MRI在心脏瓣膜病中的诊断价值

目的 探讨多序列MR扫描在心脏瓣膜病中的诊断价值。方法 回顾性分析56例心脏瓣膜病患者的影像学资料，患者分别采用超声心动图（UCG）、二维（2D）黑血及亮血序列、K-空间节段真实稳态进动快速扫描序列（True FISP）对瓣膜病进行定性评价，15例患者还进行小角度快速激发（FLASH）电影序列和流速编码电影（VEC）定量分析，并将MR结果与UCG进行对比。结果 UCG和MRI诊断二尖瓣狭窄（MS）2例，二尖瓣关闭不全（MI）23例；主动脉瓣狭窄（AS）7例，其中二瓣畸形5例；主动脉瓣关闭不全（AI）13例；三尖瓣关闭不全（TI）2例；复合或联合瓣膜病9例。受累心腔的增大和升主动脉的扩张是其主要形态学改变，异常的血液湍流信号是受累瓣膜的直接征象。VEC-MR定量分析与多普勒超声一致性好：6例AS，MR和UCG检查结果相关性分析，相关系数和校正相关系数分别为：R=0，975、Rsq=0．951（P〈0．01），AI9例，分别为R=0．965、Rsq=0．932（P〈0．01）。结论 MR多序列综合扫描可对心脏瓣膜病特别是主动脉瓣疾病进行准确的定性及定量评价。     

Primary carcinoma of gallbladder in Yazd, Iran: A 14-year study (1992–2006)

Aim: To investigate the clinico‐pathological profile and stage of disease at presentation of patients with carcinoma of the gallbladder diagnosed during 1992–2006 in Iran. Methods: During this study period 34 consecutive patients with gallbladder carcinoma were identified using a pathology‐based tumor database. The data extracted for each study patient included their gender, age at diagnosis, signs and symptoms, presence of gallstones and histopathological pattern of the gallbladder carcinoma and the UICC/AJCC TNM staging system was used for labeling the stages of the disease. Results: The median age of the 34 patients studied was 69.50 with most between 61 and 70 years of age. The age range of the men was between 53 and 80 years with a median age of 71.50 years and that of the women was between 33 and 79 years with a median age of 68.50 years. The most common symptom was pain in the right hypochondrium. More women had gallstones (15/34) than men (3/10). Adenocarcinoma was the most common histopathological type (91.18%) with the commonest subtype being papillary (47.06%). Eighteen patients had stage IB and stage IIA (52.94%) carcinomas whereas stages IIB and III were observed in six (17.6%) and seven cases (20.6%), respectively. Only three cases (8.82%) were seen in stage IV. The follow up of gall bladder carcinoma (GBC) patients in this study ranged from 6 to 60 months. However, there was a progressive reduction of patients attending follow‐up oncology clinic, particularly by those who had stages III and IV of the disease. Conclusion: Most patients (52.94%) presented with early disease (stage IB and IIA) which carries a good prognosis. Early detection of GBC and a national consensus for the evidence‐based management of GBC in Iran should be the major components of a strategy aimed at improving therapeutic outcome.     

The Experiment of Gene Therapy for Gallbladder Carcinoma Cell in Vitro with Herpes Simplex Virus Thymidine Kinase/Ganciclovir

Objective To evaluate preliminarily the effect of HSV - tk/GCV system on gallhladder carcinoma cells in vitro.Methods Recombinant retroviral vector PLtkSN containing tk suicide gene was transfacted into gallbladder carcinoma cells, mediated by LipofectAMINETM 2000 liposome, and the growth - inhibiting rotes of GBC, SD/tk cells in the different GCV concentrations were measured by MTr methods; GBC - SD cells were mixed in the different proportions, and death rotes of the mixed cells treated with GCV were detected to verify by stander effect. Resuts GCV could lead GBC - SD/tk cells to significant death, and there was striking difference compared with the control cells （p〈0.01）. When the concentration of GCV was 1,10, 50,100,500ug/ml, the killing rate of GBC - SD/tk cells was respecfively 6.8%, 2.5.2%, 54.5%, 66.3%, 89.3%, indicating dose - dependent phenomenon; With GBC - SD/tk cells in the proportion of 0, 10%, 20% ,50%, 70%, 100%, the killing rate of the mixed cells treated with GCV was 0, 19.7%, 40.3%, 77.7%, 88.0%, 93.5%, respectively. It was apparent that bystander effect was observed in the experiment. Condusion HSV - tk/GCV system could be a potential tool for the treatment of carcinoma.     

Portsite and intraabdominal metastases of unsuspected gallbladder carcinoma after laparoscopic cholecystectomy: Report of a case

We herein report a rare case of portsite metastasis of gallbladder carcinoma which occurred after laparoscopic cholecystectomy. A 64-year-old man underwent laparoscopic cholecystectomy at another hospital for symptomatic cholecystolithiasis. The histological examination revealed an adenocarcinoma of the gallbladder infiltrating the entire wall. Despite the physician's advice the patient refused any additional treatment. Thirteen months after surgery he visited our hospital because of a palpable mass at the scar of the right trocar incision. The nodule was removed and histological examination confirmed metastasis from the gallbladder carcinoma.     

Spontaneous gallbladder perforation—An unusual presentation of carcinoma of the pancreas

A 50 year old man with a two month history of upper abdominal pain and a one month history of anorexia and weight loss, presented with icterus and evidence of peritonitis. Laparotomy revealed biliary peritonitis which had been caused by a rupture of the fundus of the gallbladder. The common bile duct was dilated and there was a large growth in the head of the pancreas with multiple hepatic metastases. A cholecysto-jejunostomy and gastrojejunostomy were done and the patient had an uneventful recovery.     

A comparative study of acute and chronic diseases induced by two subgroups of Theiler’s murine encephalomyelitis virus

Theiler’s murine encephalomyelitis viruses (TMEV) are divided into two subgroups on the basis of their different biological activities. The GDVII strain produces acute polioencephalomyelitis in mice, whereas the DA strain produces demyelination with virus persistence in the spinal cord. A comparative study of GDVII and DA strains suggested that low host immune responses are responsible for the development of acute GDVII infection and that the persistence of infected macrophages plays a crucial role in the development of chronic white matter lesions in DA infection. All 78 mice infected with GDVII died or became moribund by day 13, while none of 54 mice infected with DA died. In the acute stage, the distribution of viral antigens in the central nervous system (CNS) tissue was similar in both GDVII and DA infections, although the virus titer was higher in GDVII infection. In DA infection, a substantial number of T cells were recruited to the CNS on day 6 when they were virtually absent in GDVII infection. The titer of neutralizing antibody was already high on day 6 in DA infection but was negligible in GDVII infection. Development of chronic paralytic disease from day 35 of the DA infection was accompanied by focal accumulation of viral antigen-positive macrophages in the spinal white matter. In addition, white matter lesions comparable to those in chronic DA infection were induced in the spinal cord within 7 days after intracerebral injection of DA-infected murine macrophages. Received: 26 June 1995 / Revised, accepted: 27 December 1995     

Quantitative observation by enzyme cytochemistry of human rectal adenocarcinoma cells killed by LAK cells

Activity of succinic dehydrogenase(SDH)and acid phosphatase(AcPase)of effector-target cells during the process of LAK cells killing HR8348 cells was estimated by enzyme cyto-chemistry technique.SHD positive granules and AePase gray level were assayed with MIAS-300image analyser.The results showed:(1)After cocultivation of effector and target cells for vari-ous times,the activity of AcPase of HR8348 cells was apparently higher than that of the controlgroup,and it increased following prolonged coincubation.SDH activity of target cells increasedmarkedly within 30 and 60 rain cocultivation,but became low after 90 min treatment.(2)Ac-Pase content within LAK cells at 60,90,120,180 and 240 rain cocultivation was significantlyhigher than that of control group(P<0.01).The phenomenon of high AcPase and SDH activitywithin effector-target cells indicates that the function of the two types of cells was in an activestate.At the early stage of effector-target combining,the increase of SDH with HR8348 cellsmay be related to defensive function of the target cells.Higher AcPase activity of target cells in-dicates the activation of lysosomal enzyme which serves as the material basis for autolysis of thecells.     

肺系疾病从脾胃论治的探讨

本文论述与肺与脾胃在生理，病理诸方面的密切关系；提出了肺系疾病从脾胃治疗的必要性和重要性；讨论了肺病从脾胃论治之常用７法：即健脾化痰法，芳香醒脾法，健脾利水法，通腑降气法，健脾补肺法，养胃益肺法，补益脾肾法等，对肺系疾病的临床治疗有一定的启发作用和应用价值。     

凋亡相关基因突变与人类疾病

细胞凋亡 (又称细胞程序性死亡 )过程由多种不同基因产物的协同作用来完成。其中某些凋亡基因的突变 ,已被认定为人类疾病的病因或相关因素。作者综述了当前对凋亡基因突变所致人类疾病的认识 ,以及将凋亡的基础研究成果应用到临床疾病诊治的情况     

温州市外来流动人口传染病的监测

目的：为了解温州市流动人口传染病的发病情况，加强这些人群的传染病防制和监测工作。方法：我们对温州市1997－2000年甲，乙类传染病报告资料进行调查，整理和分析。结果：（1）流动人口传染病年均报告发病率为44．75／10万；（2）省外流动人口传染病报告发病率（55．55／10万）高于省内（12．03／10万）；（3）流动人口传染病发病率以呼吸道，肠道，血源和性传播疾病为高，而虫媒与自然疫源性疾病和新生儿破伤风相对较低；（4）流动人口中肺结核，乙肝，甲肝和痢疾的发病率较高，其发病数均占总病数的10％以上；（5）流动人口疟疾和新生儿破伤风发病率高于当地人群，而其它传染病发病率则低于当地人群。结论：目前，流动人口传染病问题已日益突出，对社会稳定和经济发展将发生严重影响，采取合适的防制措施对控制流动人口传染病是非常迫切和必要的。