Pacs系统在影像学科的应用

随着信息时代的到来,数字化、标准化、网络化作业已经进入医学影像界,并以奔腾之势迅猛发展,伴随着一些全新的数字化影像技术陆续应用于临床,如ct、mri、数字减影、血管造影,正电子体层成像、计算机放射摄影及数字放射摄影等,医学影像诊断设备的网络化已逐步成为影像科室的必然发展趋势,同时在客观上要求医学影像诊断报告书写的计算机化、标准化、规范化。医学影像存档与通讯系统。     

放射科技师怎样提高患者满意度思考

<正>随着科技的飞速发展国内各大医院都在引进计算机放射成像(CR)、直接数字化X射线摄影(DR)、数字胃肠造影、CT、磁共振成像(MRI)、数字减影血管造影(DSA)等数字化设备。影像检查和诊断已经进入崭新的数字化、网络化、信息化时代。与此同时患者所承受的检查费用也相应增加,从而患者     

放射科信息化建设

全数字化放射科是指在放射科内实行图像数字化采集、储存、传输、浏览及管理 ,无胶片化、无纸化的信息化模式 ,取代传统放射科以胶片为基础和手工方式进行的图象存储、传输和管理模式。数字化放射科的总体规划中应包括数字化成像设备、放射信息系统 (radiologyinformationsys tem ,RIS)和图像获取和传输系统 (picturearchivingandcom municationsystem ,PACS)以及与医院信息系统 (hospitalinfor mationsystem ,HIS)整合四个部分。HIS的建设正在国内外各个医院内蓬勃兴起。RIS和PACS数据量大、软件和硬件要求高、实时性强、临床工作…     

数字化摄影的临床应用综述

近20年,许多放射科用数字化成像设备取代了传统的屏胶成像模式。现在,制造商能够运用各种探测器和阅读器技术来提供多种多样的数字成像设备,使用数字探测器可以得到全数字的图像,并可以数字化存储和传输,供随时调阅,运用网络技术,实现图像在医院的无损传输。其它特点包括提高患者处理速度、提高剂量的利用率,利用数字探测器的高动态范围而较少患者的受线量,放射技术未来必然是数字化的,     

CR与DR的应用比较研究

1 序言 在现代医学科学发展过程中，数字化医学影像设备，将逐步取代传统的X线摄影技术，医学影像技术将全面实现数字化。关于放射科普通X线检查数字化成像领域，近年来一直存在两种看法，一种看法认为，目前处理能力更大的直接数字化放射成像（DR）系统由于工作效率高，而有望取代计算机放射成像（CR）系统；另一种看法则认为，性价比更高的C财是更为实际的选择，原因是DR系统过高的价格会增加病人的负担，且我国大多数中小型医院受检者量并不大，     

数字X线摄影系统量子检出效率的研究进展

随着X线摄影探测器研制水平的提高以及数字化影像技术的发展 ,数字X线摄影 (DR ,digitalra diography)系统开始应用于临床诊断。这些数字化X线成像设备提供了较之常规X线摄影系统更大的动态范围 ,并可对所生成的影像进行后处理 ,从而更好的满足了临床诊断的要求。然而与传统放射成像技术不同 ,数字X线摄影系统其成像过程较为复杂 ,因此评价传统放射影像质量的技术方法与指标难以适应数字X线摄影系统成像质量评价。量子检出效率 (DQE)是 6 0年代应用于评价天体物理摄影系统成像质量的一个物理量[1] ,它描述了从探测器输入到探测器输出的…     

放射诊断学的新进展

放射学已经融入了计算机化医疗服务这一发展趋式 ,以满足降低价格、提高效益和加速放射科与用户科室之间信息沟通的需求。数字采像已成为血管造影、超声、计算机体层摄影术 (ＣＴ)、磁共振成像 (ＭＲＩ)和放射性核素显像管等现代化设备的标志 ,但大多数放射学图像仍以Ｘ线胶片的方式记录、分析和贮存。由于更高效率的和具有足够存贮功能的荧光系统不断增加 ,一般放射图片不难数字化 ,从而“无胶片”放射科将成为现实。本文对这一题目进行讨论并涉及放射学技术的进展对临床实践影响的其他方面。　　 方法近年来 ,介入放射学获得巨大进展 ,但…     

医学影像数字化发展和PACS的应用

随着放射学和计算机技术的迅速发展，数字化已成为放射影像学发展的必然趋势，医学影像设备数字化也已逐步成为影像科室必然发展的趋势。随之产生的医学影像存储与传输系统（PACS）是集放射学、影像医学、数字化图像技术、计算机技术及通信技术为一体的医学影像系统，其设计与应用实现了多种医学影像融合软件技术，将各种成像设备生成的图像融合到一个画面上显示，突破了以往只能在放射科才能进行的影像处理以及影像工作站只能显示单一格式的图像限制，更有利于医生的诊断。     

放射科的发展与管理模式的转变

20世纪70年代中期以来,放射科的发展出现了突飞猛进的局面.新的影像学设备层出不穷,如电子计算机体层摄影(CT)、磁共振成像(MRI)、数字减影血管造影(DSA)等.在硬件方面使放射科规模不断扩大,甚至已经突破了"放射"的内涵.在成像方式上已由单纯的二维模拟成像,转变为三维、四维、多平面重组的数字化图像.随着硬件的不断改进和电子计算机技术的日臻成熟,应用范围更加广泛.不仅如此,放射学诊断目前已经突破了单纯反映宏观结构的范畴,向着功能成像、分子成像、基因成像等多种成像领域扩展.[1,6]介入放射学的兴起,更使医学影像学从单纯诊断走向诊断加治疗的全新领域.介入放射学所开创的微创治疗学,现已成为和内、外科并列的治疗学之一.专业的拓展,使专业人员队伍不断扩大,需掌握的知识量、信息量不断增多.[2]面对医学影像学飞速发展的状况,我国大中型医院放射科内部应采取怎样的管理模式,更能适应医学影像学发展的需要,是一个值得探讨和亟待解决的新课题.下面就这一问题结合本人的实践经验,谈一点看法.     

CR的工作原理及临床应用

自1895年X线的发现及其医学上的应用以来,随着电子技术的高速发展,医学影像设备的数字化已成为影像科室的必然发展趋势,最终实现数字化、网络化、无胶片化,使X线摄影数字化得到了发展.传统的X线摄影是以胶片作为成像的介质,发展到计算机摄影(computel radiography)简称CR、直数接数字摄影(diqited radiogaph,DR),是将X线拍摄的影像信息记录在IP板(image plate,IP)上,经读取装置读取,由计算机算出一个数字化图像,复经数字/模拟转换器转换,于荧屏上显示灰阶图像.CR与DR同属数字化图像,提高了图像的密度分辨力和显示能力,增加图像的后处理功能,实现放射科网络化和无胶片化管理.为医院建设PACS、RIS、HIS系统做好准备.     

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.