MR弥散加权成像在评估宫颈癌放化疗疗效中的应用价值

目的探讨磁共振弥散加权成像DWI在评估宫颈癌放化疗疗效中的应用价值。方法 32例经病理证实为宫颈癌的患者,分别在治疗前和外照射20GY后进行常规的盆腔MRI扫描和DWI扫描,并测量肿瘤的最大径和ADC值。治疗结束6个月随访,根据RECIST标准将患者分成有效组和无效组。比较两组治疗前、外照射20GY后肿瘤的ADC值和ADC值提高率,并比较两组治疗前、外照射20GY后肿瘤的最大径及退缩率。结果有效组25例,无效组7例,两组治疗前、外照射20GY后的ADC值和最大径、退缩率无统计学差异(P0.05),而两组的ADC值提高率有统计学差异(P0.05)。结论宫颈癌有效组在治疗早期ADC值的提高率明显高于无效组,证实DWI序列能早期预测宫颈癌放化疗的治疗效果,为优化患者后续的治疗方案提供帮助。     

ADC值在监测肺癌脑转移瘤择时放疗中的价值

目的:探讨磁共振弥散加权成像(DWI)表观弥散系数(ADC)值在监测肺癌脑转移瘤择时放疗中的价值.方法:随机选取我院肺癌脑转移瘤放疗时段分别在6:00～8:00和16:00～18:00的A组和B组各50例,所有病例均在择时放疗前和放疗后1周作DWI检查.选择与放疗前增强扫描图中显示最大直径≥1.0 cm以上实质性转移瘤病灶的放疗前后一致层面的DWI图,依据ADC伪彩图,分别计算出肿瘤实质感兴趣区(ROI)的ADC值.结果:放疗前A、B组肿瘤实质部分ADC值分别为(1.09±0.26)×10-3、(1.05±0.21)×10-3 mm2·s-1,两组ADC值差异无统计学意义.放疗后A、B组肿瘤实质部分ADC值分别为(1.34±0.17)×10-3、(1.12±0.09)×10-3 mm2·s-1.A组放疗前后ADC值差异有统计学意义(P<0.01),B组放疗前后ADC值差异无统计学意义.放疗后A、B两组ADC值差异有统计学意义(P<0.01).结论:ADC值在监测肺癌脑转移瘤择时放疗中有一定的临床应用价值,采取择时放疗可进一步提高疗效.     

探讨DWI在宫颈鳞状细胞癌诊断中的价值

目的 探讨扩散加权成像(DWI)在宫颈鳞癌诊断中的价值,并分析ADC值与病理分级相关性.方法 收集47例宫颈鳞癌,宫颈病灶最小直径大于或等于3cm,于MRI检查时未做过任何治疗;收集同期23例正常宫颈病例作为对照组.均行常规MRI及DWI(b值取0、500、1000s/mm2),分别观察DWI信号强度,并测量ADC值.分析正常宫颈与宫颈癌间关系,并将宫颈癌病灶体积与宫颈癌ADC值、宫颈癌ADC值与宫颈癌细胞分化程度进行比对.结果 正常宫颈ADC值为(1.416±0.188)×10-3mm2/s,宫颈癌ADC值为(0.865±0.184)×10-3mm2/s,两者差异有统计学意义(P<0.05).宫颈癌病灶体积与ADC值无相关性(r=0.139,P=0.351);宫颈癌ADC值与病理分级有相关性(r=0.848,P=0.000).结论 DWI对宫颈癌原发灶具有良好的对比度,可以清晰观察病灶形态、边缘.定量指标ADC值与病理分化程度存在相关性,可以用来提示肿瘤分化程度.临床分期低、ADC值高的病灶,预后会更好.     

磁共振ADC值在女性盆腔良恶性肿瘤鉴别中的价值研究

目的探讨磁共振扩散加权成像ADC值在鉴别诊断女性盆腔良恶性肿瘤的价值。方法回顾性分析42例经手术病理证实女性盆腔肿瘤患者的MRI资料,分析肿瘤DWI信号强度及ADC值的差异。结果女性盆腔良性肿瘤病变DWI信号表现不同,可以呈等、较高或高信号,恶性肿瘤性病变在DWI上大部分表现为高信号。良性病变平均ADC值为(1.55±0.48)×10-3mm2/s,恶性病变平均ADC值为(1.23±0.37)×10-3mm2/s,恶性病变的ADC低于良性现变(P=0.023)。结论磁共振扩散加权成像(DWI)信号和ADC值可为良恶性肿瘤的鉴别诊断提供依据。     

3.0T MR扩散加权成像在宫颈癌诊断中的应用价值

目的探讨正常宫颈、宫颈癌DWI的表现特征和表观扩散系数(ADC)值,评估DWI在宫颈癌诊断中的应用价值。方法对44例宫颈癌患者术前行常规MRI、增强及扩散加权成像,测量宫颈癌癌灶ADC值,并以20例成年健康女性志愿者宫颈扩散加权成像做为对照组,测量正常宫颈三层结构的弥散信号强度,分别计算ADC值,并与宫颈癌组进行比较;绘制ROC曲线,寻找鉴别宫颈癌和正常宫颈的最佳ADC值截断点。结果正常子宫颈三层结构的弥散图像信号强度有显著性差异,内膜信号最高,肌层次之,结合带最低,两两比较,差异有统计学意义(P0.05);正常宫颈各层ADC值:肌层(1.911±0.305)×10-3mm2/s内膜(1.590±0.311)×10-3mm2/s结合带(1.361±0.203)×10-3mm2/s,两两比较,有显著性差异(P0.05)。宫颈癌ADC值为(0.924±0.110)×10-3mm2/s,低于正常宫颈内膜、结合带、肌层ADC值(t值分别为-7.438,-7.140,-11.221,P=0.000)。以1.120×10-3mm2/s为最佳截断点,鉴别宫颈癌与正常宫颈内膜,敏感性和特异性分别为100%和95.5%。结论宫颈癌与正常子宫颈三层结构DWI和ADC值存在差异,扩散加权成像有助于鉴别正常宫颈和宫颈癌组织。     

鼻咽癌转移性淋巴结化放疗疗效应用DWI监测价值分析

目的临床应用弥散加权成像(DWI)于鼻咽癌转移性淋巴结化放疗中,并通过监测治疗过程中表观弥散系数(ADC)变化情况来评价DWI对患者化放疗的应用价值。方法选取本院经手术及病理证实的60例鼻咽癌患者进行研究,并采用化放疗治疗。分别于首次化疗前1天、第二次化疗前1天、首次放疗前1天、第15天放疗当日和第30次放疗当日及治疗结束1个月后采用MRI及DWI进行检查。结果 (1)治疗前,淋巴结平均ADC值为(0.792±0.019)×10-3mm2/s明显低于正常舌肌ADC值(1.387±0.035)×10-3mm2/s,P0.05;(2)随着治疗的进行,患者转移性淋巴结ADC值随之而不断上升,但第1-15次放疗期间上升最为显著;(3)经治疗后,患者残留淋巴结ADC值平均为(1.399±0.079)×10-3mm2/s较治疗前明显增高,P0.05;但其与治疗后正常舌肌ADC值比较,P0.05。结论通过采用DWI及MRI监测鼻咽癌转移性淋巴结患者化放疗治疗过程中ADC值变化,可有效评估临床疗效,从而为患者临床合理化治疗提供参考。     

宫颈癌的磁共振扩散加权成像研究

目的:分析宫颈癌(UCC)和正常子宫颈扩散加杈成像(DWI)的特点,研究宫颈癌放化疗前后表观扩散系数(ADC)值的变化,探讨DWI在UCC诊断及放化疗疗效监测方面的价值.方法:对临床经病理确诊的50例宫颈癌患者行常规MRI和横断位DWI (b=600、800、1000 s/mm2)检查,同时收集年龄与实验组相匹配的健康志愿者或因非宫颈疾病行盆腔MRI检查者40例,对正常子宫颈行常规MRI和横断位DWI(b=600、800、1 000 s/mm2)检查.比较正常宫颈和UCC病灶的ADC值;比较UCC放化疗前后的ADC值.结果:①b=600 ～0 s/mm2,800 ～0 s/mm2,1000～0 s/mm2时,正常子宫颈平均ADC值分别为[(1.799±0.220)×10-3 mm2/s]、[(1.714±0.227)×10-3 mm2/s]、[(1.654±0.223)×10-3 mm2/s],UCC放化疗前的平均ADC值分别为[(0.901±0.120)×10-3 mm2/s]、[(0.870±0.133)×10-3 mm2/s]、[(0.840±0.130)×10-3 mm2/s],UCC放化疗后的平均ADC值分别为[(1.543±0.225)×10-3 mm2/s]、[(1.470±0.209)×10-3 mm2/s]、[(1.404±0.197)×10-3 mm2/s].②正常子宫颈和UCC放化疗前、后的平均ADC值差异均有统计学意义(P=0.000);放化疗后ADC值较放化疗前明显升高,两者差异有统计学意义(P=0.000).③b值高低影响正常子宫颈和UCC的ADC值,b值越小,ADC值越大.结论:DwI对UCC显示敏感性高,b值选择800 s/mm2和1 000 s/mm2较理想.DWI能够区分UCC和正常宫颈组织,可用于UCC侵犯范围的评价,DWI对UCC放化疗疗效的监测具有重要的临床意义.     

两种高b值的DWI成像在直肠癌的应用价值比较

目的比较两种高b值磁共振弥散加权成像(diffusion weighted imaging,DWI)在直肠病变诊断中的应用价值。方法使用3.0T MRI对直肠癌进行常规直肠扫描及DWI扫描,DWl采用平面回波(echo planar imaging,EPI)序列,选用2个不同的b值(1000s/mm~2、2500s/mm~2),测量肿瘤及同侧臀大肌在不同b值下DWI图像上表观弥散系数(apparent diffusion coefficient,ADC),并进行比较分析。结果 b值等于1000s/mm~2时,肿瘤的ADC值为(0.923±0.15)×10-3mm~2/s,而臀大肌的ADC值为1.57±0.091×10~(-3)mm~2/s,b值等于2500s/mm~2时,肿瘤的ADC值为(0.642±0.07)×10~(-3)mm~2/s,而臀大肌的ADC值为(0.925±0.12)×10~(-3)mm~2/s。所得肿瘤与臀大肌的ADC比值两组间存在差异。结论 b值等于1000s/mm~2组的DWI图像的ADC比值高于2500s/mm2组,更加有利于显示病变,ADC值可作为直肠癌诊断及评价预后的指标之一。     

MRI联合DWI在宫颈癌诊断中的价值

目的探讨磁共振成像(MRI)联合弥散加权成像(DWI)在宫颈癌诊断中的价值。方法选取2015年1月至2017年10月在我院治疗的宫颈癌患者63例,所有患者均行常规MRI和DWI扫描。结果宫颈癌MRI分期、MRI+DWI与病理分期Kappa值分别为0.507和0.794,P0.05;宫颈癌MRI+DWI分期总体准确率为84.13%,明显高于MRI分期(P0.05);宫颈鳞癌和腺癌组织表观扩散系数(ADC)值比较差异无统计学意义(P0.05);放化疗后病灶ADC值为(1.50±0.21)×10~(-3)mm~2/s,明显高于放化疗前(P0.05);完全缓解(CR)患者病灶ADC值为(1.52±0.12)×10~(-3)mm~2/s,明显高于部分缓解(PR)患者(P0.05)。结论 MRI联合DWI在宫颈癌诊断中有较好的价值,在宫颈癌分期诊断中有较高的准确性,且DWI定量指标ADC在放化疗效果评价中有一定作用。     

MRI表面弥散系数在诊断乳腺良恶性肿瘤中的价值

目的:探讨弥散加权成像(DWI)的表面弥散系数(ADC)鉴别乳腺良恶性病变的价值.方法:对经手术病理证实的36例乳腺病变(恶性肿瘤20例.良性病变16例)进行磁共振DWI检查,并计算病变的ADC值.结果:20例乳腺癌及16例良性乳腺病变完成弥散成像.恶性肿瘤组ADC值(0.784±0.178)×10-3mm2/s明显小于良性病变ADC值(1.734±0.345)×10-3mm2/s(P<0.05.b=800 s/mm2).结论:ADC值是鉴别乳腺良恶性病变的一个很有价值的参数.     

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.     

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     

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.     

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.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.