早期强直性脊柱炎骶髂关节病变90例X线平片、CT和MRI诊断对比分析

目的:探讨X线平片、CT和MRI在早期强直性脊柱炎(AS)骶髂关节病变中的诊断价值。方法:回顾分析90例早期AS骶髂关节病变患者的X线平片、CT及MRI资料,总结相应影像学表现及病变分级,并作平行对照研究。结果:①CT与MRI对早期AS骶髂关节改变检出率明显高于X线平片(P<0.05),但CT与MRI的检出率无显著性差异(P>0.05)。②早期AS骶髂关节病变0^Ⅱ级,X线平片与CT、MRI分级有显著性差异(P<0.05)。结论:早期AS骶髂关节主要表现为骨质疏松、侵蚀、囊变以及关节软骨肿胀等,CT、MRI较X线平片对这些表现的检出率要高,尤其是对于那些临床疑似AS但X线平片难以准确判断的早期病变,CT与MRI检查具有较高的诊断价值。     

强直性脊椎炎的影像学分析

目的:分析强直性脊椎炎(AS)骶髂关节受累的X线平片、CT和MRI的影像学特点,进一步提高诊断水平。方法:回顾分析48例AS患者的骶髂关节的X线、CT及MRI影像学表现特点。结果:X线检查23例,骶髂关节受累检出率17.4%;CT检查32例,骶髂关节受累检出率59.4%;MRI检查40例,骶髂关节受累检出率90.0%。MRI显示AS骶髂关节受累的检出率优于X线平片和CT(P0.05)。结论:X线平片对典型AS能作出准确诊断,但对AS的早期诊断不如CT、MRI;MRI能显示X线平片和CT不能显示的AS骶髂关节受累的急性炎症改变,滑膜炎所致的少量积液和滑膜异常强化是骶髂关节受累最常见的MRI表现。     

女性强直性脊柱炎骶髂关节病变的早期诊断

目的:研究女性强直性脊柱炎的骶髂关节病变的早期X线平片、CT影像表现,探讨影像学对强直性脊柱炎的骶髂关节病变诊断价值.方法:对临床确诊的22例强直性脊柱炎的双侧骶髂关节(SIJ)摄X线平片,同时作CT扫描.总结其影像表现及病变分级,作平行对照研究,并进行分析.结果: 强直性脊柱炎的骶髂关节病变的患者主诉以髋部疼痛、腰痛、弯腰受限、颈椎受限出现的百分率依次为40.91%、36.36%、18.18%、4.55%.X线骶髂关节影像表现正常、关节变毛糙、模糊、硬化、关节融合分别为13.64%、59.10%、22.73%、4.55%;CT分别为0%、50.0%、45.55%、4.55%.X线与CT诊断的符合率从0级～Ⅳ级分别为0%、66.6 %、85.71%、100%.结论:女性强直性脊柱炎的骶髂关节病变的早期诊断受女性自身解剖结构复杂等因素影响,X线平片的早期诊断困难,对临床怀疑而平片难以确诊的早期病变,CT检查有较高价值.平片表现为早期病变(0～Ⅱ级)的患者CT对其分级更为准确,可提高1～2个级别.     

CT与X线、MRI对早期强直性脊柱炎诊断作用的对比研究

目的：探讨早期强直性脊柱炎骶髂关节病变影像学的诊断作用。方法收集34例早期强直性脊柱炎骶髂关节病变患者分别采用CT、X线、MRI检查的影像学资料,回顾性分析早期强直性脊柱炎骶髂关节病变在3种影像学检查中的特征表现、检出率及不同分期检出率。结果34例患者X线、CT与MRI检查骶髂关节病变检出率分别为44.12%、70.59%和94.12%,CT检查其骶髂关节病变总检出率明显高于X线检查（P＆lt;0.05）,MRI检查其骶髂关节病变总检出率明显高于X 线和CT检查（P＆lt;0.05）;对病变0级,CT检出率明显高于X线检出率（P＆lt;0.05）,MRI检出率明显高于X线检出率（P＆lt;0.01）;对病变Ⅰ级,CT、MRI检出率明显高于X线检出率（P＆lt;0.05）;CT与MRI相比差异无统计学意义;对病变Ⅱ级,CT与X线、MRI相比差异均无统计学意义。结论 CT对早期强直性脊柱炎的诊断与X线、MRI检查相比,X线平片对早期骶髂关节炎诊断比较困难,易漏诊,而CT、MRI检查对其诊断敏感性和特异性高,对控制强直性脊柱炎早诊断、早治疗有积极意义。     

早期强直性脊柱炎X线片与CT诊断价值

目的 分析强直性脊柱炎(AS)所致骶髂关节改变的X线与CT表现,探讨早期影像学特征,比较X线片与CT对早期AS诊断的价值.方法 搜集确诊的40例AS患者,摄取骶髂关节正侧位平片,其中30例做骶髂关节至腰椎CT扫描,总结其影像学的表现、病理改变及临床分期,并对X线与CT检查结果进行对比分析.结果 AS早期骶髂关节改变的影像学表现为:X线Ⅰ级2例,仅表现为关节面不清,间隙存在;Ⅱ级(诊断为早期病变)9例,表现为髂骨侧关节中下部关节面下骨质侵蚀破坏.CTⅠ级2例,双侧骶髂关节面骨质疏松及软骨下骨质轻度糜烂;Ⅱ级12例,软骨下局限性硬化,骨质模糊不清,斑块脱钙侵蚀及微小囊变,骨质硬化.对Ⅲ-Ⅳ级AS病变,X线与CT诊断基本相同,但对AS早期病变CT明显优于X线平片,能够做出较为准确的诊断.结论 骶髂关节骨质疏松及软骨下骨质糜烂,斑片脱钙侵蚀、小囊变、骨质硬化是AS早期征象.CT更能准确清楚的显示早期病变.     

单排CT诊断骶髂关节病变的价值分析

目的:探究单排CT在诊断骶髂关节病变上的临床诊断价值。方法:选取87例骶髂关节病变患者为研究对象,对所有入选患者分别进行X线片以及单排CT诊断,比较两种检查方法在诊断骶髂关节病变征象的检出率。并依据相关参考文献制定骶髂关节病变分级标准,依据标准对两种检查方法在诊断骶髂关节病变分级上的准确性进行对比性评价。结果:单排CT在关节面模糊、软骨侵蚀、软骨增生硬化、关节间隙狭窄或增宽、软组织肿胀的检出率分别为94.12%、93.48%、97.56%、100.00%、87.50%,与X线片的诊断结果比较差异有统计学意义(P<0.05)。单排CT在骶髂关节病变分级Ⅰ~Ⅳ级的诊断准确度分别为94.44%、92.59%、95.65%、100.00%,与X线片的诊断结果相比,差异有统计学意义(P<0.05)。结论:单排CT在骶髂关节病变诊断上诊断敏感性更高,在骶髂关节早期病变诊断上较X线片更具优势。     

早期强直性脊柱炎骶髂关节病变X线平片、CT和MRI诊断对比研究

目的 研究对比X线平片、CT、MRI在早期强直性脊柱炎骶髂关节病变中的诊断价值,为本病的临床诊断提供更准确科学的依据.方法 选取早期强直性脊柱炎患者57例,对所有患者的X线平片、CT、MRI的影像学表现检出率和3种影像学方法中的病变分级检出率进行分析,对比3种影像学方法的差异.结果 在关节边缘模糊、关节面侵蚀的早期AS影像学表现中,MRI的检出率高于CT与X线平片,差异有统计学意义(P＜0.05);在病变分级Ⅰ级、Ⅱ级检出率的比较中,MRI的显著高于CT与X线平片,差异有统计学意义(P＜0.05).结论 3种影像学方法中MRJ明显优于其他两种影像学方法,对于AS的早期骶髂关节病变具有较高的诊断价值.     

强直性脊柱炎的临床、实验室与放射学关系的探讨

目的 :探讨强直性脊柱炎 (AS)临床、实验室及放射学改变之间的关系。方法 :确诊为AS的患者 35例 ,测定其ESR及IgG、IgM、IgA和HLA -B2 7,并同时做骶髂关节平片和CT扫描 ,研究其相互关系。结果 :本组双侧骶髂关节受累者达 10 0 %。HLA -B2 7阳性率 90以上。 35例中 ,10例平片诊断Ⅰ～Ⅱ级 ,CT诊断Ⅱ～Ⅲ级 ;15例平片诊断Ⅱ～Ⅲ级 ,CT诊断Ⅲ～Ⅳ级。AS骶髂关节炎分级越高 ,其临床表现、免疫学指标均加重 ,红细胞沉降率在Ⅱ～Ⅲ级中最快。结论 :AS与HLA -B2 7高度相关。AS患者骶髂关节炎分级基本可反映病情程度。两性AS患者存在差异 ,女性病情轻 ,预后好。CT对AS骶髂关节炎的诊断较平片敏感一个级别     

骶髂关节MRI检查在强直性脊柱炎诊断中的价值

目的探讨强直性脊柱炎（AS）早期骶髂关节MRI表现及对诊断的价值。方法对23例患者行骨盆X平片及双侧骶髂关节MR扫描,对比分析X线、MRI扫描征象。结果23例AS患者中X线检出率52.2%,MRI检出率87.0%。Ⅰ-Ⅱ级患者MRI可见关节软骨增厚、信号异常,滑膜信号异常,以及骨髓水肿;Ⅲ-Ⅳ级患者除有Ⅰ-Ⅱ级的表现之外,还可见大范围的骨质硬化、骨髓内脂肪沉积。Ⅰ-Ⅱ级病变MRI检出率高于X线,差异有统计学意义（P〈0.05）,对Ⅲ、Ⅳ级病变两种方法检出率相似（P〉0.05）。结论MRI能够显示AS患者骶髂关节的早期病理改变,可作为AS早期诊断的首选方法。     

MRI检查对强直性脊柱炎早期骶髂关节炎的诊断价值

目的探讨核磁共振成像(MRI)检查对强直性脊柱炎(AS)早期骶髂关节炎的诊断价值。方法选取2016年5月至2019年5月中信中心医院收治的80例AS患者,均接受MRI、CT检查,以病理结果为金标准。比较两者诊断AS早期骶髂关节炎的结果和诊断符合率。结果病理及MRI诊断结果均显示,AS患者骶髂关节炎Ⅰ级0例,Ⅱ级18例,Ⅲ级25例,Ⅳ级26例,Ⅴ级11例;CT诊断结果显示,AS患者骶髂关节炎Ⅰ级1例,Ⅱ级16例,Ⅲ级23例,Ⅳ级27例,Ⅴ级13例。MRI诊断早期骶髂关节炎符合率[97.67%(42/43)]高于CT[79.07%(34/43)],差异有统计学意义(P<0.05);MRI和CT诊断晚期骶髂关节炎符合率比较,差异无统计学意义(P>0.05);MRI诊断骶髂关节炎总符合率[97.50%(78/80)]高于CT[86.25%(69/80)],差异有统计学意义(P<0.05)。结论 MRI检查AS早期骶髂关节炎诊断符合率较高,有助于临床早期诊断与治疗。     

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.