C-TIRADS及BRAFV600E基因检测对细针穿刺细胞学难以定性的甲状腺结节的诊断价值

目的 探讨中国版甲状腺影像数据与报告系统（C-TIRADS）、BRAFV600E 基因检测及二者联合对细针穿刺细胞学难以定性的甲状腺结节的诊断价值。方法 纳入我院2020年1月—2021年4月的甲状腺手术患者53例行回顾性分析,术前完成超声、细针穿刺抽吸及BRAFV600E基因检测,选取细针穿刺细胞学难以定性的患者作为研究对象,53例患者共62个结节。以手术病理结果作为金标准,比较C-TIRADS、BRAFV600E基因检测及二者联合诊断对甲状腺结节的诊断效能。结果 C-TIRADS诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为92.50%、50.00%、77.08%、78.57%、77.42%。BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为55.00%、100.00%、100.00%、55.00%、70.97%。C-TIRADS联合BRAFV600E基因诊断甲状腺癌的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为95.00%、50.00%、77.55%、84.62%、79.03%。C-TIRADS及联合诊断对甲状腺癌诊断的敏感性高于BRAFV600E基因检测（P<0.001）,BRAFV600E基因检测特异性及阳性预测值高于C-TIRADS及联合诊断（P<0.05）。C-TIRADS、BRAFV600E基因检测及联合诊断对甲状腺癌诊断的阴性预测值和准确性差异无统计学意义（P>0.05）。结论 C-TIRADS及BRAFV600E基因检测对于细胞学难以定性的甲状腺结节均有良好的诊断效能,术前联合应用可以更好地评估甲状腺结节     

芪苈强心胶囊联合尼可地尔对射血分数保留性心力衰竭患者心功能及细胞因子的影响

目的 探讨芪苈强心胶囊联合尼可地尔对射血分数保留性心力衰竭患者心功能及细胞因子的影响。方法 连续入选2019年10月至2020年10月诊断为射血分数保留性心力衰竭的患者共90例,随机分为观察组(45例)与对照组(45例)。对照组给予常规抗心力衰竭药物加芪苈强心胶囊治疗,观察组在对照组治疗基础上,加用尼可地尔治疗。比较两组患者一般临床资料、细胞因子水平、心功能各项指标。随访1年患者心功能情况、细胞因子水平以及不良心脑血管事件(MACCEs)发生情况。结果 两组患者接受治疗1年后脑钠肽(BNP)、左室舒张末期内径、白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)均降低,射血分数(EF)值较治疗前升高,差异有统计学意义(P<0.05)。组间对比发现,两组患者入院时基础BNP、细胞因子、超声心能指标(LVEF、左室舒张末期内径、左房内径)差异无统计学意义(P>0.05);接受治疗1年后观察组IL-1β、IL-6、TNF-α、BNP、左室舒张末期内径低于对照组,EF值高于对照组,差异有统计学意义(P<0.05)。随访1年对照组共有7例发生终点事件,观察组共有4...     

改良尿道板重建卷管尿道成形术与尿道板纵切卷管尿道成形术治疗儿童尿道下裂的疗效对比

目的 比较改良尿道板重建卷管尿道成形术（又称Koyanagi术）与尿道板纵切卷管尿道成形术（TIP）在儿童尿道下裂中的临床疗效。方法 回顾性分析2018年1月—2021年10月甘肃省妇幼保健院收治的104例尿道下裂患儿的临床资料,其中53例患儿行改良Koyanagi术（研究组）,51例患儿行TIP（对照组）。两组患儿术后均随访12个月。比较两组手术时间、术中出血量、术后疼痛及排尿功能、手术成功情况,对比两组术后并发症发生情况。结果 两组手术时间、术中出血量比较,差异均无统计学意义（P >0.05）。两组患儿术后4、12、24和48 h的FLACC评分比较,采用重复测量设计的方差分析,结果 ①不同时间点FLACC评分差异有统计学意义（F =10.871,P =0.000）;②研究组与对照组FLACC评分差异无统计学意义（F =1.849,P =0.157）;③研究组与对照组FLACC评分变化趋势差异无统计学意义（F =2.516,P =0.085）。两组患儿术后12个月的最大尿流率、平均尿流率、排尿量、尿流时间、手术成功率比较,差异均无统计学意义（P >0.05）。研究组术后总并发症发生率低于对照组（P <0.05）。结论 改良Koyanagi术与TIP治疗儿童尿道下裂疗效相近,均可获得满意效果,但改良Koyanagi术在降低术后并发症方面具有优势。     

利用密度的指数原理优化X射线中骨骼的边缘

利用指数衰减原理来抑制 x射线图像中小密度组织对骨骼边缘的影响 ,利用该方法很容易使用直方图原理提取出骨骼的边缘和内部结构变化的二值图 ,并有效地抑制了背景对骨骼边缘的影响 ,结合 canny算子的结果 ,可以有效地提取人体复杂结构中骨骼的边缘。     

紫外线对两种聚四氟乙烯电荷储存稳定性的影响

利用在室温下的栅控恒压电晕充电后经不同强度紫外线辐照的表面电位测量,研究了紫外线对聚四氟乙烯(polytetrafluoroethylene,PTFE)多孔膜、聚四氟乙烯非多孔膜驻极体电荷储存稳定性的影响,探讨了两种聚四氟乙烯驻极体医疗产品使用紫外消毒方法的可行性.结果:(1)在常温条件下,紫外线辐照对两种聚四氟乙烯驻极体的电荷储存稳定性的影响不大;(2)聚四氟乙烯多孔膜驻极体的电荷储存能力随环境湿度的提高而略有下降;(3)聚四氟乙烯医用驻极体产品可采用紫外消毒法消毒.     

Development of a Western Blot Assay for Detection of Antibodies against Coronavirus Causing Severe Acute Respiratory Syndrome

To identify a major antigenic determinant for use in the development of a rapid serological diagnostic test for severe acute respiratory syndrome (SARS) coronavirus infection and to study the immune response during SARS coronavirus infection in humans, we cloned the full length and six truncated fragments of the nucleocapsid gene, expressed them, and purified them as glutathione S-transferase-tagged recombinant proteins. The reactivities of the recombinant proteins to a panel of antibodies containing 33 SARS coronavirus-positive sera and 66 negative sera and to antibodies against other animal coronaviruses were screened. A truncated 195-amino-acid fragment from the C terminus of the nucleocapsid protein (N195) was identified that had a strong ability to detect antibodies against SARS coronavirus. No cross-reaction was found between the N195 protein and antibodies against chicken, pig, and canine coronaviruses. The N195 protein was used to develop a Western blot assay to detect antibodies against SARS coronavirus in 274 clinically blinded samples. The specificity and sensitivity of this test were 98.3 and 90.9%, respectively. The correlation between our Western blotting assay and an immunofluorescence assay (IFA) was also analyzed. The results of our Western blot assay and IFA for the detection of SARS coronavirus-positive sera were the same. Thus, the N195 protein was identified as a suitable protein to be used as an antigen in Western blot and other possible assays for the detection of SARS coronavirus infection.     

Ontogenetic transition in fetal wound transforming growth factor-beta regulation correlates with collagen organization

Fetal rat skin transitions from scarless fetal-type repair to adult-type repair with scar between day 16 (E16) and day 18 (E18) of gestation (term = 21.5 days). Deficient transforming growth factor (TGF)-beta 1 and -beta 2 injury response has been proposed as a mechanism for scarless fetal-type repair. However, previous fetal studies have inconsistently reported the degree of TGF-beta induction after injury. To minimize developmental variables in fetal versus adult TGF-beta regulation, we narrowed our study to wounded fetal animals. We hypothesize that TGF-beta ligand and receptor expression will be differentially regulated during the transition from early gestation (E16) wounds manifesting scarless fetal-type repair to late gestation (E19) wounds manifesting adult-type repair with scar. In this study, decreased and rapidly cleared TGF-beta 1 and -beta 2 expression accompanied by increased and prolonged TGF-beta 3 levels in wounded E16 animals correlated with organized collagen deposition. In contrast, increased and prolonged TGF-beta 1 and -beta 2 expression accompanied by decreased and delayed TGF-beta 3 expression in wounded E19 animals correlated with disorganized collagen architecture. Similarly, expression of TGF-beta receptors type I and II were also increased or prolonged in E19 animals. Our results implicate increased TGF-beta 1, -beta 2, and decreased TGF-beta 3 expression, as well as increased type I and II receptor expression in late gestation fetal scar formation.     

Plurihormonal pituitary adenomas: immunostaining of all pituitary hormones is mandatory for correct classification

AIMS: We studied the clinicopathological characteristics of plurihormonal pituitary adenomas. METHODS AND RESULTS: The study material included 167 plurihormonal adenomas, which consisted of 31% of the surgically removed pituitary adenomas that we collected during a 12-year period. The mean age of patients with plurihormonal adenoma was 45.7 years (range 13-75 years). There were 86 men and 81 women. All tumours were fully classified by immunohistochemical staining for seven pituitary hormones or subunits. Thirty immunohistochemical subtypes of plurihormonal adenomas were recognized. Hormonal symptoms were present in 70% of patients, while serum hormonal levels were increased in 89% of patients. Most patients had symptoms related to only one of the hormones and only 7% of patients had symptoms related to two hormones. The most common hormonal symptom was acromegaly (50%); symptoms related to hyperprolactinaemia ranked second (20%). Double immunostaining of all the possible combinations of the hormones was performed in 30 selected tumours, and they all showed mixtures of hormones in individual adenoma cells in any hormonal combinations studied. The latter finding supported the view that plurihormonal adenomas are monomorphous adenomas. CONCLUSIONS: Plurihormonal adenomas are common pituitary adenomas. Immunohistochemical staining of all pituitary hormones is mandatory for correct classification.     

胃泌素对大鼠胃粘膜环氧合酶及生长因子表达的影响

目的：探讨胃泌素对大鼠胃粘膜环氧合酶（COX）及生长因子表达的影响。方法：雄性SD大鼠皮下注射胃泌素1 μg/kg、10 μg/kg或100 μg/kg，Western blot和免疫组化检查胃粘膜COX-1、COX-2、肝细胞生长因子（HGF）和肝素结合表皮生长因子样生长因子（HB-EGF）表达。评价胃泌素受体拮抗剂YM022对COX-1、COX-2、HGF和HB-EGF表达的影响。结果：胃泌素剂量依赖性地增加大鼠胃粘膜COX-2和HB-EGF表达，而对COX-1和HGF表达无明显影响；YM022阻断胃泌素诱导的COX-2和HB-EGF表达。 结论： 胃泌素调节大鼠胃粘膜COX-2和HB-EGF蛋白表达，提示COX-2和HB-EGF参与与胃泌素相关联的胃粘膜增生和胃癌等的发病过程。