彩色多普勒超声在布-加综合征诊断及分型中的价值

目的:探讨彩色多普勒超声在布-加综合征(BCS)诊断及分型中的应用价值。方法:51例经下腔静脉造影或手术证实的BCS患者,分析其彩色多普勒超声直接和间接征象,并根据肝段下腔静脉和(或)肝静脉的阻塞情况进行分型。结果:51例BCS中,下腔静脉型22例,肝静脉型9例,混合型16例,漏诊4例,超声诊断符合率92.2%(47/51),超声分型与血管造影或手术诊断一致。直接征象表现为肝静脉和(或)下腔静脉隔膜或纤维性狭窄、闭塞或栓塞;而肝尾叶增大、肝内交通支和下腔静脉侧支是重要的间接征象。超声漏诊4例均为下腔静脉型,与诊断意识不足和超声成像的局限性有关。结论:彩色多普勒超声有助于明确布-加综合征诊断和分型,可作为临床首选的检查方法。     

彩色多普勒超声对巴德-吉亚利综合征的诊断价值分析

目的分析布加氏综合征患者应用彩色多普勒超声检查的价值。方法选取2018年4月至2019年3月在我院接受布加氏综合征诊治的113例患者为研究对象,为所有患者提供彩色多普勒超声检查,分析彩色多普勒超声诊断结果和彩色超声影像检查结果。结果 4例外源性肝肿瘤压迫造成下腔静脉狭窄,占3.5%,7例下腔静脉血栓形成,占6.19%,16例肝段下腔静脉闭塞型,占14.2%,15例肝静脉合并下腔静脉病变,占13.3%,43例肝段下腔静脉狭窄型,占38.0%,15例下腔静脉隔膜阻塞型,占13.3%,13例单纯肝静脉阻塞型,占11.5%。7例患者由于脾脏重度肿大、门静脉高压以及大量腹腔积液误诊为肝硬化,误诊率为6.2%,诊断准确率为93.8%。结论彩色多普勒超声检查能够使布加氏综合征的血管阻塞范围、程度、部位以及侧支循环得到充分显示,而且超声检查具有收费低、可重复以及无创等优点,能够作为布加氏综合征诊断的主要诊断方式。     

彩色多普勒超声在布加氏综合征诊断中的临床应用

目的探讨布加氏综合征的彩色多普勒超声特征及诊断价值。方法回顾性分析23例由彩色多普勒超声诊断的并经下腔静脉造影或手术证实的布加氏综合征患者的超声图像特征。结果23例中,22例为下腔静脉肝段梗阻,1例为肝静脉狭窄、尾叶肿大压迫使下腔静脉变细。结论彩色多普勒对布加氏综合征的诊断有重要意义。     

彩色多普勒超声对布-加综合征的诊断价值

目的探讨彩色多普勒超声对布-加综合征的诊断价值。方法应用二维超声图像和彩色多普勒超声血流特点对32例布-加综合征的血流形态特点进行统一诊断分析,并根据不同表现进行分型。结果32例患者中,9例为肝静脉阻塞型,20例为下腔静脉阻塞型,3例为混合型。二维声像图表现为肝静脉和／或下腔静脉不同程度狭窄或闭塞,肝静脉间交通支形成,彩色多普勒表现为肝静脉、下腔静脉内血流变细呈花色或无血流通过。结论彩色多普勒超声可以明确布-加综合征血管病变的部位、范围及类型,准确反映下腔静脉、肝静脉及门静脉的血流方向及流速,可为临床提供可靠的诊断治疗依据。     

彩超对布加氏综合征血管病变的诊断价值

目的探讨彩色多普勒超声对布加综合征血管病变的诊断价值。方法彩超探测布加氏综合征44例,并经临床及其它影像学检查证实。结果肝静脉阻塞或闭塞（Ⅰ型）5例,下腔静脉阻塞或闭塞（Ⅱ型）35例,肝静脉和下腔静脉混合病变（Ⅲ型）4例。其中显示肝静脉交通支18例,副肝静脉9例。结论狭窄段高速、平坦、单向血流,是诊断本病的最直接的证据,肝静脉交通支及扩张的副肝静脉是血管闭塞可靠的间接依据。彩色多普勒可作为诊断布加氏综合征的首选方法 。     

彩色多普勒超声对Budd-Chiari综合征的诊断价值

[目的]探讨彩色多普勒超声对Budd-Chiari综合征（BCS）的诊断价值。[方法]回顾分析我院2001-2006年经下腔静脉造影证实的22例BCS的彩色多普勒超声表现。[结果]15例下腔静脉膜性阻塞,5例下腔静脉血栓性阻塞,2例单纯肝静脉阻塞。彩色多普勒超声对其中21例作出正确诊断,漏诊1例,诊断符合率为95%。[结论]彩色多普勒超声可以准确诊断病变的位置、性质以及程度,而且具有无创、简便、价廉、无辐射等优势,可以作为本病的首选影像诊断方法。     

彩色多普勒超声在诊断布-加综合征中的应用价值

目的探讨不同类型布-加综合征(BCS)患者的彩色多普勒声图像特征及其诊断价值。方法回顾性分析48例经血管造影或手术证实的BCS患者,对其二维及彩色多普勒声像图特征进行分析和比较,并计算超声诊断的准确率。结果 48例BCS中,超声诊断准确率91.7%(44/48),其中肝静脉型8例,下腔静脉型21例,混合型15例。副肝静脉、右后下肝静脉和腰升静脉是常见的侧支循环通路。肝尾状叶增大是BCS最多见的间接征象(42/48)。结论彩色多普勒超声可以准确诊断不同类型BCS,在侧支血管检出方面优势明显,可作为诊断此病的首选影像学检查方法。     

彩超对布加氏综合征的诊断与误诊分析

目的探讨结彩超对布加氏综合征的诊断价值。方法应用彩色多普勒超声对31例布加氏综合征的超声表现特征及诊断结果进行分析,并对误诊原因进行探讨。结果下腔静脉阻塞型22例,肝静脉阻塞型9例,全部经院外血管造影或手术确诊。下腔静脉阻塞型组,B超诊断17例（77.2%）,彩超诊断22例（100%）;肝静脉阻塞型组,B超诊断1例（11.1%）,彩超诊断6例（66.6%）。B超诊断符合率58.1%,彩超诊断符合率90.3%。结论彩色多普勒超声可准确提供血管阻塞的部位、范围、类型、原因、梗阻程度及有否侧枝循环建立,对临床尽快明确诊断、选择治疗方法和疗效观察等具有重要价值,可作为基层医院诊断布加氏综合征的首选方法。     

彩色多普勒血流显像在诊断布加综合征中的临床应用

目的 前瞻性探讨彩色多普勒血流显像(CDFI)在诊断布加综合征(BCS)中的临床应用价值.方法 经造影证实BCS患者19例,将其术前1周内的CDFI检查结果与造影结果进行对照研究,观察和总结CDFI诊断BCS的表现及特征.结果 经造影证实的19例BCS中,单纯肝静脉阻塞7例,肝静脉和下腔静脉同时阻塞12例,CDFI正确诊断19例,诊断符合率为100%.结论 CDFI诊断BCS准确率较高,将成为诊断BCS重要的无创伤性检查方法.     

Budd-Chiari综合征的彩色多普勒超声诊断

目的探讨彩色多普勒超声对布-加综合征(Budd-Chiari Syndrome,BCS)的诊断价值。方法回顾性分析经临床及其它影像检查证实的21例布-加综合征的二维超声表现及血流变化特点。结果肝静脉病变(Ⅰ型)5例,下腔静脉病变(Ⅱ型)14例,肝静脉和下腔静脉混合病变(Ⅲ型)2例。彩色多普勒超声检测出19例,漏诊2例,诊断准确率90.5%。结论彩色多普勒超声对布-加综合征能做出非常准确的诊断,具有重要的临床意义及价值。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.