COVID-19, chronic inflammatory rheumatic disease and anti-rheumatic treatments

Clinical Rheumatology - Since December 2019, the pandemic caused by coronavirus disease 2019 (COVID-19) raises a real public health problem. COVID-19 appeared in Wuhan (Hubei province) in China....     

不同病理类型原发性甲状旁腺功能亢进症临床表现的比较分析

目的 分析不同病理类型甲状旁腺功能亢进（PHPT）的临床表现特点。方法 回顾性分析1958-2005年北京协和医院收治经手术病理证实的280例PHPT患者的临床资料。按病理类型分为甲状旁腺腺瘤组208例，甲状旁腺增生组52例及甲状旁腺腺癌组20例。结果 腺癌组中男性高于另外2组（P〈0．05）。增生及腺癌组中骨畸形、骨软化比例较低，增生组骨吸收、病理性骨折比例低于腺瘤组；胃肠道症状、多饮多尿及泌尿系统病变在腺癌组中高于另外2组（P均〈0．05）。血总钙（TCa）、血游离钙离子（ICa）及24h尿Ca在腺癌组显著高于腺瘤组及增生组（P均〈0．01），在腺瘤组与增生组间差异无统计学意义（P〉0．05）。出现高钙危象的比例在腺癌组显著高于另外2组（P〈0．01）。腺癌组病灶重量高于增生组，腺瘤组病灶直径小于增生组（P均〈0．05）。结论 在本组病例中，腺癌组男性比例较高，泌尿系统病变更为多见，出现高钙危象的比例显著增高，术后复发的比例较高。增生组骨骼系统病变相对较轻，其病变甲状旁腺重量低于腺癌与腺瘤组。     

人工生物材料和医疗器具的安全性与可靠性

本文重点论述人工生物材料的可靠性、安全性及其保证措施。     

Integrating PET and CT information to improve diagnostic accuracy for lung nodules: A semiautomatic computer-aided method.

Our objective was to develop and evaluate 3 semiautomatic computer-aided diagnostic (CAD) schemes for distinguishing between benign and malignant pulmonary nodules by use of features extracted from CT, 18F-FDG PET, and both CT and 18F-FDG PET. METHODS: We retrospectively collected 92 consecutive cases of pulmonary nodules (<3 cm) in patients who underwent both thoracic CT and whole-body PET/CT. Forty-two of the nodules were malignant and 50 benign, as confirmed by pathologic examination and clinical follow-up. The interval between CT and PET was less than 1 mo. Four clinical parameters, including patient age, sex, smoking status, and history of previous malignancy, were used for the CAD schemes. Sixteen CT features based on size, shape, margin, and internal structure of nodules were independently rated subjectively by 2 chest radiologists. Four PET features were viewed on a PET/CT workstation. CAD schemes based on clinical parameters together with CT features, PET features, and both CT and PET features were then used to differentiate benign from malignant nodules. Finally, the output from the CAD schemes was evaluated by use of receiver-operating-characteristic analysis. RESULTS: When we used clinical parameters and CT features as input units (CAD scheme 1), the area under the receiver-operating-characteristic curve (A(z) value) of the CAD scheme was 0.83. When we used clinical parameters and PET features as input units (CAD scheme 2), the A(z) value for the computer output was 0.91. However, when we used all data as input units (CAD scheme 3), the A(z) value for the computer output was 0.95. The performance of CAD scheme 3 was better than that of CAD scheme 1 or 2. A statistically significant difference existed between the A(z) values of CAD schemes 3 and 2 (P = 0.037) and between those of CAD schemes 3 and 1 (P = 0.015). CONCLUSION: Our CAD scheme based on both PET and CT was better able to differentiate benign from malignant pulmonary nodules than were the CAD schemes based on PET alone and CT alone.     

Bilirubin and the laboratory. Advances in the 1980s, considerations for the 1990s

The limitations of current methods of measuring bilirubin are well established and relate to the broad dynamic range and inability of the technique to determine different but structurally similar bilirubin species. New instrumentation and methodology circumvent these limitations, and clinical studies are beginning to reveal their increased diagnostic usefulness. Nevertheless, in several clinical situations, for example, the prediction of kernicterus, better bilirubin determinations may not eliminate the controversy surrounding appropriate therapeutic interventions.     

Partial purification and osteoinductive activity of swine bone morphogenetic protein.

Bone morphogenetic protein (BMP) was isolated from the bone matrix of swine and partially purified by means of differential precipitation and molecular sieve chromatography. The molecular weight of BMP estimated by SDS-gel electrophoresis was 19,000 dalton. Bioassay by implanting two milligrams of BMP fraction into thigh muscles of mice resulted in bone formation in 100% of the experimental animals.

     

肿瘤抑制基因P53突变与肾细胞癌的关系

采用ＤＮＡ聚合酶链反应－单链构象多态性分析和直接序列测定技术，检测２５例肾细胞癌组织中Ｐ５３基因５－８外显子，２５例肾细胞癌仅有２例肿瘤组织存在Ｐ５３基因点突变，分别位于１５４和２７３密码子上，核苷酸序理分析突变形式分别为Ｇ→Ｔ，Ｃ→Ｔ。结果提示：肾细胞癌组织中Ｐ５３基因突变并不显著，表明肾细胞癌的发生可能是一个多基因变化的过程。     

地尔硫卓联合地高辛治疗心力衰竭并慢性快速房颤分析

目的观察地尔硫卓联合小剂量地高辛对心力衰竭并慢性快速房颤患者血压、心室率和心功能的影响。方法 :心功能Ⅱ～Ⅲ级慢性房颤患者 10 6例 ,随机分为二组 ,对照组 5 0例 ,单用地高辛 ,治疗组 5 6例 ,地尔硫卓与地高辛联用 ,其余治疗二组相同 ,7～ 10d为一疗程 ,观察治疗前后血压、心率、左室射血分数 (LVEF)、心输出量 (CO)。结果 :治疗组较对照组心室率明显下降 ,控制满意 ,血压、LVEF及CO变化二组相似。结论 :地尔硫卓联合小剂量地高辛治疗心衰并慢性快速房颤患者心室率较单用地高辛效果更好 ,且较为安全。     

海藻、甘草及其相伍用对小鼠肝药酶的影响

目的：研究海藻、甘草单煎液及其不同比例合煎，单煎后混合液以及单体A、B；C、D、E对小鼠肝药酶的影响。方法：取小鼠随机分组，分别ig给药，qd,连续4d后禁食20h，处死取肝脏，称重后制成匀浆，紫外分光光度计于450nm,490nm波长下测其光密度值，计算肝匀浆中细胞色素P－450的含量。结果：甘草、甘草与海藻合煎液及单体A，B，C，D，E均能显著提高小鼠肝匀浆中细胞色素P－450的含量，而海藻，甘草与海藻单煎后混合液未能提高小鼠肝心浆中的细胞色素P－450的含量。结论：甘草，甘草与海藻合煎液及单体，A，B，C，D，E均能显著提高小鼠肝匀浆中细胞色素P－450的含量，对肝药酶有诱导作用。