彩色多普勒超声诊断宫内妊娠合并宫外妊娠的临床价值

目的:探讨彩色多普勒超声检查对宫内妊娠合并宫外妊娠的诊断价值。方法:回顾分析2010年1月至2013年12月收治的19例体外受精-胚胎移植术后临床诊断为宫内妊娠合并宫外妊娠患者的术前彩色多普勒超声图像特征,并随访其预后。结果:19例患者中,术前超声诊断为宫内妊娠合并宫外妊娠18例(合并宫角妊娠8例,合并输卵管妊娠10例),1例漏诊。19例患者均住院手术治疗并进行随访,其中13例宫内妊娠已分娩或继续妊娠,2例行手术终止妊娠(1例因胚胎枯萎行手术终止妊娠,1例因难免流产行手术终止妊娠),2例自然流产,2例失访。结论:彩色多普勒超声对诊断宫内妊娠合并宫外妊娠有重要价值,能够及早发现宫内妊娠合并宫外妊娠并指导临床处理。     

新生儿肺出血血栓素B2和纤维蛋白肽A的变化及其临床意义

目的探索新生儿肺出血的发病机制和早期监测的方法，为防治肺出血提供理论基础。方法对新生儿窒息和新生儿硬肿症的肺出血和无肺出血患儿血液中血栓素Ｂ２（ＴＸＢ２）和纤维蛋白肽Ａ（ＦＰＡ）进行了对照观察。分别采用高效液相色谱法及放射免疫法测定血浆ＦＰＡ和ＴＸＢ２的浓度。同时对肺出血患儿作血气分析。结果新生儿硬肿症肺出血组和新生儿窒息肺出血组ＴＸＢ２及ＦＰＡ的浓度无明显差异（Ｐ＞０．０５）；新生儿硬肿症肺出血组ＴＸＢ２及ＦＰＡ值较新生儿硬肿症无肺出血组、正常新生儿组明显升高（Ｐ＜０．０１）；新生儿窒息肺出血组ＴＸＢ２及ＦＰＡ值较新生儿窒息无肺出血、正常新生儿组明显升高（Ｐ＜０．０１）。结论新生儿肺出血患儿存在血小板活化和异常凝血；窒息和硬肿症所致的新生儿肺出血都存在止血凝血功能障碍这一共同因素；ＴＸＢ２和ＦＰＡ可作为预测新生儿肺出血的早期客观监测指标     

第二届“医学影像学专业”建设座谈会纪要

1993年5月6日—8日临床医学影像杂志社在昆明市召开第三届全国临床医学影像学术会议暨第二届医学影像学专业建设座谈会,邀请设置“医学影像学专业”的高等医学院校的院、系领导和有关教研室主任、教授及教学管理干部参加。参加会议的有中国医科大学、哈尔滨医科大学、天津第二医学院、泰山医学院、南京铁道医学院、牡丹江医学院、广州医学院、苏州医学院、白求恩医科大学及部分地方医院的有关专家共22人。国家教委高等教育司医药教育处姜常胜处长出席     

某市农村社区健康老年人主观幸福度评定的相关因素分析

目的探讨重庆市农村社区老年人主观幸福度及其影响因素。方法采用多级分层随机抽样方法,以纽芬兰大学幸福度量表(MUNSH)作为评定工具,对重庆市588名60岁及以上农村社区健康老年人主观幸福度进行调查。并采用多元回归分析方法分析影响老年人主观幸福度的相关因素。结果在588名健康老人中,MUNSH总分6～48分,平均(33.78±8.16)分,其中大于24分500例(85.03%);正性情感分(5.99±2.33),负性情感分(1.93±2.32),正性体验分(8.81±3.43),负性体验分(3.11±2.77)。MUNSH评分显示,低文化、无配偶、独居、亲子关系不良、经济收入低、有慢性病、生活能力差、认知水平高、社会支持低的老年人主观幸福度较低,差异有统计学意义(P<0.05)。认知水平、精神质、婚姻、社会支持、掩饰性、神经质、文化、亲子关系、内外向进入回归方程,决定系数R2=38.2%。结论农村社区健康老年人幸福度以正性情感占优势;影响老年人幸福度得分的主要因素包括认知水平、性格特征及家庭因素;提高老年人幸福度,应从这几个方面综合考虑。     

蛋氨酸合酶基因A275 6G位点多态性与非综合征型唇腭裂的关联性研究

Objective To study the association of the A2756G polymorphism of the methionine synthase (MS) gene with nonsyndromie cleft lip with or without cleft palate (NSCL/P) in Chinese. Methods Ninety-seven NSCL/P case-parent triads were selected as the case group. One hundred and four healthy subjects and their biological parents were selected as control group. For all subjects the A2756G polymorphism of the MS gene was examined by PCR-RFLP method. Results There was no statistical difference in genotype and allele frequencies for MS A2756G variants among family members between case group and control group. The GG genotype was not detected in the offsprings and mothers. The odds ratio and confidence interval of genotype AG in offspring, father and mother were 1.78(0.74-4.34), 0.80(0. 36-1.79) and 1.26(0. 54-2.93) respectively. The odds ratio and confidence interval of allele G in offspring, father and mother were 1.70(0.78-3.73), 0. 88(0. 49-1. 75) , and 1.23(0.59-2.60) respectively. The G allele did not increase the risk of NSCL/P. Transmission disequilibrium test (TDT) analysis yielded no evidence of linkage disequilibrium (χ2=0.034,P>0. 05). The results of haplotype-based haplotype relative risk (HHRR) analysis (χ2=0.03,P>0.05) and family-based association tests (FBAT) (Z=0. 186, P> 0.05) failed to show association between the MS A2756G variant and the risk of NSCL/P. Conclusion The A2756G polymorphism of the MS gene was not associated with NSCL/P in Chinese in the present study.     

多普勒血流频谱法估测肺出血新生儿肺动脉压的研究

目的　研究肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。方法　用M型二维超声多普勒和脉冲多普勒方法分别测定28例肺出血新生儿和28例非肺出血新生儿(含17例正常新生儿)心脏收缩功能及主肺动脉血流速度频谱,以肺动脉血流峰速时间/右室射血时间(TPV/RVET)比值反映肺动脉压力,分析肺出血新生儿心脏收缩功能和肺动脉压力变化及临床影响因素。结果　肺出血新生儿TPV/RVET比值(0.253±0.041)明显低于正常对照组(0.329±0.058)和非肺出血组(0.301±0.022)(P＜0.01);肺出血新生儿恢复期该比值(0.294±0.033)升高,肺出血死亡组TPV/RVET比值(0.219±0.022)和缩短分数［FS(31±5)%］明显低于存活新生儿(0.270±0.031,TPV/RVET39±7,FS)(P＜0.01);TPV(52±12)ms明显低于存活新生儿(44±8)(P＜0.05)。早产儿肺出血组TPV明显缩短(P＜0.01)。肺出血组TPV/RVET比值与动脉血pH值高度相关(r=0.84,P＜0.01)。结论　肺出血新生儿伴有肺动脉压力升高,严重者心脏收缩功能降低,导致心力衰竭,致新生儿死亡。     

胎儿生长受限仔鼠脂肪组织中葡萄糖转运蛋白4的表达和细胞转位变化

Objective To investigate the effects of fetal growth restriction (FGR) on the expressions and translocation of glucose transporter 4 (GLUT4) in adipose tissue of male offsprings and its relationship with insulin resistance in FGR. Methods Male 8-week-old offspring from maternal with protein-malnutrition or normal diet were studied. The weight of rats at 8 weeks of age were obtained and insulin resistance index (IRI) was examined at 4 weeks and 8 weeks of age. Perinephric fat pads were harvested to measure the expression of GLUT4 mRNA by fluorescent quantitative RT-PCR and the GLUT4 protein level and insulin-stimulated transloeation were assessed by Western blot. Results Birth weight of FGR animals were significantly lower than that of control (t=6.399, P<0.01), but surpassed the control at 8 weeks with increased fasting IRI(P<0.05). The GLUT4 mRNA expression in adipose tissue of FGR rats (0.36± 0.04) was lower than that of control (1.01±0.11) (t=2.854, P<0.05). Declined total GLUT4 protein concentration(913.47±87.32) was also noted in the FGR group compared with the controls (1248.30± 131.52) (t=2.617, P<0.05). After administration of insulin, plasma membrane associated-GLUT4 concentration significantly increased to 897.03±102.87, which was equal to 2.12 times of the basal level (423.05±41.26) in control rats(t=4.759, P<0.01). However, insulin-responsive GLUT4 transloeation was markedly blunted in FGR rats(525.12±54.96) compared with controls, only increased to 1.38 times of the basal level (379.57±38.71)(t=2.083, P<0.05). Conclusions Decreased GLUT4 expression and insulin-stimulated translocation in adipose tissue of the male FGR offspring might be caused by exposure to protein malnutrition during pregnancy, which may disturb the uptake and utilization of glucose and subsequently be related to diabetes mellitus in later life.     

细节管理对护理服务流程再造效果的影响

目的探讨细节管理对护理服务流程再造的作用。方法在床边交接班、发口服药以及患者入院等流程引入细节管理的方法。记录每一细节的事件并予以评价。结果主管护士对患者夜间起居饮食情况的知晓率加权平均值上升(P<0.01),床头柜平均置药杯数、入院患者到达病区后安排床位平均耗时明显减少(P<0.01),患者满意度明显提高(P<0.05)。结论细节管理有利于改善护理服务流程的效果。     

沈阳地区绝经后妇女绝经年限与腰椎骨密度关系的分析

随机调查沈阳地区289例健康的绝经后妇女,年龄和绝经年限,身高、体重、正位腰椎BMD,应用SPSS软件统计分析.发现腰椎L2部位BMD低于其它部位,随绝经年限的增加腰椎各部位BMD有下降的趋势,绝经后前6年间腰椎各部位BMD下降较快,以后下降减慢,并且相对而言L2的BMD下降速度高于其它部位.以年龄和体重指数(BMI)为协变量,经协方差分析显示各绝经年限L2及L3部位BMD有显著差异.提示对绝经后妇女应注意绝经后的前6年的腰椎BMD变化,特别是L2部位的BMD变化.     

从高级医学影像人才的急需看成人高教的紧迫性

从高级医学影像人才的急需看成人高教的紧迫性中国医科大学第二临床学院李书琴，严桂芬，戴巍，李晓晖近年来医学影像技术发展异常迅速，各种新型医学影像设备不断出现，并广泛地应用于疾病的诊断和治疗，促进了医疗水平地提高。医务界已把传统的放射线学，医学超声学，影...