低场强弥散加权磁共振对急性脑梗死的早期诊断价值

目的探讨低场强弥散加权磁共振成像（DWI）在急性脑梗死中的早期诊断价值。方法分析49例脑梗死患者（超急性8例、急性期16例、亚急性期25例）的DWI成像和常规MR、T1WI、T2WI检查的影像学资料,比较不同序列间病灶的信号强度。结果超急性、急性和亚急性脑梗死在DWI上均表现为高信号,其中8例超急性脑梗死仅在DWI上显示异常信号,对16例急性脑梗死病例,DWI比常规T2WI多显示6例异常信号。结论低场强磁共振DWI对于超急性及急性脑梗死较常规扫描系列具有更高的敏感性,T2WI和DWI结合可以鉴别新旧梗死病灶。     

急性脑梗死磁共振液体翻转恢复与T2WI加权像对比分析

目的:探讨急性脑梗死在磁共振液体衰减翻转回复(fluid attenuation inversion_recovery,FLAIR)序列与常规SE序列T2WI加权像上的表现,并对比分析双序列在急性脑梗死MR诊断的敏感性。方法:分析初发50例急性脑梗死病人在磁共振FLAIR序列与T2WI加权像中的影像表现,并进行相关比较分析。结果:在50例急性脑梗死中FLAIR序列显示病灶46枚,T2WI加权像显示病灶29枚,有17个梗死病灶仅在FLAIR序列中显示,20个病灶的信号强度、范围及边界在FLAIR序列较T2WI加权像显示清楚。结论:FLAIR序列能够抑制脑脊液的信号,显示病灶较T2WI加权像信号高,特别是临近脑室、脑沟及脑池的脑梗死病灶,在诊断急性脑梗死中较T2WI加权像敏感,可作为常规颅脑检查的补充序列。     

磁共振弥散加权成像诊断急性脑梗死的价值

目的：评价弥散加权成像（DWI）在急性脑梗死诊断中的应用价值。方法：22例脑梗死患者（超急性2例，急性期12例，亚急性期8例）经DWI成像、T1WI、T2WI及FLAIR检查，比较不同序列间病灶的信号强度表现及病灶数目。结果：单纯脑梗死DWI均表现为高信号，伴有出血时表现为混杂信号；而T2WI/FLAIR检查中2例超急性患者未显著责任病灶，急性期内仅2例表现为高信号，其余表现为略高信号或等信号。综合比较三种检查中病灶与对侧相应部位信号强度，DWI组与FLAIR组及T2WI组间差别均有显著意义（方差分析PFLAR=0.001，PT2WI=0.038），DWI优于FLAIR及T2WI。本组共有9例于T2WI显示为多处病灶，而DWI均为单发病灶，且单发病灶部位与患者的症状及体征相符。结论：DWI对于急性脑梗死比T2WI及FLAIR具有更高的敏感性；有助于多次梗死患者急性责任病灶的检出；有助于诊断出血性脑梗死。     

低场强磁共振不同成像序列对超急性、急性脑梗死的诊断价值

目的探讨低场强磁共振不同成像序列对超急性、急性脑梗死的诊断价值。方法收集85例发病时间〈24 h、临床高度怀疑脑梗死的病人进行常规SE序列T2WI、FLAIR和DWI扫描检查,并进行影像对比分析。结果 17例超急性期脑梗死DWI显示为图像清晰、对比度好的高信号,而FLAIR、T2WI在影像上没有改变。68例急性期脑梗死,DWI显示68例,FLAIR显示62例,T2WI显示54例,而且DWI序列显示梗死灶信号强度较FLAIR序列和T2WI序列高,病灶范围亦较FLAIR序列和T2WI序列大。85例超急性、急性期脑梗死共有127个梗死灶,DWI上显示病灶数目127个,显示率100%（127/127）;FLAIR上显示病灶数目106个,显示率83.5%（106/127）;T2WI上显示病灶数目59个,显示率46.5%（59/127）。结论低场强磁共振DWI对急性脑梗死,尤其是超急性脑梗死的显示明显优于常规FLAIR、T2WI。     

低场强弥散加权成像对早期脑梗死的临床应用价值

目的:探讨低场强MR弥散加权成像(DWI)对早期脑梗死的诊断价值.方法:对25例怀疑早期脑梗死患者进行常规MRI和水抑制(FLAIR)扫描,加扫弥散加权成像(DWI),比较早期脑梗死MRI和DWI的表现.结果:急性和超急性期脑梗死24例28处病灶,DWI均显示异常高信号,显示率100%,T2FLAIR显示18例20处病灶,显示率71%,T2WI显示14例17处病灶,显示率为61%,T1WI显示5例5处病灶,显示率21%.1例一过性脑出血,DWI和常规MRI均无异常信号.结论:低场强DWI对早期脑梗死的发现和确定有高敏感性,对临床早期诊断和治疗有很好的指导意义.     

超急性期脑出血的低场MR表现

目的：探讨超急性期脑出血的低场MR表现特点。方法：32例在低场强机器作常规横断自旋回波（SE）序列T1WI、T2WI及FLAIR序列扫描。结果：T1WI低信号2例（6.2%）,等信号24例（75%）,高信号6例（18.8%）;T2WI高信号13例（40%）,等信号14例（43.7%）,低信号5例（16.3%）;FLAIR序列高信号29例（90.6%）,低信号3例（9.4%）。结论：低场MRI对超急性期脑出血各阶段的显示具有特征性,通过与其他征象的结合可明确诊断,与脑梗死鉴别。     

急性脑梗死低场磁共振FLAIR序列与T2WI加权像对比分析

目的:比较低场磁共振液体衰减翻转恢复(FLAIR)序列和常规SE序列T2WI加权像在急性脑梗死中的敏感性。方法:23例急性脑梗死患者均行FLAIR序列和常规SE序列T2WI扫描并进行两组图像的对比分析。结果:在低场中FLAIR序列可清晰显示脑室、脑沟及脑池周围及脑干边缘的脑梗死病灶。本组23例急性脑梗死患者中共有29个梗死灶,FLAIR序列显示病灶29个,显示率为100%(29/29),T2WI加权像显示病灶14个,显示率为48.3%(14/29),有15个梗死灶仅在FLAIR序列中显示,11个病灶的信号强度、范围及边界在FLAIR序列较T2WI序列加权像显示清晰。结论:低场中FLAIR序列对急性脑梗死病灶的显示明显优于T2WI加权像,特别是脑室、脑沟、脑池周围及脑干边缘的脑梗死病灶,在诊断急性脑梗死中较T2WI加权像敏感。     

Propeller DWI技术对超早期脑梗死的诊断价值

目的 评价磁共振扩散加权成像(DWI)和表观扩散系数(ADC)图像在超早期脑梗死诊断中的应用价值.方法 回顾分析50例超早期脑梗死患者,发病时间1～6h,均行磁共振T1WI,T2WI,FLAIR,DWI序列采用Propeller DWI技术检查并各序列对照观察.结果 49例患者在发病时间3～6h于DWI序列均出现异常高信号,ADC图像呈低信号.1例患者发病1h DWI序列表现正常,3h复查DWI序列表现为明显高信号.50例患者T1WI,T2WI,FLAIR序列均未见异常信号.DWI对超早期脑梗死病灶的敏感性及特异性均达98%以上.结论 DWI结合ADC图像对比常规T1WI,T2WI,FLAIR具有较高的敏感性及特异性,能发现常规T1WI、T2WI、FLAIR序列不能发现的超早期脑梗死病灶,具有十分重要的应用价值.     

磁共振弥散成像在早期脑梗死诊断中的价值

目的:探讨磁共振弥散成像(DWI)诊断早期脑梗死的价值。方法:回顾分析122例早期脑梗死患者的弥散成像(DWI)和常规MRI(包括T1WI、T2WI及FLAIR)图像特点。结果:48例超急性期脑梗死患者DWI全部显示为高信号,27例在T1WI、T2WI及FLAIR均为正常;21例T1WI未见异常,T2WI及FLAIR呈稍高信号影。74例急性期脑梗死病例,DWI、T2WI及FLAIR序列显示为高信号、略高信号,T1WI序列显示为低信号、略低信号。结论:DWI在早期脑梗死诊断中具有重要价值,结合常规磁共振可以准确判断超急性及急性期脑梗死。     

急性脑梗塞磁共振FLAIR序列与T2WI加权像对比分析

目的 比较磁共振FLAIR序列和常规SE序列T2WI加权像在急性脑梗塞中的敏感性.方法 69例急性脑梗塞患者接受FLAIR序列和常规T2WI检查,评价病变的显示范围、边界及对比度.结果 在69例急性脑梗塞中FLAIR序列显示病灶87个,T2WI加权像显示病灶43个,有44个梗塞病灶仅在FLAIR序列中显示,27个病灶的信号强度、范围及边界在FLAIR序列较T2WI加权像显示清楚.结论 FLAIR序列显示病灶较T2WI加权像信号高,特别是临近脑室、脑沟及脑池的脑梗塞病灶,在诊断急性脑梗塞中较T2WI加权像敏感,可作为常规颅脑检查的补充序列.     

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.