脊髓内血管母细胞瘤的MRI诊断

目的 评估脊髓内血管母细胞瘤的MRI表现。方法 本文回顾分析了8例经手术病理证实的髓内血管母细胞瘤。使用场强为0.35T（特斯拉）的超导型MR成像仪（SE系列,多回波技术）对全部病例行矢状面、横断面T1加权成像和矢状面T2加权成像。5例行Gd-DTPA增强扫描,剂量为0.1mmol/kg.b.w.,静脉注射。结果 8例中,7例位于颈髓内,只有1例位于胸段,MRI成像中所有病例均显示受侵脊髓弥漫性增粗,与正常脊髓信号比较,T1加权成像呈等低信号,T2加权成像呈高信号,5例行Gd-DTQA增强T1加权成像,所有病变呈现一伴随囊腔的界限清楚的强化肿块,全部病例均见迂曲的曲血流空现象,结论 MR图像可多平面成像,适于评估脊髓肿瘤,适于评估脊髓肿瘤,Gd-DTPA增强MR成像能在大的囊变区精确确认多血管的肿瘤病灶。     

散发性脊髓血管母细胞瘤MRI特征分析(附6例报道)

目的:分析散发性脊髓血管母细胞瘤MRI特征.方法:回顾性分析6例经病理证实散发性脊髓血管母细胞瘤MRI表现,结合文献比较与Von Hippel-Lindau(VHL)病相关脊髓血管母细胞瘤MRI表现差异.结果:6例散发性脊髓血管母细胞瘤均为髓内单发病灶,其中3例位于胸髓,2例位于颈髓,1例同时累及延颈髓;病灶长径1.7-7.3 cm.5例病灶为实性,1例为囊实性,肿瘤均位于脊髓背侧,边界清楚,肿瘤实性部分表现为以等或稍长T1、长T2信号为主的混杂信号,强化明显,囊实性病灶囊壁亦明显强化,1例胸髓病例邻近软脊膜线样强化的“尾征”;合并流空血管影、脊髓空洞各4例,1例囊实性肿瘤并囊内出血,矢状位T2加权图像见液-液平面.结论:散发性脊髓血管母细胞瘤MRI表现具有特征性,与VHL病相关脊髓血管母细胞瘤病灶常多发、体积较小,预后较差且易复发相区别.     

低场磁共振诊断脊髓病变的要点

目的总结脊髓病变的MRI表现,掌握髓内病变的诊断要点。探讨低磁共振成像技术在脊髓肿瘤诊断中的应用。方法回顾性总结了经手术病理证实的MR影像资料31例脊髓肿瘤。进行MR平扫及增强扫描检查,重点对病变部位、大小、边缘是否清晰、信号是否均匀、强化程度及方式等进行分析。结果星形细胞瘤确定病变上下缘的范围具有重要意义。增强检查可显示整个肿瘤的范围,对滴状种植转移灶的显示也好。椎间盘在T2加权图像上出现信号减低。结论星形细胞瘤和室管膜瘤确定病变上下缘的范围具有重要意义,血管母细胞瘤可在髓内形成囊性病灶。     

脊髓血管母细胞瘤的MR特征探讨

目的探讨脊髓血管母细胞瘤特征性的MR表现,提高术前诊断的准确性。方法回顾分析6例经手术病理证实的脊髓血管母细胞瘤的MR表现,6例均行常规MR平扫及T1WI压脂增强扫描。结果 6例均为单发,位于脊髓背侧,发生于延颈交界区1例,颈段2例,胸段3例,5例为实性,1例为囊实性,肿瘤信号主要表现为等T1、稍长T2信号,增强扫描肿瘤结节明显强化,囊性部分不强化,5例伴有明显的脊髓空洞,5例病灶内可见迂曲的血管流空信号,4例邻近脊髓表明可见葡行血管流空信号。结论脊髓血管母细胞瘤具有特征性的MR表现,有助于术前正确诊断。     

恶性萎缩性丘疹（Degos病）的视神经和脊髓表现

报道1例死于恶性萎缩性丘疹（Degos病）的病例，该患者的视神经和脊髓受累。视神经的MRI显示，静注钆喷酸葡胺后的脂肪抑制T1加权成像信号异常增强，在矢状面T2加权成像上，超过7个椎体节段的脊髓可见锯齿图形。尸检显示，左侧视神经有髓鞘神经纤维严重缺失，同时有视网膜中央动脉血栓栓塞。脊髓各节段均可见海绵状变性，并伴由蛛网膜下腔血管内皮增殖和血栓形成所致斑片状和虫蚀状损坏。MRI检查结果与病理检查结果一致。     

多形性胶质母细胞瘤患者蛋氨酸PET和MR成像显示病灶分布差异:PET和MR联合成像研究

目的:研究多形性胶质母细胞瘤PET成像时11C-甲基蛋氨酸(MET)的聚集情况,确定代谢异常区域的分布,并与MRI进行比较。方法:对10例未经治疗的多形性胶质母细胞瘤患者,同时行MRI和MET-PET检查。比较PET成像时MET聚集范围(MET区)、MRIT1加权像钆增强区(Gd区)和T2加权像上的异常高信号区(长T2区)的差异。结果:MET区大于Gd区并将其全部包括在内。随着肿瘤直径的增大,MET和Gd区体积的差异也增大。平均而言,58.6%的MET区面积位于Gd区内,90.1%位于Gd区外10mm范围内,98.1%位于20mm范围内,99.8%位于30mm范围内。直至研究开始,10例患…     

颅内血管母细胞瘤的CT和MRI诊断

目的探讨CT和MRI对颅内血管母细胞瘤的影像学诊断价值。方法回顾性分析1991年9月-2011年11月间经手术病理证实的10例颅内血管母细胞瘤的CT和MRI资料结,合文献总结颅内血管母细胞瘤的CT和MRI特点。结果 10例颅内血管母细胞瘤患者中,CT平扫4例,10例均行MR平扫及增强扫描。单发9例,其中幕上大脑半球2例,1例破坏颅骨;幕下7例,其中5例位于小脑半球,2例位于下蚓部四脑室出口。2例呈实质型,4例呈囊实性,3例呈囊结节型。多发1例共3个病灶,2个位于小脑半球,1个位于延髓背侧。其中大病灶位于小脑半球呈囊结节型,另2个病灶呈结节样实质型。CT平扫4例病灶囊性部分呈低密度,实行部分呈稍低密度,1例发现骨质破坏,病灶内均未发现钙化和出血;10例MR平扫发现囊性部分呈长T1WI、长T2WI信号;实性部分呈等或稍长T1WI、稍长T2WI信号;MR增强扫描病灶实性部分明显强化。MR扫描8例发现流空血管影。结论 CT和MRI是颅内血管母细胞瘤的有效影像学检查方法,病灶实性部分明显强化及发现病灶内流空血管影对诊断有一定的特异性。     

小脑血管母细胞瘤MR表现及病理分析

目的探讨小脑血管母细胞瘤的MR影像表现与病理特点,以提高术前诊断准确率。方法回顾性分析经手术病理证实的22例小脑血管母细胞瘤,全部患者均行MR平扫及增强扫描。结果单发21例,多发1例,所有病灶均位于小脑内。21例单发病例中,MR表现大囊小结节型17例,实质型2例,单纯囊型2例。肿瘤的囊液部分显示为长T1长T2信号,T2-FLAIR为稍低、等或稍高信号;实性部分或瘤结节呈稍长T1稍长T2信号,增强后明显强化。SWI序列可见到瘤内或瘤周的异常扭曲血管影。1例多发病例表现为1个大囊小结节型及2个小结节状实质型病灶。病理组织学检查肿瘤主要由两种成分构成:不同成熟阶段的毛细血管和毛细血管网之间丰富的间质细胞。结论小脑血管母细胞瘤具有典型的MR表现,且与其病理基础密切相关。MR是诊断小脑血管母细胞瘤的有效检查方法。     

幕上血管母细胞瘤的CT及MRI诊断

目的 探讨幕上血管母细胞瘤的CT及MRI表现特征,以提高对该病的认识.方法 搜集经手术、病理证实的9例幕上血管母细胞瘤患者的影像学资料,分析其CT与MRI表现.9例均行CT平扫,其中8例行MRI平扫,增强扫描及扩散加权成像（DWI）序列.结果 病变均为单发.大囊小结节型6例,单纯囊型2例,实质型1例.8例CT平扫囊腔呈低密度,1例呈高密度,肿瘤壁结节均呈等密度 7例MRI平扫囊腔T1WI呈低信号,T2WI呈高信号,DWI呈明显低信号 肿瘤壁结节T1WI呈等信号,T2WI呈稍高信号,液体衰减反转恢复（T2-flair）序列呈高信号 8例MR增强扫描壁结节及实质性肿块均呈明显均匀强化,囊壁未见强化 3例肿瘤周围或肿瘤内可见流空血管,MRA显示瘤周或瘤内增多、增粗、迂曲的动脉血管.结论 幕上血管母细胞瘤的CT及MRI表现有一定特征性,影像学检查有助于其定位及定性诊断.     

卵巢卵泡膜细胞瘤MRI表现

目的:评价卵巢卵泡膜细胞瘤的MR表现.方法:回顾分析7例经手术病理证实卵巢卵泡膜细胞瘤MR表现7例均行常规MR扫描,应用T1.T2加权序列作轴面,矢状面扫描,且均应用T1 WISE作轴面,矢状面增强扫描.结果:7例肿瘤在T1WI上呈低信号或等低混杂信号,在T2WI上呈高信号或混杂信号,增强后均不均一强化.结论:卵巢卵泡膜细胞瘤的MRI表现具有特征性.MRI还有利于明确肿瘤的位置和范围,以及外科治疗计划的制定.     

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.