三维超声容积自动测量技术检测胎儿胆囊发育的可行性分析

目的:分析三维超声容积自动测量技术检测胎儿胆囊发育的可行性。方法:筛选出至中山市小榄人民医院就诊的20~39周之间的孕妇共500例,其中每个孕周分别有45例孕妇,对胎儿进行三维超声容积检测及分析。结果:进行相关分析得知,随着孕周的递增,正常胎儿的胆囊大小将会随之递增,最显著的为胆囊的长径与容积,P<0.05;并且可以获取不同孕周胎儿的胆囊形态。结论:对胎儿进行三维超声容积自动测量技术便于探查其胆囊发育情况,通过建立胎儿正常胆囊大小参考值范围,建立胎儿孕周与其胆囊容积间的曲线方程,并依据曲线方程改变,可以估测不同孕周胎儿的胆囊大小正常范围。     

应用三维超声容积自动测量技术评价胎儿胆囊发育

目的应用三维超声容积自动测量技术,检测胎儿胆囊发育的可行性,建立不同孕周胎儿胆囊容积的正常参考值范围。方法对2011年11月~2013年9月来该院就诊的孕19~38周孕妇进行产前超声检查,对符合标准的每个孕周筛选出30例共计600例。常规测量胎儿胆囊二维径线值,应用三维超声容积自动测量技术估测胎儿胆囊容积。结果相关分析显示正常胎儿胆囊大小随孕周的增加呈不同程度的增加,其中胆囊长径与容积相关性最显著。同时获得不同孕周胎儿胆囊形态。结论胎儿胆囊容积与孕周呈曲线相关关系,随孕周的增加而有不同程度的增加,曲线呈"S"形生长曲线形式。建立正常胎儿胆囊大小的的参考值范围以及胆囊容积与孕周之间的曲线方程,根据曲线方程,可以通过孕周来估测胆囊的正常范围,将估测值与实际测得值进行比较,可为诊断胎儿胆道异常提供一些有价值的信息。     

三维彩超诊断胎儿小下颌畸形

目的:运用二维彩色多普勒及实时三维成像探讨胎儿小下颌畸形的超声表现及各指标综合诊断方法,提高其超声诊断准确率,总结其临床应用价值。方法:应用二维彩色多普勒超声测量6 300例孕周为18-32周的胎儿下颌骨纵径(FML),左右径,下颌骨纵径与双顶径的比值即下颌指数(JI),胎儿下颌面部角度(IFA)。观察胎儿正中矢状面下颌曲线及冠状面下颌显像,并应用实时三维表面成像技术进一步显示胎儿下颌结构。结果:正常胎儿下颌骨左右径及纵径FML与其孕周正相关(R分别为0.952,0.954,P均<0.01);小下颌组胎儿JI、IFA较正常对照组胎儿显著减小,差异有统计学意义(P<0.05),FML明显小于正常同孕周胎儿。结论:胎儿FML明显小于同孕周正常值,JI<31%,IFA<45%为产前诊断小下颌畸形的超声综合数据指标,二维及实时三维彩超联合应用诊断胎儿小下颌畸形明显优于传统诊断方法,具有其他影像学检查不可取代的临床应用价值。     

B型超声显象仪测量孕期胎儿股骨长度的临床意义

以 B 型超声显象仪对228例无并发症孕妇(26～40周)的胎儿股骨长度进行测量,结果显示股骨随孕龄增加而增长,r=0.9916,应用回归方程得 Y(孕龄)=-3.028+0.165X(股骨长度),此系估计胎龄的另一项准确指标。动态观察胎儿股骨长度能了解胎儿宫内发育情况。本文中股骨长度/胎头双顶径比率平均为71.96±2.3%,若测得比率异常,可为临床诊断胎儿脑积水、小头畸形、短肢侏儒症等提供参考。     

超声方法判断孕周范围与胎儿肝脏体积大小的相关性研究

目的：通过三维超声方法判断孕周范围与胎儿肝脏体积大小的相关性关系。方法：回顾性总结在我院进行产前检查的孕妇共计110例,分别用三维超声扫查后获得数据,利用计算机平面体积测量法计算FLV值,最后通过统计学软件包计算相关系数和回归方程。结果：胎儿肝脏FLV值第一次超声测量结果的RSD值为3．2％,其中胎儿肝脏体积小于40cm3者共23例,40～65cm3者30例,65～80cm3者32例,＞80cm3者25例,与第二次超声数据测量结果（RSD值为3．4％）差异无统计学意义（P＞0．05）;超声检测胎儿肝脏FLV值与孕妇孕周大小高度相关（ r＝0．96,P＜0．05）,回归方程为Y＝－90．22＋4．901X（ R2值为0．88,P＜0．05）。结论：孕周范围与胎儿肝脏体积大小呈明显的直线相关,可以通过回归方程预测胎儿肝脏FLV值。     

二维超声+四维超声在不同孕周胎儿畸形诊断中的效果研究

目的:探讨二维超声+四维超声在不同孕周胎儿畸形诊断中的应用效果。方法:选取2015年12月-2017年11月本院不同孕周孕妇128例,按照孕周不同分为孕早期(孕11~17+6周)42例、孕中期(孕18~27+6周)43例、孕后期(孕28~40+6周)43例。对上述不同孕周孕妇进行二维超声检查,并对初步怀疑为胎儿畸形的孕妇进行二维超声联合四维超声检查。结果:二维超声联合四维超声对不同孕周孕妇的畸形胎儿的总体检出率为96.00%,高于二维超声的64.00%,比较差异有统计学意义(P0.05);二维超声联合四维超声对不同类型畸形胎儿的总体诊断准确率为92.00%,高于二维超声的60.00%,比较差异有统计学意义(P0.05)。结论:二维超声+四维超声在不同孕周胎儿畸形诊断中的应用效果肯定。     

正常妊娠中晚期胎儿甲状腺体积的超声检测及分析

目的 利用三维超声检测妊娠中、晚期胎儿甲状腺的体积大小与孕周的关系,以超声辅助判定胎儿甲状腺的生长发育水平.方法 选取进行产前检查的正常妊娠22 ～ 36周的健康孕妇100例,超声检测胎儿一般发育状况的同时应用三维超声计算机辅助分析(3DUS-VOCAL)技术检测胎儿甲状腺体积的大小,并评估胎儿甲状腺体积与孕周的相关性.结果 妊娠中期与妊娠晚期胎儿的甲状腺体积差异有统计学意义,P＜0.01.胎儿甲状腺体积随孕周的增加而增大,两者呈正相关关系,体积=-1.29 +0.08GA(r =0.873,P＜0.01).结论 三维超声检测妊娠中、晚期胎儿甲状腺体积大小有助于评估胎儿甲状腺的发育情况及早期诊断胎儿甲状腺异常,亦可随访判断作为宫内治疗是否有效的依据.     

产科特殊检查

981029胎儿胆道的B超检测/昊细香…//中国超声医学杂志一1998,14(6)一61一63 报告202例胎龄为20一42周正常胎儿胆道的超声检查方法,声像图特征及胆囊纵切面的长径、横径。对37周以上不同性别的胎儿胆囊大小进行了比较。结果:胎儿胆囊切而的二个测值与胎龄呈高度、中度正相关(I=0.97,0.68,p<0.05)37周以上胎JL胆囊男性长于女性,与成人招似-作者对超声探测胎儿胆道的可行性及其临床意义进行了讨论.(冯碧玉)981030B型超声诊断胎儿幽门梗阻2例/T中…少中国超声医学杂志一1998,14(l)一引 2例孕妇,分别孕33周、40周,超声所见:胎头大小正常,胎心…     

超声诊断胎儿胆囊结石一例

近年来,随着超声诊断设备的不断完善和超声医生诊断技术的不断提高,胎儿的异常被检出率也不断的增多,但胎儿胆囊结石仍是罕见的.我院最近发现一例,现报道如下: 1临床资料 孕妇,30岁,孕2产1,孕38周.于2011年4月8日来我院行产前常规超声检查,孕妇一般情况好,无近亲结婚及遗传病史.超声检查:胎儿左枕前位,双顶径91mm,股骨长72 mm,胎心率151次/min,脊柱排列整齐,胎盘位于后壁,羊水深度42 mm.胎儿胆囊大小27 mm×7 mm,囊腔内几乎充满强光点回声(图1).超声诊断:①宫内妊娠单活胎,相当于38周.②胎儿胆囊泥沙样结石.一周后,孕妇娩出一男婴,新生儿一般情况好.一个多月后复查胆囊B超,患儿胆囊大小正常,囊腔内仍几乎充满强光点回声(图2).     

正常胎儿胼胝体发育的产前超声研究

目的 探讨孕20～40周正常胎儿胼胝体发育规律.方法 应用超声对340例清晰显示胼胝体的孕20～40周正常胎儿进行胼胝体长径、横径、厚径的测量,并将其各径线与孕周进行直线相关分析比较.结果 正常胎儿胼胝体各径线与孕周（GA）呈正相关,长径=3.605＋1.269 （GA） （r=0.961,P＜0.01）,宽径=1.257＋0.177 （GA） （r=0.987,P＜0.01）,厚径=0.532＋0.053 （GA） （r=0.952,P＜0.01）.结论 正常胎儿胼胝体的发育与孕周呈正相关,不同孕周各径线的参考值为产前超声诊断胼胝体发育不全提供直接诊断依据,可用于胎儿孕周的确定,并评价胎儿宫内发育迟缓情况.     

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.     

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.     

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     

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.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.