64层螺旋CT血管成像对肠系膜上动脉活体形态的显示及临床应用

目的探讨64层螺旋cT血管成像（CTA）对肠系膜上动脉（SMA）活体形态的显示及临床应用价值。方法对80例临床疑有腹部、盆腔疾病的患者行64层螺旋CTA扫描,然后利用容积再现（VR）、多平面重建（MPR）、最大密度投影（MIP）、反向MIP（I—MIP）和薄层MIP（TS．MIP）等技术进行后处理。80例患者分为正常组（30例）和异常组（50例）两组,对正常组采用多种重建技术显示SMA各级分支,并测量SMA的直径,观察SMA起始段的走行;在MPR像上测量SMA与腹主动脉（AA）的夹角（An）,在左肾静脉（LRV）平面测量SMA至AA的距离（M）,在左侧肾门旁测量LRV最大前后径（A）,在SMA与AA问测量LRV最小前后径（B）。对异常组采用多种重建技术显示SMA,分析SMA特点。结果VR、MIP、I-MIP像均可显示正常组SMA整体解剖形态,TS-MIP对小分支显示优于其他重建技术。不同重建方式对SMA直径的测量无显著差异（F=0．71,P〉0．05）。SMA起始段走行方向为右下走行90％,前下走行占6．7％,左下走行占3．3％。An平均为（61．06±22．79）°。M平均为（14．62±4．00）mm,A平均为（9．16±1．91）mm,B平均为（6．00±2．01）mm,A与B比值〉2者占20．0％,〉3者占3．3％。异常组中有5例小肠先天性旋转不良及2例小肠扭转,SMA轴位像主要表现“回旋征”,VR表现为“螺旋征”;1例SMA分支栓塞;消化道肿瘤19例,其中8例供血动脉为SMA分支;回盲部动静脉畸形1例;余22例肝脏、泌尿生殖系统病变SMA无明显异常。结论64层螺旋CTA能很好地显示SMA的活体形态特征,具有重要的临床应用价值。     

CT诊断甲状腺肿块18例临床分析

目的探讨甲状腺肿块的CT诊断价值。方法回顾分析18例甲状腺肿块的CT特征,并与手术病理对照。结果CT诊断18例甲状腺肿块与手术病理符合率的情况：（1）结节性甲状腺肿7例,诊断符合率71％（5／7）;（2）甲状腺腺瘤8例,诊断符合率63％（5／8）;（3）甲状腺癌3例,诊断符合率67％（2／3）。结论CT对甲状腺肿块的诊断虽然有很大价值,但是部分甲状腺肿块CT表现无特征性,定位诊断准确,定性诊断困难。     

17例脾脏肿瘤CT及超声影像分析

目的探讨脾脏肿瘤的影像学表现及诊断的要点。方法对17例经手术病理被证实的脾脏肿瘤影像学特征回顾性分析。结果脾炎性假瘤2例,呈单发灶,密度不均匀,可有钙化;血管瘤5例,为实性肿块或多囊性肿块,不均匀强化;淋巴管瘤4例,特点为多发低密度灶;恶性淋巴瘤5例,在脾内为单发或多发灶;脾的转移瘤1例呈低密度灶。结论认真分析影像学特征,提高脾脏肿瘤诊断的准确率是可能的。     

多排螺旋CT扫描对胃癌的诊断价值

目的评价多排螺旋CT扫描对胃癌的诊断价值。方法对62例胃癌病例行气体对比薄层动态增强CT扫描三维重建技术,层厚0．5mm,在此基础上进行CT仿真胃镜和VRT技术,对获取的图像进行分析。全部病例均经手术和病理证实。结果检出痛变位于胃窦部31例（50％）.胃底贲门部10例（16％）,体部9例（15．7％）,弥漫型12例（19．3％）,病变检出率为100％。多薄层动态增强cT扫描三维重建技术表现为局限性胃壁增厚50例,广泛性胃壁增厚12例;其中早期胃癌10例,进展期胃癌52倒;局部和远处淋巴结转移24例;远处转移17例;本组CT定性诊断准确率为96％。结论薄层动态增强CT扫描三维重建技术能清晰显示胃壁及腔内、外病变,并直观反映胃癌大体形态及肿瘤的范围,在胃癌的定位、定性和定量诊断中发挥其独特的优势,是一种最具潜力的检查方法。     

CT血管造影对脑血管性疾病的临床诊断价值

目的评价64层螺旋CT血管成像对脑血管病的诊断及临床应用价值。方法64层螺旋CT血管成像检查确诊脑血管疾病患者60例,50例在1周内行DSA检查。采用减影方法进行后处理,分别得到VR,MIP,TSMIP图像,利用这三种方法重建图像综合评价脑血管病变。结果①脑动脉狭窄或闭塞者46例,其中36例有DSA对照,98．8％的狭窄或闭塞的脑血管与DSA诊断一致,CT血管成像的敏感性,特异性,准确性分别为100％、98．5％、98．8％;②烟雾病3例,均有DSA对照,表现为单侧或双侧大脑中动脉重度狭窄,远端分支异常增多;③脑动脉瘤患者12例,均有DSA对照,后交通动脉瘤7例,前交通动脉瘤3例,大脑中动脉瘤1例,大脑后动脉瘤1例,CT血管成像与DSA显示一致。结论64层螺旋CT层血管成像能快速,准确地诊断各种脑血管疾病,结合减影处理方法提高了诊断的效率和准确性,为临床提供了全面的信息,可作为脑血管疾病患者的首选诊断方法。     

CTGF在肺癌中的研究进展

结缔组织生长因子（CTGF／CCN2）属于即刻早期基因编码的CCN家族中的一员,参与正常细胞增殖、黏附、迁移、凋亡及新生血管形成,在创伤修复、纤维化疾病和肿瘤形成中也具有重要的作用。新近研究发现,CTGF在肺癌组织中表达较正常肺组织降低,与肺癌的发生、发展密切相关,被视为肺癌转移和预后的评价指标。本文简要介绍了CTGF的结构、功能及在其肺癌中的研究进展,以期为肺癌的临床治疗提供新的思路。     

Cellular and secreted tumor plasminogen activator: The effects of NaCl

Summary Plasminogen activator, secreted by metastatic tumor cells, was strongly inhibited in buffer or tissue culture medium containing physiological concentrations of NaCl. Intact cells, however, expressed strong activity under similar conditions. Thus, if plasminogen activator is involved in invasion and metastasis, the cellular activity, acting as an ectoenzyme, may be more important than secreted enzyme under physiological conditions.     

Recent insights into the role of integrins in cancer metastasis

Integrins have been repeatedly found involved in cancer metastasis. The past two years have seen considerable evolution in our knowledge on the role of these integrins in tumour cells. This includes the elucidation of different signalling pathways by which integrins dictate the anchorage-independent growth, survival and motility of tumour cells. Moreover, integrins may have a more complex role in cancer metastasis as they cooperate with serine proteases and metalloproteases to promote tumour cell invasion and angiogenesis. Finally, integrins favour tumor cell extravasation.     

The Ras family of GTPases in cancer cell invasion

The ability of tumoral cells to invade surrounding tissues is a prerequisite for metastasis. This is the most life-threatening event of tumor progression, and so research is intensely focused on elucidating the mechanisms responsible for invasion and metastasis. The Ras superfamily of GTPases comprises several subfamilies of small GTP-binding proteins whose functions include the control of proliferation, differentiation, and apoptosis, as well as cytoskeleton organization. The development of metastasis is a multistep process that requires coordinated activation of proliferation, motility, changes in normal cell-to-cell and cell-to-substrate contacts, degradation of extracellular matrix, inhibition of apoptosis, and adaptation to an inappropriate tissue environment. Several members of the Ras superfamily of proteins have been implicated in these processes. The present review summarizes the current knowledge in this field.     

The cellular functions of clathrin

Membranes and proteins are moved around the cell in small vesicles. A protein coat aids the budding of such vesicles from donor membranes. The major type of coat used by the cell is composed of clathrin, a three-legged protein that can form lattice-like coats on membranes destined for trafficking. In this review, I outline what we know about clathrin and discuss some recent advances in understanding the basic biology of this fascinating molecule, which include building a molecular model of a clathrin lattice and discovery of a new function for clathrin that occurs during mitosis. Received 12 December 2005; received after revision 21 March 2006; accepted 29 March 2006