CT能谱成像在术前评估胃癌患者病理类型的临床价值

目的探讨CT能谱成像在术前评估胃癌患者病理类型的临床价值。方法选取93例胃癌患者,对患者行CT能谱成像,对病灶水、碘浓度进行测量,并计算标准化后碘浓度比,分析比较不同病理类型碘浓度、碘浓度比、水浓度水平。结果胃黏液癌患者静脉期、实质期的碘浓度、碘浓度比均低于胃非黏液癌患者,差异均具有统计学意义(P<0.05);胃非黏液癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与胃黏液癌患者比较差异无统计学意义(P>0.05)。黏液腺癌患者静脉期、实质期的碘浓度、碘浓度比均低于印绒细胞癌患者,差异均具有统计学意义(P<0.05);黏液腺癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与印绒细胞癌患者比较差异均无统计学意义(P>0.05)。中高分化腺癌患者静脉期、实质期的碘浓度、碘浓度比均低于低分化腺癌患者,差异均具有统计学意义(P<0.05);中高分化腺癌患者动脉期、静脉期、实质期水浓度和动脉期碘浓度比、碘浓度与低分化腺癌患者比较差异均无统计学意义(P>0.05)。结论 CT能谱成像在胃癌患者术前评估中发挥重要作用,胃癌病理类型不同,碘浓度会发生相应变化, CT能谱成像可对胃癌病理类型有效评估,有利于患者临床治疗指导,具有非常高的临床应用价值。所以,在胃癌患者病理类型评估中, CT能谱成像应进一步推广和应用。     

探讨血浆D-二聚体及超敏C-反应蛋白水平对冠心病的诊断价值

冠心病（coronary heart disease,CHD）是临床心内科常见病、多发病之一,具有发病率高、死亡率高、病程长、难治愈等特点。临床可分为急性心肌梗死（AMI）、不稳定型心绞痛（UAP）、稳定型心绞痛（SAP）和隐匿性冠心病。     

献血员单采前后生化指标的分析

目的：对献血员单采前后及2周后生化指标进行连续监测，研究单采血小板对献血员健康的影响。方法：对37例单采血小板献血员在单采前、后以及2周后血液生化指标进行测定和分析。结果：K^＋、Ca^＋、Mg^＋、P^＋、Cu^＋、Zn^＋、iron、血糖、尿素氮、肌酐、尿酸、胆固醇、甘油三脂、总蛋白、白蛋白、ALT、AST、总胆红素、直接胆红素指标采集前后均存在显著性差异（P〈0．01）；血糖、Na^＋、Cl^-差异不显著。与采后2周相比，除血糖、总蛋白、白蛋白存在显著性差异（P〈0．01）外，其余均为无差异。结论：时间间隔适当的条件下，单采血小板对献血员的健康在生化指标方面无影响。     

Pathological features of gastric cancer in Zhuanghe high-risk area in China during 1992–2005

Objective  To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992–2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention. Methods  A total of 1003 gastric cancer specimens resected surgically between 1992–2005 in Zhuanghe Center Hospital were studied. The specimens were fixed in formalin and diagnosed by routine pathology. Results  The incidence of patients with gastric cancer was highest at age of 60–69, the next high was at age of 50–59 and it was significantly higher in male than in female (P<0.001), the ratio was 3.0:1. During the past 14 years, there were 159 (15.9%) EGC, 195 (19.4%) moderate and 649 (64.7%) advanced gastric cancer detected. In macroscopical features, type III remained dominant in EGC, the next was mixed type in EGC. In advanced gastric cancer the Borrmann’s type III remained the dominant, the next was type II. For nodal metastasis, positive cases were decreasing and negative were increasing in EGC, moreover negative cases were higher than positive ones each year. There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year. In histological features, papillary, moderately and poorly differentiated tubular adenocarcinoma remained downtrend, mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year. The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion  There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years. This work was supported by the National “Tenth-Five” Key Technologies R&D Program of China (2004BA703B04-02)     

原发性肺癌64 层CT 灌注增强的血管影像特征

目的: 探讨原发性肺癌在64 层CT 灌注增强中显示的特异性血管征象。方法: 对57 例病人( 中央型
肺癌38 例、周围型肺癌9 例,炎性结节10 例) 的64 层CT 灌注增强在肺动脉期、主动脉期以先后顺序显示的血
管征象进行特异性,敏感性分析。结果: 受损肺动脉和瘤血管影见于肺癌; 病灶及周围走形规则、均匀扩张血管
影见于炎性结节。肺动脉期病灶相关残根或截断状或侵蚀狭窄等受损肺动脉影,其特异性分别为中央型肺癌
84%,周围型肺癌14%( P＜0． 05) ;敏感性分别为中央型肺癌97%,周围型肺癌67% ( P＞0． 05) 。主动脉期病灶
内蚓状、斑点状、网状及血湖状等瘤血管影,其特异性分别为中央型肺癌82%,周围型肺癌18% ( P＜0． 05) ; 敏感
性分别为中央型肺癌95%,周围型肺癌89%( P＞0． 05) 。结论: 64 层CT 灌注增强能顺序完整显示诊断肺癌的特
异血管征象。     

X线平片分析颈椎融合术后相邻节段骨化的临床研究

目的利用X线平片确定颈椎融合术后相邻节段骨化发展和成熟的时间,研究颈椎前路钛板<椎体高度1/2和≥椎体高度1/2的患者骨化发展的不同。方法对42例患者的77个椎间盘,用术后颈椎侧位X线片测量钛板和椎体高度,将相邻椎间盘分为钛板<椎体高度1/2组和钛板≥椎体高度1/2组。在术后的第3,6,12,24个月,每年1次评价骨化的表现和严重性,记录分成4级,分析0级或1级骨化的椎间盘是否在24个月或者剩下的随访时间(平均45个月)进展为晚期(2级或3级)骨化。结果与钛板<椎体高度1/2的节段相比(50%,11/22),钛板≥椎体高度1/2的节段骨化发生率(86%,47/55)明显提高。15个进展为晚期骨化病例中,13例(86.7%)的钛板≥椎体高度1/2。结论利用颈椎侧位X线片可以评价颈椎术后相邻节段骨化情况。钛板≥椎体高度1/2患者比钛板和钛板小于椎体高度1/2患者的相邻节段更容易发生骨化。     

X线平片分析颈椎融合术后相邻节段骨化的临床研究

目的利用X线平片确定颈椎融合术后相邻节段骨化发展和成熟的时间,研究颈椎前路钛板〈椎体高度1/2和≥椎体高度1/2的患者骨化发展的不同。方法对42例患者的77个椎间盘,用术后颈椎侧位X线片测量钛板和椎体高度,将相邻椎间盘分为钛板〈椎体高度1/2组和钛板≥椎体高度1/2组。在术后的第3,6,12,24个月,每年1次评价骨化的表现和严重性,记录分成4级,分析0级或1级骨化的椎间盘是否在24个月或者剩下的随访时间（平均45个月）进展为晚期（2级或3级）骨化。结果与钛板〈椎体高度1/2的节段相比（50%,11/22）,钛板≥椎体高度1/2的节段骨化发生率（86%,47/55）明显提高。15个进展为晚期骨化病例中,13例（86.7%）的钛板≥椎体高度1/2。结论利用颈椎侧位X线片可以评价颈椎术后相邻节段骨化情况。钛板≥椎体高度1/2患者比钛板和钛板小于椎体高度1/2患者的相邻节段更容易发生骨化。     

直肠癌开腹手术与腹腔镜手术术后免疫功能的研究

目的:比较直肠癌开腹手术与腹腔镜手术术后免疫功能的变化。方法:47例没有远处转移的直肠癌分为开腹手术组(22例)和腹腔镜手术组(25例)。术前,术后24、48和72 h测定患者血中白细胞、单核细胞计数,C反应蛋白,白细胞介素6(IL-6),白细胞介素8(IL-8),单核细胞表达的人白细胞DR抗原(HLA-DR),生长激素,催乳素和氢化可的松的水平。结果:腹腔镜手术组术后短期免疫功能得到保存。腹腔镜术后24 h,单核细胞的HLA-DR表达明显升高(75%vs 58%,P=0.024),IL-6水平没有明显升高(4.8 vs 11.5,P=0.002)。开腹和腹腔镜手术患者的白细胞和单核细胞计数、C反应蛋白、IL-8、生长激素、催乳素和氢化可的松水平没有统计学差异。结论:腹腔镜直肠癌术后短期免疫功能得到保存而炎症反应更轻微,说明腹腔镜手术创伤比开腹手术要小,可能有利于抑制术后肿瘤细胞转移。