多层螺旋CT灌注成像技术在肝硬化中的应用价值

Objective To research the value of hepatic perfusion with multi - slice spiral CT in the diagnosis of liver cirrho-sis. Methods Using Philips Brilliance 6 spiral CT and post - processing software to study 25 cases normal person CT perfusion ima-ging data and 32 cases patients with cirrhosis. Results Compared with the control group,TTP of hepatic artery has no difference, in portal vein,liver tissue and spleen tissue were delayed, and the peak of TIP were reduced in Liver and spleen. BF were reduced, BV were reduction, MTT were significantly slowed down. Conclusion Multi - slice spiral CT perfusion imaging technology not only pro- vides the morphology of cirrhosis information, but also provide hepatic hemedynamic changes. CT perfusion technology can be used as a routine examination in patients with liver cirrhosis.     

CR系统在床旁胸部摄影中的应用

Objective To study and analyze the image‘s quality and apphcation value of CR system in bedside X - ray of chest. Methods 100 cases, which half of them were examined by CR system and others by traditional X- ray, were compared by experienced doctors and operators. Results In CR system, 16 are excellent, 21 are good, 13 are passed, none is rejected. But in traditional X - ray, only 3 are excellent, 11 are good, 32 are passed, and 4 are rejected. Conclusion CR system is better than traditional X- ray examining.     

磁共振成像在急性脊柱脊髓创伤中的诊断价值

Objective To study the diagnostic value of MRI in acute 70 patients suffered from acute trauma of the spine and spinal cord, and compared the manifestations in different imaging techniques. Results MRI is superior to CT and plain film in detecting acute spinal cord injury, slight vertebral body fracture, intraspinal and soft tissue injuries adjacent to vertebral body. Conclusion MRI is indispensable in the diaghosis of acute trauma of the spine and spinal cord.     

软骨样副脊索瘤（附病例报告）

To study the clinical pathological characteristics and differentiation diagnosis of the chondroid parachordoma from primary tumors or metastatic to ulna, femur and radius. Methods Three cases of primary chondroid parachordoma of the ulma, femur and radius were studied by histopathological observation and immunohisto chemical staining and by pathological consultation. Results The histological features of tumor were composed of two the chordoma ceils subtotal and the chondrosareoma ceils of small - portio. The tumor was arranged vary in sizes of lobular and brink of lobular were seplum small girder of chondroid, or the tissue fiber. The tumor cells were distributed sheet, trabecula with or island -like in the intralobular, and the tumor ceils were vary in size and the karyon heterotypic were no patent and the cytoplasm of rich shows large vacuole. The chondroidosarcomas intra - lobular were viewed ceils both nucleus and uninuclear of chondrolacunae and the stroma were hyaling cartilage with or blennoid in the mesenchyma, and that picture of typical chondrosarcoma. EMA, CK, Vimentin, S - 100 protein, NSE with immunohistochemical method (ABC) staining were positive and Desmin, CD34 negative in the all of tumor cells. The chondroid parachodoma was diagnosed in the pathological read- section- conference and consulation. Conclusion Primary ulna, femur and radius chondroid parachordoma is a rare in rate of neoplasm and is diagnosed diflqculdy. Immunohistochemical method would be helpful to diagnosis.     

血清基质金属蛋白酶3与颈动脉粥样硬化斑块及缺血性脑卒中的关系

Objective To investigate the relationship between the matrix metalloproteinase-3(MMP-3)and the stability of carotid artery plaque,and explore MMP-3's prediction role on the attack and relapse of acute ischemic cerebrovascular events.Methods 100 patients with the first ever acute cerebral infarction,100 patients with chronic cerebral circulation insufficiency(CCCI)and 40 persons without cerebrovascular diseases were enrolled in this study.According to the carotid ultrasound examination,100 cerebral infarction patients were divided into three subgroup: unstable plaque group(45 patients,mixed plaque,soft plaque),stable plaque group(35 patients,plaque Group)and endometrial coarse group(25patients).Matrix metalloproteinase-3(MMP-3)levels of all the subjects were measured by enzyme-linked immunosorbent assay(as basal level).All the subjects were followed up for one year to observe cerebral infarction events.Serum MMP-3 levels of each group,and the basic serum MMP-3 levels were compared among patients who were attacked or relapsed cerebral ischemic with those who had not been attack cerebral ischemic during this period of time.Results 5 patients in the cerebral infarction group had relapse (5%),2 patients in the CCCI group were attacked by cerebral ischemic(2%),and no one in the normal control group was attacked by cerebral ischemic.Serum MMP-3 levels in the acute cerebral infarction group were significantly higher than CCCI group,and both groups were significantly higher than normal control group (P ＜0.05).The basic serum MMP-3 levels in all patients who were attacked by cerebral ischemic were significantly higher than those who had not been attack by cerebral ischemic during this period of time(P ＜0.05).The serum MMP-3 levels of the unstable plaque group were significantly higher than stable plaque group.And both groups were significantly higher than endometrial coarse group(P ＜0.05).Conclusions Elevated levels of matrix metalloproteinase-3(MMP-3)might have something with the stability of carotid atherosclerotic plaque,and participate the attack and the relapse of acute cerebral infarction.Determination of MMP-3 might be used to predict the attack and relapse of acute cerebral infarction.     

后踝关节面解剖复位和内固定在踝关节骨折手术治疗中的临床意义

目的 总结治疗踝关节骨折中后踝骨折的手术方法和治疗效果.方法 自2005年3月至2010年6月,手术治疗后踝骨折54例.男36例,女18例;根据CT分类Ⅰ型36例,Ⅱ型10例,Ⅲ型8例.应用改良的Baird-Jackson评分系统对其术后疗效进行评定,并将骨折类型、骨折固定方法、术后功能锻炼时间与最终功能的关系进行分析.结果 随访时间为6～36个月,平均18个月.54例疗效:优29例,良18例,可5例,差2例,优良率为87.03%.除4例长时间行走有轻微疼痛外,其余患者均无疼痛.结论 手术治疗后踝骨折可取得满意的骨折复位和临床疗效,复位的质量与疗效密切相关,判断骨折类型和选择固定方法对于提高复位质量,改善远期疗效十分重要.

Abstract：

Objective To evaluate the clinical significance of anatomic reduction and internal fixation of posterior malleolar fracture in ankle fracture surgical treatment. Methods Fifty-four patients with posterior malleolar fracture were treated with anatomic reduction and internal fixation from March 2005 to June 2010. The patients groups consisted of 36 males and 18 females. According to CT scan classification,the group was made up of 36 type Ⅰ cases, 10 type Ⅱ and 8 type Ⅲ cases. All patients were evaluated with modified Baird-Jackson scoring system. The relationship between final result and fracture pattern , fixation methods, the time of exercise initiation fitted operation were analyzed respectively. Results The followedup period varied from 6 months to 36 months, with an average of 18 months. The number of patients whose result was excellent, good, fair and poor was respective 29,18 ,5 and 2. The total percent age of good to excellent clinical result was 87. 03%. There were 4 patients who had only slight pain after long time walking ,the remainder patients were completed with no pain. Conclusion Operative treatment may provide satisfactory fracture anatomic reduction and internal fixation for posterior malleolar fracture. Correct fracture pattern estimation and proper internal fixation are important to achieve and improve reduction quality, and to ameliorate better long term results.     

11例甲型H1N1流感孕产妇的临床分析

Objective To study the clinical characteristics and therapeutic effect of pregnant women infected with severe influenza A(H1N1), to survey the disease effects for the newborns. Methods The clinical data of 11 pregnant women infected with influenza A(H1N1 ) in our hospital from November to December 2009 were analyzed retrospectively. Results All the cases were in serious conditions, and 3 cases were in critical. All the patients were with symptoms of fever and cough, the temperature were in 38.7-39.6 ℃, and duration were 3-14 days. There were 9 cases with low lymphocytes, and 9 cases with high WBC. CRP were elevated in all the cases ( 12-129 mg/L), 9 cases were with hypochromia (22.4-30.2 mg/L). X ray showed increases of pulmonary hilar density for all the cases. By comprehensive treatment, 10 patients were cured and one showed marked progress. 9 cases continued pregnacy. One infant with septicemia was cured, other newborns and fetus were in good condition. Conclusions Pregnant women infected with influenza A (H1N1) are likely to develop severe condition. It is important to use antiviral treatment promptly,supplementary comprehensive treatment. Continuing pregnancy is safe, but the outcome to newborn needs further study.     

On the Procedures for the Demonstration of the RF Safety of Active and Passive Implants in MRI Environments

As a diagnostic method,magnetic resonance imaging(MRI)is not allowed to be used in patients with medical implants,including both active implants(such as cardiac defibrillators or deep brain stimulators)and passive implants(such as orthopedics implants and support).MRI imaging scanning can produce magnetic fields,which will produce concentrated electromagnetic induction on metal edges of the implants,such as electrodes.The magnetic field can also significantly increase the temperature of surrounding tissues.Besides,the currents and voltage produced by active implants when exposed to MRI scanning can lead to damage and malfunction of pulse generators.Therefore,patients with medical implants cannot receive MRI as a diagnostic method.This safety protocol prevents a large group of patients from receiving MRI diagnosis.This leads to the conclusion that the safety evaluation of implants under MRI environment requires the combination of accurate data analysis and experimental techniques so as to establish the standard testing program.     

34例肺部结节SPECT-CT的99m Tc-MIBI显像分析

目的 评价同机图像融合技术99mTc-MIBI显像对肺部恶性肿瘤的诊断价值.方法 临床经X线平片或CT扫描发现肺部结节患者34例,共计48个肺部结节样病灶,以GE公司InfiniaHawkeye 4 SPECT-CT行10min及2h延迟胸部断层99mTc-MIBI显像,以ROI技术测定其T/NT比值,并以同机螺旋CT扫描同机图像融合,对早期及延迟图像分别读片,判断显影结果,并对其T/NT比值根据其最终病理结果进行统计分析.结果 34例患者共计48个肺部结节,早期显像阳性结节数21,延迟显像阳性结节数16,(T/NT比值＞3.33),以延迟显像阳性为最终判定标准,肺部恶性病灶其T/NT比值较良性病灶差异有统计学意义(P＜0.05).阴性结节数为27,经手术病检证实13例为肺部恶性肿瘤病灶,假阳性结节数3,假阴性结节数为2,其灵敏度88.88%,特异性90.9%,阳性预测值+PV 84.21%,阴性预测值-PV 93.75%.结论 99mTc-MIBI作为一种肿瘤阳性显像剂,对于肺部占位性病变的灵敏度高,但其特异性不高,而99mTc-MIBI显像和CT扫描,其可提高其诊断价值,与普通SPECT显像相比,灵敏度及特异性均有显著提高.可在不具备PET-CT及符合探测SPECT设备的基层医院及经济欠发达地区运用.

Abstract：

Objective To evaluate the value of the fusion of 99m Tc-MIBI imaging technology apply in the diagnosis of malignant lung tumor. Methods Thirty - four cases with lung nodules proved by X-ray and/or CT scanning, a total of 48 lung nodular lesions. And the imaging with-99m Tc-MIBI of chest performed at 10 minutes and 2 hours delayed after injection by GE Infinia Hawkeye 4 SPECT-CT. then the regions of interesting ( ROI) were drawn in the tumor and contra lateral position to calculate the radioactivity ratios of tumor to normal ( T/NT) , and fused with the spiral CT scanning image in the same machine, and reading the early and delayed image respectively. Judged the result of the image develops, and statistical analysis of the ratio (T/NT) according to the final pathologic consequence. Results All cases with total of 48 nodular lesions, 21 nodules were positive in early imaging, 16 nodules were positive in delayed imaging (the ratio T/NT over 3. 33). defined the delayed image positive as the final criterion, The(T/NT)ratios of Malignant lung lesions were significantly higher than the benign lesions ( P ＜0. 05). Negative nodes 27, 13 cases of lung cancer lesions were malignant, confirmed by postoperative pathologic examination. The falsepositive nodules 3, false-negative nodules 2. The sensitivity was: 88.88%, the specificity was: 90.9% positive predictive value ( +PV) was: 84. 21% , negative predictive value (-PV) is: 93.75%. Conclusion 99mTc-MIBI as a tumor positive imaging agent is highly sensitivity to lung lesions, but specificity is not so high.     

新疆哈萨克族人群代谢综合征患病率调查

Objective To analyze the prevalence of metabolic syndrome (MS) in Kazakh population, using the NCEP-ATP Ⅲ, CDS, IDF MS standards. Methods Questionnaire-based survey,physical examination and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang. 2745 samples were collected and diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards to analyze the prevalence, with the distribution of its main components of MS, among the Kazakhs population. Results The prevalence rates of MS diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards were 18.5%, 14.2% and 26.6%, while they became 14.2%, 10.9% and 20.1% after standardized by age. The prevalence of MS diagnosed by NCEP-ATP Ⅲ and IDF standard in males were higher than in females, while CDS was in the opposite situtation. The prevalence of MS by these three standards increased with age. Among all the main components of MS diagnosed after these three standardization process, the prevalence of obesity, blood pressure rising and the abnormity of HDL-C were rather high. The prevalence of MS main components ≥1, ≥2, ≥3, ≥4, 5 ranked the highest compared to the lowest as to the IDF, ATP Ⅲ ' and CDS diagnostic. standards Conclusion The prevalence rates and gender distribution of MS diagnosed by different standards among Kazakhs were different. The prevalence of IDF standard was the highest, with the IDF standard better than the others in early identifying the risk factors of cardiovascular disease.     

新疆哈萨克族人群代谢综合征患病率调查

Objective To analyze the prevalence of metabolic syndrome (MS) in Kazakh population, using the NCEP-ATP Ⅲ, CDS, IDF MS standards. Methods Questionnaire-based survey,physical examination and blood testing were conducted according to cluster random samplings in Kazakh residents in Xinjiang. 2745 samples were collected and diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards to analyze the prevalence, with the distribution of its main components of MS, among the Kazakhs population. Results The prevalence rates of MS diagnosed by NCEP-ATP Ⅲ, CDS,IDF standards were 18.5%, 14.2% and 26.6%, while they became 14.2%, 10.9% and 20.1% after standardized by age. The prevalence of MS diagnosed by NCEP-ATP Ⅲ and IDF standard in males were higher than in females, while CDS was in the opposite situtation. The prevalence of MS by these three standards increased with age. Among all the main components of MS diagnosed after these three standardization process, the prevalence of obesity, blood pressure rising and the abnormity of HDL-C were rather high. The prevalence of MS main components ≥1, ≥2, ≥3, ≥4, 5 ranked the highest compared to the lowest as to the IDF, ATP Ⅲ ' and CDS diagnostic. standards Conclusion The prevalence rates and gender distribution of MS diagnosed by different standards among Kazakhs were different. The prevalence of IDF standard was the highest, with the IDF standard better than the others in early identifying the risk factors of cardiovascular disease.     

Inhibition of hepatitis C virus core and NS3 protein expression by siRNA

Objective To construct two kinds of plasmids with one for gene expression and the other for RNA expression. Methods Hepatitis C virus (HCV) core and NS3 genes were firstly inserted into the upstream of the reporter genes marked with Rellina (hRluc) luciferase and Firefly luciferase (hluc + ). And then the established Plasmids were cotransfected into HEK293 cells. Six short hairpin RNAs targeted HCV core and NS3 genes were designed, and expressed by siRNA expression vector. Inhibition effects with the luminescent intensity were observed. Results Light density in the cells cotransfected with core gene and anti-Core siRNA was obviously weaker, meanwhile, those with NS3 gene and anti-NS3 siRNA had no difference in contrast with the control group. Transfected the anti-NS3 siRNA into the stable expression cells and detected them by real-time PCR and western-blot. The four siRNAs have efficiently suppressed the expression of NS3 at some level. Conclusion The results demonstrated that siRNA was effective in inhibiting HCV protein expression, and may have therapeutic potential to limit HCV replication in chronically infected patients.     

紫外线蓝光照射和树脂吸附清除血浆胆红素

Objective To study the clearance of bilirubins from the plasma by ultraviolet-blue ray irradiation and resin adsorption. Methods The plasma from artifitial liver treatment were irradiated by the ultraviolet-blue ray and then filtrated the strongly basic anion exchange resin(D201) or adsorbent resin(D4006) to eliminate bilirubins. Results ① The mean level of total bilirubins(TBil), direct bilirubin( DBil) and indirect bilimbin( IBil) decreased significantly after the irradiation( P <0.01) ,and there was no significant decrease about albumin after the irradiation. ②For the group of irradiation then D201 adsorption, the clearance rates of TBil, DBil and IBil were 85.3% , 85.8% and 85.1% respectively; for the group of D201 adsorption without the irradiation, the rates were 58.3% ,50.8% and 61.7% respectively, and there was statistical difference between the two groups ( P < 0.05, P < 0.01). There were no difference between two groups in the recovery rates of total protein and albumin( P > 0.05). ③For the group of irradiation then D4001 adsorption, the clearance rates of TBil, DBil and IBil were 71.0%, 74.5% and 68.6% respectively; for the group of D4006 adsorption without the irradiation, the rates were 19.8%, 17.6% and 21.2% respectively, and there was statistical difference between the two groups ( P < 0.01). There were no difference between two groups in the recovery rates of total protein and albumin( P > 0.05). ④For the groups of irradiation followed by the resin adsorption, the clearance rate of IBil by D4006 (68.6%) was lower than that by D201 (85.1%)(P<0.05), but the recovery of albumin by D4006 was more than that by D201 (P < 0.05). Conclusions The ultraviolet-blue ray irradiation on plasma could directly decrease bilirubin concentrations and the irradiation followed by the resin adsorptions could decrease bilirubin concentrations further with a little influence to the recovery of albumin.     

紫外线蓝光照射和树脂吸附清除血浆胆红素

Objective To study the clearance of bilirubins from the plasma by ultraviolet-blue ray irradiation and resin adsorption. Methods The plasma from artifitial liver treatment were irradiated by the ultraviolet-blue ray and then filtrated the strongly basic anion exchange resin(D201) or adsorbent resin(D4006) to eliminate bilirubins. Results ① The mean level of total bilirubins(TBil), direct bilirubin( DBil) and indirect bilimbin( IBil) decreased significantly after the irradiation( P <0.01) ,and there was no significant decrease about albumin after the irradiation. ②For the group of irradiation then D201 adsorption, the clearance rates of TBil, DBil and IBil were 85.3% , 85.8% and 85.1% respectively; for the group of D201 adsorption without the irradiation, the rates were 58.3% ,50.8% and 61.7% respectively, and there was statistical difference between the two groups ( P < 0.05, P < 0.01). There were no difference between two groups in the recovery rates of total protein and albumin( P > 0.05). ③For the group of irradiation then D4001 adsorption, the clearance rates of TBil, DBil and IBil were 71.0%, 74.5% and 68.6% respectively; for the group of D4006 adsorption without the irradiation, the rates were 19.8%, 17.6% and 21.2% respectively, and there was statistical difference between the two groups ( P < 0.01). There were no difference between two groups in the recovery rates of total protein and albumin( P > 0.05). ④For the groups of irradiation followed by the resin adsorption, the clearance rate of IBil by D4006 (68.6%) was lower than that by D201 (85.1%)(P<0.05), but the recovery of albumin by D4006 was more than that by D201 (P < 0.05). Conclusions The ultraviolet-blue ray irradiation on plasma could directly decrease bilirubin concentrations and the irradiation followed by the resin adsorptions could decrease bilirubin concentrations further with a little influence to the recovery of albumin.     

Influencing factors of post stroke cognitive impairment in patients with acute ischemic stroke and their correlation with cognitive scoresCSCD

Objective To analyze the influencing factors of post stroke cognitive impairment (PSCI) and their correlation with cognitive scores in patients with acute ischemic stroke. Methods In this cross‑section study, 36 patients diagnosed with acute ischemic stroke and post stroke cognitive impairment (PSCI) admitted to the Department of Vascular Neurology of Beijing Tiantian Hospital Affiliated to Capital Medical University from June 1, 2022 to September 30, 2022 were selected as the PSCI group. And one to one matching was performed for patients without PSCI (PSNCI group) with an age±1 year and same gender admitted to the hospital during the same period (as control, 36 cases). Basic clinical data of the two groups were collected, the laboratory and imaging examinations were completed. Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) were used for cognitive evaluation by neuropsychologists. Hypothesis testing was used to compare the differences in basic data, laboratory tests and lesion sites between the two groups. Multi‑factor conditional logistic regression was performed to analyze the influencing factors of PSCI, and Spearman correlation analysis was carried out to analyze the correlation between influencing factors of PSCI and the cognitive scores. Results Compared with those in PSNCI group, the proportion of patients with stroke/transient ischemic attack history, hyperhomocysteinemia (HHcy), apolipoprotein E(ApoE) ε4 carriers and the ratio of temporal lobe and thalamus infarction were higher in PSCI group (41.7% vs 13.9%, 36.1% vs 2.8%, 30.6% vs 5.6%, 22.3% vs 2.8%, 25.0% vs 5.6%), the MMSE and MoCA scores were lower in PSCI group [16.50 (8.25, 19.00) vs 28.00 (27.00, 30.00), 10.00 (4.25, 14.50) vs 27.00 (25.00, 28.00)] (all P<0.05). Logistic regression analysis showed that HHcy was a positive correlation factor for PSCI (OR=2.342, 95%CI= 1.186-4.622, P=0.014). Spearman correlation analysis showed that MMSE (r=-0.415) and MoCA (r= -0.417) scores were negatively correlated with homocysteine (Hcy) (both P<0.05). Conclusion HHcy is an important factor affecting the occurrence and development of PSCI in patients with acute ischemic stroke, and Hcy level is negatively correlated with cognitive scores in those patients. © 2022 Chinese Medical Journals Publishing House Co.Ltd     

漂浮电极导管法临时心脏起搏器的围手术期应用

Objective To discuss the application of implantation temporary cardiac pacing by balloon-tipped floating catheter for peroperative period patients. Method Thirty-three patients with severe bradyarrhythmia were received the balloon-tipped floating catheter to RV by Seldinger puncture technique.Meantime, the pacing signals of ECG were observed. The threshold and QRS waves to ensure the electrode position were determined. Result All of 33 cases were successfully punctured and 32 cases get paced, except 1 case had the electro - mechanical dissociation (EMD). Pacing threshold was less than 0. 9V, and mean remaining time was 12.47 ～ 161 (67. 05 ±34. 48) hours. Apical pacing was operated in 23 patients,and right ventricular outflow tract pacing in 10 patients. No severe complications were occurred. Conclusion The implantation method of temporary cardiac pacing by balloon-tipped floating catheter was convenient and safe. It could help the patients get safety in anesthesia and peroperative period.     

西安地区92例帕金森病患者药物治疗情况调查

Objective To investigate the treatment status of antiparkinsonism in Xi'an. Methods Six general hospitals were randomly chosen in Xi' an and all Parkinson' s disease (PD) patients were interviewed by questionnaire from Jan. 2007 to Apr. 2007. Results 92 PD outpatients were enrolled in, including 48 males and 44 females, from 43 to 86 years old (mean 65.6±17.1) with duration of the disease from 0.2 to 27.8 years (mean 4.4 ±9.4). The preference of the drug use from the patients were: 40 (43.5%) preferred taking levodopa, 25 (27.2%) with amantadine and/or trihexyphenidyl, 14(15.2%) with levodopa and others, 4(4.4%) with dopamine agonist and others, 2 (2.2%) with other drugs, 7 (7.6%) with no treatment. There were 69 (75.0%) patients onset with resting tremor, 15 (16.3%) with bradykinesia, 6 (6.5%) with rigidity, and 2 (2.2%) with unknown symptoms. There was no startically significant difference in anti-PD drugs among the patients onset with different symptoms (P>0.05). 45 patients appeared the onset of disease before 65 years old and with no dementia, 47 onset after 65 with or without dementia. There was no significant difference of anti-PD drugs between the two groups (P>0.05). Most patients initiated anti-PD treatment with levodopa but few of them chose dopamine agonist. According to the classification of Hoehn & Yahr, 25(27.2%) belonged to Grade Ⅰ, 53(57.6%) to Grade Ⅱ ,8(8.7%) to Grade Ⅲ ,3(3.3%) to Grade Ⅳ and 3 (3.3%) to Grade Ⅴ. There was no significant differences of anti-PD drugs between different grades of the disease (P>0.05). 55.3% of the patients changed their anti-PD drugs randomly during the therapy, but with no relation to their gender, age, educational level, dementia, the number of family members, course of diseases, or the degree of Hoehn & Yahr, frequency and categories of medicine. Conclusion Anti-PD treatment in Xi' an did not strictly follow the standardized protocol, with few patients using dopamine agonist and over 50% of the patients changed their drugs randomly.     

关于嗜酸性粒细胞性肺疾病分类和诊断的商榷

Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.     

多层螺旋CT面神经管曲面重建图像的解剖与临床应用研究

目的 探讨多层螺旋CT面神经管曲面重建图像的解剖与临床应用.方法 选择2010年1-11月收治的面部神经疾病患者50例作为研究组,50例面部神经正常者作为对照组.采用多层螺旋CT对患者进行扫描,扫描将眼眶上缘至外耳道下缘连线作为水平线,范围从乳突下缘至颞骨岩部上缘,将获得的数据在Wizard工作站中进行重建.所有测量数据均为两位以上医生的测量结果 的平均值.结果 对照组面神经管均可以在一幅图像中清晰地显示出来,显示率为100.00%(50/50),且各段数据可以准确测量得到;轴向重建、冠状位重建和矢状位重建三个方向测量的结果 比较,迷路段、水平段和垂直段的长度和直径的差异均无统计学意义(P＞0.05),且第一弯曲角度和第二弯曲角度的差异均无统计学意义(P＞0.05);与对照组比较,研究组不同面部神经疾病患者的显示率均明显下降,差异均有统计学意义(P＜0.05).结论 多层螺旋CT曲面重建技术对面部神经疾病的诊断具有十分重要的临床意义,值得推广应用.

Abstract：

Objective To probe into the anatomy and clinical application of the facial nerve canal surface by multislice spiral CT image curved planar reformation. Methods Fifty patients with facial nerve disease were selected as study group from January to November in 2010, 50 healthy subjects were selected as control group, using models of multislice spiral CT scan for the patient, scanning from the upper edge of the orbital under external auditory canal edge of the connection as a horizontal line, ranging from the lower edge of mastoid process to the petrous bone on the edge of the data obtained in the Wizard workstation reconstruction. All the measurements were more than two measurements of the average physician. Results Normal facial nerve canal in control group could be displayed clearly in an image, display rate was 100.00%(50/50), and the segment data could be accurately measured; axial reconstruction, reconstruction of coronal and sagittal reconstruction of the three comparison of measured direction, fan sections, horizontal and vertical segments of the length and diameter were not significantly different (P＞0.05), and the first and second bending angle of bending angle was no significant difference (P ＞ 0.05 ). Compared with control group, the patients with vascular disease in study group showed significantly decreased rate, the difference was significant (P ＜ 0.05). Conclusion Curved planar reformation of multislice spiral CT diagnosis of facial nerve canal disease has great clinical significance, should be widely applied.     

上海市区居民1973-2005年结直肠癌发病趋势分析

Objective To explore the time trends of colorectal cancer incidence rates in urban Shanghai from 1973 to 2005. Methods Data on the incidence rates of colorectal cancer were obtained from a population-based cancer registry in Shanghai. A total of 32 962 colon cancer patients and 24 662 rectal cancer patients were registered. Population estimation were based on periodic censuses, with age-and sex-specific annual estimates derived for the remaining years. The rates were adjusted to the world standard population by using the direct method. Annul percent changes (APCs) in rates were estimated by means of a linear regression of the logarithm of the respective rates on calendar, weighted by the number of incidence cases. Results The incidence rates of colorectal cancer increased steadily during 1973 to 2005, the age-adjusted incidence rates of colon cancer increased from 6.09 and 5. 70 to 14.70 and 14. 35 per 100 000 in male and female respectively. The APCs were 3. 03 % (t=14. 77, P < 0. 01) and 3.21% (t=22. 15, P < 0. 01). The rates of rectal cancer increased from 7.68 and 6. 51 to 11.45 and 8. 28 per 100 000 in male and female respectively. The APCs were 1.34% (t=7. 28,P <0. 01) and 0. 93% (t=7. 34,P <0. 01). The top APCs for colon and rectal cancer in female were 5. 86% and 2. 79% at age above 85 and in male those were 4. 64% and 2. 38% at age of 80-. The APCs of colon cancer were greater than those of rectal cancer at the groups above 45 years old. The average ages when diagnosed were delayed from 57-60 to 66-70 during these 33 yearn The average diagnosed ages of colon cancer were later than those of rectal cancer slightly(from 2003 to 2005,the onset age of male colon cancer: 68. 61±12.17,male rectal cancer: 66.81±12. 62, t=4. 90, P < 0.01; female colon cancer:69. 20±12. 13, female rectal cancer:67. 75±12. 54,t=3. 81,P < 0. 01). Conclusion The incidence rates of colorectal cancer increased steadily during 1973 to 2005, especially for colon cancer. Further research is needed to identify the causes resulting in these changes.