高频彩色多普勒超声在类风湿性关节炎腕关节病变疗效评价中的应用

目的探讨高频彩色多普勒超声在类风湿性关节炎（RA）腕关节病变疗效评价中的应用价值。方法本组RA患者124例,测量其腕关节滑膜厚度、血流分级,并观察关节腔及骨面情况,治疗后行彩超复查。结果治疗前本组类风湿关节炎患者腕关节滑膜厚度为（3．59±1．37）mm。滑膜血流分级：0级21只,Ⅰ级47只,Ⅱ级109只,Ⅲ级71只。阻力指数（RI）为（0．53±0．15）。治疗3个月后滑膜厚度、血流分级及RI值差异有统计学意义（P〈0．01）。结论高频彩色多普勒超声可为RA腕关节病变治疗后评价疗效提供影像学依据。     

类风湿性关节炎腕关节滑膜彩超下改变研究

目的:探讨高频超声显示类风湿性关节炎腕关节滑膜及血管增殖病变的价值.方法:应用高频二维、彩色多普勒、能量多普勒及频谱多普勒超声技术研究了38例类风湿性关节炎患者腕关节滑膜二维声像图、血流信号显示情况及血流动力学改变.结果:①73个腕关节滑膜增厚(96.05%),厚度0.72～1.12 mm(平均0.92mm),腔面毛糙不平,有的可见类似绒毛状突起.②滑膜血管增生,6个关节滑膜内显示少量星点状血流信号(8.21%),显示率与滑膜厚度有关.能量多普勒(CDE)可提高彩色多普勒血流显像(CDFI)为Ⅰ级的滑膜内血管显示率.③频谱多普勒检测,增生滑膜能显示血流均为I级血流,故不能检测到血流速度.结论:高频超声是显示早期类风湿性关节炎腕关节滑膜改变的无创性敏感方法,可准确地显示关节滑膜增生及血管增殖等重要的病理改变.     

彩色多普勒超声对类风湿关节炎腕关节、手部关节病变的临床诊断价值

目的探讨彩色多普勒在类风湿关节炎（rheumatoid arthritis;RA）腕关节、手部关节病变中的诊断价值。方法应用高分辨力超声（10 Hz以上的高频探头）检查临床初诊为类风湿关节炎患者32例,86个关节,观察腕关节、掌指关节、指间关节、近端指间关节滑膜的厚度,血流供应、骨面及软组织情况。结果类风湿关节炎超声图像显示73%腕关节滑膜增生,11%手部关节滑膜增生,89%腕关节及29%的手部关节增生的滑膜内见血管过度增生,病变关节数的10%可见软骨下骨的病变。结论彩色多普勒超声可以从类风湿关节炎腕关节、手部关节病变、滑膜炎症、血管翳形成中寻求出病理改变。超声检查也有助于类风湿关节炎肢体侵犯的诊断和鉴别,有助于治疗方法的选择。     

高频彩色多普勒超声对类风湿关节炎骨关节病变的诊断价值

目的:探讨高频彩色多普勒超声在类风湿关节炎(RA)骨关节(膝、肘、腕、踝)病变中的诊断价值。方法:选取2010年6月-2012年5月入住我院或就诊的类风湿关节炎骨关节病变的患者50例(共400个关节),并按1∶2的匹配选择方式,选择同期健康志愿者25例(共240个关节)为正常对照组,应用高频彩色多普勒超声检测对比观察膝关节、肘关节、腕关节、踝关节滑膜的厚度、血流供应、骨关节面及关节周围软组织情况。结果:RA组共检测出279个关节腔积液,251个关节滑膜增生,213个关节内血管过度增生。结论:高频彩色多普勒超声能显示RA病变关节中滑膜炎症,血管增生等病理改变,由于其无辐射,易重复的特点,是RA患者骨关节病变的首选方法之一。     

高频超声在腕关节类风湿关节炎中的应用研究

目的 应用高频超声及多普勒超声技术,定量评价腕关节滑膜内动脉的阻力指数对类风湿关节炎(rheumatoid arthritis,RA)滑膜病变的临床应用价值.方法 选择临床确诊的RA患者92例进行腕关节高频超声检查,观察并测量滑膜厚度及滑膜内动脉阻力指数.结果 92例RA患者,彩色多普勒血流显像0级25例(27.2%),Ⅰ级5例(5.4%),Ⅱ级33例(35.9%),Ⅲ级29例(31.5%).探测出滑膜内血流67例(72.8%).其中乏血流组38例,富血流组29例.富血流组RA患者腕关节滑膜内动脉的阻力指数(resistance index,RI)值明显低于乏血流组 (P<0.01).富血流组和乏血流组相比,腕关节滑膜厚度差异无统计学意义(P>0.05).RA患者腕关节的滑膜厚度与滑膜内动脉的RI值无明显相关性(P>0.05).结论 高频超声能够较好的观察RA滑膜病变,滑膜血流丰富的RA,其RI值较低.     

彩色多普勒超声对类风湿关节炎腕关节、手部关节病变的诊断价值

目的探讨彩色多普勒在类风湿关节炎（RA）腕关节、手部关节病变中的诊断价值。方法选择健康对照组30例,RA病人40例,应用彩色多普勒超声检测对比观察腕关节、掌指关节、指间关节、近端指间关节滑膜的厚度,血流供应、骨面及软组织情况。结果RA组共检查出73%腕关节滑膜增生,11%手部关节滑膜增生,89%腕关节及29%的手部关节增生的滑膜内见血管过度增生。病变关节数的10%见软骨下骨侵蚀。结论彩色多普勒超声能够显示RA病变关节的滑膜炎症,血管翳形成,软骨下骨侵蚀等病理改变,由于其无辐射、易重复的特点,是诊断RA病人腕关节、手部关节病变的首选方法之一。     

彩色多普勒超声对类风湿性关节炎腕关节病变的应用价值

目的探讨彩色多普勒超声对类风湿性关节炎腕关节病变的应用价值。方法选取在我院就诊的类风湿性关节炎患者共50例作为观察组,选择同期在我院健康体检人员50例为对照组。两组均接受彩色多普勒超声检查腕关节,观察并比较两组关节腔滑膜结构及滑膜内血流情况的差异。结果观察组患者的腕关节滑膜厚度明显大于对照组,差异有统计学意义(P0.05);观察组患者腕关节滑膜增厚、关节腔积液及骨质破坏百分比均明显高于对照组,差异均有统计学意义(P0.01);观察组患者腕关节滑膜内血流信号丰富百分比明显高于对照组,差异均有统计学意义(P0.05);观察组患者腕关节滑膜动脉血流RI值明显低于对照组,差异均有统计学意义(P0.05)。结论彩色多普勒超声能较好地显示类风湿性关节炎腕关节病变情况,能为临床早期诊断及治疗提供客观的依据。     

高频超声对类风湿性膝关节炎滑膜病变的观察

目的：观察类风湿性关节炎（RA）膝关节滑膜病变的声像图特点,评价高频超声对于类风湿性关节炎的辅助诊断及观察疗效的价值。方法：应用高频超声及彩色多普勒技术观察42例RA伴有膝关节病变84个膝关节,观察测量膝关节腔积液、滑膜厚度、滑膜内血流信号变化及血管增殖等情况,并进行治疗前后对比。结果：RA滑膜超声改变表现为滑膜厚薄不均,表面粗糙不平,向腔内凸起呈绒毛状,以低回声为主,与滑膜囊积液之间有清楚的界限。治疗前髌上囊积液81个,深度为（7．15±1．72）mm;滑膜增厚,厚度（5．03±2．32）mm;滑膜内血管增生,67个关节滑膜内显示低速血流信号,显示率为79．8％。治疗后髌上囊积液、滑膜厚度有显著改变,髌上囊积液、滑膜厚度明显减少,滑膜内血流信号显示率降低。结论：高频超声能够敏感而准确地显示RA患者滑膜炎症、血管翳形成等病理改变,能为临床辅助诊断RA及评价治疗效果提供依据。     

超声在类风湿关节炎膝关节病变中的应用

目的:探讨超声检查在类风湿关节炎(RA)膝关节病变诊断中的应用价值.方法:类风湿关节炎患者36例,应用日本东芝SSA-350A型彩色多普勒超声诊断仪分别对膝关节进行对比检查,观察滑膜、关节腔、骨面特征及血供表现.结果:RA组36例共72个关节,共检出67个关节异常(93%),表现为65个关节(90.2%)滑膜增厚,其中42个关节腔积液,9个关节出现骨质破坏.滑膜内探及血流信号.结论:超声检查可以很好地显示类风湿关节炎患者膝关节病变,诊断RA膝关节病变有较高的应用价值.     

高频彩超在类风湿性关节炎腕关节病变诊断和治疗中的应用

目的探讨高频彩超在类风湿性关节炎(RA)腕关节病变诊断和治疗中的价值。方法对广东省东莞市第三人民医院风湿免疫科2011年1月~2014年1月收治的RA患者86例(RA组)、同期健康体检者40例(对照组)进行腕关节高频彩超检查,比较两组声像图表现及腕关节滑膜厚度,分析RA患者滑膜血流分级与动脉血流阻力指数(RI),对RA组进行DR摄片检查,比较超声和DR摄片对骨侵蚀的检出率。对RA组进行3个月的中西医结合治疗,比较治疗前后滑膜厚度、血流分级及RI值变化情况。结果对照组关节腔未见积液,滑膜内未见血流信号;RA组161个(93.6%)腕关节滑膜增生,137个(79.7%)腕关节显示关节腔积液;彩色多普勒成像显示141个(82.0%)关节滑膜内可见血流信号。RA组滑膜厚度高于对照组,差异有高度统计学意义[(3.21±1.42)mm比(1.59±0.62)mm,t=9.772,P=0.000];滑膜血流RI值与分级呈负相关(r=-0.81,P<0.05);病程<2年的RA患者超声检查对骨侵蚀检出率高于DR摄片,差异有统计学意义(35.1%比13.5%,χ2=4.698,P=0.030),病程≥2年的RA患者超声检查与DR摄片对骨侵蚀的检出率差异无统计学意义(P>0.05)。治疗3个月后,RA组患者滑膜厚度降低[(3.21±1.42)mm比(2.35±0.86)mm,t=6.794,P=0.000],RI值增加[(0.52±0.11)比(0.60±0.12),t=6.445,P=0.000],血流分级0、Ⅰ级患者增加,Ⅱ、Ⅲ级患者减少,与治疗前比较差异有高度统计学意义(Z=8.619,P=0.006)。结论高频彩超可较好显示RA腕关节病变,并对疗效的评价提供依据,在RA的诊断和治疗中有较高的临床价值。     

肱骨远端全骺分离

肱骨远端全骺分离在5岁以下儿童中是较常见的肘部损伤,且极易误诊为肱骨髁上骨折或肘关节脱位。本组25例肱骨远端全骺分离均为向内侧移位,年龄11个月至14岁,平均5.6岁,属Salter-HarrisⅠ型或Ⅱ型。对本症骨骺损伤的解剖学和组织学,诸骨(和骨化中心)之间的对应关系以及骨骺损伤的诊治进行了简短的讨论。     

食指背侧皮瓣的临床应用

通过对右手虎口挛缩以及左拇指皮肤剥脱损伤各一例应用直指背侧皮瓣修复的成功经验,提出该手术的适应症和优点,并重点介绍其应用解剖学和手术方法。     

Investigation of hypoglycemic,hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark in diabetic rats

Objective

To investigate the hypoglycemic, hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark (AETPB) in streptozotocin (STZ)-induced diabetic rats.

Methods

Acute toxicity was studied in rats after the oral administration of AETPB to determine the dose to assess hypoglycemic activity. In rats, diabetes was induced by injection of STZ (60 mg/kg, i.p.) and diabetes was confirmed 72 h after induction, and then allowed for 14 days to stabilize blood glucose level. In diabetic rats, AETPB was orally given for 28 days and its effect on blood glucose and body weight was determined on a weekly basis. At the end of the experimental day, fasting blood sample was collected to estimate the haemoglobin (Hb), glycosylated haemoglobin (HbA1c), serum creatinine, urea, serum glutamate-pyruvate transaminase (SGPT), serum glutamate-oxaloacetate transaminase (SGOT) and insulin levels. The liver and kidney were collected to determine antioxidants levels in diabetic rats.

Results

Oral administration of AETPB did not exhibit toxicity and death at a dose of 2 000 mg/kg. AETPB treated diabetic rats significantly (P<0.001, P<0.01 and P<0.05) reduced elevated blood glucose, HbA1c, creatinine, urea, SGPT and SGOT levels when compared with diabetic control rats. The body weight, Hb, insulin and total protein levels were significantly (P<0.001, P<0.01 and P<0.05) increased in diabetic rats treated with AETPB compared to diabetic control rats. In diabetic rats, AETPB treatment significantly reversed abnormal status of antioxidants and lipid profile levels towards near normal levels compared to diabetic control rats.

Conclusions

Present study results confirm that AETPB possesses significant hypoglycemic, hypolipidemic and antioxidant activities in diabetic condition.     

Association of smoking,alcohol and NSAIDs use with expression of cag A and cag T genes of Helicobacter pylori in salivary samples of asymptomatic subjects

Objective

To determine the association of smoking, alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) use with presence and virulence of Helicobacter pylori (H. pylori) infection in a representative sample of a random adult population of asymptomatic subjects.

Methods

Non virulent 16S rRNA and virulent cag A and T genes from salivary samples of 854 asymptomatic subjects were determined using polymerase chain reaction. The presence and absence of virulent and non virulent infection was statistically compared with consumption of smoking, alcohol and NSAIDs.

Results

The prevalence of infection in male and female subjects was found to be 69.25% and 66.90%, respectively. The prevalence of infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (31.22%), former (52.20%) and never (43.58%). The prevalence of infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (88.80%), former (57.14%) and never (33.33%). The prevalence of infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 82.75% and 21.16%, respectively. Virulence in male and female subjects was found to be 60.00% and 50.00%, respectively. The presence of virulent infection in the population of asymptomatic subjects with respect to consumption of alcohol was as follows: current (28.57%), former (40.15%) and never (50.00%). The prevalence of virulent infection in the population of asymptomatic subjects with respect to smoking of cigarettes was as follows: current (79.32%), former (75.00%) and never (50.00%). The prevalence of virulent infection in the subject population consuming NSAIDs and not consuming NSAIDs frequently was found to be 88.23% and 66.66%, respectively.

Conclusions

It can be concluded that smoking and NSAIDs consumption are aggravating factors for virulence of H. pylori and alcohol can inhibit H. pylori infection in asymptomatic subjects.     

大肠多发原发性癌:危险因素、诊治和预防(附8例报告)

综述分析1954～84年国内外文献,探讨了大肠多发原发性癌的诊断标准、发病情况、临床表现、发病危险因素、外科处理以及预防和诊断检测技术等问题,强调了大肠腺瘤,遗传基础、免疫缺陷、慢性溃疡性结肠炎等在发病上的作用,及高危险组患者应按方案进行常规检测监护之重要性。述介了大肠多发原发性癌系一种原发性大肠癌多中心发生的形式,在诊治上前者与后者有一致性,亦各有其独特性。报告宁夏医学院附属医院肿瘤科1977～84年收治的8例住院大肠多发原发性癌病例的临床资料,对诊治经过进行了初步总结。     

具有抗细菌黏附和杀菌双重功能的(HA/CHI-Van)5涂层的制备

目的：研究开发一种涂覆(HA/CHI-Van)5多层膜结构的骨科内植入物以用于预防骨内植入物感染。方法：将透明质酸（HA）和壳聚糖-万古霉素（CHI-Van）溶液进行层层自组装,制备得到(HA/CHI-Van)5多层膜结构;通过zeta电位检测组装过程,通过活细菌染色实验评价多层膜的抗细菌黏附效果,通过越狱实验和FE-SEM实验检测体外抗菌效果。SD大鼠随机分为空白组、(HA/CHI-Van)5组和假手术组,并以X线、Micro-CT、骨组织切片等方法检测该材料的体内动物实验效果。结果：每次组装不同的单层,zeta电位交替变化,证明多层膜组装成功。活细菌染色实验显示多层膜结构中的CHI具有一定的抗细菌黏附作用。越狱实验和FE-SEM实验证明(HA/CHI-Van)5多层膜结构在体外具有良好的抗菌作用。在体外实验中,(HA/CHI-Van)5组的X线评分为0.7,而空白组的评分为12.3,(HA/CHI-Van)5组在骨密度、骨小梁数量、骨体积分数、骨组织切片方面均优于空白组（均P＜0.05）,且非常接近假手术组（均P＞0.05）。结论：通过在骨科内植入物表面涂覆(HA/CHI-Van)5多层膜结构能够获得一定的抗细菌黏附功能和良好的抗菌作用,可以预防骨内植入物感染。     

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective

To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia.

Methods

In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni (S. mansoni) ova. Children who were found positive for S. mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration. Four weeks post-treatment, stool specimens were collected from the same children and examined following the same procedure as in the pre-treatment. Drug efficacy was determined based on cure and egg reduction rates.

Results

Pre-treatment prevalence of S. mansoni infection was 74.9% with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6% (P<0.000 1, OR: 8.33, CI: 5.3–13.1) and egg reduction rate of 68.2% (P=0.03, F=0.64). The cure rate showed significant association with age (χ²=11, P=0.004), the highest rate being observed in the 15–22 age group. 83% of S. mansoni infected children showed various treatment-related symptoms, the most frequent being headache, nausea, and abdominal pain. These symptoms were associated with age (P<0.001) and pre-treatment intensity of infection (P<0.05).

Conclusions

The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia. Hence, in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated, treatment failure, or reduced susceptibility of the parasite. Treatment-related side effects observed were transient and tolerable.     

NGR修饰唑来膦酸长循环脂质体制备及其表征研究

目的:制备具有肿瘤血管靶向的NGR修饰唑来膦酸长循环脂质体,并对其进行表征研究。方法：采用薄膜分散法制备NGR修饰唑来膦酸长循环脂质体,,并对其进行表征研究,并测定包封率。结果：制备得到的NGR-PEG-ZOL-LPs平均粒径为(271.43±9.23)nm,Zeta电位为-(36.20±0.20)mv,多分散系数(PDI)为(0.15±0.03),理化性质相对稳定;NGR-PEG-ZOL-LPs包封率为8.41%;电镜下显示NGR-PEG-ZOL-LPs呈类圆形,大小分布均匀,无明显聚集。结论：采用薄膜分散法制备的NGR修饰唑来膦酸长循环脂质体具有较高的稳定性,从而为体内药效学研究奠定基础。     

Control of Tetranychus urticae Koch by extracts of three essential oils of chamomile,marjoram and Eucalyptus

Objective

To evaluate the acaricidal activity of extracts of three essential oils of chamomile, marjoram and Eucalyptus against Tetranychus urticae (T. urticae) Koch.

Methods

Extracts of three essential oils of chamomile, marjoram and Eucalyptus with different concentrations (0.5%, 1.0%, 2.0%, 3.0% and 4.0%) were used to control T. urticae Koch.

Results

The results showed that chamomile (Chamomilla recutita) represented the most potent efficient acaricidal agent against Tetranychus followed by marjoram (Marjorana hortensis) and Eucalyptus. The LC₅₀ values of chamomile, marjoram and Eucalyptus for adults were 0.65, 1.84 and 2.18, respectively and for eggs 1.17, 6.26 and 7.33, respectively. Activities of enzymes including glutathione-S-transferase, esterase (α-esterase and β-esterase) and alkaline phosphatase in susceptible mites were determined and activities of enzymes involved in the resistance of acaricides were proved. Protease enzyme was significantly decreased at LC₅₀ of both chamomile and marjoram compared with positive control. Gas chromatography-mass spectrometer (GC-MS) proved that the major compositions of Chamomilla recutita are α-bisabolol oxide A (35.251%), and trans-β-farersene (7.758%), while the main components of Marjorana hortensis are terpinene-4-ol (23.860%), p-cymene (23.404%) and sabinene (10.904%).

Conclusions

It can be concluded that extracts of three essential oils of chamomile, marjoram and Eucalyptus possess acaricidal activity against T. urticae.