DR与螺旋CT诊断急诊胸腹部创伤中的临床应用价值分析

目的探讨DR与螺旋CT诊断急诊胸腹部创伤中的临床应用价值。方法统计分析2015年1月至2017年1月之间在我院影像科接受检查100例胸腹部创伤患者的临床资料,全部患者均分别接受DR与螺旋CT诊断,比较两种方法的诊断符合率。结果 DR检查对于纵隔气肿、肺不张、气胸、胸腔积液、肺挫伤、锁骨骨折、肩胛骨骨折、肋骨骨折、皮下气肿等的诊断符合率较高,不同类型胸腹部创伤患者DR与螺旋CT诊断符合率对比统计学差异明显(P0.05)。结论在急诊胸腹部创伤临床检查和诊断中应用DR与螺旋CT技术,能够有效提高患者诊断的准确性,因而临床应用价值较高。     

DR与螺旋CT诊断急诊胸腹部创伤中的临床应用价值分析

目的探讨DR和螺旋CT在急诊胸腹部创伤中的临床诊断效果及应用价值。方法选取2011年1月到2015年3月我院收治的190例急诊胸腹部创伤患者资料进行分析,入选患者均采用DR及其CT诊断,分析患者DR及其CT影像学表现,研究DR和螺旋CT在急诊胸腹部创伤中的临床诊断效果及应用价值。结果两种诊断方法对于肺挫伤、纵隔气肿、皮下气肿、肋骨骨折、胸腔积液、气胸以及膈肌损伤诊断差异不显著(P0.05);CT诊断方法确诊率均能够达到100%,显著高于DR诊断方法(P0.05)。结论急诊胸腹部创伤患者诊断过程中采用螺旋CT诊断效果理想,该诊断方法具有较高的准确率,能够对创伤部位进行精确定位和评估,值得推广使用。     

60例脊柱创伤患者的CT诊断分析

目的探讨多层螺旋CT扫描及图像重建在脊柱创伤诊断中的应用价值.方法对从2010年2月-2012年2月到本院就治的60例脊柱创伤患者采用多层螺旋CT诊断,对螺旋CT图像进行多平面及三维重建,分析脊柱创伤的CT图像特点,并将螺旋CT诊断结果与临床病理诊断结果相比较.结果60例脊柱创伤患者的螺旋CT诊断显示,椎体变扁19例,附件合并椎体骨折16例,椎体前缘骨折10例,椎体后缘骨折8例,椎管狭窄4例.螺旋CT诊断结果与临床病理学诊断结果完全相符,螺旋CT诊断正确率高达100.00%.结论多层螺旋CT扫描对于脊柱创伤的诊断正确率高,其能将脊柱创伤的位置、范围、形态、病变程度等清晰显现出来,降低脊柱创伤的误诊率及漏诊率.     

多排螺旋CT在急诊胸腹部创伤中的诊断价值

目的:分析在急诊胸腹部创伤中多排螺旋CT的诊断价值。方法:对我院2014年1月-2015年1月急诊收治的胸腹部创伤患者62例螺旋CT征象进行回顾性分析。结果:多排螺旋CT扫描出肋骨骨折32例,发生率最高,纵膈气肿和纵膈血肿3例,发生率最低。结论:多排螺旋CT能够快速、直观的显示急诊胸腹部创伤影像特点,能够帮助医生正确判断患者的病情,使患者得到及时救治,挽救患者的生命。     

多层螺旋CT诊断急性胸腹部创伤的临床价值分析

目的分析多层螺旋CT诊断急性胸腹部创伤的临床诊断价值。方法选取2017年4月至2019年4月收治的急性胸腹部创伤患者90例为研究对象,分别进行X射线诊断以及多层螺旋CT诊断,以手术诊断结果作为金标准,对比X射线诊断以及多层螺旋CT诊断符合率。结果 90例患者均经手术诊断确诊,确诊率为100.00%。其中6例皮下气肿、4例肋骨骨折、8例肩胛骨骨折、3例锁骨骨折、5例肺挫伤、5例胸腔积液、6例气胸、8例肺不张、4例纵膈气肿、8例纵膈血肿、5例肝脏损伤、4例脾脏损伤、3例肾脏损伤、5例胰腺损伤、6例腹腔积血、5例肠系膜撕裂伤、5例膈肌损伤。X射线诊断皮下气肿、肋骨骨折、肩胛骨骨折、锁骨骨折、肺挫伤、胸腔积液、气胸、肺不张、纵膈气肿、纵膈血肿、肝脏损伤、脾脏损伤、肾脏损伤、胰腺损伤、腹腔积血、肠系膜撕裂伤、膈肌损伤符合率分别为83.33%、75.00%、87.50%、66.67%、80.00%、80.00%、50.00%、100.00%、100.00%、100.00%、60.00%、100.00%、100.00%、100.00%、83.33%、80.00%、80.00%;多层螺旋CT诊断纵膈气肿符合率为75.00%、肾脏损伤符合率为66.67%,其余均为100.00%。多层螺旋CT诊断符合率(97.78%)均明显高于X射线诊断(84.44%)(P0.05)。结论多层螺旋CT可显著提高急性胸腹部创伤诊断准确性,且操作方便,临床价值较高,值得借鉴。     

DR与螺旋CT诊断急诊胸腹部创伤的临床应用研究

目的研究X线计算机(DR)与螺旋CT诊断急诊胸腹部创伤的临床应用效果。方法将选自于2016年11月19日~2017年11月19日期间本院收治的174例急诊胸腹部创伤患者作为该次研究对象,所有患者均采用DR与螺旋CT诊断检查。对比两种诊断方式的病理诊断符合率,并对比两组患者对诊断方式的满意度情况。结果在病理诊断符合率方面,螺旋CT诊断的皮下气肿、肋骨骨折、肩胛骨骨折、锁骨骨折、肺挫伤、胸腔积液、气胸、肺不张、纵隔气肿、肝脏损伤、脾脏损伤、肾脏损伤、胰腺损伤、腹腔积血、肠系膜撕裂伤以及膈肌损伤的病理诊断符合率均为100.00%。除却肺挫伤、纵隔气肿、血肿以及肾脏损伤和胰腺损伤方面,其他胸部创伤的病理诊断符合率均高于DR诊断,差异具有统计学意义(P0.05);对于螺旋CT诊断,患者的满意度评分明显高于DR诊断(P0.05)。结论在急诊胸腹部创伤的诊断中,采用螺旋CT诊断的效果更佳,可提高临床诊断符合率,值得进一步推荐应用。     

多层螺旋CT在腰椎峡部裂诊断中的临床应用

目的探讨多层螺旋CT（MSCT）后处理技术一曲面重组（CPR）在腰椎峡部裂中的临床应用。方法本院CT室对30例经手术证实为腰椎峡部裂患者的病例资料进行回顾性分析,并将多层螺旋CT后处理技术一曲面重组图像与常规X线和常规横断面CT图像进行比较。结果多层螺旋CT曲面重组图像能较清晰显示30例峡部裂的部位及形态。22例为单椎体峡部裂,其中,L5椎体15例,L3椎体5例,L4椎体2例;8例同时合并L3、5椎体峡部裂。18例行普通X线检查,检出12例（67％）。15例行常规CT检查,仅检出6例（40％）。结论多层螺旋CT曲面重组图像时正确诊断腰椎峡部裂并指孚临床手术有着重要意义。     

螺旋CT在胸腰椎爆裂性骨折诊断中的临床价值分析

目的探讨螺旋CT在胸腰椎爆裂性骨折诊断中的临床价值。方法选取我院2016年5月至2018年6月收治的68例胸腰椎爆裂性骨折患者,均行X线片及多层螺旋CT检查,对比不同检查方式对患者椎体骨折个数、椎管分度及附件骨折处数的诊断情况。结果多层螺旋CT平扫诊断患者椎体骨折个数、椎管分度及附件骨折处数的准确率较X线片高,差异有统计学意义(P<0.05);多层螺旋CT轴位平扫及多平面重建(MPR)诊断患者椎体骨折个数、椎管分度及附件骨折处数的准确率较容积再现(VRT)高,差异有统计学意义(P<0.05);MPR患者椎体骨折个数、椎管分度及附件骨折处数的准确率较轴位高,差异有统计学意义(P<0.05)。结论螺旋CT在胸腰椎爆裂性骨折诊断中具有较高的临床价值,其可有效诊断椎体骨折个数、椎管分度及附件骨折情况,尤其是后处理技术MPR,准确度更高。     

多层螺旋CT与X线在急性胸腹部创伤诊断中的应用价值

目的 探究在急性胸腹部创伤诊断中,应用多层螺旋CT、X线的诊断价值.方法 选取本院2019年1月至2020年1月收治的120例胸腹部创伤患者为研究对象,均实施X线、多层螺旋CT检查,以手术病理结果为金标准,评价影像学检查诊断检出率.结果 多层螺旋CT创伤情况各项检出率为100.00％,高于X线的93.22％,差异有统计学意义(P<0.05).结论 在对急性胸腹部创伤影像学诊断中,多层螺旋CT诊断效果理想,且显著优于X线,可为急性胸腹部创伤治疗提供参考依据.     

256层螺旋CT在胸部创伤诊断中的应用

目的比较256层螺旋CT和64层螺旋CT对胸部创伤患者的诊断价值。方法选取110例胸部创伤患者,均采用两种多层螺旋CT(64层和256层螺旋CT)检查;比较两种检查方法对于骨折、肺损伤、气胸及液气胸的检出率和两种检查方法的射线剂量情况(包括扫描长度、有效剂量、扫描时间)。结果 256层螺旋CT对骨折、肺损伤、气胸及液气胸检出率(95.5%、70.9%、31.8%)均显著高于64层螺旋CT(84.5%、5.5%、20.0%,P<0.05)。与64层螺旋CT比较,256层螺旋CT有效剂量更低[(4.97±1.49)mSv比(6.03±1.26)mSv,P<0.05],扫描时间更短[(5.38±1.52)s比(9.26±1.37)s,P<0.05]。结论 256层螺旋CT诊断胸部创伤临床效果优于64层螺旋CT。     

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.