骨关节闪烁显像在强直性脊柱炎早期诊断中的价值

目的：探讨放射性核素骨关节显像在强直性脊柱炎(AS)早期诊断中的价值。方法：对依“修订纽约标准”临床诊断肯定AS患者23例,符合临床标准而无确定放射学改变的可能AS病人27例,及正常对照31例进行了骨关节闪烁显像研究。经静脉注射~(99m)Tc－MDP 3小时后,所有受检者均采集1.5倍放大的骨盆后位像,分别在两侧骶髂关节(SIJ)和骶骨取相同大小的矩形感兴趣区(ROI),计算其比值SI/S作为骶髂关节指数,进行定量分析(QSS);全身骨关节闪烁显像(WB)进行视觉分析。结果：对照组SI/S为1.20±0.17,可能AS组与肯定AS组分别为1.58±0.36和1.44±0.22(P<0.01)。以每例有一侧SI/S大于1.5为异常,两侧均小于1.5为正常,则可能AS组与肯定AS组阳性率分别为74.07％和47.83％(P<0.55)。WB显示AS患者存在SIJ外多处关节骨质代谢活跃灶,典型椎肋关节和脊椎明显不均匀性高摄取作为诊断依据,可能AS组与肯定AS组阳性率分别为44.44％和60.87％(P<0.05)。结合QSS与WB可能AS组和肯定AS组阳性率分别达85.19％和82.16％。结论：QSS有益于早期AS的诊断,而QSS与WB结合可进一步提高诊断灵敏性,并可明确病变的进展和累及部位。     

Evaluation of growth in children using quantitative bone scintigraphy

Our aim was to assess the value of quantitative bone scintigraphy for evaluating long-bone growth and to establish the normal uptake patterns of the growth plate in children. Subjects (180 girls, 154 boys) of normal weight and height, aged 2-20 years, were investigated using skeletal scintigraphy. Regions of interest were outlined over posterior images of the distal femoral growth plate and femoral diaphysis. The average number of counts per fixel in each region of interest was determined. The ratio of uptake in the distal femoral growth plate to that in the femoral diaphysis (GP:D ratio) was calculated for all subjects, and its relationship with age was determined. Peak GP:D ratios in girls and boys were reached at ages 11 and 13 years, respectively (8.26 in girls and 8.18 in boys), corresponding to the periods of most rapid growth. Our findings suggest that determining the scintigraphic GP:D ratio may be useful for evaluating growth and development in children if normal standard GP:D ratios are established.     

肿瘤放射治疗部位核素骨显像特征

目的：探讨恶性肿瘤患者放射治疗部位骨显像的放射性分布改变。方法：５３例乳腺癌、３０例鼻咽癌、４９例肺癌,２２例食管癌患者行＾９９Ｔｃ－ＭＤＰ全身显显像,对放射治疗部位骨显像剂浓聚的情况进行观察分析。结果：１５４例口才中７７例（５０％）放射性浓聚异常。其中４７例（３０．５％）局部软组织浓聚,３２例（２０．８％）避部骨放射性浓聚减低,１２例（７．８％）局部骨放射性浓聚增高。８例有两种改变,３例有三种改     

大范围扩散加权成像检测恶性肿瘤骨转移瘤:与骨扫描相对照

目的 评价大范围扩散加权成像(DWI)在恶性肿瘤骨转移瘤检测中的应用.方法 18例手术证实的各种恶性肿瘤患者纳入本研究.所有患者均在1个月内同时接受大范围DWI检查和99mTc-MDP骨扫描检查. 结果 18例患者中,15例经常规MRI证实存在骨转移瘤,其中7例为多发骨转移瘤(>10处),另8例共证实23处转移瘤;余3例未见转移瘤.除外7例全身多发骨转移瘤(>10处)患者,对其余11例有(8例)或无(3例)骨转移瘤患者计数病灶数,以患者为单位计算的大范围DWI和骨扫描诊断骨转移瘤的敏感性均为100%,特异性分别为100%、33.33%;曲线下面积分别为1.00和0.67,差异有统计学意义(P=0.04).以病灶为单位计算的大范围DWI和骨扫描诊断骨转移瘤灶的敏感性分别为86.96%、78.26%,特异性均为60.00%;曲线下面积分别为0.74和0.69,差异无统计学意义. 结论 大范围DWI可用于恶性肿瘤骨转移瘤的筛查.     

Far-field potentials in muscle: a quantitative investigation.

Far-field potentials have been produced from muscle tissue and shown to arise from both the proximal and distal musculotendinous junctions after the activation of a small group of muscle fibers. This investigation demonstrated that the polarity of muscle far-field potentials is consistent with the predictions of the leading/trailing dipole model. Far-field potential polarity was dependent upon the active electrode's orientation with respect to the positive or negative aspect of the trailing dipole after extinction of the leading dipole at the musculotendinous junction. This study also quantitatively measured the duration and magnitude of the two far-field potentials generated in the human biceps muscle by both proximal and distal muscle stimulation. The muscle far-field potential resulting from distal muscle stimulation closest to the musculotendinous junction was consistently shorter in mean duration (5.2msec +/- 2.1) but larger in mean amplitude (22.3 microV +/- 12.9) compared with the second far-field potential mean duration (10.4msec +/- 3.9) and amplitude (10.0 microV +/- 3.7). The mean areas under the curve for these far-field potentials, however, were comparable at 48.0msec microV and 48.7msec microV. Proximal muscle stimulation resulted in similar findings for the first far-field potential's mean duration, amplitude, and area (6.0msec; 19.7 microV; 50.6msec microV, respectively) in relation to those of the second far-field potential (12.5msec; 9.1 microV 49.1msec microV). The differences in amplitude and duration of the two far-field potentials, with similar areas, are consistent with, and can be adequately explained by, temporal dispersion effects of the muscle fiber action potentials' propagation over distance.     

卵巢肿块400例超声诊断与病理对照分析

目的 了解不同病理类型的卵巢肿块在各年龄组中的分布,更好地帮助超声诊断及其鉴别诊断.方法 选择B超声诊断卵巢肿瘤并行手术治疗病理结果 400例,按不同年龄分组进行超声诊断分析及病理分析.结果 超声诊断卵巢肿瘤并手术者,病理结果 卵巢良性肿瘤257例(64.3%),恶性肿瘤6例(1.5%),巧克力囊肿70例(17.5%),其他瘤样病变67例(16.8%).超声诊断与病理符合率巧克力囊肿、畸胎瘤、浆液性囊腺瘤、黏液性囊腺瘤分别为87.5%、96.6%、47.8%和40.0%;超声诊断囊性包块病理良性100.0%,囊实性包块病理良性占96.2%,恶性占3.8%;超声诊断实性包块病理良性占100.0%,恶性占100.0%.结果 超声诊断卵巢肿块简便、客观,可有效地帮助临床诊疗.     

X线骨骼摄片与核素骨显像在多发性骨髓瘤骨破坏的比较

目的 评价X线骨骼平片与放射性核素全身骨显像在多发性骨髓瘤(multiple myeloma，MM)患者骨损害的应用价值。方法 对20例初发MM患者X线骨骼平片和放射性核素(99MTC—MDP)全身骨显像对比研究。结果 X线骨骼平片穿凿样溶骨性骨破坏占90％(18／20例)，病理性骨折占80％(16／20例)，弥漫性骨质疏松占80％(16／20例)。放射性核素骨显像阳性率45％(9／20例)，其表现是放射性核素浓聚灶、稀疏区，分布不均。结论 放射性核素骨显像对MM骨损害检查不如x线骨骼平片敏感、特异性高。X线骨骼摄片检查仍是诊断MM骨骼损害的首选。     

Socioeconomic effects of ankylosing spondylitis in females: a comparison of 25 female with 25 male subjects

25 men and 25 women with ankylosing spondylitis were interviewed, using a structural questionnaire, covering a profile of the disease and of socioeconomic areas. Particular attention was paid to sexual activity, pregnancy and child-rearing. Significant problems in most areas asked about were found, although childbearing was not curtailed. Tiredness was responsible for a lot of disability but the women managed housework reasonably well and also had a fairly good employment record.     

强直性脊柱炎脊柱骨折的影像学表现

目的 探讨强直性脊柱炎(AS)脊柱骨折的多种影像学特征和影像诊断的价值.方法 回顾性分析20例AS合并脊柱骨折患者的影像学和临床资料.结果 损伤节段位于颈椎5例(25.00%),胸腰椎15例(75.00%),其中屈曲型损伤11例(55.00%),屈曲过伸型损伤9例(45.00%),前中后三柱同时损伤14例(70.00%),伴脊髓损伤8例(40.00%).X线平片共发现脊柱损伤征象43个,多层螺旋CT(MSCT)发现93个,MRI发现102个.结论 AS脊柱骨折常表现为累及三柱的贯通性骨折,MRI和MSCT是早期诊断的重要手段,MRI显示脊髓损伤和后柱损伤有明显优势,是评估AS合并脊柱骨折的首选影像学检查方法.     

强直性脊柱炎骶髂关节的CT表现

目的探讨强直性脊柱炎骶髂关节病变的CT表现。方法收集分析52例强直性脊柱炎患者的骶髂关节CT资料。结果50例患者骶髂关节有异常表现,包括：早期：骨关节面受侵蚀,骨皮质局限增厚、硬化,关节间隙正常;后期：关节面呈虫蚀状改变,关节面皮质密度不规则增高,关节间隙增宽或变窄,最终关节间隙消失,关节强直。结论强直性脊柱炎患者CT检查有助于早期诊断。     

强直性脊柱炎骶髂关节CT表现特点(附31例分析)

目的:通过对31例强直性脊柱炎(AS)骶髂关节CT扫描,总结AS骶髂关节的CT表现。方法:31例临床确诊为AS的患者,男21例,女10例,年龄14~64岁,平均24.5岁。全部病例行双侧骶髂关节CT平扫,就其CT表现进行分析。结果:31例中有30例骶髂关节异常,其中Ⅰ级5例(16.1%),Ⅱ级7例(22.5%),Ⅲ级16例(51.6%),Ⅳ级2例(6.5%)。骶髂关节早期CT表现为对称性关节面骨皮质粗糙,局限性微小皮质破坏,但关节间隙正常;进展期为双侧骶髂关节面广泛骨皮质破坏,呈锯齿状或毛刷状,局部骨质硬化明显,关节间隙增宽;晚期为关节僵直,关节面下骨质疏松。结论:骶髂关节CT检查有助于AS的早期诊断,提高诊断准确性,其骶髂关节的CT表现对临床病情监测有重要价值。     

Diagnostic and prognostic potentials of microRNA-27a in osteosarcoma

AimGrowing evidence suggest that the microRNA (miR)-23a/24-2/27a cluster may play a crucial role in mammary tumorigenesis and act as a novel class of oncogenes. Among these members, miR-27a has been reported to promote proliferation, migration and invasion in human osteosarcoma cells. The aim of this study was to detect the serum levels of miR-27a in osteosarcoma patients and to investigate its associations with clinicopathological features and prognosis.MethodsmiR-27a levels in sera from 166 osteosarcoma patients and 60 healthy controls were detected by real-time quantitative RT-PCR. Then, the associations of serum miR-27a level with clinicopathological factors or survival of osteosarcoma patients were further evaluated.ResultsCompared to healthy controls, the serum levels of miR-27a were significantly increased in osteosarcoma patients (P < 0.001). Importantly, miR-27a could efficiently screen osteosarcoma patients from healthy controls (Area under receiver operating characteristic curve, AUC = 0.867). Then, high miR-27a expression was more frequently occurred in osteosarcoma patients with advanced clinical stage (P = 0.001), positive distant metastasis (P = 0.01) and poor response to chemotherapy (P = 0.008). In Kaplan–Meier survival analysis, high miR-27a expression was a significant indicator for poor overall survival (P = 0.006) as well as poor disease-free survival (P = 0.01). Furthermore, multivariate analysis demonstrated that miR-27a expression was an independent and significant prognostic factor to predict overall survival (P = 0.01) and disease-free survival (P = 0.03).ConclusionmiR-27a expression may be elevated in sera of osteosarcoma patients and in turn contributes to aggressive progression of this malignancy. Detection of serum miR-27a levels may have clinical potentials as a non-invasive diagnostic/prognostic biomarker for osteosarcoma patients.     

跟骨定量超声评估强直性脊柱炎患者的骨质疏松

目的:研究强直性脊柱炎(ankylosingspondylitis,AS)患者骨矿物质密度(bonemineraldensity,BMD)的变化,并探讨强直性脊柱炎患者发生骨质疏松的机理。方法:采用定量超声骨密度仪测定210例AS患者跟骨的骨密度,其中男165例,女45例,并与性别、年龄匹配的健康人作对照,分析AS的骨质疏松发生率。结果:AS患者早期即有较高的骨质疏松发病率,AS组骨密度(患者骨密度观测定和年轻人骨密度峰值的比较,t-Score)均显著低于对照组(男:-2.32±1.19和1.26±0.89,女:-1.01±1.18和1.45±0.36;t=29.8,13.7,P<0.05);AS组骨质疏松发生率(男47.9%,女2%)与对照组(男7.3%,女4%)比较差异有显著性意义(χ2=8.77,0.35,P<0.05)。HLA-B27(+)与HLA-B27(-)患者骨密度(-2.26±1.15和-2.56±0.70)比较无显著性差异(t=1.47,P>0.05)。结论:骨质疏松是AS患者的常见并发症,疾病早期即有骨质疏松发生,超声骨密度可敏感检测AS继发骨质疏松,提示对AS患者早期既应注意骨质疏松的防治。     

基于腰椎定量CT分析强直性脊柱炎合并肌少症危险因素

目的 基于腰椎定量CT(QCT)分析强直性脊柱炎(AS)合并肌少症的危险因素。方法 前瞻性纳入100例AS患者(AS组)及100名健康体检者(对照组),行腰椎QCT检查；测量并计算腰椎骨密度(BMD)、L3骨骼肌面积(SMA)、椎后肌群肌肉面积(MA)、椎后肌群脂肪面积(FA)、椎后肌群脂肪浸润(MFI)程度及竖脊肌CT脂肪百分数(CTFF),根据L3骨骼肌指数(SMI)将AS组分为肌少症亚组(n=26)和非肌少症亚组(n=74)。以Pearson或Spearman相关分析观察AS组病程、体质量指数(BMI)、腰椎BMD、椎后肌群MFI及竖脊肌CTFF与L3 SMI的相关性；构建多因素logistic回归模型，分析影响AS合并肌少症的独立因素。结果 AS组腰椎BMD、L3 SMI及椎后肌群MA均低于对照组(P均<0.05),而椎后肌群FA、MFI及竖脊肌CTFF均高于对照组(P均<0.05)。肌少症亚组BMI及腰椎BMD均低于非肌少症亚组(P均<0.05),而病程、椎后肌群MFI及竖脊肌CTFF均高于非肌少症亚组(P均<0.05)。AS组BMI及腰椎BMD均与L...     

Serum lipoprotiens in four European communities: a quantitative comparison

Serum lipid and lipoprotein concentrations have been measured in 985 men and women sampled from communities in London, Naples, Uppsala and Geneva. This was done to define normal ranges, detect inter-population differences, and relate such differences to levels of lipids in the major lipoprotein classes of plasma. Cholesterol and triglyceride concentrations showed substantial differences between the four populations; levels of these lipids showed parallel trends, which were attributable to differences in low density lipoprotein and very low density lipoprotein concentrations. By contrast, high density lipoprotein cholesterol concentrations showed little or no interpopulation differences. Geographical differences in serum triglyceride and cholesterol levels were not correlated with variation in the prevalence of obesity.