CT、MRI对肾上腺病变的诊断分析

目的:分析探讨CT、MRI诊断对肾上腺病变的作用与价值。方法:MarconiMX8000 4层螺旋CT机,增强造影剂使用非离子型制剂,常规扫描及增强。应用西门子MAGNETOM1.5T磁共振机,增强造影剂使用Gd-DTPA制剂,常规T1WI、T2WI、脂肪抑制、化学位移同反相位及增强。对25例经手术及病理资料诊断证实的肾上腺病变进行CT、MRI诊断回顾性分析。结果:可清楚显示肾上腺病变的侧别、数目、大小、范围及可能的性质。结论:CT是肾上腺病变最佳影像检查方法,MRI具有重要辅助及补充诊断价值。     

Stoppa入路在骨盆髋臼骨折中的初步应用

目的 探讨在骨盆髋臼骨折中采用耻骨联合上缘横形或下腹正中切口,真骨盆内操作(Stoppa人路)的初步临床经验. 方法对2008年3月至11月问应用Stoppa入路治疗的10例骨盆髋臼骨折患者进行总结.5例骨盆患者均为Tile C型,Stoppa入路复位同定前环的高位耻骨支骨折.髋臼骨折为横行2例,双柱、T型及后柱(四边体粉碎骨折伴中心脱位)骨折各1例,单纯Stoppa入路2例,联合Kocher-Langenbeck及髂腹股沟入路3例. 结果所有骨盆骨折均复位优,所有髋臼骨折均解剖复位.Stoppa入路平均切口长度10 cm(9～12 cm),平均手术时间88 min(75～105 min),半均出血560 mL(250～800 mL),无手术并发症.7例获得4～8个月随访,功能结果均满意. 结论 Stoppa入路可以替代髂腹股沟入路治疗高位耻骨支骨折,也可单独或联合其他入路治疗髋臼骨折,具有操作简单、并发症少的优点.     

获得性骨肥大综合征1例

获得性骨肥大综合征,即滑膜炎、痤疮、脓包疮、骨肥厚、骨炎综合征(synovitis,acne,pustulosis,hyperostosis,osteitis,SAPHO),包括骨关节病变和皮肤病变,是一种少见的原因未明的慢性进行性骨病,笔者遇到1例,现报告如下。患者男,50岁。因右胸锁关节处隆起、压痛、翻身疼痛难忍逐渐加重2年而来就诊。自述两年前曾因此处疼痛在当地医院就诊,诊为“畸形性骨炎”,用抗炎药物治疗后,症状有缓解。但近年来上述症状逐渐加重遂来本院就诊。检查:前上胸、双侧锁骨区及胸锁关节处隆起,以右胸锁关节隆起明显,局部皮肤无红、热,触诊质地硬,有压痛,无波…     

FasL基因表达对缺氧状态下直肠癌细胞增殖凋亡的影响

Objective To elucidate the effect of FasL gene expression on the proliferation and apoptosis of hypoxic rectal carcinoma cells. Methods The normoxic expression level of FasL in HR-8348 subtype cells (HR-8348B, HR-8348L, HR-8348F and HR-8348As) with different invasive power were verified by Western blot. Hypoxia models for HR-8348B, HR-8348L, HR-8348F and HR-8348As were constructed with chemical modeling, then the FasL levels in all groups at 12 h after hypoxia were quantitated by Western blot. Distribution of different cell life cycles was determined with flow cytometry. Cell reproductive activities were detected with MTT method, and cell apoptesis was assessed with TUNEL. Results FasL protein was pigmentized at the position of 40 000 by Western blot, and the expression level of FasL was significantly higher in HR-8348F cells than those in HR-8348B, HR-8348L and HR-8348As cells(F=361.149, P<0.01) in normoxia. At 12 h after hypoxia, the FasL level was also significantly higher in HR-8348F cells than those in other groups (F=278.766, P<0.01), but was not markedly different as compared to themselves in normoxia (t=1.762, P>0.05). The proliferation index was significantly higher in HR-8348F (60.43±3.72) than those in HR-8348B (40.01±3.30), HR-8348L (41.30±4.06) and HR-8348As cells (35.87±4.39), respectively (F=39.477, P<0.01). However, both inhibition rate of proliferation and apoptotic index were remarkably lower in HR-8348F (17.30±1.98 and 13.10±1.04) than those in HR-834B (33.70±4.33 and 21.60±1.31), HR-8348L (34.20±3.92 and 20.10±1.15), and HR-8348As (38.00±4.55 and 23.90±1.23), respectively (F=28.811 and 76.462, respectively, P<0.01). Conclusion The expression enhancement of intracellular FasL in rectal carcinoma in hypoxia can lead to accelerated proliferation and reduced apeptosis of cells, which will promote tumor cells to adapt microenvironmental hypoxia.     

Extragastrointestinal stromal tumor possibly originating from the prostate

We report a case of extragastrointestinal stromal tumor possibly originating from the prostate. The patient underwent radical prostatectomy because of no metastatic evidence. No recurrence and metastasis have been found during 14 months of follow up. To our knowledge, this may be the third such case published in a report in terms of pathological type.     

高频超声诊断新生儿卵巢增大、并腹股沟疝的临床意义

新生儿期卵巢增大,可形成卵巢囊肿、影响卵巢进入正常位置而形成腹股沟疝,导致小儿性早熟,影响小儿身高及心理发育等。自2006年1月-6月我们连续发现5例新生儿卵巢增大,予以报道。1材料与方法临床资料见表1,应用彩色多普勒超声诊断仪:Philps HD、HDI 5000,高频探头7-10mmHz。行常规下腹部及腹股沟、会阴区扫查。2结果超声检查所见及诊断结果见表1。表1 5例临床资料与超声检查结果比较异及丘脑-垂体-卵巢器质性病变产生过多激素,刺激胎儿卵巢内卵泡增生过大、内液潴溜,是导致卵巢增大的原因[3]。5例新生儿8枚卵巢增大的原因分析,说明胎儿期…     

试论七情发生和脑主神明与抑郁症病机证治的关系

抑郁症是一组以抑郁心境自我体验为中心的临床症状群或状态.中医多将其归在郁证之类,对其理论解释的重点多是在心主神明论指导下的以五脏为中心的肝,临床治疗亦多遵疏肝解郁这一基本大法,并取得了一定成效.     

发作性睡病与HLA—DQB1＊0602基因的相关性研究

目的 探讨发作性睡病与HLA—DQB1基因的相关性。方法 对30例发作性睡病患者的临床资料进行分析。用序列特异性引物-聚合酶链反应（PCR-SSP）分型技术测定HLA—DQB1等位基因，并与44例健康人检测的数据进行比较。结果 发作性睡病患者组DQB1＊0602基因频率为40％，与正常对照组9．09％相比较明显增高；未检出DQB1＊0401—0402基因，与正常对照组9．09％相比较，经统计学分析，差异有显著性（P〈0．05）。结论 HLA—DQB1＊0602基因为中国发作性睡病人群的易感基因；HLA-DQB1＊0401—0402基因为中国发作性睡病人群的保护基因。     

MRI对累及头颈部淋巴组织病变的鉴别意义

目的:基于累及头颈部淋巴组织病变的临床不典型性,旨在探讨MRI对其进行鉴别诊断的客观依据。方法:对本组22例可疑累及头颈部淋巴组织的各类病变进行MRI检查并与病理学结果进行对照。结果:MRI对本组22例累及淋巴组织病变的诊断与病理学诊断的符合率(21/22)约为95%。结论:MRI是对累及头颈部淋巴组织病变的重要检查手段,并能为明确其诊断提供客观依据。     

高血压家系802人的高血压患病率、知晓率、治疗和控制状况调查

目的了解高血压家系人群高血压患病率、治疗率和控制率特点。方法用整群随机抽样调查的方法调查高血压家系高血压的流行和控制情况，分析比较相关指标的差异。结果家系成员高血压患病率为55．86％，存在危险因素聚集现象。高血压的知晓率、治疗率、控制率分别为79．46％、62．72％、19．64％。结论该地区高血压家系高血压患病率较高，遗传因素是重要原因。虽高血压控制水平较高，但需加强高血压的一级预防。