乳腺局灶性病变三维剪切波弹性成像图像质量影响因素

目的 探讨乳腺局灶性病变三维剪切波弹性成像（3D-SWE）图像质量的影响因素。方法 对187例乳腺局灶性病变患者行3D-SWE成像,并按图像质量分为1级（非常满意）、2级（基本满意）和3级（不满意）。分析操作有无附加压力、乳腺分型、耦合剂厚度、病变位置、大小、深度及病理性质对3D-SWE图像质量的影响。结果 图像质量1级105例（105/187,56.15%）,2级59例（59/187,31.55%）,3级23例（23/187,12.30%）。操作中有无附加压力、病变位置、病理性质、病变最大径、病变深面距离皮肤最长垂直距离及病变前方脂肪层最厚厚度均为3D-SWE图像质量的影响因素（P均<0.05）。结论 操作有无附加压力、病变位置、大小、深度及病理性质可影响3D-SWE图像质量。     

ERCC2 Asp312Asn/Lys751Gln基因多态性与 晚期非小细胞肺癌铂类药物化疗敏感性相关性的临床观察

目的观察和评价切除修复交叉互补基因2(ERCC2) Asp312Asn/Lys751Gln基因多态性与晚期非小细胞肺癌(NSCLC)对铂类药物化疗敏感性的相关性。方法回顾性分析2017年4月至2018年12月空军第986医院和海军特色医学中心收治的以铂类药物为主要化疗方案的76例NSCLC患者。应用基因芯片方法检测患者的ERCC2Asp312Asn和Lys751Gln基因型,比较不同基因型与化疗疗效的关系。结果 76例患者化疗总有效率为28. 95%(22/76)。ERCC2 Asp312Asn基因型和Lys751Gln基因型分布均符合hardy-weinberg平衡,表明该组病例具有群体代表性。76例NSCLC患者中,ERCC2 Asp312Asn的Asp/Asp、Asp/Asn基因型频率分别为94. 74%和5. 26%; Lys751Gln的Lys/Lys、Lys/Gln基因型的频率分别为88. 16和11. 84%,均未检测到2个位点的突变纯合基因型。ERCC2 Asp312Asn和Lys751Gln基因型在化疗有效患者和无效患者之间的分布无统计学差异(P 0. 05)。结论 ERCC2 Asp312Asn和Lys751Gln单核苷酸多态性与晚期NSCLC对铂类药物化疗敏感性无关。     

丹参酮ⅡA磺酸钠对海水浸泡人肺上皮A549细胞水通道蛋白5的影响

目的 探讨水通道蛋白5(AQP5)在海水浸泡致细胞损伤中的变化,同时了解丹参酮Ⅱ A可能的作用机制.方法 体外传代培养肺腺癌细胞株A549细胞,接种于培养皿中,按不同海水含量分为空白对照组及15%、25%、50%、75%、100%海水组;以25%海水浸泡不同时间分为空白对照组及海水1、4、8 h组;按给予不同剂量丹参酮ⅡA干预分为空白对照组、25%海水组及25、50、75、100μg/ml丹参酮ⅡA干预4 h组.用蛋白质免疫印迹法(Western blotting)检测AQP5蛋白表达;用免疫组化法检测AQP5阳性表达.结果 Western blotting结果显示,25%与50%海水组8 h时A549细胞AQP5蛋白表达均较空白对照组明显增高(1.053±0.231、1.116±0.316比0.101±0.081,均P＜0.05);海水1 h组AQP5表达较空白对照组稍有增加(0.306±0.125比0.288±0.098,P＞0.05),4 h组(1.423±0.377)明显增加(P＜0.01),8 h组AQP5表达(1.507±0.461)较4 h组略有增加,但差异无统计学意义;25μg/ml与50 μg/ml丹参酮Ⅱ A组4 h时AQP5蛋白表达较25%海水组明显减少(0.580±0.186、0.499±0.172比1.013±0.287,均P＜0.05).免疫组化显示,25%海水4 h组AQP5阳性表达较空白对照组明显增多(7.21±0.78比0.41±0.07,P＜0.01),染色变深;25μg/ml丹参酮ⅡA干预4 h组AQP5阳性表达(3.02±0.23)较25%海水4 h组明显减少(P＜0.05).结论 丹参酮Ⅱ A在25μg/ml浓度时毒副作用最小,对海水浸泡A549细胞的保护作用最佳,其机制可能与抑制AQP5的过度表达有关.

Abstract：

Objective To explore the effects of tanshinone Ⅱ A on the activity of aquaporin-5 (AQP5)in human alveolar epithelial cells (A549) after seawater exposure and its possible mechanism. Methods Routinely cultured A549 cells were divided into different groups according to different content of seawater:blank control group, 15%, 25%, 50%, 75%, 100% seawater groups; they were divided into different groups according to the duration of exposure to 25 % seawater : blank control group, 1, 4, 8 hours groups ;they were also divided into different groups according to concentration of tanshinone ⅡA and exposed to seawater for 4 hours: blank control group, 25% seawater group, 25, 50, 75, 100 μg/ml tanshinone ⅡA intervention groups. The expressions of AQP5 were respectively assayed by Western blotting and immunohistochemistry. Results The results of Western blotting showed that the expressions of AQP5 were remarkably higher at 8 hours of exposure to seawater in 25% and 50% seawater groups than those in blank control group (1. 053±0. 231, 1. 116±0. 316 vs. 0. 101±0. 081, both P＜0. 05); the expression of AQP5 in 1-hour group showed a slight increase compared with blank control group (0. 306±0. 125 vs. 0. 288±0. 098,P＞0. 05), that in 4-hour group was increased significantly (1. 423±0. 377, P＜0. 01), and in 8-hour group (1. 507± 0. 461 ) it was slightly higher than that in 4-hour group without statistical significance. The AQP5 expression was significantly lower in tanshinone ⅡA 25 μg/ml and 50μg/ml intervention groups than that in 25% seawater group (0. 580 ± 0. 186, 0. 499 ± 0. 172 vs. 1.013 ± 0. 287, both P ＜ 0. 05). Immunohistochemistry showed that the expression of AQP5 was markedly up-regulated after A549 cells were stimulated with 25% seawater for 4 hours as compared with blank control group (7.21±0. 78 vs. 0. 41 ±0.07, P＜0.01), but intervention of tanshinone ⅡA significantly inhibited the up-regulation of AQP5 expression (3.02±0.23) induced by 25% seawater (P＜0.05). Conclusion The experimental results showed that tanshinone ⅡA is innocuous to A549 at a dosage of 25 μg/ml, and it can decrease the overexpression of AQP5 induced by seawater.     

含碳球团厚料层穿流干燥的实验研究

以正交原理为基础,进行了含碳球团厚料层穿流干燥研究,研究了不同热风温度、热风流速、球团初始湿含量、生球尺寸以及料层厚度对球团干燥过程的影响。由实验数据回归得到了反映以上各因素对平均干燥速率、瞬时干燥速率、干燥时间、干燥过程温度影响程度的多元指数方程,且误差在允许范围内。方程很好地反映了各个因素对球团干燥过程的影响,对含碳球团干燥有一定的指导意义。     

经皮胆管超声造影与X线造影对肝门部胆管癌进行分型的比较研究

目的 探讨经皮胆管超声造影在肝门部胆管痛Bismuth分型中的准确性和有用性.方法 纳入30例经手术确诊为肝门部胆管癌的患者进行前瞻性研究.所有患者分别接受了二维超声、声诺维经皮超声胆道造影(PUSC)和泛影葡胺经皮经肝X线胆道造影(PTC),并经手术或临床确诊为肝门部胆管癌.以手术结果为金标准,比较三者对肝门部胆管癌进行Bismuth分型的准确性.结果 普通超声分型的准确率为23.3%(7/30),PUSC和PTC分型的准确率均为73.3%(22/30).普通超声分型准确率与PUSC及PTC之间差异具有统计学意义.结论 超声胆管造影提高了超声评估肝门部胆管癌的能力,对肝门部胆管癌进Bismuth分型的效能与PTC相近.     

腹主动脉瘤超声造影表现与CT血管成像的比较

目的比较腹主动脉瘤超声造影与CT血管成像(CTA)的表现,探讨超声造影(CEUS)在腹主动脉瘤诊断及术后随访中的应用价值。方法采用超声造影检查对18例(术前检查10例,术后复查8例)腹主动脉瘤患者进行术前诊断或术后复查,所有患者均同时行CT血管成像检查。将两种方法诊断术前患者真性动脉瘤、夹层动脉瘤、假性动脉瘤及术后有无内漏情况进行对比研究。结果术前超声造影诊断为真性动脉瘤5例,夹层动脉瘤4例,假性动脉瘤1例;术后随访8例中支架置入及人工血管置换各4例,均未见内漏,与CTA结果一致。结论应用超声造影对腹主动脉瘤进行术前诊断及术后随访,结果和CTA一致,值得推广应用。     

肝血管平滑肌脂肪瘤的超声造影表现

Objective To investigate the features of hepatic angiomyolipoma(AML) on contrast enhanced ultrasound (CEUS). Methods Ten pathologically proved AML lesions in 9 patients were evaluated by using baseline ultrasound and CEUS. CEUS was performed with contrast pulse sequencing technique and the contrast agent of SonoVue. Results On baseline ultrasound, 7 lesions exhibited mixed echoic,which was obvious hyperechoic combined with partly of hypoechoie; 3 lesions exhitited obvious hypereehoic. On color Doppler flow imaging artery signals were detected in all lesions. And the lesions had plenty or slightly plenty of artery supply,with resistive index about 0.53 4±0.10 (0.48~0.62). On CEUS, in the arterial phase, 9 lesions exhibited hyper-enhanced. In the portal phase, 5 lesions exhibited iso-enhancement,1 lesion was slightly hyper-enhancement and 3 lesions was hypo-enhancement. In the late phase 6 lesions were iso-enhancement and 3 lesions were hypo-enhancement. One lesion was all hypo-enhancement in all three phases. Conclusions There are some characteristic manifestations of hepatic AML in CEUS, which are helpful for the diagnosis of hepatic AML in a way,but we still need more experiences.     

Sonazoid超声造影肝实质特异相开始时间的初步探讨

目的 初步探讨Sonazoid超声造影肝实质特异相开始的时间.方法 Wistar大鼠54只,分别在注射生理盐水(n=6)后2 min,注射SonoVue(n=24)和Sonazoid(n=24)后2 min,5 min,10 min和20 min对肝进行原位灌洗,定量比较灌洗前后肝增强水平.结果 对照组肝回声水平灌洗后显著升高.SonoVue注射后2 min和5 min时灌洗后肝实质增强水平均显著降低,但10 min和20 min时灌洗后肝实质增强水平则显著升高.Sonazoid注射后2 min时灌洗后肝脏增强水平显著降低,但5 min、10 min和20min时肝实质增强水平灌洗前后无显著差异.结论 Sonazoid超声造影肝实质特异相的起始时间可早至造影剂注射后5 min.     

三维超声在肝脏疾病介入性诊疗中的应用

【目的】评价三维超声在肝脏疾病介入性诊疗操作中的应用价值。【方法】肝病患者 5 7例 ,介入性诊疗操作 72次 ,用二维及三维超声观察穿刺针并判断穿刺针与病灶的位置关系。【结果】72次操作中 ,三维超声对针尖的显示优于二维超声 (P <0 .0 5 ) ,对针杆的显示与二维超声无明显差异 (P >0 .0 5 )。三维超声在判断穿刺针与病灶的位置关系时 ,信心水平明显提高 (P <0 .0 1)。 72次操作中 ,三维超声观察到 12次(16 .7% )操作中针尖位置不理想 ,需要重新穿刺或调整针尖位置。【结论】三维超声在肝脏疾病介入性诊疗操作中能更好地发挥导向作用。     

结核性胸膜炎胸液ADA测定的临床意义

结核性胸膜炎是淋巴细胞介导为主的多种细胞，多种细胞因子参与的综合病理性免疫反应。它是结核杆菌及其自溶产物、代谢产物进入超敏感机体的胸膜腔而引起的胸膜炎症，由于它是对结核菌成份在胸膜产生超敏反应的发生机理，故胸液中不易查到结核杆菌，早期确诊有一定的难度。近年来腺苷脱氨酶（ADA）测定用于胸水性质的诊断研究较多，