时间减影在静脉肾盂造影中的应用价值研究

目的探讨数字X线机(DFR)时间减影对静脉肾盂造影的诊断价值,并与常规单纯DFR静脉肾盂造影比较。方法对38例运用数字(DFR)静脉肾盂造影的检查者,同时采用时间减影进行分析。检查结果正常16例,肾盂积水、肾结石、输尿管畸形、输尿管结石等22例。结论数字静脉肾盂造影检查 时间减影检查,较好地克服了传统造影方法的不足,为泌尿系统的诊断和治疗提供了更全面和确切的依据,取得了较好的临床效果。     

番泻叶联合甘露醇用于静脉尿路造影前肠道准备

目的探讨番泻叶联合甘露醇用于静脉尿路造影前肠道准备的效果。方法选择需行静脉尿路造影检查的患者100例,随机分为两组,对照组;造影前1日晚餐后2h用番泻叶20g加水泡服2000ml左右,造影晨用生理盐水清洁灌肠;观察组：造影前1日晚餐后2h用番泻叶20g加水300ml泡服,而后口服20％甘露醇250ml,造影前12h禁食和控制饮水。结果两组摄片效果及不良反应率比较,差异有显著性意义（均P〈0．05）。结论番泻叶联合甘露醇行静脉尿路造影前肠道准备,效果显著,既减轻患者痛苦,又减少护士工作量,提高了工作效率。     

不同危险分层急性肺栓塞患者D-二聚体与纤维蛋白原比值、中性粒细胞与淋巴细胞比值、白蛋白的变化及其与预后的关系研究

摘要 目的：探讨不同危险分层急性肺栓塞（APE）患者D-二聚体与纤维蛋白原比值（DFR）、中性粒细胞与淋巴细胞比值（NLR）、白蛋白（Alb）的变化及其与预后的关系。方法：选择2019年3月至2021年12月我院收治的APE患者154例作为APE组,根据《肺血栓栓塞症的诊断与治疗指南(2015)》分为低危组48例、中危组69例和高危组37例,另选择同期我院体检健康志愿者40例作为对照组,比较各组DFR、NLR、Alb水平。根据不同预后将APE患者分为存活组125例,死亡组29例,比较两组DFR、NLR、Alb水平。应用受试者工作特征（ROC）曲线分析DFR、NLR、Alb对APE预后的预测价值。结果：APE组DFR、NLR显著高于对照组,Alb水平显著低于对照组（P<0.05）。随着危险分层增加,APE患者DFR、NLR逐渐升高,Alb水平逐渐降低,不同危险分层APE患者DFR、NLR、Alb水平比较有统计学意义（P<0.05）。死亡组DFR、NLR显著高于存活组,Alb水平显著低于存活组（P<0.05）。ROC曲线分析显示,DFR、NLR、Alb对APE死亡预测具有较高的敏感度、特异度,其中DFR、NLR、Alb联合检测对APE死亡预测的曲线下面积（AUC）、敏感度、特异度最高。结论：APE患者DFR、NLR异常升高,Alb异常降低与APE危险分层增加及不良预后相关,DFR、NLR、Alb联合检测对APE患者预后不良的预测价值更高。     

紫杉醇联合化疗治疗晚期胃癌39 例的护理探讨

目的：以紫杉醇联合5-氟尿嘧啶（5-Fu）、顺铂治疗晚期胃癌的临床护理探讨。方法：39例均为经病理组织学确定的晚期胃癌患者,接受以紫杉醇为主的联合化疗,使用中心静脉置管术和外周静脉穿刺术,应用百特泵输注5-氟尿嘧啶。结果：39例患者中除一例因过敏反应停药外,其余38例CR7例,PR18例,总有效率65．8％。毒副反应主要为骨髓抑制,消化道反应,还有外周静脉的炎症。大多数患者能忍受。结论：紫杉醇、顺铂（DDP）联合四氢叶酸钙（CF—Ca）＋5-氟尿嘧啶持续静滴48小时治疗晚期胃癌的临床治疗与护理效果是肯定的。     

植物二氢黄酮醇4-还原酶基因的研究进展

二氢黄酮醇4-还原酶（DFR）是花青素合成途径的关键酶,在花色的修饰中起重要作用。我们简述了DFR基因及其调节基因的研究进展,构建的系统进化树体现了部分单子叶与双子叶植物间的亲缘关系与进化差异,阐述了DFR调控基因的调控机制及DFR基因的应用前景。     

光学相干断层成像在临床医学中的应用

光学相干断层成像(OCT)是一种基于弱相干光学断层成像技术,可以对生物组织活体断层成像,是继计算机X射线摄影(CR)和数字X射线摄影(DR)、超声、电子计算机断层扫描(CT)、磁共振成像(MRI)之后又一新的生物组织成像方法。OCT在眼科、皮肤科、心血管科、肿瘤科、骨科、口腔科、妇科等对组织病变的早期光学诊断和实时动态监测方面具有广泛的应用及重要的临床价值。本文就OCT的基本原理、研究现状、主要的临床应用和应用过程中存在的问题进行综述并展望未来相关的发展趋势。     

二氢黄酮醇4-还原酶的生物信息学分析

花色素苷是影响花色的主要色素,DFR是花色素苷合成的关键酶。采用生物信息学的方法分析已经在Gen-Bank上注册的拟南芥、金鱼草、兰花、山茶、番茄、水稻、矮牵牛和玉米等植物的DFR核酸及相应氨基酸序列,并对其理化性质、生化功能、系统发育关系和结构特征等进行预测。结果表明,金鱼草和山茶DFR定位于叶绿体,矮牵牛DFR定位于线粒体,山茶和矮牵牛DFR都是跨膜蛋白。DFR拥有一个NADB_Rossmann superfamily保守结构域和coiled-coil结构;所构建的DFR基因系统发育关系与形态学上的物种发育关系基本吻合;α-螺旋和无规则卷曲是DFR的主要二级结构元件;DFR的空间结构分为两个部分,松散C-末端和致密球状结构。     

蓝粒小麦花青素生物合成途径中的二氢黄酮醇4-还原酶基因的分子克隆

蓝色色素在蓝粒小麦种子糊粉层中的生物合成途径的分子生物学机制至今仍不清楚。应用RT—PCR和RACE方法从蓝粒小麦正在发育的种子中克隆到一个编码二氢黄酮醇4-还原酶的基因(DFR)。推测其为花青素生物合成途径中的一个关键基因,且与蓝粒小麦中蓝色色素形成密切相关;其开放阅读框编码一个包含354个氨基酸残基的多肽,与一些从其他植物中已克隆到的DFR有很高的同源性：大麦(94％)、水稻(83％)、玉米(84％)。从长穗偃麦草(2n=70)、蓝粒小麦、浅蓝粒小麦自交产生的白粒后代小麦以及中国春的基因组中分别分离到一个全长DFR序列。经聚类分析表明DFR cDNA核甘酸序列与从中国春基因组中克隆的DFR具有100％的同源性,且与长穗偃麦草、蓝粒小麦、白粒小麦基因组中分离的DFR均有很高的同源性。4个DFR基因组DNA均含有3个内含子,且它们之间的差异主要在内含子区,表明该基因在进化上很保守。经Southern杂交分析,DFR小麦中至少有3-5个拷贝,不同小麦材料间未见明显差异,但与长穗偃麦草有明显差异,属于一个DFR超基因家族。Northern分析表明该DFR在蓝粒和白粒种子的不同发育时期的表达存在明显差异,都在开花后大约18d表达最强,在同一时期的蓝白种子中,DFR蓝粒种子中的表达量高于白粒。DFR转录本在小麦和长穗偃麦草的幼叶中积累多,但在芽鞘中的表达显著低于幼叶中;在小麦的根和长穗偃麦草的发育种子中均未检测到DFR的表达。推测蓝粒小麦中可能存在调控DFR在蓝粒小麦中表达的调控基因,类似于玉米花青素合成途径中的调节基因。     

200例下肢静脉造影分析

目的 分析下肢静脉疾病的分类,造影表现及造影对下肢静脉疾病的诊断价值。方法 对200例疑有下肢静脉疾病的患者进行常规或数字减影下肢静脉造影,根据造影表现进行分析。结果 200例307侧肢体下肢静脉造影结果：交通静脉瓣膜功能不全116侧肢体(37．8％),深静脉瓣膜功能不全39侧(12．7％),静脉阻塞性疾病85侧(27．7％),静脉瘤样病变6侧(1．9％),阴性61侧(19．9％);其中60岁以上老年患者124例197侧肢体中：静脉阻塞性疾病75侧(38．1％),交通静脉瓣膜功能不全69侧(35％),深静脉瓣膜功能不全21侧(10．7％),静脉瘤样病变3侧(1．5％),阴性29侧(14．7％)。结论 本组病例下肢静脉疾病中以静脉阻塞性疾病的比例较高(27．7％)与老年患者比例较高有关,其造影表现为各种治疗措施的选择提供可靠的依据。     

蓝粒小麦花青素生物合成途径中的二氢黄酮醇4-还原酶基因的分子克隆

蓝色色素在蓝粒小麦种子糊粉层中的生物合成途径的分子生物学机制至今仍不清楚.应用RT-PCR和RACE方法从蓝粒小麦正在发育的种子中克隆到一个编码二氢黄酮醇4-还原酶的基因(DFR).推测其为花青素生物合成途径中的一个关键基因,且与蓝粒小麦中蓝色色素形成密切相关;其开放阅读框编码一个包含354个氨基酸残基的多肽,与一些从其他植物中已克隆到的DFR有很高的同源性:大麦(94%)、水稻(83%)、玉米(84%).从长穗偃麦草(2n=70)、蓝粒小麦、浅蓝粒小麦自交产生的白粒后代小麦以及中国春的基因组中分别分离到一个全长DFR序列.经聚类分析表明DFR cDNA核甘酸序列与从中国春基因组中克隆的DFR具有100%的同源性,且与长穗偃麦草、蓝粒小麦、白粒小麦基因组中分离的DFR均有很高的同源性.4个DFR基因组DNA均含有3个内含子,且它们之间的差异主要在内含子区,表明该基因在进化上很保守.经Southern杂交分析,DFR在小麦中至少有3～5个拷贝,不同小麦材料间未见明显差异,但与长穗偃麦草有明显差异,属于一个DFR超基因家族.Northern分析表明该DFR在蓝粒和白粒种子的不同发育时期的表达存在明显差异,都在开花后大约18 d表达最强,在同一时期的蓝白种子中,DFR在蓝粒种子中的表达量高于白粒.DFR转录本在小麦和长穗偃麦草的幼叶中积累多,但在芽鞘中的表达显著低于幼叶中;在小麦的根和长穗偃麦草的发育种子中均未检测到DFR的表达.推测蓝粒小麦中可能存在调控DFR在蓝粒小麦中表达的调控基因,类似于玉米花青素合成途径中的调节基因.     

Synthesis and antitumor properties of 3'-desamino-3'-dimethylformamidinorubomycin

Interaction of rubomycin (daunorubicin) chlorhydrate with dimethylformamidine diethyl acetal yielded 3'-desamino-3'dimethylformamidinorubomycin chlorhydrate (DFR). Comparative antitumor activity of DFR and rubomycin was studied on mice with respect to ascitic lymphadenosis NK/Ly and Ehrlich carcinoma, hemocytoblastosis La, leukemia P-388 and two solid tumors i. e. lymphosarcoma LIO-I and sarcoma 180. The highest antitumor effect of DFR was observed in the mice with Ehrlich carcinoma and lymphadenosis NK/Ly after the drug intravenous administration for 4 times. By selectivity of the antitumor effect DFR was inferior to rubomycin with respect to lymphosarcoma LIO-I and sarcoma 180. It was shown that the antileukemic activity of DFR and rubomycin with respect to hemocytoblastosis La was practically the same. In the experiments with leukemia P-388 DFR was inferior to rubomycin.     

Different susceptibility of various immune reactions to suppressive effect in the tumor-bearing state

Summary Suppression of various types of immune reactions including antibody (Ab) production, cell-mediated cytolysis (CMC), and delayed footpad reaction (DFR) was compared in EL-4 lymphoma-bearing syngeneic mice. In the primary response, the suppression of Ab production and CMC was detected 4 days after tumor inoculation, reached a peak on day 8, and then disappeared. The suppression of DFR was detected on day 1 and persisted to day 12. The suppressive effects of tumor-bearing mice could be transferred with sera to normal recipients, and the degree of the suppressive effect in tumor-bearing hosts correlated with the suppressive effect of sera but not with tumor size. In the secondary response, the suppressive effect of the tumor-bearing state was detected only on DFR. Spleen cells of these hosts were able to transfer positive DFR adoptively to normal recipients, indicating the presence of sensitized lymphocytes in the absence of expression. DFR of normal mice in the primary response was suppressed by transfer of sera of tumor-bearing mice befor elicitation, at which time sensitized lymphocytes should already have been raised. The very high susceptibility of DFR to the suppressive effects of the tumor-bearing state may be ascribed to the distinct susceptibility of mononuclear cells, probably of the macrophage series, which are required as secondary cells for expression of DFR. Further studies with Sephadex G-200 fractionation of the sera from the tumor-bearing mice showed that the immunosuppressive activity appeared in the initial fraction containing relatively high-molecular-weight materials.     

A Drosophila receptor-type tyrosine kinase (DFR1) acts as a fibroblast growth factor receptor in Xenopus embryos

Members of the fibroblast growth factor (FGF) family play important roles in various developmental processes in vertebrates. Since two genes closely related to the vertebrate FGF receptor (FGFR) genes DFR1 and DFR2/breathless have already been reported in Drosophila , the existence of a Drosophila FGF has been predicted. In the present study, we examined whether DFR1 is functionally interchangeable with a vertebrate FGFR in the Xenopus system. First, we found that the expression of DFR1 promoted Ca²⁺ efflux in response to human basic (b)FGF in Xenopus oocytes, whereas the coexpression of a dominant negative form of DFR1 (ΔDFR1) with a chick FGFR1/cek1 inhibited promotion of Ca²⁺ efflux induced by the expression of cek1 in the oocyte. Second, the expression of ΔDFR1 was observed to induce a defect in the posterior structure of the Xenopus embryo at stage 30, as observed with a dominant negative form of cek1 (Δcek1). Third, we found that the expression of ΔDFR1 inhibited the expression of FGF-regulated genes such as Xbra, Xnot , and Xshh in Xenopus embryos at stage 11, while the coexpression of DFR1 with ΔDFR1 could rescue the inhibited expression of FGF-regulated genes. These results indicate that DFR1 acts as an FGFR in Xenopus embryos and that an FGF is likely to exist in Drosophila .     

A comprehensive analysis of six dihydroflavonol 4-reductases encoded by a gene cluster of the Lotus japonicus genome

Dihydroflavonol 4-reductase (DFR) is the first committed enzyme of the anthocyanin and condensed tannin pathways. Several DFR cDNAs have been cloned, and different specificities of DFR isozymes in the substrate hydroxylation patterns have been reported, but only fragmentary knowledge of DFR gene organization is available. Reported here is a comprehensive analysis of DFRs of a model legume, Lotus japonicus. A total of five DFR genes were found to form a cluster within a 38 kb region in the L. japonicus genome, whereas six cDNAs, including two splicing variants resulting from a transversion at a splicing acceptor site, were cloned. All the genes were expressed, with different organ specificities, in the mature plant. Three of the DFR proteins heterologously expressed in Escherichia coli showed catalytic activity, and their substrate preferences agreed with the variation of a specific active site residue (Asp or Asn) reported to control the specificity. The hydroxylation patterns of anthocyanidins and condensed tannin units in the stems did not reflect the substrate specificity of the expressed isozymes, implying complex regulation mechanisms in the biosynthesis. The two splicing variants and one DFR with Ser at the specificity-controlling position failed to show the activity, but a revertant protein replacing the unusual splicing restored the activity. The phylogenetic tree, constructed with known DFR sequences, showed evolutionary divergence of some of the DFR genes prior to the plant speciation. This work affords the basis for genetic and biochemical studies on the diversity of DFR and the flavonoid products.     

Molecular analysis of herbivore-induced condensed tannin synthesis: cloning and expression of dihydroflavonol reductase from trembling aspen (Populus tremuloides)

In order to study condensed tannin synthesis and its induction by herbivory, a dihydroflavonol reductase (DFR) cDNA was isolated from trembling aspen (Populus tremuloides). Bacterial overexpression demonstrated that this cDNA encodes a functional DFR enzyme, and Southern analysis revealed that DFR likely is a single-copy gene in the aspen genome. Aspen plants that were mechanically wounded showed a dramatic increase in DFR expression after 24 h in both wounded leaves and unwounded leaves on wounded trees. Feeding by forest tent caterpillar (Malacosoma disstria) and satin moth (Leucoma salicis) larvae, and treatment with methyl jasmonate, all strongly induced DFR expression. DFR enzyme activity was also induced in wounded aspen leaves, and phytochemical assays revealed that condensed tannin concentrations significantly increased in wounded and systemic leaves. The expression of other genes involved in the phenylpropanoid pathway were also induced by wounding. Our findings suggest that the induction of condensed tannins, compounds known to be important for defense against herbivores, is mediated by increased expression of DFR and other phenylpropanoid genes.     

Dihydroflavonol 4-reductase cDNA from non-anthocyanin-producing species in the Caryophyllales

Two types of red pigment, anthocyanins and betacyanins, never occur together in the same plant. Although anthocyanins are widely distributed in higher plants as flower and fruit pigments, betacyanins have replaced anthocyanins in the Caryophyllales. We isolated cDNAs encoding dihydroflavonol 4-reductase (DFR), which is the first enzyme committed to anthocyanin biosynthesis in the flavonoid pathway, from Spinacia oleracea and Phytolacca americana, plants that belong to the Caryophyllales. The deduced amino acid sequence of Spinacia DFR and Phytolacca DFR revealed a high degree of homology with DFRs of anthocyanin-producing plants. The DFR of carnation, an exception in the Caryophyllales that synthesizes anthocyanin, showed the highest level of identity. In the phylogenetic tree, Spinacia DFR and Phytolacca DFR clustered with the DFRs of anthocyanin-synthesizing dicots. Recombinant Spinacia and Phytolacca DFRs expressed in Escherichia coli convert dihydroflavonol to leucoanthocyanidin. The expression and function of DFR in spinach and pokeweed are discussed in relation to the molecular evolution of red pigment biosynthesis in higher plants.     

Relative value of amino-terminal pro-B-type natriuretic peptide testing and radiographic standards for the diagnostic evaluation of heart failure in acutely dyspneic subjects

To define more clearly the relationship between the information provided by the chest radiograph (CXR) and the natriuretic peptide (NT-proBNP) test as part of the evaluation of dyspneic patients presenting to the emergency department with suspected acute heart failure (HF), we evaluated the PRIDE cohort of 599 patients with and without HF, focusing on blinded NT-proBNP and unblinded CXR information. Clinical characteristics and diagnostic performance for each test were compared. We found that NT-proBNP measurement is superior to routine CXR interpretation for diagnosis or exclusion of acute HF and that normal CXR results should not be used to exclude HF in this population.     

The CR digital radiography system in traditional X-ray studies (according to the materials of the Moscow Regional Clinical Research Institute)

The basic idea of the author's paper is to attempt to estimate and prove whether it is advisable to use the CR digital radiography system in a multidisciplinary therapeutic institution mainly at the municipal level. The pre-requisites for this were the results of diagnostic studies of different diseases of organs and systems. Emphasis is laid on the specific features of use of this digital system; namely, it can convert several analogue X-ray apparatuses to digital ones and it is more profitable than indirect image numeralization apparatuses and produces lower radiation loads. This all makes the use of these digital systems tempting in traditional X-ray study. A comparatively large material (4237 cases) was used to show the efficiency of the CR digital radiography system in the diagnosis of ENT diseases, osteology, interventional radiology, gastroenterology, pediatrics and to demonstrate a modernized approach to having a solid copy of a digital image, the possibilities of postprocessing that may enhance the validity of existing X-ray symptoms. This all allows the author to recommend that the CR digital radiography systems be used in traditional X-ray study for the diagnosis of various diseases occurring in a multidisciplinary health care facility mainly at municipal and regional levels.