X线与CT联合分析腰椎退变滑脱92例报告

目的探讨X线平片和CT对腰椎退变性滑脱的诊断价值。方法收集腰椎退变性滑脱92例,对其X线平片和CT进行回顾性分析。结果腰椎退变性滑脱好发于第4腰椎,滑脱程度多在Ⅰ度以内,多合并不同程度的退行性变。X线平片能直观地显示腰椎退变性滑脱,是诊断本病最简单而有效的方法,而CT能清楚显示椎间盘、硬膜囊、关节突和椎管内外结构的变化。结论X线平片与CT结合对腰椎退变性滑脱的诊断和治疗有着重要作用。     

腰椎退变性滑脱的平片和CT影像对比研究

为了评从是平片和ＣＴ对腰椎退变性滑脱的诊断价值，总结分析了１９９２年７月至１９９５年９月因腰腿痛进行Ｘ线检查的病例，共４４４０例。根据不同的检查方法为３组：（１）单纯平片检查３４７２例；（２）ＣＴ检查９６８例；（３）平片加ＣＴ检查３０例。而ＣＴ的优势在于能清楚地表现枞璋盘，硬膜囊，关节和椎管内外结构的变化。     

56例腰椎退变性滑脱X线平片分析

目的：通过对腰椎退变性滑脱进行X线分析，了解其退变性滑脱的特点。方法：收集56例腰椎退变性滑脱X线平片，其中，22例加摄腰椎左、右斜位片，采用Meyerding氏法测量椎体滑脱情况。结果；个椎体滑脱共38例，阶梯状滑脱18例；椎体向前滑脱39例，向后滑脱17例。椎体移位程度为3.0-9.0mm，平均为6.0mm，滑脱程度均为Ⅰ度。结论：腰椎平片能直观地显示腰椎退变性滑脱的部位及程度，对临床治疗具有重要的参考价值。     

退变性腰椎滑脱52例CT诊断

目的提高对退变性腰椎滑脱CT表现的认识。方法 对52例退变性腰椎滑脱的CT平扫所见进行回顾性分析。结果 52例病例中,第四腰椎滑脱33例,第五腰椎滑脱19例。CT可见椎体滑脱导致椎体后缘呈＂双边＂征,椎间盘膨隆或突出,椎管前后径变窄,椎间小关节不同程度脱位,并可见关节呈退行性改变,椎管内后突的椎间盘钙化或黄韧带钙化等。结论 CT检查是诊断退变性腰椎滑脱的有效方法,与X线平片结合,能较好地对本症作出准确的定性、定位诊断。     

腰椎退行性滑脱的影像诊断价值

目的:探讨腰椎退行性滑脱的X线平片、CT扫描以及MRI在退行性腰椎滑脱中诊断的价值.方法:回顾性分析对比2005～2009年85例退行性腰椎滑脱病例患者的X线、CT、MRI图片资料.结果:3种方法均可对退行性腰椎滑脱作出定性诊断.X线对诊断滑脱的程度价值较大,CT能直观地反映出滑脱后椎管的形态,还可显示硬膜囊在椎体后弓之间受压及侧隐窝狭窄、关节突增生、硬化、椎间关节积气及黄韧带肥厚、间盘突出,MRI能准确显示腰椎滑脱症的发生部位和滑脱程度;能显示椎弓峡部裂,能有效显示滑椎关节突关节形态异常,还能显示滑椎的椎间盘变性、膨出、脱出及椎管的形态变化.结论:影像诊断,CT可以作为必要检查方法,MRI可以作为诊断补充检查手段,而普通X线平片则可以作为常规检查.     

16例腰椎退变性滑脱症的临床CT分析

腰椎退行性滑脱是腰腿痛的常见原因之一。CT检查除能确定腰椎滑脱及其程度外，尚能清楚显示滑脱的原因和继发改变，为临床提供更多的信息，为了提高对腰椎退变性滑脱症CT认识，本文对16例腰椎退变性滑脱症CT资料进行回顾性分析。     

CT对于腰椎退变性滑脱的诊断价值

目的：探讨腰椎退变性滑脱（DS）的临床CT特征及诊断价值。方法：回顾性分析腰椎退变性滑脱病例56例。结果：56例均显示腰椎前滑脱,分布以L4、L5为主;小关节间隙变窄,关节面硬化增生56例,关节腔真空症32例;均表现为椎间孔变形变窄;侧隐窝狭窄,均合并不同程度的腰椎间盘改变。结论：CT对于临床主要表现为腰腿疼痛而高度怀疑腰椎退变性滑脱有重要的诊断价值。     

腰椎退变性滑脱症的X线与CT分析

目的：通过X线与CT征象分析探讨腰椎退变性滑脱的病因。方法：对65例71个滑脱部位、程度进行分析。结果：椎间盘变性退变，脊柱周围韧带的松弛、薄弱造成的脊柱椎体力学失稳是腰椎退行性滑脱的主要因素。结论：X线平片是诊断该病的首选方法，CT对于判断滑脱原因、选择治疗方法有重要意义。     

真假性腰椎滑脱的影像学表现及鉴别价值

目的:评价平片和CT对真假性腰椎滑脱的诊断价值.方法:分析212例有完整影像及临床资料的腰椎滑脱症的影像表现特征.结果:212例腰椎滑脱中,真性滑脱79例,假性滑脱133例.X线片检出峡部裂56例,CT检出79例;真假性滑脱均可出现假性椎间盘膨出、双椎体后缘、椎管狭窄,而真性滑脱还有椎弓裂隙征、锥管冗长征.平片能直观的显示真假性滑脱的椎体滑移情况,CT对椎管前后径、椎间孔、侧隐窝狭窄的显示明显优于平片.结论:CT对腰椎滑脱症的分型、椎管狭窄情况的判断优于平片.     

螺旋CT对复杂骨关节损伤的诊断价值

目的：探讨螺旋CT对复杂骨关节损伤的诊断价值。方法：采用回顾性方法：对50例复杂骨关节损伤病人CT片进行分析，其中31例同时做了X线平片和CT检查，将CT片与平片结果进行对照研究。结果：50例病人，CT显示骨折152处，关节脱位25个，椎管狭窄13例，脊髓损伤12例，蛛网膜下腔出血1例，胸水4例，关节积液6例，上颌窦积血6处，鼓窦，乳突积血4处，软组织损伤10例，31例中CT显示骨折104处，平片显示46处，CT显示关节损伤21个，平片显示9个，CT显示椎管狭窄10例，脊髓损伤9例，关节积液5例，平片均未显示；CT显示椎弓畸形1例，平片诊断椎弓骨折可能，经手术证实为畸形；股骨粗隆间骨折1例，CT，平片均未显示，结论：（1）螺旋CT能直观，准确判断骨折类型，骨折片大小，数目及位置；（2）能充分显示骨折片移位对附近组织造成的损伤情况；（3）能充分显示关节损伤程度并判定其稳定性；（4）对损伤骨关节周围的软组织改变显示清晰，对复杂骨关节损伤有很高的诊断价值，但对线性骨折显示欠佳，可造成漏检，应采取其它检查方法避免。     

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.