动态增强MR灌注成像在脑胶质瘤诊断中的价值

目的　探讨动态增强T2 WMR灌注成像在脑胶质瘤术前分级预测及鉴别诊断中的价值。资料与方法　有病理或追踪结果的 4 8例脑病变患者 ,其中胶质瘤 2 5例 (高、低级别胶质瘤分别为 16例和 9例 ) ,非胶质瘤病变 2 3例。全部病例均行常规T1WI、T2 WI和EPI SE序列动态增强MR灌注成像。计算每个病灶的最大相对脑血容量 (rCBV)比值 (病灶最大rCBV/对侧正常脑白质rCBV)。分析胶质瘤的最大rCBV比值与其组织学级别的关系 ,并比较胶质瘤与非胶质瘤的灌注异常及常规MRI强化表现。结果　高级别胶质瘤 ( 16例 )的最大rCBV比值为4 .6 0± 1.98( 2 .5 5～ 9.2 2 ) ,低级别胶质瘤 ( 9例 )的最大rCBV比值为 1.86± 1.5 2 ( 0 .85～ 5 .72 ) ,经t检验 ,两组之间有显著统计学差异 (P <0 .0 1)。脑膜瘤、转移瘤、血管母细胞瘤、淋巴瘤均显示有局部高灌注 ,最大rCBV比值为5 .35± 2 .39( 3.15～ 12 .39) ,而有强化表现的脑梗死、脑炎性灶及放射性脑损伤表现为低、等灌注 ,最大rCBV比值为1.2 7± 0 .36 ( 0 .85～ 1.72 )。结论　MR灌注成像在胶质瘤的术前影像学分级预测上有重要价值 ,在脑胶质瘤的某些鉴别诊断上亦具有一定的参考价值     

快速眼动睡眠剥夺后大鼠脑内神经元骨架蛋白及超微结构的变化

目的探讨经历不同时间快速眼动（REM）睡眠剥夺对大鼠皮质及海马各区神经元形态结构的影响。方法选择微管相关蛋白（MAP2）和神经丝（NF）作为正常神经元结构的标识物，利用免疫组织化学法和Western blot技术观察REM睡眠剥夺1、3、5、7 d4个时间点大鼠皮质及海马MAP2和NF表达的时空变化规律。同时运用电镜技术观察睡眠剥夺后神经元超微结构的变化。我们的实验是用改良的多平台睡眠剥夺模型进行REM睡眠剥夺，结合免疫组织化学染色技术和蛋白质电泳以及电镜超微结构分析。结果REM睡眠剥夺后5d大鼠皮质、海马CA1及齿状回神经元结构蛋白MAP2和NF表达较对照组明显减少（P〈0．05）；电镜神经元核仁偏位，胞质中出现少量肿胀的线粒体和内质网；部分神经轴突的髓鞘溶解与浓集。环境对照组、REM睡眠剥夺5d和7d组，皮质中超微结构改变的神经元所占比例分别为1．2％、3．6％和5．8％。结论REM睡眠剥夺能够导致大鼠脑内神经元的超微结构发生异常变化。     

Angiopoietin1/Tie2 and VEGF/Flk1 induced by MSC treatment amplifies angiogenesis and vascular stabilization after stroke.

Bone marrow stromal cells (MSCs) increase vascular endothelial growth factor (VEGF) expression and promote angiogenesis after stroke. Angiopoietin-1 (Ang1) and its receptor Tie2 mediate vascular integrity and angiogenesis as does VEGF and its receptors. In this study, we tested whether MSC treatment of stroke increases Ang1/Tie2 expression, and whether Ang1/Tie2 with VEGF/ vascular endothelial growth factor receptor 2 (VEGFR2) (Flk1), in combination, induced by MSCs enhances angiogenesis and vascular integrity. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAo) and treated with or without MSCs. Marrow stromal cell treatment significantly decreased blood-brain barrier (BBB) leakage and increased Ang1, Tie2, and occludin (a tight junction protein) expression in the ischemic border compared with MCAo control. To further test the mechanisms of MSC-induced angiogenesis and vascular stabilization, cocultures of MSCs with mouse brain endothelial cells (MBECs) or astrocytes were performed. Supernatant derived from MSCs cocultured with MBECs significantly increased MBEC expression of Ang1/Tie2 and Flk1 compared with MBEC alone. Marrow stromal cells cocultured with astrocytes also significantly increased astrocyte VEGF and Ang1/Tie2 expression compared with astrocyte culture alone. Conditioned media from MSCs alone, and media from cocultures of MSCs with astrocytes or MBECs, all significantly increased capillary tube-like formation of MBEC compared with control Dulbecco's modified Eagle's medium media. Inhibition of Flk1 and/or Ang1 significantly decreased MSC-induced MBEC tube formation. Knockdown of Tie2 expression in MBECs significantly inhibited MSC-induced tube formation. Our data indicate MSC treatment of stroke promotes angiogenesis and vascular stabilization, which is at least partially mediated by VEGF/Flk1 and Ang1/Tie2.     

肺隔离症的影像诊断和介入治疗

目的探讨肺隔离症的影像学表现及介入治疗的应用价值. 资料与方法对5例肺隔离症患者的X线平片、CT、MRI表现进行分析,并对隔离的肺组织的供血动脉进行栓塞. 结果 X线平片主要表现为囊状或团状高密度影及支气管扩张样改变,CT、MRI可发现部分异常供血动脉,血管造影均能发现供血动脉,经异常供血动脉采用不锈钢圈栓塞后临床症状逐渐减轻、消失,随访6个月～1年,症状未再复发. 结论在影像诊断方面,X线平片难以确诊,CT、MRI可部分确诊,而DSA检查是肺隔离症诊断的金标准.经异常供血动脉栓塞治疗肺隔离症安全,患者痛苦小,并发症少,是一种有效的治疗方法.     

腰椎间盘突出症的针灸治疗近况及作用机理探讨

腰椎间盘突出症（1umbar intervertebral discprotrusion，LIPD）是一种临床上常见的疾病，好发于青壮年，发病急骤，病程迁延反复，临床主要表现为腰腿疼痛，下肢活动障碍，严重者可下肢瘫痪，给病人带来极大的痛苦及经济负担。目前关于LIPD的治疗的研究报道很多，总的来说可以分为两大类：手术治疗与非手术治疗，在非手术治疗方法的报道中针灸及以针灸为主的综合疗法占有非常重要地位，西医界一些著名专家也把针灸、触发点（triggerpoint）刺激、药物局部注射视为LIPD最常规的治疗方法。本文就LIPD的针灸治疗近况及作用机理作如下综述。     

青年性前部视网膜劈裂锯齿缘断离及视网膜脱离

目的：探讨青年性前部视网膜劈裂锯齿缘断离及视网膜脱离的临床特点、治疗及其预后。方法：对青年性前部视网膜劈裂锯齿缘断离合并视网膜脱离患者10例20只眼进行常规检眼镜眼底及Goldmann三面镜联合巩膜压陷检查，根据不同情况进行激光光凝，或巩膜冷凝外加压手术治疗，并随访1～5年。结果：共lO例，年龄17～32岁，8例为双眼患病，病变位于颞下，双侧对称。11眼同时患有前部视网膜劈裂、锯齿缘断离及视网膜脱离，3眼患有前部视网膜劈裂及锯齿缘断离，1眼仅有前部视网膜劈裂，3眼仅有锯齿缘断离其中2眼合并视网膜脱离。13眼合并视网膜脱离者采用巩膜冷凝外加压术，全部一次治愈，5眼行激光封闭锯齿缘断离及劈裂区。随访期间未见视网膜脱离，视力均有不同程度提高。结论：青年性前部视网膜劈裂锯齿缘断离及视网膜脱离有典型的临床特点，尽早发现、适宜治疗，预后良好。     

多种底物在免疫金银染色检测抗核抗体试验中的联合应用

将多种底物联合应用于免疫金银染色检测ANA试验,与各底物单独应用比较,可明显改善检测的敏感性与核型显示。其中,两种鼠脏器印片联合应用的结果可与Hep-2细胞的结果相当,三种及四种鼠脏器印片联合应用的结果可与Hep-2细胞和一种鼠脏器印片联合应用的结果相当,且均不使正常人ANA阳性率明显升高。     

补肾抗衰口服液对大鼠衰老模型免疫器官影响的实验研究

研究补肾抗衰口服液对大鼠衰老模型免疫器官胸腺和脾脏的影响.结果显示,模型组大鼠胸腺和脾脏重量减轻,胸腺重/体重比值、脾重/体重比值减小,胸腺组织学观察,显示萎缩改变;药物组大鼠胸腺和脾脏重量、胸腺重/体重、脾重/体重比值接近正常对照组,胸腺组织学观察,未显示萎缩改变.本研究结果表明,补肾抗衰口服液能延缓胸腺和脾脏萎缩,保护机体的正常免疫功能,提示该药有抗衰老的作用.     

A cross-reactive idiotype in scleroderma

Autoantibodies to centromere proteins (anti-CENPs) and to topoisomerase-I are highly specific for scleroderma. Unlike most autoantibodies in other diseases, these autoantibodies are mutually exclusive. We have analysed the idiotypes (Ids) expressed by anti-CENP-B, antitopoisomerase-I, and IgGs from 20 scleroderma patients. Rabbit anti-Ids were prepared to antitopoisomerase-I from two scleroderma patients, and to anti-CENP-B from four patients. These six anti-Ids were used to study the purified autoantibodies from 20 scleroderma patients: four antitopoisomerase-I, 10 anti-CENP-B, and six purified IgG from scleroderma patients who were negative for both autoantibodies. In addition, we studied sera from 40 normal autoantibody-negative controls, and sera and purified immunoglobulins from 17 systemic lupus erythematosus (SLE) patients containing high titres of anti-double-stranded DNA, and/or autoantibodies to extractable nuclear antigens (ENA). Using direct binding, and competitive inhibition ELISAs and immunoblots, we identified an Id present in the heavy chains of all the affinity-purified antitopoisomerase-I, and anti-CENP-B. Interestingly, this Id was also present in the immunoglobulins of the scleroderma patients who had neither of the two autoantibodies. By contrast, cross-reactive Id-EM was not found in the sera or immunoglobulins from 17 SLE patients, or in the sera from 40 normal subjects. Several samples from two patients showed that this cross-reactive Id-EM was stable over time. The scleroderma disease-specific autoantibodies may be identified through a common structural feature at the variable region of the heavy chain: cross-reactive Id-EM.