DCE-MRI参数联合IFIT1基因对腰椎间盘突出患者椎间盘退变程度的评估价值

探讨DCE-MRI参数及IFIT1基因对腰椎间盘突出症(LDH)患者椎间盘退变(IDD)程度的评估价值。随机选取确诊的66例LDH患者作为研究对象,根据改良Pfirrmann分级法将患者分为2组:轻中度IDD(Ⅰ~Ⅲ级)组(46例)和重度IDD(Ⅳ~Ⅴ级)组20例。通过DCE-MRI检查考察患者的K-trans值,采用日本骨科学会评分(JOA)评估腰椎功能,采用视觉模拟评分法(VAS)评估腰部疼痛,采用RT-PCR检测外周血单个核细胞(PBMC)中IFIT1的mRNA表达。轻中度IDD组的K-trans值显著低于重度IDD组。轻中度IDD组患者PBMC中的IFIT1 mRNA相对表达量显著低于重度IDD组。K-trans值与PBMC中的IFIT1 mRNA水平和VAS评分正相关,与JOA评分负相关(P<0.05)。PBMC中的IFIT1 mRNA水平与VAS评分正相关,与JOA评分负相关(P<0.05)。K-trans值和PBMC中的IFIT1 mRNA水平联合诊断重度IDD的AUC值、敏感性和特异性分别为0.991、91.3%和100.0%,AUC值和特异性均高于单独诊断。DCE-MRI检查中的K-trans值联合PBMC中的IFIT1 mRNA水平可用于LDH患者IDD程度的诊断。     

多参数MRI对子宫肉瘤与良性子宫肌瘤的鉴别诊断价值及与肿瘤细胞恶性程度的关系

本文选取子宫肉瘤(US)患者103例作为观察组,另选取同期良性子宫肌瘤患者103例作为对照组,探究多参数MRI对US与良性子宫肌瘤的鉴别诊断效果及与肿瘤细胞恶性程度的关系。结果发现,观察组达峰时间(TTP)、扩散系数(ADC)低于对照组;随临床分期增加,TTP、ADC呈下降趋势,TopoⅡα、AgNOR、PDGFα、Matriptase mRNA相对表达量呈升高趋势,TTP、ADC与TopoⅡα、AgNOR、PDGFα、Matriptase mRNA相对表达量呈负相关,且TTP、ADC联合鉴别诊断US和良性子宫肌瘤的AUC值最大,提示US与良性子宫肌瘤MRI参数存在显著差异,且TTP、ADC值与增殖分子、侵袭分子活性直接相关,可为临床鉴别诊断提供数据支持。     

MRI增强扫描联合DWI检测在乳腺癌诊断中的应用

本文探究了MRI增强扫描(DCE-MRI)联合磁共振扩散加权成像(DWI)检测对乳腺癌的诊断效果。回顾性分析2015年8月~2017年8月本院收治的经手术病理证实的乳腺癌患者81例,术前均行DCE-MRI和DWI检查,根据数据绘制时间-信号强度曲线(TIC),并计算扩散系数(ADC)值。以病理结果为金标准,计算单一检测及联合检测的诊断准确率,并采用ROC分析ADC值诊断乳腺癌良/恶性的效能。结果显示,81例患者经手术病理诊断显示良性37例、恶性44例;DCE-MRI与DWI联合检测的敏感度与准确度显著高于单一检测(P<0.05);良、恶性病灶的TIC分型分布比较,差异具有统计学意义(P<0.05);恶性病灶ADC值较良性病灶低(P<0.05);ADC值诊断乳腺癌良/恶性最佳界限值为1.28×10-3 mm 2/s,灵敏度和特异度分别为86.5%和90.9%。因此,DCE-MRI与DWI联合检测可明显提高乳腺癌良/恶性病变诊断的准确度,为临床诊断提供可靠影像学依据。     

甲状腺良恶性结节SWE技术参数与超声造影参数的相关性及联合诊断价值分析

本文主要探讨甲状腺良恶性结节剪切波弹性成像(SWE)技术参数与超声造影(CEUS)参数相关性及SWE技术、CEUS联合诊断甲状腺良恶性结节的价值。选取甲状腺恶性结节患者51例作为恶性组,甲状腺良性结节患者63例作为良性组,均行SWE、CEUS检查,分析诊断价值,研究结果发现,E_(min)、E_(mean)、E_(max)与Peak呈负相关,与Tp呈正相关(P0.05);SWE、CEUS联合诊断甲状腺恶性结节的AUC值为0.952,大于任一指标单独诊断(P0.05);E_(min)、E_(mean)、E_(max)、Tp、MTT与临床分期、结节大小、钙化情况呈正相关,与分化程度呈负相关,Peak与临床分期、结节大小、钙化情况呈负相关,与分化程度呈正相关(P0.05),这些结果可以证实,SWE技术、CEUS联合诊断甲状腺良恶性结节有较高价值,对指导临床制定治疗方案具有重要作用。     

彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用研究

本研究探讨了彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用价值。选取行超声引导下肝穿刺活检的慢性乙肝患者300例,其中235例有肝纤维化(观察组)和65例无肝纤维化(对照组),统计分析了这两组患者和不同肝纤维化分期患者的彩色多普勒超声参数[门静脉主干内径(mPVD)、脾静脉内径(SVD)、门静脉血流量(mPBF)、门静脉主干平均血流速度(mPVm)、门静脉淤血指数(CI)、脾静脉平均血流速度(sVm)、脾静脉血流量(sVBF)]和肝脏硬度值(LSM)。结果显示,各参数联合诊断CHB肝纤维化的AUC最高,为0.876(P<0.05);SVD、mPVD、CI、LSM与肝纤维化分期呈正相关,mPVm与肝纤维化分期呈负相关(P<0.05);LSM诊断肝纤维化分期的AUC最大(P<0.05)。可见采用彩色多普勒超声与FibroScan定向瞬时弹性成像系统检测SVD、mPVD、CI、mPVm、LSM参数可诊断CHB肝纤维化,且各参数均与肝纤维化程度密切相关,有望成为评估肝纤维化及严重程度的无创性检测方法。     

多层螺旋CT多平面重建在胃肠道淋巴瘤诊断中的应用及与临床分期的相关性研究

为研究多层螺旋CT多平面重建在胃肠道淋巴瘤诊断中的应用价值及检测结果与临床分期的相关性,本次研究筛选我院2016年1月~2019年6月收治的50例经病理学检查证实的胃肠道淋巴瘤患者为观察组,另选同期50例非胃肠道淋巴瘤患者为对照组,均实施多层螺旋CT多平面重建,对比两组及观察组内不同组织类型、不同临床分期患者CT重建参数(图像客观噪声、信噪比)的差异,利用Pearson相关性分析法对CT重建参数与胃肠道淋巴瘤临床分期的相关性进行检验。病理学检查证实,50例胃肠道淋巴瘤患者中有弥漫性大B细胞淋巴瘤25例、黏膜相关淋巴瘤19例、小B细胞淋巴瘤4例、套细胞淋巴瘤2例,与多层螺旋CT多平面重建符合率差异无统计学意义(P>0.05)。观察组图像客观噪声低于对照组,信噪比高于对照组,差异有统计学意义(P<0.05)。观察组内不同组织类型患者、不同临床分期患者CT重建参数差异有统计学意义(P<0.05)。Pearson相关性分析结果提示,多层螺旋CT多平面重建参数中图像客观噪声与胃肠道淋巴瘤临床分期呈负向相关性(r=-0.74,P<0.05),信噪比与胃肠道淋巴瘤临床分期呈正相关性(r=0.71,P<0.05)。据此可得,在胃肠道淋巴瘤诊断中多层螺旋CT多平面重建取得的效果更佳且CT重建参数与临床分期密切相关,对于辨别组织类型和判断临床分期具有重要参照价值,值得推广。     

经腹彩色多普勒超声检查对子宫内膜异位症的诊断价值

本研究选取我院100例子宫内膜异位症患者作为病例组、同期健康妇女100例作为对照组,探讨了经腹彩色多普勒超声检查对子宫内膜异位症患者子宫动脉血流特征、子宫特征的诊断价值。结果显示,病例组的子宫体积、子宫内膜厚度测定值均大于对照组(P<0.05);摆动子宫颈后,病例组的EDV测定值低于对照组,RI测定值大于对照组(P<0.05);通过绘制ROC曲线,可知EDV、RI、子宫体积大小、子宫内膜厚度诊断子宫内膜异位症的AUC值均超过0.65,灵敏度和特异度都较高,漏诊率和误诊率也在可控范围内。本研究证实,通过经腹彩色多普勒超声检测子宫动脉血流参数及子宫形态特征,对诊断子宫内膜异位症具有一定的临床参考价值。     

毛细管电泳-电化学检测法用于生物碱电离常数线性模型的研究

依据毛细管区带电泳的特性，推导出在不同pH条件下，有效淌度的倒数(1/μep)与缓冲溶液中氢离子浓度([H^ ])成线性关系，进而建立了用毛细管电泳-电化学检测法测定四种生物碱：苯异丙胺、苯丙醇胺、麻黄碱和甲基麻黄碱电离常数的线性模型和测定方法，测得的pKa值，与紫外分光光度法测定值及文献值比较，结果令人满意．可望在药物离解常数测定的应用中得到推广．     

定量能谱CT多参数成像诊断多发性骨髓瘤价值及临床意义

本文探讨能谱CT多参数成像定量分析对多发性骨髓瘤(MM)的诊断价值及与实验室指标、疾病分期的关系。选取MM患者62例作为研究组,另随机选取同期健康者62例作为对照组,均行能谱CT检查。结果发现,研究组40 keV、50 keV、60 keV、70 keV、80 keV、90 keV、100 keV能量水平的CT值、能谱曲线斜率均低于对照组(P<0.05);上述能量水平的CT值、能谱曲线斜率联合诊断的AUC为0.875;40~100 keV能量水平的CT值、能谱曲线斜率与Hb呈正相关,与CREA、BUN、β2-MG、疾病分期呈负相关(P<0.05)。因此能谱CT多参数成像定量分析在MM诊断方面具有较高价值,且与患者Hb、CREA、BUN、β2-MG水平、疾病分期密切相关。     

超声弹性成像参数联合血清MK和VEGF对分化型甲状腺癌的诊断价值及与肿瘤恶性程度关系研究

本研究选取了分化型甲状腺癌(DTC)患者106例为甲状腺癌组,同期106例甲状腺腺瘤患者为甲状腺腺瘤组,检测比较了两组患者的超声弹性成像参数(弹性比值、蓝色面积比值)、血清中期因子(midkine,MK)、血管内皮生长因子(VEGF)水平。研究结果发现,弹性比值、蓝色面积比值、血清MK和VEGF水平与DTC患者淋巴结转移、包膜侵犯、临床分期相关(P<0.05);弹性比值、蓝色面积比值、血清MK和VEGF水平联合诊断DTC的曲线下面积(AUC)为0.888;弹性比值、蓝色面积比值、血清MK及VEGF水平与DTC患者组织中趋化因子受体(CXCR)4、解聚素金属蛋白酶(ADAM)9、靶向Xklp2靶蛋白(TPX2)基因表达量呈正相关,与程序性细胞死亡因子(PDCD)4基因表达量呈负相关。这些结果提示超声弹性成像参数、血清MK及VEGF水平上调可能用来评估DTC患者病情程度及肿瘤恶性程度,三者联合对DTC具有可靠诊断价值,可为临床诊治提供参考。     

三维经阴道超声对宫腔粘连患者宫腔容积及血流变化的评估

为了观察宫腔粘连患者行三维经阴道超声(3D-TVS)检查时宫腔容积及血流的变化,本文纳入2016年11月~2018年11月于我院收治的68例宫腔粘连患者为观察组,另选取同期来我院体检的健康女性68例为对照组,均于月经周期中晚期行3D-TVS检查,并以病理诊断结果为金标准,观察了3D-TVS诊断宫腔粘连的灵敏度及特异度。同时,对比了两组患者3D-TVS参数如子宫内膜容积(EV)、血流指数(FI)、血管血流指数(VFI)及内膜区血管指数(VI)的变化,并分析了宫腔粘连不同分级患者上述3D-TVS参数的变化情况。经病理确诊的68例患者中,3D-TVS诊断为宫腔粘连64例,其中Ⅰ型21例,Ⅱ型31例,Ⅲ型9例,Ⅳ型3例。3D-TVS诊断宫腔粘连的灵敏度为92.65%,特异度为98.53%,准确率为95.59%,阳性预测值为98.44%,阴性预测值为93.06%,Kappa值为0.91。观察组EV、FI、VFI、VI均显著低于对照组。Ⅰ型宫腔粘连者EV显著大于Ⅱ、Ⅲ、Ⅳ型者,Ⅱ型宫腔粘连者EV显著大于Ⅲ、Ⅳ型者,Ⅲ型宫腔粘连者EV显著大于Ⅳ型者;Ⅰ型宫腔粘连者的VFI、VI显著大于Ⅲ、Ⅳ型者。上述结果证实3D-TVS对宫腔粘连患者宫腔容积及血流变化具有重要的评估价值。     

Effect of free volume and temperature on the structural relaxation in polymethylphenylsiloxane: a positron lifetime and pressure-volume-temperature study

The microstructure of the free volume and its temperature dependence in polymethylphenylsiloxane (PMPS) have been examined using positron annihilation lifetime spectroscopy (PALS) and pressure-volume-temperature experiments. The hole-free volume fraction h and the specific hole-free and occupied volumes, Vf=hV and Vocc=(1-h)V, were estimated employing the Simha-Somcynsky (SS) lattice-hole theory. From the PALS spectra analyzed with the new routine LT9.0 the hole size distribution, its mean, , and mean dispersion, sigmah, were calculated. A comparison of with V and Vf delivered a constant specific hole number Nh'. Using a fluctuation approach the temperature dependency of the volume of the smallest representative freely fluctuating subsystem, , is estimated to vary from approximately 8.5 nm3 at Tg to approximately 3 nm3 at T/Tg>or=1.15. Unlike other polymers, the segmental relaxation from dielectric spectroscopy of PMPS follows the Cohen-Turnbull free volume theory almost perfectly in the temperature and pressure ranges between 243 and 279 K and 0 and approximately 100 MPa. This behavior correlates with the small mass of the SS lattice mer which indicates the high flexibility of the PMPS chain. Above 293 K and approximately 150 MPa, the free volume prediction gives relaxation times that are too small, which indicates that effects of thermal energy must be included in the analysis. To quantify the degree to which volume and thermal energy govern the structural dynamics the ratio of the activation enthalpies, Ei=R[(d ln taudT1)]i (tau-relaxation time of alpha relaxation), at constant volume V and constant pressure P, EV/EP, is frequently determined. The authors present arguments for necessity to substitute EV with EVf, the activation enthalpy at constant (hole) free volume, and show that EVf/EP changes as expected: increasing with increasing free volume, i.e., with increasing temperature and decreasing pressure. EVf/EP (=0.04-0.1) exhibits remarkably smaller values than EV/EP (=0.44-0.53), which leads to the inference that the free volume plays a distinctly larger role in dynamics than traditionally concluded from EV/EP. This conclusion is in agreement with the results of our more direct Cohen-Turnbull free volume analysis.     

经阴道彩色多普勒超声在子宫内膜病变诊断中的应用研究

目的探讨经阴道彩色多普勒超声在诊断子宫内膜病变中的临床价值。方法回顾性分析湖北省浠水县妇幼保健院自2014年1月—2015年6月收治的54例子宫内膜病变患者的临床资料,其中28例经阴道超声诊断患者设为观察组,26例经腹部超声诊断患者设为对照组,比较两组患者超声诊断结果与病理诊断结果的差异。结果观察组患者超声诊断总符合率为88.89%,明显高于对照组的61.11%,差异具有统计学意义(P0.05);观察组患者子宫内膜增生、子宫内膜息肉及子宫黏膜下肌瘤的诊断符合率分别为90.91%、93.33%、88.89%,明显高于对照组的63.64%、66.67%、55.56%,差异具有统计学意义(P0.05);两组患者萎缩性子宫内膜和子宫内膜癌的诊断符合率差异不明显,无统计学意义(P0.05)。观察组良性病变患者的血流信号显示率、动脉阻力指数分别为27.27%和(0.70±0.12)和恶性病变患者的100%、(0.35±0.08)差异明显,有统计学意义(P0.05)。结论经阴道超声检查诊断子宫内膜病变准确率明显高于经腹部超声检查,而且能够在一定程度上反映子宫内膜病变性质,具有较高的临床推广价值。     

动态增强磁共振成像与16层螺旋CT对小肾癌诊断及术前评估的价值对比

本文比较动态增强磁共振成像(DCE-MRI)与16层螺旋CT(MSCT)对小肾癌诊断及术前评估中的价值。选取64例疑似小肾癌患者作为研究对象,均接受DCE-MRI与MSCT检查。以术后病理结果为参照,比较DCE-MRI和MSCT检查对小肾癌诊断及术前评估的灵敏度、特异度和准确度,并分析这两种检查的参数与Fuhrman分级的相关性。结果表明,DCE-MRI和MSCT的检查参数均与Fuhrman分级呈正相关关系,DCE-MRI对小肾癌的诊断灵敏度、特异度和准确度明显高于MSCT。DCE-MRI对于小肾癌诊断、术前评估和临床治疗具有重要意义。     

结肠镜联合CEA、CA242鉴别结直肠息肉与癌变的效能研究

本文探讨了通过结肠镜评估病灶直径、病灶数量,联合癌胚抗原(CEA)、糖类抗原242(CA242)鉴别结直肠息肉与癌变的效能。选取2018年1月~2020年1月212例结直肠癌患者作为观察组,另选取同期收治的100例结直肠息肉患者作为对照组。比较两组患者的临床资料、病灶直径、病灶数量和CEA、CA242表达水平,发现将年龄、家族结直肠癌史等因素控制后,病灶直径、病灶数量、腺瘤性病灶、CEA、CA242表达仍与结直肠癌显著相关(P<0.05);各指标联合鉴别诊断结直肠癌的AUC为0.870,大于任一单一指标(P<0.05)。因此结肠镜下病灶直径、病灶数量、病理类型与CEA、CA242表达水平有关,均是结直肠癌发病的相关影响因素,联合检测各指标有望为诊断鉴别结直肠息肉与结直肠癌提供一个新途径。     

多普勒超声联合血清FE3、ACTA预测孕妇羊水过少并胎儿窘迫

选取224例羊水过少孕妇作为观察组,60例羊水正常孕妇作为对照组,探讨多普勒超声测定肾动脉(RA)、大脑中动脉(MCA)、脐动脉(UA)阻力指数,以及血清游离雌三醇(FE3)、激活素A(ACTA)水平,对孕妇羊水过少并胎儿窘迫预测价值及临床意义。结果显示,观察组RA和UA阻力指数、血清ACTA水平高于对照组,羊水量、MCA阻力指数及血清FE3水平低于对照组(P<0.05);羊水过少孕妇RA和UA阻力指数、血清ACTA水平与羊水量呈负相关,MCA阻力指数、血清FE3水平与羊水量呈正相关;上述指标联合预测胎儿窘迫的AUC最大,为0.918(P<0.05)。说明多普勒超声测定RA、MCA、UA阻力指数结合血清FE3、ACTA水平检测对羊水过少孕妇并胎儿窘迫有较高预测价值。     

Interpretation of solute retention of some monovalent inorganic anions in anion-exchange chromatography using a dicarboxylic Acid as an eluent.

In single-column anion-exchange chromatography, the retention volume of some monovalent inorganic anions (Cl(-), Br(-), NO(3)(-), NCS(-) and NO(2)(-)) were observed as a function of the pH of a mobile phase at a fixed concentration of 2-phenylmalonic acid or 1,4-benzenediacetic acid used as an eluent. The experimental retention volume of such an anion was decreased with an increase in the pH of a mobile phase, and was able to be described by the following equation taking account of anion-exchange equilibria of a sample anion with a hydrogen dicarboxylate ion (HE(-)) and with a dicarboxylate ion (E(2-)): alpha(1s)/V(R)'[HE(-)] = 1/m(T)wK(ex1) + (2K(a2)/m(T)w(2)K(ex2))(V(R)'/alpha(1s)[H(+)]), where V(R)', m(T), w, K(a2), K(ex1) and K(ex2) are the adjusted retention volume of a given sample anion, the capacity for the anion-exchange of column packings and the weight of column packings packed into a separating column, the second acid-dissociation constant of the dicarboxylic acid used as an eluent, and equilibrium constants for the anion exchange of a sample anion with a monovalent hydrogen dicarboxylate ion and with a divalent dicarboxylate ion, respectively. The term alpha(1s), defined as K(as)/([H(+)] + K(as)), where K(as) is the acid-dissociation constant of HX, is the mole fraction of a sample anion, X(-), and is equal to 1 when using a strong acid anion as a sample anion.     

Na-nitroprusside and HgCl2 modify the water permeability and volume of human erythrocytes

The passage of water through the aquaporin-1 (AQP1) transmembrane channel protein of the human erythrocyte is known to be inhibited by organic mercurials such as p-chloromercuribenzoate (pCMB), which react with the free SH-group of the critical cysteine (Cys189) located near the constriction of the AQP1 water-specific channel. Sodium nitroprusside (SNP), which is known as a nitric oxide (NO) donor in interactions with SH-containing molecules, is shown here to suppress the diffusional water permeability (P(d)) of the erythrocyte membrane, presumably as a result of reaction with the Cys189 of the human erythrocyte AQP1 water channels. Further, treatment of erythrocytes with HgCl(2) is found to result in a cell volume decrease that can be related to activation of membrane K(+)-selective Gárdos channels and subsequent loss of intracellular K(+) and cell shrinkage. The variations in P(d) and volume of the erythrocyte were deduced from induced variations in the measured proton ((1)H) nuclear magnetic resonance (NMR) transverse (T(2)) relaxation functions of water exchanging between diamagnetic intracellular and paramagnetic extracellular compartments of the 20-25% hematocrit samples. The extracellular solvent contained 10 mM membrane-impermeable paramagnetic Mn(2+) ions. The (1)H-T(2) NMR technique allows determination of the time constant tau(exch) (for exchange of the erythrocyte intracellular water) that is inversely proportional to the permeability coefficient P(d) when the intracellular water volume is left unmodified, as in the case of SNP-treated erythrocytes. However, for HgCl(2)-treated erythrocytes, this technique showed simultaneous variation of both tau(exch) and the volume ratio V(in)/V(out) of intracellular and extracellular water in proportions suggesting that P(d) was left unmodified. The HgCl(2) effect has been found to be partly reversible by the reducing activity of added mercaptoethanol.