松果体区肿瘤的放射治疗27例临床分析

 自1978年2月～1992年2月共收治松果体肿瘤患者27例。年龄分布9～36岁，其中25岁以下23例（85．2％），男女之比为2：1。有3例经组织学证实，18例采用脑室分流术加术后放疗，9例行单纯放疗。3年、5年生存率分别为66．7％（18／27）和55．6％（15/27），主要死因是局部复发。因为手术治疗本病有较高的并发症和死亡率，虽然大多数肿瘤不能全切，但对放射线敏感。因此，在无法取得组织寻诊断时，可采用脑室分流术和术后放疗。     

Ⅰ型疫苗衍生脊髓灰质炎病毒循环的发现和基因特点

目的分析贵州省2004年Ⅰ型循环的疫苗衍生脊髓灰质炎(脊灰)病毒(cVDPVs)的基因特征,阐述cVDPVs的出现为全球消灭脊灰带来的挑战。方法2004年中国疾病预防控制中心(CDC)病毒病预防控制所国家脊灰实验室对各个省送检的每1个脊灰病毒分离株进行聚合酶链反应-限制性酶切片段长度多态性分析(PCR-RFLP)和酶联免疫吸附试验(ELISA)两种方法的型内鉴定。毒株型内鉴别显示异常时,则对该株病毒进行VP1编码区全基因的序列测定和分析。结果2004年从贵州省CDC送检的脊灰病毒株(或粪便标本的复核)中,共发现9株Ⅰ型疫苗衍生脊灰病毒(VDPVs)。这9株VDPVs从2例急性弛缓性麻痹(AFP)病例和4名接触者的粪便标本中分离到。其中8株分离于贞丰县挽兰乡的2例AFP病例和3名接触者,另外1株分离于贞丰县白层镇的1名AFP病例接触者。结论对9株cVDPVs的VP1编码区的序列测定和分析证实,它们有相似的核苷酸序列,共享5个核苷酸突变位点,说明VDPVs已发生了循环。cVDPVs很可能来源于2003年秋季的1次口服脊灰减毒活疫苗病毒的传播。对其中5株VDPVs的3D区和1株VDPV(8229-2)的全序列测定和分析,未发现脊灰病毒血清型之间的重组,也未发现与非脊灰肠道病毒的重组。     

Rheumatoid arthritis of the craniocervical region: assessment and characterization of inflammatory soft tissue proliferations with unenhanced and contrast-enhanced CT

The aim of this study was to depict and characterize inflammatory soft tissue proliferations caused by rheumatoid arthritis (RA) in the craniocervical region by unenhanced and contrast-enhanced CT. Computed tomography of the craniocervical region was performed in 35 patients in the axial plane before and after the i. v. administration of contrast material. According to the densities and contrast enhancement of the inflammatory soft tissue proliferations, four groups were classified. Ancillary findings, such as a compression of the dural sac or spinal cord, erosions of the bony structures, and atlantoaxial subluxation, were also evaluated. Inflammatory soft tissue proliferations were depicted in 28 of 35 patients and could be differentiated by unenhanced and contrast-enhanced CT according to the above defined criteria: effusion in 6 patients (17 %); hypervascular pannus in 8 (23 %); hypovascular pannus in 5 (14 %); and fibrous tissue in 9 patients (26 %). A compression of the dural sac was seen in 11 (31 %) patients; 3 of these had neurological symptoms. Erosions of the odontoid process were found in 20 (57 %) patients; 16 (80 %) of these also showed erosions of the atlas. Atlantoaxial subluxation was seen in 11 (31 %) patients. Inflammatory soft tissue proliferations in the craniocervical region caused by RA can be reliably demonstrated and classified by unenhanced and contrast-enhanced CT, which can differentiate between joint effusion and various forms of pannus and depict ancillary findings. Computed tomography is an alternative method for patients unable to undergo an MRI examination. Received: 4 October 1999; Revised: 7 March 2000; Accepted: 14 March 2000     

Interpretation of Wada memory test for lateralization of seizure focus by use of (99m)technetium-HMPAO SPECT

PURPOSE: Although the intracarotid amobarbital procedure (IAP) or Wada test is useful in lateralizing seizure focus in patients with temporal lobe epilepsy (TLE), the results of the IAP memory test are frequently nonlateralizing. An insufficient suppression of the medial temporal region contralateral to the seizure focus may contribute to the failure of lateralization. We tried to correlate IAP memory results with the functional changes in the contralateral medial temporal region as measured by single photon emission computed tomography (SPECT) during IAP. METHODS: We performed a (99m)technetium-(Tc) hexamethylene-propylene-amine-oxime (HMPAO) brain SPECT in 19 medial TLE patients during a contralateral IAP (sodium amobarbital injected contralateral to the seizure focus). Regional cerebral blood flow (rCBF) was measured in the contralateral medial temporal region. The amount of decrease in the rCBF was calculated by subtracting the previous measurement from the one obtained with the interictal SPECT. RESULTS: Ten (53%) patients passed and nine (47%) failed the contralateral IAP. The mean percentage decrease in rCBF was 5.3+/-5.3%. There was a significant negative correlation between a decrease in the rCBF and the IAP memory-retention score by Spearman correlation (p = -0.53: p<0.021). Patients with smaller decreases in rCBF (<5%) more frequently passed the contralateral IAP memory test than did those with larger decreases (80 vs. 22%; p<0.023). CONCLUSIONS: We suggest that an insufficient suppression of the contralateral medial temporal function is partly responsible for nonlateralizing IAP memory tests. An IAP-SPECT may be useful in interpreting IAP memory tests for the lateralization of seizure focus in TLE patients.     

凉山农村彝族人群HIV/AIDS知识及相关行为特征分析

目的　了解农村彝族一般人群的HIV/AIDS知识知晓情况及相关行为特征 ,为开展综合干预提供依据。方法　随机抽取 3个彝族聚居的行政村 ,使用自行设计的问卷进行面对面的访谈调查 ,共调查到 15～ 4 9岁彝族村民 10 0 8人。用SPSS软件进行统计分析。结果　村民普遍缺乏HIV/AIDS防制知识 ;8 4 %的村民曾尝试过吸毒 ;13 5 %的人有多性伴现象 ;外出者中近 4 0 %为盲流 ,为吸毒贩毒创造了条件。结论　该地区农村彝族人群存在多种艾滋病相关危险因素 ,缺乏知识和贫困导致的盲流是该地HIV传播流行的主要原因。应及时开展形式多样的HIV/AIDS相关知识的宣传教育工作 ,同时开展扶贫工作 ,使艾滋病防制工作获得可持续性的发展     

PCR技术在赫坎按蚊复合体近缘种鉴别中的应用

目的应用聚合酶链反应（PCR）技术分析湖北省不同地区媒介按蚊的种型.方法采用传统的形态学方法和新建立的基因鉴别技术对现场捕获的按蚊分别进行形态特征鉴别和基因鉴别及比较.结果现场捕获181只按蚊,形态学确认176只为中华按蚊,而PCR鉴定172只为中华按蚊,另4只为八代按蚊;经形态学特征鉴别的5只嗜人按蚊中,PCR鉴别有4只为嗜人按蚊,另1只为八代按蚊.结论采用PCR基因鉴别技术能准确鉴别赫坎按蚊种团内中华按蚊、嗜人按蚊、八代按蚊等近缘种按蚊,较传统的按蚊形态学鉴别方法准确,适用于复合媒介地区的疟疾媒介调查和监测.     

子宫内膜癌染色体不稳定性研究

目的探讨子宫内膜癌染色体不稳定性。方法取21例子宫内膜癌患者外周血淋巴细胞体外常规培养、制片、GTG显带分析染色体畸变(CAR),Brdu法分化染色分析姊妹染色单体交换(SCE)、微核(MN)、核仁组织形成区(NOR)。结果内膜癌组(21例)染色体结构畸变以出现次数的多少排列为:1、3、2、5、7、8号,染色体数目、结构畸变率分别为12.86%6、.1%,SCE频率、MN率、Ag-NOR分别为7.4±1.5次/细胞(、6.6±1.9)‰、7.1±1.6个/细胞,对照组(10例)染色体数目、结构畸变率分别为3.4%、0.4%,SCE频率、MN率、Ag-NOR分别为4.8±0.6次/细胞(、2.0±0.9)‰、4.9±1.1个/细胞,内膜癌组均明显高于对照组(P<0.01)。结论子宫内膜癌病人外周血淋巴细胞染色体数目和结构畸变率增高。     

婴幼儿骶尾部良性畸胎瘤的MRI诊断

目的：评估婴幼儿骶尾部良性畸胎瘤的MRI诊断价值。方法：回顾性分析6例经手术病理证实的骶尾部良性畸胎瘤的MRI表现。6例均用MRI的快速自旋回波序列扫描，结合短时反转恢复脂肪抑制序列及增强扫描。结果：骶尾部良性畸胎瘤起源于盆腔内末端骶尾区，属于后腹膜肿瘤，MRI通常表现为圆形、类圆形或不规则形巨大均质或非均质性肿块，边界一般较清楚，信号混杂，其中有代表囊性或实性成分的信号区域，实性部分常见脂肪或钙化。结论：MRI可清楚显示盆腔内、外的成分和解剖细节，有助于对骶尾部良性畸胎瘤的诊断以及合适手术计划的选择。     

前纵裂入路切除鞍区巨大肿瘤

背景与目的：鞍区巨大肿瘤手术难度较大，本文探索前纵裂入路切除鞍内、鞍上向单双侧海绵窦、第三脑室、蝶窦及伴颞叶发展的巨大肿瘤的手术适应症、方法与优缺点方法：总结分析2002年1月至2004年5月我科经前纵裂入路切除鞍区各部位发展的肿瘤17例。结果：肿瘤全切14例，近全切2例．部分切除1例；术后视力改善12例，无改变5例，尿崩或电解质紊乱8例，死亡1例，随访时间3～32个月，有1例复发，系巨大侵袭性垂体瘤术后，行γ-刀治疗后肿瘤基本得到控制。结论：前纵裂入路是切除鞍内、鞍上向单双侧海绵安、第三脑室、蝶窦及伴颞叶发展的肿瘤较理想的入路，利用自然脑裂的分离，手术视野、操作角度好、肓区少，有利于显露重要血管、神经及双侧海绵窦内侧壁，肿瘤全切率高。     

桥小脑角区肿瘤的低场MRI诊断

目的探讨低场磁共振成像(MRI)对桥小脑角区肿瘤的临床诊断价值。方法经临床、手术病理证实的桥小脑角区肿瘤61例,回顾性分析其低场MRI表现。结果听神经瘤33例,表皮样囊肿9例,脑膜瘤7例,三叉神经瘤6例,蛛网膜囊肿4例,室管膜瘤2例。结论低场MRI对桥小脑角区肿瘤也有很高的临床诊断价值。