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。     

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     

pcDNA3．1-VEGF165质粒转染骨髓基质干细胞后血管内皮生长因子的表达

目的:检测pcDNA3.1-VEGF165载体转染对兔骨髓基质干细胞血管内皮生长因子表达的影响。方法:实验于2005-07/2006-01在山东省青岛市市立医院中心试验室完成。①pcDNA3.1-VEGF165质粒由华中科技大学同济医学院附属协和医院骨科杨述华教授惠赠。②选取1月龄新西兰大白兔1只,无菌条件下取胫骨和股骨,进行骨髓基质干细胞的分离与培养。③转染前24h计数细胞,每孔5×105细胞接种于6孔板,待骨髓基质干细胞达到80%～90%融合时准备转染,设立未转染组、空载体组和载体组。未转染组无特殊处理,空载体组转染pcDNA3.1载体,载体组转染pcDNA3.1-VEGF165。④转染后72h,反转录聚合酶链反应检测各组骨髓基质干细胞中血管内皮生长因子165mRNA的表达;酶联免疫吸附法检测各组骨髓基质干细胞中血管内皮生长因子165蛋白的含量。结果:①骨髓基质细胞分离培养形态观察:初始分离的骨髓细胞呈圆形,大小不一;24h后有少量细胞贴壁;48h后贴壁细胞部分为成纤维样细胞;72h贴壁的成纤维样细胞数不断增加;96h后贴壁生长的细胞主要为梭形的成纤维样细胞;分瓶后细胞形成克隆;传代后细胞贴壁生长,分裂相增多,并不断增殖分化形成均一的梭形细胞。②转染72h后各组细胞血管内皮生长因子165mRNA的表达情况:反转录聚合酶链反应检测到载体组在576bp处有明显条带,空载体组和未转染组均未见血管内皮生长因子165表达。③转染72h后各组细胞血管内皮生长因子165蛋白含量检测结果:酶联免疫吸附结果显示,载体组转染pcDNA3.1-VEGF165载体的骨髓基质细胞培养上清液中血管内皮生长因子165蛋白浓度为(170.1±14.3)ng/L,而空载体组与未转染组均未检测到血管内皮生长因子165蛋白表达,差异有显著性意义(t均=42.206,P=0.000)。结论:应用pcDNA3.1-VEGF165载体转染,可使兔骨髓基质干细胞获得外源性血管内皮生长因子165基因和蛋白的表达。