低场磁共振FLAIR成像技术在脑梗塞中的应用评价

目的评价FLAIR（液体反转恢复）序列在脑梗塞中临床应用价值。方法对100例脑梗塞患者行快速自旋回波（FSE）序列及FLAIR序列扫描,比较FLAIR序列及T2W像显示脑梗塞病灶的差异。结果在100例脑梗塞患者中,FLAIR共显示病灶171个,而T2加权像只显示136个,有78个病灶仅在FLAIR图像中显示,105个病灶的内部结构及边界在FLAIR像较T2像显示清晰。结论FLAIR像显示皮层和皮层下邻近脑沟、脑室旁病变及微小病灶优于T2加权像,对急性脑梗塞病变的显示较T2W敏感,有助于对新旧病灶的判别,可给临床治疗提供指导。     

FLAIR和FSE序列在早期脑梗死临床诊断中的应用价值比较

目的:比较FLAIR序列和FSE序列T1WI、T2WI在早期脑梗塞中的临床应用价值。方法:收集40例早期脑梗塞患者,其中超急性期(<6h)4例,急性期(6h～72h)36例。每一例患者均先后进行FSE序列T1WI、T2WI和FLAIR扫描,对FLAIR序列上的异常信号与FSE序列T1WI、T2WI上的异常信号作对比分析。结果:4例超急性期患者,FLAIR序列显示2例异常信号,FSE序列无1例发现异常信号。36例急性期脑梗死,FLAIR发现34例,FSE序列发现32例。FLAIR序列对脑梗死病灶的显示比T1WI和T2WI更清晰。结论:FLAIR序列诊断早期脑梗死优于FSE序列T1WI、T2WI,特别对检出脑皮层和脑室旁病灶更佳。     

低场磁共振FLAIR序列在脑梗塞中的应用

目的　评价液体衰减反转恢复 (FLAIR)序列在低场MR中对脑梗塞的应用价值。方法　 75例脑梗塞患者 ,均进行FLAIR序列和FSE T2 WI检查 ,比较两种序列对病灶的显示能力。结果　MRI共发现 30 2个脑梗塞灶。FLAIR序列显示病灶 30 0个 ,检出率为 99 34% ;FSE T2 WI显示病灶 2 4 2个 ,检出率为 80 . 13% (P <0 .0 1) ;尤其是在显示脑皮层、皮层下和脑室旁的病灶FLAIR序列比FSE更敏感、更清晰。FLAIR对急性和亚急性梗塞显示更清晰。慢性梗塞灶FLAIR表现为低信号或中央低周边高信号。结论　在低场中 ,FLAIR序列对脑皮层、皮层下和脑室旁梗塞灶的显示较常规FSE T2 WI具有更高的敏感性 ;FLAIR序列有助于鉴别急性和陈旧性脑梗塞。FLAIR序列应该成为诊断脑梗塞的常规序列。     

FLAIR成像技术在脑梗塞磁共振诊断中的应用价值

目的 评价FLAIR（液体反转恢复）序列在脑梗塞磁共振诊断中的应用价值。方法 对40例脑梗塞病人行快速自旋回波（FSE）序列及FLAIR序列扫描。比较FLAIR序列及T2像在显示脑梗塞病变的差异。结果 在40例脑梗塞病人,FLAIR序列共显示病灶187个,而T2加权像上只显示126个,有61个病灶只在FLAIR像中显示,105个病灶的内部结构、边界、大小在FLAIR像上较T2像显示清晰。结论 FLAIR像显示脑缺血性病变的大小,数目,边界及内部结构均优于T2像。     

磁共振DWI、T_2WI、FLAIR在评价不同时期脑梗塞中的价值

目的 :评价磁共振弥散加权成像、T2 WI及FLAIR图像在不同时期脑梗塞诊断中的应用价值。方法 :用单次激发平面回波弥散加权MRI和常规MRI技术检查了 32例不同时期脑梗塞患者 ,对所得DWI图像在工作站上进行重建 ,得到ADC图及Isotropic(各向同性图 ) ,比较脑梗塞在DWIIsotropic图像上、常规T2 WI及FLAIR图像上的信号特点、梗塞面积、病灶数目 ,比较各种序列在不同时期的敏感性。结果 :DWI对超急性期、急性期脑梗塞高度敏感 ,显示率达 10 0 % ;亚急性期T2 WI/FLAIR在病灶检出数量上要高于DWI ;而在慢性期T2 WI/FLAIR显示率达 10 0 % ,DWI却不能显示。FLAIR序列和DWI对病变的显示范围、对比均优于常规T2 WI,以DWI对病变显示更佳。结论 :DWI能显示超急性期、急性期脑梗塞 ,且优于常规MR ,结合T2 WI/FLAIR有助于鉴别新旧梗死灶。     

低场FlAIR和DWI序列在脑部MRI的应用价值

目的 评价低场液体衰减反转恢复技术(FLAIR)和弥散成像(DWI)序列在脑部MRI应用价值.方法 应用0.35T 永磁MRI系统,对111例脑部MRI受检者分别使用FLAIR与常规FSE T2WI及DWI序列进行对比分析.结果 FLAIR序列检出病变199枚,常规FSE T2WI序列检出172枚,前者较后者敏感性高.结论 FLAIR可以抑制脑脊液信号并提高灰白质的对比度从而进一步发现或明确部分常规序列(FSE序列)没有显示或可疑病灶,特别是皮层下和脑室旁病变.DWI对脑缺血尤其是急性脑梗塞非常敏感同时DWI对急性脑梗塞可做定量分析.FLAIR和DWI可作为常规FSE T2WI序列的重要补充.     

PROPELLER FSE 弥散加权成像在诊断超急性脑梗塞中的价值

目的 比较 PROPELLER FSE 和 EPI两种扩散加权成像序列,探讨 PROPELLER技术在诊断超急性脑梗塞中的应用价值.方法 选取 67例临床疑诊急性脑梗塞的患者分别行常规 T1WI,T2WI,T2WI FLAIR序列检查和 PROPELLER FSE 扩散加权成像、 EPI扩散加权成像,比较两种不同的弥散加权成像序列的图像质量,病灶检出率和对病变的显示程度. 结果 两个序列均可分辩出所有非颅底区域梗塞灶,对 12个颅底病灶 PROPELLER FSE DWI序列检出率达 100%,而 EPI DWI序列可检出率达 58.3%.结论 PROPELLER FSE扩散加权成像能提高图像信噪比,并有效消除颅底磁化率伪影 ,改善图像质量,提高颅底病变的检出率.     

快速FLAIR序列在脑梗塞MRI诊断中的应用初探

目的：探讨快速FLAIR序列在脑梗塞诊断中的应用价值。材料与方法：对30例脑梗塞患者行常规的FSE序列及FLAIR序列扫描，并对比分析常规的T2WI与FLAIR成像对脑梗塞病变的显示能力。结果：在30例脑梗塞患者当中，FLAIR共显示出63处病灶，而T2MI仅显示出49处，有14处病灶在FLAIR上清晰显示，在T2WI上未显示或显示不清楚。结论：快速FLAIR序列有助于鉴别急性或陈旧性脑梗塞；在显示皮层表面、皮层下、脑室周围的病变优于T2WI像，应作为脑梗塞患者颅脑MR检查常规序列的重要补充，从而提高病变检出率，减少漏诊。     

快速液体衰减反转恢复(FAST FLAIR)序列在脑部疾病诊断中的应用价值

目的:探讨快速液体衰减反转恢复(FAST FLAIR)序列在脑部疾病诊断中的应用价值。方法:108例脑缺血性疾病患者同时行T2加权FSE序列和FLAIR序列检查。结果:FLAIR序列显示异常信号病灶426个,T2加权FSE序列显示异常信号病灶324个,而且前者比后者边界显示清晰。结论:FLAIR序列在发现病灶数目,病灶与周围脑实质的对比度明显优于T2加权FSE序列。FLAIR序列在脑缺血性疾病诊断中的有较高的价值。     

低场FIAIR和DWI序列在脑部MRI的应用价值

目的评价低场液体衰减反转恢复技术（FLAIR）和弥散成像（DWI）序列在脑部MRI应用价值。方法应用0.35T永磁MRI系统,对111例脑部MRI受检者分别使用FLAIR与常规FSE T2WI及DWI序列进行对比分析。结果FLAIR序列检出病变199枚,常规FSE T2WI序列检出172枚,前者较后者敏感性高。结论FLAIR可以抑制脑脊液信号并提高灰白质的对比度从而进一步发现或明确部分常规序列（FSE序列）没有显示或可疑病灶,特别是皮层下和脑室旁病变。DWI对脑缺血尤其是急性脑梗塞非常敏感同时DWI对急性脑梗塞可做定量分析。FLAIR和DWI可作为常规FSE T2WI序列的重要补充。     

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.