骸骨Merchant轴位在膝关节数字化X线摄影中的临床应用

目的 探讨髌骨轴位(Merchant位)投照的临床应用及其买用意又.万法取仰卧位投照髌骨,患者仰卧,膝于床边屈曲45°X线通过髌骨相对于垂直线角600°中心线经髌骨内缘垂直入探测器.结果 采用仰卧髌骨轴位摄影者176例,其中169例显示髌股关节面完整,无重叠:关节间陈对称,评为"优良"片占96,均获得了满意的髌骨抽位影像.另外7例屈膝关节因患者配合大佳,弯曲角度过小或过大,显示髌膝关节重叠,关节间隙不对称,列为不合格度片占4.结论 采用仰卧位髌骨Merchant轴位投照技术,对比最常用的髌骨轴位(日出位)投照,显示髌股关节面较佳,操作更为简便,对外伤患者尤为适用,成为我料髌骨的常挽检查方法.     

膝关节骨性关节炎摄影体位的探讨及临床应用价值

目的 探讨膝关节骨性关节炎的不同摄影体位对其的临床诊治价值.方法 通过采用双膝关节站证负重前后正位及侧位、双膝关节站立负重后前屈膝正位、双髌骨负重屈膝轴位、双下肢全长负重位等体位的投照,获取膝关节关节腔和髌股关节的各体位影像及下肢力线的准确数据.结果 选取75例膝关节骨性关节炎患者,分别测最负霞与非负重下膝关节关节面夹角值,通过统计学软件采用配对t检验,P＜0.05具有统计学意义.60例采用双髌骨负重屈膝45°位,经测量显示73%的患者存在髌骨轨迹发生改变,而非负重屈膝位仅显示42%,经统计学t检验,P＜0.05具统计学意义.膝关节采用负重和特殊体位的投照,可得到比传统体位更准确、更全面的影像学资料.结论 膝关节骨性关节炎的X线榆查,应根据患者的临床病情,采取多体位站立负重摄影,对患者的诊断和治疗以及膝关节置换手术前后的评估,有着重要的临床应用价值.     

骸骨Merchant轴位在膝关节数字化X线摄影中的临床应用

目的 探讨髌骨轴位(Merchant位)投照的临床应用及其买用意又.万法取仰卧位投照髌骨,患者仰卧,膝于床边屈曲45°X线通过髌骨相对于垂直线角600°中心线经髌骨内缘垂直入探测器.结果 采用仰卧髌骨轴位摄影者176例,其中169例显示髌股关节面完整,无重叠:关节间陈对称,评为"优良"片占96,均获得了满意的髌骨抽位影...     

坐位髌骨轴位X线投照技术的临床应用

目的:探讨坐位髌骨轴位X线摄影技术的临床应用及其实用意义。方法:取坐位投照髌骨,患者髋关节保持自然屈曲90°,屈膝角度范围30°～80°,然后调整中心线的入射角及入射点进行投照。结果:采用坐位髌骨轴位摄影者共138例,其中78例膝关节屈曲70°～80°,显示髌股关节完整,无重叠,关节间隙对称,评为“优”级片占5 7% ;5 5例膝关节屈曲5 0°～6 0°,显示髌股关节无重叠,关节间隙略不对称,评为“良”级片,占4 0 % ;两者均可获得满意的髌骨轴位影像,优良率达97%。另外5例屈膝关节为30°～4 0°,显示髌股关节重叠,关节间隙明显不对称,对诊断有影响,列为废片,占3%。结论:采用坐位髌骨轴位投照法,符合膝关节和髌骨之间的解剖特点及活动规律。其操作简便,患者舒适可配合摆位。屈膝关节4 0°～70°范围内均可获得髌骨轴位的良好影像,提高临床影像诊断准确率,临床实用性好,可以作为髌骨的常规检查。     

髌股关节摄影新技术介绍

目的 对髌股关节切线位摄影新技术的讨论与研究.方法 选取50患者作为研究对象.对其进行膝关节倒位平片测量膝关节屈曲角,髌骨后缘线与股骨长轴,弪骨长轴及胫骨前皮肤线之间的夹角.对三组夹角间的关系进行分析并得出髌骨后缘线与股骨间夹角与膝关节屈曲角成直线相关关系.根据结果 研制出辅助摄影台并将体位调整为仰卧位屈膝30°进行检测.结果对50例患者58个髌股关节进行切线位X线片.根据四个等级进行判断为优19个,良31个,中7个,差1个.优良率为86,2%.摄片效果较差多由于髌韧带较多造成髌胫前角过小或负角造成.结论 仰卧位屈膝300进行投照能更好的显示髌股关节,有助于提高诊断准确率.     

青少年髌股关节紊乱诊断与治疗

目的探讨青少年髌股关节紊乱关节镜下诊断与治疗.方法总结了共16例髌股关节紊乱的青少年患者,患者术前皆无髌股关节紊乱的典型症状、体征,髌股关节轴位 X 片及髌股关节 CT 皆正常.关节镜下发现髌骨皆向外倾斜,软骨退变1~2级,松解髌外侧支持带后,髌骨轨迹恢复正常.结果术后随访3~12个月,膝部症状全部消失,无复发.结论青少年髌股关节紊乱难确诊,关节镜是诊断和治疗青少年髌股关节紊乱的有效方法.     

髌骨轴位摄影方法的改进

目的 探讨髌骨轴位的体位设计和摄影角度,建立一种最佳的投照方式.材料和方法:对92例患者进行髌骨轴位摄影,在力求体位舒适的情况下,根据膝关节实际屈曲角度的不同,而采用不同的投照角度.膝关节屈曲30°～90°时,X线球管向头侧倾斜5°～12°,中心线与髌骨长轴平行,从髌股关节面水平摄入. 结果由此方法获得的髌骨轴位片,优片占90.2%;良片占6.5%;优良率为96.7%.结论 经过改进的髌骨轴位投照方法,在实际操作中简便易行,患者易于配合,且图像质量大大提高,更能符合 临床诊断要求.     

双膝同片负重位和多角度髌骨轴位的投照技术

目的 :对膝关节负重位和多角度髌骨轴位的 X线投照技术探讨 ,以建立一个最佳的投照方式。材料与方法 :应用自制的多角度髌骨轴位投照架 ,对膝关节在同片不同屈曲度数时的 X线投照进行对比 ,以及双膝关节在负重位时 X线投照条件的对比。结果 :在屈膝 30°、4 5°、90°时 ,X线球管水平中心线向上、向头侧分别倾斜 5°、7°、10°时 ,髌骨呈单边影像 ,达到诊断要求。结果 :膝关节负重位和多角度髌骨轴位 (即屈膝 30°、4 5°、90°)。 X线投照技术是对膝关节病变经济有效的方法之一。     

双膝同片负重位和多角度髌骨轴位的投照技术

对膝关节负重位和多角度髌骨轴位的X线投照技术探讨,以建立一个检查膝关节病变的最佳投照方式。材料与方法:应用自制的多角度髌骨轴位投照架,双膝关节在同片不同屈曲度数时以及双膝关节在负重位时X线投照的影像对比。结果:在屈膝30°、45°、90°时,X线球管水平中心线向上、向头侧分别倾斜5°、7°、10°时,髌骨呈单边影像,达到诊断要求。结论:膝关节负重住和多角度髌骨轴位(即屈膝30°、45°、90°)。X线投照技术是对膝关节病变经济有效的检查方法之一。     

髌骨不稳定所致髌股关节撞击的影像学改变

目的:明确髌股关节排列异常所致辞髌骨撞击的影像学改变,产生机理。方法:选择前膝痛(AKP)中50岁以下,行25°髌骨轴位摄片或25°髌股关节CT扫描资料完整,并除外髌股关节排列异常以外的其他疾患,共100例,测量髌股关节相应影像学数据,从中观测髌骨运动轨迹异常(PMA)变化,以及由此出现的髌股关节撞击症(PAHS)的影像学改变。结果:在100例髌股关节排列异常病例中,其影像学阳性率从高到低依次为PFI、CA、LS、PTA,分别为69%、63%、56%、21%。在测得的髌股关节排列异常病例中,出现影像学能观察到的髌股关节面及髌骨位置异常改变者23例,占23%。骨关节炎9例。结论:因髌股关节排列异常导致的髌骨位置异常及其运动轨迹改变的发生率很高。由异常撞击产生髌股关节滑槽面及沟底软骨下骨板碎裂、塌陷、退变及增生,髌骨凹凸不平,与临床AKP的疼痛部位相一致,从而在AKP检诊中,通过小角度髌股关节轴位摄片及CT扫描,能及时发现髌股关节影像学异常改变存在,早期干预可减少骨关节炎的发生。     

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.