严重胸部创伤16例CT诊断分析

目的 探讨县级医疗机构CT扫描检查对严重胸部创伤的价值.方法 使用机型为GE Hispeed dual的双层螺旋CT,对我院严重胸部创伤患者16例用胸部螺旋CT以10 mm层厚及间隔进行扫描,部分病灶采用后重建(拆薄)方法,进行观察分析影像.结果 16例严重胸部创伤病例,其中肺挫伤10例,肺撕裂伤2例,支气管断裂伤1例,肺不张2例,肺萎陷10例,血气胸8例,单纯气胸3例,血胸5例;发生肋骨骨折16例,双侧锁骨骨折2例,单侧锁骨骨折3例,第3、4胸椎爆裂性骨折合并椎体侧方脱位及2～4多发肋粉碎性骨折1例,肩胛骨骨折3例.皮下气肿16例,纵隔气肿4例,胸壁血肿1例,肝破裂2例,脾破裂3例,肾破裂1例,颈椎脱位及骨折2例,颅脑损伤4例.结论 CT检查较普通X线检查能提供更多的诊断信息,目前县级医疗机构均有螺旋CT,CT扫描费用也在大幅下调,所以对严重胸部外伤的患者应及时采用CT扫描,以及时明确病变的部位、性质、程度,迅速明确诊断,及时进行手术,挽救危重患者的生命.     

30例肝内胆管细胞癌的CT诊断分析

目的探讨肝内胆管细胞癌的CT诊断价值。方法对本院2007年1月～2011年6月进行CT检查的30例肝内胆管细胞癌患者进行分析,总结其CT特点。结果30例患者中,21例为单发病灶,9例肿块周围可见卫星灶。增强扫描：17例为肿块周边呈不规则强化,9例为肿块周边呈环形或结节状明显强化。结论肝内胆管细胞癌的CT表现有一定的特征性,在临床上有较高的应用价值。     

MRI和~1H-MRS在脑胶质瘤诊断中的价值

目的探讨MRI影像结合氢质子磁共振波谱（1H-MRS）在胶质瘤诊断、分级和鉴别诊断中的价值。方法对30例MRI符合胶质瘤患者配合1H-MRS检查[测N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）、乳酸（Lac）、脂质（Lip）、肌醇（mI）值]进行综合分析。结果 1H-MRS显示病变区与正常脑实质比较NAA下降、Cho升高、Cr总量变化不大且无规律性和部分出现异常Lac和（或）Lip峰,mI含量表现为轻度下降,同时可显示肿瘤周边区域的Cho升高等异常。结论 MRI影像结合1H-MRS分析对颅脑胶质瘤分级、诊断、范围确定和鉴别诊断有重要价值,能有效提高脑胶质瘤的诊断正确性。     

低张气钡双对比造影检查对早期贲门癌的诊断价值探讨

目的评价低张气钡双对比造影检查对早期贲门癌的诊断价值。方法回顾分析本科2007年6月～2010年6月采用低张气钡双对比造影检查诊断出早期贲门癌的28例患者的临床资料,与采取胃镜检查及病理检查做出的诊断进行比较。结果 28例患者中后经病理证实为早期贲门癌26例,其中隆起型12例,溃疡型8例,平坦型6例。误诊2例（1例为胃底静脉曲张,1例为炎性息肉）。结论低张气钡双对比造影检查因为经济、方便、无创,它是早期贲门癌最直接、有效的检查方法,如果结合胃镜检查及病理检查可以提高诊断准确率。     

MRI弥散加权成像对弥漫性轴索损伤的诊断价值

目的探讨MRI弥散加权成像（difussion—weighted imaging,DWI）在诊断脑弥漫性轴索损伤（diffuse axonal in—iury,DAI）中的价值。方法回顾性分析16例经临床及影像学诊断为DAI患者的常规MRI和DWI的资料,分别比较DWI、T1加权像（T1 weightedimaging,TlwI）、T2加权像（T2 weighted imaging,T2WI）、液体衰减反转恢复（fluidat—tenuated inversion recovery,FLAIR）序列对DAI病灶的检出数目,并分析其分布特点和信号特征。结果DAI病灶主要分布在白质、皮髓交界区、基底节、胼胝体、脑干及小脑等区域。DWI对DAI病灶的检出率最高。与其它序列的差异有统计学意义（P〈0．05）。结论常规序列和DWI联合应用为临床DAI诊断提供可靠的影像学依据,应作为MRI检查DAI的常规和首选序列。     

超声心动图在心肌梗死诊断中的价值研究

目的探讨超声心动图在心肌梗死中的诊断价值。方法对2008年10月～2011年5月于本院进行检查的60例疑似心肌梗死患者为研究对象,分别采用超声心动图和心电图进行检查诊断,两次检查诊断时间间隔不超过30min,并将结果与冠状动脉造影手术结果对照。结果超声心动图的急性心肌梗死及陈旧性心肌梗死的诊断符合率均高于心电图,经比较,均P〈0.05,差异均有统计学意义。结论超声心动图在心肌梗死诊断中的价值要高于心电图,可用于提高各型心肌梗死的诊断率。     

38例乳腺癌的彩色多普勒超声诊断价值分析

目的探讨彩色多普勒超声诊断乳腺癌的临床价值。方法回顾性总结分析2009年1月～2012年1月笔者所在医院收治的38例乳腺癌患者超声声像图特征。结果 38例乳腺癌患者形态不规则,呈"蟹足样"改变28例,边缘不光滑,呈毛刺样改变,肿块多为低回声,可见细沙粒样钙化灶(共16例)。后方回声衰减10例,CDFI显示纵横比≥1共8例。血流分级:0级3例,I级9例,Ⅱ级10例,Ⅲ级14例,检出率为94.7%,2例未见血流信号。腋窝淋巴结肿大8例(21.1%)。结论彩色多普勒超声检查能清晰显示乳腺癌的大小、形态、内部结构及血流分布情况,因此,彩色多普勒超声可以作为诊断乳腺癌的常用手段之一,值得推广和应用。     

常规超声与超声弹性成像对乳头溢液的诊断价值分析

目的探讨常规超声与超声弹性成像对乳头溢液的诊断价值,分析其效果。方法选择2010年9月～2012年3月50例经手术病理证实为乳头溢液的患者作为研究对象,患者在术前进行常规超声及实时超声弹性成像检查,采用平行于乳腺导管的放射状方法对其进行扫描检查,要针对患者的乳晕区域的扩张导管以及占位的常规超声声像图的表现而为患者诊断,诊断结果有BI-RADS1～5级,实时弹性的成像要依据病灶的成像特征进行分析,分为1～5级,此次所有患者的全部病变均或者手术的病理。结果笔者所在医院此次研究的50例患者,其中良性病变为40个,恶性病变为10个,在常规超声的基础上加强使用弹性成像,对病变诊断的敏感度达到100%。结论常规超声如果发现导管扩张伴有内部局限性回声病变,则应为患者使用超声弹性成像检查,可有效提高诊断的特异性。     

Usefulness of serum S100B as a marker for the acute phase of aquaporin-4 autoimmune syndrome

The aquaporin-4 (AQP4) water channel antibody is used in the diagnosis of neuromyelitis optica (NMO) due to its high sensitivity and high specificity. However, some patients are reported to have neither optic neuritis nor myelitis despite being positive for the AQP4-autoantibody (AQP4-Ab). Therefore, recent reports suggest that such patients should be diagnosed as having 'AQP4-autoimmune syndrome'. In this study, we quantified the levels of glial fibrillar acidic protein (GFAP) and S100B by enzyme-linked immunosorbent assay (ELISA) in CSF and serum samples simultaneously obtained in the acute phase of ten AQP4-autoantibody (AQP4Ab)-positive and seven AQP4Ab-negative patients. Serum levels of S100B were significantly higher in the acute phase of the AQP4Ab-positive patients (2.92±1.22pg/ml) than in the AQP4Ab-negative patients (0.559±0.180pg/ml, p=0.0250), while serum levels of GFAP were not different between the two groups (AQP4Ab-positive vs. AQP4Ab-negative: 0.120±0.113ng/ml vs. 0.00609±0.00609ng/ml, p=0.193). Furthermore, the CSF and serum levels of S100B had a significant positive correlation in AQP4Ab-positive patients (n=10, r=0.673, p=0.0390). Our results raise the possibility that serum levels of S100B, but not GFAP, examined in the acute phase of the disease might be a useful biomarker for the relapse of AQP4 autoimmune syndrome.     

Guided motor training induces dendritic spine plastic changes in adult rat cerebellar purkinje cells

Schizophrenia is a complex disorder with a high heritability. Relatives with schizophrenia have an increased risk not only for schizophrenia but also for schizophrenia spectrum disorders, such as schizotypal personality disorder. A single nucleotide polymorphism (SNP), rs1344706, in the Zinc Finger Protein 804A (ZNF804A) gene, has been implicated in susceptibility to schizophrenia by several genome-wide association studies, follow-up association studies and meta-analyses. This SNP has been shown to affect neuronal connectivities and cognitive abilities. We investigated an association between the ZNF804A genotype of rs1344706 and schizotypal personality traits using the Schizotypal Personality Questionnaire (SPQ) in 176 healthy subjects. We also looked for specific associations among ZNF804A polymorphisms and the three factors of schizotypy-cognitive/perceptual, interpersonal and disorganization-assessed by the SPQ. The total score for the SPQ in carriers of the risk T allele was significantly higher than that in individuals with the G/G genotype (p=0.042). For the three factors derived from the SPQ, carriers with the risk T allele showed a higher disorganization factor (p=0.011), but there were no differences in the cognitive/perceptual or interpersonal factors between genotype groups (p>0.30). These results suggest that the genetic variation in ZNF804A might increase susceptibility not only for schizophrenia but also for schizotypal personality traits in healthy subjects.