乳管内窥镜对乳腺导管内病变的诊断和治疗价值

目的评价乳管内窥镜(FDS)对乳腺导管内疾病的诊断和治疗价值。方法回顾性分析近2年来FDS检查的548例乳头溢液患者的临床资料。结果548例乳头溢液病例中,FDS下诊断为乳管炎59例(10.8%),乳腺导管扩张症117例(21.4%),乳腺导管扩张合并乳管炎185例(33.4%),乳管内乳头状瘤159例(29.0%),乳管内乳头状瘤病12例(2.2%),乳腺癌16例(2.9%)。135例在我院接受手术治疗,其中91例在FDS定位下行肿瘤切除或区段切除手术(甲组),44例按常规经溢液乳管内注射染料美蓝后再行选择性区段切除(乙组)。甲组术后FDS诊断符合率97.8%(89/91)明显高于乙组的86.4%(38/44)(χ2=6.96,P=0.008)。结论FDS不仅是诊断乳腺导管内病变的可靠方法,而且可以帮助手术中定位切除乳腺导管内新生物。FDS定位下手术能够避免盲目性,为病灶的切除提供可靠的帮助。     

局部手法按摩用于扩张皮瓣的初步探讨

目的总结局部手法按摩用于扩张皮瓣的初步经验。方法自2006年至2007年，我们将手法按摩用于扩张器置入预扩张皮瓣患者21例（35个扩张器）。采用预定的按摩手法，对置入扩张器的皮瓣进行适当按摩。结果本组21例患者，1例因感染取出扩张器，余20例效果满意。与以往未经手法按摩扩张器置入术比较，注水速度明显增快，扩张周期明显缩短。结论局部手法按摩用于扩张皮瓣，安全可靠，效果明显，值得推广。     

腹腔动脉的CT解剖研究及临床意义

目的:利用多层螺旋CT血管成像(MSCTA)研究腹腔动脉的解剖特点,旨在指导介入治疗。方法:随机选择150例行多层螺旋CT肝脏三期扫描的患者,选择5.0mm×2.5mm的扫描参数,行层厚3.0mm间隔1.5mm的轴面重建,采用容积再现(VR)后处理方法。结果:腹腔动脉开口位于T12中部~L1上部平面128例占85.3%。腹腔动脉与腹主动脉的下夹角呈锐角占86.7%,呈钝角占13.3%。由腹腔动脉干分为胃左、脾及肝总动脉三支者占92%,发现8%有正常变异。肝固有动脉走行与肝总动脉呈钝角占88.4%,呈锐角占11.6%。胃十二指肠动脉与肝总动脉呈钝角占71%,呈锐角占29%。脾动脉形态常见为上弧型、上升型、水平上升型、水平型、下弧型、下弧上升型等,波浪型及回旋型少见占5.1%。结论:腹腔动脉CT解剖研究对介入工作具有重要的指导意义。     

自体骨髓基质干细胞复合珊瑚修复犬下颌骨节段缺损的初步研究

目的应用自体骨髓基质干细胞(bonemarrowstromalcells,BMSCs)复合珊瑚构建组织工程化骨,修复犬下颌骨节段性缺损。方法体外扩增培养、成骨诱导犬BMSCs。将第二代细胞复合珊瑚后修复犬自体右侧3cm的下颌骨节段缺损(n=6);以单纯珊瑚植入缺损处为对照(n=6),术后12、32周分别通过影像学,大体形态观察,组织学和生物力学的方法检测骨缺损的修复效果。结果成骨诱导的BMSCs在珊瑚支架上生长良好。X线片显示12周时实验组骨痂较多,对照组材料明显吸收;32周时CT、X线片和大体观察显示术后实验组骨愈合良好,对照组为骨不连;骨密度检测示实验组显著高于对照组(P<0.05);组织学示实验组有较多成熟骨呈骨性愈合,对照组为纤维性愈合;生物力学测试实验组与正常下颌骨力学强度差异无统计学意义(P>0.05)。结论自体成骨诱导BMSCs复合珊瑚形成的组织工程化骨可修复犬下颌骨节段缺损。     

弱精子症患者精子蛋白的初步研究

目的从蛋白质水平探讨弱精子症患者精子蛋白的改变,以期寻找精子活动力低下的原因。方法运用蛋白凝胶电泳技术分离90例特发性弱精子症患者和30例正常供精者精子标本的总蛋白质,结合免疫印迹技术鉴定差异蛋白,并对试验数据进行统计学分析。结果患者组与对照组精子蛋白表达量存在差异,且患者组中精子活力低下不同严重程度者的蛋白含量也存在差异(P<0.05),对于差异显著条带的Western Blotting分析显示差异蛋白为DDX4。结论精子活力与蛋白质差异表达有关,主要差异蛋白DDX4可作为评估精子活力的生物标志物。     

进驻海拔4300m不同时间对移居青年血流动力学的影响

目的探讨进驻海拔4 300 m不同时间对移居青年血流动力学的影响。方法对进驻海拔4 300 m 1年和3年的健康青年,分别用XG-Ⅲ型血液循环功能自动测试仪检测血流动力学并与海拔1 400 m青年比较。结果进驻1年者较海拔1 400 m青年P,TPR,AR,η,CCP增加非常显著,BV,SV,VPE,mAP降低非常显著(P<0.01);ALT,PAWP增加显著,ETK降低显著(P<0.05)。进驻3年较进驻1年者η和ALT增加非常显著(P<0.01),SV和mAP降低显著(P<0.05);TPR,AR,PAWP,CCP增加,BV,VPE,ETK降低,但无统计学意义。结论青年人进驻海拔4 300 m 1年时血流动力学为低排高阻性改变;进驻3年时其低排高阻性改变较1年时有所加重。     

脉冲电磁场影响人骨髓基质干细胞缝隙连接通讯的实验研究

目的研究脉冲电磁场(PEMFs)对人骨髓基质干细胞(hBMSCs)缝隙连接所介导细胞间通讯(GJIC)的影响。方法透射电镜观察BMSCs超微结构,应用荧光漂白恢复(FRAP)技术,通过激光共聚焦显微镜检测hBM-SCs经PEMFs刺激后GJIC的功能变化。结果经PEMFs刺激后的hBMSCs,平均荧光漂白恢复率为(64.12±0.83)%,较对照组犤(35.26±0.76)%犦有显著性增加(P<0.05)。结论PEMFs刺激能促进hBMSCs的缝隙连接通讯功能。     

Insulin reduces the BOLD response but is without effect on the VEP during presentation of a visual task in humans.

Functional magnetic resonance imaging (fMRI) based on blood oxygen level-dependent (BOLD) contrast has become an invaluable tool in the assessment of in vivo neuronal activation. Quantification of the BOLD response is determined by the hemodynamic and metabolic changes that occur in response to brain stimulation. However, these changes may vary by changes in insulin, a hormone known to be vasoactive in some tissues. To determine if insulin has an effect on fMRI, we measured the BOLD response to a visual stimulus in five normal volunteers in which insulin was first suppressed and then brought to a high physiological concentration. In addition, we also examined the effect of insulin on activation of the visual cortex as measured by the visual-evoked potential (VEP). We found that the BOLD response measured in the presence of insulin (serum insulin=236+/-29 pmol/L) was significantly lower (P<0.001) than that measured in its absence (serum insulin=8+/-2 pmol/L). Insulin was without effect on P100 amplitude or latency acquired in the presence or absence of insulin in 28 subjects using the same stimulus as that used for the fMRI experiments. Our observations suggest that insulin may have effects on cerebral blood flow and/or metabolism that affect the BOLD signal that are independent of its effects on neuronal activation identified by event related potentials (ERP). These findings highlight the complexity that must be considered when interpreting differences in fMRI responses between groups of subjects that differ in insulin concentration and/or insulin sensitivity.     

Single-shot ADC imaging for fMRI.

It has been suggested that apparent diffusion coefficient (ADC) contrast can be sensitive to cerebral blood flow (CBF) changes during brain activation. However, current ADC imaging techniques have an inherently low temporal resolution due to the requirement of multiple acquisitions with different b-factors, as well as potential confounds from cross talk between the deoxyhemoglobin-induced background gradients and the externally applied diffusion-weighting gradients. In this report a new method is proposed and implemented that addresses these two limitations. Specifically, a single-shot pulse sequence that sequentially acquires one gradient-echo (GRE) and two diffusion-weighted spin-echo (SE) images was developed. In addition, the diffusion-weighting gradient waveform was numerically optimized to null the cross terms with the deoxyhemoglobin-induced background gradients to fully isolate the effect of diffusion weighting from that of oxygenation-level changes. The experimental results show that this new single-shot method can acquire ADC maps with sufficient signal-to-noise ratio (SNR), and establish its practical utility in functional MRI (fMRI) to complement the blood oxygenation level-dependent (BOLD) technique and provide differential sensitivity for different vasculatures to better localize neural activity originating from the small vessels.     

群集钙化对鉴别乳腺良恶性病变的意义

目的评价乳腺钼靶片群集钙化对鉴别乳腺良恶性病变的意义。方法分析76例乳腺X线钼靶片群集钙化病例,全部经手术病理证实,其中,乳腺恶性病变52例,良性病变24例。采用下列4项指标分析上述76例群集钙化的特征并进行良恶性对照研究:a)病灶钙化总数;b)每平方厘米钙化数目(N/S);c)钙化灶的大小、形态;d)钙化灶合并肿块。结果76例群集钙化病例中钙化总数大于30个、N/S大于等于10个、钙化灶大小形态不一致、钙化合并肿块,这4项指标诊断恶性钙化的特异性和敏感性分别为83.3%和69.2%,79.2%和76.9%,62.5%和92.3%,62.5%和53.8%。结论N/S大于等于10个、钙化总数大于30个及钙化灶大小、形态不一致这3个特征对恶性钙化最具有诊断价值。