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...     

空腹血糖以及糖化血红蛋白对糖尿病前期患者的诊断效果评价

目的探讨空腹血糖(FPG)与糖化血红蛋白(Hb A1c)对临床中糖尿病前期的诊断价值。方法将黑龙江省佳木斯大学第一附属医院接收治疗的120例疑似糖尿病患者作为研究分析对象,将所选患者按诊断方式分为对照组和研究组(n=60),对照组采用糖化血红蛋白(Hb A1c)进行诊断,研究组采用空腹血糖(FPG)进行诊断,比较两组诊断正确率及两年内发展为糖尿病的发病率。结果研究组42例(70.0%)被确诊为糖尿病前期患者,18例(42.86%)患者发展为糖尿病;对照组中28例确诊为糖尿病前期患者,5例(17.85%)患者发展为糖尿病,确诊后转变率观察组高于对照组,差异有统计学意义(P0.05)。结论诊断糖尿病前期采用空腹血糖(FPG)与糖化血红蛋白(Hb A1c),前者临床价值更显著,建议将两种诊断方式联用,临床价值更大。     

CT联合MRI在评估CAD患者左心功能中的应用价值

本文探讨多排CT(MDCT)、心脏磁共振成像(CMRI),以及二者联合评估冠心病(CAD)患者左心功能的临床应用价值.对93例CAD患者进行MDCT及CMRI检查,计算舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF),并分析两种检查方式间各指标的相关性及一致性.93例CAD患者中心绞...     

CTA和CTP评价AIS患者侧支循环建立及脑灌注的研究

本研究探讨CT血管成像(CTA)、全脑CT灌注成像(CTP)在评估急性缺血性脑卒中(AIS)患者侧支循环建立及脑灌注情况的价值,并分析CTA、CTP与患者预后的关系。选取139例AIS患者接受256层螺旋CT扫描;根据格拉斯哥预后评分(GOS)将患者分为良好组(95例)和不良组(44例)。以DSA侧支循环检出结果作为诊断金标准,CTA诊断AIS患者颅内动脉侧支循环建立的灵敏度为95.12%、特异度为91.23%;良好组患者的侧支循环程度评分、脑血容量(CBV)、脑血流速度(CBF)、达峰时间(TTP)、平均通过时间(MTT)测定值均高于不良组(P<0.05);AIS患者入院时NIHSS评分高、梗死灶面积较大、脑血管闭塞是其不良预后的独立危险因素(P<0.05);良好的侧支循环、CBV及CBF脑灌注水平较高,有利于患者后期的预后恢复(P<0.05)。CTA对AIS患者颅内动脉侧支循环建立的检出敏感度较高,同时,早期观察患者侧支循环建立及脑灌注水平,对评估患者预后恢复具有一定的临床价值。     

TCD定量评价ICA狭窄致缺血性卒中患者侧支循环的研究

本研究探讨临床上应用经颅多普勒(TCD)定量评价颈内动脉(ICA)狭窄致缺血性脑卒中患者侧支循环建立及神经功能康复效果的价值。选取经数字剪影血管造影(DSA)确诊的单侧ICA狭窄或闭塞致缺血性脑卒中患者138例,所有患者均接受TCD检查,以DSA作为金标准,评估TCD诊断患者侧支循环建立的价值;TCD诊断前交通动脉、后交通动脉、眼动脉的侧支循环开放与DSA的符合率分别为91.53%、90.91%、86.05%;诊断单侧ICA狭窄或闭塞致缺血性脑卒中患者侧支循环的诊断灵敏度为89.88%、特异度为90.65%;138例单侧ICA狭窄或闭塞致缺血性脑卒中患者,其中侧支循环良好的患者有60例、侧支循不良的患者有78例,良好组患者的TCD量化评分显著高于不良组(P<0.05);且脑CBF、CBV值均显著大于不良组(P<0.05),而脑MTT、TTP值均显著小于不良组(P<0.05)。临床上采用TCD诊断与定量评估ICA狭窄致缺血性脑卒中患者侧支循环建立情况具有较高的准确性,且可以通过TCD量化评估侧支循环建立情况对患者神经功能缺损程度及恢复情况进行判断。     

DCE-MRI联合超声在乳腺癌临床诊断中的应用与分析

本文探讨动态增强MR扫描(DCE-MRI)联合超声在乳腺癌临床诊断中的应用价值。回顾性分析100例乳腺肿瘤患者相关资料,所有患者均接受超声、DCE-MRI检查,分析良恶性肿瘤DCE-MRI特征差异,比较两种检查方式下乳腺影像报告及数据系统(BI-RADS)分级评估乳腺良恶性肿瘤的价值,分析两者联合的诊断价值。DCE-MRI检查显示,良性及恶性肿瘤形状、边缘、内部强化特征、TIC曲线等征象比较,差异具有统计学意义(P<0.05);恶性肿瘤容量转移常数(Ktrans)、速率常数(Kep)高于良性肿瘤,血管外细胞间隙容积分数(Ve)低于良性肿瘤(P<0.05);超声诊断乳腺良恶性肿瘤的敏感度、特异度、准确度分别为94.12%、83.67%、89.00%,DCE-MRI的敏感度、特异度、准确度分别为98.04%、89.79%、94.00%,两者联合的敏感度、特异度、准确度分别为100.00%、97.95%、99.00%,联合诊断准确度高于超声诊断(P<0.05)。DCE-MRI及乳腺超声对乳腺病灶性质具有较好的诊断价值,两者联用可为患者病情诊断提供更多参考依据。     

声速匹配技术对甲状腺癌的诊断价值

本研究的目的是分析声速匹配技术对甲状腺癌的诊断价值。选取了159例甲状腺病变患者设为甲状腺病变组,健康志愿者40例设为甲状腺正常组,行声速匹配技术检查,分析特征并对比ZSI值,评估了声速匹配技术对甲状腺癌的诊断价值。结果显示,甲状腺癌组ZSI值较高(P<0.05)。ZSI值预测甲状腺癌的ROC曲线下面积(AUC)为0.867(0.729~1.004),灵敏度为86.67%,特异度为60.00%,似然比为2.167,ZSI值临界值为50.42 m/s。预后不良组甲状腺癌患者ZSI值高于预后良好组(P<0.05)。由本文结果可知声速匹配技术对不同类型甲状腺癌的诊断准确性均较高,可准确测出患者甲状腺声速值,稳定性良好,可用于临床甲状腺癌的诊断和预后预测。     

MRI在诊断舌部鳞癌致颈部淋巴结转移中的应用

本研究探讨磁共振成像(MRI)在手术前评估舌鳞状细胞癌导致颈部淋巴结转移、肿瘤浸润深度中的应用价值。选取在手术治疗的71例舌鳞状细胞癌患者作为临床对象进行回顾性分析,所有患者术前均接受了MRI检查,评估颈部7个淋巴结区域的转移阳性率、肿瘤浸润深度,以病理学结果作为诊断金标准计算MRI术前评估颈部淋巴结转移的价值;分析MRI检测肿瘤浸润深度与病理学诊断结果的相关性。术前MRI检查结果与病理学结果比较,Ⅰ区诊断符合率为87.50%、Ⅱ区诊断符合率为77.78%、Ⅲ区诊断符合率为75.00%、Ⅳ区诊断符合率为75.00%、Ⅴ区诊断符合率为100.00%;MRI正确诊断颈部淋巴结转移的灵敏度为79.59%、特异度为86.36%;T1WI、T2WI术前诊断舌鳞状细胞癌浸润深度测定值与术后病理学结果比较,差异无统计学意义(P>0.05)。MRI在手术前评估舌鳞状细胞癌导致颈部淋巴结转移具有较高的灵敏度和特异度,术前评估肿瘤浸润深度与病理学结果具有极高的相关性。     

慢性乙型肝炎患者呼出气体的电喷雾萃取电离质谱分析

应用电喷雾萃取电离质谱法对慢性乙型肝炎患者(41例)及正常人(34例)的呼出气体样本进行检测,迅速获得其一级质谱指纹谱图,采用化学计量学方法主成分分析(PCA)和聚类分析(CA)对所获得的一级质谱数据进行处理后,可有效区分患者与正常人群,且不同临床类型慢性乙肝聚类分析图谱有不同表现,此结果有助于慢性乙型肝炎的临床诊断和病情分析.另外,本方法也为发展简单、快速、非侵入性慢性乙型肝炎临床诊断方法提供解决思路.     

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,Emin,Emean、Emax与Peak呈负...     

The IL-10 gene is not involved in the predisposition to inflammatory bowel disease

Although genetic predisposition for inflammatory bowel disease (IBD) is well established, little is known about the accountable genes. The pathogenesis of IBD is characterized by an imbalanced activation of Th1- and Th2-lymphocytes. IL-10 represents an anti-inflammatory cytokine which downregulates the production of Th1-derived cytokines. To evaluate the role of the IL-10 gene in IBD, two polymorphisms in the promoter region (G/A at position -1082 and C/A at position -592) were genotyped in 142 patients with Crohn's disease (CD), 104 patients with ulcerative colitis (UC), and 400 healthy controls. Significant differences were not apparent, neither in the allele frequencies of either polymorphism, nor in the haplotype frequencies. Screening of the coding region of the IL-10 gene by polymerase chain reaction--single strand conformation polymorphism (PCR-SSCP) analysis revealed a rare sequence variation in exon 1 leading to an amino acid exchange (G-->A; G15R) in two patients with CD and five healthy controls. Therefore, polymorphisms of the IL-10 gene are not demonstrably involved in the predisposition of IBD in our cohorts of patients.     

(Poly)phenols in Inflammatory Bowel Disease and Irritable Bowel Syndrome: A Review

(Poly)phenols (PPs) may have a therapeutic benefit in gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD). The aim of this review is to summarise the evidence-base in this regard. Observational evidence does not give a clear indication that PP intake has a preventative role for IBD or IBS, while interventional studies suggest these compounds may confer symptomatic and health-related quality of life improvements in known patients. There are inconsistent results for effects on markers of inflammation, but there are promising reports of endoscopic improvement. Work on the effects of PPs on intestinal permeability and oxidative stress is limited and therefore conclusions cannot be formed. Future work on the use of PPs in IBD and IBS will strengthen the understanding of clinical and mechanistic effects.     

Emerging nanomedicine and prodrug delivery strategies for the treatment of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic and recurrent disease of the gastrointestinal tract, mainly including Crohn's disease (CD) and ulcerative colitis (UC). However, current approaches against IBD do not precisely deliver drugs to the inflammatory site, which leads to life-long medication and serious side effects that can adversely impact patients’ adherence. It is necessary to construct optimal drug delivery systems (DDSs) that can target drugs to the region of inflammation, thereby improve therapeutic efficacy and reduce side effects. With the burgeoning development of nanotechnology-based nanomedicines (NMs) and prodrug strategy, remarkable progresses in the treatment of IBD have been made in recent years. Herein, the latest advances are outlined at the intersection of IBD treatment and nanotherapeutics as well as prodrug therapy. First, the pathophysiological microenvironment of inflammatory sites of IBD is introduced in order to rationally design potential NMs and prodrugs. Second, the necessity of NMs for the IBD therapy is elaborated, and the representative nanotherapeutics via passive targeted and active targeted NMs developed to treat the IBD are overviewed. Furthermore, the emerging prodrug-based therapeutics are summarized, including 5-aminosalicylic acid-, amino acid-, and carbohydrate-conjugated prodrugs. Finally, the design considerations and perspectives of these NMs and prodrugs-driven IBD therapeutics in the clinical translation are spotlighted.     

Coumarin Derivatives in Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a non-communicable disease characterized by a chronic inflammatory process of the gut and categorized into Crohn’s disease and ulcerative colitis, both currently without definitive pharmacological treatment and cure. The unclear etiology of IBD is a limiting factor for the development of new drugs and explains the high frequency of refractory patients to current drugs, which are also related to various adverse effects, mainly after long-term use. Dissatisfaction with current therapies has promoted an increased interest in new pharmacological approaches using natural products. Coumarins comprise a large class of natural phenolic compounds found in fungi, bacteria, and plants. Coumarin and its derivatives have been reported as antioxidant and anti-inflammatory compounds, potentially useful as complementary therapy of the IBD. These compounds produce protective effects in intestinal inflammation through different mechanisms and signaling pathways, mainly modulating immune and inflammatory responses, and protecting against oxidative stress, a central factor for IBD development. In this review, we described the main coumarin derivatives reported as intestinal anti-inflammatory products and its available pharmacodynamic data that support the protective effects of these products in the acute and subchronic phase of intestinal inflammation.     

Elemental composition of hair and bone density measurements at diagnosis in paediatric inflammatory bowel disease

A dual energy X-ray absorptiometry (DEXA) system has been employed to measure the bone mineral density (BMD) of children with inflammatory bowel disease (IBD); Crohn's disease (CD) and ulcerative colitis (UC) at diagnosis. The results of the study indicate that even at diagnosis, a significantly reduced bone mineral density measured in terms of the Z-score, was observed in the lumbar spine and whole body of the IBD subjects. This was found to be more pronounced in Crohn's disease than in the ulcerative colitis subjects. Furthermore, the study was extended to investigate the elemental composition of hair of IBD subjects and age matched controls using instrumental neutron activation analysis (INAA). The concentrations of 11 elements; Al, Br, Ca, Cl, Cu, I, K, Mg, Mn, Na and V were determined. A significantly reduced concentration of Ca, Cu, K, Mn, and V were observed in the hair of IBD subjects as compared to the control group. This revised version was published online in August 2006 with corrections to the Cover Date.     

Exploring Effects of Chitosan Oligosaccharides on the DSS-Induced Intestinal Barrier Impairment In Vitro and In Vivo

Intestinal barrier dysfunction is an essential pathological change in inflammatory bowel disease (IBD). The mucus layer and the intestinal epithelial tight junction act together to maintain barrier integrity. Studies showed that chitosan oligosaccharide (COS) had a positive effect on gut health, effectively protecting the intestinal barrier in IBD. However, these studies usually focused on its impact on the intestinal epithelial tight junction. The influence of COS on the intestinal mucus layer is still poorly understood. In this study, we explored the effect of COS on intestinal mucus in vitro using human colonic mucus-secreted HT-29 cells. COS relieved DSS (dextran sulfate sodium)-induced mucus defects. Additionally, the structural characteristics of COS greatly influenced this activity. Finally, we evaluated the protective effect of COS on intestinal barrier function in mice with DSS-induced colitis. The results indicated that COS could manipulate intestinal mucus production, which likely contributed to its intestinal protective effects.     

Computational modeling and in-vitro/in-silico correlation of phospholipid-based prodrugs for targeted drug delivery in inflammatory bowel disease

Targeting drugs to the inflamed intestinal tissue(s) represents a major advancement in the treatment of inflammatory bowel disease (IBD). In this work we present a powerful in-silico modeling approach to guide the molecular design of novel prodrugs targeting the enzyme PLA₂, which is overexpressed in the inflamed tissues of IBD patients. The prodrug consists of the drug moiety bound to the sn-2 position of phospholipid (PL) through a carbonic linker, aiming to allow PLA₂ to release the free drug. The linker length dictates the affinity of the PL-drug conjugate to PLA₂, and the optimal linker will enable maximal PLA₂-mediated activation. Thermodynamic integration and Weighted Histogram Analysis Method (WHAM)/Umbrella Sampling method were used to compute the changes in PLA₂ transition state binding free energy of the prodrug molecule (??G^tr) associated with decreasing/increasing linker length. The simulations revealed that 6-carbons linker is the optimal one, whereas shorter or longer linkers resulted in decreased PLA₂-mediated activation. These in-silico results were shown to be in excellent correlation with experimental in-vitro data. Overall, this modern computational approach enables optimization of the molecular design of novel prodrugs, which may allow targeting the free drug specifically to the diseased intestinal tissue of IBD patients.