肝硬化中医证型与超声特征的相关性研究

目的:探讨肝硬化中医证型与超声特征的相关性,为肝硬化中医证型的辨证提供客观依据。方法:应用彩超检测200例六种中医证型肝硬化患者的肝包膜厚度、肝表面形态、肝右叶最大斜径、门静脉内径、肝静脉内径、胆囊壁厚度、脾大小、脾静脉直径等各项超声指标。结果:肝郁脾虚、湿热蕴结型可能处于肝硬化的初始阶段,气滞血瘀、水湿内停当处于肝硬化的中期阶段,脾肾阳虚和肝肾阴虚型当处于肝硬化的晚期。结论:肝硬化的六种中医证型是同一疾病的不同发展阶段,有主次之分,轻重缓急之异。肝硬化的超声特征与中医辨证分型相辅相成,两者有机地结合则可以较为准确地反映疾病各阶段特点。     

血源性骨髓炎中医证型的超声研究

目的：寻找血源性骨髓炎的超声辨证分型标准，以提高本病辨证分型的准确性。方法：本组42例患者，采用双盲法进行临床中医分型和超声分型研究，验证两种分型方法的准确性。结果：血源性骨髓炎临床中医辨证分型准确率为85．7％，B超分型准确率为95．2％。结论：超声检查可以为血源性骨髓炎提供辨证分型的客观标准，为临床医生选择治疗方案提供客观的依据，且方便迅速，易于掌握，准确性高。     

女性盆腔肿块超声征象与中医证型关系初探

<正> 为了探讨妇女下腹肿块疾病与中医临床证型的关系,以B超检查为依据,进行了一些探索,现总结如下。1资料与方法 本组56例,平均年龄38.5岁(25-52岁)。患     

超声在脉象客观化研究中的应用

脉搏波是心脏射血活动引起的血液和血管壁的振动波叠加而成、沿着动脉迅速向外周血管传播形成的表现波。现代超声技术对血管内流体力学及管壁运动力学的研究取得了明显成果。运用现代超声技术探索脉象形成机制,以便为中医脉象客观化研究提供新思路、新方法。     

慢性高原反应中医证型诊断标准的探讨

本文根据中医学气血相关的理论,结合慢性高原反应的临床表现及实验室的有关检测指标,提出本病的基本病机在于气血失和、气虚血瘀。证候类型可分为高原气虚证和高原血瘀证,前者是以心、肺功能异常和体内高能物质代谢不足、抗氧化酶活性减弱为主要病变特征,而后者则突出地反映在血液流变学、微循环等方面的异常改变。由此揭示,慢性高原反应虚实不同的证候类型各具有一定的内在物质基础。     

腰椎间盘突出症中医证型影像研究进展

腰椎间盘突出症(Lumbar Disk Herniation,LDH)是髓核经纤维环向周围组织突出,常伴有髓核和纤维环的变性.大多为慢性损伤所致,以重体力劳动者和职业运动员发病率为高,急性外伤可以使症状出现或加重.若纤维环破裂,髓核可向前、后或两侧方突出.由于椎间盘纤维环前厚后薄,后侧中央又有后纵韧带加强,因此发生破裂突出时,破口常在后纵韧带的两旁(侧后方),即神经根进入椎间孔的部位,从而产生神经根或脊髓的压迫症状.腰椎间盘突出症是骨科的常见病和多发病.Gaskiff[1]综合国际上各方面报道发现,不管是发达国家或发展中国家,均有约60%～80%成年人在他们一生中的某一个时期发生过腰腿痛,复发率占80%～85%.     

眩晕中医证型与椎动脉系统多普勒超声相关性研究

眩晕是以头晕和旋转感为主要特征的急性常见症状,多见于梅尼埃病、高血压病、脑动脉硬化和椎基底动脉供血不足。为了探讨不同中医证型之间血流动力学变化,我们应用多谱勒超声的方法对199例患者进行了比较分析,现报告如下。1资料与方法1·1资料与分组:199例患者均为我院住院和门     

颈椎病的相关因素与中医证型

颈、肩臂痛是颈椎病的常见和主要临床症状。颈椎病的发生是由于颈部的急慢性损伤和／（或）椎间盘退行性变后随椎间盘突出和相邻椎体后缘骨赘形成,而引起脊髓和神经功能出现障碍。本文通过影像学表现结合中医理论试述与颈椎病发生有关的因素和中医辨证施治。     

呼吸系统常见疾病证型及影像学诊断

<正> 中医学对呼吸系统常见病积累了丰富的辨证治疗经验,影像医学尤其是X线技术在呼吸系统常见疾病的诊断中具有明显优势。如何利用影像医学技     

胃脘疾患胃镜征象与中医证型关系初探

<正> 为运用胃镜检查来探讨西医诊断与中医辨证分型之间的相关性,现将我院消化内科按中医辨证分型的596例胃脘疾患患者与胃镜检查诊断结果分析如下。     

超声在双胎输血综合征中的应用进展

双胎输血综合征是发生于单绒毛膜双胎的一种严重并发症,胎儿死亡率高,存活儿可存在长期神经系统并发症,其发病机制与胎盘存在血管吻合有关,超声在双胎输血综合征的筛查、诊断、分级、治疗及预后评估中均发挥重要作用。     

肘管综合征行高频超声检查的价值

目的探讨高频超声检查技术对肘管综合征(CUTS)的诊断价值。方法选择31例肘管综合征患者的患侧手臂尺神经作为CUTS组,健侧手臂尺神经作为对照组,应用高频超声成像技术观察尺神经的连续性、内部结构、回声、有无局限性膨大及比邻结构关系,取横断面测量所有患者患侧尺神经与健侧尺神经的横截面积(CSA)。结果尺神经受压明显时神经局段变细,变细处回声明显减低,束状结构欠清晰,卡压近端及远端神经增粗;尺神经卡压瘢痕粘连时,神经增粗回声减低,外膜及束膜回声增强,与周围组织界限模糊;个别患者未见明显卡压段,仅见肘管内尺神经全程肿胀。31例肘管综合征患者患侧肘管尺神经与健侧肘管尺神经比较,患侧尺神经横截面积较健侧明显增大并存在统计学差异(P<0.05)。结论高频超声能动态观察尺神经卡压征象及其周围结构损伤情况,对肘管综合征的诊断有着重要的应用价值。     

Integrated medical school ultrasound: development of an ultrasound vertical curriculum

Background

Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate.

Methods

The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings.

Results

Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum.

Conclusions

Focused ultrasonography is an evolving concept in medicine. It has been shown to improve education and patient care. The indications for and implementation of focused ultrasound is rapidly expanding in all levels of medicine. The ideal method for teaching ultrasound has yet to be established. The vertical curriculum in ultrasound at The Ohio State University College of Medicine is a novel evidenced-based training regimen at the medical school level which integrates ultrasound training into medical education and serves as a model for future integrated ultrasound curricula.     

Renal ultrasound in acquired immune deficiency syndrome

Ten patients with clinical and laboratory features of acquired immune deficiency syndrome (AIDS) underwent renal ultrasonography prior to biopsy because of proteinuria, azotemia, or uremia. Four patients had a history of intravenous heroin abuse and were considered separately so as to exclude it as a cause of nephropathy. Histological examination revealed focal segmental glomerulosclerosis (FSGS), which in patients with AIDS is characterized by rapid progression to severe uremia (though FSGS can also occur in several other forms of renal disease). The authors recommend that AIDS-associated FSGS be considered as a cause of type I parenchymal disease and suggest that serial sonograms may be useful in monitoring progressive renal involvement.     

超声对卵巢过度刺激综合征的诊断价值

目的:探讨超声对卵巢过度刺激综合征(OHSS)的诊断价值。方法:选择1999年9月~2005年1月在我院诊治的中、重度OHSS的病例30例。结果:中度OHSS15例,重度OHSS15例。结论:超声是诊断卵巢过度刺激综合征的可靠方法。     

High-resolution cranial ultrasound in the shaken-baby syndrome

With limited near-field resolution and accessible acoustic windows, sonography has not been advocated for assessing central nervous system injuries in the shaken-baby syndrome. Our purpose was to correlate high-resolution ultrasonographic characteristics of central nervous system injuries in whiplash injuries and the shaken-baby-syndrome with MRI and CT. Ultrasonographic images of 13 infants, aged 2–12 months, with whiplash or shaking cranial trauma were reviewed and compared with MRI in 10 and CT in 10. Five patients had serial ultrasonography and MRI or CT follow-up from 1 to 4 months after the initial injury. With ultrasonography we identified 20 subdural haematomas. MRI and CT in 15 of these showed that four were hyperechoic in the acute stage, three were mildly echogenic in the subacute stage, and that one subacute and seven chronic lesions were echo-free. Five patients had acute focal or diffuse echogenic cortical oedema which evolved into subacute subcortical hyperechoic haemorrhage in four, and well-defined chronic sonolucent cystic or noncystic encephalomalacia was seen at follow-up in two. Using ultrasonography we were unable to detect two posterior cranial fossa subdural haematomas or subarachnoid haemorrhage in the basal cisterns in three cases, but did show blood in the interhemispheric cistern and convexity sulci in two. Ultrasonography has limitations in demonstrating abnormalities remote from the high cerebral convexities but may be a useful adjunct to CT and MRI in monitoring the progression of central nervous system injuries in infants receiving intensive care. Received: 25 October 2000 Accepted: 25 October 2000     

Intersection syndrome: ultrasound imaging

Objective

To evaluate the use of ultrasound for the diagnosis of intersection syndrome.

Materials and methods

A total of 1,131 reports from hand and wrist ultrasound examinations performed between 1 January 2008 and 31 December 2012 were re-evaluated. Two hundred and fifteen video clips present in the electronic database were reviewed by two musculoskeletal radiologists with 20 years of experience.

Results

Of the 215 video clips reviewed, 21 patients were diagnosed with intersection syndrome. The mean age was 45 years (ranging from 22 to 60); 15 were male (13 with proximal intersection syndrome, 2 with distal intersection syndrome) and 6 female (5 with proximal intersection syndrome, 1 with distal intersection syndrome).

Conclusion

Intersection syndrome was identified in 1.9 % of all patients evaluated in the setting of a specialized hospital. Ultrasound is a non-invasive, simple, and economical method for the identification of intersection syndrome, tendon sheath anatomy (individual or separate sheaths) and to exclude other pathological conditions.     

肺癌癌因性疲乏中医辨证论治探讨

癌因性疲乏（cancer related fatigue,CRF）是肿瘤患者最常见的临床症状,发生率60%～90%。肺癌是我国近10年来发病和病死率上升最快的肿瘤,因肺癌本身或各种治疗不良反应所导致的CRF严重影响患者的生存质量,CRF的治疗引起了临床医生的高度重视,其中以整体观念、辨证论治思想指导的中医药治疗在临床实践中发挥了重要作用。作者近5年对肺癌内科治疗阶段CRF进行了系统研究,在辨证分型、处方用药、随证加减等方面取得了部分经验,将肺癌CRF分为气血两虚、气阴两虚、脾虚痰湿、气滞血瘀、阴阳俱损5个证型并辨证论治。     

Computed tomography and ultrasound findings in Klippel-Trenaunay syndrome

Computed tomography (CT) and ultrasound were used to evaluate two patients with Klippel-Trenaunay (K-T) syndrome. Bowel and bladder hemangiomas were demonstrated in these cases. Computed tomography demonstrated multiple low attenuation areas in the liver and spleen in one case. Computed tomography is capable of noninvasively demonstrating bowel and bladder wall hemangiomas in K-T syndrome. Both CT and ultrasound may reveal silent lesions in the upper abdominal viscera, such as liver and spleen.