CEUS灌注模式鉴别诊断甲状腺良恶性结节

目的 探讨CEUS灌注模式鉴别诊断甲状腺良恶性结节的价值。方法 回顾性分析111例甲状腺结节患者（111个结节）的颈部CEUS图像及临床资料,通过评价造影灌注模式判断结节的良恶性。以病理结果为最终诊断标准,评价CEUS对甲状腺良恶性结节的诊断效能。结果 病理诊断甲状腺良性结节14例,恶性结节97例。CEUS诊断甲状腺结节良恶性的敏感度为92.78%（90/97）,特异度64.29%（9/14）,准确率89.19%（99/111）,阳性预测值94.74%（90/95）,阴性预测值56.25%（9/16）。结论 CEUS灌注模式对鉴别诊断甲状腺良恶性结节具有一定价值。     

2008年山东省碘缺乏病高危地区核实调查

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8-10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3+-Ce4+catalyzing speetrophotometry for ultra iodine examination. Twenty women aged 18-40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% (18/241),6.2% (15/241) and 5.0% (13/259), 1.2% (3/259), respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Licheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.     

苦参碱治疗肝癌化疗乙肝病毒再激活的临床观察

研究肝癌化疗对乙肝活动状态的影响及苦参碱的作用。检测89例肝癌患者的血清乙型肝炎病毒标志物及其HBV DNA定量,分为2组,均采用GP方案(吉西他滨 顺铂)化疗,单纯化疗者42例,联合苦参碱者47例,化疗期间、化疗后8周监测HBV DNA及标志物、肝功能。化疗后HBV DNA量较化疗前增加(P<0．01),乙肝病毒再激活与肝炎活动相关,联用苦参碱可减轻肝功能损害,与单纯化疗组相比差异有显著性,但对降低血清HBV DNA载量作用不明显。肝癌化疗可引起乙肝病毒再激活,并导致肝炎活动,苦参碱能保护肝细胞,改善肝功能,对乙肝病毒再激活引起的肝损害有保护作用,但抗病毒作用不明显。     

淮河水系毛毕吸虫自然疫源地调查报告

目的 调查淮河水系是否存在毛毕属吸虫及其尾蚴性皮炎流行。方法 取现场采集和实验室感染的耳萝卜螺压片、镜检，分离母胞蚴、子胞蚴和尾蚴，并将分离获得的尾蚴接种雏鸭；收集淮河沿岸家鸭和人工感染的雏鸭粪便，用水洗沉淀法查找虫卵、孵化分离毛蚴，并用此毛蚴感染实验室饲养的耳萝卜螺；解剖家鸭和人工感染的雏鸭分离成虫。对沿岸部分村民作现场查询和体检，以确定有无该皮炎表现及伴随症状。结果 现场采集耳萝卜螺的感染率为0．39％（71／18000）；家鸭粪便毛毕吸虫卵阳性率为33．50％（201／600），雏鸭接种23d后，从粪中可查见虫卵，且所获虫卵可孵化出毛蚴；解剖部分虫卵阳性家鸭和经尾蚴感染的雏鸭可分离出成虫。从虫卵、毛蚴、尾蚴及成虫形态观察，均属毛毕属吸虫。沿岸村民接触有鸭活动的水体后，在胸腹部及下肢等处皮肤可见弥漫性突出皮肤的红色丘疹，周围有红晕，并可见成片的风疹团，患处刺痒或奇痒。结论 淮河水系存在毛毕属吸虫，并有血吸虫尾蚴性皮炎流行。     

脂蛋白脂酶基因S447X及HindⅢ位点多态性与冠心病的关系

目的:探讨脂蛋白脂酶(LPL)基因S447X及HindⅢ多态性与冠心病的关系.方法:对249例经冠状动脉造影证实为冠心病的患者及167例经冠状动脉造影证实无冠状动脉病变的对照者进行研究,采用酶法测定血脂各项水平,采用多聚酶链反应-限制性内切酶片段长度多态性(PCR-RFLP)分析LPL基因中S447X及HindⅢ多态性.结果:冠心病组与对照组比较,LPL S447X及HindⅢ基因型及等位基因分布频率均无显著性差异,P＞0-05.而按血浆TG水平分组可见低TG组(TG＜1.7mmol/L)的SX/XX基因型频率及X等位基因频率均明显高于高TG组(TG≥1.7mmol/L),P＜0.05.且低TG组中SX/XX基因型与SS基因型比较各项血脂水平(sLDL除外)均有显著性差异,P＜0.05.结论:S、X、H 、H-等位基因频率在冠心病组及对照组之间无明显差异.LPLS447X及HindⅢ多态性并不是冠心病发病的独立危险因素,但S447X变异由于对血脂代谢产生了有益的影响(TC、TG、LDL-C、sLDL、VLDL-C及ApoB水平均降低,HDL-C升高)因而可被认为是冠心病的保护因素之一.     

Short‐ and long‐term effects of balloon dilatation on esophageal motility in achalasia

OBJECTIVE: To explore the effect of balloon dilatation on esophageal motility in patients with achalasia. METHODS: In 48 patients diagnosed with achalasia based on clinical observations, barium radio­graphy, endoscopy and esophageal manometry, the following parameters were evaluated before dilatation, and 4 and 12?24 weeks after dilatation: symptom score, maximal width of esophagus (MWE), lower esophageal sphincter pressure (LESP), lower esophageal sphincter relaxation rate (LESRR), and contraction amplitude of esophageal body. RESULTS: The symptom score and MWE decreased significantly after dilatation (P < 0.05). The LESP decreased (P < 0.05) and LESRR increased (P < 0.05) significantly 4 weeks and 12?24 weeks after dilatation. The percentages of patients with LESP <2.67 kPa were 45.41% before dilatation, and 82.48% and 85.87% 4 weeks and 12?24 weeks after dilatation, respectively (P < 0.05). The percentages of patients with LESRR ≥80% were 6.74% before dilatation, and 55.97% and 43.78% 4 weeks and 12?24 weeks after dilatation, respectively (P < 0.05). Peristaltic waves were not observed after dilatation in any patient. CONCLUSIONS: Balloon dilatation may significantly improve the symptoms of achalasia and reduce esophageal distention by decreasing LESP and increasing LESRR. The mechanism by which balloon dilatation increases LESRR needs to be further studied.     

不同地理株杂交培育的柔嫩艾美球虫及其免疫保护率

目的　培育 3个不同地理株柔嫩艾美球虫 (Eimeriatenella)的杂交株 ,以探讨研制球虫疫苗的可能性。　方法　通过免疫试验 ,从 5个不同地理株中选择 3株作为杂交亲本株 ,对此 3株分别进行两次杂交 ,获得的后代混合卵囊经单卵囊分离、扩增 ,分别提取卵囊DNA ,利用随机扩增多态性DNA(RAPD)进行分析 ( 3 0条引物 ) ,分离、培育出两代杂交株。再进行免疫试验 ,比较杂交株与亲本株的免疫保护性。　结果　选择了免疫原性较好、免疫保护率较高的广州株、保定株、长春株作为杂交亲本 ,分别进行保定株×长春株、广州株×F1株两次杂交 ,获得的后代卵囊 ,提取卵囊DNA ,RAPD分析后 ,得到了保定株×长春株的杂交株F1(F1Z7)和广州株×F1株的杂交株F2 (F2Z3 )。免疫试验结果 ,杂交株F1与F2的免疫保护率分别为 80 %和 84% ;亲本株广州株为 77% ,保定株为 69% ,长春株为 63 %。　结论　分离、培育出了F1、F2两代杂交虫株。其免疫保护率均高于各亲本株 ,提示杂交株获得了亲本株的部分保护性 ,其免疫的雏鸡对各虫株的攻击均有好的保护力。尤其是F2株 ,免疫保护率平均达到 84%。     

广西疟疾监测措施研究

目的探讨广西基本消除和消除疟疾地区疟疾监测措施及其效果,为制订疟疾监测方案提供依据。方法采用病原学、血清学和昆虫学同步综合监测方法,对监测点发热病人血检疟原虫;小学生取滤纸血用IFAT测定疟疾抗体水平;半通宵(19:00～22:00)室外人诱捕蚊加早晨(5:00～7:00)50床蚊帐内捕蚊观察叮人率。结果监测点3个乡(镇)平均疟疾发病率和血检疟原虫阳性率2005年分别为0.69/万和0.26%,至2007年均下降为0;小学生年平均疟疾抗体阳性率为0.25%;3年间监测点未发生输入疟疾继发病例。结论早期发现和及时根治传染源是控制疟疾传播的关键措施。     

Graves病患者甲状腺细胞凋亡的初步研究

目的　研究Graves病 (GD)甲状腺细胞凋亡和凋亡相关蛋白Fas、可溶性Fas(sFas)及Fas配基 (Fas L)的表达特征 ,探讨Fas介导的细胞凋亡与GD发病机制之间的内在联系。方法甲状腺组织取自 7例GD手术患者和 3例意外死亡健康个体 ,采用原代甲状腺细胞 (TEC)培养技术、流式细胞术、ELISA及半定量RT PCR法检测TEC凋亡率及Fas、sFas和Fas L的表达情况。结果(1)GDTEC凋亡率为 (3.42± 0 .81) %,明显高于正常对照 (P <0 .0 1)。 (2 )GDTECFas表达率为 (8.3± 1.7) %,与正常对照相比差异无显著性。 (3)GDTEC培养上清液中sFas含量明显高于正常对照(P <0 .0 1)。 (4 )正常及GDTEC均表达Fas及sFasmRNA ,而Fas LmRNA仅在GDTEC表达。与正常对照相比 ,GDTECFasmRNA差异无显著性 ,sFasmRNA含量则明显升高 (P <0 .0 1)。结论GD患者甲状腺细胞存在细胞凋亡和Fas系统的异常表达 ,提示Fas介导的细胞凋亡参与GD的发病过程 ,sFas产生增加可能与甲状腺细胞增殖有关。     

阻塞性睡眠呼吸暂停综合征与心律失常

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种常见的睡眠呼吸调节障碍性疾患,具有潜在危险性。近年来研究证实OSAS与心律失常密切相关,现阐述二者相关的流行病学、病理生理机制以及治疗。