基于虚拟仿真实验的化妆品检验与安全性评价实验教学改革探讨

虚拟仿真实验是利用虚拟仿真技术对实验过程、实验仪器进行模拟,具有直观性、共享性、节约成本等优点。由于化妆品检验与安全性评价传统实验形式单一,易受实验时间、场所、经费的限制,因此本研究尝试将虚拟仿真实验应用于化妆品检验与安全性评价实验教学,从优选实验项目、组织开展虚拟仿真实验、教学效果评价三个方面阐述,探讨虚拟仿真实验在化妆品检验与安全性评价实验教学中的应用。     

256层CT灌注成像评价兔失神经支配缺血后肢急性期毛细血管床血容量的动态变化

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.     

256层CT灌注成像评价兔失神经支配缺血后肢急性期毛细血管床血容量的动态变化

目的 探讨兔失神经支配缺血后肢急性期毛细血管床血容量(blood volume,BV)动态变化及256层CT灌注成像的评估价值.方法 健康成年大耳白兔40只,采用数字表法随机分为联合造模组、缺血组、失神经组和假手术组,每组10只.分别制作右后肢股动脉切除联合股神经离断、单纯股动脉切除、单纯股神经离断及单纯分离股动脉假手术模型.于术后第1、7、14、21和28天行256层CT灌注扫描,计算各组右后肢与左后肢肌肉组织的BV比值(rBV).于术后第14和28天各组采用数字表法随机处死动物4只,分别切取双侧内收肌进行免疫组织化学染色,计算右后肢与左后肢内收肌毛细血管密度比值(rMVD).各组不同时点rBV采用2×2析因设计方差分析,采用Pearson相关分析rBV与内收肌rMVD的相关性.结果 术后第1天,联合造模组、缺血组、失神经组和假手术组rBV分别为0.31 ±0.15(6只)、0.29±0.12(6只)、0.98±0.08(6只)、0.98±0.07(6只),术后第7天分别为1.69±0.45(5只)、1.63±0.43(6只)、0.99±0.07(6只)、1.00±0.08(6只),术后第14天分别为1.58±0.18(5只)、1.49±0.25(6只)、0.94±0.08(6只)、1.01±0.05(6只),术后第21天分别为1.42±0.41(4只)、1.43 ±0.31(4只)、0.94 ±0.05(5只)、1.02±0.05(5只),术后第28天分别为1.00±0.25(4只)、0.99±0.08(4只)、0.92±0.09(5只)、1.02±0.13(5只),除术后第28天外(F(A)=0.214,P>0.05),缺血因素对灌注参数rBV的影响具有主效应(F(A)值分别为274.268、30.044、65.787、18.886,P值均<0.01),而单纯失神经因素在各时点均未表现出主效应,两因素在各时点均无交互作用.各组rMVD支持上述改变;rBV与rMVD的相关系数为r=0.862(P<0.01).结论 兔后肢缺血后急性期毛细血管床血流灌注表现呈动态变化,合并失神经支配时,并未影响此过程.256层CT可以无侵袭性、半定量评估兔失神经缺血后肢急性期毛细血管床的动态变化.     

256层CT灌注成像评价兔失神经支配缺血后肢急性期毛细血管床血容量的动态变化

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.     

慢性乙型肝炎患者肝组织病理改变的影响因素

目的 了解影响谷丙转氨酶(alanine aminotransferase,ALT)正常和轻度异常的慢性乙型肝炎(简称乙肝)患者肝组织病理学特征的因素.方法 对句容市人民医院2008年09月～ 2013年05月的住院慢性乙肝患者的治疗数据进行分析,根据肝组织病理炎症或者纤维化是否达到2级(期),把52例ALT≤2 x ULN的慢性乙型肝炎患者分为两组,比较不同年龄、血生化指标和病毒学指标之间的差异.结果 肝组织高纤维化或炎症组白蛋白(albumin,ALB)水平低于低纤维化或炎症组,且差异有统计学意义(t=2.45,P=0.018).HBeAg阴性患者的ALT、谷草转氨酶(casparate aminotrans ferase,AST)及总胆红素(total bilirubin,Tbil)均高于阳性患者,但差异均无统计学意义(均有P＞0.05).年龄、ALT、AST、Tbil及血清病毒载量对肝组织病理学改变均无影响(均有P＞0.05).结论 白蛋白水平的下降和HBeAg阴性有助于预测肝组织病理学改变特征.     

腹部脏器CT灌注成像临床应用现状与展望

自从Axel在1980年首先提出了CT灌注成像(computer lomography perfusion,CTP)的理论,即通过常规CT动态增强来计算组织灌注状态,1991年Miles等将此项技术应用于肝、脾、肾等腹部实质器官的灌注评价.近年来,随着螺旋CT的发展,扫描长轴方向空间分辨率和扫描速度的提高,灌注CT由单层动态发展到多层容积灌注,使CT成像技术不仅能够清晰显示组织器官和病变组织生理和病理解剖形态信息,而且可以无创、定量或半定量评估组织器官的血流动力学状态及其功能情况.目前,CTP已广泛应用于临床,本文阐述了其在肝脏、胰腺、肾脏灌注成像中的应用.     

股骨骨促结缔组织增生性纤维瘤的影像学特征

目的 探讨股骨骨促结缔组织增生性纤维瘤(DFB)的影像学特征。 方法 回顾分析经病理证实的10例股骨DFB患者的影像学资料。 结果 X线平片显示,股骨干骺端见偏心性或中心性类圆形或梭形透亮影,病灶长轴沿股骨的长轴走向。CT可见股骨干骺端局部软组织肿块,邻近骨皮质缺损,骨质向内凹陷,边缘稍硬化,病灶内可见点状钙化。MRI表现为肿瘤在T1WI、T2WI均呈低信号。 结论 DFB具有侵袭性特征,手术时需要较大的切除范围;其影像特征与非骨化纤维瘤等相似,易导致误诊,鉴别诊断有重要临床价值。     

肝动脉化疗栓塞序贯沙利度胺靶向治疗中晚期肝癌近期疗效观察

目的:观察肝动脉化疗栓塞(TACE)序贯沙利度胺治疗中晚期肝癌近期疗效,监测治疗前后血清血管内皮生长因子(VEGF)、甲胎蛋白(AFP)变化情况,观察毒副反应。方法:将不能手术切除的中晚期肝癌54例随机分为两组,每组27例。治疗组采用TACE序贯沙利度胺;对照组单纯行TACE。治疗组沙利度胺100-200mg/d,口服至少3个月。两组患者至少行TACE术2次,于术前及术后4周检测VEGF、AFP水平。结果:治疗组有效率为59.3%,对照组为48.1%,差异无统计学意义(P>0.05);治疗组疾病控制率77.8%,对照组为59.3%,差异有统计学意义(P<0.05);治疗组术后血清VEGF水平较对照组术后显著降低(144.35±70.63ng/L vs 254.35±154.48ng/L),差异有统计学意义(P<0.05);对照组内TACE前后血清VEGF水平比较差异无统计学意义(P>0.05);治疗组术后与对照组术后AFP降低例数比较,治疗组高于对照组(18 vs13),差异有统计学意义(P<0.05);治疗组嗜睡、疲劳、头昏、皮疹等症状较对照组高,两组毒副反应均可耐受。结论:TACE术序贯沙利度胺治疗中晚期肝癌能提高疾病控制率,一定程度上降低血清VEGF、AFP水平,且毒副反应可控,值得进一步研究。     

乙型肝炎病毒父婴垂直传播及预防免疫的临床研究

目的:探讨乙型肝炎病毒(HBV)父婴垂直传播(P-FT)的关系及预防措施。方法:选取2002年3月~2005年6月因婚检筛查丈夫血清HBV-DNA阳性,妻子无HBV感染的病例。以乙肝疫苗(HBVac)免疫至抗-HBs抗体阳性后再妊娠的17例夫妇作为研究组,自孕28周起每4周肌注乙肝免疫球蛋白(HB IG)200 U至产前。另筛选入院时孕妇无HBV感染(乙肝两对半各指标均阴性),而丈夫血清HBV-DNA(+)的21例夫妇作为对照组。两组新生儿均于出生后24 h内采血检测血清HBV-DNA及抗-HBs抗体,观察两组新生儿HBV感染率及抗-HBs抗体阳性率。结果:研究组新生儿HBV感染率为17.65%(3/17),明显低于对照组的47.62%(10/21),差异有显著性意义(P<0.05);研究组抗-HBs抗体阳性率为52.94%(9/17),明显高于对照组的0(0/21),差异有非常显著性意义(P<0.01)。结论:HBV存在父婴垂直传播而引起宫内感染,孕前肌注乙肝疫苗,孕晚期肌注乙肝免疫球蛋白可有效预防HBV的父婴垂直传播。