皮质下动脉硬化性脑病的临床与CT特征

目的 分析皮质下动脉硬化性脑病（SAE））的临床及CT特点。方法 经临床及CT诊断的SAE42例。根据Goto分型将CT分为Ⅰ、Ⅱ、Ⅲ型，用MMSE评分将患者认知功能进行评估。结果 ①SAE脑白质的缺血程度与年龄有一定的关系（p〈0．05），随着年龄的增长，脑白质缺血程度愈重。②认知功能障碍的程度与脑白质损害范围有关系（p〈0．05），脑白质损害范围愈大，认知功能障碍愈重。结论 SAE常见于60岁以上的老人，早期存在智能障碍，逐渐发展为痴呆，应结合CT，提高对本病的早期诊断。     

皮质下动脉硬化性脑病的临床与CT特征

目的分析皮质下动脉硬化性脑病(SAE))的临床及CT特点.方法经临床及CT诊断的SAE 42例.根据Goto分型将CT分为Ⅰ、Ⅱ、ⅢⅡ型,用MMSE评分将患者认知功能进行评估.结果①SAE脑白质的缺血程度与年龄有一定的关系(p＜0.05),随着年龄的增长,脑白质缺血程度愈重.②认知功能障碍的程度与脑白质损害范围有关系(p＜0.05),脑白质损害范围愈大,认知功能障碍愈重.结论SAE常见于60岁以上的老人,早期存在智能障碍,逐渐发展为痴呆,应结合CT,提高对本病的早期诊断.     

皮质下动脉硬化性脑病患者智力变化的研究

皮质下动脉硬化性脑病患者智力变化的研究吕涌涛，曹克涌山东省交通医院神经内科，山东医科大学附院神经内科戴郑生山东省精神卫生中心皮质下动脉硬化性脑病（ＳｕｂｃｏｒｔｉｃａｌＡｒｔｅｒｉｏｓｃｌｅｒｏｔｉｃＥｎｃｅｐｈａｌｏｐａｔｈｙ，ＳＡＥ），亦称Ｂｉｎ...     

皮质下动脉硬化性脑病患者CT，TCD与智力的关系

皮质下动脉硬化性脑病患者ＣＴ、ＴＣＤ与智力的关系周仕钧湖南湘潭市第一人民医院神经内科皮质下动脉硬化性脑病（Ｓｕｂｃｏｒｔｉｃａ１ＡｒｔｅｒｉｏｓｃｌｅｒｏｔｉｃＥｎｃｅｐｈａｌｏｐａｔｈｙ）于１８９４年由Ｂｉｎｓｗａｎｇｅｒ首先报告，故被称之为Ｂｉｎ...     

皮质下动脉硬化性脑病相关危险因素及临床特点分析（综述）

皮质下动脉硬化性脑病（subcortical arteriosclerotic encephalopathy，SAE）又称Binswanger病（Binswanger＇s disease，BD）或慢性进行性皮质下脑病，是一种老年性脑血管疾病，是脑血管性痴呆的主要原因之一，极大地损害了老年人的身心健康。同时，由于SAE伴发的痴呆、运动障碍等也给社会、家庭造成了极大的负担。     

皮质下动脉硬化性脑病17例临床分析（附2家系报告）

皮质下动脉硬化性脑病又称为Binswanger病(BD)。早在1894年Binswanger就对该病作了首次报道。162年Olszewski就提出了“皮质下动脉硬化脑病”这一概念。本文就1991年1月～1994年1月225例急性脑梗塞患者中17例BD的临床表现及CT、MR／之特征做一分析讨论。     

皮层下动脉硬化性脑病的CT诊断与分析(附120例)

目的 探讨皮层下动脉硬化性脑病(SAE)的颅脑CT诊断价值.方法 选择经颅脑CT检查结合临床资料确诊的病例120例,进行回顾性分析.结果 本病常见于60岁以上的老人,CT特点为双侧侧脑室周围脑白质及半卵园中心脑白质对称影,病变模糊不清,可伴有腔隙性脑梗塞和脑萎缩.结论 结合临床材料,颅脑CT检查可以对SAE作出早期诊断,有助于早期治疗.     

皮质下动脉硬化性脑病血压及心率变异性分析

目的和方法：采用动态检测技术观察３１例皮质下动脉硬化性脑病和对照组３１例健康人血压和心率的变异性。结果：患者均存在动态血压异常，其中平均收缩压、平均舒张压超过正常值者２７例（８７％），夜间基底血压异常升高２２例（７１％），血压异常波动２０例（６４％），昼夜节律逆转４例（１３％）。患者心率变异时域指标２４小时内全部正常心动周期的标准差、２４小时内５分钟节段平均正常心动周期的标准差、在一定时间内相邻两正常心动周期差值大于５０毫秒的个数所占的百分比均明显低于对照组，收缩压与心率无显著相关性。结论：提示血压波动及持续的夜间升压现象在该病中起着一定作用，而这种异常可能与患者植物神经系统功能失调有关     

超声与MRI诊断乳腺癌及不同病理分型影像特点分析

探讨超声与MRI诊断乳腺癌的效果及不同病理分型影像特点。方法:比较分析112例疑似乳腺癌表现患者的超声、MRI及联合检查诊断效果及病理分型情况。结果:超声、MRI及联合诊断对乳腺癌的检出率并无统计学差异（90.36% vs 95.18% vs 98.80%, P>0.05）;联合诊断漏诊率和误诊率均显著低于超声诊断（1.79% vs 13.39%,0.89% vs 6.25%, P<0.05）;联合诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值均显著高于超声诊断（97.59% vs 81.93%, 96.55% vs 75.86%, 97.32% vs 80.36%, 98.78% vs 90.67%, 93.33% vs 59.46%, P<0.05）;联合诊断准确率显著高于MRI诊断（97.32% vs 89.29%, P<0.05）;超声与MRI图像特征与病理分型有一定联系,二者与手术病理结果符合率较高。结论:超声与MRI联合诊断乳腺癌能够提高诊断准确率,二者图像特征能够为乳腺癌诊断和病理分型判断提供良好依据。     

A reliable and efficient high resolution typing method for HLA-C using sequence-based typing

Abstract: Serological typing of HLA-C has been poor and almost half of its alleles are serologically undetectable blanks in most populations. Therefore, DNA typing techniques have been used to identify and type for the HLA-C gene. Sequence-based typing (SBT) has proven a major typing strategy for highly polymorphic HLA genes. The technique enables direct identification of all sequence motifs without the need to continuously adjust primers. Here we describe a reliable solid-phase SBT strategy for HLA-C which can be used to distinguish all currently known HLA-C alleles without prior knowledge gained by low resolution typing. Exons 2 and 3 were amplified and sequenced and if necessary sequences of exons 1 and 5 were determined. A total of 257 individuals were typed for HLA-C using this protocol and 30 of the 42 known HLA-C alleles were detected. All heterozygous combinations found in this study were unambiguously discriminated.
One hundred and forty-four individuals from the Dutch population were typed randomly. In this group Cw*0701 and *0702 were the most frequently detected alleles. Of the serological Cw blank alleles Cw*1203 was found to have the highest frequency (16%). From the total group 212 individuals were typed serologically and 106 were retyped with 97 selected antisera to further compare serological and molecular defined phenorypes. Discrepancies between serological typing and SBT are mainly attributable to the serologically Cw blank alleles Cw*12–18.
The high resolution SBT protocol described will be a valuable tool for the identification of HLA-C alleles and the determination of the role of HLA-C in marrow and organ transplantation.     

肝性脊髓病7例颅脑MRI表现及临床意义

目的分析肝性脊髓病（HM）患者颅脑MRI表现并讨论其临床意义。方法确诊为HM男性患者7例,年龄33～58岁。有慢性肝硬化病史1～11年,乙肝后肝硬化4例,丙肝后肝硬化1例,慢性酒精性肝硬化2例,其中曾行脾切除及门脉分流术4例。所有患者均行GE1．5T超导MRI常规扫描、颅脑CT、MRI、肝功能和血氨等检查,4例行脊髓MRI。结果7例患者中颅脑CT有轻度脑萎缩2例,脊髓MRI无异常信号4例。MRI扫描结果,7例颅脑对称性双侧苍白球、3例于中脑大脑脚及内囊前肢T1WI像不同程度的高信号,7例T2WI像和FLAIR无异常表现。结论HM时颅脑MRI苍白球特征性改变是T1WI高信号,脊髓MRI变化不明显,这一变化有助于HM的诊断。     

血管腔内介入治疗下肢动脉硬化闭塞症40例

目的：探讨下肢动脉硬化闭塞症腔内治疗的临床经验。方法：采用血管腔内介入方法治疗下肢动脉硬化性闭塞症（ASO）患者40例（44条肢体）,包括髂动脉病变18例,其中单纯球囊扩张术（PTA）6例,内置支架术（PTA＋stenting）12例;股浅动脉病变13例,其中PTA5例,PTA＋stenting8例;腘动脉病变2例,行PTA治疗;膝下动脉病变7例,单纯deep球囊扩张,不放置支架。结果：本组无手术死亡。髂动脉18例手术全部获得成功;股浅动脉13例,11例获得成功,1例致血栓形成取栓治疗成功,1例介入失败转为人工血管转流手术;腘动脉2例获得成功;膝下动脉7例中5例获得成功。结论：血管腔内介入治疗下肢ASO,操作简单,短期效果良好,值得临床推广应用;     

Twenty-three years of Klebsiella phage typing: a review of phage typing of 12 clusters of nosocomial infections, and a comparison of phage typing with K serotyping

Objective   To review phage typing of 12 clusters of nosocomial Klebsiella infections which occurred between 1974 and 1997, and to compare phage typing and K serotyping.
Materials and methods   A total of 489 clinical and laboratory Klebsiella isolates were phage typed using 110 different phage preparations and K typed by counter current immunoelectrophoresis against 77 K antisera.
Results   A total of 152 phage types (PT) and 82 K types were found. Thirty-six phage types and 14 K types were represented only by the reference type strains. Of the remaining 68 K types, 60 could be subdivided into from two to 10 phage types . Ten out of 12 clusters of nosocomial Klebsiella infections could be verified as outbreaks by phage typing, whereas two clusters were found to be accumulations of sporadic cases. K typing performed retrospectively confirmed these results. In addition, for a subset of 104 epidemiologically unrelated isolates, O typing and pulsed field gel electrophoresis typing data were available. Based on these results the discriminative power of phage typing was found to be comparable with that of K typing, but phage types were less stable and reproducible.
Conditions   In an outbreak situation, phage typing was found to be very useful, although it seems less suitable for long-term surveillance purposes.     

Comparison of serological and molecular typing for HLA-A and -B on cord blood lymphocytes

Abstract: HLA class I typing by standard microcytotoxicity testing has been unsatisfactory for 14.5% of 1644 cord blood samples. In this study, we evaluated the capacity of PCR-SSP in solving problems in HLA-A,B typing with serological methods. With this aim we have compared serology with PCR-SSP in 100 cord blood samples with doubtful or unreliable HLA-A,B typing. PCR-SSP was successful in amplifying HLA-A,B alleles in all 100 cord blood samples. Forty-six typings gave discrepant results with the 2 methods (serology and PCR-SSP). Typings were considered discrepant also in the case of inability to define a split. For 19 specimens, no serological conclusion was drawn due to high mortality of the cell suspension, while PCR-SSP allowed the definition of a clear typing. In 6 cases it was necessary to infer information from serology to define the current typing. Finally, in 3 other cases it was impossible to exclude or attribute the antigen/allele B67 or B4802. PCR-SSP for HLA-A,B can improve the overall reliability of HLA-A,B typing requiring a small amount of blood although, with the set of sequence specific primers adopted, a number of alleles are still poorly defined.     

A new simplified method of gene typing

Abstract: SSP-PCR (sequence-specific primer) DNA typing was performed in Terasaki trays using 1.5 μ1 of DNA, and the ethidium-stained PCR product was measured by direct fluorometric reading. Elimination of the gel electrophoresis step greatly simplified the SSP method. 17 serological DR specificities were discriminated for 239 DNA samples utilizing the new method, standard SSP, sequence-specific oligonucleotide probe (SSOP), and restriction fragment length polymorphism (PCR-RFLP). Results showed 98% concordance between the SSP-PCR assay and conventional methods. DRB1 alleles were determined by PCR-RFLP in 59 samples, by SSP in 110 samples, and by consensus (all methods) in the remaining samples.     

椎管内肿瘤的MRI诊断与鉴别

目的根据常见椎管内肿瘤的MRI表现,对肿瘤定位、定性诊断进行探讨,提高MRI对常见椎管内原发肿瘤的定位定性诊断水平。方法:回顾性分析145例经病理证实的椎管内原发肿瘤的MRI表现。结果髓内肿瘤36例,35例定位诊断正确,25例定性诊断正确;髓外肿瘤109例,106例定位诊断正确,88例定性诊断正确。按解剖隔间定位诊断正确率97.2%,定性诊断正确率77.9%。结论MRI对常见椎管内原发肿瘤的诊断与鉴别诊断有有较高的价值。     

胸腹联合伤29例临床分析

目的：总结胸腹联合伤诊断与手术治疗的经验.方法：手术治疗胸腹联合伤患者29例,其中单纯剖胸手术6例,单纯剖腹手术12例,取剖腹＋剖胸两个切口手术9例,胸腹联合切口2例.8例于术前获得诊断,9例于术中探查确诊,2例延迟诊断.结果：29例中,手术治愈25例,术后死亡4例,病死率13.7﹪.结论：胸腹联合伤病情复杂凶险,及时准确的诊断和手术是挽救患者生命的关键,手术入路选择应视具体伤情而定.     

Inter-laboratory assessment of PrPSc typing in creutzfeldt-jakob disease: a Western blot study within the NeuroPrion Consortium

Molecular typing is of considerable importance for the surveillance and epidemiology of human transmissible spongiform encephalopathies (TSEs). It relies on the detection of distinct protease-resistant prion protein (PrP^Sc) core fragments that differ in molecular mass and/or glycoform ratio. In this collaborative study, we tested the inter-laboratory agreement in TSE molecular typing. Sixteen characterized brain specimens from sporadic TSEs and variant Creutzfeldt-Jakob disease (vCJD) cases were distributed blindly to seven laboratories for molecular characterization by a defined protocol and classification. Agreement between laboratories in the classification of samples was excellent. In particular, there were no differences in the distinction between PrP^Sc type 1, type 2A, and type 2B with one exception, which eventually was identified as a case with types 1 and 2 co-occurrence. This shows that the general technique and particular classification system used here are robust and represent a reliable basis for diagnostic and epidemiologic purposes. The subtle further distinction of subtypes among type 1 and type 2 groups requires high-sensitivity gel electrophoresis protocols that are unsuitable for routine diagnostic needs and must be reserved for research investigations. Further research is necessary on the identification and significance of co-occurrence of PrP^Sc types 1 and 2 within one brain.     

Analysis of HLA-A and -B serologic typing of bone marrow registry donors using polymerasee chain reaction with sequence-specific oligonucleotide probes and DNA sequencing

Unrelated volunteer donors (69) recruited by the National Marrow Donor Program were HLA typed by DNA-based methods for both the HLA-A and -B loci. Each donor had been previously typed by serology by at least two independent laboratories. Of the 69 samples, all serologic laboratories were in concordance for HLA-A in 62 typed samples and for HLA-B in 48 typed samples. Of the serologically concordant samples, 5 samples typed for HLA-A and 7 samples typed for HLA-B received DNA and serology types differing in their level of resolution. One sample typed for HLA-A and 3 samples typed for HLA-B by DNA methods gave different results from their serologic assignments. Of the samples exhibiting disparities among the different serologic typing laboratories, the DNA-defined types of 7 samples typed for HLA-A and 18 samples typed for HLA-B were consistent with at least one of the serologic assignments. The DNA types for the remaining 3 HLA-B typed samples did not agree with the serologic assignments and their alleles were subsequently sequenced. One of these sequences was a previously undefined allele, B*1537. Sharing of polymorphic sequences among HLA allelic products creates difficulties for consistent serologic assignments of some types complicating the process of identifying potential donors from bone marrow registries. Thus, the use of DNA-based typing techniques for characterization of donor class I types should allow a more consistent definition of types and should speed the donor selection process.