~(13)CO_2呼气试验在脂肪代谢研究中的应用

脂肪吸收不良是常见的病症,但确诊较困难.胆盐缺乏、小肠粘膜受损及胰腺外分泌功能不全均可导致脂肪吸收不良,相互鉴别更是不易.用无创伤性、无放射性的~(13)CO_2呼气试验不但能简便、可靠地诊断脂肪吸收不良,而且还能有效地作出胰源性与胰外性脂肪吸收不良的鉴别诊断.     

肿瘤分子核医学的进展

该文综述了正电子、单光子核素肿瘤示踪剂的发展、肿瘤细胞摄取的分子学基础以及今后的研究方向.随着正电子核素标记物的广泛应用,对价格低、适应我国国情的符合电路SPECT和高档次PET/CT的发展作了比较.在临床应用中,重点介绍18F-FDG显像在甲状腺癌、肺癌、淋巴瘤以及乳腺癌的早期诊断、分期、疗效、预后以及在今后放射治疗中的应用.     

重组质粒hTSHR转染低分化甲状腺癌细胞株后对摄碘能力及特异性基因表达的影响

目的 探讨重组真核表达质粒pcDNA3.1/人TSH受体（hTSHR）体外转染TSHR表达下降的低分化滤泡状甲状腺癌细胞株后,细胞摄取放射性碘功能以及甲状腺癌相关基因mRNA表达 的变化.方法 pcDNA3.1/hTSHR转化DH5a感受态菌,进行扩增、酶切,再以核苷酸测序方法鉴定.体外转染pcDNA3.1/hTSHR,通过免疫荧光检测TSHR表达产物,井型γ计数仪检测摄碘率,相对定量实时荧光PCR验证其表达的TSHR蛋白功能和特性.采用SPSS 13.0软件,对计量资料行t检验.结果pcDNA3.1/hTSHR经PCR扩增hTSHR-cDNA片段约113 kb,Kpn Ⅰ和Xha Ⅰ双酶切：hTSHR-cDNA的片段约2.3 kb,pcDNA3.1（＋）的片段约5.5 kb,均同预期片段大小相符;核苷酸测序方法鉴定测序结果与GenBank中收录的hTSHR全长序列一致,表明真核表达质粒构建正确.在hTSH刺激下,转染pcDNA3.1/hTSHR细胞与转染pcDNA3.1（＋）细胞比较：（1）在甲状腺肿瘤细胞胞质、胞膜有增强的绿色荧光,（2）前者125 I摄取率是后者的2.9倍（t=28.63,P＜0.01）,（3）甲状腺碘摄取相关基因TSHR、钠碘转运体（NIS）、甲状腺过氧化物酶（TPO）、Tg的mRNA的表达分别升高1.74倍（t=5.959,P＜0.01）、7.2倍（t=3.807,P＜0.05）、2.88倍（t=4.769,P＜0.01）和2.67倍（t=6.388,P＜0.01）.结论 pcDNA3.1/hTSHR体外转染甲状腺癌肿瘤细胞后,可有效提高碘的摄取;这可为放射性碘治疗失分化甲状腺癌提供新的实验依据.     

Graves病患者131I治疗前、后TRAb和FT3、FT4、TSH的变化及其临床意义

甲状腺疾病是临床上一种常见的内分泌疾病,各年龄均可发生.Graves病是临床上最常见的甲状腺疾病,尤以女性多发,男女之比为1:4～6[1].人血清促甲状腺素受体抗体(TRAb)是自身免疫性甲状腺疾病患者体内存在的影响甲状腺滤泡功能和生长的自身抗体,在Graves病中起重要作用.     

分化型甲状腺癌131Ⅰ治疗中多种核素显像的联合应用

目的 探讨提高分化型甲状腺癌(DTC)复发灶或转移灶检出率的最优化核素显像方法 .方法 对89例DTC患者的临床资料进行回顾性分析.核素显像方法 包括血清甲状腺球蛋白(Tg)检查结合放射性碘(131Ⅰ)治疗剂量全身显像、99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像,对三种核素显像的结果 进行对比分析.结果 131Ⅰ治疗剂量全身显像、99mTc-MIBI 肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像的灵敏度分别为83.05%、79.66%和16.95%.结论 99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像作为补充检查手段,可弥补血清Tg检查结合131Ⅰ全身显像的局限性,对DTC患者复发灶或转移灶的检出、疗效评估及进一步治疗方案的制定具有重要意义.     

儿童和青少年分化型甲状腺癌131I治疗分析

目的 回顾性分析放射性碘(131Ⅰ)治疗儿童和青少年分化型甲状腺癌(DTC)的特点及其疗效.方法 回顾性分析20例首次接受131Ⅰ治疗时年龄≤2l岁(5～21岁)DTC患者的临床及随访资料.20例患者中,乳头状癌18例.滤泡状癌2例;单纯淋巴结转移7例,肺转移8例.所有患者均接受131Ⅰ清除剩余甲状腺治疗;根据患者年龄、病情、转移灶位置以及病灶摄取131Ⅰ的程度等调整转移灶的131Ⅰ治疗剂量.以131Ⅰ全身显像、18F-FDG肿瘤显像及血清甲状腺球蛋白及其抗体水平评价疗效,同时观察不良反应发生情况.结果 中位随访时间为48.50个月(6～110月),患者生存率为100%.20例患者中,病灶消除13例,好转或稳定5例,无效或进展2例.7例单纯淋巴结转移患者消除4例,8例肺转移患者消除4例.随访期间未发生肺纤维化、继发肿瘤及生长发育异常等不良事件.结论 对于儿童和青少年DTC患者(尤其是已发生转移的患者),131Ⅰ是一种安全且有效的治疗方法 .     

胃癌组织β-catenin和P53异常表达与螺旋CT征象的相关性研究

目的:探讨胃癌组织β-catenin(β-cat)和P53蛋白异常表达与螺旋CT征象异常的关系。方法:采用免疫组化法(两步法)检测胃癌手术切除的109例标本中β-cat和P53蛋白的表达。结果:胃癌β-cat阳性表达率为56.9%(62/109),且阳性表达与螺旋CT提示的淋巴结转移相关(P     

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.     

131^I治疗分化型甲状腺癌淋巴结转移的疗效及影响因素分析

淋巴结转移是分化型甲状腺癌（DTC）最主要的转移途径。本研究回顾性分析了131^I治疗DTC淋巴结转移的疗效及其影响因素,现报道如下.     

分化型甲状腺癌131I治疗中多种核素显像的联合应用

目的 探讨提高分化型甲状腺癌(DTC)复发灶或转移灶检出率的最优化核素显像方法 .方法 对89例DTC患者的临床资料进行回顾性分析.核素显像方法 包括血清甲状腺球蛋白(Tg)检查结合放射性碘(131Ⅰ)治疗剂量全身显像、99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像,对三种核素显像的结果 进行对比分析.结果 131Ⅰ治疗剂量全身显像、99mTc-MIBI 肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像的灵敏度分别为83.05%、79.66%和16.95%.结论 99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像作为补充检查手段,可弥补血清Tg检查结合131Ⅰ全身显像的局限性,对DTC患者复发灶或转移灶的检出、疗效评估及进一步治疗方案的制定具有重要意义.