A new method for early diagnosis of carcinoma in bile duct-sonography of common bile duct before and after injection of ceosunin.

42 cases of dilatation (7-15 mm) of extrahepatic bile duct after ceosunin injection (cholagogic method) were observed ultrasonographically. Among the 18 cases of testified obstructive lesions of the bile duct, 13 (72%) showed widening of the bile duct with an increase of calibre from 9.8 mm to 11.7 mm, 3 (16%) had no obvious change, and 2 (12%) shrank. Among the 24 cases of non-obstruction 22 (92%) shrank with a decrease calibre from 9.6 mm to 6.3 mm, and 2 (8%) showed no obvious change. After receiving cholagogue, 9 cases of periampullary carcinoma in the obstructive group were confronted with widening of the bile duct calibre. After longitudinal and transverse rotation scanning method was used, 8 of the 9 cases had their tumor mass visualized. Combined cholagogic and rotation scanning methods raised the lesion manifestation rate of lower bile duct from 41% to 88%. A dilated bile duct unable to show shrinkage of calibre after cholagogue injection is believed to be a criterion for judging the presence of     

Transcutaneous ultrasound of the cervical esophagus in patients with esophageal carcinoma.

Transcutaneous ultrasound of the cervical esophagus was performed in 46 patients with esophageal carcinoma and in 35 controls. The former had 24 upper segmental lesions and 22 lower segmental lesions. The level of the sternoclavicular joint was used to divide the esophagus into the upper segmental (USE) and lower segmental esophagus (LSE). The anterior esophageal wall thickness and luminal dimensions were measured before and immediately after phonation. The mean wall thickness in the controls was 1.8 mm before phonation and 2.1 mm after phonation, with a significant difference (t test,P<0.05). The mean wall thickness in the USE carcinoma group was 4.3 mm and 4.4 mm before and after phonation respectively. There was a significant difference between the controis and USE carcinoma groups (t test, P<0.05). The cross sectional area, which was calculated as the product of anteroposterior and lateral diameters, averaged 28 mm~2 before phonation in the controls and increased to 44 mm~2 after phonation (t test, P     

Pasini型显性营养不良型大疱性表皮松解症一家系11例

先证者(Ⅲ8)女,26岁。出生后约10天躯干四肢出现水疱,每于轻微搔抓或摩擦后局部起大小不等的水疱。随年龄增大症状有所加重。伴有剧烈的瘙痒,起疱和瘙痒夏季明显加重,冬天缓解。先证者5岁开始躯干、四肢关节部位出现细小坚实白色的粟丘疹,同时也见许多类似扁平苔藓红白色丘疹,并缓慢增大至直径约10mm大小。查体:发育正常,智力正常。皮肤专科情况:躯干四肢见较多水疱及大疱,全身关节部位可见大小不等分布较密集的粟丘疹。头发分布正常,部分指趾甲呈营养不良改变。先证者白色丘疹损害的组织切片标本光学显微镜显示,存在不成熟的胶原束和不定形…     

恶性胰岛细胞瘤肝转移一例

患者女性 ,6 2岁 ,胰岛细胞瘤切除术后 6年 ,因腹胀、消瘦、发现上腹部巨大包块于 1998年 7月入院。ＣＴ检查见肝内多发低密度灶 ,疑诊转移性病变 ,但定性诊断困难。超声检查见全肝为大小不等的囊肿占据 ,囊壁薄而规整 ,未见实性占位 (图 1)。经超声引导分别对 3个囊肿穿刺抽液行细胞组织活检。从 1个囊内抽出黄色混浊液 ,病理检查为泡沫细胞 ,蛋白浆液 ;另 2个囊内抽出暗红色混浊液 ,内可见间皮细胞 ,少数腺上皮细胞及中性粒细胞。在肝及囊壁取活检 ,组织学检查见肝细胞 ,部分细胞有异型性。以上检查均未见肿瘤细胞 ,诊断仍然不明确。 1周…     

腔内超声对直肠癌术前分期诊断的应用价值

目的:评价腔内超声(ELUS)对直肠癌术前分期诊断的准确性及局限性.方法:对58例直肠癌术前行ELUS检查,参考TNM分期标准进行术前分期诊断,并与手术及术后病理结果对照.结果:ELUS对58例直肠癌浸润深度诊断符合率达79.3%,T1、T2、T3、T4各期诊断灵敏度分别为100%、58.8%、87.5%、83.3%.对T2期诊断灵敏度最低,误诊7例中6例过深判断为T3期,且均为溃疡型腺癌.ELUS对54例直肠癌淋巴结转移诊断灵敏度、特异度、准确度分别为76.9%、75.0%、75.9%.淋巴结转移ELUS漏诊6例,淋巴结转移ELUS诊断假阳性7例.结论:ELUS对直肠癌浸润深度及肠周淋巴结转移诊断准确度较高,可成为直肠癌术前分期诊断良好的方法.对T2期的过深判断为影响诊断符合率的重要因素,肿瘤导致肠腔明显狭窄或肿瘤位于直肠上段也影响ELUS的准确性.     

龙血竭联合磺胺嘧啶锌涂膜治疗糖尿病足溃疡临床疗效

目的观察龙血竭联合磺胺嘧啶锌涂膜外敷治疗糖尿病足溃疡的临床疗效。方法将99例糖尿病足溃疡住院患者随机分为两组,对照组(49例)给予常规消毒及磺胺嘧啶锌涂膜换药、包扎等常规治疗,治疗组(50例)在常规治疗的基础上加用龙血竭外敷治疗。结果治疗组有效率(90.0%)明显高于对照组(69.4%)(P<0.05),治疗组糖尿病足溃疡愈合时间明显短于对照组,差异均有显著性意义(P<0.01)。结论龙血竭联合磺胺嘧啶锌涂膜外敷对糖尿病足溃疡具有促进疮面愈合的作用。     

超声引导射频消融治疗肉瘤肝转移癌的应用价值

[目的]探讨肉瘤肝转移癌进行超声引导射频消融（RFA）治疗的应用价值。[方法]RFA治疗肉瘤肝转移12例共59个瘤灶．平均大小2．5cm。[结果]12例59个病灶肿瘤灭活率为96．6％（57／59）；肿瘤局部复发率为8．5％（5／59）；随访6～49个月，患者中位生存时间为26个月。[结论]射频消融治疗是肉瘤肝转移较为适宜的治疗手段．     

卡介菌多糖核酸联合咪唑斯汀治疗慢性荨麻疹

目的 观察卡介菌多糖核酸联合咪唑斯汀治疗慢性荨麻疹的疗效和安全性。方法 将110例慢性荨麻疹随机分成两组，观察组每2天臀部肌注卡介菌多糖核酸2ml及每天口服咪唑斯汀10nag共4周；对照组仅每天口服咪唑斯汀10n唱，连服4周。结果 观察组总有效率95％，明显高于对照组78％（P〈0．01）。结论 卡介菌多糖核酸联合咪唑斯汀治疗慢性荨麻疹疗效较好且安全性高。     

右室Tei指数评价左向右分流先天性心脏病患者右心室功能的价值

目的 探讨由超声组织多普勒测得的右分流心室Tei指数对左向右先天性心脏病(CHD)患者右心室功能的应用价值.方法 左向右分流CHD患者60例,其中35例为CHD伴有肺动脉高压组,25例为CHD不伴肺动脉高压组,33例为健康对照组.运用超声组织多普勒方法计算右室Tei指数,分析比较各组间Tei指数的差异.结果 CHD肺动...     

二维超声应变成像评价急性心肌梗死患者左室心肌收缩功能

目的应用二维超声应变成像评价急性心肌梗死左心室心肌功能并探讨其临床应用价值。方法急性前壁心肌梗死28例、正常对照组30例,分别记录左心室心尖四腔、三腔、两腔切面图像,应用二维应变软件测量各个节段的二维应变和应变率值,并分析其与左心室收缩末容积（LVEDV）、舒张末容积（LVESV）、室壁运动积分（WMSI）、左心室射血分数（LVEF）的相关性。结果①心肌梗死组梗死节段收缩峰值应变值较对照组明显减低,P〈0．01;而远离梗死区域的心肌应变值与对照组比较无差异;②心肌梗死组LVEF、LVEDV、LVESV、WMSI较对照组明显减低P〈0．01;③收缩峰值总应变、总应变率与LVEF、LVEDV、LVESV、WMSI相关良好。结论二维超声应变成像技术可准确评价急性心肌梗死患者的左心室局部和整体心肌收缩功能。