腹膜后支气管源性囊肿的CT表现(附2例报告并文献复习)

支气管源性囊肿(bronchogenic cyst)是一类较为少见的发育异常性疾病,常发生在纵隔内,发生于腹膜后的支气管源性囊肿则较为罕见.现将笔者所见的2例报道如下,并对本病的相关文献进行复习.     

宫腔镜下改良子宫纵隔切除术治疗流产20例分析

目的:探讨宫腔镜下改良子宫纵隔切除术对流产的治疗效果。方法:将40例因子宫纵隔导致流产的患者分为宫腔镜手术组(治疗组)与药物治疗组(对照组),每组20例。治疗组行改良宫腔镜下子宫纵隔切除手术;对照组让其自然观察妊娠,妊娠后给予药物安胎治疗。结果:治疗组经改良子宫纵隔切除术后,19例术后1年内妊娠,受孕率达95%,18例妊娠致足月分娩,成功率达90%,其中1例于孕早期出现流产症状而终止妊娠;对照组自然妊娠17例,受孕率达85%,2例妊娠致足月分娩,成功率为10%,其中15例于孕早期及中期出现流产症状而终止妊娠,失败率达88%。两组受孕率比较无统计学差异,但妊娠成功率差异具有统计学意义(P0.01)。结论:宫腔镜下改良子宫纵隔切除术对因子宫纵隔导致流产的患者,在术后提高妊娠率及降低流产率方面有明显的疗效。     

中国汉族正常成人扣带回的高分辨率MRI测量

Objective To explore the normal range of cingulate cortex volumes of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers ( age range = 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e.,Group A (age range = 18 to 30), B (age range=31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.Cingulate cortex volume (including bulk volume and the left/right volume) was measured semi-manually using 3D volume analysis software.Cingulate cortex volumes among age groups were compared by one-way ANOVA.Right and left cingnlate cortex volumes between sexualities were analyzed by paired samples t test.The relationship between cingulate cortex volume and age was analyzed by Pearson correlations and regression analysis.Results Cingulate cortex volumes of male and female were (20 347 ± 2504) and ( 19 432 ± 2184) mm3 respectively, and the male's was significantly larger than that of female's (two sample t'-test for independent samples, t'= 6.156, P < 0.05 ).Right and left cingnlate cortex volumes of male were ( 10 717 ± 1629) and (9630 ± 1498) mm3 respectively, and those of female's were ( 10 064 ± 1407 ) and ( 9368 ± 1441 )mm3 respectively.The volumes of cingulate cortex were significantly different between right and left in male or female ( t = - 12.960, - 8.511, P < 0.05 ),and right was larger than left.Bilateral cingulate cortex volume in male among group A, B, C, D and E[left: ( 10 132 ± 1291 ), ( 10 113 ± 1638), (9599 ± 1576), (9594 ± 1288), (8710 ± 1212) mm3 ; right:(11 212±1442), (11 096±1602), (11 040±1403), (10 633±1638), (9604±1522) mm3] had statistical differences (F = 16.738, 18.707, P < 0.01 ) ; and those in female among five age groups[left:(9689 ± 1426), (9652 ± 1676), (9347 ± 1500), (9098 ± 1225), (9053 ± 1233) mm3 ; fight: ( 10 558 ±1325), ( 10 266 ± 1463), ( 10 100 ± 1497), (9779 ± 1304), (9617 ± 1254) mm3] also had significant differences (F = 16.859,7.528,P <0.01 ).Bilateral cingnlate cortex volume in both male and female were negatively correlated with age ( r = - 0.330, - 0.324, - 0.169, - 0.243, P < 0.05 ), though the correlation coefficient is not high.Conclusions Cingnlate cortex volume could be accurately measured on the high-resolution MRI with 3D volume analysis software, which can provide morphological data for the construction of database for Chinese Standard Brain.The results may provide normal range for the diagnosis of the volumetric deficits of cingulate cortex.     

质谱仪鉴定革兰氏阴性杆菌的评价

目的：比较质谱仪鉴定革兰氏阴性杆菌结果与全自动微生物鉴定仪的一致性。方法：连续收集革兰氏阴性杆菌371例,同时使用质谱仪和全自动微生物鉴定仪对其进行鉴定,分别在菌属和菌种的水平比较两者鉴定结果的一致性。结果：两种方法鉴定革兰氏阴性杆菌的一致性很高,菌属和菌种的一致性分别为97.0%和93.8%,Kappa一致性检验结果分别为0.828和0.773。结论：质谱仪鉴定革兰氏阴性杆菌与全自动微生物鉴定仪一致性很好。     

胰腺癌延时诊断一例

目的探讨胰腺癌早期诊断的要点及误诊因素。方法回顾性分析2009年7月8日收治的1例以腹胀、呕吐为主要表现的胰腺癌患者。结果患者经及时剖腹探查确诊为胰腺癌并行手术切除。结论胰腺癌起病隐匿,其早期误诊率高,进行胰腺癌的早期诊断、避免误诊是提高预后的重点和难点。     

中国汉族正常成人扣带回的高分辨率MRI测量

Objective To explore the normal range of cingulate cortex volumes of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers ( age range = 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e.,Group A (age range = 18 to 30), B (age range=31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.Cingulate cortex volume (including bulk volume and the left/right volume) was measured semi-manually using 3D volume analysis software.Cingulate cortex volumes among age groups were compared by one-way ANOVA.Right and left cingnlate cortex volumes between sexualities were analyzed by paired samples t test.The relationship between cingulate cortex volume and age was analyzed by Pearson correlations and regression analysis.Results Cingulate cortex volumes of male and female were (20 347 ± 2504) and ( 19 432 ± 2184) mm3 respectively, and the male's was significantly larger than that of female's (two sample t'-test for independent samples, t'= 6.156, P < 0.05 ).Right and left cingnlate cortex volumes of male were ( 10 717 ± 1629) and (9630 ± 1498) mm3 respectively, and those of female's were ( 10 064 ± 1407 ) and ( 9368 ± 1441 )mm3 respectively.The volumes of cingulate cortex were significantly different between right and left in male or female ( t = - 12.960, - 8.511, P < 0.05 ),and right was larger than left.Bilateral cingulate cortex volume in male among group A, B, C, D and E[left: ( 10 132 ± 1291 ), ( 10 113 ± 1638), (9599 ± 1576), (9594 ± 1288), (8710 ± 1212) mm3 ; right:(11 212±1442), (11 096±1602), (11 040±1403), (10 633±1638), (9604±1522) mm3] had statistical differences (F = 16.738, 18.707, P < 0.01 ) ; and those in female among five age groups[left:(9689 ± 1426), (9652 ± 1676), (9347 ± 1500), (9098 ± 1225), (9053 ± 1233) mm3 ; fight: ( 10 558 ±1325), ( 10 266 ± 1463), ( 10 100 ± 1497), (9779 ± 1304), (9617 ± 1254) mm3] also had significant differences (F = 16.859,7.528,P <0.01 ).Bilateral cingnlate cortex volume in both male and female were negatively correlated with age ( r = - 0.330, - 0.324, - 0.169, - 0.243, P < 0.05 ), though the correlation coefficient is not high.Conclusions Cingnlate cortex volume could be accurately measured on the high-resolution MRI with 3D volume analysis software, which can provide morphological data for the construction of database for Chinese Standard Brain.The results may provide normal range for the diagnosis of the volumetric deficits of cingulate cortex.     

BARD1和Aurora-A在甲状腺癌中的表达及意义

目的 检测甲状腺癌组织中BARD1和Aurora-A的表达,探讨BARD1与Aurora-A在甲状腺癌发生中的作用.方法 采用免疫组织化学SP法检测31例甲状腺癌,18例甲状腺瘤和5例正常甲状腺组织中BARD1和Aurora-A蛋白表达.结果 31例甲状腺癌组织中BARD1和Aurora-A蛋白表达的平均灰度值为（115.22±11.38）和（105.24±13.28）,与对照甲状腺组织BARD1和Aurora-A蛋白表达的平均灰度值为（129.70±9.740）和（128.08±12.39）,BARD1和Aurora-A的表达在甲状腺癌和对照组中有显著性差异（F=552.25,P=0.000;F=8.53,P=0.003）,而且BARD1和Aurora-A的表达具有相关性（r=0.399,P=0.000）.结论 BARD1和Aurora-A在甲状腺癌发生中起重要作用,BARD1和Aurora-A的联合检测有助于提高甲状腺癌诊断率.     

331例HIV抗体筛查阳性标本的确证结果分析

目的探究HIV初筛试验与确证试验的结果之间的关系,通过随访研究确证试验不确定结果的抗体进展情况。方法 2014年1月—2016年8月解放军302医院HIV抗体初筛阳性的地方患者331例,初筛方法为化学发光法,以免疫印迹法(Westem blotting,WB)作为确证试验,分析结果。并对不确定患者进行随访,分析其出现的条带,对转阳以及转阴的结果汇总统计。结果初筛S/CO值在1~5之间的有84例,阳性符合率为0.00%,5~20之间的有36例,阳性符合率为22.22%,20~100之间的有65例,阳性符合率为67.69%,大于100的有146例,阳性符合率为98.63%。免疫印迹法检测后,72例不确定结果中存在多种条带,终判定为阳性的病人有13例,判定为阴性的病人为38例,失访21例。结论化学发光试剂存在有一定的假阳性,随着S/CO值的升高,其与确证试验的阳性符合率也会升高,但是高S/CO值的标本并不一定代表感染了HIV。同时免疫印迹法检测HIV也有一定的局限性,所以建议HIV抗体的报告应该用初筛试验、复检试验、确证试验的结果进行综合判断。     

实验性室性心律失常心外膜标测研究——心律失常源的细胞电生理及超微结构改变

本文报道10只室性心律失常犬模型的心外膜等时标测结果,并将自律性增高性室早、室性融合波、折返性室性心动过速等标测结果绘制成直观心外膜传导示意图。在此基础上,进行了心律失常源区组织细胞电生理及细胞超微结构的检查与观察。本文的结论是:1.通过心外膜等时标测从中了解到室性过早搏动(室早)和室性心动过速(室速)的发生机理、起源点、传导径路、折返环等。2.心肌梗塞(心梗)后室性心律失常源区心肌细胞APA下降,RMP降低,ERP/APD比值减少。3.心梗后室性心律失常源的超微结构呈现细胞线粒体肿胀,脊断裂等缺氧改变。     

《中国循证医学杂志》第二届编委会简介(二)

ProfessorChrisWilliamsChrisWilliams教授 ,英国人 ,英国肿瘤治疗委员会前任主席 ,肿瘤试验顾问委员会成员 ,指导委员会和数据监测委员会主席 ,负责正在进行的 4个大规模的卵巢和乳腺肿癌的随机临床对照试验。主要研究方向是实体肿瘤的系统评价和随机临床试验 ,主编 1 9本专著和 1 0 0余篇论文。ProfessorChrisWilliams,PastChairmanofCancerTherapyCommitteeofMRC(UK) ,ChairofCoalitionforCancerInformation (UK) ,MemberofEORTCProtocolReviewCommittee ,MemberofOncologyTrialsAdvisoryCommittee ,Chairofsteer inggro…