绝经后乳腺浸润性导管癌超声表现与雌激素受体、孕激素受体表达的关系

目的探讨绝经后乳腺浸润性导管癌二维及彩色多普勒超声表现与雌激素受体(ER)、孕激素受体(PR)表达的关系,评价超声表现术前预测ER、PR表达的可行性。方法对空军总医院2002年6月-2007年6月收治的经手术病理最终证实的96例绝经后乳腺浸润性导管癌临床资料进行分析,比较超声声像图特征与术后标本免疫组织化学染色的ER、PR表达水平。结果ER、PR阳性表达率分别为54.17%(52/96)、50%(48/96)。ER、PR双阳性、双阴性表达率分别为41.67%(40/96)、37.5%(36/96),超声表现为蟹足状或毛刺状乳癌中,ER有较高的阳性表达率(P<0.05),内部回声不均质及后方有声衰减组乳癌中,ER、PR单阳性及共同阳性均有较高的表达(P<0.05)。当ER、PR共同阴性表达时,肿块内血流信号增多(P<0.05)。结论绝经后乳腺浸润性导管癌二维及彩色多普勒超声表现可大致反映ER、PR的表达水平,联合ER、PR的表达检测对判断预后及指导治疗具有临床价值。     

运动对大鼠胸主动脉损伤后c-myc、c-fos和p53表达的影响

采用原位杂交方法分析了大鼠胸主动脉损伤后原癌基因ｃ ｍｙｃ、ｃ ｆｏｓ和抗癌基因ｐ５３表达情况,并观察运动对其影响。结果表明：动脉损伤后ｃ ｆｏｓ、ｃ ｍｙｃ表达明显增加,ｐ５３表达下降;运动组ｃ ｆｏｓ和ｃ ｍｙｃ明显被控制,ｐ５３表达增强。研究结果提示运动对纠正原癌基因和抗癌基因表达失衡有作用,为运动防治平滑肌细胞过度增殖性疾病的分子生物学机制研究提供了线索     

中风康复期CT影像及其与康复关系研究

目的:明确中风恢复期、后遗症期的时间范围,探索其CT影像规律,并试对其康复前景作出评价,以指导临床治疗。方法:临床确诊中风病患者130例,在恢复期及后遗症期行CT扫描,研究其CT影像变化规律,结合其临床症状及体征,对远期康复作出评价。结果:中风恢复期以水肿消退、病变逐渐吸收为主要病理过程,CT表现主要为病灶的吸收、缩小,CT值的较快降低,脑室或中线结构的受压、移位情况恢复;中风后遗症期CT表现主要以病灶的软化、囊变、穿通畸形、脑萎缩为主,后遗症期病灶变化不大。结论:中风恢复期CT表现为病灶的恢复过程,是中风病患者远期良好恢复的关键时期,应在此期尽早开始功能锻炼;中风后遗症期CT表现为病灶稳定,此期的功能锻炼需持久系统进行,对远期恢复有一定帮助。     

肿瘤血管阻力指数和内径在乳腺良、恶性肿瘤鉴别中的应用

目的:探讨肿瘤血管阻力指数和内径对乳腺良、恶性肿瘤的鉴别诊断价值.材料和方法:应用彩色多普勒和频谱多普勒超声检测30例正常乳腺和120例乳腺肿瘤(良性66例,恶性54例),观察其血流分布,计测阻力指数(RI)和血管直径(D).结果:120例乳腺肿瘤中112例(良性60例,恶性52例)能检出血流信号,良性组与正常组相比,血管RI及D差异不显著(P＞0.05);恶性肿瘤组与正常组及良性肿瘤组比较,RI增高和D增宽(P<0.01);乳腺肿瘤动脉RI≥0.82和D≥0.28提示恶性肿瘤敏感性、特异性分别为79%、91%.结论:肿瘤血管阻力指数增高和内径增宽是乳腺良、恶性肿瘤鉴别诊断的重要指标,能提高乳腺恶性肿瘤的诊断准确性.     

Musculoskeletal Oncologic Interventions: Proceedings from the Society of Interventional Radiology and Society of Interventional Oncology Research Consensus Panel

Musculoskeletal interventions are increasingly used with palliative and curative intent in the multidisciplinary treatment of oncology patients with bone and soft-tissue tumors. There is an unmet need for high-quality evidence to guide broader application and adoption of minimally invasive interventional technologies to treat these patients. Therefore, the Society of Interventional Radiology Foundation and the Society of Interventional Oncology collaborated to convene a research consensus panel to prioritize a research agenda addressing the gaps in the current evidence. This article summarizes the panel’s proceedings and recommendations for future basic science and clinical investigation to chart the course for interventional oncology within the musculoskeletal system. Key questions that emerged addressed the effectiveness of ablation within specific patient populations, the effect of combination of ablation with radiotherapy and/or immunotherapy, and the potential of standardization of techniques, including modeling and monitoring, to improve the consistency and predictability of treatment outcomes.     

中国养羊业现状及发展对策(上)

本文主要对我国绵羊，山羊的发展及其分布作了论述，并对2010年肉类（猪、牛、羊）比例做了预测。到2001年我国绵羊数量比解放初期增长了4.22倍，羊毛产量增长了11.08倍，其个体产毛量、羊毛品质均得到大幅度的提高和改进，并育成细毛、半细毛羊品种20多个。从1993年起存栏羊数中山羊超过了绵羊，现山羊占50%，绵羊占46%。在品种结构上，已向肉用和绒用方向发展。目前山羊肉产量占羊肉产量的60%。     

Active knee joint flexibility and sports activity

The aim of the study was to estimate active knee flexion and active knee extension in athletes and to investigate the potential association of each to different types of sports activity. Active knee extension and active knee flexion was measured in 339 athletes. Active knee extension was significantly higher in women than in men and significantly positively associated with weekly hours of swimming and weekly hours of competitive gymnastics. Active knee flexion was significantly positively associated with participation in basketball, and significantly negatively associated with age and weekly hours of soccer, European team handball and swimming. The results point to sport-specific adaptation of active knee flexion and active knee extension.     

胸腹水与血清胆固醇联合测定对胸腹水性质的鉴别诊断意义

目的探讨患者胸腹水和血清中胆固醇浓度联合测定对良、恶性胸腹水以及渗出液、漏出液鉴别的临床意义。方法将127例患者的胸腹水分为两组,良性胸腹水组65例,恶性胸腹水组62例,根据胸腹水形成原因又将127例胸腹水分为渗出液和漏出液两组,渗出液82例,漏出液45例,分别对两组胸腹水和相对应血清中胆固醇测定,并对检测结果进行比较分析。结果良性胸腹水组和恶性胸腹水组中的胆固醇浓度结果比较有统计学差异(P<0.01);良性胸腹水组和恶性胸腹水组中胸腹水/血清胆固醇比值比较有统计学差异(P<0.05);渗出液组和漏出液组的胆固醇浓度比较有统计学差异(P<0.01);渗出液组和漏出液组中胸腹水/血清胆固醇比值比较有统计学差异(P<0.01)。结论胸腹水中胆固醇浓度和胸腹水/血清胆固醇比值联合测定对鉴定胸腹水的性质以及对渗出液和漏出液的鉴别具有一定的价值。     

大鼠C6脑胶质瘤生长的MRI评价及与其病理组织学的关系

目的:探讨大鼠C6脑胶质瘤MR I所测参数与其组织病理学的相关性。材料和方法:运用立体定向方法建立大鼠C6胶质瘤模型,并于C6细胞植入后1、2、3周行MR I平扫及增强扫描,同期取脑行病理组织学检查,对MR I所测肿瘤体积、肿瘤增强程度和EI与MVD和VEGF表达进行相关分析。结果:大鼠C6脑胶质瘤MR影像表现与文献报道相似,新生肿瘤血管和VEGF表达主要位于肿瘤周边;随着C6细胞植入时间的延长,肿瘤体积、EI、MVD逐渐增大,其差别具有统计学意义;VEGF表达与MVD呈正相关,二者分别与肿瘤体积、肿瘤增强程度、EI之间呈正相关。结论:MR I能够反映大鼠C6脑胶质瘤的动态生长特征,与VEGF表达和MVD的动态变化密切相关。     

多层螺旋CT血管成像诊断主动脉离断和缩窄的初步应用

目的:探讨多层螺旋CT血管成像(MSCTA)对主动脉弓离断(IAA)和缩窄(CoA)的诊断价值,并与超声检查进行比较。方法:回顾性分析11例术前临床疑诊IAA和CoA患者的MSCTA和超声检查结果,并与手术结果进行对比分析。11例中IAA3例,CoA7例,主动脉折曲1例;合并动脉导管未闭(PDA)5例,室间隔缺损(VSD)4例。结果:11例中MSCTA诊断IAA3例,疑诊1例;诊断CoA6例、假性主动脉缩窄1例。超声检出IAA2例,其中1例为疑诊,漏诊IAA1例;诊断CoA8例,其中1例为误诊。MSCTA检出VSD2例,PDA3例;超声检出VSD5例,PDA6例。MSCTA可较好显示主动脉离断和缩窄的部位、程度及其合并的心内外畸形和侧支循环的情况。结论:MSCTA是诊断主动脉离断和缩窄的重要方法,为临床提供直观参考,结合超声检查可提高对合并心内畸形的诊断。     

补体受体1型的结构功能及sCR1基因克隆表达的策略

补体受体1型（Complement receptor type 1,CR1）具有外源性及内源性活性,既可灭活组装于非自身细胞膜上的C3/C5转化酶,也可灭活自身细胞膜上形成的C3/C5转化酶。CR1是唯一既对经典,替代及植物凝集素（MBL）3个补体激活途径的,对C3/C5转化酶拥有衰变加速活性,又有辅助1因子裂解C3b和C4b作用的补体调节蛋白。对补体分子的过度活化具有抑制和调节作用,在防治补体介导的缺血再灌注损伤以及异种器官移植超急性排斥反应等疾病具有广阔的应用前景。本文主要综述CR1的结构功能及生物学活性,sCR1基因的克隆与表达及在创伤、缺血再灌注损伤中的应用研究现状。     

大鼠星形胶质细胞和少突胶质细胞的纯化培养与鉴定

目的 纯化培养并鉴定大鼠脑组织星形胶质细胞和少突胶质细胞。方法 根据星形胶质细胞和少突胶质细胞的生长时间差异、细胞生长方式及细胞对培养层粘附等特性的不同,改进ＭｃＣａｒｔｈｙ方法纯化培养星形胶质细胞和少突胶质细胞,用免疫组化法对其鉴定。结果 （１）混合培养的星形胶质细胞和少突胶质细胞生长分化状况均优于纯化后的生长,以少突胶质细胞表现更为明显;（２）星形胶质细胞呈向心性生长,细胞相邻的接触面有较多的     

Working together for health and human rights*

The right to a standard of living adequate for health and well‐being is being denied to vast numbers of people all over the world through increasing disparities in income and in wealth. In the name of economic development, a number of international and national policies have increased the grossly uneven distribution of income, with ever‐growing numbers of people living in poverty as well as in increasing depths of poverty. Globalization, crippling levels of external debt, and the ‘structural adjustment’ policies of international agencies have expanded the numbers and the suffering of people living in poverty and have resulted in the neglect of government‐funded social programs, of regulations protecting the environment, and of human development. Access to medical care, an essential element in the protection of health, is difficult for many, including the 44 million people in the United States who lack insurance coverage for the cost of medical care services. Working together for health and human rights also requires promotion of the right to peace. The right to life and health is threatened not only by the existence and active deployment of weapons of mass destruction, including nuclear, chemical and biological weapons and anti‐personnel landmines, but also other weapons. The twentieth century has been the bloodiest in human history, with an estimated 250 wars, more than 110 million people killed, countless people wounded and at the least 50 million refugees. Health workers must work together with people in our communities for the promotion of health and human rights, which, in Sandwell and elsewhere, are inextricably intertwined.     

食管反流促进肿瘤发生与抑癌基因mRNA表达的相关性

为研究胃二十指肠食管反流的大鼠诱癌过程中食管组织内p53,p16,p21等抑癌基因的mRNA表达，制作3种食管反流动物模型及对照组，术后均注射致癌剂，用原位杂交法检测术后20，26周时食管组织中p53,p16,p21基因的mRNA表达。结果显示，各反流组食管上皮中p53的mRNA表达均较对照组显著增强，其中十二指肠食管反流组（D组），十二指肠胃食管反流组（DG组）的表达较胃食管反流组（G组）更强，D组与DG组结果相似；D，DG组的p16,p21基因mRNA表达较C组减弱，而G组与C组相比差异无显著性意义。提示胃液及十二指肠内容物反流可改变抑癌基因在转录水平的表达，促进大鼠食管肿瘤的发生，其中十二指肠内容物的作用较强。     

大鼠深静脉血栓形成模型建立及观察

目的建立大鼠深静脉血栓形成（DVT）模型,观察实验大鼠术前及术后不同时间凝血酶原时间、纤维蛋白原含量、D-二聚体含量及血栓长度的变化情况。 方法将30只SD大鼠用结扎阻断下腔静脉及其分支,并用微血管夹钳夹损伤静脉壁的方法诱导深静脉血栓形成。于术前第1天及术后第1、4、7、10、14、21天采静脉血检测纤维蛋白原含量、D-二聚体含量及凝血酶原时间,并行血管造影观察血栓及血管再通情况。 结果共23只大鼠深静脉血栓模型制作成功,功率76.67%（23/30）。纤维蛋白原含量、凝血酶原时间及D-二聚体含量在术前与术后之间的差异有统计学意义,但术后不同时间之间差异无统计学意义;术后血栓长度在不同时间的差异均有统计学意义。 结论凝血酶原时间、纤维蛋白原及D-二聚体可作为是否有血栓形成的重要参考指标,但在评价病情进展及严重程度方面价值有限;血栓长度随时间先增长,后又溶解,直至消失。     

胰腺囊腺癌的影像分析

目的：胰腺囊腺癌是一种低度恶性肿瘤，临床非常少见。本着重探讨其影像学特点及临床应用价值。方法：分析8例手术和病理证实的胰腺囊腺癌的影像学表现，其中腹部平片检查3例，上消化道检查4例，B超及CT检查8例。结果；腹部平片与上消化道检查可见胃体缓压移位，B超可以显示肿瘤大小，位置轮廓及了解肿瘤囊壁厚度，分离情况。增强后囊肿不强化，囊壁实性结节明显强化。结论：熟悉胰腺囊腺癌的影像直接、间接征象及临床特点，有利于其诊断及鉴别诊断。     

Validation of clinical photography and a laser fluorescence device for assessment of enamel demineralization during multi-bracketed fixed orthodontic treatment

AimTo compare the validity of DIAGNOdent pen™ 2190 and clinical photographs in the diagnosis (presence or absence) and assessment of white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment.MethodsA total of 1607 readings from 99 patients were obtained using DIAGNOdent pen™ 2190, clinical photographs, and visual assessment criteria to assess WSLs at 6 -, 12- and 18 months after bonding of brackets. Receiver operating characteristic curves were constructed, and areas under the curve (AUC) were calculated to assess the presence or absence of WSLs and distinguish the severity of WSLs as slight or severe. Sensitivities, specificities, and AUC were calculated for outcomes at an alpha of 0.05 and 95% confidence intervals (CIs).ResultsThe values of sensitivity and specificity of DIAGNOdent pen™ 2190 were found to be 0.78 and 0.83, respectively, to distinguish presence/absence of WSLs with good accuracy (AUC= 0.855; 95% CI: 0.820–0.889) and for digital photographs, accuracy was excellent (AUC= 0.973, 95% CI: 0.956–0.991) with sensitivity and specificity of 0.96 and 0.99, respectively. However, the accuracy of DIAGNOdent pen™ 2190 was poor (AUC= 0.543, 95% CI: 0.418–0.668) in delineating slight and severe WSLs with a sensitivity of 0.31 and specificity of 0.83; while the values of sensitivity and specificity for distinguishing slight or severe lesions for clinical photographs were 0.96 and 0.99, respectively with excellent accuracy (AUC=0.978, 95% CI: 0.936–1.000).ConclusionsClinical photographs had better validity than DIAGNOdent pen™ 2190 in diagnosis and assessment of severity of demineralized lesions during multi-bracketed fixed orthodontic treatment.     

药物对高原人体运动时NO和NOS的影响

目的：探讨药物对高原人体运动时一氧化氮（NO）及其NO合酶（NOS）的影响;方法：对进驻海拔4100m高原20天的50名健康青年随机分为吸入NO组、红景天组、乙酰唑胺组、西氏胶囊组和对照组,每组10人,在安静时、服（吸入）药前后及踏阶运动后分别检测血中NO、NOS含量;结果：5组青年安静时、服（吸入）药前、踏运动后NO和NOS均无显著性差异（P＞0．05）;运动后较安静时NO组、NO组NO和NOS均增高,有显著性意义（P＜0．05或P＜0．01）;乙酰唑胺组、西氏胶囊组NOS增高,有显著性意义（P＜0．05）,NO无统计学意义（P＞0．05）;与对照组比较,NOS均增高显著（P＜0．05或P＜0．01）,NO在吸入NO组和红景天组增高显著（P＜0．05）,乙酰唑胺组、西氏胶囊组NO、NOS均降低显著（P＜0．05或P＜0．01）,红景天组无统计学意义（P＞0．05）;与红景天组比较,乙酰唑胺组、西氏胶囊组NOS降低非常显著（P＜0．01）,NO怃统计学意义（P＞0．05）;乙酰唑胺组与西氏动时NOS活性,增加血中NO含量,但吸入NO和服用红景天效果更明显,这可能是吸入NO扩张血管作用、增加组织供血量和红景天抗缺氧机制。     

ERCP、CT、B超对胰胆管下段疾病的诊断准确性

目的 比较ERCP、CT、B超对胰胆管下段疾病的诊断准确性。方法 100例临床表现为梗阻性黄疸，反复上腹痛、恶心呕吐的患均经ERCP、CT及B超检查本组患经手术病理或活检证实为良性病变(胆总管结石)57例，恶性肿瘤31例，其中胆总管癌11例，胰头癌13例，以及壶腹癌8例。上述3种方法术前的定性诊断准确率均与手术病理结果对照。结果 对胆总管结石的定性诊断准确率：ERCP为98％(n=56)，CT为72％(n=41)，B超为61％(n=35)；对恶性肿瘤的定性诊断准确率：ERCP为97％(n=31)，CT为78％(n=25)，B超为63％(n=20）。结论 ERCP对胰胆管下段良恶性病变的定性诊断准确率明显高于CT和B超，但因CT与B超均属无创性操作且对某些恶性肿瘤也有较高的定性诊断准确率，因此在影像诊断中应考虑3项技术优势互补。     

活动监测仪在临床医学和航空航天医学的应用研究进展

目的综述活动监测仪在临床医学和航空航天医学的应用研究进展。资料来源与选择该领域的相关研究论文和综述。资料引用国外公开发表的论文和综述29篇。资料综述简介活动监测仪的基本原理和功能及其在国外的临床医学、航空航天医学等领域的应用研究进展。结论活动监测仪具有廉价、方便、可靠等特点，在航空航天、军事作业等需要长时间、连续监测睡眠的医学领域具有广阔的应用前景。