胡桃夹综合征的多层螺旋CT检查和应用价值

目的：探讨多层螺旋CT（MSCT）在诊断胡桃夹综合征（NCS）中的应用价值。方法：分析30例NCS患者（病例组）和120例正常人（对照组）的MSCT影像资料。观察NCS左肾静脉（LRV）的MSCT表现及伴随征象;测量病例组和对照组的肠系膜上动脉（SMA）与腹主动脉（AA）的夹角、LRV中心层面处SMA与AA之间距离、LRV在夹角受压处的截面积（S1）和近肾端最宽处的截面积（S2）,并计算其比值（S2/S1）,进行统计学分析。结果：病例组中2例可见左肾增大,2例左肾灌注慢,7例清晰显示侧枝循环建立,30例均可见LRV呈＂漏斗样＂变。两组比较各测量数据差异有统计学意义（P〈0.05）。结论：MSCT检查能清晰显示LRV的形态、能精确测量各数值,直观地评估LRV的受压变窄程度,还可观察NCS的伴随征象,为诊断提供有力的证据。     

Factors associated with treatment lag in infantile spasms

Aim The aim of this study was to evaluate the conditions in which infantile spasms are diagnosed and their possible impact on the course of the disease. Method We carried out a retrospective study of the reasons for delayed treatment of infantile spasms (treatment lag) in western France over the period 1990–2003. A total of 156 infants, 87 male (55%) and 69 female (45%), with infantile spasms were identified, in 45 (29%) of whom the spasms were symptomatic. They were aged 1 week to 24 months (median 20wks, mean 22.4, SD 13.3) at first symptoms. To be included in the study, participants had to exhibit a combination of clusters of spasms, altered psychomotor development, and paroxysmal electroencephalographic (EEG) activity, as defined by the International League Against Epilepsy. We did not restrict onset to the first year of life as infantile spasms may begin after the age of 1 year. Results The mean time from appearance of first symptom to first visit to a medical practitioner was 4 weeks. In 14% of cases, the reason for the visit was non‐neurological, the parents having noticed no neurological symptoms before the visit. The diagnosis was missed at first visit in 38% of the cases examined, with the incorrect diagnosis mostly commonly being gastro‐oesophageal reflux or no abnormality. This increased to 74% after a second visit, in all cases based on an abnormal EEG. However, in 5% the time between first presentation and diagnosis was over 2 months and up to 10 visits were required. The time lag between first presentation and diagnosis was significantly longer for individuals presenting to general practitioners than to paediatricians (p=0.03). Response to treatment was poorer in those in whom diagnosis was delayed. Interpretation Various steps could be taken to reduce treatment lag such as training general practitioners, informing the parents of individuals at risk about the possibility of infantile spasms, and recommending that EEG is performed before brain imaging in children with unexplained psychomotor delay.     

T2 values in the human brain: comparison with quantitative assays of iron and ferritin

Magnetic resonance (MR) imaging with a whole-body imager was performed in 10 fresh, unfixed whole human brains selected randomly from cadavers. All subjects were neurologically intact before death. T2 time constants were measured within the caudate nucleus, putamen, globus pallidus, cortical gray matter, subcortical white matter, and optic radiation. These regions were then excised, and T2 values were measured again with a 1.5-T MR spectrometer. Quantitative assays of iron, ferritin, and protein from these areas were then performed. Iron concentration varied significantly among brain regions, whereas ferritin and protein concentrations were constant among brain regions and among individuals. Neither iron nor ferritin concentration showed any consistent correlation with T2 values. Histologic examination of brain micro-sections with iron- and ferritin-specific stains of demonstrated poor correlation with biochemical assays of ferritin and iron concentrations. Results indicate that T2 values correlate poorly with iron and ferritin concentrations found in neurologically intact brains.     

正交法优选安宫牛黄微丸处方药材的醇提工艺

目的优选安宫牛黄微丸的最佳提取工艺。方法以干膏率和3种成分的含量（黄芩苷、栀子苷、盐酸小檗碱）为检测指标,以乙醇浓度、用量、提取时间、提取次数为考察因素,采用正交试验优选最佳提取工艺。结果最佳提取工艺为12倍量70%的乙醇溶液,回流提取3次,2h/次。结论该工艺简便,稳定,合理,可用于工业化生产。     

Pheochromocytoma and paraganglioma: comparison of MR imaging with CT and I-131 MIBG scintigraphy

To ascertain the magnetic resonance (MR) imaging characteristics of pheochromocytomas and paragangliomas and to compare MR with computed tomography (CT) and iodine-131 metaiodobenzylguanidine (I-131 MIBG), 19 patients (18 with pheochromocytomas, one with a paraganglioma) were studied. The 18 patients with pheochromocytomas had had positive findings with I-131 MIBG scintigraphy. Abdominal pheochromocytomas were generally hypointense compared with normal liver on T1-weighted MR images and extremely hyperintense on T2-weighted MR images. MR imaging was preferable to CT in the evaluation of primary pheochromocytomas due to superior tissue characterization, particularly in the patient with hypertension and borderline catecholamine levels. For patients with recurrent or metastatic disease, the data suggest that I-131 MIBG scintigraphy is the examination of choice.     

不同微生物诱导家蝇幼虫表达抗菌肽的特性

研究不同微生物诱导家蝇幼虫表达的抗菌肽特性.用3种不同的病源菌通过针刺感染的方法诱导家蝇幼虫表达抗菌肽,通过Sephadex G25分离,用Hult mark改进法和抑菌圈测定法作抑菌试验,用毛细管电泳（CE）分析不同微生物诱导得到的抗菌肽样品差异,检测抗菌肽的热稳定性和酸碱耐受性.发现不同微生物诱导产生的家蝇抗菌肽具有广谱抑菌性,但不同样品对不同病源菌抑菌活性有差异,不同测定抑菌效果的方法对抑菌结果有影响,各种抗菌肽样品CE蛋白谱具有明显不同.抗菌肽样品都具有热稳定性和酸碱耐受性.说明不同微生物诱导产生的家蝇抗菌肽类型以及抗菌肽含量与诱导源有关,抗菌肽为家蝇幼虫体内固有成分,诱导增加了抗菌肽的表达量同时刺激新抗菌肽的产生.用志贺氏菌、金黄色葡萄球菌、鼠伤寒沙门氏菌诱导家蝇幼虫可产生较多含量高活性好的抗菌肽.     

经肝动脉途径行肝癌化疗栓塞后胆汁瘤形成的CT表现与临床意义

目的 探讨肝癌经动脉穿刺化疗栓塞（transcatheter arterial chelnoelnbolization，TACE）治疗后肝内胆汁瘤形成的CT表现和临床意义。方法 搜集我院2000年至2004年经CT检查系列随访的肝癌TACE后患者共3948例。观察TACE术后有无胆管阻塞和扩张等表现。结果 共发现35例（09％，35／3948）胆汁瘤，其中沿Glisson鞘呈分支样分布的低密度区4例，残癌病灶周围柱状改变7例，囊状改变33例。结论 胆汁瘤是肝癌介入治疗后并发症之，随病情进展可以有不同CT表现。治疗上可采取以内科保守治疗为主的多种方法。     

Serum levels of Cartilage Oligomeric Matrix Protein (COMP) increase temporarily after physical exercise in patients with knee osteoarthritis

Background  

COMP (Cartilage oligomeric matrix protein) is a matrix protein, which is currently studied as a potential serum marker for cartilage processes in osteoarthritis (OA). The influence of physical exercise on serum COMP is not fully elucidated.