带状灰质异位的磁共振弥散张量白质束成像研究

目的采用磁共振弥散张量白质束成像技术,观察带状灰质异位脑白质异常分布情况,探讨异位灰质的神经病理机制以及弥散张量白质束成像技术的应用价值。方法采用磁共振弥散张量白质束成像技术,对1例癫痫症状的带状灰质异位患者进行白质束描绘,观察其不同灰、白质的分布情况,并和1例正常人进行对比研究。结果弥散张量白质束成像技术很好地描绘了白质束结构。整体观察发现带状灰质异位患者脑白质整体结构紊乱,与正常人相比其联络弓状纤维稀疏、大部缺失,胼胝体纤维稀疏不整;局部分析发现内层灰质为主要的白质纤维发出处,而外层灰质仅发出细碎短小的纤维。结论对于带状灰质异位,异位的内层灰质不仅具有神经生理功能,并且可能起着主要作用,外层"正常"的灰质由于脑结构紊乱而丧失主要功能地位;灰质结构的紊乱导致白质纤维结构的缺失;弥散张量白质束成像技术可以很好地应用于带状灰质异位的神经机制研究。     

SPM5软件分析癫痫患者脑PET图像的应用研究

Objective To investigate the value of statistical parametric mapping 5 (SPM5) and its parameter settings in analysis of PET imaging for epilepsy patients. Methods Seventeen epilepsy patients and seventeen controls were scanned with PET. The datns were analyzed using PET and SPM5 with qualitative and semiquantitative analysis, statistical analysis of the percentage (numbers of agent distribution decreasing in focus to brain) for different parameters combinations, which were value adjustment to contral-p and voxels-k. Results There was decreasing of agent distribution at temporal lobe in epilepsy patients detecting with PET; the T/NT of focus to cerebellum was 1.07±0.24, the T/NT of normal tissue in opposite side to cerebellum was 1.27±0.18, there was a significant difference (t=1.87, P<0.05). Dealing with SPM5, there was more significant decreasing of agent in regions 19, 21, 39 of temporal lobe, regions 7, 19, 31, 40, 47 of parietal lobe and occipital lobe in epilepsy patients. With different value of k, the percentage was (27±22)%, (29±24)%, (32±23)%, (35±27)%, (39±31)%respectively, there was not significant difference (F=0.59, P>0.05) ; for different value of p, the percentage was (42±30) %, (29±25) %, (26±21) % respectively, with a significant difference (F=3.60, P<0.05); there was linear regression in value adjustment to contral-p and the percentage(b=-18.24, t=2.57, P<0.05). Conclusions Semiquantitative analysis by SPM5, the setting of value adjustment to contral-p would affect the results, the smaller of value adjustment to contral-p, the better of the result. SPM5 would be more objective and accurate to locate the focuses.     

衰老红细胞与带3蛋白

循环系统里的成熟红细胞在其生命过程里经历着氧化性衰老，相应细胞组份出现血红蛋白变性、膜蛋白交联、带3蛋白聚集以及带3蛋白降解等多种修饰。这些修饰作为红细胞膜上的衰老信号参与构成衰老细胞抗原，由此启动与IgG自身抗体(主要为带3蛋白抗体)的结合以及补体的沉淀，最终是免疫吞噬系统对异常细胞的识别清除．现就衰老红细胞与带3蛋白的关系作一综述。     

A cross-reactive idiotype in scleroderma

Autoantibodies to centromere proteins (anti-CENPs) and to topoisomerase-I are highly specific for scleroderma. Unlike most autoantibodies in other diseases, these autoantibodies are mutually exclusive. We have analysed the idiotypes (Ids) expressed by anti-CENP-B, antitopoisomerase-I, and IgGs from 20 scleroderma patients. Rabbit anti-Ids were prepared to antitopoisomerase-I from two scleroderma patients, and to anti-CENP-B from four patients. These six anti-Ids were used to study the purified autoantibodies from 20 scleroderma patients: four antitopoisomerase-I, 10 anti-CENP-B, and six purified IgG from scleroderma patients who were negative for both autoantibodies. In addition, we studied sera from 40 normal autoantibody-negative controls, and sera and purified immunoglobulins from 17 systemic lupus erythematosus (SLE) patients containing high titres of anti-double-stranded DNA, and/or autoantibodies to extractable nuclear antigens (ENA). Using direct binding, and competitive inhibition ELISAs and immunoblots, we identified an Id present in the heavy chains of all the affinity-purified antitopoisomerase-I, and anti-CENP-B. Interestingly, this Id was also present in the immunoglobulins of the scleroderma patients who had neither of the two autoantibodies. By contrast, cross-reactive Id-EM was not found in the sera or immunoglobulins from 17 SLE patients, or in the sera from 40 normal subjects. Several samples from two patients showed that this cross-reactive Id-EM was stable over time. The scleroderma disease-specific autoantibodies may be identified through a common structural feature at the variable region of the heavy chain: cross-reactive Id-EM.     

泪腺肿瘤中P53蛋白表达的意义

目的了解P53基因在泪腺肿瘤的表达及其临床病理学意义。方法应用免疫组织化学ABC法检测57例泪腺上皮性肿瘤患者和10例正常人泪腺组织中P53蛋白的表达情况，并与病理分级、复发相联系。结果10例正常人泪腺组织中P53表达全部为阴性；恶性肿瘤患者的表达率为48．6％，良性肿瘤中P53达率为18％，二者相比有显著性差异（P＜0．025）；复发患者阳性率为76．9％，明显高于未复发患为31．8％（P＝0．015）。结论P53基因参与了泪腺肿瘤的发生发展并与肿瘤的分化和复发有关。     

氢化可的松对大鼠脊髓星形胶质细胞体外分泌TNF-α及释放EAAs的影响

目的观察氢化可的松对体外培养的大鼠脊髓星形胶质细胞分泌TNF-α及释放EAAs的影响.方法体外纯化培养大鼠脊髓星形胶质细胞,分为正常对照(C组),LPS终浓度为0.1 mg/L(L1组);LPS终浓度为1 mg/L(L2组);LPS终浓度为1 mg/L及氢化可的松终浓度为10-6mol/L(HC1组),LPS终浓度为1mg/L及氢化可的松终浓度为10-5mol/L(HC2组).分别孵育0,1和2h后取细胞培养液,应用酶联免疫分析方法(ELASA)检测上清液中TNF-α的浓度;用高效液相色谱仪测定各组培养细胞在0,1和2 h时谷氨酸(Glu)、天门冬氨酸(Asp)的释放量.结果在1,2 h时,与C组相比,L1、L2组TNF-α分泌量,Glu,Asp释放量均显著升高(P＜0.05);与L2组比较,HC1,HC2组的TNF-α分泌量降低(P＞0.05和P＜0.05),HC1,HC2组的Glu,Asp释放量降低(P＜0.05).结论氢化可的松在体外抑制脊髓灰质星形胶质细胞分泌TNF-α及释放EAAs,抑制程度与浓度相关.     

经纤维胃镜取出食管内刀片方法的初步实践

目的：为了在运用胃镜从食管中取出刀片之手术中，探讨有效的操作方法，以提高胃镜取异物的成功率。方法：观察6例从食管中取出单刃刀片及金属异物的技术操作过程。结果：3例单刃刀片取出术和1例铝片取出术获得成功，2例失败。结论：选用鳄嘴状异物钳作为手术器械是最有效的手段，因力可防止刀片滑脱；选用安全保护套管可以防止食管损伤。刀片体积相对过大、食管生理狭窄发生痉挛水肿时不宜施行此类手术。     

2 132 例不同人群血清中SARS-CoV抗体水平调查

目的：探讨SARS-CoV(IgG)抗体检测辅助诊断非典型肺炎的临床应用价值。方法：采用ELISA方法及蛋白芯片法对2132例不同人群的血液标本检测SARS-CoV(IgG)抗体，分析SAILS康复者与其它疾病患者和正常人群抗体水平的差异。结果：用ELISA方法测定SARS康复者、肾病、恶性肿瘤、肺部疾病和糖尿病患者、其它疾病的SARS-CoV(IgG)抗体阳性率分别为75．6％(118／156)、29．3％(22／75)、22．3％(19／85)、22．7％(10／44)、13．6％(8／59)，500例健康查体人员全部为阴性，500例密切接触人员也为阴性。蛋白芯片方法测定SARS康复者的抗体阳性率为86％，对62例ELISA方法阳性的非SARS患者测定，仅发现4例阳性。结论：SARS-CoV(IgG)抗体可辅助回顾性诊断是否有SARS-CoV的感染。与ELISA方法相比，蛋白芯片方法具有更高的特异性和灵敏度。     

内侧型蝶骨嵴脑膜瘤的显微外科治疗

目的 提高内侧型蝶骨嵴脑膜瘤的全切率,降低病死率和致残率.方法 对25例内侧型蝶骨嵴脑膜瘤显微外科治疗病例的临床资料进行回顾性分析.结果 冠状位计算机体层摄影术有助于判断肿瘤的生长点.磁共振成像可显示肿瘤与海绵窦、颈内动脉的关系.1例肿瘤侵入海绵窦,11例肿瘤包绕颈内动脉和主要分支.肿瘤附着点为前床突和(或)小翼的内侧.18例达Simpson Ⅰ、Ⅱ级全切除.无手术死亡,疗效满意.结论 显微手术可明显提高肿瘤全切率,减少术后并发症,降低病死率.手术要点是尽早离断肿瘤基底并沿颈内动脉床突上段由近向远分离切除包绕的肿瘤.由于多数存在肿瘤与血管之间的蛛网膜界面,提倡在第1次手术中采用积极的显微外科治疗.     

慢性非细菌性前列腺炎/慢性盆腔疼痛综合征患者前列腺液中炎症因子差异表达的临床意义

Objective To investigate the role of inflammatory cytokines in the pathogenesis of chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) patients. Methods The 38 cases with CAP/CPPS patients (18 cases of CAP and 20 cases of CPPS) and 20 cases of healthy controls were selected. The differential expressions of 40 kinds of inflammatory cytokines were detec-ted by antibody arrays in prostate fluid. Results The inflammatory cytokines which increased more than 1.5 times expression have been found. There were seven kinds in CAP including monocyte che-moattractant protein (MCP)-1, solution tumor necrosis factor receptor Ⅱ(s TNF R Ⅱ), platelet-de-rived growth faetor-BB (PDGF-BB), interleukin (IL)-β, IL-11、IL-6、MCP-2 and five kinds in CPPS groups including MCP-1、PDGF-BB、MCP-2、s TNF R Ⅱ、It-11 respectively, compared with healthy control group. The cluster analysis results showed that protein expression of Monocyte chemoattrac-tant protein 1 (MCP-1)and platelet-derived growth factor BB (PDGF-BB) were significantly increased in CAP (3.47 and 2.07 times) and CPPS (2.25 and 2.19 times) compared with healthy control group and were the final polymerization of inflammatory cytokines. The protein expression of interleukin 1 β (IL-1 β), MCP-1 and soluble tumor necrosis factor Ⅱ (s TNF R Ⅱ) in CAP group was increased more than 1.85,1.55,1.67 times compared with CPPS group. Conclusions Elevated expression of inflammatory cytokines may play an important role in the course of CAP/CPPS disease. The extent of the inflammatory response of CAP was higher than CPPS. The inflammatory factors of MCP-1 and PDGF-BB could serve as a novel diagnostic marker.