彩色多普勒超声诊断主动脉夹层动脉瘤

目的 评价彩色多普勒超声诊断主动脉夹层动脉瘤的临床价值。方法对应用彩色多普勒超声诊断技术检查诊断的22例主动脉夹层动脉瘤患者进行总结分析。结果 经超声诊断的主动脉夹层动脉瘤与CT、MRI、DSA检查诊断的符合率分别为87．5％、83．3％、81．8％。检查方法、探测部位、所用切面影响诊断结果的准确性。结论 彩色多普勒超声检查对诊断主动脉夹层动脉瘤具有重要的临床价值。     

彩色多普勒超声在主动脉夹层动脉瘤诊断中的价值

【目的】探讨彩色多普勒超声诊断主动脉夹层动脉瘤的临床价值。【方法】对采用彩色多普勒超声检查诊断的49例主动脉夹层动脉瘤患者进行回顾性总结分析。【结果】DebakeyⅠ型21例、DebakeyⅡ型11例、DebakeyⅢ型17例;术前正确诊断46例(93.88%),漏诊3例;经彩色多普勒超声诊断的主动脉夹层动脉瘤与CT、MRI、DSA检查诊断的符合率高。【结论】彩色多普勒超声检查对诊断主动脉夹层动脉瘤具有重要的临床价值。     

诊断主动脉夹层动脉瘤的影像学比较

目的 讨论彩色多普勒超声、多层螺旋CT(multislice spiral CT,MSCT)及MRI对主动脉夹层动脉瘤(aortic disection,AD)的诊断价值,评价3种检查方式的优势与不足,为临床选择检查提供依据.方法 回顾性分析2008年1月-2010年6月期间,32例经手术证实为AD患者的彩色多普勒超声...     

探析多层螺旋CT血管成像技术在主动脉夹层动脉瘤中的诊断性能及临床应用价值

目的:分析多层螺旋CT血管成像技术(MS-CTA)在主动脉夹层动脉瘤中的诊断性能及临床应用价值。方法:回顾性分析我院2014年1月至2016年8月期间收治的50例主动脉夹层动脉瘤(ADA)患者的临床资料,根据双盲法将其分为研究组(25例)与对照组(25例)。研究组25例ADA患者给予多层螺旋CT血管成像技术(MS-CTA)检查,对照组25例ADA患者给予彩色多普勒超声检查;对比两组ADA患者的动脉壁钙化、夹层血栓、ADA累及分为、破口位置、主动脉破口数以及AD分型等指标差异。结果:两组ADA患者的破口位置、主动脉破口数以及ADA分型无显著差异,无统计学意义(P0.05);与对照组相比较而言,研究组25例ADA患者的动脉壁钙化、夹层血栓以及ADS累及分支范围的阳性率明显更高,差异有统计学意义(P0.05)。结论:主动脉夹层动脉瘤诊断中多层螺旋CT血管成像技术的临床应用效果十分显著,值得在临床诊断工作中推广运用。     

彩色多普勒超声在急诊主动脉夹层动脉瘤中的应用

目的：评价彩色多普勒超声诊断急性主动脉夹层动脉瘤的临床价值。方法：对2000年8月～2002年2月间应用彩色多普勒超声技术诊断的6例急性主动脉夹层动脉瘤患者进行总结分析。结果：除1例超声诊断为Debakey Ⅰ型的患者在未能做其它检查前死亡外，另外5例Debakey Ⅲ乙型经血管造影证实，行支架型人工血管置入术治疗，1例Debakey Ⅲ乙型经增强CT扫描证实。结果：彩色多普勒超声检查对急性主动脉夹层动脉瘤的诊断及治疗方案选择具有重要的临床价值。     

彩色多普勒超声诊断腹腔干动脉瘤的临床价值

目的探讨彩色多普勒超声在诊断腹腔干动脉瘤的临床价值。方法应用彩色多普勒超声对2008年4月至2014年4月我院门诊腹痛患者进行腹腔干动脉检查,主要观察腹腔干有无瘤样结构,有无内膜分离,瘤体内有无血栓等。结果腹痛患者中彩色多普勒超声共检出真性动脉瘤10例(其中1例合并血栓形成),夹层动脉瘤5例,均为主动脉夹层累及,孤立性夹层动脉瘤1例并经超声造影确诊。二维超声可见腹腔干瘤样扩张,瘤体内为红蓝相间的旋涡状血流信号,若合并血栓则可见充盈缺损;若为主动脉夹层累及则可见分离的内膜片延续至腹腔干开口。CTA证实为真性动脉瘤6例,孤立性腹腔干夹层3例,主动脉夹层累及腹腔干5例,余2例动脉瘤未进行其他影像学检查。结论彩色多普勒超声对腹腔干动脉瘤的诊断价值较高,能够准确反映动脉瘤的部位、大小和血流动力学的特征,但超声不易显示孤立性腹腔干夹层的内膜分离,需要结合超声造影或CTA进行诊断。     

彩色多普勒超声对动脉瘤诊断的进一步研究

目的 探讨彩色多普勒超声对动脉瘤的诊断、鉴别诊断价值及治疗价值。方法 使用彩色多普勒超声观察不同类型动脉瘤的二维及彩色多普勒表现36例，包括真性动脉瘤15例，腹主动脉夹层动脉瘤5例，假性动脉瘤16例。使用彩色多普勒超声观察不同类型动脉瘤的二维及彩色多普勒表现，协助临床对假性动脉瘤行超声引导下压迫治疗。结果 1．经超声诊断的动脉瘤与血管造影、CT、核磁或临床手术对比诊断符合率在80％以上；2．真性动脉瘤彩超示血管内径局限性扩张，夹层动脉瘤可见主动脉撕裂内膜的破口及分隔形成的双腔样结构，真腔内血流特征性频谱为收缩期先前向，后逆向，舒张期前向；假性动脉瘤破口处血流呈“往复征”，往复征频谱的探测点有助于确定加压治疗的体外压迫点；3．交替使用低频、高频探头观测动脉瘤二维及频谱能提高诊断符合率及敏感度。结论 彩色多普勒超声对动脉瘤能无创、敏感地得到诊断，有较高的特异性，并可协助临床治疗，具有重要价值。     

主动脉夹层动脉瘤的螺旋CT诊断

目的：评价主动脉夹层动脉瘤的螺旋CT表现及诊断价值。方法：选择16例主动脉夹层动脉瘤患者共进行32人次螺旋CT检查．层厚5～10mm，螺距1～1．5。对其螺旋CT影像的征象进行分析。结果：显示钙化移位5例(31．3％)，显示真假腔13例(81．3％)，其中4例(25％)真腔明显较假腔变窄；内膜破裂显示7例(43．8％)；显示撕裂内膜片11例(70％)；附壁血栓显示3例。结论：螺旋CT是评价和诊断主动脉夹层动脉瘤有效检查方法。     

彩色多普勒超声诊断腹主动脉夹层动脉瘤

目的　应用彩色多普勒超声诊断腹主动脉夹层动脉瘤。方法　应用彩超测量腹主动脉内径 ,观察腹主动脉及其分支内膜分离的部位和范围 ,以及鉴别真假腔。结果　内膜分离是本病最可靠的诊断依据 ,血流分隔现象、动脉扩张和管腔内血栓等具有重要的辅助诊断价值。彩超能很好地鉴别真假腔和诊断夹层动脉瘤破裂。结论　彩超能正确地评价本病受累血管 ,是诊断腹主动脉夹层动脉瘤的一种较为可靠的影像检查方法。     

多层螺旋CT血管成像在主动脉夹层动脉瘤的应用

目的探讨多层螺旋CT血管成像（MSCTA）在主动脉夹层动脉瘤的诊断和临床治疗中的应用价值。方法15例夹层动脉瘤均进行了多层螺旋CT（MSCT）胸腹联合平扫及增强并将原始数据在SGI工作站进行多平面重建（MPR）、阴影表面显示（SSD）、最大密度投影（MIP）及容积处理（VR）等后处理。结果15例均很好地显示了主动脉全程及其分支，真腔、假腔、内膜片及夹层动脉瘤的部位、范围得到满意显示。结论MSCTA是诊断夹层动脉瘤准确、快捷、有效的首选检查方法，具有较高的临床应用价值。     

儿童遗传性心律失常的诊治进展

回顾在遗传性心律失常领域最新发表的相关研究,主要关注与儿童心源性猝死关系密切的离子通道病,包括长QT综合征（LQTS）、短QT综合征（SQTS）、Brugada综合征（BrS）和儿茶酚胺敏感性多形性室性心动过速（CPVT）,总结它们在发病机制及诊治方面的进展。     

The acoustic characteristics of the skull

Many investigators have stated that the difficulties of imaging with acoustical energy through the skull result from the marked attenuation of the energy by the skull. In the literature measurements of total attenuation have been confused with those for absorption.Measurements made by us show that absorption by compact bone varies between 2–3 dB cm^?1 MHz^?1 and, in the low megaHertz region appears to be directly proportional to frequency.It has also between shown that the convoluted inner surface of the ivory bone of the inner table of the skull may degrade the collimation and directionality of the beam by refraction.Cancellous bone, such as is present in the dipole of the skull, greatly attenuates the energy. It is postulated that this largely results from scattering. It is also postulated that the energy propagates through cancellous bone as two components, one in the soft tissues and the other partly in the bony spicules. Observations suggest that attenuation due to scattering much more markedly affects the latter of these components and scatters more greatly the higher frequencies in a pulse of broad bandwidth.The energy in each component has varying propagation paths so that the later cycles in the pulse of each component are subject to increasing interference as a result of the variations in propagation times. The two components moreover may have different propagation times so that interference may occur between the pulses of each component as well.All of these phenomena degrade the collimation, coherence, directionality, beam width, pulse length, frequency and other properties of the ultrasonic energy upon which imaging through the skull depends.The interference effects described above are least for the first cycle in the pulse which usually is not the cycle of highest amplitude. Since, in the free field, most of the energy is concentrated around the beam axis, most of the energy in the field which is deflected from its normal propagation path is deflected away from the beam axis. Thus the directionality of the beam is least degraded in the beam axis. The effects of the skull in degrading the properties of the ultrasonic pulse would therefore be lessened if the amplitude of the first cycle of the pulse and the directionality of its energy could be used for imaging.     

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.     

2017年呼吸疾病主要进展

2017年,国内外学者在呼吸系统疾病的临床和基础领域均进行了深入研究,不仅对相关指南进行了更新,并且针对一些临床热点、难点问题达成专家共识,现就2017年呼吸疾病相关进展作一简单介绍。     

家族性噬血细胞性淋巴组织细胞增生症1例并文献复习

目的加强对家族性噬血细胞性淋巴组织细胞增生症（familially hemophagocytic lymphohistiocytosis,FHL）的认识。方法报道确诊为FHL的新病例1例,结合国内外报道的FHL的病例,对该病的临床特点进行汇总分析。结果FHL2常与PRF1基因突变相关,约20%~40%的患者存在穿孔素基因突变。结论对于有阳性家族史,基因诊断明确,应尽早行化疗或者造血干细胞移植。若无家族史,未发现与继发性HLH相关的原发病因,可考虑行基因筛查以明确是否存在FHL的可能。     

COVID‐19 and COVID‐19 vaccine‐related dermatological reactions: An interesting case series with a narrative review of the potential critical and non‐critical mucocutaneous adverse effects related to virus,therapy, and the vaccination

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.     

Burkitt's lymphoma of maxillary gingiva: A case report

Burkitt's lymphoma(BL) is an aggressive form of nonHodgkin's B-cell lymphoma with three variants namely endemic, sporadic, and immunodeficiency-associated types. It is endemic in Africa and sporadic in other parts of the world. While the endemic form is widely reported to occur in early childhood and commonly involves the jaw bones, the sporadic form typically presents as an abdominal mass. This presentation reports a rare case of sporadic form of BL clinically manifesting as a generalized gingival enlargement in an immunocompetent adult male which demonstrated an aggressive behavior. The patient reported with a prominent anterior gingival swelling of 6 mo duration which slowly enlarged in size and associated with multiple lymph node involvement. Microscopic examination of the lesion using H, E and immunohistochemical diagnosis confirmed the diagnosis as BL. The patient succumbed to the disease before any therapy could be instituted. Since a wide array of causes can be attributed to gingival enlargements, it is necessary to consider malignancies as one of the important differential diagnosis so as to facilitate the need for appropriate diagnosis and prompt treatment.     

Real‐life effectiveness of biological therapies on symptoms in severe asthma with comorbid CRSwNP

BackgroundWe aimed to evaluate the effectiveness of different antibody therapies on nasal polyp symptoms in patients treated for severe asthma.MethodsWe performed a retrospective analysis of patients with severe asthma and comorbid CRSwNP who were treated with anti‐IgE, anti‐IL‐5/R or anti‐IL‐4R. CRSwNP symptom burden was evaluated before and after 6 months of therapy.ResultsFifty patients were included hereof treated with anti‐IgE: 9, anti‐IL‐5/R: 26 and anti‐IL‐4R: 15 patients. At baseline median SNOT‐20 was similar among groups (anti‐IgE: 55, anti‐IL‐5/R: 52 and anti‐IL‐4R: 56, p = 0.76), median visual analogue scale (VAS) for nasal symptoms was 4, 7 and 8 (p = 0.14) and VAS for total symptoms was higher in the anti‐IL‐4R group (4, 5 and 8, p = 0.002). After 6 months SNOT‐20 improved significantly in all patient groups with median improvement of anti‐IgE: −8 (p < 0.01), anti‐IL‐5/R: −13 (p < 0.001) and anti‐IL‐4R: −18 (p < 0.001), with larger improvement in the anti‐IL‐4R group than in anti‐IgE (p < 0.001) and anti‐IL‐5/R (p < 0.001) groups. VAS nasal symptoms improved by median anti‐IgE: 0 (n.s.), anti‐IL‐5/R: −1 (p < 0.01) and anti‐IL‐4R: −3 (p < 0.001), VAS total symptoms by anti‐IgE: −1 (n.s.), anti‐IL‐5/R: −2 (p < 0.001) and anti‐IL‐4R: −2 (p < 0.001).ConclusionsTreatment by all antibodies showed effectiveness in reducing symptoms of CRSwNP in patients with severe asthma, with the largest reduction observed in anti‐IL‐4R‐treated patients.     

Recalcitrant giant orf recurrence after amputation: A case report and review of the literature

Orf is caused by a parapoxvirus. We present a recurrent, giant digital orf case in a female patient with a history of hairy cell leukemia. In spite of shave excision, the lesion progressed and recurred after digital amputation. Treatment with topical imiquimod cream and systemic subcutaneous interferon alfa‐2a was successful.