经阴道彩色多普勒超声在卵巢肿瘤诊断中的价值

①目的　探讨经阴道彩色多普勒超声在卵巢良、恶性肿瘤诊断中的价值。②方法　应用经阴道彩色多普勒超声观察 73例卵巢良、恶性肿瘤的声像图特征及血流情况。③结果　经手术和病理证实 ,73例中 6 8例为卵巢肿瘤 ,超声诊断符合率为 91% ,其中良性肿瘤 4 9例 ,声像图多呈囊性包块 ;恶性肿瘤 19例 ,声像图呈囊实混合性或实性包块。恶性肿瘤的血管脉搏指数、阻力指数明显低于良性肿瘤 ,差异有显著性 (t=3.2 9、5 .76 ,P <0 .0 1)。以脉搏指数 <1.0、阻力指数 <0 .4为临界值预测恶性肿瘤有较好的灵敏度和特异度。④结论　经阴道超声在卵巢肿瘤诊断中具有重要价值     

经阴道超声对卵巢肿瘤诊断的临床价值

目的探讨经阴道彩色多普勒超声鉴别卵巢良恶性肿瘤的特点。方法对62例67个卵巢肿瘤经阴道彩色普勒进行检查,比较良恶性肿瘤形态学改变,周边及内部血流显示。结果良性肿瘤形态规则,包膜完整;恶性肿瘤形态不规则,包膜不完整,多数伴有腹水。良恶性肿瘤周边均可探到血流信号,恶性肿瘤内部血流比良性者显示率高,恶性者阻力指数(RI)小于0·45。结论阴道彩色多普勒超声对卵巢良恶性肿瘤的鉴别诊断具有一定临床价值。     

经阴道彩色多普勒超声检查对卵巢良、恶性肿瘤的鉴别诊断价值

目的:探讨经阴道彩色多普勒超声检查对卵巢良、恶性肿瘤的鉴别诊断价值。方法:对76例卵巢肿瘤患者术前行经阴道彩色多普勒超声检查,分析瘤内血流分级、瘤内动脉血流参数。结果:卵巢良性肿瘤组血流以0级、Ⅰ级为主,占88.9%,恶性组以Ⅲ级为主,占71.2%,两组比较差异有统计学意义(P<0.05);交界性肿瘤患者血流以Ⅱ级、Ⅲ级为主,与良性肿瘤患者比较差异有统计学意义(P<0.05),与恶性肿瘤患者比较差异无统计学意义(P>0.05)。卵巢恶性肿瘤动脉血流阻力指数(RI)、搏动指数(PI)明显低于良性肿瘤患者(P<0.05)。结论:RI、PI、血管分级是鉴别卵巢良、恶性肿瘤的重要指标,对评价预后有一定的参考价值。     

经阴道超声造影对卵巢肿瘤鉴别诊断的应用研究

目的：采用经阴道超声造影观察不同性质和类型的卵巢肿瘤的影像学特点和造影增强模式,探讨经阴道超声造影在卵巢良恶性肿瘤诊断及鉴别诊断中的应用价值。方法对广元市中心医院妇科收治的经阴道多普勒超声提示卵巢肿瘤且良恶性鉴别难度较大的患者50例,行经阴道超声造影检查,结合术后病理结果分析,对比不同性质和类型的卵巢肿瘤患者病灶区的多普勒血流信号和超声造影剂的灌注特征,并比较其时间‐强度曲线上造影增强的开始时间、达峰时间、峰值强度和曲线下面积等相应参数。结果经阴道超声造影对卵巢肿瘤性质鉴别的准确率（96％）显著高于经阴道多普勒超声检查（72％）,差异有统计学意义（P＜0．05）。良性肿瘤超声造影后主要表现为囊壁结构的环形增强、实性结构整体或分散的点状、树枝状增强,肿瘤形态规则、边界清楚,而恶性肿瘤主要是瘤体实性结构快速、非均质地增强。恶性卵巢肿瘤超声造影剂增强的开始时间和达峰时间均显著早于良性肿瘤（均 P＜0．05）,且峰值强度和曲线下面积显著高于良性肿瘤（P＜0．01）。结论卵巢良恶性肿瘤在超声造影剂注射后的增强模式不同,经阴道超声造影可以敏感地显示病灶局部的血流灌注情况;分析良恶性卵巢肿瘤时间‐强度曲线参数的差异可提高对卵巢肿瘤性质和类型鉴别的准确率,具有良好的应用前景。     

经阴道彩色多普勒超声鉴别卵巢肿瘤的临床价值

目的:探讨经阴道彩色多普勒超声检查在鉴别卵巢良性和恶性肿瘤方面的价值。方法:选取在我院就诊的卵巢肿瘤患者81例作为研究对象,所有对象术前均行经阴道彩色多普勒超声检查,以观察患者瘤内血流分级情况及肿瘤内动脉血流参数。结果:卵巢良性肿瘤组患者瘤内血流分级以0级和Ⅰ级为主,占90.00%,而卵巢恶性肿瘤组患者瘤内血流分级以Ⅲ级为主,占68.52%,与卵巢良性肿瘤组患者相比,卵巢恶性肿瘤组患者的血流分级明显升高;交界性肿瘤患者的瘤内血流分级以Ⅱ级和Ⅲ级为主,与卵巢良性肿瘤组患者比较有明显差异(P<0.05),与卵巢恶性肿瘤组患者相比无明显差异(P>0.05)。与卵巢良性肿瘤组患者相比,卵巢恶性肿瘤组患者的动脉血流阻力指数和搏动指数明显降低(P<0.05)。结论:血管分级、动脉血流阻力指数及波动指数有助于鉴别卵巢良性和恶性肿瘤。     

彩超对甲状腺良恶性肿瘤的鉴别诊断价值分析

目的分析彩超在甲状腺良恶性肿瘤鉴别诊断上的价值。方法选取我院患者45例,使用彩色多普勒超声诊断仪进行检查,观察诊断结果。结果病理检出良性肿瘤27例(60.0%)、恶性肿瘤18例(40.0%),彩超诊断准确率分别为92.6%、88.9%。良性肿瘤边界清晰、结构多为囊性、有包膜、无钙化、内部以强回声为主;血流信号0型多、III-IV型少,Vmax指标高、RI指标低。P0.05,差异有统计学意义。结论针对甲状腺良恶性肿瘤患者,彩超诊断准确率高,能够鉴别出良恶性肿瘤,具有较高的应用价值。     

超声、MSCT检查对良、恶性卵巢疾病的诊断价值对比

目的超探讨超声、多层螺旋CT(MSCT)检查对良、恶性卵巢疾病的诊断价值对比。方法收集2017年1月至2018年12月于绵阳市骨科医院就诊治疗的108例卵巢肿瘤患者的临床及影像学资料,总结超声、MSCT对卵巢肿瘤的检出和正确诊断率以及不同检查方法中的影像学特征。结果 MSCT对卵巢良、恶性肿瘤的诊断正确率均显著高于超声检查(P0.05);超声检查中良性病变边界清楚、轮廓规整的实质性肿物,大部分良性肿瘤病灶周围可见短条状或弧形血流;恶性肿瘤主要可见边界不清及内部回声不均实质性团块,内部存在丰富血流;CT平扫中良性肿瘤主要表现为水样低密度囊性肿块,部分病灶密度均一,增强可见轻度强化。恶性肿瘤平扫可示密度不均的类似圆形影,增强后病灶囊壁及实性成分明显强化;颗粒细胞癌在其附件区可见边界不清的囊实性包块,密度不均,增强扫描显示病灶明显强化;卵巢内胚窦瘤在附件区可见边界不清的囊实性包块,增强扫描可见包块囊壁明显强化。结论 MSCT检查对卵巢良性、恶性的诊断正确率显著高于超声检查,MSCT检查更能清晰显示肿瘤位置、形态及大小,但超声检查可清晰显示肿瘤内血流情况,故可将MSCT与超声检查相结合更有利于提高卵巢良、恶性肿瘤的诊断正确率。     

超声联合彩色多普勒超声检查对卵巢肿瘤的诊断价值

目的 探讨超声联合彩色多普勒超声（彩超）检查对卵巢良、恶性肿瘤的诊断价值。方法 对１５２例疑卵巢肿瘤的病人行常规超声和彩超检查,观察其形态结构、血流信号分布及血流阻力、血流速度的特征;对肿块的良、恶性进行术前诊断;并计算常规超声检查和超声联合彩超检查的诊断敏感性、特异性、阳性预测值、阴性预测值。结果 ９９例良性、４９例恶性卵巢肿瘤经病理证实常规超声检查诊断的敏感性为８０％,特异性为８１％,阳性预测     

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     

常见卵巢良性肿瘤的彩色多普勒超声表现

目的:探讨常见卵巢良性肿瘤的彩色多普勒超声表现。方法:总结分析60例经手术病理证实的卵巢常见良性肿瘤的彩超资料。结果:卵巢常见良性肿瘤的彩色多普勒超声表现特点为:①包膜完整,囊壁薄而光滑,形态规则。②肿瘤内部回声多为液性,有的可有细小光点及后方回声增强。③瘤内间隔多规则,壁厚薄较均匀。④无腹水。⑤瘤体、瘤壁、间隔彩色血流速度低,阻力高,瘤内及周围无或有规则的细小血流信号。结论:彩色多普勒超声是卵巢肿瘤首选的影像检查方法。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.