高摄取许莫氏结节和椎体转移瘤的18F-FDG PET/CT鉴别诊断

目的分析比较高摄取许莫氏结节和椎体转移瘤的18氟-氟代脱氧葡萄糖(18F-FDG)正电子发射计算机断层扫描仪(PET/CT)显像特征,提高两种疾病的鉴别诊断准确率。方法高摄取许莫氏结节10例,其中男5例,女5例,年龄47～78岁,平均年龄59岁。椎体转移瘤18例,其中男10例,女8例,年龄28～87岁,平均年龄58岁。观察各自的18F-FDG PET/CT影像,从CT图像形态、18F-FDG代谢的形态及两者的位置对应关系方面进行分析比较。运用ROI法测量高摄取许莫氏结节和椎体转移瘤病灶的最大标准摄取值(SUVmax),并且运用t检验的统计学方法比较高摄取许莫氏结节和椎体转移瘤的SUVmax,以确定两者之间差异是否有统计学意义。结果 10例高摄取许莫氏结节均位于椎体的上位终板或下位终板,且腰椎多见。而椎体转移瘤为胸椎多发,病灶或病灶的主体均位于椎体的松质骨内。高摄取许莫氏结节CT形态有4个特点:一是椎体的上位或下位终板局限性缺损,即使不明显,但在矢状位或冠状位CT重组图像上仍可见;二是椎体终板缺损区下骨质内低密度灶,多呈结节状,偶呈扁丘状;三是椎体内低密度结节通过椎体终板缺损区和邻近的椎间盘相连;四是低密度结节和椎体接触区有不完整的或外缘模糊的硬化带。另外,高摄取许莫氏结节邻近的椎间隙约69.2%(9/13)变窄,且有1个邻近的椎间隙内见气样密度影。高摄取许莫氏结节的高代谢区呈结节状或条带状,局限在结节和(或)结节周围的硬化带内。椎体转移瘤病灶部位呈骨质破坏、骨质硬化或两者共存,可累及椎体终板,但病灶或病灶主体仍位于椎体的松质骨内,不具备或不同时具备高摄取许莫氏结节在CT图像上的4个特点。高摄取许莫氏结节与椎体转移瘤比较,两者的SUVmax比较差异无统计学意义(t=1.563,P>0.05)。结论高摄取许莫氏结节的18F-FDG PET/CT形态有特点,可与椎体转移瘤相鉴别,而SUVmax对于高摄取许莫氏结节和椎体转移瘤的鉴别没有价值。     

Combined therapy of intensive statin plus intravenous rt-PA in acute ischemic stroke: the INSPIRE randomized clinical trial

Journal of Neurology - To investigate the safety and efficacy of intensive statin in the acute phase of ischemic stroke after intravenous thrombolysis therapy. A total of 310 stroke patients...     

Limitations of Body Surface Area–Based Activity Calculation for Radioembolization of Hepatic Metastases in Colorectal Cancer

PurposeTo calculate absorbed radiation doses in patients treated with resin microspheres prescribed by the body surface area (BSA) method and to analyze dose-response and toxicity relationships.Materials and MethodsA retrospective review was performed of 45 patients with colorectal carcinoma metastases who received single-session whole-liver resin microsphere radioembolization. Prescribed treatment activity was calculated using the BSA method. Liver volumes and whole-liver absorbed doses (D_WL) were calculated. D_WL was correlated with toxicity and radiographic and biochemical response.ResultsThe standard BSA-based administered activity (range, 0.85–2.58 GBq) did not correlate with D_WL (mean, 50.4 Gy; range, 29.8–74.7 Gy; r = −0.037; P = .809) because liver weight was highly variable (mean, 1.89 kg; range, 0.94–3.42 kg) and strongly correlated with D_WL (r = −0.724; P < .001) but was not accounted for in the BSA method. Patients with larger livers were relatively underdosed, and patients with smaller livers were relatively overdosed. Patients who received D_WL > 50 Gy experienced more toxicity and adverse events (> grade 2 liver toxicity, 46% vs 17%; P < .05) but also responded better to the treatment than patients who received D_WL< 50 Gy (disease control, 88% vs 24%; P < .01).ConclusionsUsing the standard BSA formula, the administered activity did not correlate with D_WL. Based on this short-term follow-up after salvage therapy in patients with late stage metastatic colorectal carcinoma, dose-response and dose-toxicity relationships support using a protocol based on liver volume rather than BSA to prescribe the administered activity.     

Antimetastatic effects of licochalcone A on oral cancer via regulating metastasis-associated proteases

Licochalcone A, a major phenolic constituent of the licorice species Glycyrrhiza inflata, has been proven to possess various biological benefits including anti-cancer activity. However, the detailed effects and molecular mechanisms of licochalcone A on the invasiveness and metastasis of oral cancer cells have not been fully understood. Thus, SCC-25 oral cancer cells were subjected to a treatment with licochalcone A at indicated concentrations (25, 50, and 100 μg/mL) for 36 h and then analyzed for the effect of licochalcone A on the cell migration and invasion. In vitro assays, including wound healing, cell adhesion, and cell invasion/migration assays, revealed that licochalcone A treatment significantly inhibited the cell migration/invasion capacities of SCC-25 cells. Also, results of zymography and Western blotting showed that activity and protein level of matrix metalloproteinase-2 (MMP-2) was suppressed, but TIMP-2 level was increased, indicating the important role of MMP-2 and TIPM-2 in anti-metastatic regulation of SCC-25 cells. Furthermore, licochalcone A was shown to suppress the nuclear factor-kappa B (NF-κB) signal, as evidenced by the decreased expression of phosphorylated p65 (p-65) protein in licochalcone A-treated SCC-25 cells. Notably, we also found that licochalcone A treatment increased the expression of the epithelial marker E-cadherin and decreased the expression of mesenchymal markers N-cadherin in SCC-25 cells. This is the first report describing the effects and possible mechanisms of licochalcone A on tumor invasion and metastasis of SCC-25 cells. Taken together, our findings support that licochalcone A can be developed to a potent anti-metastatic candidate for oral cancer therapy.     

不同浓度海藻酸盐凝胶的力学特性及其对软骨细胞增殖能力的影响

细胞外基质的理化性能影响着细胞的命运并调节组织形成。为探索最佳的软骨细胞体外三维生长环境,本研究通过改变藻酸盐浓度测定了海藻酸盐小球的力学特性及其对软骨细胞增殖能力的影响。凝胶的压缩机械性能通过INSTRON3365测定,结果发现浓度越高其压缩模量越大,表明凝胶对抗应变的能力越强。同时选取4w龄乳兔关节软骨细胞分别包裹在浓度为1%、2%和3%(w/v)海藻酸盐小球中连续培养4周,结果发现所有3组软骨细胞都表现出有限的增殖并形成类似于软骨组织的细胞簇,其中较低浓度组(1%和2%)增殖更明显。这些结果表明软骨细胞在海藻酸盐凝胶小球中连续培养有少量增殖,且较低浓度的藻酸盐更有利于软骨细胞的增殖,说明藻酸盐凝胶的力学特性影响了软骨细胞的增殖能力。     

水囊压迫止血对脑出血术后颅内压的影响

目的观察脑出血术后血肿腔置水囊压迫止血对颅内压的影响。方法选择15例脑出血病人,清除颅内血肿后血肿腔置水囊压迫止血,同时行侧脑室钻孔脑室外引流,引流管外接三通后接颅内压监测仪,并于术中及术后3d连续监测颅内压,根据颅内压变化情况给予脱水治疗。于术后1d、3d行头部CT复查,了解脑水肿及再出血情况。结果术中颅内压正常14例,轻度增高1例;术后1d正常10例,轻度增高4例,中度增高1例;术后2d正常8例,轻度增高5例,中度增高2例;术后3d正常5例,轻度增高6例,中度增高3例,重度增高1例。结论颅内血肿术后水囊少量注水压迫血肿腔止血,对术后颅内压影响小,安全可靠。     

间充质干细胞和Stro-1+亚群免疫抑制的比较及IDO1、IDO2在其中的作用

目的:比较间充质干细胞(MSC)和经Stro-1抗体分选的Stro-1+ MSC对淋巴细胞增殖反应的影响;探讨吲哚胺2,3二氧化酶1(IDO1)和IDO2在上述两种间充质干细胞免疫调节功能中的作用.方法:从全髋关节置换术患者的近端股骨粉碎物中得到细胞悬液,培养MSC,并筛选Stro- 1+MSC.体外设立单向混合淋巴细胞反应(MLR)体系,分别加入1×103～5× 104个经照射的Stro-1 +MSC或MSC,检测对T淋巴细胞增殖反应的影响.再分别加入IDO1和IDO2的特异性抑制剂L-1MT和D-1MT,检测T 淋巴细胞增殖反应的变化;以实时定量PCR法比较IDO1、IDO2在StRO-1+MSC和MSC中的表达,以GAPDH作为内参照基因.结果:(1)不同剂量组,Stro- 1+MSC对MLR的抑制效应均显著强于相同剂量的未经分选的MSC (P＜0.05); (2)加入L-IMT后,Stro-1+MSC和MSC对MLR的抑制作用均显著减弱(P＜0.05),而加入D-1MT后Stro-1+MSC和MSC对MLR的抑制作用与未加入抑制剂的对照组相比无显著变化(P＞0.05);(3)加入L-1MT后,Stro-1+MSC和MSC对MLR抑制的显著差异不复存在(P＞0.05),加入D-1MT后Stro-1+MSC对MLR的抑制作用仍显著强于未经分选的MSC(P＜0.05);(4)实时定量PCR检测发现IDO1在Stro-1+MSC中的表达显著高于MSC (P＜0.05),而IDO2的表达在两者间无差异(P＞0.05).结论:IDO1在MSC的免疫调节和Stro-1+MSC的强势抑制功能中发挥重要作用,该作用可被IDO1的特异性抑制剂L-1MT所抑制,而IDO2的特异性抑制剂D-1MT无此作用.     

驻海南某部海军官兵健康状况调查

目的了解海军官兵的健康状况及影响因素。方法采用整群抽样方法,用自行设计的健康调查表对648名海军官兵进行问卷调查。调查表含有与精神、循环及消化系统疾病相关的20项亚健康状态自觉症状。结果发生率位列前5项的自觉症状分别为烦躁（70.1%）、乏力（65.1%）、情绪低落（61.7%）、失眠（61.0%）、头晕（58.3%）;不同服役期的官兵组间烦躁、情绪低落、失眠发生率差异有统计学意义（P〈0.05）;干部、战士头晕的发生率以及不同文化程度官兵失眠的发生率的组间差异有统计学意义（P〈0.05）。结论本组被调查官兵均存在不同程度的健康问题,与服役年限、学历、任职有一定关系。     

复杂粉碎性髋臼骨折关节面手术重建方法的临床研究

目的 探讨复杂粉碎性髋臼骨折的手术修复方法.方法 髋臼复杂粉碎性骨折患者148例,其中关节脱位状态下手术组(对照组)46例,关节复位状态下手术组(观察组)102例,比较两组手术时间、出血量、输血量、骨折复位质量、术后并发症.结果 观察组手术时间短于对照组,术中出血量及输血量少于对照组、术后不良反应发生率低于对照组,差异...     

益气活血解毒法对溃疡性结肠炎复发患者结肠组织PPAR-γ的影响

目的:探讨益气活血解毒法对溃疡性结肠炎(UC)复发患者结肠组织过氧化物酶增生激活受体(PPAR-γ)影响.方法:90例UC复发患者随机分为2组,中药治疗组45例,西药对照组45例.治疗3个月后对完全缓解及有效病例(其中治疗组39例,对照组32例)进行检测.治疗组给予益气活血解毒立法的中药汤剂,对照组给予柳氮磺胺吡啶治疗...