双源CT双能量成像诊断胃癌周围侵犯的临床意义

目的:分析双源CT双能量成像诊断胃癌周围侵犯的临床意义.方法:我院收治的90例胃癌患者,经双源CT双能量成像扫描,以术后的病理诊断作为金标准,分析其诊断价值.结果:淋巴结、脂肪组织转移组动脉期、静脉期的标准化碘浓度均高于未转移组,差异有统计学意义(P＜0.05).结论:双源CT双能量成像诊断胃癌周围侵犯有积极意义,能确定胃癌是否有周围侵犯情况,为临床手术及预后提供准确信息.     

CT能谱多参数成像在肝癌检查中的应用分析

目的 探讨CT能谱多参数成像对肝癌的诊断价值.方法 选取2012年4月至2014年5月在我院行肝脏能谱CT扫描的33例患者,对肝癌患者的能谱定量参数进行分析.结果 肝癌患者的动脉期与门静脉期的40、50、120 keV下的CT值差异有统计学意义(P＜0.05),该两期的CT值随着keV增高而降低;肝癌动脉期能谱CT值衰减曲线斜率为(1.76±0.43),门静脉期为(2.79±0.55),动脉期和门静脉期的能谱CT衰减曲线斜率差异有统计学意义(P＜0.05);动脉期肝癌在50 keV下CNR最佳,门静脉期肝癌在70 keV下具有最佳的CNR;肝癌动脉期NIC低于门静脉期,动脉期ICRLN高于门静脉期,而两期脂肪/钙浓度和水(碘)浓度差异无统计学意义(P＞0.05).结论 CT能谱多参数成像在诊断肝癌中有较高的诊断价值.     

CT能谱成像在术前评估胃癌患者病理类型的临床价值

目的探讨CT能谱成像在术前评估胃癌患者病理类型的临床价值。方法选取93例胃癌患者,对患者行CT能谱成像,对病灶水、碘浓度进行测量,并计算标准化后碘浓度比,分析比较不同病理类型碘浓度、碘浓度比、水浓度水平。结果胃黏液癌患者静脉期、实质期的碘浓度、碘浓度比均低于胃非黏液癌患者,差异均具有统计学意义(P<0.05);胃非黏液癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与胃黏液癌患者比较差异无统计学意义(P>0.05)。黏液腺癌患者静脉期、实质期的碘浓度、碘浓度比均低于印绒细胞癌患者,差异均具有统计学意义(P<0.05);黏液腺癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与印绒细胞癌患者比较差异均无统计学意义(P>0.05)。中高分化腺癌患者静脉期、实质期的碘浓度、碘浓度比均低于低分化腺癌患者,差异均具有统计学意义(P<0.05);中高分化腺癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与低分化腺癌患者比较差异均无统计学意义(P>0.05)。结论 CT能谱成像在胃癌患者术前评估中发挥重要作用,胃癌病理类型不同,碘浓度会发生相应变化, CT能谱成像可对胃癌病理类型有效评估,有利于患者临床治疗指导,具有非常高的临床应用价值。所以,在胃癌患者病理类型评估中, CT能谱成像应进一步推广和应用。     

能谱CT成像诊断肾透明细胞癌术前分级的准确性研究

目的探讨能谱CT成像诊断肾透明细胞癌术前分级的准确性。方法回顾性分析我院2017年1月～2018年9月100例经病理组织学诊断为肾透明细胞癌患者能谱CT成像双期扫描资料,以病理结果为金标准,分析能谱CT成像肾透明细胞癌术前分级诊断结果。结果不同病理分级动脉期与髓质期能谱参数CT值比值、碘浓度比值、能谱曲线斜率结果比较,均为Ⅰ级Ⅱ级Ⅲ级(P 0.05);以患者动脉期与髓质期能谱参数为变量,患者肾透明细胞癌级别为状态量,绘制ROC曲线,病理分级Ⅰ、Ⅱ级诊断中,动脉期能谱曲线斜率AUC=0.952,高于动脉脉期CT值比值AUC=0.752、碘浓度比值AUC=0.855以及髓质期CT值比值AUC=0.898、碘浓度比值AUC=0.829、能谱曲线斜率AUC=0.786,差异有统计学意义(P 0.05);病理分级Ⅱ、Ⅲ级诊断中髓质期能谱曲线斜率AUC=0.993,高于动脉期能谱曲线斜率AUC=0.888,CT值比值AUC=0.811、碘浓度比值AUC=0.821以及髓质期CT值比值AUC=0.810、碘浓度比值AUC=0.895,差异有统计学意义(P 0.05)。结论能谱CT成像对于术前肾透明细胞癌术前分级诊断有重要的临床价值。     

宝石能谱CT成像在鉴别不同病理类型肿瘤及其转移淋巴结中的作用

目的探讨宝石能谱CT成像在不同组织来源、病理类型肿瘤及其转移淋巴结中的鉴别诊断价值。方法回顾性分析肺癌、胃癌和食管癌患者30例,其中包括转移淋巴结41枚,行能谱cT扫描并检测肿瘤原发病灶及转移淋巴结的cT值、碘（水）基含量、有效原子序数、能谱衰减曲线及其斜率等参数。采用独立样本t检验对各组间数据进行统计学分析比较。结果除肺鳞癌转移淋巴结外,不同病理类型肺癌原发灶之间、原发灶与转移淋巴结之间以及转移淋巴结之间的主要能谱特征性参数均未见统计学差异;但它们与胃癌和食管癌转移淋巴结在中低能量区CT值、碘（水）基含量和曲线斜率皆有显著统计学差异。肺鳞癌转移淋巴结与其它肿瘤原发灶及转移淋巴结之间在中低能量区下的CT值和碘（水）基含量的差异比较皆具显著性统计学意义。结论比对分析肿瘤原发病灶及其转移淋巴结能谱CT特征参数,对不同组织来源、病理类型肿瘤及其转移淋巴结的鉴别诊断有着一定的临床指导意义。     

肺部良恶性病变鉴别应用双源CT双能量技术诊断的价值分析

目的分析肺部良恶性病变鉴别应用双源CT双能量技术诊断的价值。方法 100例肺部实质病变者作为研究对象,经手术病理证实后,其中50例患者为肺部良性病变(对照组), 50例患者为肺癌(观察组)。两组患者均采用胸部常规CT和双能量增强扫描。比较两组患者动、静脉期的碘增加值、碘浓度和标准化碘浓度。结果观察组患者静脉期标准化碘浓度(31.24±20.65)%显著高于对照组的(10.84±4.12)%,差异具有统计学意义(P<0.05);观察组患者静脉期碘增加值高于动脉期碘增加值,静脉期标准化碘浓度低于动脉期标准化碘浓度,差异具有统计学意义(P<0.05);观察组患者动脉期碘浓度与静脉期碘浓度比较,差异无统计学意义(P>0.05);对照组患者动脉期碘增加值、碘浓度和标准化碘浓度与静脉期比较,差异无统计学意义(P>0.05)。结论肺部良恶性病变鉴别应用双源CT双能量技术诊断价值较高,借助静脉期的碘增加值、标准化碘浓度等指标能有效判断肺部良恶性病变,帮助临床医师尽快做出诊断并制定治疗措施,值得临床推广及应用。     

256排能谱CT成像参数在肺腺癌诊断及治疗指导中的应用观察

目的　探究256排能谱CT成像参数在肺腺癌诊断及治疗指导中的价值。方法　选择2018年5月至2022年1月期间江汉大学附属湖北省第三人民医院收治120例肺腺癌患者及83例肺鳞癌患者作为研究对象,患者均行256排能谱CT成像获得CT成像参数,比较两组患者能谱CT成像参数,分析能谱CT成像参数对肺腺癌与肺鳞癌的诊断价值;肺腺癌患者依据靶向治疗疗效进行分组,比较有效与无效组患者治疗前后能谱CT成像参数差异,分析能谱CT成像参数与疗效之间的关系。采用t检验、χ²检验、受试者工作特征曲线（ROC）、Spearman相关性分析进行分析。结果　肺腺癌患者男76例、女44例,年龄（45.26±2.95）岁;肺鳞癌患者男58例、女25例,年龄（45.11±2.07）岁。肺腺癌患者钙含量、有效原子序数、碘基值以及能谱曲线斜率分别为（3.16±0.86）mg/ml、（7.79±0.05）、（6.76±0.96）g/L、（0.94±0.24）,均低于肺鳞癌患者的（4.71±1.09）mg/ml、（7.84±0.06）、（7.92±1.13）g/L、（1.24±0.32）,差异均有统计学意义（均P<0.05）;肺腺癌患者与肺鳞癌患者水基值比较,差异无统计学意义（P>0.05）。能谱CT成像参数钙含量、有效原子序数、碘基值、能谱曲线斜率用于肺腺癌与肺鳞癌诊断曲线下面积（AUC）分别为0.832、0.754、0.792、0.722,各指标联合AUC值则为0.932;两组患者治疗后钙含量、有效原子序数、碘基值以及能谱曲线斜率较治疗前明显下降（均P<0.05）,有效组患者治疗前与治疗后钙含量、有效原子序数、碘基值以及能谱曲线斜率均低于无效组（均P<0.05）,有效组患者钙含量、有效原子序数、碘基值以及能谱曲线斜率治疗前后差值均高于无效组（均P<0.05）;Spearman相关性分析显示,钙含量、有效原子序数、碘基值以及能谱曲线斜率与疗效均为负相关关系（r=-0.413、-0.628、-0.527、-0.385,均P<0.05）。结论　256排能谱CT成像参数用于肺腺癌诊断有一定价值,能够反映患者疗效,可以作为患者病情诊断以及疗效评估的参考依据。     

Revolution CT虚拟平扫在直肠癌诊断中的应用价值研究

目的 研究Revolution CT虚拟平扫在直肠癌诊断中的应用价值。方法 搜集2017年10月至2018年7月在该院手术治疗并于术前行Revolution CT常规能谱平扫及双期虚拟平扫的70例直肠癌患者影像资料。对常规能谱平扫及双期虚拟平扫的图像质量进行主观评分及客观评价[计算对比噪声(CNR)],对直肠癌病灶的诊断准确性(包括对直肠癌肠壁厚度、浆膜面的受累情况、直肠癌周围淋巴结显示情况的评价)及扫描剂量进行评估，并进行对比研究。结果 常规能谱平扫及双期虚拟平扫图像质量主观评分比较，差异无统计学意义(P>0.05)。双期虚拟平扫CNR值均高于常规能谱平扫，差异有统计学意义(P<0.05)。常规能谱平扫及双期虚拟平扫对直肠癌肠壁厚度判断、浆膜面的受累情况、直肠癌周围淋巴结显示情况比较，差异均无统计学意义(P>0.05)。常规能谱平扫有效剂量值低于双期虚拟平扫，差异有统计学意义(P<0.05)。双期增强扫描分离出虚拟平扫图像，可以减少约30%辐射剂量。结论 在直肠癌诊断时，Revolution CT虚拟平扫代替常规能谱平扫可以在减少辐射剂量的同时满足临床诊断需求...     

胃癌和胃淋巴瘤的cT表现对比分析

目的：比较胃癌及胃淋巴瘤的CT表现，以提高临床胃淋巴瘤及胃癌的鉴别诊断水平。方法选择2011年1月至2013年1月在我院进行治疗49例进展期胃癌及49例胃淋巴瘤患者作为观察对象，分别为胃癌组及胃淋巴瘤组，回顾性分析二组患者的CT资料，比较二组患者的CT表现。结果胃癌患者CT下见胃黏膜溃疡者为49例（100%），胃淋巴瘤见胃黏膜溃疡者为2例（4.08%），胃癌近胃腔表面见“白线”征者为41例（83.67%），胃淋巴瘤患者见“白线”征者为0例，胃壁侵犯范围＞75%的胃癌患者0例，胃壁侵犯范围＞75%的胃淋巴瘤患42例（85.71%），胃壁侵犯范围＜50%的胃癌患者49例（100%），胃壁侵犯范围＜50%的胃癌患者6例（12.24%）；2个区或以上的胃周淋巴结肿大的胃癌患者0例，2个区或以上的胃周淋巴结肿大的胃淋巴瘤患者22例（44.90%）；肾门下腹膜后淋巴结肿大的胃癌患者0例，肾门下腹膜后淋巴结肿大的胃淋巴瘤患者18例（36.73%）；二组相比有明显差异（P＜0.01），有统计学意义。胃癌患者胃壁厚度为8-35mm，平均厚度为16.9mm，胃淋巴瘤患者的胃壁厚度为7-52 mm，平均厚度为18.2mm，二组相比无明显差异（P＞0.05），无统计学意义。结论胃癌与胃淋巴瘤患者的CT表现中的胃黏膜溃疡，胃黏膜“白线”征，胃壁侵犯范围，肾门下腹膜后肿大淋巴结及2个区胃周肿大淋巴结分布有明显差异，可作为胃癌及胃淋巴瘤CT鉴别诊断标准。     

第二代双源CT虚拟平扫在上腹部增强检查中的应用

目的探讨第二代双源CT上腹部虚拟平扫的临床应用价值。方法对160例患者进行第二代双源CT上腹部增强检查,包括常规平扫、动脉期、门脉期及延时期双能量扫描。取动脉期图像,利用LiverVNC软件处理得到虚拟平扫CT图像,与常规平扫比较各组织CT值、噪声、信噪比、图像质量等方面的差异。结果常规平扫和虚拟平扫所测组织CT值、图像噪声、信噪比及图像质量差异均无统计学意义（P〉0．05）。结论第二代双源CT技术改进及软件升级后,上腹部增强扫描双能量成像中,虚拟平扫可以取代常规平扫,能够减少患者接受的辐射剂量,值得临床推广应用。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.