64排CT双期增强联合MPR对T3和T4期直肠癌的诊断意义

目的探讨64排螺旋CT双期增强联合矢状位、冠状位MPR图像对T3和T4期直肠癌的分期诊断价值。方法两名评价者分别应用CT横断位图像及CT横断位联合MPR图像评价直肠癌T3期27例,T4期15例。对比两种评价方法的差异。结果两名评价者联合MPR图像评价T3、4期直肠癌的ROC曲线下面积、敏感性、特异性及两名评价者一致性分析均明显增加,显著降低不确定分期病例数。两评价方案评价阴道及子宫受侵之间的差异统计学意义。结论双期增强CT横断位联合MPR图像能够更加准确地区分T3期、T4期直肠癌,有助于预测邻近器官受侵及侵犯范围,特别是有助于阴道及子宫受侵的诊断。     

螺旋CT三维和多平面重建在胸腰椎骨折中的临床应用

目的：探讨螺旋CT三维和多平面重建在胸腰椎骨折中临床应用价值。材料和方法：回顾性分析23例胸腰椎骨折和螺旋CT扫描及三维和多平面重建资料。重点观察椎体骨折的部位、椎体序列、椎体高度、骨折线、椎体附件和旋转／脱位等的CT表现。结果：23例中轴位CT显示27个椎体骨折，25个横突骨折，3个棘突骨折，3个椎弓根骨折，15个椎板骨折，4个椎间关节脱位，0个椎体脱位，1个椎体旋转，25个椎管狭窄。三维重建显示分别为27、15、3、2、7、2、4、1、25个；多平面重建显示上述结构骨折分别为27、5、3、2、5、2、4、0、25个。三维和多平面重建显示椎体骨折效果好，但对附件的显示相对较差。在显示椎体的脱位和／或旋转方面三维重建最为直观。结论：胸腰椎骨折的螺旋CT三维和多平面重建，是辅位CT扫描有价值的补充手段。进行三维和多平面重建规范化操作流程，可提高其诊断效果。     

3-Dimensional Echocardiographic Analysis of the Tricuspid Annulus Provides New Insights Into Tricuspid Valve Geometry and Dynamics

Objectives

The authors used transthoracic 3-dimensional transthoracic echocardiography (3DE) to characterize tricuspid annulus (TA) geometry and dynamics in healthy volunteers.

多层螺旋CT联合多平面重建技术在胃癌术后复发诊断中的价值

目的:探讨多层螺旋CT(MDCT)联合多平面重建技术在胃癌术后复发诊断中的价值。方法:回顾性分析胃癌根治术120例的临床病例资料,所有患者在手术成功后4个月给予MDCT联合多平面重建技术进行诊断。结果:CT诊断为术后复发40例,复发率为33.3%,其中局部复发25例,远处转移15例,常规CT扫描与腹部多平面重建图像都有很好的特征性。胃底、胃体和胃窦肿瘤的术后复发率分别为15.0%,12.5%和53.3%,胃窦肿瘤的术后复发率明显高于胃底与胃体(P0.05)。logistic多因素回归分析显示肿瘤浸润深度与阳性淋巴结数是影响胃癌术后复发的独立危险因素(P0.05)。经病理和临床随访证实为复发42例,无复发78例,MDCT联合多平面重建技术在胃癌术后复发诊断中的应用敏感性与特异性为95.2%和100.0%。结论:肿瘤浸润深度与阳性淋巴结数是导致胃癌术后复发的危险因素,多层螺旋CT联合多平面重建技术对于胃癌术后局部复发与淋巴结转移的检出率都较高,具有很好的诊断敏感性与特异性。     

One‐year post‐hospital medical costs and relapse rates of bipolar disorder patients in Taiwan: a population‐based study

Tang C‐H, Hsieh MH, Hung S‐T, Lee IH, Lin Y‐J, Yang YK. One‐year post‐hospital medical costs and relapse rates of bipolar disorder patients in Taiwan: a population‐based study.
Bipolar Disord 2010: 12: 859–865. © 2010 The Authors.
Journal compilation © 2010 John Wiley & Sons A/S. Objectives: We examined a nationwide population‐based dataset of patients with bipolar disorder (BD) hospitalized in Taiwan, with our analyses focusing on one‐year medical costs and relapse rates. Methods: The data for this study, covering the years 2006 and 2007, were obtained from the Taiwan National Health Insurance (NHI) claims database. The study sample comprised BD patients who were discharged from hospitals between January 1 and December 31, 2006. Annual medical costs and relapse rates were described; the Kaplan–Meier method and the generalized linear models were carried out to examine the risk factors associated with cases of relapse. Results: The annual medical costs associated with relapses among the study sample were found to be approximately 7.6 times the average per‐capita NHI expenditure in Taiwan in 2006 (US$4,354 versus US$574), with a one‐year relapse rate of 55%. Those patients between 20 and 60 years old with a medication possession ratio of <80 and with depressive episodes during the recruitment period were identified as being at risk of relapse. Conclusion: Bipolar disorder, which is a very costly disease, is associated with both poor medication adherence rates and frequent recurrences. Targeting drug adherence issues during maintenance treatment may well provide a valuable opportunity to reduce the risk of such recurrences.     

Nutritional mismatch in postnatal life of low birth weight rat offspring leads to increased phosphorylation of hepatic eukaryotic initiation factor 2 α in adulthood

Objective

Epidemiological studies have established that low birth weight offspring, when faced with a nutritional mismatch in postnatal life, have an increased risk of developing the metabolic syndrome. Our laboratory and others have demonstrated that maternal protein restriction (MPR) leads to high cholesterol and insulin resistance in the offspring due to impaired liver function, though the underlying molecular mechanisms remain elusive. Recent in vitro studies have associated decreased phosphorylation of Akt1 (Serine 473), a marker of insulin sensitivity, with increased phosphorylation of eukaryotic initiation factor (eIF)-2α (Serine 51), a key regulator of protein translation attenuation. The main aim of the study was to determine whether nutritional mismatch in MPR offspring leads to elevated phospho-eIF2α (Ser51) levels in the liver.

Materials/Methods

To investigate if this occurs long-term in MPR offspring, pregnant Wistar rats were fed a control (20%) protein diet (control) or a low (8%) protein diet during pregnancy and postnatal life (LP1), or during pregnancy and lactation (LP2).

Results

At postnatal day 130, LP2 offspring exhibited increases in hepatic phosphorylation of eIF2α (Ser51) concomitant with decreases in the phosphorylation of Akt1 (Ser473), while LP1 offspring exhibited the converse relationship. Interestingly, in embryonic day 19 livers derived from control or MPR pregnancy, no changes in eIF2α (Ser51) or Ak1 (Ser473) phosphorylation were observed.

Conclusion

Collectively, our data provide robust evidence that phosphorylation of eIF2α (Ser51) is inversely correlated with phosphorylated Akt1 (Ser473) in vivo. Moreover, this study demonstrates that this inverse relationship is adversely influenced in these MPR offspring by a mismatch in the postnatal nutritional environment.     

多层CT多平面重组及三维重建在齿状突骨折中的诊断价值

目的探讨多层螺旋CT多平面重组及三维重建在枢椎齿状突骨折中的诊断价值。方法回顾性分析12例枢椎齿状突骨折的CT横轴位图像、多平面重组（MPR）图像及三维重建（3D）图像。结果10例枢椎齿状突骨折运用CT横轴位图像结合MPR及3D重建首次即明确诊断。2例隐匿性骨折首次未做MPR、3D重建而漏诊,再加做MPR、3D重建后确诊。结论多层螺旋CT的MPR、3D重建对枢椎齿状突骨折,尤其是隐匿性骨折具有重要诊断价值。     

腰椎软骨结节的多层螺旋CT分型及临床意义

目的提高对腰椎软骨结节的认识,探讨多层螺旋CT多平面重组对本病的分型及其临床意义。方法回顾性分析85例经16层螺旋CT机容积扫描的腰椎软骨结节患者,并进行多平面重组,最后由2名有经验的CT诊断医师进行评价。结果85例腰椎软骨结节分为椎体中央型、椎体前缘型和椎体后缘型（LMPN）三种类型。CT表现为椎体局部骨质缺损,其内有椎间盘密度充填,周边骨质硬化。椎体中央型46例70个结节;椎体前缘型15例15个结节;椎体后缘型（LPMN）24例24个结节,均伴发椎体后缘离断,硬膜囊及神经根容易受压,18例继发椎管狭窄。结论MSCT能明确腰椎软骨结节的分型与诊断,椎体中央型与椎体前缘型软骨结节多无临床意义,而椎体后缘型（LPMN）常继发椎体后缘离断与椎管狭窄,临床症状明显,MSCT对制订手术方案具有重要指导意义。