超声测定桥本氏病患儿甲状腺体积与血清自身抗体关系的探讨

高频超声测量甲状腺体积己成为临床常规方法 ,1 974年Ｒａｓｍｕｓｓｅｎ首先报道Ｂ超测量甲状腺体积与手术前后对照 ,其相关性良好 (γ =0 .9)。 1 978年Ｂｒｏｗｎ等提出用椭圆公式测量甲状腺体积是目前常用的方法之一。本文旨在探讨桥本氏病患儿甲状腺体积大小与血清自身抗体 (ＴＧ、ＴＭ)和ＴＳＨ之间的相关性 ,为临床选择简便易行的方法来诊断桥本氏病和判断其疗效具有十分重要的意义。资料与方法1 正常组　经体检除外甲状腺及其它各种疾病的 1 5名正常儿童 ,男 6例 ,女 9例 ,年龄 2～ 1 4岁 ,平均 7.5岁。2 甲炎组　 1 998年 9月至 …     

B超测量甲状腺体积（重量）与核素显像对比研究

应用B超和核素显像测量363例Graves甲亢患者甲状腺体积（重量），B超计算公式：每叶体积（ml）=π/6×长径（cm）×宽径（cm）×厚径（cm），按比重=1折算成重量（g）。核素显像计算公式：重量（g）=0．316×两叶平均高度（cm）×表面面积（cm2），结果表明两者的测值相关良好，r=0．93（P＜0．01），甲状腺重量在70．1～90．0g之间，两种方法测量结果无显著差异，可互相替代。但总体上核素显像平均测值大于B超平均测值．其主要影响因素是腺体厚度，核素显像法缺乏厚度，B超法较显像法更为准确。     

盐业市场放开前后宝鸡市碘缺乏病监测对比分析

目的 对比分析盐业市场放开前后年度监测结果,评估监测人群体内外环境碘营养动态状况、病情的流行趋势,为适时采取针对性防治措施和科学调整干预策略提供依据.方法 收集2016-2019年宝鸡市碘缺乏病监测资料,对比分析重点人群碘盐供应质量、碘营养水平、甲状腺加权肿大率等变化规律.结果 2016-2019年宝鸡市共检测240个乡镇的15134户儿童和孕妇家中食用碘盐,2017年非碘盐较其他年份显著升高,差异有统计学意义(χ2=215.07,P<0.05).宝鸡市调整碘盐浓度后,8～10岁儿童尿碘呈逐年下降趋势(χ2=291.01,P<0.05);孕妇尿碘呈逐年上升趋势(χ2=44.73,P<0.05);触诊检查240所学校8～10岁儿童10089例,B超检查3360例,B超法山区县高于平原县(χ2=5.39,P<0.05).结论 开放盐业市场对流通市场碘盐质量形成冲击,新浓度碘盐供应有助于不适宜水平尿碘比例减少,盐业执法队伍建设亟待加强.     

不同年龄组正常儿童脾脏体积超声方法的检测

目的：应用超声方法检测不同年龄组正常儿童的脾脏体积,得到正常参考值范围。方法：5～16岁的正常儿童120例,按年龄分为4组：5～7岁（A组）、8～10岁（B组）、11～13岁（C组）、14～16岁（D组）,每组30例,男、女各15例,通过超声方法测量脾脏特定位置的短轴切面面积,应用一元或二元三次B样条曲线插值法,建立特定的模型,将脾脏短轴切面面积值插入程序,自动计算出脾脏体积。结果：4组组间比较差异均具有显著性意义（P<0.05）,各组内男、女比较,A组及B组内男、女间差异无显著性意义（P>0.05）,C组及D组内男、女间差异有显著性意义（P<0.05）。结论：正常儿童的脾脏体积随年龄增长而增加,5～10岁儿童的脾脏体积无性别差异,11～16岁男性儿童的脾脏体积大于女性儿童。     

碘盐浓度调整后广州市8 ~ 10岁儿童甲状腺容积调查

目的 了解盐碘浓度下调后广州市8 ~ 10岁儿童甲状腺容积现况,为评价碘缺乏病防治效果提供参考和制定防治措施提供依据。 方法 采用多阶段分层随机抽样方法,在市区、近郊和远郊分别抽取监测点小学,然后每所小学抽取8 ~ 10岁儿童开展调查。 结果 广州市8 ~ 10岁儿童甲状腺容积中位数为3.53 ml。 甲状腺容积在各年龄组之间有差异,并随着年龄的增大而增大。 甲状腺肿大率（甲肿率）为3.92%,与盐碘浓度下调前相比,差异无统计学意义。 不同年龄儿童甲肿率有差异。 结论 广州市8 ~ 10岁儿童甲状腺容积整体处于正常范围内,地方性甲状腺肿患病率处于较低水平,盐碘浓度下调后儿童碘营养状况仍处于良好状态。      

绝经后妇女腔内超声特点

目的通过腔内超声建立绝经后妇女正常子宫与卵巢体积的数值及形态图像,以便筛查异常子宫病变与异常卵巢体积与卵巢肿瘤.方法经阴道对绝经后3026例妇女进行TVS检查,测量子宫、卵巢的长、宽、厚三径.结果按具体公式计算出萎缩子宫三径之和＜11cm,卵巢体积应＜10cm3或8.8ml.结论经TVS检查是测量子宫与卵巢体积与形态的最佳方法,是筛查绝经后子宫病变与卵巢癌的首选方法.     

甲状腺肿块的B超,CT图像对比分析：附140例报告

本组病例系我院1994至1997年住院患者,均进行B超。CT的检查并经手术病理证实,对其肿块图像对比回顾,总结报告如下。1资料本组140例甲状腺肿块患者,男性42例,女性98例,年龄18～70岁,平均41．2岁,B超采用美国产Acusom－128X刁10超声诊断仪,变频探头,加水囊势进行常规检查,肿块声像图用录像留档。CT采用美国通用电气公司生产Max－640,对其肿块扫描图像放大,调整好窗宽、窗位进行照像留档,并复制小片给县又名目。2结果（见附表）3肿块的B超、CT图像表现3．1甲状腺瘤B超：位于甲状腺实质内,边界清晰,呈园形或精园形,光点…     

天津市正常儿童内脏器官生长发育的超声波测量(二)331例正常儿童662个肾脏的超声波测量与年龄、身高及体重之间的关系

本文作为天津市正常儿童内脏器官生长发育的系列超声波测量内容之二,重点研究了正常儿童肾脏的长、宽、体积与其年龄、身高、体重之间的相互关系。肾脏厚度因作为测量体积而引进的一个参数,其测量在临床上不单独使用,它与身体生长发育因素之间的关系在临床上意义不大,所以在此未予展示。在前一文章中已经证明男女性别之间无显著差异,左右侧别之间有显著差异,故本文区别左右而不分男女进行了进一步的研究。     

2007年广州市2岁以下城市儿童生长发育状况调查分析

对广州市2岁以下城市儿童的生长发育和营养状况进行评价和分析.方法:选择8个社区共计1874例健康儿童,测量儿童的身高、体重,同时对儿童家庭状况、喂养史、父母受教育的程度进行调查.结果:本次调查2岁以下城市儿童各年龄组男女性别差异无显著性(P＞0.05).各年龄组内男女之间比较身高、体重和BMI差异均无统计学意义(P＞0.05),提示生长发育呈正态分布.但各个年龄组儿童的体重、身高(长)与2005年全国标准相比较,在较多的组别低于全国的标准,且差异具有统计学意义.年龄别体重(WAZ)评价指标:低体重的检出率较低,各个年龄组男女童有0.74％～3.8％的WAZ小于-2,各个年龄组都有WAZ大于2的情况.年龄别身高(长)(HAZ)评价指标:各个年龄组男女童有0.68％～7.59％的HAZ小于-2的情况,1.85％～7.14％儿童的HAZ大于2.BMI在各年龄组男、女童呈正态分布,男女之间差异均无统计学意义(P＞0.05).结论:体重、身长、BMI三项指标综合考虑能更客观反映该地区儿童的生长发育和营养状况.     

胎儿复合畸形1例报告

患者女,27岁,主诉:妊娠37周,行产前B超检查发现:胎儿颅骨光环完整,位于耻联合上方,双侧脑室不宽,胎头双顶径8.5cm,胎心搏动规律,颈椎排列规则,胸椎排列紊乱、成角、并见椎体缺失,骶尾椎未显示。双肾体积增大且彼此相邻,形态尚规整,其内呈小蜂窝状暗区回声,测量其中一个暗区大小约1.1×0.8cm,羊水最深平段约6.5cm,胎盘位于子宫前壁,其     

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.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.