The value of SPECT/CT fusion imaging for post-implantation dose verification of 125I particles in patients with bone metastases / 实用放射学杂志

Objective To investigate the value of single photon emission computed tomography/computed tomography(SPECT/CT)fusion imaging for post-implantation dose verification of 125I particles in patients with bone metastases.Methods Forty patients with metastatic bone tumors treated with 125I particles implantation were selected.Within 24 h after 125I particles implantation,patients underwent SPECT/CT fusion imaging and the radioactivity per unit(RPU)was calculated.The treatment planning system(TPS)was then used to obtain the isodose profiles of SPECT/CT fusion imaging results and to calculate the tumor target coverage.The patient's preoperative and postoperative 1 month clinical outcomes,including local tumour remission,pain assessment,quality of life and serum alkaline phosphatase(ALP)levels were compared,and a receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of tumor target coverage on postoperative outcomes.Results The mean number of particles implanted in the target area was 32.52±12.87.Within 24 h of 125I particles implantation,SPECT/CT fusion imaging analysis confirmed a strong positive correlation between the RPU of the radioactive concentration area and the mean dose received by the patient(r=0.786,P<0.05).The predicted area under the curve(AUC)for local tumor remission,pain relief,quality of life improvement and change in ALP levels was 0.789,0.757,0.804 and 0.833,respectively.Conclusion SPECT/CT fusion imaging can be used for postoperative dose verification of 125I particles for metastatic bone tumors and has some predictive value for clinical outcomes.

Bacteriological monitoring of invasive infection in patients with burns / 中国基层医药

Objective To investigate the bacteriological monitoring and antibiotic use of invasive infection in patients with burns. Method The index of burn wound、 eschar distribution、 strains of bacteria, bacterial classification、sensitivity and drug resistance were determinated in 100 cases with burns. Results The wound and eschar 382 strain were isolated from the wound and eschar;The wound bacteria 250 strain(65.4%) were significantly higher than that eschar 132 strain (34.6%) (x~2 = 3. 987,P ＜ 0.05); Gram-negative (G -) 227 strain (59. 4%) were significantly higher than that Gram-positive(G +) 155 strain(40. 6%) (x~2 = 3. 887, P ＜ 0.05); Pseudomonas aeruginosa and Enterobacteriaceae in Gram-negative is major strains,while Staphylococcus aureus in Gram-positive is major strains;The Pseudomonas aeruginosa resistance rate(10.38%) was significantly lower than gentamicin(70. 12%) (x~2 =7. 451 ,P＜ 0.01) ;The rate of methicillin-resistant(82. 14%) for Staphylococcus aureus was significantly higher than that of vancomycin(5.35%) (x~2 =7.548 ,P ＜0.01). Conclusion The Gram-negative infection could treat with imipenem,Gram-positive infections could treat with vancomycin for patients with burns.

The effects of recombinant human growth hormone on the serum levels of cytokines severely burned patients / 中国基层医药

Objective To explore the effects of recombinant human growth hormone(rhGH) on the serum levels of cytokines in severely burned patients.Methods Thirty-six burn patients were en-rolled in the study and were randomly divided into 3 groups according to the rhGH dosage used,i.e. small(0.3IU?kg -1 ?d -1 ,A),large(0.6IU?kg -1 ?d -1 ,B) dose groups and control group(C,with normalsaline).The rhGH was administered beginning from 3 postburn days(PBDs) and lasted for 20 days.The dynamic changes in the serum levels of TNF-?,IL-6,IL-8 and LPS at different time points were observed.Results When compared with these in C group,the serum levels of TNF-?,IL-6 in A,B groups were decreased,especially in B group with earlier decrease and bigger range(P0.05).Conclusions rhGH might decrease the production of postburn inflammatory mediators.The clinical application of rhGH might be a supplementary measure in preventing and ameliorating postburn SIRS and MODS in severely burned patients.

Anti-LPS antibody and antibiotic treatment in burns / 中国基层医药

Objective To study the therapeutic effect of anti-LPS antibody and different antibiotic in treatment and prevention of sepsis a common complication of serious burns.Methods Twenty-nine patients were divied into anti-LPS+antibiotic treatment group and antibiotic treatment group.Plasma endotoxin,serum TNF,IL-6 and IL-8 were detected at different time phase after burn.Results The results showed that the antibodies to LPS could decrease the level of LPS,IL-6,IL-8 and TNF obviously,but some antibiotic couldn't decrease the level of LPS,IL-6,IL-8 and TNF obviously in blood.Impenem was a weak endotoxin inducer and ceftazidime and ciprofloxacin were stronger endotoxin inducers.Conclusion The appropriate selection of antibiotics and anti-LPS antibody has a considerable influence on treating sepsis and its complications after serious burns.