Cerebral perfusion SPECT imaging for assessment of the effect of hyperbaric oxygen therapy on patients with postbrain injury neural status

Aftertheacutephaseofbraininjury ,manypatientswoulddevelopavarietyofsymptoms,suchasheadache,dizziness,insomnia ,poormemory ,epilepsy ,andhysteria.Collectivelytheseareknownclinicallyaspostbraininjuryneuralstatus.Ithasbeencontroversialwhetherthemechanismispsychologicalororganic,andthereisnoeffectivetreatmentatpresent.FromMay 1992toDecember 2 0 0 2 ,wehavetreated 32 0patientswith postbraininjuryneuralstatusdiagnosedbyneurosurgeonsandemergency physiciansinourhospital.Thepatientsweretreatedwithmedi…     

Accuracy of the clinical examination to predict radiographic instability of the lumbar spine

Forty-nine patients with low-back pain referred for flexion-extension radiographs due to suspicion of lumbar instability were studied to examine the relationship between the clinical presentation and the presence of radiographic instability of the lumbar spine. Patients had a mean age of 39.2 (±11.3) years, with a mean Oswestry score of 20.4% (±13.3). The median duration of symptoms was 78 days. All patients underwent both a radiographic and clinical examination. The reliability of the radiographic variables was high, while the reliability of clinical variables ranged from moderate to good. Twenty-eight patients (57%) had radiographic instability based on published norms. Clinical variables related to the presence of radiographic instability were age, lumbar flexion range of motion, total extension range of motion, the Beighton scale for general ligamentous laxity, and segmental intervertebral motion testing. The presence of at least 53° of lumbar flexion or a lack of hypomobility with intervertebral motion testing resulted in a positive likelihood ratio of 4.3 (95% CI: 1.8, 10.6), for predicting radiographic instability. The results of this study indicate that various factors from the clinical examination are useful for predicting radiographic instability. If the findings of this study can be replicated, these clinical factors could be used to inform treatment decision-making without a sole reliance on radiographic assessment.The opinions and assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Air Force or the Department of DefenseA comment to this article can be found at     

人工膝关节表面置换术后的X线学评价

目的；随访调查了ＮＣＵ型ＴＫＡ对术后各假体经时的Ｘ线学变化，比较性评价使用骨水泥固定与非水泥固定ＴＫＡ术后各假体组件的稳定性。方法：１９８９年至１９９５年在ＯＡ和ＲＡ患者中共施行６８例１０３关ＮＣＵ型ＴＫＡ，获得较完整的随访资料６５例９９关节，采用Ｘ线学评价法计测了术后即时最终调查时的ＦＰＡ，ＴＰＡ，ＦＰＴＡ，ＴＰＴＡ，并观察评价了Ｘ线透亮线，假体下沉及无菌性松动等项目。     

放射吸收法测量北京地区人群手指骨骨量的研究

放射吸收法（Radiographic Absorptiometry,RA) 利用放射性吸收的原理，经过对非优势侧手指骨排照X光后，经过扫描进入数码处理技术分析给出骨密度的报告，从而对骨折危险性进行预测。2001年夏，我们课题组使用美国CompuMed公司OsteoGram计算机分析系统对北京地区正常人群，10－89岁583人（其中男279人，女281人），进行了非优势手2，3，4指骨中节的RA骨密度测量。该设备先通过一个铝楔形物作为参照与手一起照射X光片，然后采用高分辨的扫描仪，对冲洗后的X光片经扫描成像后输入一个计算机分析系统，最后根据输入的图象以及被测病人的各种参数自动给出定量的骨矿密度参数及骨质疏松诊断报告。检测结果显示男性和女性的峰值骨密度均出现在20－29岁。该结果与刘忠原 教授80年代末使用SPA测量40000中国人群中远1／3前臂骨（桡骨、尺骨）结果具有极好的相关性。该结果表明RA测得的男性和女性的峰值骨密度以及BMD丢失百分率符合BMD丢失的一般规律，也具有BMD正常数据库的一般特征。     

Radiographic absorptiometry: A simple method for determination of bone mass

Bone mass measurements have been shown to be useful determinants of the risk of development of osteoporotic fractures and may help identify individuals who are most likely to benefit from both primary and secondary prevention of osteoporosis. As standard bone density measurements are not available to all physicians, there is a need for a fast, inexpensive, and widely available technique to measure bone mass. Radiographic absorptiometry of the phalanges requires only routine radiography with processing of the films done at a special off-site laboratory. We performed a preliminary investigation to see whether this simple technique could be used to predict a low bone mass as defined by dual- and single-photon absorptiometry. Correlations between radiographic absorptiometry and the standard techniques were as good as those among the standard techniques themselves (r=0.58–0.9). Radiographic absorptiometry measurements predicted low bone mass of the lumbar spine and femoral neck with 90% and 82% sensitivity respectively. If further evaluation supports these initial conclusions, radiographic absorptiometry may be useful as a screening technique for primary care physicians and in research settings where dual-photon or dual-energy X-ray absorptiometry are impossible.     

Hand radiographs: a comparative study of digital luminescent radiography (DLR) and conventional screen-film system combinations

A total of 102 matched hand radiographs were taken by digital luminescent radiography (DLR) and conventional) screen film system combinations. In DLR two differently postprocessed images were obtained from each data set: A display with low-spatial frequency enhancement filtered to took like a conventional radiograph was placed opposite a display with high-edge enhancement. Conventional and digital images were evaluated rank only and separately by four radiologists, using a questionnaire. Using DLR proved diagnostically equivalent to the conventional technique except for a diminished visibility of subtle erosions and fissures. High-frequency enhancement did not provide additional diagnostic information and led to artifacts at the edges of metal prostheses. Densitometry confirmed an optimized density of digital radiographs. The main argument for the employment of digital techniques is the availability of data for picture archiving and communications systems.     

肝移植术后淋巴组织增生性疾病的诊断和治疗(附1例报告及文献复习)

目的探讨肝移植术后淋巴组织增生性疾病(posttransplant lymphoproliferative disease,PTLD)的诊断和治疗。方法回顾性分析1例肝移植后PTLD的临床表现、诊断和治疗过程,并复习相关文献。结果 2003年10月至2011年12月在中山大学附属第三医院肝移植中心随访的336例肝移植术后患者中有1例发生PTLD,发生率为0.3%。该例患者的临床表现不典型,主要表现为反复发热、腹部不适、多处淋巴结肿大和肝脏占位病变等,淋巴结活组织检查提示B细胞源性非霍奇金淋巴瘤淋巴瘤,确诊为PTLD。经减少免疫抑制剂用量、抗炎,对症支持治疗无效后死亡。结论肝移植术后PTLD的临床表现不典型,易被误诊或延误诊断,预后甚差。治疗以减少免疫抑制剂用量、抑制淋巴细胞增殖、对症支持治疗为主。     

PADI4 polymorphisms and susceptibility to rheumatoid arthritis: a meta-analysis

The objective of the study was to investigate the association between peptidylarginine deiminase 4 (PADI4) polymorphism and susceptibility to rheumatoid arthritis (RA). An electronic searching strategy was employed to collect relevant studies on the association between PADI4 polymorphism and susceptibility to RA. The odds ratio (OR) with the 95 % confidence interval (95 % CI) was used to evaluate the RA risk presented by PADI4 polymorphism. Fixed or random effects models were selected based on heterogeneity. Publication bias was assessed using funnel plots, Begg’s test, and Egger’s test. A total of 27 studies from 21 articles were included. Six gene loci (padi4_94, 104, 92, 90, 89, and 100) were chosen for the meta-analysis. The pooled ORs (95 % CI) for allele 2 versus 1 were 1.08 (1.05–1.12), 1.17 (1.12–1.23), 1.26 (1.18–1.36), 1.17 (1.10–1.24), 1.30 (1.17–1.44), and 1.25 (1.11–1.40), respectively. All six SNPs were significantly associated with RA in Asian populations. Three SNPs (PADI4_104, 90, 89) showed significant associations, while the other three SNPs (PADI4_94, 92, 100) exhibited no associations in the European population. A dose–response relationship between allele 2 of PADI4 and the risk of RA was also identified. In conclusion, this meta-analysis suggests that PADI4 polymorphisms represent a significant risk factor for RA, especially in Asians.     

在胸部X线体检中节约胶片的设想

目的建议在胸部X线体检中节约胶片。方法①分析并计算文献中有关胸部X线体检的平均阳性率。②以X线线对测试卡为标准,对CR诊断屏及相应CR胶片上胸部图像的分辨率进行对比分析。结果①文献中胸部X线体检的平均阳性率为0.22%,胸部X线体检肺结核的平均阳性率0.13%。②CR诊断屏上,图像大小调整为原始图像的1倍、2倍及4倍时,其分辨率分别为0.8线对/毫米、1.6线对/毫米、2.5线对/毫米,相应的CR胶片上的分辨率均为2.5线对/毫米。结论胸部X线体检阳性率低。在CR诊断屏上阅片,可满足诊断要求。因此建议仅对图像结果阳性者打印胶片,从而节约胶片。     

先天性心脏病肺动脉高压X线和血液动力学、病理组织学的对照研究

本文分析１００例左向右分流先天性心脏病肺动脉高压的Ｘ线平片所见，并和血液动力学、病理组织学检查结果进行了对照研究，首次明确提出了Ｘ线分级标准，并着重阐述了Ⅲｂ的诊断标准：二尖瓣型心脏，轻度增大或不大，仅有右心室增大或以右心室增大为主，中外带肺血管纹理明显变细、扭曲，肺血无明显增多甚至减少，肺野清亮。Ⅲｂ反映肺动脉压力和全肺阻力重度升高，肺血管病变为Ⅲ级或Ⅳ级，属不可复阶段，不宜手术，预后较差。