结缔组织病伴发疾病分析

目的：对结缔组织病与其常见伴发疾病进行研究分析,探讨肿瘤等疾病与与结缔组织病的相关性。方法：收集确诊有结缔组织病患者共333例,对其临床资料并进行回顾性统计分析。结果：本文中333例结缔组织病中发生肺间质病变79例（23.7%）,发生肿瘤8例（2.4%）,出现肾损害有124例（37.2%）。结论：间质性肺病、肿瘤、肾损害在结缔组织病患者中占一定的比例,其机制可能与结缔组织病本身的病理生理改变、外源性因素等共同作用所致。     

Hepatic response to aluminum toxicity: dyslipidemia and liver diseases

Aluminum (Al) is a metal toxin that has been implicated in the etiology of a number of diseases including Alzheimer's, Parkinson's, dialysis encephalopathy, and osteomalacia. Al has been shown to exert its effects by disrupting lipid membrane fluidity, perturbing iron (Fe), magnesium, and calcium homeostasis, and causing oxidative stress. However, the exact molecular targets of aluminum's toxicity have remained elusive. In the present review, we describe how the use of a systems biology approach in cultured hepatoblastoma cells (HepG2) allowed the identification of the molecular targets of Al toxicity. Mitochondrial metabolism is the main site of the toxicological action of Al. Fe-dependent and redox sensitive enzymes in the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS) are dramatically decreased by Al exposure. In an effort to compensate for diminished mitochondrial function, Al-treated cells stabilize hypoxia inducible factor-1α (HIF-1α) to increase ATP production by glycolysis. Additionally, Al toxicity leads to an increase in intracellular lipid accumulation due to enhanced lipogenesis and a decrease in the β-oxidation of fatty acids. Central to these effects is the alteration of α-ketoglutarate (KG) homeostasis. In Al-exposed cells, KG is preferentially used to quench ROS leading to succinate accumulation and HIF-1α stabilization. Moreover, the channeling of KG to combat oxidative stress leads to a reduction of l-carnitine biosynthesis and a concomitant decrease in fatty acid oxidation. The fluidity and interaction of these metabolic modules and the implications of these findings in liver-related disorders are discussed herein.     

肝病患者血清甲状腺相关物质的检测与意义

目的探讨不同程度肝病患者血清甲状腺激素水平的变化及其意义。方法应用放射免疫法分别检测114例慢性肝炎、130例肝硬化、96例重型肝炎、120例健康体检者的血清甲状腺激素水平(T3、T4、FT3、FT4、rT3、TSH),抗甲状腺过氧化物酶抗体(抗TPO)、抗甲状腺球蛋白抗体(抗TG)的含量变化。结果肝病患者较正常人血清甲状腺素水平(T3、T4、FT3、FT4)显著降低,而抗TPO、抗TG、rT3含量显著升高,差异有统计学意义;随着肝功能受损程度的加重,血清甲状腺素水平(T3、T4、FT3、FT4)降低程度差异有统计学意义。结论肝病患者血清甲状腺激素水平的检测对评估肝功能、判断病程及预测预后有一定的临床意义。     

Fine needle aspiration of focal liver lesions

Fourteen percutaneous fine needle aspirates (FNAs) of focal liver lesions performed under ultrasound guidance at the Sultan Qaboos University Hospital (SQUH), Oman, between January 1991 and October 1992, are presented. Ten of these were cytologically diagnosed as hepatocellular carcinomas (HCC). the patients' ages ranged from 50 to 70 years and eight of these were males. the important diagnostic cytological criteria of HCC were found to be increased nucleocytoplasmic (N/C) ratio, trabecular pattern, atypical naked nuclei, bile production by malignant hepatocytes and absence of bile duct epithelium. Carcinoembryonic antigen (CEA) positivity of bile canaliculi by cross-reaction with biliary glycoprotein I (BGP I) made possible the differentiation of HCC from metastases. We stress the importance of cell blocks as these often constitute microbiopsies. Ultrasound-guided FNA of focal liver lesions is recommended as a simple, easy and quick procedure.     

Ultrasound study in the differential diagnosis of thyroid focal lesions of various origin

The present study deals with the ultrasound differential diagnosis of thyroid lesions. A hundred and ninety-two patients, including 130 patients with benign diseases (nodular colloidal goiter) (36.9%), chronic autoimmune thyroiditis (30.7%), and adenomas (32.3%) and 62 patients with malignant diseases (thyroid cancer (88%), lymphoproliferative diseases (6.4%), and recurrent thyroid cancer) (4.8%), were clinically examined. Ultrasound studies (USS) were performed in the B- and (see text symbols) modes. The diagnosis was verified from cytological and histological findings with mandatory morphological confirmation. Interdisease comparison has shown that USS is both a screening and diagnostic technique in revealing thyroid changes and determining their site, sizes, and structure. Ultrasound pathognomonic signs were detected in different morphological types of adenomas, thyroiditis, and nodular colloidal goiter, in the classical, pseudoadenomatous and pseudocystic types of thyroid cancer. At the same time there were characteristic ultrasound parameters at the stage of pronounced changes in undifferentiated thyroid cancer (pseudothyroiditis), lymphoproliferative diseases, and acute thyroiditis. The exception was the diffuse form of chronic autoimmune thyroiditis in which both thyroid lobes were always altered.     

Ultrasound evaluation of visceral fat and metabolic risk factors during early pregnancy

Objective: The objective was to study the relationships between ultrasound estimated visceral fat and metabolic risk factors during early pregnancy. Research Methods and Procedures: Thirty consecutive healthy pregnant women at 11 to 14 weeks of gestation were studied. Maximum subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were successfully measured by ultrasound. Fasting plasma glucose, insulin, triglycerides, total cholesterol, high‐density lipoprotein cholesterol (HDL‐C), and blood pressure were measured. Insulin resistance was calculated by using the homeostasis model assessment (HOMA). Results: VFT significantly correlated with diastolic blood pressure (r = 0.37, p = 0.04), glycemia (r = 0.37, p = 0.04), insulinemia (r = 0.59, p = 0.001) insulin sensitivity (HOMA; r = 0.59, p = 0.001), triglycerides (r = 0.58, p = 0.03), HDL‐C (r = ?0.39, p = 0.03), and total cholesterol/HDL‐C ratio (p = 0.002), whereas SFT was significantly correlated with only diastolic blood pressure (p = 0.03). VFT better significantly correlated with the metabolic risk factors than pre‐gestational BMI [r = 0.39, p = 0.03 for insulinemia, r = 0.42, p = 0.02 for insulin sensitivity (HOMA), and r = 0.49, p = 0.01 for triglycerides and not significant for the rest]. Discussion: Visceral fat thickness can be easily measured by ultrasound at early pregnancy and correlates better than BMI with metabolic risk factors.     

常规超声及超声造影在肝癌中的诊断及鉴别诊断价值

目的:探讨常规超声及超声造影在肝癌中的诊断及鉴别诊断价值。方法:收集2009年5月至2013年10月在我院进行住院诊治的肝癌患者120例,选择飞利浦IU22进行常规超声检查,选择飞利浦的IU22进行超声造影检查。结果:常规超声检查68例为低回声,20例为强回声,12例为等回声,17例为混合性回声,3例误诊为肝外病变,检出率为97.5%。肝癌组织的AT、TTP、ACT值明显晚于正常肝组织(P0.05),而BI、PI、MTT与BF值对比差异无明显差异(P0.05)。Spearman相关分析显示超声造影灌注参数AT、TTP、ACT与肿瘤分化程度呈正向相关性(P0.05)。结论:常规超声及超声造影在肝癌中的诊断及鉴别都有很好的应用价值,超声造影的应用可反映正常和病变组织的血流灌注情况,从而提高肝癌诊断的准确性。     

Needle biopsy of the liver for the diagnosis of nonneoplastic liver diseases

The results of 209 liver biopsy needle washings were compared with the corresponding histologic findings. An effort was made to distinguish major categories of liver disease on the basis of cytologic findings. Pigment identification and fat quantitation were also evaluated. It was found that it was often possible to determine whether a liver needle washing was normal or abnormal; however, it was rarely possible to provide specific diagnoses. Pure fatty change and primary cholestasis could be reliably differentiated from the steatosis and bile plugging seen in other liver disorders. Cirrhosis could be suggested in a limited number of cases, although in most cases the findings were nonspecific. Cytology was found to be less reliable than biopsy in the discrimination between the major pigments. Finally, cytology was an acceptable method for detecting and quantitating fatty change.     

超声造影在肝硬化合并肝内局灶性小病灶中的诊断价值

目的:探讨超声造影(CEUS)在肝硬化合并肝内局灶性小病灶(≤3.0 cm)中的诊断价值。方法:选择我院自2010年4月至2014年8月患有肝硬化合并肝内局灶性小病灶的患者100例,采用MRI、CT及病理确定病灶良恶性,同时对比影像结果,计算常规超声和CEUS的准确性。结果:MRI、CT及病理确定病灶105个,其中恶性组45例,良性组60例,超声造影技术能清晰的显示出血流灌注的情况以及动脉相、门脉相及延迟相的特点。数据统计结果显示常规超声和CEUS的准确性、特异性和敏感性分别为59.05%、77.78%、45.00%和95.24%、95.56%、95.00%,两者之间的差异具有统计学意义(P0.05)。结论:相对于常规超声,CEUS对患有肝硬化合并肝内局灶性小病灶的患者具有更高的诊断价值。     

Magnetic resonance tomography in focal diseases of the liver (review)

A review is devoted to the use of MR-tomography in the diagnosis of focal liver lesions. Various pulse sequences and a choice of an optimum variant are under discussion. A possibility of contrast intensification of MR-tomograms with paramagnetic substances is indicated, the problems of occurrence of motor artefacts are considered. A conclusion has been made that relaxation time can serve a tissue characteristic, permitting differential diagnosis on the basis of difference in relaxation time between different types of pathological changes.     

树鼩在肝脏疾病动物模型应用的研究进展

肝脏疾病已经在世界范围内导致严重的致死率和死亡率,动物模型是研究肝脏疾病的有效工具,考虑到非人灵长类实际使用的限制,树鼩作为非人灵长类替代动物具有资源丰富,成本较低,且与人类亲缘关系较近等优势,本文对树鼩在肝脏疾病动物模型中的应用进行综述.     

高强度聚焦超声在治疗肝癌中的研究进展

肝癌是我国常见的恶性肿瘤之一,手术切除是治疗肝癌的首选治疗方法,但是大多数患者发现时多数为中晚期,无法进行手术切除。高强度聚集超声(HIFU)是一种非侵袭性的治疗方法,在肝癌的治疗中发挥着举足轻重的作用。为此作者对HIFU治疗肝癌的原理、提高免疫力的作用及抑制肝癌侵袭和转移的作用进行阐述,为临床治疗该病提供参考。     

Conformational biosensor for diagnosis of prion diseases

A fluorescence technology to monitor the proliferation of amyloidogenic neurological disorders is proposed. A crude brain homogenate (0.01%) from animals infected with a transmissible spongiform encephalopathy is employed as a catalytic medium initiating conformational changes in 520 nM polypeptide biosensors (Tris/trifluoroethanol 50% mixture at pH 7). The fluorescence methods utilize pyrene residues covalently attached to the peptide ends. The coil-to-β-strand transitions in biosensor molecules cause elevation of a distinct fluorescence band of the pyrene aggregates (i.e. excimers). This approach enables the detection of infectious prion proteins at fmol, does not require antibody binding or protease treatment. Technology might be adopted for diagnosing a large variety of conformational disorders as well as for generic high-throughput screening of the amyloidogenic potential in plasma.     

基于焦点物种的北京市生物保护安全格局规划

快速城市化进程中,城市及周边地区生物栖息地的丧失和破碎化对生物多样性保护构成严重威胁。如何在景观尺度上判别对于生物保护具有重要意义的栖息地及其空间格局成为了重要问题。选取快速城市化的典型地区——北京市作为研究对象,将焦点物种和景观安全格局方法相结合,对北京市生物保护安全格局进行判别和规划。根据焦点物种的定义和选取标准,将在栖息地类型、生物学特征等各方面具有代表性的大白鹭(Casmerodius albus)、绿头鸭(Anas platyrhynchos)、环颈雉(Phasianus colchicus)选作北京市的焦点物种,应用最小阻力模型和GIS空间分析技术,对焦点物种的栖息地适宜性进行分析,并建立物种运动的等阻力面,根据阻力面的空间特征对北京市生物保护安全格局进行规划。结果显示:规划后的安全格局的斑块数量、分离度、邻近距离显著下降,平均斑块面积和最大斑块指数显著上升;该格局用约60%的土地,保护了北京市主要生境类型及关键性空间格局,可有效缓解栖息地丧失和破碎化的问题,从而达到保护整体生物多样性的目的。这一研究方法和成果可为北京市生物多样性保护和城乡生态建设提供决策依据,也对同类研究具有借鉴价值。     

超声造影联合超声弹性成像组织弥散定量分析在乳腺癌诊断中的应用

摘要 目的：探讨超声造影联合超声弹性成像组织弥散定量分析在乳腺癌诊断中的应用价值。方法：2019年1月至2020年5月选择在本院诊治的乳腺肿瘤患者148例,所有患者都给予超声造影联合超声弹性成像组织弥散定量分析,记录影像学特征。结果：在148例患者中,病理诊断为乳腺癌32例(恶性组),良性乳腺肿瘤116例(良性组)。良性组与恶性组的超声病灶形状、边缘、回声、微钙化等特征对比差异有统计学意义(P<0.05)。恶性组的超声造影增强模式、强度与良性组对比差异都有统计学意义(P<0.05)。恶性组的造影灌注参数曲线下面积(Area under the curve,AUC)、峰值强度(Peak intensity,PI)、上升支斜率(Wash in slope,WIS)值都高于良性组,达峰时间(Time To Peak,TTP)值低于良性组,对比差异都有统计学意义(P<0.05)。恶性组的组织弥散定量参数蓝色区域面积百分比(area ratio,%AREA)低于良性组,标准差(standard deviation,SD)、应变均值(mean,MEAN)值高于良性组,对比差异都有统计学意义(P<0.05)。结论：超声造影联合超声弹性成像组织弥散定量分析在乳腺癌诊断中的应用作为一种经济快捷、实时无创、重复性好的检查方法,能够定量评估乳腺癌的影像学特征,可为乳腺癌的临床治疗提供更多有价值的信息。     

表观遗传生物标志物在人类疾病早期诊治中的研究进展

表观遗传修饰异常见于人类的多种疾病(如肿瘤、老年性疾病、发育源性疾病等),影响着这些疾病的发生发展。已有的研究表明,异常表观遗传改变可以作为疾病状态和疾病预测的生物标志物。表观遗传修饰改变的可逆性和可控性也为疾病早期的预防和治疗提供了新策略。本文对DNA甲基化修饰、组蛋白共价修饰、非编码RNA等三种表观遗传方式在肿瘤、老年性疾病和发育源性疾病的研究,以及三者作为表遗传生物标志物在疾病早期诊断和治疗的应用展开介绍,以期为肿瘤、老年性和发育源性相关疾病的诊断与治疗提供借鉴和 参考。     

Increase in extracellular cross-linking by tissue transglutaminase and reduction in expression of MMP-9 contribute differentially to focal segmental glomerulosclerosis in rats

Tissue transglutaminase (tTG) is a Ca²⁺-dependent enzyme which stabilizes the extracellular matrix (ECM) through post-translational modification, and may play an important role in the pathogenesis of focal and segmental glomerulosclerosis (FSGS). Here, we have investigated whether tTG contributes to the glomerular ECM expansion in the puromycin aminonucleoside (PAN)-injection-induced experimental rat model of FSGS. The localization and expression of tTG, MMP-9 gelatinase, and the ECM component fibronectin (FN) in kidneys was determined by immunohistochemistry and measured by semi-quantitative analysis. Protein levels of tTG and MMP-9 were also analyzed by Western blotting.In situtransglutaminase activity was assayed by measurement of incorporated substrate and the immunofluorescence staining for the cross-linking product, ε-(γ-glutamyl) lysine. Prominent proteinuria, a typical pathological feature of FSGS, was observed in PAN injection group rats. tTG immunoreactivity was located markedly in glomeruli and the levels of this protein in whole-kidney homogenates of PAN injection group rats were significantly increased (361± 106% control, P< 0.05). Similarly, transglutaminase activity and ε-(γ-glutamyl) lysine were also predominately located within glomeruli and were much more intense in the PAN-injected group than that in control animals. MMP-9 was also located primarily within glomeruli. In PAN-injected kidneys, protein levels of active MMP-9 were significantly reduced (59± 27% control, P< 0.01), while pro-MMP-9 levels increased (148± 42% control, P< 0.05). Remarkable expression of glomerular fibronectin (FN) was found in PAN injection group rats. Semi-quantitative analysis demonstrated this increased intensity of FN staining in the PAN-injected rats was 149± 23% of the control values (P< 0.05). Enhanced cross-linking of ECM by tissue transglutaminase and decreased degradation due to reduced active MMP-9 expression may be at least partially responsible for the deposition of FN within injured glomeruli in experimental FSGS.