三维超声自由解剖成像技术对早期宫角与间质部妊娠的诊断价值

【摘要】 目的 探讨三维经阴道超声自由解剖成像技术(3DTVUOT)对早期宫角妊娠(CP)与间质部妊娠(ITP)的定性诊断价值。 方法 回顾性分析35例CP和36例ITP患者的临床资料。均因临床疑诊早期CP或ITP被序贯予以二维经阴道超声(2DTVU)和3DTVUOT检查，对妊娠病灶与宫腔的相通情况、病灶周围肌层完整性和厚度情况等进行比较分析；以手术 病理结果作为诊断金标准，对两种检查方法应用于CP和ITP定性诊断中的敏感性、特异性及准确性进行比较。 结果 CP患者的妊娠病灶与宫腔相通率(9143％)高于ITP(833％),病灶周围包绕肌层的厚度(608±135） mm高于ITP (195±058）mm,完整性(100％)亦高于ITP的(7222％)，组间比较差异均有统计学意义（P＜005）。2DTVU定性诊断CP和ITP的敏感性(8611％)、特异性(7714％)及准确性(8168％)均明显低于3DTVUOT（分别9444％、8571％、9014％），组间差异具有统计学意义（P＜005）。 结论 3DTVUOT对CP和ITP的早期定性诊断，具有较高的可靠性，优于2DTVU，可在临床推广应用。     

分化型甲状腺癌患者口服131I后体内活度变化及剂量水平

目的 研究¹³¹I治疗分化型甲状腺癌（DTC）患者体内放射性活度及外部剂量水平的变化规律，分析二者之间的关系，并估算400 MBq患者剂量当量率的修正因子。方法 研究对象为43例甲状腺全切术后，首次行¹³¹I"清甲"治疗的DTC患者，服药量为1 850~3 700 MBq，平均服药量（2 405±777）MBq。分别于口服¹³¹I后2、6、20、22、24、27、30、44、46、48、54、68及72 h，测定患者的体内剩余放射性活度以及患者前部0.3、1及3 m处的剂量当量率。结果 患者服¹³¹I后的体内剩余放射性活度随时间变化函数为A=A₀（1.033 16e^{-0.062 4t}+0.017 17）。可估算出"清甲"治疗的DTC患者有效半减期为12.19 h，体内放射性活度降至400 MBq仅需26.4~38.9 h。患者服用¹³¹I后距其0.3、1及3 m的标准化剂量当量率随时间变化函数分别为：Ḣ_0.3=127.220 7e^{-0.054 8t}+3.765 71、Ḣ₁=30.225 8e^{-0.064 4t}+0.824 67、Ḣ₃=4.161 9e^{-0.061 5t}+0.167 97。患者服¹³¹I后体内剩余放射性活度与1 m处剂量当量率呈正相关（r=0.982，P<0.05），函数为Ḣ₁=0.025A+1.245。DTC患者体内剩余活度分别为1 000、700和400 MBq时，距患者1 m处对应的剂量当量率分为26.2、18.7和11.2 μSv/h。估算活度为400 MBq的患者0.3、1及3 m处剂量当量率的修正因子分别为0.25、0.49及0.70。结论 服用¹³¹I活度在3 700 MBq以下的DTC患者仅需住院2日便可达到出院标准。当DTC患者体内活度降至400 MBq时，其1 m处的剂量当量率远小于25 μSv/h。单纯利用点源公式估算患者周围剂量当量率会造成高估的情况，因此对于公式估算患者周围辐射水平时使用的修正因子还需进一步研究，使模型估算结果更贴合实际情况。     

Targeted gene panel for genetic testing of south Indian children with steroid resistant nephrotic syndrome

Background

Steroid resistant nephrotic syndrome (SRNS) is a genetically heterogeneous disease with significant phenotypic variability. More than 53 podocyte-expressed genes are implicated in SRNS which complicates the routine use of genetic screening in the clinic. Next generation sequencing technology (NGS) allows rapid screening of multiple genes in large number of patients in a cost-effective manner.

Methods

We developed a targeted panel of 17 genes to determine relative frequency of mutations in south Indian ethnicity and feasibility of using the assay in a clinical setting. Twenty-five children with SRNS and 3 healthy individuals were screened.

Results

In this study, novel variants including 1 pathogenic variant (2 patients) and 3 likely pathogenic variants (3 patients) were identified. In addition, 2 novel variants of unknown significance (VUS) in 2 patients (8% of total patients) were also identified.

Conclusions

The results show that genetic screening in SRNS using NGS is feasible in a clinical setting. However the panel needs to be screened in a larger cohort of children with SRNS in order to assess the utility of the customised targeted panel in Indian children with SRNS. Determining the prevalence of variants in Indian population and improvising the bioinformatics-based filtering strategy for a more accurate differentiation of pathogenic variants from those that are benign among the VUS will help in improving medical and genetic counselling in SRNS.

     

The Emerging Roles of T Helper Cell Subsets and Cytokines in Severe Neutrophilic Asthma

Inflammation - Neutrophilic asthma (NA) is a severe type of steroid resistant asthma, and so far the immune mechanisms underlying NA are not clear. In this article, we performed a comprehensive...     

胎儿尿道下裂的产前超声诊断价值

目的 探讨超声检查应用于胎儿尿道下裂诊断中的价值。方法 回顾性分析2011年1月～2017年12月绵阳市中心医院和南充市中心医院产科31例孕妇的病历资料,产前均因疑诊胎儿尿道下裂而序贯予以2DUS和辅以3DUS检查，总结胎儿尿道下裂的超声图像特征及漏误诊情况，比较不同声像图特征的出现几率及对尿道下裂的正确诊断率。以分娩(或引产)后的结果为诊断的金标准，对两种检查方法诊断尿道下裂的敏感性、特异性及准确性进行比较分析。结果 共计31例患者，经生产(或引产)后确诊为非尿道下裂6例，尿道下裂25例。“阴茎短小”的出现率高，但特异性差；而“喷尿异常”与“尿道连续性中断”出现率低，但特异性高。31例疑诊病例，经2DUS准确诊断22例，漏诊5例，误诊4例，其诊断的敏感性、特异性、准确性分别为80.0％、33.33％、70.97％；而2DUS辅以3DUS准确诊断27例，漏诊3例，误诊1例，诊断的敏感性、特异性、准确性分别为88.00％、83.33％、87.10％。两种成像方法比较，差异有统计学意义(P＜0.05)。结论 超声检查是诊断尿道下裂的可靠手段，2DUS辅以3DUS应用于尿道下裂的产前诊断，相较于单用2DUS，能明显提高诊断的敏感性、特异性及准确性，具有重要临床应用价值。     

Development of starch based intelligent films by incorporating anthocyanins of butterfly pea flower and TiO2 and their applicability as freshness sensors for prawns during storage

Intelligent pH sensitive starch films were developed by incorporation of anthocyanin pigment extracted from butterfly pea flower (BPE) and nanosized TiO₂ using the method of solution casting. This research work evaluated the influence of BPE and TiO₂ on the physical and structural properties of starch films. The physical properties of the starch films could be significantly altered by the addition of BPE and or TiO₂. The starch films S/BPE and S/BPE/TiO₂ exhibited higher barrier properties against water vapour as compared to the control films. Incorporation of BPE and TiO₂ could decrease the thickness and moisture content of films. S, S/BPE starch films were transparent and, S/TiO₂ and S/BPE/TiO₂ films were opaque. Control starch films were colourless, whereas S/BPE films have purple colour. Owing to the inclusion of BPE and TiO₂ particles, structural characterization by X-ray diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) did not show any major changes in polymer structure. Thermogravimetric analysis revealed that the addition of TiO₂ enhanced the thermal stability of starch films to a significant extent. The color of different starch-based films was determined using the CIE Lab scale under different pH conditions and compared with the control. The fabricated (S/BPE and S/BPE/TiO₂) films exhibited visually perceptible colour changes in the pH range between 1 and 12. Consequently these films could be used as intelligent pH indicators for monitoring the freshness of prawn seafood samples. During the storage of prawn food samples for 6 days, the color of the film changed from light pink to green which is a clear indication of spoilage of food material.

Anthocyanin extracted from butterfly pea flower incorporated starch/TiO₂ films are excellent pH indicator for monitoring the freshness of food sample.     

Rhizovagine A,an unusual dibenzo-α-pyrone alkaloid from the endophytic fungus Rhizopycnis vagum Nitaf22

Rhizovagine A (1), a novel dibenzo-α-pyrone alkaloid with an unprecedented 5/5/6/6/6 fused pentacyclic skeleton, was isolated from the endophytic fungus Rhizopycnis vagum Nitaf22. The structure was elucidated by comprehensive spectroscopic analysis, in combination with quantum chemical ¹³C NMR and electronic circular dichroism (ECD) calculations for configurational assignment. A plausible biosynthetic pathway for 1 was proposed. Compound 1 displayed acetylcholinesterase inhibitory activity.

Rhizovagine A (1), a dibenzo-α-pyrone alkaloid with a 5/5/6/6/6 fused pentacyclic skeleton and acetylcholinesterase inhibitory activity, was isolated from the endophytic fungus Rhizopycnis vagum Nitaf22.     

Crucial role of copper in detection of metal-coordinating odorants

Odorant receptors (ORs) in olfactory sensory neurons (OSNs) mediate detection of volatile odorants. Divalent sulfur compounds, such as thiols and thioethers, are extremely potent odorants. We identify a mouse OR, MOR244-3, robustly responding to (methylthio)methanethiol (MeSCH(2)SH; MTMT) in heterologous cells. Found specifically in male mouse urine, strong-smelling MTMT [human threshold 100 parts per billion (ppb)] is a semiochemical that attracts female mice. Nonadjacent thiol and thioether groups in MTMT suggest involvement of a chelated metal complex in MOR244-3 activation. Metal ion involvement in thiol-OR interactions was previously proposed, but whether these ions change thiol-mediated OR activation remained unknown. We show that copper ion among all metal ions tested is required for robust activation of MOR244-3 toward ppb levels of MTMT, structurally related sulfur compounds, and other metal-coordinating odorants (e.g., strong-smelling trans-cyclooctene) among >125 compounds tested. Copper chelator (tetraethylenepentamine, TEPA) addition abolishes the response of MOR244-3 to MTMT. Histidine 105, located in the third transmembrane domain near the extracellular side, is proposed to serve as a copper-coordinating residue mediating interaction with the MTMT-copper complex. Electrophysiological recordings of the OSNs in the septal organ, abundantly expressing MOR244-3, revealed neurons responding to MTMT. Addition of copper ion and chelator TEPA respectively enhanced and reduced the response of some MTMT-responding neurons, demonstrating the physiological relevance of copper ion in olfaction. In a behavioral context, an olfactory discrimination assay showed that mice injected with TEPA failed to discriminate MTMT. This report establishes the role of metal ions in mammalian odor detection by ORs.     

三维斑点追踪成像技术评估右心双腔间隔起搏对左心室功能的影响

目的 应用三维斑点追踪成像（3D-STI）评估右心双腔间隔起搏对左心室功能的影响。方法 对42例右心双腔间隔起搏患者（起搏器组）和37名健康志愿者（对照组）行3D-STI检查,于心尖四腔切面图像获得左心室总体纵向峰值应变（GLS）、总体周向峰值应变（GCS）、总体径向峰值应变（GRS）、总体面积峰值应变（GAS）及左心室总体拧转（GTw）和左心室整体扭转（GTs）值。比较2组间三维应变参数,并分析GTw、GTs与GLS、GCS、GAS及GRS的相关性。结果 与对照组相比,起搏器组左心室GLS、GCS、GAS、GRS及GTs均明显减低（P均<0.05）;2组间GTw差异无统计学意义（P>0.05）。对照组GTs与GCS和GRS呈正相关（r=0.45、0.40;P均<0.05）,与GAS、GLS无相关性（P均>0.05）;GTw与GLS、GCS、GAS、GRS均无相关（P均>0.05）。起搏器组GTw、GTs与GLS、GCS、GAS、GRS均无相关（P均>0.05）。结论 右心双腔间隔起搏可损害左心室心肌形变能力,致左心室整体收缩功能隐匿性减低。