超声诊断在老年慢性肾病中的应用价值研究

目的比较慢性肾病(CKD)与肾功能正常的老年人肾脏结构的差异,探讨超声诊断在老年CKD中的诊断价值。方法将肾脏体积缩小的老年人根据肾小球滤过率估算值(eGFR)分为CKD组80例和对照组80例,对两组的肾脏体积、肾实质厚度、肾实质面积、肾实质面积/肾脏总面积值(PA/TA)等多项超声测量参数进行对比分析。结果两组肾脏的超声测量参数比较,除肾窦面积外其余差异均有统计学意义(P<0.05),eGFR与肾脏长径、肾体积、肾实质厚度、肾实质面积呈显著相关(P=0.000)。结论老年人肾脏有生理性缩小的特点,而CKD的肾脏结构改变与生理性改变之间存在一定差异,应用超声测量判断老年肾脏结构的改变,可以为临床及时诊断CKD提供有价值的依据。     

红河州哈尼族正常人群肝脾肾B型超声测值研究

目的研究红河州哈尼族正常人群肝脏、脾脏、肾脏B型超声测值，并建立超声测量的正常值标准．方法应用B型超声显像仪对228例研究对象（其中男性111例，女性117例）分别测量肝左叶厚径、肝右叶斜径、脾脏厚径、脾脏长径、脾脏周径、脾脏面积以及双肾长径、左右径、前后径以及周径和面积，并作统计学处理．结果（1）男性组超声测值中脾脏厚径、脾脏面积、双肾周径和双肾面积大于女性组相应的超声测值，     

B超测定正常儿童肾脏大小和形态

用Ｂ超测定６９名正常儿童肾脏长、宽、厚径、集合系统大小及肾实质厚度。结果显示正常儿童肾脏大小与性别无关，与年龄、体重呈正相关。肾脏长度（Ｙ－１，ｃｍ）与年龄（Ｘ－１，岁）和体重（Ｘ－２，ｋｇ）的关系分别为Ｙ－１＝０．３６Ｘ－１＋５．２和Ｙ－１＝０．１４Ｘ－２＋４．６。肾实质厚度（Ｙ－２，ｃｍ）与年龄（Ｘ－１，岁）和体重（Ｘ－２，ｋｇ）的关系分别为：Ｙ－２＝０．０５Ｘ－１＋０．９１和Ｙ－２＝０．０２Ｘ－２＋０．８３。左肾略大于右肾，二者无显著差异（Ｐ＞０．０５）。     

超声背向散射积分技术在糖尿病肾病的临床应用

[目的]应用超声背向散射积分技术测定不同分期2型糖尿病肾病患者肾脏背向散射积分值及肾脏体积,进而探讨超声背向散射积分（IBS）技术对糖尿病肾病（DN）的诊断价值。[方法]将临床确诊的56例2型糖尿病肾病患者根据尿白蛋白排泄率（UAER）及血肌酐水平分为三组。Ⅰ组（早期DN）30例,男14例,女16例,Ⅱ组（临床期DN）16例,男7例,女9例,Ⅲ组（终末期DN）10例,男6例,女4例。正常对照组48例,男21例,女27例。二维超声测量肾脏长、宽、厚三个径线,计算肾脏体积。再测量肾实质及肾窦区IBS值,以二者之比为肾实质校正IBS值,肾实质校正IBS值×100%,即IBS%,所得结果与同年龄段正常对照组肾实质IBS%对比分析。[结果]①Ⅰ组肾实质IBS%平均值较对照组差异无显著性意义（P〉0.05）。②Ⅱ组肾实质IBS%平均值较对照组明显升高（P〈0.05）。③Ⅲ组肾实质IBS%平均值较对照组明显升高（P〈0.01）。④Ⅰ组及Ⅱ组肾脏体积较正常对照组明显增大（P〈0.05）,且Ⅰ组及Ⅱ组之间差异有显著性意义（P〈0.05）,Ⅲ组肾脏体积较正常对照组明显缩小（P〈0.01）。[结论]将超声背向散射积分（IBS）技术与二维肾脏体积测量结合起来可以成为临床无痛创评价糖尿病肾病各期的一种安全可靠的检测手段。     

蹄铁肾移植2例

1一股资料患者均为男性，年龄分别为40岁和42岁。因慢性肾炎、肾功能衰竭、尿毒症维持性血液透析治疗6个月以上。经临床检查无绝对禁忌症，于1995年4月上旬接受肾移植治疗。供体年龄20岁，男性，因急性脑死亡供肾，供受者淋巴毒性试验小于8％。腹主动脉灌注整块切取法切除供肾后，发现供肾为下极融合肾，呈蹄铁状，双肾实质较常肾略小，约为8cm×5cm×4cm，肾盂均轻度扩张。峡部约长4Cm、宽2．scm、厚1．scm。左侧肾动静脉均为一枝；右侧肾动脉两枝；一枝位于正常位置，另一枝较细，位于肾下极。修整供肾时先行峡部切除，肾下极残端用2－0…     

颈部异位胸腺误诊为甲状旁腺腺瘤一例报告

临床资料 男性患者，12岁。6年前因肉眼血尿就诊后被发现患有双侧肾脏多发性结石，因年龄小肾脏结石未治，其后血尿反复间断性发作。此次因肾脏功能损害(肌酐293μmol／L，尿素21．4mmol／L)入院，尿液常规检验提示红细胞形态正常；腹部超声常规检查发现双侧肾脏大小、形态正常，实质厚度12mm，皮质回声略增强，双肾各锥体均表现为致密的强回声，后方伴有声影，肾盂未见分离，肾盂内亦未见结石等，超声诊断为“双肾钙质沉积症”。     

泌尿生殖系解剖

一、肾肾脏是位于腹膜后脊柱两侧浅窝中成对的、蚕豆状的器官。长约10～12cm、宽5～6cm、厚3～4cm。重约120～150g。左肾略大于右肾。肾与第二腰椎横突相对,左肾与第一腰椎横突相对。由于肝脏的关系右肾略低于左肾1～2cm。正常肾脏可上下移动1～2cm。体检时可能触到右肾下极,而触不到左肾。肾纵切面的肾实质分内外两层,外层为皮质,内层为髓质。皮质由肾小球和曲小管构成,部分皮质伸展到髓质锥体间成为肾柱。肾髓质为10～12个     

肾柱肥大误诊为肾占位12例分析

肾柱为肾皮质伸入相邻肾髓质锥体之间的部分，属于肾脏的正常结构。如果肾柱因先天性变异而突出增大、嵌入肾窦。或个别肾椎体缺如为肾皮质替代充填，则称肾柱肥大。现将我科自2003年以来将肾柱肥大误诊为肾内占位性病变的12例病例总结如下。     

二维超声诊断双肾异位1例

患者,男性,46岁,因健康查体就诊。超声检查发现,双肾区多个体位未探及肾声像图,膀脱轻度充盈状态下于下腹部盆腔探及双肾声像图,右肾于膀联右侧,大小为9.6cm×4.4cm×5．5cm,左肾于膀优左侧,大小为10．4cm×4.7cm×5．4cm,双肾形态尚规则,边缘光滑,皮、髓质间界限不很清晰,左肾肾益宽1．2cm,右肾肾益宽1．6cm,由于受肾脏位置和体位的影响,输尿管只显示部分而不能全程显示（附图）。超声诊断：双肾异位（盆腔）,右侧肾盂轻度积水。讨论：异位肾是因为肾血管的位置异常,使肾在胚胎育过程中不能上升到正常位置,而出现在骼腰…     

研究彩色多普勒超声检测肾脏血流的重要价值

目的探讨彩色多普勒超声检测肾脏血流的重要价值。方法选取本院2017年1月至2018年1月收治的肾脏疾病患者52例,采用彩色多普勒超声检测其肾动脉狭窄、移植肾、弥漫性肾脏疾病血管血流。结果观察组的肾脏血流状况,包括皮质厚度、实质厚度、肾窦厚度及实质厚度与肾窦厚度比值等均显著优于对照组(P0.05),观察组患者的RI、PI等指数均显著低于对照组,检测结果有统计学价值(P0.05)。结论在肾脏血流检测中,彩色多普勒超声的应用价值极高,有良好的临床应用价值。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.