阿尔茨海默病患者脑白质损害与认知功能的关系

目的用磁共振扩散张量成像(DTI)研究阿尔茨海默病(AD)患者脑白质损害的特点及其与认知功能改变的相关性。方法对16例AD患者和12名年龄及性别相当的健康老年人行DTI、T1液体衰减反转恢复序列(FLAIR)及T2-FLAIR检查,测量胼胝体膝部和压部、内囊前肢和后肢、额颞顶枕叶白质的部分各向异性分数值(FA)和平均弥散度(MD),分析FA、MD值与简易精神状态量表(MMSE)评分之间的相关关系。结果AD患者胼胝体压部、额叶、顶叶、颞叶FA值分别为0.602±0.043、0.270±0.034、0.294±0.043、0.302±0.032,与健康老人组相比显著下降(P<0.05),且与MMSE评分呈正相关关系,而内囊前后肢、枕叶、胼胝体膝部的FA值则无明显变化(P>0.05);胼胝体压部、顶叶白质的MD值分别为(0.918±0.029)、(0.826±0.015)×10-9m2/s,与健康老人组相比显著升高(P<0.01),且与MMSE评分呈负相关,而内囊前后肢、额叶、颞叶、枕叶和胼胝体膝部的MD值则无明显变化(P>0.05)。结论AD患者表现为脑白质的选择性损害,且损害程度与认知功能密切相关;这种选择性损害反映了AD病理机制中皮质-皮质及皮质-皮质下联系的丢失;DTI技术可以用来监测疾病的进展情况及评价AD治疗药物的临床疗效。     

危重型毛细支气管炎抢救体会：附31例分析

231例毛细支气管炎,危重型38例占16.4％,抢救成功31例占81.6％。本文讨论了危重型毛细支气管炎并多器官功能衰竭的发生与预后及平喘药物的合理选用。认为早期应用免疫疗法、迅速平喘、保护重要器官功能及合理治疗并存症是抢救成功的关键。     

Characterization of a novel metabolite intermediate of ziprasidone in hepatic cytosolic fractions of rat, dog, and human by ESI-MS/MS, hydrogen/deuterium exchange, and chemical derivatization.

Ziprasidone (Geodone), a novel atypical antipsychotic agent, is recently approved for the treatment of schizophrenia. It undergoes extensive metabolism in preclinical species and humans after oral administration, and only a very small amount of administered dose is excreted as unchanged drug. In vitro studies using human liver microsomes have shown that the oxidative metabolism of ziprasidone is mediated primarily by CYP3A4. However, coadministration of ziprasidone with ketoconazole, a CYP3A4 inhibitor, showed only a modest increase in its exposure. Therefore, in vitro metabolism of ziprasidone was investigated in hepatic cytosolic fractions to further understand its clearance mechanisms in preclinical species and humans. The major metabolite from incubation of ziprasidone in cytosolic fractions of rat, dog, and human was characterized by liquid chromatography-tandem mass spectrometry and found to be the product of reductive cleavage. Derivatization and hydrogen/deuterium exchange were used to deduce that the addition of two hydrogen atoms had occurred at the benzisothiazole moiety. Further studies to determine the enzyme involved in the formation of this metabolite are currently in progress. The identification of this novel metabolite in cytosol has clarified the clearance mechanism of ziprasidone in humans and preclinical species.     

Radiographic manifestations and pathologic basis of parosteal osteosarcoma. Analysis of 17 cases.

The authors reviewed the radiographic manifestations of 17 cases of parosteal osteosarcoma, with pathologic correlation in 15. There were two types of parosteal osteosarcoma radiologically. The majority of cases were type I with uniformly dense masses which had regular borders. They often adhered to the cortex and showed no evidence of soft-tissue invasion which correlated with low-grade pathologic malignancy and a relatively benign clinical course. Type II involved the bone, soft-tissue and the medullary cavity. These lesions were poorly differentiated and frequently accompanied by metastatic lesions.

     

指背腱膜的解剖学研究

目的 探讨指背腱膜的构成特点及临床意义。方法 在30只成人尸体手标本上，通过模拟手术，对指背腱膜的构成特点进行了应用解剖学观测。结果 指背腱膜的构成复杂，其中的外侧腱束、外侧束、外侧腱和中央束在手指畸形的发生中有着特殊的临床意义。外侧腱束主要形成伸近节指间关节的功能解剖机制；其与外侧束形成的密切纤维联系而具有协同外侧腱的功能；该腱束与屈肌腱鞘有联系又使其具有平衡屈肌和伸肌肌力的作用。中央束在指背腱膜的整体协调、畸形的发生及矫正过程中起着重要的功能。结论 通过对指背腱膜的解剖研究，可以解释因指屈、伸肌腱平衡被破坏后所形成的畸形。     

多囊卵巢综合征患者卵巢间质胰岛素样生长因子受体的表达

目的：探讨肥胖及非肥胖多囊卵巢综合征（ＰＣＯＳ）患者卵巢间质胰岛素样生长因子（ＩＧＦ－Ⅰ）受体基因的定量表达。方法：用逆转录基因扩增技术（ＲＴ－ＰＣＲ），检测３５例ＰＣＯＳ患者（肥胖组１５例，非肥胖组２０例）及２０例正常妇女（对照组）卵巢间质细胞ＩＧＦ－Ⅰ受体ｍＲＮＡ的表达量（灰度比值）。并对ＩＧＦ－Ⅰ受体基因ｍＲＮＡ逆转录的ｃＤＮＡ产物进行限制性内切酶酶切分析。结果：ＰＣＯＳ两组ＩＧＦ－Ⅰ受体基因的表达量显著高于对照组，ＰＣＯＳ两组灰度比值为１．１８４±０．２４０，对照组灰度比值为０．９９９±０．０８６（Ｐ＜０．００１）。非肥胖组（１．２３８±０．３８７）明显大于肥胖组（１．０５８±０．１０９，Ｐ＜０．１）。酶切分析证实，３组ＩＧＦ－Ⅰ受体基因扩增片段相同，ＰＣＯＳ两组未发现明显的碱基突变存在。结论：ＰＣＯＳ患者卵巢间质ＩＧＦ－Ⅰ受体基因呈过度表达。且ＰＣＯＳ非肥胖患者局部ＩＧＦ－Ｉ受体表达高于ＰＣＯＳ肥胖患者。     

高龄初产妊高征孕妇过氧化反应的研究

目的：探讨高龄初产妊高征孕妇体内过氧化反应。方法：测定正常初产妇、妊高征孕妇妊娠晚期母血过氧化脂质（LPO）、超氧化物歧化酶（DOD）的含量。结果：1．高龄初产妇母血LPO较非高龄初产妇明显升高，SOD明显下降，P＜0．05。孕妇年龄与母血LPO呈明显正相关，与SOD呈明显负相关，P均＜0．05。2．妊高征孕妇LPO较正常孕妇显著增高，SOD显著下降，P＜0．05，并随病情加重LPO水平升高、SOD水平下降更为显著，P＜0．05。3．高龄初产妊高征孕妇母血LPO含量较非高龄初产妊高征孕妇明显增高，P＜0．05，而SOD则无显著变化，P＞0．05。4.妊高征孕妇胎儿宫内生长发育迟缓（IUGR）发生率较正常孕妇显著升高，P＜0．025，各组脐血清LPO、SOD含量无显著差异，P＜0．05。结论：高龄初产妊高征孕妇体内过氧化作用明显增强，LPO水平的升高可能为高龄初产妇妊高征发生率及IUGR发生率增加的原因之一。     

抗—HCV阳性单采浆供血员HGV感染随访研究

为了解单采浆供血员庚型肝炎病毒（ＨＧＶ）感染及其转归，对１０２名抗－ＨＣＶ阳性单采浆供血员冻存血清进行抗－ＨＧＶ和ＨＧＶＲＮＡ检测，对抗－ＨＧＶ和（或）ＨＧＶＲＮＡ阳性者作３年随访研究。采用ＥＩＡ法检测抗－ＨＧＶ，包被抗原来自ＨＧＶ不同功能区的合成肽。应用ＲＴ－ＰＣＲ法检测ＨＧＶＲＮＡ，引物选自ＨＧＶＮＳ３区。结果表明，抗－ＨＣＶ阳性单采浆供血员ＨＧＶＲＮＡ阳性率为１９．６１％（２０／１０２），抗－ＨＧＶ阳性率为１７．６５％（１８／１０２），ＨＧＶ感染率（抗ＨＧＶ和／或ＨＧＶＲＮＡ阳性）为２４．５１％（２５／１０２），而对照组仅为０．９４％（１／１０６）。提示单采血浆是ＨＧＶ感染的重要危险因素。ＨＧＶＲＮＡ和抗－ＨＧＶ的３年阴转率分别为３５．００％（７／２０）和１１．１１％（２／１８），说明ＨＧＶ感染有慢性携带趋势