A pseudoisochromosome 18q and an isodicentric chromosome 18

A case of pseudoisochromosome 18q of prezygotic origin and a case of isodicentric chromosome 18 of postzygotic origin are presented to validate the differentiation between a true isochromosome and a pseudoisochromosome. This differentiation may be useful in elucidating the mechanism of the origin of an isochromosome.     

Efficient implementation of hardware‐optimized gradient sequences for real‐time imaging

This work improves the performance of interactive real‐time imaging with balanced steady‐state free precession. The method employs hardware‐optimized gradient pulses, together with a novel phase‐encoding strategy that simplifies the design and implementation of the optimized gradient waveforms. In particular, the waveforms for intermediate phase‐encode steps are obtained by simple linear combination, rather than separate optimized waveform calculations. Gradient waveforms are redesigned in real time as the scan plane is manipulated, and the resulting sequence operates at the specified limits of the MRI gradient subsystem for each new scan‐plane orientation. The implementation provides 14‐25% improvement in the sequence pulse repetition time over the vendor‐supplied interactive real‐time imaging sequence for similar scan parameters on our MRI scanner. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

临证实痛辨治

痛之命名,始见《内经》。有《素问.举痛论》之专篇论痛,百病多痛,临证习之,辨证常用六法:行气止痛、散寒止痛、活血止痛、化痰止痛、清热止痛、调神止痛。     

Multishot EPI-SSFP in the heart.

Refocused steady-state free precession (SSFP), or fast imaging with steady precession (FISP or TrueFISP), has recently proven valuable for cardiac imaging because of its high signal-to-noise ratio (SNR) and excellent blood-myocardium contrast. In this study, various implementations of multiecho SSFP or EPI-SSFP for imaging in the heart are presented. EPI-SSFP has higher scan-time efficiency than single-echo SSFP, as two or more phase-encode lines are acquired per repetition time (TR) at the cost of a modest increase in TR. To minimize TR, a noninterleaved phase-encode order in conjunction with a phased-array ghost elimination (PAGE) technique was employed, removing the need for echo time shifting (ETS). The multishot implementation of EPI-SSFP was used to decrease the breath-hold duration for cine acquisitions or to increase the temporal or spatial resolution for a fixed breath-hold duration. The greatest gain in efficiency was obtained with the use of a three-echo acquisition. Image quality for cardiac cine applications using multishot EPI-SSFP was comparable to that of single-echo SSFP in terms of blood-myocardium contrast and contrast-to-noise ratio (CNR). The PAGE method considerably reduced flow artifacts due to both the inherent ghost suppression and the concomitant reduction in phase-encode blip size. The increased TR of multishot EPI-SSFP led to a reduced specific absorption rate (SAR) for a fixed RF flip angle, and allowed the use of a larger flip angle without increasing the SAR above the FDA-approved limits.     

肿瘤患者知情权与护理满意度关系的探讨

目的 探讨肿瘤患者知情权与护理满意度之间的关系.方法 随机抽取肿瘤中心,及循环科、呼吸科及普外科患者746例,针对患者知情权和护理工作满意度制订调查问卷进行调查,并对结果进行分析.结果 不知情的肿瘤患者想获得更多关于自身疾病的真实信息,而护理人员被要求对其病情保密,这种矛盾导致了肿瘤科患者对此方面护理工作的满意度低于其他科室,差异有统计学意义,P<0.05.结论 知情权对于肿瘤患者非常重要,它可增加肿瘤患者的治疗依从性,促进沟通,接受优质护理,从而提高护理满意度.     

阿苯达唑对华支睾吸虫体壁和肠管超微结构的影响

阿苯达唑对实验大鼠体内华支睾吸虫体壁和肠管影响的超微结构观察结果表明,该药对虫体皮层和肠绒毛,在给药1h即出现皮层突起肿胀、粘连和肠绒毛肿胀,其内的点线模糊不清。给药24h损害已相当严重,皮层突起出现坏死、崩溃,部分肠绒毛溶解、坏死。而且皮层和肠管损害的发生发展过程是同步的。可以认为阿苯达唑是通过对皮层和肠管的双重损害,进而影响其生理机能,使虫体死亡的。     

温肾潜阳法治疗肿瘤晚期戴阳证1例

目的:观察中医药治疗肿瘤晚期戴阳证的临床疗效。方法:以温肾潜阳为法,处方以四逆汤合白通汤加味治疗一出现戴阳证的肾癌晚期病人。结果:经中医药治疗后,患者戴阳症状明显好转,住院期间未再发作。结论:对于晚期肿瘤病人,只要中医辨证施治得当,亦可以显著改善患者临床症状,提高癌症患者的生活质量。     

Lymphoepithelial Cyst of the Pancreas: Report of a Case

A lymphoepithelial cyst (LEC) is an extremely rare benign lesion of the pancreas. During a medical check-up, a 77-year-old man without any symptoms was found to have a cyst in the body of the pancreas. His serum carbohydrate antigen 19-9 level was slightly elevated. Computed tomography showed a multilocular, low-attenuating cyst on the superior surface of the pancreatic body. Thus, we performed distal pancreatectomy with splenectomy. Histological examination revealed that the cyst wall was lined with squamous epithelium and surrounded by abundant mature lymphoid tissue. Keratinous substances were present in the cyst. An LEC of the pancreas is associated with a good prognosis and, although unusual, it should be considered in the differential diagnosis of pancreatic cystic lesions. Minimal resection of the cyst should be performed whenever possible, and extensive surgery avoided. For patients with a high surgical risk, fine-needle aspiration biopsy may be considered.     

Dynamic Indicators That Impact the Outcomes of Thoracic Endovascular Aortic Repair in Complicated Type B Aortic Dissection

PurposeTo investigate dynamic variables obtained from retrospective computed tomography angiography for ability to predict thoracic endovascular aortic repair (TEVAR) outcomes in patients with complicated type B aortic dissection (cTBAD).Materials and MethodsSeventy-nine patients with cTBAD who received TEVAR from March 2009 to June 2018 were retrospectively enrolled. Relative true lumen area (r-TLA) was computed at the level of tracheal bifurcation every 5% of all R-R intervals. Parameters that reflect the state of intimal motion were evaluated, including difference between maximum and minimum r-TLA (D-TLA) and true lumen collapse. The endpoints comprised early (≤ 30 days) and late (> 30 days) outcomes after intervention.ResultsOverall early mortality rate was 13.9% (11/79), and early adverse events rate was 24.1% (19/79). Patients who received TEVAR within 2 days of symptom onset demonstrated the worst outcomes. A longer time of r-TLA < 25% in 1 cardiac cycle (P = .049) and larger D-TLA (P < .001) were correlated to an increased early death. In addition, D-TLA was an independent predictor of early mortality. Area under the curve of D-TLA was 0.849 (95% confidence interval 0.730–0.967) for predicting early mortality and 0.742 (95% CI 0.611–0.873) for predicting early adverse events. Survival and event-free survival rates during follow-up were decreased in the D-TLA > 21.5% group compared with the D-TLA ≤ 21.5% group (all P < .001).ConclusionsLarger D-TLA is correlated with worse postoperative outcomes and might be a crucial parameter for future risk stratification in patients with cTBAD.     

金莲花真伪鉴别与质量评价方法研究进展

金莲花具有抗氧化、抗菌、抗病毒、抗炎、抗肿瘤等多种药理作用,是金莲花片、金莲花胶囊、金莲花颗粒、金莲花口服液等常用中成药的主要原料药。但金莲花属植物性状相似度较高,容易被混用,影响金莲花质量。因此,加强金莲花真伪鉴别和质量评价研究对保障其质量及疗效具有重要意义。总结了金莲花的性状鉴别、显微鉴别、理化鉴别、红外光谱鉴别和分子鉴别等真伪鉴别方法,并从化学成分含量测定和指纹图谱等方面对金莲花质量评价方法进行探讨,以期为金莲花的质量控制提供参考。