火针联合湿润烧伤膏治疗风热毒蕴型扁平疣疗效观察

目的对比观察火针联合湿润烧伤膏治疗风热毒蕴型扁平疣的临床疗效。方法将2017年12月至2018年12月黑龙江中医药大学附属第二医院皮肤科收治的60例风热毒蕴型扁平疣患者按照随机数表法随机分为治疗组(30例)和对照组(30例),其中治疗组患者予以火针联合湿润烧伤膏治疗,对照组患者仅予以火针治疗,连续治疗4周后观察两组患者的治疗效果。结果治疗4周后,治疗组患者中痊愈7例,显效16例,有效5例,无效2例,总有效率为93.33%,明显优于对照组患者的痊愈3例,显效8例,有效13例,无效6例,总有效率80.00%,两组对比,P0.05,差异具有统计学意义。结论火针与湿润烧伤膏联合应用可通过其疏风清热、解毒散结的作用有效促进风热毒蕴型扁平疣的消退,疗效显著,值得临床推广应用。     

火针联合湿润烧伤膏治疗湿热内蕴型皮肤瘙痒症的临床疗效观察

目的对比观察火针联合湿润烧伤膏治疗湿热内蕴型皮肤瘙痒症的临床疗效。方法将2018年2月至2019年2月黑龙江中医药大学附属第二医院皮肤科收治的60例湿热内蕴型皮肤瘙痒症患者随机分为治疗组(30例)和对照组(30例),其中治疗组患者予以火针联合湿润烧伤膏治疗,对照组患者单独予以火针治疗,连续治疗4周后观察两组患者的治疗效果。结果治疗4周后,治疗组患者中痊愈7例,显效15例,有效6例,无效2例,总有效率为93.33%;对照组患者中痊愈3例,显效9例,有效14例,无效4例,总有效率为86.67%。两组对比采用等级资料的秩和检验,Mann-Whitney U=293.000,Z=-2.455,P=0.014,差异具有统计学意义。结论火针联合湿润烧伤膏治疗湿热内蕴型皮肤瘙痒症的疗效显著,值得临床推广应用。     

润燥止痒胶囊联合湿润烧伤膏治疗血虚风燥型 湿疹的临床疗效观察

目的 对比观察润燥止痒胶囊联合湿润烧伤膏治疗血虚风燥型湿疹的临床疗效? 方法 将60例血虚风燥型湿疹患者随机分为治疗组和对照组, 每组30 例?治疗组患者口服润燥止痒胶囊, 4 粒/ 次, 3 次/d,同时将湿润烧伤膏均匀涂抹于皮损处, 厚度薄于1 mm, 每4～6 h 换药1 次;对照组患者单纯口服润燥止痒胶囊,4 粒/ 次, 3 次/d;连续治疗4周后观察疗效? 结果 治疗组有效率为93.33%,对照组有效率为80.00%,两组疗效经χ2 检验, P <0.05, 差异具有统计学意义? 结论 润燥止痒胶囊联合湿润烧伤膏治疗血虚风燥型湿疹可缓解患者痛苦, 促进创面愈合, 疗效显著?     

中药外洗联合湿润烧伤膏治疗角化性湿疹的临床疗效观察

目的观察中药外洗联合湿润烧伤膏治疗手部皲裂型角化性湿疹的临床疗效。方法将2014年2月-2014年11月黑龙江中医药大学附属第二医院皮肤科收治的60例手部皲裂型角化性湿疹患者随机分为治疗组和对照组,每组30例,治疗组患者予以自拟中药方外洗联合湿润烧伤膏外涂治疗,对照组患者予以自拟中药方外洗治疗,观察两组患者治疗效果。结果治疗组痊愈8例,显效15例,有效5例,无效2例,总有效率为93.33%;对照组痊愈4例,显效7例,有效15例,无效4例,总有效率为86.67%,两组对比,P<0.01,差异具有统计学意义。结论中药外洗联合湿润烧伤膏治疗角化性湿疹疗效显著,具有收敛生肌、祛风止痒、养血润燥等作用,值得临床推广应用。     

散结止痒汤联合湿润烧伤膏治疗湿热风毒型结节性痒疹疗效观察

目的对比观察散结止痒汤联合湿润烧伤膏治疗湿热风毒型结节性痒疹的临床疗效。方法将2018年1月至2019年1月黑龙江中医药大学附属第二医院皮肤科收治的60例湿热风毒型结节性痒疹患者随机分为治疗组(30例)和对照组(30例),其中治疗组患者采用散结止痒汤口服联合湿润烧伤膏外涂治疗,对照组患者仅采用散结止痒汤口服治疗,连续治疗4周后观察两组患者的临床疗效,结果治疗4周后,治疗组患者中治愈8例,显效13例,有效7例,无效2例,总有效率为93.33%;对照组患者中治愈2例,显效7例,有效17例,无效4例,总有效率为86.67%。治疗组患者临床疗效显著优于对照组,两组对比,P0.05,差异具有统计学意义。结论散结止痒汤联合湿润烧伤膏对湿热风毒型结节性痒疹有显著疗效,值得临床推广应用。     

消痤丸联合湿润烧伤膏治疗脾胃湿热型痤疮疗效观察

目的对比观察消痤丸联合湿润烧伤膏治疗脾胃湿热型痤疮的临床疗效。方法将2015年3月—2015年10月黑龙江中医药大学附属第二医院皮肤科收治的60例脾胃湿热型痤疮患者按照随机数表法随机分为治疗组(30例)与对照组(30例),其中治疗组患者采用消痤丸联合湿润烧伤膏治疗,对照组患者单纯采用消痤丸治疗,连续治疗4周后,对比观察两组患者的治疗效果。结果治疗4周后,治疗组患者的皮损评分为(3.30±1.74)分,痊愈11例,显效10例,有效7例,无效2例,有效率为93.3%;对照组患者的皮损评分为(4.50±1.76)分,痊愈6例,显效9例,有效7例,无效8例,有效率为73.3%,两组对比,P均0.05,差异具有统计学意义。结论消痤丸联合湿润烧伤膏治疗脾胃湿热型痤疮,可有效促进皮损创面的愈合,疗效显著,值得临床推广应用。     

中药足浴联合湿润烧伤膏治疗1～2级糖尿病足临床体会

目的探讨中药足浴联合湿润烧伤膏治疗1~2级糖尿病足的临床疗效。方法将2015年7月—2016年12月大连医科大学附属第二医院创面修复科收治的90例1~2级糖尿病足患者随机分为观察组(45例)与对照组(45例),观察组患者在中药足浴后外敷湿润烧伤膏治疗溃疡创面,对照组患者在中药足浴后外敷凡士林纱布治疗溃疡创面,对比观察两组患者创面愈合时间及愈合效果。结果观察组患者创面愈合时间为(14.24±3.17)d,对照组患者创面愈合时间为(21.56±4.82)d;治疗2周后,观察组患者痊愈12例,显效18例,好转14例,无效1例,总有效率为97.78%,对照组患者痊愈7例,显效17例,好转9例,无效12例,总有效率为73.33%。两组患者创面愈合时间及愈合效果对比,P均0.05,差异具有统计学意义。结论中药足浴联合湿润烧伤膏治疗1~2级糖尿病足,可有效缩短创面愈合时间,提高创面愈合效果,疗效显著,值得临床推广应用。     

自拟中药汤剂联合湿润烧伤膏治疗面部激素依赖性皮炎的临床观察

目的观察口服自拟中药汤剂联合湿润烧伤膏治疗风热郁肺型面部激素依赖性皮炎的临床疗效。方法将215年2月-2016年2月年黑龙江中医药大学附属第二医院收治的60例激素依赖性皮炎患者根据就诊顺序随机分为治疗组(30例)和对照组(30例),治疗组采用自拟中药汤剂联合湿润烧伤膏治疗,对照组仅采用自拟中药汤剂治疗。治疗4周后,观察两组患者临床疗效;随访半年后,评价两组患者远期疗效。结果治疗4周后,治疗组有效率为86.67%,对照组有效率为63.33%,两组临床疗效对比,P0.05,差异具有统计学意义;随访半年后,治疗组复发率为15.38%,对照组复发率为42.10%,两组复发率对比,P0.05,差异具有统计学意义。结论自拟中药汤剂联合湿润烧伤膏治疗风热郁肺型面部激素依赖性皮炎比单独口服自拟中药汤剂的效果显著,值得临床推广应用。     

中药联合湿润烧伤膏治疗日光性皮炎的临床疗效观察

目的探讨中药联合湿润烧伤膏治疗日光性皮炎的临床疗效。方法将60例日光性皮炎患者随机分为治疗组(30例)和对照组(30例),治疗组给予中药内服联合湿润烧伤膏外涂治疗,每日2次;对照组给予中药内服联合氟芬那酸丁酯软膏外涂治疗,每日2次。治疗2周后观察两组治疗效果。结果两组患者治疗前后皮损评分经独立样本t检验,差异均有统计学意义(P0.05);治疗组总有效率为96.6%,对照组总有效率为83.3%,经统计学对比,P0.05,差异均有统计学意义。结论中药联合湿润烧伤膏治疗日光性皮炎见效快、疗效好、不良反应少,其效果明显优于中药联合氟芬那酸丁酯软膏的治疗效果。     

自拟中药汤剂联合湿润烧伤膏治疗湿热蕴肤型湿疹的临床观察

目的观察口服自拟中药汤剂联合湿润烧伤膏外用治疗湿热蕴肤型湿疹的临床疗效。方法将82例湿热蕴肤型湿疹患者随机分为治疗组(42例)与对照组(40例),治疗组患者在口服自拟中药汤剂的同时外用湿润烧伤膏换药治疗:对照组患者在口服自拟中药汤剂的同时外用3%硼酸溶液冷敷治疗,3周后对比观察两组临床疗效。结果治疗组患者的痊愈率为81.0%,总有效率为90.5%;对照组患者的痊愈率为37.5%,总有效率为67.5%,两组痊愈率比较,差异有统计学意义。结论口服自拟中药汤剂联合湿润烧伤膏外用治疗湿热蕴肤型湿疹疗效较好,具有消炎止痛、祛腐生肌等功效,值得临床推广应用。     

Stress MR imaging for evaluation of popliteal artery entrapment

The popliteal artery entrapment (PAE) syndrome has been recognized as a cause of arterial occlusion in young people. It is the result of an anomaly of the relationship between the popliteal artery and the gastrocnemius muscle. Eight young healthy volunteers (16 legs) and six patients (10 legs) with suspected PAE underwent magnetic resonance (MR) imaging. Gradient-echo images were obtained in axial planes with the leg at rest and during active plantar flexion against resistance. Imaging at rest allowed identification of PAE signs in only one leg, which had an anomalous medial course of the popliteal artery. In the other cases, only the stress technique was able to show signal loss in the popliteal artery due to muscular compression (two legs) or the presence of accessory muscle slip around the vessel (two legs), as confirmed at surgery. MR imaging is therefore a useful technique for the diagnosis of PAE because of its capability of combining information obtainable with other modalities.     

MR imaging of muscle and tender points in fibromyalgia

Fibromyalgia is a syndrome manifested by chronic, diffuse muscu-loskeletal aching and soreness, palpable muscle tender points, and other symptoms. Standardized clinical diagnostic criteria have recently been developed. Skeletal muscle has been postulated as the end organ in this disease. Biochemical, histologic, electromyographic, and conventional radiographic studies have demonstrated no definitive abnormality. This study sought to establish whether magnetic resonance (MR) imaging could demonstrate any abnormality in these patients. Eighteen patients were entered in the study, 14 of whom were able to complete their examinations. T1 -weighted, T2-weighted, gradient-echo, and STIR (short-tau inversion-recovery) sequences were performed in all patients, with selected patients examined with T1weighted, gadopentetate dimeglu-mine-enhanced sequences. The trapezius and suboccipital regions were imaged in patients who, clinically, had active fibro-myalgia. No abnormalities could be detected. The authors conclude that the conventional MR imaging used in this study was unable to depict any primary skeletal muscle abnormality in fibromyalgia.     

MR angiography of congenital heart disease: Value of segmented two-dimensional inflow technique and maximum-intensity-projection display

Magnetic resonance (MR) angiography of the cardiovascular system was evaluated in 41 patients with congenital heart disease by using a two-dimensional (2D) inflow technique based on a magnetization-prepared gradient-echo pulse sequence with segmented k-space data acquisition and electrocardiographic gating at 0.5 T. Inversion and saturation prepulses were used to suppress stationary tissue and enhance intravascular signal. Presaturation slabs were applied where certain vascular structures had to be suppressed. Sequence parameters were optimized by evaluating signal intensity and contrast characteristics for various flip angles and inversion and saturation delay times. The heart and intrathoracic vasculature were encompassed with 40–50 overlapping sections. Both 2D angiograms and maximum-intensity-projection images were evaluated. Combining data sets acquired in the sagittal and transverse orientations provided the most satisfactory information about the pulmonary arteries. The highest signal-to-noise ratios were obtained with a flip angle of 65° and short prepulse delay times. Two-dimensional MR angiography can provide useful diagnostic information but requires a thorough understanding of in-plane and hemodynamically induced signal intensity changes.     

MR imaging of disorders of the brachial plexus

The authors evaluated 64 consecutive patients with suspected brachial plexus (BP) abnormalities of diverse cause with magnetic resonance (MR) imaging, using the body coil and a standardized protocol. Of the 43 patients for whom follow-up was available, 25 were suspected of having neoplastic involvement of the BP, nine had sustained injuries, and nine presented with BP symptoms of uncertain cause. MR imaging was 63% sensitive, 100% specific, and 77% accurate in demonstrating the abnormality in this diverse patient population. When patients with neoplastic and traumatic disorders were considered separately, sensitivity increased to 81%, accuracy to 88%, and specificity remained unchanged. In the patients with a clinical diagnosis of idiopathic or viral plexitis, the MR imaging findings were normal, serving to exclude other structural abnormalities. It is concluded that MR imaging is valuable in the assessment of a wide range of BP disorders.     

MR imaging characteristics of noncancerous lesions of the prostate.

Radical prostatectomy specimens from 53 men with clinical stage A or B prostate cancer were retrospectively reviewed and compared with correlative axial T2-weighted magnetic resonance (MR) images obtained just before surgery. Non-cancerous lesions were evaluated for signal intensity and location. Focal high-signal-intensity areas (n = 72) were present in 81% of patients. The 26% of lesions seen in the central gland all correlated with cystic atrophy. Of the 53 lesions seen in the peripheral prostate, 47 (89%) were cystic atrophy without associated cancer, four (7.5%) cystic atrophy with cancer, and two (3.8%) focal inflammation. Focal low-signal-intensity areas (n = 42) were present in 60% of patients. Of the 31% of lesions in the central prostate, one-fifth correlated with benign prostatic hyperplasia (BPH) and four-fifths with fibrous tissue. Of the 69% of peripheral lesions, 83% corresponded to fibrous tissue, 10% to BPH, and 7% to normal tissue. Mixed lesions (n = 42) were present in 64% of patients; 86% of these were located centrally and 14% peripherally. All mixed central lesions were BPH; the peripheral lesions were areas of combined cystic atrophy and fibrosis. BPH of low or mixed signal intensity can extend into the peripheral prostate and mimic cancer. High-intensity cystic atrophy associated with cancer can mimic normal tissue.     

肾细胞癌的MRI研究进展

肾细胞癌是最常见的成人肾脏恶性肿瘤。近年来，多种功能MRI成像技术（如扩散加权成像、灌注加权成像等）、多参数MRI联合分析以及影像组学等新兴影像处理技术被证实在肾细胞癌的诊断中具有较大的价值。目前，研究热点多集中于良恶性肿瘤的鉴别、组织学亚型的区分、肿瘤分期、预测核分级及判断预后。就MRI新技术及图像处理技术在肾细胞癌中的研究进展予以综述。     

Dynamic contrast-enhanced MR imaging assessment of vascularized free fibular grafts

Magnetic resonance (MR) imaging may be a noninvasive method for assessing perfusion of vascularized bone grafts placed for treatment of avascular necrosis. One proximal femur of seven beagles was devascularized, with insertion of a vascularized fibular graft. MR imaging at 1 week (seven dogs) and 6 weeks (five dogs) after surgery included pre- and postcontrast spin-echo sequences, unenhanced twodimensional time-of-flight (TOF) vascular imaging, and dynamic gradient-echo imaging during infusion of gadolinium. Relative signal intensity values of selected regions obtained from the dynamic gradientecho images were plotted as percent enhancement versus time. In the operated hip, MR imaging did not show enhancement in six of seven femoral heads and greater trochanters at 1 week after surgery, with similar results after 6 weeks. MR imaging of fibular grafts 6 weeks after surgery showed an initial rapid increase in enhancement and a subsequent slower increase in five of five dogs, although no enhancement was seen in six of seven dogs at 1 week. These findings contrasted with a rapid initial increase in enhancement followed by slow decline in non-operated hips. Two-dimensional TOP imaging did not show the vascular pedicle of the graft in any dog. Findings of radionuclide bone scanning performed 1 week after surgery were consistent with devascularization of the operated femur and fibular graft. However, tetracycline distribution and histologic findings confirmed the viability of five of five grafts within the devascularized femurs 6 weeks after surgery. Thus, dynamic contrast-enhanced MR imaging at 6 weeks after surgery is valuable for assessing vascular bone graft perfusion, while similar imaging at 1 week may suggest otherwise.     

Influence of in vivo copper on MR images of the liver in rats

To investigate the effects of in vivo copper on magnetic resonance (MR) images, the authors studied Long-Evans cinnamon rats, which develop hepatitis and hepatocellular carcinoma as a result of abnormal copper metabolism. The livers of the rats were imaged before hepatitis developed; the absence of hepatic disease was confirmed histopathologically. The copper that accumulated in the liver of the rats was thought to exist in the form of divalent ions, which were suspected of reducing the T1 and T2 of neighboring protons. However, the signal intensities of the liver on T1- and T2*-weighted images did not change, suggesting that in vivo copper, even when accumulated abnormally, does not influence the signal intensity of MR images.     

Techniques for high-resolution MR imaging of atherosclerotic plaque

Atherosclerotic cardiovascular disease is the most common cause of death in the United States. Investigation of atherosclerotic plaque morphology and composition is important because the findings may be useful in predicting prognosis or response to therapy. This study presents high-resolution magnetic resonance (MR) imaging techniques developed on a 1.5-T whole-body imager with a custom-built surface coil, for characterizing the composition and morphology of plaque removed at carotid endarterectomy. The initial comparison of MR imaging and histologic results showed good correlation. In conjunction with MR angiography, these techniques could be used in in vivo imaging to define the size, location, and contents of atherosclerotic plaque at the carotid bifurcation.     

Dynamic MRI of the gallbladder lesions: Differentiation of benign from malignant

Forty-nine pathologically proven gallbladder lesions were evaluated in 45 patients using dynamic MRI with a spoiled gradient pulse sequence (SPGR), to access the ability of this technique to differentiate benign from malignant gallbladder lesions. The studies were reviewed retrospectively. Signal intensity of the lesions were measured. Twenty-one malignant and 28 benign lesions were classified into three categories: polypoid, diffuse wall thickening, and exophytic. Early and delayed enhancement patterns were evaluated. For the polypoid masses, malignant lesions (n = 9) demonstrated early and prolonged enhancements, whereas benign lesions (n = 14) had early enhancement with subsequent washout (P < .05). For diffuse gallbladder wall thickening, malignant lesions (n = 6) demonstrated early and prolonged enhancement and benign lesions (n = 14) showed relatively slow, prolonged enhancement (P < .05). The exophytic masses (n = 6) all were malignant and demonstrated early and prolonged enhancement. Dynamic MRI can help differentiate benign from malignant gallbladder lesions.