Evaluation of corticospinal tract injury with three-dimensional diffusion tensor tract in patients with acute cerebral infarction

Three-dimensional diffusion tensor tract (DTT) is the newest imaging to describe the structure of white matter fiber in three-dimensions, it has great significance in dividing the concrete anatomic site of gray and white matter lesions, displaying the correlation with fibrous band and judging clinical prognosis, which is incomparable by other imagings.OBJECTTVE: To observe the conditions of corticospinal tract (CST) in acute cerebral ischemic stroke patients,and analyze the relationship between motor function and the severity of CST injury.DESIGN: A case-control observation.SETTTNG: Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTTCTPANTS: Fifteen patients with acute cerebral infarction were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February to December in 2005. They all suffered from acute attack and motor disorder of hemiplegic limbs to different extent, and were conformed by CT or MRI.There were 9 males and 6 females, aging 16-87 years old, the median age was 51.7 years, and all were right handed. Fifteen right-handed normal subjects, who were matched by age and sex with the patients in the cerebral infarction group, were selected from the relatives of patients and physicians of the Imaging Department as the control group. All the subjects were informed and agreed with the study.METHODS: The patients with acute cerebral infarction and subjects in the control group received MR diffusion tensor imaging (DTI) with GE 1.5 T nuclear magnetic resonance system, fiber tracking with the software of dTV- Ⅱ. Fractional anisotropy (FA) maps and three-dimensional tractography of bilateral CST of all patients were created. Displacement, continuity and destroy of fibrous bands were observed. At the same time, muscle strength of ipsilateral hand of patients with cerebral infarction was measured with Brunnstrom standard. The correlation between the severity of CST injury and the muscle strength of ipsilateral hand was analyzed with spearman correlation analysis.MAIN OUTCOME MEASURES: ① FA values in the infarcted sites and those in the contralateral corresponding sites of patients with cerebral infarction; ② CST manifestations in the patients with cerebral infarction and the control group.RESULTS: All the 30 testees were involved in the analysis of results. ① The FA values in infarcted sites of white matter were significantly lower than those in the contralateral ones (t =4.570, P ＜ 0.001 ). ② In the control group, bilateral CST were reconstructed, they originated from precentral gyrus, went downwards to internal capsule, and extended to pontine and medulla oblongata, each fiber had good uniformity in continuous form. In the patients with cerebral infarction, the forms of contralateral CST were consistent with those in the control group with good continuity. Due to the involvement by the infarcted site to different extents, the ipsilateral CST manifested as continuous interruption and loss of uniformity in anatomic structure and form. The CST involvements were divided into three grades: integrated CST for grade I (n =2); integrated CST but compressed or displaced for grade 2 (n =5); interrupted CST for grade 3 (n =8). ③ The severity of CST injury was obviously correlated with the muscle strength of the ipsilateral hand (r=0.888, P＜ 0.05＝.CONCLUSION: ① CST is injured to different extents in patients with acute cerebral infarction, and the severity of injury is associated with muscle strength. It is indicated that it can be used to judge the prognosis of rehabilitative treatment. ②DTT can directly display the status of pyramidal tract more three-dimensionally.     

Clinical oncology—A new era

Rapid growth in biomedical research coupled with dramatic advancement in biotechnology has significantly improved our understanding of the molecular basis involving cancer development and progression. This improvement has led to the discovery of new molecular markers for cancer diagnosis and prognosis as well as new molecular targets for cancer treatment and intervention. Continuous emergence of some new developing area in molecular profiling, new therapeutic agents, tissue microenvironment and systems biology have made significant progress in clinical oncology. Clinical research and investigation that focus on these new developments have begun to show exciting results that indicate future promises in improving patient management and survival.     

控制新生儿医院内感染的护理干预

通过对不同时期儿科新牛儿室院内感染发病率的比较以及发生院内感染高危因素的分析，提出了对医护人员加强教育，护士自身的感染管理，严格消毒隔离，合理使用抗牛素等护理干预措施，以有效降低医院内感染发生。     

103例流行性出血热患者的心电图及心肌酶学分析

目的了解流行性出血热病毒(EHFV)对心脏的损害情况。方法对103例流行性出血热(EHF)患者的心电图及心肌酶学检测结果进行分析。结果72例(69.9%)患者出现心电图异常,以窦性心动过缓(27.9%)及窦性心动过速(22.3%)最常见,明显高于其它类型的心电图改变(P分别<0.05和0.001)。103例流行性出血热(EHF)患者的CK、LDH及HBDH的升高者分别为43例(41.2%)、73例(70.9%)及46例(44.7%),以LDH异常最常见。轻型、中型、重型及危重型流行性出血热患者的LDH值分别为(346.3±155.6)IU/L、(330.7±130.7)IU/L、(1114.4±872.4)IU/L及(1227.1±936.7)IU/L,经统计学处理重型及危重型的值与轻型、中型比较均有显著性或高度显者性差异。结论EHF患者并发心肌损害较普遍,而且病情愈重者,心肌损害愈严重。     

血清唾液酸对血液病临床价值的初步报告

报道64例各类血液病患血清唾液酸（SA）值的测定，并与84例健康对照组进行比较。结果经统计学分析：病例组（631．5±130．3μg/ml），病例组中的ANLL（672．6±98．38μg/ml），ALL（630．8±29．3μg/ml），CML－A（617．5±122．7μg/ml），MM（606．0±138．7μg/ml四组与对照组比较，差异有极显意义（P＜0．01）；各病型组SA阳性率明显高于健康对照组，表明SA值的测定对恶性血液病的诊断有一定的临床意义。     

Immunoadjuvant action of liposomes for entrapped Japanese Encephalitis virus E－glucoprotein

ＩｍｍｕｎｏａｄｊｕｖａｎｔａｃｔｉｏｎｏｆｌｉｐｏｓｏｍｅｓｆｏｒｅｎｔｒａｐｐｅｄＪａｐａｎｅｓｅＥｎｃｅｐｈａｌｉｔｉｓｖｉｒｕｓＥ－ｇｌｕｃｏｐｒｏｔｅｉｎ￥ＨｕＪｕｎ（胡军）；ＭａＷｅｎｙｕ（马文煜）；ＨｕａｎｇＱｉｎｇｓｈｅｎｇ（黄庆生）...     

慢性特发性荨麻疹患者血清组胺释放活性的检测

目的 检测慢性特发性荨麻疹患者血中组胺释放活性。方法 自身血清皮肤试验和嗜好性粒细胞组胺释放试验。结果 自身血清皮肤试验和嗜碱性组胺释放试验的阳性率分别为３７．５％和４３．７５％。结论部分慢性特发性荨麻疹患者血中组胺释放活性增高,揭示该类病人具有特殊的肥大细胞和嗜碱性粒细胞激活机制,很可能与自身免疫有关。     

乳腺叶状肿瘤预后因素的统计学分析

目的:探讨乳腺叶状肿瘤的预后因素。方法:对有随访结果的203例肿瘤的15个临床、病理学参数作统计学Log-Rank检验和Cox单及多因素分析。 结果和结论:术式、核分裂、瘤细胞异型性、肿瘤性坏死、瘤组织分化方向、瘤实质内薄壁血管数、单视野内核分裂增多、病理性核分裂、切除后复发、组织学等级和间质细胞密度11个参数为单风险因素,核分裂和肿瘤性坏死是独立的风险因素。     

护士人格特质与服务态度满意度的相关性研究

目的　研究护士人格特质与患者对护士服务态度满意度的相关情况。方法　使用 16 PF测查 376名护士的人格特质 ,使用自行编制的“住院病人对所住科室护士服务态度调查表”测查现住的 1334名住院病人对所住科室护士服务态度的满意度并量化 ,将两个量表的分值进行相关性分析。结果　 16 PF中 A、B、C、F、G、H、I、Q3等因子与患者满意度分值呈正相关 ,E、L、M等因子呈负相关 ,其它因子相关性不明显 ;其中 ,A、C、G、L、M等因子相关性达到显著性水平 (P<0 .0 5 )。结论　护士的人格特质影响着护患关系及患者对护士服务态度的满意度 ,护理管理人员对护士应加强心理知识技能的训练及心理综合品质的培养     

S-1 monotherapy as second line chemotherapy in advanced gastric cancer patients previously treated with cisplatin/infusional fluorouracil

The treatment choice of advanced gastric carcinoma after failure from first-line therapy is quite limited. To evaluate the efficacy and toxicity of S-1 monotherapy in patients with advanced gastric cancer after failure of first line cisplatin and fluorouracil combination (CF). S-1 monotherapy as a second line treatment was given to the patients who had failed to CF combination in SC-101 study. The efficacy and toxicity of S-1 monotherapy were evaluated exploratory. The results indicated that forty-one patients received S-1 as a second line therapy after disease progression. The overall response rate and disease control rate were 14.6% and 41.5%, respectively. The median progression free survival (PFS) was 5.1 months (ange: 2.9~6.2 month). The median overall survival time was 6.4 months. The survival rates at 6 month and 1 year were 56% and 7.3%, respectively. Grade 3/4 adverse events were uncommonly occurred, including anemia (2.4%), neutropenia (2.4%), thrombocytopenia (4.9%) and rash (2.4%). There were no unexpected or life-threatening toxicities. Only one patient experienced dose reduction due to grade 3 rash. In conclusion, S-1 monotherapy provided a mild response rate and overall survival, and a favorable toxicity profile in the second line setting after the first line failure to cisplatin and fluorouracil combination.