磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

康复护理卫生适宜技术推广运行模式

本文论述了康复护理卫生适宜技术推广运行模式,提出了健全组织架构,明确职责任务;根据基层需求,筛选推广项目;卫生行政部门参与,加大推广力度;采取多种多样的推广方式、实施学分管理、严格制度管理,提高推广质量;扩大辐射面,充分发挥资源是确保适宜技术有效持续推广的保证。     

实验性急性心肌梗塞的酶组织化学

取狗8只,缩扎左冠状动脉前降支20 min后,分别取缩扎上、下方的心肌组织,冰冻切片。6只以脱氢酶染色,2只为对照,观察切片发现缩扎上、下方的心肌纵切面上,有酶染蓝色颗粒聚积在闰盘两侧呈“竹节”样,部分心肌有扭曲、断裂,横切面上心肌酶染颗粒不均匀。这皆说明冠状动脉缺血初期伴明显反射性心肌收缩。小部分心肌可见变色反应,说明心肌缺血中的渐进性坏死过程。所以,心肌梗塞早期必伴动力型心肌梗塞(DMI)及静力型心肌梗塞(SMI)两个过程。而心绞痛发生似乎以动力型心肌变化为主,故在决定防治上应全面考虑。     

磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

家兔大鼠延髓呼吸中枢压力感受区的细胞构筑

24只家兔和10只大鼠的延髓呼吸中枢压力感受区(BSA),经HE、Cajal等染色及免疫组化技术作细胞构筑学研究。BSA在软脑膜2～82μm之下,范围为390μm×490μm×1000μm,由中、小型多极和梭形神经元构成,属B1/35-羟色胺能神经元。其表层的胶质纤维及神经纤维与脑表面平行呈板层状排列。BSA富于毛细血管。     

B超引导下经阴道穿刺孕囊治疗剖宫产术后瘢痕妊娠的护理

总结35例B超引导下经阴道穿刺孕囊治疗剖宫产术后子宫瘢痕妊娠的护理。护理重点为心理护理,做好孕囊穿刺术前、术中、术后的护理,严密观察病情变化,做好药物不良反应的护理以及出院后延续护理服务。35例患者全部保留子宫,保存了生育能力,恢复良好。     

心理行为干预在乳腺癌新辅助化疗患者中的应用

目的探讨心理行为干预对缓解乳腺癌新辅助化疗患者不良情绪的效果。方法用抑郁自评量表和焦虑自评量表测试40例乳腺癌新辅助化疗患者的情绪反应,给予教育性干预、行为放松训练、社会支持。结果心理行为干预前后患者焦虑、抑郁分值比较,分别为t=2．64,P〈0．05;t=3．46,P〈0．05。结论心理行为干预能有效缓解乳腺癌新辅助化疗患者的不良情绪。     

磁共振弥散加权成像评价肝纤维化的临床病理对照研究

Objective To evaluate the clinical practical value of apparent diffusion coefficient (ADC) measurements based on diffusion-weighted MR imaging (DWI) for quantification of liver fibrosis and inflammation for hepatitis viral infection.Methods Diffusion-weighted MRI with parallel imaging was prospectively performed on 85 patients with chronic hepatitis and on 22 healthy volunteers within a single breath-hold using a single-shot spin-echo echo-planar sequence at b values of 100, 300, 500,800 and 1000 s/mm2 respectively. ADC values of liver were measured with five different b values. The inflammation grades and fibrosis stages were evaluated histologically by biopsy. One-way analysis of variance and Spearman' s rank correlation test were used for statistical analysis. Receiver operating characteristics analysis was used to assess the performance of ADC in predicting the presence of stage ≥2 and stage ≥3 hepatic fibrosis, and grade ≥1 hepatic inflammation. Results There was moderate negative correlation between hepatic ADC values and fibrosis stage. And the best correlation was obtained for a b value of 800 s/mm2 (r = - 0. 697, P=0.000). At all b values there was a significant decrease in hepatic ADC in patients with stage ≤1versus stage ≥2 fibrosis and stage ≤2 versus stage ≥3 fibrosis (P <0. 05). Hepatic ADC was a significant predictor of stage ≥2 and ≥3 fibrosis. The areas under the curve were 0. 909 vs 0. 917, sensitivity 76. 6% vs 80. 0% and specificity 88. 3% vs 91.5% (ADC with a b value of 800 s/mm2, 1.26 × 10<'3> mm2/s or less and 1.19 × 10-3 mm2/s or less). There was weak to moderate negative correlation between ADCs and inflammation grade. Hepatic ADC was a significant predictor of grade ≥1 inflammation with an area under the curve of 0. 781, sensitivity of 60. 0% and specificity of 86. 4% (ADC with a b value of 500 s/mm2, 1.54 × 10-3 mm2/s or less). Conclusion The D WI measurement of hepatic ADC can be used to quantify liver fibrosis and inflammation. It will be a new approach for early diagnosis and therapeutic follow-up of hepatic fibrosis.     

结合雌激素对去势雌性大鼠骨量和血脂代谢的影响

目的了解结合雌激素倍美力对去势雌性大鼠的骨量和血脂的影响。方法鼠龄6月的Wistar雌鼠30只,分为假手术（SHAM）组、卵巢切除（OVX）组、卵巢切除加倍美力（OVX＋E）组。双侧卵巢去势或假手术后7d,每天予倍美力0.5mg/kg体重或安慰剂,共3月。处死大鼠时,测定3组全身骨密度、股骨骨密度、股骨去脂干重、灰重、骨钙含量、抗弯力强度、子宫湿重、血清碱性磷酸酶AKP、血清钙、尿Ca/Cr及总胆固醇（TC）、三酰甘油（TG）、血浆高密度脂蛋白（HDL-c）、低密度脂蛋白（LDL-c）、载脂蛋白A（ApoA）、载脂蛋白B（ApoB）。结果OVX+E组的全身骨密度、去脂干重、灰重、子宫湿重、血浆HDL-c、TG水平明显高于OVX组,而血浆LDL-c、TC水平明显低于OVX组,其TG水平也明显高于SHAM组,其他骨量及血脂指标各组之间差异无显著性。结论结合雌激素能抑制Wistar雌鼠去势后的骨丢失,升高血浆HDL-c水平,降低血浆LDL-c和TC水平,对骨骼和心血管系统有保护作用。     

组织细胞坏死性淋巴结炎

组织细胞坏死性淋巴结炎 (ＨＮＬ)又称Ｋｉｋｕｃｈｉ病〔1〕,患者常因发热、淋巴结肿大而就诊 ,临床与病理组织学诊断都易误诊为恶性淋巴瘤。本文复习 11例ＨＮＬ的临床及病理组织检查资料 ,结合免疫组织化学和网状纤维染色进行分析 ,以加深对ＨＮＬ的认识。临床资料1.标本收集 :收集 1985～ 1999年间我院病理科淋巴结活检标本 42 0例 ,取蜡块 ,复查组织切片 ,排除化脓性、结核性、寄生虫、霉菌以及嗜酸性淋巴肉芽肿等坏死性淋巴结炎 ,确诊11例供分析。组织经 10 %福尔马林固定 ,常规石蜡切片、ＨＥ、网状纤维染色 ,5例用Ｅｎｖｓｉｏｎ二…