阴道超声辅助行腹腔镜剔除术在治疗多发性子宫肌瘤中的临床疗效

目的：研究分析阴道超声辅助行腹腔镜剔除术在治疗多发性子宫肌瘤中的临床疗效。方法：随机选取2015年1月~2016年1月于我院就诊的多发性子宫肌瘤患者82例,随机均分为观察组与对照组,各41例。对照组行腹腔镜子宫肌瘤剔除术,观察组使用阴道超声辅助行腹腔镜子宫剔除剔除术,观察并对比两组患者的临床疗效与预后。结果：两组患者手术时间、术中出血量、肠胃功能恢复时间、住院时间等对比差异不显著,无统计学意义(P>0.05);且两组患者术后并发症发生率对比差异不显著,无统计学意义(P>0.05);观察组患者的术后肌瘤残留率显著低于对照组(P<0.05),肌瘤直径显著小于对照组(P<0.05);观察组患者的术后1年复发率显著低于对照组(P<0.05);结论：在多发性子宫肌瘤治疗中采用阴道超声辅助行腹腔镜子宫肌瘤剔除术,能够有效降低子宫肌瘤残留率,并显著降低术后1年的复发率,预后效果较好,具有较高的临床应用价值,值得推广使用。     

高频超声对Ⅱ型糖尿病周围神经病变患者腓总神经的临床观察

目的 探讨高频超声观察Ⅱ型糖尿病周围神经病变患者腓总神经的临床价值。方法 选取62例2型糖尿病患者,分为周围神经病变组32例和无周围神经病变组30例,并选择同期28例非糖尿病患者作为对照组,应用高频超声观察各组腓管处腓总神经图像变化,测量并比较腓总神经前后径、横径及横截面积,并结合神经电生理检查进行相关性分析。结果 周围神经病变组腓总神经前后径、横径及横截面积较无周围神经病变组和对照组均增大,差异均有统计学意义（均P＜0.05）。糖尿病伴周围神经病变组患者腓总神经的横截面积与腓总神经感觉传导速度呈显著负相关（r=-0.552,P＜0.01）。结论 高频超声能显示糖尿病合并周围神经病变患者腓总神经的异常改变,为临床诊断提供客观依据。     

实时超声弹性成像技术结合TI-RADS标准在甲状腺结节性质鉴别诊断中的应用价值

目的 探讨实时超声弹性成像技术(UE)结合TI-RADS标准在甲状腺结节性质鉴别诊断中的应用价值。方法 选取2015年1月至2016年12月于我院超声科检出的125例甲状腺结节患者作为研究对象。所有患者均经手术及病理证实为甲状腺结节并明确结节性质,共发现190处结节,根据结节直径将所有结节分为<1cm组与≥1cm组,患者均接受常规超声以及UE检查,参考甲状腺影像学报告及数据系统(TI-RADS)以及弹性评分评估结节的性质,构建UE、TI-RADS的工作特征曲线,评估单纯TI-RADS、单纯UE、二者联合对甲状腺结节性质的鉴别诊断价值。 结果 UE诊断甲状腺结节的灵敏度与准确度明显高于TI-RADS,二者联合诊断的灵敏度、特异度、准确度均明显高于单纯应用UE、TI-RADS;<1cm组中UE诊断准确率高于TI-RADS,但在≥1cm组中TI-RADS诊断准确率高于UE;UE构建的ROC曲线下面积明显大于TI-RADS,联合后构建的ROC曲线SAUC明显高于单纯UE、TI-RADS组(P<0.05)。 结论 UE结合TI-RADS标准对甲状腺良恶性结节的鉴别诊断具有较高的准确性,诊断效能高,通过UE结合TI-RADS可相互弥补单一技术在鉴别诊断应用中的缺陷与不足,具有较好的临床应用及推广价值。     

甲状腺乳头状癌的超声征象与颈侧区淋巴结转移的相关性研究

目的 分析甲状腺乳状癌(papillary thyroid carcinoma,PTC)患者颈侧区淋巴结转移(lateral lymph node metastasis,LLNM)的相关危险因子。方法 收集本院2014年1月～2017年1月接受手术治疗的208例PTC患者的病历资料及其肿瘤的声像图资料,就PTC患者中央区淋巴结转移 (central lymph node metastasis ,CLNM)、肿瘤与甲状腺被膜关系、双侧、最大径、多发性、钙化、位置、肿瘤边缘及内部具有丰富血流信号、患者年龄及性别与LLNM之间的关系进行回顾性分析。结果 二项分类Logistic逐步回归分析方法筛选出LLNM的危险因子：CLNM、肿瘤与甲状腺被膜的关系、多发、位于上极、肿瘤边缘及内部具有丰富血流信号,建立回归方程,当预测概率≥0.33时,诊断LLNM的敏感度、特异度分别为92.3%及79.9%,其曲线下面积(area under curve, AUC)值为0.923。当CLNM数目≥3枚时,诊断敏感度、特异度分别为79.7%及91.6%,其AUC值为0.915;当CLNM率≥0.37时,诊断敏感度、特异度分别为87.1%及79.0%,其AUC值为0.882。结论 术前超声检查预评估PTC患者LLNM的发生风险,对指导临床决定是否行治疗性颈侧区淋巴结清扫术具有重要意义。     

超声在颈部淋巴结良恶性鉴别中的研究进展

颈部淋巴结肿大涉及多种疾病,对于肿瘤患者,明确是否具有颈部淋巴结转移,对于治疗方案的选择至关重要。超声检查具有安全方便、经济快捷、可重复性好等优点,随着超声造影、弹性成像技术及超声引导下穿刺活检技术的发展与普及,超声在颈部淋巴结良恶性鉴别中的应用价值日益提高。     

模块化PBL教学法在产前系统超声培训中的应用

目的探讨基于问题的学习模式(PBL)联合模块化教学法在产前系统超声培训中的应用价值。方法纳入2015～2017年在陕西省产前超声培训基地进行规范化培训的陕西省10个市78个县内人民医院及妇幼保健院的360名超声医师为研究对象;对理论笔试及双盲操作考核等进行教学效果评价。结果培训后理论笔试及操作考核成绩均明显提升,培训前后成绩比较差异有统计学意义(P0.05)。结论模块化PBL教学理论与实践紧密结合,有效提升了教学质量和效果。     

超声在新生儿肺炎诊断中的应用

新生儿肺炎作为新生儿常见疾病,严重危害新生儿健康,是导致其死亡的重要原因。目前临床诊断新生儿肺炎的主要方法为X线摄片。随着超声技术的发展,其在肺部疾病诊断中的应用也越来越多。本文就超声在新生儿肺炎的辅助诊断及治疗随访中的应用现状与进展进行综述。     

超声引导下的神经阻滞术临床应用进展

传统的神经阻滞与临床经验密切相关,成功率低、安全性较差。近年来,随着超声技术的快速发展,超声引导下的神经阻滞技术得到了广泛应用与飞速发展。超声引导下的神经阻滞技术的出现已使临床神经阻滞的方式发生了根本性变革。临床医师可以通过超声显像观察外周神经及其周围结构,并在超声实时、动态引导下穿刺到目标神经周围,实施精准地神经阻滞,避免了对周围重要组织结构的损伤,提高了操作的成功率,减少了并发症,并大大提高了阻滞效率。本文将综述超声引导下的神经阻滞术临床应用进展。     

HPAEC-PAD quantification of Haemophilus influenzae type b polysaccharide in upstream and downstream samples

Due to the rapidly increasing introduction of Haemophilus influenzae type b (Hib) and other conjugate vaccines worldwide during the last decade, reliable and robust analytical methods are needed for the quantitative monitoring of intermediate samples generated during fermentation (upstream processing, USP) and purification (downstream processing, DSP) of polysaccharide vaccine components. This study describes the quantitative characterization of in-process control (IPC) samples generated during the fermentation and purification of the capsular polysaccharide (CPS), polyribosyl-ribitol-phosphate (PRP), derived from Hib. Reliable quantitative methods are necessary for all stages of production; otherwise accurate process monitoring and validation is not possible. Prior to the availability of high performance anion exchange chromatography methods, this polysaccharide was predominantly quantified either with immunochemical methods, or with the colorimetric orcinol method, which shows interference from fermentation medium components and reagents used during purification. Next to an improved high performance anion exchange chromatography-pulsed amperometric detection (HPAEC-PAD) method, using a modified gradient elution, both the orcinol assay and high performance size exclusion chromatography (HPSEC) analyses were evaluated. For DSP samples, it was found that the correlation between the results obtained by HPAEC-PAD specific quantification of the PRP monomeric repeat unit released by alkaline hydrolysis, and those from the orcinol method was high (R² = 0.8762), and that it was lower between HPAEC-PAD and HPSEC results. Additionally, HPSEC analysis of USP samples yielded surprisingly comparable results to those obtained by HPAEC-PAD. In the early part of the fermentation, medium components interfered with the different types of analysis, but quantitative HPSEC data could still be obtained, although lacking the specificity of the HPAEC-PAD method. Thus, the HPAEC-PAD method has the advantage of giving a specific response compared to the orcinol assay and HPSEC, and does not show interference from various components that can be present in intermediate and purified PRP samples.     

Efficacy of a high potency O1 Manisa monovalent vaccine against heterologous challenge with a FMDV O Mya98 lineage virus in pigs 4 and 7 days post vaccination

Early protection with a high potency (>6PD₅₀) foot-and-mouth disease (FMD) O₁ Manisa (Middle-East South Asia lineage) vaccine against challenge with O/VIT/2010 (O Mya98 lineage) was tested in pigs. Only two pigs that were vaccinated seven days prior to challenge had any demonstrable antibodies as a result of vaccination at the time of challenge. However, 80% and 60% of pigs that were vaccinated seven and four days prior to coronary band challenge were protected. Vaccination significantly reduced the amount of virus excreted in nasal swabs, saliva and faeces compared to unvaccinated and infected controls. Virus and viral RNA could be detected in some pigs until termination of the experiment 14 days after challenge. Antibodies to the non-structural proteins (NSP) were detected in only one pig that was challenged four days post vaccination (dpv) and transiently in two pigs that were challenged seven dpv at only one time point. For each vaccine and control group, a group of unvaccinated pigs were kept in the same room but with no direct contact with the infected pigs to determine whether vaccination prevented transmission. Despite the presence of live virus and viral RNA in these indirect contact pigs, the groups in contact with the vaccinated and infected pigs did not develop clinical signs nor did they sero-convert. Contact pigs in the same room as unvaccinated challenged controls did show signs of disease and virus infection that resulted in sero-conversion to the NSP. A breach of the wall that separated the two groups at nine days post challenge might have contributed to this finding. This study showed that high potency vaccine can provide protection to pigs soon after vaccination and that aerosol transmission within rooms is a rare event.