CT在良恶性孤立性肺结节鉴别诊断中的系统评价

目的 应用Meta分析方法对胸部CT扫描中鉴别诊断孤立性肺结节(SPNs)良恶性的价值进行评价.方法 收集并筛选出与CT扫描SPNs有关的文献,采用Metadisc、SPSS13及Stata10.0软件对数据进行分析,计算汇总灵敏度、特异度及其95%可信区间,绘制出汇总受试者工作特征曲线(SROC),计算曲线下面积,评...     

Classification decision tree algorithm assisting in diagnosing solitary pulmonary nodule by SPECT/CT fusion imaging

Objective To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78. 57e, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P=0.204), but greater than that of residents (P<0.001). Conclusion Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.     

构建及鉴定携带角蛋白启动子和人乳头瘤病毒16E6/E7基因的重组腺病毒

目的利用AdEasy系统构建携带人角蛋白启动子的人乳头瘤病毒-16(HPV-16)E6/E7基因重组腺病毒,并通过RT-PCR方法检测E6/E7基因的表达。方法应用PCR方法从含有HPV-16全基因序列的质粒上扩增E6/E7基因,构建pCDNA3.1(-)-K14-E6/E7-polA载体,扩增、酶切获得K14-E6/E7-polA片段插入腺病毒穿梭载体质粒pAdTrack上,构建重组穿梭载体pAdTrack-K14-E6/E7-polA,线性化后与骨架载体AdEasy-1在细菌BJ5183内同源重组得到腺病毒质粒pAd-K14-E6/E7-polA,经人胚肾293细胞包装后得到重组腺病毒pAd-K14-E6/E7-polA。氢化铯(CsCl)梯度离心纯化病毒,提取病毒再感染后的293细胞总RNA,通过RT-PCR方法检测E6/E7基因的表达。结果通过同源重组的方法构建了腺病毒pAd-K14-E6/E7-polA载体,经酶切和测序鉴定该质粒构建成功。293细胞包装3d后观察到绿色荧光蛋白(GFP)表达,CsCl梯度离心纯化最终获得7.2×1010pfu/mL滴度的重组病毒;用该滴度病毒重新感染293细胞3d后,提取细胞总RNA,RT-PCR检测E6/E7有表达。结论利用新型腺病毒载体AdEasy系统可在短期内制备同时表达GFP和E6/E7的重组腺病毒pAd-K14-E6/E7-polA。这将为进一步研究HPV-16E6/E7基因功能及利用基因治疗女性宫颈癌奠定了基础。     

THE EXPESSION OF ENDOTHELIN-1 IN VENTRICULAR SPETAL DEFECT WITH PULMONARY HYPER TENSION

Ｔｈｅｖｅｎｔｒｉｃｕｌａｒｓｅｐｔａｌｄｅｆｅｃｔ (ＶＳＤ )ｏｆｃｏｎｇｅｎｉｔａｌｈｅａｒｔｄｉｓｅａｓｅ (ＣＨＤ )ｗｉｔｈ ｐｕｌｍｏｎａｒｙｈｙｐｅｒｔｅｎｓｉｏｎ (ＰＨ )ｉｓａｓｅｒｉｏｕｓｃｏｍｐｌｉｃａｔｉｏｎ ,ｗｈｉｃｈｄｉｒｅｃｔｌｙｉｎｆｌｕｅｎｃｅｓｔｈｅｐｒｏｇｎｏｓｉｓｏｆＣＨＤ ,ｂｕｔｉｔｓｐａｔｈｏｇｅｎｅｓｉｓｔｈａｔｓｔｉｌｌｗａｓｎｏｔｃｌｅａｒ .Ｒｅｃｅｎｔｒｅｓｅａｒｃｈｅｓｒｅｖｅａｌｅｄｔｈａｔｖａｓｃｕｌａｒｅｐｉｔｈｅｌｉｕｍｏｆｐｕｌｍｏｎａｒｙ…     

基于Web平台孤立性肺结节影像计算机辅助诊断的研究

目的构建基于Web文本层面的孤立性肺结节(SPN)计算机辅助系统,探讨计算机帮助医生对SPN性质进行辅助诊断的可能性及价值。方法系统硬件设备包括1台路由器、1台交换机、2台服务器以及若干计算机和其他外部设备。Web服务器采用的操作系统为Windows 2000 Server,Web服务程序为Web Logic 8.1。数据库服务器采用的操作系统为RedHat Linux9.0,数据库系统为Oracle9i for Linux,在J2EE架构下开发SPN辅助诊断系统。SPN辅助诊断系统包括病例上传子系统、辅助诊断子系统以及维护和管理子系统。结果将待诊的SPN临床及CT图像原始文字信息录入辅助诊断子系统,该诊断模型依据输入的SPN属性,自动访问诊断规则数据库并提取相应SPN诊断规则进行比对分析,其诊断结果以报告的形式出现,包括典型层面的CT图像和诊断意见两部分,诊断意见分为5个层次:恶性、可能恶性、良性、可能良性、不能确定,并附有可信度值。结论基于Web的SPN计算机辅助诊断系统构建的方法是可行的,该系统可以辅助医师对SPN的良恶性做出辅助诊断。     

癌胚抗原放射免疫分析的临床应用

本文报告了663例住院病人之血清CEA及36例胸水CEA放射免疫测定结果。476例肺、胃、肠道、肝、食道癌肿之血清CEA阳性率分别为64.29％、47.27％、40.63％、33.33％、31.48％;187例良性病人(食道除外),假阳性率分别为4.76％、11.96％、7.7％、26.47％;36例胸水中有17例肺癌患者,阳性率为94.12％;17例良性病变中无1例假阳性。结果认为测定胸水CEA水平对鉴别肺良、恶性疾病有其独特的临床价值。血清CEA水平不能独立地作为某些肿瘤的诊断依据。但鉴别原发与继发肝癌、肿瘤的术后随访以及对慢性萎缩性胃炎患者进行动态观察尚有一定意义。     

Magnetic resonance imaging of atherosclerotic lesion with new devised animal surface coil

The ability of dynamic contrast enhanced magnetic resonance imaging(DCE MRI) with a new devised animal surface coil was analyzed in identifying atherosclerotic plaques in the rabbit medium-sized iliac artery(IA).Then a comparative analysis of multi-detector computed tomography(MDCT) and DCE MRI was done in discerning morphology and components of 80 atherosclerotic plaques identified by histopathology.It shows that the DCE MRI may be an emerging noninvasive and economic way to characterize atherosclerotic plaques at present.What's more, a new devised animal surface coil would further improve the signal-to-noise ratio(SNR) and the quality of imaging.However, CT angiography(CTA) may be better than MR angiography(MRA) in detecting vessel stenosis.     

缩血管受体在下肢曲张静脉中的作用及意义

目的探讨内皮素受体和5-羟色胺(5-HT)受体在下肢慢性静脉功能不全中的作用。方法取下肢静脉功能不全患者的曲张静脉为病变组,以正常静脉做对照,制成血管环,用血管张力描记法记录血管收缩。结果在内皮完整时,曲张静脉对5-HT引起的最大收缩(Emax)明显低于对照静脉[(72.8±42.5)%vs.(226.8±98.1)%,n=10,P<0.01];内皮素受体-B激动剂S6c对曲张静脉收缩的Emax明显低于对照静脉[(9.61±1.32)%vs.(30.14±12.89)%,n=12,P<0.01];曲张静脉对内皮素-1(ET-1)收缩的Emax亦明显低于对照静脉[(19.24±12.94)%vs.(132.30±43.42)%n=10,P<0.01],差异均具有统计学意义。静脉去内皮后,曲张静脉对5-HT、S6c和ET-1引起收缩的Emax也明显低于对照静脉(P<0.01)。结论静脉组织中5-HT受体、内皮素-A受体和内皮素-B受体可能参与下肢慢性静脉功能不全病变的发生和发展。     

THE DETECTION OF HPV16E6，E7 GENES IN TISSUES AND THEIR ANTIBODIES IN THE SERA OF PATIENTS WITH CERVICAL CARCINOMA

ＴＨＥＤＥＴＥＣＴＩＯＮＯＦＨＰＶ１６Ｅ６，Ｅ７ＧＥＮＥＳＩＮＴＩＳＳＵＥＳ　ＡＮＤＴＨＥＩＲ　ＡＮＴＩＢＯＤＩＥＳＩＮＴＨＥＳＥＲＡＯＦＰＡＴＩＥＮＴＳＷＩＴＨ　ＣＥＲＶＩＣＡＬＣＡＲＣＩＮＯＭＡＬｉｕＴｉａｎｊｕ；ＬｉｕＨｕａ；，ＳｕｎＹｉ；，Ｓ...     

EFFECTS OF DIPSACUS ASPER AND VITAMIN E ON THE SS NEURONS IN THE HIPPOCAMPAL FORMATION OF RAT MODELS OF ALZHEIMER‘S DISEASE

Ａｌｚｈｅｉｍｅｒ’ｓｄｉｓｅａｓｅ (ＡＤ)ｉｓｔｈｅｍｏｓｔｃｏｍｍｏｎｄｅｍｅｎｔｉａｉｎｔｈｅｓｅｎｉｏｒ ,ａｎｄｔｈｅｒｅｉｓｎｏｃｕｒｅｏｒｅｆｆｅｃ ｔｉｖｅｔｒｅａｔｍｅｎｔ .ＡｌｔｈｏｕｇｈｔｈｅｅｔｉｏｌｏｇｙｏｆＡｌｚｈｅｉ ｍｅｒ’ｓｄｉｓｅａｓｅｉｓｎｏｔｆｕｌｌｙｕｎｄｅｒｓｔｏｏｄ ,ａｃｃｕｍｕｌａｔｉｎｇｅｖｉｄｅｎｃｅｄｅｍｏｎｓｔｒａｔｅｓｔｈａｔｂｏｔｈｔｈｅｃｏｎｃｅｎｔｒａｔｉｏｎｏｆｔｈｅｓｏｍａｔｏｓｔａｔｉｎ (ＳＳ)ａｎｄｔｈｅＳＳｎｅｕｒｏｎｓｉｎｔｈ…     

缺血后处理对大鼠肝大部切除后残肝缺血再灌注损伤的影响

目的探讨缺血后处理对肝大部切除后残肝缺血再灌注损伤的影响。方法选取健康清洁级雄性SD大鼠115只,体重230～280g,其中25只随机分为5组:70%单纯肝切除1组(PH1)、70%肝切除合并缺血再灌注1组(PHIR1)、10s-10s循环3次后处理组(IPO1)、30s-30s循环3次后处理组(IPO2)和60s-60s循环3次后处理组(IPO3)。再灌注6h后取各组大鼠下腔静脉血及残肝组织,测定血清ALT、AST活性及肝细胞凋亡指数,选取保护效果最佳的后处理方案。剩余90只大鼠随机分为3组:PH2组、PHIR2组和IPO组,并于再灌注1、6、12、24、48h取各组大鼠下腔静脉血及残肝组织,每时点6只,测定血清ALT、AST活性及肝组织丙二醛(MDA)、超氧化物岐化酶(SOD)、髓过氧化物酶(MPO)水平。结果与PH1组比较,PHIR1组、IPO1组、IPO2组和IPO3组血清ALT和AST活性、肝细胞凋亡指数均升高(P<0.05);与PHIR1组比较,IPO1组、IPO2和IPO3组血清ALT和AST活性、肝细胞凋亡指数均降低,但仅IPO2组差异有统计学意义(P<0.05)。选择IPO2组作为后处理方案,与PHIR2组比较,IPO组各时点ALT、AST活性和MDA、MPO表达水平降低(P<0.05),SOD表达水平升高(P<0.05)。结论缺血后处理可以减轻肝大部切除后残肝的缺血再灌注损伤,其机制与抑制氧化反应,减少自由基生成,减轻炎细胞浸润等有关。     

DIFFERENTIAL DIAGNOSIS IN THE INTRACRANIAL DISEASES： PROTON MAGNETIC RESONANCE SPECTROSCOPY STUDY

Protonmagneticresonancespectroscopy (1H MRS)isanewtechniqueoffunctionalimaginginbrainandprovidesauniquenoninvasivetoolforex aminingmetabolisminvivonow .Inrecentyear ,therearesomereportsaboutprotonMRSingrowthofbrainandhypoxia ischemicencephalopathy(HIE) [1- 4] ,butfewarticlesaboutclinicalapplica tionofprotonMRSindiagnosistumoursandtheirdifferentiationfromnon neoplasticlesions .WestudiedMRSin 38braintumorsand 14brainnon neoplasticlesions.Herewereporttheresults .MATERIALSANDMethods1　…     

THE HUMORAL AND CELLULAR IMMUNE RESPONSES INDUCED BY HPV18L1-E6/E7 DNA VACCINES IN MICE

Objective To construct eukaryutic expression vector of HPV18 L1- E6, E7 chimeric gene and examine the humorul and cellular immune responses induced by this DNA vaccines in mice. Methods The C-terminal of major rapsid protein L1 gene and mutant zinc finger domains of early E6/7 oncogenes in HPV18 were integrated and inserted into eukaryotic expression vector pVAX1 to generate vaccines pVAX1-L1E6Mxx, ETMxx. CHO cells were transiently transfected with the individual construct. Target protein expressions in the lysate of the transfected cells were measured by ELISA and immunocytochemistry After BALB/c mice were vaccinated with various recombinant plusmids（pVAX1- L1-E6M3 or pVAX1-L1-E7M3 ） and immunie adjuvants （pLXHDmB7-2 or LTB） through different administration routes （intramuscular or intranasal） , the great cellular immune responses were produced us revealed by delayed-type hypersensitivity （DTH） and lymphocyte proliferation, and the expression of IL-4 and IFN- 7 cells in CD4^＋ and CD8^＋ subpopulations. Results The highly efficient expression of pVAX1-L1E6Mxx, E7Mxx vector in host eukaryotic cells were demonstrated both by ELISA and immunocytochemistry. The level of specific serum IgG against HPV in experiment groups mice was much higher than that of control group, and intranuscular immunization group had the highest antibody level. Intramuscular immunization groups were superior to intranasal immunization groups in DTH response, splenocyte proliferation and CD8^＋ IFN-γ^＋ cells number, but CD4^＋ IL4^＋ cell number was higher in intranasul immunization groups. The immunization groups using pLXHDmB7.-2 as adjuvant were superior to other groups in immunorespouse. Conclusion These DNA vaccines produce remarkable cellular and humorul immune responses in the mouse and may provide us prophylatic and therapeutic candidates for HPV induced cancer treatment.     

用聚合酶链反应检测口腔癌组织中人乳头状瘤病毒的E_6转化基因

作者采用聚合酶链反应（ＰＣＲ），并对照核酸斑点杂交法对１０例口腔恶性肿瘤组织中ＨＰＶ１６Ｅ６转化基因进行了检测。这些肿瘤包括６例口腔粘膜鳞癌（ＳＣＣ），２例涎腺腺样囊性癌（ＡＣＣ），１例涎腺恶性多形性腺瘤（ＭＰＡ）和１例腭部软组织胚胎性横纹肌肉瘤（ＥＲ）。对照组为１０例非肿瘤组织，包括唇裂、腭裂粘膜组织标本各５例。结果表明两种方法检测结果基本一致，肿瘤组阳性６例（６／１０），包括４例ＳＳＣ，１例ＡＣＣ和１例ＥＲ（除外１例ＡＣＣ用核酸杂交法检测为弱阳性），其余为阴性；对照组用核酸杂交法检测４例，除１例唇裂标本为弱阳性以外，均为阴性（０／４）；用ＰＣＲ法检测１０例均为阴性结果（０／１０）。两组间ＨＰＶ１６Ｅ６转化基因的检出率有明显差异（Ｐ＜０．０５）。这一结果为开展口腔癌的ＨＰＶ病因学研究提供了参考资料。     

涎腺肿瘤中Survivin蛋白的表达及意义

目的探讨涎腺肿瘤中Survivin蛋白的表达情况,明确其表达与涎腺肿瘤的发生、发展及临床病理的关系。方法制备组织芯片,应用pictureTM法进行免疫组化染色。结果①Survivin蛋白在涎腺良性肿瘤中的阳性表达率显著低于交界性肿瘤、恶性肿瘤及癌旁腺体中的表达(P均<0.005);交界性肿瘤与恶性肿瘤中的表达无显著性差异(P>0.05);而恶性肿瘤中的表达高于癌旁腺体中的表达,且差异有显著性(P<0.01)。②在恶性肿瘤中,低分化者的Survivin阳性表达率明显高于高分化者(P<0.0005);有淋巴结转移者明显高于无淋巴结转移者(P<0.0005);复发瘤明显高于原发瘤(P<0.05);而不同性别、年龄及不同大小的肿瘤间均无显著性差异(P>0.05)。结论Survivin蛋白表达与涎腺恶性肿瘤的发生、发展及预后有关,可作为涎腺恶性肿瘤早期诊断及预后判断的可靠指标。     

香烟烟雾影响血管收缩功能的作用与尼古丁无关

目的研究香烟烟雾的二甲基亚砜溶解物(DSP)及尼古丁对血管内皮功能及血管收缩性的影响。方法取大鼠肠系膜上动脉,与DSP或尼古丁共培养,用小血管张力描记技术记录其张力。结果乙酰胆碱(ACh)浓度依赖性地舒张5-羟色胺预收缩的肠系膜动脉;0.8mL/L DSP(含尼古丁0.11mg/L)与血管培养6h和12h非平行右移ACh的舒张曲线,最大舒张(Rmax)显著低于对照组(P<0.01)。在培养6h和12h的血管,0.11mg/L尼古丁组ACh的浓度-舒张曲线与对照组比较无显著性变化,Rmax和pEC50与对照组比较无明显差异(P>0.05);而1.92mg/L尼古丁组的ACh浓度-舒张曲线轻度非平行右移,但移动程度弱于0.8mL/L DSP。肠系膜动脉与0.4mL/L DSP(含尼古丁0.06mg/L)培养24h,明显左移ETB和ETA受体介导的动脉浓度-收缩曲线,抬高Emax。动脉与0.06mg/L尼古丁培养24h,对S6c及ET-1诱导的浓度-收缩曲线无明显影响;动脉与0.96mg/L尼古丁培养24h,能左移ETB受体介导的动脉的浓度-收缩曲线,提高Emax,但与0.4mL/L DSP组比较无显著性差异。结论 DSP可降低大鼠肠系膜动脉内皮依赖性舒张功能,增强ETA及ETB受体介导的收缩,而这种作用与其中所含的尼古丁无关。     

妇科肿瘤组织中端粒酶活性的检测

为明确妇科肿瘤中端粒酶的活性，探索端粒酶活化在妇科肿瘤形成中的作用，应用以ＰＣＲ为基础的端粒酶测定方法（ＴＲＡＰ）对７８例妇科肿瘤和对照组织标本进行端粒酶活性测定。结果表明，端粒酶活性在子宫颈癌、卵巢癌和子宫内膜癌标本中阳性率为９１％（３０／３３）；子宫肌瘤、卵巢良性肿瘤和宫颈湿疣等良性增生病变中阳性率为１５％（３／２０）；正常对照组全部阴性。恶性肿瘤组阳性率明显高于后两组（Ｐ＜０．００５）。提示端粒酶活化是妇科恶性肿瘤中的普遍现象，在妇科肿瘤形成中有重要作用。     

β,β-胡萝卜素改善H_2O_2对成骨细胞损伤的影响

目的研究β,β-胡萝卜素增强成骨细胞抗自由基损伤的作用。方法用H2O2作用M3T3-E1成骨细胞,建立自由基损伤细胞模型。培养的成骨细胞分为对照组、模型组、β,β-胡萝卜素低剂量组(1×10-8mol/L)、β,β-胡萝卜素中剂量组(1×10-7mol/L)和β,β-胡萝卜素高剂量组(1×10-6mol/L)。测定不同处理组细胞活力、超氧化物歧化酶(superoxide dismutase,SOD)活性、活性自由氧(reactive oxygen species,ROS)含量、脂质过氧化物(lipid oxygen,LPO)含量,同时利用荧光偏振法测定细胞膜流动性。结果模型组细胞活力、SOD活性、细胞膜流动性均比不同β,β-胡萝卜素剂量组有显著降低(P<0.01),而ROS、LPO含量均比不同β,β-胡萝卜素剂量组有显著升高(P<0.01)。结论H2O2摄入会导致成骨细胞的氧化损伤,而β,β-胡萝卜素可以预防或降低此类损伤对细胞的影响。     

涎腺肿瘤组织中人乳头瘤病毒DNA的检测

为探讨腺上皮起源的涎腺良、恶性肿瘤与人乳头瘤病毒（Ｈｕｍ ａｎ ｐａｐｉｌｌｏ ｍ ａｖｉｒｕｓ, ＨＰＶ）感染的关系,应用聚合酶链反应技术（ＰＣＲ）,采用共有引物检测４４例涎腺肿瘤组织中的ＨＰＶ ＤＮＡ的存在状况。１０ 例正常涎腺组织作为对照。结果显示：肿瘤组织中ＨＰＶ ＤＮＡ 阳性检出率达７０．４５％ （３１／４４）,其中恶性肿瘤 ＨＰＶＤＮＡ 阳性率为７７２７％ （３１／４４）;良性肿瘤ＨＰＶＤＮＡ阳性率为６３６３％ （１４／２２）;而正常对照组织中ＨＰＶ ＤＮＡ阳性率仅为１０％ （１／１０）。提示：涎腺肿瘤的发生可能与ＨＰＶ感染有关     

癌胚抗原测定对宫体恶性肿瘤诊断及预后的意义

用放射免疫法测定了子宫体恶性肿瘤组３６例，子宫体良性病变组４６例，正常组５０例的子宫内膜、晨尿、血清的ＣＥＡ含量。结果示子宫体恶性肿瘤组３种标本的ＣＥＡ含量均值高于２对照组，而子宫体良性病变组与正常组间无显著差异。血标本ＣＥＡ升高的阳性率于良恶性病变组间无差异。子宫内膜ＣＥＡ含量与子宫体恶性肿瘤的临床分期呈正相关。子宫内膜ＣＥＡ含量可能与恶性肿瘤的预后有关。同时测定３种标本ＣＥＡ值有助于区别子宫体良、恶性病变。