分别含K88,K99和LT-B亚单位抗原基因的重组痘苗病毒的构建

本文构建了分别含K88,K99和LT-B亚单位抗原基因的重组痘苗病毒,并观察了这3种基因的表达情况。首先将K88亚单位基因克隆入痘苗转移或体PGJP-5中,得到嵌合质粒P_5-K88,将K99和LT-B亚单位基因分别克隆至痘苗转移载体PJ16中,得到重组质粒PJK-9和PLT-B。再经细胞体内同源重组技术,将以上3种基因分别插入到痘苗病毒天坛株的TK基因中,经5-BUdR的选择压力在人TK~--143细胞中挑选TK~-表型病毒,分别以相应的~(32)P标记的基因片段为探针进行杂交筛选重组病毒株。我们得到7株含K99亚单位基因的重组病毒V-K99(Ⅰ～Ⅷ),5株含K88亚单位基因的重组病毒V-K88(Ⅰ～Ⅴ);1株含LT-B亚单位基因的重组病毒V-LTB,ELISA检测结果表明,在以上3种重组病毒感染的人TK~--143细胞培养液和细胞裂解物中均未测出相应的基因表达产物。以上结果表明这3种基因可能不易在痘苗系统内有效表达。     

Verlaufsformen und Mikrobiologie der bakteriellen Osteomyelitis

Zusammenfassung Wegen der vielfältigen klinischen Präsentation der Osteomyelitis werden diese Patienten von Ärzten verschiedenster Fachrichtungen gesehen. Verschiedene Klassifikationen spiegeln die Konzepte zur Diagnostik und Therapie der Osteomyelitis wider. Ursprünglich wurde die Osteomyelitis nur in eine akute und eine chronische eingeteilt. Die klassische Einteilung nach Waldvogel berücksichtigt die Pathogenese. Nach Wagner wird beim diabetischen Fuß der fließende Übergang von der Weichteilinfektion zur Osteomyelitis und zur Gangrän beschrieben. Die Einteilung nach Cierny-Mader nützt v. a. der Therapie durch den Traumatologen/Orthopäden. Das Erregerspektrum ist abhängig von Art der Osteomyelitis, geographischer Epidemiologie, Patientenalter, Komorbidität, mikrobiologischer Technik und Infektionsdauer. S. aureus spielt bei jeder Form die wichtigste Rolle. Bei Bildung von Biofilm und small-colony variants neigt der Keim zu Persistenz und Rezidiv. Die Antibiotikaresistenz nimmt seit 20 Jahren zu. Nicht nur die In-vitro-Resistenz, sondern auch die Wirkung der Antibiotika auf nichtwachsende und adhärierende Keime bei Implantatinfektionen sind wichtig. Zur optimalen Antibiotikatherapie sollte immer der Keimnachweis versucht werden.     

SPECT显像诊断小儿Meckel''s憩室并出血

目的 :评价SPECT显像在美克耳憩室并出血诊断中的价值。材料和方法 :对 17例疑为美克耳憩室并出血的患儿进行了高锝酸盐 (99mTcO4- )腹部平面显像 ,2例作了断层显像。结果 :阴性显像 6例 ,5例经临床表现及相关检查排除美克耳憩室 ,1例经手术证实为美克耳憩室。阳性显像 11例 ,9例经手术及病理证实为美克耳憩室 ,1例为空肠及其系膜巨大海绵状血管瘤 ,1例为回肠管状重复畸形。SPECT显像对美克耳憩室诊断的敏感性、特异性和准确性分别为 90 .0 %、71.4%和 82 .4%。结论 :SPECT显像简单易行 ,是诊断美克耳憩室并出血的首选影像学方法 ,加采断层显像可以提高敏感性。     

SPECT/CT融合显像评价下肢骨折远期愈合的初步探讨

目的:探讨SPECT/CT融合显像在评价下肢骨折远期愈合能力方面的价值.方法:回顾性分析59例下肢骨折患者术后6个月后的SPECT/CT融合图像,分析骨折愈合情况,并与随访或手术比较,计算SPECT/CT融合显像对下肢骨折远期愈合的诊断准确率.结果:59例常规影像学检查均不能判断是否具有远期愈合可能.SPECT/CT示...     

A case of sudden cardiac death due to mitochondrial disease

A 25-year-old, emaciated man without medical treatment was found to have died suddenly at home by his mother. At autopsy, there were no injuries to his body, but significant circulatory insufficiency was observed. Electron microscopy revealed abnormal mitochondria in cells of the cardiac conduction system. The conduction system was filled with mitochondrial size abnormalities and mitochondrial cristae abnormalities. No notable abnormal findings were observed in other organs. Genetic examination of the blood revealed the mitochondrial pathogenetic variant m.3243A>G. Epileptic seizures, diabetic ketoacidosis, and hyperosmolar hyperglycemic state were unlikely to be the cause of sudden death. The cause of death was diagnosed as arrhythmia possibly induced by the failure of the cardiac conduction system due to mitochondrial disease. This is a rare case of sudden death caused by an accumulation of abnormal mitochondria in the cardiac conduction system.     

The aluminum content of bone increases with age, but is not higher in hip fracture cases with and without dementia compared to controls

Aluminum is considered a potentially toxic metal, and aluminum poisoning may lead to three types of disorders: aluminum-induced bone disease, microcytic anemia and encephalopathy. This is well known in patients with chronic renal failure, but since healthy subjects with normal renal function retain 4% of the aluminum consumed, they are also at risk of long-term low-grade aluminum intoxication. Included in this study were a total of 172 patients (age range 16–98 years) with the aim of examining whether aluminum accumulates in bone with increasing age. Additionally, we aimed to investigate whether the aluminum content of bone differs between controls and hip fracture cases with and without dementia, in particular in those with Alzheimers disease. During operations for all cases, bone biopsies were taken with an aluminum-free instrument from the trabecular bone. The samples were measured for their content of aluminum using an inductively coupled mass spectrometer. We found an exponential increase in aluminum content of bone with age. The average aluminum values, adjusted for age, were similar in men and women (P=0.46). No significant differences in sex- and age-adjusted mean aluminum values between the controls and the hip fracture cases with (P=0.72) and without (P=0.33) dementia could be detected. The average aluminum concentration among cases with Alzheimers disease was also similar to the values of hip fracture patients with other types of dementia (P=0.47). Odds ratios of hip fracture for each quartile of aluminum content in bone were also estimated to detect non-linear effects, but we did not find any statistically significant association remaining after age and sex adjustment. Thus, our results indicate that we accumulate aluminum in bone over our life span, but this does not seem to be of major pathogenetic significance for the occurrence of hip fracture or dementia.     

99Tcm-MDP SPECT/CT显像用于骨肉瘤肺转移的诊断

目的：观察骨肉瘤肺转移的发生率,评价99Tcm-MDP SPECT/CT显像中的骨显像与胸部CT对肺转移的检出效能及其影响因素。方法178例骨肉瘤患者使用SPECT/CT行全身骨显像的同时获得胸部CT,以诊断有无肺转移发生。通过回顾性分析,将影像学诊断结果与最终临床诊断进行对照,计算肺转移的发生率;评价骨显像和胸部CT对肺转移的检出效能;分析转移灶钙化对骨显像检出率的影响;分析血清碱性磷酸酶（ALP）水平在有肺转移与无肺转移者之间、转移灶有钙化与无钙化者之间以及转移灶骨显像阳性与阴性者之间的差异。结果178例患者肺转移的发生率为24．2%;骨显像与胸部CT对其诊断的灵敏度分别为44．2%和100%;特异度分别为100%和89．6%;骨显像对有钙化转移灶的检出率显著高于无钙化转移灶（χ2=8．4,P＜0．01）;患者血清ALP水平与肺转移的发生相关,但与病灶内有无钙化以及病灶是否在骨显像中呈阳性无关。结论骨肉瘤患者肺转移的发生率较高,使用SPECT/CT同时行全身骨显像和胸部CT检查对其检出具有较高诊断价值,尤其适用于血清ALP升高的患者。     

心肌灌注显像放射性稀疏区成因与组织衰减的实验研究

目的探讨正常心肌灌注显像放射性稀疏区的成因.材料与方法对5例猪心行99mTc-MIBI在体和离体心肌灌注显像,并用ROI技术测量左室各部位心肌的放射性水平(计数/像元),由该值在两种状态下的差值计算衰减程度(%).结果两种状态间壁后部和后壁放射性水平最低;在体心肌前壁中段衰减程度(7.9%)高于其前段和后段,该区衰减程度与胸壁厚度呈正相关;后壁衰减程度最高(11.9%).结论胸壁是造成前壁中段稀疏影的原因,膈肌是形成后壁稀疏影的重要原因之一.心肌图像重建时可根据衰减程度作适当补偿.     

Technetium-99m labeling of a molecule bearing easily reducible groups

Chemical stability of the naphthol-azo dye Evans Blue (EB) was examined in the presence of acidic stannous chloride (SnCl₂), with a view to preparing an instant cold kit. EB was found to be reactive toward this reducing agent, yielding the metal-chelating molecule 1,7-diamino-8-naphthol-2,4-disulfonic acid at high acidity and high stannous concentrations. This reduction reaction was undesirable in the cold kit preparation. The conditions were determined where reduction was inhibited, at pH = 5.0 and with a mole ratio of EB to SnCl₂ = [10:1], effecting the facile preparation of stable cold kits. Successful ^99mTc-labeling of an EB cold kit using these conditions resulted in the desired product with 98% radiochemical purity. Based on the radiolabeling efficiencies of chosen model compounds, it was rationalized that ^99mTc metal predominantly coordinated with the 1-amino-8-hydroxy groups in the EB molecule to form ^99mTc-EB.     

A solid-phase technique for preparation of no-carrier-added technetium-99m radiopharmaceuticals: application to the streptavidin/biotin system

A high effective specific activity (HESA) formulation of a biotin-containing ^99mTc ligand [RP488: dimethyl-Gly-Ser-Cys(Acm)-Lys(Biotin)-Gly] conveniently prepared from solid phase was compared to a typical low effective specific activity (LESA) solution formulation to demonstrate improved targeting to streptavidin in an in vitro assay and in an in vivo rat model. RP488 was coupled to a maleimide-functionalized polyethylene glycol resin via a thiol ether linkage and labeled with ^99mTc-gluconate at room temperature, followed by elution of the HESA ^99mTc-RP488 in saline (minimum specific activity 1000 TBq/mmol by amino acid analysis). Both HESA and LESA ^99mTc-RP488 labeled at > 90% purity. In vitro, HESA ^99mTc-RP488 incubated with streptavidin-agarose was bound quantitatively, but there was competition from addition of increasing amounts of cold RP488. In rats, radiotracer uptake was evident at the site of implantation of streptavidin-agarose beads for the HESA dose, less uptake of low effective specific activity (LESA) material, and no appreciable uptake in the control rats of the LESA or HESA dose. The target-to-background ratio for HESA ^99mTc-RP488 was 5.4 times that of the control. The solid-phase technology offers a convenient way to prepare high specific activity receptor-targeting ^99mTc radiopharmaceuticals.