常规MRI与弥散加权成像测量的肿瘤容积对直肠癌TN分期的诊断价值

目的探讨常规MRI与弥散加权成像(DWI)测量的肿瘤容积对直肠癌TN分期的诊断价值。材料与方法对经肠镜确诊的74例直肠癌患者行盆腔3.0 T MRI检査。分析MRI对直肠癌术前TN分期的准确性,用检验评价MRI术前TN分期与病理分期的一致性。用单因素方差分析评价DWI(b=10000 s/mm~2)测量的肿瘤容积与病理TN分期的相关性。结果MRI诊断直肠癌T、N分期的准确率分别为87.8%(66/74)、66.2%(49/74);病理学和MRI对T分期诊断有较好的一致性(Kappa=0.78,P=0.000)、对N分期诊断一致性较差(Kappa=0.33,F=0.000)。在DWI上测量肿瘤容积≤T2期、T3期、T4期分别为(4145.13±718,00)mm~3、(14939.73±3591.38)mm~3、(22714.76±4251.71)mm~3;N0期、N1期、N2期分别为(14367.15±6425.83)mm~3,(17967.69±5259.88)mm~3、(19464.00±3588.77)DWI测肿瘤容积越大直肠癌T分期越高,差异有统计学意义(F=75.189,P=0.000);肿瘤容积与直肠癌不同N分期间差异有统计学意义(F=3.545,P=0.034)。结论MRI评价直肠癌T分期准确率较高,对N分期也有一定诊断价值。MR肿瘤容积测量对直肠癌TN分期有重要参考价值。     

肝脏ESWAN与血清铁蛋白定量评价肝纤维化的实验研究

目的探讨重度T_2~*加权的三维梯度回波成像序列及血清铁蛋白诊断肝纤维化和评估纤维化严重程度的可行性。材料与方法新西兰大白兔64只,8只正常对照组,56只腹腔注射CCL4建立肝纤维化模型。造模第6、8、10及12周进行MRI扫描,肝脏染色进行纤维化METAVIR分期,酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)测量兔血清铁蛋白含量。结果随着肝纤维化的进展,T_2~*值和幅度值均呈下降趋势(r=-0.588、-0.388,P0.05),血清铁蛋白呈上升趋势(r=0.409,P0.05)。T_2~*值能区分正常组分别与F_2、F_3、F_4期(P0.05),及F_1期分别与F_4期、F_(2~4)期(P0.05),曲线下面积(area under cure,AUC)值均≥0.74。幅度值能区分正常对照组与F_4期、F_1期与F_4期及F_(1~3)期与F_4期(P0.05),AUC值均≥0.822。血清铁蛋白能区分正常组分别与F_3、F_4期(P0.05),AUC值均≥0.873。结论 T_2~*值、幅度值及血清铁蛋白能定量诊断肝纤维化以及评估肝纤维化的严重程度。     

围绝经期抑郁症与性激素的关系

目的 探讨围绝经期抑郁症及围绝经期不同阶段雌激素和雄激素水平的关系,并了解血管舒缩综合征与性激素的关系.方法 收集40例在围绝经期内首次出现中、重度抑郁症状的患者(病例组)和40例围绝经期健康对照者(对照组),依据月经状况将病例组和对照组分为病例绝经期组、病例绝经后期组、对照绝经期组和对照绝经后期组4个亚组,依据有无血管舒缩症状将所有入组者分为有血管症状组和无血管症状组2个亚组.采用电化学发光免疫法分别测定血清中雌二醇(E2)、睾酮(T)的水平,并对病例组进行汉密顿抑郁量表评分.结果 ①病例组E2水平显著低于对照组(P<0.01),与汉密顿抑郁评分呈负相关趋势(rs=-0.783, P<0.01);且无论是绝经期(P<0.05)还是绝经后期(P<0.01),E2水平都低于同阶段的健康对照组;②病例组T水平明显高于对照组(P<0.01),且病例绝经期亚组T水平也高于对照绝经期亚组(P<0.01),但绝经后期病例组与对照组T水平比较差异无统计学意义(P＞0.05);并且病例组T水平与汉密顿抑郁评分无相关性(rs=0.311, P＞0.05);③病例组与对照组E2/T比较差异有统计学意义(P<0.01);④有血管症状亚组与无血管症状亚组E2水平比较差异无统计学意义(P＞0.05),而T水平明显升高(P<0.01).结论 ①雌激素是围绝经期抑郁症的保护因素;②睾酮与围绝经期抑郁症关系尚不明确;③机体内激素间动态平衡被打破,激素间比例失衡也是抑郁症的危险因素;④围绝经期出现的血管舒缩症状与雌二醇水平下降无关,而可能与睾酮水平升高有关. Abstract： Objective To explore the correlations between serum estralio(E2),testosterone(T)levels and perimenopause depression.To find out relationships between sex hormones and vascular symptoms.Methods We collected 40 women with perimenopausal depression as case group and 40 healthy women as control group. All the subjects were assigned to six groups: menopausal transtion period case and control,postmenopausal case and control,subgroup with vascular symptoms and subgroup without vascular symptoms.Electrochemiluminescence immunoassay (ECLIA) was used to measure the levels of the serum E2 and T. Results ①The level of E2 in case group was significantly lower than that in control group(P<0.01),and had negative correlation with HAMD scales(P<0.01);In both the menopausal transition period and the postmenopause period, the level of E2 in case group was lower than that in the matched control group (P<0.05,P<0.01).②The level of T in case group was significantly higher than that in control group(P<0.01), and had the same finding between menopausal transition period'case and control(P<0.01),but had no significant difference between postmenopause'case and control (P＞0.05) .Furthermore, no association could be detected between the level of T and HAMD scales in case group(P＞0.05);③The E2/T in case group and control group had significant differences(P<0.01);④The level of T in subgroup with vascular symptoms was higher than that in subgroup without vascular symptoms(P<0.01),but the difference about E2 between the two subgroups was not statistically signifcant(P＞0.05). Conclusions ①The level of Serum E2 is a protective factor of depression;②What the real relationships between the T level and perimenopausal depression is uncertain;③The imbalance of the ratios of every sex hormones,and the dynamic equilibrium in human body being broken,can cause depression;④The higher level of serum T, not lower level of serum E2, may be related to vascular symptoms in perimenopause.     

脊柱结核的MRI诊断

脊柱结核在骨关节结核中最为常见,治疗不及时可导致椎体严重破坏,脊柱畸形和各种神经损害等严重并发症,早期诊断和治疗尤为重要。MRI是显示脊柱结核病灶和范围最有效的方法,可在发现椎体内早期炎性水肿的同时显示神经结构。其良好的对比度分辨率在显示连续的椎体受累、跳跃性病灶和椎旁脓肿中非常有用。对于有神经损害表现的病人,MRI提供了脊髓及硬膜外脓肿方面的关键信息。常规MRI检查结合新的成像序列如弥散加权成像,对脊柱结核病变的准确诊断和鉴别诊断有着重要意义。     

硫酸阿托品眼膏基质处方及制备工艺的改进

目的 改进硫酸阿托品眼膏的配制方法,提高制剂质量.方法 改变主药硫酸阿托品的加入方法,调整眼膏基质处方用量,对硫酸阿托品眼膏配制工艺进行改进.结果 配制方法的改进大大提高了工作效率和眼膏质量.结论 改进方法确实可行,既保证了制剂质量,又便于操作.     

慢性下肢缺血旁路术后早期再狭窄相关因素的研究

目的 探讨慢性下肢缺血行人工血管旁路术后早期发生再狭窄的相关因素.方法 回顾性分析2006年1月至2007年9月40例行单侧股胭动脉人工血管旁路术的慢性下肢缺血患者,其中男性36例,女性4例,年龄(66±9)岁.于术前、术后2周行血脂、纤维蛋门原及超敏C反应蛋白检测,术后6个月根据吻合口再狭窄程度分为轻、中、重度狭窄组,分析三组间伴随疾病、高危因素,比较3组血脂、纤维蛋门原、超敏C反应蛋白、同型半胱氨酸、IL-6及转化生长因子β1水平.结果 糖尿病和吸烟的患者旁路术后再狭窄程度更严重,相对危险度分别为6.47和7.92.三组术前的各项生化指标差异无统计学意义,术后6个月三组间总胆固醇、低密度脂蛋白、纤维蛋白原、超敏C反应蛋白、IL-6及转化生长因子β1差异有统计学意义.多元线性回归分析示,纤维蛋白原、转化生长因子β1增高与术后内膜增生程度相关.结论 吸烟、伴随糖尿病及纤维蛋白原增高是人工血管旁路术后内膜增生及吻合口再狭窄的临床危险因素.     

初中生乐观人格、解释风格与心理健康的相关研究

目的探讨初中生的乐观人格、解释风格与心理健康的关系。方法采用生活取向测量修订版（LOT-R）、儿童解释风格问卷和中国中学生心理健康量表对770名初中生进行调查。结果初中生的乐观人格与乐观解释风格之间存在显著的正相关。初中生的乐观人格（r=-0.389,P〈0.01）、乐观解释风格（r=-0.309,P〈0.01）与心理健康得分存在显著负相关。结论初中生的人格越乐观,其解释风格越乐观,他们的心理健康水平就越高。     

螺旋CT和彩色多普勒血流显像检查对胰腺癌可切除性的评估价值

Objective To determine the value of helical computed tomography (HCT) and color doppler flowing imaging (CDPI) in evaluating the resectability of pancreatic cancer. Methods The clinical data of 114 patients with pancreatic cancer who had been admitted to the Affiliated Hospital of North Sichuan Medical College from January 1995 to December 2002 were retrospectively analyzed. The values of HCT and CDPI in assessing the resectability of pancreatic cancer were determined according to the results of operation and pathological examina-tion. All the data were analyzed by chi-square test and Fisher exact probability. Results Of all patients, 109 were examined by HCT, 97 by CDPI and 96 by HCT+CDPI. For patients examined by HCT, the resection rates of pancreatic head cancer, pancreatic body and tail cancer and total pancreatic cancer were 45.3% (39/86), 26.3% (5/19) and 0 (0/9), respectively. The resection rate of pancreatic head cancer was higher than that of pancreatic body and tail cancer (χ2=8.965, P<0.05). With the increase of tumor size, the invasion rate and metastasis rate were increased and the resection rate was decreased (z=6.15, 5.35, 7.18, P<0.01). The sensitivity rate and specificity rate were 77.8% and 82.2% of HCT, 73.3% and 80.6% of CDPI, 90.6% and 92.4% of HCT+CDPI in assessing the resectability of pancreatic cancer. The values of Kappa identity test of HCT, CDPI and HCT+CDPI were 0.58, 0.52 and 0.82, respectively. Conclusions Combined application of HCT and CDPI can further improve the accuracy in assessing the resectability of pancreatic cancer.     

全程护理服务模式对鼻咽癌放疗患者的应用效果评价

目的：探讨应用全程护理服务模式和常规护理服务对患者关于鼻咽癌相关健康教育知识的掌握程度以及护理服务满意度的不同影响。方法：对80例初诊的鼻咽癌患者分别采用不同的护理服务模式,出院前进行相关问卷调查。结果：实施全程护理服务模式的患者（实验组）对鼻咽癌6项相关健康教育知识基本了解率高于对照组（P〈0.05）,差异有显著性;实验组患者对护理服务满意率也高于对照组（P〈0.05）,差异有显著性。结论：全程护理服务模式采用多种健康教育形式,可以提高患者对疾病的认识,达到自我照顾、提高生活质量的目的。     

西部地区医学院校师资队伍建设浅析

师资队伍建设是高校赖以生存和发展的主题,而西部地区医学院校由于地域和经济的局限,师资队伍建设显得尤为重要和艰难。近年来,川北医学院结合学校的发展目标和实际情况,采取了一系列有效措施引进和稳定高层次人才队伍,师资队伍建设取得明显成效。对西部地区的医学院校可提供一定的借鉴意义。