胃淋巴瘤的CT诊断

目的探讨胃淋巴瘤的CT表现特征,提高CT对其的诊断价值。方法对32例经病理证实的胃淋巴瘤的CT表现,包括胃受累的部位、病灶大体形态、侵犯范围、胃壁厚度、浆膜及胃周脂肪间隙受累情况、增强后病灶与周围肌肉的比较、有无坏死、有无其他器官受累、胃周及其他腹部淋巴结情况进行分析。结果本组32例病例大多数发生在胃窦和胃体,胃壁累及范围均大于胃周径的75%,胃壁厚度不均,胃壁最大厚度〉10 mm的有25例（78%）。27例（85%）有一处或一处以上胃周、腹膜后、肝门区、肠系膜淋巴结肿大。20例（61%）病人有腹膜后肾门水平下淋巴结的肿大。24例（75%）病例合并脾肿大。结论胃淋巴瘤的CT表现有一定特征性,有助于其诊断。     

多排螺旋CT对原发性胃淋巴瘤的CT征象分析

目的：分析原发性胃淋巴瘤（primary gastric lymphoma,PGL）的CT表现。方法回顾性分析经胃镜活检或手术切除病理证实的51例PGL患者的CT表现,分析肿瘤的部位、形态、密度、强化程度、淋巴结情况等。结果该组51例PGL病例均为非霍奇金淋巴瘤,以同时累及胃体、胃窦部多见（占45.1%）;全部病例均出现胃壁增厚,以弥漫性增厚多见（占49.2%）;CT显示增厚胃壁密度均匀,未见坏死区,增强扫描轻中度均匀强化;68.6％的病例可见溃疡样改变,41.2%的病例伴有胃周淋巴结肿大。结论 PGL的CT表现具有一定特征性,在PGL的诊断与鉴别方面起重要作用。     

原发性胃淋巴瘤MSCT影像特征及其应用价值分析

目的 分析原发性胃淋巴瘤的多层螺旋CT(MSCT)表现,总结诊断价值高的影像特征,提高影像诊断准确率。方法 回顾性分析20例经手术及病理证实的原发性胃淋巴瘤患者的MSCT检查资料,结合病理结果,总结具有特征性诊断价值的影像特征。结果 病理证实均为非霍奇金淋巴瘤(NHL)。CT表现为胃壁增厚：其中胃壁弥漫性增厚14例,节段性增厚4例,局限性增厚2例,均为多部位受累。胃壁轻-中度均匀性强化：11例胃黏膜呈细线样强化,4例见血管漂浮征,1例见轨道征。1例胃黏膜破坏中断,2例胃浆膜面毛糙,9例胃周、腹膜后可见淋巴结肿大。结论 在原发性胃淋巴瘤的诊断中,CT检查对诊断有重要价值,对提高诊断准确性有重要意义。     

64排螺旋CT对胃淋巴瘤的CT征象分析

目的 分析64排螺旋CT对胃淋巴瘤的CT征象特点,并探讨其对该病的诊断价值.方法 回顾性分析21例经胃镜活检或手术切除病理证实淋巴瘤的64层螺旋CT表现.结果 本组21例患者均为非霍奇金氏淋巴瘤.病变部位:3例胃窦,5例胃体,9例累及两个及以上部位,4例为弥漫浸润,同时累及两个及以上部位的占61.90%;胃壁呈不均匀增厚,厚度范围为1.3～5.4 cm,均数3.4 cm,其中9.52%呈局限性增厚,4.29%呈节段性增厚, 76.19%呈弥漫性增厚,2例显示深溃疡形成,1例胃黏膜呈"梳齿征".增强扫描病灶呈中度强化.95.24%病灶显示胃腔形态可改变.80.95%病灶胃周围脂肪间隙清晰.结论 胃淋巴瘤的CT表现具有一定的特征性,多个部位或弥漫性胃壁不均匀增厚,黏膜皱襞结节样增厚,胃周脂肪间隙清晰,胃壁有一定扩张度和柔软度时高度提示胃淋巴瘤可能.     

胃弥漫大B细胞淋巴瘤与黏膜相关淋巴组织淋巴瘤CT比较研究

目的探讨胃淋巴瘤两种主要类型：弥漫性大B细胞淋巴瘤（Diffuse large B—ceil lymphoma,DLBCL）和黏膜相关淋巴组织淋巴瘤（Mucosa-gssociated lymphoid tissue Iymphoma,MALToma）CT征象的异同,为胃淋巴瘤的生物学行为评价和影像学鉴别诊断提供依据。方法回顾分析我院规范CT检查胃淋巴瘤病例42例,均经胃镜或手术病理证实。根据病理结果将全部病例分为DLBCL和MALToma。分析两种类型淋巴瘤CT影像学征象特征,包括病变所处胃的分部、范围、形态、厚度、强化、黏膜及浆膜面情况、淋巴结转移、腹腔大血管及脏器侵犯情况、腹腔转移及有无腹水等。统计学分析比较两种类型淋巴瘤的CT征象差异。结果DLBCL多累及胃的多个部分,且以近端胃受累为主,MALToma以胃的单一部分受累更为多见,且以胃远端分布为主,差异有显著性。DLBCL癌肿平均厚度（275±152）cm,大于MALToma癌肿平均厚度（123±064）cm,差异存在显著性（P〈0．01）。DLBCL胃壁以弥漫性、不均匀增厚为主,MALToma以局限性、均匀增厚为主;DLBCL较MALToma更易侵犯浆膜,淋巴结转移率较MALToma高,转移淋巴结体积大、分布更为广泛,侵犯腹腔干分支大血管及腹腔脏器的比例均高于MALToma。DLBCL静脉期强化0T值（6909±1349）HU．低于MALToma静脉期强化CT值（81．79±25．82）Hu。MALToma黏膜面“白线征”显示率高于DLBCL;DLBCL浆膜侧“血管穿行征”显示率高于MALToma。结论GT影像学征象可反映DLBCL和MALToma的生物学行为,显示两种胃淋巴瘤侵袭性的差异,可作为两者鉴别的重要手段。MALToma黏膜面“白线征”、DLBCL浆膜侧“血管穿行征”丰富了胃淋巴瘤的CT征象,为鉴别诊断及生物学行为评价提供了新的指标。     

原发性胃淋巴瘤的CT和MR影像表现对比

目的对比分析原发性胃淋巴瘤CT和MR影像学表表现,为临床诊断提供参考。方法回顾性分析我院收治原发性胃淋巴瘤患者临床资料,整理CT和MR影像学表现。结果 CT和MRI诊断均能够清晰显示原发性胃淋巴瘤病变范围、部位以及周围淋巴结情况,3例近累及胃体,7例累及胃体和胃窦,6例累及胃底,3例同时累及胃体、胃底和胃窦,3例累及贲门和胃底,所有患者均出现胃壁增厚情况,CT诊断3例患者浆膜面模糊,MRI诊断6例患者浆膜面模糊。CT扫描20例患者均匀轻度强化,2例患者重度不均匀强化,MRI诊断11例患者增强,其中9例均匀轻度强化,2例中度不均匀强化,所有患者DWI信号出现高信号,突出显示肿瘤及转移淋巴结高信号,对比明显。结论原发性胃淋巴瘤CT和MR影像学表现存在一定特点,联合使用对诊断有更高的价值。     

原发性胃淋巴瘤的多排螺旋CT表现及病理对照分析

目的 分析胃淋巴瘤病理特点及多排螺旋CT表现,旨在提高对该病的认识及诊断水平。方法 回顾性分析安徽医科大学第一附属医院2017年1月至2019年12月经活检或手术病理证实的11例原发性胃淋巴瘤患者的CT图像,其中男性7例、女性4例,年龄40~75岁,分析CT图像上病变部位、形态及强化特点。结果 11例均为非霍奇金淋巴瘤,其中9例为弥漫大B淋巴瘤,1例为套细胞淋巴瘤,1例为黏膜相关淋巴组织结外边缘区淋巴瘤。CT均表现为胃壁较广泛增厚,呈均匀软组织密度,无明显钙化及低密度坏死区,增强扫描呈轻中度均匀强化,黏膜破坏较轻,病变多发生于胃体、胃窦部,伴胃腔扩张4例,3例伴有胃周淋巴结肿大。结论 胃淋巴瘤CT表现具有一定的特异性,可以全面反映胃壁受累范围及病灶与邻近组织关系、腹腔及腹膜后淋巴结肿大情况,对临床诊断及治疗具有重要意义。     

原发性胃淋巴瘤的多排螺旋CT诊断

目的 分析原发性胃淋巴瘤的CT表现,探讨CT诊断原发性胃淋巴瘤的价值.方法 回顾性分析经手术病理免疫组织化学证实的16例原发性胃淋巴瘤的临床及影像学资料.结果 16例原发性胃淋巴瘤患者均为非霍奇金淋巴瘤;CT表现为胃壁不均匀增厚,其中弥漫性增厚9例,节段性增厚4例,局限性增厚3例;14例呈均匀强化,2例内见片状低密度坏死;12例胃壁黏膜完整,4例黏膜破坏;胃壁浆膜面模糊1例,浆膜面清晰15例; 5例胃周淋巴结肿大.结论 CT检查对原发性胃淋巴瘤诊断有较高价值,并有助于肿瘤的定位、定性诊断.     

胸部结节病的CT诊断与分析

【目的】分析结节病的CT表现，以提高对本病的认识和诊断水平。【方法】回顾性分析经活检证实52例胸部结节病的CT表现。【结果】52例结节病中，肺门、纵隔淋巴结肿大46例（88．5％），其中仅见肺门或／和纵隔淋巴结肿大16例（30．7％），肺门或／和纵隔淋巴结肿大伴有肺内改变30例（57．5％），仅见肺部侵润性改变而无淋巴结肿大2例（3．8％），肺纤维性改变4例（7．7％）。肺内主要表现为结节影（30例），支气管血管束增粗（14例），小叶间隔增厚（8例），实变影（2例），磨玻璃影（2例）。【结论】双侧肺门对称性淋巴结肿大和／或纵隔淋巴结肿大以及沿支气管血管束分布的结节影是胸部结节病的特征性表现；不典型者需密切结合临床检查及治疗后随访。     

胃壁增厚的CT研究及应用价值

目的 提高CT对于引起胃壁增厚的胃部病变的诊断及应用价值重要性的认识.方法 回顾性分析经手术病理及胃镜病理证实的82例胃壁增厚患者CT表现,并与正常胃壁厚度相比较,从胃壁增厚的程度、形态等来诊断及鉴别胃壁增厚的病变.结果 82例胃部疾病,其中胃癌45例、胃淋巴瘤17例、间质瘤12例、胃炎8例,累及范围共122处;其中胃窦部56处,平均厚度(19.3+11.8)mm;胃体部45处,平均厚度(32.6+12.3)mm;胃底贲门部21处,平均厚度(39.1+7.5)mm;与正常各区胃壁厚度有显著性差异.本组82例病例胃壁增厚的CT类型:条形或梭形增厚(30)、肿块形增厚(14)、结节形增厚(5)、溃疡型增厚(10)、不规则形增厚(8)、混合型增厚(15)等.结论 CT对于胃壁增厚的厚度、形态等的观察有很大的价值,能够较好地准确诊断胃壁增厚的相关疾病及鉴别诊断.     

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.