各向同性的3D T2 SPAIR SPACE序列在正常人肘部神经显像的应用

目的:观察磁共振3D T2 SPAIR (spectral adiabatic inversion recovery) SPACE序列在正常人肘部神经的显示情况,并观察其在不同人群中的显示差异?方法:在3.0 T MR下对64例正常人的2D FS-T2WI序列及3D T2 SPAIR SPACE序列平扫?对每个志愿者的3D T2 SPAIR SPACE序列的原始数据进行尺神经?正中神经及桡神经的曲面重建及最大密度投影重建,分别重建出矢状位及冠状位图像?分别统计3根神经的两种重建方法在上臂?肘关节及前臂的显示率?统计3根神经在2D FS-T2WI序列及3D T2 SPAIR SPACE序列上相对周围肌肉信号增高的比率? 结果:64例志愿者的尺神经?正中神经及桡神经在曲面重建上可以全部清晰显示?尺神经在上臂?肘关节及前臂的最大密度投影图像上的显示率分别为92%?83%?98%,正中神经在上臂?肘关节及前臂的最大密度投影图像上的显示率分别为81%?89%?80%,桡神经在上臂?肘关节的最大密度投影图像上的显示率分别为94%?95%?尺神经信号增高在2D FS-T2WI序列上为55%,而在3D T2 SPAIR SPACE序列上仅仅为30%?结论:3D T2 SPAIR SPACE序列对正常人的肘部神经显示效果好,对正常人尺神经信号增高显示更可靠?     

腹腔镜和输尿管镜联合治疗15例医源性输尿管狭窄

目的 探讨联合镜种技术(腹腔镜+输尿管镜)治疗医源性输尿管狭窄的安全性、可行性和有效性.方法 回顾性分析2018年1月-2020年12月在娄底市中心医院用联合镜种技术(腹腔镜+输尿管镜)治疗的15例医源性输尿管狭窄患者的临床资料.其中,男8例,女7例;年龄31～65岁,平均(38.50±7.10)岁;术前病变侧肾脏积水...     

基于UPLC-DAD指纹图谱结合化学计量学及6种成分含量测定的桑叶质量研究

[目的]建立超高效液相色谱法(UPLC)-DAD指纹图谱方法,结合化学计量学与多指标含量测定综合评价桑叶质量.[方法]采用Agilent EC-C18(2.1 mm×100 mm,1.7μm),柱温35℃;检测波长分别为290 nm(检测没食子酸甲酯、隐绿原酸)和360 nm(检测芦丁、异槲皮苷、山奈酚-3-O-芸香糖...     

MRI成像对子宫内膜癌侵犯肌层的评估

目的探讨MRI对子宫内膜癌肌层浸润深度的评估价值。方法回顾性分析67例经分段刮宫并施行手术治疗的子宫内膜癌患者MRI表现,并与术后病理结果进行对照。结果 MRI判断子宫内膜癌局限于内膜、浸润浅肌层、浸润深肌层及浸透浆膜层的准确性分别为92.5%、80.5%、88.0%、80.5%。结论磁共振可多方位、多序列、多角度成像,对软组织有较高分辨率,对准确判断子宫内膜癌肌层有无浸润具有明显优势。     

Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer

Background Bladder cancer is the ninth most common cancer in the world; fewer than 15％ of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still under debate.The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy （IAC） with gemcitabine and cisplatin （GC） on locally advanced bladder cancer.Methods This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011.Patients were studied in two groups based on IAC and followed up for up to 5 years.Results Among 60 patients,there were 25 patients who underwent IAC （GC） after radical cystectomy （the IAC group） and 35 patients who underwent radical cystectomy alone （the control group）.Although not significant,the relapse rates were slightly reduced in the IAC group than in the control group.Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years.Specifically,IAC significantly reduced about 82％ of mortality within the first year （hazard ratio=0.18,95％ Cl 0.03-0.97,P=-0.04）.Additionally,IAC was well tolerated and safe.The most common adverse effect was transient myelosuppression （10/25,40％）,which was resolved by various medical treatments.Conclusions Compared with radical cystectomy alone,radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality.Our preliminary data showed only marginal benefit for the early survival.However,a randomized clinical study is needed to determine the long-term survival benefit.     

内镜下抗反流黏膜切除术和贲门缩窄术治疗胃食管反流病的临床疗效对比

目的 对比内镜下抗反流黏膜切除术（anti-reflux mucosectomy,ARMS）和贲门缩窄术（endoscopic cardial constriction ligation,ECCL）治疗胃食管反流病的临床疗效。方法 回顾性分析2015年12月—2018年8月在郑州大学第一附属医院行ARMS或ECCL治疗,并定期随访的48例胃食管反流病患者病例资料,其中20例行ARMS（ARMS组）,28例行ECCL（ECCL组）,比较两种术式短期及长期临床疗效。结果 两种术式的操作成功率均为100.0%,ECCL组手术时间明显短于ARMS组[（8.43±1.59）min比（34.05±12.35）min,t=－9.227,P＜0.001]。术后2个月随访,ECCL组和ARMS组症状改善有效率分别为89.3%（25/28）和60.0%（12/20）,差异有统计学意义（χ2=4.128,P=0.042）,ECCL组GERD Q评分低于ARMS组[（6.24±1.22）分比（7.35±1.79）分,t=-2.400,P＝0.023]。术后1年随访,两组症状改善有效率、GERD Q评分,以及DeMeester评分和pH＜4时间百分比差异均无统计学意义（P＞0.05）。结论 ARMS和ECCL治疗胃食管反流病的长期临床疗效相当,但ECCL短期疗效更具优势。     

Prophylactic juxtapapillary laser photocoagulation in pediatric morning glory syndrome

AIM: To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment (RD) in a cohort of pediatric patients diagnosed with morning glory syndrome (MGS). METHODS: A total of 24 eyes of 22 consecutive patients aged 0-15y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed. Data including demographics, ocular examination, anatomic and visual outcomes, following treatment and complications were collected. RESULTS: Two patients had bilateral laser treatment and 20 had monocular laser treatment. The age at treatment of 13 (59.1%) patients was less than 12mo. The presenting symptoms included strabismus (6/22, 27.3%), decreased vision (2/22, 9.1%), and routine fundus screening (14/22, 63.6%). Fifteen (68.2%) patients underwent cranial magnetic resonance imaging (MRI) examinations, and 3 of those 15 (20.0%) had abnormal findings in the nervous system. Based on preoperative wide-field fundus photography and B-scan echography, all (100.0%) eyes had no obvious RD. On postoperative 1mo and 6mo and the following follow-ups, the anatomic outcomes of all eyes remained stable. The mean follow-up duration was 27.7±17.5mo. No severe complications were found. Preoperative visual acuity acquired from 2 (9.1%) patients ranged from light perception to 20/200. Postoperative acuity acquired from 11 (50.0%) patients ranged from light perception to 20/125. CONCLUSION: The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up. Further long-term clinical observation will be needed to confirm its efficacy and safety.     

血尿酸与骨质疏松性骨折的相关性

目的系统评价血尿酸与骨质疏松性骨折之间的关系。方法通过PubMed数据库、Cochrane Collaboration数据库、中国知识资源总库(CNKI)、万方数据知识服务平台和Sino Med数据库进行检索,查找关于高血尿酸与骨质疏松性骨折发生风险的相关文献。结果依纳入标准,共纳入7个研究,含30 855例患者。Meta分析结果显示:高血尿酸水平患者发生骨质疏松性骨折风险明显下降(HR=0.88,95%CI为0.83～0.93,P0.001)。发表偏倚及敏感性分析显示:漏斗图及Egg检验未见明显发表偏倚,敏感性分析提示结果较稳定。结论高血尿酸可降低骨质疏松性骨折发生风险。