肺及部分左心房切除治疗肺癌一例

１临床资料患者，男性，４３岁，胸痛咳嗽咯血４个月，于１９９５年１０月２日入院。Ｘ线胸片示左全肺不张。胸腔Ｂ超见左胸８．３ｃｍ×４．７ｃｍ大小实质性回声团块。肺及纵隔平扫及增强ＣＴ见左肺门区一６．５ｃｍ×５．７ｃｍ大小肿块；增强后病灶呈不均匀强化，左主...     

肺内立结节CT隔窗,肺窗与病理对照研究

对４０例经手术切除的肺内孤立性结节在ＣＴ纵隔窗、肺窗及病理大体标本上的最大径进行了对照研究（其中肺癌２５例，良性结节１５例。）结果认为，在ＣＴ片结节大小的测量中，纵隔窗更为准确。在良恶性结节鉴别中，肺窗与纵隔窗相差≥０．５ｃｍ，恶性可能性大，肺窗与纵隔窗相差≤０．２ｃｍ，良性可能性大。     

恶性滋养细胞肿瘤结节型肺转移52例X线表现及动态变化

对经诊刮或阴道排泄物脱落细胞病理检查证实的恶性滋养细胞肿瘤（ＭＴＴ）５２例结节型肺转移的Ｘ线表现,动态变化与临床及血清ＨＣＧ和（或）β－ＨＣＧ的关系进行分析,呈多发性转移３９例（７５％）,孤立性转移１３例（２５％）;Ｘ线表现为边缘模糊且密度浅淡的圆形结节３８例（７３．１％）,边缘清楚,密度中等的圆形或椭圆形结节１４例（２６．９％）,其中５例直径＞４ｃｍ。经正规化疗１～２个疗程后边缘模糊密度浅淡的结节,数目减少直至完全消失３７例（７１．２％）,继续进展、增大或呈非同步吸收的１０例（１９．２％）。分析认为,ＭＴＴ结节型肺转移化疗后病灶吸收的快慢与转移灶的数目、大小、密度均有密切的关系,血清ＨＣＧ和（或）β－ＨＣＧ的峰值随病灶吸收消失而逐渐降至正常。对多次检测血清ＨＣＧ和（或）β－ＨＣＧ为正常的肺部孤立性大结节宜手术切除。     

CT对特发性肺纤维化诊断价值探讨

为评价ＣＴ对特发性肺纤维化（ＩＰＦ）肺内病变判定的有用性，对ＩＰＦ的ＣＴ（ＨＲＣＴ）和胸片所见与临床，肺功能及支气管肺泡灌洗细胞这变化进行相关性分析，结果发现，胸膜下弧形影或新月征是ＩＰＦ较具特征性的ＣＴ改变，ＣＴ或胸片所见与呼吸困难程度，ＦＶＣ（％ｐｒｅｄ）ＤＬｃｏ（％ｐｒｅｄ）及ＢＡＬＦ中性粒细胞有显著相关性，而相关性的程度ＣＴ高于胸片，认为ＣＴ或胸片均要对ＩＰＦ的临床床和肺功能损害及肺泡炎的     

肾细胞癌的CT诊断(附112例分析)

为了进一步研究ＣＴ对肾细胞癌的诊断价值,笔者分析了经手术切除病理证实的１１２例肾细胞癌的临床ＣＴ表现。结果ＣＴ特征表现为：（１）８４例肿块呈分叶状,边界不清,有短毛刺,并与肾周筋膜相连;（２）１７例肿块周边弧线状或中心斑点状钙化;（３）４６例肿块直径超过５ｃｍ者,密度不均,增强后坏死、囊变呈更低密度区;（４）８例直径≤３ｃｍ的小肾癌,长在肾实质内,边缘较清楚,密度不均。并就肿瘤分期及鉴别诊断进行了讨论。认为ＣＴ是诊断肾细胞癌最有价值的检查方法之一,ＣＴ表现可为术前定性诊断及术前分期,确定治疗方案及估计预后提供重要依据。分叶状肿块边缘有短毛刺并与肾周筋膜相连是肾细胞癌的特征性表现。     

鱼刺炎性肉芽肿误诊肺癌1例报道

患者,男,６１岁．咳嗽、咳痰、痰中带血丝伴低热半年,经抗炎治疗效果不佳．查体：右锁骨上可触及淋巴结．胸部正位片右肺下野中内带片状密度增高影,边缘不清,毛糙．右侧位片下叶内基底段片块影,有毛刺及分叶,纵隔肺门未见确切淋巴结增大,肋隔角清晰．右侧倾后斜体层肿块使下叶内基底段支气管腔阻塞,直径约３ｃｍ,有长短毛刺,分叶明显（见图１）．１月半后复查胸片肿块增大约５ｃｍ．图１　胸部正侧位片右肺下叶内段不规则块影,分叶状、边缘有毛刺．ＣＴ扫描见右肺下叶内基底段类圆形致密块影,约２４ｃｍ×２５ｃｍ,边缘有…     

多原发性肺癌1例

１ 临床资料 患者，男，６８岁。咳嗽、咳血３个月，左胸痛１周人院。有长期吸烟史，近期进行性消瘦。白细胞数１２．０× １０９／Ｌ，癌胚抗原９．３ μ ｇ／Ｌ。支气管镜示左肺下叶鳞癌。胸片示左肺上叶、下叶分别见密度均匀肿块影。ＣＴ见左肺上叶５．０ｃｍ × ６．5ｃｍ软组织密度肿块，边缘清楚，呈浅分叶；左下叶６．０ｃｍ × ７．1 ｃｍ软组织肿块，边缘模糊，中央见低密度影，左下叶肺不张。手术后病理：左肺上叶腺癌，左下叶鳞癌。２ 讨论 多原发性肺癌是指肺内发生两个或两个以上的原发性肺癌灶。国内报道很少，仅为０．５％～…     

肺内孤立结节CT纵隔窗、肺窗与病理对照研究

对４０例经手术切除的肺内孤立性结节在ＣＴ纵隔窗、肺窗及病理大体标本上的最大径进行了对照研究（其中肺癌２５例，良性结节１５例）。结果认为，在ＣＴ片结节大小的测量中，纵隔窗更为准确。在良恶性结节鉴别中，肺窗与纵隔窗相差≥０．５ｃｍ，恶性可能性大，肺窗与纵隔窗相差≤０．２ｃｍ，良性可能性大。     

肺血管外皮细胞瘤一例

肺血管外皮细胞瘤一例郭德和万荣华韩育宁（宁夏医学院附属医院胸心外科７５０００４）患者女，３３岁。间断性咳嗽、咯血３月；Ｘ线胸片见左上肺约４ｃｍ×３ｃｍ的圆形块影，密度欠均匀，边界较清。ＣＴ扫描左上肺有约４ｃｍ×３ｃｍ肿物，肺门和纵隔未见肿大淋巴结。１...     

6例肺原发性肉瘤及癌肉瘤的X线和CT诊断

肺原发性肉瘤及癌肉瘤很少见，笔者收集到６例，均经手术和病理证实，现结合文献分析如下。１病例介绍例１，男，４８岁。胸痛、咳嗽、血痰４个月。体检无阳性体征。正位胸片示：左肺门外下方见一５ｃｍ×５ｃｍ的圆形块影，边缘清楚，分叶状。侧位片见块影位于左肺下叶背...     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.