缺血性中风患者急性期DWI影像ADC值与中医证候的关系探讨

目的:通过观察缺血性中风患者急性期扩散加权成像(DWI)ADC值的变化,对照其中医证候变化,探究二者的相关性。方法:选择符合纳入标准的缺血性中风急性期患者60例,按中医证候标准分为风、火热、痰、瘀、气虚、阴虚阳亢六大证候,观察发病6～48 h及10 d时的证候变化。同时分别于发病6～48 h及10 d时检查ADC值,并与证候值的变化比较,进行统计学处理。结果:各证候的ADC值在发病6～48 h内组间比较差异无统计学意义;发病10 d时均明显升高,与发病6～48 h比较差异有统计学意义(P<0.05),组间比较风证和火热证的ADC值升高明显,较其他证候差异有统计学意义(P<0.05)。结论:中医证候的演变与ADC值有相关性,并且风证和火热证的ADC值变化较其他证候差异有统计学意义,可把ADC值升高明显者作为风证、火热证辨证的客观参考指标之一。因此,DWI影像ADC值的变化可以作为中医证候诊断的客观辅助指标和手段。     

持续性植物状态的中医证侯学研究

目的：研究持续性植物状态（PVS）患者中医证侯学。方法：采用临床流行病学方法,以采集中医四诊信息为基础,结合PVS特点,建立中医证型临床流行病学调查表,随机抽样调查102例PVS患者,录入全部四诊症状资料。然后进行中医辨证,确定PVS患者的证候类型。并分析证型的分布特点等。结果：6种主要证候类型分别为：气虚血瘀型、血虚风动型、痰热闭窍型、心脾两虚型、痰湿阻窍型、肾精虚衰型。结论：PVS的中医证型有规律可循,可用以指导临床。     

中医“带下”病证的超声影像观察

中医临床辨证的客观化研究是中医现代化研究的主要内容之一,已得到众多医学影像学者们的关注。我们应用超声检查技术,通过对119例中医称“带下”病症（急、慢性盆腔炎）的中医临床证型与超声特征进行观察、分析,从中发现一些有规律或证型特征性表现,现报告如下。     

老年2型糖尿病合并颈动脉粥样硬化患者不同中医证型的颈动脉超声影像分析

目的:回顾性分析老年2型糖尿病合并颈动脉粥样硬化患者的中医证型及其斑块的超声影像特点,为中医辨证论治提供客观化指标。方法:选取52例老年2型糖尿病合并颈动脉粥样硬化患者作为研究对象,收集其临床资料、颈动脉超声检查结果,并对其进行中医辨证分型,统计分析不同中医证型颈动脉超声的影像特点。结果:52例中阴虚热盛型20例(38.5%)、气阴两虚型24例(46.2%)、阴阳两虚型8例(15.4%),证型分布差异有统计学意义(χ~2=104.00,P0.001)。不同中医证型间颈动脉狭窄的发生率比较差异有统计学意义(χ~2=76.00,P0.001),其中气阴两虚型颈动脉狭窄发生率最高(20/38,52.6%)。不同证型间斑块的发生部位及性质比较差异均无统计学意义(χ~2=1.32,3.58;P=0.86,0.46)。不同中医证型间硬斑、软斑、混合斑检出率比较差异均有统计学意义(χ~2=126.00,46.00,116.00;均P0.001);不同中医证型间颈动脉内-中膜厚度比较差异无统计学意义(F=0.17,P 0.05)。超敏C反应蛋白水平阴虚热盛型与阴阳两虚型比较差异有统计学意义(P0.05);3种证型空腹血糖、糖化血红蛋白、三酰甘油、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇差异均无统计学意义(均P 0.05)。结论:老年2型糖尿病合并颈动脉粥样硬化患者的中医证型与年龄、病程、实验室检查指标及超声影像特点关系密切,了解其规律可为中医辨证论治提供量化指标和依据。     

中风先兆证的头颅CT影像及其与血液流变学关系研究

目的 :通过对 5 3例中风先兆证患者头颅CT影像及相关血液流变学检查研究 ,探索中风先兆证的CT影像规律性及相关血液流变学变化。方法 :对 5 3例中医诊断为中风先兆证的患者进行前瞻性双盲法CT影像研究 ,观察其病变性质、部位、大小范围、脑实质弥漫性病变与陈旧病变等情况 ,同时进行血液流变学的观测。结果 :中风先兆证的头颅CT影像有一定的规律性 ,其血液流变学也有相应的变化 ,但具体各证候之间缺乏显著性差异。结论 :头颅CT扫描可以为中风先兆证的患者提供一定的辨证、辨期客观依据。     

甲状腺结节中医分型与超声造影模式关系探讨

目的 :运用超声造影技术,研究甲状腺结节的造影模式与中医分型之间的相关规律。方法 :随机选取门诊及住院患者122例,行超声造影检查及中医辨证分型,并进行对比研究。结果:痰结血瘀型、气郁痰阻型和肝火旺盛型超声造影以环状增强为主,多为良性结节;心肝阴虚型则以低增强为主,多为恶性结节。结论:通过观察甲状腺不同证型结节的超声造影表现,可为中医辨证提供影像依据。     

超声、CT定量诊断脂肪肝与中医证型相关性的比较

目的:通过超声、CT对非酒精性脂肪肝的定量诊断,分析两者诊断的脂肪肝严重程度与中医证型的相关性。方法:选取非酒精性脂肪肝229例,分为肝郁脾虚、痰湿内阻、痰瘀互结、肝肾不足、湿热内蕴5个中医证型,同时进行轻、中、重度分级。应用超声与CT检查对脂肪肝进行定量诊断,分析脂肪肝程度与中医各证型的关系。结果:①各中医证型在2种检查方法定量诊断脂肪肝分级的分布结果,均显示肝郁脾虚证以轻度脂肪肝为主,肝肾不足证以重度脂肪肝为主,经χ2检验,各中医证型间的脂肪肝程度差异均有统计学意义(P0.01);②2种影像学方法诊断的轻中重度脂肪肝进行中医证型间的两两比较,其中肝郁脾虚证与痰瘀互结证、肝郁脾虚证与痰湿内阻证、肝郁脾虚证与肝肾不足证、肝郁脾虚证与湿热内蕴证、痰湿内阻证与肝肾不足证、肝肾不足证与湿热内蕴证的脂肪肝程度分级比较差异均有统计学意义(P0.001)。结果显示2种影像学方法的统计结果基本一致。结论:中医辨证分型与脂肪肝严重程度密切相关,对判断各证型脂肪浸润程度具有参考价值;提示超声、CT检查均可作为规范脂肪肝中医证型的可行方法。     

糖尿病患者脑白质疏松的MRI表现与中医证候要素的相关性分析

目的:分析糖尿病患者脑白质疏松(leukoaraiosis,LA)的MRI表现,探讨其与中医证候要素之间有无相关性。方法:分析98例糖尿病患者伴LA的MRI表现,将其分为轻、中、重度,并对其进行中医证候分型,分析MRI表现与中医证候分型之间有无关联性。结果:98例中,痰、血瘀、气虚和阴虚是其主要中医证候要素。LA严重程度与中医证候要素之间无明显关联性,而与糖尿病病程之间具有相关性,糖尿病病程越长,LA程度较重。结论:糖尿病伴LA患者多有痰、血瘀、气虚和阴虚等主要证候要素,其LA程度随糖尿病病程延长而加重,应引起临床重视。     

小柴胡汤加减对脑卒中后眩晕患者中医证候积分及血管内皮功能的影响

目的探讨小柴胡汤加减对脑卒中后眩晕患者中医证候积分及血管内皮功能的效果。方法选择2017年1月-2019年3月接受治疗的脑卒中后眩晕患者100例,随机分为两组,各50例。对照组实施常规西药治疗,观察组实施小柴胡汤加减治疗,对比两组治疗前后中医证候积分及血管内皮功能的情况。结果观察组中医证候积分低于对照组,血栓调节蛋白(TM)、内皮素-1(ET-1)值均较对照组低,一氧化氮(NO)值较对照组高,差异有统计学意义(P<0.05)。结论小柴胡汤加减治疗可有效降低脑卒中后眩晕患者的中医证候积分,改善血管内皮功能,促进患者快速恢复。     

军人功能性消化不良的中医证型分布及病因调查

目的探讨军人功能性消化不良(FD)的发病情况及中医证候分布规律和病因。方法按照功能性胃肠病罗马Ⅲ诊断标准设计FD症状量表,采用整群完全随机抽样方法对陆军某部汽车训练队及通讯连290名官兵进行调查。结果军人FD发病率约为41.72%,中医病因:情志失调占40.49%,饮食失常占21.48%,劳倦过度占16.52%,以上3种因素可能是军人FD的主要成因。中医证型:肝郁脾虚占44.63%,肝郁气滞占23.14%,构成了军人FD的主要证型。FD患者的Hp感染率为58.67%,呈现实证高于虚证的感染趋势。结论军人FD的中医证型以肝郁脾虚占多数,Hp感染可能与其他因素一起,促发军人中较高的FD发生率。     

Technology and archives in radiology research: a sampling analysis of articles published in the AJR and Radiology. American Journal of Roentgenology.

OBJECTIVE: Our aim was to determine the use of advanced technology and archiving and the contribution of countries other than United States in the articles published in the American Journal of Roentgenology (AJR) and Radiology. We analyzed the association of these features with the type of research, the main technical features of the modalities used, and the countries of origin. MATERIALS AND METHODS: We determined the proportion of articles published in 18 randomly selected issues of the AJR and Radiology that required advanced imaging techniques and relied on the analysis of archived data. "Advanced technology" was defined as imaging techniques that serve a purpose other than simple anatomic imaging or that are not widely available because of the high cost of the technology, such as functional imaging and computer programming designed for an individual study or simulation studies. We analyzed the association of these features with the country of origin, the topic, and the methodology used. RESULTS: Sixteen percent of the studies required advanced technology. MR imaging, CT, and sonography were the most frequently used modalities (31%, 27%, and 15% of studies, respectively). Archiving was used in 37% of the studies, and 67% of the original articles were prospective. The articles most commonly originated in North America (67%), Europe (20%), and Asia (12%). CONCLUSION: Only a small percentage of published research studies required advanced technology and approximately one third of the studies used archiving. These results may suggest that other criteria, such as the design of the study, its relevance for daily clinical use, and the originality of the paper, have a major impact on the acceptance of papers in clinically oriented radiology journals.     

多模态纳米分子探针在动物模型易损斑块中靶向分子成像的研究进展

易损斑块的破裂常常导致急性冠状动脉综合征,造成严重的心血管事件。早期监测易损斑块对于预防急性冠状动脉综合征具有重要意义。目前,分子影像技术能在细胞和分子水平对疾病进行早期检测,其中,用于监测易损斑块的分子影像技术有核医学分子显像、超声分子成像、MRI和光学成像等。近年来,多模态分子影像技术由于结合了多种分子影像技术的优势,能够提供更多解剖与生物代谢信息,因此在监测易损斑块中具有更高的价值。多模态分子探针的制备与构建对疾病的分子影像诊断至关重要,寻找合适的靶点、增强分子探针的靶向性有利于提高疾病的检出率,为更敏感地检出早期易损斑块提供可能。纳米颗粒因其特殊的性能与优点已被广泛应用于多模态分子探针的研究中,然而,此类探针尚处于临床前研究阶段,主要应用于动物模型中。笔者针对易损斑块在组织学以及细胞与分子生物学变化中出现的各种生物标志物,综述多模态纳米分子探针在动物模型易损斑块中靶向分子成像的研究进展。     

MRI在帕金森叠加综合征与帕金森病的鉴别诊断及疾病进展预测中的应用

帕金森叠加综合征（PPS）是一组部分临床症状与帕金森病（PD）相重叠的慢性进行性神经退行性疾病,两者症状的相似性导致了临床鉴别困难。随着神经影像技术的发展,MRI凭借其对结构、扩散、灌注及功能等多模态成像的优势在揭示PPS和PD的脑区灰质体积改变、白质纤维束完整性改变,局部脑区的铁沉积、血流灌注及功能连接等的异常改变方面提供了诸多信息。就MRI在PPS及PD鉴别诊断及疾病进展预测中的应用进展予以综述。     

2003-2013年国内外转化医学文献的对比分析

目的运用文献计量学的方法探讨2003—2013年国内外转化医学的发展现状、国家间合作、学科分布以及研究热点等特点,为相关研究提供参考。方法计算机检索PubMed、Web of Science、万方数据知识服务平台、中文科技期刊数据库、中国知网期刊全文数据库和中国生物医学文献数据库,查找国内外关于转化医学研究的文献,检索时间均限定为2003年1月1日—2013年12月31日。运用Excel 2013提取文献的基本信息,社会网络分析软件Ucinet 6.0分析国家间的合作关系,HistCite 12.03进行文献时间序列分析。结果共纳入中外文转化医学研究文献4 143篇。通过对文献的国家分布及其合作情况进行分析,显示开展转化医学研究的63个国家主要集中在欧洲和北美地区,其中美国的发文量、文献的被引用频次以及与其他国家的合作度最高。从文献的期刊和学科分布来看,国外发表转化医学相关期刊的种类比国内多（711比314）,刊均载文量也比国内多（4.5比2.8）。国内外转化医学研究热点主要集中在基础实验和肿瘤方面,此外国内还特别关注了中医药的转化研究。引文时间序列分析显示与转化医学研究发展相关的重要文献有50篇,主要集中在2003—2011年。结论转化医学研究是当前医学研究中的热点,欧洲和北美国家处于主导地位。国内转化医学研究水平与国外差距较大,主要体现在文献的数量、被引用情况以及与其他国家的合作度均较低。     

Neuroimaging diagnosis in neurodegenerative diseases

Dementia affects about 8% of people age 65 years and older. Identification of dementia is particularly difficult in its early phases when family members and physicians often incorrectly attribute the patient's symptoms to normal aging. The most frequently occurring ailments that are connected with neurodegeneration are: Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and multiple sclerosis. A variety of powerful techniques that have allowed visualization of organ structure and function with exact detail have been introduced in the last twenty-five years. One such neuroimaging technique is positron emission tomography (PET), which measures in detail the functioning of distinct areas of the human brain and as a result plays a critical role in clinical and research applications. Radiotracer-based functional imaging provides a sensitive means of recognizing and characterizing the regional changes in brain metabolism and receptor binding associated with cognitive disorders. The next functional imaging technique widely used in the diagnosis of cognitive disorders is single photon emission computed tomography (SPECT). New radiotracers are being developed and promise to expand further the list of indications for PET. Prospects for developing new tracers for imaging other organ diseases also appear to be very promising. In this review, we present current opportunities of neuroimaging techniques in the diagnosis and differentiation of neurodegenerative disorders.     

基于Pubmed数据库近6年卵巢癌分子成像研究的文献计量学分析

目的了解近6年卵巢癌分子成像领域的研究状况,为进一步研究提供参考信息。方法检索PubMed数据库中2012年1月1日—2017年12月31日发表的卵巢癌分子成像研究文献,采用Bicomb2.0软件统计分析文献的发表年代、来源期刊及期刊所属国家、第一作者、高频主题词分布情况、不同分子成像技术及主要示踪剂的发文情况。将出现频次≥4次的主要主题词+副主题词作为高频主题词,建立词篇矩阵,使用SPSS 22.0软件进行聚类分析,获得该领域高频主题词的共词聚类分析树图,分析该领域的研究热点。结果筛选出相关文章171篇,分别发表在88种期刊上,其中54篇(31.58%)发表在核心区的7种期刊上。有15人发表相关文献至少2篇。PET分子成像方面的文章共97篇(56.7%)。主要用于临床研究的分子示踪剂为~(18)F-FDG和~(99)Tc~m。高频主题词共37个,经聚类分析得出近6年卵巢癌的分子成像研究热点主要集中在卵巢癌的分子成像诊断、疗效监测及肿瘤代谢、肿瘤复发及转移灶的诊断、病理诊断4个方面。结论通过对卵巢癌分子成像领域的文献计量分析,可以揭示该领域的研究热点,为进一步研究提供一定参考。     

Positron emission tomography in neuroscience. An integrative part of clinical diagnostic methods and experimental research

The role of molecular neuroimaging techniques is increasing in the understanding of pathophysiological mechanism of diseases. To date, positron emission tomography is the most powerful tool for the non-invasive study of biochemical and molecular processes in humans and animals in vivo. With the development in radiochemistry and tracer technology, a variety of endogenously expressed and exogenously introduced genes can be analyzed by PET. This opens up the exciting and rapidly field of molecular imaging, aiming at the non-invasive localisation of a biological process of interest in normal and diseased cells in animal models and humans in vivo. Besides its usefulness for basic research positron emission tomography has been proven to be superior to conventional diagnostic methods in several clinical indications. This is illustrated by detection of biological or anatomic changes that cannot be demonstrated by computed tomography or magnetic resonance imaging, as well as even before symptoms are expressed. The present review summarizes the clinical use of positron emission tomography in neuroscience that has helped elucidate the pathophysiology of a number of diseases and has suggested strategies in the treatment of these patients. Special reference is given to the neurovascular, neurodegenerative and neurooncological disease.     

放射性核素显像探针在细胞凋亡中的研究进展

目前细胞凋亡的体外检测方法很多，但这些检测方法在取材、组织活检时具有创伤性，大多需要处死动物，且只能离体研究，限制了其在临床中的应用与转化。体内检测方法因可在活体内无创、实时监测凋亡，成为目前研究的热点。放射性核素凋亡细胞显像技术因具备无创、早期、动态、灵敏、定量、可在活体内检测等优势，具有良好的研究前景，是目前研究最为广泛、技术最为成熟的体内细胞凋亡检测技术。核素凋亡显像已广泛应用于心血管疾病、中枢神经系统疾病、器官移植排斥反应中的细胞凋亡检测，以及恶性肿瘤放化疗的疗效评价和预后判断等方面。笔者主要通过对放射性核素显像探针在细胞凋亡中的研究进展作一综述。     

Characteristics and Trends of Radiology Research: A Survey of Original Articles Published in AJR and Radiology between 2001 and 2010

Purpose: To determine the characteristics and trends of the original articles published in two major American radiology journals, AJR American Journal of Roentgenology (AJR) and Radiology, between 2001 and 2010. Materials and Methods: This was a retrospective bibliometric analysis that did not involve human subjects and was exempt from institutional review board approval. All 6542 original articles published in AJR and Radiology between 2001 and 2010 were evaluated. The following information was abstracted from each article: radiologic subspecialty, radiologic technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, affiliation of the first author, and country of the first author. In addition, all the variables examined were presented along with the trend over time. Results: The most common subspecialty of study was abdominal (1219 of 6542, 18.6%), followed by vascular/interventional (804 of 6542, 12.3%). A total of 3744 (57.2%) original articles used magnetic resonance (MR) imaging or computed tomography (CT), 5495 (84.1%) were clinical research articles, 3060 (46.8%) had sample size of more than 50, 4087 (62.5%) were retrospective, 4714 (72.1%) performed statistical analysis, 6225 (95.2%) showed positive study outcome, 4784 (73.1%) were not funded, 3942 (60.3%) had four to seven authors, and 5731 (87.6%) were written by the primary author who was from a department of radiology or radiology-related specialties. The United States published 45.5% (2975 of 6542) of the articles, followed by Japan (n = 525, 8.0%), Germany (n = 485, 7.4%), and South Korea (n = 455, 7.0%). In the time trend analysis, the following variables showed a significantly positive trend: cardiac subspecialty, CT and MR imaging as the radiologic techniques, type of research as other (nonbasic, nonclinical), sample size of more than 50, four to seven as the number of authors, medicine-related department of the first author, and South Korea and Italy as countries of the first author. On the other hand, pediatric subspecialty, combined (basic and clinical) type of research, and number of authors fewer than four showed a significantly negative trend. Conclusion: The bibliometric analysis of the AJR and Radiology journals with articles published between 2001 and 2010 revealed characteristics and trends of the current radiology research that may provide useful information to researchers and editorial staff in radiology. ? RSNA, 2012.