脑外伤患者脑脊液中游离氨基酸的测量及治疗后的变化

目的:通过测量脑外伤患者脑脊液中17种游离氨基酸的含量及治疗后变化情况,了解脑外伤患者脑脊液中游离氨基酸变化规律,为临床治疗提供依据。方法:采用日本日立835—50高速氨基酸分析仪,检测患者脑损伤后(1d、3d、7d)脑脊液中游离氨基酸的含量及治疗后变化情况。结果:脑外伤后有11种氨基酸有明显变化,6种变化不明显。其中谷氨酸、天门冬氨酸这二种兴奋性氨基酸含量明显增高,经治疗后逐渐恢复正常。结论:脑外伤患者在伤后脑脊液中游离氨基酸含量17种中有11种显著增高,6种变化不明显。经治疗7d后,基本恢复正常。     

肾病患者血、尿氨基酸含量的变化及意义

肾脏是氨基酸代谢的重要器官,当肾脏发生病变时蛋白质分解合成紊乱,引起血,尿氨基酸含量变化。本研究测定了31例肾病患者血、尿21种游离氨基酸含量,对其含量变化及意义进行初步探讨。 健康对照组65人,测定血清游离氨基酸,年龄20～70岁,平均年龄38.3岁,其中男40人,女25人。肾病组31例,测定血清、尿游离氨基酸,年龄15～47岁,平均年龄27岁,其中男17例,女14例,临床分型:肾病综合征25例,慢性肾炎普通型4例,狼疮性肾炎2例,血尿素     

食管癌病人血清及癌组织游离氨基酸谱的临床研究

应用氨基酸自动分析仪，对２２ 例食管癌病人血清，正常食管组织和食管癌组织游离氨基酸含量分析。结果表明：食管癌病人血清有６ 种氨基酸降低，２ 种升高；食管癌组织游离氨基酸较正常食管组织显著增多，血清下降显著的几种氨基酸，在癌组织中增加比例明显。提示食管癌病人血和组织游离氨基酸代谢紊乱。     

脑创伤患者脑脊液中钙、镁的变化及意义

通过测定56例脑创伤脑脊液中钙、镁的含量，并与正常对照组22例进行比较，发现脑创伤患者脑脊液中钙、镁浓度均下降，且其下降程度与创伤程度有关。     

恶性肿瘤特异生长因子(TSGF)检测的临床应用评价

目的:评价恶性肿瘤特异生长因子(TSGF)对恶性肿瘤临床检测的应用价值。方法:对510例恶性肿瘤患者、157例健康体检者及113例良性肿瘤患者进行血清TSGF含量测定。结果:恶性肿瘤患者血清中TSGF水平与正常对照组相比有显著性差异(P<0.01)。结论:TSGF检测可作为临床上恶性肿瘤早期诊断的良好指标,是健康人群早期发现恶性肿瘤的较好的过筛实验。     

脑外伤患者脑脊液中兴奋性氨基酸的测量及钙拮抗剂治疗后的变化

目的 通过测量脑外伤患者脑脊液中兴奋性氨基酸(EAA)含量及使用钙拮抗剂治疗后的变化,了解脑外伤患者EAA的变化规律及钙拮抗剂治疗效果。方法 采用日本日立835-50高速氨基酸分析仪,检测患者脑损伤后(1d、3d、7d)脑脊液中EAA的含量及钙拮抗剂尼莫地平治疗后其含量的变化。结果 脑外伤患者伤后EAA(谷氨酸GLU、天门冬氨酸ASP)明显增高。治疗3d,EAA含量下降;加用尼莫地平治疗后,EAA下降更明显;治疗7d,EAA含量接近正常。结论 提示尼莫地平可有效地减少脑外伤患者EAA的产生,有较好的治疗作用。     

食管、贲门癌患者血浆蛋白质及血清游离氨基酸谱的临床研究

食管、贲门癌55例,空腹静脉血测定血浆蛋白总量、白蛋白,蛋白电泳及28项血清游离氨基酸值。健康成人65例血清游离氨基酸值作为对照。病人组血清氨基酸谱中有15项下降,4项升高。根据病变部位,病程、病变范围分组对比所测各项指标,大都无显著差异。手术36例,术前及术后第一天比较,术后血浆蛋白及白蛋白值明显下降,血清氨基酸下降者13项,升高者2项。这些监测结果可作为食管、贲门癌病人术前,术后营养评价及辅助治疗的参考。     

天然冬虫夏草 冬虫夏草菌丝及发酵液游离氨基酸的种类及含量测定

目的对天然冬虫夏草、冬虫夏草菌丝及发酵液样品进行24种游离氨基酸的分析;进一步了解三者游离氨基酸的种类和含量,为它们的应用研究提供可用的信息及参考。方法采用安捷伦1200HPLC,C18反相柱梯度分离,邻苯二甲醛-芴甲酯（OPA—FMOC）柱前自动衍生化,利用已知浓度氨基酸标准品进行外标法定量,根据已知浓度氨基酸标准品的峰面积与样品峰面积之比计算出游离氨基酸的含量。结果分析结果表明在24种游离氨基酸的测定中,天然冬虫夏草含有19种,冬虫夏草菌丝含22种,发酵液含23种,三者所缺少的游离氨基酸种类互不相同。三者游离氨基酸的含量有着明显差别和变化,其原因是由于天然冬虫夏草是在野外天然生长,冬虫夏草菌丝和发酵液是人工发酵培养,处于不同的温度和环境条件的原故。结论天然冬虫夏草,冬虫夏草菌丝及发酵液的游离氨基酸的种类和含量并不等同,建议临床配合使用。     

脑脊液C反应蛋白水平变化与颅脑损伤患者预后相关分析

收集65例重型颅脑损伤病例临床资料,按轻、中、重分3组。于伤后1～7d内采集脑脊液,测定脑脊液中C反应蛋白(CRP)水平,结果提示脑脊液CRP水平对脑损伤患者预后有一定的指示作用。     

结核性脑膜炎血清脑脊液结核抗体联合测定意义

结核性脑膜炎(以下称结脑)是最危险的肺外结核病之一.由于不典型病例增多,脑脊液的实验室检测十分重要.国内外一些资料已报道脑脊液中结核分支杆菌抗体检测,有助于结脑的诊断与鉴别诊断.自1999年以来,以PPD为抗原,采用ELISA法对28例结脑患者的血清、脑脊液中结核抗体联合测定,并同时测定肺结核11例,其他疾病(非结核病)12例血清、脑脊液中的结核抗体并作对比.     

血氧水平依赖功能磁共振评价脑肿瘤恶性程度与脑皮层功能区距离和激活体积的相关性

目的 利用血氧水平依赖功能磁共振(BOLD-fMRI)评价脑肿瘤恶性程度与脑皮层功能区距离和激活体积的相关性.资料与方法 33例经手术病理证实的位于或邻近中央前回的脑肿瘤患者,包括恶性肿瘤组16例和良性肿瘤组17例,术前采用对指模式的组块(BLOCK)刺激方法,应用BOLD-fMRI成像技术,分析良恶性肿瘤与脑功能区边缘的距离及激活体积的相关性.结果 恶性肿瘤组BOLD激活体积为(31.29±10.87),良性肿瘤组BOLD激活体积为( 79.53±16.27),差异有统计学意义(P＜0.05);良性肿瘤组肿瘤边缘距脑皮层运动功能区距离平均(5.65±2.29) mm,恶性肿瘤组肿瘤边缘距脑皮层运动功能区距离平均(5.00±2.76) mm;恶性肿瘤组肿瘤至脑皮层功能区的距离与激活体积比呈正相关(R2=0.407,P＜0.01),良性肿瘤组肿瘤至脑皮层功能区的距离与激活体积比呈正相关(R2=0.25,P＜0.05),恶性肿瘤组较良性肿瘤组肿瘤至脑皮层功能区的距离与激活体积比的相关性更加显著.结论 脑肿瘤对周围脑组织产生影响,影响运动激活区状态,且在恶性肿瘤中更明显.     

眼眶肿瘤的氢质子磁共振波谱的临床应用研究

目的:总结眼眶病变MRS特征,研究其生化指标,以及对诊断和鉴别诊断的意义。方法:全部病例共40例,均为单发病灶,行MRI和MRS检查。术后均得到病理证实。其中良性肿瘤和类肿瘤病变30例,恶性肿瘤10例。结果:对照组和肿瘤组比较,不同的眼眶肿瘤,各化合物的变化不同,同对照组比较,眼眶肿瘤NAA均有不同程度下降(P<0.05),海绵状血管瘤下降达52.5%,而小细胞性恶性肿瘤和腺样囊性癌升高明显。良性肿瘤和恶性肿瘤的比较,Cho、Ace和Lac峰有明显差异,恶性肿瘤组明显高于良性肿瘤组。Cr峰相差不明显。Cho/Cr比值有明显增高。结论:肿瘤和正常脑组织的波谱有区别。表现在Lac、Ace的不同变化特征。良性肿瘤和恶性肿瘤的MRS波峰有明显差异,表现为Cho,Cr峰值增高,尤其是Cho/Cr比值的增高,此外Lac和Ace在恶性肿瘤增高明显,提示可作为区别肿瘤与非肿瘤的标志之一。     

Tissue sodium concentration in human brain tumors as measured with 23Na MR imaging

PURPOSE: To use combined proton (1H) and sodium 23 (23Na) magnetic resonance (MR) imaging to noninvasively quantify total tissue sodium concentration and to determine if concentration is altered in malignant human brain tumors. MATERIALS AND METHODS: Absolute tissue sodium concentration in malignant gliomas was measured on quantitative three-dimensional 23Na MR images with tissue identification from registered 1H MR images. Concentration was determined in gray matter (GM), white matter (WM), cerebrospinal fluid (CSF), and vitreous humor in 20 patients with pathologically proven malignant brain tumors (astrocytoma, n = 17; oligodendroglioma, n = 3) and in nine healthy volunteers. Sodium concentration in tumors and edema was determined from 23Na image signal intensities in regions that were contrast material enhanced on T1-weighted 1H images (tumors) or regions that were only hyperintense on fluid-attenuated inversion recovery (FLAIR) 1H images (edema). Sodium concentrations were measured noninvasively from 23Na images obtained with short echo times (0.4 msec) by using external saline solution phantoms for reference. Differences in mean sodium concentration of all healthy tissue and lesions in patients were tested with a paired t test. Concentration in uninvolved tissues in patients was compared with that in the same tissue types in the volunteers with an independent samples two-tailed t test. RESULTS: Mean concentration (in millimoles per kilogram wet weight) was 61 +/- 8 (SD) for GM, 69 +/- 10 for WM, 135 +/- 10 for CSF, 113 +/- 14 for vitreous humor, 103 +/- 36 for tumor, 68 +/- 11 for unaffected contralateral tissue, and 98 +/- 12 for FLAIR hyperintense regions surrounding tumors. Significant differences (P <.002) in sodium concentration were demonstrated by using a t test for both tumors and surrounding FLAIR hyperintense tissues versus GM, WM, CSF, and contralateral brain tissue. CONCLUSION: 23Na MR imaging with short echo times can be used to quantify absolute tissue sodium concentration in patients with brain tumors and shows increased sodium concentration in tumors relative to that in normal brain structures.     

磁共振弹性成像对肝脏局灶性良恶性肿瘤鉴别价值的初步研究

目的：探讨磁共振弹性成像(MRE)在肝脏良恶性肿瘤的诊断价值。方法对36例肝脏肿瘤患者(共39个病灶,其中肝细胞癌20个,血管瘤7个,胆管细胞癌5个,转移瘤3个,平滑肌脂肪瘤2个,癌肉瘤1个,巨淋巴增生1个)以及9例健康志愿者行 MRE。通过 FUNCTOOL 后处理获得肿瘤层面弹性图。测量、比较恶性肿瘤、良性肿瘤、恶性肿瘤周围组织、良性肿瘤周围组织和健康志愿者肝组织平均弹性值。结果恶性肿瘤平均弹性值[(7.39±1.70)kPa]明显高于良性肿瘤[(4.11±0.37)kPa,P <0.001]、恶性肿瘤周围组织[(3.50±0.73)kPa,P <0.001]、良性肿瘤周围组织[(2.61±0.45)kPa,P <0.001]及志愿者正常肝组织平均弹性值[(2.38±0.24)kPa,P <0.001]。恶性肿瘤周围组织平均弹性值[(3.50±0.73)kPa]明显高于良性肿瘤周围组织平均弹性值[(2.61±0.45)kPa, P <0.001]。良性肿瘤周围组织[(2.61±0.45)kPa]稍高于志愿者正常肝组织的平均弹性值[(2.38±0.24)kPa],两者无显著差异(P >0.05)。当取截断值为5.08 kPa 时,可鉴别区分良恶性肝肿瘤和正常肝实质。结论MRE 技术可用于肝脏局灶肿瘤性病变的诊断,有助于对肝脏良恶性肿瘤的鉴别。     

Clinical magnetic resonance spectroscopy of human breast disease.

Using image-guided volume-selection techniques, in vivo phosphorus-31 magnetic resonance (MR) spectroscopic profiles were obtained from 12 patients with malignant breast tumors, six patients with benign breast tumors, and nine volunteers with no underlying pathologic condition. Phosphatic metabolites identified in the spectral profiles included the phosphomonoesters (PME), inorganic phosphate (Pi), phosphodiesters (PDE), phosphorylated glycans (PG), phosphocreatine (PCr) and adenosine triphosphate (ATP). Based on the results of previous high-resolution ex vivo 31P MR spectroscopic analyses of breast tissues, the resonance of PG was identified in malignant and benign breast tumors. Malignant tumors were found to have a significantly (P less than .05) lower concentration of (PME + Pi) than normal breast parenchyma, and were distinguishable from both benign tumors and normal breast parenchymal tissue by significantly (P less than .01) elevated levels of (PDE + PG). 31P MR spectroscopy is the first technique potentially capable of differentiating among malignant breast tumors, benign breast tumors, and normal breast parenchymal tissues based on their in vivo phosphatic metabolic profiles.     

The retention indices of 201Tl-SPECT in brain tumors

OBJECTIVE: The aim of this study was to assess the utility of 201Tl SPECT in the differential diagnosis of intracranial tumors and to determine the relationship between 201Tl uptake and histological types. METHODS: Thirty-eight patients (19 males and 19 females) with thirty-eight brain tumors were evaluated with 201Tl-SPECT. The early and delayed 201Tl uptake ratio was calculated, and the retention index (RI) was applied as follows; RI = delayed uptake ratio/early uptake ratio. RESULTS: The RI of malignant tumors was higher (0.72 +/- 0.18) than that of benign tumors (0.50 +/- 0.16) and the difference was statistically significant (p = 0.00045). The difference between high-grade glioma (0.80 +/- 0.15) and metastatic tumors (0.64 +/- 0.19) was statistically significant (p = 0.039). CONCLUSION: 201Tl-SPECT may add useful biochemical information and could differentiate malignant brain tumors from benign lesions, but the RI of metastatic tumors varied depending on the organs with the primary lesion and histological types.     

Evaluation of primary brain tumors with FLT-PET: usefulness and limitations

PURPOSE OF THE REPORT: The purpose of this report was to investigate the potential of positron emission tomography using F-18 fluorodeoxythymidine (FLT-PET) in evaluating primary brain tumors. MATERIALS AND METHODS: FLT-PET was performed in 25 patients with primary brain tumors. FLT uptake in the lesion was semiquantitatively evaluated by measuring the maximal standardized uptake value (SUVmax) and the tumor-to-normal tissue ratio (TNR). SUVmax and TNR were compared with the histologic grade and the expression of the proliferation marker (Ki-67). RESULTS: FLT uptake in normal brain parenchyma was very low, resulting in the visualization of brain tumors with high contrast. Both SUVmax and TNR significantly correlated with the malignant grade of brain gliomas, in which high SUVmax/TNR was obtained for high-grade gliomas. Patients with primary lymphoma also showed SUVmax/TNR equivalent to glioblastoma. There was a positive correlation between SUVmax/TNR and the Ki-67 index. In contrast, spuriously high SUVmax and TNR were obtained in 3 of 6 patients with suspected recurrent tumors (2 patients with recurrent grade 2 glioma and one patient with postoperative granuloma), all of which showed lesion enhancement on MRI after Gd administration. CONCLUSIONS: FLT-PET can be used to evaluate the malignant grade and proliferation activity of primary brain tumors, especially malignant brain tumors. However, the presence of benign lesions showing blood-brain barrier disruption cannot be distinguished from malignant tumors and needs to be carefully evaluated.     

MRI动态增强定量参数对肝细胞癌和肝良性肿瘤鉴别诊断的价值

目的：研究磁共振动态增强(DCE-MRI)定量参数在肝细胞癌和肝良性肿瘤鉴别的意义,探索定量参数对肝脏占位性病变良恶性诊断的界值及其诊断效能。方法对存在肝占位的25例患者进行 DCE-MRI 扫描,经病理证实或通过随访确诊肝细胞癌和肝良性肿瘤共28个病灶,利用 tissue4D 后处理软件测定病灶及周围正常肝组织的定量参数值(Ktrans 、Kep 、Ve 、iAUC),利用独立样本 t 检验比较肝细胞癌组、良性组病灶与周围正常肝组织的定量参数,同时比较2组病灶间的定量参数值,并通过绘制受试者工作特征曲线(ROC)来确定肝细胞癌和肝良性肿瘤间定量参数的最佳界值及其诊断效能。结果良性组、肝细胞癌组病灶的各定量参数均值大于周围正常肝组织,其中良性组 Ktrans 、iAUC 差异有统计学意义(P <0.05);肝细胞癌组 Ktrans 、Kep 、iAUC 差异有统计学意义(P <0.05);肝细胞癌组和良性组比较,肝细胞癌组病灶的各定量参数均值大于良性组,Ktrans 、Kep 及 iAUC 的差异有统计学意义(P <0.05)。其中 Ktrans =0.215 min-1时,敏感度为81.3%,特异度为66.7%,诊断效能大于 Kep (界值为0.477)、iAUC(界值为24.706)。结论DCE-MRI 定量参数能为肝细胞癌和良性肿瘤的鉴别诊断提供参考。     

动态增强MRI时间信号强度曲线在卵巢良恶性肿瘤鉴别中的价值

目的探讨动态增强MRI时间信号强度曲线(TIC)鉴别卵巢肿瘤良恶性的价值。方法收集2016年1月—2017年8月间于我院超声检查发现盆腔附件肿块的71例女性病人,年龄14～78岁,中位年龄52岁。所有病人行MRI常规及动态增强检查后经手术获得病理结果。利用工作站在肿块实性区和正常子宫外肌层设置兴趣区获取TIC,以子宫外肌层强化曲线为基准,对卵巢肿块实性区的TIC类型进行校正,分析曲线类型与良恶性卵巢肿瘤的关系。采用χ~2检验比较良恶性肿瘤间3种TIC类型差异。结果 71例病人中包括卵巢恶性肿瘤40例,良性肿瘤26例,交界性肿瘤5例。上述3种肿瘤的TIC类型的差异有统计学意义(P0.05)。良性肿瘤以Ⅰ型TIC为主(73.1%),恶性肿瘤以Ⅲ型TIC为主(77.5%)。MRI+TIC鉴别肿瘤良恶性的敏感度、特异度、阳性预测值和阴性预测值较单独常规MRI检查各指标均有不同程度提高。结论动态增强MRI及其TIC对卵巢良恶性肿瘤具有重要的鉴别诊断价值。     

Evaluation of delayed18F-FDG PET in differential diagnosis for malignant soft-tissue tumors

OBJECTIVE: Positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) has been used for the evaluation of soft-tissue tumors. However, the range of accumulation of 18F-FDG for malignant soft-tissue lesions overlaps with that of benign lesions. The aim of this study is to investigate the usefulness of delayed 18F-FDG PET imaging in the differentiation between malignant and benign soft-tissue tumors. METHODS: Fifty-six patients with soft-tissue tumors underwent whole body 18F-FDG PET scan at 1 hour (early scan) and additional scan at 2 hours after injection (delayed scan). The standardized uptake value (SUV(max)) of the tumor was determined, and the retention index (RI) was defined as the ratio of the increase in SUV(max) between early and delayed scans to the SUV(max) in the early scan. Surgical resection with histopathologic analysis confirmed the diagnosis. RESULTS: Histological examination proved 19 of 56 patients to have malignant soft-tissue tumors and the rest benign ones. In the scans of all 56 patients, there was a statistically significant difference in the SUV(max) between malignant and benign lesions in the early scan (5.50 +/- 5.32 and 3.10 +/- 2.64, respectively, p < 0.05) and in the delayed scan (5.95 +/- 6.40 and 3.23 +/- 3.20, respectively, p < 0.05). The mean RI was not significantly different between malignant and benign soft-tissue tumors (0.94 +/- 23.04 and -2.03 +/- 25.33, respectively). CONCLUSIONS: In the current patient population, no significant difference in the RI was found between malignant and benign soft-tissue lesions. Although the mean SUV(max) in the delayed scan for malignant soft-tissue tumors was significantly higher than that for benign ones, there was a marked overlap. The delayed 18F-FDG PET scan may have limited capability to differentiate malignant soft-tissue tumors from benign ones.