胸壁结核的X线及CT诊断分析

目的总结胸壁结核的X线及CT影像表现,以提高对其认识及诊断水平。方法收集资料完整15例胸壁结核患者的完整资料,回顾性分析其X线及CT影像特征,所有病例均经手术或穿刺病理证实。结果胸部X线发现7例;所有病例CT检查均有软组织肿块,凸出于胸壁7例,凸出于胸腔5例,同时凸出于胸壁和胸腔3例;形成脓肿8例;骨质破坏7例,钙化2例,4例伴有肺内结核病灶。CT均能显示病灶的位置、肿块内部结构及周边情况。结论 X线摄片是发现胸壁结核的基本手段,CT能清楚了解软组织肿块内部及周边情况,骨质破坏情况,尤其是增强CT对于诊断本病具有重要意义。     

12例胸壁结核的X线及CT诊断

目的 分析总结胸壁结核的X线及CT影像表现,以提高对其认识及诊断水平.方法 分析经穿刺、手术病理确诊的12例胸壁结核特征.结果 胸部X线发现7例;所有病例CT检查均有软组织肿块,凸出于胸壁10例,凸出于胸腔8例,同时凸出于胸壁和胸腔6例;形成脓肿8例;骨质破坏7例,钙化2例,4例伴有肺内结核病灶.CT均能显示病灶的位置、肿块内部结构及周边情况.结论 X线摄片是发现胸壁结核的基本手段,CT能清楚了解软组织肿块内部及周边情况,骨质破坏情况,尤其是增强CT对于诊断本病具有决定性作用.     

X线及CT对胸壁结核的诊断分析

目的探讨X线及CT对胸壁结核的诊断价值。方法回顾性分析均经手术或穿刺病理证实17例胸壁结核患者的临床资料,总结其X线及CT影像特征。结果胸部X线发现8例;所有病例CT检查均有软组织肿块,凸出于胸壁9例,凸出于胸腔4例,同时凸出于胸壁和胸腔4例;形成脓肿9例;骨质破坏6例,钙化3例,3例伴有肺内结核病灶。CT能清楚显示病灶的位置、肿块内部结构及周边情况。结论 X线摄片是发现胸壁结核的基本手段,CT能清楚了解软组织肿块内部及周边情况,骨质破坏情况,尤其是增强CT对于诊断本病具有决定性作用。     

胸部X线摄影术与CT诊断胸壁结核探讨

目的探讨胸部X线摄影术和CT在胸壁结核中的诊断价值。方法总结我院25例胸壁结核的X线和CT影像特征,经手术或病理确认,比较两种检查方式结果的准确性。结果胸部X线摄影发现了肿块13例,CT全部25例均有发现,X线摄影对胸腔中的肿块发现有一定的难度;肿块的清晰度和周围组织的细微情况,X线摄影不清晰,而CT则能清晰显示。结论 X线摄影术只能初步发现胸壁结核,CT扫描能清楚显示软组织肿块的精确位置和内部结构,以及肿块周边组织受损情况。对骨质受到的破坏情况,需CT甚至增强CT扫描才能了解详细情况。     

胸部X线摄影术与CT诊断胸壁结核的对照研究

目的评价胸部X线片与cT扫描在胸壁结核诊断中的价值。方法对30例经手术、穿刺活检证实的胸壁结核患者进行胸部X线摄片和CT扫描,其中18例作增强CT扫描。结果30例患者中胸部X线平片显示骨质破坏8例,CT平扫见肋骨破坏10例;CT平扫见肋骨旁软组织肿块30例,胸部X线片均未能发现（P〈0．01）。25例肿块呈边缘密度较高,而中央密度较低,其中14例可见边缘强化,4例平扫时呈多发低密度者增强后呈密度增高,内部多个大小不等的低密度灶更明显,并伴有液化表现;5例肿块呈均匀较低密度;CT扫描可见纵隔、肋间及腋窝淋巴结肿大10例,胸片未检出（P〈0．01）。结论CT结合增强扫描是确诊本病的首选方法。     

胸壁疾病的X线诊断

目的 分析胸壁疾患的X线表现,以提高对其认识. 方法 回顾性分析胸壁疾患26例,其中胸壁软组织疾患4例;发生在肋骨的疾患13例;胸椎疾患8例;颈部恶性淋巴瘤1例的X 线表现. 结果 26例胸壁疾患均在肺野或纵隔形成异常X线阴影.胸壁软组织脂肪瘤1例,胸壁软组织纤维瘤2例均表现为肺野内阴影在切线位时与胸壁相连,基底较宽,与胸壁形成钝角.血管瘤1例表现为肺尖部散在圆形钙化影.肋骨结核并寒性脓肿4例,肋骨海绵状血管瘤1例,肋骨软骨肉瘤1例,肋骨转移瘤5例均有不同程度骨质破坏,肋骨软骨瘤2例表现为肋骨呈膨胀性改变,其间可见钙化.胸椎结核流注脓肿5例均至肺野或纵隔旁形成肿块状阴影,胸椎骨赘2例,胸脊膜膨出1例在椎旁形成圆形阴影.颈部恶性淋巴瘤表现为肺尖部阴影. 结论 正确认识胸壁疾患的X线表现对确定合理的治疗有重要意义.     

胸壁结核的诊断与治疗

目的　探讨胸壁结核的诊断与治疗。方法　对 68例胸壁结核诊治进行分析。根据脓肿穿刺确诊者 46例 ,依据病史、胸部X线及CT检查确诊者 13例 ,依据局部窦道久治不愈确诊者 9例。结果　所有病例均经手术治疗 ,单纯胸壁软组织结核病灶清除术 10例 ,肋骨切除加肌瓣填塞 5 0例 ,胸壁结核病灶清除加胸膜剥脱术 5例 ,局部胸廓成形术 3例。术后复发 5例 ,经再次手术而愈。结论　胸部CT检查对胸壁结核的诊断和治疗有重要的指导意义 ;预防术后复发是外科治疗的重点 ,正确设计切口是充分显露结核病灶的前提 ;清除病灶内结核性坏死组织和切除结核感染的肋骨、肋软骨以及覆盖的窦道上方的肋骨是彻底清创的关键 ;邻近肌瓣填塞创腔和术后加压包扎是消灭残腔的方法 :术前术后有效的抗结核治疗是外科治疗效果的保障     

胸壁结核35例临床分析

<正> 我院自1986～1996年共手术治疗胸壁结核35例,现报道如下。1 临床资料35例中男23例,女12例,年龄16～58岁,其中胸痛伴胸壁包块18例,胸痛伴胸壁包块表面窦道形成2例,无痛性胸壁包块14例,无明显包块面剧烈胸痛1例。既往有肺结核病史者18例,渗出性胸膜炎病史者11例。10例病人就诊时有结核中毒症状。30例首诊为胸壁结核,5例首诊为胸壁肿瘤、肋间神经痛等,此5例均于术前明确胸壁结核诊断。X线检查:18例肺内有纤增灶和钙化灶,11例显示胸膜增厚,肋膈角闭塞。35例均显示病变区软组织肿块影,16例肋骨边缘不整呈溶骨性破坏。胸壁包块切线位片30例显示胸壁软组织阴影呈半弧形突向胸壁。所有病人均未显示胸椎结核性病变。手术时予胸壁病灶彻底清除。切除两根肋骨者28例,两根以上者7例。创面以5％碳酸氢钠浸洗,以0.1％洗心泰冲洗,将链霉素粉1.0g撒丁刨面上,创口置乳胶管负压引流,以带蒂肌瓣充填残腔,术后局部加压包扎2周,抗结核治疗1年以上。治疗结果:一次手术成功32例,复发3例。其中     

骨母细胞瘤的X线诊断

目的：探讨骨母细胞瘤的X线表现及恶变征象。方法：8例行X线平片检查，其中2例做CT扫描，均经手术病理证实为骨母细胞瘤，1例局部恶变为侵袭性骨母细胞瘤，1例为骨母细胞型骨肉瘤，结果：骨母细胞瘤以脊柱，四肢长骨好发，呈囊状膨胀性骨质破坏，边缘有轻度硬化，内见小点片状，斑点状钙化，骨化影，部分有软组织肿块，一般无骨反应。结论：X线平片对骨母细胞瘤的诊断有一定价值。CT扫描更能显示肿瘤的内部结构，当破坏边缘模糊，病灶内钙化，骨化影模糊或减少，软组织肿块有钙化及术后复发，多提示有恶变可能。     

色素沉着绒毛结节性滑膜炎的CT诊断

目的分析色素沉着绒毛结节性滑膜炎的CT征象，以提高对该病的CT诊断能力。方法回顾性分析5例术后经病理证实的该病的X线、CT资料。结果5例中关节周边均可见软组织肿块影，4例可见相邻骨质虫蚀状破坏，软组织肿块呈中等程度强化，1例平扫软组织内可见砂粒状钙化斑。结论色素沉着绒毛结节性滑膜炎CT征象多样，确诊有赖于病理。     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.