18F-FDGPET/MRI评估宫颈癌大小、分化程度、肌层浸润深度和周围组织受累

Objective: To observe the maximum standard uptake value (SUV_max) and the minimum apparent diffusion coefficient (ADC_min) on ¹⁸F-FDG PET/MRI for evaluating the size, differentiation degree, myometrial invasion depth and surrounding tissue involvement of cervical cancer. Methods: PET/MRI of 45 patients with cervical cancer were retrospectively analyzed. The patients were divided into medium-high differentiation group (n=20) and low differentiation group (n=25) according to postoperative pathology. The long and short diameter of cervical cancers were measured, and the mean diameter, SUV_max and ADC_min were calculated, the value of SUV_max and ADC_min for evaluating the size, degree of differentiation, depth of myometrial invasion and surrounding tissue involvement of cervical cancer were observed. Results: The mean diameter of 45 cervical cancer lesions was (27.67±11.63)mm, and there was no significant difference of the mean diameter between medium-high differentiation group ([27.68±2.71]mm) and low differentiation group ([27.67±2.26]mm, P>0.05). MRI showed myometrial invasion depth of cervical cancer ≤1/2 myometrium in 15 cases, including 11 cases being consistent with pathological findings, while >1/2 myometrium 30 cases, including 28 cases being consistent with pathological findings, and the coincidence rate of pathology and MRI was 86.67% (39/45). Pathological results showed involved uterine body in 10 cases, involved parauterine adipose tissue in 3 cases, involved vagina in 8 cases and involved accessories in 3 cases, and MRI detection rate of the above involvements was 80.00% (8/10), 66.67% (2/3), 75.00% (6/8) and 66.67% (2/3), respectively. Moderately positive correlation was detected between SUV_max and the mean diameter of cervical cancer (r=0.536, P<0.01), while there was no significant difference of SUV_max between groups (P>0.05). Moderately negative correlation was found between ADC_min and mean diameter of cervical cancer (r=-0.525, P<0.01), and ADC_min of medium-high differentiation group ([0.744±0.122]×10^-3mm²/s) was significantly higher than that of low differentiation group ([0.654±0.132]×10^-3mm²/s, P<0.05). Conclusion: SUV_max and ADC_min of cervical cancer on ¹⁸F-FDG PET/MRI were helpful to evaluating the size, differentiation degree, myometrial invasion depth and surrounding tissue involvement of tumor, especially ADC_min. Copyright © 2021 by the Press of Chinese Journal of Medical Imaging and Technology.     

机用镍钛器械TFA和Mtwo根管预备效果的比较

目的 比较机用镍钛锉Twisted File Adaptive(TFA)与Mtwo的根管预备效果,为根管预备器械选择提供参考。方法 将2019年1～12月在安徽省立医院口腔医学中心行单根管前磨牙根管治疗的患者64例随机均分为两组,分别采用TFA(T组)和Mtwo(M组)镍钛锉进行根管预备,最后均采取热牙胶垂直加压技术进行根管充填。比较两组根管预备时间、根管成形效果及术中器械分离发生情况。结果 根管预备时间T组为(23.45±3.40)s,M组为(36.08±3.00)s,差异有统计学意义(P<0.05);两组均未出现侧壁穿孔、台阶形成、根管偏移及根尖堵塞等情况;M组发生1例器械分离,T组未发生器械分离,两组差异无统计学意义(P>0.05)。结论 TFA与MTwo镍钛锉都能实现良好的根管成形效果,但TFA更高效省时。     

探讨胃肠肿瘤病人术前插入胃管的改良方法

目的 探讨胃肠肿瘤病人术前插入胃管的改良方法,了解胃管的选择和插入深度及固定方法.方法 采用传统组术前插入胃管方法与目前我科术前插入胃管的改良方法两种方法对比,有效固定胃管的位置,从而提高插入胃管的成功率,减轻病人的痛苦.结果 胃肠肿瘤病人术前插入胃管方法的改良,对临床护理工作有积极意义.     

分子伴侣Tapasin在介导免疫反应中的作用

分子伴侣Tapasin是抗原提呈相关转运蛋白的基因产物,和MHC-Ⅰ同为免疫球蛋白超家族的成员,与MHC分子和多肽装配密切相关,是MHC-Ⅰ类分子与TAP之间的桥梁.Tapasin在抗原提呈过程中有着重要作用,因而了解其生物学特征、在介导免疫反应中的作用及与疾病的相关性具有重要意义.     

数字化方法测量种植体周围骨嵴上软组织高度可行性分析

目的 探讨数字化方法测量种植体周围骨嵴上软组织高度的可行性。方法 选择2022年8—12月于中国科学技术大学附属第一医院（安徽省立医院）口腔医学中心就诊的牙种植患者36例,共计43个种植牙位。所有患者完成口腔种植手术当天立即获取术后锥形束CT (CBCT)影像学资料与术前获取的口内数字化印模,导入口腔种植手术规划软件中进行图像的拟合,然后在种植区放置相同规格的虚拟种植体,调整种植体位置,与CBCT图像里的种植体影重叠,在种植体视图界面测量骨嵴上软组织高度（STH）（记为数字化方法测量组）。术中按照标准窝洞制备方法逐级制备种植窝洞并植入植体,使种植体上缘与牙槽嵴顶平齐,采用牙周探针测量STH （记为牙周探针测量组）。采用配对t检验比较数字化方法测量组与牙周探针测量组的STH差异,Bland-Altman检验分析两种方法的一致性,组内相关系数（ICC）检验不同测量者使用数字化方法测量结果的可信度。结果 两种方法测量种植区STH的差异无统计学意义（P>0.05）,Bland-Altman检验分析两种方法的一致性较好,但下颌后牙测量结果显示牙周探针测量结果大于数字化方法测量组,不同测量者...     

FST指导下团队干预联合赋能心理护理在老年胃癌患者术后护理中的应用

目的：探讨快速康复外科(FST)指导下团队干预联合赋能心理护理在老年胃癌患者术后护理中的应用效果。方法：选取2017年6月1日～2021年6月30日行胃癌根治术的60例老年患者作为研究对象,随机分为对照组和实验组各30例,对照组实施常规术后护理,实验组采用FST指导下团队干预联合赋能心理护理。比较两组围术期指标,心理状态[采用罗森伯格自尊量表(RSS)、汉密顿抑郁量表(HAMD)、汉密顿焦虑量表(HAMA)和癌症复发恐惧量表(FCRI-CV)],舒适度(采用Kolcaba简化舒适状况量表),术后并发症发生率和护理满意度情况。结果：实验组首次肠鸣音时间、首次排气时间、首次排便时间、首次下床活动时间、导尿管留置时间和住院时间均短于对照组(P<0.01,P<0.05);护理2周,两组RSS、HAMD、HAMA、FCRI评分均低于护理前(P<0.05),且实验组低于对照组(P<0.01);护理2周,实验组Kolcaba量表生理、心理精神维度评分及总分均高于对照组(P<0.01);实验组术后并发症总发生率低于对照组(P<0.05);实验组人文关怀、沟通能力、护...     

锁骨骨折合并锁骨下动、静脉损伤形成动静脉瘘一例报告

患者,男,39岁,因骑摩托车摔伤致左肩疼痛、肿胀5d伴左上肢麻木、无力4d于2005年2月24日入院。伤后在当地私人诊所以“8”字绷带固定。给予输液等治疗(具体不详)无效。第2天开始自觉左上肢麻木、无力,并呈持续加重。查体:左肩部、左胸部、左颈部软组织肿胀,皮下淤血,左锁骨前区可扪及一约5cm×6cm大小肿块,随心跳搏动,壁张力大,可闻及血管杂音。左上肢肌力Ⅰ级,左手垂腕垂指,夹纸试验(+),左上肢痛觉减弱。患侧腋动脉、肱动脉、桡动脉搏动消失,皮温较健侧低,末梢循环较健侧差。辅助检查:左肩正位X线片示:左锁骨中段粉碎性骨折,骨碎片向下移位…