于氨双唑钠对局部晚期非小细胞肺癌放射增敏作用的疗效观察

目的：探讨甘氨双唑钠（CMNa）对III期肺癌的放射增敏作用及不良反应。方法：采用随机分组的方法将经病理学确诊的Ⅲ期非小细胞肺癌（NSCLC）患者分为实验组（A组,放疗加甘氨双唑钠）及对照组（B组,单纯放疗）。两组放疗方法均一样。A组在放疗同时,加用CMNa（800mg／m^2）,每周3次,至疗程结束;B组为单纯放疗,评价两组疗效及观察不良反应。结果：A组的CR＋PR为82．6％（19／23）,显著高于B组的52．2％（12／23）,P〈0．05,差异有统计学意义。两组的不良反应比较,P〉0．05,差异无统计学意义。结论：甘氨双唑钠对局部晚期非小细胞肺癌有放射增敏作用．可提高有效率（CR＋PR）,但不增加不良反应。     

不同标准空腹血糖受损人群葡萄糖负荷后血糖代谢特征

目的：分析两种标准空腹血糖受损人群葡萄糖负荷后血糖代谢特点。方法：对3828名40岁以上居民进行流行病学调查,对空腹血糖≥5.6mmol/L者行75g葡萄糖负荷试验,据不同空腹血糖受损诊断标准分析负荷后2h血糖代谢情况。结果：在以空腹血糖为6.1mmol/L为切点诊断的245例空腹血糖受损（IFG）人群中,糖耐量减低（IGT）的患病率为41.22%,女性（25.71%）高于男性（15.51%）;2型糖尿病（T2DM）患病率为20.82%,女性（11.84%）高于男性（8.98%）。在以空腹血糖为5.6mmol/L为切点诊断的627例空腹血糖受损人群中,糖耐量减低的患病率为37.00%,女性（23.76%）高于男性（13.23%）;2型糖尿病患病率为13.88%,女性（9.52%）高于男性（4.63%）。结论：以空腹血糖为5.6mmol/L和6.1mmol/L为切点诊断的空腹血糖受损人群葡萄糖负荷后2h血糖代谢异常率分别为50.88%和62.04%,患病率女性均高于男性。     

慢性肾小球肾炎伴肾衰患者血清α1肾上腺素受体和抗血管紧张素Ⅱ受体1型自身抗体检测结果分析

目的 探讨抗血管紧张素Ⅱ受体1型（AT1-受体）、α1-肾上腺素受体（α1-受体）、自身抗体是否与慢性肾小球肾炎（CaN）发病有关。方法 以合成的AT1受体和α1受体多肽片段为抗原，应用酶联免疫吸附测定（ELISA）技术，检测66例CGN患者、58例高血压病患者及柏例正常人血清中抗AT1和α1受体自身抗体。结果 CGN肾功能不全组抗AT1和α1受体抗体阳性率分别为56．1％（37／66）和53．0%（36／66），高于高血压无肾损害组（分别为15．5％和12．1％）及正常对照组（分别为10％和12．5％），P〈0．01。结论 抗G蛋白偶联型受体自身抗体可能与慢性肾小球肾炎发病有关。     

A crucial role for TNF-α in mediating neutrophil influx induced by endogenously generated or exogenous chemokines,KC/CXCL1 and LIX/CXCL5

Background and purpose:

Chemokines orchestrate neutrophil recruitment to inflammatory foci. In the present study, we evaluated the participation of three chemokines, KC/CXCL1, MIP-2/CXCL2 and LIX/CXCL5, which are ligands for chemokine receptor 2 (CXCR2), in mediating neutrophil recruitment in immune inflammation induced by antigen in immunized mice.

Experimental approach:

Neutrophil recruitment was assessed in immunized mice challenged with methylated bovine serum albumin, KC/CXCL1, LIX/CXCL5 or tumour necrosis factor (TNF)-α. Cytokine and chemokine levels were determined in peritoneal exudates and in supernatants of macrophages and mast cells by elisa. CXCR2 and intercellular adhesion molecule 1 (ICAM-1) expression was determined using immunohistochemistry and confocal microscopy.

Key results:

Antigen challenge induced dose- and time-dependent neutrophil recruitment and production of KC/CXCL1, LIX/CXCL5 and TNF-α, but not MIP-2/CXCL2, in peritoneal exudates. Neutrophil recruitment was inhibited by treatment with reparixin (CXCR1/2 antagonist), anti-KC/CXCL1, anti-LIX/CXCL5 or anti-TNF-α antibodies and in tumour necrosis factor receptor 1-deficient mice. Intraperitoneal injection of KC/CXCL1 and LIX/CXCL5 induced dose- and time-dependent neutrophil recruitment and TNF-α production, which were inhibited by reparixin or anti-TNF-α treatment. Macrophages and mast cells expressed CXCR2 receptors. Increased macrophage numbers enhanced, while cromolyn sodium (mast cell stabilizer) diminished, LIX/CXCL5-induced neutrophil recruitment. Macrophages and mast cells from immunized mice produced TNF-α upon LIX/CXCL5 stimulation. Methylated bovine serum albumin induced expression of ICAM-1 on mesenteric vascular endothelium, which was inhibited by anti-TNF-α or anti-LIX/CXCL5.

Conclusion and implications:

Following antigen challenge, CXCR2 ligands are produced and act on macrophages and mast cells triggering the production of TNF-α, which synergistically contribute to neutrophil recruitment through induction of the expression of ICAM-1.     

Pressure erosions of bone in rheumatoid arthritis: a subject review

Pressure, or compressive, erosions of bone in various locations in patients with rheumatoid arthritis are described. Possible pathophysiologic mechanisms that account for the appearance and distribution of these erosions include osteopenia, soft-tissue laxity, soft-tissue pressure on bone, bone pressure on bone, and muscular forces.     

3D DESS磁共振序列诊断神经根型颈椎病临床价值

目的：探讨3D双回波稳态进动（dual echo steady state ,DESS）磁共振序列在显示椎管内臂丛神经的形态解剖学信息的情况,以及在显示突出椎间盘与椎管内臂丛神经的关系的临床应用价值。方法对35例有颈肩痛和上肢麻痛等颈丛和臂丛神经根受压症状,临床高度怀疑神经根型颈椎病患者行颈椎M RI常规序列（矢状位 T1 WI ,T2 WI ,横轴位T2WI）和3D DESS序列,3D DESS序列的所有图像均采用3D最大信号强度投影（MIP）与曲面重组等后处理,由2位高级职称M RI影像诊断医师通过对重建后图像所显示的臂丛神经椎管内神经根的形态、长度以及突出椎间盘与椎管内臂丛神经的关系的影像表现,评价3D DESS序列在神经根型颈椎病影像诊断中的临床应用价值。结果3D DESS序列重建图像和常规MRI T2WI序列图像对臂丛神经椎管内神经前根的显示率分别为94．3％（33／35）和88．6％（31／35）,对臂丛神经椎管内神经后根的显示率分别为94．3％（33／35）和80％（28／35）,3D DESS序列明显优于常规层厚 T2 WI图像,差异有显著性意义（P ＜0．05）;在臂丛神经椎管内神经前后根完整性的显示方面,两者间差异无统计学意义（P ＞0.05）。结论3D DESS序列经重建后的图像,可提供更多的椎管内臂丛神经的形态解剖学信息,能清晰显示突出椎间盘对神经根的压迫情况,为临床治疗提供明确依据。     

Shoulder joint: arthrographic CT and long-term follow-up, with surgical correlation

One hundred two computed tomographic (CT) arthrograms of the shoulder were retrospectively reviewed and compared with conventional double-contrast arthrograms from 101 patients (24 females and 77 males aged 9-70 years). One- to 4-year follow-up was obtained in 84 patients, 40 of whom underwent open-shoulder surgery or arthroscopy. Morphology of the normal portions of each labrum was categorized according to length, width, and tip shape. Correlation between morphology and age was weak, but abnormal labra were more common in younger patients. Conventional radiography was more accurate for detecting bony glenoid margin fractures, but CT was more accurate for detecting Hill-Sach fractures. CT was also more reliable than conventional arthrography in the detection of rotator cuff tears. Hence, few if any conventional radiographs are necessary between contrast material injection and CT imaging. A reduction in the number of images obtained will result in decreased radiation dose, less cost, and shorter examination time without loss of diagnostic accuracy.     

Breast specimen radiography: evaluation of a compression device

The irregular shape and uneven tissue thickness of excised breast specimens makes radiographic evaluation difficult, especially when calcifications are not present. Xeroradiographs before and after compression of 20 separate excised breast specimens were compared, and 17 of the same specimens were compared after compression combined with immersion in water. Specimen compression improved visibility of the lesion on average in 88% of cases, and visibility was equal in 12%. Combined compression/immersion further improved visibility of the lesion on average in 37% of cases. More significantly, evaluation of the compressed specimen led to a change in interpretation of the radiographs in 45% of cases. Compression of the specimen in specimen radiography is recommended in all cases in which pre-biopsy localization is performed.