正常成人眶尖的CT和MRI研究

目的：研究正常人眶尖的CT和MRI检查图像,探讨对疾病诊断的意义。方法对52例正常成人眶尖分别采用CT和MRI检查,CT进行横断及冠状位扫描,MRI进行横断、冠状及斜矢状位扫描。结果眶尖骨性结构可以通过高分辨率CT清晰显示;其他结构比如视神经、动眼神经、眼动脉、总腱环及眼外肌、脂肪分布等通过常规CT及MRI全部或者部分显示。结论高分辨率CT可对眶尖骨性构成清晰显示,眶尖其他部位采用CT及MRI扫描可以全部或者部分显示,其中以MRI显示效果更好。研究正常人眶尖的CT和MRI检查图像对疾病诊断有积极的意义。     

眼眶爆裂骨折的CT诊断(附226例报告)

目的：回顾性复习眼眶爆裂骨折的CT资料，探讨CT检查方法对眼眶爆裂骨折的显示及诊断价值。方法：对226例患者行CT冠状位扫描和／或横断扫描，分析其CT表现的直接和间接征象。结果：本组226例病例，其中单纯内壁骨折105例(占46．46％)，单纯下壁骨折13例(占5.75％)，双壁(内、下壁)骨折23例(占10．18％)，眼眶复合型骨折85例(占37．61％)。眼眶爆裂骨折CT表现的直接征象为眶壁骨质断裂移位、粉碎和曲度异常。眼眶爆裂骨折CT表现的间接征象中眼外肌改变及眶内肌锥外积气在骨折中发生率较高。结论：冠状CT扫描是眼眶爆裂骨折的首选检查方法，眼眶爆裂骨折的间接征象尤其是眼外肌改变及眶内肌锥外积气对诊断有重要意义。     

眶尖区外伤CT和MRI的诊断及比较

目的:探讨64排CT和1.5TMRI在诊断眶尖区外伤的价值。方法:53例眶尖区外伤病例行64排CT和1.5T MRI检查。结果:64排CT显示本组眼眶壁全部骨折,视神经损伤32例,眼外肌损伤37例,球后血肿12例。1.5T MRI显示视神经损伤47例,眼外肌损伤51例,球后血肿11例。结论:1.5TMRI检查对外伤性视神经和眼外肌损伤等软组织损伤优于64排CT检查,而64排CT检查对眶壁骨折优于1.5TMRI检查。     

眶爆裂性骨折的影像学诊断

目的：探讨分析眶爆裂性骨折发病机理、影像学表现及手术适应症。方法：回顾性分析37例眶爆裂性骨折的临床及影像学资料。结果：眶内壁骨折平片主要为患侧筛实密度增高，眶内缘不清、眶下壁骨折主要表现为上颌窦上壁不清。CT除显示骨折外还显示眶内脂肪、眼外肌的疝出和嵌顿情况。眶下壁骨折时冠状位扫描优于轴位扫描。结论：凝有眶爆裂性骨折时应首选CT检查。平片着重观察眶缘是否清晰、完整和鼻窭的透亮度。     

Graves眼病的CT和MRI影像学分析

目的：评价CT、MRI和Graves眼病诊断中的价值。方法：回顾性分析36例经临床和（或）实验室检查诊断Graves眼病的CT扫描、MRI等临床资料。结果：眼球突出29例，眼外肌肿胀36例、眶尖眼外肌增厚14例，视神经增粗6例，眼上静脉扩张2例、泪腺肿大1例。结论：CT、MRI检查可做为Graves眼病诊断的重要依据。     

眼眶MRI在不同分期弥漫性甲状腺肿伴甲亢眼病患者检测中的影像学特征及意义

目的:探讨眼眶MRI在不同分期弥漫性甲状腺肿伴甲亢眼病患者检测中的影像学特征及意义。方法:选取32例弥漫性甲状腺肿伴甲亢眼病(Graves)患者作为观察组,另选取同期在本院体检的无任何眼科疾病的32例健康志愿者作为对照组。两组均接受眼眶MRI检查,比较两组Graves眼病活动期与非活动期泪腺横断位短径、横断位长径、横断位截面积、冠状位短径、冠状位长径、冠状位截面积、泪腺与同侧颞肌的信号强度比(SIR)、体积等各定量参数,并分析泪腺/颞肌SIR与临床活动性评分(CAS)相关性分析、Graves眼病眼眶MRI影像学特征,统计MRI诊断Graves眼病不同分期符合率。结果:观察组泪腺横断位短径、横断位长径、横断位截面积、冠状位短径、冠状位长径、冠状位截面积、体积、泪腺/颞肌SIR值较对照组大,差异有统计学意义(P<0.05);Graves眼病活动期泪腺横断位短径、横断位长径、横断位截面积、冠状位短径、冠状位长径、冠状位截面积值与非活动期相比,差异无统计学意义(P>0.05);但活动期泪腺/颞肌SIR值较非活动期高,差异有统计学意义(P<0.05);经Spearman检验可知,泪腺/颞肌SIR与CAS评分之间呈正相关,差异有统计学意义(P<0.05);Graves眼病患者多数表现为双侧眼球突出,肌锥内外脂肪组织增多,纺锤样增粗,其中以肌腹增粗为主;眶尖部视神经受到压迫;MRI诊断Graves眼病不同分期符合率为84.38%。结论:活动期与非活动期弥漫性甲状腺肿伴甲亢眼病患者眼眶MRI检测的泪腺定量参数不等,使用脂肪抑制T2加权序列可提高活动期患者眼外肌内水肿和炎性成分辨别敏感度,有助于指导临床治疗及预后评估。     

中耳鼓室内迷走颈内动脉一例

患者女，17岁．右耳听力进行性下降半年．偶有耳鸣，无搏动性：临床检查：鼓膜后见红色肿块。CT横断面和冠状面高分辨率CT（HRCT）显示：颈内动脉水平段明显迂曲、膨胀性扩大．鼓室内见软组织影，经下鼓室管与颅底外颈内动脉相连，下鼓室管扩大（图1）。增强横断位CT因部分容积效应鼓室内肿块强化显示欠清．MRI扫描：T1WI（图2A）和T2WI（图2B）在耳蜗外下方鼓室区未见明显异常信号病变，     

颈动脉海绵窦瘘的影像学表现

目的 分析首诊于眼科的颈动脉海绵窦瘘患者的影像学表现及其诊断意义。方法 对9例10眼颈动脉海绵窦瘘患者采用B超、CT和／或MRI检查。结果 三种医学影像学检查均发现眼上静脉扩张、眼外肌肥大、眶内脂肪垫增厚；部分CT或MRI检查还显示扩张的海绵窭。结论 影像学检查在颈动脉海绵窦瘘检查中有特征性的表现．有助于诊断。     

伴有不典型斜视的单侧垂直后退综合征的MRI表现

对两例单侧垂直后退综合征患者临床表现及核磁共振结果的分析,探讨其发病机制。MRI显示发自总腱环的与眼外肌等信号的条索样结构至于眼球后壁,两位患者眶内异常结构均附着于眼球的颞下方,表现出不同的斜视。连续斜冠状位核磁共振结果示两患者眼眶内异常结构起止点不尽相同,且具有可疑的异常神经支配,与患者上方注视时眼球后退、睑裂变小相关。     

Graves眼病的影像学诊断分析

目的：探讨B超、CT及MRI对Graves眼病的诊断价值。方法：全部病例均做B超、CT、MRI检查。常规行头部轴位、矢状位、冠状位、视神经平行位扫描。结果：病变发生在双眼者5例，单眼者2例。全部眼肌受累的2例，剩余依序受累，其中侵及上下直肌7例，内直肌6例，外直肌4例，上下斜肌2例，均表现为肌腹肥大；4例视神经受到影响。结论：Graves眼病多累及下直肌，其次为内直肌，上直肌及外直肌，受累眼外肌肌腹一致性肥大，肌附着点正常。B超、CT及MRI均可见特征性影像改变，其中MRI可进行多方位扫描，观察上述变化优于B超及CT。     

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.