肾脏集合管癌的CT诊断

目的　提高对肾脏集合管癌CT表现的认识。方法　报告 3例经病理证实的肾脏集合管癌的螺旋CT所见 ,并作文献复习。结果　男 2例 ,女 1例 ,肿瘤位于右肾者 2例 ,左肾 1例。位于右肾的 1例 ,肿瘤累及肾皮质和髓质 ,并突出于肾轮廓之外 ,大小约 8 0cm× 8 0cm ,平扫CT值约37～ 4 5HU ,其内见高密度的斑点状钙化灶。增强动脉期 (皮质期 )及静脉期 (髓质期 )扫描示病变呈不均匀性强化 ,无包膜 ,CT值约 5 2～ 10 7HU ,CT诊断为右肾癌 ,但不排除肾结核。另外 2例肿瘤同时累及肾皮质、髓质及肾盂 ,其中位于左肾的 1例 ,肿瘤大小约 7 0cm× 7 5cm ,平扫病变区CT值约2 2HU ,增强动脉期 (皮质期 )扫描示肾皮、髓分界不清 ,病变区CT值约 70HU ,静脉期 (髓质期 )示肾静脉内癌栓形成 ,排泄期 (肾盂期 )扫描示左肾盂、肾盏未见显影 ,CT诊断为左肾癌 (集合管癌可能性大 )。另外 1例位于右肾 ,肿瘤大小约 8 0cm× 14 0cm ,平扫CT值约 32HU ,增强动脉期 (皮质期 )及静脉期 (髓质期 )扫描示肿瘤与正常的肾组织无明显分界 ,CT值约 4 5～ 72HU ,排泄期 (肾盂期 )扫描示左肾盂、肾盏未见显影 ,CT诊断为右肾癌 ,但不排除肾结核。 3例中 2例可见肾周脂肪囊及肾筋膜受侵犯 ,2例有局部淋巴结转移 ,1例有肋骨转移。结论　CT对肾脏集     

卵巢甲状腺肿的CT和MRI表现

【摘要】目的：卵巢甲状腺肿（SO）临床罕见，且无典型症状和体征，术前容易误诊。本研究分析SO的CT及MR表现，以提高影像诊断水平。方法：回顾性分析10例经手术和病理证实的SO患者的影像学资料，其中7例行CT平扫及增强扫描，3 例行MR平扫及增强扫描。结果：10例SO均为单侧发病，右侧6例，左侧4例；其中囊实性7例，囊性2例，实性1例；肿瘤最大径1.4~15.6cm，平均（7.7±3.9）cm。 ①CT表现：7例CT检查病变均表现包膜完整，2例伴钙化。5例囊实性病变实性部分明显强化，CT值79~145HU；1例囊性病变内含圆形高密度区，CT值65~98HU，增强后无强化；1例实性病变明显强化，CT值128HU。②MR表现：3例MR检查病变中，2例囊实性病变实性部分T1WI等信号，T2WI稍高信号，增强后明显强化，囊性部分T1WI呈低信号，T2WI呈高信号，增强未见强化；1例囊性病变T1WI呈低信号，T2WI呈高信号，病变内见类圆形极低信号区。结论:卵巢甲状腺肿的MRI、CT 表现具有一定特征性，有助于诊断及鉴别诊断。     

多层螺旋CT检查肠系膜脂膜炎的临床价值分析

目的探讨多层螺旋CT在诊断肠系膜脂膜炎中的应用价值。方法对45例肠系膜脂膜炎患者的临床表现及影像学资料进行了分析,评价肠系膜病变组织及与邻近腹膜后正常脂肪组织的CT值差异情况。结果 45例肠系膜脂膜炎均累及小肠系膜,直达小肠肠袢,表现为小肠系膜的云雾状密度增高影,且与周围正常腹腔和腹膜后脂肪有较清楚的界限,平扫CT值-40HU~-70HU;32例可见类似肿瘤的"假包膜征"形成。26例可见"脂肪环征"(fat ring sign),其中10例可见钙化。23例脂膜炎病变内小结节,边界清晰,且可见淋巴结门影,其内密度均匀,增强示明显强。肠系膜病变部位的CT值(-60.32±15.23)HU与腹膜后正常脂肪组织(-102.35±7.78)HU相比存在显著差异。结论多层螺旋CT诊断肠系膜脂膜炎具有一定特征,可对病变大小、范围及血管受累情况等进行评估。     

儿童腹膜后节细胞神经瘤的CT表现

目的探讨儿童腹膜后(包括肾上腺区)节细胞神经瘤的CT表现,以提高对本病的认识。资料与方法回顾性分析6例经病理证实的儿童腹膜后节细胞神经瘤的CT影像资料,包括病变部位、大小、形态、边界、密度、钙化、囊变及坏死、病灶强化幅度、病变与周围血管的关系等征象。结果 6例肿瘤均单发,3例位于腹膜后,3例位于肾上腺区,肿瘤大小平均为(7.7±5.1)cm。6例病灶CT平扫相对肌肉呈均匀低密度,CT值为(36±8)HU,1例合并细粒样钙化。所有病灶未见囊变或坏死。增强扫描1例动脉期轻度强化,5例未见明显强化,实质期6例病灶呈不同程度的轻、中度强化,增强幅度相对于平扫CT,CT值增加(23±9)HU。结论儿童腹膜后节细胞神经瘤是一种边界清晰、密度较低、轻至中度渐进性强化的良性肿瘤,把握其影像特点有助于准确诊断。     

CT对右下腹占位性病变的诊断价值

目的 探讨CT对右下腹占位性病变的诊断价值。材料与方法 对54例临床考虑为右下腹肿瘤或非肿瘤性病变的患者行CT检查,除1例回盲部肠结核外,均经手术及病理证实。结果 54例中恶性病变38,其CT表现为软组织肿块和弥漫性肠壁增厚,包括肠外压性软组织肿块,肠周浸润,增强扫描检查呈明显均匀或不均匀强化。良性病变16例,主要是炎症性病变,CT表现为肠壁增厚,周围腹膜增厚,少有软组织肿块,轻或中等度强化。结论 CT对右下腹的肿瘤和非肿瘤性病变的诊断和鉴别诊断具有一定的价值。     

原发性腹膜后脂肪肉瘤的CT诊断

目的 探讨原发性腹膜后脂肪肉瘤的CT表现及鉴别诊断要点.资料与方法 回顾性分析经手术病理证实的20例原发性腹膜后脂肪肉瘤的CT资料.20例均行CT平扫,19例行增强扫描.结果 (1) 肿瘤大小约10 cm×14 cm×16 cm～15 cm×17 cm×30 cm;肿瘤的形态绝大多数不规则.所有肿瘤均位于腹膜后间隙.(2) 20例脂肪肉瘤中,17例肿块中含有典型的脂肪成分,其CT值为-20～-130 HU,增强扫描时肿块内的脂肪成分无强化,软组织成分轻度强化,其中1例伴有钙化;1例肿瘤的上部呈软组织密度,下部呈囊性改变;另2例为黏液型脂肪肉瘤,平扫CT值为20 HU,1例增强无强化,另1例未行增强扫描.结论 CT在原发性腹膜后脂肪肉瘤的定位诊断以及判断肿瘤与邻近器官的关系方面具有十分重要的价值,而且对分化型脂肪肉瘤或含脂肪的其他类型脂肪肉瘤能够明确诊断.     

肾脏急性炎症性病变CT增强延迟扫描表现及其与肾盂癌的鉴别

目的 探讨CT增强延迟扫描对肾脏炎症性病变的诊断价值。方法 采用德国西门子SOMATOM Emotion6多层螺旋CT机对14例肾脏病变包括临床证实的12例急性炎症病变和术后病理证实的肾盂癌起先均经CT增强和延迟扫描。对肾急性炎症病变和肾盂癌的延迟CT表现进行了对比分析。结果 肾脏炎症性病变绝大多数平扫及增强扫描显示的低密度区在延迟期有明显的强化。肾肿瘤无延迟强化。结论 肾脏CT增强延迟扫描在肾脏炎症性病变的诊断及其与肾肿瘤的鉴别诊断中有重要价值。     

青年和中老年胰腺实性假乳头状瘤患者CT表现对比研究

目的 :通过分析青年和中老年胰腺实性假乳头状瘤(SPTP)患者的CT特征,提高放射科医师对SPTP CT特征的认识。方法:回顾性分析29例(中老年11例,青年18例)SPTP的CT平扫及增强扫描表现。观察病变的位置、形态、边界、强化情况等CT特征。采用χ~2检验、Fisher精确检验及t检验进行统计学分析。结果:29例均为单发。中老年组肿瘤边界清晰5例,模糊6例;青年组肿瘤边界清晰15例,模糊3例;2组差异有统计学意义(P0.05)。中老年组肿瘤实性部分增强扫描后动脉期、实质期CT值分别为(57.6±14.9)、(58.8±12.0)HU,囊性部分CT值为(21.5±5.0)HU;青年组肿瘤实性部分增强扫描后动脉期、实质期CT值分别为(62.6±10.6)、(69.1±11.3)HU,囊性部分CT值为(24.0±4.6)HU。其中实性部分实质期CT值2组差异有统计学意义(P0.05)。结论:中老年SPTP与青年患者相比肿瘤实质期CT值更低,更易出现边界模糊。     

颅内胶质肉瘤的CT与MRI表现

目的 探讨颅内胶质肉瘤的临床表现及影像学特征。方法 回顾性分析15例经手术病理证实的胶质肉瘤影像资料。结果 肿瘤均位于幕上,其中颞顶区13例,枕叶1例,丘脑1例。形态为圆形或类圆形。病灶直径为3.0-9.0cm(平均4.6cm)。CT扫描7例为低等混杂密度,4例为低密度,CT值18－22HU,4例为略高密度,CT值48－55HU。增强扫描呈不规则强化。边界清晰,周围有水种。6例行MRI检查,T1WI呈不规则长T 1低信号,T2WI呈稍高信号,强化后呈不均匀实质性增强。结论 颅内胶质肉瘤术前定性诊断困难。CT、MRI表现结合临床可做出倾向性诊断。增强检查有利于与胶质母细胞瘤鉴别。     

腰大肌神经鞘膜瘤一例

患者女,39岁。体检:B超发现腹膜后肿块。CT扫描示:左侧后腹壁前方可见一圆形低密度影(CT值32 HU),其中间以不均匀高密度影(CT值61 HU)(图1);增强扫描见病灶不均匀强化(平均CT值57 HU)(图2)。大小约4.6 cm×4.8 cm,境界清楚,与腰大肌关系紧密。手术所见:肿瘤大小约5 cm×6 cm,界     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.     

CLIP相关技术的研究进展

在真核生物基因表达的转录后调节中,RNA结合蛋白（ RBP）起着关键作用,很多RBP的异常与人类疾病的发生密切相关。自2000年的RNA免疫沉淀和芯片分析方法（ RNA immunoprecipitation with differential display or microarray analysis , RIP-ChIP）出现以来,人们开始就RBP与RNA相互作用进行了系统而广泛的研究。经过改良和发展,基于体内实时紫外交联免疫沉淀法（ ultraviolet crosslinking and immunoprecipitation , CLIP ）、交联免疫沉淀cDNA文库高通量测序法（ high-throughput sequencing of CLIP cDNA library , HITS-CLIP）、光催化核糖核苷增强交联和免疫沉淀法（ photoactivatable-ribonucleoside-enhanced crosslinking and immunprecipitation , PAR-CLIP）以及提高个别核苷酸分辨率交联和免疫共沉淀法（ individual nucleotide resolution CLIP , iCLIP）等RIP-ChIP衍生方法相继产生,使用这些方法,可以解析RBP的RNA识别特异性,而且通过与高通量测序技术结合,可以实现转录组尺度的RBP的靶序列的鉴定,分辨率也得到极大提高。该文就RNA与蛋白的相互作用的基本原理及其研究进展、相关技术存在的问题以及发展趋势进行简要综述。     

Cross-sectional and longitudinal comparisons of self-reported and device-assessed physical activity and sedentary behaviour

ObjectivesTo examine the longitudinal associations and differences between self-reported and device-assessed physical activity (PA) and sedentary behaviour (SB), using a multifaceted statistical approach.DesignLongitudinal measurement burst.MethodsIn total, 52 university students (78% female) aged 18–38 years (mean = 21.94 ± 4.57 years) participated. The study consisted of three blocks of six days of measurement, during which participants wore an accelerometer on their wrist for the entire block, and self-reported their PA over the 6 days at the end of each block.ResultsMeaningful latent differences between methods were observed for moderate PA and SB across all three assessment periods, such that participants underreported the time spent in each activity. Bland–Altman plots revealed a positive mean difference for vigorous PA, with over-reporting increasing as mean levels increased. Negative mean differences were observed for all other intensities. Underreporting of moderate PA increased as the mean level increased, whereas for light PA and SB, underreporting decreased at high levels. Repeated measures correlations revealed a meaningful association for vigorous PA only, suggesting that as self-reported minutes increase so too do device-measured minutes.ConclusionsWe found evidence of cross-sectional and longitudinal differences and weak associations between self-reported and device-assessed PA and SB. Future work is needed to enhance the quality of self-reported methods to assess PA and SB (e.g., face and content validity), and consider improvements to the processing of device-based data.     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.