磁共振功能成像观察猫播散性皮层抑制

目的 利用磁共振功能成像(fMRI)研究KCl诱导猫脑模型的播散性脑皮层抑制(SCD)现象.方法 雌猫6只,双侧上侧裂回上方开颅,以备分别注入KCl凝胶和生理盐水凝胶.磁共振检查首先行垂直相交的横断面、矢状面、冠状面T1WI及T2WI扫描,分析各方位图像的解剖特点;然后分别行静息期、KCl刺激期及对侧生理盐水刺激期BOLD采集.最后取局部脑组织行病理学检查.结果 包括双侧上侧裂回和边缘回的冠状面图像能显示脑回的长轴及相邻脑回的关系.脑激活图显示KCl刺激区上侧裂回及邻近边缘回脑皮层出现激活区者5例,同侧边缘回后部出现激活区者5例.时间-信号强度曲线显示注入KCl后,fMRI信号立即显著增高,并持续维持于高水平.病理检查显示KCl刺激局部神经细胞水肿.结论 包括双侧上侧裂回和边缘回的冠状面是磁共振功能成像研究SCD的理想成像层面;fMRI能准确检测出SCD伴发的脑血流量的变化.     

分娩后一年内垂体的磁共振影像变化

目的：前瞻性纵向评价分娩后一年内垂体在磁共振T1W1上体积和信号强度的变化，并探讨了终止哺乳是否对这些数据产生影响。方法：13例自愿（年龄26～32岁，平均28岁）在分娩后第2周和第4周行磁共振检查。然后在分娩后一年内，每隔半个月至2个月检查一次。有8例受试在研究期间中止了哺乳。     

孕期监测宫颈长度与先兆早产的相关性

目的：探讨孕期监测宫颈长度与先兆早产的相关性,预测孕妇发生早产的临床价值,为今后临床诊治提供参考和借鉴。方法本研究随机选取我院2012年10月～2013年10月期间收治的无任何合并症及并发症孕妇177例,孕期内行常规超声监测宫颈长度,按分娩时间分为两组：先兆早产（A）组138例,早产（B）组39例,分析孕期监测宫颈长度与先兆早产的相关性。结果A组平均宫颈长度为（3.29±0.62）cm明显长于B组的（2.67±0.64）cm,差异有统计学意义（t=3.5083,P=0.0132）;宫颈长度改变是孕妇先兆早产的主要特征。以宫颈长度3.0cm为界,宫颈长度预测孕妇发生早产的敏感度为92.31%（36/39）,特异度为93.47%（129/138）,阳性预测值为80.00%（36/45）,阴性预测值为97.73%（129/132）。结论宫颈长度改变是孕妇先兆早产的主要特征,对宫颈长度＜3.0cm的孕妇应高度警惕其发生早产,对于宫颈长度＞3.0cm的孕妇,应根据其具体的临床表现对症用药,保证母婴安全。采用超声监测孕期宫颈长度能客观、准确地预测早产,是一种安全、有效、可靠的监测方法,值得在临床实践中广泛的应用和推广。     

个体化胰腺双能量增强扫描与单能量增强扫描在胰腺癌诊断中图像质量及辐射剂量的对比研究

目的 研究对比个体化胰腺双能量增强扫描与单能量增强扫描在胰腺癌诊断中的图像质量及辐射剂量情况.方法 选取2014年1月至2015年1月纳入临床疑似胰腺占位行CT增强扫描的患者62例为观察组,对观察组所有患者实施个体化胰腺双能量CT增强扫描;另回顾性分析30例胰腺癌患者个体化胰腺单能量增强扫描患者资料作为对照组,比较2组患者扫描情况.结果 经过单能能谱分析,胰腺癌患者病灶的CNR随着能量水平的增加而不断增加,当CNR达到最大值时逐渐走低,呈单峰分布,且所有30例患者CNR能谱图高度一致.观察组胰腺癌CNR平均值为(3.94 ±0.73),对照组为(2.93±0.86),观察组明显高于对照组,差异有统计学意义(P＜0.05).观察组增强扫描期间产生的DLP为(375.11±67.70) mGy·cm,ED为(5.63±1.02) mSv,对照组DLP为(309.95±57.33) mGy·cm,ED为(4.64±0.86) mSv,观察组显著低于对照组,差异有统计学意义(P＜0.05).结论 双能量CT扫描能够在一定程度上提高胰腺癌病灶的对比噪声比,虽然这样会导致辐射量出现一定程度的提高,但是对于胰腺癌的检出以及诊断意义重大.     

刺血急救对脑梗死急性期脑血流图的影响

目的观察刺血急救对脑梗死急性期患者脑血流图的影响。方法随机选取20例患者进行急救穴刺血疗法治疗,疗程7d;观察治疗前后脑血流图波幅、上升时间及转折高比值的变化。结果刺血疗法治疗后梗死侧波幅升高、上升时间缩短、转折高比值增大;非梗死侧脑血流图各项指标治疗前后无明显差异。结论刺血疗法具有良性调整作用,可使低下或亢进的脑功能恢复正常,而对正常功能状态无明显影响。     

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。     

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。     

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.     

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)     

梅花针叩刺结合辨证配穴治疗痤疮48例

资料与方法４８例均为门诊病人，其中男３１例，女１７例，年龄最小者１６岁，最大３２岁；病程最短为２个月，最长５年。临床表现为颜面潮红，粉刺掀热，疼痛或有脓疱，苔薄舌红，脉角细数等症状，辨为肺经风热型，共计２５例；表现为皮疹红肿疼痛，伴有便秘溲赤，纳呆腹...