脑内海绵状血管瘤的影像学分析

目的:探讨脑内海绵状血管瘤的影像学(CT、MRI及DSA)表现.方法:回顾性分析21例脑内海绵状血管瘤患者,均做MRI检查,9例并作了MRI增强扫描;11例同时曾做CT检查,3例增强CT扫描;曾同时5例作CTA/MRA+DSA检查,7例曾作手术治疗和病理检查,对各例的CT、MRI及DSA的影像学表现进行分析.结果:脑内海绵状血管瘤CT表现为稍高密度或高密度影;MRI中T1WI大部分为高信号,T2WI为低信号环围绕的桑葚状混杂信号灶,大多数病灶周围无水肿带;CT和MRI增强扫描无或轻度增强;CTA/MRA/DSA检查未见异常.结论:脑内海绵状血管瘤在影像学诊断时,应综合CT、MRI及DSA的表现,其影像学的表现对诊断脑内海绵状血管瘤有特异性.     

脑内海绵状血管瘤的CT和MRI诊断

目的:分析脑内海绵状血管瘤的CT和MRl表现及诊断价值.方法:回顾性分析23例脑内海绵状血管瘤的CT和MRI影像资料,MRl检查23例,CT检壹15例,均经手术病理证实.结果:脑内型海绵状血管瘤可位于脑内任何部位,单发病灶多见,无明显占位效应,周围无或有轻度水肿.CT检查的全部病例呈稍高及混杂密度影,增强扫描大都无强化;MRI检查T2WI表现为"桑葚状"混杂高信号,周围有云絮状低信号环,增强后病灶仅少数轻度强化.结论;脑内海绵状血管瘤的CT与MRl表现具有一定的特征性,MRl优于CT.     

颅内脑外海绵状血管瘤的MRI诊断

目的探讨颅内脑外海绵状血管瘤的MRI表现和诊断价值。方法回顾性分析经手术病理证实颅内脑外海绵状血管瘤15例的MRI表现。结果病灶均位于中颅窝和鞍旁,MRI呈圆形或类似哑铃形肿块,较均匀的稍长T1、长T2信号,增强扫描一般见明显均匀强化。结论颅内脑外型海绵状血管瘤的MRI表现较有特异性,结合临床资料和影像学征象的综合分析可以诊断。     

脑海绵状血管瘤32例影像诊断分析

目的:探讨脑海绵状血管瘤的影像学诊断价值.方法:对32例脑海绵状血管瘤的MRI、CT影像特征进行回顾分析.结果:32例均行MRI常规扫描,8例增强扫描,31例共有39个结节状或圆形病灶,分别呈T1加权像(WI)、T2WI高或低混合信号,T1WI稍低信号、T2WI高信号,T1WI、T2WI均高信号,T1WI、T2WI均低信号;1例7个痛灶呈散在分布圆点形,T1WI、T2WI均低信号.16例行CT检查,显示20个病灶,均为较高密度病灶或不均匀稍高密度.结论:脑海绵状血管瘤的MRI显示信号具有特征性,多数脑海绵状血管瘤结合MRI及CT检查可以明确诊断.     

脑内型海绵状血管瘤的CT、MRI和DSA综合诊断

目的：探讨脑内型海绵状血管瘤的CT、MRI及DSA的表现。方法：回顾经手术病理证实的脑内型海绵状血管瘤20例，均行CT扫描、MRI检查，5例DSA检查。结果：脑内型海绵状血管瘤CT表现为稍高密度或高密度，MRI为低信号环围绕的桑葚状混杂信号灶，大多数病灶周围无水肿带，DSA检查未见异常染色。结论：脑内型海绵状血管瘤在MRI上有比较特异性，诊断时应综合CT、MRI及DSA的表现。     

颅内海绵状血管瘤的影像特点及治疗分析

目的探讨颅内海绵状血管瘤(ICA)的临床表现、影像学特点及治疗方法。方法回顾性分析52例经病理或随访证实的ICA患者的临床及影像学资料,着重观察CT、MRI表现及治疗效果。结果 52例患者中单发者48例,多发者4例,共有病灶63个。脑内型54个,脑外型9个。脑内型好发于幕上脑实质,以额、颞叶多见(38/54,70.37%)。CT多表现为结节状高密度灶,部分可见钙化,边界清,大多无占位效应。MR信号特点复杂,根据分型,以Ⅱ型病灶最多见(32/54,59.26%),T_1WI、T_2WI均为混杂信号,呈桑葚样或爆米花样改变;T_2WI上病灶周围低信号环也是其特征性表现(46/54,85.18%)。增强扫描呈点片状轻度强化(59.26%)或无明显强化(40.74%)。脑外型多见于中颅窝海绵窦,T_2WI呈高信号及增强显著强化是其特点,常伴占位效应。经手术治疗39例(39/52,75%),经伽马刀放射治疗5例(5/52,9.62%),保守治疗8例(8/52,15.38%),术后出现脑出血者4例,神经功能损害者3例。结论颅内海绵状血管瘤的CT、MRI表现对诊断具有重要价值,对指导治疗方案有一定的帮助。ICA治疗方法以手术切除为主,保守治疗或放射疗法也可作为选择。     

颅内脑外型海绵状血管瘤5例MRI诊断分析

目的：分析颅内脑外海绵状血管瘤的MRI表现,探讨其诊断价值。方法：收集整理5例经手术病理证实的颅内脑外海绵状血管瘤资料,全部病例均行MRI平扫及增强扫描。结果：5例均为单发,3例位于颅中窝,2例位于鞍旁。MRI平扫表现为类圆形或哑铃状肿块,T1WI为等或低信号,T2WI为明显高信号,增强扫描后病灶明显强化。结论：颅内脑外海绵状血管瘤MRI表现有一定特点,结合临床资料和影像学资料可提高诊断正确性。     

中枢神经系统血管外皮细胞瘤的CT及MRI影像学特征比较研究

目的:观察和探讨中枢神经系统血管外皮细胞瘤的MRI及CT影像学特点,以提高诊断水平。方法:回顾性分析2010年2月到2017年10月经手术病理证实的中枢神经系统血管外皮细胞瘤6例。6例行MRI平扫及增强,6例行CT平扫,5例增强。结果:5例位于颅内脑外,1例位于髓外硬膜内;CT上,6例均为高密度肿块,2例伴坏死,1例伴钙化,增强后5例均明显强化,3例伴脑膜增厚强化。MRI上,4例(66.67%)呈与脑白质等信号的稍短T1信号,1例呈与灰质等信号的等T1信号,1例呈稍长T1信号;T2WI上,5例(83.3%)呈与灰质等信号的T2信号,1例呈稍长T2信号;增强后5例均明显强化,囊变坏死无强化,4例(66.67%)邻近硬脑膜或脊膜均增厚、强化,3例(50.0%)见典型"脑膜尾征";4例(66.67)颅内病灶伴水肿。2例伴骨质破坏。结论:中枢神经系统血管外皮细胞瘤具有一定的CT、MRI特征性,最终诊断依靠病理。     

脑内海绵状血管瘤的CT、MRI诊断

目的评价脑海绵状血管瘤的影像学表现。方法对20例经过手术病理证实的和典型的脑海绵状血管瘤的进行影像学分析，所有病例均行CT、MRI平扫及增强扫描。结果肿瘤位于幕上14例，幕下2例，脑外4例；直径〈2．0cm16例，〉5．0cm4例。脑海绵状血管瘤MRI表现肿块无包膜，大多数形态呈类圆形，CT增强扫描轻度强化或明显强化。结论熟悉颅内海绵状血管瘤的CT、MRI形态、大小及强化特点，对于诊断与鉴别诊断有重要价值。     

脑内海绵状血管瘤的影像学诊断及其临床意义

目的　探讨脑内海绵状血管瘤(CA)的影像学表现并评价其临床意义。方法　搜集经手术病理证实的脑内海绵状血管瘤21例,21例均行CT检查,16例行MRI检查。结果　CT发现22个病灶,MRI发现23个病灶,多发者5例,病灶位于皮层及皮层下区共18个。16个病灶具有典型脑内型CA的MRI表现,即由低信号环围绕的混杂信号团块。结论　MRI是脑内型CA最佳检查方法,且具有重要的临床意义。     

儿童遗传性心律失常的诊治进展

回顾在遗传性心律失常领域最新发表的相关研究,主要关注与儿童心源性猝死关系密切的离子通道病,包括长QT综合征（LQTS）、短QT综合征（SQTS）、Brugada综合征（BrS）和儿茶酚胺敏感性多形性室性心动过速（CPVT）,总结它们在发病机制及诊治方面的进展。     

The acoustic characteristics of the skull

Many investigators have stated that the difficulties of imaging with acoustical energy through the skull result from the marked attenuation of the energy by the skull. In the literature measurements of total attenuation have been confused with those for absorption.Measurements made by us show that absorption by compact bone varies between 2–3 dB cm^?1 MHz^?1 and, in the low megaHertz region appears to be directly proportional to frequency.It has also between shown that the convoluted inner surface of the ivory bone of the inner table of the skull may degrade the collimation and directionality of the beam by refraction.Cancellous bone, such as is present in the dipole of the skull, greatly attenuates the energy. It is postulated that this largely results from scattering. It is also postulated that the energy propagates through cancellous bone as two components, one in the soft tissues and the other partly in the bony spicules. Observations suggest that attenuation due to scattering much more markedly affects the latter of these components and scatters more greatly the higher frequencies in a pulse of broad bandwidth.The energy in each component has varying propagation paths so that the later cycles in the pulse of each component are subject to increasing interference as a result of the variations in propagation times. The two components moreover may have different propagation times so that interference may occur between the pulses of each component as well.All of these phenomena degrade the collimation, coherence, directionality, beam width, pulse length, frequency and other properties of the ultrasonic energy upon which imaging through the skull depends.The interference effects described above are least for the first cycle in the pulse which usually is not the cycle of highest amplitude. Since, in the free field, most of the energy is concentrated around the beam axis, most of the energy in the field which is deflected from its normal propagation path is deflected away from the beam axis. Thus the directionality of the beam is least degraded in the beam axis. The effects of the skull in degrading the properties of the ultrasonic pulse would therefore be lessened if the amplitude of the first cycle of the pulse and the directionality of its energy could be used for imaging.     

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.     

2017年呼吸疾病主要进展

2017年,国内外学者在呼吸系统疾病的临床和基础领域均进行了深入研究,不仅对相关指南进行了更新,并且针对一些临床热点、难点问题达成专家共识,现就2017年呼吸疾病相关进展作一简单介绍。     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus,therapy, and the vaccination

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP

BackgroundWe aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.MethodsWe performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.ResultsFifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).ConclusionsTreatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.     

Recalcitrant giant orf recurrence after amputation: A case report and review of the literature

Orf is caused by a parapoxvirus. We present a recurrent, giant digital orf case in a female patient with a history of hairy cell leukemia. In spite of shave excision, the lesion progressed and recurred after digital amputation. Treatment with topical imiquimod cream and systemic subcutaneous interferon alfa‐2a was successful.