不同影像技术对胰腺癌模型兔原位种植建模效果的评价与比较

目的:比较CT、MRI及超声平扫检查对胰腺癌模型兔建模效果的评价价值。方法:建立胰腺癌模型兔10只,对每只模型兔采用CT、MRI、超声平扫等影像检查,比较不同影像技术对模型兔肿瘤病灶的检出率;并对肿瘤采用磁共振波谱(MRS)分析肿瘤代谢情况。结果:建模成功3周末,死亡5只,存活5只;3种检查方式均能发现胰腺区的肿瘤病变和腹腔积液,检出率均能够达到100%。在对肿大淋巴结和血管包绕的检出中,MRI与CT的检出率相当,均优于超声平扫;在对远处转移的检出中,MRI要优于另外两种方式,但三种影像检查方法的病灶肿大淋巴结、血管包绕及远处转移等检出率比较,差异均无统计学意义(χ²=3.619,χ²=3.000,χ²=6.857;P>0.05)。MRS分析能够清晰显示胆碱(Ch)、肌酐(Cr)和N-乙酰天门冬氨酸(NAA)峰。结论:对动物肿瘤模型采用CT、MRI和超声平扫检查,可以获得较为满意的检测效果,但是在行动物实验过程中,需要根据实际的肿瘤种植位置和肿瘤转移位置采用合适的影像检查方法。     

El manejo de la torsión testicular en Urgencias: lecciones aprendidas de las reclamaciones por responsabilidad profesional médica

ObjectiveTo evaluate emergency care for testicular torsion in medical professional liability claims.MethodClaims related to testicular torsion from 2000 to 2018 were located. The assistance provided and the association with medical professional liability were analyzed.ResultsEighty complaints were identified, testicular pain was reported in 83.75% of first consultations, with a mean evolution time of 15.5 h. The mean time to diagnosis was 7.98 days. The first consultation was at the hospital in 75.1% of cases, but an ultrasound was performed only in 7.5%. When testicular torsion diagnosis was performed, 97.3% had undergone ancillary tests. The medical professional liability was significantly associated with non-criminal proceedings and with less than 6 h of symptoms’ evolution, and, within this subgroup, without undergoing an ultrasound scan.ConclusionsLate consultations, wrong diagnosis and late diagnosis are claimed. When medical professional liability are claimed by means of non-criminal law, the existence of responsibility is frequently considered, even more in those cases when the consultation took place before 6 h of evolution with no ancillary tests having been performed.     

Role of shear wave elastography measured in the flaccid state in predicting arteriogenic erectile dysfunction

The gold-standard method for diagnosing arteriogenic erectile dysfunction (AED) is the penile Doppler ultrasonography. We proposed a novel method for predicting AED using ultrasonic shear wave elastography (SWE) considering that the former was invasive and variable. A total of 98 male patients were enrolled in our study, referred for ED between December 2018 and October 2020. For comparison, we also included 42 volunteers from the Healthy Physical Examination Center of our hospital. The Penile Doppler Ultrasonography (PDU) and SWE were performed for all patients with the intracavernosal injection (ICI). We named three groups as AED group, nonvascular ED group and healthy controls group. No statistically significant differences were found among the three groups in terms of demographic and clinical characteristics. There were no significant differences in IIEF-5 between AED and nonvascular ED. A significant (r = 0.642, p < 0.0001) positive correlation between flaccid and erectile SWE was observed. With a cut-off value of 13.45 KPa, the area under curve, specificity, and sensitivity of the SWE values under the flaccid state in distinguishing AED from healthy subjects were 0.867, 0.786 and 0.896 respectively. The SWE value in the flaccid state can distinguish the AED from healthy subjects.     

血清Toll样受体4联合超声血流指标与子痫前期围生儿结局的相关性

目的探讨血清Toll样受体4 (TLR4)联合超声血流指标与子痫前期围生儿结局的相关性。方法选择2017年2月-2019年6月在南充市中心医院住院分娩的子痫前期孕妇125例作为病例组,同期选择孕期健康和血压正常的孕妇125例作为对照组,所有入选者都给予超声血流检查,检测血清TLR4表达情况,调查病例组围生儿的结局并进行相关性分析。结果病例组孕妇大脑中动脉超声RI与PI值都显著高于对照组孕妇,血清TLR4值显著高于对照组孕妇,差异均有统计学意义(P<0.05)。所有围生儿都顺利分娩,病例组围生儿的1 min Apgar评分与5 min Apgar评分都显著低于对照组,差异有统计学意义(P<0.05)。在病例组中Pearson相关分析显示围生儿的5 min Apgar评分水平都与血清TLR4值及RI、PI呈现负相关性(P<0.05)。结论子痫前期患者表现为血清TLR4表达量上升与超声血流指标升高,且与患者的围生儿结局密切相关。     

超声技术在肝纤维化诊断中的应用进展

肝纤维化是临床上各类慢性肝病进行性发展的重要病理过程之一,可进一步发展为肝硬化甚至肝癌。肝纤维化的早期诊断对预防各类肝病发展为肝硬化及肝癌具有重要意义。肝穿刺活检是诊断肝纤维化的“金标准”,但其具有创伤性,易引起多种并发症,目前无法作为常规筛查手段。近年来,超声检查技术作为一种无创性肝纤维化诊断方法在临床上得到越来越多的应用,并取得了诸多进展。本文就超声技术在肝纤维化诊断方面的研究现状作一综述。     

超声耦合剂最佳声阻的近似计算

目前国内超声医学界对最佳耦合剂声阻数值的选择尚无较为准确的说法。作者从声束通过介质薄层透射率公式出发，用近似计算方法，找出了最佳耦合剂数值的大小，并对适宜的声头材料、耦合剂材料提出建议。     

2158 例神经管缺陷儿的产前B型超声波诊断分析

回顾性分析1990～1993年全国28省、市、自治区233所医院,住院分娩的孕满28周的2158例神经管缺陷儿的产前诊断情况,了解我国神经管缺陷儿产前B型超声波诊断情况.结果显示:我国神经管缺陷产前诊断的比例为61.8%,产前B型超声波诊断的比例为56.5%,其中无脑畸形、脑膜脑膨出、脊髓外翻的产前B型超声波诊断比例分别为66.7% 、62.5%、52.5%.胸段(46.4%)、腰段(43.4%)的脊柱裂产前B型超声波诊断的病例较颈段 (35.5%)、骶段(31.7%)高(P<0.05).省级、市级、县级及部队工矿医院神经管缺陷的产前B型超声波诊断比例分别为55.7%、59.4%、49.0%、57.2%.1991～1993年神经管缺陷产前B型超声波诊断比例分别为53.5%、55.8%、60.7%、54.7%.无脑畸形、脑膜脑膨出、脊髓外翻产前B型超声波诊断的比例较高.     

青海省甘德县人群包虫病流行病学调查

用Ｄｏｔ－ＥＬＩＳＡ和Ｂ超、Ｘ线在果洛州甘德县进行了人群包虫病的流行病学调查。结果表明,人群包虫病血清阳性率为１０．８３％。男性和女性分别为９．２９％和１２．９２％。Ｂ超、Ｘ线检查阳性率为５．７７％,男性和女性分别为４．８３％和７．０５％。女性高于男性不同职业血清阳性率和Ｂ超、Ｘ线检查阳性率均以牧民最高（１７．５６＾和１１．５６％）随年龄增加,人群包虫病血清阳性率和Ｂ超、Ｘ线检查阳性率越高。不同地