B超检查诊断胎儿脐带绕颈的价值

1998年 2月至 2 0 0 0年 2月。我们对 15 92例临产孕妇进行B超检查 ,发现脐带绕颈胎儿 35 0例 ,产后证实 339例。现分析如下。资料与方法 :足月临产孕妇 15 92例 ,孕周平均 36周。临产前行 B超检查 ,检查时将 B超探头沿胎儿后颈部作纵向扫查。声像图显示脐带在胎儿颈部有“U”型压迹 ,上方有一小圆形衰减包块 ,为脐带绕颈 1周 ;颈背部有“W”型压迹为绕颈 2周 ;胎儿颈背部压迹成锯齿状 ,上方有一长串念珠状衰减包块为绕颈 3～ 5周。同时对胎儿行胎心监护 ,监护时间 2 0～ 4 0分钟 ,并进行无激惹试验 (NST) ,NST有反应表现为 :2 0分钟内…     

B超诊断胎儿脐带绕颈148例分析

1994～1999年，我院应用B超诊断胎儿脐带绕颈148例，效果满意。现报告如下。     

B超诊断胎儿多囊肾2例

胎儿多囊肾的发生率为1：6000～1：14000^[1]。我院自2002-01/2002—08应用B超诊断2例此病胎儿，孕妇自愿终止妊娠后，胎儿尸体解剖证实诊断。     

B超引导穿刺活检诊断原发性肝脏类癌一例

患者男 ,46岁 ,广东梅州市籍。因阴囊红斑、丘疹伴瘙痒 2年 ,泛发全身 1月余入院。患者于入院前 2年无明显诱因出现阴囊部红斑 ,呈散在片状 ,上有针头至粟粒大小的丘疹及丘斑疹 ,部分融合 ,边界不清楚 ,伴有剧烈瘙痒 ,在当地医院就诊 ,按“阴囊湿疹”予以治疗 ,症状稍缓解 ,但不久又反复出现上述症状 ,且患部皮肤渐增厚 ,表面粗糙 ,伴色素沉着 ,治疗效果不佳。1月前突然出现全身广泛性红斑、丘疹 ,伴有剧烈瘙痒 ,为进一步诊治而入我院。病后无畏寒、发热及全身乏力 ,无腹痛、腹胀、腹泻 ,无一过性颜面潮红、发作性哮喘及心悸 ,未见高血压、…     

触诊与B超测量对比分析

目前,国内即将开展碘缺乏病基线调查工作,按照国际标准要求用超声波水平的甲状腺肿大率来表示病情。我国监测方案(试行)规定把触诊法肿大率作为必检指标,而B超肿大率仅为选择指标。众所周知,触诊法误差大其误差与B超法究竟有多大、触诊检查时特别注意些什么,怎样才能最大限度地减少误差等很值得探讨研究。因此,作者在进行“全国十大城市碘营养调查”时,对西安市区10岁儿     

B 超检查在肝脏外伤诊断中的应用价值

为探讨Ｂ超检查在肝脏外伤诊断中的应用价值,本文对１０７例肝脏外伤病例进行了总结,其中急诊手术８６例（８０．３７％）,并对不同程度的肝损伤的Ｂ超声像图特征及诊断要点作了详细描述。结果提示Ｂ超对肝脏外伤的诊断准确性较高,其中肝肾间隙、腹腔内出现液性暗区是其重要征象,有助于Ｂ超诊断。     

胎儿出生体重与剖宫产的关系

对 1994～ 1999年分娩的 2 799例胎儿的体重及分娩方式进行回顾性分析 ,以了解胎儿出生体重与妊娠结局的关系。临床资料 :2 799例均为 3 7～ 4 2孕周。胎儿均为单胎、头先露、无合并症、出生体重≥ 2 5 0 0 g,按胎儿出生体重分 4组 :A组 ( 2 5 0 0～ 2 999g) 4 0 1例 ,B组 ( 3 0 0 0～ 3 4 99g) 13 2 4例 ,C组( 3 5 0 0～ 3 999g) 85 0例 ,D组 (≥ 4 0 0 0 g) 2 2 4例。方法 :对所有病例的剖宫产指征、分娩方式、出生体重、孕周等进行统计分析 ,包括 χ2 检验、相关分析等。其中剖宫产指征仅选择最主要的一种作统计。结果 :14组分娩方式比…     

超声对肝脏疾病的临床诊断意义

正常时肝脏内部的回声由大小相似、灰度相近、分布均匀的细小光点组成。而肝功能异常时相关指标出现不同程度的改变,这对临床诊断有着重要意义。由于B超检查具有无损伤、无痛苦、安全可靠、能反复检查的优点,很受患者的欢迎。尤其对肝脏疾病,B超检查能起到辅助诊断的作用。     

Value of electrocardiogram in predicting and estimating infarct size in man.

The value of the electrocardiogram in assessing infarct size was studied using serial estimates of the MB isomer of creatine kinase (CK MB) in plasma, serial 35 lead praecordial maps in 28 patients with anterior myocardial infarction, and serial 12 lead electrocardiograms in 17 patients with inferior myocardial infarction. In patients with anterior infarcts, sigma ST, sigma R, sigma Q, sigma R/(Q+S), and the number of sites with ST elevation more than 2 mm or with QS waves, were obtained from each map. Correlation between both maximum sigma Q and maximum sigma ST with cumulative CK MB was highly significant. There was also a significant correlation between sigma R and sigma R/(Q+S) with cumulative CK MB. There was no significant correlation between maximum number of sites with ST elevation or with Q or QS waves and cumulative CK MB. Maximum sigma ST and number of sites with ST elevation predicted maximum sigma Q and number of sites with QS or Q waves at a time when infarction was not complete. In patients with inferior infarcts, there was a significant correlation between maximum sigma Q and maximum sigma ST in leads II, III, and a VF, and cumulative CK MB. This study shows that all the waves in the electrocardiogram are useful in assessing infarct size. The fact that maximum sigma ST predicts final sigma Q may be used to assess the efficacy of interventions designed to salvage ischaemic myocardium.     

安徽省部分县既往有偿献血人员基数估计

目的 探索既往有偿献血员基数的估计方法，对安徽省4个县既往有偿献血人员基数进行估计。方法 采用枚举法，根据不同行政村中人群既往献血员分布的密集程度分层抽样调查；用各层人口数分别乘以该层人群中献血员百分比及其95％可信区间，计算、汇总，获取目标人群基数。结果 4个县21．8％（93／1891）的行政村有既往有偿献血员，且呈集中分布；估计既往献血员基数为13086人（11820人～14351人）；调查前后样本村分层一致率为72％。结论 枚举法适合于对既往有偿献血人群基数的估计，但要根据知情人提供信息的真实度调整估计结果，则会更为全面、真实地估计当地既往有偿献血员基数。     

Causal models for estimating the effects of weight gain on mortality

Suppose, in contrast to the fact, in 1950, we had put the cohort of 18-year-old non-smoking American men on a stringent mandatory diet that guaranteed that no one would ever weigh more than their baseline weight established at the age of 18 years. How would the counterfactual mortality of these 18 year olds have compared to their actual observed mortality through 2007? We describe in detail how this counterfactual contrast could be estimated from longitudinal epidemiologic data similar to that stored in the electronic medical records of a large health maintenance organization (HMO) by applying g-estimation to a novel of structural nested model (SNM). Our analytic approach differs from any alternative approach in that, in the absence of model misspecification, it can successfully adjust for (i) measured time-varying confounders such as exercise, hypertension and diabetes that are simultaneously intermediate variables on the causal pathway from weight gain to death and determinants of future weight gain, (ii) unmeasured confounding by undiagnosed preclinical disease (that is, reverse causation) that can cause both poor weight gain and premature mortality (provided an upper bound can be specified for the maximum length of time a subject may suffer from a subclinical illness severe enough to affect his weight without the illness becomes clinically manifest) and (iii) the presence of particular identifiable subgroups, such as those suffering from serious renal, liver, pulmonary and/or cardiac disease, in whom confounding by unmeasured prognostic factors is so severe as to render useless any attempt at direct analytic adjustment. However, (ii) and (iii) limit the ability to empirically test whether the SNM is misspecified. The other two g-methods--the parametric g-computation algorithm and inverse probability of treatment weighted estimation of marginal structural models--can adjust for potential bias due to (i) but not due to (ii) or (iii).     

Effect of bran particle size on stool weight.

The increase in stool weight after feeding 20 g (dry weight) of bran daily was measured when this was of large particle size and after milling to small particle size. Twenty-eight investigations were carried out in 21 normal subjects. With coarse bran, stool weight was significantly greater than with the fine bran (mean 219.4 g/d coarse bran, 199-0 g/d fine bran: difference 20.4 g SE +/-6.4, P less than 00.1). The coarse bran also had a greater water-holding capacity (7.3 g water/g coarse bran, 3.9 water/g fine bran). Coarse bran was 2 1/2 times the volume of fine gran for a given weight and more fine bran will, therefore, be taken when bran is prescribed by the spoonful.     

Effects of weight loss surgeries on liver disease

Obesity is the single most significant risk factor for the development of nonalcoholic fatty liver disease (NAFLD) in children and adults. NALFD is estimated to occur in 30 to 100% of obese adults, and in approximately 53% of obese children. The majority of obese patients have ultrasonographic evidence of fatty liver; 30% have histologically documented nonalcoholic steatohepatitis (NASH). Up to 25% of patients with NASH may progress to cirrhosis. In the United States, an estimated 65% of adults are overweight and 31% are obese. Between 2001 and 2002, the number of people with severe obesity, who are more than 100 pounds overweight, rose to nearly 11 million. Since 1970, levels of childhood and teen overweight have climbed to approximately 16% in those aged 6 to 19 years. Recent findings indicate that key features of NAFLD and NASH improve or resolve dramatically with weight loss. This article discusses weight loss surgeries and their effects on liver disease.     

QRS计分系统对心肌梗死面积测定意义的新评价

为评价QRS计分系统对心肌梗死面积测定的临床意义,比较观察101例伴或不伴心电学干扰因素病人心电图QRS计分法和定量解剖学方法对左心室心肌梗死面积的测定结果,及人工测量与计算机自动测量QRS波群的差别。结果QRS计分系统对无心电影响因素的梗死面积测定与病理解剖学存在正相关关系(r=0.45—0.88),但有心电学干扰因素存在时,两者无相关性。人工测量与计算机测量有高度正相关(r>0.7)。认为QRS计分系统对估测前壁心肌梗死具有良好的实用价值,有心电学干扰因素时不够精确;对进一步改善测定梗死面积的QRS计分系统提供了实验依据。     

Clinical estimation of liver size

Summary and conclusions 1. Studies were undertaken to determine the reliability of evaluating hepatic projection below the thoracic cage and determining anterior linear surface projections of this organ in estimating liver size. Graphic visualization with I¹³¹ rose bengal scintiscans was used as a reference. Results indicate hepatic projection below the costal margin does not provide an accurate assessment of hepatic surface area. In contrast, anterior linear surface measurements provide a reliable index to liver size and should be used routinely in clinical practice. Scintiscans are also of practical value since they provide an objective record of liver size, facilitate detection of minimal hepatomegaly, and permit evaluation of liver size in patients with obesity, ascites, and physical deformities which interfere with physical measurements.2. Variations in physical habitus, thoracic—abdominal relationship, and position or shape of the liver influence linear measurements but do not affect surface area obtained from scintiscans. Scintiscans do not provide an accurate index to size when infiltrative lesions invade the border of the liver. Normal adult subjects in this series had an over-all hepatic surface area of 95±10 sq. cm. per square meter of body surface area, an over-all right midclavicular linear surface projection of 15.1±2.3 cm., and a midline linear surface projection of 4.5±1.1 cm. A larger series is desirable to establish expected difference with age, sex, and over-all body size.Supported in part by NIH Training Grant 5236 (Cl).The authors gratefully acknowledge the aid provided by Mr. Peter Philbin, Mrs. Louise Marshiello, Dr. Jonathan Gibbs, and Dr. Cody Webb during this study.Seton Hall College of Medicine     

Preferential suppression of low molecular weight natural tumor suppressor of human fetal liver origin on the growth of leukemic cells in vitro

A natural tumor suppressor of human fetal liver origin with low molecular weight (LMW-NTS) was studied. The methanol extract of human fetal liver supernatant (FLS-MeOH), a crude preparation of LMW-NTS, showed preferential suppression on the growth of leukemic cell lines HL-60, L833, WEHI-3, and L1210, but less effect on the growth of normal bone marrow granulocyte-macrophage colony-forming units (CFU-GM) in vitro. Preliminary experiments showed that FLS-MeOH also exhibited preferential suppression on the growth of leukemic colony-forming units (L-CFU) from six patients suffering from acute myeloid leukemia (AML). In combination with a long-term in vitro liquid culture system, FLS-MeOH could be adopted as an effective purging agent in the autologous bone marrow transplantation treatment of myeloid leukemia.     

Estimating liver weight of adults by body weight and gender

AIM: To estimate the standard liver weight for assessing adequacies of graft size in live donor liver transplantation and remnant liver in major hepatectomy for cancer. METHODS: In this study, anthropometric data of body weight and body height were tested for a correlation with liver weight in 159 live liver donors who underwent donor right hepatectomy including the middle hepatic vein. Liver weights were calculated from the right lobe graft weight obtained at the back table, divided by the proportion of the right lobe on the computed tomography. RESULTS: The subjects, all Chinese, had a mean age of 35.8±10.5 years, and a female to male ratio of 118:41. The mean volume of the right lobe was 710.14±131.46 mL and occupied 64.55%±4.47% of the whole liver on computed tomography. Right lobe weighed 598.90±117.39 g and the estimated liver weight was 927.54±168.78 g. When body weight and body height were subjected to multiple stepwise linear regression analysis, body height was found to be insignificant. Females of the same body weight had a slightly lower liver weight. A formula based on body weight and gender was derived: Estimated standard liver weight (g) = 218 BW(kg)×12.3 gende×51 (R2 = 0.48) (female = 0, male = 1). Based on the anthropometric data of these 159 subjects, liver weights were calculated using previously published formulae derived from studies on Caucasian, Japanese, Korean, and Chinese. All formulae overestimated liver weights compared to this formula. The Japanese formula overestimated the estimated standard liver weight (ESLW) for adults less than 60 kg. CONCLUSION: A formula applicable to Chinese males and females is available. A formula for individual races appears necessary.