单开门颈椎管扩大椎板成形术对颈椎运动的影响

目的：研究单开门颈椎管扩大椎板成形术对颈椎运动功能的影响及相关因素。方法：对52例因脊髓型颈椎病接受单开门颈椎管扩大椎板成形术患者进行回顾性研究，平均随访37．5个月，在颈椎过屈、过伸侧位X线片上比较手术前后颈椎总的运动范围(总活动度)、各椎体间活动度。结果：术后3年颈椎总活动度、总屈曲及总仰伸角度均减小(P≤0．001)，与术前相比平均下降15％，其中42例伴有颈部僵硬、疼痛等症状。颈椎总活动度的改变与神经功能的改善无相关性。各椎体间的屈伸运动范围从C2至C6均明显减小，而C6／7却稍有增加；椎体间滑移在C3／4、C4／5两个节段明显减少(P≤0．05)。结论：单开门颈椎管扩大椎板成形术可以使颈椎总活动度和各椎体间活动度均减少并伴有颈部僵硬和疼痛。术后短期围领制动并早期主动伸、屈颈部的锻炼可能有助于减少颈部僵硬和疼痛的发生。     

中药饮片加工炮炙在临床中的意义

本文简述了中药炮炙的根据、原理、方法以及各种不同辅料和炮炙方法对饮片药性与作用的影响。说明不同的炮炙方法可以直接影响和改变中药的药性和作用,影响到临床疗效,因此,必须重视中药饮片的炮炙工作。以确保临床安全有效的用药。     

眼球破裂伤相关因素分析

目的 观察眼球破裂伤的致伤原因、常见部位、视力预后。方法 眼科住院眼球破裂伤51例的回顾性总结分析。结果 眼球破裂伤的首要致伤因素是打架斗殴(占43％)、其次工伤(占20％)、家庭休闲和旅游误伤(占17％)，交通事故(10％)，其他(10％)。眼球破裂伤的常见部位是上方角膜缘(占45％)，颞侧、鼻侧角膜缘和肌止点后巩膜(各占15％)。经过治疗，Ⅰ度破裂伤7／13获得0．02以上视力，Ⅱ度破裂伤9／20保留光感以上视力，Ⅲ度破裂伤1／18保留光感视力。结论 打架斗殴是眼球破裂伤首要致伤因素，常见伤口位置是上方角膜缘，眼球破裂伤的预后和损伤程度密切相关。     

Changes in cardiovascular function induced by verapamil in healthy subjects and in patients with ischemic heart disease

Alterations in cardiovascular function induced by the acute intravenous administration of verapamil (5 or 10 mg) in 52 patients (29 with ischemic heart disease and 23 without heart disease) were evaluated with use of invasive techniques (right and left heart catheterization, left ventricular cineangiography, and coronary arteriography). The most significant changes were represented by a decrease in systemic vascular resistance and systemic arterial pressure, and an increase in heart rate and cardiac output. Contractility indexes were not depressed in either group, and altered ventricular wall motion tended to improve to a slightly smaller degree than in patients treated with nitroglycerin. The use of verapamil in patients with ischemic heart disease appears to be safe, and concern about the negative inotropic influences in humans no longer seems justified.     

Phase-derivative analysis in MR angiography: Reduced Venc dependency and improved vessel wall detection in laminar and disturbed flow

A problem of current MRA techniques is the inability to accurately depict the vascular anatomy, particularly in areas of disturbed flow. Various reasons, such as intravoxel phase dispersion, saturation, temporal variations, and maximum intensity projection (MIP) nonlinearity, cause a wrong delineation of vessel boundaries. A phase contrast (PC)-based postprocessing operation, the phase derivative (PhD), is introduced to detect phase fluctuations indicating flow. Two-dimensional and three-dimensional angiographic reconstruction algorithms are presented. Mathematical formulas are derived to predict the effect of sampling to flow profiles and the effect on the PhD of these profiles. Numerical, phantom, and preliminary in vivo experiments demonstrate that PhD images do not suffer from phase wraps and allow a velocity dynamic range extension only limited by a differential phase change. It is also shown that PhD MIPs produce higher signal-to-noise ratios than conventional PC angiograms and give a better impression of the anatomy of (stenotic) vessels and of their diameters for both laminar and disturbed flow.     

CT仿真结肠内窥镜的临床应用研究

目的:研究CT仿真结肠内窥镜(CT Virtual Colonoscopy,CTVC)的使用价值,应用方法及镜下表现。方法:使用Hispeed FX/i扫描机,扫描层厚3～5mm,螺距1～2,重叠重建率50％～67％。利用Navigator Smooth软件对容积扫描数据进行三维重建,获得仿真结肠内窥镜的影像,并与纤维肠镜和/或手术所见对照分析,全部病例经病理证实。结果:通过选择不同的观察方位,角度和阈值,CTVC能清楚显示靶器官内正常解剖结构的立体影像和病变的部位、大小、形态及其侵犯范围。CTVC对结肠病变形态的显示与FC或/和标本显示具有良好的对应性,另外,CTVC能从闭塞和狭窄的远端观察病变。但CTVC不能显示组织的颜色变化,不能活检。结论:CTVC作为一种新的非侵袭性结肠检查方法,可以作为纤维结肠镜的有效补充手段,有较好的临床应用价值。     

Vessel enhancement filtering in three-dimensional MR angiograms using long-range signal correlation

Small vessels in three-dimensional MR angiograms have low visibility in maximum-intensity projection images because of their low contrast. In a previous study, we had two nonlinear filters that appeared to give significant improvement in small vessel detail. In this paper, we report on a generalization of this filter that allows a more general modeling of the vessels and a more complete suppression of background. One implementation of the general filter gave a vessel mean contrast-to-noise ratio that is 2.52 and 3.51 times higher than the vessel mean contrast-to-noise ratio obtained using our previously reported maximum-minimum (max-min) filter and cross- section filter, respectively.     

改进虎杖、鸡血藤炮制方法的研究

对虎杖、鸡血藤作了切制、干燥时间和成品、主要成分及水浸出物的比较。结果表明,趁鲜切片优于传统切块、再切片,既能提高饮片的规格质量和成分含量,亦能减少重复劳动,节约能源,避免药材的浪费。