目的 探讨头颈部CT血管造影(CTA)血管成像对于自发性脑出血(ICH)病因学诊断的应用价值.方法 回顾性分析2016年1月至2018年12月安徽医科大学第一附属医院200例ICH病人的头颈CTA资料及相关临床资料.分析ICH病人不同病因学发病年龄之间的差异,比较CTA与数字减影血管造影(DSA)诊断的符合度及CTA血肿内造影剂外渗所致斑点征对于预测脑出血血肿扩大的意义,从而评价头颈CTA在ICH病人中的应用价值.结果 200例ICH病人中由动脉瘤、动静脉畸形、烟雾病等血管性疾病所致的脑出血共计65例,高血压性脑出血106例,不明原因所致脑出血29例,其中高血压性脑出血病人所占比例(53.0％),明显高于由其他血管性疾病所致ICH.CTA与DSA比较诊断效率达94.3％.头颈CTA斑点征对于预测ICH病人后续血肿扩大差异有统计学意义(F=13.2,P<0.001),其作为血肿扩大的预测因素阳性预测值达80％,阴性预测值达92.9％.结论 头颈部CTA可以作为ICH病人常规检查方法指导临床治疗.

OBJECTIVE:To investigate the application value of contrast-enhanced ultrasound (CEUS) technique to assist the repair of oral and maxillofacial defects by superficial inferior epigastric artery perforator flap.METHODS:Sixteen oral cancer patients, 10 males and 6 females, who were to undergo superficial inferior epigastric artery perforator flap repair between June 2018 and February 2020, were selected, with an average age of 55.8 years (range, 24-77 years). There were 13 cases of squamous cell carcinoma, 2 cases of adenoid cystic carcinoma, and 1 case of mucinous epidermis-like carcinoma. The color Doppler ultrasound (CDUS) and CEUS were used to screen the superficial inferior epigastric artery, assisted in the design of the flap, and compared it with the actual intraoperative exploration. The sensitivity, specificity, positive predictive value, and negative predictive value of CEUS and CDUS examinations were analyzed. Fourteen of 16 patients were repaired with superficial inferior epigastric artery perforator flap, and 2 patients were repaired with superficial iliac artery flap because the source artery was not found. After surgery, regular follow-up was performed to check for disease recurrence and metastasis and to evaluate the appearance of the patien's donor area, the recovery of transoral feeding function, and the presence of complications.RESULTS:Comparison of preoperative CDUS and CEUS findings and intraoperative exploration showed that CEUS had 100% sensitivity, specificity, positive predictive value, and negative predictive value for vascular exploration of the superficial inferior epigastric artery perforator flap, compared with 57%, 100%, 100%, and 25% for CDUS. The preoperative CDUS identified 25 penetrating vessels in 14 cases repaired with superficial inferior epigastric artery flaps. All vessel signals were enhanced by CEUS enhancement, and an additional 11 penetrating vessels were identified confirmed intraoperatively. The preoperative CEUS measurements of the initial diameter of superficial arteries in the abdominal wall were significantly higher than both CDUS and intraoperative measurements ( P<0.05); the difference in peak systolic velocity between CEUS and CDUS measurements was significant ( t=3.708, P=0.003). One case of superficial epigastric artery perforator flap developed venous embolism crisis at 48 hours after operation, the wound healing delayed. The other incisions in donor sites healed by first intention. All the patients were followed up 3-12 months, with an average of 8 months. No recurrence or metastasis appeared during the follow-up. There was no serious complications such as abdominal wall hernia, the location of abdominal scarring was hidden, and transoral feeding was resumed.CONCLUSION:The superficial inferior epigastric artery perforator flap with small injury in supply area and hidden scar location is a better choice for repairing oral and maxillofacial defects. The use of CEUS technique to assist the preoperative design of the superficial inferior epigastric artery perforator flap has good feasibility and high accuracy.

57 cases of patients were treated with dual energy spectral CT scanning in a retrospective study and the effective atomic number and histogram were adopted to determine the stone composition.The results of infrared spectroscopy were used as reference standards.The sensitivity for detecting pure uric stones,pure non-uric acid stones and mixed stones were 100%,91.7%,97.0%,respectively;with specific degree 100%,97.4%,95.7%,respectively;with positive predictive value 100%,84.6%,98.5%,respectively;and the negative predictive value were 100%,98.7%,91.7%,respectively. Dual energy spectrum CT through effective atomic number combining histogram has high accuracy in the diagnosis of pure uric acid stones, pure non-uric acid stones and mixed stones and can accurately distinguish uric acid stones and non-uric acid stones in vivo.

Objective To investigate the application value of adaptive statistical iterative reconstruction ( ASIR) combined with au-tomatic tube current modulation ( ATCM) in the dose reduction of urinary CT scanning. Methods Twenty-five urinary patients underwent spiral CT scanning in routine dose and low dose, respectively, with scanning conditions of tube voltage 120 kV, tube current 10~400 mA, screw pitch 1. 375:1, rotation speed 0. 5 second per lap, and the ATCM technique was applied. The noise index (NI) in the routine group was 13, and it was 25 in the low-dose group. The imaging construction in the two groups was simultaneously performed with layer thickness of 1. 25 mm and five different ASIR weighting coefficients (0, 20%, 40%, 60% and 80%), thus 10 suites of imagings were achieved. The noise values of abdomens aorta at the level of right lobe of the liver and L1 vertebral pedicle and the CT value of renal parenchyma at hilum renalis in these 10 suites of imagings were measured, and their signal noise ratios ( SNR) were calculated. The CT dose index volumes ( CT-DIvol) , dose length product ( DLP) and effective dose ( ED) received in the patients of both groups were recorded, and the imaging quality was independently and blindly evaluated on a five-point scale by two radiologists with more than 5-year diagnositic experiences of epigastric le-sions. Statistical analysis was performed with Wilcoxon signed-rank test and comparative t-test. Results In the routine group, the CDTIvol and ED were (8. 44 ± 1. 97) mGy and (6. 13 ± 1. 55) mSv, respectively, and in the low-dose group, they were (2. 46 ± 0. 70) mGy and (1. 79 ±0. 54) mSv, with significant differences between the two groups (P<0. 05). The mean radiation dose in the low-dose group de-creased about 70%, and the imagings obtained from both groups were subjectively scored≥3, all meeting the quality needs of clinical diag-nosis. As the ASIR weighting coefficient increased, the noise values of imagings reduced gradually and SNR increased. Conclusion Appli-cation of ASIR combined with ATCM in the low-dose urinary CT scanning will significantly decrease the radiation dose to patients, while the acquired medical imagings still could meet the quality needs of clinical diagnosis, and so it is worthy of clinical promotion.

通过成组法和升降法对A7N01S-T5铝合金焊接接头在NaCl溶液中的腐蚀疲劳性能进行研究,主要考察介质浓度和pH值对条件腐蚀疲劳极限的影响.结果表明,介质浓度的增加和pH值的降低会导致焊接接头腐蚀疲劳极限的降低.焊接接头的腐蚀疲劳断口呈现疲劳条带和解理共存的形貌,微观形貌观察表明,腐蚀疲劳裂纹萌生于表面腐蚀坑,在交变载荷作用下,蚀坑深度和表面积迅速增加,当蚀坑增大到临界尺寸时,由于蚀坑应力集中,在交变应力持续作用下,短裂纹作为相邻点蚀坑间的“桥梁”,最终导致腐蚀疲劳裂纹形成、扩展,直至断裂.

Objective To investigate the effect of different contrast media with different injection speeds on the enhanced effect of coronary angiography by 64-detector row helical CT.Methods Sixty consecutive patients with the BMI of 20.20 ～25.80 kg/m2 undergoing coronary angiography by 64-slice CT were divided into three groups.Group A was injected contrast medium of 350 mgI/ml with the speed of 4.5 ml/s and group C was 4.3 ml/s,group B was injected contrast medium of 370 mgI/ml with the speed of 4.3 ml/s.The enhanced effect and picture quality of three groups in ascending aorta,descending aorta,the trunk and branch of coronary artery were compared.Results The enhanced values of LCX were smaller than those of the other vessels in the same group.Except LCX,the enhanced values in other vessels of group A exceeded those of group C.The enhanced values of group B exceeded those of group A and C;except in aorta of group B and C,the difference of enhancement in other vessels between group A and C,group A and B,group B and C was not significant.Except left circumflex,the enhanced values of group C were less than those of group A.The average score of picture quality in group C surpassed that in group A and B.The score between group A and B existed significant difference,but there was no significant difference between group A and C,group B and C.The contrast medium of 350 mgI/ml could obtain the optimal enhanced image.Conclusion The optimum concentration of contrast medium in coronary angiography by 64-detector row helical CT is feasible and more excellent enhanced image can be gained.

结合胶原纤维凝胶的形成和羟基磷灰石的原位生长制备了胶原-羟基磷灰石(COL-HA)复合骨组织引导再生膜,采用体外细胞复合培养法用成骨细胞对复合膜的细胞相容性进行测试.结果表明,细胞在复合膜表面生长形态良好.与对照膜(纯胶原膜和共混膜)相比,细胞在复合膜中显示最快的增殖速度和最强的碱性磷酸酶活性.制备的胶原-羟基磷灰石复合膜具有好的细胞相容性.

OBJECTIVE:To investigate the efficacy of a new collagen-hydroxyapatite (COL-HA) composite membrane on bone regeneration of SD rat cranial defects.METHODS:Four defects were produced in the calvaria of 24 SD rats. The animals were divided into four groups: Empty defects without membrane (group 1); defects covered by COL-HA single-layer dense membranes (group 2); defects covered by COL-HA double-layer membranes (group 3); defects covered by Bio-Gide membranes (group 4). At 2, 4, 8 and 12 weeks after surgery, 6 rats were sacrificed and the following parameters were analyzed: Macroscopic observation, X-ray examination, descriptive histology, regenerate bone quantitative histology. Statistical analysis consisted of generalized linear models/factorial design analysis of variance and LSD-t test was performed.RESULTS:Since two weeks after surgery, there were a small amount of bone regenerated in three groups except group 1. At 12 weeks after surgery, the opaque sclerous tissues filled with the defects in three groups, and residual membrane fragments still could be found. X-ray pictures showed the density of regenerate bone in group 3 and group 4 was closed to the original bone and greater than that of group 2. Quantitative analysis of regenerate bone showed that in initial stage, group 4 had more bone regeneration than the other groups (P < 0.05), and at 12 weeks after surgery the differences between group 4 and group 2/group 3 had no statistically significant.CONCLUSION:The COL-HA composite membranes can guide bone regeneration of rat cranial defects. The efficacy of bone regeneration of COL-HA double-layer membrane is superior to COL-HA single-layer dense membrane, because its property is more propitious to the adherence and proliferation of osteoblasts.

Guided bone regeneration (GBR) is a technique utilizing membrane as a physical barrier to separate and create a secluded space around the bone defect. This permits the regeneration of bone tissue and reduces the fast growth of connective tissues. Moreover, GBR membranes sustain a protected space during tissue-healing period. Nowadays there are many kinds of GBR membranes used in study and practice, and each of them has its characteristic merits and defects respectively. This paper reviews the studies of GBR membranes, with the emphases on the structure and properties of membrane materials as well as their biological functions.

A composite gel composed of collagen,alginate and synthetic HA powder was formed by using collagen assembly,and freeze-drying of the composite gel gave rise to collagen-alginate-HA porous materials.Scanning electron microscopy,X-ray diffraction,Fourier transform infrared spectroscopy and Ultra-violet spectroscopy were used to characterize the physiochemical properties of the prepared materials and to reveal the possible interactions between molecular species.The results indicated that the scaffolds had interconnected porous structure with typical pores ranging between 200-600μm.Inorganic phase,poorly crystallized hydroxyapatite,was formed uniform dispersion with the organic substances.The introduction of alginate,to some extent,influenced the collagen assembly process.The materials prepared in this study could be a promising scaffolds for bone tissue engineering.

目的:比较国内四个厂家生产的替硝唑固体制剂(片剂,胶囊剂)的体外溶出情况.方法:选用人工胃液为溶出介质,以紫外分光光度法测定替硝唑的含量和各制剂的体外溶出度,用单指数模型法,威布尔分布模型法,以及希古契方程拟合.结果:除一厂家生产的样品因包有薄膜衣而溶出较慢外,其余各制剂在10分钟时已基本溶出,其溶出度无明显差异.结论:除包有薄膜衣的制剂外,其余厂家生产的替硝唑固体制剂在人工胃液中的溶出行为没有显著差异,并不影响疗效.

目的:建立复方甲硝唑含漱液中甲硝唑及醋酸洗必泰的含量测定方法.方法:用多波长系数倍率法消除各组分间的相互干扰,分光度法则定组分含量.结果:测定波长为260、281、340、312、349 nm.甲硝唑、醋酸洗必泰含量测定的平均回收率分别为100.9%,RSD=0.5%和102.0%,RSD=0.69%.结论:本方法简便,结果可信.