目的:探讨核素心肌灌注扫描和全身骨扫描,患者受检时的剂量当量,了解这两项检查在日常工作中对医务人员及周围环境辐射剂量率的影响.方法:选择2015年1月～2018年1月在本院接受治疗的40例患者作为研究对象,使用Rad-60个人报警剂量仪对其进行测量,其中心肌灌注扫描20例,全身骨扫描20例,采集的同时将数字化个人剂量仪分别放置于受检者胸口及肝脏处,进行近距离测量,并且在距离患者1m处放置数字化个人剂量仪两个分别对准胸口及肝脏位置进行5min的远距离测量.结果:20例心肌灌注扫描患者近距离测量胸口辐射7～8μSv/h,肝脏辐射10～18μSv/h,1m之外,胸口及肝脏测量结果均为0.20例全身骨扫描患者近距离测量胸口辐射4～7μSv/h,膀胱5～8μSv/h,1m之外,胸口和膀胱均为0.结论:心肌灌注扫描和全身骨扫描的患者对于病房的医护人员及周围的人员不存在辐射安全隐患,对近距离摆位的工作人员存在一定的放射性辐射.

目的 评价应用Ommaya囊进行32 P胶体内放射治疗颅咽管瘤的临床效果.方法 将Ommaya囊导管植入8例患者的颅咽管瘤囊腔内,其中3例仅行瘤囊摘除术;5例行囊液清除术,待伤口愈合后,将计算所需放射性活度的32 P胶体注入瘤囊腔内,为增强治疗效果,可鼓励患者多变换头位,以使瘤囊内的放射性胶体尽可能均匀分布在瘤囊壁的各个部位.定期随访临床疗效,通过CT/MRI等影像检查对比并记录瘤体大小变化.结果 经1～4次32 P胶体注入瘤囊腔内,内照射治疗3个月至38年的随访观察,8例患者均显示出症状缓解/瘤囊缩小等较显著的疗效.结论 应用Ommaya囊进行32 P胶体内照射治疗,可有效改善颅咽管瘤患者的生存质量,提高患者生存率.

目的:评价脑池核素显像检查是否可为脑积水的临床分型提供参考依据.方法:选取 2018 年 4 月~2019 年 7 月我院收治的 80 例脑积水患者纳入本次研究,所有患者全部经 CT、MRI检查予以明确确诊.将年龄＜18 岁的患者纳入儿童组(n＝41);年龄＞18 岁纳入成人组(n＝39),所有患者全部采用脑池核素显像检查,分析检查结果.结果:①交通性脑积水 42 例,没有发现囊肿和蛛网膜下腔相交通,有 32 例(76.19%)表现为大脑凸面显像剂减少或者没有分布、10 例(23.81%)显示分布基本正常;②非交通性脑积水 38 例,大脑凸面显像剂分布减少或者未见分布与分布基本正常的患者各占 19 例(50.00%)结论:可将脑池核素显像的检查结果作为脑积水分型的鉴别依据.

目的:探讨全身骨显像操作技术中常见的影响因素及其质量控制,以期获得优质的骨显像图像.方法:对我科2012年11月-2012年12月526例患者全身骨显像资料进行回顾性分析.结果:526例全身骨显像图像中,447例图像质量良好,占85％,79例图像质量较差,占15％.影响全身骨显像图像质量的主要因素有:放射性药物的标记技术;患者的准备;操作技术.结论:影响全身骨显像质量的环节和因素很多,尤以患者显像前的准备和医务人员操作技术等人为因素为主.

目的探索血清CEA、Tg联合检测在甲状腺良、恶性肿瘤中的临床价值。方法采用化学发光法分别检测经病理证实的68例分化型甲状腺癌（DTC）术前和手术联合131I清甲治疗后、65例甲状腺腺瘤、55例正常对照的CEA、Tg水平,并将结果应用SPSS13.0软件进行统计学分析。结果术前DTC组的CEA水平明显高于腺瘤组（P＜0.05）、Tg水平与腺瘤组差异无统计意义（P＞0.05）;DTC组患者手术联合131I清甲治疗后的Tg水平有显著性下降（P＜0.05）;术后I和II期DTC患者的Tg、CEA水平明显低于III和IV期的（P＜0.05）。结论血清CEA、Tg联合检测对手术及131I清甲治疗后DTC患者的治疗效果及预后判断有较大价值,CEA检测对确诊中晚期的DTC患者有辅助诊断作用。

放射免疫分析技术在操作过程中影响因素多,操作者的操作技术、测量仪器以及整个反应体系等任何步骤的不规范都会直接影响患者的检测结果,导致错误的诊断,因此找出放射免疫分析过程中引起误差的各种因素、认清误差的来源,做好误差控制方法有重要的意义。

Objective:To investigate the clinical significance of squamous cell carcinoma antigen(SCC-Ag) as a tumor marker in the diagnosis and clinical monitor of cervical squamous cell carcinoma,and the relationship between serum SCC-Ag level and clinical stage of cervical cancer.Methods:Squamous cell carcinoma antigen(SCC-Ag) was measured in serum from 107 cervical squamous cell carcinoma patients and control group.Results:Serum SCC-Ag level in patients with squamous cell carcinoma of cervix increased with elevation of clinical stage(P0.01).Conclusion:SCC-Ag is a specific tumor marker of the squamous cell carcinoma of cervix.SCC-Ag can be used as a marker for adjuvant diagnosis of cervical cancer and to estimate the surgical efficacy and as a clinical monitor.

Objective To synthesize 99Tcm labeled hydrazine-nicotinamide ( HYNIC)-c (RGDfK)and evaluate its biodistribution and imaging in the severe combined immunodeficiency (SCID) nude mice bearing human lung adenocarcinoma.Methods ( 1 )Tcm-HYNIC-c(RGDfK) was prepared by a two-step method using tricine and ethylenediamine diacetate (EDDA) as coligands and HYNIC as the dual functional chelator.The bioactivity of 99Tc m-HYNIC-c (RGDfK) was measured by cell binding experiments.(2) The nude mice bearing human A549 lung adenocarcinoma were randomly divided into 7 groups with 5 in each group.The 7 th group was the competitive inhibition control group and was administrated 100 μg HYNIC -c (RDGfK) 30 min earlier before the injection of 99Tcm-H Y N IC-c ( RGDfK ).The nude mice were scanned at 0.5,1,2,4,8 and 12 h respectively after intravenous injection of 7.4 MBq 99Tcm-HYNIC-c(RGDfK).The biodistribution of the agent was measured as ％ ID/g.The uptake ratio of tumor to muscle (T/NT) was also measured by placing ROI on 99Tcm-HYNIC-c(RGDfK) SPECT imaging.(3)Gamma imaging was performed in 6 mice including 3 in the competitive inhibition control group at 0.5,1,2,4,8 and 12 h post injection.Results The labeling yield of 99Tcm-HYNIC-c(RGDfK) was more than 90％,and the radiochemical purity was more than 95％.99Tcm-HYNIC-c(RGDfK) can specifically bind with A549 adenocarcinoma cells with a binding rate up to 36.14％.Biodistribution study showed that the uptake in the kidney was above 20 ％ ID/g during 0.5 - 8 h post injection.The ％ ID/g in tumor was 10.52 ± 1.48 at 0.5 h,17.26 ±2.81 at 8 h,and 8.93 ±0.90 at 12 h.However,the ％ ID/g in tumor was only 2.29 ±0.85 in the competitive inhibition control group at 0.5 h.The highest T/NT was 6.87 at 8 h by the ROI analysis.Xenograffted tumors could be visualized at 1 h and delineated more clearly from 4 to 8 h post injection of 99Tcm-HYNIC-c(RGDfK).Conclusions 99 Tcm-HYNIC-c (RGDfK) can be readily synthesized.Its binding with A549 lung adenocarcinoma cells is specific and the binding rate is high.

The aim of the study was to evaluate the effect of phosphorus-32 colloid ([32P]) intracavitary irradiation on the treatment of patients with cystic craniopharyngiomas.

Objective: To develop a method to label HYNIC-Octreotide with 99Tcm indirectly and evaluate its potential as a clinical imaging agent. Methods: SnCl2 as a reducing agent was adopted to label HYNIC-Octreotide with 99Tcm indirectly, to observe the stability of the labeled drugs; 6 rabbits, 3 healthy volunteers and 3 patients with meningioma were examined by this somatostatin receptor agent. Results: The label rate of 99Tcm-HYNIC-Octreotide was 97.8%±0.55%. The stability of the labeled drugs: ①The stability after 4 hours were above 90%. ②The replace test of cysteine: with the increase of cysteine, free 99Tcm was found to raise slowly, about 23% free 99Tcm was break away from 99Tcm-HYNIC-Octreotide when the concentration of cysteine was up to 200mmol/L. ③Plasma binding: the rate of 99Tcm-HYNIC-Octreotide combined with plasma is 17.04%±0.01% for 24 hours. ①Character of distribution with the radionuclide drug in rabbits and volunteers: Intense uptake was found in bladder and kidney, moderate uptake in liver, mild uptake in mucous membrane of nose, no obvious uptake in brain, lung and intestinal tract. ②Intense uptake was found in 3 patients with meningioma, the average value of T/NT was 5.36 after 4 hours. Conclusions: This method to label HYNIC-Octreotide with 99Tcm is promising; it has a high label rate and stability. 99Tcm-HYNIC-Octreotide has a potential as an agent imaging to meningioma.

· AIM: To investigate the evaluation of orbital somatostatin receptor scintigraphy with 99mTc-OCT in patients with activity Graves' ophthalmopathy's response to corticosteroid therapy. · METHODS: OCT, a somatostatin analog, was labeled with 99mTc by a direct method. The compound's labeling efficiency was confirmed by paper chromatography. There were 15 patients with Graves' ophthalmopathy (GO) and 4 volunteers (control group, CG) without eye disease or GO in the study. Single photon emission computed tomography (SPECT), computed tomography (CT) and left/right lateral position planar imaging of the head were obtained 4 hours after the i.v. injection of 740MBq of 99mTc-OCT, corticosteroid therapy (methylprednisolone,10mg qo t i d. for 1 month) was given for all patients at the next day. In all patient SRS was performed again after 1 month. Radioligand uptake within each orbit (O) and occipital (OC) was measured using the region of interests (ROI) method and the O-to-OC ratio was determined before and after corticosteroid treatment. Clinical activity of GO was evaluated before and after treatment by calculating the ophthalmopathy index (OI). · RESULTS: A significant change of O/OC ratio was observed between pre- and post-treatment in 12 patients with active GO (1.64±0.13 vs 1.21±0.09, P<0.05), and in those CG (1.16±0.04, P <0.05) at the scintigraphy. No significant change of O/OC ratio was observed between CG and posttreatment GO (1.16±0.04 vs 1.21±0.09, P>0.05) nor of O/OC ratio was observed in the 3 patients with inactive GO(P >0.05) both pretreatment and post-treatment, and in those CG (P >0.05). · CONCLUSION: In patient with active GO, SRS showed markedly increased orbital uptake of 99mTc-OCT. The study demonstrated that 99mTc-OCT scintigraphy can predict the clinical response to corticosteroid therapy in patient with GO, and may be considered an objective and safety approach to select the patient for the proper treatment. ·

气道管理是护理工作的一项重要内容,直接关系着病人的生命安危.我们对2例患者气道意外发生的护理过程进行分析,对于气道管理中意外的发生重在预防.