Utility of the 3‐Vessel and 3‐Vessel and Trachea Views in Prenatal Diagnosis of a Pulmonary Artery Sling

A pulmonary artery (PA) sling is a very rare congenital cardiovascular anomaly, and only a few studies have reported PA slings in fetuses. The relationship of the PA, aorta, ductus arteriosus, and trachea can be evaluated in the 3‐vessel and 3‐vessel and trachea views during fetal echocardiography. A PA sling can be detected by abnormal positioning of the left PA in relation to the trachea when sweeping from the 3‐vessel view cranially to the 3‐vessel and trachea view. Here we report 3 cases of fetal PA slings and their follow‐ups. Two cases were confirmed by postnatal echocardiography, and the other case was confirmed by a cardiovascular cast after pregnancy termination. We emphasize that the 3‐vessel and 3‐vessel and trachea views are of crucial importance in the prenatal diagnosis of a PA sling.     

细菌性阴道炎患者致病菌分布与耐药性分析

目的分析细菌性阴道炎患者主要致病菌分布及耐药状况,为临床治疗提供依据。方法回顾性分析2013年1月至2015年10月送检本院检验科的450例细菌性阴道炎患者的临床资料,将阴道分泌物标本分别进行细菌培养和PCR检测,比较两种方法检出的细菌性阴道炎患者主要致病菌分布,药敏试验观察主要致病菌的耐药状况。结果细菌培养法和PCR法检出的主要致病菌依次为金黄色葡萄球菌,凝固酶阴性葡萄球菌,大肠埃希菌,肺炎克雷伯菌等,比较差异具有统计学意义(P<0.05);药敏试验结果显示,G~+球菌对青霉素、红霉素耐药率较高,而对头孢唑啉、万古霉素的耐药率较低;G-杆菌对复方新诺明、庆大霉素的耐药率较高,而对青霉素、亚胺培南的耐药率较低。结论革兰氏阳性(G~+)球菌是细菌性阴道炎的主要致病菌;临床上应根据致病菌的耐药状况,慎重及合理使用抗生素,以降低细菌性阴道炎的发病率。     

166Ho-DOTMP radiation-absorbed dose estimation for skeletal targeted radiotherapy.

166Ho-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene-phosphonate (DOTMP) is a tetraphosphonate molecule radiolabeled with 166Ho that localizes to bone surfaces. This study evaluated pharmacokinetics and radiation-absorbed dose to all organs from this beta-emitting radiopharmaceutical. METHODS: After two 1.1-GBq administrations of 166Ho-DOTMP, data from whole-body counting using a gamma-camera or uptake probe were assessed for reproducibility of whole-body retention in 12 patients with multiple myeloma. The radiation-absorbed dose to normal organs was estimated using MIRD methodology, applying residence times and S values for 166Ho. Marrow dose was estimated from measured activity retained after 18 h. The activity to deliver a therapeutic dose of 25 Gy to the marrow was determined. Methods based on region-of-interest (ROI) and whole-body clearance were evaluated to estimate kidney activity, because the radiotracer is rapidly excreted in the urine. The dose to the surface of the bladder wall was estimated using a dynamic bladder model. RESULTS: In clinical practice, gamma-camera methods were more reliable than uptake probe-based methods for whole-body counting. The intrapatient variability of dose calculations was less than 10% between the 2 tracer studies. Skeletal uptake of 166Ho-DOTMP varied from 19% to 39% (mean, 28%). The activity of 166Ho prescribed for therapy ranged from 38 to 67 GBq (1,030-1,810 mCi). After high-dose therapy, the estimates of absorbed dose to the kidney varied from 1.6 to 4 Gy using the whole-body clearance-based method and from 8.3 to 17.3 Gy using the ROI-based method. Bladder dose ranged from 10 to 20 Gy, bone surface dose ranged from 39 to 57 Gy, and doses to other organs were less than 2 Gy for all patients. Repetitive administration had no impact on tracer biodistribution, pharmacokinetics, or organ dose. CONCLUSION: Pharmacokinetics analysis validated gamma-camera whole-body counting of 166Ho as an appropriate approach to assess clearance and to estimate radiation-absorbed dose to normal organs except the kidneys. Quantitative gamma-camera imaging is difficult and requires scatter subtraction because of the multiple energy emissions of 166Ho. Kidney dose estimates were approximately 5-fold higher when the ROI-based method was used rather than the clearance-based model, and neither appeared reliable. In future clinical trials with 166Ho-DOTMP, we recommend that dose estimation based on the methods described here be used for all organs except the kidneys. Assumptions for the kidney dose require further evaluation.     

人体蠕形螨的生物学研究

用透明胶带法观察蠕形螨在人体面部的寄生、逸出及其在体外的存活能力。结果表明：毛囊蠕形螨（Ｄｅｍｏｄ－ｅｘｆｏｌｉｃｕｌｏｒｕｍ，Ｄ．ｆ．）主要以颚体朝向毛囊底部寄生，且常常有多条群居现象，而皮脂蠕形螨，（Ｄｅｍｏｄｅｘｂｒｅｖｉｓ，Ｄ．ｂ．）一般为单条独居生活。两种人体蠕形螨昼夜均可主动爬出毛囊口出现在皮肤表面，Ｄ．ｆ．以白天１０００～１８００为逸出高峰；Ｄ．ｂ．则以夜间２２００～２００逸出最多。此外，蠕形螨在体外有较强的活动力和存活力。透明胶带法在人体蠕形螨的流行病学调查和生物学研究方面具有较高的应用价值     

305例尿石成份分析及预防对策

目的研究一种快速、简便的方法对泌尿系结石进行分析,并探讨其防治方法。方法用化学常量法对305例患者的尿石标本进行化学成份测定,并结合临床资料进行分析。结果发现结石发病男性多于女性(比例为3.2∶1),20~50岁多发,上尿路结石多于下尿路结石(5.4∶1)。结石中草酸钙检出率达82%,尿酸盐55.2%,磷酸钙48.6%,磷酸镁铵与碳酸磷灰石则多见于泌尿系感染病例,胱氨酸结石少见。结论化学常量法分析泌尿系结石简便、快捷、准确。结石成份分析对于了解结石成因、预防结石复发具有一定的意义。     

备劳特联合爱喘乐雾化吸入治疗儿童哮喘急性发作的疗效观察

目的 :观察氧雾化吸入备劳特和爱喘乐治疗儿童哮喘急性发作的疗效。方法 :选择 15 8例哮喘急性发作患儿作为研究对象 ,分为观察组和对照组。观察组采用氧驱动雾化吸入备劳特和爱喘乐 ;对照组静脉滴注氨茶碱和地塞米松。结果 :观察组显效率 87.3% (96 /110 ) ,总有效率 99.1% (10 9/110 ) ,临床治愈率 94 .5 % (10 4 /110 ) ;对照组显效率 2 2 .9% (11/48) ,总有效率 6 0 .4 % (2 9/48) ,临床治愈率 5 4 .2 % (2 6 /48)。观察组显效率、总有效率及临床治愈率皆显著高于对照组 ,差异有高度统计意义 (P <0 .0 1)。观察组治疗后心率较治疗前明显下降 ,差异有统计意义(P <0 .0 5 )。结论 :采用氧驱动雾化吸入备劳特和爱喘乐能快速、有效地控制哮喘发作。     

射精管异位开口于苗勒管囊肿

报告２例射精管异位开口于苗勒管囊肿。均以血精、血尿就诊，通过经皮输精管穿刺造影及染色尿道镜检查确诊。经抗炎及窥视下纵行剪开苗勒管囊肿前壁。１例治愈，１例好转。对本病的病因、临床表现、诊断、治疗及预后进行了讨论。     

带蚓状肌的游离足趾再造拇、手指

自１９７２年以来，在游离足趾再造拇、手指手术中，应用足趾蚓状肌与缺损拇、手指蚓状肌残端或关节囊进行缝合的方法共完成手术３００例，由于再造拇、手指的蚓状肌得到修复，既改善了其指间关节屈曲畸形，又防止了掌指关节的过伸。术后随访１－２２年，再造拇、手指的外形及功能均满意。     

肾上腺皮质腺癌的诊断与治疗

目的 探讨肾上腺皮质腺癌的早期诊断、手术及围手术期处理。方法 回顾分析了1990年至2001年间31例肾上腺皮质腺癌临床资料．并与1978年至1989年同种病例作比较。结果 近10年患者病理分期更趋向早期，更易行根治性切除，5年的存活率明显提高。结论 影像学的发展，使患者易早期诊断；围手术期的充分准备是减少手术并发症及死亡率的关键。     

提高抗恶性疟独特型单抗克隆出现频率的方法学探讨

用Protein A-Sepharose亲和层析法提纯McAb-IgG,皮下多点和腹腔免疫雄性Wistar大鼠,间隔两周共3次,融合前3天采用腹腔、尾静脉和脾内注射等三种加强免疫方法,以间接ELISA法和抗体竞争ELISA法筛选Anti-Id阳性克隆。结果显示:融合前大鼠血清抗小鼠IgG或抗免疫原McAb-IgG滴度,静脉组和脾内组比腹腔组高一个滴度;Anti-Id阳性克隆出现频率,腹腔组为0.9％和0.3％,静脉组为11.0％和13.3％,脾内组为16.4％和12.9％,静脉组和脾内组明显高于腹腔组(P<0.01);上述三种加强免疫方法对抗小鼠IgG阳性克隆出现频率无明显影响(P>0.05);与腹腔加强免疫组相比,静脉和脾内加强免疫组也可提高细胞融合效果(P<0.01).本实验结果提示,腹腔和皮下多点多次长程基础免疫结合静脉或脾内加强免疫是制备Anti-Id McAb比较好的免疫方案。