低场磁共振STIR序列在交叉韧带损伤诊断中的应用价值探讨

目的探讨低场磁共振STIR序列在膝关节交叉韧带损伤中的应用价值。方法对61例经手术证实的膝关节交叉韧带损伤患者MRI资料进行回顾性分析。结果MRI诊断73条交叉韧带损伤,单纯前交叉韧带损伤32条,单纯后交叉韧带损伤1条,前、后交叉韧带均损伤40条。Ⅰ级损伤16条,Ⅱ级损伤27条,Ⅲ级损伤30条。55例伴有其他结构损伤,占90.2%,其中副韧带损伤38条,半月板损伤43个,骨挫伤50例,骨折14例,关节囊积液54例。MRI诊断交叉韧带损伤的准确性87.7%、敏感性86.7%、特异性61.5%。结论低场磁共振STIR序列能清晰显示膝关节交叉韧带损伤部位、范围,可对其准确诊断并进行分级,亦能发现多种合并损伤,在膝关节交叉韧带损伤诊断中具有重要价值。     

膝关节侧副韧带及其损伤的MRI研究

目的：研究正常和损伤的膝关节侧副韧带的MRI表现,方法：对32例（36条）有侧副韧带损伤的膝关节和56例正常膝关节的MRI图像进行回顾性对比观察。结果：正常胫,腓副韧带在T1和T2加权像上均呈扁平条状低信号,平均长度分别为6．8cm和5．7cm,36条侧副韧带损伤,单纯胫侧,腓侧副韧带损伤18条和12条,两侧同时损伤3例6条,I级侧副韧带损伤18条,Ⅱ级11条,Ⅲ级7条,25例（78％）出现合并损伤,其中前前叉韧带损伤13条,后交叉韧带损伤9条,半月板损伤12个,骨挫伤和骨折7例,关节囊积液20例,结论：MRI能清楚显示膝关节侧副韧带解剖结构,能准确诊断侧副韧带损伤并分级,还能发现多种合并损伤,宜列为膝关节外伤的选择性检查。     

膝关节操作的MRI检查方法及表现

目的探讨膝关节操作的检查方法及MRI表现.方法应用SIEMENS MAGNETON 1.0超导MR系统,采用膝线圈,自旋回波(SE)序列,脂肪抑制序列,膝关节外旋15-20度,对40例膝关节损伤行T1、T2加权、质子加权、脂肪抑制矢状位、冠状位扫描.结果检查发现半月板损伤24例(占60%),其中内侧半月板损伤11例,外侧13例,前角损伤10例,后角损伤14例,前后角损伤6例,十字韧带损伤15例占(37.5%),侧副韧带损伤11例,占(27.5%).关节软骨损伤8例占20%.     

MRI在膝关节前交叉韧带损伤与半月板撕裂诊断中的应用研究

目的研究探讨在膝关节前交叉韧带损伤与半月板撕裂诊断中采用MRI的临床诊断价值。方法选取膝关节前交叉韧带损伤与半月板撕裂病患48例,对本组病患均给予MRI及关节镜检查,将关节镜检查结果作为金标准,探讨MRI的诊断效果。结果本组48例病患,前交叉韧带损伤的MRI分级Ⅰ级诊断敏感度为37.5%,Ⅱ级诊断敏感度为64.3%,Ⅲ级诊断敏感度为63.6%,Ⅳ级诊断敏感度为60.0%;半月板撕裂的MRI分级Ⅰ级诊断敏感度为40.0%,Ⅱ级诊断敏感度为81.8%,Ⅲ级诊断敏感度为63.6%,Ⅳ级诊断敏感度为66.7%。结论在膝关节前交叉韧带损伤与半月板撕裂诊断中采用MRI,有着一定的诊断价值,值得在临床上推广。     

MRI对膝关节损伤的诊断价值

目的：探导MRI对膝关节损伤的诊断价值。方法：对经手术或临床证实的36例损伤的膝关节与30例正常膝关节进行回顾性MRI对比观察。结果：正常膝关节在T1加权像中，组成关节的骨端松质骨呈高信号，骨性关节面呈低信号，关节软骨呈中等强度信号。半月板、肌肉、韧带呈低信号，脂肪组织为高信号。半月板撕裂：Ⅰ度7例；Ⅱ度和Ⅲ度各5例；盘状半月板5例。交叉韧带损伤19例；侧副韧带损伤12例；骨挫伤及骨折6例；关节积液25例。结论：MRI能清楚显示膝关节的解剖结构，能准确诊断半月板损伤、盘状半月板、交叉韧带损伤、侧副韧带损伤、关节积液等。宜列为膝关节的损伤的常规检查。     

低场MRI在膝关节损伤的诊断价值及评价

目的 探讨低场MRI在膝关节损伤的诊断价值.方法 回顾性分析 80例膝关节损伤的MRI资料.结果 骨折25例.隐匿性骨折及骨挫伤30例.关节软骨损伤21例.单纯外伤性骨髓水肿35例.半月板损伤 37例.韧带损伤16例.关节积液42例.结论 MRI对于膝关节损伤的诊断具有重要的临床价值.     

低场磁共振在膝关节创伤中的应用价值

目的分析膝关节创伤的MRI表现,探讨低场MRI的诊断价值。方法回顾性分析46例膝关节创伤患者的低场MRI资料。结果骨损伤36例,其中骨折伴骨挫伤12例,隐匿性骨折伴骨挫伤3例,单纯性骨挫伤21例;软骨损伤34例,其中软骨表面光滑26例,表面凹凸不平8例;半月板损伤29例34个,其中I级损伤11个,Ⅱ级损伤14个,Ⅲ级损伤9个;韧带损伤25例35根,其中部分撕裂29根,完全撕裂6根;关节积液46例。结论低场MRI是一种全面的诊断检查技术,在膝关节创伤中具有重要的临床应用价值。     

膝关节骨挫伤的MRI诊断及分析

目的 探讨膝关节骨挫伤的MRI表现.方法 回顾性分析68例膝关节骨挫伤患者的MRI资料：记录患者的年龄、骨挫伤病灶的部位、范围、MRI的表现及附属结构损伤的情况.结果 膝关节骨挫伤好发于各类人群.35.3%股骨外侧髁及胫骨外侧平台的骨挫伤伴有前交叉韧带的损伤;26.5%的骨挫伤合并侧副韧带损伤,其中55.6%为同侧骨挫伤,44.4%对侧有骨挫伤;44.1%骨挫伤合并半月板损伤,其中发生于骨挫伤同侧的半月板损伤占66.7%,对侧占20%,内外侧半月板同时累占13.3%;关节软骨的损伤均伴有软骨下的骨挫伤;68例骨挫伤中100%伴有关节腔内不同程度的积液.结论 膝关节骨挫伤的发病率高,MRI表现具有特征性,是膝关节损伤中最常见的MRI征象,还可作为关节其他结构损伤的一个提示性指征.需要更仔细地观察前交叉韧带、内外侧副韧带及半月板的损伤.     

膝关节半月板损伤MRI诊断与关节镜对比研究

目的：探讨MRI对膝关节半月板损伤的诊断及分级对指导临床关节镜手术的价值。方法收集自2013年9月-2014年9月期间,使用GE 1.5T Hde MRI行膝关节检查并行关节镜手术的患者共83例,共计166个半月板,以关节镜检查结果为金标准,对MRI检查诊断膝关节半月板损伤的结果进行对比分析。结果关节镜检查发现60个正常半月板,38个未破裂半月板,68个半月板撕裂;MRI诊断0级65个,Ⅰ级11个,Ⅱ级14个,Ⅲ级56个,Ⅳ级20个。其中假阳性4.8%（8/166）,假阴性7.8%（13/166）;MRI检查对半月板损伤总的灵敏度、特异度、准确性、阳性预测值及阴性预测值分别为87.7%、86.7%、87.3%、92.1%、80%。MRI与关节镜两种检查方法对比差异无明显统计学意义(X2=0.76,p＞0.25)。结论 MRI能够比较准确的对膝关节韧带损伤进行诊断,可做为关节镜手术前有效的筛查方法,为临床治疗提供可靠的诊断依据,指导临床手术方案的制定。     

膝关节损伤的MRI诊断分析

目的:探讨膝关节损伤的MRI表现、病理基础及临床意义.方法:回顾性分析40例经手术或关节镜证实的膝关节损伤的MRI表现.结果:40例膝关节损伤中有半月板损伤18例,MRI表现为半月板内点状、不定形、线状或弥漫高信号.关节韧带损伤30例,MRI表现为黑色条索状韧带影局灶或弥漫增粗、不连续或消失,出现不规则异常信号.骨挫伤10例,骨折11例,关节积液19例,膝关节周围软组织肿胀36例.结论:MRI可以清晰地显示半月板、韧带、滑膜、肌腱等形态、位置及其信号的变化,对膝关节损伤具有很高的诊断价值及临床意义,MRI已经成为膝关节损伤诊断的理想方法.     

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.