腰椎小关节综合征的CT诊断

目的　探讨CT对腰椎小关节综合征的诊断价值。方法　回顾性分析 1 2 0例腰椎小关节综合征的临床表现及CT所见。结果　腰椎小关节综合征小关节异常主要表现为 :(1 )小关节突增生肥大、骨赘形成 1 0 3例 (85 83% ) ;(2 )关节间隙变窄86例 (71 6 0 % ) ;(3)关节面改变 35例 (2 9 1 7% ) ;(4 )小关节真空现象 2 1例 (1 7 5 0 % ) ;(5 )侧隐窝或 /和椎间孔狭窄 1 9例(1 5 83% ) ;(6 )关节囊钙化 9例 (7 5 % ) ;(7)椎小关节半脱位 6例 (5 % )。结论　CT扫描可清楚显示椎小关节的解剖结构和病理改变 ,为腰椎小关节病的诊断提供了可靠的影像学依据 ,对改进临床诊断和治疗腰腿痛有重要意义     

腰椎小关节综合征的CT诊断价值

目的：评价CT对腰椎小关节综合征的诊断价值。方法：回顾分析100例椎小关节综合征的CT表现。结果：CT表现：小关节突增生肥大、骨赘形成;小关节间隙狭窄、关节面硬化、囊变及关节面边缘缺损;小关节真空征;小关节半脱位;关节囊钙化;两侧小关节不对称等。结论：CT可充分显示椎小关节解剖结果及病理改变,为椎小关节病的诊断提供可靠的影像学根据。     

腰椎小关节病的CT征象及临床相关分析

目的　探讨腰椎小关节病的CT征象、发病机理及临床意义。方法　回顾性分析 12 0例腰椎小关节病的CT表现、好发部位和临床表现。结果　CT扫描见关节面不对称 ;小关节突增生、肥大 ;关节骨赘形成 ;关节软骨下骨硬化、糜烂、关节间隙狭窄 ;关节真空现象 ;关节半脱位 ;关节周围及关节囊钙化。其中 2 5例关节真空及关节半脱位伴腰椎退行性滑脱。 5 6例见腰椎间盘突出或膨出。结论　CT是腰腿痛查因的极具价值的检查方法 ;腰椎小关节真空现象及小关节半脱位是腰椎退行性滑脱的重要征象     

腰椎小关节退变的CT诊断价值(附136例分析)

目的分析腰椎小关节退变的CT影像表现,评价其诊断价值.方法收集腰椎小关节退变的CT影像136例,对其影像表现进行回顾性分析.结果 CT扫描显示:(1)小关节突增生、肥大、骨赘形成,导致椎管、椎间孔、侧隐窝狭窄.(2)关节面软骨及软骨下骨质增生、碎裂,致小关节间隙变窄、关节面凹凸不平.(3)关节腔内积气.(4)小关节半脱位.结论 CT扫描能清楚显示腰椎小关节解剖结构及病理变化,对诊断及治疗椎小关节病变具有重要价值.     

腰椎小关节综合征的CT诊断

目的评价CT对小关节综合征的诊断价值。方法回顾分析50例小关节综合征的CT表现，男36例，女14例。年龄38-75岁，平均年龄52．5岁。结果腰椎小关节异常的主要CT表现：(1)小关节突增生、肥大及骨赘形成，并导致关节间隙、侧隐窝、椎问孔及椎管狭窄；(2)关节面硬化，硬化骨质内囊样低密度区及关节面边缘缺损；(3)关节腔内“真空”现象，小关节不对称及关节半脱位；(4)下关节突间距(IAD)和小关节角(FJA)明显缩小。结论CT可充分地显示椎小关节的解剖结构和病理改变，为小关节疾病的诊断提供了可靠的影像学依据。     

腰椎关节突关节骨性关节炎的CT征象分析

目的 探讨腰椎关节突关节骨性关节炎的CT征象及其临床意义.方法 回顾性分析2011年8月-2013年9月在天水市第三人民医院就诊的153例腰痛患者的腰椎CT资料,采用观察CT骨窗轴位像关节突关节面、关节间隙、骨赘形成及骨质改变情况,依据LFJOA的CT征象将其分级.结果 Ⅰ级48例,Ⅱ级48例,Ⅲ级57例.腰椎小关节骨性关节炎累及3节椎间小关节90例,2节42例,1节21例;同时伴有椎间盘膨出和（或）突出,累及3节椎间盘膨出63例,2节57例,1节33例.椎间盘膨出导致LFJOA的病变率高于椎间盘突出（P＜0.05）,腰椎4～5（L4～5）小关节骨性关节炎发生率最高,其次是腰5～骶1（L5～S1）和腰3～4（L3～4）（P＜0.01）.结论 腰椎关节突关节骨性关节炎病变程度CT分级与椎间盘退变具有一致性,多层螺旋CT对腰椎关节突关节退变程度的评估和研究有临床指导意义.     

腰椎小关节力学机制的有限元分析

目的 研究腰椎小关节在各种形式负荷作用下的承载功能.方法 取青壮年男性新鲜尸体的L4-L5运动节段标本,经螺旋CT扫描得到断面图像,在ANSYS软件中建立L4-L5节段的三维有限元模型.对模型施加400N轴向压缩载荷和/或8Nm前屈、后伸、左右侧弯弯矩和左右轴向旋转力矩,测量分析小关节面所受的压力.分析各种加载方式下小关节面的接触应力,评价小关节的承载功能.结果 L4-L5小关节约承受轴向压缩载荷的20%.前屈时小关节受力减小.后伸时受力增大;侧弯时对侧小关节受力增大,同侧小关节受力减小;轴向旋转时同侧小关节不受力,对侧小关节则受力极大.结论 腰椎小关节具有重要的承载功能,临床上应注意保护和维持小关节的完整性.     

椎小关节退变的CT表现与临床意义

目的 CT扫描对腰椎小关节退变的诊断及临床意义.方法 268例临床疑诊腰椎小关节退变患者于临床症状出现后就诊,均接受了CT扫描.结果 CT扫描证实,268例中有406个腰椎小关节发生改变.腰椎小关节退变的CT表现主要是关节突增生肥大合并骨赘形成,椎小关节间隙变窄或消失,关节腔内"真空征",关节面毛糙硬化,小关节半脱位,以及伴发椎间盘突出、膨出,黄韧带肥厚和钙化等.结论 CT扫描可准确显示腰椎小关节的形态、结构及其异常改变,对椎小关节退变的早期诊断提供可靠依据,对临床诊断及治疗评估具有一定意义.     

腰椎小关节综合征普通X线与CT征象诊断的对照研究

目的 探讨腰椎小关节综合征的普通X线及CT征象.方法 通过76例腰椎小关节综合征常规摄取X线片正侧位及双斜位片,CT常规扫描加向头侧,足侧扫描层面.结果 腰椎小关节综合征X线及CT共同征象为小关节突肥大、骨赘形成、关节间隙变窄.而关节面下囊性变,关节内真空征,关节囊钙化,侧隐窝、椎管狭窄X线片难以显示,而CT却能显示清楚.结论 X线片及CT综合对照研究不仅提高了腰椎小关节综合征的准确率,而且为早期诊断、临床有效治疗及观察术后疗效提供客观依据.     

小关节面综合征的CT研究

目的 研究小关节面综合征的CT表现和应用价值.方法 对93例腰椎小关节进行CT扫描.结果 小关节面综合征的CT表现:骨性关节面增生硬化凹凸不平88例,关节间隙变窄消失60例,关节突增生肥大53例,软骨下骨质疏松囊样骨吸收45例,关节真空41例,关节囊钙化32例,关节半脱位23例.结论 CT扫描是提高小关节面综合征诊断准确率的有效方法.     

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.