CT扫描在胸膜外孤立性纤维瘤中的诊断价值

目的探讨CT扫描在胸膜外孤立性纤维瘤(E-SFT)中的诊断价值。方法回顾性分析2015年4月至2018年4月于我院接受手术治疗的90例E-SFT患者术前CT检查影像资料和术后病理、免疫组织化学资料,评估CT检查在E-SFT诊断中的应用价值。结果 90例E-SFT患者均为单发肿瘤,免疫组织化学及病理学检查示良性80例,恶性10例;CT检查结果为良性72例,平扫表现为圆形或类圆形软组织密度影,密度不均匀,大部分边缘清晰,增强扫描表现为均匀强化;恶性18例,平扫示肿瘤体积较大,边界不清,密度不均,可见大片不规则低密度区,增强扫描瘤体强化不均匀,低密度区无明显强化;CT诊断的敏感度、准确度、特异性阳性率、阴性率分别为60%(6/10)、82%(74/90)、85%(68/80)、33%(6/18)、94%(68/72)。结论 E-SFT的CT检查影像图像具有一定的特征性,尤其是增强扫描有助于评估纤维瘤的良恶性,可将其作为术前诊断及术后复查评估的有效依据用于临床诊疗工作中。     

Anorectal function in the solitary rectal ulcer syndrome

The anorectal function of nine patients with solitary rectal ulcer syndrome (SRUS) (5 F: 4 M, median age, 27 (range, 19–41 years) and nine control subjects (5 F: 4 M, median age, 47 (35–66)P<0.01) has been investigated by a new technique that radiologically visualizes the anorectum during voiding of a semisolid contrast medium, while simultaneously measuring intrarectal pressure and anal sphincter EMG activity. A degree of rectal prolapse was demonstrated in eight of the SRUS patients; six of these lesions were clinically occult. Abnormal failure of the anal sphincter to relax on voiding was present in seven of the SRUS patients. These abnormalities resulted in the SRUS patients requiring a greater increase in intrarectal pressure (median, 100 cm water) to void than the control subjects (median, 65 cm water,P<0.01). This combination of high intrarectal pressure and rectal prolapse during straining seems to be the cause of SRUS This work was supported by a grant from the Medical Research Council.     

Solitary fibrous tumor of the inguinal region

Solitary fibrous tumors (SFT) have recently been established to be of mesenchymal origin. Although there are numerous reports of SFTs arising from the pleura, reports of the tumor arising from extrapleural sites are comparatively rare [Fletcher CDM, Unni K, Mertens F (eds) World Health Organization classification of tumors, pathology & genetics, tumors of soft tissue and bone. IARC Press, Lyon, pp 86–901, 2002]. We report a case of SFT arising in the inguinal region.     

应用最大似然法鉴别诊断周围型肺癌、肺错构瘤和结核球的初步研究

目的:探讨应用最大似然法鉴别周围性肺癌、肺错构瘤及结核球3种孤立性肺结节(SPN)的诊断价值。方法:对150例经临床和手术病理证实的SPN(周围性肺癌、肺错构瘤、结核球各50例)的HRCT影像学征象进行分类统计分析,运用最大似然判别法,将其各种征象转化为记分值,以数值的大小来判定肺结节所属的类型。结果:最大似然法对周围型肺癌、肺错构瘤及结核球的诊断正确率分别为86%、92%及90%,平均诊断正确率为89.3%,高于常规阅片法的82%,但两组间差异无统计学意义(χ2=2.434,P>0.05)。最能提示为肺癌的征象依次为空泡征、分叶征、支气管充气征和血管集束征;最能提示为肺错构瘤的征象依次为脂肪、边缘清楚及钙化;最能提示为结核球的征象依次为空洞、卫星灶、钙化及胸膜凹陷征。结论:最大似然法对常见SPN的鉴别诊断正确率有所提高,是一种辅助影像学诊断的有价值的方法。     

超声诊断甲状腺腺瘤与单发结节性甲状腺肿的价值

目的　探讨超声在甲状腺腺瘤与单发结节性甲状腺肿鉴别诊断中的价值。方法　对两种疾病的二维及彩色多普勒声像图进行分析并比较。结果　甲状腺腺瘤与单发结节性甲状腺肿比较 ,甲状腺大小、结节大小、结节内回声及周围回声组间差异均无统计学意义 (P >0 .0 5 ) ;结节边缘晕环及结节内部和周边血流信号差异有显著性 (P <0 .0 5 )。结论　单发结节性甲状腺肿易误诊为腺瘤 ,结节边缘晕环及结节内部和周边血流信号对鉴别诊断可提供帮助     

肺部小孤立病灶的鉴别诊断

本文对我院胸外科自1984年至1991年肺部X线片显示孤立病灶,其直径小于或等于3cm的78例住院患者作回顾性分析,提出其常见病种及鉴别诊断要点,对诊断未肯定的病灶是否立即手术要视病灶的良恶性可能性等因素来决定,特别强调医生的临床经验与分析能力对鉴别诊断的作用.     

椎管内原发性孤立性纤维性肿瘤临床病理观察(附2例报告)

目的探讨椎管内孤立性纤维性肿瘤的临床病理特征、诊断和鉴别诊断,以期提高对该肿瘤的诊断水平。方法复习2例椎管内原发性孤立性纤维性肿瘤的临床资料,并观察其组织学特征和免疫组化标记。结果2例患者男、女各1例,年龄分别为23岁和32岁,临床表现为局部神经压迫症状。MRI示椎管内髓外硬膜内占位。组织学特征为梭形、卵圆形细胞呈束状、波浪状或旋涡状排列,富于胶原纤维及伴有分支状薄壁血管。细胞未见异型性和核分裂像。免疫组化示瘤细胞Vimentin( ),CD34( ),CD99( ),Bcl-2( ),AACT(-),Actin(-),S-100(-),EMA(-),GFAP(-),CD68(-),CD117(-),SMA(-),NF(-)。结论椎管内原发性孤立性纤维性肿瘤是一种罕见的肿瘤,诊断主要依靠病理形态学及免疫组化,并应与椎管内的其他梭形细胞肿瘤鉴别。     

螺旋CT动态增强扫描对孤立性肺结节定性诊断的价值

目的:分析良恶性孤立性肺结节(SPN)的动态强化特点,探讨动态SCT增强扫描对SPN定性诊断的价值。方法:对50例SPN患者进行螺旋CT同层动态增强扫描,对比剂总量100ml,注射流率3ml/s,延迟15s开始扫描,至180s结束,测量结节中心增强前后的CT值,分析最大强化值及时间-密度曲线(TAC),全部病例经手术病理证实。结果:肺炎性结节及恶性结节均显著强化,肺炎性结节强化峰值的时间较肺癌结节延迟。恶性结节的TAC表现为陡峭的上升支后有一较长的平台期,炎性结节的TAC表现为上升支平缓,部分见降支。结核球等其它良性SPN无明显强化。结论:动态SCT增强扫描对SPN定性诊断有较高价值。SPN的强化峰值及TAC形态有助于良、恶性病变的鉴别诊断。     

Projections of the bed nucleus of the stria terminalis to the mesencephalon,pons, and medulla oblongata in the cat

Summary Injections of HRP in the nucleus raphe magnus and adjoining medial reticular formation in the cat resulted in many labeled neurons in the lateral part of the bed nucleus of the stria terminalis (BNST) but not in the medial part of this nucleus. HRP injections in the nucleus raphe pallidus and in the C2 segment of the spinal cord did not result in labeled neurons in the BNST. Injections of ³H-leucine in the BNST resulted in many labeled fibers in the brain stem. Labeled fiber bundles descended by way of the medial forebrain bundle and the central tegmental field to the lateral tegmental field of pons and medulla. Dense BNST projections could be observed to the substantia nigra pars compacta, the ventral tegmental area, the nucleus of the posterior commissure, the PAG (except its dorsolateral part), the cuneiform nucleus, the nucleus raphe dorsalis, the locus coeruleus, the nucleus subcoeruleus, the medial and lateral parabrachial nuclei, the lateral tegmental field of caudal pons and medulla and the nucleus raphe magnus and adjoining medial reticular formation. Furthermore many labeled fibers were present in the solitary nucleus, and in especially the peripheral parts of the dorsal vagal nucleus. Finally some fibers could be traced in the marginal layer of the rostral part of the caudal spinal trigeminal nucleus. These projections appear to be virtually identical to the ones derived from the medial part of the central nucleus of the amygdala (Hopkins and Holstege 1978). The possibility that the BNST and the medial and central amygdaloid nuclei must be considered as one anatomical entity is discussed.Abbreviations AA anterior amygdaloid nucleus - AC anterior commissure - ACN nucleus of the anterior commissure - ACO cortical amygdaloid nucleus - AL lateral amygdaloid nucleus - AM medial amygdaloid nucleus - APN anterior paraventricular thalamic nucleus - AQ cerebral aqueduct - BC brachium conjunctivum - BIC brachium of the inferior colliculus - BL basolateral amygdaloid nucleus - BNSTL lateral part of the bed nucleus of the stria terminalis - BNSTM medial part of the bed nucleus of the stria terminalis - BP brachium pontis - CA central nucleus of the amygdala - Cd caudate nucleus - CI inferior colliculus - CL claustrum - CN cochlear nucleus - CP posterior commissure - CR corpus restiforme - CSN superior central nucleus - CTF central tegmental field - CU cuneate nucleus - D nucleus of Darkschewitsch - EC external cuneate nucleus - F fornix - G gracile nucleus - GP globus pallidus - HL lateral habenular nucleus - IC interstitial nucleus of Cajal - ICA internal capsule - IO inferior olive - IP interpeduncular nucleus - LC locus coeruleus - LGN lateral geniculate nucleus - LP lateral posterior complex - LRN lateral reticular nucleus - MGN medial geniculate nucleus - MLF medial longitudinal fascicle - NAdg dorsal group of nucleus ambiguus - NPC nucleus of the posterior commissure - nV trigeminal nerve - nVII facial nerve - OC optic chiasm - OR optic radiation - OT optic tract - P pyramidal tract - PAG periaqueductal grey - PC cerebral peduncle - PO posterior complex of the thalamus - POA preoptic area - prV principal trigeminal nucleus - PTA pretectal area - Pu putamen - PUL pulvinar nucleus - R red nucleus - RF reticular formation - RM nucleus raphe magnus - RP nucleus raphe pallidus - RST rubrospinal tract - S solitary nucleus - SC suprachiasmatic nucleus - SCN nucleus subcoeruleus - SI substantia innominata - SM stria medullaris - SN substantia nigra - SO superior olive - SOL solitary nucleus - SON supraoptic nucleus - spV spinal trigeminal nucleus - spVcd spinal trigeminal nucleus pars caudalis - ST stria terminalis - TRF retroflex tract - VC vestibular complex - VTA ventral tegmental area of Tsai - III oculomotor nucleus - Vm motor trigeminal nucleus - VI abducens nucleus - VII facial nucleus - Xd dorsal vagal nucleus - XII hypoglossal nucleus     

神经脉冲波传播形态的研究

Hodgkin-Huxley模型（H—H模型）是研究神经电生理不可或缺的数学依据。但是，到目前为止，对H—H神经元模型的分析缺少解析研究。本文对经典的H-H模型进行具体分析，得到简化H—H模型以及Nagumo方程，利用齐次平衡方法首次求出简化H-H方程和Nagumo方程的孤波解。研究表明：神经冲动可以孤波的模式传播。