64层CT诊断肝局灶性结节增生与肝腺瘤的临床价值分析

目的探讨64层CT诊断肝局灶性结节增生与肝腺瘤临床效果。方法选择2007年12月-2012年12月在我院治疗的肝局灶性结节增生者26例,肝腺瘤者11例,行多期螺旋CT检查。结果肝局灶性结节增生平扫期CT值为(48.5±1.8)HU明显低于肝实质(61.5±1.7HU),差异有统计学意义,P<0.05;肝腺瘤平扫期CT值为(42.3±1.6)HU明显低于肝实质(61.5±1.7)HU,差异有统计学意义,P<0.05;肝局灶性结节增生平扫期CT值为(48.5±1.8)HU与肝腺瘤(42.3±1.6)HU比较差异无统计学意义,P>0.05。肝局灶性结节增生动脉期CT值为(123.7±2.6)HU明显高于肝腺瘤、肝实质(82.5±1.9)HU、(74.2±2.3)HU,差异有统计学意义,P<0.05。肝局灶性结节增生门脉期CT值为(110.3±2.3)HU与肝腺瘤、肝实质(107.4±2.1)HU、(110.5±2.2)HU比较差异无统计学意义,P>0.05。结论64层CT诊断肝局灶性结节增生与肝腺瘤简单方便,为临床治疗提供了影像学证据。     

无症状非吸烟者肺HRCT定量分析及其与肺功能的相关性研究

目的探讨健康成人随年龄的变化,吸呼气相HRCT肺密度指标的变化及其与肺功能的相关性。方法对63例无症状非吸烟者进行肺吸气末与呼气末HRCT扫描,其中32例进行肺功能测试。将所有受试者按年龄分为5组,分别测定各组的HRCT定量指标,进行分析。所测肺功能与定量指标进行相关性分析。结果随着年龄的增长,各肺野及全肺的呼气相CT平均肺密度及差值均随着年龄的增加而逐渐降低,有极显著统计学意义(P<0.01)。用力肺活量(FVC)、1 s用力呼气容积(FEV1)、肺总量(TLC)与吸气相各个肺野及全肺的平均肺密度均有极显著的相关性(P<0.01);残气容积(RV)与吸气相中肺野平均肺密度极显著相关(P<0.01),与上、下肺野及全肺则为显著相关(P<0.05)。结论无症状非吸烟者随年龄增长,吸呼气相HRCT肺密度定量指标发生了变化,能够评价肺功能指标的一些轻微改变。     

吸烟对股骨头微血管渗透性影响的定量DCE MRI研究

【摘要】目的：使用DCE-MRI探讨吸烟人群股骨头血管渗透性的改变及其与烟龄的关系。方法：将40例吸烟者和40例年龄、性别、体重和体质指数（BMI）相匹配的健康志愿者（对照组）纳入本研究,所有受检者行髋关节常规MRI及动态对比增强扫描（DCE-MRI）,获得时间-信号强度曲线,在每例被试的左侧股骨头勾画ROI,经软件后处理,可获得ROI的渗透性相关参数值（Ktrans、Kep、Ve和Vp）。根据烟龄将吸烟组分为4个亚组（A组,<5年;B组,≥5但<10年;C组,≥10但<20年;D组,≥20年）。采用配对秩和检验分别比较4个亚组与对照组间各项渗透性参数值的差异,采用Pearson相关分析对吸烟组内各项渗透性参数值与烟龄的关系进行分析。结果：A组与对照组间各项渗透性参数值的差异均无明显统计学意义（Ktrans：Z=1.00,P<0.001;Kep：Z=－0.137,P=0.891;Ve：Z=－1.018,P=0.309;Vp：Z=－0.314,P=0.753）。B组与对照组间各项渗透性参数值的差异均有统计学意义（P<0.05）,吸烟组的Ktrans和Kep高于对照组,而Ve和Vp则低于对照组。Ktrans和Kep与烟龄呈正相关关系（r=0.906和0.859,P<0.001）,Ve和Vp与烟龄呈负相关关系（r=－0.889和－0.932,P<0.001）。结论：吸烟可以导致股骨头内血管渗透性的改变,且与烟龄密切相关。     

64排螺旋CT导向经胸穿刺活检对评价肺部小结节的临床应用

目的探讨64排螺旋CT导向肺部小结节经胸穿刺活检的准确性及临床应用价值。方法收集有手术病理或临床随访结果的肺部小结节（直径小于2cnl）CT导向经胸穿刺活检者118例，其中经64排螺旋CT导向57例，经普通CT导向61例。比较64排螺旋CT导向和普通CT导向肺部小结节穿刺活检在诊断正确率和并发症发生率的差异。结果64排螺旋CT导向肺深部小结节穿刺活检诊断正确率91．23％（52／57）高于普通CT导向的诊断正确率77．05％（47／61），差异有显著性意义（P〈0．05）。64排螺旋CT导向肺部小结节穿刺活检的并发症发生率14．04％（8／57）低于普通CT的并发症发生率26．23％（16／61），但差异无统计学意义（P〉0．05）。结论与普通CT比较，64排螺旋CT导向肺部小结节穿刺活检是一种更安全、准确的诊断和鉴别诊断方法。     

3TMRI与双源CT评估健康人肺静脉与左心房关系的比较研究

目的比较MRI与双源CT在评估左心房与肺静脉关系中的应用,探讨3T MRI评估左心房与肺静脉关系的可行性。资料与方法于2009年9月至2010年5月纳入健康志愿者64名,其中包括MRI组受试者32名,采用3TMRI全心对比增强成像技术;双源CT组来源于行双源CT冠状动脉成像检查的志愿者,共32名。对MRI及双源CT组图像进行多平面重组(MPR)、容积再现技术(VRT)后处理,观察和测量左心房与肺静脉间的解剖关系。结果组间年龄、性别差异无统计学意义(P>0.05)。两种检查方法中肺静脉无变异,均为4支。右上、左上、左下肺静脉长径、宽径、面积两种方法测量差异无统计学意义(P>0.05)。右下肺静脉长径、宽径两种方法测量差异无统计学意义(P>0.05),面积测量差异有统计学意义(P<0.05)。水平面、冠状面与X轴间夹角,两种检查方法测量差异无统计学意义(P>0.05)。结果 3TMRI在评价左心房与肺静脉间关系上与双源CT有很好的一致性。     

磁共振成像联合螺旋CT诊断小儿细微性骨折研究

目的 分析磁共振成像（MRI）联合64排螺旋CT诊断小儿细微性骨折的准确率。方法 选定郑州市骨科医院2020年1月至2022年1月接诊的75例细微性骨折患儿，分别给予MRI、64排螺旋CT检查，将外科手术作为本次研究诊断金标准，比较MRI、CT、MRI+CT总检出率、诊断准确率、灵敏度及特异度，Kappa检验MRI、CT、MRI+CT与外科手术的一致性。结果 MRI+CT(96.0%)、MRI(92.0%)总检出率均高于CT(80.0%)，差异有统计学意义（P<0.05）。MRI+CT(98.7%、98.6%)、MRI(93.3%、94.5%)诊断准确率、灵敏度均高于CT(81.3%、82.2%),P<0.05,MRI+CT(100%)、MRI(50.0%)诊断特异度与CT(50.0%)比较，差异无统计学意义（P>0.05）,Kappa检验CT与外科手术的一致性一般（Kappa值=0.60），差异有统计学意义（P<0.05）,MRI、MRI+CT与外科手术的一致性较好（Kappa值=0.77、0.79），差异有统计学意义（P<0.05）。结论 MRI、MR...     

18F-FDG和18F-FLT PET/CT在肺部良恶性肿瘤鉴别诊断中的价值

目的:分析18F-FDG(18F-脱氧葡萄糖)和18F-FLT(18F-胸腺嘧啶)两种显像剂的PET/CT检查在肺部肿瘤中的不同影像学表现,提高PET/CT在肺部良恶性肿瘤鉴别诊断中价值,从而为临床治疗方案的选择提供可靠依据。方法:收集肺肿瘤患者55例为研究对象,其中男性33例,女性22例,年龄17～82岁,28例为肺内孤立肿块,其余为2～3个肿块,肿块大小0.6～11.0cm,所有患者均行肺部18 F-FDG和18 F-FLT PET/CT检查,分析18 F-FDG和18 F-FLT标准摄取值(SUV)与肺肿瘤患者的年龄、肿块大小及病理类型等相互关系和统计学意义。结果:18 F-FDG和18 F-FLT PET/CT的SUV与肺肿瘤患者的年龄、肿块大小均无统计学差异(P>0.05),18 F-FDG PET/CT的SUV与患者的病理类型亦无统计学差异(P>0.05),而18F-FLT PET/CT的SUV与患者的病理类型有统计学差异(P<0.05)。结论:肺肿瘤患者的肿块病理类型是影响18F-FLT PET/CT的SUV的重要因素,18F-FLT PET/CT的SUV在肺部良恶性肿瘤鉴别诊断中具有重要的价值。     

256层螺旋CT对吸烟肺的形态学分析

目的 探讨256层螺旋CT评价吸烟肺的影像学征象的临床应用价值.方法 非吸烟组51例和吸烟组65例,均无呼吸系统症状.全部受试者均行吸气末和呼气末HRCT扫描.图像观察时将两肺按上、中、下肺区分成6个区域:上肺区,隆突水平以上的肺区;中肺区,隆突与右肺下静脉之间肺区;下肺区,右下肺静脉水平以下肺区.观察的内容包括:肺气肿、肺微结节、磨玻璃密度影、小叶间隔增厚、空气潴留5项征象,然后进行评分,每一肺区出现1种上述CT征象计为1分,未出现计为0分,最后算出总分值.应用SPSS13.0统计学软件分析上述各CT征象在吸烟组与非吸烟组之间的差异及总分值与吸烟指数的关系.结果 肺气肿、肺微结节、小叶间隔增厚、空气潴留4个征象在吸烟组与非吸烟组之间差异有统计学意义(χ2值分别 为16.81、5.66、14.41和8.23,P均<0.05);而磨玻璃密度影征象无统计学意义(χ2=1.91,P>0.05).总积分值与吸烟指数呈高度 正相关(r=0.79,P<0.01).结论 吸烟肺的HRCT征象主要有肺气肿、肺微结节、小叶间隔增厚、磨玻璃密度影、空气潴留,这些改变随吸烟指数增加而加重.HRCT对评价吸烟肺形态学改变有重要价值.     

年龄及术前合并症对口腔癌患者术后并发症的影响

目的探讨老年口腔癌患者年龄及术前合并症等因素对术后并发症的影响。方法回顾性分析2014年1-7月解放军总医院口腔科收治的行手术治疗的106例口腔癌患者(老年口腔癌患者66例,非老年口腔癌患者40例)的资料,分析年龄及术前合并症与患者术后并发症的关系。结果老年口腔癌组术前高血压、心脏病、肺部疾病、贫血及多种合并症与非老年口腔癌组比较明显增高(P<0.05);但两组间术后并发症发生率差异无统计学意义。老年口腔癌组27例存在≥2种合并症的患者中14例(51.9%)术后发生并发症,与老年口腔癌组并发症的总体发生率(17例,25.8%)比较差异有统计学意义(P=0.0244)。非老年口腔癌组中,15例存在合并症的患者中术后有6例(40.0%)发生并发症,与老年口腔癌组并发症的总体发生率比较差异无统计学意义(P=0.4462)。糖尿病、肺部疾病、低蛋白血症和贫血等4种术前合并症均与无并发症的老年口腔癌组比较差异有统计学意义(P<0.05)。结论年龄不是老年口腔癌患者术后并发症的独立因素,糖尿病、肺部疾病、贫血、低蛋白血症等术前合并症是老年口腔癌患者术后发生并发症的高危因素。     

宝石能谱单能量成像及自适应统计迭代重建技术在腹部低剂量CT扫描中的可行性研究

【摘要】目的：探讨在腹部低剂量CT扫描中使用宝石能谱单能量成像（GSI）结合自适应统计迭代重建技术的成像质量。方法：90例患者使用GE Discovery CT750 HD 64排CT机行腹部CT平扫及双期增强扫描。实验组A（30例）采用GSI 技术（60keV+ASIR 50%）+对比剂碘剂量450mg I/kg;实验组B（30例）采用常规扫描（120kVp）+对比剂碘剂量300mg I/kg;对照组（30例）行常规扫描（120kVp）+对比剂碘剂量450mg I/kg。每组均测量腹部大血管（动脉期/静脉期）、脏器和肌肉（三期）共26个ROI的CT值并计算相应的SNR,使用5分法（Likert分级）对各部位的图像质量进行主观评价。结果：三组患者的年龄、身高、体重及身体质量指数（BMI）间的差异均无统计学意义（P>0.05）。A组中26个ROI的CT值均高于对照组,除平扫和动脉期肝脏CT值和平扫肌肉CT值外,其它23个ROI的CT值在两组间的差异均有统计学意义（P<0.05）。B组各ROI的CT值均低于对照组,但差异无统计学意义（P>0.05）。A组中（除SMA外）各ROI的SNR均高于对照组,仅门脉左支、动脉期肝和脾、平扫和静脉期胰腺的SNR在两组间的差异无统计学意义（P>0.05）。B组的SNR均低于对照组,但差异无统计学意义（P>0.05）。主观评价方面,三组间图像质量评分的差异无统计学意义（P>0.05）。A组与对照组间辐射剂量的差异有统计学意义（P<0.001）;B组对比剂剂量与对照组间的差异有统计学意义（P<0.001）。结论：在能谱CT 成像结合ASIR技术的帮助下,使用低管电压能得到较好的腹部CT图像质量。     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.     

CLIP相关技术的研究进展

在真核生物基因表达的转录后调节中,RNA结合蛋白（ RBP）起着关键作用,很多RBP的异常与人类疾病的发生密切相关。自2000年的RNA免疫沉淀和芯片分析方法（ RNA immunoprecipitation with differential display or microarray analysis , RIP-ChIP）出现以来,人们开始就RBP与RNA相互作用进行了系统而广泛的研究。经过改良和发展,基于体内实时紫外交联免疫沉淀法（ ultraviolet crosslinking and immunoprecipitation , CLIP ）、交联免疫沉淀cDNA文库高通量测序法（ high-throughput sequencing of CLIP cDNA library , HITS-CLIP）、光催化核糖核苷增强交联和免疫沉淀法（ photoactivatable-ribonucleoside-enhanced crosslinking and immunprecipitation , PAR-CLIP）以及提高个别核苷酸分辨率交联和免疫共沉淀法（ individual nucleotide resolution CLIP , iCLIP）等RIP-ChIP衍生方法相继产生,使用这些方法,可以解析RBP的RNA识别特异性,而且通过与高通量测序技术结合,可以实现转录组尺度的RBP的靶序列的鉴定,分辨率也得到极大提高。该文就RNA与蛋白的相互作用的基本原理及其研究进展、相关技术存在的问题以及发展趋势进行简要综述。     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.     

Kidney and iodinated and gadolinium-based contrast agents

In patients with renal failure, iodinated contrast agents may cause acute deterioration of the renal function and gadolinium-based contrast agents (GBCAs) may cause nephrogenic systemic fibrosis (NSF). The administration of a contrast agent must thus be reviewed for each patient and evaluation of renal function is paramount even though its estimation using formulas derived from the creatinine level may fluctuate. For iodinated contrast agents, contrast induced nephropathy is reduced by hydratation, preferably intravenous, when the GFR is less than 60 ml/min. The risk for intravenous injections is less than the risk for arterial injections, and the GFR threshold may be reduced to 45 ml/min. For gadolinium-based contrast agents, patients at risk for NSF are those with end-stage renal disease and patients undergoing dialysis. In such cases, the injection of a gadolinium-based contrast agent is only considered after a risk-benefit analysis has been completed, an alternate linear or macrocyclic agent issued and the dose limited to 0,1 mmol Gd/kg. Recently, recommendations from US and European agencies have converged. Learning objectives: to be familiar with the risk factors of CIN with iodinated contrast agents; to be familiar with hydration procedures for patients at risk of CIN; to be familiar with the diagnostic criteria of NSF; to be familiar with the classification of GBCA with regards to the risk of NSF; to be familiar with the contraindications of the different groups of GBCA.