动态增强磁共振成像在评估女性乳房乳头乳晕血供的应用

目的探究动态增强磁共振成像(DCE-MRI)用于评估女性乳房乳头乳晕血供特点的可行性,为乳房整形手术提供乳头乳晕的血供参考。方法从2012年3月至2019年10月华中科技大学同济医学院附属同济医院影像数据库中收集女性乳腺DCE-MRI图像资料,选择未发现肿物的正常乳房的DCE-MRI图像进行研究。在西门子工作站将患者乳腺DCE-MRI图像通过图像减影获取乳房血管图像,分别对轴位、冠状位和矢状位的最大密度投影(MIP)图像进行评估,结合三维MIP图像识别所有供应乳头乳晕的血管。乳头乳晕的血供被划分为内上、内侧、内下、外上、外侧、外下、中央、上方和下方9个象限,对各个象限血管进行统计和分析,并测量血管至乳房皮肤表面投影的最大距离。采用SPSS 19.0软件进行统计分析,通过卡方检验分别比较左侧与右侧乳房的乳头乳晕复合体(NAC)血供象限分布构成比。计算血管到皮肤距离的平均值、标准差及95%置信区间,通过方差分析比较各象限血管至皮肤距离的差异。P<0.05为差异具有统计学意义。结果共收集到245例患者490只女性乳房DCE-MRI图像,其中97例患者97只乳房发现有乳腺肿物,其余393只为正常乳房(97例单侧乳房、148例双侧乳房),将其作为研究对象。患者年龄23~72岁,平均43.7岁。393只乳房(左侧200只、右侧193只)共发现有637条(左侧311条、右侧326条)乳头乳晕供应血管。在637条血管中,内上象限269条(42.2%),外上180条 (28.3%),内侧57条(8.9%),下方37条(5.8%),中央30条(4.7%),内下25条(3.9%),外下25条(3.9%),上方11条(1.7%),外侧3条(0.5%)。卡方检验表明左侧乳房和右侧乳房在NAC血供象限分布构成比差异无统计学意义(χ2 =6.4,P=0.602)。除中央象限血管以外,所有血管到皮肤表面投影最大距离的平均值为0.91 cm, 95%置信区间为0.86~0.96 cm。方差分析表明各象限供血血管到皮肤投影的最大距离,差异有统计学意义(F=11.4,P<0.001)。结论 DCE-MRI可以清晰地显示乳头乳晕的血供来源。乳头乳晕血供主要来源于内上象限和外上象限的血管,血管在皮下约1 cm深度走行。     

Medical library education in China

This paper describes the establishment of faculties of medical library and information science in four of the national medical universities in the People's Republic of China. These faculties were established in the mid-1980s, and each is fully integrated into its university. Students receive three years of non-clinical medical training followed by two years of training in library and information science. The first students to follow this five-year curriculum will graduate in 1992.     

RADIATION INDUCED PROGRESSIVE DECREASING IN THE EXPRESSION OF REVERSE TRANSCRIPTASE GENE OF hEST2 AND TELOMERASE ACTIVITY

Objectites. In order to identify the relationship between telomerase and the biological effect of radiation injury, and investigate the role of human telomerase catalytic subunit gene (hEST2) reverse tranacriptase(RT) seg-ment in the expression of telomerase activity. Methods. Tumor FIeLa cells, KB cells and A431 cells were employed to measure the change in telomeraseactivity after 60Co-ray irradiation at RNA level and protein level. Quantitative PCR and Northern blotting wereused to determine the expression of bEST2 RT segment that encodes seven motifs of the human telomeres, a PCR-besed telomeric repeat amplification protocol (TRAP)was used to assay telomerase activity after exposure toradiation. Results. Both of telomerase activity and the expression hEST2 RT segment were decreased with increasingdosage of radiation. In addition, testing the expression of motifs domain is similar to the measurement of telomerase activity. Conclusion. The detection of the hEST2 BT segment by Northern blotting and quantitative PCR are new methods for testing Uflomerase activity. Furthermore, radiation can cause a dose-dependent decrease in telomerase activity. The effect of radiation on telomerase is one possible reason for the death of cancer ceils after irradiation.     

Effect of vagotomy on acute pancreatitis in rats

Acute pancreatitis ( AP) is a common surgicalabdomen,which has a high mortality,especiallyhemorrhagic necrotic pancreatitis.Many things areunknown for its pathogen,pathogenesis and clinicaltreatment.Restraining secretion of pancreatin so asto decrease its complication is used now in clinicalpractice[1] .A lot of information indicates that vagushas directdomination on exocrine of pancreas[2 ] .Thepurpose of this study was to investigate whether thevagotomy ( VG) had effect on AP in rats.1　M…     

低氧对体外培养的肺血管周细胞免疫表型的影响

用细胞培养、免疫细胞化学染色、图像分析及流式细胞术观察低氧和猪肺动脉缺氧内皮细胞条件培养液(HECCM)对体外培养的新生大鼠肺血管周细胞 (PC)α- SM- actin、 CD34 、 S- 10 0和 PCNA的表达及细胞周期的影响。结果发现 ,低氧和 HECCM可促进 PC表达α- SM- actin和 PCNA,而抑制 CD34 和 S- 10 0的合成 ,促进 PC由静止期 (G0 /G1 期 )进入 DNA合成期 (S期 )及有丝分裂期 (G2 M期 )。提示 ,低氧不仅能促进 PC增殖 ,而且还可促进其向平滑肌样细胞转化。故 PC是慢性低氧性肺动脉高压时无肌型细动脉肌化的重要细胞来源。     

Characterization and phylogenetic analysis of a neurovirulent Zika virus isolated from Cambodia in 2019

The geographic range of Zika virus (ZIKV) has expanded from Asia to the Americas, leading to the 2015–2016 pandemic with enhanced neurovirulence. At present, ZIKV is continuously circulating in many Southeast Asian countries. Unfortunately, the persistent evolution of ZIKV in Southeast Asia and its influence on the biological characteristics of the virus remain incompletely understood. In this study, the in vitro and in vivo properties of a new ZIKV isolate obtained from Cambodia in 2019 (CAM/2019) were characterized and compared with those of the Cambodian strain (CAM/2010). Compared with CAM/2010, the CAM/2019 virus showed similar plaque morphology and growth curves in cell cultures and induced comparable viremia and organ viral loads profiles in both BALB/c and A129 (IFNAR1^−/−) mice upon intraperitoneal (i.p.) inoculation. Remarkably, the CAM/2019 virus exhibited enhanced neurovirulence in neonatal mice compared with CAM/2010, with a 74-fold reduction in the 50% lethal dose (LD₅₀). Consistently, CAM/2019 produced higher viral loads in the brains of BALB/c neonatal mice than CAM/2010 did. Sequence alignment showed that the CAM/2019 virus has acquired 12 amino acid substitutions, several of which were found to be associated with neurovirulence. In particular, the CAM/2019 virus shared an A1204T substitution in NS2A with the Thai isolate SI-BKK02 that was isolated from a microcephaly case. Taken together, our results indicate that a ZIKV strain isolated with specific mutations has emerged in Cambodia, highlighting the need for extensive molecular and disease surveillance in Cambodia and other Asian countries.     

血清HA、PCⅢ对慢性肝炎、肝硬化的诊断价值

目的 探讨血清ＨＡ、ＰＣⅢ对慢性肝炎,肝炎肝硬化的诊断价值,ＨＡ与ＰＣⅢ意相关关系以及它们的变化对预后的影响。方法 采用ＲＩＡ法同时检测慢性肝炎、肝炎肝硬化患者血清ＨＡ、ＰＣⅢ含量,比较ＨＡ,ＰＣⅢ间关系,肝炎肝硬化组中存活病例与死亡病例的ＨＡ、ＰＣⅢ变化情况。     

HIV-1 infected mononuclear phagocyte secretory products affect neuronal physiology leading to cellular demise: relevance for HIV-1-associated dementia

Viral and cellular products from HIV-1-infected and/or immune competent mononuclear phagocytes (MP) (brain macrophages and microglia) affect neuronal function during HIV-1-associated dementia (HAD). Neurotoxic MP factors include, but are not limited to, pro-inflammatory cytokines, chemokines, platelet activating factor, arachidonic acid and its metabolites, nitric oxide, progeny virions and viral structural and regulatory proteins. The mechanisms for immune-mediated neural injury in HAD, only now, are being unraveled. In this regard, we reviewed the current knowledge of how postmitotic neurons, which can neither divide nor be replaced, are damaged by MP secretory activities. Linking neuronal function with brain MP activation was made possible by placing viral and/or immune products onto neurons and measuring cell signaling events or through ex vivo electrophysiological tests on MP-treated brain slices. Such linkages are shown, in this report, by select demonstrations of MP factors which cause neuronal dysfunction in HAD.     

RP-HPLC测定犬血浆中卡托普利

目的　采用反相高效液相色谱法测定犬血浆中卡托普利浓度。方法　以对溴苯乙酰基溴为衍生剂 ,血浆样品经衍生反应后 ,用乙酸乙酯 -苯 (1∶1)提取 ,以ODSC18为固定相 ,乙腈∶水∶冰醋酸 (4 5∶5 5∶0 2 )为流动相 ,UV2 5 8nm紫外检测。结果　在 2 5～ 6 0 0 μg·L-1浓度范围线性良好 ,最小检测浓度为 12 5 μg·L-1。其日内差及日间差RSD分别小于 4 95 %和 2 88% ,相对回收率大于 94 8%。结论　方法简便灵敏 ,为卡托普利样品分析及临床药物监测提供了检测方法。     

Cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor, in combination with gemcitabine for advanced pancreatic cancer: a multicenter phase II Trial.

PURPOSE: To determine the response rate, time to disease progression, survival duration and rate, and toxicity with the combination of cetuximab and gemcitabine in patients with epidermal growth factor receptor (EGFR)-expressing advanced pancreatic cancer. PATIENTS AND METHODS: Patients with measurable locally advanced or metastatic pancreatic cancer who had never received chemotherapy for their advanced disease and had immunohistochemical evidence of EGFR expression were eligible for the multicenter phase II trial. Patients were treated with cetuximab at an initial dose of 400 mg/m(2), followed by 250 mg/m(2) weekly for 7 weeks. Gemcitabine was administered at 1,000 mg/m(2) for 7 weeks, followed by 1 week of rest. In subsequent cycles, cetuximab was administered weekly, and gemcitabine was administered weekly for 3 weeks every 4 weeks. RESULTS: Sixty-one patients were screened for EGFR expression, 58 patients (95%) had at least 1+ staining, and 41 were enrolled onto the trial. Five patients (12.2%) achieved a partial response, and 26 (63.4%) had stable disease. The median time to disease progression was 3.8 months, and the median overall survival duration was 7.1 months. One-year progression-free survival and overall survival rates were 12% and 31.7%, respectively. The most frequently reported grade 3 or 4 adverse events were neutropenia (39.0%), asthenia (22.0%), abdominal pain (22.0%), and thrombocytopenia (17.1%). CONCLUSION: Cetuximab in combination with gemcitabine showed promising activity against advanced pancreatic cancer. Further clinical investigation is warranted.