鼻咽癌CT类型和放射治疗剂量与鼻咽癌预后的初步研究

探讨鼻咽癌ＣＴ类型和放射剂量与鼻咽癌预后的关系，为设置合理的放疗剂量提供依据，方法５６例疗前ＮＰＣ，均有完整的放疗后３年追踪资料，鼻咽癌复发者１７例，鼻咽正常３９例；根据疗前ＣＴ表现，５６例ＮＰＣ分为Ⅰ型１３例，Ⅱ型２８例，Ⅲ型１５例；鼻咽癌     

鼻咽癌周围深层蔓延和预后与P53 蛋白表达的相关性研究

目的研究鼻咽癌（NPC）的CT影像所表现的深层蔓延程度、预后与P53的关系,更全面的认识NPC的生物学特性。方法收集放疗前进行过CT检查并有详细临床记录的NPC活检标本70例,采用S-P法进行P53免疫组织化学染色,详细分析P53蛋白表达与NPC局部蔓延情况和临床预后的关系。结果本组NPC,P53阳性表达率68.57%,其与组织学类型和病理分级无关;Ⅱ型和Ⅲ型NPC的P53阳性率高于Ⅰ型NPC;P53的表达与有无颈淋巴结转移无关,但与转移颈淋巴结大小有关,即＜4cm者的P53阳性率高于≥4cm者;P53表达与NPC放疗后局部复发和远处转移无关。结论随肿瘤向鼻咽深层蔓延,P53阳性表达率增高,恶性程度加大,按CT影像所分3种类型,反映了NPC的生物学特性。     

颈部淋巴结结核的CT及B超表现

目的：复习１４例以头颈部肿瘤就医,组织学诊断为颈淋巴结结核的ＣＴ及Ｂ超表现,旨在提高对颈淋巴结结核的影像学诊断的认识。材料与方法：女性患者１３例,男性１例。ＣＴ平扫１例,直接增强扫描１３例,Ｂ超扫描８例,结果：以内颈链下组及锁骨上下区受累最常见,均为多个淋巴结同时受累（１００％）,病变部分或全部与邻近肌肉粘连者７８．０％,ＣＴ增强扫描分３型：Ⅰ型：均匀等密度强化;Ⅱ型;薄环形周边强化,中央低密度相     

结肠癌术后复发的钡灌肠与CT诊断

探讨结肠癌术后复发的钡灌肠与ＣＴ诊断。材料与方法：７５例结肠癌,有４３例术后复发,２８％局部复发同时合并远处转移,２３％,单纯远处转移。术后１－２年局部复发者为５７％（１２／２１）,远处转移者为６３％（１４／２２％）。ＣＴ扫描层厚和层间距均为８ｍｍ,吻合口部部位加作薄层扫描。结肠双重造影用７０％Ｗ／Ｖ混悬钡液。     

直肠癌手术后 CT 扫描随诊的价值

目的：评价ＣＴ检查对直肠癌手术后随诊的价值。方法：回顾性地分析了５１例直肠癌患者手术后ＣＴ扫描所见，随诊时间为１～６０个月，其中经腹会阴切除术３６例、部分切除仍保留部分直肠和肛门１５例。结果：５１例中，有４１例肿瘤局部复发和／或转移，３例为单纯远处转移，７例为局部术后改变。复发和／或转移距手术后时间为３～６０个月，中位时间为１３～１４个月，ＣＴ表现为骶骨前区软组织肿块、吻合口腔内充盈缺损、不对称肠壁增厚、有时伴有邻近器官的浸润或远处转移。结论：不同的手术方式造成不同的术后改变，了解手术方式有助于肿瘤复发的早期诊断和提高术后生存质量，直肠癌术后应作基础ＣＴ检查和定期ＣＴ复查。     

声门上型喉癌颈淋巴结转移规律的CT分区探讨

目的:探讨声门上型喉癌颈部淋巴结转移规律及其临床意义。方法:结合CT分区回顾性分析64例声门上型喉癌颈部淋巴结转移的CT表现及其特点。结果:64例声门上型喉癌并颈部淋巴转移。CT平扫颈淋巴结密度均匀或不均,增强淋巴结强化明显,呈环状强化及不均匀强化。Ⅰ区2例,Ⅱ区21例,Ⅲ区12例,Ⅳ区5例,无Ⅴ区、Ⅵ区、Ⅶ区淋巴结转移,其中Ⅱ区、Ⅲ区同时淋巴结转移14例,Ⅰ区、Ⅱ区同时淋巴结转移7例,Ⅰ区、Ⅲ区同时淋巴结转移3例。结论:声门上型喉癌易发生Ⅱ区、Ⅲ区颈部淋巴结转移,特别是Ⅱ区单发淋巴结转移最多见于声门上型喉癌,喉癌颈淋巴结转移的规律对分区淋巴结清扫及调强放射治疗具有重要的意义。     

肝门部胆管癌的影像分型及其与治疗的关系

目的：作者分析了７５例肝门部胆管癌，探讨其影像分型和治疗间的关系。材料与方法：患者男５７例，女１８例，年龄３０～７８岁。全部病例均经ＥＲＣＰ、ＣＴ和ＵＳ检查。结果：按Ｂｉｓｍｕｔｈ分型法，本组中Ⅰ型１９例，Ⅱ型８例，Ⅲ型１８例（Ⅲａ７例，Ⅲｂ１１例）及Ⅳ型３０例。总切除率２０％（１５例），其中Ⅰ型７例，Ⅱ型３例，Ⅲａ型２例，Ⅲｂ型３例，而Ⅳ型均未能切除。Ⅳ型较Ⅰ、Ⅱ及Ⅲ型的未能切除率有非常显著性差异（χ２检验，Ｐ＜０．０１）。６０例未切除中，４８例行引流管引流，９例行胆肠Ｒｏｕｘ－ｅｎ－Ｙ吻合术。未能切除的主要原因有局部或远处转移，侵犯肝动脉和（或）门静脉。放置引流管是一种较好的姑息疗法。结论：影像分型可为选择治疗方法提供重要的依据。     

头颈部恶性肿瘤隐匿性颈淋巴结转移的CT诊断

作者对２２例病人２６侧拟行预防性颈淋巴结清扫术而临床触诊阴性的头颈部恶性肿瘤病人颈淋巴结状态行术前ＣＴ扫描评估，并与术后颈淋巴结病理检查结果相对照，表现：ＣＴ检查头颈部恶性肿瘤病人颈部，可使隐匿性颈淋巴结转移的误诊率从临床触诊检查的４６．１５％（１２／２６侧）下降为ＣＴ检查的１８．７５％（３／１６侧）。说明ＣＴ在诊断头颈部恶性肿瘤隐匿性颈淋巴结转移方面确有一定的价值。     

鼻咽癌CT表现类型与c-erbB-2蛋白表达的相关性研究

目的探讨鼻咽癌(NPC)CT表现类型与c-erbB-2的关系，更全面的认识NPC生物学特性。材料与方法搜集放疗前进行CT检查并有详细临床记录的NPC标本70例，采用S-P法进行c-erbB-2免疫组织化学染色，分析c-erbB-2表达与NPCCT表现类型和临床预后关系。结果NPC的c-erbB-2阳性率为84.29％，与病理组织学类型和病理分级无关；11I型NPC的c-erbB-2阳性率显著高于Ⅱ型(P=0、018)；c-erbB-2的表达与颈淋巴结转移和放疗后局部复发以及远处转移无关。结论远离鼻咽腔生长的NPC较邻近鼻咽腔生长者，c-erbB-2阳性率要高，恶性程度更高。     

颈淋巴结结核的CT诊断

提高对颈淋巴结结核的认识和CT诊断的正确性。材料和方法：经CT检查的颈淋巴结结核33例，与同期颈肿块（除颈器官肿瘤外）49例作CT对照研究，均经病理及临床证实。结果：（1）结核发病中位年龄29．2岁，明显年轻于恶性肿瘤组（556岁）。（2）结核淋巴结坏死率和包膜高度强化率均高达81．82％，结内坏死面积（≥1／2）者达7576％。（3）本文依颈淋巴结结核的CT形态分布提出分型：单纯型（Ⅰ－Ⅳ）、混合型：单纯型又可分为Ⅰ型（单个淋巴结，直径＜20mm）、Ⅱ型（串珠型）、Ⅲ型（多房型）、Ⅳ型（融合呈大单房或单个直径≥20mm）。其中Ⅱ型具诊断特异性。结论：CT对颈淋巴结结核有诊断价值。     

Rays as weapons

PURPOSE: Ionizing radiation is being regarded as life threatening. Therefore, accidents in nuclear power plants are considered equal threatening as nuclear bomb explosions, and attacks with dirty bombs are thought as dangerous as nuclear weapon explosions. However, there are differences between a nuclear bomb explosion, the largest imaginable accident in a nuclear power plant, and an attack with a dirty bomb. It is intended to point them out. METHOD: The processes are described, which damage in a nuclear bomb explosion, in the largest imaginable accident in a nuclear power plant, and in an attack with a dirty bomb. Their effects are compared with each other, i.e. explosion, heat, shock wave (blast), ionizing radiation, and fallout. RESULTS: In the center of the explosion of a nuclear bomb, the temperature rises to 100Mio degrees C, this induces damaging heat radiation and shock wave. In the largest imaginable accident in a nuclear power plant and in the conventional explosion of a dirty bomb, the temperature may rise up to 3000 degrees C, heat radiation and blast are limited to a short distance. In nuclear power plants, explosions due to oxyhydrogen gas or steam may occur. In nuclear explosions the dispersed radioactive material (fall out) consists mainly of isotopes with short half-life, in nuclear power plants and in dirty bomb attacks with longer half-life. The amount of fall out is comparable in nuclear bomb explosions with that in the largest imaginable accident in a nuclear power plant, it is smaller in attacks with dirty bombs. An explosion in a nuclear power plant even in the largest imaginable accident is not a nuclear explosion. In Hiroshima and Nagasaki, there were 200,000 victims nearly all by heat and blast, some 300 died by ionizing radiation. In Chernobyl, there have been less than 100 victims due to ionizing radiation up till now. A dirty bomb kills possibly with the explosion of conventional explosive, the dispersed radioactive material may damage individuals. The incorporation of irradiating substances may kill and be difficult to detect (Litvinenko). A new form of (government supported) terrorism/crime appears possible. CONCLUSION: The differences are important between a nuclear weapon explosion, the largest imaginable accident in a nuclear power plant, and an attack with a dirty bomb. Nuclear weapons kill by heat and blast; in the largest imaginable accident in a nuclear power plant, they are less strong and limited to the plant; an attack with a dirty bomb is as life threatening as an ("ordinary") bomb attack, dispersed radiating material may be a risk for individuals.     

Sleep extension: getting as much extra sleep as possible

Nearly all people, whether they consider themselves sleep deprived or not, can initially obtain extra sleep. However, as accumulating extra sleep reduces carryover sleep debt, a point is reached where it is no longer possible to obtain extra sleep. If there were a practical method to make a precise measurement of a person's daily sleep requirement, it may be possible to show that most individuals are carrying a very large sleep debt. Several observations and studies demonstrate that almost everyone is sleep deprived and carries some amount of sleep debt. How long such an indebtedness will persist without change if no extra sleep is obtained is not known.