能量多普勒定量检测甲状腺肿瘤血管生成的应用研究

目的:应用能量多普勒(CDE)在体外检测甲状腺肿瘤血管生成,并进行定量分析,期望发展一种无创性评价肿瘤血管生成方法,提高良恶性肿瘤诊断准确率.方法:入选经病理证实的35例甲状腺良性肿瘤(结节性甲状腺肿21例,腺瘤14例)和21例甲状腺癌病人术前均行能量多普勒(CDE)检查,包括CDE值、血流动力学参数、血流频谱.并对其差异进行分析.结果:良恶性肿瘤的CDE值及血流动力学参数(Vmax、RI)存在极显著差异(P<0.01);良恶性肿瘤的血流频谱特征存在差异:收缩期峰值位置存在极显著差异(P<0.01),舒张期始波位置存在显著差异(P<0.05).结论:CDE能够在体外原位评价甲状腺肿瘤血管生成及其活性,对鉴别甲状腺良恶性肿瘤具有重要意义.     

彩色多普勒超声对甲状腺良恶性肿瘤的鉴别诊断

为探讨彩色多普勒超声对甲状腺良恶性肿瘤的鉴别诊断价值 ,对 110例患者在二维超声基础上行彩色多普勒血流显像检查 ,观察血流信号分布情况 ,估测最高动脉流速 ( Vmax)、搏动指数 ( PI)、阻力指数 ( RI)等参数。对照组织病理学检查结果 ,良、恶性肿瘤超声诊断符合率分别为 94.2 5 %和 86 .96 %。恶性肿瘤 2 3例检出血流 2 1例 ( 91.3 0 % ) ,血流信号以内部多见 ( 6 0 .87% ) ,Vmax0 .3 0± 0 .0 7ms;良性肿瘤 87例检出血流 5 7例 ( 6 5 .5 2 % ) ,血流信号均以周边多见 ( 47.13 % ) ,Vmax0 .19± 0 .10 m/s。两者相比差异均有显著性 ( P<0 .0 5 )。提示 ,恶性肿瘤表现为肿瘤内部有较丰富的高速血流信号分布 ,良性肿瘤彩超特征为肿瘤周边见有环状低速血流信号 ,彩超对鉴别甲状腺良恶性肿瘤有较高临床应用价值     

二维超声及彩色多普勒血流显像在原发性骨肿瘤诊断中的价值

目的：探讨二维超声检查及彩色多普勒血流显像（CDFI）技术在骨肿瘤诊断中的应用价值。方法：采用Acuson 128XP／10型及G-50型彩色多普勒显像仪。对93例原发性骨肿瘤患者进行二维及彩色多普勒超声检测观察骨质、骨膜及周围软组织情况，测量血流动力学指标。结果：骨质破坏、骨膜反应、周围软组织肿物在二维图像中显示清晰。CDFI可清晰显示肿瘤内部血流情况。恶性肿瘤收缩期最大血流速度（Vmax），舒张期最小血流速度（Vmin）高于良性肿瘤（P〈0．01），阻力指数（RI），搏动指数（PI）则恶性肿瘤低于良性肿瘤（P〈0．01）。结论：通过二维图像及CDFI观察肿瘤形态及血流动力肇参数时原发性骨肿瘤的诊断及良、恶性鉴别诊断有很大的临床价值。     

彩色多普勒超声对乳腺肿块良、恶性的鉴别诊断

目的 利用彩色多普勒(CDFI)和二维超声及结合临床病理学检查提高乳腺肿块良、恶性鉴别诊断.方法 采用直接接触扫查法.首先观察病灶的二维图像特征,然后用彩色多普勒血流显像测定肿块内血流峰值血流速度、阻力指数(RI).选择流速最高的一束血流脉冲多普勒参数.结果 118例患者经手术病理证实为乳腺实质性肿块,其中良性78例,恶性40例.结论 彩色多普勒血流显像结合二维声像图及RI值对诊断乳腺肿块良、恶性有临床意义.     

彩色多普勒超声在乳腺肿瘤诊断中的价值

目的：探讨彩色多普勒超声在诊断乳腺良、恶性肿块中的应用价值。方法：使用高频及彩色多谱勒成像技术,对乳腺肿块二维图像及彩色多普勒的血流和血管频谱、动力学参数进行观察、分析。结果：乳腺良、恶性肿瘤在肿瘤形态、边界、回声、与周围组织有无浸润、彩色多普勒血流情况等方面均具有明显差异。结论：二维超声与彩色多普勒超声联合检测,可以提高乳腺良、恶性肿瘤的诊断及鉴别诊断。     

彩超在乳腺肿瘤诊断与鉴别诊断中的应用价值探讨

目的:探讨高频彩超诊断与鉴别诊断乳腺肿瘤的准确性.方法:使用(5~10)MHz高频探头和彩超观察肿瘤的特征性二维声像图和彩色多普勒的血流和血管的动力学参数、阻力指数、频谱形态,并且对其进行分析诊断.结果:98例乳腺肿瘤患者中,75例为良性肿瘤患者,23例为恶性肿瘤患者,其中4例良性肿瘤曾被误诊为恶性肿瘤.结论:利用彩超观察乳腺肿瘤的二维声像图特征和彩色血管形态和血流频谱能够为诊断和鉴别诊断乳腺肿瘤的良恶性提供准确的诊断依据,是临床诊断中的首选方法.     

高频彩超对腮腺肿瘤的诊断价值

目的:探讨高频彩超对腮腺肿瘤的诊断价值.方法:应用高频彩色多普勒超声对腮腺肿瘤49例行二维超声及彩色多普勒超声显像,经频谱多普勒测量肿瘤血流的收缩期峰值流速和阻力指数.结果:腮腺良恶性肿瘤的二维超声声像图无明显特异性,而彩色多普勒血流参数、收缩期峰值流速和阻力指数两者比较差异均有统计学意义(P＜0.05).结论:高频彩超对腮腺良恶性肿瘤的鉴别诊断提供了重要的诊断方法.     

多普勒超声动脉血流参数在鉴别乳腺良恶性肿瘤中的应用

目的 探讨多普勒超声动脉血流参数在乳腺良恶性肿瘤鉴别诊断中的价值.方法 选择38例乳腺良性肿瘤患者及58例乳腺恶性肿瘤患者,采用美国GE-LOGIQ9彩色多普勒超声诊断仪检测96例患者的肿瘤血流动力学参数,如收缩期峰值血流速度(PSV)、阻力指数(RI)及搏动指数(PI).比较PSV及RI诊断乳腺良、恶性肿瘤的准确性、敏感度、特异度及阳性预测值.结果 乳腺恶性肿瘤组PSV、RI、PI与良性肿瘤组比较,差异有统计学意义(P<0.01).以PSV>20 cm/s,RI>0.7作为恶性肿瘤判定标准,PSV与RI的定性诊断乳腺肿瘤的准确性分别为66.8%和82.1%,敏感度分别为70.3%和83.2%,特异度分别为65.2%和82.6%,阳性预测值分别为73.2%和85.5%.PSV与RI联合诊断乳腺肿瘤的准确性、敏感度、特异度、阳性预测值分别为83.2%、84.6%、82.5%和85.7%.结论 多普勒超声血流动力学参数PSV、RI对乳腺良、恶性肿瘤的鉴别诊断具有重要应用价值,RI的鉴别诊断价值优于PSV.     

超声对乳腺良恶性肿瘤的诊断价值

目的探讨乳腺良恶性肿块的鉴别诊断,对恶性肿瘤早期发现,早期治疗。方法观察186例乳腺肿块的二维图象特征及彩色多谱勒血流显像持点。结果乳腺良恶性的鉴别,主要以肿瘤的边界、内部回声及血流信号、RI为鉴别要点。恶性肿瘤形态不规则,无完整包膜．彩色多谱勒检出丰富血流信号．频谱为高速高阻,RI在0．8以上。RI越高,恶性肿瘤可能性越大。良性肿瘤边界清．有包膜,内回声均质,血流信号少,RI低。结论二维及彩色多谱勒超声对乳腺良恶性肿瘤鉴别诊断符合率较高,方法简便．具有较大的临床价值。     

彩超对乳腺良恶性肿瘤的诊断与鉴别诊断进展

目的：探讨彩超对乳腺肿瘤诊断与鉴别诊断的准确性与诊断进展。方法：使用彩超和5～12MHz高频探头观察肿瘤的特征性二维声像图和彩色多普勒的血管和血流频谱形态、阻力指数、动力学参数等进行分析诊断。结果：96例乳腺肿瘤中36例为恶性肿瘤,60例为良性肿瘤,3例良性肿瘤开始误诊为恶性肿瘤。结论：彩超通过观察乳腺肿瘤的二维声像图特征和彩色血流频谱和血管形态等对于乳腺肿瘤良恶性的诊断与鉴别诊断可提供准确的诊断依据,是首选的检查方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.