传染性单核细胞增多症误诊12例分析

20 0 1- 0 5～ 2 0 0 1- 12我科共收治传染性单核细胞增多症 (以下简称传单 ) 32例 ,其中 12例误诊 ,误诊率为 37.5 % ,现将其误诊原因分析如下。1　临床资料本组男 7例 ,女 5例 ,年龄 :<1岁 5例 ,～ 3岁 2例 ,～ 7岁2例 ,～ 13岁 3例。均有发热 ,t37.5℃～ 4 0℃不等 ,热程 3～ 15d,肝脾肿大 8例 ,淋巴结肿大 5例 ,皮疹 3例 ,扁桃体炎 3例 ,皮肤出血点 5例 ,高热惊厥 3例 ,呕吐、腹泻 4例 ,头痛 3例 ,精神萎靡 2例 ,支气管炎 3例。实验室检查 :WBC<1× 10 9/ L者 3例 ,1.0～ 2 .0× 10 9/ L者 3例 ,2 .0～ 3.0× 10 9/ L者 5例 ,>3.0× …     

家兔心脏报告基因表达的单光子发射计算机断层显像研究

目的 以单纯疱疹病毒1-胸苷激酶(HSV1-tk)为报告基因,以131I标记的氟-碘阿糖基脲嘧啶(FIAU)为报告探针,对心肌内转染HSV1-tk的家兔行心脏报告基因单光子发射计算机断层(SPECT)显像,以探讨该报告系统应用于SPECT心脏报告基因显像的可行性,为SPECT报告基因心脏显像最佳转染滴度、显像时间选择提供依据.方法 制作腺病毒(Ad)为载体携带HSV1-tk基因的重组体Ad-tk,家兔心肌内注射Ad-tk.实验分2部分:(1)转染报告基因后不同时间埘显像的影响:家兔心肌注射不同滴度的Ad-tk(1×109、5×108、1×108、5×107、1×107 pfu),2 d后耳缘静脉注射131IFIAU 600 μCi行6、24、48和72 h心肌SPECT显像,注射1×109 pfu Ad-tk的家兔继续行96和120 h显像.(2)不同Ad-tk滴度对显像的影响:家兔心肌注射不同滴度的Ad-tk(1×109、5×108、1×108、5×107、1×107pfu),2 d后耳缘静脉注射131I-FIAU 600 μCi行6、24和48 h心肌SPECT显像,显像结束后处死家兔,取出心脏,测量γ计数值,行逆转录-聚合酶链反应(RT-PCR)研究,并对SPECT图像和RT-PCR图像行半定量分析.结果 SPECT图像可见Ad-tk在注射局部表达,而非注射部位未见表达,对照组心肌除6 h可隐约显影外,其余时间均未见显影.RT-PCR证实HSV1-tk在注射部位表达.不同的Ad-tk滴度,SPECT靶/非靶比值与γ计数值旱正相关(r2=0.933,P＜0.01),与HSV1-tk的表达亦呈正相关(r2=0.877,P＜0.01).SPECT可检测到滴度低至1×107pfu的Ad-tk在心肌内的表达.结论 应用HSV1-tk为报告基因,FIAU为报告探针的SPECT心肌报告基因显像是可行的.SPECT心肌报告基因显像可半定量地监测报告基因在体内的表达.     

99Tcm标记抗VEGF多肽ATWLPPR及其在正常小鼠体内生物学分布

血管内皮生长因子(VEGF)及其受体在肿瘤血管生成过程中发挥关键作用,已成为肿瘤诊断与治疗中一个新的靶向目标.丙氨酸-苏氨酸-色氨酸-亮氨酸-亮氨酸-精氨酸(Ala-Thr-Trp-Leu-Pro-Pro-Arg,ATWLPPR)是从随机噬菌体随机七肽库构建的合成肽库中筛选出来的小肽,能阻断VEGF与细胞表面受体的结合[1].故探讨ATWLPPR的锝标记方法以及标记物在正常小鼠体内的分布,对研究恶性肿瘤的早期、特异性诊断有积极的意义.     

子宫内膜异位症分子影像学诊断的研究进展

子宫内膜异位症（简称内异症）是常见的妇科疾病,在育龄期女性中的发病率较高,其发病部位广,通过常规影像学检查和腹腔镜无法有效检出全身的、微小的、隐匿的内异症病灶。放射性核素标记的胆碱类似物、雌激素类似物和生长抑素类似物等具有检出内异症病灶的潜能,并能够提供内异症病灶的功能和代谢信息,对内异症的诊断具有特殊价值。笔者就内异症的诊断方法进行综述,并探讨内异症分子影像学诊断的研究进展。     

金纳米颗粒在急性心肌梗死诊疗中的应用

金纳米颗粒是一种由金构成的纳米材料,它具有生物相容性、导电性、抗氧化性等优点.在急性心肌梗死诊疗方面,基于金纳米颗粒的研究已获得显著进展,如可用作递送载体降低心肌梗死标志物水平、改善损伤的心肌结构及参与心脏组织工程支架材料的构建等.     

HER2的表达及其分子影像的研究进展

人表皮生长因子受体2（HER2）是一种具有酪氨酸激酶活性的跨膜受体,同时也是一种高表达于各种癌细胞的生物标志物。高表达HER2的肿瘤往往预后不良。HER2分子影像主要是利用放射性核素、磁性材料、发光物质等标记配体能与HER2特异性结合的特性,对患者体内HER2高表达病灶进行显像,从而协助HER2阳性疾病的诊断,筛选出抗HER2治疗有效的患者,并可用于疗效评估,是近年来肿瘤精准医疗研究的热点之一。     

利用报告基因rNIS监测大鼠骨髓间充质干细胞移植大鼠心肌的可行性研究

Objective To investigate the feasibility of rat sodium/iodide symporter (rNIS) as a reporter gene monitoring rat bone marrow mesenchymal cells (rBMSC) transplanted to rat myocardium in vivo.Methods Recombinated adenovirus vector was constructed by rNIS/enhanced green fluorescence protein (EGFP) (Ad-rNIS/EGFP).rBMSC transfected by Ad-rNIS/EGFP were studied using fluorescence microscope.Fifteen rats were transplanted with rBMSC and randomly divided into three groups:rNIS group (with rNIS transfection), blocked group (with rNIS transfection) by oral intake of perchloric sodium before planar imaging(GE Millennium MPR SPECT), and control group (without rNIS transfection).All rats underwent 99Tcm-pertechnetate planar imaging.The biological distribution of 99Tcm-pertechnetate was studied.The expressions of rNIS gene and protein in myocardium were measured by real time polymerase chain reaction (PCR) and western blot, respectively.The expressions of CD29, CD44, CD90, CD11b, CD34 and CD45 were measured by immunohistochemistry.Results rBMSC transfected by Ad-rNIS/EGFP showed EGFP expression under fluorescence microscope.The transplanted rat myocardium could be visualized on 99Tcm-pertechnetate planar imaging in rNIS group.The relative uptake ratio( Rheart/Rhmb, RUR) was 6.7 ±0.4.RUR in control group (3.0 ±0.2) was lower than that in rNIS group (t =2.78, P=0.03).The percentage injection dose per gram of tissue (% ID/g) of the transplanted myocardium was 60.2 ± 20.8 in rNIS group,which was higher than that (2.5 ± 0.4) % ID/g of control group ( t = 7.13, P＜0.001 ).rNIS gene and protein were highly expressed in transplanted myocardium in rNIS group but less expressed in control group.The expressions of CD29, CD44 and CD90 were positive, CD45 and CD45 negative CD11b mildly positive in the myocardium transplanted with infective rBMSC.Conclusion rNIS can efficiently monitor rBMSC transplanted to rat myocardium.     

乳腺摄取~(131)I的甲状腺癌活检证实为良性病变

1例29岁女性患者,体检发现甲状腺结节,诊断为乳头状甲状腺癌,做了甲状腺次全切除,术后给予甲状腺素抑制治疗。术后6年颈部又出现包块,99m　Tc甲状腺显像显示右锁骨上部有多个放射性浓聚区,提示为残留甲状腺组织,肿瘤复发和转移。给予131　I去除治疗后7个月仍有结节存在,患者又相继做了两次手术,131　I扫描及血清甲状腺球蛋白(Tg)随访阴性。9个月后,131　I全身扫描证实双侧前胸部有放射性浓聚,胸部骨显像正常,血清Tg为2.6ng/ml,促甲状腺激素56.5mIU/ml,泌乳素19.9ng/ml,为轻度升高;无泌乳,乳腺检查正常,无结节;胸部X线片正常,双侧乳腺造…     

~(18)F-FDG PET/CT显像在泌尿系肿瘤中的临床应用

18F-脱氧葡萄糖正电子发射断层显像/CT技术(18F-FDG PET/CT)显像在多种恶性肿瘤的诊断、鉴别诊断、分期、随访监测、疗效与预后评估中起重要作用,但是其在泌尿系肿瘤中却因为18F-FDG由泌尿系统排泄而影响观察,肾细胞癌与前列腺癌原发肿瘤病灶则表现为少摄取或不摄取18 F-FDG而呈现假阴性表现。本文旨在探讨18F-FDG PET/CT显像在泌尿系统肿瘤中的潜在临床应用价值。     

A Novel Technique for the Preparation of ~（125）I-5-trimethylstannyl-1-（2-deoxy-2-fluoro-beta-D-arabino-furanosyl） Urail and Its Biodistribution Pattern in Kunming Mice

In this study, a novel technique for the preparation of 125I-5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FIAU) was developed, 125I-FIAU biodistribution profile was detected in Kunming mice and the possibility of using FTAU radio-labeling for reporter gene imaging was explored. 5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FTAU) was labeled with radioiodine (125I). A rotary evaporation method was used to remove excess methanol. The reactant was purified through a Sep-Pak C18 reversal phase column. The radiochemical purity and in vivo stability were determined using silica gel thin layer chromatography (TLC). The biodistribution of 125I-FIAU in Kunming mice was also detected. The results showed that 125I-FIAU could be radiolabeled effectively with FTAU, with mean labeling rate being (81±0.38)% (n =5). The mean radiochemical purity of (98.01±0.40)% (n=5) was achieved after a reversal phase Sep-park column purification. 125I-FIAU was stable when incubated in normal human serum or in saline at 37°C, with a radiochemical purity >96% during a 0.5-24 h time period. Biological experiments exhibited rapid clearance of 125I-FIAU from the blood pool. 125I-FIAU was mostly excreted by kidneys. 125I-FIAU in myocardium dropped conspicuously after 8 h and there was hardly retention at 24 h. We were led to concluded that the new method of radioiodinization of FTAU for the preparation of 125I-FIAU is easy, highly effective and stable in vivo. The biodistribution of 125I-FIAU in Kunming mice showed it can serve as an imaging probe for myocardial reporter genes.