二维及彩色多普勒血流显像诊断下肢静脉病变的意义

目的 评价彩色多普勒血流显像检测临床下肢静脉病变的应用价值。方法 对临床下肢静脉病变90例107条下肢静脉进行彩色多普勒血流显像检查。结果 彩色多普勒血流显像可迅速清晰地显示下肢的解剖图像，其中检出61例64条下肢静脉有血栓形成（急性血栓31例，慢性血栓30例），8例9条深静脉瓣功能不全，31例34条为下肢静脉曲张。结论 下肢深静脉血栓形成有一定的声像特征，彩色多普勒血流显像检出敏感性高，可对血栓作出定位，定范围和管腔阻塞程度的判断，是帮助临床选择治疗方案和客观评价药物疗效的重要方法。判断有无深静脉功能不全，可为临床手术和治疗提供可靠依据。     

头低位卧床对眼内压、近视力、视野的影响及其中药防护

目的观察头低位卧床模拟失重对人体眼压、视野、近视力的影响 ,及中药对抗模拟失重的效果。方法 1 0名被试者随机分成对照组和中药组 ,用头低位 - 6° 2 1d卧床模拟失重 ,分别于卧床前、中、后测量两组被试者眼内压、近视力及视野。结果眼内压及近视力在卧床期间呈波动下降趋势 ,两者间存在一定相关性 ;中心视野变化无显著性 ;服中药可在一定程度上防止近视力下降。结论 1 )头低位卧床可引起眼压、近视力下降 ;2 )服中药可在一定程度上对抗模拟失重对近视力的不良影响     

Air-trapping zone surrounding sclerosing hemangioma of the lung

We present two cases of sclerosing hemangioma of the lung with a peculiar radiologic finding: an air-trapping zone surrounding the tumor. On microscopic examinations, the tumor was of the hemangiomatous subtype, and the radiolucent zone corresponded to enlarged alveoli with septal destruction. A possible mechanism in the production of an air-trapping zone around a sclerosing hemangioma is bleeding from the highly vascular tumor followed by expectoration in communication with an airway. We reviewed the literature on the air meniscus sign in sclerosing hemangioma and concluded that although it is not a common finding, it could be of help in the confident diagnosis of sclerosing hemangioma and in differentiating it from other benign tumors of the lung.     

数字化X线胸部摄影管电压选择对影像质量影响的研究

Objective To study the relationship between the selection of tube tension in digitalchest radiograph and image quality.Methods When tube current was fixed at 4 mAs, the choice of X-ray tube voltage changed from 60 to 120 kV.CDRAD2.0 contrast details phantom and normal human chest were exposed by X-ray system with 7 kinds of tube voltage (the difference between tube voltage was 10 kV) ,and the X-ray incidental dose of phantom surface was measured.Five radiologists with 3 years working experience evaluated the image quality on monitor and calculated the image quality factor (IQF) and image reading score.Statistics analysis was then performed by using ANOVA test and t test.According to the results, the optimum tube voltage range was determined.Results (1) The incidental dose of phantom surface increased with the higher tube voltage.(2)When the tube voltage was changed from 60 kV to 120 kV, the IQF value observed in CDRAD2.0 phantom image on monitor was 75.0±10.4,57.1±6.4,52.7±2.5,47.9±4.5, 46.0±3.8,46.0±2.8,45.2±3.5 ,there was significant statistical differences between groups(F=19.10, P<0.01).(3)The integrated score of the chest image quality in the tube voltage 90 kV and 120 kV were 12.4±0.9 and 13.0±0.7, respectively, and there was no statistical difference between two groups(t= 1.500,P>0.05).Conclusions (1)With the increase of tube tension,the display capacity of display device gradually strengthened.When the tube tension exceeded 90 kV, the increase of image quality on monitor was not evident.(2) With proper radiation dose, the value of tube tension in digital X-ray chest photograph was about 90 kV.     

放射线联合p53基因及内皮抑素治疗小鼠前列腺癌皮下移植瘤

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.     

藻参胶囊的毒理学实验研究

目的 评价藻参胶囊的毒理学安全性.方法 通过急性毒性试验、骨髓微核试验、小鼠精子畸形试验、鼠伤寒沙门菌/哺乳动物微粒位酶(Ames)试验以及30 d喂养试验,对藻参胶囊进行毒理学评价.结果 (1)藻参胶囊对小鼠经口急性毒性试验MTD>15 g/kg体质量;(2)Ames试验、骨髓微核试验、精子畸形试验均为阴性;(3)30 d喂养试验显示藻参胶囊无毒性,未见体内蓄积中毒.结论 藻参胶囊属无毒级产品无致突变作用,无遗传毒性,无明显体内蓄积中毒.     

The Efficacy of Metallic Stent Placement in the Treatment of Colorectal Obstruction

Objective

To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression.

Materials and Methods

Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used.

Results

Thirty of 31 attempted placements in 26 patients were successful, with a technical success rate of 96.8% (30/31) and a clinical success rate of 80.0% (24/30). After clinically successful stent placement, bowel decompression occurred within 1-4 (mean, 1.58 ± 0.9) days. Five of six clinical failures involved stent migration and one stent did not expand after successful placement. In the preoperative group, 11 stents, one of which migrated, were placed in ten patients, in all of whom bowel preparation was successful. In the palliative group, 19 stents were placed in 15 patients. The mean period of patency was 96.25 ± 105.12 days: 146.25 ± 112.93 for type-A, 78.82 ± 112.26 for type-B, and 94.25 ± 84.21 for type-C. Complications associated with this procedure were migration (n=6, 20%), pain (n=4, 13.3%), minor bleeding (n=5, 16.7%), incomplete expansion (n=1, 3.3%), and tumor ingrowth (n=1, 3.3%). The migration rate was significantly higher in the type-B group than in other groups (p=0.038).

Conclusion

Newly designed covered and non-covered metallic stents of a larger diameter are effective for the treatment of colorectal obstruction. The migration rate of covered stents with flaring is higher than that of other types. For evaluation of the ideal stent configuration for the relief of colorectal obstruction, a clinical study involving a larger patient group is warranted.     

Idiopathic Synovial Osteochondromatosis of the Hip: Radiographic and MR Appearances in 15 Patients

Objective

To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip.

Materials and Methods

Radiographs and MR images of 15 patients with idiopathic synovial osteochondromatosis of the hip were assessed. The former were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified bodies, 2) osteophytes, 3) bone erosion, 4) juxta-articular osteopenia, and 5) joint space narrowing, while for the latter, analysis focused on 1) the configuration of intra-articular bodies, 2) bone erosion, 3) synovial thickening, 4) conglomeration of intra-articular bodies, and 5) extra-articular extension.

Results

At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 of the 15 patients (80%), bone erosion in eight (53%), osteophytes in seven (47%), juxta-articular osteopenia in five (33%) and joint space narrowing in five (33%). In eight patients (53%), MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, and areas of iso-intensity at T1WI and hyperintensity at T2WI. In three (20%), intra-articular bodies of focal low signal intensity and areas of hyperintensity at all pulse sequences were observed, with areas of iso-intensity at T1WI and hyperintensity at T2WI, while in four (27%), intra-articular bodies of only focal low signal intensity at all pulse sequences were apparent. Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).

Conclusion

The most common radiographic finding of synovial osteochondromatosis of the hip was the presence of juxta-articular calcified and/ or ossified bodies. MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI. In addition, the presence of an extra-articular herniation sac was not uncommon.     

经导管动脉栓塞术在骨盆骨折并大出血急救中的临床应用

目的 探讨经导管动脉栓塞术在骨盆骨折合并大出血急救中的临床应用。方法 搜集19例骨盆骨折并发盆腔大出血休克的患者，男11例，女8例，年龄18－46岁，平均28岁。术前血压为（40－90）／（0－60）mmHg(1mmHg=0.133kPa) ,急诊行出血动脉和（或）髂内动脉主干栓塞术，其中2例伴有脾破裂患者同时行脾动脉栓塞术。术后严密观察生命体征的变化，并进行必要的外科处理，结果 15例患者可见明显的对比剂外溢，出血动脉内髂内动脉主干3例，臀上动脉5例，阴部内动脉或闭孔动脉7例，2例表现为髂内动脉分支中断，2例血管造影未见明显阳性表现。全部19例均在1h内完成栓塞治疗，术后24h内全部患者血压逐步回升至正常水平[(90-120)/(60-90)mmHg]。未出现严重的栓塞并发症。1例于血压稳定后膀胱直肠手术修补时死亡，3例于72h内死于弥漫性血管内凝血（DIC）。结论 经导管动脉栓塞术是骨盆骨折大出血的1种安全，迅速，有效的急救止血措施。     

冠心病患者PTCA术前后核素心脏显像结果对比分析

目的　应用99Tcm 甲氧基异丁基异腈心肌灌注断层显像及心室显像随访经皮冠状动脉腔内成形术 (PTCA)及支架置入术后的效果。方法　患者在成功的PTCA及支架置入术前及随访期进行负荷 /静息或静息 /含硝酸甘油心肌灌注断层显像及心室显像检查。结果　 44例患者在术前及术后平均 11.4个月进行了心肌灌注断层显像 ,其中 40例患者进行了心室显像。结果显示 ,术后患者心肌缺血及不可逆缺损节段数减少 ,分别为 2 .5± 0 .4与 1.5± 0 .3(P =0 .0 6 )及 3.5± 0 .5与 2 .3± 0 .4(P <0 .0 5 ) ;左室射血分数、高峰射血率及高峰充盈率无明显变化 ,运动低下节段数有所下降 ,但未达到统计学差异。结论　成功的PTCA及支架置入术后心肌缺血明显改善 ,左室功能无明显变化 ,部分节段运动改善