肝门部胆管癌的磁共振诊断价值

目的评价磁共振成像（MRI）及磁共振胰胆管造影（MRCP）在肝门胆管癌中的诊断价值.方法回顾分析22例经手术和病理证实的肝门部胆管癌患者的MRI及MRCP表现,以了解其影像特征和肿瘤的组织病理学特点.结果按肿瘤形态分：弥漫型16例,结节型4例,乳头型2例,22例肝门胆管癌均可见肝门肿块、肝内胆管扩张、肝门胆管中断,MRCP表现为阻塞、狭窄或充盈缺损;肿瘤侵及门静脉3例,表现为门脉侧壁浸润、门脉缩窄或闭塞.结论MRI检查能较充分显示肝门胆管癌病变的大小、分型及其侵犯范围,对肝门胆管癌的诊断和鉴别诊断有重要价值,但对肿瘤侵犯血管估价尚有不足.     

磁共振水成像在诊断胆系和尿路梗阻性病变中的价值

探讨磁共振水成像在诊断胆系与尿路梗阻性病变中的价值。方法对２８例临床怀疑胆系或尿路梗阻患者同时进行常规磁共振扫描（ＭＲＩ）和胰胆管成像（ＭＲＣＰ或尿路成像（ＭＲＵ）检查,并与手术及病理结果对照。结果：ＭＲＣＰ与ＭＲＵ对显示胆系与尿路梗生病变定位诊断的正确率为１００％;定性诊断的正确率为８０．７％;对于显示等腔外病变范围或手术或除性效果均不佳。结论ＭＲＣＰ和ＭＭＲＵ是诊断胆系和尿路梗阻性病变十分有效     

磁共振和磁共振胆道成像对肝门胆管癌的诊断价值

用ＭＲＩ和ＭＲＣ技术检查２２例肝门胆管癌，在Ｔ１加权像上，１６例（７２．７％）显示肝门胆管癌的阳性征像，包括肝门区见软组织块影１１例，肝门区结构紊乱３例，左右肝管壁增厚及肝总管内见等信号肿块影各１例，上述病灶经Ｇｄ－ＤＰＴＡ增强后扫描均显示不同程度地强化，在Ｔ２加权像上，２２例（１００％）均显示肝内胆管不同程度地扩张，２１例（９５．９％）显示肝门胆管癌的阳性征象。在ＭＲＣ图像上，以肝门胆管不规则截     

PTC在肝门胆管癌分型诊断中的应用

目的：探讨经皮肝穿刺胆道造影术（ＰＴＣ）在遥门胆管癌分型诊断中的作用。方法：２２例肝门胆管癌，１５例（７例拒绝）术前行ＰＴＣ检查；其中经右侧穿刺３例，左侧穿刺７例，双侧穿刺５例。结果：１５例均根据ＰＴＣ结构诊断肝门胆管癌并作出Ｂｉｓｍｕｔｈ分型，其中Ⅰ型２例，Ⅱ型４例，ⅢＡ型３例，ⅢＢ型１例，Ⅳ型５例。结论：ＰＴＣ有助于肝门胆管癌的诊断和分型，应作为肝门胆管癌诊断和分型诊断首选方法。     

磁共振胰胆管成像在胆管恶性梗阻诊断中的作用

目的：探讨磁共振胰胆管成像（ＭＲＣＰ）在胆管恶性梗阻诊断中的作用。方法：对７９例胆管恶性梗阻患者行ＭＲＣＰ检查,其中６９例经手术证实。结果：病例包括胆管癌４１例,壶腹癌９例,胰头癌１７例,肝门区转移性病变１２例。所有病例ＭＲＣＰ均明确显示了病变位及其近侧胆管扩张程度,定位诊断符合率达１００％,胆管恶性梗阻常见胆管影呈截断状缺损或鸟嘴状变窄。结论：ＭＲＣＰ是一种安全,无创,可靠的检查方法。     

磁共振胆胰管造影在胆道外科临床中的应用(附 56 例报告)

目的：探讨磁共振胆胰管造影（ＭＲＣＰ）在胆外科临床中的应用价值。方法：对５６例可疑梗阻性黄疸的虱进行ＭＲＣＰ检查。４２例（７５％）行手术治疗。１４例（２５％）行非手术治疗。结果：５６例虱中５３例（９４．６％）可通过ＭＲＣＰ明确诊断，并经手术或临床证实；２例（３．６％）硬化性胆管炎需结合其他临床资料做出诊断；１例（１．８％）胆总管结石误诊为胆管癌．结论：ＭＲＣＰ对胆道疾患诊断具有无创性、高灵敏度、高     

磁共振胰胆管造影在肝外胆管梗阻诊断中的价值

目的 探讨磁共振胰胆管造影（ＭＲＣＰ）在肝外胆管梗阻性疾病诊断中的价值。方法 ＭＲＣＰ采用ＳＳＦＳＥ序列重Ｔ２Ｗ１扫描,对５３例肝外胆管梗阻性疾病（良性梗阻２３例,恶性梗阻３０例）进行ＭＲＣＰ检查,并与临床综合诊断或手术和病理结果对照分析。结果 全部５３例ＭＲＣＰ检查一次成功,均获得较满意的ＭＲＣＰ图像。ＭＲＣＰ对肝外胆管梗阻定位诊断准确率为１００％,定性诊断准确率为９０．６％。结论 ＭＲＣＰ对肝     

0.5T MR成像仪胆胰管造影临床应用研究

采用 Ｐｈｉｌｉｐｓ Ｇｙｒｏｓｃａｎ Ｔ５ － Ⅱ型０ ．５ Ｔ 超导磁共振成像仪,体部包裹线圈,快速自旋回波序列重 Ｔ２ 加权扫描和最大强度投影算法重建图像。对２５ 例正常志愿者和７２ 例胆胰病变患者作磁共振胆胰管造影（ Ｍ Ｒ Ｃ Ｐ） 检查。并对 Ｍ Ｒ Ｃ Ｐ、 Ｕ Ｓ、 Ｃ Ｔ和 Ｅ Ｒ Ｃ Ｐ进行对比分析。结果说明,中场强 Ｍ Ｒ 机 Ｍ Ｒ Ｃ Ｐ 能清楚显示肝外胆道结构和扩张的肝内胆管。其对胆道结石、胆道肿瘤的敏感性、特异性和正确性均较高。其定位、定性准确率高于 Ｕ Ｓ,比 Ｅ Ｒ Ｃ Ｐ成功率高。     

0.5T MR成像仪胆囊胰管造影临床应用研究

采用Ｐｈｉｌｉｐｓ Ｇｙｒｏｓｃａｎ Ｔ５－Ⅱ型０．５Ｔ超导磁共振成像仪,体部包裹线圈,快速自旋回波序列重Ｔ２加权扫描和最大强度投影算法重建图像。对２５例正常志愿者和７２例胆胰病变患者作磁共振胆胰管造影（ＭＲＣＰ）检查。并对ＭＲＣＰ、ＵＳ、ＣＴ、ＥＲＣＰ进行对比分析。结果说明,中场强ＭＲ机ＭＲＣＰ能清楚显示肝外胆道结构和扩张的肝内胆管。其对胆道结石、胆道肿瘤的敏感性、特异性和正常性均较高。其定位、     

磁共振胰胆管成像技术的临床应用

目的　探讨磁共振胰胆管成像（Ｍａｇｎｅｔｉｃ　ｒｅｓｏｎａｎｃｅ　ｃｈｏｌａｎｇｉｏｐａｎｃｒｅａｔｏｇｒａｐｈｙ,ＭＲＣＰ）技术的优势及临床意义。方 法３４例疑有胆道梗阻的患者,在常规ＭＲＩ扫描后,再以ＭＲＣＰ术行快速自旋回波重Ｔ２ＷＩ序列扫描,图像采用最大 强度投影法（ＭＩＰ）重建。结果２９例阳性患者清晰地显示了梗阻的部位、形态及肝内胆管扩张情况。结论　采用ＭＲＣＰ 技术,可以在不注入造影剂的情况下,取得类似内窥镜逆行胰胆管造影（ＥＲＣＰ）和经皮肝穿胆道造影的造影效果。它对 胆道梗阻有很高的敏感性和特异性。最大优势是无创伤性、无并发症。对年高、体弱及胆肠吻合术后ＥＲＣＰ插管困难者 尤为适宜,有望取代部分创伤性胆道造影技术。     

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.