复发性脑膜瘤的MRI表现及病理特点研究

目的探讨复发性脑膜瘤的MRI表现及病理特点。资料与方法回顾性分析15例复发性脑膜瘤,对其MRI表现及病理特点进行研究。结果 MRI示复发瘤位于大脑镰旁4例、矢状窦旁1例、蝶骨嵴3例、鞍区3例、小脑幕2例、桥小脑角区1例、枕骨大孔区1例;颅内多发7例,形态不规则或分叶状12例,瘤内囊变坏死8例,脑膜尾征4例,瘤周水肿6例,1例发生C5椎体及椎旁软组织转移;瘤体T1WI为等或稍低信号,T2WI和T2FLAIR为略高信号,增强扫描多为明显的不均匀强化。病理证实:恶性13例,良性2例;连续复发7例;良性肿瘤全切术后,首次复发平均时间为3年,而恶性肿瘤为1.4年,连续复发者首次复发后平均每1～2年肿瘤再次复发;组织学类型改变5例,其中4例从低级别向高级别发展。结论复发性脑膜瘤有独特的MRI表现及病理特点,充分认识并确定其特征性改变,有助于提高诊断的准确率。     

TGF-β1/Smad3信号转导通路与创伤后瘢痕形成

目的对近年TGF-β1/Smad3信号转导通路与创伤后瘢痕形成的相关研究作一综述。方法广泛查阅国内外近年有关TGF-β1/Smad3信号转导通路及与创伤后瘢痕形成的文献,并进行综述。结果 TGF-β1是纤维化疾病的重要影响因子,通过TGF-β1/Smad3信号通路转导产生其生物学效应。该途径受多种因子调控并在细胞及分子水平与其他信号通路串话。该途径参与创伤后早期炎性反应、创面愈合及后期病理性瘢痕的形成。在分子水平干预转导途径的各个环节,可以影响纤维化及细胞外基质沉着的进程。结论 TGF-β1/Smad3信号转导途径是影响创伤后瘢痕形成及细胞外基质沉着的重要途径。对该途径进行深入研究,可为临床促进创面的愈合及病理性瘢痕的防治奠定理论基础。     

Functional MR imaging of kidneys in patients with lupus nephritis

Objective To evaluate the functional magnetic resonance (MR) imaging in the assessment of renal involvement and pathological changes in patients with lupus nephritis (LN). Methods Seventeen patients with LN and 10 healthy controls underwent coronal echo?planar diffusion?weighted (DW) MR imaging and blood oxygen level dependent (BOLD) MR imaging of the kidneys with a single breath?hold time of 16 s. The apparent diffusion coefficient (ADC) and R2* value of the kidneys were calculated with high b values (b=500 s/mm2). The correlation between the renal injury variables and the ADCs or R2* values was evaluated. Results The mean ADC value of kidneys in patients with LN was (2.43±0.24)×10-3 mm2/s, the mean R2* values of the renal cortex and medulla were (11.72±2.35)/s and (13.07±2.35)/s respectively, which were all significantly lower than those in volunteers (P=0.045,P=0.048 and P=0.001, respectively). In the patients with LN, the mean ADC values were positively correlated with estimated glomerular filtration rate (eGFR) (r=0.558, P<0.05). There was a negative correlation between the ADC values of the right kidneys and pathological chronic indexes (r=-0.493, P<0.05). Moreover, the R2*values of the renal medulla were negatively correlated with 24 hours proteinuria, serum creatinine, pathological active indexes. The patients were assigned to group A (class Ⅲ, Ⅳ, Ⅴ, n=8) and group B (class Ⅴ+Ⅲ and Ⅴ+Ⅳ, n=9). The tubulointerstitial lesions in group B were more severe than those in group A, while the mean ADC values and R2* values of the renal cortex in group B were lower as compared to group A. Conclusion DW MR imaging and BOLD MR imaging may be used to non?invasively monitor the disease activity and evaluate the efficacy in lupus nephritis.     

创面信息管理系统:一种标准化的创面信息采集、存储和处理方案

目的 利用新型创面信息管理系统,探讨客观、标准化和便利的创面信息管理方案.方法 选择创面信息采集终端,确定创面信息采集内容,制作相关软件,建立创面信息数据库和创面信息管理系统.在临床应用中评价其效能. 结果 由第3代手机和操作软件共同构成标准化创面信息采集系统,借助终端手机可以从数据库中获取相关信息,包括创面的文字描述、图像及治疗方案等.使用4个月,共录入就诊信息232例次,已自动生成38例患者的完整资料. 结论 该系统能够将创面信息采集标准化并传输储存,适用于医院特别是基层卫生机构,为未来大样本的流行病学调查提供了良好的数据平台.     

上游处理前后正常形态精子百分率与体外受精-胚胎移植结局的关系

目的:探讨取卵当日上游处理前后精子形态与体外受精-胚胎移植(IVF-ET)治疗结局的关系。方法:选取因单纯输卵管因素不孕而拟行IVF-ET治疗的夫妇94对。使用Kruger标准评价取卵当日上游处理前后的精子形态。以正常精子形态百分率10%为界,分别将上游处理前后的精子分成两组:B1组上游处理前正常形态≥10%,B2组<10%;A1组上游处理后正常形态≥10%,A2组<10%。分别比较B1和B2组以及A1和A2组的IVF-ET治疗结局。结果:上游处理前,B1组的受精率、卵裂率、优质胚胎率、妊娠率和胚胎种植率分别为(72.90±4.23)%、(95.20±2.61)%、(23.35±5.19)%、39.58%、18.35%;B2组分别为(71.33±5.10)%、(95.71±2.88)%、(20.18±6.15)%、41.86%、21.28%;各项指标两组之间差异均无统计学意义(P>0.05)。上游处理后,A1组受精率、卵裂率、优质胚胎率、妊娠率、胚胎种植率分别为(72.72±3.35)%、(95.64±2.04)%、(24.39±4.57)%、50.00%、23.87%;A2组分别为(70.27±8.82)%、(94.82±4.94)%、(13.45±7.39)%、9.52%、6.25%;两组之间受精率及卵裂率差别无统计学意义(P>0.05),但A1组的优质胚胎率、妊娠率及种植率明显高于A2组(P<0.05)。结论:取卵当日经上游处理后的正常精子形态百分率对IVF-ET结局有较好的预测价值。     

低温环境下家兔急性心肌缺血时心肌细胞形态学的变化

目的：探讨低温环境下家兔急性心肌缺血时心肌细胞形态学的变化规律。方法：将112只家兔分为实验组和对照组,每组各56只。实验组是结扎家兔左冠状动脉左室支中下1／3处建立急性心肌缺血模型,对照组是开胸但不阻断冠状动脉血流。两组家兔均在自然低温环境下（10℃、5℃、0℃、-5℃）暴露30min、60min后做心肌HE染色,观察心肌细胞形态学的变化情况。结果：10℃和5℃自然低温环境下对照组心肌细胞形态学无明显变化。当环境温度从0℃降至-5℃ 的过程中,对照组心肌纤维从排列较整齐逐渐变为心肌纤维拉长、排列疏松,心肌间质细胞水肿。当环境温度从10℃降至-5℃的过程中,实验组心肌纤维逐渐从拉长,排列疏松至排列呈波浪状改变并有部分心肌纤维断裂,心肌细胞问质水肿,小血管明显淤血。结论：随着环境温度的下降,可使心肌细胞变性损伤,实验性急性心肌缺血家兔的心肌细胞损伤更加明显。提示低温环境的变化是心肌细胞损伤的重要因素,对已有缺血改变的心肌细胞损伤更严重     

Techniques to evaluate glenoid bone loss

Assessing glenoid morphology as well as quantifying bone loss is critical when treating patients with recurrent anterior glenohumeral instability because this greatly affects surgeons surgical planning. Although many surgeons agree that 3-dimensionally reconstructed computed tomography (3DCT) images with humeral head digitally subtracted has been considered to be a gold standard when assessing glenoid morphology, there are some surgeons who are making an attempt to replace computed tomography with magnetic resonance imaging to reduce cost for imaging studies and avoid possible radiation exposure, and demonstrated that MRI was equally valuable as 3DCT to quantify glenoid bone loss. However, the role of preoperative imaging study is not only quantifying glenoid bone loss but to assess the glenoid shape and morphology to facilitate surgeons stabilizing the shoulder. In this view, 3DCT is the most recommended preoperative imaging study for bony tissue which provides critical and substantial information of the glenoid.     

色素性微囊肾嫌色细胞癌临床病理观察

目的 探讨色素性微囊肾嫌色细胞癌的临床病理特点、诊断及鉴别诊断.方法 对1例色素性微囊肾嫌色细胞癌的临床资料、组织学形态及免疫组化结果进行分析,并复习相关文献.结果 肿瘤界限清楚,无明显包膜;切面灰白、灰黄至棕黄色.镜下瘤细胞排列呈微囊及腺样结构,可见色素沉着,肿瘤间质内可见钙化灶.免疫组化:瘤细胞CAM2.5、AE1/AE3、CK7、EMA、E-cadherin和CD117(+),S-100、HMB45和vimentin(-).结论 色素性微囊肾嫌色细胞癌是一种少见的肿瘤,最重要的特征是具有相对良性的生物学行为,远处转移很少见.     

星形胶质细胞与阿尔茨海默病

阿尔茨海默氏病(AD)是目前最常见的神经退行性疾病,主要表现为进行性的认知和记忆力下降,其发生、发展与星形胶质细胞在内的多种因素有关。近年来发现,星形胶质细胞可通过多种机制影响AD病理过程,如增加Aβ的产生及沉积、加速异常Tau蛋白的缠结、通过炎症因子加剧Aβ的神经毒性、能量供应不足及神经递质释放障碍损害神经功能正常活动等。各个因素在AD不同阶段反复作用,互相影响,形成恶性循环,导致淀粉样斑块形成、神经元纤维缠结、突触减少及神经元丢失。保护星形胶质细胞的正常功能可能成为AD治疗的新靶点。     

Reversible transdifferentiation of secretory epithelial cells into adipocytes in the mammary gland

Mammalian breast adipose tissue is replaced by a milk-secreting gland during pregnancy; the reverse process takes place upon interruption of lactation. Morphological and bromodeoxyuridine studies provide indirect evidence that mouse mammary adipocytes transform into secretory epithelial cells during pregnancy and revert to adipocytes after lactation. By using the Cre-loxP recombination system we show that the mammary gland of whey acidic protein (WAP)-Cre/R26R mice, in which secretory epithelial cells express the lacZ gene during pregnancy, contains labeled adipocytes during involution. Conversely, adipocyte P2-Cre/R26R mice, in which adipocytes are labeled before pregnancy, contain labeled secretory epithelial cells during pregnancy. We conclude that reversible adipocyte-to-epithelium and epithelium-to-adipocyte transdifferentiation occurs in the mammary gland of adult mice during pregnancy and lactation.