卵巢肿瘤和肿瘤样病变的CT诊断

回顾性分析手术、病理证实71例卵巢肿瘤和瘤样病变的CT表现。结果,CT表现囊性肿块42例、囊实性肿块15例和实性肿块12例。恶性囊性肿块有不规则或厚的边缘或分隔或壁结节;囊性畸胎瘤有一些脂肪或钙化。CT检出敏感性为97.2%,但诊断准确率为87.3%。     

卵巢肿块的CT诊断

68例卵巢肿瘤的表现特点及诊断价值；（1）非赘生性囊肿和囊腺瘤的特征为薄壁囊性肿物，壁与间隔薄且规则。（2）囊实性肿块内含脂肪成份，囊壁隆起的实性结节处见结节状钙化或牙齿是畸胎瘤的特征性表现。（3）恶性囊性肿瘤特征为囊壁与间隔不规则增厚，其内可发现乳头状或不规则实性成份；（4）恶性肿瘤实质性部分较多或为主，但少数良性肿瘤也常常有实性成份，认为CT在卵巢病变的诊断中有较高的价值。     

卵巢畸胎瘤的CT诊断

目的:探讨卵巢畸胎瘤的CT表现,提高CT诊断及鉴别诊断水平。方法:搜集经手术病理证实的16例卵巢畸胎瘤,对其CT表现进行回顾性分析。结果:16例卵巢畸胎瘤中,成熟性畸胎瘤13倒,未成熟性畸胎瘤3例。13例为囊性,2例为囊实性,1例为实性,后者均为未成熟性。13例畸胎瘤含脂肪密度成分,12例见向囊内突起的壁结节,13例瘤内见钙化或牙齿,13例瘤内见毛发。本组16例肿瘤CT平扫的敏感度100%,特异度93.7%,诊断符合率93.7%。结论:卵巢畸胎瘤绝大多数有典型CT表现特征,少数不含脂肪的未成熟性畸胎瘤定性有一定困难。     

42例卵巢源性盆腔巨大肿块CT分析

目的探讨女性卵巢源性盆腔巨大肿块的cT表现。方法回顾性分析42例经手术病理证实的卵巢源性盆腔巨大肿块的cT表现。CT征象包括肿块的形态、成分、增强特点及有无腹水、钙化等。结景42例中,良性24例（粘液性囊腺瘤5例,浆液性囊腺瘤、混合性囊腺瘤及囊性畸胎瘤各4例,囊肿5例,卵泡膜细胞瘤及卵泡膜纤维瘤各1例）;恶性18例（浆液性囊腺癌7例,内膜样癌3例,透明细胞癌及转移瘤各2例,颗粒细胞瘤、无性细胞瘤、不成熟畸胎瘤及低分化腺癌各1例）。良、恶性肿块的形态、最大径、成分密度、实质部分强化程度及与邻近组织器官的关系间的差异均具有统计学意义（P〈0．05）。良性肿块大多数表现为均匀或含纤细分隔的椭圆形囊性肿块,而恶性肿块则多表现为含壁结节的囊性、囊实性或实性肿块。结论卵巢源性巨大肿块组织来源、生物学行为各异,其CT表现有一定特异性,CT对肿块定位及观察肿块内部成分及肿块周围结构改变等方面能发挥较大作用,为诊断和鉴别诊断提供重要信息。     

卵巢囊性畸胎瘤的CT表现

作者分析了２４例经手术病理证实的卵巢囊性畸胎瘤，其中２３例为良性畸胎瘤，１例为囊性畸胎瘤恶变为囊腺癌。ＣＴ表现为这缘清晰的囊性肿块，内有脂肪、钙化及软组织密度影。认为，通过卵巢囊性畸胎瘤典型的ＣＴ表现，可作出正确的诊断和良、恶性肿瘤的鉴别诊断。     

原发性卵巢恶性肿瘤CT诊断（附49例分析）

目的评价原发性卵巢恶性肿瘤的CT诊断价值。方法搜索49例手术病理证实的卵巢原发性肿瘤进行CT回顾性分析。结果卵巢恶性肿瘤CT显示厚壁、不规则或伴壁结节的囊性肿块9例,实性肿块12例,囊实性肿块28例。所有肿块边缘均不规则。增强扫描示囊壁及壁结节和实性部分均有强化。结论CT能很好地显示卵巢恶性肿瘤的诊断,同时对确定腹腔内有无转移也有一定的诊断价值。     

卵巢原发非上皮源性肿瘤的 CT、MRI 诊断

目的：探讨卵巢原发非上皮源性肿瘤的 CT、MRI 表现及其诊断价值。方法回顾性分析行多层螺旋 CT 及/或1．5T MRI 平扫及动态增强扫描并经手术病理证实的性索间质肿瘤12例、生殖源性肿瘤17例共29例32个卵巢非上皮源性肿瘤的 CT、MRI 特征。结果性索间质肿瘤中,颗粒细胞瘤及卵泡膜细胞瘤以实性为主,颗粒细胞瘤伴小囊变且多位于周边,增强扫描实性部分轻度强化。两性母细胞瘤囊实性相间呈“蜂巢”状改变,增强后实性部分轻、中度强化。硬化性间质瘤呈周边实性、中央大片囊变,MRI 动态增强扫描早期周边明显强化,随时间延长造影剂渐进性向中央填充。生殖源性肿瘤中,成熟型畸胎瘤及未成熟畸胎瘤呈脂肪、钙化、软组织混杂密度/信号,成熟型畸胎瘤各成分间分界清晰,未成熟型畸胎瘤各成分间分界模糊。MRI 显示少量脂肪较 CT 敏感, CT 对小钙化检出率较 MRI 高,二者增强扫描软组织成分轻度强化。甲状腺肿呈多房囊性为主肿块,可见点、条状钙化。MRI 示囊腔信号高低不等,房隔及壁呈等/稍高信号,增强后房隔及壁显著强化。无性细胞瘤呈较大实性为主肿块,MRI T2WI 示稍高信号,肿块内见线状稍低信号影,增强后肿块轻度强化,线状影明显强化。卵黄囊瘤 CT平扫呈囊实性,中央大片囊变区,增强后病灶周边及内部见多发显著强化血管影。结论MRI 检查应作为卵巢原发非上皮源性肿瘤的优选影像检查方法。多数卵巢原发非上皮源性肿瘤影像表现有一定特征,结合临床及生化检查可作出定性诊断。     

卵巢畸胎瘤的CT诊断

目的：探讨卵巢畸胎瘤的CT表现特点及诊断价值。方法：回顾性分析经手术病理证实的34例43个卵巢畸胎瘤的CT资料,与术前B超结果对照。结果：CT和B超对肿块的检出率均为100％,诊断符合率分别为93．02％和58．14％。30例38个成熟囊性畸胎瘤,CT明确诊断27例35个,均含有脂肪密度区,5 个见脂液平面,11个浮球征,16个有钙化或牙齿状影。4例5个未成熟畸胎瘤呈囊性或实性为主肿块,肿块内均多见多发斑点状钙化和少许小片状脂肪密度影,其中1例实性成分内见盘曲的带状略低密度影。结论：卵巢畸胎瘤的CT表现具有特征性,与B超相比,CT是更好的检查方法。     

妇科盆腔肿瘤的CT诊断(附88例分析)

通过分析８８例经手术病理证实的盆腔肿瘤的ＣＴ征象，以提高ＣＴ对此类肿瘤的诊断水平。全部病例经ＣＴ平扫，其中７１例行ＣＴ增强扫描。结果良性肿瘤６７例，包括：子宫肌瘤、卵巢囊肿、卵巢囊腺瘤、畸胎瘤、卵巢脓种、卵巢ＴＢ及盆腔平滑肌瘤。肿瘤在ＣＴ上主要表现为囊性、囊实性、实性及混杂密度，多边界清晰，呈圆形或卵圆形，增强后实性部分及囊壁可中等度强化。恶性肿瘤２１例，包括：宫颈癌、子宫体瘤、卵巢癌。多密度不均     

31例卵巢良恶性肿瘤CT诊断回顾

【目的】回顾分析卵巢良恶性肿瘤的CT表现,探讨其特征。【方法】搜集经临床病理证实的卵巢良恶性肿瘤31例CT照片,对所有CT影像进行分析,结合有关文献资料,对卵巢良恶性肿瘤主要CT表现作了总结归纳。【结果】31例中良性20例占64．5％,恶性11例占35．5％。主要CT表现良性：轮廓形态多为圆形椭圆形,有均一薄壁或不能察觉,内部结构均一,囊性为液体,实性为软组织密度,CT值10－20HC,范围局限、境界清楚,囊性者无强化,实性者轻度均一强化,器官脂肪轮廓存在等。恶性：轮廓形态多为不规则分叶,不规则厚壁,内部结构多为囊实性,不均一,混合密度以实性为主,CT值40－50HU,多累及盆、腹腔,境界不清,病灶内有不定形钙化,明显不均一强化或瘤内有小灶状增强灶,器官脂肪轮廓消失等。【结论】CT是检查卵巢肿瘤的重要方法,掌握CT表现及其特征,一般都能作出诊断。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.