经会阴二维超声对女性压力性尿失禁诊断价值

目的:探讨经会阴二维超声对女性压力性尿失禁(S U I)的诊断价值.方法:选取87例患有SUI的术前患者及72例同年龄组无SUI的女性作为对照组,应用经会阴二维超声技术,在静息状态下测量膀胱逼尿肌厚度,在Valsalva动作下测量膀胱颈的移动距离、近端尿道旋转角、膀胱尿道后角及观察尿道内口漏斗是否形成.结果:对照组与SUI组间静息下膀胱逼尿肌厚度比较差异无统计学意义(P>0.05),Valsalva动作下SUI组膀胱颈的移动距离,近端尿道旋转角、膀胱尿道后角及尿道内口漏斗形成率明显高于对照组(P<0.05).结论:经会阴二维超声技术可对女性SUI的诊断进行评估.     

女性尿道旁腺囊肿28例治疗经验总结

目的探讨女性尿道旁腺囊肿的诊断与治疗。方法分析28例女性尿道旁腺囊肿的临床资料。其中包括尿道旁腺囊肿18例,尿道旁腺囊肿合并感染7例,尿道憩室3例。结果18例尿道旁腺囊肿和3例尿道憩室行囊肿切除术,7例合并感染的尿道旁腺囊肿行尿道内切开引流术。随访3～24个月,无囊肿复发、尿道狭窄和尿瘘等并发症。结论触诊、B型超声波检查方法是诊断的主要手段,根据是否合并感染分别采取尿道旁腺囊肿切除术或尿道内切开引流术是有效的治疗方法。     

女性尿道旁腺囊肿28例治疗经验总结

目的探讨女性尿道旁腺囊肿的诊断与治疗。方法分析28例女性尿道旁腺囊肿的临床资料。其中包括尿道旁腺囊肿18例，尿道旁腺囊肿合并感染7例，尿道憩室3例。结果18例尿道旁腺囊肿和3例尿道憩室行囊肿切除术，7例合并感染的尿道旁腺囊肿行尿道内切开引流术。随访3—24个月，无囊肿复发、尿道狭窄和尿瘘等并发症。结论触诊、B型超声波检查方法是诊断的主要手段，根据是否合并感染分别采取尿道旁腺囊肿切除术或尿道内切开引流术是有效的治疗方法。     

TPMSC联合BMI、AMH对人工授精助孕结局的预测价值

目的分析经会阴二维和三维超声对盆底功能障碍性疾病(PFD)的临床诊断价值。 方法选取女性盆底功能障碍性疾病患者56例为PFD组,同期盆底功能正常女性56例为对照组。两组均经会阴行二维和三维超声检查,比较二维和三维超声对盆底功能障碍性疾病的临床诊断价值。 结果与对照组比较,PFD组静息、缩肛、张力状态下肛提肌厚度较小,盆膈裂孔前后径、横径、面积较大(P＜0.05)。经会阴三维超声对PFD诊断的阳性预测值、阴性预测值、ROC曲线下面积、灵敏度、特异度、诊断符合率均高于经会阴二维超声(P＜0.05)。 结论经会阴三维超声诊断PFD的临床诊断价值高于经会阴二维超声检查,值得临床应用和推广。     

三维超声多平面成像联合超声断层显像技术诊断女性尿道憩室的效果分析

目的探讨三维超声多平面成像联合超声断层显像（TUI）技术诊断女性尿道憩室（UD）的效果。方法2020 年7月至2022年7月浙江大学医学院附属金华医院收治的女性UD患者9例，均行膀胱软镜检查和经阴道UD切除术。术前使用腔内三维容积探头行经会阴二维、三维盆底超声检查，利用三维超声多平面成像联合TUI技术观察尿道及尿道周围组织，并将超声诊断结果与手术结果进行比较分析。结果二维超声检查结果显示9例UD边界清晰；单发憩室8例，多发憩室1例；憩室大小1.1~5.8（3.6±1.5）cm；囊壁厚0.2~0.5（0.3±0.1）cm；6例无血流显示，3例囊壁或分隔有少量血流信号；6例憩室形状为环形，2例为马鞍形，1例为类圆形；2例憩室内伴强回声结石，7例无强回声结石；6例憩室呈囊性无回声，2例呈絮状弱回声，1例呈完全强回声；6例憩室内多发分隔，3例内无分隔；复杂性UD6例，单纯性UD3例；9例憩室均未见实性肿瘤。三维超声TUI模式下显示，9例患者UD颈部与尿道之间均可见尿道内括约肌的缺损处呈“裂隙征”；三维超声多平面成像模式下显示，A平面UD颈部与尿道外口距离1.5~3.0（2.1±0.4）cm，8例为单发的尿道括约肌缺损，1例为多发的尿道括约肌缺损。8例患者顺利完成经阴道UD切除术，1例患者行膀胱软镜检查；术中或膀胱软镜检查显示UD位置、开口、大小、形状、内部结构与三维超声表现相符。术后复查三维超声，未见明显憩室及开口。结论三维超声多平面成像联合TUI技术有助于UD的准确诊断与定位，为临床治疗提供更多信息。     

女性尿道旁腺囊肿32例诊疗经验总结

目的:探讨女性尿道旁腺囊肿的病因、早期诊断及手术方法。方法:回顾性分析32例经病理证实的女性尿道旁腺囊肿,其中17例行尿道旁腺囊肿切除术,15例行囊肿开窗术,对诊疗问题进行讨论。结果:本组患者都获得随访,时间1个月～2年。全部单次手术治愈,均恢复正常排尿,性生活满意度明显提高,未发现囊肿复发、尿道狭窄、尿失禁或尿道阴道瘘等并发症。结论:触诊是诊断女性尿道旁腺囊肿的基本手段,彩超、CT、MRI等影像学检查是目前最可靠的诊断方法。囊肿切除术是治疗女性尿道旁腺囊肿的首选方法,囊肿开窗术具有治愈率高、创伤性小、简便易行、安全可靠等优点。     

彩超对肾脏囊性病变的鉴别诊断价值

目的：探讨彩色多普勒超声在肾脏囊性病变鉴别诊断中的价值。方法：对临床和病理证实的4例囊性肾癌，8例肾脓肿，2例肾包虫，3例肾结核，30例肾囊肿的二维超声及彩色多普勒超声表现进行了分析，对每例病灶的大小、形态、边界、囊壁回声、囊液回声、囊内分隔及彩色血流的有无、性质进行比较。结果：二维超声和彩色多普勒超声可以反映肾脏囊性病变的结构特征及血流特征。囊性肾癌中，囊壁、囊壁结节及分隔内检出血流信号，囊内出现分隔、囊壁有结节的比例显著高于肾脓肿、肾结核和肾囊肿。结论：二维超声或囊壁结节上检出血流信号对囊性肾癌的诊断有很高的敏感性。     

女性尿道旁腺囊肿26例临床分析

女性尿道旁腺分布于尿道中下段的黏膜下层，有细小的腺管通向尿道外口的两侧。如果腺管排出口阻塞，腺体分泌物堆积而扩张，则可形成尿道旁腺囊肿；一旦感染，常成为慢性尿道炎的隐性病灶，亦可形成尿道旁腺脓肿。我科于1994年8月至2006年12月共收治26例女性尿道旁腺囊肿，均经手术治疗取得良好效果。[第一段]     

女性盆腔囊性病变鉴别诊断中经腹壁超声与MRI的应用价值探讨

目的探究经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中的应用价值。方法回顾性分析本院2019年1月至2019年6月收治的86例盆腔囊性病变患者的临床资料,患者分别行经腹壁超声与MRI扫描检查,同时获取病例患者术后病理结果,分析经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中的应用价值。结果盆腔囊性病变者MRI影像学表现:卵巢囊肿,T₁WI低信号、T₂WI高信号,增强扫描后可见壁、分隔及附壁结节强化信号。单纯卵巢囊肿信号均匀、呈圆形或椭圆形,T₂WI水样高信号,T₁WI水样低信号,囊壁薄且光整,无壁结节。盆腔脓肿,呈长T₁、长T₂及压脂成高信号,内壁光滑整齐,无内壁结节;增强扫描后有明显环形强化。子宫平滑肌瘤,T₁WI等低信号、T₂WI低信号,强化程度较正常子宫实质低。腹部超声表现:盆腔脓肿,呈较厚囊壁且包膜完整;卵巢囊肿,为囊性无回声,部分表现为囊壁薄且均匀,亦见囊壁呈乳头状且囊壁增厚,囊肿内部无明显钙化,囊壁乳头状区域存在部分彩色血流信号;子宫平滑肌瘤,低回声、边界清晰,可见少量血流信号。术后病理结果显示卵巢囊肿50例、盆腔脓肿28例、子宫平滑肌瘤8例,而MRI对盆腔囊性病变的整体准确率明显高于经腹壁超声(P<0.05)。结论经腹壁超声与MRI在女性盆腔囊性病变鉴别诊断中均可提供有价值的参考信息,MRI于女性盆腔囊性病变中的诊断优势高于经腹壁超声,但考虑到MRI检测时间长及价格高等限制,临床实践中可根据实际情况合理选择。     

女性尿道旁腺囊肿4例报告

女性尿道旁腺囊肿(囊状扩张或潴留囊肿)临床上较为少见,由于本病未受到普遍重视,往往被忽略而延误诊断。作者收集了4例,报告如下。临床资料自1971～1983年本院共收治患尿道旁腺囊肿的女病人4例,年龄分别为42,49,28和36岁。例1、例2患复发性尿路感染5年及2年多,肾功能有不同程度减退。检查发现双侧尿道旁腺管口隆起,局部水肿、充血,有压痛,沿阴道前壁向尿道口按压时,可见脓液从管口流出,诊断为尿道旁腺积脓。施行尿道旁腺管切开及囊肿去顶术,例1追踪12年,症状消失,尿路感染无复发;例2术后1年内症状消失,以后失访。例3因反复发作下尿路感染4年而就诊,例4则于10天前性交时觉尿道口疼痛而引起注意。此2例均为尿道旁腺潴留囊肿,后者更合并感染,均施行囊肿切除术,切出直径1cm及2cm的囊肿后,症状未再发。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.