超声造影规范化护理专家共识

为了实现超声对比剂（也称超声造影剂）高效、合理、安全、规范化输注，国内相关医护专家总结了国内外文献证据及临床经验，按照循证医学原则充分讨论后，制订了该共识，旨在为我国超声对比剂安全输注的规范化和标准化提供参考意见。共识介绍了超声对比剂的应用现状和安全性、相关法规与流程，造影前、中、后的规范化护理，并提出16条推荐意见。提出目前国内批准上市使用的超声对比剂安全性高，建议医护人员根据最新说明书或专家共识进行配药和给药，并从造影室管理、风险预案、人员资质等方面予以规范。     

Combined splenocaval or mesocaval C shunt and portoazygous devascularization in the treatment of portal hypertension: analysis of 150 cases

BACKGROUND: Portal hypertension is a common disease and its major surgical therapeutic approaches include devascularization and shunting. This study was undertaken to investigate the effects of combined splenocaval or mesocaval C shunt and portoazygous devascularization (combined procedures) on portal hypertension. METHODS: The clinical data of 150 patients with portal hypertension who had undergone combined procedures at the First Affiliated Hospital of Zhengzhou University from May1990 to May 2003 were analyzed retrospectively. RESULTS: The mean free portal pressure (FPP) was 25.6±1.83 mmHg, 18.0±2.07 mmHg and 18.4±2.19 mmHg before operation, after splenectomy plus splenocaval or mesocaval C shunt, and combined procedures, respectively. There was no operative death in all patients. The 1-7 year follow-up of 100 patients showed rebleeding in 3 patients, encephalopathy in 4, thrombosis of artificial vascular graft in 3, and dying from liver failure in 2. CONCLUSIONS: The combined procedures can not only decrease portal pressure but also preserve hepatic blood flow to some extent. It may be one of the best choices for treating portal hypertension in China.     

Grey matter volume abnormalities in patients with bipolar I depressive disorder and unipolar depressive disorder:a voxelbased morphometry study

Bipolar disorder and unipolar depressive disorder(UD) may be different in brain structure. In the present study,we performed voxel-based morphometry(VBM) to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder(BP1) and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls(HCs) using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.     

化学修饰的茯苓β-D-葡聚糖结构与抗胃腺癌活性的关系

目的:探讨茯苓多糖及其衍生物的结构与抗胃腺癌活性之间的构效关系.方法:对从茯苓菌核中提取的(1→3)-?-D-葡聚糖PCS3-Ⅱ及其硫酸酯、羧甲基、羟乙基、羟丙基和甲基化衍生物,用粘度法、激光光散射(LLS)及尺寸排除色谱和光散射仪联用(SEC-LLS)表征了他们在磷酸缓冲液(PBS)中37℃下的[?]、Mw及z1/2等分子参数.然后用MTT法研究了PCS3-Ⅱ和几种衍生物对不同分化程度的胃腺癌细胞株MKN-45、SGC-7901和MKN-28生长的抑制作用.结果:S-PCS3-Ⅱ、C-PCS3-Ⅱ、M-PCS3-Ⅱ、HE-PCS3-Ⅱ和HP-PCS3-Ⅱ衍生物在PBS溶液中Mw值分别为3.8×104、18.9×104、16.0×104、76.8×104和224.3×104,未改性?-葡聚糖PCS3-Ⅱ几乎无抗胃腺癌活性,而他的硫酸酯和羧甲基衍生物对细胞株MKN-45、SGC-7901和MKN-28却显示较高的抑制率.结论:天然茯苓菌核多糖体外没有抗胃腺癌活性;水不溶性多糖PCS3-Ⅱ链上引入羧甲基和硫酸酯基后,其衍生物溶于水,且链刚性增大,同时其抗胃腺癌活性增强;良好的水溶性、较高的链刚性和适当大的分子量有利于茯苓多糖抗胃腺癌活性的提高.     

survivin基因在非小细胞肺癌中的表达及与P53、c-myc、k-ras蛋白表达的关系

目的：探讨survivin基因在非小细胞肺癌（NSCLC）中的表达,及与P53、c-myc、k-ras蛋白表达的相互关系。方法：逆转录PCR法检测了76例NSCLC肿瘤组织,20例良性瘤样病变和21例病灶旁正常肺组织survivin mRNA表达,免疫组织化学法检测P53,c-myc,k-ras蛋白表达,并将结果进行了相关分析。结果：61％NSCLC癌组织表达survivin mRNA基因,而良性瘤样病变和正常组织则分别为30％和19％（P＜0．001）。survivin基因表达与肺癌组织细胞类型,分化程度,TNM分期及淋巴结转移无明显相关关系。P53蛋白,c-myc与survivin基因表达显著相关,k-ras蛋白表达与survivin基因表达未见明显相关。结论：（1）survivin基因在肺癌组织中表达上调,提示该基因对NSCLC发生发展起重要作用。Survivin基因有望成为肺癌基因治疗的新靶点。（2）抑癌基因P53的失活和癌基因c-myc的上调与survivin基因的表达可能在NSCLC癌变中起协同作用。survivin和k-ras基因则可能通过各自不同的机制参与NSCLC的发病机制。