颈动脉CTA过程中应用大螺距扫描配合能谱CT双低减影法的效果及对辐射剂量和对比剂用量的影响

本研究选取了86例因颈动脉病变引起脑供血不足的患者,均行颈动脉CTA检查,其中43例作为对照组,行常规扫描模式,另选43例作为研究组,配合能谱CT双低减影法行大螺距扫描,以探讨大螺距扫描配合能谱CT双低减影法在颈动脉CT血管成像(CTA)过程中的应用效果及对辐射剂量、对比剂用量的影响.结果 显示,研究组颈动脉各段血管腔...     

高信号血管征与大脑中动脉狭窄程度和脑梗死面积的关系研究

本文探讨急性大脑中动脉供血区脑梗死磁共振成像T2液体衰减反转恢复序列(MRI T2-FLAIR)上高信号血管征(HVS)出现情况及与大脑中动脉狭窄情况、脑梗死面积的关系。选取125例急性大脑中动脉供血区脑梗死患者,均给予MRI T2-FLAIR序列扫描,分析HVS阳性和阴性患者临床资料、大脑中动脉狭窄程度、脑梗死面积及侧支循环等差异。HVS阳性患者美国国立卫生研究院卒中量表(NIHSS)评分明显高于HVS阴性患者(P<0.05)。HVS阳性患者大脑中动脉狭窄程度、脑梗死面积、有侧支循环比例明显高于HVS阴性患者(P<0.05)。HVS与NIHSS评分、大脑中动脉狭窄、脑梗死面积及侧支循环呈正相关(P<0.05)。远端HVS阳性患者NIHSS评分、大脑中动脉狭窄程度明显低于近端HVS阳性患者(P<0.05)。急性大脑中动脉供血区脑梗死患者MRI T2-FLAIR上存在HVS,其大脑中动脉狭窄程度较重,脑梗死面积较大。     

CTA在急性复杂性大咯血患者行介入栓塞术前的应用价值分析

本文探讨了CT血管造影(CT angiography,CTA)在急性复杂性大咯血患者行介入栓塞术前的应用价值。回顾性选择49例急性复杂性大咯血患者CTA影像资料,通过与术中数字减影血管造影(digital subtraction angiography,DSA)结果进行对比,发现CTA对罪犯血管诊断准确率为89.33%,对多动脉交通吻合诊断准确率为86.96%。Kappa检验CTA与DSA检查结果一致性较高,受试者特征曲线(ROC)分析CTA诊断急性复杂性大咯血罪犯血管的曲线下面积(AUC)为0.947(95%CI:0.903~0.990,P=0.000),灵敏度89.33%,特异度100.00%。通过随访发现CTA指导下行介入栓塞术治疗有效率91.84%,术后1年无大咯血复发病例。     

双源CT双能量参数联合血清miR-126、miR-204检测对肺癌诊断价值及与临床病理特征关联性

回顾性选取肺癌患者86例为肺癌组,同期肺良性结节患者86例为对照组,患者均行双源CT双能量、血清miR-126、miR-204水平检测,发现静脉期标准化碘浓度(NIC)、动脉期NIC、miR-204、miR-126水平在肺癌组中呈异常表达,并与肺癌组病理类型、临床分期、淋巴结转移存在一定相关性,三者联合对肺癌具有一定诊...     

DSA、CTA联合MR影像评估AIS患者脑支循环及预后性关系

探讨数字减影血管成像(DSA)、计算机断层扫描血管成像(CTA)联合磁共振(MR)影像评估急性缺血性卒中(AIS)患者脑支循环及预后性关系。选取60例大脑中动脉M1段急性闭塞所致AIS患者为研究对象,根据DSA、CTA与MR影像对其脑侧支循环评估,比较患者基线资料、结局指标等,并分析预后性。结果发现:基于DSA、CTA与MR影像对AIS患者脑侧支循环评估结果一致性良好;3种影像模式下脑侧支循环良好组与不良组结局资料差异显著(P<0.05);多因素分析显示,FVH-ASPECTS评分、rLMC评分、ASITN/SIR分级量表均为AIS患者神经功能预后的独立影响因素。总之,DSA、CTA、MR影像对AIS患者脑侧支循环评估具有一致性,且FVH-ASPECTS评分、rLMC评分、ASITN/SIR分级量表均为AIS患者神经功能预后的独立影响因素。     

CTA和CTP评价AIS患者侧支循环建立及脑灌注的研究

本研究探讨CT血管成像(CTA)、全脑CT灌注成像(CTP)在评估急性缺血性脑卒中(AIS)患者侧支循环建立及脑灌注情况的价值,并分析CTA、CTP与患者预后的关系。选取139例AIS患者接受256层螺旋CT扫描;根据格拉斯哥预后评分(GOS)将患者分为良好组(95例)和不良组(44例)。以DSA侧支循环检出结果作为诊断金标准,CTA诊断AIS患者颅内动脉侧支循环建立的灵敏度为95.12%、特异度为91.23%;良好组患者的侧支循环程度评分、脑血容量(CBV)、脑血流速度(CBF)、达峰时间(TTP)、平均通过时间(MTT)测定值均高于不良组(P<0.05);AIS患者入院时NIHSS评分高、梗死灶面积较大、脑血管闭塞是其不良预后的独立危险因素(P<0.05);良好的侧支循环、CBV及CBF脑灌注水平较高,有利于患者后期的预后恢复(P<0.05)。CTA对AIS患者颅内动脉侧支循环建立的检出敏感度较高,同时,早期观察患者侧支循环建立及脑灌注水平,对评估患者预后恢复具有一定的临床价值。     

豚鼠肺组织中β肾上腺素能受体的分布及其在实验性过敏性哮喘时的变化

本文用放射自显影受体显示法,对正常和实验性过敏性哮喘豚鼠肺组织中β肾上腺素能受体的分布密度进行了研究。结果表明,β受体在肺脏各种组织结构中均有分布。实验性过敏性哮喘豚鼠肺某些组织结构中β受体明显低于对照组的,具有显著性差异。其中细、小支气管平滑肌的β受体分别比对照组低23.73％和18.65％;细、小支气管粘膜上皮和肺泡上皮的β受体分别比对照组低23.53％,14.23％和17.16％。上述结果提示,实验性过敏性哮喘豚鼠细、小支气管平滑肌β受体减少可能是使支气管平滑肌张力增高的重要原因之一。     

联合低频振幅和度中心性的高度近视患者脑功能研究

探讨联合低频振幅(ALFF)和度中心性(DC)方法在高度近视(HM)患者静息状态下局部大脑的功能变化。选取45例患者作为HM组,选择与之匹配的46例双眼正常视力参与者作为对照组。所有被试进行静息态功能磁共振成像扫描。ALFF和DC的方法进行局部脑功能差异的分析。组间比较采用基于体素层面的独立样本t检验。结果显示与对照组相比,HM组在左眶部额下回、右距状裂周围皮层、右前扣带与旁扣带脑回、左丘脑、左顶下缘角回、右顶下缘角回和左中央旁小叶的ALFF值存在统计学差异(P<0.05);HM组在右颞下回、左颞下回、右前扣带与旁扣带脑回、左眶内额上回、左距状裂周围皮层、右梭状回、左顶下缘角回和左中央旁小叶的DC值存在统计学差异(P<0.05)。联合低频振幅和度中心性在HM患者大脑神经元活动及脑功能网络改变判断中具有较高的应用价值。     

TCD检测MCA供血区非痴呆型血管性认知障碍的血流动力学相关性研究

目的探讨TCD检测MCA供血区非痴呆型血管认知障碍患者的血流动力学的变化关系。方法选取2015年10月至2016年10月在佳木斯大学附属第一医院门诊和住院部被确诊为MCA供血区缺血性脑梗死的患者80例,将被诊断为非痴呆型血管性认知障碍36例患者为观察组,同时选取被确诊为无血管性认知障碍的44例患者为对照组。通过TCD检测两组患者MCA的血流速度、脉动指数。比较两组的血流速度及脉动指数的关系。结果观察组患者非痴呆型血管性认知障碍与认知正常的对照组之间TCD脑血流动力学存在差异,观察组的各期血流速度均较对照组降低(P0.05),而脉动指数增高(P0.05),均具有统计学意义。结论 TCD检测MCA供血区缺血性脑卒中患者的血流速度和脉动指数可以指导临床医师早期对VCI-ND的辅助诊断。     

一站式CT检查系统在急性胸痛患者干预方案中的应用

本研究探讨一站式CT检查系统在急性胸痛患者管理中干预方案的应用。将符合急性胸痛患者49例纳入研究,采用自动触发方式采集患者上胸部volume数据集和心胸部volume数据集,经过处理后获得胸主动脉、冠状动脉、肺动脉及全胸部图像。本研究中,测量结果发现平均CT值主动脉弓是(332±51)Hu,升主动脉是(435±53)Hu,肺动脉干是(491±93)Hu,降主动脉是(454±70)Hu,而左冠状动脉和右冠状动脉分别是(425±60)Hu、(415±62)Hu。病变鉴定发现,急性肺栓塞12例,主动脉弓动脉粥样硬化斑块破裂8例,肺组织实变4例,慢性肺栓塞伴右心衰竭2例,胸腔积液2例,左冠状动脉非关键性狭窄11例,右冠状动脉非关键性狭窄7例,心包积液2例,复合解剖畸形1例。总之,本研究通过一站式CT检查系统对急性胸痛患者干预方案的制定提供了重要指导。     

Monocrotaline-induced pulmonary hypertension correlates with upregulation of connective tissue growth factor expression in the lung

Pulmonary hypertension (PH) is characterized by structural and functional changes in the lung including proliferation of vascular smooth muscle cells (VSMCs) and excessive collagen synthesis. Although connective tissue growth factor (CTGF) is known to promote cell proliferation, migration, adhesion, and extracellular matrix production in various tissues, studies on the role of CTGF in pulmonary hypertension have been limited. Here, we examined CTGF expression in the lung tissues of male Sprague Dawley rats treated with monocrotaline (MCT, 60 microg/kg), a pneumotoxic agent known to induce PH in animals. Establishment of PH was verified by the significantly increased right ventricular systolic pressure and right ventricle/left ventricle weight ratio in the MCT-treated rats. Histological examination of the lung revealed profound muscular hypertrophy in the media of pulmonary artery and arterioles in MCT-treated group. Lung parenchyma, vein, and bronchiole did not appear to be affected. RT-PCR analysis of the lung tissue at 5 weeks indicated significantly increased expression of CTGF in the MCT-treated group. In situ hybridization studies also confirmed abundant CTGF mRNA expression in VSMCs of the arteries and arterioles, clustered pneumocytes, and infiltrated macrophages. Interestingly, CTGF mRNA was not detected in VSMCs of vein or bronchiole. In saline-injected control, basal expression of CTGF was seen in bronchial epithelial cells, alveolar lining cells, and endothelial cells. Taken together, our results suggest that CTGF upregulation in arterial VSMC of the lung might be important in the pathogenesis of pulmonary hypertension. Antagonizing the role of CTGF could thus be one of the potential approaches for the treatment of PH.     

Imaging of the bronchial blood flow usingg RI-angiography--study on its procedure and application of dual radioisotope technique (author's transl)

RI-angiography with 99mTcO4- was carried out using a scintillation camera with a digital minicomputer for the purpose of imaging of bronchial blood flow in various lung diseases, and as application of dual radioisotope techniques, other imagings such as tumor imaging with 197HgCl2 or 67Ga-citrate and/or perfusion imaging with 99mTc-MAA, were performed simultaneously in patients remaining the same position, too. The image as a iso-count map extracted out of the image of 197HgCl2, 67Ga-citrate or 99mTc-MAA, was superimposed to the brightness image of RI-anigogram (aortic phase). By these procedures, the image of bronchial blood flow were obtained in some patients with lung cancer, pulmonary tuberculosis, lung abscess, and chronic bronchitis. The dual radioisotope techniques using RI-angiography and the other imaging were useful to make isotope diagnosis of lung diseases more reliable, and the image superimposition methods using RI-angiogram and the image of tumor or perfusion, were useful to improve anatomic orientation of the former.     

多层螺旋CT灌注成像评价介入性热化疗治疗中晚期肝癌的价值

为探讨多层螺旋CT灌注成像(CT perfusion imaging,CTPI)在评价介入性热化疗对中晚期肝癌疗效方面的应用价值,本文分析了72例采用介入性热化疗的中晚期肝癌患者在治疗前后的CTPI灌注参数和血清肿瘤学标志物水平。通过与治疗前数据比较,发现治疗后癌灶区CTPI灌注参数明显改善,血清肿瘤标志物明显降低。CTPI灌注参数、血清肿瘤学标志物在碘油完全沉积和部分沉积组、客观缓解和未缓解组均表现出显著的统计学差异。Pearson相关分析结果显示CTPI灌注参数与肝癌血清肿瘤标志物之间存在显著相关性。由此可见,CTPI灌注参数可有效反映介入性热化疗前后晚期肝癌患者的动脉血供变化,为临床疗效评估提供有价值的参考。     

Lung assist device technology with physiologic blood flow developed on a tissue engineered scaffold platform

There is no technology available to support failing lung function for patients outside the hospital. An implantable lung assist device would augment lung function as a bridge to transplant or possible destination therapy. Utilizing biomimetic design principles, a microfluidic vascular network was developed for blood inflow from the pulmonary artery and blood return to the left atrium. Computational fluid dynamics analysis was used to optimize blood flow within the vascular network. A micro milled variable depth mold with 3D features was created to achieve both physiologic blood flow and shear stress. Gas exchange occurs across a thin silicone membrane between the vascular network and adjacent alveolar chamber with flowing oxygen. The device had a surface area of 23.1 cm(2) and respiratory membrane thickness of 8.7 ± 1.2 μm. Carbon dioxide transfer within the device was 156 ml min(-1) m(-2) and the oxygen transfer was 34 ml min(-1) m(-2). A lung assist device based on tissue engineering architecture achieves gas exchange comparable to hollow fiber oxygenators yet does so while maintaining physiologic blood flow. This device may be scaled up to create an implantable ambulatory lung assist device.     

孤立性肺结节的CT形态学特征结合GSI模式的诊断学研究

本研究探讨CT联合能谱成像(GSI)模式诊断孤立性肺结节的临床价值。选取经肺穿刺活检或手术病理学证实的肺孤立性结节患者110例(110个肺结节),对患者的CT平扫、GSI平扫资料进行分析。根据病理学结果分为良性组(炎性结节、非典型腺瘤样增生)41例、恶性组(肺癌小结节)69例,对比两组患者的肺小结节形态学特征综合评分、动静脉期的能谱曲线斜率、40 keV CT值、标准化碘浓度(NIC)的差异。结果显示,恶性组患者的毛刺征和棘突征、分叶征、血管集束征、胸膜凹陷征、支气管征、病灶内钙化、病灶强化值及孤立性肺结节形态学特征总分均高于良性组(P<0.05);恶性组患者的动脉期、静脉期的能谱曲线斜率、40 keV CT值、NIC均低于良性组(P<0.05)。肺部孤立性恶性结节的形态学特征与肺部良性结节差异显著,恶性结节的能谱曲线斜率、40 keV CT值、NIC值与良性结节差异明显。因此,综合分析结节的形态学特征及GSI参数对其良恶性诊断具有重要意义。     

Ursolic Acid inhibits cigarette smoke extract-induced human bronchial epithelial cell injury and prevents development of lung cancer

Cigarette smoking is the main cause of chronic obstructive pulmonary disease and lung cancer. The present study was aimed to explore the chemopreventive effect of ursolic acid (UA) on these diseases. In the CSE treated normal human bronchial epithelial cell model, UA alleviated cytotoxicity caused by CSE, recovered the intracellular redox balance, and relieved the stimulation of external deleterious factors as well. UA mitigated CSE-induced DNA damage through the Nrf2 (nuclear factor erythroid 2-related factor 2) pathway. Moreover, UA inhibited lung cancer development in the model established by A549 cells in nude mice in vivo. For the first time, our results indicate that UA could be developed as a potential lung cancer chemopreventive agent.     

肺结核与肺癌病人全血微量元素观察

选取肇庆市第一人民医院传染病区和肿瘤病区的住院病人全血微量元素观察．结核组72例，肺癌组65例．从14种微量元素观察结果中作统计学处理，发现肺癌病人的3种有害元素N1，Cd。Pb对的含量高于肺结核．而Sr与常量元素Ca的含量亦明显高于肺结核．本文认为在肺结核与肺癌的鉴别诊断上能利用微量元素结果的差异提供一早期鉴别诊断途径．同时提示肺结核病人在治疗时应注意补充钙．