Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning.     

小藤铃儿草的生物碱成分

自小藤铃儿草Dactylicapnos torulosa(Hook.f ct Thomas.)Hutchins中分得六个单体,通过UV,IR,MS,~1HNMR和~(13)CNMR解析,鉴定了四个,其中一个为新化合物,命名为紫金龙碱(zijinlongine,Ⅰ),其他三个为已知化合物:氯化1-甲氧基小檗碱(1-methoxylberberium chloride,Ⅱ),氯化三乙基苯胺(triethylphcnylamium chloride,Ⅲ)和异紫堇定(isocorydine,Ⅳ)。Ⅱ和Ⅲ系首次从植物中得到。     

Comparison of gonosomal aneuploidy in spermatozoa of normal fertile men and those with severe male factor detected by in-situ hybridization

The purpose of the study was to analyse the frequency of sex-chromosome numerical abnormalities in human spermatozoa of infertile men by using a standardized experimental protocol of double target in-situ hybridization (ISH). The experiments were performed on decondensed sperm heads from 15 infertile patients (six cases of unexplained infertility and nine cases of severe oligoasthenoteratozoospermia). Three men of proven fertility were used as controls. The probes employed recognized the centromeric regions of human X chromosome and the long arm of the Y chromosome. In a smaller number of cases, additional experiments of double ISH were performed using centromeric probes for chromosomes 1 and 17. Signal detection was based on protocols of enzymatic cytochemical reactions. A total of 24,508, 24,679 and 42,285 cells were scored in the control, unexplained infertility and severe male factor groups of patients respectively. In all the patients in the ISH efficiency result was approximately 98%. In controls, unexplained infertility and severe male factor patients, the frequency of morphologically normal sperm cells carrying an abnormal chromosome constitution (XX or YY or XY or > 2 sex chromosomes signals) was 0.86, 0.75 and 1.35% respectively. The value of this last group of patients (severe male factor) was significantly higher than in the other two groups of patients (P < 0.008). The same findings were made using the autosomic probes. Our preliminary data support the possibility of an increased risk from paternal origin sex chromosome aneuploidies in children born after intracytoplasmic sperm injection (ICSI). Further investigations of the cytogenetic constitution of spermatozoa from severe male factor patients is warranted.      

肾移植术后服药前和服药后2小时新山地明血药浓度监测的临床意义比较

目的:新山地明给药后,个体间吸收变异相当明显,血药浓度监测管理对减少急性排斥反应发生及降低肝肾毒性十分重要。比较传统的服药前血药浓度(谷值)、服药后2h血药浓度(峰值)监测的临床意义。方法:选择2005-01/2006-04在中山大学附属第一医院行首次同种异体尸肾移植的受者60例,均知情同意。按随机数字表法分成服药前血药浓度组和服药后2h血药浓度组,各30例。两组患者肾移植后前3个月均接受新山地明5～7mg/(kg·d)、霉酚酸酯1.0～1.5g/d和皮质激素三联治疗。采用荧光偏振法测定患者新山地明服药前和服药后2h血药浓度,比较服药前血药浓度与服药后2h血药浓度监测方法预测肾移植急性排斥反应和不良反应(肝毒性、肾毒性)的有效性。结果:60例患者全部进入结果分析。①60例患者在术后3个月内急性排斥反应发生率为13.3%(8/60);不良反应发生率为28.3%(17/60),肝毒性发生率为20.0%(12/60),肾毒性发生率为8.3%(5/60)。②急性排斥反应发生时与非急性排斥反应时服药前血药浓度差异无显著性意义(P=0.08);急性排斥反应发生时服药后2h血药浓度显著低于非急性排斥反应时服药后2h血药浓度(P<0.01)。③发生肝肾毒性1周内的服药前血药浓度与未发生时服药前血药浓度差异无显著性意义(P=0.15);发生肝肾毒性1周内的服药后2h血药浓度显著高于肝肾毒性未发生时(P<0.01)。结论:在肾移植术后早期,与服药前血药浓度相比,服药后2h血药浓度能更敏感的反映急性排斥反应和不良反应的发生。     

CCU病房患者应激状态下发生精神异常2例

1　临床资料　患者,A,男,81岁,西安市人,农民,主因间断胸闷、气短、双下肢浮肿8mo余,加重10d于1999-12-10急诊收住西京医院心内科CCU病房.入院查体:BP19.3/13.3kPa,神志清,端坐位呼吸,查体合作,口唇紫绀,肝颈反流征(+),双肺布满干湿罗音,以中下肺野中小水泡音为主,心界左扩,心率75次·min-1,律齐,心前区可闻及级收缩期杂音,肝大肋下2指,生理反射存在,病理反射未引出.入院后心电图示:心肌供血不足.胸片提示:心影大,心胸比0.69,肺瘀血.入院诊断:1高血压病级、高心病、急性左心衰.2冠心病.1999-12-12因目睹邻床青年患者病危抢救全过程,于当…     

帕米膦酸二钠的合成

目的：合成二钠３－氨基－１－羟基－亚丙基－二膦酸盐（帕米膦酸二钠）。方法：有,无溶剂的两种合成路线,并对工艺进行改进,所得产物经元素分析,红外光谱,质谱等分析确证结构。结果;两种路线均可合成目标化合物。路线Ａ收率高于路线Ｂ。结论：溶剂的加入使本反应体系均一,有利于产物生成。     

肿瘤相关抗原Tn及其低聚体的合成

目的展示肿瘤相关抗原Tn及其低聚体合成的进展.方法查阅国内外文献,概括肿瘤相关抗原Tn及其低聚体合成的方法.结果肿瘤相关抗原Tn是由糖基供体与保护丝氨酸(苏氨酸)缩合,去保护基后而得,Tn抗原低聚体通过Tn的逐步缩合或直接缩合而得.结论肿瘤相关抗原Tn及其低聚体的合成是肿瘤疫苗研究中的一个热点.     

US of the biceps tendon apparatus

High-resolution real-time sonography of the biceps tendon was performed on 80 patients referred for shoulder arthrography. The arthrograms and sonograms were compared at the levels of the biceps tendon groove and distal tendon. Sonography and arthrography were equally successful in facilitating the evaluation of the bony configuration of the biceps tendon groove, but sonography gave a superior image of the biceps tendon within the groove. In 16 patients, biceps tendon sheath effusions or swelling was detected using sonography; 15 of these patients had associated pathologic conditions elsewhere in the joint. Arthrograms did not disclose a biceps tendon or sheath abnormality in any of these patients. We conclude that sonography could be the imaging method of choice in patients with suspected biceps tendon lesions and that the presence of a biceps tendon or sheath abnormality indicates an increased likelihood of abnormalities elsewhere in the joint.     

细胞周期素依赖激酶4在颌骨软骨肉瘤的表达及意义

目的：分析细胞周期素依赖激酶４（ＣＤＫ４）在颌骨软骨肉瘤的表达及意义。方法利用免疫组化法检测ＣＤＫ４在２０例颌骨软骨肉瘤、８例骨软骨瘤和８例骨质增生中的表达。结果６５．０％（１３／２０）的软骨肉瘤中ＣＤＫ４呈阳性表达ＣＤＫ４表达率随病理学分级的升高呈增高趋势,但未见统计学差异（Ｐ〉０．０５）;ＣＤＫ４在骨软骨瘤和骨质增生中的阳性表达率分别为１２．５％（１／８）和０（０／８）,且均与软骨肉瘤有显性     

肾包膜内注射骨髓间充质干细胞在链脲佐菌素糖尿病模型大鼠体内的定位及功能测评

目的:观察骨髓间充质干细胞在体外不诱导条件下,移植于链脲佐菌素所致糖尿病大鼠后在胰腺的定位及胰岛素分泌情况。方法:实验于2004-08/2006-03在2级实验室唐山工人医院中心实验室和具有国家认证的屏障动物环境实验室华北煤炭医学院动物中心完成。①实验材料:青年清洁级SD大鼠购自华北煤炭医学院动物中心(SCXK2002-0003),4周龄,体质量180～250g,动物级别:SPF/VAF。②实验方法:体外培养雄性SD大鼠骨髓间充质干细胞,并采用流式细胞仪鉴定。选取雌性SD大鼠,按65mg/kg剂量腹腔注射链脲佐菌素建立糖尿病大鼠模型。给药后二三天,大鼠血糖升高,当血糖≥16.7mmol/L且稳定2d,认为糖尿病模型建立成功。将建模成功的40只大鼠完全随机分为对照组、实验组,每组20只。对照组大鼠右侧肾包囊注射磷酸缓冲液0.2mL,实验组大鼠右侧肾包囊下注射骨髓间充质干细胞0.2mL,细胞数为4×105L-1。于移植前及移植后第3,5,7天采大鼠尾静脉血检测血糖。③实验评估:于移植前及注射后7d采大鼠心脏血检测C-肽值,移植后7d取大鼠胰腺组织作石蜡切片,应用原位杂交技术检测Y染色体细胞。结果:40只大鼠全进入结果分析。①骨髓间充质干细胞鉴定:骨髓间充质干细胞呈梭形、放射状,形成数个细胞克隆时排列整齐,原代培养7～10d即可长满,按1∶3传代,生长四五天达融合。流式细胞术表面标志鉴定显示,培养的原代骨髓间充质干细胞表面标志CD90阳性,基质细胞表面标志CD44阳性,造血细胞表面标志CD45及内皮细胞表面标志CD31阴性。②大鼠尾静脉血血糖值、心脏血C-肽值分析:血糖结果显示,对照组治疗后第3,5,7天血糖值及C-肽值与治疗前相比,无明显变化(P>0.05);实验组治疗后第3,5,7天血糖值较治疗前明显下降,治疗后第7天C-肽值明显上升,与对照组对应时间比较,差异均显著[实验组治疗前:(21.75±2.44)mmol/L,(0.21±0.01)μg/L;实验组治疗后:(12.23±1.95)mmol/L,(14.00±2.85)mmol/L,(12.75±2.86)mmol/L,(0.26±0.01)μg/L;对照组治疗后:(21.63±1.34)mmol/L,(23.03±1.11)mmol/L,(22.48±1.92)mmol/L,(0.21±0.01)μg/L,P均<0.01]。③原位杂交技术检测Y染色体细胞:对照组大鼠胰腺组织切片中未见黄绿荧光Y染色体,实验组大鼠胰腺组织切片中可见黄绿荧光Y染色体,存在于胰腺腺泡间隙,或胰腺组织中。结论:雄性大鼠骨髓间充质干细胞在肾包囊注射下可到达雌性糖尿病大鼠胰腺组织,使糖尿病大鼠血糖下降,C-肽值升高,具有分化为胰岛素分泌细胞的可能性。