多层螺旋CT对自发性蛛网膜下腔出血病因诊断与临床应用价值

目的探讨多层螺旋CT血管造影（CTA）在蛛网膜下腔出血（SAH）病因诊断中的临床应用价值。方法对2008年1月至2011年2月收治入院的56例SAH患者行CTA检查,其中52例同时接受数字减影血管造影（DSA）检查。分析CTA检查结果并与DSA检查结果比较。结果56例患者中CTA检出动脉瘤43例,动静脉畸形（AVM）5例,静脉窦血栓3例,阴性5例;在同时接受DSA检查的患者中,发现动脉瘤45例,AVM5例,阴性1例,其中除1例CTA发现并经临床证实的动脉瘤DSA检查为阴性外,其余全部证实CTA诊断。CTA对SAH病因诊断中的敏感性和特异性均为95．8％,DSA分别为98％和100％。结论多层螺旋CTA对SAH的病因诊断是一种无创、快速、便捷的影像学检查方法,其脑血管立体成像技术对自发性蛛网膜下腔出血的病因诊断准确性高,可显示血管的空间立体结构及周边关系,有助于临床手术治疗方法的选择和难度的评估,可作为急诊SAH的首选检查方法。     

128层螺旋CT血管成像在自发性蛛网膜下腔出血病因诊断中的价值

目的:探讨128层螺旋CT血管成像在自发性蛛网膜下腔出血(SAH)病因诊断中的价值。方法:收集我院2011年10月至2012年3月的SAH病例35例行128层螺旋CT血管成像检查,其中27例行脑血管造影(DSA)检查。结果:以DSA和手术结果为标准,本组35例患者中CTA正确诊断动脉瘤24例27个,动静脉畸形4例,阴性4例;误诊1例,漏诊2例。CTA对SAH病因诊断敏感性为93.33%,特异性是80.00%。CTA对SAH病因诊断结果与DSA比较无统计学差异。结论:128层螺旋CT血管成像对SAH诊断安全、快速、准确,可用作SAH病人病因诊断的首选检查方法。     

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。     

256层螺旋CT血管造影在蛛网膜下腔出血诊断中的应用

目的 探讨256层螺旋CT血管造影(256-CTA)在蛛网膜下腔出血(SAH)诊断中的应用价值.方法 对2010年12月到2011年12月54例SAH患者行MSCTA检查与数字减影血管造影(DSA)检查,分析256-CTA与DSA检查结果并相互比较.结果 54例患者中256-CTA检出动脉瘤42例,静脉窦血栓2例,动静脉畸形6例,阴性4例;DSA结果显示动脉瘤44例,动静脉畸形5例,静脉窦血栓2例,阴性3例,其中经临床与DSA证实1例CTA假阳性.结论 256-CTA是一种无创、快速、便捷的影像学检查方法,可清晰显示血管的空间立体结构与周边关系,对治疗方法的选择和难度的评估有利,且对SAH的病因诊断具有重大意义.     

CT血管造影在急性蛛网膜下腔出血中的诊断和治疗作用

目的 评价CT血管造影(CTA)在急性自发性蛛网膜下腔出血(SAH)患者中的诊断和治疗作用. 方法 36例SAH行CTA,其中16例同时行数字减影血管造影(DSA)检查. 结果 CTA检查的36例SAH中动脉瘤29例,脑动静脉畸形(AVM)4例,阴性3例.所有CTA检查结果与手术相符,其中经DSA检查的16例与CTA检查结果完全一致.结论 CTA可作为SAH患者早期诊断的有效手段及制定治疗方案的辅助手段.     

CT血管成像对自发性蛛网膜下腔出血病因的诊断价值

目的：探讨CT血管成像对自发性蛛网膜下腔出血(SAH)病因的诊断价值。方法42例临床拟诊为SAH的患者进行螺旋CT血管成像(CTA)检查和数字减影血管造影(DSA)检查,对其影像资料进行回顾性分析。结果42例患者中CTA诊断脑血管动脉瘤31例35枚(包括误诊1例),脑动静脉畸形2例,MoyaMoya病1例,阴性8例（包括漏诊3例）;DSA诊断脑血管动脉瘤33例37枚;脑动静脉畸形2例,MoyaMoya病1例,阴性6例。结论 CTA成像可以快速、准确的判断自发性蛛网膜下腔出血的病因,可以作为临床筛查的首选检查方法之一。     

64排螺旋CT血管造影在外伤性蛛网膜下腔出血诊断中的价值

目的:探讨64排螺旋CT血管造影(CTA)在外伤性蛛网膜下腔出血诊断中的意义.方法:对38例蛛网膜下腔出血患者术前行CTA检查,与全脑血管造影(DSA)检查结果比较.结果:CTA检查,检查出动脉瘤8例,动静脉畸形3例,其中大动脉瘤3例,小动脉瘤2例,一般动脉瘤3例;DSA检查发现动脉瘤9例.结论:CTA和DSA检查蛛网膜下腔出血患者结果基本一致.     

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.     

头颅CTA在自发性蛛网膜下腔出血病因诊断中的价值

目的 探讨CT血管造影(CTA)在自发性蛛网膜下腔出血(SAH)病因诊断中的应用价值.方法 对81例SAH的患者行头颅CTA检查,应用各种后处理技术显示颅内动脉,以明确病因.结果 本组81例SAH患者经CTA 检查发现动脉瘤62例,动静脉畸形(AVM)1例,阴性18例.结论 头颅CTA检查对SAH的患者,能够及时明确诊断,可作为SAH病因诊断的首选检查.     

CT、CTA、DSA在蛛网膜下腔出血中的应用

[目的] 分析蛛网膜下腔出血(SAH)的CT、CTA、DSA影像表现，以提高对SAH之病因诊断的准确性。[方法] SAH患者66例，男35例，女31例，年龄17～74岁，平均45岁，全部CT检查，其中55例行DSA检查，15例行CTA检查。[结果] CT检查，检出动脉瘤5例；DSA检查，其中检出动脉瘤45例，动静脉畸形6例；15例CTA检查，检出动脉瘤12例，动静脉畸形1例。[结论] CTA与DSA在SAH的病因诊断中有着重要的价值，CTA作为简便的非损伤性血管检查方法，对危重及术后复查患者更具实用价值。     

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…