多参数MR成像全肿瘤直方图分析三阴性乳腺癌与其他亚型的鉴别

正摘要目的利用多参数MR成像图谱和全肿瘤直方图分析三阴性(TN)乳腺癌与其他分子亚型鉴别的影像学生物标志。方法本回顾性研究包括134例浸润性导管癌病人。从     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

冠心病患者血清总胆红素和高敏C反应蛋白与冠状动脉病变程度的关系

冠心病是导致老年人群死亡和致残的主要疾病,如何评估冠心病的危险因素,对预测心血管事件的发生具有重要价值。近年来,除传统的心血管危险因素,如血脂异常、高血糖、高血压、吸烟、肥胖等,血清胆红素、高敏C反应蛋白作为新的冠心病的危险因素日益受到重视。我们通过分析冠心病患者血清总胆红素和高敏C反应蛋白水平的变化,以探讨其与冠状动脉病变严重程度的关系,现报道如下。1资料与方法选自2004年9月~2006年9月在我院心内科住院并经冠状动脉造影证实冠心病的患者60例,平均年龄(60.2±4.6)岁,其中男性40例,女性20例,除外心肌病、慢性心力衰…     

妇科肿瘤病人血清锌,铜,铁,锰含量测定及分析

探讨妇科肿瘤病人血清锌、铜、铁、锰含量与肿瘤发生关系。采用火焰原子化原子吸收测定法对２７１例妇科肿瘤病人血清锌、铜、铁、锰含量进行测定及分析。结果显示子宫颈癌、卵巢癌、外阴癌及子宫内膜癌病人血清锌值明显降低（Ｐ〈０．０５），血清铜值明显升高（Ｐ〈０．０５），子宫肌瘤病人血清铁明显降低（Ｐ〈０．００１）。结果提示：血清铜升高及血清锌降低可做为判定妇科恶性肿瘤的一项参考指标。     

危重病例病案书写存在的问题与规范化要求

病案是疾病诊断、治疗过程的载体，也是提供医疗、科研、教学活动素材和依据的重要文献，特别是危重病案，对疑难疾病的诊断、救治、研究提供更为详细的I临床资料。通过对危重疾病的治疗、抢救过程的详细描述，可以为提高危重疑难疾病的抢救成功率提供有效的宝贵经验。在我院从2004年起执行《江苏省病案书写规范》（第4版）以来，在对出院的1641份危重抢救病案的检查中，发现有以下几方面书写不规范的问题：     

Effects of hypoxic preconditioning on the changes of expression of neuroglobin mRNA and labeled positive cells following cerebral ischemia in gerbils

INTRODUCTION Neuroglobin (NGB) is a recently discovered member of the vertebrate globin family [1], predominantly expressed in various brain regions of human and vertebrate. The expression of NGB was increased in case of ischemia, which may play a role in…     

P17 Pharmacology in the integrated course ＂Basic Medical Sciences＂ in Zhejiang University School of Medicine

According to traditional teaching mode, the courses in preclinical medicine including pharmacology are separately run. This mode causes a series of disadvantages including loose connection between knowledge in different disciplines and weak ability to bridge basic preclinical knowledge and clinical practice. In order to overcome the disadvantages and promote the teaching efficiency, we constructed a new integrated course-Course of Basic Medical Sciences, which includes 6 traditional courses, anatomy, histology and embryology, physiology, pathology, pathophysiology and pharmacology. We integrated these courses based on the human organ systems and according to the principle-＂ From macro to micro, From morphological to functional, From normal to abnormal and From disease to drug therapy＂ and published the series of textbook in 2004. The contents of pharmacology are taught just after pathology and pathophysiology in every organ system. In comparison with the traditional teaching mode, teachers of pharmacology need not spend a lot of time to review preceding knowledge of anatomy and histology, physiology, pathophysiology and pathology. This is helpful in saving time and improving the teaching efficiency.     

接种流脑疫苗异常反应1例

患者男,16岁,接种A群脑膜炎球菌多糖疫苗,按瓶签标示量加疫苗所附的灭菌注射用水0.5mL稀释冻干A群脑膜炎球菌多糖疫苗,待完全溶解后,用1mL注射器抽吸,在上臂外侧三角肌处用75%酒精消毒,干后皮下注射0.5mL。疫苗注射约20min后,出现烦躁、呼吸急促、寒战、面色苍白、虚汗。查体:神志清楚,脉搏108次/min,呼吸28次/min,血压70/50mmHg,双肺呼吸音清晰,腹平软,右下腹有一新愈合切口。经快速诊查初步诊断为:与接种流脑疫苗有关的过     

A PRELIMINARY STUDY OF THE ACTION OF MALE HOR MONE ON HIGH DENSITY LIPOPROTEIN-CHOLESTEROL

Plasma testosterone and estradiol are determined in 72 patients with abnormal high density lipoprotein. cholesterol (HDL-C) and high density lipoprotein cholesterol/total cholesterol (H/T) ratio values, and in 72 randomly chosen males with normal HDLC and H/T values. The results showed that plasma testosterone levels in the groups with abnormal HDL-C and H/T were obviously lower than those in the controls. Statistically significant differences were found in all the abnormal groups in comparison with the controls (P0.20). Testosterone levels lowered further with increasing age in the groups with abnormal HDL-C and H/T., the most obvious drops were in the groups around 56 years of age (P<0.005). The data indicate that male hormone deficiency may reduce HDL-C and H.'T and facilitate the process of atherosclero_is. Therefore, it seems rational to treat such patients with male sex hormone preparations or to use the traditional Chinese medicines which strengthen Yang (maleness) in a new attempt to treat and prevent CHD.     

ISCHEMIC PAPILLOPATHY AND CONTRACEPTIVES

In January and again in April 1985, a 30-year old woman received 150 mg injections of Depo-Provera for contraception. 3 days after the 2nd injection, she experienced blurred vision in both eyes and was diagnosed as having bilateral papilledema. Her vision improved after treatment with vitamin B1 and other drugs. But optic atrophy of the right eye and papilledema of the left eye remained. In July 1985, after an injection with Depo-Provera, her vision again worsened. The woman received no more Depo-Provera after this time. In early 1987, she was referred to Beijing's Tong Ren Hospital, where she was diagnosed as having bilateral ischemic papillopathy and optic atrophy. There have been few documented cases in medical literature of ocular complications related to use of contraceptives. In 1981, Petursson et al. reported a case of macula edema resulting from oral contraceptives. In animal studies, oral contraceptives have been linked to papilledema and retinal vein obstruction. The case reported here is the 1st to link use of Depo- Provera with ocular complications.