较多放射性摄取[（15．89±1．84）％ID／g和（10．83±1．66）％ID／g];而心脏和血液的放射性摄取较少,相应的T／NT分别为5．70±0．21和12．40±0．11。注射^99Tc^m-RET后4．5～6．0h肿瘤显影清晰。结论^99Tc^m-RET具有亲肺癌的特性,有可能成为一种亲肺癌显像剂。     

骨转移癌治疗药物^153SmEDTMP辐射剂量研究

^153Rm-EDTMP(乙二胺甲甲撑膦酸）是一种可望用于骨转移癌缓解治疗的放射性药物，注入示踪量^153Sm-EDTMP，准确计算离红骨髓的吸收剂量，是建立安全，有效的骨转移癌治疗方案的重要组成部分，本介绍了计算吸收剂量的一般原理和方法，并综述了近期在^153Sm-EDTMP辐射剂量及其效应方面的研究进展。     

153Sm-EDTMP治疗转移癌性骨痛

目的 探讨影响^153Sm-乙二胺四亚甲基磷酸盐（EDTMP）治疗转移癌性骨痛疗效的相关因素。方法 按国际原子能机构区域合作计划组织中国多中心研究,3年内收集^153Sm-EDTMP治疗转移癌性骨痛234例,根据治疗响应分为有效及无效2组,比较其个人情况,临床特点,原发病种,骨转移特点及治疗方法等因素,以SAS软件进行分组与多因素分析。结果 183例治疗有效,51例治疗无效,2组间在年龄、非核素治疗、^153Sm-EDTMP用量、转移灶数目、占骨骼比重、放射性摄取程度等方面无明显差别。但无效组中男性（43例,84.3%）、肺癌（34例,66.7%）、脊柱、骨盆与下肢转移的比例明显不同于有效组。多因素分析证实患者性别、肿瘤类型和转移部位与治疗效果相关。结论 ^153Sm-EDTMP治疗对肺癌、男性和下半身转移者效果可能较差。     

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.