脊柱结核的CT诊断与鉴别诊断(附52例分析)

目的：旨在提高脊柱结核的ＣＴ诊断与鉴别诊断。方法：对临床怀疑或已诊断脊柱结核的５２例病人进行ＣＴ扫描，并分析了ＣＴ影像表现。结果：５２例脊柱结核均经手术病理证实。４９例显示椎体破坏，４６例椎旁脓肿，２例病变侵及椎管，４１例椎间盘破坏，４例椎体附件破坏。结论：ＣＴ对脊柱结核的诊断与鉴别诊断优于常规Ｘ线，特别是对于估价骨质破坏程度和侵及椎管及椎旁软组织块影的范围更有价值     

脊柱溶骨性转移瘤的CT诊断

目的　分析脊柱溶骨性转移瘤的CT表现 ,探讨CT对该病的诊断及鉴别诊断价值。方法　分析 46例 72个椎骨溶骨性转移瘤的CT表现 ,并与其中 2 8例的X线平片结果进行比较。结果　 46例脊柱溶骨性转移瘤的 72个转移椎骨中 ,椎体破坏 45例共 74个病灶 ,椎弓根破坏 2 2例 ,累及横突 15例 ,椎板和棘突 (受累 )各 11例。微转移病灶集中在椎体 ( 4 5 /4 9)。CT发现骨破坏、椎管受累及椎旁软组织肿块分别为 10 0 %、67.85 %及 71.4% ,而X线对三者的发现率仅为 5 3 .6%、14 .3 %及 3 2 .1%。结论　脊柱转移瘤首先侵犯椎体 ,椎体转移瘤是椎弓根、椎板、横突和棘突破坏的基础。CT扫描在发现和评估病变方面较X线平片检查敏感     

脊柱结核的影像学诊断

目的：评价X线平片、CT、MRI在脊柱结核的诊断价值。方法：回顾40例经手术病理或临床结果证实为脊柱结核病人的X线平片、CT、MRI影像表现。结果：X线平片可了解椎体破坏、塌陷、椎间隙变窄情况，及脊柱是否后凸畸形。40例CT均可较清楚显示椎体骨质破坏的数目（有21例分别两个椎体受累）、范围及病变是否进入椎管，其中19例形成寒性脓疡。9例行MRI均可显示椎体骨质破坏，周围软组织肿胀、寒性脓疡范围，及椎管、脊髓情况。结论：X线平片结合CT平扫可对脊柱结核进行较全面细致的观察并做出诊断。与肿瘤不易鉴别时需加CT增强扫描。若有神经症状时应补充MRI检查。     

脊柱结核的CT诊断

目的探讨脊柱结核的CT表现及脊柱结核CT检查的重要意义。方法对30例临床和病理确诊的脊柱结核病例的CT表现进行回顾性分析。结果脊柱结核的CT表现包括:(1)椎体及附件不规则虫蚀样和囊状骨质破坏。(2)沙砾样和斑片样死骨形成。(3)椎间盘坏死及椎间隙狭窄、消失。(4)椎旁脓肿、纵隔脓肿、腰大肌脓肿。(5)椎体后部的骨质破坏产生的碎骨片和坏死物质可进入椎管压迫硬膜囊和神经根。(6)椎体塌陷呈楔形。结论CT对脊柱结核的诊断和鉴别诊断有重要价值,尤其脊柱结核对椎体附件和椎管的累及范围、程度可清楚地显示,对指导手术治疗和判断预后有重要意义。     

儿童脊柱嗜酸性肉芽肿的影像学诊断

目的探讨儿童脊柱嗜酸性肉芽肿(eosinophilic granuloma,EG)的影像学表现,提高对该病的认识。方法回顾性分析经临床病理证实的23例脊柱EG患者的影像资料,包括23例X线摄片,12例CT和5例MRI扫描检查。结果23例中累及单个椎体19例,多个椎体4例,共28个椎体,包括颈椎6个,胸椎13个,腰椎9个。脊柱正侧位X线平片发现23个病变椎体,漏诊5个,准确诊断19个,3个误诊为结核,1个误诊为缺血性坏死。主要表现为椎体变扁,前后径增大,椎间隙正常或稍增宽,其中5例椎旁有软组织肿块,3例脊柱局部后突畸形。CT扫描示椎体不同程度骨质破坏,6例出现软组织肿块,2例椎弓破坏。MRI示破坏椎体在T1WI呈低或等低信号,T2WI呈高或等高混杂信号,2例出现软组织肿块及椎间隙稍增宽。结论 X线平片是EG的首选检查方式且能明确诊断大部分病例,CT和MRI对于观察骨质破坏、软组织肿块及附件受累情况更具优势。     

脊柱结核CT诊断价值(附56例分析)

目的:探讨分析脊柱结核的CT表现及诊断价值。方法:利用螺旋CT对有脊柱结核的56例患者进行扫描。结果:56例有不同程度的骨质破坏、椎旁软组织肿胀、腰大肌脓肿,死骨形成,椎间盘破坏及椎管狭窄。结论:螺旋CT扫描图像清晰,分辨率高,能显示X线检查难以发现的骨质破坏,揭示病变范围及其对椎管的累及程度,有助于对病变的术前评价和术后分析。     

脊柱结核与脊柱转移瘤的多排螺旋CT鉴别诊断

目的分析脊柱转移瘤和脊柱结核的CT表现,探讨二者的CT鉴别诊断。方法回顾性分析我院2005～2011年经手术、病理及临床证实的脊柱结核与转移瘤40例,观察椎体、附件骨、椎间盘破坏方式,椎旁、椎管内脓肿的范围及脊髓受压情况,分析两组患者的CT影像学表现。结果 26例脊柱结核CT表现为骨质破坏、高密度死骨形成、椎体压缩、椎间盘破坏、椎旁、腰大肌脓肿、或椎管狭窄等症状;14例脊柱转移瘤征象是椎骨骨质破坏、增生或两者并存;以溶骨性破坏多见,常伴有椎旁软组织肿块形成,椎体引起压缩。结论多层螺旋CT能对脊柱转移瘤和脊柱结核的诊断及鉴别诊断提供帮助。     

脊柱非霍奇金淋巴瘤影像表现分析

目的 探讨脊柱非霍奇金淋巴瘤(NHL)的影像学特征,着重分析其MRI表现.方法 回顾性分析经病理证实的16例脊柱NHL的MRI、CT及平片影像征象.结果 16例脊柱NHL中7例为单椎病变,9例为多椎病变,并呈跳跃性改变.MRI上均有椎体骨质改变,其中10例为溶骨性骨质破坏,6例为骨髓浸润,11例同时累及附件形成同性质病灶;4例椎体有压缩变扁;4例形成椎旁肿块,8例同时形成椎旁及椎管内硬膜外肿块,肿块信号或密度较均匀,9例围椎生长,7例呈与脊椎纵轴一致长条梭形.结论 脊柱NHL椎体溶骨性骨质破坏或骨髓浸润,同时可累及附件,少数椎体压缩变扁,形成椎旁及硬膜外肿块范围大于骨质病变范围,有"围椎纵向生长"趋势.     

50例脊柱结核的CT及X线平片表现分析

选择５０例经ＣＴ诊断及手术病理证实的脊柱结核，对ＣＴ及Ｘ线平片表现进行回顾性分析，结果表明：ＣＴ发现椎体及附件骨破坏特别是较小较轻微的骨破坏及椎管内侵犯的能力、显示死骨及局限性脓肿的能力优于平片，能区别脓肿及肉芽肿。而Ｘ线平片显示椎间隙狭窄、脊柱滑脱等优于ＣＴ。结合文献讨论了与脊柱转移瘤的鉴别诊断。     

原发性脊柱恶性淋巴瘤的X线平片、CT、MRI研究

目的探讨原发性脊柱恶性淋巴瘤的影像学表现,评价X线平片、CT、MRI诊断的作用。资料与方法12例原发性脊柱恶性淋巴瘤患者均经穿刺或手术病理证实,均有X线平片和MRI平扫加增强扫描。5例CT检查,其中3例有增强扫描。结果12例均为非霍奇金淋巴瘤。其中颈椎1例,胸椎7例,腰椎2例,胸腰椎受累2例,共有30个椎体受累。附件受累4例,软组织肿块10例,椎管内、硬膜外肿块6例,病理性骨折3例。X线平片表现为椎体骨质破坏、椎弓根影消失、椎体压缩性骨折。CT示椎体为溶骨性骨质破坏,平扫肿瘤为中等密度,增强扫描肿瘤轻至中度强化。MR T1WI上肿瘤呈略低及等信号,T2WI上呈低、等、高多种信号,增强扫描肿瘤呈轻至中度强化。结论(1)原发性脊柱恶性淋巴瘤绝大多数为非霍奇金淋巴瘤;(2)肿瘤可侵犯相邻多个椎体,软组织肿块常较大且极少坏死,增强扫描肿瘤轻至中度强化;(3)MR T1WI上肿瘤信号较低可能与肿瘤细胞密集和含较多纤维组织有关：(4)肿瘤较易侵入椎管内沿硬膜外向上、下呈袖套状生长：(5)X线平片对发现病变及定性诊断价值有限,MRI显示骨内病灶较CT更敏感。     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.     

CLIP相关技术的研究进展

在真核生物基因表达的转录后调节中,RNA结合蛋白（ RBP）起着关键作用,很多RBP的异常与人类疾病的发生密切相关。自2000年的RNA免疫沉淀和芯片分析方法（ RNA immunoprecipitation with differential display or microarray analysis , RIP-ChIP）出现以来,人们开始就RBP与RNA相互作用进行了系统而广泛的研究。经过改良和发展,基于体内实时紫外交联免疫沉淀法（ ultraviolet crosslinking and immunoprecipitation , CLIP ）、交联免疫沉淀cDNA文库高通量测序法（ high-throughput sequencing of CLIP cDNA library , HITS-CLIP）、光催化核糖核苷增强交联和免疫沉淀法（ photoactivatable-ribonucleoside-enhanced crosslinking and immunprecipitation , PAR-CLIP）以及提高个别核苷酸分辨率交联和免疫共沉淀法（ individual nucleotide resolution CLIP , iCLIP）等RIP-ChIP衍生方法相继产生,使用这些方法,可以解析RBP的RNA识别特异性,而且通过与高通量测序技术结合,可以实现转录组尺度的RBP的靶序列的鉴定,分辨率也得到极大提高。该文就RNA与蛋白的相互作用的基本原理及其研究进展、相关技术存在的问题以及发展趋势进行简要综述。     

Cross-sectional and longitudinal comparisons of self-reported and device-assessed physical activity and sedentary behaviour

ObjectivesTo examine the longitudinal associations and differences between self-reported and device-assessed physical activity (PA) and sedentary behaviour (SB), using a multifaceted statistical approach.DesignLongitudinal measurement burst.MethodsIn total, 52 university students (78% female) aged 18–38 years (mean = 21.94 ± 4.57 years) participated. The study consisted of three blocks of six days of measurement, during which participants wore an accelerometer on their wrist for the entire block, and self-reported their PA over the 6 days at the end of each block.ResultsMeaningful latent differences between methods were observed for moderate PA and SB across all three assessment periods, such that participants underreported the time spent in each activity. Bland–Altman plots revealed a positive mean difference for vigorous PA, with over-reporting increasing as mean levels increased. Negative mean differences were observed for all other intensities. Underreporting of moderate PA increased as the mean level increased, whereas for light PA and SB, underreporting decreased at high levels. Repeated measures correlations revealed a meaningful association for vigorous PA only, suggesting that as self-reported minutes increase so too do device-measured minutes.ConclusionsWe found evidence of cross-sectional and longitudinal differences and weak associations between self-reported and device-assessed PA and SB. Future work is needed to enhance the quality of self-reported methods to assess PA and SB (e.g., face and content validity), and consider improvements to the processing of device-based data.     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.