胶质瘤的CT灌注成像研究

目的:探讨CT灌注成像对胶质瘤术前分级的价值.方法:30例胶质瘤患者,低级别组11例,高级别组19例.在常规CT扫描的基础上行CT灌注成像检查.分析灌注图像.测量肿瘤实质部分的脑血流量(CBF)、脑血容量(CBV)、对比剂平均通过时间(MTT)及表面通透性(PS)的绝对值和相对值,并对两组进行比较.结果:低级别胶质瘤的r CBF、r CBV、r MTT、r PS均值分别为1.41±0.16、2.31±0.28、1.69±0.83、6.67±2.28;高级别胶质瘤的r CBF、r CBV、r MTT、r PS均值分别为4.96±2.17、4.69±1.65、1.29±0.55、19.19±8.65.两组r CBF、r CBV、r PS间差异具有显著意义.结论:CT灌注成像对胶质瘤术前分级具有临床实用价值.     

脊柱转移瘤68例GRE-T2* WI的诊断分析

目的:分析68例脊柱转移瘤GRE-T2*WI序列的诊断价值。方法:分析68例脊柱转移瘤之常规GRE-T2*WI、T2WI及STIR序列的表现。结果:68例共累及178个椎体,77个椎体T1WI呈低信号,T2WI呈高信号,57个椎体T1WI、T2WI均呈混杂信号,44个椎体T1WI高信号T2WI呈高信号,GRE-T2*WI序列能清晰显示以上所有异常。结论:GRE-T2*WI序列易于发现脊柱转移灶,可较准确地判断肿瘤的侵袭范围及程度,并有助于转移瘤的鉴别诊断。     

刺血急救治疗急性脑梗塞近期疗效观察

目的:观察刺血急救疗法对急性脑梗塞的治疗作用。方法:将35例病程在48h以内的患者随机分为刺血急救合药物组20例,药物组15例,观察治疗前后神经功能缺损积分的变化。结果:两组患者的神经功能缺损评分治疗后均有明显恢复(P<0.01)。刺血急救合药物组恢复(7.4±2.3)分,药物组恢复(4.5±1.8)分,刺血急救合药物组的疗效明显优于药物组(P<0.01)。结论:急救穴刺血疗法对脑梗塞急性期具有治疗作用。     

胰岛素样生长因子结合蛋白-1用于检测胎膜早破的临床意义

目的:探讨胰岛素样生长因子结合蛋白-1用于检测胎膜早破的临床意义,为今后临床诊治提供参考和借鉴。方法:本研究选取2012年5月-2013年11月本院确诊为胎膜早破的孕妇160例,根据孕妇的临床表现,将其胎膜情况分为三组,A组为胎膜已破组45例,B组为胎膜仍完整组55例,C组为怀疑胎膜已破组60例,对所有孕妇阴道分泌物进行胰岛素样生长因子结合蛋白-1(IGFBP-1)检测、pH试纸检测、阴道液涂片检测,对比分析三种检测方法的阴性预测值、阳性预测值、灵敏度、特异性。结果:IGFBP-1检测孕妇胎膜早破的阴性预测值为91.53%,阳性预测值为99.00%,灵敏度为95.24%,特异性为98.18%,明显高于pH试纸的63.33%、83.00%、79.05%、69.09%,也明显高于阴道液涂片的65.57%、84.85%、80.00%、72.73%,差异均有统计学意义(P0.05)。结论:胰岛素样生长因子结合蛋白-1用于检测胎膜早破较pH试纸检测、阴道液涂片检测更具准确性及灵敏性,诊断胎膜早破可靠且安全,值得在临床实践中广泛的应用和推广。     

Study on the Regulatory Effect of Electro-acupuncture on Hegu Point （LI4） in Cerebral Response with Functional Magnetic Resonance Imaging

Objective To study, through blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI), the cerebral activated areas evoked by electro-acupuncturing (EA) the right Hegu point (LI4) or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods EA was applied at volunteers’ right LI4 (of 9 subjects in the LI4 group) and facial non-acupoint points (of 5 subjects in the control group), and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm³ used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients’ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group (P<0.01). In the LI4 group, the areas which showed signal activation were: midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were: bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were: bilateral frontal lobe, postcentral gyrus, Reil’s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect’s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research. Supported by the National Natural Science Foundation (No. 90209031)     

基于高通量测序技术的英德市育龄人群地中海贫血基因型分布研究

目的 阐明英德市地中海贫血流行现状及基因型分布,优化防控策略,降低出生缺陷,提高出生人口素质。方法 选取2019年7月至2020年10月英德市育龄人群4 004名,均接受血常规及血红蛋白电泳检测,并运用高通量测序（NGS）等技术,分别进行地中海贫血基因型分布的统计分析。结果 4 004名受检者中共检出地中海贫血基因携带897例,检出率为22.80%。常见基因和非常见基因检出率分别为20.85%(835例)、1.95%(78例);英中、英西和英东3个片区的基因检出率差异无统计学意义（P>0.05）。检出α地中海贫血基因610例,检出率为15.23%,检出率最高的为αα/--SEA、αα/-α 3.7、αα/-α 4.2;检出非常见α基因5例,检出率为0.12%。检出β地中海贫血基因210例,检出率为5.24%,检出率最高的为βIVS-Ⅱ-654/βA和βCD41-42/βA;检出非常见β基因16例,检出率为0.40%。检出α合并β地中海贫血基因40例,检出率为1.00%,检出率最高的为αα/--SEA合并βCD41-42/βA;检出非常见α合并β基因4例,检出率为0.10%。检出异...     

脑型血吸虫病的MRI诊断

目的 探讨脑型血吸虫病的MRI表现特点.方法 回顾性分析了38例经临床或病理证实的脑型血吸虫病的MRI表现.结果 脑型血吸虫病的MRI表现主要有:①26例位于大脑半球,7例位于小脑;脑实质内病灶位于皮层及皮层下区者34例;②病灶多发者36例,其中呈大小不等结节者27例;36例中32例的主体病灶有集中于某一区域的倾向,28例病灶有融合表现;③36例病灶较均匀明显强化,16例伴脑膜强化,6例邻近脑沟内血管强化明显;④31例伴中重度灶周水肿.结论 脑型血吸虫病的MRI表现具有一定的特征性,结合临床及实验室检查能较准确诊断.     

能谱CT对晚期肺癌非手术治疗的疗效评价研究进展

近年来肺癌是发病率和死亡率最高的恶性肿瘤之一,由于早期症状不明显,很多病人就诊时已进入晚期,失去了最佳手术机会。随着医学技术的发展,晚期肺癌的非手术治疗方式也取得了一些进步。例如传统的放疗化疗、分子靶向治疗及免疫治疗等逐步应用于临床,其疗效评价是依据实体瘤疗效评价标准来判定的。多种影像学技术可应用于评估实体瘤疗效,其中能谱CT成像的基物质图像,在肺癌的疗效评价中能提供更多的功能学信息。本文就能谱CT在晚期肺癌的疗效评价中的应用价值进行综述。     

温针结合手法治疗寰枢关节紊乱症58例

寰枢关节紊乱症是临床上一种多发病，患者主要表现为颈枕部疼痛酸胀、头痛、眩晕、视物不清、上肢肌力减弱等。笔者2006—2009年采用温针结合推拿手法治疗本病58例，取得满意疗效。报告如下。     

Abernethy畸形一例

患者 女．19岁：右季肋部疼痛2年余．偶尔有全身浮肿．无呕血史。实验室检查：甲胎蛋白（AFP）〈0.9μg/L：总胆红素36.6μmol／L，而氨酸转氨酶（ALT）49IU／L，天冬氨酸转氨酶（AST）91IU／L．γ-谷氨酰转肽酶（γ—GGT）81IU／L。总蛋白51.6g／L，白蛋白30g/L，尿酸412．7μmol／L，余无异常。