羟甲芬太尼立体异构体的晶体结构

对强效镇痛剂羟甲芬太尼的两个光学异构体体cis-(3R,4S,2′R)-羟甲芬太尼(I)和trans-(3R,4R,2′S)-羟甲芬太尼(Ⅱ)进行了X-射线衍射晶体结构分析。两个异构体均有一个sp³N(l)原子和一个sp²N(7)原子。哌啶环呈椅式构象,顺式异构体I的3-甲基处于直立键,4-N-苯基丙酰胺基处于平伏键;反式异构体II的3-甲基与4-N-苯基丙酰胺基均处于平伏键。在I分子中,C(4)原子与4-丙酰胺基组成的平面与N-苯环平面近似相互垂直,而在II中,两平面的二面角近似为100℃。两异构体分子中均存在分子内氢键O(1)一H…N(1),反式异构体II还存在分子间氢键O(1)一H(A)…O(2)(B)。     

Nonconvulsive Status Epilepticus After Intravenous Contrast Medium Administration

Summary: Purpose: We describe a 52-year-old man with a glioblastoma multiforme who had a prolonged partial seizure immediately after undergoing a computed tomography (CT) scan of the head with intravenous contrast medium.
Methods: Earlier computed tomography (CT) had demonstrated a ring-enhancing hypodense mass. The patient was treated with a regimen of intravenous Tirapazamine and brain irradiation. After CT scan performed on the day of his second hospitalization, the patient became aphasic. EEG showed continuous high-voltage semirhythmic sharp and slow waves in the left posterior temporal and parietal regions consistent with status epilepticus (SE). Intravenous lorazepam and a loading dose of phenytoin were administered.
Results: On the next morning, the patient's condition had improved almost to baseline. He had no recurrent seizures. EEG at 2-month follow-up showed no epileptiform discharges.
Conclusion: This appears to be the first reported case of contrast medium-induced status epilepticus.     

骨血管瘤的X线诊断

目的：探讨骨血管瘤的X线表坎特点及诊断和鉴别诊断。材料和方法：对发生于脊柱、颅骨、长管状骨、肋骨、肩胛骨共15例进行X光摄片、结果：骨血管瘤的基本X线表现是：椎体为栅栏状或网眼状、颅骨为放射状、长管状骨为泡沫状等改变。结论：骨血管瘤发生在不同部位有不同的特点，这些特点具有较高的诊断和鉴别诊断价值。     

Inclusion complexation of glibenclamide with 2-hydroxypropyl-β-cyclodextrin in solution and in solid state

Phase solubility diagrams have been used to investigate complexation between 2-hydroxypropyl-β-cyclodextrin (HPBCD) and glibenclamide (GM) in aqueous medium. More stable GM-HPBCD complexes were formed in alkaline medium (in which the drug is in ionized form) than in acid medium (in which the drug is in non-ionized form). The formation of solid GM-HPBCD inclusion complexes has been evaluated by using kneading, spray-drying and freeze-drying methods. Characterization of the resulting mixtures by X-ray diffraction, infrared spectroscopy and differential scanning calorimetry indicated that inclusion complexes can be obtained by spray drying and freeze drying but not by kneading. According to the phase solubility results, drug solubility in alkaline medium was greatly improved by inclusion with HPBCD, whereas in acid medium inclusion with HPBCD had no appreciable effect. Cyclodextrin complexation of ionized drug molecules in alkaline medium resulted in greater total solubilization, i.e., solubilization of the drug due to both cyclodextrin complexation and ionization.     

11例类似肿瘤的包裹性结核性腹膜炎的X线和B型超声诊断

本文报告了11例类似肿瘤包裹结核性腹膜炎的X线和B型超声(简称B超)诊断,提出了与本病有关疾病的鉴别诊断,最后讨论了本病肿块诊断、传染途径、性别因素以及预后等问题。     

肺大细胞癌的X线诊断

本文报告27例肺大细胞癌的X线研究结果,全部病例均病理证实。男性24例,女性3例,男女之比为8:1。周围型比较多见,生长迅速,转移较早。中心型大细胞癌或发生纵隔与肺门淋巴结转移者,其X线表现类似胸内淋巴瘤。周围型肿块可以坏死形成空洞或发展成大的实质性肿块。本病X线诊断不难,使用适当的活检技术,70～90％的病例可以确诊。     

应用64层CT评价左冠状动脉前降支动脉硬化狭窄程度与左心功能的相关性

目的 利用64层CT对左冠状动脉前降支动脉硬化狭窄与左心功能变化之间的相关性进行评估.方法 经64层CT确诊的左冠状动脉前降支动脉硬化狭窄共104例,正常对照20例,均行64层螺旋CT心功能分析,分别计算出左心室质量、左心室射血分数、左心室舒张期末容积和左心室收缩期末容积等参数.根据管腔狭窄程度把104例左冠状动脉前降...     

髋关节病变的CT影像分析

目的 阐明髋关节病变的CT表现,评价CT在诊断髋关节病变中的价值.方法 回顾分析经临床确诊或病理证实的126例髋关节病变的CT征象,其中股骨头缺血性坏死32例,退行性骨关节病24例,强直性脊柱炎伴髋关节改变8例,髋关节炎性改变(包括结核)19例,转移瘤17例,髋臼或股骨头、颈部骨折26例.对126例患者采用双侧髋关节对照常规位CT扫描,层厚5 mm,间距5 mm.结果 股骨头缺血坏死显示股骨头硬化、囊变及软骨下骨折,晚期继发骨性关节炎改变;退行性骨关节病以承重区关节畸形和骨性关节面改变为主,软骨下囊变特别明显;强直性脊柱炎累及髋关节表现为髋臼关节面锯齿状或毛刷状破坏;髋关节结核关节面广泛骨质破坏,可见到小死骨和寒性脓疡;类风湿性关节炎关节间隙普遍狭窄,关节面下小囊肿周围无明显骨硬化;滑膜骨软骨瘤病显示滑膜增厚和其内小钙化灶,较大的骨软骨体呈桑椹状表现.结论 各种髋关节病变的CT表现不同,CT能清楚显示髋关节解剖结构及病变的部位、范围和病理解剖细节,在鉴别诊断、了解病情的发展和疗效观察方面有很大优越性.     

CT测量标定穿刺路径在椎体成形术中的应用

目的探索理想的椎体成形术穿刺路径和穿刺方法、提高穿刺精准性。方法椎体成形术穿刺前全部行伤椎CT扫描,根据椎弓根形态、椎弓根与椎体正中线的夹角大小,对伤椎穿刺进针路径进行CT测量标定。术中按CT测量的穿刺路径应用椎体成形穿刺导向器导引穿刺,穿刺针到位后摄伤椎正、侧位X线片,了解穿刺针位置是否符合。术后再行伤椎CT扫描观察穿刺针道是否符合。结果术中拍摄伤椎正侧位X线片与术后CT扫描穿刺针道分析显示,365个椎体节段,穿刺路径与CT测量路径符合者324节段,穿刺符合率88．8％。41节出现明显偏差,不符合率11．2％。结论CT下测量标定穿刺路径并指导穿刺在椎体成形术中的应用是有效的方法。     

腮腺基底细胞腺瘤的CT诊断

目的探讨基底细胞腺瘤的CT表现特点及其临床应用价值。方法回顾分析经手术及病理证实的10例腮腺基底细胞腺瘤的CT表现,所有患者均进行了腮腺CT平扫及增强扫描。结果边界清楚、大小不等、增强扫描显著强化的软组织块影是腮腺基底细胞腺瘤的特征性CT表现,增强扫描较平扫CT值增加最高约200Hu,平均增加84Hu。结论腮腺基底细胞腺瘤CT表现具有一定特征性,结合临床特点能够在术前作出定性诊断。