微型探头监测精神负荷诱发的心肌缺血

为了确定精神应激与心肌缺血之间的关系，用微型探头γ心功能仪对１０例正常人及３０例冠心病（ＣＡＤ）患者进行精神应激试验及运动踏车试验，结果正常对照组于精神负荷状态下左室射血分数（ＬＶＥＦ）由安静时５８．２％±９．８％，增至６３．８％±６．１％（Ｐ〈０．０１），运动试验ＬＶＥＦ增至６８．２％±１２．９％（Ｐ〈０．０１），而ＣＡＤ组中２８例患者精神应激状态下ＬＶＥＦ比对照组降低１２．９％±５．４％，持续     

网球运动对老年人淋巴细胞转化及免疫球蛋白水平的影响

对１０６例从事１０年网球运动的老年人和１００例不参加任何运动的同龄老年人（对照组）的淋巴细胞转化率和血清免疫球蛋白（Ｉｇ）水平进行了测定。淋巴细胞转化率采用３Ｈ－ＴｄＲ掺入法，Ｉｇ用单向免疫扩散法。淋巴细胞转化率运动组为０．２４±０．０２，对照组为０．１５±０．０５，两组差异显著（Ｐ＜０．０１）。ＩｇＧ、ＩｇＡ和ＩｇＭ（ｇ／Ｌ）运动组分别为２６．９９±１２．４９、３．６±１．２２和１．９５±０．８５；对照组分别为１５．１５±４．５７、１．６３±０．４１和１．４０±０．６１，两组差异显著（Ｐ＜０．０１）。结果说明，网球运动可提高老年人机体免疫功能；血淋巴细胞转化率和血清Ｉｇ水平可作为评价体育锻炼的客观指标。     

高原低氧性肺动脉高压的多普勒超声研究

应用脉冲式或连续式多普勤超声技术，对１８例海拔３２００ｍ高原正常人及２５例高原性心脏病（ＨＡＨＤ）患者测定其肺动脉压。正常组及ＨＡＨＤ无瓣膜返流组１０例（４０％）应用Ｈａｈａｍ回归方程，ＰＡＭＰ分别为２．８４±０．４及３．７３±０．５７（ｌｋＰａ＝７．５ｍｍＨｇ）；ＨＡＨＤ有三尖瓣返流组８例（３２％）用ＴＲＰＧ法测得ＰＡＳＰ为６．１３±１．７３ｋＰａ；ＨＡＨＤ有肺动脉瓣返流组７例（２８％）用ＰＲＰＧ法测得ＰＡＤＰ为４．０±０．７３ｋＰａ。表明多普勒超声技术的不同方法可用于不同病理状态上高原低氧性肺动脉高压的测定，并揭示了出现瓣膜返流改变时高原低氧性肺动脉高压的程度。     

^99mTc—ECD SPECT断层影像采血法和非采血法定量测定rCBF和C …

目的：应用＾９９ｍＴｃ－ＥＣＤ ＳＰＥＣＴ断层影像采血和非采血法定量测定ｒＣＢＦ和ＣＢＦ。材料和方法。正常对照组１５例,疾病组１０例;采血法用动脉化静脉血样求得血中＾９９ｍＴｃ－ＥＣＤ的浓度。非采血法用头颈平面像求得血中＾９９ｍＴｃ－ＥＣＤ浓度。结果;正常对照组采血法ｒＣＢＦ２５．０±４．０－５９．１±７．６１ｍｌ．ｍｉｎ＾－１．（１００ｇ）＾－１,ＣＢＦ４３．０±３．６ｍｌ．ｍｉｎ＾－１．（１０     

扩散加权平面回波成在肝占位性病变中的应用探讨

目的 探讨扩散加权平均回波成像在肝占位性病变中的应用,以及 散系数（ＡＤＣ）评估肝占位病变的价值。方法 对４８例共有５８个肝占位病灶患者进行了扩散加权平面回波成像,５８个肝占位病灶中肝癌３０个,肝血管瘤１６个,肝囊肿１２个。应用不同梯度因子ｂ值的扩散图像拟合出ＡＤＣ图,并获取ＡＤＣ值。结果肝同肝血管瘤和肝囊肿的平均ＡＤＣ值分别为：（１．２５±０．５１）×１０＾－３ｍｍ＾２／ｓ,（１．７５±０．６０     

改良Webster症状评分量表评估帕金森病的手术疗效

目的：通过改良Ｗｓｂｓｔｅｒ记分量表评价电生理引导脑内核团毁损术治疗帕金森病的疗效。病人与方法：应用改良Ｗｅｂｓｔｅｒ症状评分表,对帕金森病人分别在手术前后进行１０组症状记分,１～１０分为轻度障碍;１１～２０分为中度障碍;２１～３０分为重度障碍;术后改善２５％以下为无效,２６％～５０％为有效,５１％～７５％为显效,７５％以上为特别显效。结果：术前评分为１９．９０±５．２７,术后评分１０．５７±６．１０,平均改善（８．９５±３．３７）分,差异非常显著,但无１例症状完全消除：其中特别显效４例（９．５％）;显效１７例（４０．５％）;有效１６例（３８．１％）,总有效率为８８．１％,单靶点毁损３４例,改善８．５９±３．５３,双靶点８例,改善（１０．００±４．１４）分,两组差别无统计学意义。分组统计结果表明,症状轻者术后改善的百分比较高。讨论：电生理引导脑内核团毁损术尚不能完全消除帕金森病的症状,但可使其明显改善;单侧双靶点毁损与单靶点毁损的疗效差别无显著意义,可能与病例数较少有关;症状较轻者术后改善明显。本文对手术适应症、禁忌症、并发症以及手术注意事项也进行了讨论。结论：对于药物疗效降低以及出现毒副作用的帕金森病患者     

人脑弥散加权平面回波磁共振成像

目的：探讨正常人脑及脑乐散加权平面回波成像（ＤＷ－ＥＰＩ）的特点。材料与方法：２８例健康志愿者及１５脑梗塞患者均作ＤＷ－ＥＰＩ,分析其表现并计算正常人脑组织、脑梗塞区的表面弥散系数（ＡＤＣ０及相对ＡＤＣ。结果：正常人脑脊液,灰质、顶、额、枕叶白质的ＡＤＣ平均值分别为３．１２、０．８９、０．７１、０．８０、０．８４×１０＾－３ｍｍ＾－２／ｓ;急性期脑梗塞在ＤＷＩ上表现为高信号,ＡＤＣ值下降为０．５７     

内毒素血症中降钙素基因相关肽的变化及其对血流动动力学的影响

观察了内毒素血症时血浆降钙素基因相关肽的变化及其与血流动力学改变的关系。结果表明，用辣椒素抑制ＣＧＲＰ再注射内毒素时，血浆ＣＧＲＰ的释放量仅为内毒素血症对照组的３９．１％，同时动物的平均动脉压，中心静脉压和总末梢阻力的降低幅度明显减少（分别为８７．５０±６．５７，３．８７±０．８８，３．０４±０．２７ｋＰａ）。当再次注射ＣＧＲＰ时，随着血浆ＣＧＲＰ含量的增加，ＭＡＰ，ＣＶＰ和ＴＰＲ又明显降低（分别     

正常寰枢间放射学测量及临床意义

通过对１２０ 名正常国人寰枢椎放射学测量，提供临床放射学意义。拍摄颈椎侧位屈曲位，伸展位和中立位Ｘ光片，测量３ 项指标：寰齿间距（ＡＤＩ） ，脊髓有效间隙（ＳＡＣ） 和脊髓有效间隙变化率即不稳定指标（ＩＩ） ，所得结果进行统计学分析。测量结果，正常成人ＡＤＩ中立位、屈曲位、伸展位分别为１ ．３６ ±０ ．６２（ｘ ±Ｓ，下同）ｍ ｍ ，（１．３１ ±０ ．６８）ｍ ｍ 和（１ ．３５ ±０ ．７５）ｍ ｍ 。ＳＡＣ分别是（２０ ．３ ±１ ．１）ｍ ｍ ，（２０ ．１ ±０ ．９）ｍ ｍ ，（２０．４ ±１ ．３）ｍ ｍ 。ＩＩ为（１１ ．８５ ±４ ．５６） ％ 。结果提示ＡＤＩ≥４ ｍ ｍ 时即可诊断寰枢椎不稳，≥３ ｍ ｍ 时应高度怀疑寰枢椎不稳。ＳＡＣ≤１４ ｍ ｍ 可论断Ｃ１ 平面椎管狭窄。ＩＩ≥２２ ％ 即有临床诊断意义。     

在非何杰金氏淋巴瘤和慢性淋巴细胞白血病患者中影响~(131)I-Lym-1药代动力学和辐射剂量学的因素

目的：确定１３１　Ｉ－Ｌｙｍ－１（一种优先以恶性淋巴细胞为目标的单克隆抗体）起始治疗量在非何杰金氏淋巴瘤（ＮＨＬ）和慢性淋巴细胞白血病（ＣＬＬ）患者中的药代动力学和辐射剂量学，并将肿瘤剂量与１３１　Ｉ－Ｌｙｍ－１剂量及其他患者参数比较。方法：在最大耐受剂量（ＭＴＤ）或低剂量（ＬＤ）试验中，５１例３期或４期淋巴瘤患者（男３２例、女１９例，平均５７岁，其中ＮＨＬ４６例、ＣＬＬ５例）予以１３１　Ｉ－Ｌｙｍ－１０．７４～８．０４ＧＢｑ（２０～２１７ｍＣｉ）治疗。每个患者所给予的１３１　Ｉ－Ｌｙｍ－１总量…     

Caffeine ingestion and antigen‐stimulated human lymphocyte activation after prolonged cycling

This study investigated the effect of caffeine ingestion on antigen‐stimulated T‐ (CD4⁺ and CD8⁺) and natural killer (NK)‐ (CD3^?CD56⁺) cell activation after prolonged, strenuous cycling. In a randomized cross‐over design, nine male endurance cyclists (age: 22 ± 3 years, V?O_2peak: 62 ± 4 mL/kg/min, mean ± SD) cycled for 90 min at 70% V?O_2peak 60 min after ingesting 6 mg/kg body mass of caffeine (CAF) or placebo (PLA). Venous blood samples were obtained before supplementation, pre‐exercise, immediately post‐exercise and 1 h post‐exercise. Whole blood was stimulated with Pediacel (five in one) vaccine. At 1 h post‐exercise the number of antigen‐stimulated CD4⁺ cells expressing CD69 decreased on CAF compared with PLA [15 (17) × 10⁶ vs 23 (22) × 10⁶ cells/L, P<0.05]. In addition, the geometric mean fluorescence intensity (GMFI) of CD69 expression on antigen‐stimulated CD8⁺ cells decreased on CAF compared with PLA 1 h post‐exercise [78 (10)% vs 102 (24)%, P<0.05]. At the same time‐point GMFI of CD69 expression on antigen‐stimulated CD3^?CD56⁺ cells was increased on CAF compared with PLA [103 (9)% vs 87 (8)%, P<0.05]. These findings suggest that caffeine reduces antigen‐stimulated CD69 expression on T cells while at the same time increases NK‐cell activation 1 h after intensive cycling.     

原发性胆汁性肝硬化患者Siglec-1蛋白的表达及其临床意义

目的检测Siglec-1(CD169)在原发性胆汁性肝硬化(PBC)患者外周血单核细胞上的蛋白表达,并探讨其与原发性胆汁性肝硬化发生发展的作用及临床意义。方法流式细胞术检测35例原发性胆汁性肝硬化患者及35例健康对照者、35例肝炎后肝硬化对照者外周血CD14CD169双阳性细胞的表达率;生化常规测定所有入选者血清生化指标水平。结果流式细胞术检测结果显示:原发性胆汁性肝硬化组外周血CD14CD169双阳性率为(13.0±2.2)%,显著高于健康对照组(1.0±0.2)%,及肝炎后肝硬化对照组(4.1±0.4)%,差异具有统计学意义(P<0.01)。并且Siglec-1表达与GGT(r=0.44,P<0.01)和ALP水平(r=0.33,P<0.05)密切相关。结论原发性胆汁性肝硬化患者单核细胞表面siglec-1蛋白表达显著增高,说明原发性胆汁性肝硬化患者外周血单核细胞已经发生巨噬细胞化,单核巨噬细胞介导的免疫炎症反应在原发性胆汁性肝硬化发生发展过程中起重要作用。     

Amifostine enhances recovery and expansion of peripheral FAS/CD95+ T- and NK-cell subpopulations during radiotherapy of patients with head-neck cancer

Purpose:?Experimental studies suggest that the FAS/APO-1/CD95 (cytokine receptor protein TNF-receptor superfamily, member 6) cell surface molecule is involved in the apoptotic effect of radiotherapy. In this study we investigated the role of amifostine in protecting the CD95+ (CD: cluster of differentiation) lymphocytic subpopulation in patients with head and neck cancer undergoing radiotherapy.

Materials and methods:?Using flow-cytometry we examined the expression of FAS/CD95 antigen on CD4+ (helper/inducer T cells), CD8+ (suppressor/cytotoxic T cells) and CD56+ (NK, natural killer) T-lymphocytes of 28 patients with head and neck cancer undergoing radiotherapy (with and without amifostine).

Results:?The numbers of peripheral blood lymphocytes were significantly reduced after treatment from (mean value ± STD error) 1477 ± 129 to 1015 ± 77 for T lymphocytes, 700 ± 70 to 454 ± 38 for CD4, 449 ± 46 to 296 ± 34 for CD8 and, 140 ± 18 to 118 ± 13 for NK, before and after treatment, respectively. CD95 expressing lymphocytes showed a faster recovery rate in patients receiving amifostine. CD95 expressing CD56 lymphocytes increased during radiotherapy in patients receiving daily cytoprotection with amifostine to values higher than the pre-treatment levels (p = 0.004).

Conclusion:?It is suggested that amifostine enhances recovery of T- and NK-lymphocyte subpopulations expressing the CD95 antigen in head-neck cancer patients undergoing RT and may enhance the efficacy of the later by interfering FAS-related immunological pathways.     

熊果酸对TGF-β1诱导肝细胞凋亡的抑制作用及其机制

目的 研究熊果酸(UA)对转化生长因子β1(TGF-β1)诱导肝细胞凋亡的干预作用及其机制.方法 采用原位灌注法分离健康SD大鼠原代肝细胞,随机分成空白对照组、UA自身对照组(UA 25μmol/L)、TGF-β1组(TGF-β12.5ng/ml)、UA干预组(UA 25μmol/L+TGF-β12.5ng/ml)、DPI干预组(DPI 0.5μmol/L+TGF-β12.5ng/ml).药物作用相应时间后,采用流式细胞术检测肝细胞增殖及凋亡情况,荧光定量PCR法检测肝细胞内CD95(Fas) mRNA的表达,Western blotting检测肝细胞内CD95蛋白的表达以及NADPH氧化酶(NOX)亚基p47phox移位至胞膜的蛋白量,并采用活性氧(ROS)检测试剂盒检测肝细胞内ROS水平.结果 在TGF-β1刺激肝细胞前30min加入UA进行干预可明显降低TGF-β1诱导的肝细胞凋亡率(80.53％±1.56％vs 63.97％±3.19％,P＜0.01),肝细胞增殖指数明显增加(10.83％±2.03％vs 18.67％±1.60％,P＜0.01),细胞内CD95 mRNA及蛋白表达均明显下调(2.40±0.25 vs 1.28±0.15,P＜0.01;1.37±0.18vs 1.05 ± 0.15,P＜0.05),p47phox向膜移位明显减少(1.76±0.22 vs 1.13±0.12,P＜0.01),肝细胞中ROS水平明显降低(3.23±0.53vs2.12±0.45,P＜0.01).结论 UA可能通过抑制肝细胞内NOX激活,减少ROS产生,下调CD95的表达来抑制TGF-β1诱导的肝细胞凋亡.     

Effects of iomeprol,a new nonionic contrast medium,vis a vis iopamidol and nitroglycerin,on coronary diameter and blood flow in chronically instrumented dogs

The effects of an intracoronary administration of iomeprol, a new nonionic tri-iodinated water-soluble contrast medium, on coronary circulation were compared to those of iopamidol and those of nitroglycerin in 6 chronically instrumented conscious dogs. A pair of 10 MHz piezoelectric crystals and an electromagnetic flow probe were placed on the left circumflex coronary artery (LCCA) to measure the epicardial coronary diameter (CD) and coronary blood flow (CBF). Polyethylene tubing for drug administration was inserted into the LCCA proximal to the sonomicrometers. Iomeprol at the dose of 1 ml and 3 ml/min for 1 min significantly increased CD by 0.6±0.1% and 1.4±0.3%, respectively and CBF by 44.5±9% and 70±10%, respectively. Iopamidol at the same rates also significantly increased CD by 0.8±0.1% and 1.5±0.3% and CBF by 50±11% and 82±14%, respectively. There was no statistically significant difference between iomeprol-and iopamidol-induced increases in CD and CBF. However, the duration of the increase in CD was significantly shorter (p<0.05) after iomeprol than after iopamidol. Nitroglycerin (10 μg/kg) significantly increased CD by 4.5±1% and CBF by 105±10%. The increases in CD and CBF in response to iopamidol and iomeprol were significantly smaller (p<0.01) than to nitroglycerin. We conclude that vasodilating effects of iomeprol and iopamidol on the large epicardial coronary artery and coronary blood flow are comparable in conscious dogs and significantly lower than after nitroglycerin in the doses used by us. This study was supported by a grant from the EI-ZA1 Pharmaceutical Co., Tokyo, Japan.     

小儿传染性单核细胞增多症免疫状况动态观察

目的研究小儿传染性单核细胞增多症(IM)免疫功能动态变化,观察EB病毒(EBV)感染对免疫功能影响,为判断预后及治疗提供依据。方法应用流式细胞术对23例IM患儿急性期及恢复期外周血淋巴细胞CD3+、CD4+、CD8+、CD19+抗原进行检测,并与30例对照组健康儿童比较。结果IM患儿急性期外周血淋巴细胞CD3+、CD4+、CD8+、CD19+抗原分别为(80.74±8.51)%、(17.53±6.08)%、(57.38±14.90)%、(7.35±6.24)%,CD3+、CD8+显著高于对照组[(68.47±7.01)%、(24.10±4.65)%,P<0.01],CD4+、CD19+较对照组降低[(38.63±6.14)%、(19.00±5.27)%,P<0.01]。恢复期CD8+降低[(34.52±12.28)%],仍高于对照组(P<0.01);CD4+升高[(26.91±6.24)%],仍低于对照组(P<0.01)。结论IM患儿急性期外周血淋巴细胞亚群显著异常,恢复期机体仍处于免疫紊乱状态,CD4+T细胞持续低下可能需免疫调节治疗。     

术中亚低温治疗急性颅脑损伤后CD4~+、CD8~+及比值变化

目的探讨术中亚低温对颅脑损伤者CD4+、CD8+变化的影响。方法选择2010年1月—2015年12月在湖北随州市曾都医院实施开颅血肿清除的患者80例,按治疗方法不同分为两组(各40例)。观察组男性29例,女性11例;年龄31~60岁,平均45.2岁;入组GCS评分8~13分,平均10.3分。对照组男性30例,女性10例;年龄31~60岁,平均45.3岁;入组GCS评分8~13分,平均10.4分。对照组行常规去骨瓣减压血肿清除术,观察组在对照组基础上结合术中亚低温,比较干预后CD4+、CD8+、CD4+/CD8+、免疫球蛋白、欧洲脑卒中评分(ESS)、Barthel指数及Fugl-Meyer评分变化情况。结果干预后观察组CD4+、CD8+高于对照组[(35.1±2.0)%vs.(26.0±0.9)%,(30.6±1.3)%vs.(24.4±1.0)%,P0.05],CD4~+/CD8~+高于对照组(1.9±0.3 vs.1.6±0.2,P0.05),Ig M、Ig G、Ig A高于对照组(1.60±0.03 vs.1.32±0.02,9.52±0.12 vs.8.84±0.10,3.91±0.20 vs.1.83±0.15,P0.05),ESS、Barthel指数、Fugl-Meyer评分高于对照组(P0.05)。结论术中亚低温能有效减少手术对患者免疫功能影响,促进神经功能恢复,提高生活质量及肢体功能。     

Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data

The purpose of this study was to investigate whether the severity of acute pulmonary embolism (PE) could be quantitatively assessed with spiral CT angiography (SCTA). Thirty-six consecutive patients without underlying cardiopulmonary disease and high clinical suspicion of PE underwent prospectively thin-collimation SCTA and echocardiography at the time of the initial diagnosis (T0) and after initial therapy (T1; mean interval of time T1–T2: 32 days). The CT severity score was based on the percentage of obstructed surface of each central and peripheral pulmonary arterial section using a 5-point scale (1: <25%; 2: 25–49%; 3: 50–74%; 4: 75–99%; 5: 100%). The sum of the detailed scores attributed to 5 mediastinal, 6 lobar and 20 segmental arteries per patient led to the determination of central, peripheral and global CT severity scores and subsequent determination of percentages of obstruction of the pulmonary circulation. Echocardiographic severity criteria included the presence of signs of acute cor pulmonale and/or systolic pulmonary hypertension (>40 mm Hg). The SCTA depicted acute PE in all patients at T0 with complete resolution of endovascular clots in 10 patients at T1. At T0, the mean percentage of obstruction of the pulmonary arterial bed was significantly higher in the 22 patients with echocardiographic signs of severity (56±13 vs 28±32%; p<0.001). A significant reduction in the mean percentage of pulmonary artery obstruction was observed in the 19 patients with resolution of echocardiographic criteria of severity between T0 and T1 T0: 57±14%; T1: 7±11%; p<0.001).The threshold value for severe PE on CT angiograms was 49% (sensitivity: 0.773; specificity: 0.214). The mean (±SD) pulmonary artery pressure was significantly higher in the 26 patients with more than 50% obstruction of the pulmonary artery bed (45±15 mm Hg) than in the 10 patients with less than 50% obstruction of pulmonary artery bed at T0 (31±11 mm Hg; p<0.01). The CT severity score evaluated in the present study enables quantitative assessment of acute PE severity on spiral CT angiograms, readily applicable in routine clinical practice. Electronic Publication     

Intradiscal temperature monitoring using double gradient‐echo pulse sequences at 1.0T

Purpose:

To validate an unspoiled gradient‐recalled echo pulse sequence with dual echo acquisition as a means to increase temperature sensitivity while monitoring intradiscal laser ablation therapy.

Materials and Methods:

Phantom experiments as well as in vitro thermal ablation simulations were performed in an open 1.0T magnetic resonance (MR) scanner. Three methods of noninvasive MR‐thermometry based on the signal void decrease caused by T1‐relaxation time increase (T1), the temperature‐dependent proton resonance frequency (PRF) shift, and a combination of both methods with complex differences (CD) were compared. Temperature accuracy and reliability of temperature distribution were the main assessment criteria.

Results:

The optimum temperature sensitivity was found using CD in phantom experiments. During in vitro experiments the PRF showed the smallest margin of error (T1: ±1.64°C, PRF: ±1.23°C, CD: ±1.29°C) and the best qualitative evaluation of temperature.

Conclusion:

Intradiscal temperature monitoring with an unspoiled dual‐echo sequence is most accurate with PRF‐thermometry in combination with the long echo time. Magnitude images with an initial short echo time permit high image detail of the heat‐induced lesion. J. Magn. Reson. Imaging 2010;31:1499–1503. © 2010 Wiley‐Liss, Inc.     

Computed tomography of the small bowel in adult celiac disease: the jejunoileal fold pattern reversal

The aim of this retrospective study was to establish whether the distinctive intestinal fold pattern of celiac disease (CD), known by barium studies as jejunoileal fold pattern reversal (JFPR) may be recognized at CT. The number of intestinal folds per 2.5 cm, seen at CT, were counted in the jejunum and in the ileum of 22 adult patients with CD and compared with the folds of 30 consecutive subjects in whom an intestinal disease had been excluded. The results were submitted to statistical analysis by Student's t-test. In the control group the number of folds per 2.5 cm were 4.88 (SD ± 0.78) in the jejunum and 2.84 ( ± 0.62) in the ileum; in the CD group the number of folds were 2.42 ( ± 1.61) in the jejunum and 5.11 ( ± 1.24) in the ileum. There was a statistically significant difference in the number of jejunal and ileal folds between the CD patients and the control group (in both cases p < 0.001). The JFPR was seen in 15 patients with CD (68.2 %) but in none of the controls. Our study shows that JFPR is not a normal finding and can be demonstrated by CT in the majority of patients with CD. Received: 21 January 1999; Revised: 25 May 1999; Accepted: 26 May 1999