CT冠状位扫描对气道异物的诊断价值

目的探讨螺旋CT冠状位扫描对气道异物的诊断价值。方法回顾性分析经支气管内窥镜证实的23例气道异物的临床及影像学资料，所有病例均行呼、吸二相胸部摄片、胸部透视及冠状位CT扫描。结果23例中多数为透光异物。异物发生于气管3例，右侧支气管12例，左侧支气管8例。胸片及胸透表现主要为阻塞性肺气肿、阻塞性肺炎、纵隔摆动以及心影大小反常等间接征象。23例冠状位CT扫描均清晰显示气管、支气管内异物存在，并能显示其形态和密度。结论冠状位CT扫描可明确气道异物的存在及其性质，对儿童气道异物的诊断具有重要价值。     

气道冠状位CT扫描对儿童气道异物的诊断价值

目的:探讨气道冠状位CT扫描对儿童气道异物诊断的应用价值.方法:回顾性分析51例气道异物的胸部普通x线检查(呼吸相胸部平片及透视)和冠状位CT表现.所有病例均经纤维支气管镜证实.结果:51例中气管异物8例,支气管异物43例,冠状位CT扫描均清楚显示,普通x线检查分别发现6例和37例.结论:冠状位CT扫描可敏感而直观的显示气道内异物,对气道异物的诊断具有重要价值.     

螺旋CT多平面重建在副鼻窦检查中的价值

目的：探讨螺旋CT多平面重建技术在副鼻窦检查中的价值。方法：对26例副鼻窦炎患者,均行副鼻窦轴位及冠状位扫描,利用多平面重建（MPR）技术得到冠状位、矢状位、轴位的多平面重建图像,观察鼻副窦结构及病变范围,对图像资料进行影像分析。结果：螺旋CT多平面重建图像从各种角度、多切面地显示副鼻窦的解剖、病变部位、范围及气道情况,清楚显示各鼻窦及窦口。结论：重组冠状位图像可获得与直接冠状位扫描相同的图像效果,可以取代直接冠状位扫描,为鼻副窦炎及其原因的临床诊断提供可靠的影像资料。     

副鼻窦冠状CT扫描时头架角度控制及成像研究

目的 探讨仰卧式头架螺旋CT副鼻窦冠状扫描时机器摆动角度对冠状成像质量的影响.材料与方法:对2004年9月～2007年10月116例门诊及住院患者行副鼻窦冠状位扫描,采用仰卧式头架,对部分病例采用近似冠状位扫描.结果:与OML线成67°～90°的近似冠状位扫描基本能满足依赖冠状位副鼻窦CT图像诊断的需要.结论:近似冠状位扫描在某些情况下是切实可行的扫描方法.     

螺旋CT冠状面与轴位扫描对眼眶骨折诊断价值的比较

目的 比较眼眶骨折螺旋CT冠状面、轴位扫描的CT诊断结果,探讨螺旋CT冠状面扫描对眼眶骨折诊断的价值.方法 回顾分析经临床治疗及手术证实28例外伤性眼眶骨折患者的螺旋CT冠状面与轴状位扫描CT资料,并对其诊断结果进行对比.结果 28例眼眶骨折中CT冠状面扫描显示骨折线27例(96.4%),轴位扫描显示骨折线20例(71.4%),两组比较有统计学意义(P＜0.05).结论 在外伤性眼眶骨折诊断中螺旋CT冠状面扫描优于轴位扫描.     

128层螺旋CT低剂量扫描三维重建在儿童先天性中心气道疾病诊断中的应用

目的评价128层螺旋CT低剂量扫描三维重建在儿童先天性中心气道疾病诊断的应用价值。方法征得患者父母同意,对疑诊中心气道疾病的患儿行多层螺旋CT扫描,将图像数据重建获得三维重建图像,并将观察结果与纤维支气管镜检查结果进行对照分析。结果 55例疑诊中心气道疾病的患儿平均年龄4岁(1月至11岁,男性40例),经过纤维支气管镜检查,气管支气管异常47例,8例气管支气管软化症。128层螺旋CT低剂量扫描三维重建观察结果,真阳性者43例,假阴性者4例,假阳性者1例,真阴性者7例。CT三维重建与纤维支气管镜检查结果相对较,显示两者诊断儿童中心气道疾病无显著性差异(P=0.486)。CT三维容积重建灵敏度和特异度分别是91.4%(43/47)和87.5%(7/8),全部准确率为90.9%。结论 128层螺旋CT低剂量扫描发现儿童中心气道疾病有较高的灵敏度和特异度,诊断儿童中心气道疾病有重要的应用价值。     

窦口鼻道复合体的螺旋CT冠状位扫描方式研究

目的:探讨螺旋CT对窦口鼻道复合体(OMC)的最佳冠状位扫描方式和成像效果。方法:对106例门诊患者行鼻腔及鼻窦冠状位3mm薄层扫描,56例采用标准冠状位扫描,50例采用冠状倾斜位扫描,将所有图像均进行多平面(MPR)及三维(3D)重建。结果:冠状倾斜位薄层扫描对钩突、中鼻甲、筛泡、半月裂、筛漏斗的显示情况与薄层标准冠状位扫描无明显差异(P>0.05),但对额窦引流通道的显示优于标准冠状位薄层扫描(P<0.05)。结论:螺旋CT冠状倾斜位薄层扫描能全面显示OMC的结构,尤其能良好显示额窦的引流通道,是显示OMC的最佳扫描方式。     

多层螺旋CT的低剂量扫描及其后处理技术在儿童气道异物诊断中的应用

目的探讨多层螺旋CT(MSCT)的低剂量扫描及其后处理技术在儿童气道异物诊断中的应用价值。方法收集42例经支气管镜证实有气道异物患儿的肺部MSCT资料,其中26例为低剂量扫描,16例为常规剂量扫描,分别对2组图像资料观察分析。结果26例低剂量扫描患儿中,MSCT显示气道异物25例,检出率为95%。16例常规剂量扫描患儿中,MSCT显示气道异物16例,检出率为100%,两者差异无统计学意义(P>0.05)。结论MSCT的低剂量扫描与常规剂量扫描在儿童气道异物的显示方面差异无统计学意义,它可以确定异物的具体位置,对手术定位起到了指导作用,而且大大降低了射线量,儿童气道异物的CT检查应优先使用低剂量扫描。     

儿童体部螺旋CT扫描技术

目的 探讨儿童体部的螺旋CT扫描方法，重建方法和增强方法。材料与方法 回顾性的选择2002年4月至2002年12月的儿童体部扫描病例共计527例，其中增强121例，对其扫描重建参数，增强方法和图像质量进行评比和分析。结果 图像质量优良者422例，扫描参数合理者426例，重建参数合理者454例，增强效果好的110例。结论 儿童体部螺旋CT扫描，合理的设置扫描重建参数、造影剂总量、注射速率和延迟时间，可做到保证图像质量和增强效果，降低射线剂量。     

双层螺旋CT改进扫描技术在茎突综合征中的临床应用

目的 研究双层螺旋CT改进扫描技术后对人体茎突的显示、观察及测量,为茎突综合征的诊断与治疗提供最可靠的依据.方法 采用双层螺旋CT并改进扫描技术对48例临床疑似茎突综合征的患者扫描,后重建原始数据,再多层面重建及三维重建,观察、测量茎突的形态、长度、粗细、倾斜角度及发育变异等内容.结果 48例患者的双侧茎突均得到完整、清晰的显示,茎突长度2.7～6.8 cm,其中>3 cm者42例,双侧茎突均过长者30例,左侧茎突过长者8例,右侧茎突过长者10例,向内向前倾斜角度>40°者17例(侧),向内向前倾斜角度<20°者9例(侧).结论 经过改进后的双层螺旋CT扫描技术在人体茎突的显示及测量方面具有很好的应用价值,能为临床诊断与治疗茎突综合征提供最可靠的影像学依据.     

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.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.