髂骨和耻坐骨尤文氏肉瘤的影像学诊断及鉴别诊断

目的：探讨髂骨和耻坐骨尤文氏肉瘤的影像学表现及鉴别诊断,以提高本病的术前诊断率。方法回顾性分析本院经手术后病理证实的15例髂骨和耻坐骨尤文氏肉瘤的影像学表现。所有病例均行 X 线平片检查,12例行 CT 检查,11例行 MRI 检查。结果15例中髂骨尤文氏肉瘤8例,耻坐骨尤文氏肉瘤7例。X 线平片呈单纯溶骨性骨质破坏12例,混合型骨质破坏3例,病灶周围见软组织包块15例;CT 扫描见病灶边缘膨胀、内部溶骨性骨质破坏7例,骨质破坏周围见不规则瘤骨或骨硬化5例,病灶周围见不规则骨膜反应6例。病灶周围软组织包块环绕12例;MRI 扫描病灶呈长 T1长 T2信号7例,长 T1混杂 T2信号4例,抑脂序列呈不均匀高信号5例,11例均见骨质破坏及软组织包块。结论髂骨和耻坐骨尤文氏肉瘤较少见,具有一定的影像特点, X 线平片结合 CT 扫描可以提高术前诊断准确率,MRI 检查有助于手术范围确定和治疗。     

C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效

目的 评价C臂CT引导经皮无水乙醇消融术(PEI)在巨块型肝癌经肝动脉化疗栓塞术(TACE)后的可行性及近期疗效.方法 回顾分析巨块型肝癌患者95例,其中40例行单纯TACE治疗(对照组),55例行TACE联合PEI治疗(联合组).对照组1个月后重复TACE治疗1次.联合组TACE1周后行PEI.术前经C臂CT扫描评估碘油沉积情况,定位穿刺路径及注入部位.2周后对碘油沉积缺损部分追加PEI.3个月后两组复查CT,对碘油沉积分布情况进行统计学分析.结果 联合组初次PEI术后显示碘油沉积为Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为41.8％ (23/55)、49.1％(27/55)、7.3％ (4/55)和1.8％(1/55);2周后分别为25.4％ (14/55)、50.9％(28/55)、16.4％(9/55)和7.3％(4/55).再次对除Ⅰ型病灶外的41例患者行PEI.3个月后复查CT,对照组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为7.5％ (3/40)、30％(12/40)、42.5％(17/40)、20％(8/40);联合组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为30.9％(17/55)、40％ (22/55)、23.6％(13/55)、5.5％(3/55).两组差异有统计学意义.结论 C臂CT成像技术在TACE术后联合PEI治疗巨块型肝癌的指导和评估中具有重要价值,保证了手术的安全性、准确性和有效性.     

脾动脉阻断联合射频消融术治疗脾功能亢进的疗效观察

目的：总结脾动脉球囊阻断联合脾脏射频消融术（RFA）治疗肝硬化门静脉高压型脾功能亢进的有效性及经验。方法在脾动脉球囊阻断状态下对15例脾功能亢进患者行经皮穿刺脾脏RFA, RFA平均时间为（46．4±5．4）min。术后3 d、1周、1个月、3个月和6个月监测血常规,术后1个月复查腹部CTA。结果1例患者术后出现左侧大量血性胸腔积液,给予止血及胸腔积液引流后好转,其余患者未发生严重并发症。 RFA后1个月行腹部CTA检查示RFA毁损范围占脾脏总体积的比率为34．3％～71.8％,平均（56.20±13.09）％。术前血细胞计数示：白细胞为（3.88±1.75）×109/L,红细胞（4.06±0.37）×1012/L,血小板（48.14±11.33）×109/L。 RFA术后1个月复查示：白细胞（5.62±1.61）×109/L,血小板（132.29±33.20）×109/L;与术前相比,血小板和白细胞显著升高（P<0．05）。结论脾动脉球囊阻断联合RFA治疗肝硬化门静脉高压型脾功能亢进具有较高的安全性,且近期疗效可靠。     

祛白酊的质量控制方法研究

目的建立祛白酊的质量控制方法。方法采用微乳薄层色谱法,对祛自酊中的枙子、红花进行定性鉴别;以Diamonsil C₁₈（250 mm×4.6 mm,5μm）为固定相,采用HPLC法对栀子中有效成分栀子苷和红花中有效成分羟基红花黄色素A进行含量测定,以（A）乙腈-水（15:85）,（B）甲醇-0.83%磷酸溶液（30:70）为流动相,梯度洗脱,检测波长:0¹0 min,238nm,10²0 min,403 nm,流速:1.0 ml·min^-1,柱温:25℃,进样量:10μl。结果栀子和红花薄层色谱中与对照药材主斑点相应位置斑点清晰,阴性对照无干扰;栀子苷和羟基红花黄色素A分别在9.6¹44.0、2.4³6.0μg·ml^-1范围内线性关系良好,加样回收率分别为100.30%和100.08%。结论本方法简便、准确、重复性好,可作为祛白酊的质量控制方法。     

Establishment of uric acid associated nephropathy animal model and the underlying mechanisms

Objective To establish an uric acid associated nephropathy (UAN) animal model and explore the mechanisms involved. Methods Eighteen (6-8 weeks old) male Sprague-Dawley rats weighed 200-220 g were randomly assigned into 2 groups: the control group (n=9), the uric acid associated nephropathy group (n=9). UAN rat model was established by oral administration of adenine (0.1g/kg) and potassium oxonate (1.5 g/kg) mixture daily for 3 weeks. After 3 weeks, the rats were sacrificed and blood and kidney samples were collected. Serum uric acid, creatinine and other biochemistry index were measured weekly. PAS and Masson staining were conducted to evaluate renal pathology and renal fibrosis. Serum activity of xanthine oxidase (XOD) was examined. Expression of p-EGFR and EGFR were detected by western blot and α-SMA expression was detected by immunohistochemical staining. Results After 3 weeks, the model group rats got 1.5 folds increased serum creatinine and significantly elevated serum uric acid. PAS and Masson staining showed that the UAN kidney developed glomerulosclerosis, tubulointerstitial damage and inflammatory cell infiltration. Serum activity of xanthine oxidase (XOD) was significantly upregulated in UAN group [(52.68±9.79) μmol/L vs (32.23±6.72) μmol/L, P＜0.05]. Western blot showed that EGFR was activated and α-SMA expression increased remarkably in renal interstitial area of UAN rats. Conclusions The mixture of adenine and potassium oxonate can successfully establish UAN model. Phosphorylation of EGFR may mediate the activation of renal interstitial fibroblasts and accelerate the development and progression of UAN.     

In vivo multiplexed molecular imaging of esophageal cancer via spectral endoscopy of topically applied SERS nanoparticles

The biological investigation and detection of esophageal cancers could be facilitated with an endoscopic technology to screen for the molecular changes that precede and accompany the onset of cancer. Surface-enhanced Raman scattering (SERS) nanoparticles (NPs) have the potential to improve cancer detection and investigation through the sensitive and multiplexed detection of cell-surface biomarkers. Here, we demonstrate that the topical application and endoscopic imaging of a multiplexed cocktail of receptor-targeted SERS NPs enables the rapid detection of tumors in an orthotopic rat model of esophageal cancer. Antibody-conjugated SERS NPs were topically applied on the lumenal surface of the rat esophagus to target EGFR and HER2, and a miniature spectral endoscope featuring rotational scanning and axial pull-back was employed to comprehensively image the NPs bound on the lumen of the esophagus. Ratiometric analyses of specific vs. nonspecific binding enabled the visualization of tumor locations and the quantification of biomarker expression in agreement with immunohistochemistry and flow cytometry validation data.OCIS codes: (170.5660) Raman spectroscopy, (170.2150) Endoscopic imaging, (110.2350) Fiber optics imaging, (170.0170) Medical optics and biotechnology, (170.2680) Gastrointestinal, (160.4236) Nanomaterials     

Schistosomiasis in a migrating population in the lake region of China and its potential impact on control operation

Coverage of migrating people in schistosomiasis control program is a growing concern in China. Schistosomiasis caused by Schistosoma japonicum is still one of the major infectious diseases of public health importance in China though tremendous efforts have been made to control the transmission over the past decades. Along with the rapid social-economic development, migrant population has been remarkably increasing across the country. The infected migrants may introduce a new souse of infection to endemic areas or the areas where the transmission had been controlled or interrupted but the intermediate host Oncomelania snail is still present. Preliminary studies for surveillance on schistosomiasis prevalence in migrants were reported, but there is little basic information provided. We carried out an investigation on the prevalence in immigrants, emigrants and permanent residents in three villages of Hunan province located in the main endemic area of lake region, and analyzed the potential impact of migration on control practice. In the study villages, the migrant population accounts for 53.6% of the total. Schistosoma infection was detected by modified Kato-Katz method and miracidium hatching test. Questionnaire survey was conducted comprising knowledge of disease and its transmission, water contact, personal protective measures, and whether examined and treated after water contact. The survey indicated that the migrants and permanent residents had similar life style, and the majority of them experienced water contact in agricultural work or routine life activities. However, the infection rate in immigrants was significantly higher than that in permanent residents. It was also found that the migrants had significantly less knowledge about the disease than the permanent residents, and took no personal protective measures. This is due to that the control program could not cover the migrants when they were absent at the time the program being implemented. The present study suggested that the surveillance and intervention for migrants, immigrants in particular, should be included and strengthened in schistosomiasis control program and a feasible scheme be developed.     

儿童遗尿的评估和治疗进展

遗尿(NE)俗称尿床,在5岁儿童人群中发病率高达8%~20%。虽然遗尿治疗方法很多,但仍有部分患儿治疗效果不佳或停药后复发。近年来,强调根据患儿的病史、体格检查、排尿日记、尿常规等资料,必要时行尿动力学检查,找出可能的病因和发病机制,并考虑患儿年龄、遗尿类型及治疗意愿等因素制定个体化的治疗方案。     

腹腔镜手术时CO2气腹和体位对老年直肠癌患者循环功能的影响

目的探索腹腔镜手术中CO2气腹和头低足高体位对老年直肠癌患者循环功能的影响。方法回顾性分析48例老年直肠癌患者在麻醉前(T1),麻醉后(T2),建立气腹后(T3),摆放头低足高位后(T4),手术开始后30(T5)、60(T6)、90(T7)及120 min(T8)时的(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心输出量(CO)、心脏指数(CI)、中心静脉压(CVP)、p H、动脉血氧分压(Pa O2)及动脉血CO2分压(Pa CO2)资料,探索腹腔镜手术中CO2气腹和头低足高体位对老年直肠癌患者循环功能的影响。结果重复测量资料的方差分析结果显示,HR、SBP、DBP、MAP、CO、CI、p H、Pa O2及Pa CO2的时间效应均无统计学意义(P>0.05);而CVP的时间效应具有统计学意义(P<0.05),与T1和T2时间点比较,T7和T8时间点的CVP值均较高(P<0.05)。结论对于老年直肠癌患者实施腹腔镜手术时,患者的CVP随着手术时间的延长会逐渐升高,但积极做好术前评估和基础疾病的治疗控制、加强围手术期管理后,腹腔镜手术对于老年直肠癌患者是比较安全的。