磁共振扩散加权成像技术在颅内囊性病变鉴别诊断中的应用

目的探讨磁共振扩散加权成像（DWI）技术对颅内囊性病变中表皮样囊肿、蛛网膜囊肿、脑脓肿及囊性坏死性脑肿瘤（单发囊性转移瘤、神经上皮肿瘤）的鉴别诊断价值。方法对2004年5月-2006年5月行神经外科手术治疗并经病理证实的50例颅内囊性病变患者的磁共振扩散加权成像资料进行回顾性分析．其中表皮样囊肿10例、蛛网膜囊肿10例、脑脓肿10例、单发囊性转移瘤8例及神经上皮肿瘤12例，均进行常规MRI平扫及DWI检查，生成DWI图及表观扩散系数（ADC）图，观察囊变区信号特征并测量该区的表观扩散系数值。结果（1）表皮样囊肿在扩散加权成像显示为高信号，其表观扩散系数图显示为低或稍低信号，表观扩散系数测量值为（0．924-0．12）×10^-3mm^2／s，蛛网膜囊肿扩散加权成像显示为低信号，表观扩散系数图呈高信号，测量值为（3．094-0．21）×10^-3mm^2／s；两组表观扩散系数测量值差异有统计学意义（t=22．278，P=0．000）。（2）脑脓肿之囊变区于扩散加权成像显示为高信号，表观扩散系数图呈低及等信号，表观扩散系数测量值为（0．524-0．08）×10^-3mm^2／s；单发囊性转移瘤和神经上皮肿瘤之囊变区在扩散加权成像上显示为低信号，表观扩散系数图显示为高信号。表观扩散系数测量值为（2．354-0．41）×10^-3mm^2／s，与脑脓肿组相比差异有统计学意义（t=13．939，P=0．000）。结论不同颅内囊性病变在磁共振扩散加权成像上的表现特点及病灶囊变区表观扩散系数测量值的变化。具有诊断与鉴别诊断价值。     

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目的　探讨一种更精确而行之有效的测量甲状腺残留量的方法。方法　自 1996～ 2 0 0 1年对 15例原发性甲状腺功能亢进症病人于术前经CT对甲状腺进行体积测量 ,于双侧甲状腺次全切除术后 ,再用增强CT对上述病人残留甲状腺进行体积测量 ,并与术中测得残留量比较。结果　术中测得残留量 2 8～ 13 0 g ,术后CT测量为 3 4～ 16 6g ,二者之间有一定误差 (P =0 0 6 7) ,产生原因主要为术者对残留甲状腺背面气管旁沟处的不规则腺体测量不准确。体积切除率 83 1%～ 97 9% ,体积残留率 2 1%～ 17 9% ,活体组织相对体积质量 (1 0 5 4 8± 0 0 2 0 5 ) g/cm3 ,离体组织相对体积质量 (1 0 6 4 8± 0 0 188) g/cm3 。结论　CT测量更接近实际残留量 ,可重复性强 ,可比性强。体积残留率比腺体残留重量、手术切除率更具有个性化参考意义。     

少、弱精子症中精子形态缺陷类型及发生率的检查分析报告

目的 探讨在少、弱精子症中精子形态缺陷类型及其发生率.方法 对精液常规和改良巴氏染色检查的结果进行统计学分析.结果 （1）男性不育症中畸形精子症的发生率约为75%;精子头部缺陷的发生率约为70%,各种头部缺陷中空泡头畸形的发生率占首位,约为20%.（2）少精子症患者的正常形态精子百分率的中位数约为2.97%（P=0）,弱精子症患者的中位数为6.67%（P=0.003）.结论 （1）精子头部缺陷是精子畸形的主要类型;（2）少、弱精子症的畸形精子比例升高;（3）精子形态缺陷分析对选择辅助助孕方式具有应用价值.     

两步极体活检对小鼠卵母细胞体外受精和胚胎发育的影响

目的评价两步活检一、二极体对小鼠卵母细胞体外受精(IVF)和相应胚胎发育的影响。方法8～12周龄雌、雄昆明小鼠。雌鼠促排卵,取成熟卵母细胞行卵胞浆内单精子注射(ICSI),序贯培养胚胎至囊胚孵出。分别于ICSI后激光透明带打孔活检第一极体,两步活检一、二极体,在受精后打孔同时活检一、二极体。比较各处理组与对照组受精、卵裂、优质胚胎、囊胚形成、扩张和孵出情况。结果两步活检一、二极体和同时活检一、二极体受精率、卵裂率、优质胚胎率和囊胚形成率与对照组均无明显差异。启动孵出率明显高于对照组;完全孵出率虽高于对照组,但无统计学意义。结论一、二极体活检不影响小鼠卵母细胞IVF和相应胚胎发育,而且可能有助于胚胎孵出,是安全可行的植入前遗传学诊断(PGD)活检取材方法,以两步活检法为最佳极体活检方案。     

带臀中肌蒂骨移植加内固定治疗股骨颈骨折

应用带臀中肌蒂骨移植加加压螺纹钉内固定治疗不稳定型股骨颈骨折.通过对31例5年以上的随访,骨折愈合率达96.8%,优良率达92.9%.切除该肌骨瓣不影响臀中肌功能,骨块用七号丝线固定.对采用Watson—Jones氏切口行切开整复的不稳定型股骨颈骨折,本法可首选.     

温阳健心灵口服液治疗充血性心力衰竭的临床与实验研究

以煎剂形成筛选治疗CHF的处方，发现温阳益气方改善泵血功能的效果优于单纯益气和养阴益气的处方。根据前方制备的温阳健心灵口服液保持了原煎剂的疗效，并被毒理学试验证明毒性极低。动物药效学及临床试验发现该药不仅能改善心衰犬和病人的左室收缩功能，还能改善其舒张功能。除此，它还具有利尿作用和使PAWA、SVR和PVR下降的作用，这也是它抗心衰的机理之一。90例的临床观察（疗程2周）表明该药总有效率、近期治愈率和显效率分别达88．9％、7．4％和18．5％，其效与开搏通组无明显差异。     

A study comparing biopharmaceutic characteristics of four once daily controlled release diltiazem preparations

Summary— In the present study we have compared the steady state biopharmaceutic characteristics of four diltiazem once daily controlled release capsules: Mono-Tildiem LP 300® (300 mg), Adizem® XL (300 mg)¹, Cardizem® (300 mg) and Dilacor® (240 mg). Sixteen healthy male volunteers (aged 22.9 ± 3.3 years, range 19–31 years) completed an open label, multiple oral dose, randomized, four-period crossover study without a washout period in between. The volunteers received each diltiazem formulation once daily for four days. Trough diltiazem and metabolites plasma concentrations were determined on days 3 and 4. The 24-h plasma concentration-time profiles were assessed after the dose on day 4 of each period. The following steady state pharmacokinetic parameters for diltiazem were calculated: the minimum plasma concentration (c_min), the maximum plasma concentration (c_max), the time to reach that concentration (t_max), the time interval during which the plasma concentration exceeds 50% of c_max (t₅₀), the area under the plasma concentration-time curve (AUC_72–96) and the peak-to-trough fluctuation (PTF). For the metabolites of diltiazem, N-mono-desmethyl-diltiazem (NDM) and desacetyldiltiazem (DAD), AUC_72–96 (AUC_NDM and AUC_DAD) and the ratio metabolite/parent compound were calculated. Steady state was achieved on day 3. Except one, all controlled release formulations have satisfactory controlled release properties allowing once daily administration. However, significant (P < 0.05) differences were found between the pharmacokinetic characteristics which do not allow exchange of the various formulations. Concentrations well below 50 ng·mL^-1 in the morning hours were observed for Dilacor® (240 mg) and Adizem® XL (300 mg), which could be a disadvantage of these formulations as it is well-known that ischaemic events occur at a higher rate during that part of the day. The plasma concentration profiles of NDM and DAD, the major circulating metabolites, parallel the plasma concentration profiles for the parent compound. From a clinical point of view, all treatments were well tolerated.     

Autogenous bronchial pedicle flap for tracheoplastic procedures]

Nine cases of large tracheal defect due to resection of tumor or scar were repaired by using autogenous bronchial pedicle flap. The symptoms of airway obstruction rapidly disappeared after operation. The normal part of the right main bronchus and bronchus intermediate was used as material for repair, both lower and middle lobes were preserved in one case, and the lower lobe was preserved in another. We believe that in tracheoplasty with autogenous bronchial flap for large tracheal defect is satisfactory.