CT增强延时扫描在泌尿系统先天性畸形诊断的价值

目的：探讨CT增强延时扫描在泌尿系统先天性畸形诊断的临床价值。方法：对14例泌尿系统先天性畸形病人(包括肾盏憩室2例，膀胱憩室2例，先天性融合型横过异位合并巨大肾盂1例、肾盂输尿管重复畸形4例，肾盂输尿管交界部狭窄2例，单纯输尿管囊肿3例)行螺旋CT普通扫描、增强扫描和增强延时扫描。结果：CT增强延时扫描能够明确显示憩室内囊液的延迟强化和持续长时间强化；显示发育异常的肾脏、输尿管的结构、位置和功能。结论：CT增强延时扫描在泌尿系统先天性畸形诊断中很有价值，对某些疾病的诊断是十分必要的。     

Pancreatic adenocarcinoma: the different CT criteria for peripancreatic major arterial and venous invasion

OBJECTIVE: To establish preliminarily the different diagnostic criteria for peripancreatic arterial and venous invasion in pancreatic carcinoma by comparing their multidetector-row computed tomography (MDCT) appearances with surgical exploration. METHODS: Among 101 patients with pancreatic carcinoma examined by MDCT, 54 candidates accepting surgery were preoperatively evaluated for vascular invasion based on CT signs (A-E): arterial embedment in tumor or venous obliteration; tumor involvement exceeding one-half of the circumference of the vessel; vessel wall irregularity; vessel caliber stenosis; teardrop superior mesenteric vein (SMV). The peripancreatic major vessels (n = 224) were examined carefully by surgeons during the operation. RESULTS: During surgical exploration, 78 vessels were found to be invaded. With sign A (B, C, or D) as the CT criterion for peripancreatic vascular invasion, the sensitivity of arterial and venous invasion was 66% (97%, 45%, or 41%) and 14% (49%, 63%, or 55%), respectively; the specificity of absence of arterial and venous invasion was 100% (91%, 99%, or 100%) and 100% (all 100%). In this study, there were 3 SMVs appearing teardrop (sign E), which were all confirmed to be invaded. CONCLUSIONS: It is recommended that the CT diagnostic criteria for arterial and venous invasion should be dealt with differently. The criteria of arterial invasion are the presence of sign A or the combination of sign B with one of signs C and D. The criteria of venous invasion are the presence of one of the following signs: sign A, sign B, sign C, sign D, and sign E.     

髓内扩张自锁钉与外固定架治疗胫骨开放性骨折的疗效评估

目的评估髓内扩张自锁钉(IESN)和外固定架治疗胫骨开放性骨折的疗效。方法自2003年10月—2005年9月采用髓内扩张自锁钉治疗胫骨开放性骨折41例,与38例采用外固定架治疗胫骨开放性骨折疗效进行对比分析。结果全部病例随访12~20个月,平均15.4个月,IESN组手术时间、术后平均发热时间和住院天数,骨折愈合时间分别为45min,2.3d,21d,9.5周,外固定架组分别为63min,3.2d,27d,13.2周。两组相比差异有统计学意义(t值分别为2.775,2.712,2.874,2.869,P均<0.01);IESN组无骨折延迟愈合及畸形愈合,无感染及内固定失败等并发症,而外固定架组出现9例感染,7例畸形愈合。结论髓内扩张自锁钉内固定在治疗胫骨开放性骨折中损伤小,并发症少,固定可靠,同时最大限度地保护骨断端血运,符合生物力学要求,在治疗胫骨开放性骨折中是一种有效的好方法。     

hTERT-siRNA表达载体的构建及对MCF-7细胞生长、端粒酶活性的抑制作用

目的 构建人端粒酶逆转录酶(hTERT)基因的RNA干扰(RNAi)表达载体,并研究该载体对乳腺癌MCF-7细胞端粒酶活性及细胞增殖的影响,为针对端粒酶的乳腺癌基因治疗提供新的途径.方法 设计针对人端粒酶逆转录酶催化亚基(hTERT)的干扰靶序列TGTTCAGCGTGCTCAACTA,构建重组siRNA表达质粒pGenesil-hTERT,同时构建不针对任何基因的阴性对照重组pGenesiL-HK.两种重组质粒经酶切、电泳分析和测序鉴定后,用脂质体转染法分别转染乳腺癌MCF-7细胞,应用端粒酶重复序列扩增聚合酶链反应(TRAP-PCR)及聚丙烯酰胺凝胶电泳检测端粒酶活性,流式细胞仪测定细胞凋亡率.结果 酶切电泳测序分析表明插入序列正确,重组质粒构建成功.转染pGenesil-hTERT的MCF-7细胞,凝胶电泳见端粒酶特征性条带明显减少,端粒酶活性受到明显抑制pGenesil-hTERT转染细胞后凋亡率较对照组明显升高(P＜0.01),且转染48h凋亡率最高,达54.7%±2.41%.结论 hTERT-siRNA可有效抑制乳腺癌MCF-7细胞端粒酶活性、促进细胞凋亡,此法有望应用于肿瘤基因治疗.     

电磁脉冲辐照后小鼠红细胞形态和电泳率的改变

目的 研究不同场强的电磁脉冲(EMP)对红细胞形态和电泳率的改变,以探讨其量效关系.方法 BALB/c雄性小鼠50只,随机分为5组即50、100、200、400kV/m组和对照组,每组10只.用EMP辐照小鼠,EMP参数为场强0～400kV/m,前沿3ns,脉冲次数200个,脉冲间隔4s.照后小鼠尾部取全血,采用扫描电镜观察受照小鼠红细胞膜表面的形态改变;用显微细胞电泳法,观察红细胞电泳率和胞膜带电性的变化,研究其场强与效应的关系.结果 200kV/m辐照后扫描电镜观察红细胞胞膜上出现多个棘突小泡;各组红细胞膜带电特性均为负电,随着EMP场强(0～400kV/m)的增加,受照小鼠的红细胞电泳率逐渐降低,以照后2h时最为显著,200kV/m、400kV/m组电泳率降低最为显著(P＜0.01),0kV/m组电泳率为0.917±0.040μm·s-1/V·cm-1,这两组电泳率分别降低至(0.600±0.076)μm·s-1/V·cm-1和(0.484±0.064)μm·s-1/V·cm-1.随着照后时间的延长,辐照组细胞电泳率逐渐恢复,照后2天已恢复至正常水平.结论 EMP可引起受照小鼠红细胞膜棘突改变和电泳率降低,EMP场强与红细胞电泳率之间存在一定的量效关系.     

16层螺旋CT冠状动脉造影伪影分析

目的：探讨16层螺旋CT冠状动脉造影伪影表现和成因，提高冠状动脉CT血管造影质量和诊断准确性。材料和方法：回顾性分析400例16层螺旋CT冠状动脉造影中失败及假狭窄诊断的38例图像，以DSA冠状动脉造影为金标准，分析上述病例中的伪影及假狭窄的CT表现。结果：伪影分为呼吸伪影、心律不齐伪影、冠状动脉搏动伪影、上腔静脉高浓度造影剂产生假斑块伪影、冠状动脉重度钙化产生的伪影，上述各种伪影均具有独特的影像特征。结论：准确分析CT冠状动脉成像伪影的影像表现及成因，对提高CT成像质量，减少诊断失误有很大的临床意义。     

红景天强身剂与复方丹参滴丸抗缺氧作用对比实验研究

目的 :对比红景天强身剂与复方丹参滴丸对小鼠常压缺氧条件下存活时间的影响 ,以及小鼠夹闭气管后 ,两种制剂对其心电消失时间的影响。方法 :缺氧存活实验 :将小鼠灌胃给药 13d后 ,分别放入等体积密闭容器内观察其存活时间。心肌缺氧保护实验 :将灌胃给药 6d的小鼠麻醉后分离气管 ,夹闭 ,用心电仪观察其心电消失时间。结果 :在两个实验中 ,两种药物常规治疗剂量组的各项指标均无显著性差异 ;但与生理盐水对照组比较 ,各项指标均存在显著性差异 (P<0 0 1或P <0 0 5)。结论 :两种药物均能显著延长小鼠的缺氧存活时间 ,并对心肌缺氧有保护作用。     

体外循环术后肺损伤机制的研究现状

体外循环(CPB)术后肺损伤仍然是一个最常见的临床问题。几乎所有的患者CPB术后均有不同程度的肺损伤,轻者仅为一过性症状,重者可出现急性呼吸功能衰竭,本文就目前CPB术后肺损伤发生的机制及CPB术后肺损伤的保护策略进行了综述。     

MR imaging for blunt pancreatic injury

Objective

To study the MR imaging features of blunt pancreatic injury.

Materials and methods

Nine patients with pancreatic injury related to blunt abdominal trauma confirmed by surgery performed MR imaging. Two abdominal radiologists conducted a review of the MR images to assess pancreatic parenchymal and pancreatic duct injury, and associated complications.

Result

Diagnostic quality MR images were obtained in each of the nine patients. In the nine patients, pancreatic fracture, laceration and contusion were depicted on MR imaging in five, one and three patients, respectively. There were six patients with pancreatic duct disruption, eight patients with peripancreatic fluid collections, and four patients with peripancreatic pseudocyst or hematoma, respectively. All of the MR imaging findings was corresponded to surgical findings.

Conclusion

MR imaging is an effective method to detect blunt pancreatic injury and may provide information to guide management decisions.     

Expression and function of Erbin protein in renal ischemia-reperfusion injury

Objective To investigate the expression of ErbB2 interacting protein (Erbin) in renal ischemia-reperfusion injury (IRI) in vivo and in vivo, and the effect of Erbin over-expression on IRI. Methods (1) In vivo, the model of renal IRI was constructed in mice, and set up sham group and reperfusion 3, 6, 12, 24 and 48 h IRI group. BUN and Scr were detected and PAS staining was used to observe the pathology change of renal tissues. Cell apoptosis was detected by TUNEL staining. Erbin and NF-κB expression in renal tissue was detected by Western blotting, and immunohistochemistry was used to detect the distribution of Erbin. (2) In vivo, IRI model in HK2 cells was constructed and cells were harvested after culturing in normal medium for 3, 6, 12 and 24 h. Erbin expression was detected by Western blotting. Flow cytometry and ELISA were used to evaluate the level of cell apoptosis and inflammatory cytokine secretion respectively. HK2 cells were transiently transfected with Prk5-myc-Erbin plasmid via lipofectamine 2000, and were divided into control group, IRI group, Erbin group and Erbin+IRI group. The protein expression of Erbin and NF-κB, cell apoptosis and inflammatory cytokine secretion was detected. Results (1) Compared with sham group, serum BUN and Scr were dramatically increased in IRI model, especially in 24 h after reperfusion (P＜0.05). Moreover, PAS staining showed that a lot of renal tubular epithelial cells were necrosis and fell off, and many protein cast were formed, renal injury score and apoptotic index were higher in 6 h, 12 h, 24 h, 48 h IRI model than those in sham group (all P＜0.05). The expression of Erbin, which was expressed in renal tubules, and nuclear NF-κB in 24 h IRI model were significantly increased, as compared with sham group (all P＜0.05). (2) Compared to those in control group, nuclear NF-κB expression, apoptosis and inflammatory cytokine secretion were significantly increased in IRI group. Meanwhile, Erbin expression was also induced and peaked at 24 h (P＜0.05). Compared to those in IRI group, cell apoptosis, the expression of nuclear NF-κB, inflammatory cytokine IL-6 and TNF-α were decreased in Erbin+IRI group (all P＜0.05). Conclusions Erbin expression is up-regulated in renal IRI, and over-expression of Erbin can partly inhibit NF-κB activation, cell apoptosis and inflammatory cytokine secretion in IRI group, which indicates Erbin may playing a protective role in renal IRI.