飞行学员低常远视力变化趋势的动态追踪观察

目的 追踪观察低常远视力飞行学员远视力变化趋势,为现行招飞体检标准的修订提供客观依据.方法 选择招飞时0.8≤远视力＜1.0的飞行学员共137人为观察组;同期招飞时远视力≥1.0的飞行学员134人为对照组;分别复查双眼散瞳前后远视力,采用配对秩和检验、x2检验进行组内不同时间远视力的比较及组间比较.结果 ①1年后观察组远视力散瞳前后达标率分别为95.62%和98.18%,对照组为94.78%和97.76%;散瞳后最低远视力两组分别为0.6和0.7.⑦两组远视力在招飞时、散瞳前和散瞳后呈逐步提高趋势,差异有统计学意义(Z=230.72、12.76,P＜0.01).③复查时两组远视力均较招飞时提高,散瞳后尤为明显.④两组均存在不同程度的睫状肌调节痉挛,观察组更为显著.结论 两组远视力绝大多数都符合招飞体检标准;调查阶段两组远视力均以稳定和上升趋势为主. Abstract： Objective To figure out the change tendency of flying cadet's subnormal distant vision based on one year follow-up study and to provide objective reference to the standards of physical examination for pilot recruitment.Methods One hundred and thirty-seven flying cadets, who had the subnormal distant vision in the range from 0.8 to 1.0 (include 0.8) that determined in physical examination of recruitment, were chosen as study group while other 134 homo-session flying cadets with 1.0 or better distant vision were randomly selected as control group.The distant vision of both groups was respectively rechecked under ante- and post-mydriasis states 1 year after enrollment.Results were statistically compared between states and between groups by matched-pairs rank test.Results ① Most cadets of study group remained stable distant vision according to 1 year later recheck and respectively 95.62% and 98.18% cadets, corresponding to ante- and post-mydriasis states, kept up to standard, comparing to 94.78% and 97.76% in control group.There were only few cadets in 2groups had their distant vision declined after 1 year and there was no significant difference between groups.The worst case was the going down to 0.6 and 0.7 post mydriasis vision respectively in study and control group.② Comparing to 1 year ago, both groups showed gradually improved distant vision both for with and without mydriasis and significance was found between groups (Z= 230.72, 12.76,P＜0.01).③ The distant vision of 2 groups showed significant increase under both ante- and postmydriasis state comparing to that of one year before, especially for the post-mydriasis state.④ The episode of ciliary muscle cyclospasm was appeared in various degrees in both groups.Conclusions Most of flying cadets in two groups keep their distant vision in stable improvement and match exam standard according to 1 year follow-up.Since ciliary muscle cyclospasm is common in flying cadets the oriented education of eye protection should be strengthened.     

脉搏波传导速度和踝臂指数在飞行人员动脉硬化早期检测中的应用

目的 探讨脉搏波传导速度(pulse wave velocity,PWV)和踝臂指数(ankle brachial pressure index,ABI)在飞行人员动脉硬化早期检测中的应用价值.方法 应用动脉硬化检测仪,检测107例飞行人员的PWV和ABI,并与107例地方体检人员进行对比分析.结果 飞行人员组发现PWV异常10例(9.3%),对照组发现36例(33.6%);对照组发现1例ABI异常,而飞行人员组未见ABI异常;两组人群PWV均值随着年龄的增长而增大(F=3.314～13.819,P＜0.05),但飞行人员PWV均值显著低于同年龄组一般人群(t=2.187～4.208,P＜0.05).线性回归分析结果表明,飞行人员PWV与年龄、血压、腰围和体重指数显著相关(β=0.439～0.634,P＜0.01).结论 年龄、血压、腰围或体重指数的增加是飞行人员大动脉弹性降低的主要危险因素,PWV可以作为飞行人员血管早期病变检测与评价的功能指标. Abstract： Objective To explore the value of using pulse wave velocity (PWV) and ankle brachial pressure index (ABI) to detect the early arteriosclerosis in flying personnel. Methods PWV and ABI were detected in 107 cases of flying personnel by arteriosclerosis detector and 107 civil personnel were examined as control group. Results 10 cases (9.3%) of abnormal PWV were found in flying personnel group while 36 cases (33.6%) found in control group. Only one abnormal ABI case was in control group but in flying personnel group. The mean PWV of both groups' showed significant increase with the age growing (F= 3. 314-13. 819, P＜0. 05). The mean PWV of flying personnel group was significantly lower than that of the control group in same age segment (t= 2. 187-4. 208,P＜0.05). Linear regression analysis showed that PWV was closely related to the age, blood pressure, waist circumference (WC) and body mass index (BMI) in flying personnel group (β=0. 439-0. 634, P＜0. 05). Conclusions The increases of age, blood pressure and WC or BMI are the major risk factors of causing aorta elasticity decreased in flying personnel. It is suggested that the PWV would be an applicable functional index in early diagnosis of vascular pathological changes and in medical evaluation.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军飞行员角膜内皮细胞的初步分析

Objegtive To preliminarily study the endothelial density baseline and the morphological characteristics of the corneal endothelial cell of Chinese Air Force pilot. Metheds Density and morphology of corneal endothelial cells were observed by Topcon-2000 noncontact specular microscope and analyzed by Imagenet 2000 software(version 2.53)on 56 pilots(112 eyes)While other 30 healthy men(60 eyes)who were with the comparable age and uncorrected visual acuity were compared and analyzed as the control group. Results The data showed that the average corneal endothelial cell density was 2797.0±330.3/mm2 in pilot group which was significantly lowet than 2917.57±318.04/mm2 in control group(t=2.286,P=0.024).The mean constituent ratio of hexagonal cell was 56.46±7.19 in pilot group compared with 60.33±7.68 in control group(t=8.253,P=O.001)and it was gradually reduced with the age growing in both groups(r=-0.395,-0.268,P=0.000.0.038).With the growing of flying hours the mean area of cell was increased under the eontrolled age factor according to partial correlation analysis(r=0.244,P=0.0 1).Conclusions Measuring of the corneaI endothelial cellular morphologic parameters and implementing corresponding analysis are helpful to know pilot's corneal endotheliurn changes in flight.     

空军招飞医学选拔复选、定选肾下垂检查结果的对比研究

目的 对比空军招飞医学选拔复选和定选中肾下垂检查结果的差异,分析产生的可能原因,探讨更为合理的体检方法.方法 收集2016年某地区参加空军招飞体检复选和定选2次选拔的1334名学员的肾触诊结果,对比肾下垂检查结果的差异.结果 本研究入选的学员均否认腰酸、腰痛、反复泌尿系感染等肾下垂相关临床症状,且化验尿常规均正常.复选中,肾下垂阳性(肋下触及肾)检出率为10.2%,定选中肾下垂阳性检出率为5.5%,两者存在显著性差异(P<0.001);对复选和定选的肾下垂检出率进行比较,二者差异具有统计学意义(Z=-2.942,P=0.003);复选时肾下垂淘汰率为1.3%,定选肾下垂淘汰率为0.22%,二者存在显著性差异(P=0.001);且肾下垂程度的分布情况具有统计学差异(Z=-6.987,P<0.001).结论 复选和定选中肾下垂的医学选拔结果具有较大差异,提示我军目前肾下垂的体格检查精确度不高.有必要对招飞体检中如何进行肾下垂科学检查进行更深入的探究,改进体检方法,制定更为科学合理的体检标准.     

两种方式吸入布地奈德联合异丙托溴铵治疗急性感染性喉炎效果比较

 目的 比较经空气压缩雾化吸入与超声雾化吸入布地奈德联合异丙托溴铵治疗急性感染性喉炎的临床疗效,以及对患者白细胞介素-4(interleukin-4)和免疫球蛋白E(immunoglobulin E,IgE)水平的影响。方法 选取2015-01至2016-06接受治疗的120例急性感染性喉炎患者作为研究对象,按照随机数字表法随机分为对照组60例和观察组60例。常规治疗基础上,所有患者均给予布地奈德联合异丙托溴铵雾化吸入治疗。对照组患者给予空气压缩雾化吸入治疗,观察组患者给予超声雾化吸入治疗。疗程结束后,比较对照组和观察组患者临床疗效、临床症状改善时间及血清IL-4、IgE水平。结果 临床疗效显示,观察组患者治疗总有效率明显高于对照组(95.0% vs 83.3%,P<0.05)。与对照组相比,观察组咳嗽、声音嘶哑、喉鸣等临床症状改善时间显著缩短[(3.3±0.8)d vs (4.2±1.0) d,(3.5±0.6)d vs (4.3±1.2) d,(6.4±0.9)d vs (7.9±1.4) d,P均＜0.05]。治疗后,与对照组相比,观察组患者血清IL-4、IgE水平明显降低[(7.24±1.83)ng/L vs (15.19±2.36) ng/L,(50.43±9.62)μg/L vs (82.25±10.45)μg/L,P均＜0.05]。结论 对于急性感染性喉炎,与空气压缩雾化吸入布地奈德联合异丙托溴铵治疗相比,超声雾化吸入治疗总有效率高,临床症状改善时间短,血清IL-4、IgE降低更明显,具有更显著优势。     

MRI对急性心肌梗死后不同心脏状态下干细胞移植后体内再分布与疗效评价的动物实验研究

目的 探讨MRI在研究停跳与不停跳两种心脏状态下,经猪心肌梗死模型心肌注射骨髓间充质干细胞后全身各主要脏器(心、肝、脾、肾)干细胞的早期再分布及疗效评价中的应用价值.方法 干细胞提取自雄性猪并用超顺磁性氧化铁标记.雌性猪制成急性心肌梗死模型7 d后数字表随机方法分为4组.第1组为心脏停跳细胞注射组(6只),体外循环后心脏停跳,超顺磁性氧化铁标记的干细胞(1×108)经心肌注入心肌梗死周边区.第2组为不停跳心脏细胞注射组(6只),相同的细胞在心脏跳动下经心肌注入心肌梗死周边区.第3组停跳心脏对照组(6只)和第4组不停跳心脏对照组(6只)中,相同剂量的生理盐水分别在停跳和不停跳状态下经心肌注入心肌梗死周边区.3 d后,行MR T2*WI示踪和心功能检查.并取动物心、肝、脾、肺、肾的标本,用实时定量聚合酶链反应(qRT-PCR)检测雄性细胞特异性的性别决定区域(SRY)基因定量检查.统计学分析采用方差分析和t检验.结果 第1～4组术前左心室舒张末期容积(LVEDV)分别为(56.8±5.3)、(54.8±6.8)、(57.4±4.3)和(56.8±2.8) ml,术后LVEDV分别为(65.2±5.2)、(63.2±3.7)、(60.2±4.7)和(62.2±4.4) ml,术前左心室收缩末期容积(LVESV)分别为(33.5±7.6)、(32.3±5.3)、(33.5±3.6)和(32.7±4.6) ml,术后LVESV分别为(37.3±5.6)、(36.3±6.9)、(34.3±5.4)和(36.3±8.1) ml;术前左心室射血分数值(LVEF)分别为(42.3±7.2)%、(41.7±6.8)%、(41.8±8.6)%和(42.7±7.7)%,术后LVEF分别为(44.5±8.7)%、(43.1±7.4)%、(42.8±5.6)%和(43.3±8.4)%;术前心肌梗死面积(MI)分别为(6.5±2.1)、(6.4±1.9)、(6.5±2.5)和(6.4±2.6) cm2,术后MI分别为(6.4±2.3)、(6.2±2.6)、(6.3±2.5)和(6.4±2.8) cm2,差异均无统计学意义(术前P值均＞0.05,F值分别为0.277、0.066、0.066、0.003;术后P值均＞0.05,F值分别为1.137、0.182、0.021及0.008).心脏中第1组较第2组T2*降低显著[(-22.3±2.2)和(-17.0±0.8) ms,t=-5.489,P＜0.01],而脾脏中第2组较第1组T2*值降低显著[(-7.7±0.7)和(-13.3±1.1) ms,t=9.055,P＜0.01],在肝脏及肾脏2组差异无统计学意义(肝脏t=-0.532,P>0.05,肾脏t=-0.113,P>0.05).SRY基因和qRT-PCR结果,第1组及第2组心脏[(150±62)和(72±4) U/L]、脾脏[(131±1)和(233±17) U/L]及肝脏[(17±1)和(9±5) U/L]差异有统计学意义(P值均＜0.05,t值分别为3.109、-13.286及3.492),病理学检查可以见移植细胞呈普鲁士蓝染色阳性,与MRI有很好的一致性.结论 干细胞氧化铁颗粒标记后,MRI可以作为方便而有效的手段在移植早期活体示踪干细胞,评价其在体内的分布情况.在心脏停跳状态下经心肌注射骨髓间充质干细胞将更有利于细胞在心脏的滞留.

Abstract：

Objective To evaluate the efficacy of MRI for assessment of re-distribution of bone marrow mesenchymal stem cells injected intramyocardially in main organs (heart, liver, spleen and kidney) under different heart status (beating or arresting) in a porcine model. Methods Bone marrow-derived mesenchymal stem cells were obtained from the male swine and labeled with iron oxide during culture. Acute myocardial infarction was created in female swine, one week later, the survivors were randomly divided into 4 groups. Cardiopulmonary bypass was set up to arrest the heart, and then labeled cells (1×108) were intramyocardially injected into the border of the infracted myocardium in group 1 (n=6). The same volume of cells was grafted into the beating heart in group 2 (n=6). In group 3 and 4, saline was injected into either the arresting or beating myocardium. Three days later, re-distribution of stem cells and cardiac function were assessed by T2*WI and cine MRI, respectively. All animals were sacrificed for histology and real-time quantitative polymerase chain reaction (RT-PCR) of sex-determining region on Y-chromosome (SRY) investigation.The ANOVA and t test was used for statistics. Results The left ventricular end-diastolic volume (LVEDV) before transplantation for group 1-4 were: (56.8±5.3),(54.8±6.8),(57.4±4.3)and(56.8±2.8) ml, and after transplantation for group 1-4 were: (65.2±5.2),(63.2±3.7),(60.2±4.7)and(62.2±4.4) ml. The left ventricular end-systolic volume (LVESV) before transplantation for group 1-4 were: (33.5±7.6),(32.3±5.3),(33.5±3.6)and(32.7±4.6) ml,and after transplantation for group 1-4 were: (37.3±5.6),(36.3±6.9),(34.3±5.4)and(36.3±8.1) ml. The left ventricular EF values (LVEF) before transplantation for group 1-4 were: (42.3±7.2)%,(41.7±6.8)%,(41.8±8.6)% and(42.7±7.7)%,and after transplantation for group 1-4 were: (44.5±8.7)%,(43.1±7.4)%,(42.8±5.6)% and(43.3±8.4)%. The myocardial infarction area (MI) before transplantation for group 1-4 were: (6.5±2.1),(6.4±1.9),(6.5±2.5)and(6.4±2.6) cm2,and after transplantation for group 1-4 were: (6.4±2.3),(6.2±2.6),(6.3±2.5)and(6.4±2.8) cm2 . There were no statistical differences before and after transplantation in these 4 groups[P values of before and after transplantation for LVEDV, LVESV, LVEF,MI were >0.05 (F= 0.277, 0.066,0.066, 0.003); and >0.05 (F= 1.137,0.182,0.021,0.008),respectively]. The T2 value of the infracted myocardium in group 1 decreased more obviously than that in group 2[(-22.3 ± 2.2) vs (-17.0 ± 0.8) ms, t=-5.489, P＜0.01], while the T2 value of the spleen decreased more significantly in group 2 than that in group 1[(-7.7 ± 0.7) vs (-13.3 ± 1.1) ms,t=9.055, P＜0.01]. The T2 values of the liver and kidney were no significant differences in group 1 and 2 (liver, t=-0.532,P>0.05 and kidney, t=-0.113,P>0.05). The results of RT-PCR in group 1 and 2 showed significant differences in heart[(150±62) vs (72±4) U/L ,P<0.05, t=3.109], spleen[(131±1) vs (233±17) U/L, P＜0.01, t=- 13.286]and liver[(17±1) vs (9±5) U/L ,P<0.01,t= 3.492]. Pathological examination demonstrated that the transplanted stem cells were positive for Prussian blue staining, which had a good correlation with MRI results. Conclusion MRI can serve as a convenient and efficient imaging method to track the migration of stem cells with SPIO labeled in early stage and evaluate its early re-distribution in vivo. Injection of bone marrow mesenchymal stem cells in the arresting heart could favor retaining more cells in the myocardium.     

应用延迟增强多层螺旋CT观察替罗非班对猪急性心肌梗死再灌注损伤的影响

目的 应用延迟增强多层螺旋CT(DE-MSCT)评价单独应用替罗非班对猪急性心肌梗死(AMI)再灌注后无复流的影响.方法 采用完全随机设计方法将中国试验用小型猪分为对照组(10只)和替罗非班组(9只).通过介入球囊封闭冠状动脉的方法堵闭左前降支中段90 min后,撤出球囊制作AMI再灌注模型.所有实验动物在AMI再灌注后1、24、48和72 h进行DE-MSCT检查,观察无复流和梗死心肌面积的变化,采用Spearman秩相关和Wilcoxon秩和检验进行统计分析.结果 对照组10只、替罗非班组9只实验猪成功穿刺并行冠状动脉造影.对照组和替罗非班组各6只猪的心肌梗死再灌注模型制作成功,对照组4只、替罗非班组3只实验动物DE-MSCT检查出现无复流现象.2组无复流区体积在AMI再灌注后1～72 h均呈增大趋势.替罗非班组无复流体积百分比在再灌注后1～72 h各时间点均小于对照组[1 h分别为(4.78±0.66)%和(9.62±3.05)%;24 h分别为(5.84±1.19)%和(13.44±3.33)%;48 h分别为(6.41±1.24)%和(15.10±3.76)%;72 h分别为(6.63±0.82)%和(15.94±4.62)%;t值均为6.000,P值均＜0.05].梗死心肌体积百分比在再灌注后各时间点明显小于对照组[24 h分别为(19.74±2.94)%和(25.08±4.68)%,t=25.000,48 h分别为(20.34±2.46)%和(27.07±5.44)%,t=26.000;72 h分别为(20.72±2.10)%和(26.17±5.19)%,t=24.000,P值均＜0.05].结论 DE-MSCT可以作为评估无复流的方法,替罗非班能够减小AMI再灌注后的无复流和梗死心肌范围.     

低剂量技术降低CT引导下经皮肺切割活检吸收剂量的临床研究

目的 探讨临床应用低剂量技术降低CT引导下经皮肺穿刺自动切割活检(ACNB)辐射剂量的可行性。方法 412例ACNB中146例(A组)采用传统方法引导,266例(B组)采用低剂量技术引导,按图像颗粒均匀性、解剖结构细节、界面清晰度和有无伪影等评定图像质量,比较2组穿刺活检准确率、操作时间及辐射剂量,并探讨CT引导中降低辐射剂量的方法。结果 B组图像解剖结构细节分辨率降低,但不影响穿刺成功率。A、B组穿刺准确率分别为95.9%、95.1%,操作时间为(16±2.2)、(15.9±2.0)min,组间差异均无统计学意义。A、B组有效剂量为(1.74±0.7)及(0.59±0.14)mSv,B组有效剂量降低66%,差异有统计学意义(t=19.3415,P(0.05)。结论 CT引导下经皮肺穿刺活检是诊断和鉴别肺部病变的重要方法,低剂量扫描、缩小扫描范围及减少扫描次数能显著降低受检者X线辐射剂量,但不影响诊断效果。     

三维人工智能定位技术在CT胸部扫描中的应用

目的:探讨三维人工智能（AI）定位技术在胸部CT平扫中的应用价值。方法:回顾性分析2020年9月至10月在南京大学医学院附属鼓楼医院因新型冠状病毒肺炎筛查接受胸部平扫CT检查的患者100例,采用区组随机分组法分为人工定位组和三维AI定位组,每组50例。2组患者使用相同的胸部扫描协议。测量2组患者的定位偏离距离、CT剂量...     

双向Glenn分流术后上腔静脉-肺动脉吻合口形态和血流的MRI与超声心动图对比测量分析

目的 对比研究MRI与超声心动图(UCG)评估双向Glenn分流术(BGS)后上腔静脉-肺动脉吻合口(腔-肺吻合口)形态和血流的差异.方法 应用3.0T相位对比(PC) -MRI对22例BGS术后患者上、下腔静脉进行血流测量,应用对比增强(CE) -MRI显示腔-肺吻合口及其邻近血管形态,用Report Card软件计算腔-肺吻合口宽度、峰值流速、压差,采用UCG进行对比测量分析.MRI测量上、下腔静脉血流参数,以及MRI和UCG测量腔-肺吻合口宽度、峰值流速和压差值采用配对样本t检验和Pearson相关分析.结果 上腔静脉血流量[(1.002±0.208) L/min]显著低于下腔静脉血流量[(1.794±0.392) L/min](t=- 15.148,P＜0.01),上腔静脉反流分数[(26.54±12.82)％]显著高于下腔静脉反流分数[(17.44±10.17)％](t=11.060,P＜0.01);CE-MRI能清楚显示腔-肺吻合口及其邻近血管狭窄、血栓形成等形态异常改变,UCG未显示上述形态异常改变.MRI测量腔-肺吻合口宽度[(12.46±3.43) mm]显著大于UCG[ (11.04±2.63) mm](t=4.048,P＜0.01),测量峰值流速[ (47.77±10.44) cm/s]显著小于UCG[(52.19±9.63) cm/s](t=-2.237,P＜0.05),测量压差[(0.95±0.42)mm Hg(1 mm Hg =0.133 kPa)]与UCG[( 1.12±0.38) mm Hg]差异无统计学意义(t=-2.010,P＞0.05);二者测量腔-肺吻合口宽度、峰值流速及压差呈显著正相关(r值分别为0.858、0.489、0.427,P值均＜0.05).结论 3.0 T MRI测量腔-肺吻合口宽度、峰值流速及压差与UCG具有较好相关性,但MR1显示腔-肺吻合口宽度及形态异常显著优于UCG.     

MRI上抽动秽语综合征患者基底节核团体积的变化

目的 探讨MR测量基底节核团体积对抽动秽语综合征(Tourette's syndrome,TS)病因诊断的价值.方法 选取10例TS患者(TS组)和10名健康志愿者(对照组)进行MR扫描,分别测量双侧尾状核、壳核、苍白球的体积,对两侧的基底节体积采用配对t检验进行比较分析;将大脑ROI体积数值进行标准化处理,对TS组和对照组之间基底节体积采用独立样本t检验进行比较分析.结果 正常对照组左侧尾状核、壳核、苍白球体积及3者之和均大于右侧(P值均＜0.05),TS组上述结构两侧比较差异尤统计学意义(P值均＞0.05).根据大脑体积进行标准化处理后,TS患者左侧尾状核、壳核、苍白球体积分别为(7.06±0.48)、(8.81±1.01)、(2.64±0.38)cm3,正常对照组分别为(11.05±1.86)、(9.97±1.11)、(3.04 ± 0.37)cm3,TS组较对照组减小(t值分别为-6.577、-2.457、-2.376,P值均＜0.05);TS组右侧尾状核体积[(7.32 ± 0.26)cm3]较对照组[(9.81 ±1.83)cm3]减小(t=-4.258,P＜0.01),右侧壳核、苍白球体积与对照组比较差异尤统计学意义(P值均＞0.05).结论 MRI显示TS患者基底节核团体积减小,这对研究其病理生理机制及神经病理变化有一定的价值.     

原发性甲状旁腺机能亢进甲状旁腺细胞增生与骨矿密度相关性研究

目的 探讨原发性甲状旁腺机能亢进(PHPT)中甲状旁腺细胞增生与骨矿含量的关系。方法 健康成年中国白兔80只,采用简单随机化分组法分成2组,对照组40只以正常饮食(Ca∶P＝1.0∶0.7)喂养,实验组40只以高磷饮食(Ca∶P＝1.0∶7.0)喂养,诱发原发性甲状旁腺机能亢进动物模型。在第3、4、5、6个月末,分别对...