MR 平面回波快速成像技术应用研究

目的 结合不同类型ＥＰＩ成像技术的特点,研究不同对比度ＥＰＩ的颅脑疾病诊断中的临床应用价值。方法 各类颅脑疾病患者１３６例所有病例行常规的ＭＲ扫描及ＥＰＩ。结果 ①应用ＥＰＩ扩散加像（及ＡＤＣ图）与ＥＰＩ－Ｔ２加权像对超急性期脑中风的诊断灵敏性与特异性均为１００％,联合ＴＳＥ－Ｔ２ＷＩ与Ｔ１ＷＩ的灵敏性与特异性分别为０％与４２．８５％（ｘ＾２＝１４．０８,Ｐ〉０．０１）。②常规ＭＲＩ上胆脂瘤表现为     

The efficacy of helical CT in the diagnosis of small bowel obstruction

OBJECTIVE: To evaluate the usefulness and reliability of helical computed tomography (CT) for patients with small bowel obstruction. METHODS AND MATERIAL: Helical CT findings of 41 patients were evaluated prospectively on the basis of the presence and the cause of obstruction, and the presence of strangulation. RESULTS: In the determination of the cause of the obstruction sensitivity and specificity of CT were 84 and 90%, respectively. Of the 19 patients undergoing surgery, 6 had strangulation and were correctly identified by CT. CONCLUSION: Helical CT is an accurate method in the detection of small bowel obstruction, especially for evaluating the cause and vascular complications of obstruction.     

Disabled infectious single cycle herpes simplex virus (DISC-HSV) is a candidate vector system for gene delivery/expression of GM-CSF in human prostate cancer therapy

BACKGROUND: DISC-HSV is a replication incompetent herpes simplex virus that is a highly efficient vector for the transduction of genes in vivo and in vitro. We examine the ability of DISC-HSV to infect human prostate cancer cell-lines and xenograft tumor models, and induce expression of reporter and therapeutic cytokine genes. METHODS: Infection was confirmed by cellular staining for the beta-galactosidase reporter gene product, and by EM. Human GM-CSF production following DISC-hGMCSF infection was measured using ELISA. The metabolic activity of infected cells was determined by NADP/NADPH assay. Cell death was estimated by cell-cycle analysis using flow cytometry with propidium iodide staining. RESULTS: Infection of DU145, PC3 and LNCaP cells with DISC-HSV was dose dependent. Cells infected with DISC-hGM-CSF released significant levels of hGM-CSF for 3 days. NADP/NADPH assay suggested that infected cells continued to be metabolically active for 3 days post-infection, which was consistent with flow cytometry findings that cell death did not occur within 7 days of infection. Tumor xenografts injected with DISC-HSV expressed beta-galactosidase, and intracellular viral particles were demonstrated using EM. CONCLUSIONS: We have previously reported the rejection of established tumors following intra-tumoral injection of DISC-GMCSF. This study demonstrates the ability of DISC-HSV to infect prostate cancer and express GMCSF at significant levels. We suggest that prostate cancer is a potential target for therapy using DISC-HSV containing GM-CSF.     

Promoter variants in tissue inhibitor of metalloproteinase-3 (TIMP-3) protect against susceptibility in pigeon breeders' disease

BACKGROUND: Tissue inhibitors of metalloproteinases (TIMPs) play a major role in extracellular matrix turnover in the lung. However, in chronic lung disorders such as idiopathic pulmonary fibrosis (IPF) and pigeon breeders' disease (PBD), TIMPs may promote an adverse non-degradative environment. We hypothesised that polymorphisms in TIMP-3 could affect susceptibility to IPF and PBD. METHODS: Two promoter variants, -915A>G and -1296T>C, were genotyped in 323 healthy subjects, 94 subjects with IPF, 115 with PBD, and 90 exposed to avian antigen but without PBD. The severity of fibrosis in lung tissue and the clinical outcome after 1 year was determined in the PBD group. RESULTS: The variants did not influence susceptibility to IPF, but the rare alleles of both variants appeared to be protective against susceptibility to PBD (odds ratio (OR) for carriage of at least one rare allele from either variant 0.48, 95% CI 0.30 to 0.76, p = 0.002). Haplotype analysis of positions -915 and -1296 estimated four haplotypes: *A*T, *G*T, *A*C and *G*C, respectively. Their frequencies differed overall between subjects with PBD and healthy subjects (p = 0.0049) and this was attributable primarily to the *G*C haplotype (OR 0.53, 95% CI 0.36 to 0.77, p = 0.001). The severity of fibrosis correlated with poorer outcome in the PBD group (r = 0.73, p<0.01) but no relationship was seen between the *G*C haplotype and outcome or fibrosis. However, PBD subjects with the *G*C haplotype did have proportionally fewer lymphocytes in their bronchoalveolar fluid than those with the common *A*T haplotype (p = 0.029). CONCLUSIONS: TIMP-3 variants appear to contribute to susceptibility to PBD. This may be through the inflammatory reaction rather than the fibrotic reaction.     

结肠慢传输型便秘与突触素和 P物质及血管活性肠肽的临床研究

目的探讨突触素(synapses,SY)、P物质(substanceP,SP)和血管活性肠肽(vasoactiveintestinepolypeptide,VIP)在结肠慢传输型便秘(slowtransitconstipation,STC)中的变化及病理学意义。方法应用免疫组织化学技术和病理显微镜分析图像系统,在中倍光镜下计算22例STC患者(STC组)和12例非梗阻性结直肠癌患者(对照组)的阳性染色区域的面积并进行对比。结果STC组患者结肠内SY、VIP和SP镜下阳性面积均较对照组明显减少。STC组和对照组SY分别为[(1.53±0.92)×105]μm2和[(3.33±1.09)×105]μm2;两组比较,P<0.001。SP分别为[(1.41±0.85)×105]μm2和[(2.22±1.31)×105]μm2,两组比较,P<0.05。VIP分别为[(1.22±0.72)×105]μm2和[(2.14±1.35)×105]μm2,两组比较P<0.05。结论STC患者存在肠神经系统突触功能障碍,从而导致肠神经递质下降。     

戊酸雌二醇对更年期大鼠脾细胞凋亡及卵巢功能的作用

目的了解戊酸雌二醇(E2)对更年期大鼠脾细胞凋亡的作用并观察卵巢组织形态学变化。方法SD雌性大鼠30只分为青年组(2.5月龄)、更年组(12月龄)、雌激素组(12月龄)3组。青年组、更年组均予蒸馏水1ml/d灌胃,雌激素组予戊酸E2800μg.kg-1.d-1灌胃。3个月后颈动脉放血处死。放射免疫法测定血清E2水平,AnnexinV-FITC/PI双染色流式细胞仪测定脾细胞凋亡率,逆转录聚合酶链反应(RT-PCR)技术检测相关凋亡基因Bcl-2、Bax的表达。光镜下对各组双卵巢切片进行组织形态学观察,IMS细胞自动图像分析系统对卵巢黄体数(个)、卵巢最大纵切面面积进行计量分析。结果更年组大鼠血清E2水平明显低于青年组而脾细胞凋亡率明显高于青年组,这与其促凋亡基因Bax表达明显升高有关。雌激素组血E2水平明显高于青年组和更年组,其脾细胞凋亡率也明显高于青年组,这与其抗凋亡基因Bcl-2表达降低及Bax表达升高有关。雌激素组抗凋亡基因Bcl-2表达也明显低于更年组。更年组与雌激素组都显示卵巢纵切面积缩小、黄体计数少等功能衰退表现。结论更年期大鼠脾细胞凋亡的增龄性改变与血清E2水平负相关;本研究中E2治疗未能逆转更年期大鼠脾细胞凋亡的增龄性变化,这与外源性雌激素导致的超生理浓度的E2水平有关。过高的E2浓度不能改善更年期大鼠衰退的卵巢功能。实验显示衰老与性腺功能衰退密切相关。     

Benefits of perfusion MR imaging relative to diffusion MR imaging in the diagnosis and treatment of hyperacute stroke

BACKGROUND AND PURPOSE: The development of thrombolytic agents for use with compromised cerebral blood flow has made it critical to quickly identify those patients to best treat. We hypothesized that combined diffusion and perfusion MR imaging adds vital diagnostic value for patients for whom the greatest potential benefits exist and far exceeds the diagnostic value of diffusion MR imaging alone. METHODS: The cases of patients with neurologic symptoms of acute ischemic stroke who underwent ultra-fast emergent MR imaging within 6 hours were reviewed. In all cases, automatic processing yielded isotropic diffusion images and perfusion time-to-peak maps. Images with large vessel distribution ischemia and with mismatched perfusion abnormalities were correlated with patient records. All follow-up images were reviewed and compared with outcomes resulting from hyperacute therapies. RESULTS: For 16 (26%) of 62 patients, hypoperfusion was the best MR imaging evidence of disease distribution, and for 15 of the 16, hypoperfusion (not abnormal diffusion) comprised the only imaging evidence for disease involving large vessels. For seven patients, diffusion imaging findings were entirely normal, and for nine, diffusion imaging delineated abnormal signal in either small vessel distributions or in a notably smaller cortical branch in one case. In all cases, perfusion maps were predictive of eventual lesions, as confirmed by angiography, CT, or subsequent MR imaging. CONCLUSION: If only diffusion MR imaging is used in assessing patients with hyperacute stroke, nearly one quarter of the cases may be incorrectly categorized with respect to the distribution of ischemic at-risk tissue. Addition of perfusion information further enables better categorizing of vascular distribution to allow the best selection among therapeutic options and to improve patient outcomes.     

多层螺旋CT无创性冠状动脉造影对冠状动脉疾病的诊断价值

目的:探讨16层螺旋CT冠状动脉造影对冠状动脉病变的临床诊断价值。方法:57例疑似冠状动脉病变的患者行16排螺旋CT检查和冠状动脉造影,不包括5例为冠状动脉支架置入术后(支架12个)。将冠状动脉分为13个节段,分析所有管腔大于2mm的节段,评价图像是否能满足管腔评价。管腔狭窄大于50%认为有意义,以常规冠状动脉造影作为金标准,比较16层螺旋CT在诊断有意义的冠状动脉狭窄方面的敏感性、特异性、阳性预测值、阴性预测值。结果:在所有638个节段中,588个节段(占92.16%)能够满足冠状动脉管腔评价。对于16层螺旋CT能够显示有意义冠状动脉狭窄,与ICA相对照,若以动脉节段计数,MSCT显示中度以上狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确度分别为93.61%、91.11%、89.79%、98.12%和94.63%。以动脉主干计数,MSCT显示中度以上狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确度分别为92.82、、91.31%、80.43%、97.37%和82.08%。以患者计数,MSCT显示中度以上狭窄的敏感性、特异性、阳性预测值、阴性预测值和准确度分别为94.73%、90.00%、93.01%、92.99%和82.75%。结论:16层螺旋CT结合回顾性心电门控技术冠状动脉成像无创、简单易行。既能显示管腔情况又能显示冠脉管壁,弥补了ICA的不足;经严格控制影响因素,具有较高的敏感性和特异性,较高的阴性预测值可避免不必要的有创性检查。对支架术后的随访也有较高的应用价值,对血管变异的显示直观确切。可作为一种有效的筛查和随访手段应用于临床。     

吸液态氧对高原移居青年氧耗量的影响

目的 :探讨在高原吸入液态氧对移居青年氧耗量的影响。方法 :将进驻海拔 370 0m半年的 4 0名健康青年随机分为两组 ,每组 2 0人。对照组用EGM型踏车功量计做坐位踏车运动 ,初始负荷功率 2 5W ,每 3min递增 5 0W ,以 6 0r/min连续踏车直至力竭。实验组在运动前 10min开始用面罩吸液态氧 ,每分钟吸入量为 4L ,在踏车运动中全程吸氧 ,踏车方式同对照组。结果 :心率在 10 0～ 170 /min时 ,两组氧耗量随心率增加而呈线性增加 (P <0 .0 1)。结论 :在高原运动时吸液态氧能提高移居青年心脏作功效率和改善肺功能。     

银杏叶片对高原人体运动后自由基代谢的影响

目的:探讨银杏叶片、酪氨酸冲剂和红景天对高原人体力竭运动自由基代谢的影响。方法:将进驻海拔3700 m高原半年的30名健康男青年随机分为银杏叶片组、红景天组和酪氨酸组,每组 10 人。在服药前、服药第 15 d分别采用功率自行车进行递增负荷运动至力竭,测定血清中超氧化物歧化酶(SOD)、谷胱苷肽过氧化物酶(GSH Px)和丙二醛(MDA)含量。结果:3组青年服药前运动后较安静时GSH Px、MDA增高,有非常显著性差异(P<0 .01);SOD无统计学差异(P>0 .05)。服药后运动后较安静时SOD、GSH Px、MDA均增高,有非常显著性差异(P<0 .01)。服药后较服药前SOD、GSH Px增高,MDA降低,有非常显著性差异(P<0. 01)。3组之间比较,SOD、GSH Px、MDA均无统计学差异(P>0. 05)。结论:银杏叶片、酪氨酸冲剂和红景天均具有较强的自由基清除能力,能延缓运动性疲劳发生,提高高原作业效率。