陆金根运用拖线法治疗肛瘘经验探讨

介绍陆金根教授运用现代技术诊断肛瘘瘘管的走向、拖线的设置及术后创面的处理等临床经验。     

Preparation of clinical‐scale 177Lu‐Rituximab: Optimization of protocols for conjugation,radiolabeling, and freeze‐dried kit formulation

Rituximab is a monoclonal chimeric antibody, which has been approved by the US Food and Drug Administration for immunotherapy of non–Hodgkin lymphoma. Bexxar and Zevalin are the two other approved radiolabeled antibodies for radioimmunotherapy of non–Hodgkin lymphoma; however, they are of murine origin that reduces their treatment efficacy. So as to circumvent this, efforts have been made to radiolabel Rituximab with various therapeutic radioisotopes. In the present study, an effort has been made to optimize the conjugation (bifunctional chelating agent and antibody) and radiolabeling procedures for the preparation of clinical‐scale ¹⁷⁷Lu‐labeled Rituximab. An attempt was also made to prepare the freeze‐dried Rituximab kit for the easy and convenient clinical translation of the agent. Clinical‐scale ¹⁷⁷Lu‐Rituximab (40 mCi, 1.48 GBq) was prepared with >95% radiochemical purity using the kit. Biological evaluation of ¹⁷⁷Lu‐Rituximab was performed by in vitro cell binding studies in Raji cell lines, which showed satisfactory binding at 4°C and 37°C. Pharmacokinetic behavior of the agent, evaluated by biodistribution studies in normal Swiss mice, revealed high blood and liver uptake at the initial time points, although it exhibited slow and gradual clearance with time. The study indicates that clinical‐scale ¹⁷⁷Lu‐Rituximab could be conveniently formulated using the methodology described in the present article.     

陆灏运用温胆汤治疗痰热内扰型消渴经验

介绍陆灏教授运用温胆汤加减治疗痰热内扰型消渴的思路和方法,分析温胆汤应用指征与方证,并举验案1则。     

六安地区健康成人超敏Ｃ反应蛋白参考区间研究

目的：建立六安地区成人超敏C反应蛋白（hs-CRP）的参考区间。方法按照CLSI文件C28-A3《临床实验室如何确定和建立生物参考区间》要求,于2014年1～8月筛选前来六安市第二人民医院进行健康体检者137名,采用颗粒增强免疫透射比浊法测定血清hs-CRP浓度。结果去除3例离群值后,134例六安地区健康成人血清hs-CRP明显呈偏态分布,经对数转换,男女之间无组间差别（Z＜Z*）,参考上限为2.0664 mg／L。结论本研究为六安地区健康成人血清hs-CRP参考区间的建立提供了科学依据。     

Automated synthesis of 68Ga/177Lu-PSMA on the Trasis miniAllinOne

Prostate-specific membrane antigen (PSMA)-based radioligands for positron emission tomography (PET)/computed tomography (CT) studies represent the gold standard for detection of recurrent prostate cancer (PCa). [⁶⁸Ga]PSMA-HBED-CC is a PET radiotracer suitable for detection of PCa, and its clinical use has become widespread over the last few years. In this contribution, we detail our GMP-compliant production of [⁶⁸Ga]PSMA-HBED-CC using the Trasis miniAllinOne radiosynthesizer and report synthetic and clinical data for the first 100 productions of 2019. Additionally, we detail our efforts towards a GMP-compliant production of the radiotherapeutic [¹⁷⁷Lu]PSMA-I&T using the same synthesis module. PSMA-based radioligand therapy (RLT) offers a possible future treatment in cases of metastatic castration-resistant PCa, and GMP-compliant routine production methods are therefore called for. This report highlights how PSMA-based agents for theranostic purposes can be conveniently produced at a single radiochemistry Good Manufacturing Practice (GMP) site, thereby facilitating optimized detection and treatment of PCa.     

陆真翘从三焦论治湿火

介绍陆真翘先生从三焦论治湿火的学术思想及临床经验。在卫气营血辨证体系基础上结合脏腑辨证施治,在湿火发展的每一阶段辨明病位所在,分析湿与火孰轻孰重的主次关系,探究湿火相关脏腑的运气特点。针对上焦火重于湿,中焦湿火俱盛,下焦湿重于火的特点,提出三焦分治,以脾胃为本,分解湿与火为要,并顺二者之性各予出路的学术观点。     

177Lu-奥曲肽治疗神经内分泌肿瘤肾脏吸收剂量估算

目的 估算¹⁷⁷Lu-奥曲肽（¹⁷⁷Lu-DOTA-TATE）治疗神经内分泌肿瘤肾脏所受吸收剂量,评估辐射安全并指导治疗。方法 ¹⁷⁷Lu-DOTA-TATE治疗患者行单光子发射断层扫描（single photon emission computed tomography,SPECT）平面显像,勾画计数全身和肾脏区域并转换为活度,构建时间-活度单指数曲线方程,计算全身/肾脏的有效半衰期和累积活度,以MIRD （medical internal radiation dose）方法估算肾脏的吸收剂量。结果 总共11名神经内分泌肿瘤患者进行了18例次¹⁷⁷Lu-DOTA-TATE药物治疗,全身和肾脏的有效半衰期分别为（20.0~99.8）和（38.2~75.2） h,平均有效半衰期分别为（57.3±21.4）和（53.1±2.5） h;肾脏所吸收的剂量为（0.25~1.48） mGy/MBq,平均吸收剂量为（0.90±0.31） mGy/MBq。患者单次疗程肾脏受到的吸收剂量最小1.8 Gy,最大9.6 Gy,多个疗程肾脏受到最大吸收剂量21.7 Gy。结论 准确估算¹⁷⁷Lu-DOTA-TATE治疗神经内分泌肿瘤患者危险器官肾脏吸收剂量,结果低于耐受剂量限值,有望为患者的精准化治疗提供指导。     

陆金根教授诊治肛肠外科疾病的学术思想初探

陆金根教授在肛肠外科疾病的诊疗中,提倡局部整体观,既强调把局部作为一个整体来认识,又强调局部的问题要从整体的观念来分析;同时他对"瘿痈"、"肛疽"等疾病的命名,以及便秘的论治均有自己独特的见解;对肛肠病内外之治,主张择机而施,临证施治务要摆正"手术"与"药"的位置,"谨守病机,各司其属"。