MRI及MSCT用于肝内胆管细胞癌临床诊断的效能分析

目的 分析磁共振成像(MRI)和多层螺旋计算机断层扫描(MSCT)对肝内胆管细胞癌(ICC)的诊断价值。方法 2017年3月至2022年3月徐州医科大学附属医院收治的原发性肝癌患者70例,患者均接受MRI和MSCT检查,以手术后组织病理学检查和穿刺活检为金标准,MRI、MSCT联合诊断时任意一种方法诊断为ICC即判定为ICC,评估MRI和MSCT单独及联合诊断ICC的效能。结果 病理诊断结果显示70例原发性肝癌患者中23例为ICC、47例为肝细胞癌(HCC)。MRI诊断结果显示,70例原发性肝癌中20例为ICC、50例为HCC。MRI诊断ICC的敏感度为69.6%、特异度为91.5%、准确率为84.3%、Kappa值为0.632。MSCT诊断结果显示,70例原发性肝癌中22例为ICC、48例为HCC。MSCT诊断ICC的敏感度为65.2%、特异度为85.1%、准确率为78.6%、Kappa值为0.509。MRI联合MSCT诊断结果显示,70例原发性肝癌中21例为ICC、49例为HCC。MRI联合MSCT诊断ICC的敏感度为82.6%、特异度为95.7%、准确率为91.4%、Kappa值...     

肝细胞癌早期诊断血清学标志物的研究进展

肝细胞癌(HCC)是一种发生率和致死率均较高的严重威胁人类健康的疾病。目前尚无一种血清学指标可以单独早期诊断HCC。总结了近年发现对HCC早期诊断有潜在价值的血清学标志物,并对其在诊断HCC的敏感性和特异性以及判断疾病进展等方面进行阐述,认为对HCC早期诊断应通过联合其他血清学标志物以弥补甲胎蛋白在敏感性方面的不足。     

GP73在肝脏疾病中表达的研究进展

高尔基体膜蛋白73(GP73)是一种相对分子质量为7.3×104的位于高尔基体的Ⅱ型跨膜糖蛋白,可在多种正常细胞中表达。现有的研究表明,GP73高表达与多种肝脏疾病有关,尤其是与肝细胞癌(HCC)密切相关,它有望成为一种新的肝细胞癌诊断标志物。     

原发性输卵管癌的超声诊断分析

原发性输卵管癌是妇科肿瘤中最少见的一种恶性肿瘤。由于该病临床症状不典型,早期诊断往往有一定困难。本文对6例原发性输卵管癌患者的超声图像进行回顾性分析,旨在提高对原发性输卵管癌的认识,以便对患者及早诊断、及早治疗,延长他们的寿命,提高他们的生存质量。     

前列腺特异抗原在前列腺癌诊断中的临床意义

目的探讨前列腺特异性抗原(PSA)在前列腺癌诊断中的敏感性和特异性。方法收集我院患者,其中前列腺癌30例;前列腺增生与肥大50例,并取正常人50例为阴性对照。然后分别对他们采取血液进行PSA水平的定量检测,比较3组PSA的含量。结果前列腺癌组阳性率为96.7%;敏感性为100%;特异性为96.7%。结论 PSA阳性结果可以诊断为前列腺癌或前列腺增生与肥大,PSA的阴性结果可排除前列腺癌。PSA可作为一种高度敏感性和特异性的血液标记物,可以早期诊断前列腺癌和前列腺增生与肥大。     

CEA在人原发性肝癌血清及癌组织中表达的意义

癌胚抗原(CEA)是一种重要的肿瘤胚胎蛋白，目前已成为多种恶性肿瘤的重要标记物，广泛地应用于原发性肿瘤及转移性肿瘤的诊断和研究中。本研究旨在通过检测CEA在原发性肝癌患者血清和肝癌组织中的表达，探讨CEA在血清和肝癌组织中表达的相互关系，为临床原发性肝癌的诊断提供一定的参考依据。     

肺不典型类癌诊治分析并文献复习

目的探讨肺不典型类癌诊断和治疗的临床特点。方法报告2例肺不典型类癌并复习相关文献。结果2例以咳嗽咳痰为主的患者，通过X胸片、胸部CT等检查，初步诊断为肺癌，行外科手术治疗。病理组织学诊断为肺不典型类癌。术后恢复良好，随访12个月无复发。结论肺不典型类癌是一种少见疾病，临床医生应充分认识这一疾病的特点，并在肺部肿块病变中认真加以鉴别。     

超声诊断肝细胞癌破裂出血的研究进展

超声作为一种实时、便捷的检查手段，被广泛用于肝细胞癌破裂出血急诊或床旁诊断。近些年发展起来的超声造影技术目前成为快速诊断肝细胞癌破裂出血的首选方法。本文对超声诊断肝细胞癌破裂出血的研究进展进行综述。     

Barrett食管的近代诊断和治疗

Barrett's Esophagus(简科BE)是指食管下段的复层鳞状上皮被单层柱状上皮替代的一种病理现象。这种病变由英国病理学家Barrett氏于1950年首先描述,1957年被正式命名。随着诊断技术不断提高,本病的发现也日渐增多,而且与食管腺癌的发生密切相关,是食管腺癌的一种癌前病变,近年来国外已广泛重视。本病的发病率并不少见,常规尸检中发现率12％,大多数文献报道为2～20％。其发病年龄自出生1个月至92岁均有报道。平均年龄为35岁,男性多发。     

GGT-Ⅱ与AFP对原发性肝癌诊断价值的比较

为了正确评价γ-谷氨酰转肽酶同工酶Ⅱ(GGT-Ⅱ)在原发性肝癌(PHC)诊断中的地位,我们采用AFP和GGT-Ⅱ联合检测336例肝内外良恶性疾病患者。PHC组58例,GGT-Ⅱ和AFP阳性例数分别为51例(87.9％)和35例(60.3％);良性肝病组162例,阳性率分别为21.0％和17.9％;肝外肿瘤组,阳性率分别为4.0％和1.0％。经统计学处理,GGT-Ⅱ和AFP对PHC诊断的敏感性差异有显著性意义(P<0.005);特异度和诊断符合率两者无显著性差异(P>0.05)。另外,血清AFP水平与GGT-Ⅱ阳性之间无明显相关性。结果表明,血清GGT-Ⅱ可作为PHC的一种新的特异诊断方法和指标,具有较高的临床参考价值。敏感性优于AFP,特异性与诊断符合率与血清AFP无显著差异。血清GGT-Ⅱ和AFP联合检测可提高对PHC的检出率。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.