彩色多普勒超声对甲状腺结节良恶性鉴别的应用探讨

目的：探讨彩色多普勒超声在鉴别甲状腺结节良恶性中的应用价值。方法对2015年6月—2016年3月于我院就诊的118例甲状腺结节患者采用彩色多普勒超声检查,鉴别甲状腺结节良性和恶性,将超声检查结果与术后病理诊断结果进行对照分析。结果病理诊断结果显示,118例甲状腺结节患者中的良性组以结节性甲状腺肿与滤泡型腺瘤为主,其次为慢性淋巴细胞性甲状腺炎,以毒性结节性甲状腺肿最为少见,恶性组以乳头状腺癌为主,其次为滤泡状腺癌与髓样癌,以未分化癌与微小癌最为少见;彩色多普勒超声诊断为良性结节88例（74.58%）、恶性结节30例（25.42%）,超声诊断准确率为96.61%,误诊率为1.69%,漏诊率为1.69%。结论彩色多普勒超声对甲状腺结节良恶性鉴别诊断准确度较高,值得临床推广应用。     

彩色多普勒超声对甲状腺结节的诊断价值研究

目的：探讨彩色多普勒超声对甲状腺结节的诊断价值,为临床医师诊治提供依据。方法：对我院收治的85例甲状腺结节患者的超声特征与病理结果进行回顾性分析,观察彩色多普勒超声对甲状腺结节良、恶性鉴别诊断的价值。结果：彩色多普勒超声对良性结节的诊断符合率为92.96%,对恶性结节的诊断符合率为73.68%,误诊10例（11.76%）。结论：彩色多普勒超声对甲状腺结节良、恶性的鉴别诊断具有很高的临床价值,但对良、恶性结节的鉴别及微小癌的诊断有局限性。     

二维超声和彩色多普勒超声诊断甲状腺良恶性结节的临床应用价值研究

目的 探究二维超声和彩色多普勒超声诊断甲状腺良恶性结节的临床价值。方法 从贵州航天医院2020年8月—2021年8月收治的甲状腺结节患者中随机抽取100例为本次研究对象,对所有患者均实施二维和彩色多普勒超声诊断。以病理诊断结果作为金标准,对比分析两种诊断方式对甲状腺结节良恶性的诊断符合率。结果 100例患者中,经病理诊断甲状腺良性结节70例（共142个结节）,甲状腺恶性结节30例（共66个结节）。彩色多普勒超声对甲状腺腺瘤、结节性甲状腺肿、乳头状癌、滤泡状癌、髓样癌的诊断符合率均高于二维超声。良性结节肿瘤血流分布主要以周边为主,而恶性结节的血流分布主要以内部为主,其次为周边,有明显差异（P<0.05）。良性结节周围和内部血流参数中Vmax、RI均低于恶性结节,差异具有统计学意义（P<0.05）;良性结节和恶性结节的Vmin比较无明显差异（P>0.05）。结论 相较于二维超声,彩色多普勒超声对甲状腺结节良恶性具有更高的诊断符合率,可为诊疗提供重要的参考,值得进一步研究。     

彩色多普勒超声对甲状腺良、恶性结节的诊断与鉴别价值分析

目的 探讨彩色多普勒超声对甲状腺良、恶性结节的诊断与鉴别诊断的临床价值.方法 对241例甲状腺结节患者的彩色多普勒声像图资料与病理检查结果进行对比分析,归纳甲状腺良、恶性结节的声像图特征及诊断与鉴别诊断要点,总结彩色多普勒超声对甲状腺结节性疾病的诊断与鉴别诊断价值.结果 彩色多普勒超声检查诊断为甲状腺良性结节212例、甲状腺恶性结节23例、未确定良恶性结节6例,术后经病理检查诊断为甲状腺良性结节215例、甲状腺恶性结节26例;以术后病理诊断结果为金标准,则彩色多普勒超声诊断甲状腺良性结节的符合率为98.6％(212/215)、诊断甲状腺恶性结节的符合率为88.5％(23/26).结论 彩色多普勒超声检查诊断甲状腺结节性疾病具有较高的效率与准确性,能够对甲状腺结节性疾病做出较准确的诊断和鉴别诊断.     

能量多普勒在甲状腺结节诊断中的价值

目的探讨能量多普勒超声在甲状腺良恶性结节鉴别诊断中的价值。方法对96例甲状腺结节患者进行能量多普勒超声检查,与手术、病理结果对照分析,观察甲状腺结节血管分布、血流丰富程度。结果良性结节血管分布以无血管型和边缘血管型为主,占75%;恶性结节以中央血管为主型和混合血管型为主,占83.3%。恶性结节血流信号较良性结节丰富。结论能量多普勒超声提供了甲状腺结节血供图像特征,为良恶性结节诊断及鉴别诊断提供了更多信息,具有重要的临床应用价值。     

彩色多普勒超声对判断甲状腺结节良恶性的诊断价值

目的：探讨彩色多普勒对判断甲状腺结节良恶性诊断价值。方法：对手术治疗的甲状腺结节患者90例超声检查及病理诊断进行回顾分析。结果：90例甲状腺患者中,良性诊断符合率为88．5％,恶性结节的诊断符合率为50％。结论：超声对甲状腺良恶性的判断有一定的诊断价值,综合分析二维超声图像特征及彩色多普勒超声征像有助于提高甲状腺结节的诊断率。     

彩色多普勒超声在甲状腺结节性质诊断及鉴别诊断中的应用价值

目的：探讨甲状腺结节性质诊断及鉴别诊断中应用彩色多普勒超声检查的临床价值。方法：选取2020年1月-2021年1月成武县人民医院收治的甲状腺结节患者150例为研究对象。所有患者给予彩色多普勒超声检查,以手术病理检查结果为金标准,分析彩色多普勒超声的诊断价值;比较良性、恶性甲状腺结节患者超声图像及回声情况。结果：150例甲状腺结节患者手术病理结果良性结节138例、恶性结节12例;彩色多普勒超声检查结果显示良性结节137例、恶性结节13例,诊断准确良性136例,恶性11例,2例良性结节被误诊为恶性结节,1例恶性结节漏诊。彩色多普勒超声检查准确率、灵敏度、特异度与手术病理检查比较,差异无统计学意义(P>0.05)。良性甲状腺结节形态规则、边缘清晰、有完整包膜,恶性甲状腺结节有明显钙化,血流信号丰富;良性、恶性结节图像征象比较,差异有统计学意义(P<0.05)。恶性甲状腺结节以低回声为主,良性甲状腺结节以混合回声为主;良性、恶性甲状腺结节低回声及混合回声占比比较,差异有统计学意义(P<0.05)。结论：彩色多普勒超声在甲状腺结节性质诊断及鉴别诊断中具有较高诊断效能,甲状腺良性...     

彩色多普勒超声血流显像及造影增强模式在甲状腺良恶性结节鉴别诊断中的价值分析

目的：探讨良恶性甲状腺结节彩色多普勒超声血流显像及造影增强模式特征。方法：回顾经手术治疗的甲状腺结节患者58例（131个结节）的超声资料,总结常规声像图特征、结节血流丰富程度及血流形态及增强模式。结果：恶性组甲状腺结节回声、声晕形态及内部钙化分布与良性组比较,差异均有统计学意义（ P＜0．05）。良性组甲状腺结节血流丰富程度以0级／1级为主（68．25％）,恶性组以2级／3级为主（73．53％）,差异有统计学意义（P＜0．05）;良性组血流形态以I型／II型为主（73．02％）,恶性组以Ⅲ型／Ⅳ型／Ⅴ型居多（76．47％）,差异有统计学意义（ P＜0．05）。良性组甲状腺结节80．95％环状增强、恶性组86．76％不均匀增强,差异有统计学意义（ P＜0．05）;利用不均匀增强模式诊断甲状腺恶性结节,敏感度86．76％、特异度87．30％、阳性预测值88．06％、阴性预测值85．94％、准确率87．02％;利用环状增强诊断甲状腺良性结节,敏感度80．95％、特异度97．06％、阳性预测值96．23％、阴性预测值97．06％、准确率89．31％。结论：彩色多普勒超声血流显像及造影增强模式有助于甲状腺良恶性结节诊断及鉴别诊断,为临床手术治疗提供重要信息,具有临床应用价值。     

彩色多普勒超声对甲状腺结节良恶性的诊断价值

目的：通过回顾性分析甲状腺良恶性结节超声影像的不同特点,探讨甲状腺良恶性结节的彩色多普勒超声鉴别诊断价值。方法：回顾分析2010-03--2012-05因甲状腺结节就诊并行手术治疗的病人200例,共记录结节358个。手术前行甲状腺彩色多普勒超声检查：记录结节的边界,结节内部回声性质,结节中心部钙化情况,结节内部及边缘血流情况等超声特征。结果：术后病理：甲状腺良性结节253个,恶性结节105个。结节边界不清楚或形态不规则,结节内部呈实性低回声,结节中心部伴砂粒体样微钙化,结节内部不规则丰富血流信号等超声特征在恶性结节中较为常见。结论：对于甲状腺结节而言,没有一项超声特征为良性或恶性结节所独有,须综合分析甲状腺结节彩色多普勒超声影像特点,以提高其鉴别良恶性结节的诊断价值。     

彩色多普勒超声鉴别甲状腺良恶性结节的价值分析

目的：评价彩色多普勒超声对良恶性甲状腺结节的鉴别诊断价值。方法回顾性分析132例甲状腺结节患者的彩色多普勒超声检查情况,并与病理结果进行对照,探讨其对良恶性结节的诊断准确率及其声像图特征。结果本组甲状腺结节患者单发82例,多发50例,经术后病理证实良性结节107例,恶性结节25例;彩色多普勒超声诊断的敏感性为84.00%,特异性为94.39%,误诊的10例中4例恶性结节误诊为良性,6例良性结节误诊为恶性。良恶性结节在形态、边界、纵/横比、内部回声、后方衰减、沙砾样钙化、血流、阻力指数（RI）、颈部淋巴结变化有显著差异（P﹤0.05）。结论结合二维及彩色多普勒血流显像表现进行综合分析,彩色多普勒超声可为良恶性甲状腺结节的鉴别诊断提供有价值的信息。     

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.