经阴道子宫输卵管声诺维三维超声造影诊断输卵管性不孕症的初步探讨——附36例检测报告

目的：探讨经阴道子宫输卵管声诺维三维超声造影（3D-SonoVue-HyCoSy）诊断输卵管性不孕症的可行性及诊断效能。方法：选择36例不孕症患者共72条输卵管,利用经阴道子宫输卵管3D-SonoVue-HyCoSy诊断输卵管的通畅性和盆腔黏连情况,以腹腔镜下通液检查结果为标准,评价3D-SonoVue-HyCoSy对输卵管通畅性的诊断效能。结果：3D-SonoVue-HyCoSy诊断输卵管阻塞的阳性预测值为87%,诊断输卵管通畅的阴性预测值为84%,诊断通而不畅的符合率为20%,判断输卵管通畅与否的准确度是76%,诊断输卵管阻塞的敏感度为84%,诊断输卵管通畅的特异度为75%。在通畅及通而不畅的35条输卵管的3D-SonoVue-HyCoSy图像中,83%输卵管可见伞端溢出,通畅的25条输卵管中88%可见同侧卵巢周边造影剂溢出环,10条通而不畅的输卵管中7条可见同侧卵巢周边少量溢出;检出盆腔黏连的敏感度15%。结论：经阴道子宫输卵管3D-SonoVue-HyCoSy诊断输卵管性不孕症是可行和有效的,自动三维容积成像功能和声诺维超声造影剂的使用明显提高了输卵管内造影剂持续流动信号的探测水平和输卵管伞端造影剂溢出的识别水平。     

绒毛组织冷冻切片与靶向超声微泡造影剂的结合特性研究

目的本研究旨在探讨耦合抗β-人绒毛膜促性腺素（β-HCG）抗体靶向超声微泡造影剂（TMCA）的稳定性及其与妊娠绒毛组织冷冻切片的结合特性。方法将制备好的TMCA与异硫氰酸荧光素（FITC）标记兔抗鼠IgG抗体稀释液混匀后,用流式细胞仪器检测不同时间点声诺维（SonoVue）微泡和抗β-HCG抗体的结合率。同时用妊娠绒毛组织冷冻切片、正常子宫内膜组织冷冻切片分别与TMCA、声诺维微泡进行结合反应,比较各组结合率、冲洗前后及抗β-HCG抗体预处理前后的结合率。结果流式细胞仪检测结果显示,声诺维微泡与FITC标记兔抗鼠IgG抗体的结合率随时间变化越来越高。寻靶实验发现,TMCA与绒毛组织、子宫内膜组织的结合率差异有显著的统计学意义[（83.30±2.15）%vs.（13.30±2.58）%,P〈0.01];绒毛组织与TMCA、声诺维微泡的结合率差异有显著的统计学意义[（83.30±2.15）%vs.（15.00±3.07）%,P〈0.01]。磷酸盐缓冲液（PBS）冲洗前后TMCA与绒毛组织的结合率差异无统计学意义[（83.30±2.15）%vs.（78.30±4.36）%,P〉0.05]。抗β-HCG抗体预处理前后TMCA与绒毛组织的结合率差异有显著的统计学意义[（83.3±2.15）%vs（16.7±2.5）%,P〈0.01）。结论 TMCA与绒毛组织在体外一定条件下能高效率、高强度、高特异性地稳定结合。     

新型白三烯拮抗剂ONO-1078对人游离支气管收缩的抑制与反转效应

ONO-1078是一种新型白三烯(LT)拮抗剂,可显著抑制LTC_4、LTD_4诱发的豚鼠支气管收缩;但对LTC_4、LTD_4以及抗原诱发的人游离支气管收缩作用的抑制与反转效应,尚待研究。支气管组织来源于肺癌术者。ONO-1078(10~(-8)M～10~(-6)M)对LTC_4、LTD_4诱发的支气管收缩的抑制作用具有浓度依赖性,浓度-反应曲线平行右移,提示为非竞争性,且这种非竞争性的抑制不受I-丝氨酸硼酸酯复合物(可抑制LTC_4转化为LTD_4)的影响,表明ONO-1078是人气管平滑肌中LTC_4和LTD_4的拮     

芒针温针灸对慢传输型便秘肠道传输功能的影响

目的观察芒针温针灸对慢传输型便秘(STC)的治疗效果。方法将209例STC患者随机分为治疗组(106例)和对照组(103例),治疗组采用芒针温针灸治疗,对照组采用西沙必利口服,分别对两组治疗效果和结肠传输功能进行疗效评估。结果经治疗后,治疗组总有效率为92.45%,明显高于组总有效率(79.61%,P0.05)。与治疗前比较,两组均可加速肠道内标记物清除速度(P0.01),治疗组肠道内标记物的清除速度更快(P0.01)。结论芒针温针灸治疗可明显改善STC患者结肠传输功能。     

某评价检测机构擅自更改、简化职业卫生技术服务程序和相关内容案

目的 为提高卫生健康监督人员的办案能力和技巧,加强对职业卫生技术服务机构的监督力度.方法 通过分析对某职业卫生技术服务机构监督检查中发现的问题,依据相关法律法规的要求分析监督人员办案过程中的重点和难点.结果 某职业卫生技术服务机构已接受行政处罚,并对违法行为进行了整改.结论 提高职业卫生技术服务机构的工作质量,为职业卫...     

原发性气管癌1例

患者，女性，２８岁。１８个月前剧烈咳嗽后咯血，当地给予“三七”等药物治疗，２０天后血止。２个月后出现颈前肿痛，颈前可见一绿豆大小凸起，触痛，不影响呼吸及饮食，近半个月颈前肿痛逐渐加剧。１５天前行颈部Ｂ超检查示气管内肿物；行Ｘ线气管分层摄片示颈段气管内...     

三维子宫输卵管超声造影检查和图像分析

目的初步探讨三维子宫输卵管造影对输卵管通畅性的诊断价值。方法回顾分析2008年4月—2010年12月在本院就诊并自愿接受三维子宫输卵管超声造影检查的不孕症患者197例。结果通畅、通而不畅和阻塞的输卵管中,伞端明显可见率依次为89.0%、30.3%、4.0%;卵巢周边明显光环显示率分别为90.0%、52.3%、17.3%;将197例患者按照输卵管通阻情况分为6组,各组子宫直肠窝造影剂明显积聚发生率从高到低依次为97.1%、82.7%、68.2%、40.0%、17.6%、0.0%;有明显阻力发生率从高到低依次为72.2%、35.3%、30.0%、27.3%、3.8%、2.9%;有明显不适发生率各组间差异有统计学意义。结论综合分析三维和编码对比显像模式下输卵管伞端、卵巢周边明显光环显示率等可用于评估输卵管通畅性,三维子宫输卵管造影动态、简单、无创,可作为检测输卵管通畅性的重要方法。     

输卵管声诺维三维超声造影的临床综合评价

目的：探讨经阴道子宫输卵管声诺维三维超声造影（3D-HyCoSy）诊断输卵管性不孕症的诊断效能及优势。方法收集1043例行输卵管3D-HyCoSy 检查不孕症患者的造影资料,分析3D-HyCoSy的影像分级、其诊断输卵管通畅的三维特征以及不良反应。总结95例随后行腹腔镜下通液检查不孕症患者的输卵管3D-HyCoSy及腹腔镜下通液检查结果,以腹腔镜下通液检查为金标准,分析3D-HyCoSy对输卵管阻塞的诊断效能。结果1043例患者的3D-HyCoSy检查结果中,易读图像为853例,占81.8％。在通畅的输卵管中,鸟尾状或树枝状伞端溢出的出现率为93.9％。检查过程中仅8例有明显痛感。以腹腔镜下输卵管通液为金标准,3D-HyCoSy检查诊断95例患者输卵管阻塞的敏感度为93％、特异度为88％、总符合率为90％、阳性预测值为86％,阴性预测值为94％。3D-HyCoSy和腹腔镜下输卵管通液检查的一致性检测的Kappa值为0.8550（P＜0.01）,超过0.75,有良好的一致性。结论子宫输卵管3D-HyCoSy检查具有其独特的三维影像学特征,用于评估不孕症患者输卵管通畅性安全、有效,可作为目前无创性判断输卵管通畅性的首选方法之一。     

胎儿胃畸胎瘤的超声诊断价值

目的探讨胎儿胃畸胎瘤产前超声诊断的意义。方法回顾性分析近年来在我院产前诊断检出的胎儿胃畸胎瘤患者2例的临床、超声及病理特点,并进行文献复习。结果2例均引产,男死婴,超声下胎儿腹腔内混合回声包块,声像特点符合畸胎瘤声像特征;病理结果1例为胃未成熟畸胎瘤,1例为胃成熟畸胎瘤。结论胎儿胃畸胎瘤罕见,容易误诊,最终确诊有赖于病理检查,但超声波是该病简便,直接的检出方法,对判断胎儿预后有很好的帮助。     

Effects of electroacupuncture of different frequencies on SP and VIP expression levels in colon of rats with slow transit constipation

Objective

To observe the effects of electroacupuncture (EA) of different frequencies on the expression levels of substance P (SP) and vasoactive intestinal peptide (VIP) in the colon of rats with slow transit constipation (STC).

Methods

One hundred healthy male Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group, a low-frequency EA group, a high-frequency EA group and a variable-frequency EA group, with 20 rats in each group. The rats in the normal group were fed with normal diet. The rats in the other groups were fed with phenethylpiperidine in the diet at a dose of 8 mg/(kg·bw) per day, for 120 d, to establish the STC model. Rats in the normal group and the model group did not receive any treatment; rats in the low-frequency EA group were treated with 2 Hz continuous wave EA, rats in the high-frequency EA group were treated with 100 Hz continuous wave EA, and rats in the variable-frequency EA group were treated with 2 Hz/100 Hz sparse-dense EA. The current intensity of the EA was determined by the slight vibration of the rat limbs without painful screaming. The intervention was performed once a day, 15 min/time for continuous 15 d. After treatment, the intestinal transit function and the expression levels of SP and VIP in the colon of the rats in each group were determined.

Results

After treatment, the defecation duration of the first dark stool in the model group was significantly longer than that in the normal group (P<0.05); the defecation durations of the first dark stool in the low-frequency EA group, high-frequency EA group and variable-frequency EA group were significantly shorter than the duration in the model group (all P<0.05); compared with the low-frequency EA group, the first dark stool defecation duration of rats in the variable-frequency EA group was significantly shorter (P<0.05); compared with the normal group, the SP and VIP expression levels in the colon of the model group were significantly decreased (both P<0.01); the SP and VIP expression levels in the colon of the low-frequency EA group, the high-frequency EA group and the variable-frequency EA group were significantly higher than those in the model group (all P<0.05); compared with the high-frequency EA group, the SP expression levels in the colon in the low-frequency EA group and the variable-frequency EA group were significantly increased (both P<0.05); compared with the low-frequency EA group, the VIP expression levels in the colon in the high-frequency EA group and the variable-frequency EA group were significantly increased (both P<0.05).

Conclusion

EA improves the intestinal function of STC model rats by regulating the expression levels of SP and VIP in rat colon. The EA stimulation with 100 Hz continuous wave, 2 Hz/100 Hz sparse-dense wave shows a better improvement in the colonic transit function in STC rats, followed by 2 Hz continuous wave.