腹腔镜辅助阴式子宫切除术与经腹子宫切除术的前瞻性随机对照研究

目的　比较评估腹腔镜辅助阴道子宫切除术与经腹子宫切除术两种手术的临床效果。方法　 12 0例妇科良性疾病患者需行子宫切除术 ,但有经阴道子宫切除术的相对禁忌证、子宫不超过孕 16周 ,随机分成两组 ,甲组 (6 0例 )行腹腔镜辅助阴式子宫切除术 ,乙组 (6 0例 )行经腹子宫切除术。结果　两组患者年龄、产次、术前血红蛋白水平、子宫平均重量、术中失血、手术时间的差异无显著性 (P >0 .0 5 )。甲组术后疼痛程度、术后住院时间明显少于乙组 (P <0 .0 1) ,两组均未出现严重手术并发症。结论　腹腔镜辅助阴式子宫切除术具有创伤小、恢复快、住院时间短等优点 ,妇科医师经过良好的腹腔镜手术操作技能培训 ,能对大部分原不宜行阴式子宫切除术而需行经腹子宫切除术的患者行腹腔镜辅助阴式子宫切除术。     

Muscarinic receptor-mediated hydrolysis of phosphatidylinositols in human neuroblastoma (SH-SY5Y) cells is sensitive to pertussis toxin

Effects of pertussis toxin or cholera toxin on carbachol-stimulated inositol-1-phosphate ([3H]IP1) accumulation were studied using the human neuroblastoma cell line (SH-SY5Y). The maximal carbachol-stimulated [3H]IP1 accumulation in the SH-SY5Y cells was decreased from 51.4 fmol/10(6) cells to 42.4 fmol/10(6) cells (P less than 0.05) and 22.1 fmol/10(6) cells (P less than 0.01) in the absence and presence of 1 microgram/ml and 10 micrograms/ml pertussis toxin, respectively while the EC50 values did not change. Cholera toxin (1 mg/ml) did not alter carbachol-stimulated [3H]IP1 accumulation in these cells. These results suggest that a pertussis toxin sensitive G-protein may be involved in muscarinic receptor-phosphatidylinositol hydrolysis coupling in SH-SY5Y cells.     

Evaluation of peripheral blood involvement of mantle cell lymphoma by fluorescence in situ hybridization in comparison with immunophenotypic and morphologic findings.

Mantle cell lymphoma is non-Hodgkin's B-cell lymphoma characterized by the t(11;14)(q13;q32) translocation. Peripheral blood involvement of mantle cell lymphoma is usually associated with a poor prognosis and therefore, its identification is clinically important. In this study, we performed cyclin D1/IgH-probe fusion fluorescence in situ hybridization analysis on 223 peripheral blood samples: 185 from 125 mantle cell lymphoma patients, and 38 normal controls. The cutoff values for the test were established using normal controls. Flow cytometry on peripheral blood and corresponding bone marrow samples was used to evaluate this test. In all, 26% of the 185 peripheral blood samples and 27% of the 161 corresponding bone marrow samples were flow cytometry positive for mantle cell lymphoma. The mean numbers of single and- double-fusion signals and the mean number of CD5/CD19-positive cells, absolute blood lymphocyte count, and white blood cell count were significantly higher in peripheral blood and corresponding bone marrow samples with mantle cell lymphoma-positive flow cytometry. Double-fusion signals were more specific than single-fusion ones. Fluorescence in situ hybridization was far more likely to be positive for mantle cell lymphoma when the peripheral blood and the corresponding bone marrow samples had positive flow cytometry results or morphology (P<0.01). Our study indicates that cyclin D1/IgH-fusion fluorescence in situ hybridization analysis could be used to determine the presence and character of circulating mantle cell lymphoma cells in peripheral blood, thus enhancing our ability to evaluate leukemic mantle cell lymphoma and minimum residual disease.     

造影剂到达腹主动脉的峰值大小与患者因素的关系

目的探讨造影剂到达腹主动脉的峰值大小与患者因素之间的关系。方法108例患者以2.5ml/s注射欧乃派克(300mgI/ml)20ml,12s后采用testbolus技术在腹腔干水平同层动态扫描腹主动脉,用dynamic evaluation软件测得腹主动脉的峰值大小,采用单因素回归分析和多因素逐步回归分析法研究患者的性别、年龄、身高、体重、心率、血压、注射位点、达峰时间及是否有心脏病、糖尿病、或化疗史对造影剂到达腹主动脉峰值大小是否有影响及影响程度。结果造影剂到达腹主动脉峰值大小,在男性平均比女性低;其随年龄、身高、体重、达峰时间的增加而逐渐降低,注射位点在手背静脉其值平均比在肘部静脉低;其不受心率、血压、是否有心脏病、糖尿病或化疗史的影响。参考公式:峰值大小(HU)=383.8400-身高(cm)×1.0909-体重(kg)×0.6760 注射位点×16.7878-达峰时间(s)×1.6882。结论可根据患者的性别、年龄、身高、体重、注射位点和达峰时间来适当调整患者CT血管成像时造影剂用量。     

军人花粉症106例快速免疫治疗

目的　探讨军人花粉症治疗的有效方法。方法　采用提高起始浓度和快速递增浓度 ,上臂外侧皮下注射的方法对 10 6位军人花粉症患者行快速免疫治疗 ,并对每一位患者治疗前后检测血清中总IgE和嗜酸细胞阳离子蛋白 (ECP)。 结果　治疗前后患者总IgE和ECP值有显著性差异。 10 6例患者经 1～ 3年随访复查 ,78例 2个以上发病季节未发作 ,或仅有轻微鼻痒、眼痒 ,18例症状减轻 ,发病时间缩短半月 ,10例症状无明显改善。显效 82例 ,有效 14例 ,无效 10例 ,总有效率为 90 .5 7%。结论　快速免疫治疗能使患者血清总IgE和ECP下降 ,对军人花粉症疗效好。     

A case of congenital supratentorial tumor: Atypical teratoid/rhabdoid tumor or primitive neuroectodermal tumor?

Two embryonal CNS tumors, atypical teratoid/rabdoid tumor (AT/RT) and primitive neuroectodermal tumor (PNET), may be confused with each other and misdiagnosed. Here we report an infant with a congenital supratentorial tumor, which was detected by fetal MRI at 37 weeks gestation. On routine histological examination, the tumor was composed mainly of small undifferentiated cells, among which many rhabdoid cells and occasional sickle‐shaped embracing cells were observed. No mesenchymal or epithelial areas were evident. Our impression was that the tumor was an atypical example of AT/RT. Immunohistochemically, almost all the tumor cells were strongly positive for vimentin. However, epithelial membrane antigen was notably negative, and most of the tumor cell nuclei were clearly positive for INI1. In addition, many tumor cells were positive for neurofilament protein. There were also occasional small areas containing many tumor cells positive for glial fibrillary acidic protein. Finally, a diagnosis of PNET, with a rhabdoid phenotype and expression of neuronal and glial markers, was made. In the present case, application of INI1 immunostaining was very helpful for distinguishing PNET from AT/RT.     

Cerebral Cortical Aquaporin-4 Expression in Brain Edema following Cardiac Arrest in Rats

OBJECTIVES: Brain edema occurs following clinical as well as experimental cardiac arrest (CA) and predicts a poor neurologic outcome. The objective of this study was to determine the expression of cerebral cortex aquaporin (AQP)-4, a member of a family of membrane water-channel proteins, in brain edema formation following normothermic or hypothermic CA. METHODS: Twenty-four rats were subjected to time-matched normothermic (N-Sham, 37.5 degrees C +/- 0.5 degrees C, n = 6) or hypothermic (H-Sham, 34 degrees C +/- 0.5 degrees C, n = 6) sham experiments and normothermic (N-CA, n = 6) or hypothermic (H-CA, n = 6) CA induced by asphyxiation for 8 minutes. Hypothermia was induced before CA. The animals were resuscitated with cardiopulmonary resuscitation, ventilation, and epinephrine administration. Brain edema was determined by brain wet-to-dry weight ratio at one hour of resuscitation. AQP4 immunoactivity in the cerebral cortex was determined using immunohistochemical staining and was semiquantified as an intensity of staining with an automated cell imaging system. RESULTS: Mild hypothermia in the sham experiments did not alter cerebral cortex AQP4 immunoactivity (mean +/- SD) (55.0 +/- 3.7 in H-Sham vs. 53.3 +/- 1.7 in N-Sham, p > 0.05). N-CA resulted in a significant increase in AQP4 immunoactivity (61.8 +/- 4.5) compared with N-Sham (p = 0.01) and H-Sham (p = 0.03). H-CA attenuated AQP4 compared with N-CA (53.4 +/- 1.3, p = 0.01). Brain wet-to-dry weight ratios were 4.41 +/- 0.07 in N-Sham, 4.40 +/- 0.08 in H-Sham (p > 0.05 vs. N-Sham), 4.55 +/- 0.04 in N-CA (p = 0.004 vs. N-Sham; p = 0.005 vs. H-Sham), and 4.43 +/- 0.09 in H-CA (p = 0.02 vs. N-CA; p > 0.05 vs. N-Sham and H-Sham). CONCLUSIONS: Cerebral cortical AQP4 expression is up-regulated after normothermic CA, which is attenuated by hypothermia induced before CA.