剪切波弹性成像对甲状腺髓样癌和甲状腺乳头状癌的鉴别诊断价值

目的 探讨剪切波弹性成像（SWE）对甲状腺髓样癌（MTC）和甲状腺乳头状癌（PTC）的鉴别诊断价值。方法 回顾性分析2005年2月至2021年5月四川大学华西医院经病理诊断的32例MTC和127例PTC病人SWE资料,采用Mann-Whitney U检验对两者SWE参数进行对比分析,对其中差异有统计学意义的参数进行受试者操作特征曲线（ROC）分析。结果 MTC杨氏模量平均值（Emean）为23.50(12.40)kPa小于PTC Emean 36.15(18.65)kPa,差异有统计学意义,（P<0.001）;MTC杨氏模量最小值（Emin）为1.50(7.80)kPa小于PTC Emin 13.70(20.25)kPa,差异有统计学意义（P<0.001）;MTC与PTC杨氏模量最大值（Emax）、结节与周围正常组织的杨氏模量比值（Eratio）比较,均差异无统计学意义（P>0.05）。ROC曲线分析显示Emean截断值为27.80 kPa,ROC曲线下面积（AUC）为0.77,灵敏度为0.72,特异度为0.76。Emin截断值为10.10 kPa,AUC为0.75,...     

常规超声联合实时剪切波弹性成像在诊断桥本甲状腺炎背景下甲状腺癌中的应用

目的：探讨常规超声联合实时剪切波弹性成像(SWE)在诊断桥本甲状腺炎背景下甲状腺癌的诊断价值。方法：分析本院2019年1月至2022年12月收治的108例(138个结节)HT合并甲状腺结节患者的常规超声、SWE检测结果，以病理结果为“金标准”,分析常规超声、SWE及其联合检测对HT背景下甲状腺结节良恶性的鉴别价值。结果：138个结节中良性结节90个(65.22%),包括结节性甲状腺肿72个(80.00%,72/90),甲状腺腺瘤12个(13.33%,12/90),结节腺瘤样变3个(3.33%,3/90),增生结节3个(3.33%,3/90);恶性结节48个(34.78%),乳头状甲状腺癌46个(95.83%,46/48),髓样癌2个(4.17%,2/48);常规超声、SWE联合的灵敏度为93.75%明显高于单用常规超声或弹性成像的75.00%、77.08%(P<0.05);但联合检测的特异度、准确度、阳性预测值及阴性预测值较常规超声、弹性成像检测比较无明显差异(P>0.05)。结论：常规超声联合SWE对HT背景下甲状腺癌有较高的诊断鉴别价值，联合较单用对HT背景下恶性甲状腺...     

安徽省某三甲医院医护人员的甲状腺结节检出情况及其影响因素分析

目的调查安徽某三甲医院医护人员的甲状腺结节患病情况,并对其影响因素进行分析。方法收集2020年皖南医学院弋矶山医院医护人员健康体检数据,包含一般情况(性别、年龄、身高体质量、收缩压、舒张压)、血常规、血脂四项、肝功能十项、肾功能四项、尿常规、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)以及甲状腺B超结果等,分析甲状腺结节的检出率,分析甲状腺结节发生的影响因素。结果甲状腺结节检出600例,检出率为51.37%(男性甲状腺结节有157例,检出率为43.73%;女性甲状腺结节有443例,女性检出率为54.82%)。在甲状腺结节组内高血压178例,糖尿病57例,分别占40.18%和9.5%,与非甲状腺结节组相比差异有统计学意义(P<0.05)。甲状腺结节组与非甲状腺结节组在年龄［(52.41±18.25)岁比(40.10 ±14.54)岁］和收缩压上比较,差异有统计学意义(P<0.05)。甲状腺结节组与非甲状腺结节组在嗜酸性细胞百分比［1.80(1.20,2.68)%比1.90(1.20,3.00)%］、红细胞(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、平均红细胞体积(MCV)、平均血红蛋白量(MCH)、血小板(PLT)、血小板比积(PCT)、空腹血糖(GLU)、总胆固醇(TC)、高密度脂蛋白(HDL)、胱抑素C、尿素氮(Bun)、糖化血红蛋白a［(5.94 ±0.73)%比(5.70 ±0.45)%］、糖化血红蛋白c［(1.42 ±0.85)%比(1.31 ±0.80)%］、CEA上比较,差异有统计学意义(P<0.05)。采用多因素logistic回归分析,结果显示年龄、糖尿病、嗜酸性细胞百分比是甲状腺结节发生的独立影响因素。结论医护人员甲状腺结节发生率较一般人群的发生率高,且年龄、糖尿病是甲状腺结节发生的危险因素,嗜酸性细胞百分比是甲状腺结节发生的保护因素。     

超声剪切波弹性成像技术在乳腺良恶性肿块诊断中的应用价值

目的应用超声剪切波弹性成像技术定量测定乳腺实性肿块的弹性模量值,探究乳腺肿块良恶性病变的弹性硬度的差异及规律。方法选取 2017年 3月至 2018年 12月上海市浦东新区公利医院超声科就诊检查的女性乳腺肿瘤病人 51例 54个病灶,测量乳腺肿块的弹性模量值,比较乳腺良恶性病灶的各弹性参数的差异。结果 54个乳腺病灶中,恶性病灶 23个,良性病灶 31个。乳腺良性病灶与恶性病灶的 SWE指标即最大值( Emax)［(34.9±9.9)比( 72.1±23.7)kPa］、平均值( Emean)［(25.7±8.0)比( 47.8±11.3)kPa］、最小值( Emin)［(16.4±5.2)比( 28.7±9.1)kPa］、标准差( Esd)［(5.7±2.0)比( 17.3±10.0)kPa］、病变 /脂肪弹性比( Eratio)［(4.5±2.8)比( 10.7±3.3)kPa］比较,均差异有统计学意义( P＜0.05)。把 SWE指标值绘制 ROC曲线, Emax、Emean、 Emin、Esd、Eratio的R OC曲线下面积( AUC)分别为 0.955、0.931、0.879、0.926和 0.898,Emax的 AUC高于 Emean、Emin、Eratio。结论超声剪切波弹性成像技术对乳腺肿块良恶性的鉴别诊断有较好的应用价值。     

多模态超声在中、高度可疑恶性甲状腺结节鉴别中的诊断价值#br#

摘要：目的　探讨多模态超声对甲状腺中、高度可疑恶性结节的诊断价值。方法　以2015美国甲状腺协会（ATA）指南为参考,采用多模态超声成像［二维超声（US）、超微血管显像技术（SMI）和剪切波弹性成像（SWE）］分析评估323个中、高度可疑恶性甲状腺结节,其中中度237个（73.4%）、高度86个（26.6%）。依据受试者工作特征（ROC）曲线,对照手术病理结果,评估SMI、SWE、US,以及联合SMI、SWE和US对中、高度可疑恶性甲状腺结节良恶性的诊断效能。结果　323个甲状腺结节经手术病理学检查确定良性结节205个（63.5%）、恶性结节118个（36.5%）。甲状腺恶性结节的血管分布模式主要以穿支血管为主;良性结节的剪切波速度最大值和平均值均低于恶性结节（均P＜0.05）;联合SMI、SWE和US的多模态超声鉴别中、高度甲状腺结节的敏感度、特异度、准确性、阳性预测值、阴性预测值和Youden指数分别为95.7%、92.7%、93.8%、91.9%、95.0%和0.884,均显著高于单一超声模式。中、高度可疑恶性甲状腺结节多模态超声的不必要细针穿刺活检（FNA）率分别为24.1%和3.5%。结论　多模态超声可以提供全面的甲状腺结节信息,有助于提高对甲状腺中、高度可疑恶性结节的诊断价值。     

3T磁共振动态配准技术灌注成像在识别肝硬化结节恶变中的应用

目的 分析3.0T磁共振(MRI)动态配准技术(DynaVIBE)灌注成像(PWI)在识别肝硬化结节恶变中的应用价值.方法 选择2014年7月至2016年6月于本院拟行手术治疗且经常规MRI检查存在可疑肝硬化结节恶变的30例患者,均作DynaVIBE PWI扫描,并与病理结果进行对照.结果 癌结节血流量(BF)为(330.15±98.36) ml·min-1·ml-1、血容量(BV)为(30.45±14.26) ml/min、肝动脉灌注量(HAP)为(210.33±50.46) ml·min-1·m1-1、肝动脉灌注指数(HPI)为(0.52±0.11)均高于肝硬化结节[(149.01 ±73.12) ml· min-1· ml-1、(17.66±6.84) ml/min、(65.71±21.55) ml·min-1·ml-1、(0.26±0.05)]与不典型增生结节[(211.54±90.25)ml· min-1·ml-1、(25.33±15.32)ml/min、(145.21±30.64)ml·min-1·m1-1、(0.44±0.06)](P＜0.05),不典型增生结节上述各参数高于肝硬化结节;同时癌结节平均通过时间(MTT)、峰值时间(TTP)[(7.46±1.79)s、(25.22±1.75)s]快于肝硬化结节[(10.24±4.76)s、(39.55±1.66)s]与不典型增生结节[(8.71±2.11)s、(35.86±1.38)s](P＜0.05),而不典型增生结节MTT、TTP快于肝硬化结节(P＜0.05).结论 PWI可直接反映肝硬化结节血流灌注情况,为良恶性肝硬化结节鉴别提供依据.     

前列腺穿刺术后血清前列腺特异性抗原与前列腺疾病良恶性的关系研究

目的探讨前列腺穿刺(PB)术后血清前列腺特异性抗原(PSA)变化与前列腺疾病良恶性的关系。方法对特定的36例住院患者进行直肠超声引导,穿刺活检后进行血清PSA测定,同时进行病理检查。根据患者的穿刺活检结果将其分为非前列腺癌组和前列腺癌组,进一步深入研究。结果①PB前非前列腺癌组(22例)PSA平均值为(11±7)ng/mL,该组PB后10、30、60、90minPSA平均值分别为(42±32),(35±27),(31±23),(30±21)ng/mL。PB前与PB后各组间差异有统计学意义(P<0.05)。②PB前前列腺癌组(14例)PSA平均值为(75±24)ng/mL,PB后前列腺癌组10、30、60、90minPSA平均值分别为(85±24),(84±25),(82±26),(83±26)ng/mL。PB前与PB后各组间差异有统计学意义(P<0.05)。两组PSA变化差异有统计学意义(P<0.05)。结论前列腺穿刺后血清PSA水平会突然升高,非前列腺癌患者的血清PSA升高程度要较前列腺癌患者显著升高。     

彩色多普勒超声成像及定量参数在甲状腺结节鉴别诊断中的价值分析

目的 研究彩色多普勒超声成像及其定量参数在甲状腺结节中的诊断价值.方法 146例甲状腺结节患者根据患者病理分为良性结节组(n=124)和恶性结节组(n=22),采用彩色多普勒超声诊断系统进行检查,观察2组患者超声诊断结果 与病理诊断准确率.观察患者甲状腺结节的内部回声、形态、边界、声晕、质地钙化、结节数量、甲状腺周边淋巴结肿大情况和结节血供情况;观察患者血流情况:收缩期峰值流速(PSV)、血流血管指数(VFI)、舒张末期血流速度(EDV)、阻力指数(RI),上述数据重复测量5次,取平均值.结果 超声诊断良性结节121例(82.9%),恶性结节25例(17.1%),与病理诊断对照,诊断准确137例(93.8%),误诊9例(6.2%).从病理诊断结果 可以看出良性结节组中以结节性甲状腺肿和滤泡型甲状腺瘤多发,占良性结节的83.9%(104/124),二者在结节性患者中的检出率为71.2%(104/146).恶性结节中乳头状腺癌多发,占恶性结节的50.0%,其次为滤泡状腺癌和未分化癌,分别占18.2%和13.6%.良性结节组内部回声、形态、边界、声晕、质地、钙化、结节数量、周边淋巴结肿大、血流情况与恶性结节组比较,差异有统计学意义(P<0.05).2组PSV、VFI、EDV和RI水平比较,差异有统计学意义(P<0.05).结论 彩色多普勒超声在甲状腺结节良恶性诊断和鉴别中,具有较高的敏感性和较低的误诊率,结合超声成像及血流动力学参数对患者进行综合评价,能较好的发挥其临床应用价值.     

彩色多普勒超声成像及定量参数鉴别诊断甲状腺结节的临床意义

目的:探究彩色多普勒超声成像及定量参数在甲状腺结节鉴别诊断中的应用价值。方法:选择2019年1月—2022年7月本院接受彩色多普勒超声、病理学检查和诊断的80例甲状腺结节患者为观察对象，将病理结果作为诊断金标准，分析彩超诊断效能及声像图特征，并观察和记录血流动力学参数。结果:彩色多普勒超声鉴别诊断良性、恶性甲状腺结节的灵敏度是92.59%(25/27)、特异度是90.57%(48/53)、准确度是91.25%(73/80)；良、恶性结节患者在结节质地、内部回声、声晕、钙化、形态、血流、边界方面对比，差异均有统计学意义（P<0.05）；良性结节组患者的EDV值高于恶性结节组，但PSV、RI、VFI值均低于恶性结节组，差异有统计学意义（P<0.05）。结论：彩色多普勒超声能有效鉴别诊断良、恶性甲状腺结节，减少误诊和漏诊发生，再结合超声成像、定量参数能综合评价患者病情，为后续临床治疗提供准确参考依据。     

克拉霉素对替硝唑大鼠体内药动学的影响

目的探讨克拉霉素对替硝唑大鼠体内药动学过程的影响。方法大鼠随机分为两组,每组5只,其中一组大鼠灌胃给药替硝唑后测定血浆中药物的质量浓度,另一组灌胃给药克拉霉素,连续5 d,于第6天联合给药替硝唑与克拉霉素,而后测定血浆中替硝唑药物质量浓度,计算药动学参数。用DAS软件程序进行数据处理并采用SPSS软件进行统计学分析。结果单独给药替硝唑组的主要药动学参数为:ρmax为(27.08±2.98)mg.L-1,t1/2为(2.16±0.76)h,AUC0-24 h为(138.04±5.84)mg.h.L-1。联合给药组的替硝唑主要药动学参数为:ρmax为(32.73±8.37)mg.L-1,t1/2为(2.76±1.69)h,AUC0-24 h为(160.45±7.83)mg.h.L-1。其中,两组间AUC及Cl/F存在显著性差异(P<0.05)。结论克拉霉素对替硝唑大鼠体内药动学过程影响较小。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.