不同结构α干扰素对裸鼠体内人肾腺癌形成的影响

目的比较国产长效干扰素PEG IFN α-1b与原型IFNα-1b及进口PEG IFN α-2b对荷瘤裸鼠的治疗效果。方法以对数生长期的人肾腺癌ACHN细胞接种于雄性BALB/c裸鼠体内制备荷瘤小鼠模型,接种后4周按肿瘤大小将ACHN荷瘤鼠随机分为溶剂对照、PEG IFN α-1b、PEG IFN α-2b和IFN α-1b4个组。溶剂或受试药均连续5周皮下注射给药,给药后每周1次测量动物体重及肿瘤体积。给药后第5周末将动物全身麻醉后处死,称量肿瘤重量,并计算肿瘤抑制率。结果显示第5周末PEG IFN α-1b、PEG IFN α-2b和IFN α-1b组的肿瘤抑制率分别为37.68%、44.31%、48.10%,与溶剂对照组相比,差异均有统计学意义(P<0.05)。结论3种α干扰素对裸鼠体内ACHN肿瘤生长均有明显地抑制作用。     

荷人胃癌皮下移植瘤及细胞免疫功能重建的裸鼠模型构建及其特征

目的 探讨荷人胃癌皮下移植瘤及细胞免疫功能重建的裸鼠模型构建方法及其特征.方法 10只裸鼠随机分为2组,实验组(n=5)腹腔注射人外周血T淋巴细胞(HuPBTL)并皮下接种人胃癌细胞,对照组(n=5)仅皮下接种人胃癌细胞.观察肿瘤潜伏期、成瘤率和肿瘤体积,流式细胞仪检测裸鼠外周血中人T细胞,MTT法检测实验组鼠脾T细胞体外杀伤作用.皮下瘤行病理组织学检查.结果 两组肿瘤潜伏期无统计学差异(P＞0.05),成瘤率均为100%.第3周末,两组肿瘤体积相比无统计学差异(P＞0.05);实验组鼠外周血中人CD3 、CD4 和CD8 T细胞分别为46.86%±9.14%、31.68%±10.17%和17.91%±1.38%,而对照组鼠外周血中则无人T细胞;当效靶比为20∶1和40∶1时,实验组鼠脾T细胞的特异性杀伤率分别为15.37%±1.58%和19.86%±2.86%,且随着效靶比增高而增强(P＜0.05).两组荷瘤鼠均无肝、肺转移;胃癌细胞保持亲代细胞的形态学特征.结论 采用腹腔注射HuPBTL和皮下接种人胃癌细胞的方法成功构建了人胃癌-HuPBTL-裸鼠模型,能模拟具有一定细胞免疫功能的胃癌患者的荷瘤状态.     

低剂量辐射对小鼠种植肿瘤的生长及红细胞免疫SOD活性的影响

目的探讨低剂量辐射对小鼠种植肿瘤的生长及红细胞免疫、SOD活性的影响.方法昆明种雄性小鼠右后肢腹股沟皮下接种S180肉瘤细胞,接种前6 h X射线全身照射75 mGy,照射后5 d观察肿瘤发生率,隔日测量肿瘤体积,绘成生长曲线.15 d后杀鼠,测量肿瘤重量,病理切片观察肿瘤坏死面积、肿瘤浸润性淋巴细胞.同时检测荷瘤小鼠红细胞免疫功能、SOD活性变化.结果与直接荷瘤组相比,低剂量照射组肿瘤发生率明显降低(P＜0.01),肿瘤坏死面积、肿瘤浸润性淋巴细胞增多.低剂量组红细胞免疫功能、SOD活性明显高于直接荷瘤组(P＜0.05).结论低剂量辐射可明显提高机体抗肿瘤的作用,提高红细胞免疫功能及SOD活性,可能具有肿瘤治疗的潜在临床意义.     

125Ⅰ粒子植入治疗荷人肝癌裸鼠移植瘤的实验研究

目的探讨125Ⅰ粒子植入对荷人肝癌裸鼠移植瘤生长和细胞增殖及凋亡相关蛋白的影响.方法建立12只荷人肝癌BEL-7402裸鼠模型,治疗组和对照组各6只.治疗组每只裸鼠移植瘤内植入1枚活度为33.3 MBq的125Ⅰ粒子,对照组不进行干预.治疗后每3～4 d测量1次肿瘤直径,并计算治疗组肿瘤的体积抑制率.21 d后处死裸鼠,制作肿瘤组织标本,进行常规病理学检查和免疫组织化学检测增殖细胞核抗原(PCNA)、bcl-2和bax的表达.结果125Ⅰ粒子治疗组肿瘤体积最大抑制率为49.2%,病理检查显示近粒子处肿瘤细胞变性坏死,远离粒子处可见存活肿瘤细胞.免疫组织化学显示治疗组PCNA表达强度和bcl-2/bax比值均低于对照组.结论125Ⅰ粒子植入低剂量持续照射可直接杀死荷瘤鼠肝癌细胞或抑制肿瘤生长.     

环氧化酶-2抑制剂塞来昔布对胰腺癌荷瘤裸鼠的治疗作用

目的探讨环氧化酶-2(COX-2)抑制剂塞来昔布对胰腺癌荷瘤裸鼠的治疗作用。方法构建胰腺癌荷瘤裸鼠模型,将成瘤裸鼠随机分为4组,分别给予纯水(对照组)和含有不同浓度(0.05%、0.1%、0.15%)的塞来昔布饮水,观测裸鼠肿瘤生长情况并测量不同时间的体积变化,于治疗28 d后处死裸鼠,测瘤体重量,应用caspase-3试剂盒检测caspase-3活性,免疫组织化学法检测肿瘤增殖指数(PI)和微血管密度(MVD)。结果治疗组裸鼠肿瘤体积的变化呈浓度依赖性和时效性;治疗28 d后,治疗组瘤重量均明显低于对照组[(0.96±0.09)g、(0.78±0.06)g、(0.64±0.07)g vs(1.16±0.12)g,P<0.01)];治疗组caspase-3相对活性明显高于对照组(0.021±0.002、0.026±0.003、0.031±0.002 vs 0.006±0.001,P<0.01)。0.1%组、0.15%组的PI和MVD均明显低于对照组(P<0.05);0.05%组的PI和MVD虽均低于对照组,但差异无统计学意义(P>0.05)。结论COX-2抑制剂塞来昔布可显著抑制荷胰腺癌裸鼠的肿瘤生长,其作用机制可能是通过提高caspase-3活性来诱导细胞凋亡,通过抑制肿瘤细胞的增殖和新生血管的形成来发挥抗肿瘤效应,在临床上具有潜在的应用价值。     

干扰素联合茵莲清肝颗粒治疗慢性乙型肝炎的临床研究

目的研究在病毒性慢性乙型肝炎（CHB）的治疗中,采用干扰素（IFN）α-2b联合茵莲清肝颗粒治疗的临床疗效。方法选取94例病毒性慢性乙型肝炎患者为研究对象,随机分为3组,分别采取单纯的护肝药物治疗、IFNα-2b（肌注）,及IFNα-2b联合茵莲清肝颗粒治疗,三组疗程均为24周。观察血清HBV-DNA及HBsAg、HBeAg的阴转情况。结果联合组的HBV-DNA下降程度及HBsAg阴转率则高于IFN-α2b组（P〈0.05）;完全应答率和部分应答率比较,IFN-α2b组和联合组均高于对照组（P〈0.05）;联合组则高于IFN-α2b组（P〈0.05）。结论干扰素联合茵莲清肝颗粒治疗慢性乙型肝炎,可发挥协同抗病毒作用,提高治疗效果。     

^125I粒子植入治疗荷人肝癌裸鼠移植瘤的实验研究

目的 探讨^125I粒子植入对荷人肝癌裸鼠移植瘤生长和细胞增殖及凋亡相关蛋白的影响。方法 建立12只荷人肝癌BEL-7402裸鼠模型，治疗组和对照组各6只。治疗组每只裸鼠移植瘤内植入1枚活度为33．3MBq的^125I粒子，对照组不进行干预。治疗后每3～4d测量1次肿瘤直径，并计算治疗组肿瘤的体积抑制率。21d后处死裸鼠，制作肿瘤组织标本，进行常规病理学检查和免疫组织化学检测增殖细胞核抗原（PCNA）、bcl-2和bax的表达。结果 ^125I粒子治疗组肿瘤体积最大抑制率为49．2％，病理检查显示近粒子处肿瘤细胞变性坏死，远离粒子处可见存活肿瘤细胞。免疫组织化学显示治疗组PCNA表达强度和bcl-2／bax比值均低于对照组。结论 ^125I粒子植入低剂量持续照射可直接杀死荷瘤鼠肝癌细胞或抑制肿瘤生长。     

喉和鼻咽鳞状细胞癌整合素αvβ3放射性核素显像实验研究

目的 研究99Tcm标记的聚乙二醇(PEG)4修饰的环状RGD二聚体(99Tcm-3P-RGD2)显像用于检测人喉和鼻咽鳞状细胞癌(简称鳞癌)整合素αvβ3表达的可靠性.方法 对荷人HEP-2喉鳞癌、荷人CNE-1鼻咽鳞癌裸鼠各6只进行99Tcm-3P-RGD2平面显像,采用勾画ROI技术计算T/NT.显像结束后,测量99Tcm-3P-RGD2在荷瘤鼠体内的放射性分布,计算肿瘤与各组织器官的％ID/g.取肿瘤组织,行整合素αvβ3免疫组织化学染色,并参照Fromowitz法进行半定量分析.两组间比较采用独立样本t检验,相关性分析采用线性相关法.结果 荷HEP-2、CNE-1裸鼠2h显像时T/NT 分别为2.08±0.04与1.54±0.10.体内放射性分布示:HEP-2肿瘤2h放射性摄取值为(4.56±0.67)％ID/g,肿瘤与血液、肌肉的T/NT分别为6.37±0.68与4.44±0.42;CNE-1肿瘤2h放射性摄取值为(1.69 ±0.18) ％ID/g,肿瘤与血液、肌肉的T/NT分别为2.49±0.09与1.86±0.07.HEP-2、CNE-1肿瘤αvβ3免疫组织化学染色Fromowitz评分分别为4.97±0.37与2.60±0.36.荷HEP-2裸鼠2h显像时T/NT、％ID/g及免疫组织化学染色Fromowitz评分均显著高于荷CNE-1裸鼠(t值分别为11.83、7.17和11.31,P均＜0.05).2种荷瘤鼠2h显像时T/NT与免疫组织化学染色Fromowitz评分的相关性均较好(HEP-2:r2h =0.97,P＜0.05;CNE-1:r'2h =0.97,P＜0.05).结论 99Tcm-3P-RGD2显像有望成为检测喉和鼻咽鳞癌αvβ3表达的无创和有效方法.     

99Tcm-DTPA-DG显像对乳腺癌荷瘤裸鼠化疗疗效的评价

目的 探讨99Tcm-DTPA-脱氧葡萄糖(DG)对乳腺癌荷瘤裸鼠化疗疗效的评价.方法 建立乳腺癌荷瘤裸鼠模型.取裸鼠25只,体质量20～25 g,分为5组,接种乳腺癌MCF-7细胞9 d后进行化疗.对照组:注射0.1 ml生理盐水;联合化疗1组:分别按体质量注射紫杉醇11 mg/kg和阿霉素4.7 mg/kg;联合化疗2组:分别按体质量注射紫杉醇5 mg/kg和阿霉素2.3 mg/kg;顺铂1组:按体质量注射顺铂8 mg/kg;顺铂2组:按体质量注射顺铂4 mg/kg.裸鼠化疗后分别于即刻和第7,14,21及28天注射99Tcm-DTPA-DG 3.7 MBq/只,0.5 h后显像,勾画感兴趣区(ROI),计算肿瘤/健侧对应部位放射性(T/NT)比值,并测量肿瘤体积.第28天完成显像后,处死裸鼠,测量肿瘤/血液及肿瘤/肌肉放射性比值,计算抑瘤率.结果 肿瘤组织吸收99Tcm-DTPA-DG较多,肿瘤/肌肉放射性比值对照组为5.65,高于联合化疗1组(0.98,t=8.735,P＜0.01)、联合化疗2组(1.13,t=4.826,P＜0.01)和顺铂1组(0.84,t=3.198,P＜0.05).肿瘤/血液放射性比值对照组为3.1,高于联合化疗1组(0.83,t=7.652,P＜0.01)、联合化疗2组(1.29,t=3.976,P＜0.05)和顺铂1组(0.96,t=3.945,P＜0.05);顺铂2组因不完全缓解,肿瘤/血液放射性比值为2.66,与对照组差异无统计学意义(t=2.496,P＞0.05).99Tcm-DTPA-DG可使肿瘤组织清晰显像,联合化疗1组肿瘤体积400.0 mm3,与对照组(1132.8 mm3)差异有统计学意义(t=3.952,P＜0.01);联合化疗2组肿瘤体积633.9 mm3(t=4.592,P＜0.05),顺铂1组肿瘤体积699.4 mm3(t=4.837,P＜0.05),这2组与对照组差异有统计学意义.除顺铂2组外,余各化疗组与对照组间T/NT比值差异有统计学意义(F=1018.165,P＜0.01).结论 化疗效果好的肿瘤,99Tcm-DTPA-DG显像示肿瘤体积较小,瘤体内放射性分布较少;而化疗效果差的肿瘤体积逐渐增大,瘤体内放射性分布较多.99Tcm-DTPA-DG显像可用于指导荷瘤裸鼠的化疗.     

188Re-DTPA-DG的制备和荷瘤裸鼠实验研究

目的建立^188Re标记DTPA-脱氧葡萄糖（DG）的方法，观察其在荷瘤裸鼠体内分布和治疗效果。方法DTPA—DG的^188Re标记体系有氯化亚锡、葡萄糖酸钠，pH值5．5，反应体系温度为37％，反应3h，用纸层析法以生理盐水和丙酮作展开剂，测定标记物的放化纯及其在体外的稳定性。将标记物经荷乳腺癌MCF-7裸鼠尾静脉注射，于注射后1，4，8，12，24h显像。经尾静脉注射0．1ml 92．5GBq／L的^188Re—DTPA—DG，21d后观察疗效。结果^188Re—DTPA—DG的放化纯可达到95．0％。^188Re—DTPA—DG荷瘤裸鼠显像示肿瘤组织摄取高，病灶／健侧后肢对应部位放射性计数（T／NT）比值在12和24h分别为5．9和7．8。^188Re-DTPA-DG组裸鼠治疗21d后肿瘤体积[（823．6±50．58）mm^3]明显比生理盐水组[（1162．7±73．08）mm^3]小，2组间差异有统计学意义（P〈0．01），抑瘤率为29．2％。结论^188Re—DTPA—DG经荷瘤裸鼠尾静脉注射后可被肿瘤组织高选择性摄取，其对肿瘤生长抑制作用明显，可能成为肿瘤内照射治疗药物。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.