640层螺旋CT三维成像对泌尿系梗阻的诊断价值

目的 评价640层螺旋CT泌尿系三维成像在泌尿系梗阻性疾病诊断中的价值.方法 对274例B超、KUB及IVP未明确病因的泌尿系梗阻性疾病患者,行640层螺旋CT扫描,利用后处理技术对扫描资料进行三维重建处理.结果 640层螺旋CT泌尿系成像清晰显示泌尿系的解剖结构,梗阻部位,以及病变和尿路之间的关系.274例患者中,泌尿系结石154例,肾盂输尿管重复畸形29例,输尿管良性狭窄34例,肾输尿管肿瘤26例,肾输尿管结核13例,腔静脉后输尿管8例,巨输尿管畸形1例,腹膜后肿瘤压迫输尿管9例.结石和肿瘤病例均经手术病理证实,CT诊断与临床诊断符合率100％.结论 640层CT泌尿系三维成像显示泌尿系梗阻性疾病安全、便捷,可靠,应作为首选方法之一.     

64层螺旋CT尿路成像技术在泌尿系统疾病中的临床应用

目的探讨64层螺旋CT尿路成像技术对泌尿系统疾病的诊断价值。方法收集50例手术或临床确诊的泌尿系统疾病患者,均进行64层螺旋CT尿路成像检查,对影像资料进行回顾性分析。结果 50例中,泌尿系统结石29例,泌尿系先天性畸形8例,输尿管炎性狭窄5例,肾盂癌3例、输尿管癌3例,膀胱癌2例。CT尿路成像技术能够清晰显示输尿管走行、腔内情况、梗阻部位和原因。结论 64层螺旋CT尿路成像技术能够准确的诊断泌尿系统疾病,图像清晰直观,可以作为早期确诊泌尿系统疾病的有效影像检查方法。     

多层螺旋CT尿路成像对中上尿路梗阻的诊断价值

目的探讨多层螺旋CT尿路成像（CTU）对中上尿路梗阻性疾病的诊断价值。方法回顾性分析49例中上尿路梗阻性疾病的多层螺旋CT尿路成像后处理图像及临床资料。结果本组49例尿路梗阻性疾病的患者中输尿管结石27例、肾盂-输尿管连接处狭窄（UPJ）7例、输尿管炎性狭窄4例,肾盂肿瘤累及输尿管上段3例、膀胱癌累及输尿管下段4例、宫颈癌Ⅳ期浸犯直肠、膀胱后壁、输尿管末段2例、误诊2列。以上病例经手术、术后病理及输尿管钬激光碎石为金标准,定位定性诊断符合率96%。结论多层螺旋CT具有扫描速度快、优良的图像质量和后处理功能而获得多平面重建（MPR）、曲面重建（CPR）、最大密度投影（MIP）和容积再现（VR）等多种模式的二、三维图像功能,比静脉尿路造影（IVU）有更高的显影率,对尿路阻塞性疾病有较高的检出和诊断价值。     

多层螺旋CT扫描及图像后处理技术在先天性输尿管梗阻性疾病诊断中的应用价值

目的:探讨多层螺旋CT扫描及图像后处理技术在先天性输尿管梗阻性疾病诊断中的应用价值。方法:回顾性分析经多层螺旋CT扫描及图像后处理技术诊断19例先天性输尿管梗阻性疾病患者资料,与手术结果对照。结果:19例CT诊断先天性输尿管梗阻性疾病中重复肾输尿管伴远端梗阻7例,肾盂输尿管连接部梗阻6例,输尿管异位开口并梗阻3例,巨输尿管1例,输尿管囊肿2例,所有病例均经手术证实。结论:多层螺旋CT扫描及图像后处理技术能精确显示先天性输尿管梗阻性病变的部位、性质和程度,具有很高的临床应用价值。     

泌尿系统梗阻性疾病应用16排螺旋CT的诊断价值

目的探讨泌尿系统梗阻性疾病采用16排螺旋CT实施诊断的临床价值。方法应用16排螺旋CT薄层扫描技术对57例泌尿系统梗阻患者实施扫描,将静脉肾盂造影（IVP）检查结果同16层螺旋CT扫描结果进行对比。结果通过进行16层螺旋CT扫描检查,57例患者中,3例神经源性膀胱疾病、12例肾结石疾病、29例输尿管结石疾病、6例输尿管占位性疾病、3例单纯肾盂积水疾病、2例输尿管结核疾病、2例输尿管狭窄疾病。患者进行IVP检查后,15例显影发生延迟、11例仅有一侧显影、6例没有显影。泌尿系统梗阻疾病的诊断准确率,16排螺旋CT检查显著高于IVP检查,差异具有统计学意义（P〈0.05）。结论泌尿系统疾病采用16排螺旋CT实施检查诊断,检查时间短、准确性高,可以配合常规检查方法,从而使患者得到及时诊断,实施正确的治疗。     

16层螺旋CT低张尿路造影在肾脏输尿管梗阻性疾病中的应用价值

目的 探讨16层螺旋CT低张尿路造影在肾脏输尿管梗阻性疾病中的应用价值.方法对58例临床考虑肾脏输尿管梗阻性疾病的患者肌注黄体酮20 min后,于静脉注入造影剂,30 min后行低张尿路造影16层螺旋CT扫描,并行3D尿路造影重建,将诊断结果与手术及病理结果对照.结果 58例中输尿管结石22例,输尿管狭窄11例(输尿管炎性狭窄3例,巨榆尿管2例,腹腔或盆腔肿瘤及转移灶压迫输尿管6例),输尿管肿瘤9例,肾盂肿瘤7例,输尿管结核5例,肾盂输尿管连接部狭窄(UPJ)2例,输尿管囊肿2例,定位诊断准确.手术病理结果与16层螺旋CT低张尿路造影比较,术前16层螺旋CT低张尿路造影输尿管肿瘤1例漏诊,1例误诊为炎性狭窄,1例输尿管结核误诊为输尿管癌,余55例均获得诊断,定性诊断准确率达95%.结论 16层螺旋CT低张尿路造影对肾脏输尿管梗阻性疾病有诊断价值,对炎症性病变的鉴别诊断有帮助,尤其对肾功能严重受损的上尿路梗阻性疾病具有特殊的诊断价值.患者痛苦少、效果好、可以取代常规静脉肾孟造影,值得推广.     

16层螺旋CT尿路成像在泌尿系梗阻性疾病中的临床应用

目的探讨16层螺旋CT尿路造影（CTU）对泌尿系梗阻性疾病的临床应用价值。方法对51例临床拟诊为尿路梗阻的患者行16层螺旋CT全尿路多期增强扫描,并将原始数据传入工作站进行多平面重组（MPR）、最大密度投影（MIP）、曲面重组（CPR）及容积再现技术（VR）等图像后处理,分析尿路梗阻病变性质及评价其临床价值。结果 51例泌尿系梗阻患者中,输尿管结石35例、输尿管炎性狭窄5例、单纯输尿管结核1例、结肠癌后腹膜淋巴结转移压迫侵犯输尿管1例、膀胱癌5例、左侧肾下极副肾动脉与肾盂输尿管交界处交互压迫1例、泌尿系畸形3例。所有病例均经临床或手术病理证实。结论 16层螺旋CT泌尿系成像覆盖范围广,扫描速度快,多方位显示病灶等优点,对泌尿系梗阻性疾病的诊断有重要价值,可作为泌尿系梗阻性疾病检查的首选方法之一。     

多层螺旋CT尿路成像在输尿管病变中的应用价值

[目的]探讨多层螺旋CT尿路成像在输尿管病变中的应用价值.[方法] 为35例拟诊断为输尿管病变的患者行多层螺旋CT尿路成像检查及图像三维重建,CT扫描包括平扫、皮质期、实质期、排泄期扫描共4期.对皮质期、实质期、排泄期的CT扫描图像分别重建,层厚2 mm,层间距1 mm,进行图像重组肾动脉成像、肾静脉成像、尿路成像.[结果] 35例患者中,先天性输尿管疾病8例,输尿管结石11例,输尿管息肉2例,输尿管癌14例.所有患者均得到满意的肾动脉、肾静脉及尿路图像,图像诊断与其术后病理诊断及临床诊断符合.[结论] 多层螺旋CT尿路成像可以得到优质图像,成为输尿管病变检查的首选方法.     

64层螺旋CT尿路成像对输尿管病变的诊断价值

目的探讨64层螺旋CT尿路成像技术对输尿管疾病的诊断价值。方法对126例临床怀疑输尿管梗阻患者进行64层螺旋CT容积扫描,将原始数据传至工作站,应用MPR、CPR、MIP、VR进行图像后处理。结果输尿管结石67例,输尿管先天性变异及畸形26例,输尿管炎性狭窄6例,肾输尿管结核2例,输尿管癌4例,副肾动脉压迫输尿管1例,膀胱疾病累及输尿管8例,邻近器官病变累及输尿管致输尿管梗阻6例,盆腔疾病术后粘连致输尿管梗阻5例,直肠癌术后输尿管瘘1例,以上病例均得到手术、输尿管镜检查和临床证实。结论MSCTU通过MPR、CPR、MIP、VR技术能清楚输尿管疾病的位置和形态,在输尿管疾病的诊断方面具有独特的优势。     

多层螺旋CT三维尿路造影(MSCTU)诊断泌尿系梗阻性疾病临床价值

目的:探讨螺旋CT对临床表现泌尿系梗阻性疾病的诊断价值。方法:回顾性分析62例泌尿系梗阻性疾病的的患者,通过MSCT腹部扫描检查,利用多平面、曲面重建等技术重建尿路并进行研究分析。结果:三维尿路造影(MSCTU)检查的敏感度为100%,诊断符合率98%。结论:症状和体征不典型的泌尿系梗阻性疾病临床诊断困难,易误诊,多层螺旋CT尿路造影(MSCTU)方法简单,可从不同角度观察病变部位及其周围情况,有利于鉴别诊断,提高诊断符合率,具有较高的临床价值。     

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.