颈动脉狭窄患者血管反应性研究

目的 讨颈动脉狭窄患者血管反应性的改变.方法 选择80例缺血性脑卒中患者(缺血性脑卒中组),应用彩色多普勒超声检测患者屏气期间颈内动脉的最大平均血流速度,计算呼吸抑制指数(BHI),并与同期住院的60例非缺血性脑卒中患者(对照组)进行比较.结果 缺血性脑卒中组颈动脉轻度狭窄29例,中度狭窄8例,重度狭窄5例,闭塞3例,正常35例.对照组颈动脉轻度狭窄5例,中度狭窄2例,无重度狭窄或闭塞,正常53例.缺血性脑卒中组颈动脉中重度狭窄患者屏气期间颈内动脉最大平均血流速度为(24.22±8.55)cm/s,BHI为1.17±0.37,均低于对照组颈动脉正常者[分别为(36.46±9.72)cm/s和1.39±0.94],差异均有统计学意义(P<0.05).结论 颈动脉狭窄患者血管反应性明显下降.彩色多普勒超声显示颈动脉效果良好,可作为颈动脉狭窄的筛选工具.     

彩色多普勒超声在老年脑梗死颈动脉粥样硬化诊断中的应用价值

目的探究彩色多普勒超声在老年脑梗死颈动脉粥样硬化诊断中的应用价值。方法选取医院2017年1月至2019年1月收治的52例老年脑梗死颈动脉粥样硬化患者作为试验组,选取同期在医院治疗的52例单纯颈动脉粥样硬化患者作为对照组,患者均接受彩色多普勒超声检查,比较两组颈动脉血流动力学指标、颈动脉粥样硬化斑块检出率及其类型以及动脉狭窄程度。结果试验组左右两侧颈动脉收缩期最大流速(PSV)、颈动脉舒张末期血流速度(EDV)、血管阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05)。试验组斑块检出率、软斑检出率均高于对照组,差异有统计学意义(P<0.05);两组硬斑、混合斑检出率比较,差异无统计学意义(P>0.05)。试验组动脉狭窄程度高于对照组,差异有统计学意义(P<0.05)。结论脑梗死的发生、发展与颈动脉粥样硬化关系密切,通过彩色多普勒超声诊断可了解患者动脉狭窄情况与血流速度。     

颈动脉粥样硬化与老年冠心病的相关性及临床意义

目的 探讨颈动脉粥样硬化与老年冠心病(CHD)的相关性及临床意义.方法 选择145例拟诊 CHD老年患者根据冠状动脉造影(CAG)结果分成4组:正常对照组、单支病变组、双支病变组及3支病变组,各组分别行颈动脉彩色多普勒超声检查,观察颈动脉内膜-中膜厚度(IMT),有无斑块及斑块数量、形态、大小,管腔有无狭窄阻塞等,并与冠状动脉造影结果进行对比分析.结果 CHD组颈动脉IMT和斑块检出率均高于对照组(P<0.05),且随着冠状动脉病变严重程度的增加而增高.结论 颈动脉粥样硬化与老年冠心病有明显相关性,颈动脉彩色多普勒超声检查可用于预测冠状动脉粥样硬化的病变程度.     

彩超检测颈动脉硬化斑块在脑梗死中的临床价值

目的探讨彩色多普勒超声检测脑梗死患者颈动脉粥样硬化斑块的应用价值。方法对160例经CT、MRI检查确诊的脑梗死组患者及120例健康志愿者作为对照组进行双侧颈动脉彩色多普勒超声检查,观察其斑块分布、性质及动脉管腔狭窄情况。结果脑梗死患者中,粥样斑块形成124例（77.5%）,对照组中颈动脉粥样斑块形成29例（24.2%）,差异具有统计学意义（p〈0.01）,斑块多见于颈总动脉分叉处,其次为颈内动脉起始部;脑梗死组中软斑、混合斑的检出率高于对照组,梗死侧与粥样斑块具有同侧相关性（p〈0.01）;脑梗死组中软斑、混合斑检出率明显高于对照组,两组对照差异有显著性（p〈0.01）;梗死组与对照组颈动脉狭窄发生基本相似,但脑梗死组颈动脉中、重度狭窄明显多于对照组。结论颈动脉粥样斑块是造成脑梗死的重要原因,彩色多普勒超声检测颈动脉粥样硬化对临床上脑梗死患者的预防及治疗具有指导意义。     

缺血性脑卒中与颅内外动脉粥样硬化关系的研究

目的探讨缺血性脑卒中与颈动脉粥样硬化及颅内外血管狭窄的关系。方法采用彩色多普勒超声和经颅多普勒超声诊断仪(TCD)对383例缺血性脑卒中患者颈动脉和脑底动脉进行检测,按临床发病情况分为首发组和复发组,分别观察其斑块和管腔狭窄的情况。结果复发组颈动脉粥样硬化斑块发生率、颈动脉狭窄率和颅底动脉狭窄率均高于首发组(P<0.01),复发组的梗死侧合并斑块发生率高于首发组。结论颈动脉粥样硬化斑块和颅内外血管狭窄与复发性缺血性脑卒中有密切的关系。     

冠心病患者颈动脉硬化与脂蛋白(a)的相关性研究

目的 研究冠心病患者颈动脉硬化与血清脂蛋白(a)的关系。方法 159例冠状动脉造影(CAG)阳性冠心病患者作为试验组,并进行定量Gensini积分,40例CAG正常者作为对照组,行颈动脉超声检测及血清脂蛋白(a)检查。根据颈动脉超声结果将试验组分为内膜正常组（24例）,轻度狭窄组(41例),中度狭窄组（82例）,重度狭窄组（12例）。结果 试验组颈动脉硬化检出率为84.9％(135/159),对照组颈动脉硬化检出率为42.5％(17/40),两组比较差异有统计学意义(P＜0.01)。内膜正常组与轻度狭窄组Gensini积分比较差异无统计学意义（P＞ 0.05）,其他亚组间比较差异均有统计学意义(P＜ 0.05或＜0.01),其中重度狭窄组与中度狭窄组比较差异有统计学意义(P＜0.01)。试验组脂蛋白(a)总体水平为(35.27±23.38) mg/L,明显高于对照组的(23.13±16.56) mg/L,两组比较差异有统计学意义(P＜0.01)。轻度狭窄组与内膜正常组脂蛋白(a)总体水平比较差异无统计学意义(P＞0.05),其他亚组间比较差异均有统计学意义(P＜ 0.05或＜0.01),其中重度狭窄组与中度狭窄组比较差异有统计学意义(P＜0.01)。结论 颈动脉硬化的超声检测有助于预测冠心病的危险程度;血清脂蛋白(a)水平与颈动脉硬化密切相关,在冠心病患者的病情判断上有重要价值。     

彩色多普勒超声检测颈动脉在防治脑梗塞中的应用价值

目的应用彩色多普勒超声检测探讨高血脂及颈动脉粥样硬化与脑梗塞患者的相关性。方法对118例高血脂患者双侧颈动脉彩超检测结果与对照组126例健康人群进行比较分析。结果高血脂组颈动脉粥样斑块检出率(78.2%)明显高于对照组(17.5%),两组相比差异有统计学意义(P<0.05)。结论高血脂患者颈动脉病变以粥样斑块形成、血流减速、血管阻力增高为主要特点。颈动脉粥样硬化与脑梗塞有显著的相关性。彩色多普勒超声可直观反映病变的分期、轻重程度。     

64排螺旋CT对于颈动脉狭窄患者的诊断价值探讨

目的探讨64排螺旋CT对于颈动脉狭窄的临床诊断价值。方法选取我院在2011年8月---2013年4月间接收的50例疑似颈动脉狭窄患者,将其随机分为两组,各25例,观察组患者采用64排螺旋CT进行诊断,对照组患者采用彩色多普勒超声进行诊断,评估两组患者的诊断效果。结果64排螺旋CT对于颈动脉斑块的检出率明显优于彩色多普勒超声,差异有统计学意义（ P＜0．05）。结论临床应用64排螺旋CT诊断颈动脉狭窄准确率较高,值得推广应用。     

高频彩超在颈动脉粥样硬化斑块与脑梗死相关性研究中的价值

目的探讨高频彩超在颈动脉粥样硬化斑块与脑梗死相关性研究中的价值。方法对110例经CT、MRI检查确诊的脑梗死患者及110例相应年龄的健康体检者作为对照组进行双侧颈动脉彩色多普勒超声检查,观察斑块的发生部位及性质,血流充盈缺损及管腔狭窄及闭塞程度。结果脑梗死患者中,颈动脉粥样斑块形成102例（92.72%）,对照组中颈动脉粥样斑块形成18例（16.36%）,差异具有统计学意义（P〈0.05）;脑梗死组中软斑、混合斑的检出率明显高于对照组,两组对照差异具有统计学意义（P〈0.05）;梗死组颈动脉狭窄发生率明显高于对照组,且脑梗死组颈动脉中、重度狭窄明显多于对照组,两组对照差异具有统计学意义（P〈0.05）;两组斑块均多见于颈总动脉分叉处,其次为颈内动脉起始部及颈总动脉主干,两组对照差异无统计学意义（P〉0.05）。结论颈动脉粥样硬化斑块与脑梗死有密切的相关性,尤其是颈动脉粥样硬化斑块中的软斑、混合斑是造成脑梗死的重要原因;高频彩色多普勒超声在颈动脉粥样硬化斑块与脑梗死的关系研究中具有重要作用。     

高频彩超在颈动脉粥样硬化斑块与脑梗死相关性研究中的价值

目的探讨高频彩超在颈动脉粥样硬化斑块与脑梗死相关性研究中的价值。方法对110例经CT、MRI检查确诊的脑梗死患者及110例相应年龄的健康体检者作为对照组进行双侧颈动脉彩色多普勒超声检查,观察斑块的发生部位及性质,血流充盈缺损及管腔狭窄及闭塞程度。结果脑梗死患者中,颈动脉粥样斑块形成102例（92.72%）,对照组中颈动脉粥样斑块形成18例（16.36%）,差异具有统计学意义（P〈0.05）;脑梗死组中软斑、混合斑的检出率明显高于对照组,两组对照差异具有统计学意义（P〈0.05）;梗死组颈动脉狭窄发生率明显高于对照组,且脑梗死组颈动脉中、重度狭窄明显多于对照组,两组对照差异具有统计学意义（P〈0.05）;两组斑块均多见于颈总动脉分叉处,其次为颈内动脉起始部及颈总动脉主干,两组对照差异无统计学意义（P〉0.05）。结论颈动脉粥样硬化斑块与脑梗死有密切的相关性,尤其是颈动脉粥样硬化斑块中的软斑、混合斑是造成脑梗死的重要原因;高频彩色多普勒超声在颈动脉粥样硬化斑块与脑梗死的关系研究中具有重要作用。     

Investigation and Control of Anthrax Outbreak at the Human–Animal Interface,Bhutan, 2010

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.     

Risk for Travel-associated Legionnaires’ Disease,Europe, 2009

Legionnaires’ disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires’ disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominator data from the Statistical Office of the European Union. Risk (number cases reported/number nights spent) was calculated by travel country. In 2009, the network reported 607 cases among European travelers, possibly associated with 825 accommodation sites in European Union countries. The overall risk associated with travel abroad was 0.3 cases/million nights. We observed an increasing trend in risk from northwestern to southeastern Europe; Greece had the highest risk (1.7). Our findings underscore the need for countries with high TALD risks to improve prevention and control of legionellosis; and for countries with high TALD risks, but low notification rates of Legionnaires’ disease to improve diagnostics and reporting.     

Travel-associated Diseases,Indian Ocean Islands, 1997–2010

Data collected by the GeoSentinel Surveillance Network for 1,415 ill travelers returning from Indian Ocean islands during 1997–2010 were analyzed. Malaria (from Comoros and Madagascar), acute nonparasitic diarrhea, and parasitoses were the most frequently diagnosed infectious diseases. An increase in arboviral diseases reflected the 2005 outbreak of chikungunya fever.     

Haemophilus ducreyi Associated with Skin Ulcers among Children,Solomon Islands

During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization’s yaws eradication program.     

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance,Epidemiology, and End Results Database

BackgroundActual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported.ObjectiveThis study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC.MethodsWe performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan–Meier analysis, and multivariate Cox proportional hazards model for the analyses.ResultsWe included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer–specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors.ConclusionsOvarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.     

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Three days after donation of peripheral blood stem cells to a recipient with acute myeloblastic leukemia, dengue virus was detected in the donor, who had recently traveled to Sri Lanka. Transmission to the recipient, who died 9 days after transplant, was confirmed.     

Outbreak of Panton-Valentine Leukocidin–Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team,France, 2010–2011

Staphylococcus aureus strains that produce Panton-Valentine leukocidin are known to cause community infections. We describe an outbreak of skin abscesses caused by Panton-Valentine leukocidin–producing methicillin-susceptible S. aureus (clonal complex 121) in a professional rugby team in France during July 2010–February 2011. Eight team members were carriers; 7 had skin abscesses.     

大龄单身女性寻求生育力保存的伦理问题探析

近年来,在肿瘤和卵巢相关疾病发生率逐年增加、不少大龄单身女性渴望为自己购买一份“生殖保险”等社会及个人因素催化下,人类对于生育力保存的需求急剧增加,满足这一需求正在或将成为重大挑战。对于寻求进行生育力保存的大龄单身女性来说,在合适的年龄应用玻璃化冷冻技术将其卵母细胞冻存是目前可采用的最佳生育力保存手段。而单身女性卵子冷冻将面临来自伦理道德、社会乃至法律的巨大挑战。本文概述国内外大龄单身女性卵子冷冻的现状,并对其可能涉及的相关伦理问题及解决途径进行综述,以促进理性正视单身女性卵子冷冻问题。     

Reemergence and Autochthonous Transmission of Dengue Virus,Eastern China, 2014

In 2014, 20 dengue cases were reported in the cities of Wenzhou (5 cases) and Wuhan (15 cases), China, where dengue has rarely been reported. Dengue virus 1 was detected in 4 patients. Although most of these cases were likely imported, epidemiologic analysis provided evidence for autochthonous transmission.