目的:分析骨梗死的MRI表現特點。方法:對8例臨床證實為骨梗死患者的MRI表現進行分析。結果: 7例累及雙側股骨下段及雙側脛骨上段,1例累及雙側股骨下段,均呈地圖樣信號異常。結論: 骨梗死在MRI上有特征性表現,懷疑骨梗死應行MRI檢查。
目的:探討多排螺旋CT三維重建技術結合MRI在脛骨平臺骨折診斷和治療中的價值。方法:收集57例脛骨平臺骨折患者的X線平片、 螺旋CT三維重建、MRI影像檢查資料,對照術中所見,分析、比較MRI結合多排螺旋CT三維重建技術在臨床診斷和治療中的價值。結果:在診斷正確率及分型符合率上,多排螺旋CT三維重建技術結合MRI均優于X線平片;并且MRI能明確顯示韌帶、關節軟骨受損傷情況。結論:多排螺旋CT三維重建技術能直觀、立體地顯示脛骨平臺骨折的形態,MRI能明確顯示韌帶、關節軟骨受損傷情況。兩者結合,有助于骨折的分型及手術方式的確定。
The course of chronic pancreatitis is prolonged, and pain is the main symptom, which seriously affects the quality of life and work ability of patients. Its treatment is the most important and complex problem. This article systematically describes the theoretical basis, indications, efficacy, selection and balance of drugs, endoscopy, surgery and other measures related to pain treatment.
阻塞性睡眠呼吸暫停綜合征( obstructive sleep apnea syndrome, OSAS) 是一種常見的睡眠呼吸障礙性疾病, 在成人發生率為2% ～4% , 由于睡眠中反復發生上氣道部分或完全阻塞而表現為夜間間斷低氧和高碳酸血癥、反復覺醒、睡眠結構紊亂, 臨床上常引起心、腦、腎等多器官損害。越來越多的證據表明, OSAS并發高血壓、冠心病、肺動脈高壓、心力衰竭、中風的危險性增高, 是心腦血管疾病的獨立危險因素。未經治療的重度OSAS 患者5 年病死率高達11% ～13% , 而心腦血管并發癥是主要死因。如果及時給予有效治療, 在一定程度上可以預防并發癥的發生, 甚至逆轉心腦血管并發癥的轉歸。
Objective To analyze the incidence of valve prosthesis-patient mismatch (PPM) and ventricular remodeling of elderly patients after aortic valve replacement (AVR). Methods We retrospectively analyzed the clinical data of 134 patient aged over 65 years who underwent AVR for the aortic stenosis or regurgitation at our hospital between January 2016 and December 2016. There were 73 males and 61 females aged 69.7±3.6 years ranging from 65-79 years. The clinical and ultrasound cardiography data were evaluated. PPM was defined as an effective orifice area index (EOAI) of ≤0.85 cm2/m2. The incidence of PPM and the left ventricular remodeling after surgical AVR in the patients with aortic stenosis and aortic regurgitation was analyzed, and the outcomes of aortic valve mechanical prosthesis and aortic valve bioprosthesis were compared. Results The incidence of PPM was 32.5% in aortic stenosis and 13.0% in aortic regurgitation (P<0.05). One patient died in the early post-operation, and the incidence of severe PPM was 6.0%. Conclusion The incidence of PPM after AVR in the patients with aortic regurgitation is less than that in the patients with aortic stenosis.
Objective To investigate the degenerative changes in the inner rat retina after photic injury.Methods After 24 hour-dark adaptation, sixty Lewis rats were exposed in a ventilated green plexiglass chamber that transmitted continuous green light between 480-520 nm with an intensity of 900～1 000 lx. After 24 hour exposure, the rats stayed in darkness and were sacrificed after 1 day, 3,7 or 14 days. The neurons in the inner retina were marked by immunohisto chemical technique and observed by light and electronic microscope.Results The apoptotic photoreceptor cells were noted after photic injury. The degeneration and decreasing number of rod bipolar cells were found after 3 days; the edema of horizontal cells occurred after 1 day but ameliorated gradually; decreasing number of amacrine cells was found after 1 day; sustained edema of ganglion cells and prolifeeration of the Müller cells were found after photic injury. Pyknotic and edematous neruronal degenerations of inner retina were found in ultrastructural study.Conclusion The neurons in the inner retina as well as Müller cells are involved in the degeneration after photic injury. Different neurons manifest different patterns of degeneration.(Chin J Ocul Fundus Dis，2003，19：201-268)
Abstract： Replacement of the aortic valve and aortic root has been the standard surgical strategy for patients with aortic root aneurysm for many years. Along with the increasing knowledge about the aortic root anatomy and physiology, and complications after aortic valve replacement, the technique of valve-sparing aortic root replacement has developed greatly. We focus on the etiology and classification aortic valve insufficiency, the valve-sparing techniques and clinical outcomes of valve-sparing aortic root replacement in this review.
Primary hepatocellular carcinoma is a common cancer. Many patients are found with intermediate-advanced stage, rapid development, poor treatment and high mortality. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can discover the early lesions and therefore plays an important role in diagnosis, treatment and prognosis of patients with hepatocellular carcinoma. It especially has obvious advantages in detecting metastasis and monitoring recurrence. However, 18F-FDG PET/CT imaging has poor quality and low diagnosis rate. Understanding the advantages and limitations of 18F-FDG PET/CT can provide better basis for clinical diagnosis and treatment for hepatocellular carcinoma patients. This article briefly introduces the research and application of 18F-FDG PET/CT in the diagnosis and treatment of hepatocellular carcinoma.
Simulation-based medical education is becoming increasingly common. In this paper, the status and goal of SBME development is analyzed after a brief introduction of SBME. Secondly, the essentiality and possibility of bringing SBME to a situated paradigm are clarified, because there are rich implications for situated cognition as the theory foundation of SBME. As a main discussion point, eight practical situated designing principles for SBME in theoretical and practical contexts are then expounded. Finally, a specific attitude toward the relationship between theory and practice for the SBME teachers is also elucidated.
The single ventricular circulation is notable for coexisting systemic venous hypertension and pulmonary arterial hypotension. The use of mechanical circulatory support (MCS) devices is a viable therapeutic treatment option for patients with congestive heart failure. Ventricular assisted devices, cavopulmonary assisted devices, and total artificial heart pumps continue to gain acceptance as viable treatment strategies for single ventricular physiology patients as bridge-to transplantation, bridge-to-recovery, and longer-term circulatory support alternatives. Patients with single ventricular physiology had the lower survival rates compared with those with biventricular circulation. We present a review of the current and future MCS devices for patients with univentricular circulations.