营养治疗在血液透析中应用

16例尿毒症血透患者分成三组。第一组6例常规维持血透,自由进食;第二组5例低蛋白饮食,蛋白量为0.6g·kg~(-1)/a,第三组5例极低蛋白饮食,蛋白量为0.3～0.4g·kg~(-1)/d,供给必需氨基酸或酮酸。二、三组每周血透1次,所有患者均观察6个月。结果示三组患者营养状态相似,氮平衡、总体氮流量、蛋白合成速度均有改善,二和三组患者血磷明显降低,血钙明显升高,其Ccr下降率明显慢于一组,提示血透联合低蛋白饮食或(和)加必需氨基酸可以减少血透次数,能保护残存肾单位功能。     

分化型甲状腺癌细胞株131Ⅰ照射后摄碘能力及特异基因表达变化的实验研究

目的:分化型甲状腺癌131Ⅰ治疗后可出现失分化的现象,本文通过体外培养的甲状腺癌FTC-133细胞株在低剂量131Ⅰ照射后摄碘能力的变化及甲状腺细胞特异蛋白(NIS、RSHR、TPO、Tg)及其mRNA水平变化,初步研究131Ⅰ照射与甲状腺癌失分化的关系.方法:培养的FTC-133细胞株,用诊断剂量的131Ⅰ内照射(不同时间,不同剂量),测量细胞摄125Ⅰ能力的变化,并利用蛋白印迹法、放射免疫分析和免疫荧光检测NIS、TSHR、TPO、Tg蛋白含量和定位,利用实时荧光聚合酶链反应检测上述蛋白mRNA水平的变化.结果:131Ⅰ照射使FTC-133细胞摄125Ⅰ能力(cpm/min值)下降,各试验组与对照组相比差异有统计学意义(P<0.05),利用15μCi照射48h吸碘率下降最明显,下降率为34.6%(t=12.72,P<0.01),NIS、TSHR、TPO、Tg蛋白以及mRNA均下降,在48h下降最明显,与对照组相比差异具有统计学意义(P<0.05),蛋白定位照射前后无明显变化.结论:131Ⅰ照射可使FTC-133细胞摄碘能力下降,NIS、TSHR、TPO、Tg蛋白及mRNA水平下降,131Ⅰ照射可以使分化型甲状腺癌细胞出现分化程度降低.     

分化型甲状腺癌细胞株131^I照射后摄碘能力及特异基因表达变化的实验研究

目的：分化型甲状腺癌131^I治疗后可出现失分化的现象,本文通过体外培养的甲状腺癌FTC-133细胞株在低剂量131^I照射后摄碘能力的变化及甲状腺细胞特异蛋白（NIS、RSHR、TPO、Tg）及其mRNA水平变化,初步研究131^I照射与甲状腺癌失分化的关系。方法：培养的FTC-133细胞株,用诊断剂量的131^I内照射（不同时间,不同剂量）,测量细胞摄125^I能力的变化,并利用蛋白印迹法、放射免疫分析和免疫荧光检测NIS、TSHR、TPO、Tg蛋白含量和定位,利用实时荧光聚合酶链反应检测上述蛋白mRNA水平的变化。结果：131^I照射使FTC-133细胞摄125^I能力（cpm/min值）下降,各试验组与对照组相比差异有统计学意义（P〈0.05）,利用15μCi照射48h吸碘率下降最明显,下降率为34.6%（t=12.72,P〈0.01）,NIS、TSHR、TPO、Tg蛋白以及mRNA均下降,在48h下降最明显,与对照组相比差异具有统计学意义（P〈0.05）,蛋白定位照射前后无明显变化。结论：131^I照射可使FTC-133细胞摄碘能力下降,NIS、TSHR、TPO、Tg蛋白及mRNA水平下降,131^I照射可以使分化型甲状腺癌细胞出现分化程度降低。     

利尿肾动态显像在婴幼儿后尿道瓣膜中的应用

目的观察利尿肾动态显像(DR)在婴幼儿后尿道瓣膜中的影像表现,探讨用DR进行术后随访的评价方法.方法患先天性后尿道瓣膜的男性患儿22例,年龄2月～10岁.术前1周内行DR检查,根据DR结果对肾积水进行分度,并对术后随访结果进行评分,负值=恶化;0=无改变;1%～32%=满意;33%～65%=良好;>66%=优.结果所有病例肾盂均有放射性滞留,40只肾累及肾盏(90.9%);输尿管全段扩张显影34根(77.3%);膀胱无充盈8例,扩大1例,缩小9例.随访结果,"恶化"2肾,"无改变"6肾,"满意"3肾,"良好"3肾,"优"1肾.结论DB可观察到先天性后尿道瓣膜中上尿路各个部位较具特征性的改变,可帮助诊治;用于术后结果的评价,较为全面、准确及实用.     

^99mTc—MIBI检测肿瘤多耐药基因表达产物P—gp的研 …

肿瘤多耐药基因表达产物Ｐ－ｇｐ是导致肿瘤化疗失败的主要因素。利用＾９９ｍＴｃ－ＭＩＢＩ可达到在体外诊断Ｐ－ｇｐ表达水平的目的，肿瘤摄取＾９９ｍＴｃ－ＭＩＢＩ的量与其表达的Ｐ－ｇｐ成反比关系。     

The Clinical and Experimental Research on Billings Ovulation Method During Breastfeeding

Objective The effectiveness and acceptability of Billings Ovulation Method (BOM) during breastfeeding were studied. At the same time, the monitoring indexes of fertility return were studied.Methods It was a clinical comparative study of BOM and IUD containing copper (200mm 2). The annual rate of pregnancy, discontinuation rate and continuation rate in the two groups was determined. The serum prolactin and estradiol in 90 breastfeeding mothers and urine estrogen and pregnanediol in different feeding mothers were measured.Results There were 219 subjects in the BOM group and 200 in the IUD group. The pregnancy rate in this two groups was 1. 43% and 1. 54% respectively. The rates of discontinuation and continuation in the IUD group were:8. 87% and 91. 35% as well as in the BOM group were 8. 53% and 90. 17% respectively. Neither result was statistically significant (P>0. 05). The experimtal research showed that menses return was well estimated by 0. 35 ratio of serum prolactin vs. estrodiol. Sensitivity and     

骨显像在儿童郎格尔汉斯细胞组织细胞增生症诊断及随访中的价值

目的探讨骨显像在诊断儿童郎格尔汉斯细胞组织细胞增生症(LCH)及其随访中的临床价值。方法23例LCH患儿行全身骨显像检查。结果23例LCH患儿中骨显像阳性19例，颅骨异常放射性分布灶8例，锁骨、肋骨、骨盆受累各3例，上肢2例，下肢4例，脊柱5例，胸骨下端异常稀疏灶1例。19例阳性显像中，单处骨骼病变者9例。结论骨显像的部分特征性表现有助于LCH的诊断及随访。     

Analysis on the factors affecting the efficacy of 131Ⅰ remnant ablation in patients after thyroidectomy for differentiated thyroid carcinoma

Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant.     

HTg测定和 131I全身显像检查对甲状腺癌131I治疗后随访的临床意义

目的 :评价血清HTg和 13 1I全身显像联合检查对分化型甲状腺癌 (differentiat edthyvoidcarcinoma ,DTC)患者 13 1I治疗后随访的临床意义。方法 :85例DTC患者停服甲状腺激素 4～ 6周并忌碘饮食 3 0d后 ,双抗体法测定血清HTg ,同时口服 13 1I 185～3 70MBq 2 4h后 ,和 (或 )口服治疗剂量 13 1I 4～ 7d后做全身显像。结果 :61例经临床证实有复发或转移的DTC患者中 ,3 8例(62 3 0 % )HTg高于正常 ,有肺或 (和 )骨转移者 ,血清HTg升高更加明显 ,极端甚至 >2 0 0 μg/L。2 2例肺转移及肺 (骨 )转移患者 ,其血清HTg水平随 13 1I治疗剂量的增加而呈降低趋势。 5 3例 (86 88% ) 13 1I全身显像结果和 (或 )血清HTg有阳性表现 ,只有49 18% (3 0 /61)的患者同时出现 13 1I全身显像有异常浓聚和血清HTg异常升高。 结论 :DTC术后及 13 1I治疗后 ,常规进行血清HTg测定和 13 1I全身显像检查 ,对早期发现复发或有无转移灶、13 1I治疗方案的选择以及评估 13 1I疗效具有重要的临床价值。     

Analysis on the factors affecting the efficacy of 131Ⅰ remnant ablation in patients after thyroidectomy for differentiated thyroid carcinoma

Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant.