回盲部病变23例多层螺旋CT影像学分析

目的探讨多层螺旋CT及后处理技术在回盲部病变中的诊断价值。方法23例临床拟诊为回盲部病变患者行16层螺旋CT检查,对其CT表现及后处理技术作回顾性分析,并与手术病理结果对照。结果23例回盲部病变患者中,炎性病变17例(73.9%),其中阑尾炎CT表现为阑尾肿大、增粗,壁增厚,管腔内粪石影,周围间隙模糊以及阑尾穿孔等;MPR图像显示清晰,定位效果好。肿瘤性病变5例(21.7%),其中结肠腺癌CT表现为回盲部不规则肿块,肠壁增厚显著,肠腔狭窄,呈中等或显著强化;Crohn病1例,CT表现为受累肠壁轻度增厚、肠腔狭窄、肠壁强化,MPR图像较好地显示病变肠段的范围和长度。结论多层螺旋CT在回盲部病变中具有较高的临床应用价值。     

回盲瓣脱垂症10例临床分析

回盲瓣脱垂症是指回肠粘膜自回盲瓣口向大肠脱垂、突出,或回盲瓣脂肪沉积形成的回盲瓣突起,是一种少见的消化道疾病,临床症状缺乏特异性,临床诊断困难。我院自1991年1月～2002年12月共行结肠镜检查910例,诊断回盲瓣脱垂症10例,现结合文献报告如下。     

回盲瓣脱垂症临床特点分析

回盲瓣脱垂症是指回肠黏膜自回盲瓣口向大肠脱垂、突出,或回盲瓣脂肪沉积形成的回盲瓣突起,是一种消化道少见病,临床症状缺乏特异性,临床诊断困难。我院自1991年1月至2005年12月共行结肠镜检查910例,诊断回盲瓣脱垂症10例,现结合文献报告如下。     

肠道非肿瘤性病变误诊为肿瘤的多层螺旋CT征象 分析(附7例报告)

目的 分析7例误诊为肿瘤的肠道非肿瘤性病变的多层螺旋CT动态增强表现,提高诊断正确率.方法 收集7例术前CT误诊肠道肿瘤,但手术病理或穿刺活检证实为非肿瘤性病变的患者的临床资料、术前CT及病理组织学结果 ,回顾性分析每例患者的多层CT表现及误诊原因.结果 7例患者中包括:肠缺血1例,肠结核2例,克罗恩病1例,憩室炎合并脓肿1例,子宫内膜异位症1例,回盲部慢性炎症1例.3例患者病变肠管累及回盲部,1例位于回肠末段,1例位于乙状结肠及回肠末段,2例位于乙状结肠;7例患者病变肠管肠壁呈偏心性、非对称性增厚,1例肠缺血患者CT平扫为稍高密度,增强后呈轻度强化,6例患者平扫为等或稍低密度,增强后增厚肠壁呈不均匀性强化者3例,呈分层样强化者2例,其中1例慢性炎症患者CT横断位为不均匀强化,冠状位呈分层样强化.6例患者合并肠周脂肪间隙模糊、密度增高,2例患者肠旁多发肿大淋巴结,其中1例肠结核患者合并肠旁、肝门区等多发环形肿大淋巴结.结论 肠壁偏心性、非对称性增厚的非肿瘤性病变容易误诊为肠道肿瘤,应结合临床、内镜及完整影像资料如多平面重组图像、病变肠管的受累长度、强化方式、肠旁的情况综合全面分析,可望做出正确诊断.     

急性原发性肠脂垂炎的CT诊断

目的 探讨急性原发性肠脂垂炎的CT诊断及鉴别诊断.方法 回顾性分析成都市西区医院2011年12月至2016年7月收治的7例急性原发性肠脂垂炎的临床及CT资料,其中3例经手术及病理证实.结果 7例患者中3例位于升结肠旁,4例位于乙状结肠旁.7例CT平扫表现为结肠旁卵圆形脂肪密度结节影,边缘呈薄层环状稍高密度影,5例周围脂肪间隙内显示条索状或斑片状渗出影,7例患者病灶中心均可见点状或线状稍高密度影;增强后病灶呈环状强化;邻近腹膜增厚4例,局部结肠壁水肿、增厚3例.结论 急性原发性肠脂垂炎具有特征性CT表现,正确诊断可以避免不必要的外科手术治疗.     

结肠镜诊断回盲瓣脱垂1例

患者,男性,24岁,因反复腹泻伴脐周隐痛6月就诊.查体阴性,口服抗生素及肠黏膜保护剂后能缓解.结肠镜检查见回盲开口呈广基隆起,大小约2.7×3.0cm2,充血明显,表面呈菜花样改变,中心可见黄色肠液溢出,活检质软.未见正常回盲瓣形态.结肠镜诊断为回盲瓣脱垂.活检病理组织报告:回肠黏膜炎症.既往有阑尾切除史.     

女性盆腔结核多层螺旋CT诊断价值

目的:探讨女性盆腔结核的多层螺旋CT(MSCT)表现,提高女性盆腔结核的诊断及鉴别诊断准确率。方法:回顾性分析25例经病理或临床治疗,随访证实的女性盆腔结核的MSCT表现和临床资料。结果:MSCT表现为:盆腔积液24例,占96%。盆腔内和/或双侧附件区不规则囊实性包块16例,占64%。盆腔内不规则小点状及斑片状钙化12例,占48%。双侧附件区软组织增厚,粘连,未见明显软组织肿块9例,占36%。腹膜,网膜及肠系膜增厚,粘连22例,占88%,其中16例呈结节状及粟粒样改变,占64%。回盲部回肠末段肠改变10例,占40%。淋巴结增大、增多9例,占36%。双侧输尿管增强扫描呈串珠样改变2例,占8%。膀胱壁不规则增厚,局部呈结节状改变4例,占16%,右侧髂窝及左侧髋臼内下方不规则囊实性包块1例,占4%。结论:有相对高密度的、分房或包裹性腹水,或伴盆腔、附件区囊实性包块,有网膜、腹膜、肠系膜软组织改变,腹膜结节状,粟粒样强化,淋巴结肿大等CT表现时,有助于盆腔结核诊断。     

回盲部癌46例X线诊断

目的 :提高对回盲部癌X线诊断的认识。方法 :收集经手术和病理证实的回盲部癌 46例临床资料和X线表现 ,进行回顾分析。结果 :回盲部癌的主要X线表现 :①不规则充缺和腔内肿块 ;②肠腔狭窄 ,肠壁僵硬 ;③粘膜破坏 ;④不规则龛影 ;⑤回肠末端侵犯 ;⑥肠梗阻和肠套叠。结论 :依据回盲部癌的X线表现 ,术前可以作出正确诊断     

小儿肠重复畸形的CT诊断及鉴别诊断

目的探讨小儿肠重复畸形的CT诊断及鉴别诊断。方法回顾性分析经手术病理证实的6例小儿肠重复畸形患者的临床资料及CT表现。结果 6例肠重复畸形发生于回肠3例,回盲部1例,空肠1例,结肠1例。CT平扫表现为低密度单房囊性肿块,与肠管关系密切,增强后囊壁强化。结论圆形或管形、单房、低密度液性、厚壁囊肿是肠重复畸形较具特征性的CT表现,CT对小儿肠重复畸形的诊断及鉴别诊断有一定的价值。     

临床不典型阑尾炎的多层螺旋CT薄层扫描诊断分析

目的探讨多层螺旋CT薄层扫描检查对临床不典型阑尾炎的诊断价值。方法对70例临床症状和体征不典型阑尾炎患者术前采用阑尾区层厚1.5mm多层螺旋CT扫描显示阑尾及其周围情况,并对扫描检查与手术病理结果进行对比分析。结果 70例患者均有阑尾炎的CT表现,66例阑尾增粗,壁增厚;32例阑尾周围部份回肠激惹积气;12例伴有粪石影;10例阑尾腔内或周围见气泡影;10例盲肠壁增厚,周围脂肪间隙模糊;7例回盲部软组织块影伴小肠低位梗阻;5例盲肠后内侧及腰大肌前方斑片状高密度影;5例右侧结肠旁沟及盆腔积液;4例阑尾无明显增粗,仅见周围脂肪间隙模糊。结论多层螺旋CT薄层扫描检查对临床不典型阑尾炎的诊断有重要价值。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.