FLAIR序列脑室内脑脊液搏动伪影(VCSFA)的表现及初步分析

目的探讨FLAIR序列脑室内脑脊液搏动伪影的表现及其与年龄、性别、脑室大小的关系。方法对100例正常成人行头颅MR检查,并对FLAIR序列脑室内脑脊液搏动伪影(VCSFA)进行观察统计分析。结果VCSFA表现为脑室内轻微或明显高信号,在Ⅲ,Ⅳ脑室最常见,在不同年龄组存在明显差异(P<0.05),VCSFA组Ⅲ,Ⅳ脑室左右径大于无VCSFA组(P<0.05)。结论VCSFA是由反转延迟造成的,随着年龄增长及脑室增大,VCSFA出现频率增加,与性别无关。     

过敏康Ⅱ号胶囊对AsAb阳性大鼠睾丸Bcl-2、Bax表达影响的实验研究

目的观察过敏康Ⅱ号胶囊对AsAb阳性大鼠睾丸Bcl-2、Bax表达的影响。方法选取健康成年雄性SD大鼠60只，按体重随机分为正常组，模型组，对照组，高、中、低剂量组，每组10只。采用主动免疫法建立血清抗精子抗体（AsAb）阳性动物模型10只，灌胃给药，免疫组化方法观察药物对AsAb阳性大鼠睾丸Bcl-2、Bax表达的影响。结果过敏康Ⅱ号高剂量组睾丸生精细胞和精子Bcl-2表达的平均吸光值显著高于模型组（P〈0．01），而Bax表达的平均吸光值显著低于模型组（P〈0．01）。结论调节睾丸Bcl-2、Bax的表达是过敏康Ⅱ号清除或抑制AsAb起治疗作用的机制之一。     

小肠原发性非霍奇金淋巴瘤34例临床分析

目的探讨小肠淋巴瘤的临床特点、治疗和预后。方法对1996年1月至2005年12月间收治的经组织病理学明确诊断、并作免疫学分型的原发性小肠淋巴瘤34例患者的临床资料进行分析。结果27例为B细胞淋巴瘤，7例为T细胞淋巴瘤。腹痛和肠梗阻是主要临床表现。用Ann Arbor分期，22例为Ⅰ～Ⅱ期，其中B细胞淋巴瘤20例（74．1％），T细胞淋巴瘤2例（2／7）；12例为Ⅲ～Ⅳ期，其中B细胞淋巴瘤7例（25．9％），T细胞淋巴瘤5例（5／7）；小肠B细胞淋巴瘤的分期低于T细胞淋巴瘤（P〈0．05）；27例行手术治疗，14例行6次化疗[方案为CHOP（环磷酰胺、阿霉素、长春新碱和强的松龙）]，8例同时加用抗CD20单克隆抗体Rituximab。T细胞淋巴瘤急诊手术率高于B细胞淋巴瘤（P〈0．05），B细胞淋巴瘤更易达到完全缓解（P〈0．05），累计生存率高于T细胞淋巴瘤（P〈0．05）。结论小肠B细胞淋巴瘤Ⅰ和Ⅱ期对手术和化疗效果佳，T细胞淋巴瘤的治疗效果和预后不满意。     

Expression of neuron-specific enolase and olfactory marker protein in the developing olfactory mucosa of human fetuses]

OBJECTIVE: To study the expression of neuron-specific enolase (NSE) and olfactory marker protein (OMP) in the developing olfactory mucosa of human fetuses. METHOD: The expression of NSE and OMP in the olfactory mucosa of 6 human fetuses (12, 16, 20, 24, 28 and 34 weeks) was studied using the technique of immunohistochemistry. RESULTS: NSE immunological positive reactions were seen in all 6 fetal mucosa from gestational 12 (G12) to G34, with plenty of positive-stained dual-pole neuron cells. At G12, the positive cells aligned tightly, the cell bodies were localized in the lower portion of olfactory epithelium and the positive-stained area occupied upper 2/3 of fetal nasal mucosa. With the development, the positive cells gradually became multilayer, but the density and the relative area of positive-cells reduced. At G34, the positive cells were located only in upper 1/3 of nasal mucosa. OMP-positive reactions were localized in a few dual-pole neurons at G12, the number was much less than NSE-positive cells in the same fetus. With the development, the OMP-positive cells gradually increased with most of the cell bodies located in the upper portion of epithelium, but number still relatively less than the NSE-positive cells at the same age. CONCLUSION: At G12, there were lots of olfactory neuron in the olfactory mucosa and only a few olfactory neurons had became mature. With the development, the olfactory epithelial area reduced but the number of mature olfactory neurons increased. At the last trimester, fetal olfactory sensor was almost matured.     

Atypical forms of isolated partial atrioventricular septal defect increase the risk of initial valve replacement and reoperation.

OBJECTIVE: We consider the short- and long-term outcomes of the repair of the isolated partial atrioventricular (AV) septal defect to determine the role played by the atypical forms on the initial AV valve replacement and on the risk of reoperation. METHODS: Two hundred and eight patients underwent an operation for this malformation between 1974 and 2001. Clinical and echocardiographic examinations were performed on all patients, the AV valve regurgitation was graded from 1 to 4 and a residual interatrial shunt was sought. Median age at the intervention was 5.8 years (3 months to 67 years). RESULTS: Median follow-up time was 7.5 years (range 0-22.6 years). The cumulative 30-day, 5- and 20-year survival rates were 96.5, 95.4 and 94.6%, respectively. AV valve replacement was associated with a high mortality (P<0.001). A reoperation was performed on 12 patients (5.7%) including six patients within less than a 30-day period, especially to repair residual AV valve regurgitation. We performed four AV valve repairs by annuloplasty and six AV valve replacements. Two patients who had initially undergone an AV valve replacement underwent a reoperation for valve thrombosis. The cumulative 30-day, 5- and 20-year rates of freedom from reoperation were 96.5, 93.6 and 83%, respectively. An atypical form was present in 24 patients (11.5%) and was a risk factor for initial AV valve replacement (P<0.001) and for reoperation (P<0.001). A complete AV block occurred in 13 patients (6.2%), all of them within a 30-day period. The AV valve replacement was a high risk factor for a complete AV block (P<0.001). At the end of our study 180 patients (96%) were in NYHA I and 8 in NYHA II. CONCLUSIONS: The morbi-mortality of the isolated partial AV septal defect is primarily perioperative and is linked with the presence of an atypical form of the lesion. This atypical form was the main reason for reoperation for AV valve regurgitation. The AV valve replacement was associated with a high mortality and with the occurrence of complete AV block. Using a standardized technique, the AV septal defect can be repaired with excellent long-term clinical and echographic results.     

弥漫性大B细胞淋巴瘤中CD40L的表达及意义

目的探讨弥漫性大B细胞淋巴瘤（DLBCL）组织中CD40L表达与DLBCL预后间的关系及意义。方法免疫组织化学法检测27例弥漫性大B细胞淋巴瘤、20例淋巴结反应性增生组织中CD40L的表达。结果（1）DLBCL中CD40L过度阳性率（25．93％）显著低于淋巴结反应性增生（63．64％），P〈0．05。（2）CD40L在Ⅲ、Ⅳ期DLBCL过度阳性率（14．29％）低于Ⅰ、Ⅱ期（38．46％），P〈0．05。CD40L过度阳性率在有结外浸润DLBCL（11．76％）低于无有结外浸润DLBCL（40％），P〈0．05。（3）DLBCL患者CD40L的过度阳性率与远处转移、临床分期均显著相关，P〈0．05。结论（1）CD40L过度阳性率与结外器官浸润及临床分期密切相关，其可能作为判断DLBCL侵袭性及预后的指标。（2）DLBCL中CD40L表达的减少可能是影响其发病的因素之一。     

食品中铬元素的含量分析

目的：了解常见食品中铬的含量，指导人群合理摄取铬元素，对糖尿病、动脉粥样硬化、冠心病患者的合理膳食提供理论依据。方法：用石墨炉原子吸收分光光度法测定25种食品中铬含量。选用357．9μm波长，采用二步干燥。测定回收率为92．6％--98．1％，相关系数r＝0．9987，回归方程Y＝0．0l19C 0．0766。结果：肉、蛋类中铬含量在102—532μg/kg之间，谷、豆和坚果类铬含量在104．1—355μg/kg之间，蔬菜、水果类铬合量在35．8—214．7μg/kg之间。结论：铬含量以动物性食品最高，谷类食物居中，蔬菜、水果较低。     

Partial splenic embolization for hypersplenism concomitant with or after arterial embolization of hepatocellular carcinoma in 30 patients

Purpose To study the value of partial splenic embolization (PSE) for the treatment of hypersplenism in patients undergoing embolization of hepatocellular carcinoma (HCC). Methods Transcatheter hepatic arterial embolization (THAE) combined with PSE was performed in 30 patients with HCC complicating liver cirrhosis, portal hypertension, and hypersplenism. Gelfoam sponge was used as the embolic material for PSE and limited to 100–150 pieces. Results More than 50% of splenic parenchyma was infarcted in 27 patients. Leukopenia and thrombocytopenia were corrected by PSE in 25 of 27 patients with hypersplenism. In 26 patients with esophageal varices, including 5 patients with bleeding, no rebleeding occurred during a 6–17 month follow-up. Hypersplenism was not corrected in 2 of 3 patients whose infarcted splenic parenchyma was less than 50%. No splenic abscesses or other severe complications were observed. Of the 30 patients treated, 19 are still alive after 1 year. Conclusions THAE combined with PSE is a safe and effective measure for patients with HCC.