高频超声诊断流行性腮腺炎的临床价值

目的 探讨流行性腮腺炎的二维声像图特点、彩色多普勒表现，以及该病的超声诊断价值。方法应用高频超声对临床诊断的53例流行性腮腺炎患者受侵腺体及周围淋巴结软组织进行探查，观察其二维及彩色多普勒声像图表现。结果二维图像见受侵腺体不同程度弥漫性肿大，腮腺内多发性低回声结节，腺体周围淋巴结不同程度增大。彩色多普勒见受侵腺体内血流增多，流速增快，阻力指数减低。结论流行性腮腺炎的声像图表现具有特征性，高频超声对本病的诊断、鉴别诊断和治疗效果的动态观察有重要价值。     

男性乳腺发育症的高频彩超表现

目的分析男性乳腺发育症高频彩色多普勒超声声像图特点，以提高对该病的认识水平和鉴别诊断能力。方法分析经高频彩色多普勒超声检查诊断为男性乳腺发育症并经术后或活检病理检查证实的21例男性乳腺发育症。结果男性乳房发育症高频彩色多普勒超声声像图表现为乳头下方或乳晕周围可见腺体回声，多呈盘状或结节状，边界清楚，低回声为主，光点分布欠均，血流不丰富，偶见少许血流信号，与乳腺癌声像鉴别要点在发病部位、病灶形态和血供方面有明显不同。结论男性乳腺发育症声像图表现典型，诊断多无困难，主要需与乳腺癌鉴别。     

猫抓性淋巴结炎的超声诊断

目的 探讨猫抓性淋巴结炎的超声诊断方法。方法 对7例猫抓性淋巴结炎的声像图表现进行分析。结果 猫抓性淋巴结炎的声像图特征为：(1)淋巴结肿大呈融合状；(2)肿大的淋巴结呈靶样改变；(3)淋巴结境界较清晰，有包膜；(4)彩色超声显示符合淋巴结炎的血流变化。结论 猫抓性淋巴结炎的声像图特征虽无特异性，但结合病史超声检查可为临床提供有价值的诊断。     

高频彩超对男性乳腺增生症的诊断分析

目的探讨男性乳腺增生症高频彩超声像图特点,研究超声对该病的诊断及鉴别诊断价值。方法应用高频彩色多普勒超声诊断仪,探头频率7.5 M～13 MHz,测量增生的乳腺腺体厚度,观察内部回声、血流及与周围组织的关系,并与病理或临床诊断对照分析。结果超声诊断男性乳腺发育症30例,乳腺癌及纤维瘤2例,与病理或临床诊断相符28例,误诊4例,超声诊断准确率87.5%。男性乳腺发育症声像图特点：乳头下方腺体增厚,边界欠清,无包膜,呈弥漫性稍强回声或盘状、结节状低回声,未见或可见少许血流信号。结论高频彩超对男性乳腺增生症的诊断准确、简便,并可与多种男性乳腺疾病鉴别,为临床诊断提供重要依据。     

高频彩超在小儿肠系膜淋巴结肿大疾病鉴别诊断中的临床价值

目的探讨高频超声在小儿肠系膜淋巴结肿大疾病鉴别诊断中的价值。方法对经过临床确诊的116例病因不同的肠系膜淋巴结肿大患儿，根据病因分为6组，分别对每组高频超声检查后的声像图资料进行分析，包括肠系膜淋巴结的大小、分布、形态、包膜、内部回声及彩色多普勒血流（CDFI）情况等特点作出归纳。结果116例肠系膜淋巴结肿大的患儿中，单纯性肠系膜淋巴结炎67例，超声检出64例，超声诊断符合率95．5％；急性肠炎26例，超声检出22例，超声检出符合率84．6％；阑尾炎13例，超声检出11例，超声检出符合率84．6％；肠套叠5例，彩超检出4例，超声检出符合率80．0％；淋巴结核3例，恶性淋巴瘤2例，彩超均全部检出，超声检出符合率均为100．0％。结论高频彩超对小儿肠系膜淋巴结肿大疾病的鉴别诊断准确率高，对临床治疗具有指导作用，可作为小儿肠系膜淋巴结肿大疾病疑似患儿的首选检查手段。     

高频超声发现颈部淋巴结肿大对诊断流行性腮腺炎的意义

目的探讨高频超声发现颈部淋巴结肿大对诊断流行性腮腺炎的临床意义。方法对2012年2~8月临床拟诊为流行性腮腺炎的152例患儿进行高频超声检查,并与30例非流行性腮腺炎患儿的超声声像图进行对比,分析腮腺及颌下腺大小、形态及内部回声的改变和颈部淋巴结肿大情况。结果152例流行性腮腺炎患儿中有134例(88.2%)发现腮腺和颈部淋巴结肿大;其中74例(48.68%)仅表现为颈部淋巴结肿大。声像图特点为:淋巴结形态规则,常呈椭圆形(似肾形),边界较清晰,横径>1,纵径>0.5,纵横比<1,皮髓质分界清楚。结论在流行性腮腺炎发病早期腮腺组织尚未发生病变时,通过发现颈部淋巴结肿大并结合临床症状及实验室检查,可作为腮腺炎早期临床诊断依据,为流行性腮腺炎早隔离、早治疗提供参考。     

超声诊断亚急性甲状腺炎的临床价值

目的 探讨超声检查对诊断亚急性甲状腺炎及指导其治疗的临床价值。方法 超声观察36例临床拟诊亚急性甲状腺炎的二维声像图改变，并用彩色多普勒观察腺体病灶内血流情况。结果 亚急性甲状腺炎声像图表现为不同程度的腺体增大，病灶区呈多发片状或散在小片状低回声区，也可为孤立低回声结节，病灶内血流增多。治疗后病灶缩小消失，血供减少。结论 超声检查对诊断亚急性甲状腺炎有较大的临床应用价值，并可为指导临床治疗提供客观依据。     

双侧甲状腺癌的超声诊断分析

目的：探讨双侧甲状腺癌的二维及彩色多普勒超声表现。方法：对16例双侧甲状腺癌患者进行常规二维高频超声及彩色多普勒超声检查，观察其声像图特征及血供特点，并经手术后病理证实。将超声检查结果与病理结果对照分析。结果：双侧甲状腺癌具有特征性超声表现，包括肿块内部呈低回声；肿块边缘无包膜；内部出现微小钙化灶；后方回声衰减；肿块血流供应丰富；动脉血流呈高阻力信号；颈部淋巴结肿大。结论：常规二维高频超声及彩色多普勒超声检查对双侧甲状腺癌的检出有重要的诊断价值，为术前准备提供可靠的依据。     

高频超声检查对弥漫型甲状腺癌的诊断价值

①目的 探讨弥漫型甲状腺癌的声像图特征。②方法 观察6例经手术病理证实的弥漫型甲状腺癌的超声表现。③结果 声像图表现为：甲状腺大，轮廓尚清晰，病变呈弥漫分布，可累及甲状腺大部，病变内回声呈弥漫增强，伴多发砂粒状钙化，部分病变内见斑片状低回声。彩色多普勒血流显像示低回声区内血流较丰富，其余部分血流无明显增多。④结论 高频超声检查有助于弥漫型甲状腺癌的诊断及鉴别诊断。     

高频彩超在小儿腋窝淋巴结结核诊断中的价值

目的探讨高频超声诊断小儿腋窝淋巴结结核的临床价值。方法回顾分析51例经手术后病理证实淋巴结结核的超声声像图特征及随访手术后的病理诊断,进行对照分析。结果 51例小儿腋窝淋巴结结核患者中肿大的淋巴结有139个,大部分呈单个或散在分布,少部分融合成团,病变大部分局限在左腋下,病变早期多为均质低回声,随着病变的进展,病变内部回声可有液化、钙化等不同的声像图表现,CDFI显示病变区血流较少。病理结果全部为淋巴结结核。结论高频彩超对诊断小儿腋窝淋巴结结核具有重要的临床价值。     

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.