脂肪饮食与胆石症关系的调查研究

本文通过荤食组、常食组、素食组与胆石症发病率关系的调查,发现荤食组的发病率14/35(40%)比其它两组8/35(22.85%)、2/35(5.71%)更高。同时发现与病人的高血脂水平呈正相关。荤食组的胆固醇和甘油三酯水平分别为5.4±0.85和1.88±1.02,并且比常食组5.08±1.18,1.76±0.62和素食组4.88±0.41,1.67±0.36更高。结果提示:限制大量的胆固醇和脂肪饮食可降低胆石症的发病率。     

加压螺钉治疗老年股骨转子间骨折的临床与X线分析

目的：探讨髋动力加压螺钉（ＤＨＳ）治疗老年股骨转子间骨折中的影响因素及操作技术。方法：临床应用３８例,男２３例,女１５例,平均年龄６２３岁。其中稳定型骨折１６例,不稳定型骨折２２例。随访７～３０个月,平均９个月。结果：髋关节功能根据ＭｅｒｌｅＤＡｕｂｉｇｎｅ评分方法,优２３例（１７～１８分）,良１１例（１３～１６分）,差４例（８分）。结论：ＤＨＳ治疗老年股骨转子骨折的疗效与小转子区骨折块的解剖复位、加压螺钉的位置及股骨近端的Ｓｉｎｇｈ指数等因素密切相关;加压螺纹钉的理想位置应该是Ｘ线正位像上在偏内下方,侧位像上在中央。     

CT analysis of the effect of pirfenidone in patients with idiopathic pulmonary fibrosis

Purpose

Pirfenidone is a new, anti-fibrotic drug used for the treatment of idiopathic pulmonary fibrosis (IPF). The aim of this study was to evaluate the utility of computed tomography (CT) in the imaging assessment of the response to pirfenidone therapy.

Materials and methods

Subjects were 78 patients with IPF who underwent CT on two occasions with one-year interval (38 consecutive patients treated with pirfenidone and 40 age-matched control). Changes in the fibrous lesion on sequential CTs were assessed as visual score by two radiologists. We measured the volume and change per year of fibrous pattern (F-pattern) quantitatively using a computer-aided system on sequential CTs.

Results

The baseline vital capacity (%pred VC) was 74.0 ± 14.0% in the pirfenidone group and 74.6 ± 16.6% in controls (p = NS). Deterioration of respiratory status was defined as 10% or greater decline in %pred VC value after 12-month treatment. A significantly larger proportion of pirfenidone-treated patients showed stable respiratory status (21 of 38, 65.6%) than the control (15 of 40, 37.5%). The change in fibrous lesion was significantly smaller in the pirfenidone group than the control in both of visual score (p = 0.006) and computer analysis (p < 0.001). The decline in VC correlated significantly with the increase in fibrotic lesion (p < 0.001).

Conclusion

CT can be used to assess pirfenidone-induced slowing of progression of pulmonary fibrosis.     

Is there any correlation between model-based perfusion parameters and model-free parameters of time-signal intensity curve on dynamic contrast enhanced MRI in breast cancer patients?

Objective

To find out any correlation between dynamic contrast-enhanced (DCE) model-based parameters and model-free parameters, and evaluate correlations between perfusion parameters with histologic prognostic factors.

Methods

Model-based parameters (Ktrans, Kep and Ve) of 102 invasive ductal carcinomas were obtained using DCE-MRI and post-processing software. Correlations between model-based and model-free parameters and between perfusion parameters and histologic prognostic factors were analysed.

Results

Mean Kep was significantly higher in cancers showing initial rapid enhancement (P?=?0.002) and a delayed washout pattern (P?=?0.001). Ve was significantly lower in cancers showing a delayed washout pattern (P?=?0.015). Kep significantly correlated with time to peak enhancement (TTP) (ρ?=??0.33, P?<?0.001) and washout slope (ρ?=?0.39, P?=?0.002). Ve was significantly correlated with TTP (ρ?=?0.33, P?=?0.002). Mean Kep was higher in tumours with high nuclear grade (P?=?0.017). Mean Ve was lower in tumours with high histologic grade (P?=?0.005) and in tumours with negative oestrogen receptor status (P?=?0.047). TTP was shorter in tumours with negative oestrogen receptor status (P?=?0.037).

Conclusions

We could acquire general information about the tumour vascular physiology, interstitial space volume and pathologic prognostic factors by analyzing time-signal intensity curve without a complicated acquisition process for the model-based parameters.

Key points

? Kep mainly affected the initial and delayed curve pattern in time–signal intensity curve. ? There is significant correlation between model-based and model-free parameters. ? We acquired information about tumour vascular physiology, interstitial space volume and prognostic factors.     

影响腰椎间盘内压两大因素的生物力学分析

腰椎间盘的退变年龄愈趋早化，椎间盘源性腰腿痛患者越来越多。陶甫［１］曾统计仅约１０～２０％的此类患者需用手术治疗，大多数医者亦主张手术治疗须十分谨慎，将长期保守治疗无效放在手术适应症的首位。如何在发病前积极预防，在保守治疗和手术治疗有效后巩固疗效，降低复发率是当今临床易被忽视又不容忽视的重要问题。以下对腰椎间盘内压众多影响因素中肌力和胸腹腔内压这两大主要因素进行生物力学分析，为椎间盘源性腰腿痛提供有效的防治方法。腰椎间盘平面力系建立的前提条件人体直立正面观的正中线通过脊柱，左右同名肌对称分布且相…     

hTERT启动子特异驱动IL-24重组腺病毒的包装及鉴定

目的 包装并鉴定人端粒酶逆转录酶（hTERT）启动子特异驱动白介素-24（IL-24）的重组复制缺陷型腺病毒.方法 全基因合成优化后的hTERT启动子,插入质粒pGL3-basic的多克隆位点（pGL3-phTERT）;从人外周血单核细胞扩增IL-24,插入pGL3-phTERT质粒的hTERT启动子下游获得pGL3-phTERT-IL24;随后将phTERT-IL24插入pShuttle中间质粒,使用AdEasy^TM Adenoviral Vector System包装Ad-phTERT-IL24重组腺病毒;同时包装CMV启动子驱动IL-24的腺病毒载体为阴性对照（Ad-CMV-IL24）,以空载腺病毒Ad作为空白对照.用20 MOI重组腺病毒感染SGC-7901、MKN-45、HF细胞,采用PCR及Western blot检测IL-24在RNA及蛋白水平的表达.结果 成功包装Ad-hTERT-IL24重组腺病毒.感染Ad-hTERT-IL24后,hTERT阳性肿瘤细胞内IL-24表达显著上调,但hTERT阴性的HF细胞则无IL-24表达;感染阴性对照Ad-CMV-IL24后,hTERT阳性或阴性细胞内均有IL-24表达,感染空白对照Ad后,hTERT阳性或阴性细胞内均无IL-24表达.结论 Ad-hTERT-IL24腺病毒载体可有效介导IL-24特异表达于hTERT阳性肿瘤细胞内.     

我院近8年甲状腺疾病住院患者两性间流行病学资料比较

目的 比较分析我院近8年甲状腺疾病住院患者两性间的流行病学特征.方法回顾性分析本院2004~2011年住院甲状腺疾病患者的资料.结果 8年间第一诊断为甲状腺疾病的住院患者共1997例,其中女性1455例,占72.86%,男性542例,占27.14%,男女比例差异有统计学意义.住院次数、年龄、婚姻状况、疾病分布、治愈率、手术率均有明显性别间差异,男性发病年龄高峰在30岁之前,而女性发病高峰在31~50岁.结论 我院住院甲状腺疾病患者流行病学特征有明显性别差异.     

唑来膦酸治疗绝经后骨质疏松患者2年结果分析

目的 分析唑来膦酸（商品名：密固达）治疗绝经后骨质疏松患者2年后的疗效和不良反应.方法 统计我院2009~2012年中连续使用密固达治疗2年的绝经后骨质疏松患者47例的临床资料,分析治疗前后患者骨密度变化情况及不良反应发生率.结果 首次使用密固达患者中,出现发热3例（6.4%）,肌痛3例（6.4%）,发热合并肌痛9例（19.1%）.其中1例出现高热（最高体温40.5 ℃）;1例出现双侧大腿内侧出血点,1 w后消退;其余不良反应少见.第二次输注后出现发热5例（10.6%）,但无高热发生.左侧股骨颈骨密度、左侧全髋骨密度、L2~4椎体骨密度,治疗后与治疗前以及治疗第2年与第1年比较均明显升高（P＜0.05）.结论 密固达治疗绝经后骨质疏松对骨密度提升效果明显,且总体安全性好,主要不良反应为发热和肌痛.     

高b值DWI结合T2WI对PSA异常前列腺病变的诊断价值

目的T2wI结合DWI对PSA异常患者前列腺病变的鉴别诊断价值。方法经病理证实前列腺疾病患者53例,其中前列腺癌患者13例,前列腺炎患者6例,前列腺增生（benignprostatic hyperplasia,BPH）患者34例,行MRI常规平扫及b值1000s／mm^2的DWI扫描检查,经2名有经验的副主任医师进行双盲阅片,比较T2WI与DWI结合T2wI对前列腺癌、前列腺炎、BPH的定性诊断准确率。结果T。wI对前列腺癌、前列腺炎、BPH的定性诊断准确率分别为69．2％、33．3％、73．5％,DWI结合T：wI对前列腺癌、前列腺炎、BPH的定性诊断准确率分别为84．6％、66．7％％、88．2％。结论对于前列腺PSA异常的患者,b值1000s／mm。的DWI结合TzwI能提高前列腺疾病的定性诊断率。     

术前区域动脉持续灌注化疗并栓塞治疗局部晚期乳腺癌的临床观察

目的：观察术前区域动脉持续灌注化疗并栓塞治疗局部晚期乳腺癌的效果。方法：应用术前超选择区域动脉插管持续灌注化疗结合次要供血动脉栓塞的方案,经治Ⅲａ,ｂ 期乳腺癌患者９ 例。结果：在治疗后的１ 个月内取得良好效果,有效率达８９ ％ （８／９） 。结论：局部晚期乳腺癌术前区域动脉持续灌注化疗配合次要供血动脉栓塞可有效提高术前化疗疗效,显著缩短疗程且毒副反应小、简便,值得推广应用。