颈部淋巴管瘤的CT诊断

目的探讨CT对颈部淋巴管瘤的诊断价值。方法11例颈部淋巴管瘤患儿均行CT检查。结果11例患儿,肿块仅限于颈部9例,累及颌下间隙和(或)纵隔2例。CT平扫表现为颈部多房或单房性、薄壁水样密度肿块。结论CT可清晰显示淋巴管瘤的大小、形态和延伸范围,从而指导手术治疗。     

颈部淋巴管瘤的CT诊断价值

目的探讨颈部淋巴管瘤的CT表现和诊断价值.方法回顾性分析11例经病理学证实的颈部淋巴管瘤的CT资料,CT平扫11例,同时增强扫描5例.结果11例中,囊性淋巴管瘤7例,海绵状淋巴管瘤4例.颈部淋巴管瘤的CT特点:①单囊性肿块3例,多囊性肿块4例;②肿块与周围组织分界不清;③沿疏松结缔组织浸润性生长;④合并出血或感染,瘤内显示斑片状高密度影;⑤增强扫描囊壁及分隔部分强化显影.结论CT检查对颈部淋巴管瘤具有重要价值.     

淋巴管瘤的CT诊断与评价

目的:探讨淋巴管瘤的CT影像表现和CT诊断的价值。方法:回顾分析经手术及病理证实的4 4例淋巴管瘤的CT表现。结果:发生在颈部18例,肠系膜11例,腹膜后7例,后胸壁5例,纵隔2例,左侧腋窝并同时累及颈和纵隔1例。表现为囊性、边界清楚或不清的肿块影。增强CT扫描肿块囊内不强化,囊壁或囊肿内分隔有轻度强化。结论:淋巴管瘤的CT影像具有特征性,CT可以很好地显示肿瘤的密度、大小、形状和范围,是诊断淋巴管瘤的重要方法。     

小儿颈部淋巴管瘤的高频超声与CT诊断

目的探讨小儿颈部淋巴管瘤的高频超声与CT特征。方法搜集36例经手术病理证实的颈部淋巴管瘤,均行超声和CT检查,回顾性分析其超声和CT特点。结果颈部淋巴管瘤主要超声和CT特征为从颈部至颌下和(或)纵隔间蔓延的单囊或多囊性肿块,沿周围疏松组织间隙呈浸润性生长,有占位效应。本组36例,肿块仅限于颈部26例,累计颌下间隙和(或)纵隔10例;单侧发病35例,双侧1例。结论高频超声和CT检查可清晰显示病变的大小、形态和延伸范围,多数能定性诊断,对颈部囊性病变具有重要的诊断和鉴别诊断价值。     

儿童颈部淋巴管瘤的CT诊断价值

目的 回顾性分析儿童颈部淋巴管瘤的CT表现和CT诊断价值.方法 9例淋巴管瘤中6例为囊性淋巴管瘤,3例为海绵状淋巴管瘤.螺旋CT平扫9例,平扫同时增强扫描3例.结果 淋巴管瘤在CT表现为颈部边界清晰的囊性肿物,位于颈动脉间隙或颈外侧间隙,有明显占位效应,沿邻近疏松组织间隙蔓延生长.囊性淋巴管瘤表现为水样密度,密度均匀,有分隔,囊性区无强化,囊壁及分隔轻度强化.海绵状淋巴管瘤密度不均,可见低密度背景下等密度或略高密度的点片状和条状.结构,CT增强扫描特征为低密度区无强化,囊壁及分隔呈点状、条状、网格状强化.结论 CT检查可清晰显示淋巴管瘤的位置、形态、大小和蔓延范围,依据其部位、内部结构和CT特点可作出准确的定性诊断.     

颈部囊性淋巴管瘤的CT诊断

目的探讨颈部囊性淋巴管瘤的CT诊断价值、方法结合文献，回顾性分析7例经手术病理证实的颈部囊性淋巴管瘤的CT征象。结果颈部囊性淋巴管瘤可单房或多房，以后者多见，多为单侧分布，以颈后三角多见．少数双侧弥漫性分布，范围广泛．CT特征为边界清楚、薄壁，有较大囊腔的囊状肿块。囊内呈水样密度或负值(乳糜液)、多房者纤细有分隔，增强扫描囊内无强化，囊壁和分隔无或轻度强化，体积较大者包绕或推压血管、气管等正常结构。尤以弥漫性分布者为重，合并感染者囊内密度增高，可有积气，囊壁及分隔增厚．边界模糊，其用围组织分界不清、结论颈部囊性淋巴管瘤的CT征象具有特征性，CT扫描是重要的检查诊断手段。     

小儿淋巴管瘤的高频超声诊断及病理分析

目的 探讨小儿淋巴管瘤的高频声像图特点,以提高小儿淋巴管瘤的诊断率.方法回顾性分析年龄在50天～11岁之间的23例患儿的临床资料及声像图表现,与病理组织学进行对照.结果淋巴管瘤多发于淋巴组织丰富区及淋巴管汇集区,声像图分为多房囊性分隔型,囊实性混合型,超声诊断囊性淋巴管瘤17例,诊断囊实性肿块5例,误诊腹股沟斜疝1例,诊断符合率73.9%.结论高频超声诊断小儿淋巴管瘤有一定的临床价值.     

儿童软组织淋巴管瘤影像学特征分析

目的 探讨儿童软组织淋巴管瘤影像学特征以利于临床诊治.方法 回顾性分析57例经病理证实的儿童软组织淋巴管瘤影像学资料,所有病例术前均行X线检查,其中24例行CT检查(10例增强检查),35例行MRI检查(1例增强检查),2例患者同时行CT及MRI平扫检查.结果 57例病灶X线均见局部软组织肿大.4例海绵状淋巴管瘤CT示弥漫性软组织肿胀伴多个点状低密度影;18例多房囊性淋巴管瘤表现为囊腔内水样低密度或混杂密度,其中12例颈部病变沿颈部肌间隙生长,5例多房囊性淋巴管瘤和1例单房囊性淋巴管瘤显示囊壁,分隔动、静脉期均见轻度强化(多见静脉期强化明显);13例海绵状淋巴管瘤MRI弥漫性软组织肿胀伴其内两端变钝,蚓状、匍匐状低信号,21例多房囊性淋巴管瘤中15例为稍长T1长T2信号、1例单房囊性淋巴管瘤表现为混杂信号.结论 应用X线平片结合MRI联合检查模式为儿童淋巴管瘤最佳诊断方式,此模式能够为临床提供重要诊治信息.     

儿童颈部淋巴管瘤的CT表现

目的:探讨儿童颈部淋巴管瘤的CT表现特征.方法:回顾性分析本院23例儿童颈部淋巴管瘤的CT表现.所有病例均经手术或病理证实.结果:儿童颈部淋巴管瘤的典型CT表现:肿瘤边缘光滑,呈密度均匀的囊性包块,增强扫描可见肿瘤囊壁较薄,呈轻度强化,囊内不强化.肿瘤为多囊时,可见囊内有线状分隔,合并出血时,可见囊内有"液-液"平面.结论:儿童颈部淋巴管瘤在CT检查方面有特征性表现.     

颈部合并纵隔囊状淋巴管瘤5例的手术疗效

颈部合并纵隔囊状淋巴管瘤５例的手术疗效附属医院小儿外科刘爱雅，王振华王计辰，徐晓青附属医院胸外科周宝庆，张旭，辛国华，林建关键词颈，纵隔，囊状淋巴管瘤，外科手术我院１９８１～１９９２年共收治颈部合并纵隔囊状淋巴管瘤患儿５例，均经手术治愈，其中４例同时...     

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.