超声成像特征联合Mortalin蛋白、SMOC-2蛋白在子宫内膜癌诊断中的应用价值

目的 探讨超声成像特征联合寿命蛋白(Mortalin)、SPARC相关钙粘连分子2(SMOC-2)蛋白在子宫内膜癌诊断中的应用价值.方法 选择96例子宫内膜癌患者,均能完成经阴道超声检查;术中收集癌组织和正常子宫内膜组织,采用免疫组化染色法测定Mortalin蛋白、SMOC-2蛋白表达,分析Mortalin蛋白、SMO...     

实时剪切波弹性成像及彩色脉搏波成像技术评估不同级别高血压患者颈总动脉弹性

目的应用实时剪切波弹性成像及彩色脉搏波成像技术分析高血压患者颈总动脉纵向及环向血管壁硬度,比较不同级别高血压患者颈总动脉血管壁硬度差异,探讨2种技术在高血压分级诊断中的应用价值。 方法选取2016年2至12月云南省第二人民医院收治的临床确诊的高血压患者120例。根据中国高血压防治指南（2010年版）分级分为1、2、3级高血压组3组各40例。另选取同期云南省第二人民医院体检无高血压病史的健康志愿者40名作为健康对照组。应用实时剪切波弹性成像技术获得所有研究对象颈总动脉前壁及后壁的弹性模量值（Mean、Max、Min）,得到颈动脉的纵向血管壁硬度;应用彩色脉搏波成像技术获得所有研究对象颈总动脉壁的脉搏波速度,包括收缩期开始时的脉搏波速度（PWVBS）、收缩期结束时的脉搏波速度（PWVES）,得到颈动脉的环向血管壁硬度。采用单因素方差分析比较不同级别高血压组患者与健康对照组受试者颈总动脉壁硬度值（Mean、Max、Min、PWVBS、PWVES）,进一步组间两两比较采用LSD-t检验;采用Pearson相关分析法分析高血压患者颈动脉壁硬度值（Mean、Max、Min、PWVBS、PWVES）与高血压级数的相关性。 结果颈总动脉（前壁及后壁）的弹性模量值（Mean、Max、Min）均为高血压3级组>高血压2级组>高血压1级组>健康对照组,且任意2组间比较差异均有统计学意义。Pearson相关分析结果显示,颈总动脉（前壁及后壁）的弹性模量值（Mean、Max、Min）与高血压级数均有相关性（r=0.817、0.767、0.796,P均<0.05）。随着高血压级数的增高,高血压患者颈总动脉（前壁及后壁）的弹性模量值（Mean、Max、Min）呈增高趋势。颈总动脉脉搏波速度（PWVBS、PWVES）均为高血压3组>高血压2组>高血压1组>健康对照组,且任意2组间比较差异均有统计学意义。Pearson相关分析结果显示,脉搏波速度（PWVES、PWVBS）与高血压级数均有相关性（r=0.650、0.585,P<0.05）。随着高血压级数的增高,高血压患者脉搏波速度（PWVBS、PWVES）呈增高趋势。 结论实时剪切波弹性成像及彩色脉搏波成像技术为高血压分级诊断提供了一种有价值的参考。随着高血压级数的增高,高血压患者颈总动脉壁的纵向及环向血管壁硬度均呈增高趋势,且两者具有一致性。     

Algorithm for the multidisciplinary management of hemorrhage in EUS-guided drainage for pancreatic fluid collections

Pancreatic fluid collections (PFCs), common sequelae of acute or chronic pancreatitis, are broadly classified as pancreatic pseudocysts or walled-off necrosis according to the revised Atlanta classification. Endoscopic ultrasound (EUS)-guided drainage is often considered a standard first-line therapy preferable to surgical or interventional radiology approaches for patients with symptomatic PFC. EUS-guided drainage is effective and successful; it has a technical success rate of 90%-100% and a clinical success rate of 85%-98%. Recent studies have shown a 5%-30% adverse events (AEs) rate for the procedure. The most common AEs include infection, hemorrhage, perforation and stent migration. Hemorrhage, a severe and sometimes deadly outcome, requires a well-organized and appropriate treatment strategy. However, few studies have reported the integrated management of hemorrhage during EUS-guided drainage of PFC. Establishing a practical therapeutic strategy is an essential and significant step in standardized management. The aim of this review is to describe the current situation of EUS-guided drainage of PFCs, including the etiology and treatment of procedure-related bleeding as well as current problems and future perspectives. We propose a novel and meaningful algorithm for systematically managing hemorrhage events. To our limited knowledge, a multidisciplinary algorithm for managing EUS-guided drainage for PFC-related bleeding has not been previously reported.     

Evaluation of revascularization after total arch replacement in common carotid artery occlusion

Occlusion of the common carotid artery (CCA) is rare. CCA occlusion (CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography (SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow (the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.     

自制彩超助显剂在胃癌诊断中的应用

目的 探讨理想彩超胃助显剂的制备方法和在胃癌诊断中的效果。方法 选取2014-05-01-2017-05-30在本院普外科门诊进行胃癌检查的患者1000例,采用随机对照方法分为实验组与对照组,每组各500例。经彩超筛查诊断的胃溃疡、胃癌患者常规行胃镜检查取活检,最后病理诊断确诊。结果 实验组与对照组胃癌检出率及早期胃癌、进展期胃癌诊断符合率,差异有统计学意义。结论 自研彩超胃助显剂是一种使用方便,对比度好,超声伪影少的胃腔内助显剂,能显著提高彩超筛查胃癌的检出率及诊断率。     

Is dermatological lilac really lilac?

Background/Objective

Dermatologists use the word lilac to describe a shade of erythema; especially in lichen planus, morphea, and dermatomyositis. The aim of this study to determine whether or not there is a color really consistent with a lilac color, when they perceive it.

宫颈内口处彩色多普勒超声诊断价值

目的 探讨宫颈内口处彩色多普勒超声检查的临床价值。方法 收集我院2015年1月~2017年12月门诊28周至分娩前的孕产妇共8967例,在对每位孕产妇行常规彩色多普勒超声检查的同时加用取样框置于宫颈内口处彩超检查,在常规检查基础上发现血流异常信号者加用取样框置于宫颈内口处彩超检查,收集异常血流信号病例并追踪患者的临床资料进行统计学分析。结果 在8967例孕妇中,常规检查发现异常血流信号者31例,将取样框置于宫颈内口处彩超检查发现前置胎盘18例,前置胎盘合并胎盘植入10例,中央型前置胎盘合并胎膜下出血1例,胎膜血管前置1例,脐带先露1例。结论 宫颈内口处彩色多普勒超声检查能明确诊断常规检查发现的异常血流信号并及早发现异常情况,为临床诊断提供有力的参考依据、选择合适的分娩方式,降低产时及产后大出血、子宫切除等风险。     

Endoscopic ultrasound-guided fine-needle aspiration biopsy - Recent topics and technical tips

Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips.     

Nerve hydrodissection for carpal tunnel syndrome: A prospective,randomized, double-blind,controlled trial

Introduction: In this study we explored the efficacy of nerve hydrodissection for mild-to-moderate carpal tunnel syndrome (CTS). Methods: Thirty-four participants were randomly assigned to an intervention group or a control group. One 5-ml dose of normal saline was injected into the intracarpal and subcutaneous regions in subjects of both groups, respectively. The primary outcome measure was the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score. Secondary outcomes were cross-sectional area of the median nerve and electrophysiological studies. Assessments were performed before the injection and at 1, 2, 3, and 6 months postintervention. Results: Compared with the control group, the intervention group showed significantly greater improvement at the second and third posttreatment months according to BCTQ severity score and at all time-points for cross-sectional area of the median nerve (P < 0.01). Discussion: Our study demonstrates the therapeutic effects of nerve hydrodissection for mild-to-moderate CTS. Muscle Nerve 59 :174–180, 2019     

VITA 3D-Master比色片数码颜色在Lab颜色空间的分布

目的 获得VITA 3D-Master比色板各色片的数码颜色在Lab颜色空间的色度分布情况。方法 用Nikon D700单镜头反光数码相机在D50标准光源下,对VITA 3D-Master比色板进行拍摄,用Photoshop软件直方图读取每个比色片中1/3区域的R、G和B平均值,根据该值建立新的均匀颜色图像文件作为该比色片的平均颜色,在Eye-One Photo SG软件中建立相同颜色色块的文件,读取Lab数值,进行比较和分析。结果 VITA 3D-Master比色板的26个色片在三维Lab颜色空间中的色度分布,明度轴上呈5个层面分布;在2、3、4层面内,6个色片围绕中间色片呈非等距不规则分布。结论 对VITA 3D-Master比色片的数码颜色在Lab颜色空间分布的分析,有助于提高临床工作中牙齿颜色的选择、交流和复制的准确性。