卡托普利减轻心室肌重量远期效果观察

口服卡托普利(Captopril,巯甲丙脯酸)治疗心脏病患者31例,疗程3个月。治疗前后用二维超声心动图测量出室间隔厚度、左心室后盛厚度和左室舒张末期内径,并计算出左室重量(LVM)。发现治疗后LVM较治疗前平均减轻17.2％(233.90±61.36 VS 193.68±33.96,P<0.05),而对照组治疗前后无显著差异(P>0.05)。X线心脏远达摄片测得的心胸比率亦有相应变化(0.60±0.16 VS 0.52±0.08,P<0.01)。故认为卡托普利治疗心脏增大的心脏病是可选用的药物。其作用机理可能是多方面的。     

早期肝硬化定量诊断的CT研究

目的　通过对肝硬化肝脏各叶及门静脉进行量化的研究 ,为临床影像早期诊断肝硬化提供依据。方法　选择肝硬化代偿期组、失代偿期组作为疾病组 ,选择健康人作为对照组进行对比研究 ,利用人体常用解剖轴线作为肝脏测量的基准线。门静脉系统的测量采用文献报道的常用方法。结果　肝硬化时肝脏左叶冠状径 (L1)的变化最具临床意义 ,肝硬化代偿期时该值增大 ,肝硬化失代偿期时该值缩小 ;肝叶比例不仅存在于肝叶间同时也存在于肝叶内。门静脉管径的变化主要发生于肝硬化代偿期 ,通过建立门静脉的变化与肝脏变化的数学模型对早期肝硬化进行预测。结论　可以利用肝脏各叶的测量值及门静脉管径的变化预测和诊断早期肝硬化     

心周脂肪组织与冠心病及代谢综合征的关系

目的探讨心周脂肪组织(pericardial adipose tissue,PAT)容量与冠心病及代谢综合征(metabo1ic syndrome,MS)的关系。方法回顾性分析1102例患者的双源CT冠状动脉造影资料,采用平扫图像测定PAT容量。根据代谢危险因素的数量和冠状动脉狭窄程度,将患者分为MS组338例和无MS组764例及≥50%狭窄组492例和<50%狭窄组610例。结果 MS组PAT容量较无MS组明显增多,≥50%狭窄组PAT容量较<50%狭窄组明显增多(P<0.01)。随着代谢危险因素数目的增加,PAT容量呈上升趋势,差异有统计学意义(P<0.01)。多元回归分析显示,PAT容量与≥50%狭窄(回归系数=1 7.78,P<0.01)、体重指数(回归系数=7.32,P<0.01)、腹围(回归系数=2.51,P<0.01)和LDL-C(回归系数=16.94,P<0.05)相关。结论多层螺旋CT测定PAT容量是提示患者冠心病和代谢风险的方法之一。     

儿童肺结核45例临床特点及诊断分析

目的 分析儿童肺结核的临床特点,为提高儿童肺结核的诊治水平提供依据。方法 回顾性分析45例肺结核患儿的一般资料、实验室检查以及影像学检查结果,比较并分析胸部CT与胸X线片检查结果,并查阅纤维支气管镜检查、治疗支气管内膜结核情况。结果 45例患儿中男28例,女17例。明确接种卡介苗者42例（93.3%）。有明确近期活动性肺结核接触史者11例（24.4%）,既往家庭成员有结核病史者33例（73.3%）。单纯肺结核者37例（82.2%）,合并肺外结核者以结核性胸膜炎多见。常见症状为发热、咳嗽、喘息以及结核中毒症状。儿童肺结核以不同形式起病,以支气管炎和肺炎起病29例（64.4%）,以支气管哮喘起病3例（6.7%）,以慢性咳嗽起病5例（11.1%）,以发热待查起病6例（13.3%）,手术创伤后起病2例（4.4%）。结核菌素纯化蛋白衍生物试验中度以上阳性38例（84.4%）。胸部CT比胸X线片能更好地发现病变。45例中42例进行了纤维支气管镜检查,发现支气管内膜结核13例（31.0%）,予冷冻以及利奈唑胺灌洗治疗,2～3次后支气管内壁变光滑。结论 胸部CT的诊断价值优于胸X线片;纤维支气管镜下予...     

Variability in the Spatial Structure of the Central Loop in Cobra Cytotoxins Revealed by X-ray Analysis and Molecular Modeling

Cobra cytotoxins (CTs) belong to the three-fingered protein family and possess membrane activity. Here, we studied cytotoxin 13 from Naja naja cobra venom (CT13Nn). For the first time, a spatial model of CT13Nn with both “water” and “membrane” conformations of the central loop (loop-2) were determined by X-ray crystallography. The “water” conformation of the loop was frequently observed. It was similar to the structure of loop-2 of numerous CTs, determined by either NMR spectroscopy in aqueous solution, or the X-ray method. The “membrane” conformation is rare one and, to date has only been observed by NMR for a single cytotoxin 1 from N. oxiana (CT1No) in detergent micelle. Both CT13Nn and CT1No are S-type CTs. Membrane-binding of these CTs probably involves an additional step—the conformational transformation of the loop-2. To confirm this suggestion, we conducted molecular dynamics simulations of both CT1No and CT13Nn in the Highly Mimetic Membrane Model of palmitoiloleoylphosphatidylglycerol, starting with their “water” NMR models. We found that the both toxins transform their “water” conformation of loop-2 into the “membrane” one during the insertion process. This supports the hypothesis that the S-type CTs, unlike their P-type counterparts, require conformational adaptation of loop-2 during interaction with lipid membranes.     

Imaging characteristics of esophageal cancer in multi-slice spiral CT and barium meal radiography and their early diagnostic value

BackgroundTo explore the imaging characteristics of esophageal cancer in multi-slice spiral CT (MSCT) and barium meal radiography and to analyze the value of the two examinations alone or in combination for cancer staging diagnosis.MethodsThe clinical data of 87 patients with esophageal cancer admitted to our hospital from June 2018 to June 2020 were retrospectively analyzed. According to the different examination methods, they were divided into a barium meal group (n=28 cases, X-ray barium meal radiography), an MSCT group (n=29 cases, MSCT examination), and a combined group (n=30 cases, barium meal + MSCT). The imaging characteristics from the barium meal radiography and MSCT alone versus their combined results were compared with the pathological examination results to analyze their accuracy in diagnosing esophageal cancer staging.ResultsOf the 87 cases, the esophageal cancer lesion sites were as follows: 23 cervical cases, 20 upper thoracic cases, 21 middle thoracic cases, and 23 lower thoracic cases. The X-ray barium meal examination of esophageal mucosa showed irregular filling of the esophagus. The esophageal wall was stiff or jagged, the lumen was narrow, and it was difficult for the barium to pass, the mucosa was discontinuous. The CT scan showed irregular thickening of the esophageal wall, eccentric and concentric stenosis of the esophageal cavity, and the upper part of the esophagus showed different degrees of expansion. The trachea and bronchi were invaded, deformed, and displaced under compression. The diagnostic staging results of the barium meal group and MSCT group were inconsistent with the pathological results (Kappa =0.105, 0.112; P>0.05). The diagnostic staging results of the combined group were in good agreement with the pathological results (Kappa =0.769). In addition, the accuracy of the combined group in the diagnosis of stage III–IV esophageal cancer among the three groups was significantly higher than that of the barium meal group and MSCT group alone (P<0.05).ConclusionsMSCT and barium meal radiography clearly display the imaging features of esophageal cancer and can provide reliable imaging evidence for preoperative diagnosis; the combination of both measures can effectively improve the accuracy of early diagnosis for esophageal cancer.     

基于第三代双源CT动态心肌灌注成像不同负荷后心率增量者的正常心肌血流量范围

目的:探讨基于第3代双源CT动态心肌灌注成像（CT-MPI）定量的正常心肌血流量（MBF）与负荷后心率增量的关系。方法:回顾性分析2016年10月至2019年11月于上海交通大学附属第六人民医院行动态CT-MPI及冠状动脉CTA（CCTA）检查的冠状动脉正常或冠状动脉轻微狭窄（定义为任一心外膜血管直径狭窄<25%）44...     

Integrated screening and testing for TB and COVID-19 in Peru

We describe the experience of integrating COVID-19 screening and testing into a mobile TB screening unit in Lima, Peru. All attendees received chest radiographs, which were analysed using CAD4TB and CAD4COVID; Xpert MTB/RIF Ultra was used to test for TB, and antibody and polymerase chain reaction (PCR) for SARS-CoV-2. One Xpert-positive TB case was diagnosed per 168 people screened, one person with SARS-CoV-2 antibodies per 3 people screened, and one PCR-confirmed SARS-CoV-2 infection per 8 people screened. Integrated screening can help to avoid delays in the diagnosis of both TB and COVID-19.     

先天性内耳发育畸形的多层螺旋CT表现

目的 探讨先天性内耳发育畸形的多层螺旋CT表现。资料与方法 回顾性分析17例（32耳）先天性内耳发育畸形患者的CT表现,所有患者均做多层螺旋CT横断面扫描及多平面重建,对患耳做单侧重叠放大重建,并利用容积再现技术（VRT）对骨迷路进行三维重建。结果 本组先天性内耳发育畸形有以下几种：（1）Michel型（1耳）：内耳结构完全缺如。（2）共同腔畸形（2耳）：耳蜗和前庭呈一囊状结构,二者不能相互区分。（3）不完全分隔Ⅰ型（3耳）：耳蜗缺乏完整的蜗轴,呈囊状改变,同时前庭扩大呈囊状。（4）不完全分隔Ⅱ型（Mondini型）（4耳）：耳蜗仅1．5圈,中圈和顶圈融合,前庭扩大。（5）前庭及半规管畸形（14耳）：耳蜗正常,前庭扩大,半规管短小、粗大或缺如。（6）前庭导水管扩大（14耳,其中6耳伴随其他畸形）：前庭导水管扩大呈喇叭口状或与总脚相通。（7）内耳道畸形（8耳均伴随其他畸形）：内耳道缺如、狭窄或扩大。结论 先天性内耳发育畸形有其特殊的形态学表现,多层螺旋CT扫描结合后处理成像可清晰显示各种畸形的二维和三维解剖特征,对诊断有重要价值。