多层螺旋CT对粘液性与非粘液性结直肠癌的鉴别诊断价值

目的评价多层螺旋CT用于鉴别粘液性与非粘液性结直肠癌的价值。方法收集经病理学确诊为结直肠粘液性癌患者69例和非粘液性癌患者85例的MSCT影像资料,对其MSCT特征进行回顾性分析,并比较两种肿瘤肠壁受累方式、增强形式、继发性肠梗阻、瘤内钙化、肠周脂肪浸润、以及对邻近器官侵犯等特征的差异。结果粘液性癌肠壁增厚(2.52±1.14cm)程度较非粘液性癌(1.91±0.96cm)更重(P=0.003),粘液性癌有84.1%表现为不均匀强化,较非粘液性癌(51.8%)更常见(P=0.001),且粘液性癌的低密度范围更大(P=0.001),偏心程度更高(P=0.027)。与非粘液性癌比较,粘液性癌的实性成分强化程度更低(P=0.001),瘤内钙化更常见(P=0.001)。在两种肿瘤的鉴别诊断中,不均匀强化的敏感度最高(84.1%),特异性中等(58.4%),当4种以上MSCT特征存在显著性差异时,则肿瘤很可能是粘液性癌,其特异性为90.5%。结论MSCT可作为鉴别粘液性与非粘液性结直肠癌的有效检查方法。     

女性卵巢粘液性囊腺瘤MSCT表现及与粘液性囊腺癌的鉴别诊断

目的 分析女性卵巢粘液性囊腺瘤MSCT表现及与粘液性囊腺癌的鉴别诊断。方法 收集本院2017年3月至2019年5月经手术病理检查确诊的卵巢粘液性囊腺瘤、粘液性囊腺癌患者的临床资料。所有患者在手术前均进行MSCT检查,对粘液性囊腺瘤、粘液性囊腺癌患所得MSCT图像进行分析,总结两者CT征象。结果 卵巢粘液性囊腺瘤MSCT表现:肿瘤表现为多房,囊液黏稠,CT值常高于水,但低于软组织,约为12～26HU;可见肿瘤囊壁较薄,不均匀,边界清晰,囊内可见多个细条样间隔形成多个小囊;肿瘤较大直径>10cm,少数患者可见软组织有乳头状突起;增强扫描后肿瘤分隔表现为中度强化。粘液性囊腺癌MSCT表现:卵巢粘液性囊腺癌肿瘤多为实性,肿瘤边缘可见凸起,形态不规整,瘤休常为多房形;肿瘤密度不均匀,CT值常在35HU以上;增强扫描可见实性部分明显强化,部分患者可合并腹水或出现淋巴结转移、肝脏转移等。结论卵巢粘液性囊腺瘤与粘液性囊腺癌MSCT征象存在一定差异,通过分析MSCT征象可进行鉴别诊断。     

64层螺旋CT仿真内窥镜在鉴别结、直肠病变中的应用价值研究

目的 探究64层螺旋CT仿真内窥镜在鉴别结、直肠病变中的应用价值.方法 回顾分析本院2017年7月至2019年4月收治的90例结、直肠疾病患者的临床资料,观察MSCT检查平扫和增强扫描的影像特点,以纤维结肠镜对结、直肠癌的诊断结果作为"金标准",比较CTVE与纤维结肠镜对结、直肠癌的检出率及对结、直肠息肉、慢性结、直肠...     

MSCT与MRI技术在鉴别结直肠癌术前T、N分期的诊断价值

目的探讨多层螺旋CT扫描(MSCT)与MRI在鉴别结直肠癌术前T、N分期的诊断价值。方法选取2016年2月-2017年10月本院收治的60例结直肠癌患者为研究对象,均于术前1周行MSCT、MRI扫描检查,以术后病理分期结果为金标准,评估MSCT与MRI在鉴别结直肠癌术前T、N分期的诊断价值。结果以术后病理分期结果为金标准,MRI诊断结直肠癌患者术前T、N分期的符合率较MSCT的明显高,差异有统计学意义(P0.05);典型病例图像分析结果提示MSCT和MRI在结直肠癌患者术前分期诊断中均有明确应用价值。结论 MRI在鉴别结直肠癌术前T、N分期的诊断中与术后病理分期结果的符合率较MSCT明显高,前者在结直肠癌患者术前T、N分期诊断中的应用价值更高。     

结肠癌、结肠息肉MSCT征象表现及对临床术前诊断价值研究

目的 研究结肠癌、结肠息肉多层螺旋CT(MSCT)征象表现及对临床术前诊断价值.方法 选取本院2017年2月至2020年1月收治的76例结直肠占位性病变患者作为研究对象,观察MSCT表现,以病理学活检为"金标准",分析MSCT检查对结肠癌、结肠息肉的检出情况及对结肠癌术前分期的诊断准确率.结果 MSCT对结肠癌、结肠息...     

MSCT分析结直肠癌肠壁浸润程度价值研究

目的 评估多层螺旋CT(MSCT)对结直肠癌患者肠壁浸润程度价值,探讨其在结直肠患者术前T分期诊断中的价值.方法 回顾性分析我院行结直肠根治性手术病人68例,术前均进行全腹增强CT检查,分析肠壁浸润程度,重点研究浆膜层受累情况,结合病理分期,分析其对结直肠癌T分期价值.结果 与病理T分期比较,MSCT总诊断准确率为85...     

清洁灌肠后保留灌肠MSCT扫描在结直肠癌诊断中的价值

目的:探讨清洁灌肠后保留灌肠多层螺旋CT(MSCT)扫描方法在结直肠癌诊断中的价值。方法:对85例疑有结直肠癌的患者行清洁灌肠后保留灌肠MSCT扫描,观察直肠肠腔及肠周结构显示效果。结果:85例患者病变显示阳性率为100%,CT征像有:肠壁增厚,腔内肿块,肠腔狭窄,以及肠周邻近结构侵犯情况。结论:清洁灌肠后保留灌肠MSCT检查对结直肠癌的诊断有很大价值。扫描前良好的肠道准备及扫描方法是MSCT对结直肠癌诊断的关键。此方法简单、安全、易行、创伤小,能够提高结直肠癌诊断可靠性。     

18F-FDG PET/CT在结直肠腺癌及癌前病变中的诊断价值

背景 结直肠癌发病率、死亡率高,早诊早治十分重要.但常规检查难以鉴别诊断直径≥20 mm的进展期腺瘤,造成了患者经济和心理的双重负担.目的 探讨18F-FDG PET/CT鉴别直径≥20 mm结直肠癌癌前病变与结直肠腺癌的诊断效能及相关影响因素.方法 回顾性分析2010年1月-2020年1月于解放军总医院第一医学中心明...     

应用血清蛋白质指纹谱鉴别结直肠癌与其他恶性肿瘤

目的 建立结直肠癌与其他恶性肿瘤的血清蛋白质指纹谱鉴别诊断模型.方法 收集血清标本235份,其中结直肠癌58例,乳腺癌、胃癌、食管癌、肝癌、肺癌及肾癌各15例,结直肠良性病30例及正常人57例组成建模组,应用表面增强激光解吸/电离飞行时间质谱检测其蛋白质指纹谱.用Biomarker Patterns软件分析结直肠癌与其他恶性肿瘤患者血清中的差异蛋白后,建立结直肠癌鉴别诊断最优分类树模型.再从同期住院或健康体检人群中随机抽取以上诸病种及正常人血清标本各10例组成测试组,盲法验证该模型对结直肠癌的鉴别诊断效能.结果 成功建立了由16种蛋白组成的结直肠癌鉴别诊断最优分类树模型.测试模式下对结直肠癌的鉴别诊断准确率83.8%.灵敏度和总特异性分别为86.2%和83.1%.盲法验证显示,预测总准确率为74.4%.结论 应用血清蛋白质指纹谱技术建立的结直肠癌与其他恶性肿瘤的鉴别诊断模型具有较高的敏感性与特异性,值得进一步研究.     

卵巢粘液性嚢腺瘤CT诊断与其鉴别诊断

目的 分析卵巢粘液性嚢腺瘤CT诊断与其鉴别诊断。方法 回顾分析,收集本院2017年1月至2019年10月经手术病理检查确诊的31例卵巢粘液性嚢腺瘤临床资料作为研究对象,均进行CT检查。对患者所得CT图像进行分析,并以患者病理结果为基准,计算CT检查对卵巢粘液性嚢腺瘤诊断正确率。结果 CT检查卵巢粘液性嚢腺瘤诊断正确率为96.77%,与病理结果比较未见明显差异(P>0.05);CT表现示盆腔肿块较大者占据患者大部分盆腔,肿块密度为密度大于水密度,囊内为多房表现,各房之间密度存在差异;CT值在10HU～25HU之间;囊壁与内个之间厚度均匀一致,囊壁厚度多在3mm以下,极少数患者较厚或存在小乳头状突起。增强扫描：囊壁与内隔均出现强化。结论 CT可直观显示卵巢粘液性囊腺瘤典型影像学征象,使用CT检查可为临床诊断及与其它卵巢肿瘤鉴别诊断提供参考。     

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.