IDUS、CT和MRCP对胆道恶性梗阻的诊断价值

目的探讨腔内超声（IDUS）、CT和磁共振胰胆管造影（MRCP）和对胆道恶性梗阻的诊断价值。方法回顾性分析53例胆道恶性梗阻患者的IDUS、CT和MRCP检查结果,比较3种影像学检查方法对胆道恶性梗阻的图像特征和诊断情况。结果IDUS、CT和MRCP对胆道恶性梗阻定位诊断准确率分别为65.31%、82.98%和82.93%,差异有统计学意义（P＜0.05）;而定性诊断准确率分别为63.27%、74.47%和75.61%,差异无统计学意义（P＞0.05）。3种影像学检查方法均能显示胆道恶性梗阻的部位、数量和回声/密度/信号特征：CT和MRCP对壶腹癌定位诊断、胰头癌定性诊断均有较高符合率。IDUS对胆管狭窄性质的阴性预测能力明显高于CT和MRCP（P＜0.05）。结论IDUS、CT和MRCP均能清晰显示胆道恶性梗阻的特征,各有优势,具有较高的应用价值。     

多梳基因Bmi-1 在甲状腺乳头状癌中的表达及意义

目的 研究多梳基因Bmi-1 在甲状腺乳头状癌组织中的表达及临床意义。方法 分别采用免疫组化法、Westernblot 法和RT-PCR 法检测30 例甲状腺乳头状癌组织、30 例结节性甲状腺肿组织及30 例正常甲状腺组织中多梳基因Bmi-1 及其mRNA 的表达情况,并分析Bmi-1与甲状腺乳头状癌临床病理特征的关系。结果 免疫组化法检测发现Bmi-1 在甲状腺乳头状癌组织中阳性表达率73.3%,与结节性甲状腺肿（36.7%）及与正常组织（16.7%）的阳性表达率相比差异有统计学意义（P＜0.05）。Western blot 法检测甲状腺乳头状癌中Bmi-1 表达量与结节性甲状腺肿组织及正常组织相比,差异有统计学意义（P＜0.05）。RT-PCR法检测甲状腺乳头状癌中Bmi-1mRNA 表达量与结节性甲状腺肿组织及正常组织相比,差异有统计学意义（P＜0.05）。Bmi-1 阳性表达在甲状腺乳头状癌有无淋巴结转移中的差异有统计学意义（P＜0.05）,在年龄、性别、肿瘤大小、分期等差异无统计学意义。结论 Bmi-1 在甲状腺乳头状癌中表达升高,可能在甲状腺乳头状癌的发生、发展过程中起重要作用,并可望作为甲状腺乳头状癌临床诊断的标记物之一。     

术前超声双重造影检查对胃癌患者胃周淋巴结转移的评估价值

目的探讨超声双重造影检查（DCUS）在不同部位胃癌术前淋巴结转移评估中的应用价值。方法选择180例胃癌患者,手术前3～5d内均进行DCUS及螺旋CT检查,对不同部位的胃癌患者术前均进行淋巴结分站评估,与术后病理检查结果对照得出正确率,并进行相互间比较。结果 DCUS和螺旋CT检查对远端胃切除患者淋巴结转移判断正确率分别为86.0%和83.9%,对全胃切除患者的判断正确率分别为82.5%和85.0%,两种检查方法判断准确率差异均无统计学意义（P＞0.05）;DCUS对近端胃切除患者淋巴结转移判断正确率为66.0%,明显低于螺旋CT检查的85.1%,差异有统计学意义（均P＜0.05）。结论胃癌术前淋巴结转移评价中,超声双重造影检查判断正确率与螺旋CT相当,仅对贲门胃底部癌判断正确率略低。     

实时三维超声联合右心声学造影评价肺源性心脏病患者右心室收缩功能的价值

目的应用实时三维超声心动图探讨肺源性心脏病患者右心室收缩功能的价值，比较右心造影对测值的影响。方法选择肺源性心脏病代偿组、失代偿组、正常对照组各20例分别进行造影前、后实时三维超声的采集成像，计算右心室舒张末容积（RVEDV）、右心室每博输出量（RVSV）和右心室射血分数（RVEF），并根据心内膜是否清晰可辨分为心内膜边界清晰者、心内膜边界欠清晰者，比较两者三维超声参数的组间差异。结果代偿组、失代偿组RVEDV较对照组均明显增加，RVEF值减低（均P＜0.01），代偿组与对照组RVSV差异无统计学意义（P＞0.05），但失代偿组RVSV与代偿组、对照组差异有统计学意义（P＜0.05）；失代偿组RVEDV较代偿组明显增大，RVEF明显减低（均P＜0.01）。心内膜边界欠清晰者造影后较造影前RVEDV、RVEF差异均有统计学意义（均P＜0.05）。结论实时三维超声能够客观地反映肺源性心脏病代偿期与失代偿期右心室收缩功能的变化，右心声学造影改善了心内膜边界的可识别性，提高了右心室收缩功能测值的可靠性。     

MR动态增强联合扩散加权成像技术在乳腺疾病诊断中的价值

目的探讨乳腺MR动态增强扫描联合扩散加权成像技术在乳腺疾病影像诊断中的价值。方法对48例女性乳腺患者进行MRI检查,先进行双侧乳腺常规MRI平扫,再进行双侧乳腺扩散加权平面回波（EPI）序列扫描,最后行乳腺动态增强扫描。通过后处理,得到病灶处表观弥散系数（ADC）值及时间-信号强度曲线。结果根据时间-信号强度曲线特点及ADC值,结合常规MRI形态学特点进行良、恶性病变诊断。MRI诊断为恶性肿瘤19例,良性病变29例。手术或活检病理结果证实MRI诊断为恶性肿瘤的19例患者中,18例为恶性肿瘤,另外1例为良性肿瘤（旺炽性腺瘤）;MRI诊断为良性病变的29例患者,手术或病理活检均证实为良性病变。MRI区分乳腺良、恶性病变的准确率为97.9%（47/48）,与手术或病理活检准确率（100%）比较差异无统计学意义（字2=0.044,P=0.834）。结论动态增强扫描联合扩散加权成像技术,可提高乳腺疾病影像诊断准确率。     

乳腺癌患者血清中TBX3的表达及其与临床病理特征的关系

目的探讨乳腺癌患者血清中TBX3的表达水平,探讨其与临床病理特征的关系。方法采用ELISA法检测142例乳腺癌患者、70例乳腺良性疾病患者和80例健康女性血清中TBX3的表达水平,并比较3者之间的差异,分析血清TBX3与乳腺癌患者年龄、月经状态、组织学分级、腋窝淋巴结及远处脏器转移、TNM分期以及雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（Her-2）、细胞核增殖抗原（Ki-67）之间的相关性。结果142例乳腺癌患者血清TBX3水平为2.13（1.01-6.15）ng/ml,显著高于健康对照组[1.60（0.99-2.18）ng/ml]及良性对照组[1.58（0.71-3.18）ng/ml],差异均有统计学意义（P＜0.05或0.01）。血清TBX3表达水平与乳腺癌患者年龄、月经无关,但随着乳腺癌组织学级别增加、TNM分期进展、出现腋窝淋巴结及远处脏器转移而显著升高。此外,ER阳性及Her-2过表达者血清TBX3表达水平较ER阴性及Her-2低表达者明显升高,差异均有统计学意义（均P＜0.05）。Ki-67≥14%者与Ki-67＜14%者、PR阳性者与PR阴性者之间血清TBX3表达水平的差异均无统计学意义（均P＞0.05）。结论血清TBX3在乳腺癌患者血清中高表达,且与乳腺癌组织学分级、TNM分期、腋窝淋巴结及远处脏器转移、ER及Her-2密切相关,提示血清TBX3可能可以作为乳腺癌临床诊断、预后判断及随访监测的分子标记物。     

CT在腺瘤性结节性甲状腺肿和乳头状甲状腺癌鉴别诊断中的价值

目的探讨CT在腺瘤性结节性甲状腺肿（ANG）和乳头状甲状腺癌（PTC）鉴别诊断中的价值。方法搜集经病理证实的105例112枚ANG和181例196枚PTC的CT资料,对性别、年龄、瘤体的形态、甲状腺边缘中断征、钙化、强化程度、增强后边界、淋巴结转移进行分析,统计强化程度高于周围甲状腺对ANG的诊断和甲状腺边缘中断征对PTC的诊断敏感度、特异度、阳性预测值、准确度。结果 ANG和PTC在瘤体形态、甲状腺边缘中断征、细钙化、粗钙化、强化程度、增强后瘤体边缘等方面均有统计学意义（均P＜0.05）,而在是否多发、环状钙化方面均无统计学差异（均P＞0.05）。181例PTC中,淋巴结转移75例。强化程度高于周围甲状腺对ANG诊断的敏感度、特异度、阳性预测值、准确度分别为67.9%、100%、100%、87.6%。甲状腺边缘中断征对PTC诊断的敏感度、特异度、阳性预测值、准确度分别为87.0%、91.1%、93.6%、88.6%。结论瘤体形态规则、强化程度高于周围甲状腺有助于ANG的诊断,而瘤体形态不规则、甲状腺边缘中断征、细钙化、粗钙化、淋巴结转移等有助于PTC的诊断;是否多发和环状钙化对ANG和PTC的鉴别诊断无意义。     

N-乙酰半胱氨酸对老年患者碘海醇肾损害的保护作用

目的探讨N-乙酰半胱氨酸对老年患者碘海醇肾损害的保护作用。方法选取行增强CT检查（静脉注射碘造影剂碘海醇）的老年患者74例,其中A组26例（于造影前48h和造影后48h口服N-乙酰半胱氨酸600mg,2次/d）,B组25例（于造影前48h和造影后48h口服N-乙酰半胱氨酸600mg,1次/d）;对照组23例（于造影前48h和造影后48h口服安慰剂,1次/d）。造影前和造影后48h,检测3组患者血尿素氮（BUN）、SCr、内生肌酐清除率（CCr）,并记录对比剂肾病发生率,造影前和造影后48h以及5d时,检测24h尿蛋白（PRO）、24h尿β2-微球蛋白(β2- MG)、24h尿微量白蛋白（UmAlb）。结果 A组无CIN发生,B组发生CIN5例（20%）,C发生CIN6例（26.09%）,A组CIN发生率明显低于B、C组（均P＜0.05）。3组患者造影前各指标的差异均无统计学意义（P＞0.05）。与造影前比较,3组患者造影后48h BUN、SCr、Ccr均发生明显变化（P＜0.05）;与B组、对照组比较,A组造影后48h BUN、SCr、Ccr均发生明显变化（P＜0.05）。与造影前比较,3组患者造影后48h、5d时PRO、Umalb、和β2- MG均发生明显变化（P＜0.05）;与对照组比较,A组造影后48h及5d、B组造影后48h的PRO、Umalb、和β2- MG均发生明显变化（P＜0.05）。结论口服N-乙酰半胱氨酸600mg（2次/d）能有效预防老年患者碘海醇肾损害。     

血清CEA、CA19-9、CA72-4联合检测对胃癌诊断的价值

目的 探讨肿瘤标志物联合检测在胃癌诊断中的应用价值。方法 采用电化学发光分析法测定经病理检查证实的127 例各期胃癌患者和105 例胃良性病变及98 例健康体检者的血清CEA、CA19-9、CA72-4 水平并进行统计和分析,计算单项检测与联合检测诊断胃癌的灵敏度及特异度并作比较。结果 胃癌患者的CEA、CA19-9、CA72-4水平均明显高于胃良性病变患者及正常对照者, 差异均有统计学意义（均P＜0.05）;胃良性病变患者与正常对照者比较,差异无统计学意义（P＞0.05）。3 项指标联合检测诊断胃癌的灵敏度达87.4%,明显高于其他任一单项检测的灵敏度,差异有统计学意义（均P＜0.05）;3 项联合检测的特异度为52.7%,虽明显低于其他任一单项检测的特异度,但差异无统计学意义（均P＞0.05）。胃癌术后复发者CEA、CA19-9、CA72-4 的水平明显高于未复发者,差异有统计学意义（均P＜0.01）。结论 血清多项肿瘤标记物联合检测有助于提高胃癌诊断的阳性率。     

多形性脑胶质母细胞瘤中1p/19q杂合性缺失的表达及其意义

目的探讨多形性胶质母细胞瘤（GBM）中1p/19q杂合性缺失（1p/19q LOH）的表达类型及其意义。方法通过荧光原位杂交法检测29例GBM、17例间变性星形细胞瘤（AA）和12例少突星形细胞瘤（OA）中1p/19q LOH的表达及其差异。结果 GBM、AA和OA中1p/19q LOH的发生率分别为24.1%、35.3%和75.0%，其中同时发生1p和19q LOH的比率分别为13.8%、23.5%和66.7%，GBM中1p/19q LOH的发生率明显低于AA和OA（P＜0.05）。GBM的VEGF阳性表达率和Ki-67增殖指数分别为75.9%和87.66±16.21，AA为47.1%和49.57±4.73，OA为41.7%和41.62±4.25，GBM与后两者比较，均有统计学差异（均P＜0.05）。1p/19q LOH的发生率与VEGF阳性表达和Ki-67增殖指数呈负相关（均P＜0.05）。结论1p/19q LOH的表达可能有助于评估GBM患者对烷化剂类药物治疗的敏感性及其预后。     

Qualitative Analysis of Bifurcating Solutions in the Lengyel-Epstein Model

One of the most fundamental problems in theoretical biology is to explain the mechanisms by which patterns and forms are created in the＇living world. In his seminal paper ＂The Chemical Basis of Morphogenesis＂, Turing showed that a system of coupled reaction-diffusion equations can be used to describe patterns and forms in biological systems. However, the first experimental evidence to the Turing patterns was observed by De Kepper and her associates（1990） on the CIMA reaction in an open unstirred reactor, almost 40 years after Turing＇s prediction. Lengyel and Epstein characterized this famous experiment using a system of reaction-diffusion equations. The Lengyel-Epstein model is in the form as follows     

RECENT PROGRESS ON SPHERICAL HARMONIC APPROXIMATION MADE BY BNU RESEARCH GROUP ——In memory of Professor Sun Yongsheng

As early as in 1990, Professor Sun Yongsheng, suggested his students at Beijing Normal University to consider research problems on the unit sphere. Under his guidance and encouragement his students started the research on spherical harmonic analysis and approximation. In this paper, we incompletely introduce the main achievements in this area obtained by our group and relative researchers during recent 5 years （2001-2005）. The main topics are： convergence of Cesaro summability, a.e. and strong summability of Fourier-Laplace series; smoothness and K-functionals; Kolmogorov and linear widths.     

(0,1 ;0)-INTERPOLATION ON INFINITE INTERVAL (-∞, +∞)

In this paper, we study the explicit representation and convergence of (0, 1; 0)-interpolation on infinite interval, which means to determine a polynomial of degree ≤ 3n - 2 when the function values are prescribed at two set of points namely the zeros of Hn(x) and H′n(x) and the first derivatives at the zeros of H′n(x).     

On a class of self-similar processes with stationary increments in higher order Wiener chaoses

We study a class of self-similar processes with stationary increments belonging to higher order Wiener chaoses which are similar to Hermite processes. We obtain an almost sure wavelet-like expansion of these processes. This allows us to compute the pointwise and local Hölder regularity of sample paths and to analyse their behaviour at infinity. We also provide some results on the Hausdorff dimension of the range and graphs of multidimensional anisotropic self-similar processes with stationary increments defined by multiple Wiener–Itô integrals.     

A REPRESENTATION FORMULA RELATED TO SCHR(O)DINGER OPERATORS

Schr(o)dinger operator is a central subject in the mathematical study of quantum mechanics.Consider the Schrodinger operator H = -△ V on R, where △ = d2/dx2 and the potential function V is real valued. In Fourier analysis, it is well-known that a square integrable function admits an expansion with exponentials as eigenfunctions of -△. A natural conjecture is that an L2 function admits a similar expansion in terms of "eigenfunctions" of H, a perturbation of the Laplacian (see [7], Ch. Ⅺ and the notes), under certain condition on V.     

On a class of Riemann surfaces

It is considered the class of Riemann surfaces with dimT1 = 0, where T1 is a subclass of exact harmonic forms which is one of the factors in the orthogonal decomposition of the spaceΩH of harmonic forms of the surface, namely The surfaces in the class OHD and the class of planar surfaces satisfy dimT1 = 0. A.Pfluger posed the question whether there might exist other surfaces outside those two classes. Here it is shown that in the case of finite genus g, we should look for a surface S with dimT1 = 0 among the surfaces of the form Sg\K , where Sg is a closed surface of genus g and K a compact set of positive harmonic measure with perfect components and very irregular boundary.     

Journal of the Operations Research Society of China Special issue on Operations Research in Healthcare Management

正Guest Editors:Hong Chen,Shanghai Jiao Tong University,Shanghai,China Guohua Wan,Shanghai Jiao Tong University,Shanghai,China David Yao,Columbia University,New York,USA Scope:Healthcare delivery worldwide has been fraught with high cost,low efficiency and poor quality of patient care service.For the field of operations research(OR),healthcare offers some of the biggest challenges as well as best opportunities in     

ANALYSIS IN THEORY AND APPLICATIONS Vol. 30, 2014 CONTENTS

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Boundedness for commutators of multipliers on Hardy type spaces

In this paper, we study the commutators generalized by multipliers and a BMO function. Under some assumptions, we establish its boundedness properties from certain atomic Hardy space Hb^p（R^n） into the Lebesgue space L^p with p 〈 1.