代谢综合征患者肱动脉血管顺应性的超声研究

目的:探讨代谢综合征(MS)患者肱动脉血管顺应性的改变。方法:选择MS患者38例为研究组(MS组)、健康查体者35例为对照组(NC组),采用彩色多普勒超声诊断仪检测肱动脉在静息、反应性充血和舌下含服硝酸甘油后血管舒张末期内径的变化。结果:MS组的内皮依赖性血流介导的舒张功能(FMD)及非内皮依赖性硝酸甘油介导的舒张功能(NID)明显低于对照组(P<0.05),FMD与年龄、体重指数、三酰甘油、收缩压、舒张压、血糖呈负相关。结论:代谢综合征患者存在较严重的血管顺应性减低及血管内皮功能失调,FMD及NID的测定对MS动脉粥样硬化的预测和防治具有重要意义。     

不同海拔人群肱动脉血管内皮舒张功能检测分析

目的应用彩色多普勒超声方法评价不同海拔人群血管内皮功能。方法采用便携彩色超声诊断仪探头频率7.0～12.0MHz,对1500～3800m以上不同海拔高度1130名部队官兵与职工应用高频彩色多普勒超声检测肱动脉反应性充血前后动脉内径、血流速度、血流量、血管阻力指数(RI)、心率及血流介导血管内皮舒张功能(EDD)等指标。结果随着海拔高度的上升,肱动脉检测的指标均有改变,在高海拔加压后血管内径变窄(P<0.01);血流速度减慢;血流量减少;EDD值降低。与低海拔组相比差异有统计学意义。结论不同海拔地区对血管内皮的影响是存在的,尤其在高海拔低氧环境下肱动脉各项指标的改变较大,与高原心血管疾病的发生有较密切的相关性。     

高频彩色多普勒超声评价不同海拔人群血流介导血管舒张功能

目的：应用彩色多普勒超声的方法评价不同海拔高度的血管内皮功能。方法：根据海拔高度不同,将716例分为A组（405例,1 500-2 900 m）及B组（311例,3000-3 800 m）。采用探头频率为7-12 MHz的便携式彩色多普勒超声诊断仪,在肱动脉反应性充血前后,分别检测其动脉内径、血流速度、血流量、阻力指数（RI）、心率及血流介导血管舒张百分数（FMD）。结果：二组间肱动脉检测数据存在较大差异。与A组相比,B组在反应性充血后,血管内径变窄,血流量减少,FMD降低。两组间海拔高度与FMD之间存在明显相关性（r=0.11,P〈0.01）。结论：不同海拔高度影响血管内皮功能,尤其在高海拔低氧环境下,这可能与高原心血管疾病的发生有关。     

轻度非酒精性脂肪肝血管内皮功能改变与颈动脉内中膜厚度的相关性

目的探讨轻度非酒精性脂肪肝(NAFLD)患者血管内皮功能的改变及其与动脉粥样硬化的关系。方法选择健康体检的130例轻度NAFLD患者(NAFLD组)及120例健康者(对照组)进行肱动脉内皮舒张功能和颈动脉超声检测。结果 NAFLD组肱动脉内皮依赖性舒张功能(FMD)及非内皮依赖性舒张功能(NMD)分别为(11.92±3.28)%及(17.64±2.28)%,显著低于对照组[分别为(15.34±3.00)%及(22.38±2.34)%,P均0.001)。NAFLD组颈动脉内膜中层厚度(IMT)及斑块发生率显著高于对照组[分别为(0.88±0.18)mm vs.(0.97±0.17)mm,P0.001和36.9%vs. 20.0%,P=0.003)。相关及回归分析显示,FMD及NMD与颈动脉IMT及斑块发生率呈显著负相关,在校正年龄、性别、血压、血脂及血糖等相关混杂因素后,FMD及NMD仍是颈动脉IMT及斑块发生率的独立影响因素。结论轻度NAFLD组患者存在血管内皮功能损伤和颈动脉IMT增厚,NAFLD可能通过引起血管内皮功能紊乱导致动脉粥样硬化的发生。     

超声检测高海拔地区长期居住人群及部队官兵肱动脉血管内皮功能

我们于2009-06应用高频彩色多普勒超声对3800m高海拔地区长期居住人群及部队官兵检测肱动脉内皮功能,旨在探讨在当地长期生活人群与部队官兵两组人群的血管内皮功能是否存在差异,现将检测结果报告如下。     

超声检查血管内皮功能及颈动脉和股动脉内中膜厚度临床价值分析

目的 探讨超声联合血管内皮功能及颈动脉和股动脉内中膜厚度检查对冠心病的诊断价值.方法 采用高频超声技术研究冠心病患者的肱动脉内径（D0）、血流介导的血管舒张反应（FMD）,硝酸甘油介导的血管舒张反应（NMD）等肱动脉血管内皮舒张功能,以及颈动脉、股动脉（intima media thickness,IMT）,探讨肱动脉、颈动脉以及股动脉作为反映冠状动脉粥样硬化体表窗口的可行性.结果 对冠心病组和非冠心病的对照组的肱动脉血管内皮舒张功能进行比较发现冠心病组的D0明显大于对照组;而冠心病组的FMD和NMD则明显低于对照组,且差异具有统计学意义（t=2.95、5.36、4.95,P＜0.05）.对冠心病组患者中单支病变和多支病变患者的肱动脉血管内皮舒张功能进行比较发现多支病变组的FMD和NMD则明显低于单支病变组,且差异具有统计学意义（t=3.11、4.36,P＜0.05）.在冠心病组中单支病变组的颈动脉IMT和股动脉IMT均明显低于多支病变组,而这两组的颈动脉IMT和股动脉IMT均明显高于对照组,且差异具有统计学意义（F =2.65、2.85,P＜0.05）.结论 超声检测可早期发现冠状动脉粥样硬化,为治疗和预防冠状动脉疾病提供依据.     

老年下肢动脉硬化症肱动脉及股浅动脉舒张功能的对比研究

目的　了解老年下肢动脉硬化症(LEASD)患者肱动脉及股浅动脉内皮依赖性舒张功能 (血流介导的血管扩张功能 ,FMD)和硝酸甘油介导的非内皮依赖性舒张功能 (NMD) ,并评价二者的相关性及特点。方法　采用高分辨率超声诊断系统检测 33例老年LEASD患者 (Ⅰ组 )肱动脉及股浅动脉的FMD及NMD ,并分别与 4 0例健康老人 (Ⅱ组 )及 30例具有心血管危险因素的老年非LEASD患者(Ⅲ组 )进行对照研究。结果　老年LEASD患者肱动脉的FMD(3 5 6 %±1 92 % )及NMD(8 5 4 %± 4 72 % )与股浅动脉的FMD(2 16 %±1 2 2 % )和NMD(5 2 7%± 3 6 9% )均显著低于Ⅱ组和Ⅲ组 (P <0 0 5 )。老年LEASD患者股浅动脉的FMD显著低于肱动脉的FMD(P =0 0 0 0 8) ;股浅动脉的NMD亦显著低于肱动脉的NMD(P =0 0 0 2 6 ) ;而股浅动脉的FMD与肱动脉的FMD相关性好 (r=0 9314 ,P <0 0 1) ,两者的NMD亦有较好的相关性(r=0 9191,P<0 0 1)。结论　老年LEASD患者肱动脉及股浅动脉的FMD及NMD均受损 ;对于老年LEASD患者FMD及NMD的检测 ,股浅动脉与肱动脉相关性好 ,股浅动脉的FMD及NMD能更敏感、更直接地反映老年LEASD患者的血管反应性     

妊娠期高血压和子痫前期对孕妇产后血管内皮功能的影响

目的探讨妊娠期高血压(GH)和子痫前期(PE)对孕妇产后血管内皮功能的影响。资料与方法纳入产检并分娩的123例产妇,依据《妊娠期高血压疾病诊治指南》分为正常妊娠的对照组、GH组和PE组。所有研究对象分别于孕前及产后6周、12周和24周进行右侧肱动脉内皮依赖性血流介导的血管扩张(FMD)检测。比较各组不同时间点FMD值和组间相同时间点FMD值;分析产后24周FMD值对GH和PE孕妇产后内皮功能异常的预测价值。结果对照组、GH组和PE组产妇产后不同时期FMD值呈上升趋势(P<0.05)。各组产妇不同时间点FMD值差异有统计学意义(P<0.001)。产后6周、12周及24周组间FMD值为对照组>GH组>PE组,差异均有统计学意义(P<0.05)。年龄、体重指数、舒张压为GH组和PE组FMD值变化的影响因素(P<0.05)。产后24周FMD值对GH及PE产妇产后内皮功能异常具有一定的诊断价值(DRAGON评分AUC=0.821,95%CI 0.756~0.952,P<0.001)。结论GH和PE母体产后的血管内皮功能持续受损。产后血管内皮功能异常对于识别心脑血管疾病高危人群具有重要意义。     

不同海拔人群肱动脉血管内皮舒张功能检测分析

本文应用彩色多普勒超声对不同海拔人群血管内皮功能的检测,旨在了解不同海拔及高海拔低氧环境下肱动脉各项指标的变化情况,为防治高原心血管疾病提供依据。     

超声在评价2型糖尿病血瘀证早期动脉功能减退中的价值

目的:通过应用超声多种检测技术,全面评估2型糖尿病(T2DM)血瘀证患者的动脉功能状态,初步探讨T2DM血瘀证患者早期动脉功能改变的特点及超声在糖尿病血瘀证早期动脉病变检测中的应用价值。方法:选择颈动脉内-中膜无增厚、无斑块的T2DM血瘀证患者30例,非血瘀证患者30例。应用血管回声跟踪技术(ET)、动脉硬化检测技术(PWV/ABI)及血流介导的内皮依赖性血管舒张功能检测(FMD)等技术,检测入选病例的各项指标,分析糖尿病血瘀证与非血瘀证患者动脉功能改变的特点及超声在评价T2DM血瘀证早期动脉功能减退中的价值。结果:①血瘀证组与非血瘀证组的年龄、性别比差异无统计学意义(P>0.05),血瘀证组的病程长于非血瘀证组,差异有统计学意义(P<0.01)。②血瘀证组的肱动脉内径变化绝对值、内径扩张百分率均较非血瘀证组减小,差异有统计学意义(P<0.05)。③血瘀证组的应变弹性指数(EP)、硬化参数(β)、脉搏波传导速度(PWVβ)值大于非血瘀证组,差异有统计学意义(P<0.05),顺应性(AC)值小于非血瘀证组,差异有统计学意义(P<0.05),2组的增大指数(AI)值差异无统计学意义(P>0.05)。④血瘀证组的肱踝脉搏波传导速度(baPWV)值大于非血瘀证组,差异有统计学意义(P<0.05),2组的踝臂血压指数(ABI)值无明显差异(P>0.05)。结论:①T2DM血瘀证组的病程明显长于非血瘀证组,提示糖尿病病程越长越容易发生血瘀证。②T2DM血瘀证患者血管内皮功能及弹性功能均有损害,血管功能低于非血瘀证患者,提示血瘀证患者更易发生血管病变。③超声可用于评价T2DM不同中医证型患者的动脉功能状态,可以为T2DM的中医分型治疗提供客观依据。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.