数字X线摄影和计算机X线摄影的应用比较与评价

探讨数字X线摄影(DR)和计算机X线摄影(CR)两大数字化摄影技术的临床应用.材料和方法:用德国Pehamed公司产测试板分别测量DR和CR的空间分辨率,并从100例两者所摄得的正位胸片中,分析图像质量,统计受检者的照射剂量,比较在技术操作、图像质量控制与后处理技术、工作效率、医院效益等方面的优势.结果:DR和CR均提高了图像质量,不同程度减低了被检者所受X线照射量,通过缩短检查和发报告的时间加快了工作效率,带来更高的效益,DR较之CR更具优势.结论:DR与CR相比DR图像质量、后处理功能、工作流程能力、病人吸收剂量均明显优于CR,DR具有更广阔的前景.     

床边CR摄影与传统床边摄影的对比研究

目的：评价计算机X线摄影术(CR)在床边照片的应用。方法：抽取我院CR床边按照影像和传统床过照片备1000例，由2位放射学医师及1位主管技师对影像进行分析，分别统计甲、乙、丙及废片率，同时也对条件进行分析评价。结果：(1)CR影像：甲级片率32．1％，乙级片率44.5％，丙级片率23．4％，废片率0％。(2)传统床造影像：甲级片率20．3％，乙级片率53．5％，丙片率16．8％，废片率9．4％。结论：CR床边照片质量明显比传统床边投照优秀，CR床边照片有利于放射诊断。     

锂剂促进周围神经损伤修复的初步研究

目的 探讨锂剂对周围神经损伤后神经再生的影响.方法 取48只雌性SD大鼠,制作大鼠右侧坐骨神经损伤动物模型,通过腹腔注射氯化锂,在不同时间点观察动物下肢活动情况,检测小腿三头肌神经电生理及肌湿重,并对损伤远端神经纤维的神经丝蛋白(NF200)、单核巨噬细胞抗原(ED1)、P-75和运动终板进行免疫组织化学染色观察.结果 损伤后4周,实验组动物下肢已接近正常行走步态,对照组右侧肢体仍明显跛行;损伤后2周和4周,实验组的复合肌肉动作电位(CMAP)波幅较对照组明显增大,两组间的差异有统计学意义(P＜0.05);损伤后4周、8周,实验组的小腿三头肌重量较对照组明显增大,两组间差异有统计学意义(P＜0.05);损伤后3 d,在距离损伤远端5 mm处,实验组坐骨神经纤维内NF200呈连续丝状染色,而对照组仍然是颗粒状染色;损伤后4周,在神经肌肉接头处,可观察到实验组肌肉运动终板有新生神经纤维支配,而对照组运动终板上无神经纤维支配,两组ED1及P75染色未见明显差别.结论 锂剂可有效促进周围神经损伤后的再生,但其机制仍需进一步研究.

Abstract：

Objective To evaluate the effect of lithium on nerve regeneration after peripheral nerve injury.Methods Sciatic nerve crash injury model was created on the right side of 48 female SD rats.Lithium was administered after the injury by intraperitoneal injection.Locomotion of the lower limbs, electromyography and wet muscle weight of the triceps muscles were measured at different time points after the injury.Changes of NF200, ED1, P-75 and motor end plate at the distal part of the injured nerve were detected by immunohistostaining.Results Four weeks after sciatic nerve crash injury, animals that received lithium injection restored near normal gait, whereas the control animals were limping.Two and four weeks after the injury, the lithium injection group had significantly higher CMAP amplitude than the control group.Four and eight weeks after the injury, the wet muscle weight in lithium injection group was significantly heavier than the control group.Three days after crush injury, continuous NF200 positive fibers were found 5 mm distal to the injury site in the lithium injection group, whereas in the control group, only granular NF200 positive staining was observed Four weeks after crush injury, new innervations to the motor end plate were detected in the neuromuscular junction in the lithium injection group, but not in the control group.No differences in ED1 and P75 staining were detected.Conclusion Lithium could significantly promote axon regeneration after peripheral nerve crush injury.Its mechanism is subject to further investigation.     

大鼠骨髓间充质干细胞静脉移植对脊髓损伤的修复作用

目的初步探讨骨髓间充质干细胞（BMSCs）静脉移植对脊髓损伤后神经功能恢复和神经修复的影响。方法体外培养BMSCs，改良Allen法制备大鼠脊髓损伤模型，经尾静脉移植Brdu标记的BMSCs，损伤后24h、移植后1、3、5周评价实验动物的神经功能状况，并检测BMSCs在体内迁移、存活以及分化情况，电子显微镜观察组织形态学变化。结果移植的BMSCs在宿主损伤脊髓中聚集并存活，3～5周后有部分移植细胞表达神经元特异性烯醇化酶（NSE）、神经丝蛋白（NF）、微管相关蛋白（MAP2）；BMSCs静脉移植组大鼠运动功能改善，BBB评分高于对照组（P〈0．05）；5周后组织学观察，与对照组相比移植组损伤区脊髓结构较完整。结论BMSCs经静脉移植后可向脊髓损伤处聚集并存活分化，促进神经修复及神经功能的恢复。     

中国骨肿瘤大手术静脉血栓栓塞症防治专家共识

静脉血栓栓塞症可使血管完全或不完全阻塞而引起静脉回流障碍,导致相应的机体变化。骨肿瘤患者行手术治疗的血栓栓塞症风险较高,目前国内尚无防治共识可供借鉴。中华医学会骨科学分会骨肿瘤学组组织全国三十多位专家,参考国内外相关领域的最新研究成果、指南或共识,总结骨肿瘤大手术静脉血栓栓塞症的流行病学特点、风险因素、诊断流程及防治措施,形成本共识。该共识的实施有望提高国内相关医师对骨肿瘤大手术静脉血栓栓塞症的认识及诊疗水平。     

CT严重程度指数对严重型胰腺炎发展及预后的预测价值

急性胰腺炎 (ＡＰ)是一可逆性炎性病症 ,其中大约80 %～ 85%是为轻型 ,预后良好 ,但仍有 1 5%～ 2 0 %患者会发展成严重型胰腺炎 (ＳＡＰ) ,常因休克、脓毒血症、多器官衰竭而死亡。ＳＡＰ的死亡率甚高 ,据报道可达 1 5%～ 56%。用于胰腺炎的医疗费用也令人咋舌 ,据测算 ,作者医院在三年时间内在ＡＰ上的费用就高达 650万美元 ,其中 78%系用于ＳＡＰ。因此多年来许多学者都在探索预测ＡＰ发展及预后的方法 ,以期给临床工作提供指导。其中比较优秀的有Ｒａｎｓｏｎ′ｓ预后指标、ＡＰＡＣＨＥⅡ计分系统等。然而即使广为使用的ＡＰＡＣＨＥ计…     

临床医学院教学管理中应用ISO9000族标准的探讨

中国加入WTO与经济全球一体化,我国的各行各业都必须向国际水准看齐并与世界接轨才能更快、更稳地发展.高等教育也同样面临着这个问题,尤其是在高等教育的质量管理工作上.……     

中西医结合治疗术后椎间盘炎10例

中西医结合治疗术后椎间盘炎１０例福建医学院附属第一医院（３５０００４）朱夏林建华林元泽蔡华秀笔者从１９９２年１月至１９９４年８月应用中西医结合治疗术后椎间盘炎１０例，取得较满意的效果。１临床资料根据陆宸照等提出的术后椎间盘炎４大特征为诊断依据。本组１...     

Tei指数在监测妊娠合并心脏病伴肺动脉高压患者右心室功能中的作用

Objective To investigate clinical value of Tei index used for monitoring right ventricular (RV) function in pregnant women complicating cardiac disease accompanying pulmonary hypertension(PH) and the influence on left ventricular(LV) function due to overload pressure of RV. Methods Fifty-eight pregnant women complicating cardiac disease (including 32 cases with congenital heart disease,14 cases with rheumatic heart disease and 8 cases with arrhythmia)were enrolled in this study, among 26 cases coexisted with pulmonary hypertension. According to the pressure of PH, those patients were divided into three groups:11 cases in mild group[30-49 mm Hg (1 mm Hg=0.133 kPa)],9 cases in moderate group (50-79 mm Hg)and 6 cases in severe group (≥80 mm Hg). In the mean time, 15 healthy pregnant women were matched as control. Tei index were measured for LV and RV respectively. Results (1) The isovolumetric relaxation time [IRT,(93±52) ms] and isovolumetric contraction time [ICT,(66±41) ms] of RV in PH group were significantly higher than normal controls [(39±19) ms in IRT and (38±20) ms in ICT] and the other patients without PH group[(59±12) ms in IRT and (43±19)ms in ICT, P<0.01, P<0.05;P<0.05,P<0.05]; however, ejection time (ET) was(239±46) ms significantly shortened in PH group (P<0.05,P<0.01) when compared with (250±41) ms in patients without PH and (299±38) ms in normal controls. Tei index in PH group were 0.72±0.49, which were significantly higher than 0.38±0.12 in normal controls and 0.43±0.16 in patients without PH (P<0.01,P<0.05). (2) The IRT[(99±27)ms] and ICT[(71±40) ms] of LV in PH group were significantly higher than in normal controls [(88±20) ms,(50±24)ms] (P<0.01,P<0.01). ET of LV in PH group [(202±26)ms] were significantly shortened that (290±21)ms in normal controls and (220±36)ms in patients without PH (P<0.01,P<0.05). Tei index of LV in PH group were significantly higher than 0.43±0.15 in normal controls and 0.58±0.21 in patients without PH (P<0.01,P<0.05). (3) Positive correlation between Tei index of RV and pressure of pumonaroy artery were observed (r=0.84, P<0.01). (4) Tei index of RV in severe PH were significantly higher than mild PH (0.75±0.43 vs. 0.68±0.35, P<0.01) and moderate PH (0.75±0.43 vs. 0.71±0.14, P<0.05). Conclusions (1)The Tei index is a novel efficient Doppler index in assessing RV function of pregnant women complicating cardiac disease accompanying PH. And the fluctuation of Tei index might reflect seriousness of the disease. (2) The overload pressure of RV pressure due to PH has significant influence on LV function.