甲状腺超声检查在中老年人健康体检中的应用价值

目的：探讨甲状腺病变在中老年人群中的分布情况及甲状腺超声检查在中老年人健康体检中应用价值。方法对本中心行健康体检的583例中老年人的甲状腺超声检查资料进行回顾性分析。结果583例体检者,340例检出甲状腺异常。其中,甲状腺弥漫性病变14例,甲状腺结节326例。结论随着年龄的增长,中老年人甲状腺弥漫性病变患病率呈下降趋势,而甲状腺结节的发生率呈明显上升趋势。超声检查对甲状腺疾病具有筛查作用,应作为中老年人健康查体的常规项目。     

Warthin瘤样甲状腺乳头状癌1例

<正>女,46岁,因"甲状腺结节2年"入院,入院前超声示双叶甲状腺弥漫性改变;双叶甲状腺多发结节,右叶上极10.3 mm×14 mm等回声,右叶中极4.3×7.5 mm低回声(图1),左叶中极2.3 mm×3.1 mm低回声,形态规则,界清,回声均匀。萤火虫成像:右叶上极等回声、中极低回声。CDFI:右叶上极等回声,内部及周边见点状血流。甲状腺针吸细胞学检查病理结     

老年女性甲状腺结节特征与甲状腺功能的关系

目的研究老年女性甲状腺结节的发病情况,了解结节特征及其与甲状腺功能的关系。方法对226例80岁以上老年女性行甲状腺超声检查,同时测定甲状腺功能（FT3,FT4,TSH）。结果检出甲状腺结节169例,检出率为74．8％,且各年龄组间无统计学差异（P〉0．05）。各组多发结节占优势,但无统计学差异（P〉0．05）。正常组和甲状腺结节组比较甲状腺功能各项指标差异无统计学意义（P〉0．05）。结论老年女性甲状腺结节发病率高且趋向稳定,以多发为主,对甲状腺功能无明显影响。     

甲状腺囊实性结节良恶性的高频超声鉴别诊断价值

目的 探讨甲状腺囊实性结节良恶性的高频超声鉴别诊断价值.方法 回顾性选取2017年3月至2018年11月70例甲状腺囊实性结节患者的临床资料,以手术病理检查结果为金标准,所有患者均行高频超声检查,分析高频超声图像特征、检出率、灵敏度及特异度.结果 高频超声检查诊断甲状腺囊实性结节良恶性检出率为100％(98/98)、特...     

中老年人甲状腺功能与甲状腺结节的增龄性研究

目的 :了解中老年人的甲状腺功能、甲状腺结节的超声检出情况,以及与年龄的相关性。方法 :采用分层随机抽样调查法,选择138例40岁以上行甲状腺功能检查及彩色多普勒超声检查的患者,分年龄段对甲状腺功能指标、超声检出率进行比较,以评价甲状腺结节的发生与甲状腺功能是否具有增龄性。结果:(1)游离三碘甲状腺原氨酸(FT3)随年龄增加逐渐降低(P0.05)。(2)甲状腺功能减退的总检出率为8.7%,甲状腺功能亢进发生率仅0.2%,随年龄的增加发生率无显著变化(P0.05)。甲状腺球蛋白抗体(Anti-TG)和甲状腺过氧化物酶抗体(Anti-TPO)随年龄的增加,检出率无显著变化(P0.05)。(3)超声对弥漫性病变的检出率的增龄性趋势不明显(P0.05)。(4)甲状腺结节者Anti-TG和(或)Anti-TPO阳性率高(P0.001)。(5)促甲状腺激素(TSH)的降低与甲状腺结节的发生相关(P0.05)。结论 :在健康体检中,尤其是老年人群,应行甲状腺功能和甲状腺超声检查,以早期诊断亚临床甲状腺疾病,并根据增龄性特点给予适当治疗,从而改善预后。     

甲状腺结节钙化与甲状腺癌的关系

 目的 探讨术前超声发现甲状腺结节钙化与甲状腺癌的关系。方法 回顾性分析武警总医院 2012 -06 至 2012 -08 行甲状腺结节手术的患者,术前超声检查的甲状腺结节钙化类型,以及和术中、术后病理结果之间关系。结果 58例中,良性病变31例,甲状腺乳头状癌27例。术前超声甲状腺结节钙化检出率39.7%,术后病理的钙化检出率为38%,术中冷冻的钙化检出率为17.2%。良性病变钙化检出率为16.1%,良性病变微钙化检出率6.4%;甲状腺乳头状癌钙化发生率66.7%,其中微钙化发生率为51.9%。良性病变与恶性病变之间的钙化发生率、微钙化发生率比较,差异均有统计学意义(P<0.01)。良性病变的单个结节钙化发生率为20%,恶性病变的单个结节钙化发生率为61.1%,两者比较差异有统计学意义(P<0.01)。结论 术前超声发现的甲状腺结节的微钙化与甲状腺癌的关系密切。     

CT and ultrasonography in the diagnosis of multiple nodules in thyroid

目的:探讨CT和超声(US)对甲状腺多发结节的诊断价值.方法:对176例均行CT和US检查的甲状腺多发结节患者的病例资料进行回顾性分析,根据病理结果分别计算CT、US及两者联合检查对甲状腺结节定性诊断的敏感度、特异度、符合率,对所得结果行x2检验.结果:CT组、超声组、联合组的诊断敏感度分别为51.61％、67.74％和83.87％,特异度分别为80.69％、86.21％和92.41％、符合率分别为75.56％、82.95％和90.91％.CT组与US组间敏感度、特异度、符合率差异均无统计学意义(P＞0.05),US组与联合组比较敏感度、特异度差异无统计学意义(P＞0.05),而符合率差异有统计学意义(P＜0.05).CT组和联合组间灵敏度、特异度、符合率差异均有统计学意义(P＜0.05).结论:超声应作为甲状腺多发结节的首选检查方法,CT在评价甲状腺恶性结节边界与邻近组织的关系及对远处转移的判断有一定优势,两种检查方法联合应用能明显提高对甲状腺恶性结节的诊断准确性.     

甲状腺弥漫性病变的CT诊断

目的　分析甲状腺弥漫性病变的CT影像表现 ,以期得出各种弥漫性甲状腺病变的CT鉴别诊断要点。材料与方法　回顾分析 5 0例甲状腺弥漫性疾病的CT资料 ,5 0例均作平扫 ,45例加作增强。采用薄层靶扫描多窗位、多窗宽观察。结果　 ( 1) 12例桥本病 ,10例Graves病甲状腺双叶呈弥漫对称性或基本对称性肿大 ,密度均匀减低 ,无腺内更低密度结节。 4例桥本病有腺内高密度结节 ;( 2 )结节性甲状腺肿双叶甲状腺肿大、腺内多发更低密度结节 ,大小及分布较甲状腺癌均匀 ;( 3 )甲状腺癌腺体边缘连线中断、腺外结构破坏、囊变区壁结节血管样强化及颈淋巴结肿大。结论　同病种甲状腺弥漫性病变的CT表现存在许多共同之处 ,而不同病种间亦存在着不同的CT特点 ,掌握各病种CT特点 ,有助于诊断与鉴别诊断。CT扫描及图像处理技术的灵活运用 ,对甲状腺弥漫性病变的诊断与鉴别诊断有重要意义。     

甲状腺癌合并甲状腺功能亢进的治疗选择

患者女, 50岁, 因发现甲状腺结节1年余、甲状腺功能异常2周就诊。患者2020年自觉颈部增粗, 外院甲状腺超声提示双侧甲状腺结节, 建议定期复查。2021年10月于本院复查甲状腺超声:甲状腺右叶中部见1.7 cm×1.3 cm×1.1 cm的低回声结节, 峡部偏左侧见0.4 cm×0.3 cm×0.4 cm的低回声结节, 均形态不规则, 边界不清, 右叶中部结节可见数个点状强回声, 彩色多普勒血流显像(color Doppler flow imaging, CDFI)血流信号丰富, 考虑均为有风险结节;双叶内另见数个形态规则、边界清楚的中低回声结节, 较大者位于左叶下部, 大小为3.3 cm×1.6 cm×1.6 cm, 考虑良性倾向。因甲状腺超声提示甲状腺右叶中部结节有风险, 遂行甲状腺右叶中部结节细针穿刺活组织检查(简称活检), 病理提示甲状腺乳头状癌。临床考虑甲状腺癌诊断明确, 准备行手术。     

超声新技术对甲状腺良恶性结节的鉴别诊断价值

甲状腺结节在临床上较常见。近年来,随着超声检查技术的发展,其检出率呈逐渐升高趋势。而三维超声、超声造影、超声弹性成像作为近年来发展起来的超声诊断新技术,明显提高了超声对甲状腺结节良恶性鉴别诊断的准确性。本文就超声新技术在甲状腺结节良恶性鉴别诊断中的应用价值进行综述。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。