MSCT联合MRI对女性盆腔结核诊断分析

目的分析盆腔结核的CT及MRI表现,探讨MSCT联合MRI及增强扫描对盆腔结核包块的定性和定位价值。方法选取我院经腹水病理活检或手术证实的盆腔结核肿块20例,有完整的CT、MRI及增强扫描图像。结果 20例患者当中,CA125均有不同程度的增高,CA19-9升高的有5例,CT及MRI表现为囊性者6例,囊实性者11例,实性者3例,均有不同程度腹水表现,腹膜不同程度的线状、结节状增厚有15例,淋巴结肿大的有10例,术前CT误诊7例,MRI6例。结论通过MSCT以及MRI征象的综合分析,能提高盆腔结核肿块诊断符合率,尽可能为临床提供更多信息,从而减轻盆腔肿块患者的心理负担和压力。     

超声造影、CT、MRI在卵巢肿瘤临床应用比较

目的探讨并对比超声造影、CT、MRI在卵巢肿瘤诊断中的应用价值。方法回顾性分析63例经临床病理确诊的卵巢肿瘤患者的超声造影、CT及MRI影像资料,并与病理学结果对比。结果 MRI诊断符合率、敏感性、特异性略高于超声造影检查,但组间比较无差异(P0.05);CT诊断准确率低于MRI、CT(P0.05)。超声造影上,良性肿瘤实性成分为主表现为从瘤体周边向内部灌注,囊性成分为主可见囊壁呈环状不均匀增厚。恶性肿瘤实性成分为主组织有不同程度的增强,多数肿瘤体内部向周边病灶强化;囊性成分为主组织囊壁及囊内分隔明显增强。CT表现上,良性肿瘤以囊性多见,增强扫描无明显强化;恶性肿瘤有"分叶征",或多房性;以实性成分为主增强扫描后呈均匀或不均匀强化,囊性成分肿块增强扫描后无明显强化。MRI表现上,良性肿瘤囊性成分为主组织信号复杂,增强扫描囊壁及间隔有轻、重度强化;实性成分组织为主可见MRI信号不规则,增强扫描后实性部分为延迟不均匀强化。恶性肿瘤以囊实性病灶或实性病灶为主,囊实性部分为T1WI低信号,T2WI高信号,囊壁多呈结节或乳头状从囊内突出囊外;实性部分T1WI等或低或混杂信号,T2WI高信号,增强扫描中重度明显强化。实性肿块信号不均匀,增强扫描后信号不均,部分见腹水、淋巴结转移或盆腔受侵。结论超声造影是鉴别诊断良恶性卵巢肿瘤的首选影像学方式之一。     

多层螺旋CT对肺段隔离症的诊断价值

目的探讨多层螺旋CT对肺段隔离症的诊断价值。方法对10例经手术病理、主动脉造影证实的肺段隔离症患者的CT表现进行回顾性分析,全部病例均行MSCT平扫及增强扫描。结果 10例肺段隔离症均位于双肺下叶后内基底段,7例位于左下肺,3例位于右下肺;其中CT表现6例为实质性肿块,2例为囊实性肿块,2例为囊性肿块,6例肿块周围可见肺气肿;10例均可发现异常供血动脉。结论肺段隔离症的主要CT表现为实性肿块、囊性或囊实性肿块,MSCT增强扫描,发现异常供血动脉在诊断上有定性价值。     

女性盆腔结核多层螺旋CT诊断价值

目的:探讨女性盆腔结核的多层螺旋CT(MSCT)表现,提高女性盆腔结核的诊断及鉴别诊断准确率。方法:回顾性分析25例经病理或临床治疗,随访证实的女性盆腔结核的MSCT表现和临床资料。结果:MSCT表现为:盆腔积液24例,占96%。盆腔内和/或双侧附件区不规则囊实性包块16例,占64%。盆腔内不规则小点状及斑片状钙化12例,占48%。双侧附件区软组织增厚,粘连,未见明显软组织肿块9例,占36%。腹膜,网膜及肠系膜增厚,粘连22例,占88%,其中16例呈结节状及粟粒样改变,占64%。回盲部回肠末段肠改变10例,占40%。淋巴结增大、增多9例,占36%。双侧输尿管增强扫描呈串珠样改变2例,占8%。膀胱壁不规则增厚,局部呈结节状改变4例,占16%,右侧髂窝及左侧髋臼内下方不规则囊实性包块1例,占4%。结论:有相对高密度的、分房或包裹性腹水,或伴盆腔、附件区囊实性包块,有网膜、腹膜、肠系膜软组织改变,腹膜结节状,粟粒样强化,淋巴结肿大等CT表现时,有助于盆腔结核诊断。     

女性盆腔囊性肿块超声、CT表现与术后病理对照分析

目的旨在探讨超声及多层螺旋CT在女性盆腔囊性肿块中的应用价值。方法整理分析2014年5月至2018年1月我院98例女性盆腔囊性肿块患者的临床、影像学,分析不同检查方式对女性盆腔囊性肿块的诊断正确符合率及影像表现。结果卵巢巧克力囊肿超声示圆形或椭圆形低或无回声肿块影,MSCT平扫示囊腔内有条纹状高密度影或囊壁不均匀性软组织样密度。增强示囊腔均无增厚现象。囊实性卵巢囊肿超声示囊壁乳头状区域可见彩色血流信号。MSCT平扫示囊壁薄且均匀,增强囊肿内部均未见强化。子宫肌瘤囊性病变超声有假包膜,有血流信号包绕肌瘤肿块。MSCT平扫示肌瘤肿块密度低于正常子宫肌层或与其接近。增强示囊性肿块表现为不同程度强化。卵巢囊腺瘤超声示非均匀囊壁增厚,囊壁乳头状区域可见彩色血流信号。MSCT平扫示囊实性和巨大囊性病灶。增强可见巨大多房囊性肿块,各房内密度不均匀,囊壁实性区域呈明显强化表现。结论 MSCT对女性盆腔囊性肿块的检出率和诊断符合率均更高,可更清晰的显示病灶结构和其周围组织情况,但超声检查对肿块血流情况可较好的显示,故将超声联合MSCT联合检查更有利于提高临床医生对女性盆腔囊性肿块的诊断。     

原发性输卵管癌的MRI诊断价值

目的探讨原发性输卵管癌（PFTC）的MRI诊断价值,以提高术前影像诊断的准确率。方法回顾性分析6例PFTC患者的术前MRI资料,并与术后病理结果对照。分析PFTC的3T MRI表现,尤其是T1WI、T2WI与DWI的信号特征,动态增强扫描（DCE-MRI）肿瘤的强化特点,并绘制肿瘤的时间-信号强度曲线（TIC）。结果 6例患者均表现为盆腔附件区肿块,5例为单侧,1例为双侧。表现为不规则囊实性肿块2例,输卵管迂曲扩张伴伞端实性结节2例,腊肠样或不规则实性肿块2例,实性肿块及壁结节T1WI多呈等或较低信号,T2WI多呈等或较高信号,DWI上多呈高信号;增强扫描实性肿块、壁结节及囊实性肿块的实性成分主要呈不均匀轻-中度强化,常伴囊变、坏死。TIC 3例为持续强化型,2例为平台型,1例为流出型。伴有盆腔内种植转移3例,盆腔外转移2例,腹水4例。结论 PFTC通常表现为附件区腊肠样或不规则囊实性或实性肿块,增强扫描轻-中度强化,输卵管积水伴壁结节是诊断PFTC的重要征象,不典型PFTC与卵巢癌影像表现相似,需结合临床症状及实验室检查综合诊断。     

女性盆腔少见囊实性病变MSCT表现及临床特征分析

目的 探讨女性盆腔少见囊实性病变MSCT表现及临床特征分析,提高对盆腔少见囊实性病变的认识,为术前的诊断提供新的思路。方法 收集2020年1月—2021年9月在右江民族医学院附属医院就诊的18例经手术病理证实的女性盆腔少见囊实性病变患者的临床及影像资料,分析其MSCT征象,包括病变的大小、位置、形态、数目、边界、密度及强化方式等CT征象,并且进行临床特征的分析。结果 18例患者中卵巢甲状腺肿5例,囊性部分呈较高密度,CT值超过50Hu,增强后实性部分呈“甲状腺”样明显强化;卵巢卵泡膜细胞瘤3例,平扫实性部分与子宫肌壁密度类似,增强扫描实性部分轻度强化,强化程度明显低于同层面子宫肌壁;盆腔结核性包块2例,伴有肺部结核病史,实性部分伴有条状钙化,增强扫描实性部分呈延迟强化;淋巴瘤2例,平扫密度均匀,增强扫描肿瘤中等均匀强化,肿瘤包绕血管但不侵犯;卵巢透明细胞癌1例,单侧囊实性病变,增强扫描为明显持续均匀性强化;卵巢颗粒细胞瘤5例,实验室检查雌激素水平升高,增强扫描病灶内部出现迂曲的供血动脉。结论 盆腔少见囊实性病变的MSCT表现具有一定的特征性,影像学检查结合临床病史可提高术前诊断的正确率...     

腮腺腺淋巴瘤的MSCT、MRI表现及临床病理回顾性分析

目的探讨腮腺腺淋巴瘤的MSCT、MRI表现与临床病理的关系。方法对经病理证实的48例腮腺腺淋巴瘤MSCT、MRI表现及临床病理进行回顾性分析。结果 48例腮腺腺淋巴瘤患者,其中42例为单发病灶,6例为多发病灶,肿块位于腮腺浅叶后下方44/54(81.48%),其中同时累及腮腺深叶的6个;肿块边缘清楚52/54(96.30%),包膜在MRI上表现为T1WI及T2WI上环状低信号;肿块长轴与下颌骨升支平行者40/54(74.07%),48例均行MSCT及MRI平扫,15例行MSCT增强扫描,16例行MRI增强扫描,MSCT及MRI平扫呈实性或不均匀性密度(信号)肿块,增强扫描实性部分多呈明显强化,囊性部分不强化或呈斑点、裂隙状、花斑状或豹纹状相对低密度(信号)灶,肿块周围增大淋巴结18枚;临床特点是43/48(89.58%)的病人有吸烟史,48例中,男44例,女4例,50岁以上者37/48(77.08%);病理特点是肿块包膜完整,切面可见囊腔,镜下囊腔衬覆特征性嗜酸性双层上皮细胞,上皮多呈乳头状排列,间质为淋巴细胞,送检发现22枚周围淋巴结呈反应性增生。结论腮腺腺淋巴瘤患者的MSCT、MRI表现有一定特点,其与病理也有一定的对应性,体现在肿块包膜完整及内部囊变上,再密切结合中老年男性、吸烟史进行分析可提高诊断准确性。     

盆腔脓肿的CT诊断与鉴别诊断

目的 探讨盆腔脓肿的CT征象,提高盆腔脓肿诊断及鉴别诊断的水平.方法 回顾性分析35例经手术或穿刺病理证实的盆腔脓肿的临床和CT表现,其中8例CT误诊.结果 (1)盆腔肿块:肿块呈囊实性或囊性,增强扫描后,肿块间隔及实性成分明显强化.2例囊内见积气.(2)盆腔脏器改变:17例附件增粗并明显强化,12例子宫增大、官腔积脓.(3)盆腔水肿及盆腔积液:盆腔水肿共29例,表现为骶子宫韧带增厚、盆腔脂肪和盆底筋膜模糊.盆腔积液共28例.结论 CT扫描能清楚地显示肿块的内部结构和范围及其与周围脏器的情况,为临床选择治疗方案提供准确的参考依据.CT增强扫描对于盆腔脓肿的诊断与鉴别诊断很有帮助.     

胰腺实性假乳头状瘤的CT及MRI表现

目的 探讨胰腺实性假乳头状瘤的CT及MRI表现.方法 回顾性分析2008年5月至2016年4月7例经本院手术病理证实的胰腺实性假乳头状瘤的影像表现,术前4例同时行CT及MRI平扫和增强扫描,3例只行CT平扫和增强扫描.结果 肿瘤2例位于胰头颈部,5例位于胰尾部.直径3~14 cm.均为囊实性肿块.囊性、实性成分比例各有不同.肿瘤内伴有不同程度的出血,囊壁与周围组织分界清楚,2例见钙化灶.增强扫描肿瘤实性部分及囊壁有强化,动脉期呈轻度强化;静脉期及延迟期呈轻至中度强化,延迟期肿瘤实性部分强化范围及程度更大,囊性和实性分界变得清晰,但密度均低于正常胰腺.结论 胰腺实性假乳头状瘤的影像学表现具有一定的特征性,结合临床资料,术前可做出正确诊断.     

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.