预吸氧对丙泊酚麻醉在老年患者无痛胃镜检查中的安全性

目的探讨预吸氧对丙泊酚麻醉在老年患者无痛胃镜检查中的安全性与有效性。方法将我院收治的120例无痛胃镜检查的老年患者随机分为实验组和对照组,对照组的患者给予常规不吸氧,实验组的患者给予预吸氧。结果两组患者胃镜操作时间与苏醒时间无显著差异（P〉0．05）;呼吸抑制的发生率低于对照组（P〈0．05）．胃镜检查的过程中Sp02高于对照组及HR低于对照组（P〈0．05）,具有统计学意义。结论对采用丙泊酚麻醉行无痛胃镜检查老年患者给予预吸氧,可有效的对抗检查过程中出现的不同程度呼吸抑制所造成的缺氧,提高无痛胃镜检查的安全性。     

多层螺旋CT对马蹄肾的诊断价值

目的探讨多层螺旋CT(MDCT)在诊断马蹄肾的扫描方法及其临床应用价值。方法回顾性分析19例马蹄肾的临床完整资料,均行多层螺旋CT平扫加多时相分期增强扫描检查,并在工作站对获取的平扫及多时相分期增强扫描薄层图象行多平面重组(MPR)、容积再现(VR)及四维透明显示(4D-Raysum)3种方法后重组。结果 19例马蹄肾均为双肾下极连接融合,融合的峡部肾实质相连17例,纤维组织连接2例。伴多支肾动脉供血7例,肾盂输尿管交界部狭窄5例。马蹄肾并发肾盏或肾盂结石6例,输尿管下段结石1例,肾盏肾盂积水10例。1例马蹄肾合并左肾透明细胞癌,行手术病理证实。结论应用多层螺旋CT对马蹄肾进行合理方法扫描并结合多种方法后重组,可以清楚显示马蹄肾的融合的部位、性质及并发症的发生情况,为临床提供更多的影像信息,可做为马蹄肾综合影像学评价的最好检查方法。     

慢性阻塞性肺疾病患者生活质量评估问卷与6分钟步行试验的临床应用

目的探讨老年慢性阻塞性肺疾病（COPD）患者生活质量评估问卷（CAT）、6分钟步行距离（6MWD）与肺功能的相关性及临床应用评估。方法选择62例住院COPD患者,根据肺功能结果分为四组,分别测定肺功能、CAT、6MWD并进行相关性研究。结果 COPDⅠ级、Ⅱ级、Ⅲ级、Ⅳ级四组之间的CAT、步行距离有显著性差异,CAT与6MWD、FEV1%呈负相关,6MWD与FEV1%呈正相关。结论老年人CAT、6MWD与肺功能严重程度相关性良好,作为日常肺功能的评价方法,简便、易行、安全、可靠、可操作性高。     

外伤性支气管断裂的影像诊断

目的 分析外伤性支气管断裂的X线平片及CT表现,评价影像学表现在早期诊断中的价值。资料与方法回顾性分析10例经手术病理证实的外伤性支气管断裂的影像学表现。结果 外伤性支气管断裂的主要X线表现：纵隔及皮下气肿,气胸或液气胸,肺不张,肺下垂征;CT检查可补充X线平片的不足,可显示气管支气管柱中断,气管移位或成角畸形。结论 外伤性支气管断裂有特征性的影像学表现,认识这些征象,有助于早期诊断。     

超高效液相色谱-串联四级杆质谱法测定中药材（饮片）中非法添加6种水溶性红色素通用方法的研究

目的：建立快速筛查及确证中药材（饮片）中非法添加6种水溶性红色素（日落黄、苋菜红、胭脂红、赤藓红、新品红、酸性红73）的超高效液相色谱-串联四级杆质谱的通用方法。方法：中药材（饮片）经溶剂提取后,采用超高效液相色谱法分离,以乙腈和5mmol·L^-1乙酸铵溶液为流动相,进行梯度洗脱,采用多反应监测模式,筛查中药材（饮片）中非法添加的6种水溶性红色素,并进行确证。结果：超高效液相色谱-串联四级杆质谱可在4min内快速筛选并确证是否含有非法添加的6种水溶性红色素。结论：该方法具有简便快捷、灵敏度高、结果准确的特点,适用于中药材（饮片）中非法添加6种水溶性红色素的筛查和确证工作。     

中国汉族正常成人岛叶体积的高分辨率MRI测量

Objective To explore the normal range of the insula volume of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range = 18 to 70) recruited from 16 hospitals were divided into 5 groups, i.e.,Group A ( age range = 18 to 30), B ( age range = 31 to 40 ), C ( age range = 41 to 50 ), D ( age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of bilateral insula were manually measured.The volume of bilateral insula were compared by paired sample t test.The insula volumes were compared between male and female by independent sample t test, and the differences among 5 age groups were compared by one-way ANNOVA.The relationship between the volumes of insula and age,sex or cerebral volume were analyzed using bivariate correlation, respectively.Results The left snd right side volume of insula before standarized were (7764±1165) and (7387±1128) mm3 respectively, after standarized were (8413±1201 ) and (7871±1140) mm3 respectively.The left insula volume were significant larger than that of right(t = - 10.565, - 16.014,P <0.01 ).The left and fight volume of insula were (8146±1181 ) and (7735±1113) mm3 for male, and (7393±1022) mm3 and (7050±1038) mm3for female.The left and right insula volumes for male were larger than the female's(t = 10.934,9.945 ,P <0.01 ).The left and right insula volume of male after standarized were (8779±1230 ) and (8224±1081 )mm3, female were (8043±1054) and (7515±1091 ) mm3 ,the left and right insula volume of male were larger than the female's ( t = 4.858,4.632, P < 0.01 ).The left insula volumes among Group A, B, C, D,E before standarized were ( 8268±1221 ), ( 8067±1107 ), ( 7869±1109), ( 7603±1111 ), ( 6997±934 )mm3 respectively,the right were (8028±1156), (7636±1075), (7294±986), (7249±1068), (6717±916) mm3 respectively, there were significant differences among 5 groups between left and right insula volume(F= -0.361,-0.337,P <0.01 ).The left insula volume of A,B,C,D,E after standarized were ( 9093±1105 ), ( 8679±965 ), ( 8810±1136), ( 8202±980), ( 7273±940 )mm3, the right were ( 8694±1005), (8136±1100), (8034±910), (7496±990), (6989±932) mm3, there were significant differences among 5 groups between left and right insula volume(F = -0.490, -0.512,P < 0.01 ).There was significant negative correlation between the volume and age ( before standarizded:r = -0.361, -0.337, after standardized r = -0.490, -0.512, P<0.05).Before and after standardized, there was significant correlation between the volume of right and left insula and cerebral volume ( r = 0.470,0.459, P < 0.05 ).Before and after standardized, there was significant correlation between the volume of right and left insula and weight( r = 0.141, 0.092, P < 0.05 ).Conclusions 1.5 T MR scanner has high resolution, for distinguishing the white matter from the gray matter, and provide morphological data of insula for the construction of database for Chinese Standard Brain.     

多层螺旋CT在寰枢椎骨折脱位病变中的应用

为探讨多层螺旋CT(MSCT)在寰枢椎骨折脱位病变中的应用价值,对40例可疑有寰枢椎骨折脱位患者MSCT扫描资料进行总结,常规层厚5mm,层距10mm,采用UM模式扫描,重建层厚1.25mm,层距0.63mm,并将CT薄层图像传输到工作站.结果明确诊断有32例,其中寰椎骨折6例,枢椎齿状突骨折10例,枢椎体骨折3例,枢椎椎弓骨折6例,寰枢关节不全脱位7例.多层螺旋CT能清楚显示寰枢椎骨折脱位的部位及性质,可做为寰枢椎骨折脱位首选检查.     

进展期胃癌的多排螺旋CT和胃镜检查的对比研究

目的通过多排螺旋CT(MSCT)检测进展期胃癌(AGC)的大体分型和浸润情况,探讨MSCT和胃镜对胃癌的诊断价值。方法82例经过手术证实的进展期胃癌病人,术前行腹部MSCT扫描检查。观察胃癌大体Borrmann分型,并和胃镜比较;在增强扫描下,观察癌肿在胃壁内外浸润(T分期),周围淋巴结肿大转移(N分期),周围的脏器侵犯(M分期)。结果82例AGC中:MSCT诊断BorrmannⅠ型19例,BorrmannⅡ型23例,Bor- rmannⅢ型31例,BorrmannⅣ型9例。T分期诊断准确率78%;N分期诊断准确率为62.9%;M分期诊断准确率为84%。胃镜诊断结果:BorrmannⅠ型19例,BorrmannⅡ、Ⅲ型共57例,BorrmannⅣ型6例。结论在Borrmann分型上MSCT优于胃镜,尤其对于BorrmannⅡ型与BorrmannⅢ型胃癌的鉴别、以及BorrmannⅣ型胃癌的诊断敏感性和准确性高于胃镜;胃癌造成邻近侵犯黏连和周围淋巴结和脏器转移情况的判定方面,MSCT具有独特优势。     

中国汉族成人岛叶MRI测量在临床中的应用价值

目的 研究岛叶区域的解剖特点,为岛叶病变临床手术提供可靠的数据.资料与方法 选择健康汉族成人自愿者200名(400侧),按年龄分为5组,每组40名,每组内男女各20名.对每位自愿者用1.5 T MR扫描仪进行研究,应用Aquayiusws软件手动勾画出各个解剖值,软件自动测算出其参数值.结果 在T1WI上,岛叶皮质呈等信号,岛回内的白质纤维呈高信号,岛沟与脑脊液信号相似呈低信号.结论 岛叶具有独特的解剖特点,充分掌握岛叶的解剖特点可为该区域及岛叶深部病变的手术路径选择提供帮助.