放射性脑损伤和脑肿瘤复发的鉴别诊断

放射性脑损伤是放射治疗的严重的并发症,其与脑肿瘤复发的鉴别诊断非常困难,目前主要依靠影像学诊断,核磁共振弥散加权像、磁共振波谱、正电子发射型计算机体层显像、单光子发射计算机体层显像等被认为对于鉴别诊断有一定的帮助,但其敏感性和特异性还有待于进一步研究。最终确诊依赖标本的组织学检查。     

C4d in Acute Rejection After Liver Transplantation—A Valuable Tool in Differential Diagnosis to Hepatitis C Recurrence

Hepatitis C is the most common indication for liver transplantation. Recurrence of HCV is universal leading to graft failure in up to 40% of all patients. The differentiation between acute rejection and recurrent hepatitis C is crucial as rejection treatments are likely to aggravate HCV recurrence. Histological examination of liver biopsy remains the gold standard for diagnosis of acute rejection but has failed in the past to distinguish between acute rejection and recurrent hepatitis C. We have recently reported that C4d as a marker of the activated complement cascade is detectable in hepatic specimen in acute rejection after liver transplantation. In this study, we investigate whether C4d may serve as a specific marker for differential diagnosis in hepatitis C reinfection cases. Immunohistochemical analysis of 97 patients was performed. A total of 67.7% of patients with acute cellular rejection displayed C4d-positive staining in liver biopsy whereas 11.8% of patients with hepatitis C reinfection tested positive for C4d. In the control group, 6.9% showed C4d positivity. For the first time we were able to clearly demonstrate that humoral components, represented by C4d deposition, play a role in acute cellular rejection after LTX. Consequently C4d may be helpful to distinguish between acute rejection and reinfection after LTX for HCV.     

Langerhans Cell Histiocytosis Presenting as a Varicelliform Eruption over the Entire Skin

A boy with skin eruptions resembling varicella and specific for Langerhans cell histiocytosis (LCH) is reported. At his initial visit when he was four months old, vesiculopustular lesions were present over the entire body; these had first appeared on the third day post partus. Histopathological, immunohistochemical, and electron microscopical examination confirmed the Langerhans cell phenotype and Birbeck granules in the responsible cells. He also had hydronephrosis, recurrent fever, and cutaneous bacterial infections. His parents refused further medical treatment and he died of diarrhea with cachexia about two years later. LCH may present diagnostic difficulties by manifesting as a skin eruption which resembles varicella.     

胆囊小隆起性病变的诊断及治疗

报告37例胆囊小隆起性病变，其中良性颈变34例，胆囊癌3例。结果：本组23例有临床症状，多表现为反复发作的右上腹疼痛或不适；病灶部位，大小，多少，有无合并胆石及病变性质与临床症状有关；B-us,OCG,CT的诊断符合率例如辚33／37，9／24和5／10（x^2=18.75,P<0.005)。认为对胆囊小隆起性病变的病灶≥10mm，有增大趋势，呈恶性图像，合并胆石或血清CEA升高的病例应及早手术治疗。     

甲状腺滤泡性肿瘤Logistic判别分析及预后分析

本文对８５例滤泡性腺癌（ＦＣ）、６１例滤泡性腺瘤及２３例未定性滤泡性肿瘤的临床病理指标进行了多元分析。选出１２项良恶鉴别的指标，建立了ｌｏｇｉｓｔｉｃ判别方程，判别符合率１００％。１４１例获随访结果，其中１１６例随访达１０年以上。随防结果分析显示ＦＣ微小浸润型和明显浸润型自下而上率差异显著，１１项临床病理指标对ＦＣ有预后意义。     

CT对肝内,外阻塞性黄疸的鉴别诊断价值

笔者通过对３５例阻塞怀黄疸的ＣＴ所见，指出了胆道扩张征象可作为鉴别肝内、阻阻塞性黄疸的可靠指标，再结合临床及ＣＴ的初期征象，可更加提高其鉴别诊断准确率。本文对这些指标的可靠性进行重点讨论。提出了该特点是特别胆道管囊肿的重要指征，即后者的胆道扩张为局部性或节段性。本文对良、恶性病变所致的胆道扩张形态亦进行了对照分析，发现二阻之间无明显性差异。     

Cross talk in surface electromyograms of human hamstring muscles.

Signals generated from muscles other than the muscle(s) of interest (cross talk) can confound the interpretation of surface electromyograms (EMGs). In this study, the amount of cross talk in surface EMGs of human hamstring muscles was estimated using a protocol in which the quadriceps femoris was electrically stimulated via the femoral nerve. EMGs were recorded from the vastus lateralis and the medial and lateral hamstring muscle groups. The amplitude of the EMG response of the vastus lateralis to electrical stimulation was adjusted to match that of its maximum voluntary effort (MVE) under isometric conditions. Subsequent power density spectrum analysis showed that the median frequencies of the signals generated by electrical stimulation and MVE were not significantly different. In conventional bipolar recordings, cross talk in lateral hamstring EMGs averaged 17.1% MVE and in medial hamstring EMGs 11.3% MVE (average-rectified values). The double differential technique significantly reduced cross talk to 7.6% MVE for the lateral hamstrings, and to 4.2% MVE for the medial hamstrings. The double differential technique appears to be more selective than the bipolar technique when recording EMGs from muscles with highly active neighbors and thus should be used in such situations. Software simulations of the double differential technique also appear to be more selective than the bipolar technique and may be used when the number of amplifiers available is limited.     

Infection dynamics and virus-induced apoptosis in cell culture-based influenza vaccine production—Flow cytometry and mathematical modeling

Cell culture-based influenza vaccine manufacturing is of growing importance. Depending on virus strains, differences in infection dynamics, virus-induced apoptosis, cell lysis and virus yields are observed. Comparatively little is known concerning details of virus–host cell interaction on a cellular level and virus spreading in a population of cells in bioreactors. In this study, the infection of MDCK cells with different influenza A virus strains in lab-scale microcarrier culture was investigated by flow cytometry. Together with the infection status of cells, virus-induced apoptosis was monitored. A mathematical model has been formulated to describe changes in the concentration of uninfected and infected adherent cells, dynamics of virus particle release (infectious virions, hemagglutinin content), and the time course of the percentage composition of the cell population.     

弹拨手法治疗腰椎间盘突出症臀后部肌痉挛患者的疗效观察

患者,男,22岁。主因双手近端指间关节对称性肿胀1年于2006年10月20日至我科门诊就诊。患者1年前开始出现双手多个近端指间关节肿胀,无关节痛,无关节活动受限。曾至我院骨科门诊,怀疑为“类风湿性关节炎”,口服滑膜炎冲剂、非甾体类消炎止痛药物,症状持续不缓解。现仍有双手食、中、无名指近端指间关节扁梭形肿胀,中指、无名指明显。肿胀局部无压痛,各关节活动度正常。患者无晨僵,无发热及咽痛。既往患者有下意识掰动手指弄出声响的习惯。查体:一般情况良好。双手食、中、无名指近端指间关节梭形肿胀,关节两侧皮肤增厚,未见苔藓样变(图1 a)。…     

甲状腺结节的二维及彩色多普勒超声诊断研究

目的：探讨二维及彩色多普勒超声对甲状腺良、恶性结节的诊断及鉴别诊断价值。方法：120例甲状腺结节经二维超声了解其声像图表现，然后用彩色多普勒检查，观察结节内部及周边血流分布情况，并将其分为4级。结果：120例302个甲状腺结节中，良性结节264个，恶性结节38个。二维超声显示：恶性结节以实性低回声为主，内可见砂粒样钙化，边界不清，无声晕及包膜；良性结节以等、高回声及囊性、囊实性结节为主，形态规则，边界清，多有声晕及包膜。彩色多普勒超声显示：恶性结节的血流显示率明显高于良性结节，收缩期最高血流速度及阻力指数总体上高于良性结节，且以Ⅱ、Ⅲ级血流为主。结论：二维及彩色多普勒超声诊断甲状腺良、恶性结节准确率高。具有较大的临床应用价值。