彩色多普勒超声对肱骨外上髁炎的诊断价值

目的利用彩色多普勒超声检查(CDUS)观察肱骨外上髁炎(LE)患者肘关节外上髁的超声表现,评价CDUS对LE的诊断价值。方法对27例临床诊断为LE患者的27个患侧肘关节和18例对照者25个正常肘关节行超声检查,观察肱骨外上髁伸肌总腱的厚度、内部回声、有无钙化、撕裂以及内部血流情况,肱骨外上髁骨质是否光整、有无毛糙,并进行对比分析。结果对照组伸肌总腱平均厚度约(0.40±0.06)cm,LE组伸肌总腱平均厚度约(0.56±0.13)cm,较对照组明显增厚,差异有统计学意义(t=-5.43,P<0.01)。病变伸肌总腱回声减低,内部可有钙化或撕裂,彩色血流信号较对照组明显增多。肱骨外上髁骨皮质回声毛糙、不光整。结论 CDUS对肱骨外上髁炎具有一定的诊断价值,在临床应用中可作为诊断肱骨外上髁炎的首选检查方法。     

阴道超声造影与宫腔镜在子宫内膜息肉诊治中的应用

目的评价经阴道超声宫腔造影及宫腔镜对子宫内膜息肉的诊治价值。方法对32例腹部B超和阴道超声发现子宫内膜不规则增厚患者进行阴道超声宫腔造影,然后行宫腔镜检查和治疗,取病变组织送病理检查,以宫腔镜和病理检查结果为诊断标准。结果32例腹部B超和阴道超声诊断子宫内膜增厚疑子宫内膜息肉者,经阴道超声宫腔造影诊断28例子宫内膜息肉,宫腔镜诊治最后病理确诊26例子宫内膜息肉。经阴道超声宫腔造影对子宫内膜息肉的诊断明显优于常规阴道超声,其诊断的准确性略低于宫腔镜。结论阴道超声宫腔造影是诊断子宫内膜息肉的一种无创、安全、简便且准确性高的检查方法,与宫腔镜联合应用可达到较好的诊治目的。     

子宫内膜异位症超声评估中国专家共识

子宫内膜异位症(简称内异症)是指子宫内膜组织(腺体和间质)出现在子宫体以外的部位, 其与子宫腺肌病统称为子宫内膜异位性疾病[1]。内异症是育龄期妇女常见的慢性疾病, 其主要临床症状为疼痛与不孕, 明显影响患者的生活质量, 及早诊断对该病的早期治疗具有重要临床意义。超声检查是内异症诊断、治疗及随访的主要影像学手段, 但不同级别医院超声医师在评估时仍存在检查不规范、对内异症复杂性认识不足、漏误诊较多, 以及对深部浸润型内异症病变检出率较低等诸多问题。虽然中华医学会妇产科学分会子宫内膜异位症协作组已发表《子宫内膜异位症的诊治指南》第三版[2], 但该临床指南未涉及相关超声检查规范。为此, 中华医学会超声医学分会妇产超声学组组织国内有关专家, 针对内异症超声检查常见问题, 经过反复讨论, 参考相关文献及国外共识与指南, 并结合国内临床实践, 形成本共识, 旨在促进超声医师更加全面且规范地进行内异症的超声检查与评估。     

457例红斑狼疮患者狼疮带试验结果与临床分析

红斑狼疮（lupus erythematosus,LE）是一种多见于15-40岁女性、临床表现多样、可累及全身多器官系统的自身免疫性疾病。典型的LE诊断并不困难,但常有一些不典型的病例,以某一系统受累为主,如果不提高认识就会误诊,失去早期治疗的机会,而且这种不典型的LE也常是临床中难做出诊断的一组疾病。狼疮带试验（lupus band test,LBT）特异性高,有助于LE的诊断及鉴别,     

经阴道彩色多普勒超声诊断子宫切口妊娠的临床应用价值分析

将我院进行子宫切口妊娠诊治的90例患者随机分成对照组和观察组。对照组经腹部彩色多普勒超声诊断方式,观察组经阴道彩色多普勒超声诊断方式。诊断后,与术后病理学检查结果进行比较,包括比较两组患者的诊断符合率以及超声分型结果。结果观察组诊断符合率为91.11%,对照组为75.56%,观察组高于对照组(P0.05);观察组超声分型结果准确率为100.00%,且高于对照组的66.67%(P0.05)。经阴道彩色多普勒超声诊断子宫切口妊娠具有较高的准确性、可行性,且能有效提高诊断的准确率,值得推广。     

异位妊娠的超声诊断及其临床意义

受精卵种植在子宫体腔以外部位的妊娠,称为异位妊娠.随着盆腔炎症的增多,近年来国内外报道异位妊娠率有上升趋势,其发病率据国内统计,异位妊娠与总妊娠比例为1:50～1:43.但由于诊断及治疗技术的进步,尤其是腔内超声的普及,为临床提供了早期诊治异位妊娠的新途径.本病发生在育龄妇女中,因孕卵种植位置的不同,可分为输卵管妊娠、卵巢妊娠、宫颈妊娠、残角子宫妊娠、腹腔妊娠等[1].作者对本院2001年4月至2010年5月期间经超声诊断结合人绒毛膜促性腺激素(HCG)检测诊断的183例异位妊娠病例进行回顾性分析,旨在探讨超声对异位妊娠的临床诊断价值.     

乳腺导管内乳头状瘤的超声诊断及误诊分析

乳腺导管内乳头状瘤的诊断以往多依据临床特点,如:乳头溢液、扪及小肿物且轻压可见乳头排出液体。随着超声检查在乳腺检查中的应用,对伴有导管扩张的乳腺导管内乳头状瘤超声诊断符合率较高,而单纯表现为腺体内低回声光团者,术前超声诊断符合率并不理想。     

联合经阴道超声检查与单纯经腹部超声检查对子宫腺肌病的诊断研究

探讨在子宫腺肌病诊断中采用经阴道与经腹部联合超声检查与单纯经腹部超声检查的诊断价值。对2015年12月~2016年12月我站诊治的74例经病理学检查证实为子宫腺肌病患者进行观察,先后采用经腹部超声检查、经阴道超声检查,观察两种检查方法的诊断准确率。经阴道与经腹部联合超声检查诊断准确率(87.84%)明显高于单纯经腹部超声检查(68.92%),有统计学意义(P0.05);联合检测的结果显示子宫血流量指标明显低于单独经腹部超声检测,且子宫动脉搏动指数及阻力指数明显更高(P0.05)。经阴道与经腹部联合超声检查对子宫腺肌病的检出情况明显优于单纯经腹部超声检查,提高了诊断准确率,为子宫腺肌病的诊断和下一步治疗方案提供诊断依据,具有较高的临床应用价值。     

卷首语

本期刊登的超声论文中,6篇集中在妇科疾病,1篇为女性腹盆腔结核。其中有关经阴道超声者4篇,1篇为超声造影分析诊断药物流产不全,另1篇则为卵巢畸胎瘤手术时,用术中探头探测对侧卵巢及周围脏器。上述超声诊断研究工作均与临床的需要密切结合,具良好效果及在诊治工作中的积极意义。     

心脏彩色多普勒超声诊断小儿先天性心脏病的临床价值研究

目的探讨心脏彩色多普勒超声诊断小儿先天性心脏病的临床价值。方法回顾性分析医院诊治的150例疑似先天性心脏病患儿的临床资料,均经手术病理学检查确诊,且术前接受了心脏彩色多普勒超声超声诊断,分析心脏彩色多普勒超声诊断患儿先天性心脏病的准确度、特异度、敏感度。结果与手术病理学检查相比,心脏彩色多普勒超声诊断准确度、特异度与敏感度差异无统计学意义(P 0. 05);心脏彩色多普勒超声诊断方法对本组患儿先天性心脏病的定性诊断准确性为97. 58%。结论心脏彩色多普勒超声诊断患儿先天性心脏病的临床价值显著,其诊断准确性、特异性、敏感性均较高。     

Participants' perceptions of dimensions of the therapeutic alliance over the course of therapy

The course of diverse dimensions of the therapeutic alliance as seen by the therapy participants was examined in two studies. In Study 1, use of the Penn Helping Alliance Method, Therapeutic Alliance Rating System, and Vanderbilt Psychotherapy Process Scale at the 3rd, 10th, and next-to-last therapy sessions revealed significant increases over time for therapists' mean scores on 5 of the 12 subscales. Consistency of participants' scores over time varied depending on rater perspective (therapist or client) and time interval. In Study 2, the Helping Alliance Questionnaire, Working Alliance Inventory, and California Psychotherapy Alliance Scales showed no significant change in participants' average alliance scores on the 9 subscales from the 5th to 10th sessions, and their same-scale ratings were in general consistent. Few differences were observed between therapists' and clients' average alliance ratings, but the relationship was generally perceived differently within dyads.     

Novel presentation of autoimmune polyglandular syndrome II in a child with simultaneous Addison's disease,type 1 diabetes,and Hashimoto's thyroiditis: A case report

Providers should remain vigilant of autoimmune polyglandular syndrome type II in the context of persistent low blood sugar in type I diabetes. Correction of adrenal insufficiency is key for regulation of blood sugar and thyroid function.     

Chronic Respiratory Diseases and Neurodegenerative Disorders: A Primer for the Practicing Clinician

Chronic respiratory disorders represent a world epidemic. Their incidence and prevalence in the world population is increasing, and especially among elderly subjects, they are commonly associated with other pathologies, often generating a status of high clinical complexity. Neurology, internal medicine, and pneumology specialists should be aware of the common background of these disorders in order to treat correctly the patient''s comorbid state and optimize the treatment considering potential overlaps. In this review, we aimed to focus on the relationships between chronic respiratory disorders and chronic neurodegenerative diseases at different levels; we review the shared risk factors and the interactions between disorders, the indications to explore respiratory function in neurodegenerative diseases, pathology-pathology and drug-pathology interactions in patients affected by both chronic neurologic and respiratory diseases.     

Multi-dimensional analysis on Parkinson’s disease questionnaire-39 in Parkinson’s patients treated with Bushen Huoxue Granule: A multicenter,randomized, double-blinded and placebo controlled trial

ObjectivesTo preliminarily assess the effects of Bushen Huoxue Granule (BHG) on Parkinson’s Patients with Parkinson’s Disease Questionnaire-39 (PDQ-39)and to provide data for further research.DesignA randomized, double-blinded, placebo controlled study with a 3-month intervention period and a 6-month follow-up.InterventionsParticipants were patients with Parkinson’s Disease (PD) of age ranging from 50 to 80 years and Hoehn and Yahr (H–Y) stage I–IV of the disease.120 participants were allocated to BHG group or placebo group at a 1:1 ratio. The BHG group received BHG twice a day for 3 months, and was followed-up for 6 months after treatment; the placebo group did not receive any Chinese Herb treatment for 9 months. All the patients were given the conventional therapy of levodopa (Madopar).Main outcome measuresPrimary outcome measure was PDQ-39 comprises 39 questions with five different options of answer related to the frequency of the disease manifestation.ResultsSignificant statistical difference appeared in the following PDQ-39 dimensions: mobility; emotional well-being; stigma; cognition (P < 0.01) and bodily discomfort (P < 0.05).There was no statistical difference in the dimensions of social support, ADL and communication between the data of these two group patients (P ≥ 0.05). We found that the sum index of PDQ-39 was significantly different between two groups.ConclusionThe results of this study show that BHG treatment makes significant effects in most domains of PD patients life quality,especially in mobility, emotional well-being, stigma and cognition. The affected factors should be confirmed in larger studies.     

A clinical case of Fournier’s gangrene: imaging ultrasound

Fournier’s gangrene is a rapidly progressing necrotizing fasciitis involving the perineal, perianal, or genital regions and constitutes a true surgical emergency with a potentially high mortality rate. Although the diagnosis of Fournier’s gangrene is often made clinically, emergency ultrasonography and computed tomography lead to an early diagnosis with accurate assessment of disease extent. The Authors report their experience in ultrasound diagnosis of one case of Fournier’s gangrene of testis illustrating the main sonographic signs and imaging diagnostic protocol.     

重复经颅磁刺激在神经退行性疾病中的应用进展

重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)是一项无创、安全、操作简便的神经调控技术,基础及临床研究显示,rTMS治疗精经精神疾病效果较好。神经退行性疾病是系统性疾病,药物效果较差,较难治疗。有研究显示,rTMS治疗神经退行性疾病初步显示较好的前景,因此,本文对rTMS调控神经退行性疾病的临床应用进行综述。