表阿霉素联合化疗方案治疗29例恶性肿瘤疗效观察

目的观察以表阿霉素为主的不同化疗方案对常见恶性肿瘤的疗效及其毒副作用。方法以表阿霉素为主的CEP、CEOP、TE、IEO方案治疗肺癌、非霍奇金淋巴瘤、晚期乳腺癌和横纹肌肉瘤，其中表阿霉素60mg/m^2分2天静脉注射，其他药物都为常规剂量。21～28天为1个治疗周期，治疗2～3个周期后评价疗效。结果全组29例中CR7例，PR13例，SD5例，PD4例，总有效率68．97％。主要不良反应为骨髓抑制，其次是脱发和消化道反应。对肝肾功能和心脏影响轻微。结论以表阿霉素为主的联合化疗方案对常见恶性肿瘤疗效佳，安全性好，患者能较好地耐受。     

Integrating PET and CT information to improve diagnostic accuracy for lung nodules: A semiautomatic computer-aided method.

Our objective was to develop and evaluate 3 semiautomatic computer-aided diagnostic (CAD) schemes for distinguishing between benign and malignant pulmonary nodules by use of features extracted from CT, 18F-FDG PET, and both CT and 18F-FDG PET. METHODS: We retrospectively collected 92 consecutive cases of pulmonary nodules (<3 cm) in patients who underwent both thoracic CT and whole-body PET/CT. Forty-two of the nodules were malignant and 50 benign, as confirmed by pathologic examination and clinical follow-up. The interval between CT and PET was less than 1 mo. Four clinical parameters, including patient age, sex, smoking status, and history of previous malignancy, were used for the CAD schemes. Sixteen CT features based on size, shape, margin, and internal structure of nodules were independently rated subjectively by 2 chest radiologists. Four PET features were viewed on a PET/CT workstation. CAD schemes based on clinical parameters together with CT features, PET features, and both CT and PET features were then used to differentiate benign from malignant nodules. Finally, the output from the CAD schemes was evaluated by use of receiver-operating-characteristic analysis. RESULTS: When we used clinical parameters and CT features as input units (CAD scheme 1), the area under the receiver-operating-characteristic curve (A(z) value) of the CAD scheme was 0.83. When we used clinical parameters and PET features as input units (CAD scheme 2), the A(z) value for the computer output was 0.91. However, when we used all data as input units (CAD scheme 3), the A(z) value for the computer output was 0.95. The performance of CAD scheme 3 was better than that of CAD scheme 1 or 2. A statistically significant difference existed between the A(z) values of CAD schemes 3 and 2 (P = 0.037) and between those of CAD schemes 3 and 1 (P = 0.015). CONCLUSION: Our CAD scheme based on both PET and CT was better able to differentiate benign from malignant pulmonary nodules than were the CAD schemes based on PET alone and CT alone.     

Differences in SLE disease activity between patients of Caucasian and South‐East Asian/Chinese background in an Australian hospital

Aim: We performed a semiprospective and retrospective review of all admissions to a single institution of systemic lupus erythematosus (SLE) patients, admitted due to active disease. The aim was to describe differences in disease activity as a cause of hospital admissions between patients originating from South‐East Asia/China (SAC) and Caucasians. Method: There were 210 patients admitted for active disease, with a total of 567 admissions for active SLE over a 16‐year period. Allowing for patients who had left our database, there was a total of 3415 patient years of observation. Results: Patients from SAC with a flare requiring admission presented earlier in their disease course and with more active disease than did Caucasians (median SLE Disease Activity Index 13 vs. 8, P= 0.002). They had longer inpatient stays (7 vs. 5 days P = 0.03). There was a trend to higher rates of re‐presentation to hospital for flare (59% in SAC patients vs. 41% in Caucasians, P = 0.09) with more subsequent admissions (3 vs. 2 P = 0.06) despite a shorter period of observation. Conclusions: South‐East Asian/Chinese were more likely to be diagnosed with class III/IV glomerulonephritis and require cyclophosphamide both at presentation and subsequent admissions. More patients from SAC were readmitted to hospital for severe central nervous system disease after their first hospital admission. In this population, lupus patients had more severe flares and more frequently required admission for these than Caucasians.     

头颈部良性神经源性肿瘤1H MRS的表现特点

目的：探讨头颈部良性神经源性肿瘤在单体素^1H MRS上的表现特点。材料和方法：共收集经单体素。HMRS检查，并经手术病理证实的头颈部神经源性肿瘤14例（神经鞘瘤11例，神经纤维瘤2例，颈动脉体瘤1例）。采用点分析波谱法（PRESS：TE=144ms，14例）和激励回波法（STEAM：TE=30ms，11例）进行。HMRS空间定位，以胆碱和脂质代谢物为标准评价所有肿瘤。波谱图上，胆碱和脂质分别在3．2ppm和0．9—1．4ppm区域识别。结果：采用PRESS后，14例神经源性肿瘤中检测出胆碱代谢物者11例，检出脂质代谢物者6例。胆碱和脂质代谢物同时检出者5例，仅检出胆碱者6例，仅检出脂质者1例，胆碱和脂质均未检出者2例。采用STEAM后，11例肿瘤中检出胆碱代谢物和脂质者分别为3例和8例。结论：头颈部良性神经源性肿瘤的单体素。HMRS表现具有多样性，多数肿瘤以长TEPRESS上胆碱峰的显示为特点，长TEPRESS能较STEAM更好地检出良性神经源性肿瘤内的胆碱代谢物。     

心脾综合征的多普勒超声心动图诊断

目的:探讨多普勒超声心动图对心脾综合征的诊断价值,分析其心脏伴随畸形漏诊及误诊原因,提高对心脾综合征诊断的准确率。方法:本文总结了221例心脾综合征患儿的超声检测结果,并与其心血管造影或磁共振检查结果进行对照。结果:超声心动图诊断为心脾综合征与心导管或磁共振结论符合者199例(占90.0%),诊断不符合者22例(占10.0%)。结论:多普勒超声心动图可以较准确地诊断心脾综合征,但对其心脏伴随畸形检出的准确率尚待进一步提高。     

鼠李糖脂分批式发酵动力学模型

根据3.7 L瑞士Bioengineer KLF2000型发酵罐分批发酵的实验数据,利用GraphPad Prism软件对假单胞菌BS-03产鼠李糖脂生物表面活性剂的发酵动力学模型进行非线性拟合,说明Logistic模型和L-P模型能较好的描述假单胞菌BS-03发酵过程中的菌体生长、鼠李糖脂合成和限制性基质的消耗动力学。     

预富集-石墨炉原子吸收光谱法测定药食两用中药浸泡液中痕量镉

提供了预富集-石墨炉原子吸收光谱法测定药食两用中药浸泡液中的痕量镉的新方法。采用吡咯烷二硫代氨基甲酸铵(APDC)作配位剂,在pH 5.0-8.0的条件下,用固体硅胶捕集、抽滤分离Cd-APDC配合物,然后用1 moL/L盐酸从膜滤纸上洗下硅胶,得到能够直接用石墨炉原子吸收光谱法测定的镉悬浊液。该法简便快速,富集100倍时的特征质量为2.8×10-14g。用此方法测定4药食两用中药浸泡液中的痕量镉,当n=5时,标准偏差为0.002 5-0.005 8,RSD为:0.012-0.052,样品的加标回收率为91.8%和111.1%,结果较为满意。     

螺旋CT三期扫描对肝纤维化诊断价值研究

目的探讨螺旋CT三期扫描对肝纤维化的诊断价值。方法对66例经肝穿刺活检病理证实的慢性乙型肝炎肝纤维化患者组和42例正常对照组进行螺旋CT三期增强扫描。根据纤维化程度分期进行影像资料和相关指标的统计分析。结果肝左叶增大,肝表面形态及肝实质密度的改变,脾脏增大,门静脉增宽和侧枝循环的建立等影像学改变,随着肝纤维化严重程度的加重而有统计学差异。本研究显示57例肝纤维化患者螺旋CT三期扫描诊断肝纤维化52例,敏感性91.2%,特异性77.8%。各期肝纤维化分期准确28例,准确率49.1%;准确判断轻度纤维化(S1、S2)或重度纤维化(S3、S4)44例,准确率77.2%,诊断早期肝硬化16例,准确率84.2%。结论螺旋CT三期扫描能判断肝纤维化的程度,而且是动态观察肝纤维化的病程演进和临床随访的有效手段。     

脑及脑膜转移瘤的MRI

随着MR的广泛应用，特别是MR增强扫描，极大地提高了脑及脑膜转移瘤的显示能力，但是明确诊断仍是影像诊断面临的重要课题。本文搜集临床及MR资料完整的经手术、病理证实的脑转移瘤33例，进行回顾性分析，以提高脑转移瘤的MR诊断水平。     

骨髓基质干细胞分化来源肝细胞移植的细胞准备及组织学观察

目的 探讨大鼠骨髓基质干细胞向肝细胞分化后体外标记方法及移植肝细胞的肝内组织学表现。方法 分离大鼠骨髓基质细胞，在体外诱导分化为成熟肝细胞。将5-溴脱氧尿嘧啶核苷（BrdU）掺入后的肝细胞移植入已行部分肝切除大鼠体内，分别应用免疫组织化学和免疫荧光方法观察受体肝脏内移植细胞的形态和功能。结果分化成熟肝细胞在BrdU掺入培养后细胞核染色可见特异性棕褐色标记；肝细胞移植后肝组织切片BrdU染色可定位移植细胞；白蛋白抗体染色显示移植细胞具有功能活性。结论 骨髓基质干细胞分化来源的肝细胞移植后形态功能稳定，是进行肝细胞移植的理想细胞来源。