CT三维重建成像对孤立性肺结节形态特征的显示及良恶性的诊断价值研究

目的：探讨三维重建成像对孤立性肺结节形态特征的显示及其良恶性的诊断价值。方法：选择45例孤立性肺结节患者,均行多层螺旋CT平扫及增强扫描,分别以VR、MPR、MIP重建,观察不同成像方法对孤立性肺结节相关重要征象的显示情况,并进行统计学比较分析。结果：MPR对病灶的显示能力与轴位成像相比并无明显优势（P〉0．05）;VR在显示边缘形态、内部结构及胸膜凹陷征方面明显优于轴位成像（P〈0．05）;MIP在显示病灶边缘形态及灶周支气管方面显著优于轴位成像（P〈0．05）。结论：三维重建成像可显著提升CT诊断的准确性,是鉴别肿瘤良恶性的有效方法。     

16层螺旋CT胸腹部增强扫描对纵隔淋巴结核诊断的临床价值

目的:探讨16层螺旋CT胸腹部增强扫描用于纵隔淋巴结影像学诊断的临床价值.方法:随机选取纵隔淋巴结核病例60例,采用16层螺旋CT分别选择10mm层厚及1.25mm层厚对其胸腹部进行常规平扫及增强扫描,对两组影像学数据进行分析对比.结果:16层螺旋CT胸腹部增强扫描能较强的显示细节,用于纵隔淋巴结结核诊断可大幅度提升检出率.结论:16层螺旋CT具有高速扫描和高空间分辨率扫描的特点,用于纵隔疾病的影像学诊断具有重要价值.     

静脉溶栓治疗对急性心肌梗死梗死部位存活心肌的影响

目的研究静脉溶栓治疗对急性心肌梗死患者心肌存活状态的影响.方法采用硝酸甘油介入99mTc-MIBI心肌灌注显像的方法,评价37例行静脉溶栓治疗的急性心肌梗死患者梗死部位的存活心肌.结果静息显像中136个节段灌注异常,NTG介入后有81个节段得到不同程度的改善,改善率为59.56%;静息显像平均得分为8.35±3.71,介入显像平均得分为6.05±3.16,两者比较差别有统计学意义(P＜0.001);静脉溶栓再通组存活心肌检出率为76.86%,未通组及常规治疗组为44.44%,再通组明显高于未通组,且有统计学意义(P＜0.01).结论硝酸甘油介入99mTc-MIBI心肌显像可明显提高存活心肌的检出率,成功的溶栓治疗可使梗塞区保留较多的存活心肌.     

Informed consent and moral integrity.

Informed consent is required for any medical procedure although the situations in which it is given are beset by uncertainties and indeterminacies. These make medicolegal scrutiny of such situations very difficult. Although some people find the decision in the Sidaway case incomprehensible because of its continuing regard for a 'professional practice standard' in informed consent, I will argue that an important fact in many cases is the moral integrity of the doctor concerned and the pattern of his practice. This may provide the only morally principled and legally accessible evidence enabling a correct decision to be made in a difficult case. Although the epistemological significance of a professional practice standard is thereby defended the 'prudent patient standard' for what counts as consent is left intact.     

Study of hearing screening for rural school children

INTRODUCTION Hearing loss is a com m on disease in children, w ith a prevalence rate of 1.0‰ -3.0‰ in the neonates in C hina. R ecently,alm ost every new born in C hina can receive the hearing screening,but there is no continual follow -up test. H ow ever,continual screening throughout childhood has been recognized in m any official guidelines concerning neonatal pro- gram s[1] as being vitally im portant in the early iden- tification of hearing im pairm ent. T herefore,alterna- tive o…     

骨盆巨细胞瘤影像学表现与病理结果对照分析

目的与病理结果对照,总结骨盆巨细胞瘤的影像学表现。方法回顾性分析10例经手术或骨穿刺病理证实的骨盆巨细胞瘤影像学检查资料,与病理结果进行对照,总结骨盆巨细胞瘤的影像学特征。结果术前拟诊准确率X线平片为50％（5／10）、CT为85．7％（6／7）;平片对骨嵴特征、骨壳完整性及软组织肿块的显示较差,CT能准确显示骨质破坏区内皂泡状骨嵴及单层或多层骨壳影以及骨壳的吸收变薄、中断或消失;病理诊断为2级以上的骨巨细胞瘤在CT上均可见骨壳中断、消失及软组织肿块形成。结论CT能够清晰显示巨细胞瘤瘤灶内骨嵴及周围骨包壳的细微改变,对骨盆骨巨细胞瘤的定性及分级诊断具有重要价值。而X线平片的诊断符合率较差。     

兔Vx2肝癌改良模型的建立及其DSA影像分析

目的　建立可供实验研究的稳定的兔 Vx2移植性肝癌模型 ,探讨不同植瘤方式的成功率 ,并分析该肿瘤的 DSA影像特征 .方法　新西兰白兔 6 0只 ,随机分 3组 ,每组 2 0只 .将Vx2瘤细胞 (5× 10 7个 )经肝动脉或经肝包膜分别接种于 2组兔的肝左叶 ,建立对照肝癌模型 .第 3组经肝包膜植入瘤组织块 (约含 10 6～ 10 8个瘤细胞 )建立改良肝癌模型 .观察 :1不同组植瘤的成活率 ;2改良组肿瘤 7,10 ,14,17和 2 1d时的体积(B超测 ) ,并计算肿瘤生长率 ;3大体及镜下 (光镜和电镜 )瘤组织形态特征 ;4改良 Vx2移植性肝癌的 DSA影像特征 .结果　 3组植瘤成活率分别为 7/ 2 0 ,10 / 2 0和 19/ 2 0 ,改良组植瘤成活率最高 (P<0 .0 5 ) ,瘤体呈指数性生长 ,组织病理及电镜表明该瘤在肝组织中浸润式生长 ,其形状与移植于兔其他部位的 Vx2鳞状细胞癌特征相似 .DSA影像示该移植性肝癌具有丰富的血供 .结论　成功建立了兔 Vx2移植性肝癌改良模型 ,瘤组织块种植方式成功率明显高于动脉途径和细胞液注射方式 ,为肝癌研究提供了大型实验模型 .     

SARS定点收治医院医疗设备的配置

文章分析了SARS定点收治医院对影像学检查设备、体液检查设备、支持与治疗设备以及其他医疗设备的特殊要求，并根据SARS流行病学特点，提出了建立临时性SARS定点收治医院医疗设备配置的原则：少而精、网络化、傻瓜型、一次性、同型号、非接触的原则。     

The role of preoperative magnetic resonance imaging in internal derangement of the knee

We attempted to compare the accuracy of our clinical examination and the usage of magnetic resonance imaging (MRI) in evaluating patients suspected of having internal derangement of the knee who were seen in our Orthopaedic clinic. This was done using the findings of arthroscopy as the 'gold standard'. The accuracy of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to 48-65% for clinical examination. We thus propose that MRI examination is an effective first-line investigation for patients with suspected internal knee derangement, especially menisci injuries; allowing arthroscopy to be reserved for patients in whom surgery is truly indicated.     

膝关节半月板的解剖学研究与三维重建

半月板是膝关节重要解剖结构之一,临床上膝关节损伤以半月板损伤多见,了解半月板的解剖学对诊疗半月板疾病有重要意义。阐述了膝关节半月板的形态功能、断层影像解剖学等,并介绍了膝关节三维重建的应用现状及发展前景。     

肾上腺外嗜铬细胞瘤的CT诊断

目的:探讨肾上腺外嗜铬细胞瘤的CT诊断价值。资料与方法:回顾性分析有完整病史资料及手术病理结果的肾上腺外嗜铬细胞瘤22例,所有病例均经CT检查。结果:结合临床相关资料,22例肾上腺外嗜铬细胞瘤CT定位诊断准确率达100%,定性诊断准确率达86.4%(19/22)。结论:CT扫描是肾上腺外嗜铬细胞瘤最有效的检查方法。     

小肠细菌过度生长诊断方法的研究进展

小肠细菌过度生长(SIBO)以及由其引起的菌血症、败血症、肠源性内毒素血症是很多疾病的严重状态,而一些疾病由于抵抗力下降也很容易合并SIBO。以往小肠液细菌培养被视为诊断SIBO的"金标准",但其为侵入性检查、操作复杂、取材困难,不宜推广,故寻求一种准确、方便、易接受的诊断方法,成为科研、临床工作者关注的热点。现对目前各种常见诊断SIBO方法的优缺点及临床利用价值予以综述。     

硝酸甘油介入心肌核素显像检测存活心肌的意义

目的探讨急性心肌梗死(AMI)与陈旧性心肌梗死(OMI)心肌存活状态的差异。方法应用SPECT对63例Q波MI患者行常规99mTc-MIBI心肌显像(静息显像),隔日舌下含服NTG(1.0mg)后5分钟静注99mTc-MIBI,再行心肌显像(介入显像),其中4例患者行冠脉搭桥术(CABG),3例于CABG术后3月再行心肌显像。结果静息显像中239个节段灌注异常,NTG介入后有97个节段得到不同程度的改善,改善率为40.59%,静息显像平均得分为9.65±4.31,介入显像平均得分为7.75±4.66,两者比较差别有统计学意义(P<0.001)。3例CABG术前检测有改善的6个节段,术后均得到不同程度的改善。AMI组与OMI组1月-6月组,6月-3年组相比较,存活心肌的检出率分别为43.10%,42.80%,35.15%,虽呈逐渐下降,但无统计学意义(P>0.05)。结论NTG介入99mTc-MIBI心肌显像可明显提高存活心肌的检出率,且该方法简便易行,安全可靠。OMI患者亦有存活心肌,也可从血运重建中获益。     

A study on thyroid nodules: diagnostic correlation between fine needle aspiration cytology and histopathology

This study evaluated the effectiveness of fine needle aspiration of thyroid nodules to reliably diagnose thyroid malignancy, using histopathology as the 'gold standard'. Out of 126 patients, 106 underwent surgery. The sensitivity, specificity and positive predictive value of fine needle aspiraton cytology to diagnose a papillary carcinoma in this study were 80.7%, 96.5% and 87.0% respectively. The accuracy of fine needle aspiraton cytylogy was 80.9%. Six cases that were benign by fine needle aspiraton cytology were confirmed to have malignant lesion by histopathological examination. High resolution ultrasonography could be useful in these situations for considering surgery.     

Early experience using duplex ultrasonography in the diagnosis of deep venous thrombosis; a prospective evaluation

Duplex ultrasound is used in many radiology departments as the first line of investigation for symptomatic deep venous thrombosis. Before changing the practice of our department from venography to duplex ultrasonography, we wanted to assess our ability to identify deep venous thrombosis on ultrasound. Thirty-eight patients were investigated for suspected deep venous thrombosis by venography and duplex ultrasound. The results were compared using venography as the 'gold standard'. Duplex ultrasound correctly identified 13 out of 16 limbs with deep venous thrombosis. Four of the 38 duplex ultrasound examinations (11%) were described as inadequate at the time of examination, and when these are excluded from the analysis a sensitivity of 93 %, and specificity of 80 % are achieved. We conclude that there is a significant learning curve when performing duplex ultrasound of the lower limb, and that change-over from venography to ultrasound should include a period during which both examinations are routinely performed.     

彩色多普勒超声对糖尿病眼球后血管血流动力学研究

目的：通过彩色多普勒超声观察糖尿病眼球后血管的血流动力学,研究其诊断价值。方法：共用彩色多普勒超声检查了正常人眼球、糖尿病视网膜病变（diabetic retinopathy,DR）及有糖尿病但无糖尿病视网膜病变（non-diabeticretinopathy,NDR）眼球的球后血管并与荧光素眼底血管造影及检眼镜对比。结果：随着DR的进展,糖尿病患者眼球后血管血流动力学改变的趋势是眼球后动脉的血流速度下降,阻力升高;球后静脉流速增高伴搏动性增强。结论：彩色多普勒超声技术为定量评价DR,判断其预后提供了重要的参考价值。     

高校优秀生核差生在英语学习策略使用上的差异

着重探讨采用定量分析的方式,以重庆某大学一年级学生为研究对象,调查了优秀生和差生在英语学习中使用学习策略的差异。研究发现,优秀生使用英语学习策略的宽度和频度都显著大于差生。两者使用的策略也有所不同。前者最常用的是深度策略、联想策略、二语策略、积极参与策略、外语使用策略、过程监控策略,而这些策略一般被认为是高效策略,对成功的外语学习贡献度较高。后者倾向于使用效率较低的表层策略、母语策略、死记硬背策略、词汇策略以及猜测策略。     

Budd—Chiari综合征介入治疗192例分析

目的：探讨不同类型Budd—Chiari综合征（BCS）介入治疗的路径和方法。方法：选取BCS患者192例,先行下腔静脉造影,根据造影结果,采取不同路径行下腔静脉和（或）肝静脉球囊扩张成形术,术前术后测量静脉压,效果欠佳者。及时置入血管内支架,随访6～12个月。结果：成功治疗188例,治愈率为97．9％。下腔静脉压及肝静脉压由术前的（29．20±1．05）kPa和（3．25±1．07）kPa降至（16．10±0．54）kPa和（1．53±0．52）kPa,腹胀、腹水、下肢肿胀等临床症状1周内明显改善,胸腹壁浅静脉消退。无1例严重并发症发生。1年内血管通畅率为100．0％。结论：BCS介入治疗,应根据造影的具体情况,灵活采取介入路径和方法,才能达到良好的治疗效果,减少并发症的发生。     

产前超声筛查胎儿头部畸形的意义

目的：探讨产前超声筛查胎儿头部畸形的诊断价值。方法：对17 000例孕11~42周在我院接受产前超声筛查的胎儿进行头部基本切面的扫查。结果：头、颜面部产前超声诊断畸形165例,部分经引产病理及染色体检验证实。结论：产前超声筛查是诊断胎儿颅内异常较直观、可靠、方便、安全、必要的影像学检查方法。     

颈总动脉内膜中层厚度及斑块与冠心病的关系

目的:探讨颈总动脉内膜中层厚度(IMT)及斑块与冠心病的关系,以及IMT与冠脉病变的相关性。方法:应用彩色多普勒超声对90例疑似冠心病者测定IMT及对斑块分级,并通过冠状动脉造影(CAG)检查分为冠心病组60例(其中稳定性心绞痛15例,不稳定性心绞痛25例,急性心肌梗死20例)和对照组(非冠心病)30例,观察颈总动脉IMT、斑块在各组中的变化及IMT与冠脉病变的关系。结果:颈总动脉IMT、斑块指数在对照组和冠心病各组间差异均有统计学意义(P<0.01),在冠心病各组间差异均无统计学意义(P>0.05);IMT与冠脉病变的血管数呈正相关(P<0.05),而与冠脉狭窄的程度无相关性(P>0.05)。结论:颈总动脉IMT与冠心病的发病密切相关,颈总动脉超声检查可以作为早期发现和筛选冠心病的一种方法。