188Re标记免疫靶向磁性纳米微粒及其生物学分布

目的研究^188Re标记具有HER-2／neu癌基因靶向特异性的Herceptin免疫磁性纳米微粒及其在小鼠体内的生物学分布。方法利用戊二醛作为交联剂，将人源性单克隆抗体Herceptin与化学修饰的磁性纳米微粒进行连接，构建免疫磁性纳米微粒。采用直接标记法将^188Re标记到免疫磁性纳米微粒上。采用羰基铼标记法，以fac-[^188Re（CO）3（H2O）3]^＋作为放射性标记前体，对表面固载组氨酸的磁性纳米微粒进行标记。分别测定所制备^188Re标记物的标记率和体外稳定性及免疫磁性纳米微粒的单克隆抗体免疫活性，并观察^188Re标记的磁性纳米微粒及免疫磁性纳米微粒的小鼠体内生物分布。结果经扫描电镜证实免疫磁性纳米微粒的单个粒径大小平均为60nm，而表面固载组氨酸的磁性纳米微粒的粒径平均为30nm。^188Re对Herceptin、免疫磁性纳米微粒及固载组氨酸的磁性纳米微粒的标记率均〉90％，在小牛血清中具有良好的体外稳定性，并且磁性纳米微粒上连接的单克隆抗体仍保持较高的免疫活性。小鼠体内分布实验显示^188Re标记的磁性纳米微粒及免疫磁性纳米微粒在血液中有较高的放射性分布且血循环时间较长，同时两者在肝内均有较多的摄取。结论^188Re标记的磁性纳米微粒及免疫磁性纳米微粒在体外及动物体内较稳定，无明显的^188Re脱落。可用于下一步荷瘤裸鼠体内的研究。     

抗人肝癌188Re-免疫磁性纳米微粒的生物学分布和肿瘤细胞抑制实验

目的探讨抗人肝癌188Re-免疫(Hepama-1)磁性纳米微粒免疫学活性、体内生物学分布、肝靶向性及抑瘤作用。方法对比188ReO4-、188Re-Hepama-1、188Re-磁性纳米微粒,研究尾静脉注射188Re-免疫磁性纳米微粒后4h、24h在昆明小鼠体内的分布情况;在肝区外加磁场及无磁场状态下,研究新西兰大白兔体内的肝磁靶向性;采用溴化四甲基唑法,研究4种188Re标记物对肝癌细胞株SMMC-7721的抑制效果。结果188Re-免疫磁性纳米微粒在肝内摄取量最大;在磁区肝组织放射活性较非磁区肝组织明显增加,二者的放射活性比值为1.87;对肝癌细胞株SMMC-7721半数抑制放射性活度仅为188ReO4-的1/4左右。结论188Re-磁性纳米微粒具有良好的磁感应性能、免疫活性及明显的肝靶向性。     

[188Re(CO)3(H2O)3]+间接标记免疫磁性纳米微粒的实验研究

目的探讨标记单克隆抗体磁性纳米微粒的实验条件。方法以[二（2-吡啶甲基）-氨基]-乙酸（PADA）作为双功能螯合剂，将[^188Re（CO）3（H2O）3]^＋间接标记到耦联了单克隆抗体的磁性纳米微粒。结果[^188Re（CO）3（H2O）3]^＋间接标记免疫磁性纳米微粒的标记率大于80％，在小牛血清和生理盐水中48h后稳定性仍能保持在90％以上。结论使用PADA作为双功能螯合剂，[^188Re（CO）3（H2O）3]^＋间接标记免疫磁性纳米微粒的标记率高，稳定性好，适于进一步体内研究。     

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。     

188Re—HEDP治疗肿瘤骨转移痛药代动力学研究

目的研究188Re标记的1-羟基-1,1-二膦酸钠乙烷（即依替膦酸盐,HEDP）在肿瘤骨转移患者体内的分布和排泄,分析不同剂量188Re—HEDP在患者体内的药代动力学特点。方法将40例肿瘤骨转移患者分为4组,每组10例,4组分别按体质量“弹丸”式经肘静脉注射188Re—HEDP20,30,40和50MBq／kg,给药时及给药后1,2,4,5,12,24,36,48,60和72h分别用SPECT仪采集胸前区和前后位、后前位全身图像,并收集患者尿液,测量放射性。利用感兴趣区（ROI）技术在左心室区测得经本底校正的放射性,作为血液放射性。将1h全身前位、后位放射性总计数率经死时间和时间衰减校正后的几何平均值设定为100％注射剂量（ID）,据此估算上述各时间点全身和各器官的百分注射剂量率（％ID）。各组间的计量资料采用元、中位数、范围等表示,组间比较采用方差分析或t检验。结果20～50MBq／kg范围内,188Re—HEDP在体内的时间-放射性曲线下面积（AUC）与其剂量呈线性关系,r^2=0．9376。4组均符合静脉给药二室模型,AUC值中位数分别为3．32×10^5,3．97×10^5,7．83×10^5,8．58×10^5;分布速度常数（α值）中位数分别为0．06,0．05,0．04,0．06;消除速度常数（B值）中位数分别为1．16×10^-3,1．16×10^-3,1．03×10^-3,1．15×10^-3;指数项系数A值中位数分别为3591．21,4858．23,5642．48,4167．05;指数项系数B值中位数分别为293．97,352．95,614．41,1063．82;药物分布相半衰期T1/2值中位数分别为12．51,12．83,15．41,12．02min;药物消除相半衰期T1／2（β）中位数分别为595．47,596．50,673．09,600．93min。骨组织是摄取188Re—HEDP的主要组织,给药后4h放射性摄取高,约为40％ID,其他组织未见明显摄取188Re—HEDP0188Re．HEDP主要通过泌尿系统排泄,给药后24h排出66．79％ID,其中74％在给药后5h内排出。结论20～50MBq／kg范围内,188Re—HEDP在机体内的药代动力学符合血管给药二室模型。188Re—HEDP T1/2（β）平均为616．50min。188Re—HEDP主要通过泌尿系统排泄;骨组织是摄取188Re—HEDP的主要组织。     

两种方法制备不同颗粒度度^188Re-硫化铼混悬液的生物分布研究

目的了解两种方法制备的不同粒径^188Re-硫化铼混悬液在生物体内各主要脏器的分布，以选择合适粒径范围的混悬液进行关节腔注射。方法采用超声和涡旋两种分散方法制备粒径大小区分明显的^188Re-硫化铼混悬液。36只正常兔分2组，膝关节腔分别注射不同粒径的^188Re-硫化铼混悬液，在10、30min和5、24h各处死3或6只实验兔，取脏器称重并测放射性计数。结果涡旋法所制混悬液注射10min时在肺、肝、脾等组织中的摄取[每克组织百分注射剂量率（％ID／g）分别为0．004、0．003、0．002％ID／g]明显低于超声法所得混悬液（放射性摄取分别为0．05、0．04、0．10％ID／g）：其他脏器中的放射性摄取较少，减少了对非靶组织的辐射损伤。^188Re-硫化铼在血中清除快，10min即达峰值，并很快降低；主要经肾脏排泄。结论涡旋法所制^188Re-硫化铼混悬液非靶组织摄取明显低于超声法所得混悬液，且其质量可控、制备简捷，在关节滑膜切除方面可能有更大的应用前景。     

188Re—k—ras—AGPNA诱导胰腺癌细胞凋亡及在荷瘤裸鼠体内的生物分布

目的研究胰腺癌k-ras点突变基因的反基因肽核酸（AGPNA）生物活性和”。Re—k—ras—AGPNA诱导人胰腺癌细胞凋亡及在荷瘤裸鼠体内的生物分布。方法（1）用RT—PCR检测转染k—ras．AGPNA后胰腺癌细胞k-ras癌基因的mRNA表达水平。（2）用流式细胞仪检测转染后胰腺癌细胞的k-ras蛋白表达水平。（3）给予188Re-k-ras-AGPNA和188ReO4-3～5d后,用流式细胞仪检测胰腺癌细胞凋亡率。（4）58只荷人胰腺癌裸鼠分为188Re—k—ras—AGPNA和188ReO4-2组,采取瘤内注射给药方式,在不同时间点（2组分别为15min,1h,4h,1d,3d,5d,7d与15min,1h,2h,4h,24h）显像后处死裸鼠,计算各组织的％ID／g,并计算各组织的吸收剂量（mGy／MBq）。对数据行单因素方差分析。结果（1）转染1nmol／mlk-ras—AGPNA组细胞的k-ras突变基因mRNA的灰度比和k-ras蛋白表达率分别为1．00±0．39和（15．05±5．07）％,比未给药的肿瘤细胞对照组[分别为1．86±0．07和（24．38±5．40）％]低（F=2．545,5．329,P均〈0．05）。（2）给药后4,5d,188Re-k-ras-AGPNA组漂浮细胞的凋亡率分别为（26．30±7．45）％和（27．90±10．38）％,比188ReO4组[分别为（8．75±3．11）％和（16．87±5．85）％]高（F=9．376,P均〈0．05）。（3）瘤内注射188Re—k—ra8-AGPNA后1h和1,7d肿瘤内放射性摄取分别为（37．47＋21．31）、（35．96±7．80）和（15．46±4．93）％ID／g。肿瘤内吸收剂量为15569mGy／MBq。结论k-ras．AGPNA能抑制k-ras基因在mRNA和蛋白水平的表达。188Re—k—ra,s—AGPNA能诱导胰腺癌细胞凋亡且瘤内注射后肿瘤部位摄取高、滞留时间长。     

荷人结肠癌裸鼠瘤内注射^188Re—C50放射免疫治疗实验研究

目的 评价直接法^188Re标记抗CEA单克隆抗体C50和荷人结肠癌裸鼠瘤内注射^188Re－C50放射免疫治疗效果。方法 室温条件下,取4mg维生素C还原C50,0．5h后加入氯化亚锡0．2mL和新鲜淋洗的^188Re370－740MBq,混匀后反应2h以完成整个标记过程。荷人结肠癌裸鼠瘤内分别注射不同剂量的^188Re－C50,观察其治疗作用,并与瘤内注射生理盐水组和^188Re淋洗液组进行比较。结果 标记单抗经放化纯检测,标记液中游离^188Re和胶体^188Re分别少于5％和10％。与对照组比较,瘤内注射14．06MBq以上的标记单抗,其肿生长体积或质量受到明显抑制,甚至体积缩小。结论 直接法^188Re标记C50取得预期结果;瘤内注射^188Re－C50对肿瘤生长有明显的治疗作用。     

188Re-BAC5联合PYM-BAC5导向治疗鼻咽癌的体外实验研究

目的 在前人工作的基础上,分别设计了内放疗和化疗靶向治疗药物--鼻咽癌单克隆抗体188Re标记物[188Re-鼻咽癌单克隆抗体(BAC5)]和BAC5与平阳霉素(PYM)的耦联物(PYM-BAC5),观察了两药联合使用对体外培养的鼻咽癌细胞(CNE2)的抑制作用.方法 直接法标记188Re-BAC5.以SnCl2、2-巯基乙醇(2-ME)和柠檬酸-酒石酸作还原剂和耦联剂,葡聚糖T-40被氧化成多醛基葡聚糖(PAD)用以耦联PYM和BAC5.四甲基偶氮唑蓝(MTT)法检测2种抗肿瘤药物对体外培养CNE2的抑制作用,并以188ReO4-、188Re-mIgG和PYM为对照组,生理盐水为空白对照组.结果 188Re-BAC5标记率为92%～95%,放射性浓度为5254 kBq/ml;PYM-BAC5中m(PYM):m(BAC5)=1:0.526,n(PYM):n(BAC5)=1:51.2种药单独治疗组、联合治疗组及各自对照组的抑制效应都呈明显的剂量-效应关系.但188Re-BAC5对CNE2的抑制作用随放射性浓度的增加而增加,半数抑制浓度(IC50)为264 kBq/ml,抑制作用明显强于188ReO4-(IC50=882 kBq/ml)和188Re-mIgG(IC50=1062 kBq/ml)组.PYM-BAC5的IC50为10.07 μg/ml,而单纯PYM的IC50为63.60 μg/ml;联合用药中188Re-BAC5的IC50为32.1 kBq/ml,PYM-BAC5的IC50为1.70 μg/ml,分别明显小于2种药单用时各自的IC50,以上各组差异均有统计学意义(t=22.62和37.70,P＜0.01).结论 靶向治疗组(188Re-BAC5)抑瘤效果明显好于非靶向组;联合靶向治疗组(188Re-BAC5 +PYM-BAC5)的抑瘤效果明显好于单独用药组.     

心脏肾上腺素能神经的PET应用

目的研究188Re-奥曲肽在荷瘤裸鼠体内的分布,为进一步肿瘤靶向治疗奠定基础。方法16只荷人H460非小细胞肺癌的BALB／c裸鼠分为4组,经尾静脉注射188Re-奥曲肽 18．5MBq(O．2ml)．于注射后2h,4h,24h,48h每个时间点处死一组裸鼠,取血液、肿瘤组织及主要脏器测量其放射性计数率值,经放射性衰变校正后计算每克组织的百分注射剂量率(％ID／g),观察标记物在动物体内的生物学分布。另2只荷瘤裸鼠同样尾静脉注射相同剂量的188Re-奥曲肽,于注射后相同时间点行SPECT扫描,利用感兴趣区技术对肿瘤／非瘤组织放射性比值(T／NT)进行半定量分析。结果188Re-奥曲肽标记率达(95．3±1．8)％,188Re-奥曲肽在荷瘤裸鼠体内主要分布于肿瘤组织、肝脏、肾脏及肠道,肿瘤部位在4h摄取达到高峰9．8％ID/g,此时SPECT在肿瘤部位有明显的放射性核素浓聚,T／NT在尾静脉药物注射后24h达到高值为7．1。结论 188Re-奥曲肽在BALB／c荷瘤裸鼠体内对人非小细胞肺癌具有靶向定位作用,其在肿瘤部位的分布具有较高的T／NT,188Re．奥曲肽有望用于表达生长抑素受体肿瘤的核素靶向治疗。     

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 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.     

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     

人体中的镭-226、镭-228、钋-210、铅-210

本文报道了广东阳江高本底地区6名、对照地区8名人尸体的骨²²⁶Ra、²²⁶Ra的浓度以及部分居民内脏器官中。²¹⁰Po、²¹⁰Pb的浓度。结果轰明阳江高本底地区和对照地区居民骨镭-226、镭-228的浓度分别为29.9pCi/kg, 26.9pCi/kgl 8.7pCi/kg, 8.2pCi/kg.由此估算出阳江高本底地区屠民骨中²²⁶Ra、²²⁸Ra的负薄璧及对骨衬、骨髓所产生的剂量当量分别为对照地区民民的3.4倍, 3.3倍。两地区居民内脏器官中^{210Po、210Pb的测定分析铡数较少但仍看出, 高本底地区均明显高于对照地区.}     

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.     

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.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).