THE VALUE OF 99mTc-MIBI MYOCARDIAL PERFUSION SPECT IMAGING IN DETECTING CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR DISEASE BEFORE OPERATION

Objective. The aim of this study was to detect coronary artery disease using ^99mTc-MIBI myocardial perfusion imaging in patients with valvular disease. Methods. Thirty patients with valvular disease confirmed by echocardiography underwent ^99mTc-MIBI myocardial perfusion imaging using multiSPECT lh after stress test (exercise, dipyridamole or dobutamine test) and were performed coronary angiography within 1 month before valvular operation. Results. For 29 out of the 30 patients, the results of ^99mTc-MIBI myocardial perfusion imaging were similar with those of coronary angiography, the concordance rate was 96.7 % and the negative predictabili-ty was 100%. Conclusion. ^99mTc-MIBI myocardial perfusion imaging is a reliable non-invasive method for detecting coronary artery disease in patients with valvular disease and so as to draw up suitable operation programs for them.     

~（99m）Tc－MIBI心肌断层显像硝酸异山梨酯试验对心肌存活的评价

采用９９ｍ锝─甲氧基异丁基腈异（９９ｍＴｃ－ＭＩＢＩ）结合硝酸异山梨酯静脉滴注，对２９例心肌梗塞患者进行心肌断层显像。所有患者均进行静态心肌断层显像，然后静脉给予硝酸异山梨酯，达到标准后给予９９ｍＴｃ－ＭＩＢＩ，１．５ｈ后以与静态显像相同的条件采集和处理。结果显示，静态心肌显像有３８．３％的节段呈现为灌注异常区，给予硝酸异山梨酯后有３９％的节段心肌灌注得到改善。结果表明，硝酸异山梨酯静脉输入能明显改善９９ｍＴｃ－ＭＩＢＩ对心肌梗塞患者心肌存活的探测效果。     

右室射血分数的超声心动图与核素心室造影对比研究（摘要）

右室射血分数的超声心动图与核素心室造影对比研究（摘要）中国医学科学院中国协和医科大学心血管病研究所中国医学科学院中国协和医科大学阜外心血管病医院刘醒，刘汉英，王志民，李胜亭，宋松，程克正，蔡如升右心室大部分位于胸骨之后，形态复杂，其容量估测较难。右室...     

硝酸异山梨酯介入~（99m）Tc－MIBI心肌断层显像在心肌存活判定中的价值

对３７例心肌梗塞患者进行９９ｍＴｃ－甲氧基异丁基异腈（ＭＩＢＩ）静态心肌显像，以及静脉给予硝酸异山梨酯（ＩＳＤＮ）后显像．静态心肌显像有１３４／３３３（４０．２％）个节段灌注异常，ＩＳＤＮ滴注后有５９／１３４（４４．０％）个节段心肌灌注得到改善．接受冠状动脉搭桥术患者术前ＩＳＤＮ显像改善的２０个节段，术后１７个（８５％）节段心肌灌注也有明显改善．表明ＩＳＤＮ能明显改善９９ｍＴｃ－ＭＩＢＩ对心肌存活的探测效果．     

消旋萘普生拆分工艺改进及应用

萘普生化学名d-2-(6-甲氧基-2-黄基丙酸)。作为一种良好的非甾体抗炎镇痛药物,在我厂已生产多年。随着市场对药品质量要求的不断提高,利用现有的拆分工艺,即;以消旋萘普生作为拆分前体,葡辛胺为拆分剂,甲醇为溶剂,进行拆分后得到的产品一次合格较低,需反复精制才能过到质量控制标准。这样     

鉴别多房囊性肾细胞癌的主要CT征象及临界值

目的 探讨符合WHO 2004年诊断标准的多房囊性肾细胞癌(MCRCC)患者的CT特征及与其他亚型囊性肾细胞癌(CRCC)的鉴别要点.方法 依据是否符合WHO 2004年病理诊断标准将40例患者分为两组:MCRCC组及其他亚型CRCC组(CRCC组),复阅CT片,对比肿瘤直径、边界、密度、囊壁及分隔最大厚度、钙化、强化值等CT征象.采用ROC曲线法确定相关指标的临界值及诊断的特异度、灵敏度.结果 MCRCC组17例,CRCC组23例.MCRCC多表现为囊壁薄、分隔细小、无明显结节的囊性占位.囊壁及分隔最大厚度是鉴别MCRCC及其他亚型CRCC的惟一CT征象(P＜0.01),其临界值为6mm,诊断的灵敏度和特异度分别为89%和75%.结论 囊壁及分隔厚度小于6 mm是鉴别MCRCC与其他亚型CRCC的主要CT征象.

Abstract：

Objective To determine the main CT features and the key points of differential diagnosis of multilocular cystic renal cell carcinoma (MCRCC) classified according to 2004 WHO pathological diagnostic criteria. Methods According to the criteria, 40 patients were divided into two groups: MCRCC group and other subtypes of cystic renal cell carcinoma (CRCC). The CT findings were evaluated and compared between two groups for cystic content, wall, septum, nodularity, calcification and enhancement. ROC curve was used to determine the cut-off value of the possible CT feature which could distinguish MCRCC from other subtypes of CRCC. Results Seventeen cases of MCRCC group and 23 cases of CRCC group were included in this study according to the diagnostic criteria. MCRCC appeared as a well defined multilocular cystic mass with thin wall and sepia and no expansile solid nodules. Thickness of cystic wall and/or septum is was main CT findings to distinguish MCRCC from other subtypes of CRCC (P ＜ 0.01 ). The cut-off value of the thickness was 6 mm and its sensibility, specificity was 89% ,75% respectively. Conclusion Cystic wall and/or septum with a thickness of less than 6 mm are the main CT findings to dis tinguish MCRCC from other subtypes of CRCC.     

尿路上皮癌mdm-2、p53蛋白及性激素受体免疫组化研究

目的　探讨ｍ ｄ ｍ２ 、ｐ５３ 基因蛋白及雄激素受体（ ＡＲ） 、雌激素受体（ＥＲ） 在尿路上皮癌中的表达及意义以及 ｍ ｄ ｍ２蛋白与ＡＲ 、ＥＲ 和ｐ５３ 蛋白表达的相互关系。方法　采用免疫组化技术检测６０ 例尿路上皮癌石蜡标本。结果　ｍ ｄ ｍ２ 蛋白阳性率为５５ ．０ ％ ,与肿瘤分级、分期密切相关,高分化癌、浅表性癌阳性表达显著高于低分化及浸润性癌。ｐ５３ 蛋白阳性率为５３ ．３ ％ ,在低分化及浸润性癌组织阳性率明显高于高分化及浅表性癌（ Ｐ＜ ０ ．０５） 。ＡＲ 、ＥＲ 阳性率分别为５１ ．７ ％ 及４８ ．３ ％ ,与肿瘤分级呈正相关表达（ Ｐ＜ ０ ．０５） ,与临床分期无关。男、女两性间仅ＡＲ 表达有显著差异（ Ｐ＜ ０ ．０５） 。ｍ ｄ ｍ ２ 与ＡＲ 及ＥＲ 表达呈正相关（γ值分别为０ ．４０１８ 、０ ．２２４９） ,与ｐ５３ 表达呈负相关（γ＝ － ０ ．４９８９） 。结论　提示ｍ ｄ ｍ２ ,ｐ５３ 、ＡＲ 及ＥＲ 均与肿瘤组织病理学有关,对尿路上皮癌的发生发展均有各自的作用。联合检测癌相关基因蛋白及性激素受体可了解尿路上皮癌多方面的生物学信息,为临床提供更有价值的预后判断指标。     

水杨酸鞣酸浸泡治疗某水泥厂工人手足癣继发皲裂76例

76例中男64例,女12例.年龄20~70岁.病程最短22天,最长50年.     

假性黑棘皮病一例

患者男,15岁.1990年5月因肥胖、颈、腋及腹股沟皮肤增厚5年来我院就诊.5年来,体重增加迅速,饮水多,食量大,日饭量达0.7-0.8kg,出汗多.     

皮肤型何杰金病一例

患者男,42岁,因全身瘙痒19年,右股部斑块溃疡15年,右腹股沟淋巴结肿大半年,于1983年10月4日来本院皮肤科.