早产儿运动发育迟缓的磁共振扩散张量成像研究

目的 探讨磁共振扩散张量成像(DTI)技术在评价早产儿运动发育迟缓轻重程度方面的应用价值.方法 22例运动发育迟缓早产儿纠正胎龄后依据Peabody运动发育量表总运动商值(TMQ)评分分为轻、中、重三组并行常规MRI、DTI检查.测量各组患儿相同兴趣区的分数各向异性(FA)值.结果 FA值在大脑脚、内囊后肢、放射冠各个兴趣区的组间差异均有统计学意义(P＜0.05),FA值随病情加重而减低.Pearson相关分析显示患儿三个感兴趣区FA值与总运动商(TMQ)值的评分正相关(P＜0.05).结论 测定DTI的FA值能对运动发育迟缓早产儿白质髓鞘发育损伤程度能做出较准确、客观的预测.     

帕利哌酮联合心境稳定剂治疗双相障碍躁狂发作的疗效与安全性研究

目的研究帕利哌酮联合心境稳定剂治疗双相障碍躁狂发作的疗效与安全性。方法200例双相障碍躁狂发作患者分为碳酸锂、丙戊酸钠单药治疗组和帕利哌酮+碳酸锂、帕利哌酮+丙戊酸钠联合治疗组,治疗共6周。于治疗前及治疗后1、2、4、6周末采用临床总体印象量表-双相障碍版(CGI-BP)、Young躁狂量表(YMRS)和副反应量表(TESS)等评定疗效和安全性。结果四组YMRS和CGI-BP较治疗前均有下降(p0.05),联合治疗组下降水平要强于单药治疗组(p0.05),其中帕利哌酮联合丙戊酸钠组在1、2周末下降速度和水平要强于帕利哌酮联合碳酸锂组(p0.05);四组间不良反应发生率无明显差异(p0.05)。结论帕利哌酮缓释片联合碳酸锂或丙戊酸钠能快速有效控制双相障碍躁狂发作,耐受性好。     

MR扩散成像在子宫肌瘤HIFU术后早期疗效评价中的价值

目的:探讨磁共振扩散成像在子宫肌瘤高强度聚焦超声治疗后早期疗效评价中的价值。方法:15例患者共21个肌瘤经1次性HIFU刀治疗,术前、术后0.5及24h进行常规磁共振成像及DWI成像,观察肌瘤术前、术后在常规MRI、DWI上信号及ADC值变化特点并进行分析。结果:术后18个肌瘤增强扫描无灌注区,在DWI序列上均有不同程度的信号增高;肌瘤消融区术后0.5h平均ADC值[(1.287±0.213)×10-3 mm2/s]低于术前平均ADC值[(1.442±0.233)×10-3 mm2/s]及残留未消融区平均ADC值[(1.513±0.271)×10-3 mm2/s],术后24h复查,消融靶区平均ADC值[1.369±0.220)×10-3 mm2/s]回升。术前、术后0.5及24h消融区及残留未消融区平均ADC值差异有统计学意义(P<0.05);术后0.5h消融区在DWI上高信号主要分布于外周,中央部信号强度相对较低,呈较有特征性环形高信号改变,而且外周部ADC值低于中央部ADC值。结论:DWI和ADC值是早期评价子宫肌瘤高强度聚焦超声治疗术后疗效的有效手段。     

帕利哌酮与奥氮平对首发精神分裂症患者血浆瘦素和胰岛素水平的影响

目的探讨帕利哌酮与奥氮平对首发精神分裂症患者血浆瘦素和胰岛素水平的影响。方法首发精神分裂症患者60例,随机分为帕利哌酮治疗组(30例)和奥氮平治疗组(30例),30例健康成人为对照组,治疗组在治疗前和治疗后6周末测定血浆瘦素和胰岛素水平。结果治疗后奥氮平组瘦素含量较治疗前明显升高,治疗前后胰岛素水平奥氮平组比较有统计学差异,治疗后奥氮平组BMI与治疗前比较有统计学意义,奥氮平组BMI增加值与帕利哌酮组有统计学差异(P<0.05)。结论奥氮平对血浆瘦素、胰岛素水平和BMI均有明显影响,而帕利哌酮则影响不明显。     

环孢菌素D分离方法的改进

经ＨＰＬＣ和氨基酸分析表明，采用单一溶煤分离环孢菌素Ｄ比多溶煤亲筠脱柱层收率更高，同是具有步骤简单，操作安全的优点。     

回肠粪石性肠梗阻1例

患者女,67岁,有慢性胃溃疡病史20年,上腹部隐胀痛不适1个月,5天前出现脐周明显胀痛,呈间歇性发作,伴呕吐胃内容物,平素大便干结,有时需借药物排便.体查:脐周稍压痛,无反跳痛.     

T2*血管成像序列与不同回波时间的T2*WI梯度回波序列检测大脑中动脉磁敏感征对比分析

目的 比较T2^*血管成像序列(SWAN)及不同回波时间(TE)的T2^*WI梯度回波序列(GRE T2^*WI)在检测缺血性脑卒中患者大脑中动脉血栓敏感性的差异。方法 对99例缺血性脑梗死患者进行DWI、3D TOF MRA、SWAN及TE分别为45 ms、15 ms的GRE T2^*WI序列扫描,以3D TOF MRA为标准,比较SWAN、TE 45 ms GRE T2^*WI、TE 15 ms GRE T2^*WI对大脑中动脉磁敏感征的检出效能,并通过Kappa检验比较其与MRA对血栓检出情况的一致性;对比各序列磁敏感征CNR和容积。结果 SWAN在对血栓的检出方面与MRA一致性好(Kappa＝0.76),SWAN、TE 45 ms及TE 15 ms的GRE T2^*WI检测磁敏感征的敏感度分别为83.33%(35/42)、76.19%(32/42)和 57.14%(24/42);3组(每组20例)MCA磁敏感征CNR和容积的差异均有统计学意义(P均<0.05),两两比较,SWAN序列与TE 45 ms的GRE T2^*WI间磁敏感征容积差异无统计学意义(P>0.05),SWAN序列和TE 45 ms 的GRE T2^*WI磁敏感征容积均明显大于TE 15 ms的GRE T2^*WI(P均<0.05)。结论 SWAN较常规GRE T2^*WI序列对大脑中动脉敏感征的显示更敏感、更清晰,对脑梗死血栓具有较高的诊断价值。     

增生性瘢痕组织中褪黑素受体的表达

Objective To investigate the expression and its significance of melatonin receptor in human hypertrophic scarring. Methods The expression of melatonin receptor GPR50 was detected with immunohistochemistiy and the melatonin receptors( MT1 、MT2)mRNA were assessed with RT-PCR method in 10 cases of human hypertrophic scar and normal skin. The positive production was sequenced with auto sequencing instrument. Results Positive signals of melatonin receptor could be found in the cell membrane and cytoplasm. The melatonin receptor GPR50 was located in the epithelial basal cells, sweat gland cells and hair follicle in both hypertrophic scar and normal skin. The melatonin receptor GPR50 was extensively expressed in fibroblasts of hypertrophic scar, but not in fibroblasts in normal skin. RT-PCR showed that the expression of melatonin receptor( MT1, MT2 ) mRNA in hypertrophic scar was significantly higher than that in normal skin( P <0. 05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was higher than MT2 mRNA ( P < 0. 05 ) . In normal skin and hypertrophic scar group, the expression of MT1 mRNA was 0.99081 ±0.26485 and 1.16584 ±0.21829 copy number/μl cDNA, respectively;the expression of MT2 mRNA was 0. 77083 ±0. 15927and 0. 99550 ±0. 14624 copy number/ μl cDNA, respectively. Sequencing results indicated that the positive product coincided with cDNA of human melatonin receptor in GeneBank. Conclusions Positive expression of melatonin receptor can be found in human hypertrophic scar and normal skin, but it is higher in scar. The over expression of melatonin receptor in hypertrophic scar may be related to the development of hypertrophic scar.     

儿童Ⅱ度烧（烫）伤创面转变为Ⅲ度肉芽创面8例

广东地区民间对烧伤后创面习惯于自制中草药外敷,更有甚者自行外涂酱油、醋、白酒等,部分浅度创面可愈合,但大部分创面因非正规治疗而导致创面延迟愈合或感染加深为Ⅲ度创面,最终需手术治疗,且后期瘢痕增生严重.暑假期间为儿童烧(烫)伤高发期,我院烧伤科2009年5-9月间收治儿童Ⅱ度烧(烫)伤创面经非正规治疗后转变Ⅲ度肉芽创面8例,现报告如下.     

增生性瘢痕组织中褪黑素受体的表达

Objective To investigate the expression and its significance of melatonin receptor in human hypertrophic scarring. Methods The expression of melatonin receptor GPR50 was detected with immunohistochemistiy and the melatonin receptors( MT1 、MT2)mRNA were assessed with RT-PCR method in 10 cases of human hypertrophic scar and normal skin. The positive production was sequenced with auto sequencing instrument. Results Positive signals of melatonin receptor could be found in the cell membrane and cytoplasm. The melatonin receptor GPR50 was located in the epithelial basal cells, sweat gland cells and hair follicle in both hypertrophic scar and normal skin. The melatonin receptor GPR50 was extensively expressed in fibroblasts of hypertrophic scar, but not in fibroblasts in normal skin. RT-PCR showed that the expression of melatonin receptor( MT1, MT2 ) mRNA in hypertrophic scar was significantly higher than that in normal skin( P <0. 05). In normal skin and hypertrophic scar group, the expression of MT1 mRNA was higher than MT2 mRNA ( P < 0. 05 ) . In normal skin and hypertrophic scar group, the expression of MT1 mRNA was 0.99081 ±0.26485 and 1.16584 ±0.21829 copy number/μl cDNA, respectively;the expression of MT2 mRNA was 0. 77083 ±0. 15927and 0. 99550 ±0. 14624 copy number/ μl cDNA, respectively. Sequencing results indicated that the positive product coincided with cDNA of human melatonin receptor in GeneBank. Conclusions Positive expression of melatonin receptor can be found in human hypertrophic scar and normal skin, but it is higher in scar. The over expression of melatonin receptor in hypertrophic scar may be related to the development of hypertrophic scar.