隐性骨折的MRI诊断

目的：探讨骨隐性骨折的MRI诊断价值。方法：对25例外伤患者均行X线平片及MRI检查，10例患者同时行CT检查，受伤部位分别为股骨髁、胫骨近端及MRI检查，10例患者同时行CT检查，受伤部位分别为股骨髁、胫骨近端及胸椎、腰椎。结果：本组25例X线平片均未见骨折征象，CT检查10例亦无明显骨折征象，仅见骨小梁结构较乱，周围软组织肿胀；MRI检查25例显示隐性骨折呈现长T1、短T2或不规则状线形异常信号，其周围可见不规则长T2骨挫伤水肿异常高信号影，均伴有周围软组织水肿的异常信号。结论：MRI能早期诊断骨隐性骨折，若患者局部症状明显，X线检查无阳性征象者行MRI检查应为最佳检查手段。     

高密度cDNA微阵列技术检测乳腺癌差异表达基因

目的 描绘乳腺癌的基因差异表达谱，以寻找乳腺癌新的肿瘤相关候选基因和分子标志。方法 用含14000个cDNA克隆的表达微阵列检测乳腺癌组织、乳腺癌旁组织及乳腺非癌组织的mRNA表达，并分析其表达的差异。结果 乳腺癌组织与乳腺非癌组织比较有80个差异表达基因，乳腺癌组织与乳腺癌旁组织比较有57个差异表达基因，乳腺癌旁组织与乳腺非癌组织比较有29个差异表达基因，在乳腺癌组织与乳腺非癌组织和乳腺癌旁组织比较中有14个差异表达基因是一致的。结论 用微阵列技术对乳腺癌的肿瘤相关基因和分子标志作初步探索，为了解中国女性乳腺癌发生发展的分子机制、发展新的诊断和治疗手段提供了信息。     

原发性肝癌合并糖尿病的介入治疗

目的　研究原发性肝癌合并糖尿病的介入治疗方法。方法　临床明确诊断的 3 4例肝癌合并糖尿病患者在介入治疗前后通过口服降糖药或注射胰岛素将血糖、尿糖控制在安全范围内 ,并对隐性感染或感染源进行治疗 ,然后再行肝动脉化疗灌注栓塞术。结果　 3 4例患者介入治疗前血糖均降到 9.0mmol/L以下 ,尿糖控制在 -～ ++,术后均未发生严重并发症 ,仅有 2例出现慢性胆囊炎急性发作 ,经抗炎、利胆治疗后安全出院。结论　肝癌合并糖尿病患者在血糖、尿糖降到一定的范围内 ,消除潜在的感染 ,行肝动脉化疗栓塞治疗是安全可行的     

仲景大小汤辨要

张仲景在《伤寒论》与《金匮要略》中，以大小成对命名方剂者共有六对。其命名的基本条件①凡名同者，其间必有联系；②大汤其药力强，治疗的病情重；小汤其药力弱，治疗的病情轻。理解仲景大小汤的含义，对理解仲景汤方命名规律及临床辨证具有重要意义。     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

Optical Pretargeting of Tumor with Fluorescent MORF Oligomers

Objective Pretargeting with radioactivity has significantly improved tumor to normal tissue radioactivity ratios over conventional antibody imaging in both animal studies and clinical trials. This laboratory is investigating DNA analogues such as phosphorodiamidate morpholinos (MORFs) for pretargeting using technetium-99m (^99mTc) for detection. However, the unique properties of fluorescence activation and quenching combined with oligomers with their unique properties of hybridization may be particularly useful when used together for pretargeting with optical detection. The use of linear fluorophore-conjugated oligomer duplexes have been little used in animals, and to our knowledge, have not previously been considered for pretargeting applications. Methods A MORF/cDNA pair was selected such that when hybridized, the fluorescence of the Cy5.5-conjugated 25 mer MORF (Cy5.5–MORF25) is inhibited with a BHQ3-conjugated 18 mer complementary DNA (BHQ3–cDNA18). The short BHQ3–cDNA18 was selected to dissociate in the presence of a long cMORF25 in the pretargeted tumor, thus releasing the inhibitor from the Cy5.5 emitter. In this manner, the Cy5.5 fluorescence will be inhibited everywhere but in the target. The dissociation was first examined in vitro by adding the duplex to the cMORF25 both in solution and immobilized on polystyrene microspheres and by surface plasmon resonance (SPR). Thereafter, biotinylated cMORF25 immobilized on streptavidin polystyrene microspheres were administered intramuscularly in one thigh of hairless SKH-1 mice as target while an identical weight of the identical microspheres but without the cMORF25 was administered in the contralateral thigh as control. The animals then received IV the Cy5.5–MORF25/BHQ3–cDNA18 duplex or equal molar dosage of single-chain Cy5.5–MORF25 and were imaged. Results The SPR studies showed that the immobilized cDNA18 rapidly captured the flowing MORF25 to provide a duplex with a slow dissociation rate constant. Furthermore, when cMORF25 was next allowed to flow over the now immobilized duplex, the cDNA18 was unable to prevent dissociation of the heteroduplex and the formation and release of the cMORF25-MORF25 homoduplex. Images of animals obtained soon after receiving the Cy5.5–MORF25 singlet showed intense whole body fluorescence obscuring the target thigh. However, only 5 minutes after receiving the Cy5.5–MORF25/BHQ3–cDNA18 duplex, the target thigh was clearly visible along with only the kidneys. Conclusions This first study of optical pretargeting provides a proof of concept that oligomer pretargeting found to be useful with radioactivity detection is applicable with fluorescent detection as well. In addition, our results demonstrate that by using linear oligomers for optical pretargeting, chain lengths (and base sequences) may be manipulated to provide duplexes with stabilities and fluorescence inhibition optimized for pretargeting and other in vivo applications of optical imaging.     

Fine mapping of the spatial relationship between acute ischemia and dendritic structure indicates selective vulnerability of layer V neuron dendritic tufts within single neurons in vivo.

We have evaluated the spatial relationship between clotted vasculature and the structural integrity of layer V cortical neurons in YFP (yellow fluorescent protein)-H transgenic mice 2 to 10 h after photothrombotic stroke. Fortuitously, ischemic zones could be finely mapped about dysmorphic YFP labeled axons and dendrites using histology since Texas-red dextran used to assess blood flow in vivo was trapped within fixed clotted vessels. Ischemic damage to layer V neurons located at the border of ischemia was contained within apical tuft spiny dendritic structures and did not propagate to spines on the more proximal region of the apical dendrite. The lateral spread of dendritic damage decayed sharply with distance from the edge of ischemia (50% reduction in beaded dendrites within approximately 100 microm) and increased with time up to 6 h after stroke but not thereafter. Axonal damage also increased with time but extended further laterally than dendritic damage, up to 500 microm from the stroke core. Apoptotic and necrotic cell death cascades were activated 6 h after stroke; however, only within 300 microm of the ischemic core. These data suggest that the axonal and dendritic circuitry of neurons located 300 microm outside of an ischemic zone can be relatively free of damage or commitment to cell death suggesting that they may be in an ideal position to contribute to functional recovery. Given that ischemic damage may have a larger effect on circuitry involving superficial dendrites and projecting axons, it is conceivable that surviving peri-infarct neurons may have unique structural and functional properties.     

超声刀在腹腔镜胆囊切除术中的应用研究

目的　探讨超声刀在腹腔镜胆囊切除术中的应用价值。方法　将 86例腹腔镜胆囊切除术患者随机分为超声刀组 ( 3 4例 )与电刀组( 5 2例 ) ,分别使用超声刀与单极电刀完成手术 ,比较术中及术后的效果。结果　 86例手术顺利完成 ,无中转开腹。手术时间分别为 ( 4 5±7)min和 ( 62± 9)min(P <0 0 1) ,术中出血量分别为 ( 5± 0 .8)ml和 ( 2 0± 5 )ml(P <0 .0 1) ,术后肠道功能恢复时间分别为 ( 2 0± 4)h和 ( 2 4±6)h(P <0 0 1) ,两组均无胆瘘发生。结论　超声刀在腹腔镜胆囊切除术中较电刀更快捷 ,出血更少 ,术后恢复更快     

中药治疗风疹的疗效观察

风疹是一种常见的皮肤病,笔者2000年3月～2002年10月就诊资料完整、病情较重、中药治疗效果较为满意的125例报道如下.