帕金森病CT表现及微电极导向脑内核团毁损术后CT影像分析

目的探讨帕金森病(PD)的CT表现及微电极导向脑内核团毁损术后CT影像特点。资料与方法(1)对240例PD患者术前CT影像进行回顾性分析。(2)30例PD患者在术后3~12个月(平均6·5个月)CT扫描,观测脑内核团毁损灶33个(其中3例患者为双侧手术):右苍白球腹后内侧核(Gpi)毁损灶14个、左Gpi核毁损灶6个,右丘脑腹外侧核(Vim)毁损灶2个、左Vim核毁损灶11个,对毁损灶最大层面积、术侧CT值(任意值)、健侧对应点CT值(标准值)测量,并算出毁损灶与健侧CT值的差值。结果(1)PD的CT表现主要为中央型弥漫性脑萎缩,以脑室系统扩大为主,轻度脑萎缩46.67%(112/240),中度脑萎缩40%(96/240),重度脑萎缩3.33%(8/240),正常10%(24/240)。(2)33个毁损靶灶之圆形占27·27%(9/33);类圆形占60·61%(20/33);片状不规则形占12·12%(4/33)。毁损灶的面积Gpi核平均(28·01±2.15)mm2,Vim核平均为(14.03±1.24)mm2,两者对比有显著性差异(P<0.01);毁损灶Gpi核CT值较健侧平均下降(11.80±0.87)HU,Vim核CT值较健侧平均下降(10.80±1.28)HU,两者亦有差异性(P<0·05)。结论PD患者术前CT扫描对掌握手术适应证较重要,重度脑萎缩患者提示不宜做外科手术治疗。术后CT扫描观察毁损灶之形态、面积、密度变化等影像学改变,有利于对手术疗效、并发症等评估提供一定证据。     

螺旋CT在肝脓肿诊断中的应用

目的：评价螺旋CT、双期扫描对肝脓肿的诊断价值。方法：回顾性分析经临床或病理证实的28例肝脓肿的螺旋CT表现，所有病例均行平扫及螺旋CT双期增强扫描，其中5例经薄层重建后在工作站行表面遮盖重建(SSD)，并经切割处理，显示其冠、矢状位图像。结果：28例中，平扫表现为类圆形边缘不清楚的低密度灶17例，多房或簇状9例，不规则形1例，脓腔内积气1例。增强扫描动脉期28例均表现为病灶边缘极轻或轻度环状强化，其中有15例(53．5％)出现灶周楔形或片状一过性强化；门脉期显示簇状征9例，边缘强化10例，环靶征8例；另1例平扫为不规则形，增强扫描动脉期灶周出现明显楔形一过性强化，门脉期病灶内呈不规则强化，为较特殊表现。5例三维图像直观地显示了脓肿的立体形态和位置。结论：螺旋CT双期扫描对肝脓肿诊断有重要应用价值。动脉期的灶周楔形或片状一过性强化是肝脓肿又一重要CT表现，对诊断有指导意义。     

脑血吸虫病的CT分析(附67例报告)

目的探讨脑血吸虫病的CT特征及其诊断价值. 资料与方法 67例行CT扫描,其中33例经手术病理证实,34例结合患者疫水接触史、实验室检查证实. 结果 67例病灶位于大脑半球,多发病灶9例,单发病灶58例,CT上呈等密度或稍高密度区,周围有水肿及占位效应,结节及斑片状强化,局部脑萎缩表现呈不规则低密度区,患侧脑沟增宽. 结论 CT特征性表现结合急性血吸虫感染史有助于早期诊断,可为临床选择治疗方案提供依据.     

CT在流行性乙型脑炎诊断中的应用

目的 总结流行性乙型脑炎的CT表现,探讨CT在该病诊断及预后评估中的作用.方法 回顾性分析36例流行性乙型脑炎患者的临床资料及CT图像.结果 流行性乙型脑炎的CT表现与病情的严重程度及病程有关.初期(1～3 d),100%患者CT平扫未见明显异常;极期(4～10 d)50%患者CT表现异常,主要表现为脑实质斑片状低密度影、脑水肿、脑皮层下条片状出血影;恢复期(10～14 d)95%患者CT表现异常,主要为脑萎缩、脑沟增宽、脑实质内低密度病灶.结论 乙脑脑实质损害的患者CT征象具有一定的特异性,可为临床诊断、鉴别诊断及预后提供客观的依据.     

CT扫描在胸膜外孤立性纤维瘤中的诊断价值

目的探讨CT扫描在胸膜外孤立性纤维瘤(E-SFT)中的诊断价值。方法回顾性分析2015年4月至2018年4月于我院接受手术治疗的90例E-SFT患者术前CT检查影像资料和术后病理、免疫组织化学资料,评估CT检查在E-SFT诊断中的应用价值。结果 90例E-SFT患者均为单发肿瘤,免疫组织化学及病理学检查示良性80例,恶性10例;CT检查结果为良性72例,平扫表现为圆形或类圆形软组织密度影,密度不均匀,大部分边缘清晰,增强扫描表现为均匀强化;恶性18例,平扫示肿瘤体积较大,边界不清,密度不均,可见大片不规则低密度区,增强扫描瘤体强化不均匀,低密度区无明显强化;CT诊断的敏感度、准确度、特异性阳性率、阴性率分别为60%(6/10)、82%(74/90)、85%(68/80)、33%(6/18)、94%(68/72)。结论 E-SFT的CT检查影像图像具有一定的特征性,尤其是增强扫描有助于评估纤维瘤的良恶性,可将其作为术前诊断及术后复查评估的有效依据用于临床诊疗工作中。     

经皮肝穿射频消融治疗肝脏肿瘤术CT随访扫描技术探讨

目的 评价超声引导经皮穿刺射频治疗肝癌术后CT随访的时机和扫描技术。方法 回顾性分析198例超声引导经皮穿刺射频治疗肝癌术中的盯例患者，在术后1周至6个月的CT扫描方法和CT表现。结果 超声引导经皮穿刺射频治疗肝癌术后毁损灶在不同时期的CT表现各不相同。毁损灶在早期（一个月内）CT表现呈混合密度，中央区以稍高密度为主，而周围则呈低密度，病灶边界不清。增强扫描时中央区大部无强化，而边缘则呈不均匀强化。半年后随访病灶则呈边界清楚不强化的低密度影。结论 早期CT随访判定局部是否存在出血，毁损灶大小，有着重要的作用。中后期强化扫描对病灶的残留和复发的诊断有着重要的意义。中后期CT随访时应常规进行螺旋双期扫描。     

肝内周围型胆管细胞癌的CT诊断

目的:探讨肝内周围型胆管细胞癌(IHPCC)的CT特征,加深对IHPCC的认识。方法:回顾性分析经手术和病理证实的12例IHPCC的CT表现。结果:CT平扫12例均为类圆形或不规则形低密度灶,边界不清;病灶周围肝内胆管扩张5例;局部肝包膜回缩征象4例;增强扫描:动脉期与静脉期病灶无强化或轻度强化,延迟后病灶内部呈片状、分隔状或均匀强化。结论:IHPCC的CT表现有一定的特征性,对于与肝内其它常见病变的鉴别诊断具有重要价值。     

缺血性脑梗死与出血性脑梗死的CT鉴别诊断

目的讨论缺血性脑梗死(ICI)和出血性脑梗死(HCI)的CT鉴别诊断。方法21例ICI和11例HCI于临床症状出现后3h～29d内均经头颅CT平扫,对两组病人的CT表现进行了对比分析。结果在21例ICI患者的CT像上,18例表现为大片状低密度影内边缘清楚略高密度脑回状影“脑回征”和大片状低密度影内淡片状高密度影“浮云征”,3例表现为大片状低密度影内团块状高密度影“假肿瘤征”,而在11例HCI患者的CT像上,7例表现为大片状低密度影内不规则斑片状高密度影,4例表现为大片状低密度影内边缘模糊的血肿影。结论ICI与HCI具有不同的CT征象,因此,CT扫描是鉴别这两种疾病的关键技术。     

肺粘液表皮样癌的CT影像表现

目的 探讨肺粘液表皮样癌的CT影像表现.方法 回顾分析经手术病理证实的5例肺粘液表皮样癌患者的影像资料,5例患者均行CT平扫及增强扫描.结果 5例CT均表现为支气管内边缘光滑、边界清楚的类圆形或分叶状肿块,沿支气管生长,1例位于中间干支气管,1例位于叶支气管,3例位于段支气管,直径1～4cm.2例伴阻塞性肺不张,3例伴阻塞性肺炎.1例病变内见小斑片状钙化灶,其余4例病灶密度均匀,增强扫描轻度强化.只有1例有纵隔及同侧肺门淋巴结肿大.结论 肺粘液表皮样癌是位于支气管内的少见肿瘤,CT上表现为支气管内类圆形或分叶状肿块,伴有阻塞性炎症或肺不张,肿块密度均匀,增强扫描轻度强化.     

脑型肺吸虫病的CT诊断

本文报告了肺吸虫脑病8例的CT 扫描表现,以病理学改变为基础,可将CT 图像分为三型:(1)脑炎型2例,呈片状病灶伴灶周水肿;(2)囊肿型3例,呈环形影伴强化结节和灶周水肿;(3)萎缩型3倒,见脑萎缩、软化或钙化。     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

胎龄和日龄对新生儿局部脑血流的影响

目的探讨胎龄及日龄对新生儿局部脑血流(rCBF)变化的影响及规律.方法对早产儿组、足月早期新生儿组、足月晚期新生儿组进行99Tcm-双半胱乙酯(ECD)SPECT脑血流灌注断层显像,并作半定量分析和读片分析.结果早产儿组原始感觉运动区和枕叶rCBF低于足月早期新生儿组(P<0.05),显著低于足月晚期新生儿组(P<0.01),其额叶中份、顶叶rCBF也低于足月晚期新生儿组(P<0.05),其余各叶皮质rCBF随胎龄和日龄的增大有增加趋势.早产儿组脑血流显像图与足月早期新生儿组和晚期新生儿组比较有明显差异.结论早产儿与足月儿rCBF的变化可能与新生儿大脑皮质相应区域发育成熟度和时间顺序有关.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Radiological strategy in acute stroke in children

The aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic or hemorrhagic, their etiologies and the correct diagnostic protocol for acute management.Forty-one consecutive pediatric patients (age range 5-16 years) with an acute stroke observed in acute phase during a 10-year period, were retrospectively evaluated. Twenty-three patients underwent magnetic resonance imaging (MRI), 3 cases were studied by computed tomography (CT) without MRI, and 15 underwent both CT and MRI studies. In 9 cases, intra-arterial digital subtraction angiography (IADSA) was performed after non-invasive preliminary assessment.Seventeen hemorrhagic (41%) and 24 ischemic (59%) strokes were found. Among hemorrhagic forms, 5 cases were due to arteriovenous malformation (AVM), 7 to cavernoma, and 2 to aneurysm. Among ischemic forms, 2 were due to sickle-cell disease, 1 to hyperomocysteinemia, 1 to moyamoya syndrome, 1 to pseudoxantoma elasticum, 3 to prothrombotic state, 1 to Fabry's disease, 1 concomitant with CO intoxication, 5 to venous sinus thrombosis, and 4 to cardio-embolic state. Etiology remains unknown in 8 cases (20.5%).This study shows a moderate prevalence of ischemic over hemorrhagic strokes. Moreover, personal experience suggests that MRI is always more informative than CT and in selected cases should be the first-choice examination in the acute phase.