Objective To investigate the biodistribution,excretion and other pharmacokinetics,of 188Re-1-hydroxy-1,1-ethylidene disodium phosphonate (HEDP) in cancer patients with osseous metastases who were suffering form bone pain. Methods A single dose (20,30,40,and 50 MBq/kg,10 patients in every group) of 188Re-HEDP was administered as a bolus injection,meanwhile dynamic images on patient's chest were collected for 30 min. Anterior and posterior whole-body images were obtained at 1,2,4,5,12,24,36,48,60 and 72 h after injection of 188Re-HEDP. By region of interest (ROI) technology,the curve of time-background corrected counts of left cardiac ventricle could be generated,and the background-corrected counts of various organs and total whole body could be calculated as a geometric mean using the anterior and posterior scans,and transformed to the percentage injected dose ( % ID). Urine was collected after injection of 188Re-HEDP. Counts of urine were measured by γ counter. Analysis of variance and t-test were used. Results Linear relationship of metabolism of 188Re-HEDP was observed in the doses from 20 to 50 MBq/kg,with correlation coefficient r2 = 0. 9376. A two-compartment model was the best fit for metabolism of 188Re-HEDP with the parameters median area under curve (AUC) 3.32 × 105,3.97 × 105,7.83 × 105,8.58 ×105,respectively; median α 0.06,0.05,0.04,0.06 respectively; median β 1.16 ×10-3,1.16 × 10-3,1.03 × 10-3,1.15 × 10 -3 respectively; median A 3591.21,4858.23,5642. 48,4167.05 respectively; median B 293.97,352.95,614.41,1063.82 respectively; median T1/2(α) 12.51,12.83,15.41,12.02 min respectively; median T1/2(β) 595.47,596.50,673.09,600.93 min respectively in the doses of 20,30,40and 50 MBq/kg. 188Re-HEDP was taken up mainly by bone up to 40% ID at 4 h. Urine profile showed that 66.79 % ID was eliminated within 24 h,being its 74% collected along the first 5 h after-administration.Conclusions In the doses of 20,30,40 and 50 MBq/kg,metabolism of 188Re-HEDP presented linear model. Pharmacokinetics of 188 Re-HEDP followed a two-compartment model administrated by blood vessel.Following injection,188 Re-HEDP was taken up mainly by bone and excreted by uropoietic system.

Craniofacial Abnormalities ; Humans ; Infant, Newborn ; Male ; Skull ; abnormalities

OBJECTIVETo explore the therapeutic effect of diagnosis and treatment program of integrative medicine (IM) on level 2 hypertension in the young and middle-aged patients and their ambulatory blood pressure.

METHODSA randomized, placebo parallel and controlled, multi-center clinical trial was performed. Totally 199 young and middle-aged level 2 hypertension patients were randomly assigned to the treatment group (99 cases) and the control group (100 cases). All received combined hypotensive treatment program by taking Nifedipine Sustained Release Tablet and Hydrochlorothiazide as basic drugs. Patients in the treatment group additionally took Western medicine (WM) combined Jiangyabao serial drugs (0.31 g per tablet, 2 tablets each time, twice daily), while those in the control group additionally took WM combined simulative agents of Jiangyabao serial drugs (0.31 g per tablet, 2 tablets each time, twice daily). The treatment course was 8 weeks for all, and 24-week follow-ups performed. 24 h ambulatory blood pressure and casual blood pressure, and their efficacies were compared between the two groups, and safety assessed as well.

RESULTSCompared with before treatment in the same group, daytime and night casual blood pressure, as well as 24 h ambulatory blood pressure were all obviously improved in the two groups (P < 0.01). Average diastolic and systolic blood pressures at night decreased more in the treatment group than in the control group with statistical difference (P < 0.05). There was no statistical difference in total efficacies of daytime casual blood pressure or ambulatory blood pressure (P > 0.05).

CONCLUSIONJiangyabao serial drugs combined WM in treating young and middle-aged level 2 hypertension patients showed obvious effect in improving night blood pressure, especially for night diastolic blood pressure.

Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; diagnosis ; therapy ; Integrative Medicine ; Middle Aged ; Nifedipine

Objective To summarize our experience on the treatment for severe vascular injuries in the operation of great saphenous varicose vein. Methods The clinical data of 4 cases (5 lower limbs) from December 2004 to April 2009 of severe vascular injuries were retrospectively analyzed. For the lower limbs in which from the end of femoral artery to the upper part of posterior tibial artery were stripped, reconstruction operation using blood vessel prothesis was performed, above knee amputation was performed because of limb gangrene. For three limbs in which 10 cm to 15 cm superficial femoral artery were stripped, reconstruction operation using autologous saphenous vein were performed, above knee amputation was performed for one limb 5 days after the operation. For the limb in which 2 cm superficial femoral vein were cut, reconstruction operation using autologous saphenous vein were performed. Results No cases died perioperatively,for four limbs of injuried artery, ampution were performed for two limbs(50% ) ;two limbs (50%) were saved. The patient of injuried superficial femoral vein recovered. Conclusions Severe vascular injuries can be prevented and its incidence reduced by improving the awareness for iatrogenic vascular injuries,accurate operation; once the vascular injury occurred, prompt and rational measures must be adopted.

Objective To design a method for detecting multileaf collimator (MLC) leaf position accuracy in implementing a static intensity-modulated plan and to analyze the impacts of leaf errors on dose of targets and normal organs.Methods Static intensity-modulated planning for twenty lung cancer cases through dose verification was sorted in an ascending order according to the number of segment,and then the first and the last 10 plans were sorted as the simple plan group and the complex plan group,respectively.These plans were transmitted to a Varian 600CD accelerator and implemented by it.Photos were taken with PV aS500 electronic portal imaging device (EPID) and actual position of leafs was determined by gradient algorithm to calculate the pass rate for leaf verification.MLC files were modified according to examination results and the plans were re-calculated while keeping other parameters unchanged.Thus,difference of targets and normal organs dose distribution before and after the appearance of leaf errors were obtained.Results The dose distribution of most organs after leaf errors were increased or decreased,and the maximum dose of spinal cord in the sixth and thirteen cases exceeded the limit of 45 Gy.In the group of simple plan only the changes of maximum dose to the spinal cord were statistically significant(t =-3.08,P ＜ 0.05),while in the group of the complex plan all changes of D95％ of PGTV and PTV,maximum dose of the spinal cord,V20 of lung and V40 of heart were statistically significant(t =-1.89,-1.99,-2.36,-2.55,-1.85,P ＜ 0.05).Conclusions To ensure the safety and effects,it was necessary to detect leaf position,particularly the complex intensity-modulated planning.Electronic portal imaging devices and treatment planning system could detect leaf positions during the implementation of a plan and obtain the actual dose of targets and normal organs.

Humans ; Water ; Rivers ; Skull/anatomy & histology* ; Brain/diagnostic imaging* ; Forensic Medicine ; Forensic Anthropology

Objective To assess the value of CT perfusion imaging in differentiation of mild from moderate liver fibrosis .Methods 18 patients with mild liver fibrosis (F1 phase) and 21 ones with moderate fibrosis (F2 and F3 phase) confirmed by liver biopsy were analyzed ,and all patients underwent the liver 256‐slice CT perfusion imaging .The differences in the CT parameters including hepatic arterial perfusion (HAP) ,portal venous perfusion (PVP) ,total liver perfusion (TLP) and time to peak (TTP) between dif‐ferent fibrosis were analyzed .ROC curve was used to evaluate the ability of perfusion indexes to distinguish mild from moderate liver fibrosis ,then the maximum Youden index was selected as a cutoff point to calculate the sensitivity and specificity .Results Compared with the mild fibrosis ,the TTP [(43 .86 ± 13 .41)s vs (37 .84 ± 9 .97)s ,P=0 .034)] in liver with moderate fibrosis was significantly increased .However ,no differences in the HAP ,PVP and TLP were found .The ROC curve analysis showed that a TTP threshold of 41 .7 s allowed discrimination of mild from moderate fibrosis with a sensitivity of 72 .7% and a specificity of 75% .Conclusion 256‐slice CT perfusion imaging can reflect the hemodynamic changes of liver fibrosis ,and the TTP may help to discriminate mild from moderate fibrosis .

Objective To investigate the usefulness of different-b-value diffusion weighted imaging (DWI) in patients with early cerebral infarction and obtain the optimal b value of early cerebral infarction.Methods DWI at b-value of 1,000,2,000,and 3,000 s/mm2 was performed for 40 patients within 72 h after the onset of stroke using a GE Signa HDx 3.0T MRI scanner.Post-processing was done by the DWI specific software Function Tool to gain signal intensity and mean apparent diffusion coefficient in the lesions center and the contralateral normal brain tissue,respectively.The sensitivity of conventional MRI and different-b-value DWI was calculated in the diagnosis of early cerebral infarction.Results In 40 patients with early cerebral infarction,the sensitivity of b-values of 1,000,2,000,and 3,000 s/mm2 (DWIb=1 000,DWIb=2 000,DWIb=3 000) and conventional MRI in the diagnosis of early cerebral infarction were 100％,97.5％,97.5％,72.5％,respectively.With b value increased,signal intensity and ADC value declined.Under the condition of different b values,signal intensity and ADC value were statistically significant in region of interest (P＜0.05).Conclusion DWI is superior to conventional MRI scan in monitoring early cerebral infarction.With the increase of b value,the sensitivity is the higher to hyperacute cerebral infarction,the signal contrast is obvious,while signal to noise ratio of the image reduces.It is suggested that brain tissue contrast and the sensitivity to the new cerebral infarction is more predictable on b value =1,000 DWI than on the other DWIs.

Child ; Humans ; Lung Diseases ; diagnosis ; etiology ; Male ; Radiography, Thoracic ; Tomography, X-Ray Computed

Objective To explore the application effect of a new lighted surgical aspirator in deep brain hematoma removal operation.Methods Totally 153 patients of non-traumatic basis festival area cerebral hemorrhage were randomly divided into a control group and a treatment group.Both the groups underwent clearance of intracranial hematoma and decompressive craniectomy surgical operation in the operating room,with the common aspirator involved in the control group and the lighted one in the treatment group.Results There was no significant difference between the rates of hematomal removal in the groups (P＞0.05).The treatment group had the operating time less by 59.85 min and the hospital stay decreased by 15.23 d than those in the control group (P＜0.05).The GOS score and daily viability of the treatment group was also statistically higher than those of the control group (P＜0.05),and the effective rate in the treatment group was also more than that in the control group by 24.9％ (P＜0.05).Conclusion The new aspirator solves the problems in visual field and light source,decreases the operating time and improves the disease prognosis.