~(99m)锝标记红细胞腹部γ-闪烁扫描捡测胃肠道出血

本文报告用~(99m)锝标记红细胞腹部γ-闪烁扫描检测胃肠道出血患者26例,敏感性为94％,假阴性率6％,特异性87.5％,假阳性率12.5％,定位精确性90.9％。~(99m)锝标记红细胞注入人体一周内对造血系统及肝肾功能均无明显损害。此法可持续检测24h或36h,因此对间歇性和自限性胃肠道出血有独特的诊断价值。     

~(99m)Tc-葡聚糖的制备及其在淋巴和血池显象中的初步应用

本文报告了~(99m)Tc-葡聚糖制备方法和用其进行淋巴和血池显象的初步结果。资料表明,用本文方法制备的~(99m)TC-葡聚糖放化纯接近100％,Sn-葡聚糖半成品药盒在2～4℃下可贮存3月以上。用其进行淋巴显象28例和血地显象6例,均获得优良图象,并未见明显副作用,在许多方面优于放射性胶体和~(99m)Tc-RBC,故值得临床上推广应用。     

一种新的肾脏功能显象剂~(99m)Tc-MAG_3的制备及初步应用

本文报道~(99m)Tc-MAG_3 的制备、分析及初步应用。用Whatman Ⅰ号层析纸和硅胶薄板,以生理盐水为展开剂作层析,~(99m)Tc-MAG_3 的放射化学纯度>95％。标记后的稳定性较好,0～4 小时后的标记率均>90％。家兔肾时间-放射性曲线表明,注射~(99m)Tc-MAG_3 后1分钟,肾内浓聚达较大值。随着时间的推移,肾内放射性迅速下降,30分钟后肾内残存的放射性仅10％左右。肾脏显影较好。     

柠檬酸~(67)镓扫描对恶性淋巴瘤的诊断价值

<正> 淋巴系统扫描是从1953年开始的。常用的阴性扫描剂有~(198)。金—胶体、~(99m)锝—胶体和~(99m)锝—植酸盐。目前,国外广泛应用亲肿瘤阳性扫描剂柠檬酸~(67)镓,对淋巴系统恶性肿瘤进行扫描     

同位素扫描早期诊断家兔急性骨髓炎的研究

取家兔8只,用金葡菌在右胫骨近端造成急性感染,使用~(99m)锝及~(113m)铟扫描,显示感染后24h感染侧即有同位素浓集征象,2～3天后浓集更加明显。通过病理及X线检查对比证明,同位素扫描是一种早期诊     

电解法标记~(99m)Tc-DMSNa肾脏扫描剂及其临床应用

近年来,临床多用~(203)汞—新醇作肾脏扫描剂,但其半衰期长,肾受照剂量大,注射后长期不宜作其他同位素检查,且~(203)汞的Eγ(γ射线能量)=280KeV,闪烁照相所得影像不清,故又选用短半衰期放射性~(99m)锝标记的化合物作肾脏扫描剂,如~(99m)Tc—EDTA(~(99m)-锝—乙二胺四醋酸)、~(99m)Tc—DTPA(~(99m)锝—     

~(99m)锝“母牛”肝肾显影剂药盒试制成功

~(99m)锝标记的放射性药物,目前为国际上应用最广、效果较好的脏器显影剂。~(99m)锝发生器早在一九七二年即由中国科学院原子能研究所等单位首先研制成功,但是~(99m)锝“母牛”显影剂药盒的研制生产一直未得到解决。     

骨扫描剂~(99m)锝—焦磷酸盐的电解法标记及其临床初步应用

近十多年应用一些趋骨性元素和放射性药物进行骨胳疾病的基础与临床研究,认为骨扫描和放射性核素骨显象具有早期诊断的价值。~(99m)锝标记的磷酸盐(二聚、三聚或多聚磷酸盐、EHDP等)应用较为广泛。~(99m)锝—焦磷酸盐(简称~(99m)Tc—PYP,下同)的标记多用     

~(99m)锝-磷(膦)酸盐三相骨扫描对Perthes病及成人特发性股骨头坏死研究的初步体会

本文应用了~(99m)锝-磷酸盐三相骨扫描对38例Perthes病及12例成人特发性股骨头坏死的双侧股骨头进行了初步的观察,以了解其血供情况,及代谢状态。在骨血流相中,40例(80％)患侧股骨头显示其~(99m)锝的吸收稍低于健侧。但在骨血池相中,其患侧股骨头对~(99m)锝的吸收逐步超过了健侧,在时间-强度曲线上形成了交叉现象,其发生率可达80％。到了静态相,患侧股骨头对~(99m)锝的吸收继续增强,50例中有47例(94％)显示其放射性核素明显地比健侧浓集。这些观察结果提示了该病患侧股骨头的动脉血供稍差于健侧,其主要原因可能是其毛细血管和静脉血流阻滞所至。但是,患侧股骨头在静态相中对~(99m)锝吸收的显著增加,说明了其中之骨细胞代谢比较活跃,可能是股骨头自我修复的表现。作者还认为,其血流/血池相中的时间,强度曲线的分析,有助于对早期Perthes病和成人特发性股骨头坏死的诊断,并对该病的治疗提出了意见。     

运动~(99m)Tc-CPI心肌SPECT显像在冠心病诊断中的初步应用

~(201)Tl心肌灌注显像已成为冠心病临床诊断、预后及疗效评价的重要无创作手段,但由于~(201)Tl的核性质及价格等方面的原因,限制其更广泛的临床应用。 ~(99m)Tc标记的甲酯异丙基异腈(~(99m)Tc-Carbomethoxy isopropyl isnoitrile,~(99m)Tc-CPI)是~(99m)Tc标记的异腈类化合物中较有希望的一个心肌显像剂,除了~(99m)Tc的核性质适宜和价格低廉外,还具有肺、肝清除较快、心肌图像清晰等优点,国内外初步临床应用结果比较满意。文献     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.