成人小脑中线区髓母细胞瘤的MRI表现

目的 :回顾性分析成人小脑中线区髓母细胞瘤的MRI表现,以提高术前诊断准确性。方法 :经手术病理证实的成人小脑中线区髓母细胞瘤11例,均行MRI平扫及增强扫描。结果:(1)本组11例MRI表现为小脑中线区不规则形肿块,病灶内均见坏死囊变、信号混杂。9例增强扫描呈轻中度强化,2例呈明显不均匀强化。3例病灶内可见出血信号,11例均无钙化灶形成;(2)MRI示肿瘤位于小脑蚓部5例,第四脑室6例;2例侵犯桥脑,1例伴小脑半球转移病灶。结论:成人小脑中线区髓母细胞瘤的MRI表现具有一定特征性,结合发病年龄、肿瘤部位等,可提高术前诊断准确性。     

弹性钉微创治疗成人桡骨颈骨折的临床研究

目的探讨应用钛质弹性钉(TEN)微创治疗成人桡骨颈骨折的临床疗效。方法回顾性分析解放军海军第971医院骨科2013年8月-2018年8月收治的17例成人桡骨颈骨折患者临床资料,男性9例,女性8例;年龄19~63岁,平均37.6岁。根据Mason骨折分型,Ⅱ型14例,Ⅲ型2例,Ⅳ型1例。对于MasonⅡ型骨折,手术均采用弹性钉微创固定,必要时采用克氏针经皮撬拨、推顶复位;2例MasonⅢ型骨折采用小切口切开辅助复位、克氏针联合弹性钉固定;1例MasonⅣ型骨折采用带线锚钉修复内外侧副韧带,弹性钉固定桡骨颈部骨折。术后肘关节功能根据Metaizeau标准评定。结果17例患者获得平均22.3个月的随访,无软组织感染发生。根据Metaizeau标准,14例MasonⅡ型骨折,优11例,良3例;2例MasonⅢ型骨折,中1例,差1例;1例MasonⅣ型骨折,良1例。结论弹性钉可以用于治疗成人桡骨颈骨折,对于成人桡骨颈MasonⅡ型骨折疗效显著,对于桡骨头完整的MasonⅣ型骨折也有较好的疗效,对于桡骨头碎裂严重的MasonⅢ型骨折疗效最差。     

肩锁关节脱位两种内固定方法的临床疗效比较

肩锁关节完全性脱位（TossyⅢ）型，关节稳定性遭到破坏，需要进行手术治疗．2002—2005年作者采用两种内固定方法治疗成人肩锁关节脱位64例．其中克氏针钢丝张力带治疗33例，锁骨钩钢板治疗31例，现对以上两种手术方式进行临床疗效分析与对比。     

早期成人股骨头缺血坏死的对比影像学诊断研究

目的：探讨早期成人股骨头缺血坏死（FHN）的MRI、CT、单光子发射计算机体层摄影（SPECT）和DR 4种影像学检查方法之间的对应关系及其敏感性,建立早期诊断的影像学检查途径。方法：分析和总结22例30髋随访具有典型影像学表现的早期（ARCOⅠ～Ⅱ期）成人FHN患者的髋关节影像学资料。全部病例均行同期MRI、CT、SPECT、DR检查。结果：MRI 30髋出现“线样征”,其中15髋为“单线征”,15髋为“双线征”;CT上对应部位显示为较模糊的高密度硬化线14髋,硬化线下伴行低密度带7髋;高密度硬化斑点5髋;SPECT上股骨头呈环形和弧形放射性浓聚带23髋,DR上模糊硬化条带13髋。结论：MRI上“线样征”、CT上承重区高密度硬化线和硬化线下低密度带,SPECT上股骨头环形和弧形放射性浓聚带以及DR片上模糊硬化带相互对应为诊断早期FHN的特异性征象。综合比较对早期成人FHN诊断的敏感性MRI最高。     

大面积深度烧伤创面处理与功能修复的临床分析

笔者1983年3月至1992年12月经治大面积深度烧伤42例,年龄3—60岁,10岁以下8例。成人烧伤面积50％—70％,Ⅲ度20％—40％者12例,面积80％以上,Ⅲ度45％—80％22例,儿童组烧伤面积35％—45％,Ⅲ度占15％—35％8例。治愈烧伤的最大面积为85％,Ⅲ度占80％。治疗方法是烧伤后1—10d(平     

几种肠道疾病患者肠道菌群结构特征的DNA指纹图谱分析

目的 建立肠道疾病患者肠道细菌的DNA指纹图谱,并分析其肠道菌群结构特征的整体差异.方法选取消化科37例经结肠镜确诊的肠道疾病患者,包括溃疡性结肠炎(UC)患者20例、肠易激综合征(IBS)患者6例、急性胃肠炎患者11例,另取11名健康成人作为正常对照.提取粪便标本细菌总DNA,应用肠杆菌基因间重复共有序列基因扩增技术(ERIC-PCR)建立肠道菌群的DNA指纹图谱并分析其整体差异.结果 UC患者样本DNA条带明显少于其他肠道疾病患者和正常对照,提示UC、急性胃肠炎、IBS和正常对照的肠道菌群存在整体差异.17例UC患者标本DNA主带出现在0.7kb处,11例急性胃肠炎患者样本在0.8kb和1.1kb处显示2条DNA主带,而正常对照和IBS患者样本DNA主带均无统一趋势.结论 UC可能存在较单一的肠道优势菌群,其发病机制可能与特定的肠道细菌感染有关.     

E-钙黏素及β-连环素在子宫内膜异位症中的表达

目的　观察E 钙黏素、β 连环素在子宫内膜异位症 (EM)患者在位内膜和异位内膜上皮的表达情况 ,研究其表达规律及在不同分期EM患者中的表达差异。方法　采用光镜、免疫组化SP法检测 2 4例EM患者在位和异位内膜及 2 1例健康对照在位内膜E 钙黏素、β 连环素的表达情况。结果　与正常子宫内膜相比 ,EM患者在位子宫内膜E 钙黏素、β 连环素周期性表达的规律性消失 ,且表达强度低于正常对照组 (P <0 0 5 )。EM患者异位子宫内膜E 钙黏素、β 连环素的表达高于在位子宫内膜 (P <0 0 5 )。Ⅰ、Ⅱ期患者异位子宫内膜E 钙黏素、β 连环素的表达明显低于Ⅲ、Ⅳ期 (P <0 0 5 )。结论　E 钙黏素、β 连环素在EM患者在位内膜、异位内膜上的表达异常 ,可能与内异症的发病及疾病程度有关     

骨旁骨肉瘤X线可透性的意义

骨旁骨肉瘤是一种发生于骨表面的低度恶性骨肿瘤,不同病损有不同的 X 线与组织学表现。作者为了证明骨旁骨肉瘤 X 线透亮区的组织学特征,特别是确定透亮区内是否含有间变病灶,从36例有高质量 X 线照片及与照片对应的巨检病理切片的骨旁骨肉瘤中发现18例(50%)有 X 线透亮区。女11例,男7例,年龄16—86岁;15例肿瘤累及股骨远端,3例累及股骨近端;术后随访2—15年。透亮区或在肿瘤内,或在分叶状肿瘤外的叶间裂隙;肿瘤内的透亮区可再分为深部(接近肿瘤与皮质骨分界面)与边缘(接近肿瘤边缘并远离其基底部)二     

子宫内膜异位症的发病特点、临床治疗及相关发病因素分析CSCD

目的 探讨子宫内膜异位症（endometriosis,EM）的发病特点和临床治疗进展,结合笔者临床经验研究不同年龄阶段EM的发病情况,总结EM发病的危险因素.方法 采用病例-对照研究,收集我院2012年1月至2014年6月127例EM患者（研究组）和122例非EM患者（对照组）的相关资料,针对患者月经状况和生殖活动等,填写相关调查表,并对相对危险度进行计算、分析与评价.结果 EM发病年龄多在20 ～ 50岁之间,其中31～40岁发病率最高.单因素分析显示,月经初潮年龄≤11岁、月经周期≤24 d、经期≥8 d及痛经与EM发病率增高显著相关（P＜0.05或P＜0.01）;生殖活动方面,初孕年龄≥29岁、做过人工流产手术的,EM的发病危险性增高（P＜0.05或P＜0.01）.结论 EM发病与月经初潮年龄小、月经周期短、经期长、痛经、晚孕及做过人工流产等因素有关.     

骨性Ⅲ类错he治疗后颌软硬组织变化的相关性研究

目的：探讨临床正畸、正颌联合治疗成人骨性Ⅲ类错he后，其上下颌软硬组织的相关性变化。方法：选择成人骨性Ⅲ类错he20例，通过治疗前及治疗后1周内摄取的x线头颅侧位定位片投影测量法分析，研究正畸、正颌联合治疗后上下颌软硬组织的相关性变化。结果：SNA角与上唇基角S—N’-Sn未见明显相关性；涉及下颌及颏部的SNB角与下唇基角S—N’-Si和SND角与软组织S—N’-Pg’有显著的相关性变化。结论：对正畸、正颌联合治疗的成人严重骨性Ⅲ类错he，不能仅以he、颌的分析来预测软组织侧貌的改变，而面下1／3软组织的形态变化常与硬组织变化一致，较容易预测。     

急进高原对新兵脑功能的影响

目的 初步探讨急进高原对新兵脑功能的影响.方法 在平原（海拔500 m）和高原（海拔3685 m）对30名空运入藏新兵进行神经行为核心测试组合测试;观察新兵入藏前后神经行为核心测试组合的测试分值和基础生理指标的变化,并对急性高原反应症状进行分析.结果 进入高原后的测试值与平原时比较,数字跨度、目标追踪分值明显下降（P＜0.05）;简单反应时略有增加（P＞0.05）,视觉保留和译码测试分值略有下降（P＞0.05）;提转捷度测试习惯手和非习惯手的分值明显增加（P＜0.05）.新兵进藏后,晨脉显著增快,血氧饱和度显著降低,血压无明显变化.急性高原反应的发病率为13.3%.结论 急进3685 m高原后新兵的及时听觉记忆能力、手部运动的速度及准确性明显下降.     

Scaphoid and pronator fat stripes are unreliable soft tissue signs in the detection of radiographically occult fractures

AIM: To determine the clinical value of scaphoid and pronator fat stripes in identifying occult underlying scaphoid and distal radius fractures, respectively. MATERIALS AND METHODS: In our department, all patients with clinically suspected scaphoid fractures and normal scaphoid series of radiographs undergo magnetic resonance imaging (MRI) of the wrist. We selected 50 cases with unequivocal MRI evidence of scaphoid fracture, 50 cases with distal radius fracture and 50 cases with no MRI evidence of bony injury. All 150 initial plain radiographs were examined retrospectively in random order without knowledge of the MRI findings and the scaphoid and pronator fat stripes scrutinized. RESULTS: The scaphoid fat stripe was abnormal in only 25 cases (50%) with confirmed scaphoid fracture on MRI. The pronator fat stripe was abnormal in 13 cases (26%) with confirmed distal radius fracture. In the 50 cases with no MRI evidence of bony injury, the scaphoid fat stripe and pronator fat stripe were abnormal in 25 (50%) and 15 (30%) cases, respectively. The sensitivity and specificity for an abnormal scaphoid fat stripe was 50%. The sensitivity and specificity for an abnormal pronator fat stripe was 26 and 70%, respectively. CONCLUSION: Scaphoid and pronator fat stripes are poor predictors of the presence or absence of underlying occult fractures.     

Posterior distal femoral and proximal tibial metaphyseal stripes at MR imaging in children and young adults

PURPOSE: To determine the frequency and distribution of the hyperintense stripe seen along the posterior surface of distal femoral and proximal tibial metaphyses at magnetic resonance (MR) imaging. MATERIALS AND METHODS: One hundred forty-two MR imaging studies obtained in 139 children and young adults were reviewed. The authors recorded the presence and distribution of posterior distal femoral and proximal tibial metaphyseal stripes. Presence of stripe was correlated with patient age and sex and with patency of the adjacent physis. Fifty-nine studies of adults were reviewed similarly. Two-way analysis of variance was performed to compare mean patient age for sex among four different categories that were based on stripe presence and physeal patency. Orthogonal contrasts were used to determine whether a linear trend across the categories existed. In one cadaveric femur, imaging and histologic analysis were performed. RESULTS: A metaphyseal stripe was seen in all patients with a completely or partially open physis (110 femora, 102 tibiae) and in 56 femora and 60 tibiae in the patients with fused physes. Thirty-five femora and 35 tibiae showed no stripe; all patients were skeletally mature. Correlations between metaphyseal stripe visualization and physeal patency were significant (P <.001). Differences in mean patient age among the four categories were significant for both (femoral and tibial) locations (P <.001), and a linear trend with age (P <.001) was demonstrated. This linear trend was also observed in both sexes (P <.001). Histologic analysis revealed highly vascular loose fibrous tissue. CONCLUSION: A posterior metaphyseal stripe is seen at MR imaging of the skeletally immature knee and likely reflects normal bone growth.     

Shoulder MRI: the subacromial/subdeltoid bursa fat stripe in healthy and pathologic conditions.

The MRI appearance of the subacromial/subdeltoid (SA-SD) bursa is described here in both healthy and pathological conditions. Based on one case of rotator cuff tear and intrabursal fluid outlined by two adjacent fat stripes we reviewed 20 shoulder MR examinations to define the normal and abnormal appearance of the peribursal fat. We found four pathological patterns: lateral displacement, tear-drop configuration, obliteration and double fat stripe.     

西藏腹泻患者粪便中轮状病毒基因变化规律及变异株分布的研究

用PAGE技术对西藏腹泻HRV作了基因变化规律和变异株的分析。在西藏藏族人群中,轮状病毒2个电泳型(4232,4222);2个亚组,L型(62.5％)S型(37.5％);5种(S_1、S_2和L_2—L_4)变异株同时感染,L_3型占优势,其余依次为S_2>S_1>L_2>L_4。春、冬季为流行高峰,1—5岁易感;服务业(个体)占23.23％检出率最高,职员(含干部)和学生较低(12.32％)。城市占24.47％,乡村占26.34％,农区占25.1％,牧区占24.09％,P>0.05,变异株检出差异显著,部队检出率(15％)低于当地同龄人群。基因变异与患者年龄关系密切,年龄越小变异越快,年龄越大漂移越明显。     

MR imaging of muscular sarcoidosis after steroid therapy

The nodular type of muscular sarcoidosis has been known to show characteristic MR findings; however, MR imaging features after steroid therapy have not been reported. A 48-year-old man with nodular type of muscular sarcoidosis is reported. Prior to steroid therapy, axial MR images showed peripheral increased signal intensity and central star-shaped decreased signal intensity. Coronal images showed an inner stripe of decreased signal intensity and outer stripes of increased signal intensity. After steroid therapy, axial images showed only the central star-shaped area of decreased signal intensity. Coronal images showed only the inner stripe of decreased signal intensity. It is important to know that the central area will continue to exist after steroid therapy. Received 12 August 1997; Revision received: 24 December 1997; Accepted 21 January 1998     

The team effect on doping in professional male road cycling (2005‐2016)

This article questions organizations’ (clubs, teams, etc) responsibility in doping use from the case of anti‐doping rules violations (ADRVs) sanctioned by the Union Cycliste Internationale in professional cycling. We built a database with 271 caught riders among 10 551 professional riders employed from 2005 to 2016 in the three first world divisions. We developed a time‐discrete event history model with a multilevel perspective to consider if the ADRV is related to the characteristic of a rider's career path (level 1) and/or the team by which the rider is employed (level 2). Our results confirm two hypotheses: Beginning a career before 2005 or after the age of 22 increased the risk of being caught. Each additional year in the pack increased the risk, despite the fact that a sanctioned rider's career duration average is 7.8 years (3.9 for the others). These caught riders have experienced a more tumultuous career with team changes and an interrupted path. A 2.45 Median Odds Ratio led us to assert a team effect on ADRV. By a team residual effect calculation, we identify 17 teams with a significant effect within the 129 that experienced an ADRV. Our results allow us to emphasize that to understand doping we must take into account work and employment condition, as well as team's organization. This approach completes the dominant “methodological individualism” perspective that considers athletes as analytical units and provides guidelines to the anti‐doping bodies that focus their action on individuals.     

Muscular sarcoidosis

There are four types of muscular sarcoidosis: nodular, chronic myopathy, acute myositis, and asymptomatic. The nodular type is important because it may be confused with a soft tissue tumor. Magnetic resonance (MR) imaging provides specific findings. A star-shaped central structure of decreased signal intensity, a "dark star" sign, is seen on the axial images. A long nodule with an inner stripe of decreased signal intensity and outer stripes of increased signal intensity, a "three stripes" sign, is seen on the coronal and sagittal images. In the chronic myopathy type, the role of MR imaging is limited. Gallium scintigraphy, which reflects activity of inflammation, may show increased uptake. In the acute myositis type, MR imaging shows increased signal intensity, and gallium scintigraphy shows increased uptake; however, these findings are nonspecific.     

拉萨市天然石材放射性水平调查

目的 对拉萨市天然石材进行放射性水平调查研究,了解其放射性核素比活度范围及使用限制。方法 对拉萨市各天然石材矿区进行辐射监测和调查取样,对采集的样品进行放射性核素含量分析,根据分析结果计算内、外照射指数,并根据建筑材料放射性核素限量标准进行分类。结果 拉萨市天然石材样品中⁴⁰K、²²⁶Ra、²³²Th和²³⁸U比活度均值分别为912、59.0、77.1和64.4 Bq/kg,样品内、外照射指数均<1。结论 本次调查的拉萨市产天然石材放射性核素含量水平总体低于全国平均水平,可作为建筑主体材料及A类装饰装修材料。     

西藏藏族DYS287位点多态性研究

 目的 以西藏拉萨、那曲地区藏族男性个体为研究对象,研究两地区男性Y染色体DYS287位点多态性.方法 利用PCR结合琼脂糖凝胶电泳检测方法对105例藏族男性样本(其中拉萨41例,那曲64例)DYS287位点多态性进行分析.结果 两地区人群均发现Alu插入阳性个体(即YAP阳性个体),拉萨、那曲YAP阳性率分别为41.5%和62.5%.结论 DYS287位点是一个重要、稳定的遗传标记,YAP阳性率在不同地区的同一民族中存在差异,这可能是人群间基因交流的结果.