Small renal cell carcinomas: resolving a diagnostic dilemma

Thirty-nine patients with pathologically proved renal cell carcinomas 3 cm or les in diameter were examined. Results of intravenous urography (n = 30) were true positive in 20 patients and false negative in ten (sensitivity, 67%). Renal ultrasound (US) (n = 29) had true-positive results in 23 patients and false-negative results in six (sensitivity, 79%); computed tomography (CT) (n = 36) had true-positive results in 34 and false-negative results in two (sensitivity, 94%). For selective renal angiography (n = 35%), the results were true positive in 26 and false negative in nine (sensitivity, 74%), with typical hypervascular renal cell carcinomas demonstrated in 17. Finally, the findings of percutaneous fine-needle aspiration biopsy were true positive in one of five patients when US guidance was used (sensitivity, 20%) and in five of eight when CT guidance was used (sensitivity, 62%). Small renal cell carcinomas are more frequently encountered in clinical practice than heretofore realized, and they are best imaged by CT.     

脉冲电流对胰岛素经皮渗透的促进作用

实验结果表明,脉冲电流能有效地提高胰岛素的透皮扩散速率,并随着释放池中胰岛素浓度的递增,透皮扩散速率呈线性增加。同时,胰岛素在pH值偏离等电点的酸性溶液(pH3.6)中透皮速率最高,为324.2±33.4μU/(cm²·h),而在pH值高于等电点的溶液(pH7.4)中其透皮速率降至143.7±27.3μU/(cm²·h),在pH值接近等电点(pH5.3)时,胰岛素的透皮速率最低,为78.4±21.9μU/(cm²·h)。     

IDENTIFICATION OF SUBSETS OF PATIENTS WITH GRAVES''DISEASE BY CLUSTER ANALYSIS

We have applied cluster analysis methods to forty-nine laboratory and clinical characteristics (including 26 HLA-A, B antigens) observed in 196 Graves' disease patients. Three subgroups could be identified: group I (seventy-nine patients) had small goitres, low indices of autoimmunity and a tendency to remission with medical treatment; group IIa (twenty-nine patients) had clinical and laboratory features of 'Hashitoxicosis'; Group IIb (eighty-four patients) had a high incidence of ophthalmopathy, familial aggregation, marked evidence of autoaggression and a tendency to relapsing hyperthyroidism. The prevalence of HLA-B8 was 8.9% in group I, 20.7% in group IIa and 86.9% in group IIb. This study demonstrates that Graves' disease can be subdivided using cluster analysis into clinically relevant subgroups which are further distinguished by their correlation with HLA-B8. Possible immunological bases for these observed patterns are discussed.     

Photobiomodulation as an adjunctive therapy for alveolar socket preservation: a preliminary study in humans

Lasers in Medical Science - Bone remodeling results in loss of alveolar bone height and thickness. Photobiomodulation (PBM) based on photochemical stimulation by low-intensity lasers emerges as an...     

腰椎椎弓根通道不同头尾偏角方向变化规律的数字解剖学特点

目的:观察个体化腰椎椎弓根通道在外偏角不变而不同头尾偏角方向的变化规律。方法:实验于2005-09/2006-09在广东省医学生物力学重点实验室完成。选取1例健康成人腰椎CT连续扫描数据集,应用Mimics8.11三维重建腰椎数字解剖模型,将腰椎数字模型导入Surface10.0,获得椎弓根通道的正投影区内边界及其正投影区内边界内、外切圆,获得内切圆经椎板、椎弓根与椎体的通道长度,获取各内、外切圆半径大小,对获取相关数据进行定量分析与椎弓根通道的可视化显示。结果:①内切圆半径:L1～5左右椎弓根通道正投影区内切圆半径在设定头尾偏角大小范围内变化不明显,左侧内切圆半径分别为(3.01±0.02),(3.89±0.03),(4.13±0.04),(5.16±0.43),(5.37±0.73)mm,右侧分别为(3.49±0.03),(4.34±0.06),(4.55±0.13),(5.26±0.36),(5.27±0.83)mm。②外切圆半径:L1～5左右椎弓根通道正投影区外切圆半径在设定头尾偏角大小范围内变化不明显,左侧外切圆半径分别为(7.22±0.81),(7.96±0.43),(8.04±0.34),(8.15±0.21),(11.00±0.40)mm,右侧分别为(7.82±0.55),(8.03±0.26),(7.76±0.40),(7.81±0.29),(10.77±0.30)mm。③通道长度:L1～5左右椎弓根通道正投影区内切圆通道长度随头尾角度的增大呈逐渐增大而后又逐渐减小趋势,左侧通道长度分别为(40.49±6.73),(41.49±6.12),(42.02±7.55)(37.02±7.58),(38.87±10.37)mm,右侧分别为(38.08±6.33),(41.16±5.03),(42.01±6.53),(37.94±7.71),(37.66±4.32)mm。结论:腰椎椎弓根通道大小是随头尾偏角方向不同而不同的连续动态变化过程,应用数字技术可以获得其通道大小连续动态的变化规律,临床应用选择合适直径、长度大小的螺钉及确定最佳进钉方向需要依循这一规律。     

树突状细胞在慢性乙型肝炎和肝癌治疗中的应用前景

目的:综述树突状细胞在慢性乙型肝炎和肝癌治疗中的应用前景。资料来源:应用计算机检索PUBMED2001-01/2005-12期间的相关文章,检索词为"dendritic cells,chronic type B hepatitis,hepatoma,therapy",并限定文章语言种类为English。同时计算机检索万方数据库2001-01/2005-12期间的相关文章,检索词为"树突状细胞,慢性乙肝,肝癌,治疗",并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与树突状细胞在慢性乙型肝炎和肝癌治疗中的应用相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到56篇相关文献,30篇文献符合纳入标准,排除的26篇文献为内容陈旧或重复。符合纳入标准的30篇文献中,15篇涉及树突状细胞与慢性乙型肝炎的治疗,10篇涉及树突状细胞与肝癌的治疗,5篇涉及存在的问题与展望。资料综合:慢性乙型肝炎和肝癌的发生发展与病毒的持续感染和机体的免疫功能障碍有关,树突状细胞是机体中功能最强的抗原提呈细胞,在诱导T细胞抗病毒和抗肿瘤免疫中起核心作用。①树突状细胞与慢性乙型肝炎的治疗:许多证据表明由树突状细胞介导的细胞毒T淋巴细胞反应,通过杀伤感染的肝细胞和释放抗病毒的细胞因子来清除乙型肝炎病毒。②树突状细胞与肝癌的治疗:研究证明,经肿瘤抗原致敏的树突状细胞能明显增强特异性细胞毒T淋巴细胞对肝癌细胞的杀伤活性。结论:树突状细胞与慢性乙型肝炎和肝癌的发生发展密切相关。在乙型肝炎和肝癌治疗中,如能激发、增强机体对乙型肝炎病毒和肝癌细胞的主动免疫排斥反应,可有助于清除体内的病毒和肿瘤,达到抗病毒和抗肿瘤治疗的目的。