多排螺旋CT不同重建方法在脊柱骨折中的应用

目的：探讨多层螺旋CT不同重建方法对于脊柱骨折的诊断价值。方法：112例脊柱骨折病例经多层螺旋CT扫描,并在工作站行MPR和3D-SSD图像重建,分析不同处理后图像的应用价值。结果：112例中共检出138个骨折椎体,其中爆裂型骨折84个椎体。结论：MPR和3D-SSD对于椎体骨折,椎体高度、骨折片后移及椎管狭窄显示效果好,尤其3D-SSD对于椎体旋转、脱位最有价值。通过MPR和3D—SSD重建对爆裂型骨折的分型（尤其D型和E型）更加准确,对于脊柱骨折的稳定性评价更加客观。     

多层螺旋CT对脊柱爆裂性骨折的诊断

目的:探讨多层螺旋CT(MSCT)的多平面重建(MPR)、三维重建(SVR)影像表现对脊柱爆裂性骨折稳定性判定和椎体后缘的碎骨片后移导致椎管狭窄与神经损伤之间的关系。方法:回顾性分析63例椎体爆裂性骨折的CT表现,所有患者均采用1mm螺距15螺旋扫描,获得原始数据进行MPR和SVR重建。结果:椎体向心性爆裂;碎骨片向后移位导致椎管狭窄;垂直或横向骨折;单侧或双侧椎板骨折;部分伴有关节突、棘突骨折;大部分脊柱后凸。神经损伤与椎管狭窄的程度有关。结论:MSCT的MPR和SVR能更好显示脊柱爆裂性骨折,椎管狭窄程度,显示脊柱屈曲、旋转及脱位,是判断脊柱稳定程度极其精确的方法,并对治疗方案选择及神经损伤的估计有着重要价值。     

螺旋CT和多层面重建对胸腰段脊柱爆裂性骨折术前评估的价值

目的探讨螺旋CT及多层面重建(MPR)，三维表面遮盖法(SSD)在胸腰段脊柱爆裂性骨折术前评估的价值。方法分析48例胸腰段脊柱爆裂性骨折的轴位CT多层面重建及三维CT的图像特征。结果轴位CT多层面重建(MPR)及三维重建(SSD)均能清晰显示术前脊柱爆裂骨折的细节；但SSD在显示脊柱的稳定性、椎管形态、采取何种手术入路及相应内固定方式上尚有很好的指导意义。结论多层面重建(MPR)和三维重建(SSD)是诊断脊柱爆裂骨折的有效手段，并对术前分类、指示手术入路、评估预后方面均有重要的临床意义。     

急性脊柱损伤的螺旋CT诊断

目的探讨多层螺旋CT在急性脊柱损伤诊断中的应用价值.方法回顾性分析39例急性脊柱损伤患者的螺旋CT资料,包括多平面重建(MPR)、表面遮盖显示(SSD)、最大密度投影(MIP)3种显示方法.结果全组病例显示椎体骨折36例,椎体骨折伴椎管狭窄13例,小关节脱位12例.多层螺旋CT 能很好地显示相应的骨折、脱位及椎管情况,尤其是MPR 及MIP 对椎体骨折显示率为100%.结论多层螺旋CT尤其是MPR、MIP能直观、立体、清晰、多角度地显示脊柱损伤,具有较高的临床应用价值.     

53例螺旋 CT 三维重建在椎体骨折中的应用价值分析

目的：探讨螺旋 CT 检查及三维重建技术在椎体骨折中应用价值分析。方法对53椎体骨折患者进行螺旋 CT 扫描并进行三维重建、表面遮盖 SSD 及多平面重建 MPR 等后处理,将图像资料进行比较。结果63例骨折中压缩性骨折34例,粉碎性骨折16例,骨折伴脱位13例,三维重建能立体直观显示椎体骨折的部位、类型、三柱结构、椎管狭窄及脊髓受压等情况。结论螺旋 CT 检查及三维重建、表面遮盖 SSD 及多平面重建 MPR 等后处理联合应用对椎体骨折的诊断具有重要价值。     

椎体爆裂性骨折CT诊断及三维重建的应用价值(附58例报告)

目的研究椎体爆裂性骨折的CT表现及三维重建的CT诊断的应用价值。方法分析58例胸腰段脊椎爆裂性骨折病例,分别行CT轴位片及螺旋CT三维重建多平面重建检查及技术处理。结果椎体骨折CT轴扫对三柱骨折显示有明显优越性,而三维重建及多平面重建不仅能具体、直观、形象地显示骨折情况,而且对脊髓、神经根损伤的显示清楚。结论CT轴扫并通过三维重建如SSD多平面重建(MPR)及多平面容积再现(MPVR)技术的应用对诊断及了解椎管内碎骨片的大小、形态、位置及椎管狭窄的程度有很好的实用价值。     

多层螺旋CT三维重建技术在脊柱骨折中的应用

目的探讨多层螺旋CT重建技术诊断脊柱外伤的应用。方法 45例脊柱外伤患者行多层螺旋CT扫描,并进行MIP、MPR、SSD、VR图像重建。结果 45例均明确诊断骨折。MIP、MPR、SSD、VR重建对于骨折显示效果好。结论多层螺旋CT重建技术为脊柱外伤的诊断和治疗提供重要信息,有利于治疗方案的选择。     

螺旋CT及重建技术在脊柱损伤中的应用

目的 探讨螺旋CT及重建技术在脊柱损伤中的应用价值。方法 回顾性分析31例脊柱损伤患者的螺旋CT袖位图像(TrCT)、多平面重建图像(MPR)、表面遮盖法重建图像(SSD)，根据对病变的分辨率，将三者对病变的显示能力分为优、良、差3等。结果 脊柱正、侧位CT定位像类似于常规X线摄片。TrCT、MPR对骨折、无旋转脱位、脊髓损伤显示良好。SSD对线性骨折、脊髓损伤显示差。MPR和SSD能清晰显示椎间隙宽窄、椎体滑脱；椎体旋转脱位以SSD显示最好。MPR和SSD立体感强，空间分辨率高。结论 螺旋CT应作为脊柱损伤的首选检查方法。熟悉并灵活应用CT定位像、TrCT、MPR、SSD图像，可对各种脊柱损伤作出及时而准确的诊断。     

螺旋CT三维重建在胸腰椎爆裂性骨折中的应用价值

脊柱骨折是常见的外伤之一，其中以爆裂性骨折最为常见，好发于脊柱的胸腰段，多属不稳定型骨折。收集我院胸腰椎爆裂性骨折36裂，螺旋CT扫描后进行多平面重建（MPR），表面遮盖法重建（SSD），最大密度投影（MIP）后处理，分析其图像特点，探讨螺旋CT三维重建在胸腰椎爆裂性骨折中的应用价值。[第一段]     

胸腰椎骨折的X线及螺旋CT诊断

目的：探讨X线及螺旋CT对胸腰椎骨折诊断价值。方法：24例胸腰椎骨折患者均行X线和螺旋CT检查。螺旋CT扫描后原始图像行多平面重建(MPR)及表面遮盖显示法(SSD)三雏重建。结果：单纯压缩性骨折8节,爆裂性骨折19节,骨折脱位3节。结论：X线平片对胸腰椎骨性结构椎管形态显示清晰,是胸腰椎骨折检查基本方法。而螺旋CT能直观再现胸腰椎骨折的病理解剖全貌,为临床准确分类及稳定性提供多方面有价值信息,是胸腰椎骨折较理想的检查方法。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.