肝内“假平行管征”的超声研究

目的：研究肝内“假平行管征”的超声表现及其临床意义。方法：检查正常成人214例,观察肝右后下静脉（IRHV）的超声表现,统计其显示率,并对10例肝动脉分支扩张的患者进行彩色多普勒和频谱多普勒超声检查。结果：IRHV的显示率为24％,在第一肝门水平注入下腔静脉,和门静脉右后叶支相伴而行,形成“平等管征”。肝内扩张的肝动脉分支在二维超声上与伴行门静脉分支亦构成“平行管征”,但彩色多普勒显示双管内均有血流信号,频谱多普勒分别探测动脉血流频谱和静脉血流频谱。结论：认识IRHV和肝内扩张的肝动脉分支有助于鉴别真假“平行管征”,有助于阻塞性黄疸的鉴别诊断。     

Imaging Features of Paratesticular Masses

In this pictorial essay, we review the sonographic and other imaging findings of paratesticular masses in correlation with the pathologic findings. The examples include benign and malignant tumors and also non‐neoplastic mass lesions of the paratesticular structures. Diagnostic sonographic findings of these mass lesions as well as correlative findings of other imaging methods are presented.     

组织谐波成像与CT扫描在急性胰腺炎诊断中的应用价值

目的 探讨组织谐波成像技术(THI)及常规二维超声(B-US)与CT扫描在急性胰腺炎超声诊断中的临床应用价值。方法 回顾性分析，应用THI技术与B-US诊断急性胰腺炎，均与手术、病理对照。结果 192例急性胰腺炎，应用THI技术，超声诊断符合率93．8％(180／192)，B-US检出率85．9％(165／192)，CT检出率97．4％(187／192)。对136例胆源性急性胰腺炎的病因，胆石症占89例，超声诊断符合率97．8％(87／89)，CT检出率85．4％(76／89)，胆道蛔虫占47例，超声诊断符合率97．9％(46／47)，CT检出率87．2％(41／47)。其中急性水肿型胰腺炎(间质性)154例，占80．2％(154／192)，急性出血坏死型胰腺炎(坏死性)38例，占19．8％(38／192)。结论 THI与B-US联合应用，可互相取长补短，互相印证，对胆源性急性胰腺炎的病因诊断，优于CT扫描，超声检查方法直接、简便、无痛、无创、迅速、可靠，对制定治疗方案与评估预后，具有重要的临床应用价值。     

Rethinking childhood ependymoma: a retrospective,multi-center analysis reveals poor long-term overall survival

Journal of Neuro-Oncology - Ependymoma is the third most common brain tumor in children, but there is a paucity of large studies with more than 10 years of follow-up examining the long-term...     

GnRH Agonists: Do They Have a Place in the Modern Management of Fibroid Disease?

In the management of women with fibroid disease, GnRH agonists (GnRHa) are frequently used to reduce volume and vascularity before myomectomy, apparently to render the operation easier and reduce operative blood loss, and to enable a transverse supra-pubic incision instead of a midline vertical one. They induce amenorrhoea and thus aid in the correction of pre-operative anaemia. Other gynaecologists use GnRHa to shrink sub mucous fibroids greater than 5 cm in diameter to facilitate access and reduce blood loss and operating time at transcervical resection. GnRHa are also occasionally used as a temporizing measure in women with symptomatic fibroids within the climacteric. We argue against the use of GnRHa in the management of fibroid disease because they are not cost effective, render myomectomy more difficult to apply because they destroy tissue planes, the more difficult enucleation in fact increasing rather than reducing peri-operative blood loss and operating time. When used before myomectomy, they increase the risk of ‘recurrence’ because they obscure smaller fibroids that ‘recur’ when the effects of the GnRHa wear off, and are associated with side effects in situations where they confer no benefits, or where alternative cheaper drugs with fewer side effects are available.