囊性星形细胞瘤转移瘤和脑脓肿的MRI诊断

目的探讨MRI对囊性星形细胞瘤、转移瘤和脑脓肿的诊断价值。方法回顾性分析28例囊性星形细胞瘤、14例囊性转移瘤和10例脑脓肿的MRI平扫、增强及DWI表现。结果Ⅰ￣Ⅱ级星形细胞瘤17例,壁结节呈T1等T2信号,11例囊壁和壁结节明显强化,另6例呈单纯囊性,囊壁无明显强化。Ⅲ￣Ⅳ级星形细胞瘤11例,囊壁厚薄不均,囊壁呈不规则花环样强化。转移瘤14例,囊壁厚薄均匀,内壁欠光整,壁结节囊壁明显强化。脑脓肿10例,脓肿壁囊壁厚薄较均匀呈等T1等T2信号,脓肿壁明显强化。28例囊性星形细胞瘤和14例脑转移瘤DWI囊液信号均为低信号,而10例脑脓肿则为显著高信号。结论根据囊性星形细胞瘤、转移瘤和脑脓肿MRI信号特点及DWI表现可有效鉴别三者。     

MRI在脑脓肿诊断中的应用价值

目的:探讨MRI在诊断脑脓肿中的价值。方法:对临床、手术和病理证实的35例脑脓肿分别进行常规MRI平扫、增强、T2FLAIR和弥散加权成像(DWI)检查。结果:35例脑脓肿共45个病灶,其中15个病灶在T1WI上出现"暗线"征,19个病灶在T2WI上出现"暗带"征,19个病灶在T2FLAIR上出现"亮带"征;19个病灶DWI上呈程度不等的高信号,ADC值低,6个病灶呈等、低信号,ADC值增高;45个病灶脓肿壁均强化明显,显示脓腔、脓肿壁及水肿带征象。结论:"暗带"征和ADC值对脑脓肿的MRI诊断有一定价值,对脑脓肿的MRI检查,DWI应纳入常规。     

脊柱结核的MRI诊断

目的：探讨脊柱结核的MRI表现,并与化脓性脊柱炎、转移瘤及脊柱原发肿瘤相鉴别.方法：回顾性分析20例经手术病理证实的脊柱结核患者的MRI资料,观察椎体、椎间盘、附件破坏,硬膜囊和脊髓受压情况.结果：（1）20例患者53个椎体受累,单椎体受累2例,2个椎体3例,3个椎体15例.T1W1上呈均匀低信号或混杂低信号.T2W1上呈均匀高信号或混杂高信号.增强扫描呈不均匀强化.（2）椎间盘破坏、椎间隙变窄14例,椎间隙消失6例.T1W1呈低信号,T2W1呈不均匀高信号.（3）20例均有寒性脓肿,T1W1呈低信号,T2W1呈高信号,增强扫描呈不均匀强化或环状强化.（4）4例患者椎弓根受累,17例脊髓受压.结论：MRI可观察脊柱结核受累椎体、椎间盘、附件的形态及信号改变,并清楚地显示硬膜外脓肿和/或脊柱后凸对于脊髓的压迫,脊髓变性,寒性脓肿的范围,有助于诊断和鉴别.     

28例脑脓肿的CT与MRI表现分析

28例经手术或脑穿刺病理证实的脑脓肿病例，均行CT平扫和增强检查，其中23例行MRI检查。其CT与MRI表现为：单发24例，多发4例。CT平扫示各个时期的脑脓肿表现不完全相同，典型病灶主要表现为低密度囊性病灶或等低混杂密度的囊实性病灶(20～42Hu)，其中2例病灶内含气体，增强后病灶中央无强化。周围有明显强化的壁，除6例囊壁欠光整外，其余病灶囊壁较光整。MRI平扫示病灶中央呈低T1WI、高T2WI信号灶，有环形的高信号的壁，增强后壁强化明显，病灶中央无强化。认为脑脓肿CT与MRI表现有一定特征性，CT、MRI对脑脓肿有极高的诊断价值。     

青少年鞍区肿瘤15例CT与MRI分析

目的探讨青少年鞍区肿瘤的CT和MRI表现及临床价值.方法回顾性分析15例青少年鞍区肿瘤的CT及MRI表现,其中13例经病理证实,2例经药物治疗随访病灶消失而证实.结果(1)颅咽管瘤8例,CT表现为鞍区囊性或囊实性肿块,部分囊壁蛋白壳样钙化;MRI T2W像表现为高信号,T1W像分别表现为高中低信号;(2)生殖细胞瘤5例,CT表现为鞍区等或稍高密度肿块,大部分均匀强化;MRI T2W像表现为高信号,T1W像表现为等或低信号;(3)垂体微腺瘤2例,CT无异常发现,MRI T1W像表现为垂体内略低信号小结节.结论MRI在青少年鞍区肿瘤的诊断和鉴别诊断中有重要价值.     

30例脑脓肿患者的影像学诊断

目的提高对脑脓肿CT、MRI影像学表现的认识和诊断水平。方法对30例临床怀疑或确诊为脑脓肿患者行CT和MRI检查,临床表现为头痛、呕吐、视乳头水肿等颅内压增高。结果CT典型表现为边界清楚的低密度灶,增强后脓肿包膜呈均匀环状高密度带,脓肿中央密度不变：MRI表现脓肿中央区在T1和T2加权成像均为低信号,包膜则为边界清楚的高信号环,所有脓肿壁上均有一光滑的低信号＂暗带＂,增强扫描见脓肿壁呈厚度均匀的环状强化,内缘光滑。结论脑脓肿CT、MRI表现具有一定特征性,是敏感、准确、快捷的检查方法,适用于各部位脑脓肿的诊断。     

脑脓肿的CT和MRI影像学诊断

目的：提高对脑脓肿CT、MRI影像学表现的认识和诊断水平。方法：对30例临床怀疑或确诊为脑脓肿患者行CT和MRI检查,临床表现为头痛、呕吐、视乳头水肿等颅内压增高。结果：CT典型表现为边界清楚的低密度灶,增强后脓肿包膜呈均匀环状高密度带,脓肿中央密度不变：MRI表现脓肿中央区在T1和T2加权成像均为低信号,包膜则为边界清楚的高信号环,所有脓肿壁上均有一光滑的低信号“暗带”,增强扫描见脓肿壁呈厚度均匀的环状强化,内缘光滑。结论：脑脓肿CT、MRI表现具有一定特征性,是敏感、准确、快捷的检查方法,适用于各部位脑脓肿的诊断。     

3.0TMR在颅咽管瘤诊断中的价值探讨

目的 讨论3.0T磁共振(MR)在颅咽管瘤诊断中的应用价值.方法 对我院7年间入院的41例颅咽管瘤患者的磁共振成像(MRI)图像进行回顾性诊断分析,所有患者均经手术病理证实,总结颅咽管瘤的MRI特点.结果 41例患者中,有19例患者MRI T1WI呈低信号、T2WI高信号;12例T1WI呈现高信号、T2WI高信号;8例患者T1WI为等信号、T2WI高信号;2例患者T1WI为低信号、T2WI低信号.增强后所有患者实性部分均出现明显强化,囊性部分均无强化,但出现囊壁强化.结论 颅咽管瘤的MRI诊断具有较高的准确率,掌握对本病MRI信号的认识,利于在疾病的早期作出准确的诊断.     

25例脑脓肿MRI表现分析

目的:评价MRI平扫、增强检查及弥散加权成像(DWI)、表现扩散系数(ADC)图在脑脓肿诊断中的作用。方法:对25例脑脓肿患者进行常规MRI检查和DWI检查,观察脑脓肿在常规MRI和磁共振扩散加权成像的表现。结果:本组患者隐源性脑脓肿22例,慢性中耳炎所致3例。脑炎期4例,包膜期21例;增强扫描后全部病灶均有明显的环形强化,强化环周围可见云絮状强化区,15例脓肿壁T2WI有一光滑的低信号"暗带";19例脓腔于DWI呈程度不等的高信号,ADC值低;6例DWI呈等、低信号,ADC值增高。结论:脑脓肿的MRI表现有一定的特征,其中"暗带"征、DWI、ADC对脑脓肿的诊断具有重要价值。     

细菌性肝脓肿的MRI诊断

目的:探讨不同时期肝脓肿的MRI表现,提高对肝脓肿的诊断水平。方法:分析经临床病理确诊的35例肝脓肿的MRI扫描特点,并与肝癌、肝转移瘤、肝血管瘤、炎性假瘤等对比。结果:肝脓肿病变发展阶段不同,其MRI表现不同,按照肝脓肿病变发展阶段不同,其MRI表现可分3种。早期肝脓肿(8例)MRI平扫T1WI表现为圆形、椭圆形、多房性病变,脓肿壁及分隔呈低信号,脓腔呈低或稍高信号,T2WI表现为脓肿壁及分隔呈低信号,脓腔呈高信号,病灶周围见稍高信号水肿带;典型肝脓肿(25例)MRI平扫T1WI表现为单个或多个大小不等圆形、椭圆形、分叶状病变,脓肿壁呈低信号,脓腔呈低或稍高信号,T2WI表现为脓肿壁呈低信号,脓腔呈高信号、病灶周围水肿带呈稍高信号;纤维肉芽肿性肝脓肿(2例),T1WI呈明显低信号,T2WI呈低或等信号。结论:不同时期肝脓肿MRI表现不同,不同时期均具有特征性表现。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.