166Ho-DOTMP radiation-absorbed dose estimation for skeletal targeted radiotherapy.

166Ho-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene-phosphonate (DOTMP) is a tetraphosphonate molecule radiolabeled with 166Ho that localizes to bone surfaces. This study evaluated pharmacokinetics and radiation-absorbed dose to all organs from this beta-emitting radiopharmaceutical. METHODS: After two 1.1-GBq administrations of 166Ho-DOTMP, data from whole-body counting using a gamma-camera or uptake probe were assessed for reproducibility of whole-body retention in 12 patients with multiple myeloma. The radiation-absorbed dose to normal organs was estimated using MIRD methodology, applying residence times and S values for 166Ho. Marrow dose was estimated from measured activity retained after 18 h. The activity to deliver a therapeutic dose of 25 Gy to the marrow was determined. Methods based on region-of-interest (ROI) and whole-body clearance were evaluated to estimate kidney activity, because the radiotracer is rapidly excreted in the urine. The dose to the surface of the bladder wall was estimated using a dynamic bladder model. RESULTS: In clinical practice, gamma-camera methods were more reliable than uptake probe-based methods for whole-body counting. The intrapatient variability of dose calculations was less than 10% between the 2 tracer studies. Skeletal uptake of 166Ho-DOTMP varied from 19% to 39% (mean, 28%). The activity of 166Ho prescribed for therapy ranged from 38 to 67 GBq (1,030-1,810 mCi). After high-dose therapy, the estimates of absorbed dose to the kidney varied from 1.6 to 4 Gy using the whole-body clearance-based method and from 8.3 to 17.3 Gy using the ROI-based method. Bladder dose ranged from 10 to 20 Gy, bone surface dose ranged from 39 to 57 Gy, and doses to other organs were less than 2 Gy for all patients. Repetitive administration had no impact on tracer biodistribution, pharmacokinetics, or organ dose. CONCLUSION: Pharmacokinetics analysis validated gamma-camera whole-body counting of 166Ho as an appropriate approach to assess clearance and to estimate radiation-absorbed dose to normal organs except the kidneys. Quantitative gamma-camera imaging is difficult and requires scatter subtraction because of the multiple energy emissions of 166Ho. Kidney dose estimates were approximately 5-fold higher when the ROI-based method was used rather than the clearance-based model, and neither appeared reliable. In future clinical trials with 166Ho-DOTMP, we recommend that dose estimation based on the methods described here be used for all organs except the kidneys. Assumptions for the kidney dose require further evaluation.     

人体蠕形螨的生物学研究

用透明胶带法观察蠕形螨在人体面部的寄生、逸出及其在体外的存活能力。结果表明：毛囊蠕形螨（Ｄｅｍｏｄ－ｅｘｆｏｌｉｃｕｌｏｒｕｍ，Ｄ．ｆ．）主要以颚体朝向毛囊底部寄生，且常常有多条群居现象，而皮脂蠕形螨，（Ｄｅｍｏｄｅｘｂｒｅｖｉｓ，Ｄ．ｂ．）一般为单条独居生活。两种人体蠕形螨昼夜均可主动爬出毛囊口出现在皮肤表面，Ｄ．ｆ．以白天１０００～１８００为逸出高峰；Ｄ．ｂ．则以夜间２２００～２００逸出最多。此外，蠕形螨在体外有较强的活动力和存活力。透明胶带法在人体蠕形螨的流行病学调查和生物学研究方面具有较高的应用价值     

带蚓状肌的游离足趾再造拇、手指

自１９７２年以来，在游离足趾再造拇、手指手术中，应用足趾蚓状肌与缺损拇、手指蚓状肌残端或关节囊进行缝合的方法共完成手术３００例，由于再造拇、手指的蚓状肌得到修复，既改善了其指间关节屈曲畸形，又防止了掌指关节的过伸。术后随访１－２２年，再造拇、手指的外形及功能均满意。     

提高抗恶性疟独特型单抗克隆出现频率的方法学探讨

用Protein A-Sepharose亲和层析法提纯McAb-IgG,皮下多点和腹腔免疫雄性Wistar大鼠,间隔两周共3次,融合前3天采用腹腔、尾静脉和脾内注射等三种加强免疫方法,以间接ELISA法和抗体竞争ELISA法筛选Anti-Id阳性克隆。结果显示:融合前大鼠血清抗小鼠IgG或抗免疫原McAb-IgG滴度,静脉组和脾内组比腹腔组高一个滴度;Anti-Id阳性克隆出现频率,腹腔组为0.9％和0.3％,静脉组为11.0％和13.3％,脾内组为16.4％和12.9％,静脉组和脾内组明显高于腹腔组(P<0.01);上述三种加强免疫方法对抗小鼠IgG阳性克隆出现频率无明显影响(P>0.05);与腹腔加强免疫组相比,静脉和脾内加强免疫组也可提高细胞融合效果(P<0.01).本实验结果提示,腹腔和皮下多点多次长程基础免疫结合静脉或脾内加强免疫是制备Anti-Id McAb比较好的免疫方案。     

阴茎海绵体折叠术治疗单纯阴茎下弯

对１９例先天性单纯阴茎下弯采用阴茎海绵体折叠术矫治，即在弯曲的凸面白膜折叠缝合以拉直阴茎，为减少并发症，同时加以改进措施。所有病例随访１０～７１个月，手术效果满意     

Gastro-oesophageal reflux disease: Medical or surgical treatment? Report of an interactive workshop

Gastroesophageal reflux disease (GERD) is the most common disease of the upper gastrointestinal tract. With the introduction of proton pump inhibitors medical treatment of GERD has been significantly improved. However, the development of laparoscopic antireflux surgery resulted in an increasing interest of surgeons in this disease. An interactive meeting was organized in order to develop an agreement between gastoenterologists and surgeons regarding therapeutic decisions and this is the main topic of this paper.     

有训练者和无训练者的心功能和无氧阈的关系

本文观察了10名游泳运动员和10名实验室工作人员在递增负荷运动中心功能的变化及其与无氧阈的关系.结果为:(1)游泳队员的无氧阈值明显高于无训练的实验室工作人员;(2)运动中每搏量稳定时的强度与无氧阈强度是密切相关的;(3)运动至无氧阈强度以后,心输出量的增加主要靠心率的增加来维持;(4)无训练者在运动一开始就动用心力储备,增加心率和每搏量,而游泳队员则在运动至40W以后才开始增加心率和每搏量.这些结果表明,无氧阈与心功能具有很密切的关系,可用它来反映心功能的好坏.     

重症胰腺炎合并急性呼吸窘迫综合征病人的早期治疗及护理

急性胰腺炎是常见的急腹症之一,它不仅是胰腺的局部发炎,而且是涉及多个脏器改变的全身疾病.急性呼吸窘迫综合征(ARDS)是急性出血坏死性胰腺炎常见而严重的并发症.该并发症预后差,发病机制复杂,死亡率高.如果进行早期预防和早期发现,早期治疗,可降低其发生率和死亡率.现将其治疗及护理介绍如下.     

当归或三七对兔甘油致急性肾衰的保护作用及其机制研究

目的：用甘油复制兔急性肾小管坏死(ATN)模型，观察当归、三七对ATN的保护作用，并初步探讨其机制。方法：40只健康新西兰白色家兔，等分为四组：当归组、三七组、对照组、正常组。当归、三七、对照三组均用50％甘油等渗盐水15ml/kg注入兔双后肤皮下，复制ATN模型，当归组于注射甘油后即刻，第3小时，第6小时，肌注当归注射液50mg／kg，三七组于相同时点肌注三七皂甙50mg／kg，正常组则于兔双后肢皮下注射生理盐水15ml/kg，并于相同时点注射5％葡萄糖注射液。于实验第24小时取血液、尿液和肾脏，检测血清尿素氮、肌酐、尿液总渗透压、尿总氨基酸、肾组织MDA、SOD、GSH—PX、ATP酶、Ca2^ 、肾组织病理形态学检查。结果：各组与正常组比，肌酐、尿素氮明显升高，说明模型复制成功。当归、三七纪元l例死亡，对照组死士率为30％，血清肌酐、尿素氮、丙二醛、尿总氨基酸、滤过钠排泄分数和肾组织钙含量均明显低于对照组(P＜0．01)，而肾组织ATP酶、SOD、GSH-PX活性均高于对照组(P＜0.01)，病理形态学变化轻于对照组。以上指标，当归与三七组无显著差异(P＞0．05)。结论：当归、三七对甘油所致的ATN有明显保护作用，二者效果无差异，其机制可能与二者均有改善微循环、血液流变学、抑制脂质过氧化反应、保护肾脏抗氧化酶和ATP酶活性及减轻肾组织钙超载有关。