INTEGRATION OF TRADITIONAL AND MODERN METHODS IN THE IDENTIFICATION OF AFB CULTURES ISOLATED FROM CLINICAL SPECIMENS OF PATIE

ＩＮＴＥＧＲＡＴＩＯＮＯＦＴＲＡＤＩＴＩＯＮＡＬＡＮＤＭＯＤＥＲＮＭＥＴＨＯＤＳＩＮＴＨＥＩＤＥＮＴＩＦＩＣＡＴＩＯＮＯＦＡＦＢＣＵＬＴＵＲＥＳＩＳＯＬＡＴＥＤＦＲＯＭＣＬＩＮＩＣＡＬＳＰＥＣＩＭＥＮＳＯＦＰＡＴＩＥＮＴＳＷＩＴＨＳＫＩＮＤＩＳＥＡＳ...     

CLINICAL SIGNIFICANCE OF THE DETERMINATION OF SOLUBLE INTERLEUKIN－2 RECEPTOR IN PATIENTS WITH THYROID DISORDERS

ＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＯＦＴＨＥＤＥＴＥＲＭＩＮＡＴＩＯＮＯＦＳＯＬＵＢＬＥＩＮＴＥＲＬＥＵＫＩＮ－２ＲＥＣＥＰＴＯＲＩＮＰＡＴＩＥＮＴＳＷＩＴＨＴＨＹＲＯＩＤＤＩＳＯＲＤＥＲＳＷａｎｇＤｅｑｕａｎ（王德全）ＷａｎｇＸｉｕｗｅｎ（王...     

THE MEASUREMENT AND APPLICATION OF TSH-IRMA LEVELS AMONG DIFFERENT AGE GROUPS IN AREAS WITH IODINE DEFICIENCY DISORDERS

ＴＨＥＭＥＡＳＵＲＥＭＥＮＴＡＮＤＡＰＰＬＩＣＡＴＩＯＮＯＦＴＳＨ－ＩＲＭＡＬＥＶＥＬＳＡＭＯＮＧＤＩＦＦＥＲＥＮＴＡＧＥＧＲＯＵＰＳＩＮＡＲＥＡＳＷＩＴＨＩＯＤＩＮＥ　ＤＥＦＩＣＩＥＮＣＹ　ＤＩＳＯＲＤＥＲＳＳｈｉＬｉｘｉｎ（时立新）；ＳｈｉＺｈｏ...     

CORRELATION BETWEEN THE NUMBER OF MITOTIC FIGURES AND THE PERCENTAGE OF Ki67-POSITIVE CELLS IN NON-HODGKIN’S LYMPHOMAS

ＣＯＲＲＥＬＡＴＩＯＮＢＥＴＷＥＥＮＴＨＥＮＵＭＢＥＲＯＦＭＩＴＯＴＩＣＦＩＧＵＲＥＳＡＮＤＴＨＥＰＥＲＣＥＮＴＡＧＥＯＦＫｉ６７－ＰＯＳＩＴＩＶＥＣＥＬＬＳ　ＩＮＮＯＮ－ＨＯＤＧＫＩＮ’ＳＬＹＭＰＨＯＭＡＳＨｕａｎｇＧａｏｓｈｅｎｇ；（黄高升）Ｆｅ...     

A NEW FUNCTIONAL CLASSIFICATION OF STOMACH CANCER AND ITS PATHOBIOLOGICAL AND CLINICAL SIGNIFICANCE

ＡＮＥＷＦＵＮＣＴＩＯＮＡＬＣＬＡＳＳＩＦＩＣＡＴＩＯＮＯＦＳＴＯＭＡＣＨＣＡＮＣＥＲＡＮＤＩＴＳＰＡＴＨＯＢＩＯＬＯＧＩＣＡＬＡＮＤＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥ￥ＸｉｎＹａｎ（辛彦）；ＺｈａｏＦｅｎｇｋａｉ（赵风凯）；ＧｏｎｇＷｅｉ（宫...     

EFFECT OF CHRONIC ACE INHIBITION ON GLUCOSE TOLERANCE AND INSULIN SENSITIVITY IN HYPERTENSIVE TYPE 2 DIABETIC PATIENTS

ＥＦＦＥＣＴＯＦＣＨＲＯＮＩＣＡＣＥＩＮＨＩＢＩＴＩＯＮＯＮＧＬＵＣＯＳＥＴＯＬＥＲＡＮＣＥＡＮＤＩＮＳＵＬＩＮＳＥＮＳＩＴＩＶＩＴＹＩＮＨＹＰＥＲＴＥＮＳＩＶＥ　ＴＹＰＥ２ＤＩＡＢＥＴＩＣＰＡＴＩＥＮＴＳＹｉｎＷｅｉｄｏｎｇ；（尹卫东）Ｇ．Ｓｅｇｈ...     

THE VARIATION OF INTRASEROUS NEURON—SPECIFIC ENOLASE IN THE PATIENTS WITH CORTICAL CONTUSION

ＴＨＥＶＡＲＩＡＴＩＯＮＯＦＩＮＴＲＡＳＥＲＯＵＳＮＥＵＲＯＮＳＰＥＣＩＦＩＣＥＮＯＬＡＳＥＩＮＴＨＥＰＡＴＩＥＮＴＳＷＩＴＨＣＯＲＴＩＣＡＬＣＯＮＴＵＳＩＯＮＹａｎｇＹａｎｇ（杨扬）；ＨｅＳｈｏｕｊｉａｎ（何守俭）；ＷｕＣｈｅｎｇｙｕａｎ（吴承远）...     

BONE REMODELING AFTER INTERNAI FIXATION WITH PLATES OF VARYING DEGREES OF STIFFNESS：A QUANTITATIVE HISTOLOGICAL ANALYSIS

ＢＯＮＥＲＥＭＯＤＥＬＩＮＧＡＦＴＥＲＩＮＴＥＲＮＡＩＦＩＸＡＴＩＯＮＷＩＴＨＰＬＡＴＥＳＯＦＶＡＲＹＩＮＧ　ＤＥＧＲＥＥＳＯＦＳＴＩＦＦＮＥＳＳ：ＡＱＵＡＮＴＩＴＡＴＩＶＥ　ＨＩＳＴＯＬＯＧＩＣＡＬ　ＡＮＡＬＹＳＩＳＣｈｅｎＹｏｎｇｑｉａｎｇ；（陈...     

EXPRESSION OF P53 GENE IN ORAL SQUAMOUS CELL CARCINOMA AND ITS RELATION WITH CLINICAL AND PATHOLOGICAL PARAMETERS AND PROGNOS

ＥＸＰＲＥＳＳＩＯＮＯＦＰ５３ＧＥＮＥＩＮＯＲＡＬＳＱＵＡＭＯＵＳＣＥＬＬＣＡＲＣＩＮＯＭＡＡＮＤＩＴＳＲＥＬＡＴＩＯＮＷＩＴＨＣＬＩＮＩＣＡＬＡＮＤＰＡＴＨＯＬＯＧＩＣＡＬＰＡＲＡＭＥＴＥＲＳＡＮＤＰＲＯＧＮＯＳＩＳＯＦＰＡＴＩＥＮＴＳＭａｏＣｈｉ...     

EVALUATION OF CAPTOPRIL RENOGRAPHY WITH~（99m）Tc－MAG_3 IN THE DIAGNOSIS OF RENOVASCULAR HYPERTENSION

ＥＶＡＬＵＡＴＩＯＮＯＦＣＡＰＴＯＰＲＩＬＲＥＮＯＧＲＡＰＨＹＷＩＴＨ~（９９ｍ）Ｔｃ－ＭＡＧ_３ＩＮＴＨＥＤＩＡＧＮＯＳＩＳＯＦＲＥＮＯＶＡＳＣＵＬＡＲ　ＨＹＰＥＲＴＥＮＳＩＯＮＫａｎｇＺｅｎｇｓｈｏｕ；（康增寿）ＣｈｅｎＦａｎｇ；（陈方）ａｎｄＷａ...     

Real-time Three-Dimensional Color Doppler Flow Imaging： An Improved Technique for Quantitative Analysis of Aortic Regurgitation

The recently introduced real-time three-dimensional color Doppler flow imaging （RT-3D CDFI） technique provides a quick and accurate calculation of regurgitant jet volume （RJV） and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction （RJF） in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes （LVEDV）, end-systolic volumes （LVESV） and RJV, and then RJF could be calculated. The regurgitant volume （RV） and regurgitant fraction （RF） calculated by two-dimensional pulsed Doppler （2D-PD） method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements （r= 0.93, Y=0.89X＋ 3.9, SEE= 8.6 mL, P〈0.001 ）; the mean （SD） difference between the two methods was - 1.5 （9.8） mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method （r=0.88, Y=0.71X＋ 14.8, SEE= 6.4 %, P〈0. 001）; the mean （SD） difference between the two methods was -1.2 （7.9） %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.     

64排螺旋CT与磁共振成像评价右心功能的比较研究

目的 以磁共振为对照,应用64排螺旋CT定量评价右心室功能,探讨两项技术心功能评价指标的相关性及64排螺旋CT在右心功能评价中的应用价值.方法 30名健康成年志愿者(男15名、女15名,年龄48±24岁),均自愿参加.全部志愿者均于24 h内行心脏MSCT和MRI检查.采用CT增强心脏扫描原始图像,进行右室短轴多平面重建(muhiplannar recon-struction,MPR).重建时间间隔为5%R-R间期,整个心动周期共重建0～95%共20个相位,获得20～26层连续的垂直于室间隔的右心室短轴图像.将短轴图像输入图像工作站用GE心功能分析软件进行心功能测量.最终获得舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)及射血分数(EF)等心功能参数.与MR多次屏气电影法测得的右心功能指标进行Pearson相关分析检验,并采用Bland-Ahman法评价两种测量方法的一致性.结果 MSCT短轴MPR法测得的心功能指标平均EDV(146±27)ml,平均ESV(70±20)ml,SV(75±12)ml,EF(52%±5%)与MR多次屏气电影法测得的心功能指标比较,EDV(146±25)mll(r=0.959),ESV(66±17)ml(r=0.914),sv(80±15)ml(r=0.706),EF(55%±7%)(r=0.612),差异均无统计学意义,显示出高度相关性.Bland-Altman图显示出MSCT短轴MPR法与MR多次屏气电影法测得右心功能指标具有高度相关性.结论 本研究显示64排螺旋CT与1.5 T磁共振评价右心功能各指标之间相关性高,在右心功能定量评价方面准确、可靠.     

CT灌注与MRI增强在脑膜瘤术前分型的作用

目的比较CT灌注成像与MRI增强检查对脑膜瘤分型的价值.方法对23例经手术病理证实的脑膜瘤患者行CT血流灌注成像及MRI增强扫描,计算肿瘤实质强化区的T1强化率,CT原始图像推经灌注软件处理获得灌注参数.结果 MRI增强检查纤维型、血管瘤型及上皮型脑膜瘤的T1强化程度有显著性差异.各型脑膜瘤的血容量、血流量、血管通透性间存在统计学差异.水肿程度与血管通透性的Spearman秩相关分析有显著相关性(r=0.676,P<0.01).肿瘤实质区血容量、血流量、血管通透性与相应T1强化率比较,所得Pearson相关系数分别为0.937、0.917、0.753(P<0.05).结论脑膜瘤MR T1强化率与CT血流灌注间具有明显的正相关,两者对脑膜瘤的术前分型均有一定诊断价值,但CT灌注能够在术前提供更详细明确的血液动力学信息.     

实时三维超声心动图评价心肌梗死合并室壁瘤患者左心室容积及射血分数

目的:探讨实时三维超声心动图(RT-3DE)定量评价心肌梗死合并室壁瘤患者左心室容积及射血分数的可行性及准确性.方法:应用RT-3DE、常规超声心动图双平面Simpson's法和M型超声心动图Teichholz法测量23例心肌梗死合并室壁瘤患者左心室舒张末期容积(LVEDV)、收缩末期容积(LVESV)、每搏量(SV)及射血分数(EF),以左心室造影为参考标准.结果:RT-3DE测量所得LVEDV、LVESV、SV、EF与左心室造影结果具有良好的相关性,r分别为0.92、0.90、0.88、0.91(P均＜0.001),LVEDV、LVESV、SV、EF测值均较左心室造影略小,但两者无显著性差异.二维超声心动图的双平面Simpson's法与左心室造影具有良好的相关性,r分别为0.85、0.87、0.86、0.91(P均＜0.001),LVEDV、LVESV、SV、EF测值均较左心室造影小,双平面Simpson's法与左心室造影测得的LVEDV、LVESV之间有显著差异(P＜0.05),但两者的SV、EF之间无差异;M型超声心动图Teichholz法与左心室造影结果具有一定的相关性,r分别为0.73、0.71、0.70、0.65(P均＜0.05),LvEDV、LVESV、SV、EF测值均较左心室造影大(P＜0.05或P＜0.01).结论:RT-3DE较常规超声心动图能更准确地评价心肌梗死伴室壁瘤患者左心室容积及EF.     

PiCCO血流动力学监测在肺移植患者中的应用

目的评价脉搏指示连续心排出量（PiCCO）技术在肺移植术中血流动力学监测的作用。方法20例终末期肺病患者行肺移植术,同时运用PiCCO和Swan-Ganz肺动脉漂浮导管（PAC）对术中6个时间点的血流动力学指标进行监测。分别比较胸腔内血容量指数（ITBVI）、肺动脉嵌顿压（PAWP）与每搏量指数（SVIpa）的相关性,以及相邻时间点变化值间（分别用Δ1～Δ5表示）的相关性,并运用Bland-Altman法对两种方法测得的心排指数（CI）进行一致性检验。结果ITBVI与SVIpa呈正相关（r=0.654,P〈0.05）,而PAWP与SVIpa无显著相关性（P〉0.05）。术中相邻时间点ITBVI的变化也与SVIpa变化成正相关（Δ1,r=0.621;Δ2,r=0.784;Δ3,r=0.713;Δ4,r=0.740;Δ5,r=0.747;P均〈0.05）,PAWP的变化与SVIpa变化无明显相关性（P〉0.05）。两种方法测得的CI平均偏离度为（0.09±0.5）L·min-1.m-2,一致性界限为（-0.89～1.07）L·min-1.m-2。结论在肺移植手术中PiCCO和PAC监测心脏前负荷的变化具有较好的相关性,PiCCO能够反映肺移植中血流动力学的变化。     

磁共振灌注成像及表观扩散系数图预测超急性期脑梗死患者亚急性期梗死体积的对比研究

目的：对比分析基于超急性期表观扩散系数（ADC）图及磁共振灌注成像（PWI）预测亚急性期（发病后5～7 d）脑梗死体积的临床可行性。方法：回顾性分析发病6 h内完成多模式磁共振成像（MRI）检查并于发病后5～7 d复查常规MR检查的超急性期脑梗死患者20例。应用美国GE Healthcare 3.0 T超导MR扫描仪后处理工作站自带的专用后处理软件进行图像上异常区域体积的测量。经相关和回归分析及ROC曲线分析,比较基于PWI和ADC图这2种方法预测亚急性期梗死体积及梗死体积增长之间的差异。结果：ADC图、脑血流量（CBF）图、脑血容量（CBV）图、平均通过时间（MTT）图、达峰时间（TTP）图预测梗死体积值与复查液体衰减反转恢复（FLAIR）异常区域体积值之间均呈显著线性相关（P均＜0.05）。其中ADC图预测梗死体积与V2之间的相关性（r=0.954）比PWI各参数图预测梗死体积与V2间的相关性高（P均＜0.05）。ADC不匹配与梗死体积增长间呈明显线性相关（r=0.744,P=0.001）;而CBF不匹配、CBV不匹配、MTT不匹配、TTP不匹配与梗死体积增长间均无明显直线相关关系。结论：采用设备自带后处理软件,基于超急性期ADC图预测亚急性期梗死体积及梗死体积增长的方法比基于PWI各参数图的方法可行性更强,可作为临床早期预测梗死体积变化的简便方法。     

三维超声心动图结合声学造影测量正常人右室心搏量的研究

目的 评价三维超声心动图结合右心声学造影技术测量正常人右室心搏量的准确性.方法 应用三维超声诊断仪对15例健康自愿者分别采集无造影、经静脉右心造影的心尖长轴全容积三维数据库,脱机后应用容积分析软件进行后处理分析,运用8个平面勾画右室内膜面,测量右室舒张末期容积(RVEDV)与收缩末期容积(RVESV),计算右室每搏量(RVSV),同时用多普勒频谱法计算左室每搏量(LVSV),进行左右每搏量对照分析.结果 运用右心声学造影后,右室内膜面显示更为清晰,可重复性增加.RT3DE有造影测得的RVSV与多普勒频谱法测得的LVSV之间具有很好的相关性(r＝0.894),而无造影下的相关性要低于有造影(r＝0.758).LVSV与三维超声心动图有造影的RVSV比较差异无显著性(P＞0.05);与三维超声心动图无造影的RVSV之间差异有显著性(P＜0.05).结论 右心声学造影技术可以提高三维超声心动图测量正常人右室心搏量的准确性.     

利用R2~*、T2~*值无创评估肝细胞癌血氧水平与血管生成及其成熟度的关系

目的 研究肝细胞癌(HCC)血管生成及其成熟度与磁共振成像(MRI)去氧血红蛋白参数T2~*、R2~*值及病灶/肌肉T2~*、R2~*比值关系.方法 选取行手术切除并经病理证实的肝细胞癌患者31例,术前行MRI扫描并计算T2~*、R2~*值及病灶/肌肉T2~*、R2~*比值;术后在与MRI感兴趣区相同位置取材,采用免疫组织化学技术检测血管内皮生长因子(VEGF)及其受体Flk-1表达情况和增殖细胞核抗原(PCNA)指数,病理图像自动分析系统统计微血管和成熟血管数目、平均面积、总面积、周长、直径、异型指数、血管间距,及动脉数、静脉数、血管成熟指数和平均灌注分数等.将T2~*、R2~*值及病灶/肌肉T2~*、R2~*比值与各个血管参数进行对照分析.结果 病灶边缘和中心的T2~*、R2~*值及其病址/肌肉T2~*、R2~*比值与肝脏间差异有统计学意义(P<0.05),但在病灶边缘与中心间及不同病理分级间差异均无统计学意义(P>0.05).VEGF阳性组T2~*值及其病灶/肌肉比值明显低于阴性组(P<0.05).HCC的T2~*值与微血管数目呈负相关(P=0.047,r=-0.639),与平均灌注分数呈正相关(P=0.040,r=0.655);其病灶/肌肉比值也与平均灌注分数呈正相关(P=0.048,r=0.640).R2~*值分别与微血管平均面积(P=0.028,r=0.688)、总面积(P=0.021,r=0.712)和周长(P=0.037,r=0.663)呈正相关,与平均灌注分数呈负相关(P=0.024,r=-0.702);其病灶/肌肉比值分别与微血管平均面积(P=0.043,r=0.647)和周长(P=0.026, r=0.694)呈正相关.结论 HCC新生血管形态异常导致的去氧血红蛋白变化可能影响T2~*、R2~*值.     

Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial

CONTEXT: Exercise training in patients with chronic heart failure improves work capacity by enhancing endothelial function and skeletal muscle aerobic metabolism, but effects on central hemodynamic function are not well established. OBJECTIVE: To evaluate the effects of exercise training on left ventricular (LV) function and hemodynamic response to exercise in patients with stable chronic heart failure. DESIGN: Prospective randomized trial conducted in 1994-1999. SETTING: University department of cardiology/outpatient clinic in Germany. PATIENTS: Consecutive sample of 73 men aged 70 years or younger with chronic heart failure (with LV ejection fraction of approximately 0.27). INTERVENTION: Patients were randomly assigned to 2 weeks of in-hospital ergometer exercise for 10 minutes 4 to 6 times per day, followed by 6 months of home-based ergometer exercise training for 20 minutes per day at 70% of peak oxygen uptake (n=36) or to no intervention (control group; n=37). MAIN OUTCOME MEASURES: Ergospirometry with measurement of central hemodynamics by thermodilution at rest and during exercise; echocardiographic determination of LV diameters and volumes, at baseline and 6-month follow-up, for the exercise training vs control groups. RESULTS: After 6 months, patients in the exercise training group had statistically significant improvements compared with controls in New York Heart Association functional class, maximal ventilation, exercise time, and exercise capacity as well as decreased resting heart rate and increased stroke volume at rest. In the exercise training group, an increase from baseline to 6-month follow-up was observed in mean (SD) resting LV ejection fraction (0.30 [0.08] vs 0.35 [0.09]; P=.003). Mean (SD) total peripheral resistance (TPR) during peak exercise was reduced by 157 (306) dyne/s/cm(-5) in the exercise training group vs an increase of 43 (148) dyne/s/cm(-5) in the control group (P=.003), with a concomitant increase in mean (SD) stroke volume of 14 (22) mL vs 1 (19) mL in the control group (P=.03). There was a small but significant reduction in mean (SD) LV end diastolic diameter of 4 (6) mm vs an increase of 1 (4) mm in the control group (P<.001). Changes from baseline in resting TPR for both groups were correlated with changes in stroke volume (r=-0.76; P<.001) and in LV end diastolic diameter (r=0.45; P<.001). CONCLUSIONS: In patients with stable chronic heart failure, exercise training is associated with reduction of peripheral resistance and results in small but significant improvements in stroke volume and reduction in cardiomegaly. JAMA. 2000.     

磁共振灌注成像在术前星形细胞瘤血管形成在体研究中的价值

目的:研究星形细胞瘤磁共振灌注成像与肿瘤血管内皮细胞生长因子及肿瘤血管形成的相关性,评价磁共振灌注成像在术前肿瘤血管形成的在体研究中的价值。方法:术前进行MRI成像检查且经手术病理证实的34例星形细胞瘤患者,其中Ⅰ~Ⅱ级(低分级)26例,Ⅲ~Ⅳ级(高分级)8例。运用自旋回波-回波平面成像(SE-EPI)技术行MR灌注成像。采用免疫组化方法(SP法)检测34例人脑星形细胞瘤血管内皮细胞生长因子(VEGF)表达;Ⅷ因子相关抗原单克隆抗体免疫组织化学(SP法)染色显示微血管,测量微血管密度(MVD)表示肿瘤血管生成。结果:34例星形细胞瘤最大rCBV与其对应的VEGF表达水平和对应的MVD呈显著正相关(r=0.604,P<0.001;r=0.625,P<0.001);高分级星形细胞瘤最大rCBV、VEGF表达和MVD显著高于低分级星形细胞瘤(t=3.0,7.08,3.37;P=0.017,0.01,0.011)。结论:磁共振灌注成像在术前活体研究星形细胞瘤的肿瘤血管形成及评价肿瘤的良恶性和预后中很有价值。