子宫内膜病变的超声诊断

目的:分析子宫内膜病变的超声声像图特征,研究子宫内膜病变的超声改变,提高超声诊断率。方法:回顾性分析166例超声检出子宫内膜病变患者的声像图特征,结合病理诊断进行对比分析。结果:超声对子宫内膜病变诊断符合率为91.6%,其中子宫内膜息肉符合率91.4%,子宫内膜增生过长93.5%,子宫内膜癌84.2%,黏膜下肌瘤92.6%。结论:子宫内膜病变声像图各具特征,超声检查能较准确判断子宫内膜病变类型,测量子宫内膜厚度,观察内膜形态、回声特点及内膜与肌层间的关系;结合病理综合分析,能进一步提高子宫内膜病变准确诊断率。     

子宫内膜病变的超声诊断

目的：分析子宫内膜病变的超声声像图特征,研究子宫内膜病变的超声改变,提高超声诊断率。方法：回顾性分析166例超声检出子宫内膜病变患者的声像图特征,结合病理诊断进行对比分析。结果：超声对子宫内膜病变诊断符合率为91．6％,其中子宫内膜息肉符合率91．4％,子宫内膜增生过长93．5％,子宫内膜癌84．2％,黏膜下肌瘤92．6％。结论：子宫内膜病变声像图各具特征,超声检查能较准确判断子宫内膜病变类型,测量子宫内膜厚度,观察内膜形态、回声特点及内膜与肌层间的关系;结合病理综合分析,能进一步提高子宫内膜病变准确诊断率。     

子宫内膜病变诊断中经阴道彩色多普勒超声的应用分析

目的探讨经阴道彩色多普勒超声仪器在子宫内膜病变诊断中的具体应用。方法选取我院2018年1月-2019年5月期间收治的子宫内膜病变患者110例,将所有患者进行经过阴道彩色多普勒超声和经腹部超声检查判定患者子宫内膜是否病变,以病理检查结果为标准,计算经阴道彩色多普勒超声诊断子宫内膜病变的准确率,对比不同方式检查下子宫内膜病变符合率情况。结果经过检查,经阴道彩色多普乐超声检查患者的子宫内膜病变情况与病理检查结果的符合率高于经腹部超声结果,子宫内膜病变符合率也高于经腹部超声结果,具有统计学意义(P<0.05)。结论经阴道彩色多普勒超声检查下的子宫内膜病变的准确率较高,有效提升诊断准确率,具有一定临床应用价值。     

子宫内膜病变患者采用超声诊断的临床准确性探讨

目的:探讨在子宫内膜病变诊断中应用超声对于子宫内膜病变定性诊断的作用。方法:在2019年4月至2022年5月,将近3年内我院就诊的子宫内膜病变患者共75例纳入,在75例子宫内膜病变患者中开展妇科腹部超声、阴道超声及三维阴道超声检查,将诊断金标准定为宫腔镜诊断结果,比较妇科腹部超声、阴道超声、三维阴道超声对于子宫内膜病变进行定性诊断的结果,分析在子宫内膜病变定性诊断中妇科腹部超声、阴道超声、三维阴道超声检查结果与宫腔镜诊断结果之间的一致性。结果:在75例子宫内膜病变患者中,有28例患者经宫腔镜诊断证实子宫内膜癌,其余47例患者为子宫内膜增生。依照诊断金标准,在子宫内膜病变定性诊断时,三维阴道超声在灵敏度、特异度、准确率、阳性预测值及阴性预测值方面均比妇科腹部超声、阴道超声高,而阴道超声在灵敏度、特异度、准确率、阳性预测值方面比妇科腹部超声高,均P<0.05。在子宫内膜病变定性诊断结果中,阴道超声、三维阴道超声诊断结果与宫腔镜诊断结果之间均呈高度一致,而妇科腹部超声诊断结果与宫腔镜诊断结果之间的一致性为中度。结论:在对于子宫内膜病变开展定性诊断时,阴道超声及三为阴道超声均可发挥良好的...     

超声造影在子宫内膜疾病诊断中的价值

目的探讨超声造影在子宫内膜病变诊断中的价值。方法 46例子宫内膜病变患者,体检健康者18例为对照组,经阴道常规超声和超声造影检查其子宫内膜,并与病理诊断对照。结果子宫内膜病变经阴道超声诊断符合率为79.2%(K=0.785),超声造影诊断符合率为92.2%(K=0.906)。超声造影与病理诊断具有较高一致性。结论超声造影对子宫内膜病变的定性诊断具有一定临床价值。     

经阴道超声和经腹部超声诊断子宫内膜病变的效果

目的:观察经阴道超声和经腹部超声诊断子宫内膜病变的效果。方法:我院2017年10月-2019年10月收治的100例子宫内膜病变确诊患者为本次研究对象,所有患者均行在经阴道超声检查以及经腹部超声检查,比较两种检查结果。结果:经阴道超声检查子宫内膜病变检出率(98.00%)高于经腹部超声检查检出率(78.00%),数据差异明显(P<0.05)。结论:经阴道超声检查可为子宫内膜病变临床诊断提供更为清晰的图像资料,有利于提升子宫内膜病变检出率。     

子宫内膜病变不孕患者的诊治

目的探讨阴道超声和宫腔镜检查对不孕患者子宫内膜病变的诊断价值。方法分析2006年1月至2007年12月我院部分子宫内膜病变不孕患者的资料(156例)。对自然周期超声监测内膜回声异常的52例行宫腔镜检查,超声检查内膜正常者进入促排卵周期后25例出现内膜异常情况不孕者,常规行宫腔镜检查。结果自然周期超声发现的异常内膜52例,经宫腔镜确诊为异常45例占86.54%,促排卵周期超声发现的异常内膜25例,经宫腔镜确诊3例异常(12%)。结论自然周期超声和宫腔镜检查是发现内膜病变的重要方法;促排卵周期超声发现的内膜增厚、不均匀与内膜对激素的过度反应有关,宫腔镜对这种内膜病变的诊断价值有待深入研究。     

腹部超声和经阴道超声对子宫内膜病变诊断的比较

目的评价腹部超声和经阴道超声对子宫内膜病变诊断的作用。方法腹部超声诊断子宫内膜病变的64例患者经阴道超声检查后，以诊刮病理和手术病理结果为标准，计算两种诊断方法在诊断子宫内膜息肉、黏膜下肌瘤、内膜病变及内膜癌中的准确率。结果64例患者腹部超声诊断内膜息肉、黏膜下肌瘤、内膜病变及内膜癌的准确率分别为34％，56％，67％，20％，经阴道超声诊断内膜息肉、黏膜下肌瘤、内膜病变及内膜癌的准确率分别为72％、100％、89％、60％。结论与腹部超声相比，经阴道超声对子宫内膜病变的诊断有较高的准确性，是一种简便易行的诊断方法，可为宫内膜病变的鉴别诊断提供有价值的信息。     

经腔内超声诊断子宫内膜病变的临床价值

子宫内膜病变是妇科常见疾病,临床表现主要为阴道不规则出血和月经失调。随着腔内超声的应用,子宫内膜病变的诊断率明最提高。本研究比较子宫内膜病变在腔内超声和宫腔镜的表现特点,并与病理诊断对照,探讨腔内超声对子宫内膜疾病的临床价值。     

经阴道彩色多普勒超声诊断子宫内膜病变的价值

[目的]探讨经阴道彩色多普勒超声对子宫内膜病变的诊断价值.[方法]采用经阴道彩色多普勒超声检查111例子宫内膜病变患者,分析其声像图和血流特征并与病理诊断对照.[结果]子宫内膜病变声像图特征:子宫内膜增生症血流显示3例,子宫内膜息肉5例,子宫黏膜下肌瘤8例,子宫内膜癌9例;经阴道彩色多普勒超声检查子宫内膜病变的诊断结果...     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.