CT scans in the diagnosis of cerebellar hemangioblastomas. Analysis of 21 cases

Computed tomography (CT) scans in 21 patients with pathological verified cerebellar hemangioblastoma were analysed. There were 14 cases of cystic nodular pattern, 4 cases of nodular pattern and 3 cases with the pattern of cyst only in this series. The characteristic features of hemangioblastomas on the CT scans usually consisted of large circumscribed cystic low density lesions with a small enhanced nodule in each of them. On surgical operations 20 cases in this series were classified to be of cystic-nodular pattern. In order to show the cystic-nodular pattern in a better manner on the CT the thin slice CT scan 5 should be recommended in addition to the use of an appropriately increases amount of intravenous contrast medium when hemangioblastoma of the cerebellum would be suspected.     

淋巴细胞与单核细胞比值在肝细胞癌患者中的预后价值分析

背景与目的:通过实验室血样进行评估系统性炎症的临床意义已在多种癌症中被证实。肝细胞癌(HCC)是一种炎症驱动型癌症,炎症已被证实与分化不良、微血管侵犯和微转移相关。本研究旨在探讨淋巴细胞/单核细胞比值(LMR)对HCC患者术后的预后评估价值。方法:回顾性分析2012年1月—2016年12月在南京中医药大学附属南京医院行根治性肝切除术的88例HCC患者的资料。通过ROC曲线分析LMR评估HCC预后的性能,并将其与中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)进行比较。分析LMR与HCC患者临床病理因素的关系,以及与无病生存率(DFS)、总生存率(OS)的关系。用Cox回归模型分析DFS和OS的危险因素。结果:ROC曲线确定LMR最佳诊断界值为2.87,曲线下面积(AUC)为0.757,其评估HCC预后的性能大于NLR(AUC=0.687)和PLR(AUC=0.583)。根据LMR界值将患者分为高LMR组(LMR2.87)与低LMR组(LMR≤2.87)。高LMR组中肿瘤数3的例数明显少于低LMR组(P=0.048);高LMR组的DFS与OS均明显优于低LMR组(均P0.05);在分期分层(BCLCA/B、BCLCC/D;CNLCⅠ/Ⅱ、CNLCⅢ/Ⅳ)比较结果显示,除了在CNLCⅠ/Ⅱ期组患者中,高LMR组与低LMR组的DFS无统计学差异(P=0.132),在其他分期组患者中,高LMR组患者的DFS与OS均明显优于低LMR组(均P0.05)。LMR为DFS的独立影响因素(P=0.001),而BCLC分期(P=0.000)和LMR(P=0.000)为OS的独立影响因素,此外,对LMR、PLR与NLR以连续性变量形式进行校正后,仅LMR具有预后价值(P=0.001)。结论:LMR是HCC患者术后DFS和OS的独立预后因素,且评估价值可能优于NLR和PLR。用LMR结合HCC分期对患者进行危险分级,可能做出更为精准的评估。     

Prenatal diagnosis of β-thalassemia in Guangxi Zhuang Autonomous Region, China

Purpose

The aim of this study was to establish a comprehensive prenatal diagnosis service and to control the birth of thalassemia children in Guangxi Zhuang Automonous Region, China.

Methods

Prenatal diagnosis was performed in 1,058 couples with ‘at risk’ β-thalassemia from Guangxi Zhuang Automonous Region. Fetal samplings were collected by chorionic villus sampling in the first trimester, by amniocentesis in the second trimester and by cordocentesis in the third trimester. DNA analysis was carried out using polymerase chain reaction, reverse dot blot assay, multiplex ligation-dependent probe amplification method and DNA sequencing. Automated high-performance liquid chromatography system was used to analyze the fetal hemoglobin in pregnancies in case mutations were unidentified.

Results

A total of 12 different β-thalassemia mutations were characterized from 2,116 parents. The most common mutation for β-thalassemia was CD41–42 (-CTTT) followed by CD17 (A→T). Prenatal testing revealed 315 normal fetuses, 500 carriers and 253 β-thalassemia major fetuses. The couples having fetuses with β-thalassemia major were counselled to terminate the pregnancies. Postnatal follow-up confirmed all pregnancies.

Conclusion

Our prenatal diagnosis strategy proved to be highly effective in reducing severe thalassemia in pregnant populations.     

贝伐单抗治疗复发性胶质母细胞瘤的研究进展

胶质母细胞瘤恶性程度高,局部浸润性强,复发率高。近年研究表明,血管增殖在胶质母细胞瘤的进展过程中起重要作用。贝伐单抗（bevacizumab）可以特异性阻断血管内皮生长因子（vascularendothelialgrowthfactor,VEGF）与其受体结合,抑制肿瘤血管形成,从而达到抗肿瘤的目的。贝伐单抗在复发性胶质母细胞瘤中的作用逐渐引起人们的关注。     

反刍动物情期类固醇激素对前列腺素分泌的调节机理

前列腺素是在磷脂酶A2、环氧化酶（COX）和特定的前列腺合酶的作用下产生于磷脂膜,它对调节排卵、黄体溶解、植入和分娩均有重要的作用.由子宫内分泌前列腺素（PGF2a）可使非妊娠动物在发情期末的黄体溶解.多年来已公认孕酮（P4）、雌二醇（E2）和催产素（OT）是对黄体溶解起重要作用的物质,其溶解作过程包括两个方面：一是增加子宫内膜前列腺素的合成能力;二是增加催产素受体的数量.许多研究表明：孕酮（P4）和雌二醇（E2）和可以调节前列腺素（PGF2a）的合成,但黄体溶解起始的主要原因是子宫内膜上皮细胞的催产素受体（OTR）增加.许多体内实验结果证明孕酮（P4）和雌二醇（E2）是黄体溶解所必需的物质,但其确切作用机制仍不完全清楚,本文就黄体溶解过程中对子宫前列腺素（PGF2a）的分泌调节的研究进展进行综述.     

康复训练对脊髓损伤后大鼠脊髓内再生微环境的影响

目的:观察运动训练对脊髓损伤后大鼠运动功能的影响,以及脊髓内脑源性神经营养因子(BDNF)、诱导轴突分化因子Slit2、胶质纤维酸性蛋白(GFAP)的表达规律,研究康复训练对损伤后脊髓微环境的影响.方法:雄性成年SD大鼠70只,随机分为10个实验组和4个对照组,每组5只.以改良Allen's撞击法制作脊髓损伤模型.从损伤后7天起,实验组分别进行1-4周活动平板训练,对照组不训练.训练结束时(即损伤后14、21、28、35天)分别进行运动功能评估,免疫组织化学二步法结合图像平均光密度分析观察大鼠脊髓内BDNF、Slit2以及GFAP的表达.结果:各不同训练时程后,大鼠运动功能评分均有改善(P<0.05);训练后,大鼠脊髓内BDNF以及Slit2的表达较对照组均有明显增加(P<0.05),GFAP的表达高峰延迟.结论:康复训练可能通过上调脊髓内BDNF和Slit2的表达水平,延迟星型胶质细胞的增生,使脊髓内神经元再生微环境朝有利方向变化来促进神经通路重建,改善运动功能.     

Sequential changes of body composition in patients with enterocutaneous fistula during the 10 days after admission

AIM: To investigate the sequential changes of body composition in the metabolic response that occurred in a group of patients with enterocutaneous fistula after admission to the hospital. METHODS: Sixty-one patients with enterocutaneous fistula admitted to our hospital had measurements of body composition by multiple-frequency bioelectrical impedance analysis after admission and 5, 10 days later. Sequential measurements of plasma constitutive proteins were also made. RESULTS: The body weight, fat-free mass, body mass index, and body cell mass were initially well below the normal range, especially the body mass index and body cell mass. And all the data gradually moved up over the 10-day study period, only a highly significant difference was found in body cell mass. Once the patients received nutrition supplement, ECW began to return to normal range slowly as well as ICW and TBW began to rise up, and ECW/TBW significantly declined to near normal level by day 10 in either male or female patients. There was a reprioritization of plasma constitutive protein synthesis that was obligatory and independent of changes in FFM. CONCLUSION: Serial measurements can quantify the disturbance of body composition in enterocutaneous fistula patients. The early nutritional intervention rapidly ameliorates the abnormal distribution of body water while the state-of-the-art surgical management prevents the further deterioration in cellular composition.     

岩黄连药材HPLC指纹图谱的研究

目的:采用 HPLC 法建立岩黄连药材指纹图谱。方法:应用 Shim—pack CLC—ODS 色谱柱(6.0 mm×150 mm,5μm),乙腈-缓冲溶液[0.05 mol·L~(-1)庚烷磺酸钠-0.05 mol·L~(-1)磷酸二氢钾(1:1),含0.2%乙二胺,用磷酸调 pH 3.0]梯度洗脱:0～130 min,流动相比例20:80→27:73;130～140 min,比例27:73→20:80;140～160 min,比例20:80。流速为1 mL·min~(-1),检测波长285 nm,柱温:室温。以中药色谱指纹图谱相似度评价系统的操作规范(版本2004 A)软件计算。结果:10批药材的相似度在0.765～0.989,确定了8个共有峰,建立了岩黄连药材 HPLC 指纹图谱。结论:本法可作为岩黄连药材的质量控制方法。     

克糖特Ⅱ号降血糖作用的实验研究

目的:研究克糖特Ⅱ号对链脲霉素致糖尿病小鼠的降血糖作用并初步探讨其机制.方法:对小鼠腹腔注射链脲霉素(STZ)150 mg/kg建立糖尿病模型(DM),将建模成功的小鼠随机分为5组:格列本脲组(ig格列本脲50 ms/kg·d)、克糖特Ⅱ号高、中、低剂量(ig克糖特Ⅱ号分别相当于生药25 g/kg·d,12.5 g/kg·d,6.25 g/kg·d),糖尿病模型组(ig等体积生理盐水)和空白对照组(ig等体积生理盐水),连续给药15 d.并在相应时间采血测定空腹血糖(FBG)、胰岛素、血清肌酐(Cr)、尿酸(UA)、白蛋白(Alb)等指标.结果:克糖特Ⅱ号具有明显的降血糖作用,其作用与剂量呈正相关,并能提高胰岛素水平.同时能不同程度地降低血清Cr、UA(P<0.01),升高Alb(P<0.05).结论:克糖特Ⅱ号能降低链脲霉素所致糖尿病小鼠的血糖,增加胰岛素的分泌,对糖尿病尤其并发症的治疗有潜在的应用价值.其降血糖作用机制可能与促进胰岛素分泌有关.     

经尿道前列腺等离子双极电切术与传统TURP术疗效比较

目的 :比较经尿道前列腺等离子双极电切术 (PKRP)与传统经尿道前列腺电切术 (TURP)的治疗效果。方法 :采用PKRP术治疗前列腺增生症 (BPH ) 45例与同期采用传统TURP术的 66例做比较。结果 :两种方法的手术时间、术后IPSS减分率及尿流率改善差异无显著性 (P >0 .0 5) ;但与传统TURP术比较PKRP术出血更少 ,无低钠血症及水中毒 (TURS) ,发生被膜损伤少而轻。结论 :两种经尿道 (TUR)手术都是治疗BPH的有效方法 ;PKRP有止血好、安全度大、对机体生理功能影响小、并发症少等优点 ,是一极具优势的TUR手术方法