胎儿颅脑主要结构MRI信号的生理意义

为探讨胎儿颅脑内部主要结构ＭＲＩ信号变化的生理意义。本文对４４例孕妇进行ＭＲ成像，分析其正常胎儿颅脑主要结构的信号变化。结果示：胎儿的大脑（基底核除外）、小脑实质在Ｔ１加权上为略低信号，在质子密度加权上为等信号，在Ｔ２加权上为高信号。脑干、基底核（节）在Ｔ１加权上，孕２９周前呈略低信号，孕２９周后呈等信号；在质子密度加权及Ｔ２加权上其信号同大脑、小脑实质信号。脑室信号在ＳＥ序列的所有加权上均呈低信号     

正常胎脑髓鞘发育状况的MRI研究

目的：探讨胎脑髓鞘的生长发育状况。材料与方法：采用超导０．３５Ｔ磁共振成像仪，对４４例孕妇进行ＭＲ成像，分析其正常胎脑主要结构的信号变化。结果：胎儿的大脑（基底节除外）、小脑实质在Ｔ１加权像上为略低信号，在质子密度加权像上为等信号，在Ｔ２加权像上为高信号。孕２９周前脑干、基底节在Ｔ１加权像上呈略低信号，孕２９周后呈等信号；在质子密度加权像及Ｔ２加权像上其信号同大脑、小脑实质信号。结论：脑干、基底节的髓鞘在孕２９周后形成；其形成过程由脑干开始至基底节；而在胎儿期，大脑（基底节除外）、小脑实质内髓鞘尚未形成     

磁共振成像对胎儿肝脏生长发育状况的研究

目的：探讨宫内胎儿肝脏的生长发育状况。方法：采用超导０．３５Ｔ磁共振成像仪，观察妊娠中、晚期孕妇中４２例正常胎儿肝脏的形态结构、信号变化。结果：胎肝的形态、大小以及肝内的门静脉、肝静脉等有不同程度的显示。在Ｔ１加权上，孕３２周前，胎儿肝脏的信号呈不均匀的高信号；在孕３２周后，胎儿肝脏的信号呈均匀一致的中等信号。在质子密度加权及Ｔ２加权上，胎儿肝脏的信号呈等信号，和孕周无关。结论：磁共振成像（ＭＲＩ     

磁共振成像对胎儿肝脏生长发育状况的研究

目的：探讨宫内胎儿肝脏的生长发育状况。方法：采用超导０．３５Ｔ磁共振成像仪，观察妊娠中、晚期孕妇中４２例正常胎儿肝脏的形态结构、信号变化。结果：胎肝的形态、大小以及肝内的门静脉、肝静脉等有不同程度的显示。在Ｔ１加权上，孕３２周前，胎儿肝脏的信号呈不均匀的高信号；在孕３２周后，胎儿肝脏的信号呈均匀一致的中等信号。在质子密度加权及Ｔ２加权上，胎儿肝脏的信号呈等信号，和孕周无关。结论：磁共振成像（ＭＲＩ）对胎肝生长发育状态的研究有重要价值     

常见几种肝脏占位病变磁共振成像诊断

目的：为研究几种肝脏病变的磁共振成像（ＭＲＩ）影像特点，提高对肝脏占位病变的认识和诊断。方法：收集８４例经临床证实的肝脏病变病人的ＭＲＩ检查资料，进行回顾性分析。结果：８４例肝脏占位病变的主要ＭＲＩ表现，在Ｔ１加权图像上，大多表现为略低信号，在Ｔ２加权图像上，恶性病变５６例，表现为混杂增高信号，良性病变２８例，信号均匀增高，血管瘤质子密度像即呈高信号。结论：ＭＲＩ检查对于肝占位病变的定位和定性有特     

后循环缺血性脑卒中的经颅多普勒脑血流速度测定

目的：经颅多普勒（ＴＣＤ）测定脑干、小脑梗塞与椎基底动脉供血不足患者的脑血流速度的改变，与磁共振成像（ＭＲＩ）进行对比。方法：对６６例临床诊断为后循环缺血性脑卒中患者进行ＭＲＩ和ＴＣＤ检查。将ＭＲＩ显示脑干、小脑有梗塞灶的３６例定为梗塞组；ＭＲＩ未见异常的３０例为椎基底动脉供血不足组（ＶＢＩ）；正常对照组３０例。结果：梗塞组３６例以脑桥梗塞最多见，ＴＣＤ示梗塞组、ＶＢＩ组的血流速度异常率分别为９１６％和６３３％，２组血流速度值与对照组比较均存在显著性差异（Ｐ＜００１）。结论：ＴＣＤ对脑血流动力学的研究有重要应用价值，特别是对于脑ＣＴ、ＭＲＩ等影像学结构改变以前的临床下患者，预防脑梗塞的发生有重要意义。     

多发性硬化临床与MR136例分析

目的：探讨多发性硬化（ＭＳ）临床特点与ＭＲＩ（磁共振成像）异常信号的诊断意义和相对应的关系。方法：全部符合ＭＳ的临床诊断标准并进行ＭＲＩ检查同样诊断ＭＳ的病人，结果：ＭＳ同时累及一个或多个不同部位，本组病例累及侧脑室周围及大脑半球２３例、脑干４例、小脑９例、海马部３例、脊髓１０例、视神经９例。结论：ＭＲＩ定位准确，诊断准确，凡是临床特点符合ＭＳ均可作ＭＲＩ检查，为临床诊断治疗提供重要信息。     

颅内脑膜瘤的MR影像特点

分析６７例颅内脑膜瘤的信号变化，发现７０％的脑膜瘤其信号变化和脑灰质信号变化同步，１９．４％的脑膜瘤信号随着回波时间的延长而升高，１０．４％的脑膜瘤信号在Ｔ２加权为混杂信号。同时，得出磁共振成像（ＭＲＩ）对脑膜瘤的正确诊断率达９２．５％，脑膜瘤被ＭＲＩ误诊为其它肿瘤的为７．５％，其它肿瘤被ＭＲＩ误诊为脑膜瘤的为４．６％，并探讨了ＭＲＩ的误诊原因及误诊病变的好发部位。     

颅内先天性表皮样囊肿的MRI诊断

为了探讨ＭＲＩ对颅内表皮样囊肿的诊断价值，观察了２０例经手术和病理证实的颅内先天性表皮样囊肿的ＭＲＩ表现，其中１２例有ＣＴ对照。Ｔ１加权像（Ｔ１ＷＩ）１８例呈低信号，其信号强度介于脑脊液和脑皮质之间，另２例呈明显高信号。Ｔ２加权像（Ｔ２ＷＩ）均呈高信号，但普遍有信号不均匀现象。１２例有ＣＴ者均呈低密度。颅内先天性表皮样囊肿好发于桥脑小脑角，有在中线生长的趋势，并常沿脑裂隙及脑池生长。ＭＲＩ显示病变范围优于ＣＴ，但对钙化的显示ＣＴ优于ＭＲＩ。结果提示：ＭＲＩ对颅内表皮样囊肿能作出定性诊断。     

复杂型先天性心脏病磁共振成像的诊断研究

目的：对复杂型先天性心脏病（先心病）磁共振成像（ＭＲＩ）与心血管造影（Ａｎｇｉｏ）进行对比分析研究,评价ＭＲＩ在小儿复杂型先心病的诊断价值,方法对复杂型先心病患儿４２例,应用超导磁共振仪,选用心电图门控自旋回波法技术（ＳＥ）,电影磁共振（ｃｉｎｅ－ＭＲＩ）,磁共振造影（ＭＲＡ）,获得Ｔ１加权像（Ｔ１ＷＩ）,并进行二维彩色多普勒超声心动图检查,其中３０例做了Ａｎｇｉｏ检查,２５例经手术治疗。结果ＭＲ     

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.