局部晚期鼻咽癌放疗前后氟脱氧葡萄糖PET-CT摄取值与预后关系的研究

中SUV max 较高者及淋巴结转移灶SUV max 值高于原发灶SUV max 者预后较差.     

18F-氟赤硝基咪唑PET-CT检测非小细胞肺癌乏氧的应用价值

Objective To assess the feasibility of [18F ] fluoroerythronitroimidazole (18F-FETNIM ) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer ( NSCLC) patients. Methods Forty-two patients with newly diagnosed NSCLC underwent 18F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT,23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection 18F-FETNIM. 18F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated.Results SUVmax-T ( 2. 43 ± 1. 34) was significantly higher than SUVmax-N (0.87 ±0.46, P<0.001) at 120 min. SUVmax-T (2. 80 ± 1.09) and SUVmax-N (1. 16 ± 0. 56) at 60 min were significantly higher than SUVmax-T (2. 61 ± 1. 10) and SUVmax-N (P<0.01) at 120 min. T/N (2.56 ± 0.71) at 60 min was higher than that at 120 min (2.48 ± 0.60),but the difference between them was not significant (P =0.324). Conclusion Our results indicate that 18F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.     

18F-FDG PET/CT显像监测胃癌术后复发转移的价值

Objective PET with 18F-fluorodeoxyglucose (FDG) has been used to beth detect and stage a variety of malignancies. The aim of this retrospective study was to evaluate the clinical value of 18F-FDG PET/CT for recurrence and metastasis in gastric carcinoma patients after total gastrectomy. Methods A total of 45 gastric carcinoma patients who underwent total gastrectomy were included. PET/CT scans were obtained for restaging. The " gold standard" of 18F-FDG PET/CT diagnostic accuracy was based on either histopathology or clinical follow-up. By using the t-test from SPSS 11.5, the cut-off of maximum standard-ized uptake values (SUVmax) from 18F-FDG to differentiate benign from malignant lesion at stomach were determined and calculated. Results (1) Of the 45 patients, 22 were suspicion recurrent lesion at stomach. Of the 22 patients, 12 were confirmed to have recurrent lesions. The diagnostic accuracy were 100.0% (12/ 12) for sensitivity, 70.0% (7/10) for specificity, and 86.4% (19/22) for accuracy, respectively. A higher SUVmax in malignant than benign lesion was noted (6.27 ± 3.42 vs 3.92 ± 2.24), though not reached to the significance (t = 1. 862, P > 0.05). (2) For extra-gastric lesion detection, the sensitivity, specificity, and accuracy for region lymph nodes were 78.9% (15/19), 92.3% (24/26), and 86.7% (39/ 45), for peritoneal spreading were 6/9, 97.2% (35/36), 91. 1% (41/45), and for distant sites were 86.7%(13/15), 93.3% (28/30), 91.1% (41/45). (3) False positive were found in eight sites. All were either inflammatory or physiological uptake at intestine. False negative were found in nine sites. Either due to small in size (less than 1.0 cm in diameter), well differentiation of the tumor cell or with a nature of signet ring. Conclusion 18F-FDG PET/CT had a potential to detect local, regional, and distant metastasis in gastric cancer.     

微创经皮肾镜取石术治疗肾结石

目的探讨微创经皮肾镜取石术（MPCNL）治疗肾结石的方法与效果。方法回顾性分析636例采用MPCNL治疗的肾结石患者资料,男391例,女245例。平均年龄43岁。其中单纯肾盂结石75例,单纯肾盏结石117例,肾盂和肾盏多发结石283例,肾铸形或鹿角形结石127例,双侧肾结石34例。结石大小2.0cm×1.0cm～5.0cm×4.5cm,平均3.0cm×2.0cm。结果 611例患者一期取石,25例二期取石。单通道取石549例,双通道取石78例,三通道取石9例。1次取石471例,2次取石122例,3次取石43例。结石清除率83.6%（532/636）,平均手术时间90min,平均住院12d.术中均未输血。17例术后并发出血,经输血、抗炎等保守治疗后治愈,3例并发气胸,经胸腔闭式引流术后治愈,其余未见严重并发症。结论 MPCNL具有创伤小、出血小及并以症少等优点,治疗肾结石安全有效,尤其对肾结石再次手术治疗有较大优越性。     

加减沙参麦冬汤辅助治疗肺癌患者对免疫功能及不良反应的影响

目的 探讨加减沙参麦冬汤辅助治疗对肺癌患者免疫功能及不良反应的影响。方法 遴选非小细胞肺癌(NSCLC)患者106例随机分为对照组和观察组各53例,对照组给予GP方案化疗（顺铂注射液+盐酸吉西他滨）,观察组在对照组治疗基础上给予加减沙参麦冬汤辅助治疗,对比两组临床疗效,观察治疗前及治疗8w后的中医症状积分、T细胞亚群水平和不良反应。结果 观察组的临床总有效率和病灶稳定率分别为5283%和8302%,显著高于对照组的32.08%和62.26%(P＜0.05);治疗后,两组中医症状积分中咳嗽、痰血、神疲乏力、心烦不眠、低热盗汗、大便干结的积分显著降低(P＜0.05),观察组变化幅度显著大于对照组(P＜0.05);治疗后,分析T细胞亚群指标发现,观察组的CD3+、CD4+占比及CD4+/CD8+值显著增加(P＜0.05),对照组CD8+占比显著增加(P＜0.05),CD4+/CD8+值有所降低(P＜0.05),组间治疗后对比,差异有统计学意义(P＜0.05);观察组的骨髓抑制、胃肠道反应及感染发生率分别为15.09%、5.66%及0.00%,显著低于对照组的32.08%、22.64%及9.43%(P＜0.05)。结论 加减沙参麦冬汤辅助GP化疗方案治疗对阴虚内热型NSCLC患者疗效显著,不良反应少,可有效改善患者相关症状,提高免疫系统功能。     

补阳还五汤治疗慢性硬膜下血肿

补阳还五汤治疗慢性硬膜下血肿福建省泉州市中医院（３６２０００）许笃聪，郑劲松，李亚静关键词补阳还五汤，硬膜下血肿慢性硬膜下血肿目前主要采用外科手术治疗。我们自１９９０年以来对１８例经颅脑ＣＴ扫描确诊为慢性硬膜下血肿的患者应用补阳还五汤治疗，取得较好疗...     

PET/CT在结直肠癌术后复发及转移诊断中的应用价值

对66例结直肠癌术后临床可疑复发或转移的患者行全身PET/CT显像, 根据病理诊断、临床随访结果计算PET/CT诊断复发及转移的敏感性和特异性,并与CT平扫检查结果比较.结果 PET/CT诊断结直肠癌术后复发的灵敏性和特异性分别为100%、94.6%,CT平扫分别为82.3%、85.8%;诊断术后转移的灵敏性和特异性分别为97.0%、91.7%,CT平扫分别为83.5%、76.6%. 半定量法示复发者标准摄取18F-脱氧葡萄糖(18F-FDG)最大值明显高于良性病变者(P﹤0.01).认为 PET/CT诊断结直肠癌术后复发转移具有较高的灵敏度和特异度,是结直肠癌术后理想的影像监测手段.     

PET-CT11C-胆碱和18F-FDG显像剂联合对肺占位病变鉴别诊断价值分析

目的:探讨18F-氟化脱氧葡萄糖(18 F-FDG)与11 C-胆碱PET-CT联合应用在肺部占位性病变鉴别诊断中的价值。方法:选取196例肺部占位性病变患者,注射造影剂18F-FDG和11 C-胆碱后行PET-CT检查和诊断,观察2种造影剂PET-CT检查方法的标准摄取值(SUV)以及单独和联合应用的诊断灵敏度、特异性和准确率。结果:良性和恶性患者的18F-FDG(2.20±1.23 vs 5.29±2.75)及11 C-胆碱(0.81±0.79 vs 3.28±1.76)的SUVmax差异有统计学意义,P<0.01;18F-FDG和11 C-胆碱在良性及恶性患者中差异有统计学意义,P<0.01。18 F-FDG和11 C-胆碱PET-CT各自的灵敏度(58.16%vs 58.67%)、特异性(78.05%vs 84.00%)和准确率(80.61%vs 85.20%)差异无统计学意义,P>0.05。联合诊断的灵敏度、特异性和准确率分别为53.57%(105/196)、90.11%(82/91)和94.39%(185/196),与单独应用比较,灵敏度差异无统计学意义(P>0.05),特异性和准确率均提高,P<0.01。结论:将18 F-FDG和11 C-胆碱PET-CT检查联合运用于同一患者进行综合诊断能明显提高肺部占位病变的诊断水平。     

比索洛尔对急性心肌梗死患者氨基末端脑钠尿肽原和心室重构的影响

目的 探讨急性心肌梗死(AMI)患者氨基末端脑钠尿肽原(NT-proBNP)和心室重构的关系以及β受体阻滞剂比索洛尔对两者的影响.方法 急性前壁心肌梗死患者74例随机分成两组,对照组(n=38)接受常规治疗,包括再灌注治疗,血管紧张素转换酶抑制剂、抗血小板药和他汀类药物等；试验组(n=36)在常规治疗基础上加用β受体阻...