先天性卵巢发育不全症骨骼改变的X线表现

目的探讨先天性卵巢发育不全症（TS）的骨骼改变。方法回顾性分析20例TS患者骨骼改变的X线表现。结果20例患者中,腕角征阳性者12例,掌骨征阳性者4例,指骨优势征阳性者16例。胫骨内髁增大者14例,胫骨外髁增大者10例。20例患者X线均表现为骨质疏松较明显,尤其是腕骨及关节周围骨质。结论手腕骨、膝关节的改变对TS的诊断具有重要意义。     

11例小儿孤立性高磷酸酶血症临床特点与诊疗分析

目的 分析小儿孤立性高磷酸酶血症的临床特点与诊疗过程，为临床诊断提供参考。方法 采用回顾性研究的方法，通过实验室信息系统检索北京协和医院2016年1月至2021年12月期间年龄小于10岁且无明确原因碱性磷酸酶（ALP）>1000 U/L患者，查阅病历与电话回访，对其临床表现、实验室指标、诊疗过程及预后进行回顾性分析。结果 共搜集无明确病因小儿ALP升高11例，其中儿科7例、内分泌科3例、心内科1例。患者年龄（3.5±2）岁，男5例，女6例。因查体发现ALP升高就诊3例，其余分别因身材矮小（2例）、腹痛（2例）、皮肌炎（1例）、肺动脉高压（1例）、大动脉炎（1例）、骨纤维异样增殖（1例）就诊过程中发现。ALP升高至儿童参考区间上限的2.5～12.7倍，未行针对性治疗2周到8月恢复正常。其他实验室指标无明显异常。其中4例进行了超声检查，1例进行了骨显像检查。就诊后1～5年电话随访，11名患者生长发育正常，无其他异常表现。其中8位患者家长表示就诊时未明确ALP升高原因而受困扰。11个病例均符合婴幼儿暂时性高磷酸酶血症（THI）诊断标准。结论 小儿孤立性ALP显著升高在大型综合医院比较罕...     

多发性骨肉瘤X线表现1例

患者男,21岁.4个月前无明显诱因出现右膝关节肿痛,呈刺痛,行走时发作,休息后缓解,外院给予抗生素治疗后症状有所好转但仍持续,且于1个月前出现活动受限.入院查体:右膝明显肿胀,皮温较对侧略升高.     

原发性小肠肿瘤X线及CT表现

目的分析原发性小肠肿瘤的X线及CT表现,探讨其诊断价值.方法回顾分析经手术病理证实的原发性小肠肿瘤28例的临床资料和小肠钡剂造影及CT表现.28例均行数字化小肠气钡追踪造影,2例行小肠灌肠造影,7例行多层螺旋CT扫描.结果原发性小肠肿瘤小肠气钡造影表现包括充盈缺损、管腔狭窄、黏膜破坏或受压、管壁僵硬、龛影、肠梗阻或肠套叠.CT扫描表现为软组织块影、管壁增厚及肠管受压或狭窄.结论原发性小肠肿瘤X线表现具有一定特征,结合临床表现可明确诊断,与CT检查相结合可提高诊断率.     

原发性旁路高胆红素血症1例

1　病例报告女 ,2 2岁。14岁时无诱因下出现尿黄、肤黄、眼黄。近 2 a黄疸加深。 2 0 0 1- 11起到本院住院 2次。全身情况好 ,皮肤、巩膜黄染 ( ) ,肝肋下 1cm,脾肋下触及 ,B超脾厚 6 0 mm。Hb10 0～110 g/ L,Ret1.2 %～ 2 2 .0 % ,总胆 5 8.0～ 178.7μmol/ L,间胆5 0 .7～ 16 6 .2 μmol/ L,直胆 7.3～ 12 .5 μmol/ L,抗体筛选试验阳性 ,Coomb′s直接法阴性 ,尿胆原 16～ 131μmol/ L,尿胆红素阴性 ,尿 Rous试验阴性。骨髓增生性贫血 ,幼红细胞增多。G6 PD及 Hb分子病检查正常。游离血红蛋白增高 ,结合球蛋白缺如 ,诊为自身免疫性…     

早发型先天性骨梅毒的X线表现(附4例报告)

目的探讨早发型先天性骨梅毒的X线表现特点。材料和方法报告4例早发型先天性梅毒的骨骼X线表现,并复习文献资料。结果早发型先天性骨梅毒的主要X线表现特点是四肢长骨对称性的干骺端炎、骨膜炎和骨干炎。结论对于先天性梅毒的早期发现,有必要进行骨X线检查。     

新生儿X线片骨骼生长线与产科异常关系的研究

本文就新生儿骨骼生长线的Ｘ线表现及其与之相关的产科危险因素间的关系作一分析报道。１资料与方法收集我院１９９１年２月～１９９８年４月新生儿科住院病人共３５６例，有产科异常２５０例。３５６例中２１例新生儿出现骨骼生长线，男１２例，女９例，摄片时年龄为４小...     

普伐他汀治疗95例原发性高胆固醇血症

观察普伐他汀治疗原发性高胆固醇血症的临床疗效。采用随机双盲安慰剂对照临床试验方法，观察普伐他汀治疗原发性高胆固醇血症患者的调脂疗效。普伐他汀组治疗 ４周与８周血脂水平相近。     

食管炎的特殊X线表现

目的 探讨特殊X线表现的食管炎的特征。方法 对具有特殊X线征象的16例食管炎病例进行回顾性分析。结果 病变区黏膜皱襞毛糙、扭曲、断续有小颗粒状钡斑。正常食管壁轮廓消失。黏膜相示分界清楚,但不截然。食管呈持续性扩张状态或痉挛状态。腔内龛造影剂灌注后呈梳齿状影像为急性食管炎破裂造影剂漏入纵隔内。结论 病变区如果改变恒定短期复查是必要的,内窥镜检查、随访都有膈鉴别诊断及提高诊断准确率。     

石骨症X线表现:2例报告

病例1,患者男,67岁.4年前因拔牙后下颌部疼痛、流脓、迁延不愈,于2009年7月来我院就诊,诊断为下颌骨体部右侧骨髓炎.X线平片:双侧肋骨、胸腰椎、膝关节诸骨、骨盆诸骨均不同程度骨质硬化,胸、腰椎体呈"夹心椎"样改变,诊断为石骨症.     

Doppler sonographic findings in children with idiopathic portal vein cavernous deformity and variceal hemorrhage.

OBJECTIVE: To describe the flow patterns in the portal vascular territory in children with portal vein cavernous deformity. METHODS: The study included 12 children (age 4-10 years) with hematemesis, melena, or both in whom B-mode gray scale sonography revealed small anechoic spaces replacing the site of the portal vein. The portal vein cavernous deformity was present either alone (in 8 patients) or with congenital hepatic fibrosis (in 4). Doppler sonography (color and spectral) was performed to assess the flow in the portal vascular territory, splenic vein, intrasplenic veins, and abdominal collaterals. RESULTS: Doppler sonography confirmed the venous flow waveform in the cavernous portal vein in all children with normal flow direction in the few intrahepatic portal vein branches and also in the intrahepatic veins. Splenomegaly was present in all. The intrasplenic veins were dilated in all but had normal flow direction except in 2 with spontaneous trans-splenic shunts. Gallbladder varices were shown in 4 patients, and perisplenic collaterals were shown in 3. CONCLUSIONS: Doppler sonography is a valuable noninvasive imaging technique for assessment of the portal hemodynamic profile in patients with portal vein cavernous deformity, which can affect subsequent treatment decision making. Trans-splenic shunts are uncommon, but this Doppler sonographic report documents such shunts in children with portal hypertension.     

原发性扩张型心肌病的心肌异常收缩反应

目的探讨原发性扩张型心肌病(DCM)的心肌异常收缩反应。方法应用多巴酚丁胺超声心动图负荷试验(DSE)测定18例DCM患者在基础状态和多巴酚丁胺剂量为5、10、20μg·kg-1·min-1时的室壁运动改变。DSE时室壁收缩反应分为运动改善、无改善、运动恶化、双相反应四类,无改善、运动恶化和双相反应定义为心肌异常收缩反应,其中运动恶化和双相反应定义为类缺血反应。结果18例患者全部存在室壁心肌异常收缩反应(100%),13例存在类缺血反应(72.2%)。总计225个有效心肌节段中,126节段诱发出异常收缩反应(56.0%),其中97段为无改善(43.1%),29段为类缺血反应(12.9%)。运动改善发生率在2分的节段最高(62.1%),类缺血反应发生率在3分节段最高(24.6%),无改善发生率在4分节段最高(68.4%)。结论DSE可诱发出DCM心肌异常收缩反应,推测DCM存在以缺血为表现形式的心肌能量供需失衡。     

特发性乳糜尿患者直接淋巴管造影后CT表现

目的 采用直接淋巴管造影CT(PLCT)观察特发性乳糜尿患者泌尿系统及其他腹部区域淋巴管表现.方法 观察26例乳糜尿患者PLCT图像,分析泌尿系统及腹部其他区域对比剂异常分布部位及范围,进行影像学分型;并根据临床表现进行分型,以K ap p a检验评估2种分型结果的一致性.结果 26例中,25例(25/26,96.15...     

Abnormal electrocardiographic findings in apheresis donors

Electrocardiographic (ECG) monitoring was performed on 291 donors during apheresis. Twenty-one donors (7.2%) had clinical symptoms such as discomfort, nausea, chill, numbness, and paresthesia, and 13 of this group exhibited ECG abnormalities, such as tachycardia, bradycardia, and other abnormal wave patterns. The donors with tachycardia and slight bradycardia had no symptoms. Ten donors had moderate to severe bradycardia with pulse rates less than 50 beats per minute; four of them had severe bradycardia (less than 45 beats per minute), and three of the four exhibited severe hypotension, vomiting, fainting, or convulsion. Other abnormal ECG changes, such as supraventricular and ventricular premature contractions, right bundle branch block, ST segment elevation or ST segment depression, and tall, flattened, or inverted T waves were observed in 29 donors (10%). These changes were not associated with symptoms. Only three of these donors complained of discomfort or chest heaviness. The abnormal waves appeared more often in granulocytapheresis donors than in plateletapheresis donors.     

Abnormal cerebral cortical thinning pattern in adolescent girls with idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is a 3-D spinal deformity with uncertain etiology; abnormalities in brain development represent one of the possible explanatory concepts for its pathogenesis. The objective of this study is to investigate the brain maturation by thickness of cerebral cortex among female adolescents with and without idiopathic scoliosis. Fifty AIS patients with a typical right-thoracic curve pattern were compared with 40 age-matched healthy controls. Based on the T1-weighted magnetic resonance images, the thickness of cortical gray-matter was calculated using a well-validated surface measurement method. Focusing on adolescent participants within the age range with the frequent occurrences of AIS cases (i.e., 12 to 17 years), we observed that the cortical thickness declined significantly in almost all cortical lobes in normal subjects (Spearman correlation < − 0.4; P ≤ 0.05) except temporal lobe in LH, while in AIS patients this decline was weakly correlated with age (Spearman correlation > − 0.4) and largely insignificant (P ≥ 0.05). Quadratic regression results expressed the detailed difference in the age-related cortical changing pattern between the two groups. In addition, focal cortical thickness was significantly different in AIS patients compared with healthy controls in areas involved in motor and vestibular functions as well as object recognition. The findings from this study imply a different thinning pattern of the cerebral cortex during adolescence in patients with AIS; this may be primary (i.e. etiopathogenetic) or secondary (i.e. adaptation) to the development of scoliosis.     

老年人Barrett食管的X线表现

目的探讨食管钡餐双对比造影连续摄影对提高老年人巴雷特(Barrett)食管诊断的价值。方法回顾性分析10例老年人Barrett食管,经食管钡餐双对比造影用连续摄影诊断后,经内镜检查和活检病理证实,对其X线表现进行分析。结果10例中发病部位均位于食管下段,食管钡餐双对比造影连续摄影表现为:食管黏膜皱襞紊乱10例;溃疡龛影形成10例,单发5例、多发5例,龛影尖角形或椭圆形6例,点状钡斑浅龛影4例;龛影周边衬托有长而窄透亮线或晕环透亮影8例,腔内出现充盈缺损表现2例;龛影大小约0.2～1.2cm,其中4例有1cm以上龛影;食管狭窄4例;伴有食管裂孔疝5例。结论食管钡餐双对比造影连续摄影检查能提高对老年人Barrett食管的发现,认识其影像学特点有助于鉴别诊断,指导治疗,评估预后。     

家兔水中冲击伤的胸部X线表现及与病理对照

目的 探讨动物受水下冲击波作用后的胸部X线改变。方法 清醒状态的家兔61只,置于水下2 m或6 m处,使用50 g和500 g两种不同当量球形TNT炸药引爆形成冲击波后,观察动物胸部X线改变,并与组织病理对照。结果 水下冲击波作用引起动物胸部损伤的X线表现为肺挫伤(52/61)、肺撕裂伤(38/61)、肺血肿(32/61)、血气胸(31/61)、膈肌破裂(5/61)等;病理表现肺出血(56/61)、血栓形成(33/61)、肺撕裂(35/61)、肺内血肿形成(32/61)、膈破裂(5/61)。相同实验条件下,不同当量的爆炸物与冲击波致机体损伤的程度有很大差别,这些差别与动物在水中承受的爆炸冲量、能流密度大小及所处的水深有关。结论 胸部X线检查可较为客观、准确地评价水下冲击波对动物胸部损伤的性质及程度。