颈淋巴结结核的CT诊断

提高对颈淋巴结结核的认识和CT诊断的正确性。材料和方法：经CT检查的颈淋巴结结核33例，与同期颈肿块（除颈器官肿瘤外）49例作CT对照研究，均经病理及临床证实。结果：（1）结核发病中位年龄29．2岁，明显年轻于恶性肿瘤组（556岁）。（2）结核淋巴结坏死率和包膜高度强化率均高达81．82％，结内坏死面积（≥1／2）者达7576％。（3）本文依颈淋巴结结核的CT形态分布提出分型：单纯型（Ⅰ－Ⅳ）、混合型：单纯型又可分为Ⅰ型（单个淋巴结，直径＜20mm）、Ⅱ型（串珠型）、Ⅲ型（多房型）、Ⅳ型（融合呈大单房或单个直径≥20mm）。其中Ⅱ型具诊断特异性。结论：CT对颈淋巴结结核有诊断价值。     

Infrared radiation spectrum of acupuncture point on patients with coronary heart disease

The objective of this study was to compare the acupoint infrared radiation spectrums of patients and healthy volunteers to show whether those of coronary heart disease (CHD) patients carry distinctive pathological information. PHE201, using a highly sensitive infrared spectrum detection device applied to the acupoint Neiguan (PC6) and to a control point on 50 CHD patients and 47 healthy adults. A total of 73 wavelength spots were detected. The scanned wavelengths ranged from 1.5 microm to 16 microm, and the scanning spacing was 0.2 microm. The data were automatically recorded in the database of the device for statistical analysis. Infrared radiation intensities of 23 in the 73 detected wavelength spots significantly differed in the CHD patients' Neiguan as compared to those of the healthy subjects (from p=0.048 to p=0.002), while only 12 wavelength spots at a non-acupuncture control point showed significant differences. By the chi(2) test, these differences between Neiguan and the non-acupuncture control point are statistically significant (p=0.033). At 2-2.5 microm, which is related to energy metabolism, the intensity at the CHD patients' Neiguan was significantly lower than that of the healthy adults (from p=0.026 to p=0.017). No difference was observed at the non-acupuncture control point (from p=0.094 to p=0.052). The data suggest that the changes of infrared spectrum at Neiguan in coronary heart disease patients may reflect the distinct pathological changes. This may be the result of hypoactive energy metabolism in the area of the acupoint.     

玻璃瓶及塑料瓶内复方碘溶液稀释液的稳定性比较

本文报告了复方碘溶液稀释液在玻璃瓶及塑料瓶内稳定性的研究,结果有效期在玻璃瓶内为21天,塑料瓶内为1.6天。为该制剂包装材料的选择及门诊发药量的确定提供了依据。     

氯胺酮对人肺癌A549细胞生长的影响及相关机制研究

目的:探讨麻醉类药物氯胺酮和吗啡对人肺癌A549细胞生长的影响及相关作用机制?方法:体外培养肺癌细胞系A549,细胞培养24 h后,随机分为3组:对照组(NC组,加0.9% NaCl处理)?氯胺酮组(K1?K2?K3组,分别加氯胺酮100?200?400 ?滋g/mL处理)和吗啡组(M1?M2?M3组,分别加吗啡25?50?100 ?滋g/mL处理)?持续作用24 h后,Transwell小室培养体系测定肿瘤细胞的迁移率;双荧光素酶报告基因法测定NF-κB转录活性;48 h后MTT法测定细胞增殖抑制率;Western blot技术测定NF-κB P65的蛋白表达;QPCR技术检测细胞内IL-1β和COX-2的mRNA表达?结果:①与NC组比较,M1?M2组表现为促进A549细胞迁移(P < 0.05),M3组作用不明显;K1?K2?K3组表现为抑制A549细胞迁移(P < 0.05);②与NC组比较,M1?M2组表现为促进A549细胞增殖(P < 0.05),M3组作用不明显;K2?K3组表现为抑制A549细胞增殖(P < 0.05),K1组不明显;③与NC组比较,M1?M2?M3组表现为促进IL-1β?COX-2的mRNA表达(P < 0.05);K2?K3组表现为抑制IL-1β?COX-2的mRNA表达(P < 0.05),K1组不明显;④与NC组比较,M1?M2?M3组表现为促进P65的转录和蛋白表达(P < 0.05),K1?K2?K3组表现为抑制P65的转录和蛋白表达(P < 0.05)?结论:与阿片类药物不同,氯胺酮通过NF-κB信号通路及其下游因子IL-1β和COX-2抑制人肺腺癌细胞A549的迁移和增殖,可能更适用于肺癌患者的术后镇痛?     

胰岛素瘤定位诊断方法的选择与评价

目的分析胰岛素瘤定位诊断的方法，探讨合理选用的策略。方法对1990年1月至2005年2月北京协和医院收治的137例胰岛素瘤的临床资料进行回顾性分析。结果本组126例行手术治疗，除2例外术中均发现肿瘤，包括11例定性诊断明确，但无定位诊断的病人。术前BUS、EUS、CT、MRI、DSA和ASVS定位的阳性率分别为18．3％（23／126）、68．4％（13／19）、48．5％（48／99）、20％（3／15）、83．3％（70／84）和88．2％（15／17）。结论胰岛素瘤术前定位诊断有助于手术方式的选择，可首选相对无创的增强CT和EUS检查，仍然无法获得定位的病人可选择DSA或ASVS。对定性诊断明确的病人，无论能否获得定位诊断，均应及早手术探查，以免延误治疗。     

Primary Breast Angiosarcoma: A Retrospective Study of 36 Cases from a Single Chinese Medical Institute with Clinicopathologic and Radiologic Correlations

The aim of this study was to present our experience with primary breast angiosarcoma (PBA) by describing a large series of cases with an emphasis on clinicopathologic and radiologic correlations. Thirty‐six cases of PBA diagnosed at our institution between 2006 and 2014 were retrospectively evaluated. All but one case occurred in women with a median age of 35.5 years. The majority of patients presented with a deeply located painless mass, whereas a minority manifested as diffuse enlargement or swelling of the breast. Magnetic resonance imaging showed poorly demarcated lesions with low signal intensity on T1‐weighted images, markedly high intensity on T2‐weighted images, and prolongation of enhancement upon dynamic study. Histologically, 19 cases (52.8%) were low grade, 12 cases (33.3%) were intermediate grade, and 5 cases (13.9%) were high grade. Follow‐up information was available for 27 patients and revealed local recurrence and/or metastasis in 16 patients (59.3%). Five patients (18.5%) died of the disease at a median interval of 20 months. Univariate analysis showed that tumor differentiation had effect on disease‐free survival (DFS) (p = 0.005) but failed to predict overall survival (OS) (p = 0.645). The treatment modality was related to OS (p = 0.042) but not DFS (p = 0.131). The Cox proportional hazards regression model suggested that tumor differentiation was an independent predictor of DFS (p = 0.015). We hypothesize that tumor differentiation may be used as a prognostic factor for this rare malignancy. Clinicopathologic and radiologic correlation may help pathologists to arrive at the correct diagnosis of PBA.     

氟伐他汀对老年动脉粥样硬化所致肾动脉狭窄的临床疗效观察

目的观察氟伐他汀对老年肾动脉粥样硬化所致肾动脉狭窄(ARAS)的治疗作用及其抗炎机制。方法将在我院门诊及住院的54例老年ARAS患者,随机分为治疗组及对照组,对照组给予常规降压治疗,治疗组每晚加服氟伐他汀40 mg。比较两组治疗前及治疗后尿蛋白排泄率(UAER)、血肌酐(Scr)、C反应蛋白(CRP)及肾脏血管多普勒超声中肾动脉收缩期峰值速度(PSV)、肾动脉血流加速度时间(AT),肾动脉峰值流速与肾动脉开口处腹主动脉流速之比(RAR)等指标。结果观察期间,两组上述指标均呈下降趋势,治疗组UAER,PSV,AT,RAR下降较对照组明显(P<0.05,P<0.01),治疗组CRP下降明显(P<0.05,P<0.01),对照组CRP变化不明显(P>0.05)。而且在两组血脂正常的老年ARAS所致肾动脉狭窄的患者进行比较分析也得出类似结果。结论氟伐他汀因降低CRP的致炎效应而改善肾动脉狭窄,且不依赖氟伐他汀的降血脂作用。     

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

产妇血清叶酸水平对新生儿出生特征的影响

目的:探讨产妇血清叶酸水平对新生儿血清叶酸、身长、体质量和头围的影响.方法:对80名产妇进行回顾性健康问卷调查;采用顺磁性颗粒化学发光免疫法测定血清叶酸水平;采用卧式身长计和头围尺分别测量新生儿身高和头围;电子秤称量新生儿体质量.结果:母体血清叶酸水平为(2.27±2.14)μg/,L,新生儿脐带血血清叶酸水平为(7....     

80后医学毕业生工作满意度影响因素研究

本文从实证研究入手,以80后医学毕业生为研究对象,采用因子分析拟合得到其工作满意度的3个维度,通过相关分析和回归分析发现,工作满意度（F1）的主要影响因素为工作驱动因素（F2）,间接影响因素为工作阻碍因素。单因素分析发现,薪酬和压力对工作满意度具有显著性影响（P〈0.05）,个人职业发展机遇是80后医学毕业生最为关注的因素。多因素分析依据进入方程的4个主要影响因素建立起了概率预测模型,据此模型可以通过被调查对象对4个问题的回答推算其对工作满意的概率。