Computerized Digital Imaging Techniques Provided by Digital X-ray Radiogrammetry as New Diagnostic Tool in Rheumatoid Arthritis

Purpose Our study evaluates digital x-ray radiogrammetry (DXR) and Radiogrammetry Kit (RK) as a new diagnostic method for the measurement of disease-related osteoporosis including quantification of joint space narrowing dependent on the severity of rheumatoid arthritis (RA). Materials and Methods A total of 172 unselected patients with RA underwent computerized measurements of bone mineral density (BMD) and metacarpal index (MCI) by DXR, as well as a semiautomated measurement of joint space distances at the metacarpal–phalangeal articulation (JSD-MCP 2–5), both were analyzed from plain radiographs of the nondominant hand. Results Correlations between DXR-BMD and DXR-MCI vs. parameters of RK were all significant (0.34 < R < 0.61; p < 0.01). An expected negative association was observed between RK parameters and the different scoring methods (−0.27 < R < −0.59). The maximum relative decrease in BMD vs. MCI as measured by DXR between the highest and lowest RA severity group was −27.7% vs. −27.5% (p < 0.01) for the modified Larsen Score, whereas the minimal value of relative DXR-BMD and DXR-MCI reduction could be documented for the Sharp Erosion Score (−20.8% vs. −26.8%; p < 0.01). The relative reduction of mean JSD-MCP using RK significantly varied from −25.0% (Sharp Erosion Score) to −41.2% (modified Larsen Score). In addition, an excellent reproducibility of DXR and RK could be verified. Conclusion DXR in combination with RK could be a promising, widely available diagnostic tool to supplement the different scoring methods of RA with quantitative data, allowing an earlier and improved diagnosis and more precision in determining disease progression.     

Morphology of hepatitis C and hepatitis B virus particles as detected by immunogold electron microscopy

We performed indirect immunogold electron microscopy (EM) for immunological identification and characterization of hepatitis C virus (HCV). To clarify the morphology of HCV, an indirect immunogold EM of two plasma samples from patients with high HCV RNA titers was carried out using antibodies specific for the putative HCV envelope protein (E) 1. Spherical virus particles 55–65 nm in diameter with delicate spike projections were detected in the 1.14–1.16 g/ml fractions after sucrose density gradient centrifugation. Polyclonal and monoclonal antibodies to the putative HCV E1 specifically recognized these particles. In addition, immunogold EM of the samples was also performed to uncover the morphology of HCV core particles. Spherical particles 33–40 nm in diameter (average, 37 nm) were detected in the 1.22- to 1.25-g/ml fractions by conventional EM after sucrose density gradient centrifugation. Immunogold EM using rabbit polyclonal antibody (RR8) specific for the putative HCV core protein and colloidal gold-labeled goat antirabbit IgG showed binding of the gold particles with RR8. Some of the HCV core particles showed icosahedric morphology. Optical rotation technique showed that the HCV core particles exhibit sixfold symmetry and that the length of the regular hexagon side is approximately 20 nm, suggesting that they have an icosahedric structure. Further, the detection limit of the indirect immunogold EM was evaluated in 11 plasma samples from chronic hepatitis B patients with different degrees of hepatitis B virus (HBV) DNA titers using antihepatitis B surface antigen antibody. The study showed that the detection limit of virus using this method is 10⁷ virions/ml.     

Changes in dreaming induced by CPAP in severe obstructive sleep apnea syndrome patients

To study dream content in patients with severe obstructive sleep apnea syndrome (OSAS) and its modification with Continuous Positive Airway Pressure (CPAP) therapy. We assessed twenty consecutive patients with severe OSAS and 17 healthy controls. Polysomnograms were recorded at baseline in patients and controls and during the CPAP titration night, 3 months after effective treatment and 2 years later in patients. Subjects were awakened 5-10 min after the beginning of the first and last rapid eye movement (REM) sleep periods and we measured percentage of dream recall, emotional content of the dream, word count, thematic units, sleep architecture and REM density. Dream recall in REM sleep was similar in patients at baseline and controls (51.5% versus 44.4% respectively; P = .421), decreased to 20% and 24.3% the first and third month CPAP nights, and increased to 39% 2 years later (P = 0.004). Violent/highly anxious dreams were only seen in patients at baseline. Word count was higher in patients than in controls. REM density was highest the first CPAP night. Severe OSAS patients recall dreams in REM sleep as often as controls, but their dreams have an increased emotional tone and are longer. Despite an increase in REM density, dream recall decreased the first months of CPAP and recovered 2 years later. Violent/highly anxious dreams disappeared with treatment. A dream recall decrease with CPAP is associated with normalization of sleep in OSAS patients.     

不同浓度、剂量布比卡因用于剖宫产脊麻的效果比较

目的研究比较不同浓度、剂量,等比重布比卡因对产妇的麻醉效果及新生儿的影响,为临床麻醉提供参考依据。方法选择ASAⅠ~Ⅱ级初次足月妊娠拟择期剖宫产手术孕妇80例,随机分为A、B二组,每组各40例。均在左侧卧位下行腰-硬联合穿刺,L2-3进针,见脑脊液外流后,针斜面向下注入等比重布比卡因:A组:8mg(0·5%,1·6ml;配法:0·75%布比卡因2ml+脑脊液1ml);B组:9·6mg(0·6%,1·6ml;配法:0·75%布比卡因2ml+脑脊液0·5ml),20s注药完毕。记录麻醉前(基础值)和脊麻注药后1、3、5、7、10、15min各时间点的平均动脉压(MAP)、心率(HR)、脉搏血氧饱合度(SpO2)。测定并记录麻醉起效时间、平面固定时间、最高麻醉平面点(胸,T)、麻醉完全消退时间、下肢阻滞的最大程度、麻醉并发症等。结果A组感觉阻滞起效时间长于B组(69·27±21·48vs52·43±27·61s,P<0·05);两组最高阻滞平面(T4·50±1·44vsT4·10±0·57)及最高阻滞平面的固定时间(7·69±1·36vs7·35±1·22min)相似(P>0·05)。A组麻醉完全消退时间快于B组(218·40±18·57vs256·22±16·72min,P<0·05);Bromage评分A组明显小于B组(2·03±0·68vs2·93±0·21,P<0·05);麻醉后B组低血压发生率明显高于A组(P<0·05)。两组病人的麻醉效果均优,肌松满意。所有新生儿的Apgar评分均在7分以上,无组间差异。结论两组病人均产生了良好的脊麻效果,权衡利弊剖宫产脊麻时应用8mg(0·5%,1·6ml)布比卡因更为安全合理。     

氧化修饰低密度脂蛋白在子痫前期中的测定及意义

目的测定氧化修饰低密度脂蛋白(oxLDL)在子痫前期中的变化,探讨其意义。方法采用酶联免疫吸附法(ELISA)测定子痫前期重度组、子痫前期轻度组及对照组血清oxLDL水平。结果(1)3组孕妇血清oxLDL比较,见子痫前期重度组升高(49.35±4.22)μg/d l,与对照组(31.71±3.51)μg/d l比较有显著差异(P<0.01);子痫前期轻度组(39.12±2.37)μg/d l升高,与对照组比较有显著差异(P<0.05);子痫前期重度组与轻度组比较无显著差异(P>0.05)。(2)子痫前期重度组血清oxLDL与收缩压、舒张压呈正相关(r=0.51,P<0.01;r=0.47,P<0.05)。结论研究提示oxLDL可能是子痫前期发病的重要因素。     

维生素D受体基因起始密码子和CDX2多态性与钙剂补充对绝经后妇女骨密度作用的关系

目的了解维生素D受体（vitamin D receptor，VDR）基因（VDR）起始密码子（Fok Ⅰ位点）和启动子区CDX2结合位点多态性与绝经后妇女钙剂补充对骨密度（bone mineral density，BMD）和骨转换指标作用的关系。方法200名受试对象（均为上海市汉族无亲缘关系的绝经后妇女）分为两组：高钙组（日服元素钙1000mg和维生素D400IU）和低钙组（日服元素钙300mg和维生素D300IU）各100名，期限1年。检测治疗前后BMD和骨转换指标，以及VDR基因Fok Ⅰ位点和CDX2结合位点多态性。结果其中171名完成整个研究。研究人群础Ⅰ基因型频率分布依次为Ff（48．0％）、FF（31．0％）和ff（21．0％）；CDX2基因型频率分布依次为AG（56．7％）、GG（25．7％）和AA（17．6％），上述等位基因频率分布在整个人群或2亚组中均符合Hardy-Weinberg定律。无论在整个人群组、或是2亚组中，Fok Ⅰ或CDX2各基因型间各部位BMD和各骨转换指标的基线值差异均无统计学意义；钙剂补充1年时，各部位BMD和骨转换指标的终点值和变化的百分数与Fok Ⅰ或CDX2多态性均无相关性。结论高钙或低钙的补充对上海市汉族绝经后妇女BMD或骨转换指标的影响与VDR基因Fok Ⅰ或CDX2多态性无相关性。     

Lymphatic vessel density as a prognostic indicator for patients with stage I cervical carcinoma

Lymphatic vessel density (LVD) was recently considered important for spread of several malignant tumors. However, there are no reports describing the situation in cervical carcinoma. The purpose of this study was to investigate whether LVD could serve as a risk factor for nodal metastasis and recurrence of cervical carcinoma in 147 cases of stage I patients. Other questions were if depth of invasion, proliferation rate, and tumor size could be used as predictive markers for Chinese patients with cervical carcinoma. The lymphatics were determined by immunohistochemistry with the antibody to LYVE-1, a specific lymphatic endothelium marker, and average LVD was calculated. Double immunohistochemistry and double immunofluorescence staining for LYVE-1/CD34 were used to distinguish between lymphatic and blood vessels. The results showed that average LVD in cervical carcinoma was statistically associated with inflammatory cell infiltration of carcinoma tissues, but not associated with other pathological parameters. Average LVD of the cases with nodal metastasis or recurrence was significantly higher than the cases without metastasis and recurrence in both stage IA and stage IB cervical carcinomas. The correlation between both depth of invasion and tumor size with nodal metastasis and recurrence of cervical carcinoma was also statistically significant. Ki-67 labeling index was found to be correlated with the recurrence of disease, but not to be correlated with nodal metastasis. We concluded that for the patients with stage I cervical carcinoma, increased LVD could serve as a high-risk factor for nodal metastasis and recurrence. Depth of invasion and tumor size could also be useful indicators.     

1350例骨折病人骨密度检测分析

目的检测分析武威地区骨折病人骨密度,以获得当地人群骨密度数据,并探讨骨折的危险性。方法 2008年10月～2009年9月所有骨折住院的当地病人1350例,其中30岁以下339例,30岁以上1011例;城镇人口415例,农村人口935例,均在刚入院时进行骨密度检测,对测定结果按以上分组进行统计分析。结果男性30岁以上骨密度异常者为68.30%,30岁以下为18.30%,女性30岁以上骨密度异常者为77.00%,30岁以下为13.41%,P均〈0.01;农村人口与城镇人口骨密度异常者比例分别为83.53%和83.86%,P〈0.05。结论 30岁以上人群骨密异常者显著高于30岁以下人群,骨折病人不论城市、农村人口,骨密度异常者均较高,骨折的发生有一定的必然性。     

碱性成纤维细胞生长因子与卵巢癌的关系

目的　探讨碱性成纤维细胞生长因子 (basic fibroblast growth factor,b FGF)对卵巢癌细胞增殖、浸润和肿瘤血管生成的影响 ,及 b FGF单克隆抗体 (b FGF monoclonal antibody,b FGF- MAb)的治疗作用。　方法　将人卵巢癌细胞株 SKOV3接种于 2 4孔板 ,加入不同浓度的 b FGF,每日行结晶紫染色后测定光密度 (D4 90 )值 ,绘制细胞生长曲线 ;将 SKOV3细胞团接种于铺设有细胞外基质凝胶的 4孔板 ,每日测定癌细胞在凝胶中的浸润距离 ;建立 SKOV3细胞裸鼠皮下移植瘤模型 ,每周两次分别将 b FGF、b FGF-MAb和生理盐水注射于移植瘤周围 ,8周后测量肿瘤体积 ;对移植瘤组织切片行 因子的免疫组化染色、测定肿瘤内微血管密度 (microvessel density,MVD)。　结果　 b FGF能促进 SKOV3细胞增殖并呈浓度依赖 ,实验第 5天 ,5 ng/ml、10 ng/ml组细胞 D4 90 值是对照组的 1.0 9倍和 1.2 1倍 ;b FGF能促进 SKOV3细胞浸润并呈浓度依赖 (P<0 .0 5 ) ,第 7天 ,5 ng/ml、10 ng/ml组细胞浸润距离分别是对照组的 1.5 3倍和2 .4 5倍 ;b FGF组移植瘤体积和 MVD分别是对照组的 1.80倍和 1.4 6倍 (P<0 .0 5 ) ,b FGF- MAb组移植瘤体积和 MVD分别是对照组的 6 3.7%和 6 2 .8% (P<0 .0 5 )。　结论　b FGF能明显促进卵巢癌细胞的增殖、     

冠脉造影脉冲响应分析评价心肌微循环

目的评价冠脉狭窄病人心肌微循环和冠脉血流动力学之间的变化关系。方法采用数字血管造影脉冲响应函数的原理 ,分析视频时间密度曲线 ,测定造影剂平均通过微循环时间倒数(Tmicro -1) ,作为局部心肌微循环灌注指标。结合定量冠脉造影 (QCA)、计算和测量冠脉流速并计算冠脉阻力 ,为研究心肌微循环和冠脉循环动力学提供定量指标。结果随着近段冠脉狭窄最小腔径 (MLD)缩小 ,Tmicro-1 减少(P<0.001) ;PCI治疗后 ,随着MLD增加 ,Tmicro-1 增加 ,两者之间呈良好相关 (r=0.87,P<0.001)。示意Tmicro-1 可作为评估冠脉狭窄程度的定量指标。急性冠脉综合征PCI治疗后 ,随着狭窄MLD增加 ,Tmicro-1 和冠脉流速、冠脉阻力均得到改善 ,但PCI前Tmicro-1 与冠脉流速之间并非线性相关(r=0.18,P>0.05) ,可能与大 (体循环 )、小 (微循环 )循环之间存在不同的影响因素有关 (如侧枝循环 )。结论利用数字血管造影脉冲响应原理 ,测定Tmicro -1作为评估近端冠脉狭窄局部心肌微循环的定量指标 ,结合定量冠脉造影、冠脉血流动力学定量指标 ,有助于提高常规冠脉造影解剖和生理、大 -小循环相结合的综合诊断水平。