多平面重建对支气管血管连接引起肿瘤切迹的检出

目的　从病理角度认识支气管血管切迹征 ,探讨多平面重建 (MPR)对该征检出的作用。方法　①观察病理证实的周围型小肺癌 91例 ,良性结节 5 5例。以及 9例周围型小肺癌 ,2例良性结节术后改良Heitzman法充气固定肺叶制成病理大切片 ,对良恶性支气管血管连接进行对比分析。②对恶性支气管血管连接 2 0例 ,良性 13例行MPR ,考察MPR显示切迹征的作用。结果　①支气管血管切迹征对恶性者特异性为 95 .2 %。②恶性支气管血管连接在MPR的切迹征检出率为 70 % ,与横断扫描之间有显著差异。结论　切迹征对于恶性支气管血管连接有高特异性诊断价值。MPR配合多层螺旋CT能提高此征检出率     

Craniosynostosis,ectopia lentis,and congenital heart defects: Further delineation of an autosomal dominant syndrome with incomplete penetrance

The association of craniosynostosis with ectopia lentis is extremely rare. This was recently reported in monozygotic twin sisters, supporting a genetic etiology for this syndromic association. We report on female first cousins once removed who were born with unilateral coronal synostosis. One cousin also had peripheral pulmonic branch stenosis at birth and was later found to have ectopia lentis and severe myopia. The other cousin had an atrial septal defect, mitral valve prolapse, and only mild myopia. Their intelligence is normal. The inheritance is likely autosomal dominant with variable expression and incomplete penetrance and further defines this syndrome to include congenital heart defects. These findings will have important implications for genetic counseling. © 2001 Wiley‐Liss, Inc.     

Guillain–Barré syndrome with marked pleocytosis or a significant proportion of polymorphonuclear granulocytes in the cerebrospinal fluid: neuropathological investigation of five cases and review of differential diagnoses

In cases with otherwise clinically typical Guillain-Barré syndrome (GBS), pronounced cerebrospinal fluid (CSF) pleocytosis or the mere presence of CSF-polymorphonuclear granulocytes should alert the physician to consider alternative diagnoses. Therefore, we retrospectively studied the neuropathology of central and peripheral nervous system in two cases with a CSF cell count of more than 50/microl and in three cases with a significant proportion of polymorphonuclear granulocytes in the CSF sediment. All cases fulfilled the required criteria for the diagnosis of GBS, the duration from onset to death ranged from 4 to 100 days. Neuropathological investigations included routine staining procedures and immunohistochemistry for antigens of glial and haematopoetic cells as well as for products of relevant neurotropic viruses. Demyelinating polyradiculitis was present in four cases, in one patient with a survival time of 4 days the type of damage to myelinated fibres was unclassifiable. In the central nervous system a consistent finding was diffuse activation of microglia, only one case showed mild meningeal and lower brainstem inflammation. Viral products were generally absent. In summary, the neuropathological findings confirm that marked CSF pleocytosis or the presence of polymorphonuclear granulocytes does not rule out the diagnosis of GBS.     

米利酮对豚鼠心乳头肌及主动脉条的作用

米利酮是非洋地黄，非儿茶酚胺类强心药，具有明显的正性肌力和扩血管作用。国外用于治疗难治性心衰及洋地黄中毒的心衰病人。本文用豚鼠乳头肌及主动脉条进行实验，结果表明合成与进口米利酮的正性肌力作用效价相同，对抗去甲肾上腺素缩血管的作用也等同。     

Dose-dependent headache response and dilatation of limb and extracranial arteries after three doses of 5-isosorbide-mononitrate

Summary The aim of the present study was to compare the ability of different doses of isosorbide-5-mononitrate (5-ISMN) to cause dilatation of medium sized and small arteries, and to examine the intensity and duration of any headache produced. Ten healthy volunteers each received 3 doses of 5-ISMN and placebo on separate days. The diameters of the radial and superficial temporal arteries were repeatedly measured with high frequency ultrasound and pain was scored using a 10 point verbal scale.A clear dose-relationship was found for plasma concentrations and headache, and for changes in the diameter of the temporal artery, but not for the radial artery.It is concluded that headache after 5-ISMN is caused by arterial dilatation or by mechanisms responsible for the arterial dilatation. Ultrasound monitoring of arterial diameters is an important and sensitive tool in the evaluation of nitrates and other vasodilators.     

Effects of substance P on the spontaneous binding of Salmonella minnesota R345 (Rb) to human peripheral blood lymphocytes

The effects of substance P (SP) on Salmonella minnesota R345 (Rb) binding to human peripheral blood lymphocytes (PBL) were evaluated. Two parameters of bacterial cytoadherence were considered, namely the binding lymphocytes (BL) and the number of bound-bacteria/lymphocyte (BB). The results showed that SP inhibits both BL and BB in a significant manner. Furthermore, distribution of Salmonella binding to CD4+ and CD8+ lymphocytes was studied following SP pretreatment of lymphoid cells. This neuropeptide is able to hamper the bacterial cytoadherence to both T-cell subpopulations and, in particular, the inhibitory effect on the T-suppressor/cytotoxic subset was more pronounced. These findings are discussed in terms of SP intervention in the mechanism of host protection against invading microorganisms.     

Effect of concomitant food intake on absorption kinetics of fenoldopam (SK&F 82526) in healthy volunteers

Summary Eight healthy volunteers participated in an open crossover study to assess the effect of a standardised meal on the systemic availability of a single oral dose of fenoldopam mesylate 100 mg. Subjects were studied on four separate occasions, twice fasting and twice fed in randomised, balanced order. Plasma and urine samples were obtained before and at regular intervals up to 25 h post dose. Measurement of fenoldopam (SK&F 82526) and its 8-sulphate metabolite (SK&F 87782) were by means of HPLC-EC analysis. Area under the plasma concentration time curve (AUC) and maximum detected plasma concentration (C_max) for fenoldopam and SK&F 87782 were significantly reduced whereas time to maximum concentration was significantly increased with food. Using AUC's for fenoldopam and SK&F 87782, mean relative bioavailabilities were 35% and 81% respectively under fed compared with fasting conditions. Twenty-four hour excretion of fenoldopam was significantly reduced with food, but excretion of SK&F 87782 was apparently unchanged. Mean relative bioavailabilities calculated from these data were 83% and 86% respectively. Relatively large inter-subject variability in AUC and C_max were seen, but intra-subject variability was not marked. Mild symptoms associated with vasodilation were reported on all study days.     

母血中胎儿有核红细胞的荧光原位杂交法在产前诊断中的可行性探讨

探讨荧光原位杂交法（FISH）对母血中胎儿有核红细胞（NRBC）进行无创性产前诊断的可行性。20例孕龄15-20周的孕妇外周血经不连续密度梯度离心、制片、显微镜下识别并共计数NRBC及定位，然后行Y染色体的FISH检测。结果发现10例孕男性胎儿的孕妇外周血细胞涂片中每例均有阳性杂交信号出现；阳性率为60％（24/40）。10例孕女性胎儿的孕妇外周血细胞涂片中1例出现阳性杂交信号；阴性率为95％（38/40），假阳性率仅为5％（2/40）。结果提示FISH法对于用母血中分离到的胎儿细胞进行染色体异常的无创性产前遗传学检查具有重要意义。     

应用数据挖掘技术获取周围型肺癌临床和CT诊断规则的初步研究

目的探讨数据挖掘技术对周围型肺癌影像诊断规则提取的价值。方法收集58例经过临床病理证实的周围型肺癌病例,对其临床及CT表现属性进行标准化认定,输入数据库,分别采用自主开发的基于关联规则知识发现程序与通用数据分析工具ROSETTA中的粗糙集约简算法和遗传分类算法对58例周围型肺癌临床及影像学数据进行挖掘对比研究。结果由Johnson’s Algorithm粗糙集约简算法产生诊断规则51条,由ROSETTA遗传分类算法所产生的诊断规则有5千多条,基于关联规则的挖掘算法所产生的诊断规则有123条。这3种不同的数据挖掘方法产生的最重要的诊断规则基本上都将性别、年龄、位置、毛刺、形状、毛玻璃样密度等属性作为诊断周围型肺癌的主要依据。结论数据挖掘技术在医学影像诊断和鉴别诊断中具有潜在的应用价值。     

Amputation in elderly and high-risk vascular patients

Fifty-eight patients underwent lower limb amputation for arterial disease over a 30-month period. Mean age of the patients was 72 years. Cardiopulmonary and metabolic risk factors were present in the majority of the patients. Postoperative one-year and three-year mortality rates were 24, 40, and 76%, respectively. Contralateral amputation was required in one-third of the patients after a mean period of eight months. Only younger and healthier patients returned to a meaningful social life after appropriate prosthetic fitting. In view of the high mortality and morbidity rates, above-knee amputation seems a better choice than below-knee amputation in these elderly and high-risk patients.