~(99)Tc-MDP对类风湿性关节炎患者外周血单核细胞产生细胞因子的影响

目的 :探讨“云克”(99Tc MDP)治疗类风湿性关节炎 (RA)的免疫机制。方法 :采用ELISA双抗体夹心法 ,观察“云克”体外对RA患者外周血单核细胞 (PBMC)产生白介素 1(IL 1)和可溶性白介素 2受体 (sIL 2R)的影响。结果 :“云克”有抑制RA患者IL 1的分泌及细菌脂多糖 (LPS)的促分泌作用 ,并对可溶性白介素 2受体的自发分泌及植物血素 (PHA)诱导分泌均有抑制作用。结论 :“云克”对RA的治疗机制可能与其降低IL 1和sIL 2R的作用有关     

N-MID、β-CTx在肿瘤骨转移中的临床价值

目的 探讨骨代谢标志物N端骨钙素(N-MID)、β-Ⅰ型胶原羧基端肽(β-CTx)在肿瘤骨转移中的诊断价值.方法 84例恶性肿瘤患者根据骨显像结果分为无骨转移组26例(0级)、骨转移组58例(1,2,3和4级分别17,12,16和13例),测定血清N-MID、β-CTx、25-羟基.维生素D(25-OH-D)、降钙素(CT)、Ca水平.结果 骨转移组β-CTx水平的中位数为0.42 μg/L,较无骨转移组(0.27 μg/L)明显升高,差异有统计学意义(Z=-0.784,P＜0.05);2组N-MID、25-OH-D、CT和Ca水平差异无统计学意义(P均＞0.05);随骨显像所示转移灶级别增加,β-CTx水平逐渐升高,分别为(0.24 4-0.17),(0.31 4-0.11),(0.56 4-0.19),(0.81 4-0.13)和(1.10 4-0.22)μg/L,除0和1级、1和2级外,其他各级两两比较差异均有统计学意义(F0,1=1.602,F1,2=3.890,P均＞0.05;F0,2=5.429,F0,3=9.625,F0,4=16.413,F1,3=8.796,F1,4=13.687,F2,3=4.167,F2,4=9.124,F3,4=5.128,P均＜0.05);N-MID水平有逐渐上升趋势,但各级间差异无统计学意义(P均＞0.05);25.OH-D、CT和Ca水平在各级间差异也无统计学意义(P均＞0.05).结论 血清B-CTx水平对骨转移的诊断和监测可能有一定价值,但尚需作进一步研究证实.     

99Tcm-HMIBP的生物学特性及与99Tcm-MDP的骨显像比较

目的 通过99Tcm-1-羟基-2-(1-甲基咪唑-2-基)乙烷-1,1-二膦酸(HMIBP)和鲫99Tcm-亚甲基二膦酸盐(MDP)的骨显像质量比较,评价99Tcm-HMIBP作为骨显像剂的可能性.方法 制备HMIBP冻干药盒,对HMIBP及SnCl2-2H2O含量、放化纯、药盒pH值及在4℃下的稳定性等进行了研究.测定99Tcm-HMIBP在正辛醇/水相中的分配系数(P)及血浆蛋白结合率,计算血药清除动力学方程参数.同时研究了HMIBP的半数致死剂量(LD50).新西兰兔静脉注射99Tcm-HMIBP和99Tcm-MDP后同步显像比较.结果 99Tcm-HMIBP药盒含HMIBP 5 mg,SnCl2·2H2O 0.05 mg,药盒pH值为5,标记率和放化纯均为98%;在4℃下放置180 d后标记率为96%.在pH值为7.0和7.4时,P值分别为0.0125和0.0054,血浆蛋白结合率为44.77%.小鼠血药清除动力学方程为C=3.0979 e-0.0721t+0.1250 e-0.0076.HMIBP的LD50为8.2 mg/kg.兔骨显像表明,99Tcm-HMIBP和99Tcm-MDP在3 h时均可获得清晰的图像.结论 99Tcm-HMIBP生物学性能优良,显像效果与99Tcm-MDP相当,可能成为集显像与治疗于一体的骨显像剂.     

骨显像在儿童常见恶性实体瘤骨转移中的应用

目的 探讨骨显像在诊断儿童常见恶性实体瘤骨转移中的价值。方法 202例恶性实体瘤（淋巴瘤91例、神经母细胞瘤81例、横纹肌肉瘤20例、肾母细胞瘤10例）患儿行^99Tc^m-MDP全身骨显像，观察各自骨转移发生率、表现特征及好发部位。结果 202例患儿骨显像阳性者92例，占45．5％，其中单发病灶20例，多发病灶72例。好发部位为下肢骨骼和椎体。91例淋巴瘤骨显像阳性者38例，占41．8％，单发与多发性转移灶分别占28．9％与71．1％。肾脏受累15例，占16．5％；81例神经母细胞瘤阳性46例，占56．8％，单发与多发性转移灶分别占21，7％与78．3％。原发灶显影30例，占37．0％；20例横纹肌肉瘤阳性8例，占40，0％；10例肾母细胞瘤均未见骨骼转移。结论 骨显像对诊断儿童恶性实体瘤的骨转移有一定的价值，神经母细胞瘤的骨转移最常见，肾母细胞瘤极少发生骨骼浸润。^99Tc^m-MDP骨显像可显示恶性淋巴瘤的肾脏受累情况。     

99Tcm标记MIBI与MDP骨常规及延迟显像对比研究

目的探讨99Tcm-MIBI与99Tcm-MDP骨常规及其延迟显像对骨良恶性病变的诊断、鉴别诊断及疗效评估的临床应用价值及影响因素. 方法68例临床拟诊骨病变患者分别进行99Tcm-MDP和 99Tcm-MIBI骨显像;MIBI呈阳性者均行延迟显像;最终均行手术治疗及病理检查;其中12例于术前曾行化疗和/或放疗,治疗前后均行上述2项显像. 结果①99Tcm-MIBI显像76.3%(61/80病灶)恶性肿瘤病灶肉眼可见中、高度MIBI浓聚;而良性病灶仅有27.3%(6/22)的轻、中度浓聚;恶性病灶与对侧正常组织计数比值(L/C)为3.16±1.36明显高于良性病灶(1.35±0.56),P<0.01;延迟显像有利于良性病灶假阳性的鉴别.②99Tcm-MDP显像上述所有病灶均肉眼可见MDP浓聚,但恶性病灶L/C(3.66±1.27)与良性病灶L/C(2.97±1.03)比较差异无显著性(P>0.05).③化疗及放疗可以较明显抑制99Tcm-MIBI摄取(但放疗却可增加99Tcm-MDP摄取),因此99Tcm-MIBI摄取程度与99Tcm-MDP比较能较好反应治疗效果. 结论 99Tcm-MIBI骨常规及延迟显像对鉴别诊断良恶性骨病和评估疗效有较好的应用价值,若与99Tcm-MDP显像联合应用可提供更多有价值的信息.     

Iodine-125 labeled phenylphosphonic acid: A new radiopharmaceutical for long-term investigations of the skeleton

A skeletal seeking radiopharmaceutical labeled with a long-lived radionuclide was developed to evaluate regional bone formation and its subsequent resorption. The agent is [phosphonate (phenylmethylene hydroxy) bis]-I-125 or I-125 PA. Tissue distribution studies in mice (N=16) showed approximately 40% of the administered dose to be retained by the skeleton up to 336 hours post IV injection. The percentage of the dose accumulated by the thyroid gland remained at less than 0.5%, indicating minimal deiodination of the I-125 PA. Whole body retention studies in the same species revealed a triexponential release pattern with the longest component comprising 33% of the dose with a biologic half-life of 962 days. A fractured rat tibia model was studied with I-125 PA and Tc-99^m MDP. Chronic loss of the I-125 PA relative to normal tibia was quantitated: five days (62.8%); 30 days (47.4%). Concomitant increased uptake of the Tc-99^m MDP was observed at the fracture site relative to normal: five days (186%); 30 days (1,041%). The above data suggest that I-125 PA can be utilized to measure acute bone formation and chronic resorption.     

类风湿关节炎针刺治疗原理和99mTc-MDP显像评价

目的探讨早期和活动期类风湿关节炎(RA)的针刺治疗原理,并运用9 9mTc-MDP骨关节显像对其效应进行评价.方法对36例临床确诊的早期和活动期RA患者治疗前后行99mTc-亚甲基二膦酸(MDP)全身及手足局部骨显像,随机分为对照组(Ⅰ组)和治疗组(Ⅱ组),用感兴趣区分析法计算类风湿关节区和邻近正常骨骼的放射性比(T/NT).结果针刺可促进RA关节滑膜内交感肾上腺素能神经末梢再生,减少P物质的释放;Ⅰ、Ⅱ组治疗前的T/NT值分别为4.15 1.31、4.23 1.23(t=0.45,P＞0.05),治疗后分别为3.46 1.44、2.34 1.02(t=2.69,P＞0.01),Ⅰ组治疗前后无显著性差异(t=1.50,P＞0.05),Ⅱ组则有明显改善(t=5.02,P＞0.01).结论针刺可减少P物质的释放,促进类风湿关节炎的修复,疗效显著.     

The comparison of dual phase Tc-99m MIBI and Tc-99m MDP scintimammography in the evaluation of breast masses: Preliminary report

The aim of this prospective study was to determine the diagnostic value of Tc-99m MDP scintimammography (SMG) for the detection of breast cancer in patients with breast masses and to compare the results with Tc-99m MIBI scintimammography. Twenty patients, categorized as suspicious, positive or benign for breast cancer according to the mammographic findings were included in the study. Dual phase Tc-99m MIBI and Tc-99m MDP SMG were performed in the prone lateral position within 5 days of each other. Although early and late Tc-99m MIBI SMG showed equal (90.4%) sensitivity, the specificity of late Tc-99m MIBI (87.5%) was found superior to early (62.5%) imaging. The overall sensitivity and specificity of early Tc-99m MDP SMG were 71.4% and 62.5%, respectively. Although late Tc-99m MDP imaging showed 100% specificity, its sensitivity was only 23.8%. In the patients with palpable masses, both early Tc-99m MDP and Tc-99m MIBI showed equal sensitivity (100%), but the sensitivity of early Tc-99m MIBI (37.5%) was found slightly higher than Tc-99m MDP (25.0%) for nonpalpable breast lesions. The sensitivity of Tc-99m MIBI and Tc-99m MDP SMG in detecting metastatic axillary involvement was 66.6% and 50%, respectively. High sensitivity and specificity together with its low cost, easy availability and the possibility of detecting bone metastases seems to make Tc-99m MDP a contributive agent in the evaluation of breast lesions as an alternative to Tc-99m MIBI.     

Effect of a functional monomer (MDP) on the enamel bond durability of single‐step self‐etch adhesives

The present study aimed to determine the effect of the functional monomer, 10‐methacryloxydecyl dihydrogen phosphate (MDP), on the enamel bond durability of single‐step self‐etch adhesives through integrating fatigue testing and long‐term water storage. An MDP‐containing self‐etch adhesive, Clearfil Bond SE ONE (SE), and an experimental adhesive, MDP‐free (MF), which comprised the same ingredients as SE apart from MDP, were used. Shear bond strength (SBS) and shear fatigue strength (SFS) were measured with or without phosphoric acid pre‐etching. The specimens were stored in distilled water for 24 h, 6 months, or 1 yr. Although similar SBS and SFS values were obtained for SE with pre‐etching and for MF after 24 h of storage in distilled water, SE with pre‐etching showed higher SBS and SFS values than MF after storage in water for 6 months or 1 yr. Regardless of the pre‐etching procedure, SE showed higher SBS and SFS values after 6 months of storage in distilled water than after 24 h or 1 yr. To conclude, MDP might play an important role in enhancing not only bond strength but also bond durability with respect to repeated subcritical loading after long‐term water storage.