Lymphoscintigraphy—Techniques and applications in themanagement of breast carcinoma

Radiocolloid lymphoscintigraphy is a versatile, simple technique which has been utilized extensively in the assessment of lymphatic function and structure in anatomic regions accessible to neither clinical examination nor radiocontrast lymphography, as well as in circumstances where radiocontrast lymphography is not feasible. The most important requirement for an effective study are: (a) Determination of the appropriate injection site for reproducibly visualizing the majority of the lymphatics under study and, (b) use of an agent with the optimum properties of a preformed small, uniform, well-dispersed particle colloid. Multiple applications of lymphoscintigraphy in the patient with breast carcinoma have demonstrated its value in distinguishing abnormalities of the internal mammary lymphatics shown to have significant prognostic implications, in providing accurate localization of the parasternal lymphatics for radiation therapy and its potential for determining the status of axillary lymphatics in lieu of surgical intervention. The following review is based on an experience of over 6500 studies in 5550 patients with breast carcinoma.     

阅兵保障人员甲型H1N1流感疫苗接种不良反应的观察

目的分析甲流疫苗接种后不良反应的发生情况。方法对阅兵村2009年9月10—15日接种甲流疫苗的1 150名阅兵保障人员进行调查,对不良反应发生率、不良反应出现及持续时间、转归等进行分析。结果 18名接种者发生不良反应,总反应率1.6%(18/1 150),其中局部不良反应发生率为1.1%(13/1 150),全身不良反应发生率为0.4%(5/1150),所有发生不良反应者经1~5 d均能自愈或治愈。结论甲流疫苗接种后不良反应发生率低,以局部轻型不良反应为主,持续时间短,无严重不良反应,适宜无接种禁忌症人群的普遍接种。     

舒肝安乐宁浸膏对肝纤维化大鼠肝组织TGF-β1表达和细胞外胶原沉积的影响

目的通过研究舒肝安乐宁浸膏对实验性肝纤维化大鼠肝脏组织TGF-β1mRNA表达和细胞外胶原沉积的影响,探讨舒肝安乐宁复方抗肝纤维化作用机理。方法以皮下注射CCl4花生油溶液建立大鼠肝纤维化模型,观测舒肝安乐宁浸膏不同剂量组对肝纤维化大鼠肝脏Ⅰ、Ⅲ型胶原的含量以及肝组织TGF-β1mRNA表达的影响。结果舒肝安乐宁浸膏能抑制肝组织中COLⅠ和COLⅢ的含量和TGF-β1mRNA的表达。结论舒肝安乐宁浸膏对CCl4造成的实验性肝纤维化大鼠具有一定的抗肝纤维化作用,其机制与抑制胶原蛋白的形成以及抑制TGF-β1的基因表达有关。     

Early and late diagnoses of 17β-Hydroxysteroid dehydrogenase type-3 deficiency in two unrelated patients

17β-hydroxysteroid dehydrogenase type 3 deficiency is a rare cause of 46 XY disorders of sexual development. Mutations in the HSD17B3 gene result in reduced activity of the 17β-HSD3 enzyme, decreasing the conversion of androstenedione to testosterone. In this report, two cases, admitted with different clinical findings in the neonatal and adolescent periods and were decided to be raised in different genders are presented. The first case who had complete female external genitalia presented on the third postnatal day with the complaint of swelling in the groin. He was decided to be raised as a male and was treated successfully with parenteral testosterone in order to increase phallus size before surgical correction of the external genitalia. The second case was an adolescent girl who presented due to pubertal virilisation and primary amenorrhoea and chose female gender. Molecular genetic analyses of the HSD17B3 gene revealed two different previously reported homozygous variants. We emphasise that patients with 17β-hydroxysteroid dehydrogenase type 3 deficiency can present with heterogeneous clinical findings in different age groups. Early diagnosis is important to prevent future gender confusion and related problems.     

血清中β-HCG、孕酮、癌抗原125及子宫内膜厚度在早期异位妊娠诊断中的价值

目的 比较早期异位妊娠和正常宫内孕妇女血清中β-人绒毛膜促性腺激素(β-HCG)、孕酮、癌抗原125的含量及子宫内膜厚度,来评价其在早期异位妊娠诊断中的应用价值.方法 选取确诊为异位妊娠患者95例,作为异位妊娠组;正常宫内孕妇女102例,作为对照组;2组对象均知情同意,并且既往无习惯性流产史,无放射线及化学物质接触史,无家族性遗传性疾病史.收集2组对象的基本资料,包括年龄、性别、身高、体重、孕次等信息.采用化学发光法测定实验组和对照组血清中β-HCG、孕酮、癌抗原125含量,采用探头频率为3.5 ～5 MHz的彩超检测实验组和对照组子宫内膜厚度.结果 异位妊娠组血清中β-HCG、孕酮、癌抗原125水平分别为(254.85±945.65) mIU/ml、(18.69±3.03) mmol/L、(49.26±7.08) kU/L,显著低于正常宫内孕组的(9215.23±2125.26) mIU/ml、(37.57±5.24) mmol/L、(118.53±26.90) kU/L;异位妊娠组子宫内膜厚度为(7.85±1.34)mm,低于正常宫内孕组的(13.23±2.46) mm.结论 妊娠妇女血清中β-HCG、孕酮、癌抗原125及子宫内膜厚度在用于诊断异位妊娠时具有重要的参考价值,但它们的灵敏度和差异度有一定的差异,因此,在临床诊断时可以综合各检测指标应用.     

HPLC法测定首乌胶囊中2,3,5,4 -四羟基二苯乙烯-2-O-β-D-葡萄糖苷的含量

目的：测定首乌胶囊中2,3,5,4-四羟基二苯乙烯-2-O-β-D-葡萄糖苷的含量。方法：采用高效液相色谱法。色谱柱为DiamonsilC18（4.6mm×200mm）,流动相为乙腈-水（25：75）,柱温为30℃,流速为1.0mL/min,检测波长为320nm。结果：2,3,5,4-四羟基二苯乙烯-2-O-β-D-葡萄糖苷在0.02104-0.526μg范围内线性关系良好（r=0.9999）,平均回收率为98.45%,RSD（%）=1.23%（n=5）。结论：含量测定方法快速、准确,适用于首乌胶囊质量分析控制方法。     

“消、托、补”三步法治疗胃溃疡

目的:观察"消、托、补"三步法治疗胃溃疡的疗效及对溃疡愈合情况的影响。方法:将80例胃溃疡患者随机平均分为两组,治疗过程中脱落5例,最终对照组37例,治疗组38例。对照组给予常规西医治疗,治疗组在对照组的基础上予"消、托、补"三步法中药治疗,持续治疗8周。观察两组临床疗效、胃镜疗效、临床症状积分、幽门螺旋杆菌根除情况、胃溃疡复发率,并检测胃组织增殖细胞核抗原(proliferating cell nuclear antigen PCNA)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)和再生蛋白Ⅰ(regenaration gene I,RegI)的表达。结果:治疗组在临床疗效、幽门螺旋杆菌清除率、胃溃疡复发率方面显著优于对照组(P<0.05),胃镜疗效与对照组相当(P>0.05)。与对照组相比,治疗组胃痛、反酸、纳差症状显著改善,胃黏膜PCNA表达显著升高,TGF-β1表达显著降低(P<0.05)。结论:"消、托、补"三步法可以较好地改善临床症状,促进溃疡面修复,提高黏膜愈合质量,提高幽门螺旋杆菌的根除率,减少复发,临床疗效显著。     

盐酸法舒地尔对脑梗死患者的疗效及对血清中lL-1β、TNF-α和RHO激酶影响的观察

目的:本实验观察盐酸法舒地尔对脑梗死患者的治疗作用及对血清中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和RHO激酶的影响,为临床工作提供理论帮助.方法:选取我院住院诊治的脑梗死患者186例,依患者的入院顺序分为两组,观察组共93例,在常规治疗基础上加用盐酸法舒地尔治疗,对照组共93例,只应用常规治疗...     

新生儿败血症继发血小板减少症(附26例报道)

本文对26例败血症继发血小板减少症的观察、治疗结果表明,血小板减少症在新生儿败血症中的发生率高,是导致新生儿败血症死亡的重要因素之一.动态观察血小板计数,对败血症的诊断、治疗效果的判断以及预后估计均有帮助。根据临床表现,我们分别给予静脉滴注新鲜血、血浆、低分子右旋糖酐、激素等治疗,均获得较为满意效果。     

CT与肿瘤标记物对非小细胞型肺癌N2淋巴结转移的预测作用探讨

目的：回顾性地探讨CT与肿瘤标记物结合能否提高对非小细胞性肺癌N2淋巴结转移的诊断率。方法：将1996～1999年支气管肺癌、CT诊断为N0-1淋巴结转移并行手术治疗的病人，术后根据病理结果重新分期为N0-1和N2；根据两组中血清β2-MG、CEA水平变化进行对照分析；结果：肿瘤的大小、β2-MG、CEA对CT诊断有一定的补充作用；结论：CT扫描对N2淋巴结转移有较高的预测作用，当不能确认N2转移时，肿瘤的大小、β2-MG、CEA是一种有效的补充。