血清-腹水蛋白梯度在腹水病因诊断中的价值

[目的]探讨血清腹水蛋白梯度( SAAG)在腹水病因诊断中的价值.[方法]将入诊的80例腹水患者,按腹水形成机制分为门脉高压组(42例)和非门脉高压组(38例),以同天采样同步检查的血清白蛋白浓度和腹水白蛋白浓度计算SAAG,比较2组SAAG与诊断的关系.[结果]门脉高压组的SAAG显著高于非门脉高压组(P＜0.01).[结论]SAAG对诊断腹水有重要价值,但不能完全代替其他检查方法,有时还需要联合监测以提高腹水诊断率.     

MRI evaluation of fatty liver in day to day practice: Quantitative and qualitative methods

Intracellular fat accumulation is a common feature of liver disease. Steatosis is the histological hallmark of non-alcoholic fatty liver disease (NAFLD) but also may occur with alcohol abuse, viral hepatitis, HIV and genetic lipodystrophies, and chemotherapy. This condition is common in the Western population and is typically associated with obesity and the metabolic syndrome. Early diagnosis and early treatment of NAFLD are important to prevent the development of end-stage liver disease and cancer. In addition, liver fat is a risk factor for postoperative complications after liver resection and transplantation. MRI has become a primary modality to assess hepatic steatosis, both qualitatively and quantitatively. In this article we discuss various MRI methods for evaluation of hepatic steatosis.     

Optimization of the Parameters for Diffusion Tensor Magnetic Resonance Imaging Data Acquisition for Breast Fiber Tractography at 1.5 T

IntroductionDiffusion tensor MRI has emerged as a promising tool for the analysis of the microscopic properties of tissues. Optimizing image acquisition parameters is essential for producing high-quality DTI. This study aimed to optimize the parameters for DTI data acquisition for breast fiber tractography at 1.5 T.Patients and MethodsA total of 21 healthy volunteers received breast DTI scanning using an ASSET-based EPI technique operated under different parameters including b value, the number of diffusion gradient directions, and spatial resolution. The images were analyzed for signal-to-noise, signal intensity ratio, mean number and length of reconstructive fiber tracts, and fractional anisotropy value.ResultsThe optimal acquisition parameters at 1.5 T for breast DT-MRI fiber tractography were determined as follows: axial 31 direction, b = 600 seconds per mm², matrix 128 × 128 with slice thickness of 3 mm.ConclusionThe optimization of data acquisition parameters could improve the quality of breast DT-MRI images and assist fiber tractography at 1.5 T.     

非连续密度梯度离心法分离红细胞的影响因素分析

目的 分析非连续密度梯度分离法分离红细胞效果的影响因素,探讨各因素对分离结果的影响程度.方法 采用正交设计比较不同分离条件(离心力、离心时间、离心温度)的分离效果,应用多元线性回归统计方法分析不同个体参数(红细胞平均体积、细胞浓度、个体年龄)对分离效果的影响.结果 离心力、离心时间、标本红细胞平均体积、红细胞浓度、个体年龄都对分离结果有影响,其中红细胞平均体积起主导作用.结论 不同分离条件以及同一分离条件下不同标本,其分离效果均有差异,通过对影响因素的人为控制,可以得到相对稳定的分离效果.     

密度梯度离心联合上游法的精液处理在供精体外受精胚胎移植中的应用

目的:观察供精体外受精-胚胎移植术(D-IVF)中采用密度梯度离心法联合上游法处理精液后的胚胎情况。方法:回顾本院2013年1月-2014年7月D-IVF 135个周期,观察冷冻精液复苏后经采用密度梯度离心法联合上游法处理后精子总活动率、前向运动精子活动率等精液情况,以及受精以后的受精率、卵裂率、临床妊娠率,对照组为同期46个因丈夫梗阻性无精行ICSI的周期。结果:处理后精子总活动率、前向运动精子活动率均大大提高,但是精子密度却大大下降,处理前后比较差异均有统计学意义(P0.05);受精以后的实验室资料和对照组比较,各项参数差异无统计学意义(P0.05)。结论:密度梯度离心法联合上游法的精液处理方法在D-IVF中是一种稳定可行的方法。     

HPLC-DAD法测定“武当三号金银花”不同部位中芦丁和木犀草苷的含量

目的：建立HPLC－DAD法测定“武当三号金银花”不同部位中芦丁和木犀草苷的含量。方法采用Fortis Xi Phenyl柱（250 mm ×4．6 mm,5μm）;流动相为乙腈（A）—0．5％冰醋酸溶液（B）进行线性梯度洗脱;检测波长为354 nm;柱温：30℃。结果芦丁和木犀草苷在各自测定的范围内均呈良好的线性关系（r≥0．9994）,平均回收率分别为99．4％、99．3％。结论该法操作简单,灵敏度高,重现性好,为控制“武当三号金银花”不同部位芦丁和木犀草苷的质量提供了一种可靠的方法。     

Prospective Evaluation of Transseptal TMVR for Failed Surgical Bioprostheses: MITRAL Trial Valve-in-Valve Arm 1-Year Outcomes

ObjectivesThe aim of this study was to assess 1-year clinical outcomes among high-risk patients with failed surgical mitral bioprostheses who underwent transseptal mitral valve-in-valve (MViV) with the SAPIEN 3 aortic transcatheter heart valve (THV) in the MITRAL (Mitral Implantation of Transcatheter Valves) trial.BackgroundThe MITRAL trial is the first prospective study evaluating transseptal MViV with the SAPIEN 3 aortic THV in high-risk patients with failed surgical mitral bioprostheses.MethodsHigh-risk patients with symptomatic moderate to severe or severe mitral regurgitation (MR) or severe mitral stenosis due to failed surgical mitral bioprostheses were prospectively enrolled. The primary safety endpoint was technical success. The primary THV performance endpoint was absence of MR grade ≥2+ or mean mitral valve gradient ≥10 mm Hg (30 days and 1 year). Secondary endpoints included procedural success and all-cause mortality (30 days and 1 year).ResultsThirty patients were enrolled between July 2016 and October 2017 (median age 77.5 years [interquartile range (IQR): 70.3 to 82.8 years], 63.3% women, median Society of Thoracic Surgeons score 9.4% [IQR: 5.8% to 12.0%], 80% in New York Heart Association functional class III or IV). The technical success rate was 100%. The primary performance endpoint in survivors was achieved in 96.6% (28 of 29) at 30 days and 82.8% (24 of 29) at 1 year. Thirty-day all-cause mortality was 3.3% and was unchanged at 1 year. The only death was due to airway obstruction after swallowing several pills simultaneously 29 days post-MViV. At 1-year follow-up, 89.3% of patients were in New York Heart Association functional class I or II, the median mean mitral valve gradient was 6.6 mm Hg (interquartile range: 5.5 to 8.9 mm Hg), and all patients had MR grade ≤1+.ConclusionsTransseptal MViV in high-risk patients was associated with 100% technical success, low procedural complication rates, and very low mortality at 1 year. The vast majority of patients experienced significant symptom alleviation, and THV performance remained stable at 1 year.     

SHR大鼠前额叶、纹状体突触体的提取方法

目的 介绍SHR大鼠前额叶、纹状体突触体的提取方法。方法 采用Percoll密度梯度离心法制备突触体,透射电镜观察其形态和结构完整性。结果 本实验所获取的突触体形态上呈连续膜封闭的椭圆结构,周围有完整的膜包围;突触前成分可见一个或多个线粒体和大量突触小囊泡;突触间隙清晰可见,且突触后部分特征性的致密部结构完整,形态清晰,密度较高。突触体突触前膜、突触间隙、突触后膜保存完好,突触体分布密度较高,具有典型的突触体形态结构特征。结论 本实验提供了一种耗时少,产出率高,结构完整、形态典型且可运用于精细化研究的突触体制备新技术,补充了传统技术的不足,为神经系统疾病的研究提供技术支持。     

MSCs 2种分离培养方法及其培养液中的 VEGF、SDF-1α浓度比较

目的：通过2种分离培养方法所得骨髓间充质干细胞（MSCs）的生长特征和微环境中细胞因子的比较,提供一种可以快速、安全、高效地为临床和实验提供大量优质MSCs的方法。方法提取C57BL／c小鼠的骨髓,分别作密度梯度离心法和全骨髓贴壁培养分离法分离培养MSCs ,通过流式细胞仪检测细胞表面CD29＋、CD31－、CD34－、CD45－表达水平,并比较各自所得细胞的生长曲线;ELISA检测培养液中的血管内皮生长因子（VEGF）、SDF‐1α浓度并比较二者的差异。结果与密度梯度离心法比较,全骨髓贴壁分离法所得原代细胞有较快的生长速度,较短的生长周期;培养液中VEGF和SDF‐1α浓度也稍高于密度梯度离心法。结论全骨髓贴壁培养法可以快速、方便、有效地为临床和实验提供大量MSCs ,所得细胞的培养环境优于密度梯度离心法,减少了对细胞功能的损害。