腰椎间盘突出的CT诊断价值

腰椎间盘突出是骨科常见病.CT扫描能够显示间盘组织的直接影像,是诊断间盘病变的重要方法.本文对80例腰间盘突出进行分析,探讨CT对腰间盘突出的诊断价值. 1 材料和方法 1.1 一般资料选用临床及CT表现均典型病例80例,男43例,女37例,年龄17岁～74岁,病程最短2 d,最长22 a.     

CT对腰间盘突出的分度及其临床意义

目的：了解CT对腰间盘突出的分度以及对间盘突出做出量化诊断，同时通过分度指导临床治疗，方法：本文收集200例经CT确诊腰间盘突出的病例，进行回顾性分析。200例共突出242个间盘，中央型135个，右后型58个，左后型49例，结果：Ⅰ°突出80个占33.1%，Ⅱ°突出126个占52.1%。Ⅲ°突出36个占14.8%。Ⅱ°突出中以腰4-5发病率最多占大体上（31.4%)。Ⅰ°突出适合保守治疗，Ⅱ°突出适合于经皮穿刺腰间盘切除术，而Ⅲ°突出适合于外科手术治疗，结论：CT对各型腰间突出诊断提出分度标准，提高了CT定量诊断，并且指导临床治疗。     

CT对腰骶间盘突出的诊断探讨

自1975年Altidi等首次报告应用CT观察椎管和椎旁组织以来,国外有关CT对腰间盘突出的诊断报道愈来愈多,CT已成为诊断腰间盘突出的主要手段、本文就我院经CT诊断的腰骶间盘脱出70例,作一分析。     

腰间盘突出症的症状体征在诊断中的价值

随着“B”型超声、“CT”扫描，核磁共振以及省饶、位核造影的不断开展，使腰间盘突出症的诊断享有了明显的提高。但是，我们对近三年来经过手术证实的163名患者进行总结和分析，认为腰间盘突出症的症状体征对诊断是十分重要的。而且对定位也是有绝对重要的价值。临床资料1．一般情况：本组病人中男性137例，占85．3％，女性26例，占14．7％，男女之比为5．7：1；最大年龄60岁，最小年龄19岁，平均年龄30．3岁，ZO～45岁占本组病例别／；本组中发生在L。。间盘突出gi例占55．8％，发生在L；SI间盘突出71例441／．发生在L；，；间盘突出…     

青少年腰间盘突出症的病因及诊断

目的 探讨青少年腰间盘突出症的病因、临床特点及CT影像诊断.方法 总结我院2000年-2007年间21岁以下的青少年腰间盘突出症的患者35例,并随诊观察,分析病因、临床特点及CT诊断间的关系.结果 35例患者中,平均年龄17.5岁,中央型25例,后外侧型3例,椎间孔型5例,椎旁型2例.结论 CT检查可明确青少年腰间盘突出症的诊断及程度,为下一步治疗提供重要依据.     

腰间盘突出CT与MR诊断的对比分析

38例114个腰间盘突出的CT和MR比较结果表明：①CT对膨隆型间盘的检出率明显高于MR（P＜0．05），对突出型间盘、脱垂游离型间盘的检出率两者无显著差异。CT对膨隆和突出的鉴别优于MR。②CT对钙化及积气敏感性强。MR能多方位成像，对脱垂游离型较CT提供更加确切的信息，同时还可以早期反映间盘变性程度。     

封闭加蒙药治疗腰腿痛疗效观察

1 资料和方法 1．1临床资料自2001年10月～2005年11月，在我院门诊以CT诊断为腰间盘突出或腰间盘膨出引起腰腿痛患者100例，男68例，女32例，年龄20岁～60岁。其中腰间盘突出患者89例，腰间盘膨出患者11例。     

利用多层螺旋CT的MPR替代传统腰间盘扫描方式的方法及意义

临床以腰腿痛为主要症状的患者发病率较高，其病因复杂，创伤、炎症、肿瘤和先天性疾患等四大基本病因均可囊括在内。其中以腰间盘突出症最具代表性，临床医生通常首选CT检查作为腰间盘突出症与其它引起腰腿痛病因的鉴别诊断依据。作者应用多层螺旋CT多平面重建（MPR）技术代替传统间盘扫描方式，旨在更加直观显示腰间盘的同时，提高对腰腿痛其它病因的诊断水平。     

X线摄影诊断腰椎间盘突出症30例

目的探讨腰椎间盘突出症腰椎X线片的影像学特点及临床意义。方法本院经手术确诊为腰椎间盘突出症患者30例,对其X线资料进行回顾性分析,总结腰间盘突出症的X线特点。结果本组30例患者中,24例表现为椎间隙前窄后宽或宽窄一致,占80%,21例表现为突出间盘相邻椎体缘的硬化和唇样增生,占70%,20例表现为腰椎曲度变化,占66.67%,18例表现为椎体后缘后翘,占60%,18例表现为许莫氏结节,占60%。CT检查对腰间盘突出症诊断的确诊率高于X线检查,差异有统计学意义(P0.001)。结论 CT检查优于X线检查,对手术方式的选择有重要意义。在基层医院,X线片检查仍然对诊断腰间盘突出症有重要的价值和意义。     

CT诊断腰间盘脱出及其分期的探讨

通过对200例腰间盘脱出（以下简称间脱）CT图像回顾性分析及手术对照，提出CT诊断间脱的影像依据。并结合间盘的正常解剖及其CT表现讨论了间脱的影像学分期，对其诊断标准进行了探讨。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.