磁共振成像在前列腺癌诊断中的研究进展

因MRI具有良好的软组织分辨率、多方位成像、多参数功能成像等优点,逐渐成为运用影像学诊断前列腺癌的重要检查方法。随着MRI成像技术的不断成熟,多种成像方法如磁共振灌注成像(perfusion weighted imaging,PWI)、扩散加权成像(diffusionweightedimaging,DWI)、体素内不相干运动(intravoxel incoherent motion,IVIM)扩散成像、磁共振波谱成像(magnetic resonance spectroscopy,MRS)、扩散张量成像(diffusion tensor imaging,DTI)、扩散峰度成像(diffusion kurtosis imaging,DKI)、T2 mapping技术、磁敏感加权成像(susceptibility weighted imaging,SWI)在前列腺癌的诊断中有着重要的作用,随着这些技术的发展,前列腺癌诊断的准确性明显提高,现将近年来磁共振成像技术在前列腺癌诊断中的作用展开综述。     

不同扩散模型在子宫内膜癌诊断中的应用

子宫内膜癌是绝经后女性常见的恶性肿瘤,其鉴别诊断、术前分期、病理分型、病理分级是治疗和预后的关键。常规MRI主要局限于形态学成像,不同扩散模型包括扩散加权成像(diffusion weighted imaging,DWI)、扩散张量成像(diffusion tensor imaging,DTI)、扩散峰度成像(diffusion kurtosis imaging,DKI)、体素内不相干运动成像(intravoxel incoherent motion,IVIM),能够无创地通过一系列定量、半定量数据分析为临床提供更多信息。结合国内外文献,作者就这四种扩散模型在子宫内膜癌诊断中的应用进行综述。     

MR扩散加权成像在软组织肿瘤中的应用进展

磁共振扩散加权成像是反映水分子扩散特性、检测组织微观结构变化的功能成像技术,包括单指数扩散加权成像(diffusion weighted imaging,DWI)、体素内不相干运动(intravoxel incoherent motion,IVIM)模型、扩散张量成像(diffusion tensor imaging,DTI)和扩散峰度成像(diffusion kurtosis imaging,DKI),目前已用于软组织肿瘤临床评估.本文就上述四种技术类型做简要介绍,并就其在软组织肿瘤的良恶性鉴别诊断、组织学分级预测、浸润评估、术后复发监测以及放化疗疗效评价或预测中的应用进展进行综述.     

磁共振扩散成像技术在脑膜瘤病理学分级中的应用

脑膜瘤是颅内常见的肿瘤,尽管多为良性,但部分病理学分级为世界卫生组织(World Health Organization,WHO)Ⅱ级和Ⅲ级的病变具有侵袭性和不良的预后;因此,术前明确其病理学分级具有重要的临床意义。目前,基于扩散原理的磁共振功能成像已成为脑膜瘤术前诊断的主要手段,有较好的鉴别效果。本文就扩散加权成像(diffusion-weighted imaging,DWI)、基于体素内不相干运动的扩散加权成像(intra-voxel incoherent motion DWI,IVIM-DWI)、扩散峰度成像(diffusion kurtosis imaging,DKI)及扩散张量成像(diffusion tensor imaging,DTI)在脑膜瘤病理学分级中的应用进行综述。     

IVIM及DKI在乳腺病变的临床研究进展

扩散加权成像(diffusion weighted imaging,DWI)获得的扩散信息存在一定程度的偏移,因此,为更精确描述体内扩散运动及组织微细结构,基于毛细血管微循环灌注的体素内不相干运动(intravoxel incoherent motion imaging,IVIM)模型以及基于非高斯分布的扩散峰度成像(diffusion kurtosis imaging,DKI)模型被相继提出,其相关临床应用也是目前研究的热点。本文主要介绍IVIM及DKI模型的理论基础及二者在乳腺病变中的临床研究进展。     

磁共振扩散加权成像在胰腺癌诊断中的应用

胰腺癌是最主要的胰腺肿瘤, 其5年生存率不足5%, 早期发现、有效评估及采取恰当的治疗十分关键。自1984年磁共振扩散加权成像(diffusion weighted imaging, DWI)首次被报道以来, 其临床研究和应用价值日益凸显。DWI作为磁共振成像检查序列之一, 为胰腺癌的诊断、鉴别诊断及治疗效果评价等提供重要信息。本文对DWI技术及其在胰腺癌中的应用进行综述。     

磁共振扩散加权与动态增强成像在子宫内膜癌中的应用与新进展

扩散加权成像(diffusion weighted imaging,DWI)和动态增强磁共振成像(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)为临床常用的功能磁共振成像技术,通过观察信号变化和测量定量或半定量参数来诊断和鉴别诊断及评估肿瘤的生物学特性,在子宫内膜癌的术前评估、疗效监测和预后判断方面具有重要的作用。作者就上述MR功能成像技术在子宫内膜癌中的应用进展作一综述。     

体素内不相干运动扩散加权成像在前列腺癌鉴别诊断及Gleason分级中应用的Meta分析

目的采用Meta分析方法综合探讨体素内不相干运动(intravoxel incoherent motion,IVIM)扩散加权成像(diffusion-weighted imaging,DWI)的各参数,包括表观扩散系数(apparent diffusion coefficients,ADC)、真性扩散系数(true diffusion coefficient,D)、灌注相关假性扩散系数(perfusion-related pseudo-diffusion coefficient,D*)和灌注分数(perfusion fraction,f)在前列腺癌(prostate cancer,PCa)鉴别诊断和Gleason分级中的价值。材料与方法于Embase、PubMed、Medline和Cochrane Library数据库检索自建库至2021年8月应用IVIM DWI对PCa进行鉴别诊断和Gleason分级的相关文献。采用Stata 15.0软件进行Meta分析,连续性变量资料采用加权均数差(weighted mean difference,WMD)及其95%CI作为统计效应量,并绘制森...     

体素内不相干运动扩散加权成像在肺部的应用进展

扩散加权成像(diffusion weighted imaging,DWI)技术无需对比剂即可获得组织的水分子扩散情况.然而单指数DWI无法区分组织内单纯水分子扩散和微循环灌注信息,体素内不相干运动扩散加权成像(intravoxel incoherent motion-diffusion weighted imagin...     

扩散张量成像的算法实践与应用

与传统扩散加权成像(diffusion weighted imaging,DWI)相比,扩散张量成像(diffusion tensor imaging,DTI)能够更加准确的反映分子扩散的方向性,因而在显示脑白质纤维走行及白质相关的脑部疾病等方面显示出巨大的优越性.本文从医学的角度对该方法的算法实践与应用做一综述.     

健康查体者体脂分布与糖脂代谢指标及血压的相关性分析

目的探讨健康查体者体质量指数(BMI)、腰臀比(WHR)、腰围身高比(WHtR)、臀围身高比与糖脂代谢指标及血压的相关性。 方法选取微山县人民医院体检中心2014年1—5月107例健康查体者为研究对象。测量其身高、体质量、空腹血糖(GLU)、血脂及血压(BP),计算不同性别查体者BMI、WHR、WHtR、臀围身高比并与糖脂代谢指标、血压的相关性并进行比较。 结果①男性：BMI与收缩压(SBP)、舒张压(DBP)、平均动脉血压(MAP)、甘油三酯(TG)、胆固醇(CHOL)、低密度脂蛋白(LDL-C)、极低密度脂蛋白(VLDL-C)、高密度脂蛋白(HDL-C)、谷氨酰转肽酶(GGT)、空腹葡萄糖(GLU)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛β细胞功能(HOMA-β)的相关系数分别为0.26,0.33,0.32,0.24,0.25,0.36,0.18,－0.15,0.38,0.54,0.61,0.59,－0.59,0.59; WHR与上述指标的相关系数分别为0.12,0.25,0.20,0.43,0.43,0.48,0.34,－0.15,0.36,0.43,0.49,0.55,－0.55,0.40;WHtR与上述指标的相关系数分别为0.32,0.27,0.24,0.25,0.34,0.44,0.22,－0.10,0.30,0.26,0.59,0.57,－0.57,0.54;臀围身高比与上述指标相关系数分别为0.17,0.20,0.20,0.03,0.16,0.26,0.05,－0.03,0.15,0.04,0.46,0.41,－0.41,0.46;②女性：BMI与SBP、DBP、MAP、TG、CHOL、LDL-C、VLDL-C、HDL-C、GGT、GLU、FINS、HOMA-IR、ISI、HOMA-β的相关系数分别为0.21,0.21,0.30,0.38,0.13,0.26,0.27,－0.37,0.49,0.46,0.55,0.55,－0.55,0.47;WHR与上述指标的相关系数分别为0.32,0.17,0.25,0.38,0.16,0.04,0.31,－0.02,0.34,0.15,0.18,0.15,－0.15,0.2;WHtR与上述指标的相关系数分别为0.27,0.16,0.23,0.39,0.16,0.15,0.30,－0.12,0.46,0.33,0.39,0.37,－0.37,0.36;臀围身高比与上述指标相关系数分别为0.12,0.10,0.11,0.30,0.11,0.23,0.20,－0.31,0.47,0.45,0.54,0.55,－0.55,0.47;③男性BMI与血压、糖代谢指标、GGT的相关性和WHR与TG、CHOL、LDL-C、VLDL-C的相关性均有统计学意义(P<0.05)。女性BMI与糖代谢指标、GGT的相关系数大于其他指标(P<0.01)。 结论与其他三种测量指标比较,BMI与糖代谢紊乱及GGT的升高的相关性较显著;WHR与男性TG、CHOL、LDL-C、VLDL-C的相关性较显著。     

Plantes utilis��es en m��decine traditionnelle dans le traitement des maladies cardiovasculaires, en pays Abbey et Krobou, dans le Sud de la C?te-d��Ivoire

The ethnopharmacological study carried out in Agboville (C?te-d??Ivoire) shows that Abbey and Krobou use 52 species of plants, to treat cardiovascular disorders. Drugs (bulb, carpophore, root barks, stem barks, leaves, flowers, fruits, seeds, sclerot, rhizome and tuber) are used to develop 50 medicamentous receipts, by cooking, decoction, expression, infusion, maceration, chewing, kneading, crushing, pulverization, softening, rasping, torrefaction and trituration. For the administration of the medicine, one proceeds by absorption, local application, drink, ingurgitation, bandage and purging. The traditional healers use only natural resources (plants, animals, minerals). The therapeutic effects induced by the plants are the fact of various chemical groups: alkaloids, flavonoides, lectins, mucilages, pectins, polyphenols, polyterpens, mineral salts, sterols, tanins and vitamins).     

二维斑点追踪成像技术评价完全性左束支传导阻滞患者的左心室功能及同步性

目的应用二维斑点追踪成像技术（2D-STI）探讨不同应变模式对完全性左束支传导阻滞（CLBBB）患者左心室收缩功能及同步性的影响。 方法选取2016年4月至2018年4月在中国医科大学附属第一医院接受检查的CLBBB患者90例,根据二维纵向应变特征分为经典型（CPD）组及非CPD型（n-CPD）组,再进一步选取其中左心室射血分数（LVEF）>50%的患者,同上分为CPD组及n-CPD组;另选30名健康人作为健康对照组。对各组均行常规超声心动图及2D-STI检查,测量常规超声心动图参数：左心室舒张末期内径（LVEDD）、左心室舒张末期容积（LVEDV）及LVEF等;测量并计算左心室整体纵向峰值应变（GLS）、左心室流出道与右心室流出道射血前期时间差（IVMD）、基底段和中间段左心室侧壁与室间隔的应变达峰时间延迟（b-Ssl,m-Ssl）以及左心室18节段心肌纵向应变达峰时间的标准差（SDt）。 结果与健康对照组比较,CPD组及n-CPD组LAD、RVBD、E/e′增高,E/A、EDT减低,差异均有统计学意义（t=5.12、3.67、7.29、5.69、5.89、3.15、2.05、5.89、5.22、3.83,P均<0.01）;与n-CPD组比较,CPD组LAD、E/e′增高,E/A减低,差异均有统计学意义（t=8.12、3.24、3.94,P均<0.01）。与健康对照组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=20.38、7.17、7.35、6.50、5.86、10.24、7.15、6.35、11.24、10.99、5.92、6.12,P均<0.001）;与健康对照组比较,n-CPD组QRS、LVEDD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=16.54、1.99、2.12、2.07、5.87、2.53、2.10、5.06、2.68、3.66、2.06、3.62,P均<0.05）;与n-CPD组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=4.68、5.96、6.63、5.32、5.01、5.10、5.28、4.86、7.16、4.74、7.20、3.78、3.57,P均<0.001）。进一步选择LVEF>50%的患者进行比较,组间LVEF比较,差异无统计学意义（P>0.05）,与健康对照组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=19.44、4.01、5.21、5.61、4.73、9.19、5.27、3.16、3.25、8.02、4.15、5.42,P均<0.001）;与健康对照组比较,n-CPD组QRS、LVEDD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,左心室间隔及总体纵向应变减低,差异均有统计学意义（t=20.68、2.46、3.15、3.10、6.95、3.00、4.59、6.53、3.84、4.05,P均<0.05）;与n-CPD组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、SDt增高,左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=2.73、2.13、3.88、3.06、2.19、3.94、3.00、3.25、4.38、2.90、2.30,P均<0.05）。 结论常规超声心动图结合2D-STI技术可早期发现CLBBB患者左心室收缩功能及收缩同步性减低,且CPD型CLBBB较n-CPD型CLBBB进一步减低的现象,可提示临床需密切关注CPD型CLBBB患者,及时进行治疗干预。     

腹腔镜胆囊切除术围手术期微量元素的变化

目的：探讨LC围手术期微量元素的变化,方法：对12例LC病人在术前,术终,术后血清中Ca,Mg,Fe,Zn,Cu,Mn,Se,Cr,CO,Ni,V,Mo,Ba,Al,Sr,Cd,Pb和Se的变化进行动态观察,结果：在检测的18种微量元素中,在术终Ca,Mg,Zn,CU,Mn,Se,Cr等必需微量元素均明显降低（P＜0．05,P＜0．01）,术后第1天,血清中Ca,Mg,Zn,Cu,Mn,Se,Cr均还维持在明显的水平（P＜0．05）,结论：LC对必需的微量元素有明显的影响,术后应注意补充适量的微量元素。     

Critical issues relating standards for technology to patient safety

The Committee members are: Jerry M. Calkins, PhD MD (Chairman), Dept Anesthesiology, University of Arizona, Maricopa Medical Center, Phoenix, AZ; David W. Arnett, PhD, Puritan Bennett Corporation, Carlsbad, CA; Peter Carstensen, Food and Drug Administration, Rockville, MD; Joseph A. Condurso, North American Drager, Telford, PA; Patrick A. Foster, FFA, Hershey Medical Center, Hershey, PA; Alex Gerwer, San Diego, CA; Michael Good, MD, University of Florida, Gainesville, FL; Ervin Moss, MD, NJSSA, Verona, NJ; Allen K. Ream, MD, PE (Secretary), Stanford University, Woodside, CA; Terry E. Spraker, PhD, Ohmeda, Madison, WI. Address correspondence to Dr Calkins, Department of Anesthesiology, Maricopa Medical Center, 2601 East Roosevelt, PO Box 5099, Phoenix, AZ 85010.     

Diagnosis of hemoglobinopathies: electrophoresis vs. HPLC.

BACKGROUND: Alkaline cellulose acetate and acidic citrate agar electrophoreses are the most widely utilized methods for hemoglobin analysis. However, due to their limited resolution, incorrect or unresolved diagnosis of common hemoglobinopathies are sometimes encountered. METHODS: Isoelectric focusing provides excellent resolution but is labor intensive and lacks accurate quantitation. High-performance liquid chromatographic methods have been developed for either screening or confirmation of hemoglobinopathies with relatively high sensitivity or specificity. Through the years, we have developed, refined and optimized an HPLC procedure using a porous silica coated with polyaspartic acid to improve the elution time of hemoglobin analysis while maintaining the high sensitivity and resolution necessary for both screening and confirmatory purposes. RESULTS: The method is capable of separating more than 45 commonly encountered hemoglobin variants within 12 min. These include Barts, H, A1C, Raleigh, Hope, I, F, Camden, N-Baltimore, I-High Wycombe, I-Paris, J-Baltimore, N-Seattle, Grade, Fannin-Lubbock, Malmo, South Florida, A, Chicago, G-Georgia, Lepore-Baltimore, P-Galveston, G-Coushatta, Lepore-Boston, E, Zurich, Osu Christiansborg, A2, G-Philadelphia, Korle Bu, Russ, E-Saskatoon, Richmond, D-Punjab, Deer Lodge, Koln, Montgomery, S, Q-Thailand, G-San Jose, A2', Hasharon, Q-India, Tampa, Constant Spring, SG-hybrid, C-Harlem, O-Arab, British Columbia, and C. The method provides not only the identification of the aforementioned hemoglobin and variants but also an accurate quantitation of their concentrations, particularly Hb F and A2, which are useful for the diagnosis of HPFH and beta-thalassemia, respectively. CONCLUSIONS: The simplicity of the sample preparation, superior resolution of the method, and accurate quantitation of hemoglobin concentration, combined with complete automation, make this an ideal methodology for the routine diagnosis of hemoglobin disorders in a clinical laboratory.     

抗U1核糖核蛋白抗体与系统性红斑狼疮的致病相关性

目的分析抗U1核糖核蛋白(U1RNP)抗体与系统性红斑狼疮(SLE)临床表现及实验室指标的关系,探讨其在SLE发病中的意义。方法回顾性分析161例SLE住院患者病历资料,其中抗U1RNP抗体阳性者69例,分析其主要的临床特征及实验室指标,并与92例同期住院的抗U1RNP抗体阴性者进行比较。结果抗U1RNP抗体阳性的患者抗双链DNA抗体、抗核小体抗体、抗Sm抗体、SSA、抗核糖体P蛋白阳性率较高,更易出现C3下降、C4下降,发热、皮疹、光敏感、雷诺现象、关节炎、白细胞减少的阳性率较高,肾损害阳性率较低,差异均有统计学意义(χ2值分别为10.000、26.152、14.268、15.413、5.339、8.285、6.456、4.376、8.829、4.593、4.573、4.035、4.286、6.212,P均<0.05),两组患者在ANA、抗SSB抗体、抗心磷脂抗体、口腔溃疡、浆膜炎、心包炎、胸膜炎、脱发、神经系统损害、淋巴细胞减少、血小板减少及SLEDAI差异均无统计学意义(P>0.05)。结论抗U1RNP抗体与SLE患者抗双链DNA抗体、抗核小体抗体、抗Sm抗体、SSA、抗核糖体P蛋白高阳性率、C3下降、C4下降及发热、皮疹、光敏感、雷诺现象、关节炎、白细胞减少、肾损害相关,抗U1RNP抗体在SLE的发病中有重要的临床意义。2     

2005 Annual Report of the American Association of Poison Control Centers' national poisoning and exposure database

BACKGROUND: The American Association of Poison Control Centers (AAPCC; http://www.aapcc.org) maintains the national database of information logged by the country's 61 Poison Control Centers (PCCs). Case records in this database are from self-reported calls: they reflect only information provided when the public or healthcare professionals report an actual or potential exposure to a substance (e.g., an ingestion, inhalation, or topical exposure.), or request information/educational materials. Exposures do not necessarily represent a poisoning or overdose. The AAPCC is not able to completely verify the accuracy of every report made to member centers. Additional exposures may go unreported to PCCs, and data referenced from the AAPCC should not be construed to represent the complete incidence of national exposures to any substance(s). U.S. Poison Centers make possible the compilation and reporting of this report through their staffs' meticulous documentation of each case using standardized definitions and compatible computer systems. The 61 participating poison centers in 2005 are: Regional Poison Control Center, Birmingham, AL; Alabama Poison Center, Tuscaloosa, AL; Arizona Poison and Drug Information Center, Tucson, AZ; Banner Poison Control Center, Phoenix, AZ; Arkansas Poison and Drug Information Center, Little Rock, AK; California Poison Control System-Fresno/Madera Division, CA; California Poison Control System-Sacramento Division, CA; California Poison Control System-San Diego Division, CA; California Poison Control System-San Francisco Division, CA; Rocky Mountain Poison and Drug Center, Denver, CO; Connecticut Poison Control Center, Farmington, CT; National Capital Poison Center, Washington, DC; Florida Poison Information Center, Tampa, FL; Florida Poison Information Center, Jacksonville, FL; Florida Poison Information Center, Miami, FL; Georgia Poison Center, Atlanta, GA; Illinois Poison Center, Chicago, IL; Indiana Poison Center, Indianapolis, IN; Iowa Statewide Poison Control Center, Sioux City, IA; Mid-America Poison Control Center, Kansas City, KA; Kentucky Regional Poison Center, Louisville, KY; Louisiana Drug and Poison Information Center, Monroe, LA; Northern New England Poison Center, Portland, ME; Maryland Poison Center, Baltimore, MD; Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island, Boston, MA; Children's Hospital of Michigan Regional Poison Control Center, Detroit, MI; DeVos Children's Hospital Regional Poison Center, Grand Rapids, MI; Hennepin Regional Poison Center, Minneapolis, MN; Mississippi Regional Poison Control Center, Jackson, MS; Missouri Regional Poison Center, St Louis, MO; Nebraska Regional Poison Center, Omaha, NE; New Jersey Poison Information and Education System, Newark, NJ; New Mexico Poison and Drug Information Center, Albuquerque, NM; New York City Poison Control Center, New York, NY; Long Island Regional Poison and Drug Information Center, Mineola, NY; Ruth A. Lawrence Poison and Drug Information Center, Rochester, NY; Upstate (formerly Central) New York Poison Center, Syracuse, NY; Western New York Poison Center, Buffalo, NY; Carolinas Poison Center, Charlotte, NC; Cincinnati Drug and Poison Information Center, Cincinnati, OH; Central Ohio Poison Center, Columbus, OH; Greater Cleveland Poison Control Center, Cleveland, OH; Oklahoma Poison Control Center, Oklahoma City, OK; Oregon Poison Center, Portland, OR; Pittsburgh Poison Center, Pittsburgh, PA; The Poison Control Center, Philadelphia, PA; Puerto Rico Poison Center, San Juan, PR; Palmetto Poison Center, Columbia, SC; Tennessee Poison Center, Nashville, TN; Central Texas Poison Center, Temple, TX; North Texas Poison Center, Dallas, TX; Southeast Texas Poison Center, Galveston, TX; Texas Panhandle Poison Center, Amarillo, TX; West Texas Regional Poison Center, El Paso, TX; South Texas Poison Center, San Antonio, TX; Utah Poison Control Center, Salt Lake City, UT; Virginia Poison Center, Richmond, VA; Blue Ridge Poison Center, Charlottesville, VA; Washington Poison Center, Seattle, WA; West Virginia Poison Center, Charleston, WV; Wisconsin Poison Center, Milwaukee, WI.     

Resource Reviews

Book Reviews : TOPICS IN GERONTOLOGY: SELECTED ANNOTATED BIBLIOGRAPHIES Thomas O. Blank (Ed.), Greenwood Publishing Group, 88 Post Road West, West-port, CT 06881, 203/226-3571, 1993, $65, 256 pages, ISBN 0-313-28337-0 Book Reviews : ELDER MISTREATMENT: DECIDING WHO IS AT RISK Tanya Fusco Johnson, Greenwood Publishing Group, 88 Post Road West, West-port, CT 06881, 203/226-3571, 1991, $49.95, 216 pages, ISBN 0-313-26409-0 Book Reviews : NURSING DIAGNOSES AND INTERVENTIONS FOR THE ELDERLY Meridean Maas & Kathleen Buckwalter, Addison-Wesley Nursing, 390 Bridge Parkway, Redwood City, CA 94065, 800/322-1377, 1991, $44.25, 627 pages, ISBN 0-201-12679-6 Book Reviews : COPING WITH CHRONIC ILLNESS: OVERCOMING POWERLESSNESS (2nd ed.) Judith Fitzgerald Miller, F.A. Davis Company, 1915 Arch Street, Philadephia, PA 19103, 800/323-3555, 1992, $24.95, 442 pages, ISBN 0-8036-6192-4 Book Reviews : THE COMPLETE CARE PLAN MANUAL FOR LONG-TERM CARE Connie S. March, American Hospital Publishing, 737 N. Michigan Avenue, Chicago, IL 60611, 800/242-2626, 1992, $29.95 AHA members, $37.95 nonmembers, 143 pages, ISBN 1-55648-085-7 Book Reviews : BASIC GERIATRIC NURSING Gloria Wold, Mosby-Year Book, 11830 Westline Industrial Drive, St. Louis, MO 63146, 800/325-4177, 1993, $23.95 (paperback), 400 pages, ISBN 0-8016-6647-3     

甜菜碱对非酒精性脂肪肝大鼠瘦素影响的研究

目的通过甜菜碱对非酒精性脂肪肝（NASH）大鼠瘦素的实验研究,探讨甜菜碱改善NASH的作用。方法采用高脂肪饲料加入诱导脂肪肝药物丙基硫氧嘧啶饲养方式制作NASH大鼠模型,高、低剂量组分别给予甜菜碱400mg/kg、200mg/kg灌胃,持续12周;实验结束后,腹主动脉取血,采用全自动生化仪测定Glu、ALT、AST、TG、TC,采用双抗体夹心法测定INS、LEP,并计算胰岛素抵抗指数（IRI）。结果与正常组比较,模型组大鼠TC、TG、ALT、AST、Glu、INS、IRI、LEP均明显升高（P〈0.01或P〈0.05）;与模型组比较,高剂量组TC、TG、ALT、AST、Glu、INS、IRI、LEP均明显下降（P〈0.01）,低剂量组ALT、AST、IRI、LEP也下降（P〈0.01或P〈0.05）,而TC、TG、Glu、INS有所下降,但差异无统计学意义。结论甜菜碱可降低血脂、血糖水平,可改善胰岛素抵抗,改善肝功能,作用机制可能与瘦素有关;甜菜碱改善NASH的作用机制也可能与瘦素有关。