葡萄糖利尿作用对输尿管结石CDFI超声诊断的价值

目的：探讨彩色多普勒超声（CDFI）对输尿管结石的诊断价值。方法：采用口服50％葡萄糖溶液20ml，软水300－500ml，于30分钟后施行常规断面超声加压探头扫查法。结果：460例输尿管结石，均经彩色多普勒超声（CDFI）、X线平片、静脉肾盂造影及逆行输尿管造影等检查确诊。超声符合率94．78％（436／460），经手术治疗176例及中西医结合治疗自然排石284例，均获满意疗效。结论：应用50％葡萄糖溶液利尿作用对输尿管结石的（CDFI）超声诊断，具有一定的临床应用价值。     

彩色多普勒超声诊断输尿管结石的临床价值分析

目的探讨采用彩色多普勒超声检查输尿管结石的临床价值。方法对368例输尿管结石患者分别采用黑白B超与彩色多普勒超声检查,并分析各自的检出率。结果本研究368例输尿管结石患者共计检出379枚结石,其中位于输尿管上段、下段结石199枚,应用黑白B超检出197枚,检出率为98.9%;应用彩色多普勒超声检出198枚,检出率为99.5%。位于输尿管中段结石180枚,应用黑白B超检出89枚,检出率为49.4%;应用彩色多普勒超声检出153枚,检出率为85.0%。全部379枚结石应用黑白B超检出286枚,检出率为75.5%;应用彩色多普勒超声检出351枚,检出率为92.6%。对本研究位于输尿管上段、下段结石应用黑白B超与彩色多普勒超声检查技术检出输尿管结石的检出率比较差异无统计学意义(P>0.05),位于输尿管中段结石应用黑白B超与彩色多普勒超声检查技术检出输尿管结石的检出率比较差异有统计学意义(P<0.05),输尿管结石应用黑白B超与彩色多普勒超声检查技术检出输尿管结石的检出率比较差异有统计学意义(P<0.05)。结论采用彩色多普勒超声检查输尿管结石能显著提高输尿管结石的检出率,可作为临床诊断输尿管结石的首选方法。     

使用利尿剂对输尿管结石超声诊断的价值

目的：探讨超声显像对输尿管结石的诊断价值。方法：采用口服10％葡萄糖300～500ml,于30分钟后施行常规断面超声加压探头扫查法。结果：75例输尿管结石,均经超声显像检查,X光平片、静脉肾盂造影及逆行输尿管造影等检查确诊。超声诊断符合率94．66％(71／75)、X线平片诊断准确率81．33％(61／75)、静脉或逆行输尿管造影准确率86．66％(65／75)。经手术治疗32例,中西医结合治疗自然排石43例,均获满意疗效。结论：使用利尿剂对输尿管结石的超声诊断,具有一定的临床应用价值。     

二维超声及彩色多普勒血流显像对输尿管结石的诊断价值

目的 探讨二维超声及彩色多普勒血流显像(CDFI)对输尿管结石的诊断价值和对第二狭窄处结石的定位显示及非梗阻型结石的显像特征。方法 超声检查前饮水300～500ml或口服速尿(20mg)，于30min后施行超声检查，并与X线检查、体外震波碎石、腔内震波碎石、药物排石及手术病理进行对照，根据声像图特征进行回顾性分析。结果 368例输尿管结石，经X线检查、手术、体外震波碎石、腔内震波碎石和药物排石证实完全符合。第二狭窄处的结石与髂总动脉或髂外动脉的关系清晰可见。CDFI：结石周边呈五彩镶嵌的彩色尿流信号。结论 第二狭窄处结石可根据髂动脉准确定位。非梗阻型结石沿输尿管走行方向，借助其毗邻关系寻找可疑光团，用CDFI鉴别。因此，二维超声与CDFI联合应用，不仅可有效地检出各段输尿管结石，而且可以准确定位第二狭窄处结石和检出非梗阻型结石。     

结肠声窗诊断输尿管中段结石

输尿管中段结石(即输尿管腹段与盆腔段结石),仍为超声显象检查较困难病症。我室应用灌水法来充盈结肠作声窗行B超检查诊断输尿管中段结石共21例,男11例,女10例,年龄19至56岁。常规超声显象沿输尿管走向均不能显示输尿管中段结石者,行水灌肠,再B超探头沿被水充盈结肠液暗区作声窗显示两侧输尿管中段结石。20例输尿管中段结石均通过水灌肠后才能显示,1例漏诊因过度肥胖。结石在右侧输尿管中段8例,左侧输尿管中段结石12例,结石最大者15×8mm;最小者5×4mm。均与X线照片及病     

肌注黄体酮及速尿在B型超声检查输尿管结石中的应用

作者对４０例有明显肾绞痛及血尿患者，临床高度怀疑输尿管结石，应用普通Ｂ型超声检查输尿管显示不清或结石无法探及，采用肌注黄体酮２０ｍｇ＋速尿４０ｍｇ。３０分钟作者单位：２４６２００安徽省望江县医院功能科后再行Ｂ型超声检查。用药后肾绞痛缓解２０例，消失１...     

彩色多普勒超声在诊断输尿管结石中的应用

目的 应用彩色多普勒超声提高输尿管结石的诊断水平.方法 对142例(144个结石)输尿管结石患者行二维超声和彩色多普勒超声检查,利用彩色多普勒显像协助观察输尿管走行;在可疑结石强回声后方寻找"彩色快闪伪像"以确定结石的存在;通过观察输尿管末端喷尿多普勒信号变化判断其有无梗阻.结果 144个结石位于输尿管第一狭窄及第三狭窄处共计75个,二维B超与彩超均检出74个,检出率相同;介于第一狭窄与第三狭窄之间的结石病灶共计69个,B超检出率为46%(32/69),应用彩色多普勒超声后检出率提高到77%(53/69),两者比较有显著性差异(P<0.01);超声未发现结石的17例患者,有11例显示输尿管末端喷尿次数减少、信号减弱,综合其超声及临床表现,提出疑似结石诊断,后经临床及其他影像学检查证实.结论 彩色多普勒超声能显著提高输尿管结石的诊断水平.     

彩色多普勒闪烁征在泌尿系结石诊断中的价值

目的应用彩色多普勒超声提高泌尿系结石的诊断水平。方法对300例泌尿系结石患者行二维超声和彩色多普勒超声检查,利用彩色多普勒显像协助观察,在可疑结石强回声后方寻找彩色快闪伪像以确定结石的存在;通过观察输尿管末端喷尿多普勒信号变化判断其有无梗阻。结果肾结石(结石直径小于4mm,后方声影不典型)B超检出率为90%,应用彩色多普勒快闪征检出率提高到100%,对输尿管结石位于第一狭窄及第三狭窄处二维超声与彩色多谱勒超声检出率相同。介于第一狭窄与第三峡窄之间的结石病灶B超检出率为45%,应用彩色多普勒超声后检出率提高到73%,两者比较差异有统计学意义(P<0.05)。超声未发现的8例患者,有6例显示输尿管末端喷尿次数减少,信号减弱,综合其超声表现、患侧肾盂集合系统分离程度及临床表现,提出疑似诊断,后经临床及其他影像学检查证实。结论彩色多普勒超声能显著泌尿系结石的诊断水平,充分利用彩色多普勒闪烁伪像,通过体外检查基本可达到对体内结石的定位诊断。     

腹部B超联合阴道B超对妇产科急腹症的诊断研究

目的：探讨腹部B超联合阴道B超对妇产科急腹症的诊断价值.材料与方法：本研究选取2013年3月～2014年3月期间我院收治妇产科急腹症患者90例,所有患者均行腹部B超和阴道B超检查,比较联合联合使用与单独使用对疾病诊断符合率.结果：单独使用腹部B超的符合诊断率为71.1％,单独使用阴道B超的符合诊断率为90％,联合使用两种方法的符合诊断率为100％,联合使用两种方法的诊断率较单独使用任何一种明显高,差异具有统计学意义（P＜0.05）.结论：单独使用腹部超声或者阴道超声,由于各有利弊,可能造成误诊或漏诊情况,联合应用两种超声检查方法能够显著提高对妇科急腹症的诊断的准确性.     

输尿管结石324例B超诊断分析

目的探讨B超在输尿管结石诊断中的实际价值。方法患者充盈膀胱后B超对输尿管检查诊断。结果 324例输尿管结石患者均经体外碎石及药物排石证实诊断。结论应用B超检查,能确诊输尿管结石的大小及部位,可作为诊断输尿管结石检查的首选方法。     

Relative effects of pregnancy, estradiol, and progesterone on plasma insulin and pancreatic islet insulin secretion

Influences of estrogen and progesterone on the development of hyperinsulinemia and augmented pancreatic islet insulin secretion during pregnancy were assessed in this study. Groups of female rats were injected subcutaneously for 21 days with varying daily dosages of estradiol benzoate or progesterone in oil. On day 21, pancreatic islets were isolated by a collagenase method. Total insulin secretion was measured after 90-min incubations of 10 islets in buffered medium containing glucose. Higher physiologic dosages of estradiol or progesterone, singly or in combination, significantly increased islet secretion above values of untreated control rats and were comparable to augmented islet responses of term, 3-wk pregnant rats. Diameter and protein content of islets obtained from steroid-treated and pregnant rats exceeded control measurements in these instances. However, 2-hr preincubations of control islets with 1 or 10 mug/ml of either steroid did not influence subsequent glucose-stimulated insulin output.In related studies, plasma insulin responses during 30 min intravenous glucose tolerance tests were significantly above control responses in term-pregnant rats and animals receiving comparable dosages of steroids for 3 wk. Unlike pregnancy or progesterone treatment, estradiol administration alone or with progesterone significantly lowered postchallenge plasma glucose concentrations.These results indicate that estradiol and progesterone contribute to enhanced islet insulin secretion and plasma insulin responses to glucose administration during pregnancy. This change is not acutely produced but can be related to hypertrophy of islets following chronic hormonal administration. Although the data do not distinguish between direct and indirect beta-cytotrophic effects of these sex steroids, metabolic actions of estradiol and progesterone may differ, since estrogen treatment lowers plasma glucose curves following the induction of hyperinsulinemia.     

清开灵与其他药物的配伍反应观察

目的 观察清开灵与其他药物配伍使用时其药液颜色及混浊度变化。方法 将清开灵20ml加入5％葡萄糖250ml中。接一次性输液器,分别用诺氟沙星等7种液体及氨甲苯酸等12种(已用5％葡萄糖250ml稀释)液体换下清开灵溶液,以及分别将雷尼替丁等6种药物从含清开灵溶液的莫菲式滴管内注入;将清开灵40ml加入5％葡萄糖250ml中,重复上述实验;以清开灵原液1ml与上述25种药物原液1ml混合分别观察药液颜色及混浊度变化。结果 含清开灵20ml的葡萄糖液与诺氟沙星和氨茶碱相遇分别出现混浊或变色：含清开灵40ml的葡萄糖稀释液与诺氟沙星、氨茶碱和川芎嗪相遇分别出现混浊或变色;清开灵原液与诺氟沙星、氨茶碱、川芎嗪、氨甲苯酸和肌苷相遇分别出现沉淀或变色。结论 清开灵与某些药物配伍时,应注意药物间的相互反应。     

External quality control of the laboratory determination of glucose in the urine and material for its realization

Urine of diabetics without concomitant diseases with a certain concentration of glucose was collected for preparing reference material. Water saturated with phenol (872 mmole/liter) was added to urine pool during intensive stirring on a magnetic stirrer at 20 degrees C, so that the final concentration of phenol were 50 mmole/liter. Glucose content in the resultant reference material remained stable for 130 days at 18-20 degrees C. For glucose measurements, 2 ml reference material and 0.5 ml 2.5 M sodium oxide hydrate are put in centrifuge tubes, stirred, put on boiling water bath for 2 min, cooled, and colorimetried in cuvettes with 1-mm optic route. The content of monosaccharide is calculated using the proportion rule in comparison with the values for 139 mM reference glucose solution in control urine.     

血清孕酮对异位妊娠的诊断价值探讨

目的 :对血清 β-hCG <15 0 0mIU/ml的患者进行血清P测定 ,探讨血清P对异位妊娠的诊断价值。方法 :通过对 1999年 6月～ 2 0 0 1年 12月因停经 /腹痛 /阴道流血来我院就诊的尿妊娠试验阳性的患者进行血清 β -hCG及血清P测定 ,对 β -hCG <15 0 0mIU/ml的患者进行随访并依据妊娠结果分为NIUP ,EP ,AB 3组 ,并进行回顾性分析。结果 :10 6位患者 β -hCG<15 0 0mIU/ml,其中EP4 7例 ,NIUP31例 ,AB2 8例。EP患者血清P平均值明显低于NIUP患者 (P <0 .0 1) ,而在EP和AB间无明显差异 (P >0 .0 5 )。以EP血清P第 90百分位数为临界值 (P90 =9.0ng/ml) ,区分EP与NIUP的敏感性为91.5 % ,特异性为 90 .3% ,区分EP与AB的特异性为 2 1.7%。结论 :当β -hCG <15 0 0mIU/ml时 ,以血清P值 9.0ng/ml区分EP和NI UP有较高的敏感性和特异性 ,有一定诊断价值 ,但不能鉴别EP与AB。     

Potentiation of cholecystokinin-induced exocrine secretion by both exogenous and endogenous insulin in isolated and perfused rat pancreata.

Using an isolated perfused rat pancreas preparation, the interrelationship between the endocrine and exocrine portions of the pancreas were studied. Addition of exogenous rat insulin (1-20 mU/ml) to the perfusing solution potentiated the action of cholecystokinin (CCK) (1 mU/ml) to increase both pancreatic juice flow and the release of the enzyme, amylase. Raising the glucose concentration in the perfusing solution from 2.5 to 17.5 mM both increased endogenous insulin release and potentiated the CCK-induced exocrine secretory response. Two lines of evidence indicated that this effect of glucose on the exocrine pancreas was mediated by endogenous insulin release. First, the addition of comparable amounts of xylose or galactose to the perfusion medium neither released insulin nor potentiated the CCK-induced response. Second, epinephrine blocked the effect of high glucose on both insulin release and potentiation of CCK action. Epinephrine alone did not affect the action of CCK. The magnitude of the exocrine response induced by high glucose was comparable to that of 2.5 mU/ml exogenous insulin. It seems possible that pancreatic acinar cells can be exposed to insulin levels of this magnitude in situ.     

Tissue protection by verapamil in the calcium paradox

The effect of verapamil (+/- 2 mumol/l verapamil) on calcium paradox injuries, as well as on hearts subjected to calcium-free perfusion alone, was studied in isolated perfused rat hearts. Three different protocols for calcium depletion (5 min) were followed: 5 or 45 ml of nominally calcium-free solution (1 or 9 ml/min), or 45 ml of nominally calcium-free solution to which 20 mumol/l CaCl2 was added. Ultrastructural analyses showed that verapamil protects against cellular injuries upon readmission of calcium to hearts subjected to partial calcium depletion (5 ml calcium-free solution, or 45 ml to which 20 mumol/l CaCl2 was added) by reducing the number of affected cells. No protection was found after more extensive calcium washout. However, in all groups examined, we found an inverse relationship between the number of injured cells and ATP content. Verapamil protected against contracture development and reduced the increase in tissue calcium content observed after readmission of calcium to hearts perfused with 5 ml calcium free solution, whereas no significant effect of verapamil on tissue calcium content was found in hearts perfused with 45 ml nominally calcium-free solution. In hearts studied after calcium-free perfusion no effect of verapamil treatment on the separation of the intercalated disc was found. The protective effect of verapamil could not be explained by differences in calcium or cAMP levels after calcium-free perfusion.     

Significance of progesterone in the pathogenesis and treatment of pulmonary hypertension and cardiopulmonary failure

Study of blood progesterone and diurnal urine pregnanediol revealed that progesterone level substantially increased in the initial stage of cor pulmonale formation (in respiratory failure without heart decompensation). Meanwhile as heart insufficiency and pulmonary hypertension in patients with chronic nonspecific lung diseases augmented, blood progesterone and excretion of pregnanediol dramatically fell. Application of progesterone (2.5% solution, 2 ml i.m. once a day over a week) favoured an increase in pulmonary ventilation, improvement of myocardial contractility, and pressure drop in the pulmonary artery.     

Studies of secretin-stimulated insulin responses in man

Recent studies have suggested that secretin, like glucose, stimulates a rapid insulin response from a small storage pool. In order to evaluate the mechanism of the secretin-stimulated insulin response, small (15 U) rapidly administered intravenous injections (pulses) of secretin were given before, during, and after a 20 hr 300 mg/min glucose infusion. Contrary to previous studies demonstrating that the acute insulin response to a small (5 g) pulse of glucose given 45 min after the start of the glucose infusion was significantly diminished compared to the response to the preinfusion pulse, the acute insulin response (2-5 min Deltaimmuno-reactive insulin muU/ml) to 15-U secretin pulses exhibited a greater than twofold increase (before: 31.1+/-15.4; during: 71.2+/-40.4, muU/ml, mean +/-SD, P < 0.02). The increased response to secretin was also found after 20 hr of continuous glucose infusion, but was not observed 1 hr after cessation of the infusion when plasma glucose levels returned to control values. Thus, this increased response to secretin was glucose dependent.Four 150-U secretin pulses given at 30 min intervals elicited progressively and significantly diminished acute insulin responses with each succeeding pulse, consistent with depletion of the small storage pool. Similar to the observation that the magnitude of the insulin response to secretin was glucose dependent, the glucose-stimulated output appeared to be secretin dependent. Thus the acute insulin response to 5 g glucose was increased after secretin pretreatment (presecretin: 34.9+/-14.8; postsecretin: 50.5+/-22.5 muU/ml. P < 0.02) which suggests that secretin may either enlarge the storage pool stimulated by glucose or increase its sensitivity.The effect of epinephrine and propranolol on acute insulin responses to secretin and glucose was also different. 15-U secretin pulses were unaffected by infusions of either epinephrine (pre: 31.6+/-17.9; during: 27.8+/-16.6 muU/ml) or propranolol (pre: 12.8+/-8.4; during: 10.7+/-5.5 muU/ml). The results of these studies indicate that although both glucose and secretin stimulate a rapid insulin response, these responses are easily differentiated. The data suggest that glucose and secretin stimulate functionally separate storage pools of insulin, but that the acute response to either stimulus is partly determined by exposure to the other.     

Intraoperative myocardial protection with extracellular cardioplegic solutions in patients with cardiac valve diseases

A hundred patients operated on under extracorporeal circulation (EC) with bicaval cannulation in the moderate general hypothermia mode were intraoperatively examined. According to the used cardioplegic solution, all the patients were divided into three groups: 1) Konsol; 2) Konsol MF; 3) St. Thomas (a control group). All the groups were matched by age, gender, the duration of myocardial ischemia (MI) (37-128 min), that of EC (52-186 min), and the nature of surgical interventions, of which mitral valve replacement amounted to 72-78%. To prepare a modified solution, 20 ml of 40% glucose, 20 units of insulin, and 200 mg of creatine phosphate (Neoton) were added to a flask containing 400 ml of Konsol. The efficiency of myocardial protection was evaluated by the data characterizing cardiac arrest and cardiac performance resumption, as well as by heart rate and the use of inotropic support in the reperfusion period. The parameters of central hemodynamics and systemic coronary blood flow, the concentrations of glucose and lactate, the blood gas and electrolyte composition of the coronary sinus (CS), myocardial oxygen consumption and the oxygen-utilizing coefficient were monitored. The cardioplegic solutions Consol and Consol MF were found to have a more effective cardioprotective activity in patients with cardiac valvular disease, operated on under EC and moderate hypothermia that St. Thomas'solution. Modification of the Consol solution by adding glucose, creatine phosphate, and insulin improves the protective effect of the solution, promoting a rapider transition of the myocardium from anaerobic to aerobic metabolism.     

Sex steroids in cardiopulmonary bypass

BACKGROUND: Sex steroids have immunomodulatory effects. No data exist on alterations of sex steroids during cardiopulmonary bypass (CPB). Cardiac surgery with CPB releases an immunological response with complement and cytokine activation. RESULTS: Plasma estradiol and progesterone levels before and immediately after CPB were measured in 11 patients. During CPB, mean estradiol levels decreased from 29 to 15 pg/ml and progesterone levels rose from 0.13 to 0.90 ng/ml. These changes were statistically significant. CONCLUSIONS: These are the first preliminary results evaluating plasma levels of sex steroids during CPB. Whether alterations in estradiol and progesterone levels influence complement and cytokine activation during bypass or vice versa is currently being investigated.