靶向封闭CapG基因对胰腺癌细胞运动侵袭能力的影响

目的观察靶向封闭CapG基因对胰腺癌细胞株BxPC3运动侵袭能力的影响。方法设计并体外合成靶向CapG的小干扰RNA,将其转染到BxPC3细胞中,蛋白质印迹法检测转染前后细胞中CapG蛋白的表达,采用Transwell小室检测转染前后细胞运动侵袭能力的改变。结果CapGsiRNA能有效降低BxPC3细胞中CapG的表达,CapG在蛋白质水平的表达抑制率达80％左右。抑制BxPC3细胞中CapG的表达后,BxPC3细胞的运动侵袭能力明显下降,穿过人工基底膜的细胞数显著低于阴性对照组和空白对照组（P〈0．05）。结论封闭CapG表达能明显抑制胰腺癌细胞BxPC3在体外的运动侵袭能力。     

高频彩超对小体积恶性乳腺叶状肿瘤的诊断价值

目的探讨高频彩超对小体积恶性乳腺叶状肿瘤的诊断价值,提高小体积恶性PTB的术前诊断率。方法回顾分析4例经手术病理确诊的小体积恶性乳腺叶状肿瘤的声像图表现,并与该研究在同一台机器同一探头操作、预设条件一样前提下,病灶大小接近的,患者年龄相仿的,病灶深度差不多的6例纤维腺瘤的声像图进行对比分析。结果肿块最小者2.1cm×1.8 cm,最大者4.6 cm×3.7 cm;小体积恶性乳腺叶状肿瘤的CDFI表现：血供较丰富,Ⅱ级1例,Ⅲ级3例。纤维腺瘤的CDFI表现：血供较稀疏,0级1例,Ⅰ级4例,Ⅱ级1例。结论小体积恶性乳腺叶状肿瘤的CDFI表现具有较高的特异性,容易分辨,对于诊断小体积恶性乳腺叶状肿瘤有较高的实用价值。     

双气囊小肠镜诊断不明原因消化道出血的临床研究

背景:双气囊小肠镜(DBE)是诊断不明原因消化道出血(OGIB)的常用方法,不同地区OGIB病因有所差异。目的:评价DBE诊断OGIB的有效性和安全性,分析湖北地区OGIB患者的病因特点。方法:收集2006年12月～2012年1月武汉大学人民医院诊断为OGIB的216例患者,并接受DBE检查,对诊断结果、治疗、随访、并发症等进行回顾性分析。结果:DBE的诊断率为80.6%(174/216),并发症发生率为1.9%(4/216),DBE对76.8%(166/216)患者的治疗策略产生影响。湖北地区常见的OGIB病因依次为憩室/重复畸形(23.1%)、肿瘤(21.8%)、溃疡/糜烂(21.8%)、息肉(5.6%)等。结论:DBE是一种安全、有效的OGIB诊断方法。湖北地区OGIB病因以憩室/重复畸形、肿瘤、溃疡/糜烂较为常见。     

伽玛刀治疗22例原发视神经鞘脑膜瘤的疗效分析

目的 探讨采用伽玛刀进行低分割、高剂量的分次立体定向放射治疗（FSRT）治疗原发性视神经鞘脑膜瘤的疗效。方法2004年8月至2010年3月收治原发性视神经鞘脑膜瘤22例患者,均采用Hyper SGSI型立体定向体部伽玛射线放射治疗系统进行FSRT治疗,1例进行常规分割,单次剂量2Gy;21例行低分割、高剂量的FSRT治疗,单次剂量3～5Gy靶区累积剂量为36～40Gy。治疗后6个月随访1次,中位随访时间25个月,观察患者的临床症状改善情况、视力保全率及肿瘤控制情况。 结果 截止于末次随访,全组患者的视力控制率为77.3％（17／22）,其中视力改善4例,稳定13例,下降3例,失明2例。视力控制率随时间变化略有下降,1年视力控制率为95.0％（19／20）,2年视力控制率为75.0％（9／12）,但差异无统计学意义（P＞0.05）。肿瘤控制率为100.0％,最大径缩小＞50％的8例（36.4％）,缩小25％～50％的11例（50.0％）,缩小＜10％～25％的3例（13.6％）。突眼症状改善率为100.0％,治疗前突眼度为（17.3±2.7）mm,治疗后突眼度为（14.9±1.5）mm（P＜0.05）。有10例患者出现治疗相关反应,对症治疗可恢复。 结论 采用低分割、高剂量的FSRT治疗原发视神经鞘脑膜瘤的疗效确切,但视力改善不明显,对于确切分割模式及剂量尚需进一步探讨。     

Uroporphyrinogen decarboxylase gene mutations in Danish patients with porphyria cutanea tarda

Decreased uroporphyrinogen decarboxylase (UROD) activity is a characteristic feature of the most common of the porphyrias, porphyria cutanea tarda (PCT). A subgroup of the clinically overt PCT cases is associated with mutations in the gene encoding UROD and inherited as an autosomal-dominant trait. In this study, DNAs from 53 Danish PCT patients were subjected to genetic analysis for UROD mutations using denaturing gradient gel electrophoresis. Eleven genetic variations, seven of which are possible disease causing, were identified. All but one of these mutations were previously unknown, lending further support to the assumption that PCT is a heteroallelic disease. Only 11% of the examined patients were previously recognized as familial PCT cases. However, possible disease-related UROD mutations were identified in 24% of the examined patients, indicating that genetic analysis of PCT patients may improve differentiation between familial and sporadic PCT cases.     

Measuring small gains using the ICIDH severity of disability scale: Assessment practice among older people who are blind

This paper describes an outcome-based assessment protocol that is used with older individuals who are blind. The assessment process demonstrates how the ICIDH theoretical model can be adapted to address small gains in rehabilitation outcome. The model also illustrates refinements in the ICIDH scaling to create effectiveness measures. A two-dimensional Functional Assessment Scale for measuring personal performance capacities has been found to be quite useful in determining individual needs, in quantifying small gains in rehabilitation intervention, and in evaluating programme effectiveness.     

Management of Refractory Trigeminal Neuralgia

ABSTRACT

Treatment of trigeminal neuralgia as currently provided in the United Kingdom is discussed. The role of interventional procedures when pharmacotherapy alone is inadequate is described. Perspectives from specialist in Romania and Belgium also are provided.