Current state and effectiveness of abdominal ultrasonography in complete medical screening

Purpose The current state and effectiveness of abdominal ultrasonography (US) were investigated by reviewing statistical data for US of the kidney as part of complete medical screenings conducted at our institution between April 1994 and March 2004. Methods Among 4339 individuals with US findings, computed tomography (CT) was performed on 129 individuals at our institution. Among these individuals, US findings and CT diagnoses were compared and analyzed. Results US findings indicated renal tumors in 73 of the 129 subjects, and the breakdown of CT diagnoses for these 73 individuals was as follows: no lesion, n = 45 (61.6%); simple renal cyst, n = 13 (17.8%); complicated renal cyst, n = 5 (6.8%); suspected malignant tumor, n = 5 (6.8%); renal angiomyolipoma, n = 2 (2.7%); pelvic dilatation, n = 1 (1.4%); granuloma, n = 1 (1.4%); teratoma, n = 1 (1.4%). Magnetic resonance imaging (MRI) was performed on 4 of the 5 subjects with suspected malignant tumor, and surgery was performed in all 4 cases with suspected kidney cancer. Kidney cancer was histopathologically confirmed in 2 patients, resulting in a detection rate of 0.046% for kidney cancer by US as part of a complete medical screening. In the 2 patients with kidney cancer, differentiating cystic renal cell cancer from a renal cyst was not possible based on US findings alone in 1 patient, and no thorough examinations were performed in the 3 years leading up to surgery. Conclusions These results suggest that additional US and thorough examinations are necessary if a lesion cannot be confirmed as a simple renal cyst on initial US. Furthermore, to improve the skill levels of healthcare professionals who perform and interpret US, a feedback system should be established where data related to complete medical screenings are available to the personnel involved.     

婴儿母乳喂养与学龄前肥胖症关系的病例对照研究

目的:探讨婴儿期母乳喂养行为与学龄前期单纯性肥胖症发生之间的关系,为预防儿童单纯性肥胖症提供理论依据。方法:对1800名青岛市和滨州市四五岁儿童的婴儿期母乳喂养情况及其体重指数(BMI)发育情况等进行调查,分析母乳喂养类型和持续时间与学龄前肥胖症发生之间的关系。结果:单因素分析发现4个月内只喂母乳、主要喂母乳、母乳与配方奶量基本相同、主要喂配方奶、只喂配方奶者四五岁时肥胖发生率分别为12.6%,13.0%,17.0%,18%,30%;儿童母乳喂养持续时间0,<1,1～3,4～6,7～9,9个月以上者四五岁时肥胖发生率分别为29%,30%,33%,17%,14%,12%。母乳喂养类型和持续时间不同的儿童学龄前期单纯性肥胖症发生率不同(χ2=10.407,P<0.05;χ2=20.903,P<0.001);多因素logistic回归分析发现4个月内喂配方奶量越多,肥胖发生率越高(OR=1.120,χ2=8.233,P<0.01),母乳喂养持续时间越长,肥胖发生越少(OR=0.782,χ2=6.609,P<0.05)。结论:婴儿母乳喂养对学龄前期肥胖症的发生有预防作用;婴儿期应提倡母乳喂养,并尽可能延长母乳喂养时间至9个月以上。     

有氧运动对重度单纯性肥胖少儿血载脂蛋白的影响

目的 了解有氧运动对单纯性肥胖少儿血载脂蛋白的影响。方法 对 7 名重度单纯性肥胖少儿进行 10 周有氧运动比较运动前后血载脂蛋白(Apo)的变化。结果 重度单纯性肥胖少儿的ApoB明显高于对照组( P <0.01),但 10 周有氧运动可使肥胖少儿血ApoB降低( P <0.05),且ApoAⅠ有降低趋势( P >0.05)。结论 有氧运动可改善重度肥胖少儿的血脂质代谢紊乱。     

New classification of dynamic computed tomography images predictive of malignant characteristics of hepatocellular carcinoma

Aim: The aim of this study was to elucidate whether the histopathological characteristics of hepatocellular carcinoma (HCC) can be predicted from baseline dynamic computed tomography (CT) images. Methods: This retrospective study included 86 consecutive patients with HCC who underwent surgical resection between January 2000 and September 2008. The arterial‐ and portal‐phase dynamic CT images obtained preoperatively were classified into four enhancement patterns: Type‐1 and Type‐2 are homogeneous enhancement patterns without or with increased arterial blood flow, respectively; Type‐3, heterogeneous enhancement pattern with septum‐like structure; and Type‐4, heterogeneous enhancement pattern with irregular ring‐like structures. We also evaluated the predictive factors for poorly‐differentiated HCC, specific macroscopic type of HCC (simple nodular type with extranodular growth [SNEG] and confluent multinodular [CMN]) by univariate and multivariate analyses. Results: The percentages of poorly‐differentiated HCC according to the enhancement pattern were three of 51 nodules (6%) of Type‐1 and ‐2, three of 24 (13%) of Type‐3, and eight of 11 (73%) of Type‐4. The percentages of SNEG/CMN according to the enhancement pattern were 12 of 51 nodules (24%) of Type‐1 and ‐2, 13 of 24 (54%) of Type‐3, and five of 11 (45%) of Type‐4. Multivariate analysis identified Type‐4 pattern as a significant and independent predictor of poorly‐differentiated HCC (P < 0.001) while Type‐3 pattern was a significant predictor of SNEG/CMN (P = 0.017). Conclusion: Heterogeneity of dynamic CT images correlates with malignant characteristics of HCC and can be potentially used to predict the malignant potential of HCC before treatment.     

银杏达莫联合疏血通治疗隐匿性肾炎单纯血尿72例疗效观察

目的探讨使用银杏达莫联合疏血通对隐匿性肾炎单纯血尿的治疗效果。方法 72例隐匿性肾炎单纯血尿的患者使用银杏达莫联合疏血通进行治疗,按病程、疗程及治疗前血尿情况对患者的疗效进行分析。结果患者基本痊愈41例,好转20例,无效11例;其中病程较短者及尿检红细胞＋＋＋＋~＋＋＋者治愈率较高;疗程长短与治愈率之间的关系并不确切。结论银杏达莫联合疏血通对隐匿性肾炎单纯血尿治疗效果较好,尤其对病程较短及血尿明显的患者,疗程不宜过短或过长。     

电针对单纯性肥胖大鼠下丘脑肥胖抑制素表达的影响

目的：观察电针治疗对单纯性肥胖大鼠肥胖抑制素的影响。方法：采用高脂高糖饮食制备营养性肥胖大鼠模型。将造模成功的24只肥胖大鼠随机分为模型组和电针治疗组,另选12只正常大鼠作为空白对照组。电针治疗组的大鼠予电针刺激双侧足三里、天枢、脾俞穴,连续治疗15 d;空白对照组和模型组大鼠不予干预。观察各组大鼠体质量,治疗结束后,检测内脏脂肪量,用放射免疫法检测血清肥胖抑制素含量,免疫组织化学方法检测下丘脑组织中肥胖抑制素的表达。结果：模型组大鼠体质量显著高于空白对照组（P〈0.01）。造模后饲以普通饲料,模型组大鼠的体质量和内脏脂肪量显著高于空白对照组（P〈0.01）,体质量增加量显著低于空白对照组（P〈0.01）;电针治疗组大鼠的体质量、体质量增加量和内脏脂肪量显著低于模型组（P〈0.01）,与空白对照组比较差异无统计学意义。模型组下丘脑组织中肥胖抑制素表达水平和血清中肥胖抑制素含量明显高于空白对照组（P〈0.05,P〈0.01）;模型组下丘脑组织中肥胖抑制素表达水平与电针治疗组比较,差异亦有统计学意义（P〈0.01）。结论：电针对肥胖大鼠具有良好的减肥效果,其作用机制可能与增强下丘脑组织肥胖抑制素的表达有关。     

自制简易肩垫在困难气管插管中的应用

目的:探讨急诊科困难气管插管患者中使用简易自制抬高肩部装置(以下简称自制肩垫)辅助开放气道的可行性。方法:对比观察我院急诊科30例困难气管插管患者,15例应用自制简易肩垫辅助开放气道,15例采用肩部垫枕头的方法辅助开放气道,观察两组患者开放气道需要的时间及插管成功率,分析自制肩垫的应用可行性。结果:应用自制简易肩垫辅助插管组一次插管成功率与对照组比较,差异有统计学意义(P<0.05)。结论:自制简易肩垫在困难气管插管中可以帮助我们快速有效地暴露声门,节省人力,提高气管插管成功率。     

简单皮瓣修复术在手外伤治疗中的应用

目的探讨在手外伤致皮肤软组织缺损病例中应用简单皮瓣修复技术的临床效果。方法以我院自2008年1月-2009年5月收治的手外伤致皮肤软组织缺损病例19例为研究对象,其中单纯皮肤软组织缺损10例,合并肌腱、骨外露4例,合并感染者3例,单纯指体远节缺损者2例,根据其手部皮肤软组织缺损的性质、部位、缺损大小等,选择采取腹部带蒂皮瓣、邻指皮瓣、中厚皮片移植等简单皮瓣技术进行修复。结果对19例患者行简单皮瓣修复,17例成活,2例腹部带蒂皮瓣因术后发生挤压致皮瓣缺血经纠正后成活,1例腹部带蒂皮瓣断蒂后出现皮缘部分坏死,经积极换药后愈合。术后继续随访2～6个月,移植皮瓣颜色与正常皮肤接近,弹性佳,无挛缩,手外形及功能恢复良好,日常生活影响不明显。结论简单皮瓣修复术在治疗手外伤软组织缺损时,手术方法简单,皮辨成活率高,对正常组织损伤小,术后手功能恢良好,不失为临床治疗手部皮肤软组织缺损的一种较好方法。     

贺氏针灸三通法治疗单纯性肥胖症理论探讨

针对单纯性肥胖症痰湿膏脂瘀滞＂经脉不通＂的病机,发挥贺氏针灸三通法综合治疗之优势,初期用毫针微通法治本,注重调理脾（胃）肾、通利三焦、疏通任督带脉及辨证取穴,局部结合火针温通法与刺络拔罐强通法治标,标本同治,补虚泻实,以缩短疗程、提高疗效;后期体重减轻明显阶段,侧重用微通法求本施治,防止体重反弹。三法合用疏通经络,调理脏腑,以达平衡阴阳、扶正祛邪之目的。