右主支气管软骨瘤1例

患者男,56岁。1个月前无明显诱因出现咳嗽、咳痰,咳嗽以清晨起床后及剧烈活动后明显,咳嗽时伴有胸闷,白色黏痰,量不多,咳出后胸闷感减轻。无发热、盗汗、胸痛及咳血史。7天前在本地医院胸透发现纵隔移位来院就诊。查体：口唇无紫绀,气管右偏,右侧胸廓明显缩小,吸气时无“三凹征”,听诊右肺闻及哮鸣音。     

眶下神经管多层螺旋CT图像重组和测量

目的 利用计算机断层成像(CT)薄层扫描和多平面重组技术显示并测量眶下神经管,对其临床应用价值进行探讨.方法 对105例成年人头部多层螺旋CT薄层扫描图像进行多平面重组以显示眶下神经管;测量眶下神经孔至眶下缘距离、眶下神经至正中平面距离、眶下神经管长度和中段直径;观察眶下神经管的CT表现.结果 眶下神经孔至眼眶下缘垂直距离平均(8.3±2.7)mm;眶下神经管长度和中段平均直径分别为(24.6±3.0)mm、(2.1±1.0)mm;眶下神经孔至正中线距离平均为(27.0±1.7)mm;双侧眶下神经孔基本对称.结论 多层螺旋CT扫描及多平面三维重组技术可多方位显示眶下神经管,并可进行形态学测量,熟悉其正常影像学表现对疾病诊断和术前评价具有意义.     

正常组与直肠癌组直肠系膜及筋膜的CT研究

目的探讨正常组与直肠癌组直肠系膜及其筋膜的CT表现. 方法资料分为2组,正常组54例,无盆腔疾病病史,直肠癌组51例分为外膜受侵组和外膜正常组.由两位放射科医生共同观察分析CT图像,详细记录:①直肠系膜筋膜显示情况;②直肠系膜与盆壁脂肪的密度,并测量CT值;③对直肠外膜模糊者,分别测量病变侧、病变对侧系膜CT值.采用SPSS 10.0软件对数据进行统计. 结果正常组前、后、左、右侧直肠系膜筋膜显示率分别为6.8%、15.9%、81.8%、84.1%,直肠癌组前、后、左、右侧直肠系膜筋膜显示率分别为1.8%、28.3%、81.1%、83.0%,两组间无统计学差异.无论正常组或直肠癌组,直肠系膜CT值高于盆壁脂肪CT值,多数情况下这种差异肉眼可辨,直肠癌组直肠系膜CT值高于正常组,外膜受侵组病变侧系膜CT值高于外膜正常组,统计学有显著差异.外膜受侵组病变对侧系膜CT值与外膜正常组无统计学差异. 结论螺旋CT图像能够显示直肠系膜及筋膜,侧方筋膜显示率高于前、后方筋膜.直肠系膜CT值高于盆壁脂肪,其差异肉眼可辨.直肠癌组直肠系膜的密度高于正常组,直肠外膜受侵,病变侧直肠系膜密度显著增高.     

颅中窝底后缘的HRCT测量及其临床价值

目的测量正常成人颅中窝底后缘相关解剖径线,探讨颅中窝底变异的诊断标准及临床意义.方法选取健康成人40例(80侧),在冠状位HRCT上测量颅中窝底后缘相关解剖径线并行统计分析.结果健康成人颅中窝底后缘深径左侧为(4.09±2.26) mm,右侧为(4.75±2.14) mm,总体为(4.42±2.21) mm,双侧比较(P=0.14)无显著统计学差异;95%可信区间0.09～8.75 mm.男性颅中窝底后缘深径(4.75±2.07) mm,女性(4.80±2.05) mm,男女比较(P=0.927)无显著统计学差异.结论 HRCT可以清晰显示颅中窝底后缘骨性解剖结构,当颅中窝底后缘深径大于8.75 mm时,规定为颅中窝底低位,应提示临床此种变异.     

Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy

Introduction: We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Method: Nine boys and two girls with cerebral palsy (6–12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB–BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. Results: No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2?min, p?=?0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p?=?0.424; COPM, p?=?0.484) but we found significant improvements in hand speed (p?=?0.028), smoothness (p?=?0.005) and accuracy (p?=?0.007). Conclusion: School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity.

• Implications for Rehabilitation

• School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology.

• Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance).

• The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb.

     

血清癌胚抗原升高者的PET/CT分析

【目的】用18F-FDG PET或PET/CT显像研究血清癌胚抗原(CEA)升高者的临床应用价值。【方法】81例患者中,无既往恶性肿瘤病史者42例,有恶性肿瘤病史者39例。全身PET或PET/CT显像者78例,局部显像者3例。所有患者临床随访时间皆大于6个月。【结果】81例中,随访结果证实有恶性肿瘤者70例,无恶性肿瘤者11例。PET对恶性肿瘤的检出灵敏度为91.5%,特异性为85.7%。假阳性1例,为结肠腺瘤;假阴性5例,见于肺泡癌(3例)、卵巢浆液乳头状囊腺癌(1例)和胃印戒细胞癌(1例)。真阳性患者中,肺癌 结直肠癌占72.3%。恶性病灶的多少及严重程度与CEA水平的高低无明显关系。【结论】PET在探查和诊断CEA升高者体内恶性肿瘤方面是一种很有用的显像技术。PET显像阴性者须结合其他影像技术并判断定期随访。     

肺真菌病的影像分析：附43例报告

目的:探讨对肺真菌病的X线和CT诊断。材料和方法:对43例肺真菌病的X线和CT表现进行回顾性分析。结果:66％病例累及2个肺叶以上,双下叶受累最常见。影像学的表现有5个类型8种表现,肺内浸润较有特异性,炎性假瘤出现较多,并可有坏死空洞及中央型侵犯。结论:肺真菌病可有5种形式的影像学表现,即支气管肺浸润型、坏死空洞型、炎性假瘤型、真菌球型和中央型。多叶侵犯、多形态浸润、游走性浸润及真菌球等表现有助于肺真菌病的诊断。     

On-line computer estimation of carbon dioxide response curves

Anesthesiologists are concerned with the effect of various anesthetics on a patient's central nervous ventilatory control. The most widely accepted method of determining the effect of a drug is to compare carbon dioxide response curves ( e/PetCO₂, where e = minute ventilation [in L/min] andPetCO₂ = end-tidal carbon dioxide [in mm Hg]) measured before and after administration of the drug. Additional information concerning neuromechanical control can be obtained by also including a measure of the airway occlusion pressure (generally measured 100 ms after occlusion, i.e., P₁₀₀).To facilitate these measurements we have developed a portable, computer-controlled data acquisition system. It includes an Apple II+ computer and measures e,PetCO₂, and P₁₀₀. Each subject rebreathes exhaled carbon dioxide through a two-way breathing valve attached to a 9-liter reservoir, which is initially filled with 5% carbon dioxide and balance oxygen. Exhaled carbon dioxide concentrations are measured with an infrared medical gas analyzer on samples taken through a catheter connected at the mouthpiece. The exhaled flow is measured with a pneumotachograph in conjunction with a differential pressure transducer, and P₁₀₀ is determined with a Validyne MP45 pressure transducer.     

脾脏弥漫性淋巴管瘤病1例

患者女，40岁。平日身体健康，1个月前单位体检发现脾脏囊性肿物。门诊以“脾脏囊肿”收住人院。查体：腹部平坦，腹部无压痛及反跳痛，无肌紧张；脾肿大，达肋下三指。血常规、生化、肝功能检查均正常。患者既往乙肝“小三阳”病史20余年；否认家族遗传病史。     

18F-FDG PET/CT在骨与软组织肉瘤中的应用进展

骨与软组织肉瘤发病率相对较低,但多数恶性程度高,预后差,早期诊断是改善预后的关键。~(18)F-FDG PET/CT可用于骨与软组织肉瘤的诊断及鉴别诊断、肿瘤分级、确定活检部位、检测复发及转移、评价疗效及预后等各方面。本文就~(18)F-FDG PET/CT在骨与软组织肉瘤中的应用进展进行综述。