多层螺旋CT在脑血管疾病中的诊断及应用

目的探讨16层螺旋CT血管成像在脑血管疾病中的诊断价值及其应用.方法分析了2011年1月~2011年12月我院对26例脑血管病变患者行16层螺旋CT双期增强扫描及数字减影血管造影(DSA)检查,CT扫描原始数据经后台工作站多功能后处理技术处理,并比较CT表现与DSA.结果26例脑血管病变,CT血管造影(CTA)检出急性脑血管闭塞8例,血管狭窄2例,脑内动脉瘤9例, Moyamoya病2例,动静脉畸形4例.除1例CTA显示大脑前动脉动脉瘤而DSA未能检出外,其余病例CTA与DSA检查结果一致.结论螺旋CT血管成像对脑血管疾病的诊断具有准确、快速的特点,可作为脑血管病变的首选检查方法.     

多层螺旋CT血管成像在颅内血管性疾病的应用价值

目的 应用多层螺旋CT扫描并探讨其在颅内血管畸形病变中的临床应用。方法 20例疑诊脑血管畸形及动脉瘤患者进行16层螺旋CT脑血管成像检查,对图像进行多种模式的后处理。结果 20例检查中发现Willis环及分支动脉狭窄5例,先天性变异3例,烟雾病1例,AVM6例,动脉瘤5例。多层螺旋CT脑血管成像(SCTA)准确的显示Willis环及主要分支,应用多种重建方式显示动脉瘤;明确显示动静脉畸形的所致的畸形血管团。结论 多层螺旋CT脑血管CTA是能够对临床疑诊血管畸形诊断的一种可靠检查方法,能无创的为临床治疗提供治疗选择方法。     

16层螺旋CT血管成像在脑血管病变诊断中的应用

目的探讨16层螺旋CT血管成像在脑血管疾病诊断中的应用价值。方法21例脑血管病变患者均行16层螺旋CT双期增强扫描及数字减影血管造影(DSA)检查,CT扫描原始数据送到工作站上进行最大密度投影(MIP)、多平面重建(MPR)及容积重建(VR),讨论其CT表现并与DSA进行对照。结果CT血管造影(CTA)检出脑内动脉瘤7例,动静脉畸形5例,Moyamoya病2例,急性脑血管梗塞5例,血管狭窄2例。除1例CTA显示大脑前动脉动脉瘤而DSA未能检出外,其余病例CTA与DSA检查结果一致。结论16层螺旋CT血管成像安全、快速、无创、准确性高,可作为脑血管病变的首选检查方法。     

16层螺旋CTA在颅内血管性病变的诊断应用

目的 探讨16层螺旋CT血管造影（SCTA）在颅内血管性病变的诊断价值。方法 搜集我科2004年5月～2005年9月期间,应用16层螺旋CT血管造影并使用CTA软件进行容积重建（VR）、多平面重建（MPR）、最大密度投影（MIP）、显示脑血管,诊断31例颅内血管性病变。评价其诊断病变的价值。结果 31例中诊断出颅内动脉瘤18例,动静脉畸形9例,静脉瘤2例,动脉狭窄2例。SCTA可清楚显示病变的位置、大小、形态以及与周围血管和颅骨的关系,对动静脉畸形能清晰显示供血动脉和引流静脉。结论 16层螺旋CT血管造影对颅内血管性病变的诊断,具有无创、快捷、安全、准确性高等特点,可作为颅内血管性病变的首选而有效的检查方法 。     

MSCT血管造影在颅内血管性疾病中的诊断价值

目的探讨16层螺旋CT血管造影（MSCTA）在颅内血管性疾病中的诊断价值。方法对339例患者行16排螺旋CT血管造影,同时采用容积重建（VR）、多平面重建（MPR）、最大密度投影（MIP）显示血管,其中45例动脉瘤、22例动静脉畸形、4例烟雾病和18例脑动脉狭窄随后进行了DSA检查或手术治疗。结果CTA诊断为动脉瘤的患者83例,动静脉畸形22例,静脉瘤2例,海绵状血管瘤3例,海绵窦动静脉瘘3例,单纯烟雾病3例,烟雾病合并动脉瘤1例,缺血性脑血管病22例,先天性变异等32例,正常病例186例,其中CTA诊断的45例动脉瘤、22例动静脉畸形、4例烟雾病和18例脑动脉狭窄与DSA检测结果及手术结果基本一致。结论MSCTA对头部血管性疾病的诊断,具有微创、快速、安全、准确性高的特点,可作为头部血管性疾病的首选影像学筛查。     

64层螺旋CT头颈部血管成像技术的应用

目的:探讨头颈部血管CT血管成像(CTA)的有关技术和影响因素。方法:分析64层螺旋CT头颈部血管造影检查144例,其中23例行数字减影血管造影术(DSA)对照检查。结果:144例CTA均能清楚显示4级或4级以上脑动脉血管分支,其中阴性33例、动脉闭塞11例、动脉变细或狭窄72例、动静脉畸形4例、动脉瘤23例、动脉钙化或斑块16例、其它20例。23例行DSA检查的病例中:CTA检查5例动脉狭窄病例仅1例DSA证实有狭窄,余4例中3例为阴性、1例为颅底小动脉瘤;CTA检查9例动脉瘤DSA均证实有动脉瘤存在;CTA检查3例阴性病例DSA检查也为阴性;另6例包括动静脉瘘、动脉闭塞、动脉瘤栓塞术后,两种检查结果基本符合。结论:64层螺旋CT头颈部CTA对动脉瘤的诊断价值最高;对动脉狭窄程度的诊断价值需进一步证实;脑肿瘤患者加行静脉相成像对手术指导具有一定意义。     

16层CT脑血管容积成像的临床应用

目的:探讨16层螺旋CT脑血管容积成像的技术优势及临床应用价值.方法:回顾性分析52临床怀疑脑血管性疾病患者的16层CT脑血管成像(CTA)资料,并与数字减影(DSA)脑血管造影检查结果或手术病理对照.结果:52例中,脑动脉瘤33例,16层CT容积成像清晰显示所有动脉瘤的形态、大小、生长方向、瘤颈特征及其与载瘤动脉的关系、瘤体与相邻血管和颅骨的三维结构关系,优于DSA.脑血管畸形8例,16层CT容积成像并显示畸形血管团的形态、范围大小以及供血动脉、引流静脉的形态及数量.烟雾病2例,16层CT容积成像显示闭塞血管近段及颅底异常增生侧枝血管.结论:16层螺旋CT脑血管成像对脑血管性病变的诊断具有较大价值,对临床治疗具有重要的指导意义.     

16排螺旋CT血管造影对脑血管病变的临床应用价值

目的探讨16螺旋CT脑血管造影对脑血管病变的临床应用价值。方法回顾性分析86例脑血管病变的16排CTA检查资料,应用容积重建(VR)、最大密度投影(MIP)重建和多平面重建(MPR)技术对脑血管影像表现进行评价。24例行数字减影血管造影(DSA),并与CTA检查的结果进行对照。69例手术所见与CTA结果对照。结果 86例患者中诊断为动脉瘤68例,动静脉畸形(AVM)18例。86例16排CTA的VR、MIP和MPR重建图像对脑血管主干及其主要分支显示100%,大脑中动脉5级分支显示96%(83/86)。16排螺旋CT脑血管造影均清晰显示动脉瘤位置、大小、形态、瘤颈及载瘤动脉关系。也清晰显示了18例AVM的畸形血管团、供血动脉和引流静脉。结论 16排螺旋CT脑血管造影成像技术是一种无创伤的颅内血管性病变检查方法。由于它安全、方便、快速,重建图像质量高,辐射量明显减少,定性、定位明确,16排螺旋CT血管造影能为手术计划提供详实的影像资料,可作为脑动脉瘤、脑血管畸形等脑血管病变筛选的首选方法。     

16层螺旋CT血管造影对脑血管病变的应用价值初探

目的　探讨 16层螺旋CT血管造影 (CTA)对脑血管病变的应用价值。方法　使用 16层螺旋CT对 18例病人行CTA检查 ,应用VR和MIP法重建 ,对血管显示情况进行评价。其中 2例动脉瘤与DSA对照 ,2例动脉瘤和 2例AVM与手术结果对照。结果　 18例CTA脑血管主干其主要分支显示率 10 0 % ,大脑中动脉 5级分支显示率 94.44 %(17/18) ,清晰显示了 4例动脉瘤瘤体、瘤颈、载瘤动脉的关系及与颅骨之间的空间关系。清晰显示了 2例AVM畸形血管团 ,供血动脉和引流静脉。结论　 16层螺旋CT脑血管造影重建图像质量高 ,快速、无创 ,可以作为脑血管病变首选的筛检方法。     

SCTA对出血性脑血管病诊断价值

目的对比分析DSA与SCTA检查对出血性脑血管病的确诊价值。方法对出血性脑血管病中DSA检查阳性的38例病人与之前所做的SCTA结果进行对比分析,探讨SCTA对出血性脑血管病病因诊断的准确率。结果本组病例中有29个动脉瘤在SCTA影像清晰观察到脑动脉瘤的瘤体大小、瘤颈宽度及与载瘤动脉的关系,与DSA及介入栓塞、动脉瘤夹闭术所见完全吻合,比较两种检查方法对动脉瘤瘤颈宽度、瘤体最长径数值无显著性差异,有2例在DSA检查中未发现SCTA显示部位动脉瘤,检出率为93.55%,其中大脑中动脉M2段1例、大脑前动脉A2段1例;6例动静脉畸形DSA显示清晰,SCTA清晰显示4例脑动静脉畸形血管团大小、形态及供血动脉和引流静脉,检出率为85.71%,1例显示为阴性,此例行DSA检查动静脉畸形位于胼缘动脉末端,属微小的动静脉畸形。结论 SCTA对脑血管病变的诊断既安全、方便、快速且定性、定位明确,可作为脑动脉瘤、脑血管畸形等脑血管病变筛查的首选方法。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…