CT灌注成像在肝癌TACE治疗中的应用价值

肝细胞癌(HCC)是慢性肝病患者中死亡率较高的恶性肿瘤,已成为一个主要的全球健康问题。对于失去手术切除机会的肝癌患者,肝动脉化疗栓塞(TACE)是有效的治疗方法。肝癌TACE治疗反应的评价是决定治疗成功和指导后续治疗的关键。CT灌注成像能够精确提供正常肝脏组织和局部病变的微循环信息,可以用于肝癌TACE治疗的评价。本文主要阐述CT灌注成像的基本概念及其在肝癌TACE治疗中的应用价值。     

团体心理护理对尿道膀胱肿瘤电切术后行膀胱灌注化疗患者负性情绪和生活质量的影响

目的：探讨团体心理护理对尿道膀胱肿瘤电切术后行膀胱灌注化疗患者负性情绪和生活质量的影响。方法选择尿道膀胱肿瘤电切术后行膀胱内灌注化疗的膀胱癌患者80例,按随机数字表法分为观察组与对照组,各40例。对照组实施常规护理,观察组在常规护理的基础上进行团体心理护理。干预前后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）和生活质量评定量表（EORTC QLQ－C30）比较两组患者的改善情况。结果团体心理干预后,观察组患者SAS、SDS评分分别为（42．42±3．12）,（44．11±4．43）分,均低于对照组的（52．34±4．11）,（56．25±5．13）分,差异有统计学意义（t值分别为3．586,3．264;P＜0．05）。观察组患者总体健康状况、认知功能、社会功能得分分别为（54．52±13．81）,（79．74±22．13）,（73．21±23．33）分,均高于对照组的（30．81±10．24）,（64．34±21．21）,（54．63±27．81）分,差异有统计学意义（t值分别为－12．124,－3．747,－3．614;P＜0．05）。结论团体心理护理能改善膀胱灌注化疗患者的焦虑、抑郁等负性情绪,提高患者的生活质量。     

Water content of hearts perfused with crystalloid and nutrient solutions

One hundred and twenty excised rabbits hearts were subjected to 1 h of continuous pulsatile coronary perfusion with acellular fluids in a Lindbergh-Rockefeller Institution organ perfusion apparatus. Perfusions were carried out at 26°C and 15°C. At the end of 1 h of perfusion, samples of the left ventricular myocardium were packed into nuclear magnetic resonance (NMR) tubes and the water peak area and linewidth of the water signal were determined by the steady-state NMR spectroscopy. Seventeen different perfusates were employed. Four hearts were perfused and one control heart was processed in an identical way, with each set of experiments. Results were expressed as the mean percentage increase in total myocardial water in perfused hearts, as compared to unperfused hearts. At 26°C these ranged from 9.31 (s.e. 0.66) to 35.89 (s.e. 4.09). At 15°C the range was from 13.26 (s.e. 1.03) to 39.14 (s.e. 2.06). At 26°C, the mean linewidth (Hz) in control myocardiums was 11.60 (s.e. 0.40), in perfused hearts 7.34 (s.e. 0.33); at 15°C it was 12.15 (s.e. 0.29) in control hearts, and 7.84 (s.e. 0.37) in perfused ones. Hearts perfused with lactated Ringer's solution showed the greatest interstitial water accumulation. Linewidth narrowing indicated an accumulation of “unstructured” presumably extracellular water. In edematous hearts, interstitial spaces were widely dilated. The described technique can serve as a rapid screening method for assessing myocardial edema produced by perfusion.     

Effect of Plaque Burden and Morphology on Myocardial Blood Flow and Fractional Flow Reserve

Background

Atherosclerotic plaque characteristics may affect downstream myocardial perfusion, as well as coronary lesion severity.

Assessment of the alveolar bone support of patients with unilateral cleft lip and palate: A cone-beam computed tomography study

Objective:To assess the bone support of the teeth adjacent to a cleft using cone-beam computed tomography (CBCT).Materials and Methods:The CBCT scans of 31 patients with unilateral cleft lip and palate (UCLP) were assessed. The data for teeth neighboring the cleft were compared with those of contralateral noncleft teeth. For each tooth analyzed, the distance between the cementoenamel junction (CEJ) and the bone crest (AC) at the buccal side was measured as was the thickness of the buccal bone level at 0, 1, 2, and 4 mm.Results:The bone thicknesses of the central teeth at the cleft region at the crest and 2 mm apically were statistically significantly thinner than that of the central incisor at a noncleft region. The CEJ-AC distance for central teeth at the cleft region was higher than that for central teeth in a noncleft region.Conclusions:Subjects with UCLP showed reduced bone support at teeth neighboring the cleft compared with controls. This may cause some problems during orthodontic treatment.     

A tourniquet assisted cardiopulmonary resuscitation augments myocardial perfusion in a porcine model of cardiac arrest

ObjectiveDuring cardiopulmonary resuscitation (CPR), myocardial blood flow generated by chest compression rarely exceeds 35% of its normal level. Cardiac output generated by chest compression decreases gradually with the prolongation of cardiac arrest and resuscitation. Early studies have demonstrated that myocardial blood flow during CPR is largely dependent on peripheral vascular resistance. In this study, we investigated the effects of chest compression in combination with physical control of peripheral vascular resistance assisted by tourniquets on myocardial blood flow during CPR.MethodsVentricular fibrillation was induced and untreated for 7 min in ten male domestic pigs weighing between 33 and 37 kg. The animals were then randomized to receive CPR alone or a tourniquet assisted CPR (T-CPR). In the CPR alone group, chest compression was performed by a miniaturized mechanical chest compressor. In the T-CPR group, coincident with the start of resuscitation, the thin elastic tourniquets were wrapped around the four limbs from the distal end to the proximal part. After 2 min of CPR, epinephrine (20 μg/kg) was administered via the femoral vein. After 5 min of CPR, defibrillation was attempted by a single 150 J shock. If resuscitation was not successful, CPR was resumed for 2 min before the next defibrillation. The protocol was continued until successful resuscitation or for a total of 15 min. Five minutes after resuscitation, the elastic tourniquets were removed. The resuscitated animals were observed for 2 h.ResultsT-CPR generated significantly greater coronary perfusion pressure, end-tidal carbon dioxide and carotid blood flow. There was no difference in both intrathoracic positive and negative pressures between the two groups. All animals were successfully resuscitated with a single shock in both groups. There were no significant changes in hemodynamics observed in the animals treated in the T-CPR group before-and-after the release of tourniquets at post-resuscitation 5 min.ConclusionsT-CPR improves myocardial and cerebral perfusion during CPR. It may provide a new and convenient method for augmenting myocardial and cerebral blood flow during CPR.     

下颌第三磨牙萌出状态与第二磨牙远中邻面龋坏的相关性研究

目的:研究下颌第三磨牙萌出状态与第二磨牙远中邻面龋坏的相关性。方法 :临床收集因下颌第三磨牙不适而就诊的患者204例,运用锥形束CT分析下颌第二磨牙远中邻面龋坏与第三磨牙阻生类型(高位、中位、低位)、阻生角度以及两磨牙的釉牙骨质界距离(cementoenamel junction,CEJ)等因素是否存在相关性。结果:在下颌第三磨牙存在的情况下,第二磨牙远中邻面龋坏发生率高达78.4%;性别差异无统计学意义(P=0.165);高位、中位和低位阻生的龋坏发生率差异无统计学意义(P=0.646);而当第三磨近中阻生角度为40~80°时,第二磨牙远中邻面最易发生龋坏,与其他阻生角度组的差异有统计学意义(P<0.001);当第二磨牙与第三磨CEJ距离在6~9 mm时,第二磨牙远中邻面龋坏高于其他组,差异有统计学意义(P<0.001)。结论:下颌第三磨牙近中阻生角度、第三磨牙与第二磨牙的CEJ距离与第二磨牙远中邻面龋坏的发生密切相关。当第三磨近中阻生角度在40~80°间,且两磨牙间的CEJ距离在6~9 mm时,第二磨牙远中邻面更容易发生龋坏,此类阻生齿建议尽早拔除。