胃扭转的X线诊断

目的:探讨X线钡餐造影对胃扭转的诊断价值。方法:对12例胃扭转的临床及X线检查资料作一回顾性分析。结果:12例胃扭转中,器官轴型10例,表现为胃大弯上翻位于胃小弯之上,形成一凸面向上、凹面向下的胃形,食管膈下段延长并开口于胃的下方、食管黏膜及胃黏膜交错、幽门高于十二指肠球部、双胃泡和双液气平面;网膜轴型2例,表现为胃窦部翻向左上方,致使胃大弯翻向右、胃小弯翻向左,胃黏膜呈十字交叉状、胃食管前庭段下移并拉长与十二指肠相交。结论:X线钡餐造影检查是确诊胃扭转的主要方法。     

慢性胃扭转2例X线诊断报告

1病例报告例1：男，29岁，上腹部疼痛3年，进行性加重，有恶心、呕吐，查体无阳性体征。X线胃肠造影发现胃位置异常，胃大弯上翻，胃小弯向下，胃底、胃窦各见一液平。食管腹段与胃交叉。十二指肠壶腹倒置。诊断为慢性器官轴型胃扭转。例2，男，52岁，后背部轻度不适感7年，渐进加重，偶有恶心、呕吐，体重减轻。查体，腹部未触及包块。上消化道X线造影，见食管中上段有一约scm管腔狭窄，局部管壁僵硬，粘膜破坏中断，其上方食管扩张。胃位置异常，胃大弯上翻，胃小弯向下，食管腹段延长，并与胃交叉。诊断：①食管爆。②慢性器官轴型胃扭…     

X线钡餐造影对胃扭转的诊断价值探讨

目的探讨X线钡餐造影对胃扭转的诊断价值。方法回顾性分析31例胃扭转患者采用数字胃肠Χ线机行胸腹透视的情况。结果 31例胃扭转的X线表现：器官轴型24例,经手法整复21例;网膜轴型7例,经手法整复2例。其中混合型2例。结论器官轴型胃扭转多见,手法整复成功率高;网膜轴型及混合型胃扭转较少见。X线钡餐造影检查是确诊胃扭转的主要方法。     

慢性胃扭转内镜充气复位二例

本院自1986年起试用内镜充气复位治疗慢性胃扭转二例。此二例经 X 线钡餐诊断,充气复位后均经 X 线钡餐证实复位成功。例一、女。35岁。无规律性上腹痛3月,腹胀、时呕吐.1986年5月20日 X 线胃肠钡餐诊为器官轴型胃扭转,5月25日内镜充气复位,次日 X 线胃肠钡餐复查胃扭转已复位.例二、男,48岁。无规律性上腹痛半年,食欲减退,腹胀,无呕血史。1986年6月22日 X 线胃肠钡餐为网膜轴型扭转.     

婴儿胃扭转的X线诊断(附85例分析)

目的 :进一步提高婴儿胃扭转的诊断水平。方法 :回顾性分析 85例婴儿胃扭转的X线平片及上消化道造影表现。结果 :85例患者胃窦、胃体均有不同程度的移位或 /和翻转 ,5 0例表现为纵轴型扭转 ,8例表现为横轴型扭转 ,2 7例表现为混合型扭转。结论 :X线平片及上消化道造影是诊断婴儿胃扭转的主要方法     

慢性胃扭转38例临床分析

胃扭转最早于1866年由Berti在尸检中发现,Berg于1897年首先为此病施行外科手术。本文收集6个单位的慢性胃扭转共38例,结合文献就其病因、X线诊断以及复位问题进行讨论。(一)临床资料1.一般资料:年龄3月～71岁。男29例,女9例。病程30天～30年。2.X线检查:钡餐胃十二指肠造影均按一般常规操作进行,先立位,后仰卧位,俯卧位,最后再立位,并分次饮钡液。每个患者以立位片所见作为诊断依据,有的加拍侧位片。如果在造影过程中已自行复位,则再加拍一张复位片。少数加做钡灌肠结肠造影。结果:完全性器官轴型胃扭转29例,其中在造影过程中自行复位(并未采用特殊手法和体位,以下同)者11例;部分性器官轴     

X线钡餐造影对婴幼儿期肥厚性幽门狭窄诊断价值的探讨

目的：探讨X线钡餐造影诊断婴幼儿期肥厚性幽门狭窄（IHPS）的临床意义。方法：时40例患儿通过X线钡餐造影影像学诊断结果与手术结果对比,探讨X线钡餐造影对婴幼儿期肥厚性幽门狭窄诊断价值度。结果：40例患儿中X线钡餐造影诊断结果：34例先天性肥厚性幽门狭窄,2例胃食管返流,1例胃扭转,均与手术相符,诊断符合率100％。1例幽门痉挛,经临床保守治疗痊愈得到证实。2例幽门前瓣膜误诊为先天性肥厚性出门狭窄（2／40）,误诊率5.0％,手术后得到证实。结论：X线钡餐造影是诊断IHPS的一种有价值的诊断方法。     

婴儿胃扭转的X线诊断（附85例分析）

目的：进一步提高婴儿胃扭转的诊断水平。方法：回顾性分析85例婴儿胃扭转的X线平片及上消化道造影表现。结果：85例患者胃窦、胃体均有不同程度的移位或／和翻转，50例表现为纵轴型扭转，8例表现为横轴型扭转，27例表现为混合型扭转。结论：X线平片及上消化道造影是诊断婴儿胃扭转的主要方法。     

双对比钡餐造影对早期胃癌的诊断

目的：探讨早期胃癌的双对比钡餐造影诊断价值。方法：收集资料完整的25例早期胃癌,对其接受的双对比钡餐X线检查进行回顾性分析。结果：25例早期胃癌,位于胃窦部15例,胃体部7例,胃底部3例。10例结节隆起型,5例表浅型,10例凹陷型。结论：优良的双对比钡餐造影能准确发现早期胃癌,对早期胃癌的定性和定量具有重要价值。     

胃扭转(附11例报告)

<正> 胃扭转临床少见,1977～1983年我院共收治经X线确诊者11例,其中3例经手术证实。现结合复习文献报告如下。临床资料性别与年龄:本组男性7例,女性4例。最小年龄9岁,最大71岁,平均年龄32.7岁。症状与体征:4例有上腹部疼痛;5例进食后上腹部饱满感,其中2例伴有呕吐,1例吐物为胃内容,另1例千呕;腹泻1例;胸闷及腰背部疼痛1例。上腹有压痛4例,上腹可见胃型1例。病程最短15天,长者20年。2例化验有轻度贫血。 X线表现:11例X线钡餐检查均有胃大小弯变位(上下或左右变换见封四图1)皆属器官轴型扭转。5例胃粘膜呈交叉形(见封四图2、3)。2例食管腹段延长。3例可见2个液气面,即于胃窦和胃底各有一个液气面(见封四图4),11例胃窦均高于十二指肠球部。3例左膈肌高位。2例横结肠高度充气。2例有食管裂孔疝(见封四图5)。     

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.