128层螺旋CT双期血管重建成像对肝脏肿瘤的诊断价值

目的探讨128层螺旋CT肝脏双期扫描血管重建成像对肝脏肿瘤的临床应用价值。方法对经手术方式证实的22例肝脏肿瘤进行128层螺旋CT动脉期和门静脉期扫描,在后处理工作站利用多平面重建技术（MPR）、最大密度投影法（MIP）、表面阴影显示（SSD）与容积显示（VR）等技术进行双期血管重建成像。结果肝动脉期vR和MIP等重建图像均能清晰显示腹腔干、肝总动脉、胃十二指肠动脉及肠系膜上动脉及其属支,门静脉期VR和MIP后处理成像能清晰显示门静脉主干及其属支。结论128层螺旋CT双期血管重建成像技术快速、直观、准确,有助于指导临床对肝肿瘤手术方案的制定。     

64排CT支气管动脉成像的临床应用

目的 探讨64排螺旋CT支气管动脉成像的临床应用价值。方法 回顾性分析28例病例。对28例病例行64排螺旋CT薄层扫描，用容积再现（VR）、多平面重建（MPR）、最大密度投影（MIP）进行三维重建，通过不同的角度观察支气管动脉的空间解剖细节。其中9例有DSA对照。结果 28例支气管动脉三维图均像能够清晰显示支气管动脉的起源、走行的路径和血管直径。12例肺癌病例由支气管动脉供血，未见肺动脉供血，16例支气管扩张病例显示支气管动脉主干明显扩张、迂曲。结论 64排螺旋CT三维支气管动脉成像能够准确、直观地显示支气管动脉的空间解剖特点，从而指导相关介入治疗。     

64排螺旋CT诊断肋骨骨折的临床价值

目的探讨64排螺旋CT在肋骨骨折诊断中的临床应用价值。方法回顾性分析1年来我院行64排螺旋CT肋骨骨折重建56例患者的临床资料,薄层扫描,并进行MPR、MIP、SSD、CPR及VR等方法后处理,与DR片进行对比分析。结果 56例中DR显示106处肋骨骨折,螺旋CT扫描各种重建方法发现肋骨骨折146处。结论 64排螺旋CT对肋骨骨折诊断价值更高,MPR、MIP、CPR重建成像技术在显示肋骨轻微骨折上效果较好,SSD、VR成像在显示骨折的立体形态和空间位置上效果较好。     

64排螺旋CT支气管动脉成像对支气管扩张症患者的DSA介入治疗价值分析

目的 探讨支气管扩张的支气管动脉64排螺旋CT三维成像,并与该患者的DSA表现对照分析,旨在提高支扩患者的综合影像诊断,同时提高支气管扩张症患者的介入治疗的远期疗效.方法 对2010年6月至2011年10月本院37例因为支气管扩张大咯血的患者的支气管动脉行64排螺旋CT薄层扫描,用容积再现(VR)、多平面重建(MPR)、最大密度投影(MIP)进行三维重建,通过不同的角度观察支气管动脉的空间解剖细节,之后对照相应的支气管动脉造影(DSA)的影像表现资料予以回顾性对照分析、总结.结果 37例支气管扩张患者支气管动脉的螺旋三维图像均能够清晰显示支气管动脉的起源、走行的路径和血管直径.支气管扩张患者DSA造影表现支气管动脉的主干部位均呈现出不同程度的较为明显的扩张以及迂曲.结论 支气管动脉 64排螺旋CT的三维成像技术可以较为精确清晰地显示支气管扩张患者支气管动脉的起源及空间解剖特征,以及变异情况;能够准确、直观地显示支气管动脉[1],从而指导支气管扩张患者有关支气管动脉方面的综合全面介入治疗,值得在临床上推广使用.     

多排螺旋CT血管成像技术在影像诊断主动脉夹层中的价值

目的探讨多层螺旋CT血管成像技术在主动脉夹层中应用中的价值。方法对江西省婺源县中医院36例经手术证实的主动脉夹层应用多排螺旋CT血管成像技术进行检查,对其影像诊断进行回顾性分析。使用多平面重建系统工具、最大密度重建系统工具以及容积再现等图像系统处理方法对影像进行三维立体重建。结果平面重建（MPR）显示破口32例,容积再现（VR）显示破口8例,两者比较差异有统计学意义（P〈0.05）;MPR与VR均显示内膜瓣36例,而MIP不直接显示内膜瓣,MPR、VR与MIP比较,差异有统计学意义（P〈0.05）;MPR与VR对真、假腔显示36例,而MIP显示真、假腔26例,MPR、VR与MIP比较,差异有统计学意义（P〈0.05）。结论多排螺旋CT血管成像技术诊断主动脉夹层快速准确。     

64排螺旋CT血管造影对下肢动脉疾病的诊断价值

目的:评价64排螺旋CT血管造影在诊断下肢动脉病变中的应用价值.方法:对30例疑似下肢动脉病变患者,均行64排螺旋CT血管造影,应用最大密度投影(MIP)、容积再现(VR)、多平面重建(MPR)等后处理技术进行血管重建,并结合轴位原始图像进行分析.结果:30例血管重建图像显示良好,所有CTA均显示责任血管,经介入或手术治疗后患者症状明显改善.结论:64排螺旋CT血管造影能清晰地显示下肢动脉及其病变,确定病变性质及范围,并对临床治疗方案的确定有指导作用.     

64排螺旋CT三维及多平面重建在髋臼骨折中的应用

目的：探讨64排螺旋CT多平面重建（MPR）、容积在现（VR）在髋臼骨折诊断中的价值及应用。方法：回顾性分析40例髋臼骨折患者的X线、MPR、VR图像,分析各种成像方法在髋臼骨折诊断中的价值。结果：所有病例64排螺旋CT扫描及重建均能显示骨折,MPR图像可以显示髋臼顶的骨折及移位、髋臼后壁骨折、受累范围及关节移位。VR图像立体地显示骨折线走行方向、骨碎片及股骨头移位情况。结论：64排螺旋CT对于术前充分了解损伤情况,制定严格的手术计划,具有重要的指导意义。因此,64排螺旋CT三维及多平面重建综合应用是诊断髋臼骨折的有效方法及术前常规的检查手段。     

64层螺旋CT对孤立性肠系膜上动脉夹层动脉瘤的诊断价值

目的 探讨64层螺旋CT血管成像在孤立性肠系膜上动脉夹层动脉瘤(SMA)的临床应用及价值.方法 根据6例64层螺旋CT血管造影检查,应用容积显示(VR)、最大密度投影(MIP)、多平面重组(MPR)曲面重组(CPR)技术进行肠系膜血管图像重建,分析影像特征.结果 64层螺旋CT血管成像及后处理技术可清晰显示肠系膜上动脉及分支血管,并清晰显示SMA部位、范围及分支血管受累情况.结论 64层螺旋CT血管成像及后处理技术对肠系膜上动脉夹层动脉瘤及SMA相关疾病有很好的诊断价值.     

64排螺旋CT对主动脉壁内血肿的诊断

目的评价64排CT在主动脉壁内血肿诊断中的应用价值。方法应用64排螺旋CT平扫及血管成像对图像进行VR、MIP、MPR、CPR等图形处理,分析经临床确诊的11例主动脉壁内血肿患者的CT表现。结果64排螺旋CT的强大的图像处理能清楚显示主动脉壁内血肿的大小、形态、变化及与分支血管的关系等。结论64排螺旋CT血管成像技术具有快速、准确、无创、全面等优点,对于主动脉壁内血肿选择治疗方案或术后随访观察等具有重要的临床应用价值。     

多层螺旋CT肝脏血管成像技术的应用研究

目的 :探讨多层螺旋CT(MSCT)肝脏多期扫描及肝动脉、门静脉及肝静脉 3期血管成像的可行性 ,不同后处理技术显示肝脏血管的能力及其临床应用。 方法 :对 97例患者行肝区多层螺旋CT 3期血管成像扫描。重建方法为最大密度投影法 (MIP)、容积再现技术 (VR)。同期 2 1例患者行肝动脉DSA成像。 结果 :肝动脉期血管成像可清晰显示扫描范围内的腹主动脉 ,腹腔干动脉及其分支走行与变异。MIP及VR技术显示肝动脉分级多为 2级以下 ,DSA显示肝动脉均达 3级以上。门、肝静脉期血管成像能清晰显示门静脉系统及肝静脉系统情况。MIP及VR均多能显示门静脉及肝静脉达 3级以上。两种技术显示率无统计学意义 (P >0 .0 5 )。MIP法显示细小血管清晰、真实 ,类似血管造影 ,VR立体感强于MIP。结论 :MSCT肝脏 3期血管成像是了解肝脏动脉及门、肝静脉系统情况的无创、安全、方便的检查方法 ,可为临床提供更多的有关肝动脉和门、肝静脉方面的信息。MIP与VR结合使用是较好的重建方法。     

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.