磁化传递减影图像对膝关节退行性骨关节病的诊断价值

目的分析膝关节退行性骨关节病骨髓水肿与疼痛的关系,探讨磁化传递对比梯度回波T2加权序列（MTC-GRET2WI）减影图像对骨髓水肿及软骨损伤的诊断价值。方法对122例临床诊断退性行骨关节病的病例进行MR检查;其中42例病例、行关节镜探查手术。根据患者近期临床症状,根据有、无膝关节疼痛症状分为两组,两组骨髓水肿的发生率行x0检验;MTC-GRET2W、FSE序列T1WI、T2WI显示骨髓水肿的效果比较用Wi1coxon秩和检验：MTC-GRE T2WI、T2WI序列显示软骨损伤的比较,用配对x2检验。结果122例患者中有疼痛症状病例组骨髓水肿发生率71．79％（56／78）;无疼痛症状组,骨髓水肿发生率2O．45％（9／44）。两组差异有统计学意义（X2=29．79,P〈0．05）。MTC-GRET2W与FSE序列T1WI及T2WI的骨髓水肿显示效果的比较,差异有统计学意义（T1WI与T2WI,Z=一0．327,P〉0．05：MTC-GRET1W与T1WI,Z=一7．706,P〈0．05;MTC—GRET2w与T2WI比较,Z：一7．295,P〈0．05）。以关节镜为标准,MTC-GRET2WI和T2WI序列诊断膝关节软骨损伤的KaPPa值分别为0．86和0．74,MTC-GRE检查结果与关节镜显示结果一致性好：MTC-GRE敏感度91．1％,特异度96．5％,T2WI敏感度76．9％,特异度95．7％,差异有统计学意义（X2=4．75,P〈O．05）。结论膝关节退变的急性期疼痛与骨髓的水肿密切相关,MTC-GRET2WI序列能清楚显示骨髓水肿;该序列还能够准确判断关节软骨的损伤,有较大临床应用价值。     

磁共振不同成像序列对颞下颌关节盘的显示

目的：探讨比较磁共振不同成像序列,包括快速自旋回波（FSE）T1加权（T1WI）、压脂的质子加权（PDWI）和梯度回波（GRE）序列的T2WI对颞下颌关节（temporo mandibular joint,TMJ）的显示,特别是关节盘的显示。方法：回顾性分析132例TMJ的MRI资料,其中包括髁状突骨折23例、功能紊乱84例、正常25例。采用闭口位的斜矢状位FSE序列T1WI、压脂的PDWI和GRE序列的T2WI,斜冠状位PDWI和GRE序列的T2WI。张口位的斜矢状位压脂PDWI和斜冠状位GRE序列的T2WI。扫描层厚统一选用2 mm。结果：132例共264侧TMJ解剖结构256例能显示清楚;其中FSE T1WI序列96侧（占36.4%）,PDWI序列194侧（占73.5%）,GRE序列64侧（占24.2%）能清晰显示关节盘。4例8侧（占3%）关节出现移动伪影而影响关节盘的显示。结论：TMJ的磁共振检查,通过薄层厚的不同序列的比较,在获得高质量的解剖图像前提下,PDWI序列有利于关节盘的显示。     

二维梯度回波快速小角度激发T1加权成像在磁共振颅脑成像中的应用研究

目的：通过对比分析2D－Flash T1加权图像和SET，加权图像，讨论2D－Flash T1加权成像序列在颅脑MRI中的应用价值。方法：收集颅脑磁共振成像检查者39例，分别行3D－Flash T1加权成像和SE T1加权成像，从成像时间，阅片医生对两种图像的比较，脑组织平均信噪比，脑组织灰白质对比信噪比，病灶增强前后与周围正常组织的对比信噪比，图像伪影，分别对比分析了39例平扫图像和27个病灶，并且对两种图像后与周围正常组织的对比信噪比，图像伪影，分别对比分析了39例平扫图像和27个病灶，并且对两种图像的脑组织平均信噪比，脑组织灰白质对比信噪比，病灶与周围正常组织的对比信噪比进行统计学分析。结果：除TR时间和信号采集次数不同外，其他影响成像时间的参数相同的情况下，2D－Flash T1加权的成像时间是SE T1加权成像时间的23％：本组39例平扫检查的Flash T1W1和SE T1WI反映的组织解剖关系及信号（除大的血管）二者没有明显差异，27个病灶在平扫的显示，强化程度和强化形状也无差别，脑组织平均信噪比（P＜0．001），病灶与周围正常组织的对比信噪比（平扫P＜0．001，增强后0．005＜P＜0．01）差于SET1WI，脑组织灰白质对比信噪比（P＜0．0001）好于SET1WI；本组的两种图像伪影以血管波动伪影居多，39例中有18例Flash T1WI比SET1WI血管波动伪影明显。结论：颅脑MRI 2D－Flash T1加权成像序列完全可以代替常规SE T1加权成像序列，并且有着无可比拟的时间优势。     

3.0T MRI上腹部常规FSE序列与PROPELLER序列的图像质量对比研究

目的：探讨螺旋桨（periodically rotated overlapping parallel lines with enhanced reconstruction,PROPELLER）技术在降低上腹部各种伪影及提高图像质量中的作用。方法：2012年6月至2013年1月间97例拟作上腹部3.0T MRI扫描的患者纳入本研究（年龄19～76岁,平均年龄53.8岁）,常规FSE T2WI序列与PROPELLER FSE T2WI序列的扫描参数一致。２位读片医师对图像的呼吸运动伪影,胃肠管蠕动伪影,血管搏动伪影,肝、胰腺边缘的锐利度进行3等级的评分。等级数据资料的对比采用Wilcoxon’s秩和检验;读片医师之间判断结果一致性用Cohen’s Kappa检验评估。结果：常规FSE T2WI与PROPELLER FSE T2WI相比,后者降低了呼吸运动伪影,胃肠蠕动伪影,血管搏动伪影,增加肝、胰腺边缘锐利度,２者间差异均有统计学意义（Z值分别为-5.931、-6.245、-6.481、-6.164、-5.745,P值均<0.05）;2位读片医师对上述指标的判断一致性上,结果显示为均在中等及以上一致;PROPELLER FSE T2WI的扫描时间较FSE T2WI减少5～15 s。结论：与常规FSE序列相比,PROPELLER技术能够显著降低呼吸运动、胃肠蠕动、血管搏动等运动伪影,增加了解剖细节的显示,提高了图像诊断质量,缩短了扫描时间。     

SE、FSE、IRS、GRL系列在乳腺肿块低场强MRI诊断中的应用与评价

①目的评价SE、FSE、IRS、GRL系列在乳腺肿块低场强MRI诊断中的作用。②方法对30例触诊乳腺肿块患者应用SE、FSE、IRS、GRL系列进行扫描，根据组织的信噪比、病灶显示能力对各种扫描系列进行评价。③结果SE—T1WI具有盘好的组织信噪比．乳腺正常结构显示好；FSE—T2WI病灶信号不同程度增高；FSE—T1WI可用于进行对比增强扫描；IRS—STIR对显示病灶及病灶侵犯周围组织理想；GRL—T1WI利于病变轮廓显示，也可用作对比增强扫描；GRL—T2WI显示病灶效果不如FSE—T2WI。④结论触诊乳腺肿块的低场强MR平扫．以SE—F1WI、FSE—V2WI、IRS—STIR3种系列进行对比，能更好地显示病灶及与周围正常结构的关系。FSE—T1WI及GRL—T1WI可用作对比增强扫描。     

低场MRI快速成像技术在急诊颅脑疾病的临床应用

目的研究低场MRI快速成像技术对急诊颅脑相关疾病的诊断价值。方法选取我院2012年4月-2013年4月收治的124例颅脑疾病患者作为研究对象，全部患者均接受标准SE、FSE序列成像及低场MRI快速成像。比较两种成像方法对疾病的敏感性。结果124例颅脑疾病患者经标准T1WI序列检出97例，经改进后SE序列检出66例，标准SE序列对颅脑疾病检出率更高（P〈0．01）。患者经标准TWI序列检出116例，经改进后FSE序列检出113例，两组检出率比较，差异不显著（P〉0．05）。两种方法对出血性疾病及〉10mm的缺血性疾病、脑炎、脑挫伤的检出例数相同，均为58例。病变大小在（5—10）mm的患者，标准T1WI的检出例数为34例，改进后T1WI检出29例，改进后T2WI及标准T2WI的检出例数相同，均为50例，两组检出例数比较（P〉0．05）。病变〈5mm的患者，标准T1WI的检出例数为10例，改进后T1WI检出3例；标准T2WI的检出例数为29例，改进后T2WI检出19例；两组检出例数比较（P〈0．01）。结论低场MRI快速成像技术采集时间短，可显著缩减急诊患者检查时间。低场MRI快速成像对于病变〉5mm的患者诊断率较高，对急诊颅脑相关疾病的诊断具有十分重要意义。     

金属固定假牙对头部MR图像的影响研究

目的 :探讨金属固定假牙对头部 MR图像的影响。方法 :将 5 0例有金属固定假牙的病人按假牙的多少分成单牙组及多牙组 ,其中单牙组按材料的不同分铜合金、铬镍不锈钢合金、镍铬合金 3种 ,多牙组分铜合金、镍铬合金两种。分别采用 SE/ T1 WI、FSE/ T2 WI、FAST/ T2 WI行横断面、矢状面扫描 ,比较各组中不同材料在不同序列下的伪影。结果 :金属固定假牙所形成的伪影中 ,铜合金最小 ,镍铬合金最大 ;SE序列最小 ,与 FSE序列基本相同 ,FAST序列最大 ;伪影随固定假牙的数目增多而增大。结论 :金属假牙可形成伪影而致邻近组织失真 ,伪影对颅脑、颈椎的观察无影响 ,而对眼球、上颌窦及口腔结构因扫描序列材料的不同有不同程度的影响。     

实验性肝细胞癌SPIO增强MR成像序列的选择

目的评价不同SPIO增强MRI扫描序列在实验性肝细胞癌检查中的价值。方法建立80只大鼠肝细胞癌模型,大鼠分别于灌药后第16、18、20、21、22、23、24、25周行MRI扫描,先行SE—T1WI、FMPSPGR—T1WI、GRE—T2WI和FSE．PDWI、FSE—T2WI的MR／平扫检查,再采用相同序列和参数进行SPIO增强MR／检查,并选取兴趣区获取相关参数。结果SPIO增强后,肝组织信号在所有扫描序列上均降低,GRE—T2WI上肝组织的信号降低最显著,肝细胞癌的CNR最高,而FSE—PDWI上肝组织和肝细胞癌的SNR最高。结论GRE—T2WI、PDWI是实验性肝细胞癌SPIO增强MRI的较理想序列。     

梯度回波反相位T2＊WI在检测脊柱转移瘤的应用价值

目的评价GEEOPT2＊WU（梯度回波反相位T2＊WI）序列在脊柱骨转移瘤中的应用。方法分析58例经临床和病理证实的脊柱骨转移瘤患者MR资料，比较GREOPT2＊WI、SETIWI。FSFT2WI、STIR矢状住图像并进行评价，包括病灶的检出率及显示等级、对比度（C），对比噪声比（CNR）和信噪比（SNR）。结果脊柱转移瘤检出率，GRE0PT2＋WI与SET1WI相近（P〉0．05），GREOPT2＊WI高于FSFT2WI（P〈0．01）；病灶CNB，GREOPT2＊WI高于STIR（P〈0．01），GREOPT2＊WI略高于FSF T2W1（P〉0．05）；病灶显示等级，GREOPT2·WI均明显高于FSFT2WI、STIR。结论GREOPT2‘WI有较高的对此度．对比噪声比、信噪比，提高了病变的检出率，有助于脊柱转移瘤的诊断，可作为检测的该病的首选序列。     

磁化传递对比梯度回波T2加权序列和传统序列在膝关节损伤中的对比研究

目的:探讨磁化传递对比(magnetization transfer contrast,MTC)梯度同波T2加权序列(GRE T2WI)在膝关节损伤中的诊断价值.方法:回顾性分析56例膝关节外伤后行磁共振成像(MRI)检查的病例.所有病例均行快速自旋回波(PSE)序列T1WI及T2WI矢状面、磁化传递对比梯度回波T2加权矢状面扫描,分析不同序列显示骨挫伤的大小、范围、信号均匀性、边界,比较不同序列之间的差异.结果:56例骨挫伤病例中,FSE序列T1WI显示43例,T2WI显示45例,磁化传递对比GRE T2WI显示50例.磁化传递对比GRE T2WI在显示骨挫伤的大小、边界、敏感性均高于FSE序列.两者之间差异有显著性意义(P<0.05).结论:磁化传递对比GRE T2WI在膝关节骨挫伤显示中有较高价值,明显优于FSE序列.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.