螺旋CT靶扫描及三维重建技术结合Fisher判别分析对孤立性肺结节的诊断价值

目的 探讨螺旋CT靶扫描及三维重建技术结合Fisher判别分析在孤立性肺结节（SPN）中的诊断价值。方法回顾性分析鄱阳县人民医院2021年1—12月收治的60例SPN患者临床资料,所有患者均行CT扫描,包括常规胸部扫描、螺旋CT靶扫描。将获得的图像上传至后台工作站进行三维重建处理,之后依据扫描类型分为传统轴位（常规扫描）、三维重建（靶扫描+三维重建图像）2组,分析2组间CT征象检出情况。以手术病理结果为金标准,比较良恶性组CT征象差异。结果 三维重建组分叶征等征象检出率高于传统轴位组,有明显差异（P<0.05）。手术病理结果显示,60例SPN患者中16例为良性结节、44例为恶性结节,良性结节占比依次为炎性假瘤（37.50%）、错构瘤（25.00%）、结核球（18.75%）、霉菌球（12.50%）及腺瘤（6.25%）;恶性结节中占比依次为微浸润性腺癌（38.64%）、原位癌（29.55%）、腺癌（15.91%）、腺鳞癌（6.82%）、类癌（4.55%）、小细胞癌（2.27%）、大细胞癌（2.27%）。恶性结节组分叶征等征象检出率高于良性结节组,有统计学差异（P<0.05）。F...     

肺内孤立性结节的CT诊断及鉴别诊断

目的探讨肺内孤立性结节CT诊断及鉴别诊断。方法回顾性分析2008年1月～2010年12月经手术和病理证实的40例肺内孤立性结节患者的CT检查资料。结果肺孤立性结节的CT特征表现分别为分叶、毛刺征、胸膜牵拉征、空泡及支气管充气征、血管集束征、钙化及空洞等;肺癌分叶、毛刺征、胸膜牵拉征、空泡及支气管充气征发生率高于其他疾病（P〈0．05）,6例合并不规则厚壁空洞;结核球环形钙化、薄壁空洞发生率高（P〈0．05）;炎性假瘤病灶空泡及支气管充气征、邻近胸膜反应比例高（P〈0．05）;肺错构瘤表现为爆玉米花样钙化。结论CT能够较好显示肺孤立性结节特点,是区分良恶性孤立性肺结节的有效方法。     

PET/CT双时相显像对孤立性肺结节良恶性鉴别价值

目的探讨18F-FDG PET/CT双时相显像鉴别孤立性肺结节(SPN)良恶性的价值。方法对65例SPN病人分别在注药后1 h和2～3 h进行PET/CT双时相显像;对SPN的早期显像标准摄取值(SUV)、延迟显像SUV、滞留指数进行分析。结果经病理证实恶性36例、良性29例,其中良性结节包括炎性假瘤13例,结核球12例,硬化性血管瘤2例,肺腺瘤1例,隐球菌感染1例;恶性结节中包括10例磨玻璃结节。良性组、恶性组的早期显像SUV、延迟显像SUV、滞留指数差异均无统计学意义。结论 18F-FDG PET/CT双时相显像对SPN良恶性的鉴别诊断价值有限,尚需进一步研究。     

多排CT对肺内孤立结节诊断与鉴别诊断

目的 探讨多排CT对肺内孤立结节征象的王示,以期连一步提高对砷内孤立结节诊断与鉴别诊断.方法 回顾性分析90例经手术病理或临床证实肺内孤立结节的CT表现.结果 本组90例中,良性结节23例,其中,结核球13例,错构瘤5例,炎性假瘤5例;恶性结节67例,其中肺癌63例(腺癌48例,鳞癌10例,鳞腺癌2例,大细胞癌3倒爷,小细胞癌6例),淋巴瘤4例.典型结节具有深分叶征,毛刺征,空泡征.支气管充气征,胸膜凹陷征,血管集束征对恶性的诊断具有较高价值.而良性结节大多边缘光滑,呈类圈形,较多出现同心园状,爆米花或包膜下钙化.结论 肺内孤立典型结节具有明显的CT特征,结合临床表现经过综合分析,绝大多数病例可傲出正确诊断. 0例经手术病理或临床证实肺内孤立结节的CT表现.结果 本组90例中,良性结节23例,其中,结核球13例,错构瘤5例,炎性假瘤5例;恶性结节67例,其中肺癌63例(腺癌48例,鳞癌10例,鳞腺癌2例,大细胞癌3倒爷,小细胞癌6例),淋巴瘤4例.典型结节具有深分叶征,毛刺征,空泡征.支气管充气征,胸膜凹陷征,血管集束征对恶性的诊断具有较高价值.而良性结节大多边缘光滑,呈类圈形,较多出现同心园状,爆米花或包膜 钙化.结论 肺内孤立典型结节具有明显的CT特征,结合临床表现经过综合分析,绝大多     

CT在肺内孤立结节诊断中的临床应用

目的探讨胸部孤立结节（SPN）的CT诊断和鉴别诊断。方法回顾性分析我院近10年来80例经临床病理抗炎治疗证实的SPN患者的CT资料及临床表现,60例在平扫的基础上行增强扫描。结果恶性结节49例（包括中央型肺癌,周围型肺癌,转移瘤,小细胞未分化癌）,良性结节31例（包括结核球,叶间积液,炎性假瘤,错构瘤）。结论肺内孤立结节CT表现大多都各具特征,密切结合临床表现、相关体征和相关实验室检查,窗宽窗位的适当选择,有助于诊断和鉴别诊断。     

孤立性肺结节与支气管关系的多层螺旋CT及病理对照研究

目的    研究孤立性肺结节(SPN)与支气管的关系,探讨其对SPN定性诊断的价值。方法    回顾性分析有明确诊断结果的SPN 66例,良性29例,恶性37例,所有病例均经多层螺旋CT（MSCT）扫描,工作站多平面重组(MPR),显示SPN和支气管的关系,并与病理结果相对照。结果    良、恶性SPN中与支气管有关系的分别为18例（62.1%）、33例（89.2%）,良性组与恶性组比较,差异有统计学意义（P＜0.01）。SPN与支气管关系分为5型,Ⅱ型、Ⅲ型、Ⅴ型以恶性SPN多见,Ⅱ型、Ⅲ型多见于腺癌,Ⅱ型、Ⅴ型良、恶性的差异有统计学意义（P＜0.01）。结论    MSCT轴位扫描结合MPR重组,可以充分显示SPN与支气管的关系及类型,不同类型可以反映一定的病理分型,SPN与支气管关系在SPN定性诊断中有参考价值。     

孤立性肺结节影像学特征的logistic回归分析

目的采用logistic回归分析对良、恶性孤立性肺结节（SPN）的临床及影像征象进行恶性风险因素分析,以提高早期肺癌的检出率。方法回顾分析43例SPN病人的临床及影像资料,先进行单因素分析,筛选出良、恶性组差异有统计学意义的因素,代入二元logistic回归分析进行多因素分析,得出良、恶性SPN的独立影响因素。结果43例病人共43个SPN,良性组18例（41.9%）,恶性组25例（58.1%）。孤立性肺结节良恶性的单因素分析显示,病人为女性、CT影像中结节有分叶、毛刺征、血管集束征、支气管征、胸膜凹陷征和无平直边的结节恶性率较高（P < 0.05~P < 0.01）;多因素logistic回归分析结果显示,毛刺征为恶性SPN的独立危险性因素（P < 0.05）,有平直边为良性SPN的独立保护性因素（P < 0.05）。结论良、恶性SPN的各影像征象存在重叠,毛刺征为恶性SPN的独立危险因素,而有平直边为良性结节的独立保护性因素。     

肺孤立性结节的CT诊断

目的分析肺孤立性结节（SPN）的CT表现,提高肺孤立性结节良恶性的鉴别诊断。方法回顾分析经临床手术病理证实的40例肺孤立性结节的CT表现,部分病例行HRCT、CT增强、平面重建（MPR、表面遮盖重建（SSD）、最大密度投影（MIP）及AVA软件血管分析。结果周围型肺癌15例,结核球11例,错构瘤5例,炎性假瘤6例,单发转移癌2例,肺内淋巴结1例。结论CT薄层及高分辨率扫描对SPN有很高的诊断价值,对定性诊断有较大的帮助,SPN鉴别诊断是一项理想的检查方法,对多数结节可以做出正确的诊断,对病理组织学估计有一定的限度。     

CT增强扫描对孤立性肺结节的鉴别诊断价值

目的：探讨良、恶性孤立性肺结节（SPN）增强后的CT值变化特征,为SPN的影像定性诊断提供依据。方法：采用SPN图像处理专用软件,对29例恶性结节患者和25例良性结节患者的增强前后CT扫描图像进行了分析比较。结果：良、恶性结节组的强化与非强化比较结果显示差异有显著性（P〈0．0001）;良、恶性组的不规则强化比较结果显示有显著性差异（P=0．0086）;恶性结节组的强化幅度平均为（47．3±24．1）HU,明显高于良性结节组的（16．6±15．5）HU;恶性结节组的最大强化CT值平均为（136．2±40．3）HU,明显高于良性结节组的（60±61）HU（P=0．007）;恶性结节组的强化面积与良性结节组的强化面积,两组相比差异无显著性。结论：增强扫描后的强化幅度和最大强化值,以及不规则强化影像。可作为SPN诊断的参考依据。     

孤立性肺结节的CT诊断及病理分析

目的:探讨孤立性肺结节的CT征象及对良、恶性病变的诊断价值,提高诊断水平。方法:回顾性分析我院2004年6月-2012年10月经手术病理、穿刺活检及随访证实的肺部孤立性结节48例,分析其CT表现及强化特点。结果:48例病灶中恶性32例,其中腺癌22例,鳞癌7例,小细胞未分化癌3例,良性病变16例,其中结核球12例,炎性假瘤1例,错构瘤2例,血管瘤1例。CT增强扫描中,强化程度<20HU提示良性,20~60HU提示恶性,>60HU提示炎性结节可能性大。结论:CT扫描对SPN的检出及定性诊断有一定优势,对于良恶性结节的鉴别诊断具有重要的参考价值。     

肱骨远端全骺分离

肱骨远端全骺分离在5岁以下儿童中是较常见的肘部损伤,且极易误诊为肱骨髁上骨折或肘关节脱位。本组25例肱骨远端全骺分离均为向内侧移位,年龄11个月至14岁,平均5.6岁,属Salter-HarrisⅠ型或Ⅱ型。对本症骨骺损伤的解剖学和组织学,诸骨(和骨化中心)之间的对应关系以及骨骺损伤的诊治进行了简短的讨论。     

食指背侧皮瓣的临床应用

通过对右手虎口挛缩以及左拇指皮肤剥脱损伤各一例应用直指背侧皮瓣修复的成功经验,提出该手术的适应症和优点,并重点介绍其应用解剖学和手术方法。     

Investigation of hypoglycemic,hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark in diabetic rats

Objective

To investigate the hypoglycemic, hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark (AETPB) in streptozotocin (STZ)-induced diabetic rats.

Methods

Acute toxicity was studied in rats after the oral administration of AETPB to determine the dose to assess hypoglycemic activity. In rats, diabetes was induced by injection of STZ (60 mg/kg, i.p.) and diabetes was confirmed 72 h after induction, and then allowed for 14 days to stabilize blood glucose level. In diabetic rats, AETPB was orally given for 28 days and its effect on blood glucose and body weight was determined on a weekly basis. At the end of the experimental day, fasting blood sample was collected to estimate the haemoglobin (Hb), glycosylated haemoglobin (HbA1c), serum creatinine, urea, serum glutamate-pyruvate transaminase (SGPT), serum glutamate-oxaloacetate transaminase (SGOT) and insulin levels. The liver and kidney were collected to determine antioxidants levels in diabetic rats.

Results

Oral administration of AETPB did not exhibit toxicity and death at a dose of 2 000 mg/kg. AETPB treated diabetic rats significantly (P<0.001, P<0.01 and P<0.05) reduced elevated blood glucose, HbA1c, creatinine, urea, SGPT and SGOT levels when compared with diabetic control rats. The body weight, Hb, insulin and total protein levels were significantly (P<0.001, P<0.01 and P<0.05) increased in diabetic rats treated with AETPB compared to diabetic control rats. In diabetic rats, AETPB treatment significantly reversed abnormal status of antioxidants and lipid profile levels towards near normal levels compared to diabetic control rats.

Conclusions

Present study results confirm that AETPB possesses significant hypoglycemic, hypolipidemic and antioxidant activities in diabetic condition.     

Association of smoking,alcohol and NSAIDs use with expression of cag A and cag T genes of Helicobacter pylori in salivary samples of asymptomatic subjects

Objective

To determine the association of smoking, alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) use with presence and virulence of Helicobacter pylori (H. pylori) infection in a representative sample of a random adult population of asymptomatic subjects.

Methods

Non virulent 16S rRNA and virulent cag A and T genes from salivary samples of 854 asymptomatic subjects were determined using polymerase chain reaction. The presence and absence of virulent and non virulent infection was statistically compared with consumption of smoking, alcohol and NSAIDs.

Results

The prevalence of infection in male and female subjects was found to be 69.25% and 66.90%, respectively. The prevalence of infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (31.22%), former (52.20%) and never (43.58%). The prevalence of infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (88.80%), former (57.14%) and never (33.33%). The prevalence of infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 82.75% and 21.16%, respectively. Virulence in male and female subjects was found to be 60.00% and 50.00%, respectively. The presence of virulent infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (28.57%), former (40.15%) and never (50.00%). The prevalence of virulent infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (79.32%), former (75.00%) and never (50.00%). The prevalence of virulent infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 88.23% and 66.66%, respectively.

Conclusions

It can be concluded that smoking and NSAIDs consumption are aggravating factors for virulence of H. pylori and alcohol can inhibit H. pylori infection in asymptomatic subjects.     

大肠多发原发性癌:危险因素、诊治和预防(附8例报告)

综述分析1954～84年国内外文献,探讨了大肠多发原发性癌的诊断标准、发病情况、临床表现、发病危险因素、外科处理以及预防和诊断检测技术等问题,强调了大肠腺瘤,遗传基础、免疫缺陷、慢性溃疡性结肠炎等在发病上的作用,及高危险组患者应按方案进行常规检测监护之重要性。述介了大肠多发原发性癌系一种原发性大肠癌多中心发生的形式,在诊治上前者与后者有一致性,亦各有其独特性。报告宁夏医学院附属医院肿瘤科1977～84年收治的8例住院大肠多发原发性癌病例的临床资料,对诊治经过进行了初步总结。     

具有抗细菌黏附和杀菌双重功能的(HA/CHI-Van)5涂层的制备

目的：研究开发一种涂覆(HA/CHI-Van)5多层膜结构的骨科内植入物以用于预防骨内植入物感染。方法：将透明质酸（HA）和壳聚糖-万古霉素（CHI-Van）溶液进行层层自组装,制备得到(HA/CHI-Van)5多层膜结构;通过zeta电位检测组装过程,通过活细菌染色实验评价多层膜的抗细菌黏附效果,通过越狱实验和FE-SEM实验检测体外抗菌效果。SD大鼠随机分为空白组、(HA/CHI-Van)5组和假手术组,并以X线、Micro-CT、骨组织切片等方法检测该材料的体内动物实验效果。结果：每次组装不同的单层,zeta电位交替变化,证明多层膜组装成功。活细菌染色实验显示多层膜结构中的CHI具有一定的抗细菌黏附作用。越狱实验和FE-SEM实验证明(HA/CHI-Van)5多层膜结构在体外具有良好的抗菌作用。在体外实验中,(HA/CHI-Van)5组的X线评分为0.7,而空白组的评分为12.3,(HA/CHI-Van)5组在骨密度、骨小梁数量、骨体积分数、骨组织切片方面均优于空白组（均P＜0.05）,且非常接近假手术组（均P＞0.05）。结论：通过在骨科内植入物表面涂覆(HA/CHI-Van)5多层膜结构能够获得一定的抗细菌黏附功能和良好的抗菌作用,可以预防骨内植入物感染。     

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective

To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia.

Methods

In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni (S. mansoni) ova. Children who were found positive for S. mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration. Four weeks post-treatment, stool specimens were collected from the same children and examined following the same procedure as in the pre-treatment. Drug efficacy was determined based on cure and egg reduction rates.

Results

Pre-treatment prevalence of S. mansoni infection was 74.9% with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6% (P<0.000 1, OR: 8.33, CI: 5.3–13.1) and egg reduction rate of 68.2% (P=0.03, F=0.64). The cure rate showed significant association with age (χ²=11, P=0.004), the highest rate being observed in the 15–22 age group. 83% of S. mansoni infected children showed various treatment-related symptoms, the most frequent being headache, nausea, and abdominal pain. These symptoms were associated with age (P<0.001) and pre-treatment intensity of infection (P<0.05).

Conclusions

The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia. Hence, in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated, treatment failure, or reduced susceptibility of the parasite. Treatment-related side effects observed were transient and tolerable.     

NGR修饰唑来膦酸长循环脂质体制备及其表征研究

目的:制备具有肿瘤血管靶向的NGR修饰唑来膦酸长循环脂质体,并对其进行表征研究。方法：采用薄膜分散法制备NGR修饰唑来膦酸长循环脂质体,,并对其进行表征研究,并测定包封率。结果：制备得到的NGR-PEG-ZOL-LPs平均粒径为(271.43±9.23)nm,Zeta电位为-(36.20±0.20)mv,多分散系数(PDI)为(0.15±0.03),理化性质相对稳定;NGR-PEG-ZOL-LPs包封率为8.41%;电镜下显示NGR-PEG-ZOL-LPs呈类圆形,大小分布均匀,无明显聚集。结论：采用薄膜分散法制备的NGR修饰唑来膦酸长循环脂质体具有较高的稳定性,从而为体内药效学研究奠定基础。     

Control of Tetranychus urticae Koch by extracts of three essential oils of chamomile,marjoram and Eucalyptus

Objective

To evaluate the acaricidal activity of extracts of three essential oils of chamomile, marjoram and Eucalyptus against Tetranychus urticae (T. urticae) Koch.

Methods

Extracts of three essential oils of chamomile, marjoram and Eucalyptus with different concentrations (0.5%, 1.0%, 2.0%, 3.0% and 4.0%) were used to control T. urticae Koch.

Results

The results showed that chamomile (Chamomilla recutita) represented the most potent efficient acaricidal agent against Tetranychus followed by marjoram (Marjorana hortensis) and Eucalyptus. The LC₅₀ values of chamomile, marjoram and Eucalyptus for adults were 0.65, 1.84 and 2.18, respectively and for eggs 1.17, 6.26 and 7.33, respectively. Activities of enzymes including glutathione-S-transferase, esterase (α-esterase and β-esterase) and alkaline phosphatase in susceptible mites were determined and activities of enzymes involved in the resistance of acaricides were proved. Protease enzyme was significantly decreased at LC₅₀ of both chamomile and marjoram compared with positive control. Gas chromatography-mass spectrometer (GC-MS) proved that the major compositions of Chamomilla recutita are α-bisabolol oxide A (35.251%), and trans-β-farersene (7.758%), while the main components of Marjorana hortensis are terpinene-4-ol (23.860%), p-cymene (23.404%) and sabinene (10.904%).

Conclusions

It can be concluded that extracts of three essential oils of chamomile, marjoram and Eucalyptus possess acaricidal activity against T. urticae.