螺旋CT薄层扫描对45例肺孤立结节的临床应用

目的：评价螺旋CT（SCT）薄层扫描对肺孤立性结节病变的鉴别诊断价值。方法：收集肺内孤立结节45例,分别为肺癌30例,肺结核球10例,肺炎3例,肺错构瘤2例。病灶直径在4cm以内。抽取23例肺癌和10例肺结核球的SCT薄层扫描和常规CT资料进行比较。SCT薄层扫描层厚度以3mm或5mm为主。结果：在病灶形态的显示方面两者相似;而对病灶的边缘征象,内部结构及其与相邻气管,血管的关系等方面,SCT薄层扫描优于常规CT。结论：SCT薄层扫描对肺内孤立性结节病变鉴别诊断有重要价值。如细短毛刺,分叶征,小泡征及胸膜凹陷征同时出现,对细支气管肺泡癌的定性价值较大,而钙化的形态及脂肪的检出对肺结核球和肺错构瘤的定性有帮助。     

低剂量与薄层扫描螺旋CT在检出肺结节中的研究

目的:探讨低剂量、薄层及常规剂量螺旋CT扫描在检出和诊断肺结节中是否存在显著差异。方法:对72例体检经常规剂量扫描中发现肺结节病人行肺部低剂量和局部薄层螺旋CT扫描,所得图像分别按<5mm,5mm～10mm,>10mm不同大小分组记录结节数目,并记录结节形状、内部特征以及边缘特点及形态,结节内钙化,支气管征、界面征及邻近改变等,并部分做出定性诊断,再与动态增强扫描及病理结果相对照。结果:低剂量、薄层与常规剂量螺旋CT扫描三者在检测肺结节的数目、肺结节内部与周边特征差异无显著性,而薄层螺旋CT扫描技术对结节的检测结果在总体上略占优势,但是三者在定性诊断方面均有差异。结论:低剂量加薄层螺旋CT扫描技术值得在人群普查、肺结节检出中推广应用,但仍需努力提高其诊断的准确性。     

低剂量与薄层扫描螺旋CT在检出肺结节中的研究

目的:探讨低剂量、薄层及常规剂量螺旋CT扫描在检出和诊断肺结节中是否存在差异显著性。方法:对72例体检经常规剂量扫描中发现肺结节患者行肺部低剂量和局部薄层螺旋CT扫描,所得图像分别按<5mm,5mm~10mm,>10mm不同大小分组记录结节数目,并记录结节形状、内部特征以及边缘特点及形态,结节内钙化,支气管征、界面征及邻近改变等,并部分做出定性诊断,再与动态增强扫描及病理结果相对照。结果:低剂量、薄层与常规剂量螺旋CT扫描三者在检测肺结节的数目、肺结节内部与周边特征差异无显著性,而薄层螺旋CT扫描技术对结节的检测结果在总体上略占优势,但是三者在定性诊断方面均有差异。结论:低剂量加薄层螺旋CT扫描技术值得在人群普查、肺结节检出中推广应用,但仍需努力提高其诊断的准确性。     

高分辨螺旋CT在肺孤立性结节诊断中的应用

目的：探讨高分辨螺旋CT扫描对肺孤立性结节（solitary pulmonary nodule，SPN）微细表现的价值。方法：50例在常规螺旋CT扫描基础上进行高分辨螺旋CT扫描及静脉注药高分辨螺旋CT扫描。结果：高分辨螺旋CT扫描能充分显示肺孤立性结节内的细微结构：7例炎块中4例钙化，10例结核瘤中9例钙化，2例错构瘤中既有钙化又含脂肪成份。31例恶性结节中点状钙化3例，空洞9例，密度不均匀坏死22例。结论：高分辨螺旋CT扫描显示肺孤立性结节内部结构、形态等方面尤于常规螺旋CT扫描，是区分良恶性孤立性肺结节有效方法。     

MSCT高分辨动态增强扫描在肺内孤立性结节的诊断价值

目的评价MSCT高分辨动态增强扫描在诊断肺内孤立性结节的价值。方法收集直径小于3cm的肺内孤立性结节患者43例,其中周围性肺癌25例,单发转移瘤5例,肺炎性假瘤4例,结核瘤3例,肺硬化性血管瘤2例,肺腺瘤2例、肺错构瘤2例。43例患者先行常规CT扫描,然后行兴趣区高分辨螺旋CT动态增强扫描。结果高分辨螺旋CT动态增强扫描诊断肺内孤立性小结节的正确率为90%,肺内恶性结节大多均匀增强,且增强CT值大于20Hu,平均增强CT值为36Hu。良性结节多周边增强,且增强CT值小于10Hu。结论根据病变的基本形态特征,并结合高分辨螺旋CT动态增强扫描有助于肺内孤立性结节的定性诊断。     

螺旋CT薄层扫描对45例肺孤立结节的临床应用

目的评价螺旋CT(SCT)薄层扫描对肺孤立性结节病变的鉴别诊断价值.方法收集肺内孤立结节45例,分别为肺癌30例,肺结核球10例,肺炎3例,肺错构瘤2例.病灶直径在4-cm以内.抽取23例肺癌和10例肺结核球的SCT薄层扫描和常规CT资料进行比较.SCT薄层扫描层厚以3-mm或5-mm为主.结果在病灶形态的显示方面两者相似;而对病灶的边缘征象、内部结构及其与相邻气管、血管的关系等方面,SCT薄层扫描优于常规CT.结论 SCT薄层扫描对肺内孤立性结节病变鉴别诊断有重要价值.如细短毛刺、分叶征、小泡征及胸膜凹陷征同时出现,对细支气管肺泡癌的定性价值较大,而钙化的形态及脂肪的检出对肺结核球和肺错构瘤的定性有帮助.     

血管集聚征在肺小结节CT扫描中的鉴别价值

目的探讨血管集聚征在肺小结节CT扫描中的鉴别价值。方法对40例肺内孤立性小结节(直径不超过2cm)行薄层CT扫描．分析肺结节与血管的关系。结果本组40例中23例(57．5％)出现血管集聚征．其中良性结节2例(8．7％)．恶性结节21例(91．3％)。结论血管集聚征在肺内孤立性小结节的定性诊断中具有重要的鉴别价值。     

肺内孤立结节的CT鉴别诊断

目的通过对肺结节轮廓与界面变化的CT观察,探讨肺内孤立结节的CT鉴别诊断,提高CT对肺内孤立结节定性诊断的正确性。方法对97例在行CT检查后经病理检查证实的肺内孤立结节的患者进行回顾性调查分析。结果良性结节27例,恶性结节70例;CT表现分别是：良性结节多呈圆形或椭圆形,分叶少而浅,多见结节内钙化,多数边缘有长毛刺;恶性结节的形态多为不规则形,分叶多且深,周围常见短细毛刺,并常见胸膜凹陷征、其内空泡征、血管截断或聚集征。结论肺内孤立结节常有较显著的CT特征,可提高肺内孤立结节的鉴别能力,提高诊断的准确率。     

螺旋CT扫描技术在59例肺结节患者诊断中的应用

目的探讨多层螺旋CT薄层多平面重建及动态增强扫描在孤立性肺结节良恶性判断中的应用价值.方法选取经病理证实的59例孤立性肺结节,平扫后对结节区行动态增强扫描,对所得数据进行多平面重建,分析肺内结节的形态学改变、血供特点及CT值变化.结果螺旋CT薄层多平面重建清晰地显示孤立肺结节的形态学改变;动态增强扫描良恶性结节强化形式及CT值变化不同.结论多层螺旋CT薄层多平面重建及动态增强扫描对孤立性肺结节性质的评价具有较高的敏感性和特异性,可作为评价孤立性肺结节性质首选的检查方法.     

肺部孤立性结节20例X线胸片与CT对比分析

目的对比分析肺部孤立性结节在X线胸片与CT上的表现。方法收集经手术病理证实〈3．5cm肺内孤立性结节20例，全部病例先摄X线胸片再做CT扫描，对〈2cm结节再做薄层扫描。结果下列征象对恶性病变诊断有帮助：母子灶，结节边缘分叶、棘状突起和毛刺征，空泡征，肺结节并肺门、纵隔淋巴结肿大。而小卫星灶，均匀致密的钙化，结节边缘光滑、规整，〈3cm病灶如出现空洞都以良性病变为多见。结论通过对肺内孤立性结节良、恶性病例常规X线胸片与CT进行分析探讨，可以达到优势互补的作用，以提高对本病的认识、了解。     

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.