彩色多普勒超声鉴别良恶性乳腺肿物的应用

目的 探讨彩色多普勒超声鉴别良恶性乳腺肿物的应用。 方法 95例乳腺病变住院患者，首先用二维超声明确肿块部位、形态、大小等一般情况，然后用彩色多普勒血流成像（CDFI）观察，记录血流分级，用频谱多普勒测量病灶内多处血管并记录最高的搏动指数（PI）、阻力指数（RI）和峰值流速等参数。 结果 （1）临床怀疑乳腺肿块95例，超声检出乳腺肿物93例；（2）良性组与恶性组肿物在Adle，分级存在显著性差异（P〈0.05）；（3）频谱分析显示两组间峰值流速、平均流速、PI、RI之间均存在显著性差异（P〈0．05），恶性组均高于良性组。 结论 （1）彩色多普勒超声检出乳腺肿物准确，简便；（2）综合分析和评价CDFI血流Adler分级、肿物内血流速度、PI、RI等指标有助于对乳腺良恶性肿物的鉴别。     

Lactational fenvalerate exposure permanently impairs testicular development and spermatogenesis in mice

Fenvalerate, a widely used synthetic pyrethroid insecticide, has been associated with poor semen quality in human being. However, little is known about the effects of lactational fenvalerate exposure on testicular development and spermatogenesis. The purpose of the present study was to investigate the effects of maternal fenvalerate exposure during lactation on testicular development and spermatogenesis in male offspring. Maternal mice were administered with fenvalerate (60 mg/kg) by gavage daily from postnatal day (PND) 0 to PND21. Lactational fenvalerate exposure markedly decreased the absolute and relative weights of testes and increased the number of apoptotic cells in testes of pups at weaning. Histological examinations showed abnormal seminiferous tubules with large vacuoles or complete spermatogenic failure in testes of fenvalerate-treated mice at weaning. Additional experiment showed that lactational fenvalerate exposure markedly reduced mRNA and protein levels of testicular P450scc, a testosterone (T) synthesis enzyme. Consistent with down-regulation of testicular P450scc, the level of serum and testicular T at weaning was significantly decreased in pups whose mothers were exposed to fenvalerate during lactation. Although the expression of testicular P450scc and serum and testicular T in adulthood restored to control level, the decreased weight of testes and histological changes were irreversible. Importantly, the percentage of mature seminiferous tubules (stages VII and VIII) and the number of spermatozoa were obviously decreased in adult male mice whose mothers were exposed to fenvalerate during lactation. Taken together, these results suggest that lactational fenvalerate exposure permanently impairs testicular development and spermatogenesis.     

失语症及舌三针治疗机理浅析

[目的]概述现代医学和祖国医学对失语症的认识,分析舌三针治疗失语症的机理。[方法]从中西医病因、病理、治法等方面对失语症进行总体论述,进而从穴位分布、经络循行、局部解剖以及实验研究等多角度分析舌三针治疗失语症的机理。[结果]现代医学对失语症分类、机理、评定研究深入,祖国医学侧重治疗,干预手段较多。舌三针穴位,位于咽喉部,与心、脾、肾等多条经络相关,针刺能够改善局部循环,增强神经肌肉兴奋性,对多种生物因子表达有积极的作用,能促进语言功能恢复。[结论]失语症的机制复杂,治疗难度较大,舌三针具有坚实的理论基础和临床疗效,值得传承推广。     

膀胱癌的CT诊断与分期

目的：分析膀胱癌的ＣＴ表现，探讨ＣＴ对膀胱癌分期的作用及鉴别诊断要点。材料和方法：对５０例临床可疑膀胱肿瘤的病人做ＣＴ扫描，其中男４５例，女５例，平均年龄６３岁。全部病例均经手术病理证实，其中４７例为膀胱癌，１例前列腺增生，２例慢性膀胱炎症。结果：ＣＴ检出４６例膀胱癌，敏感性为９７．９％，２例慢性膀胱炎症误诊为膀胱癌，特异性为３３％，准确性为９４％。４６例膀胱癌ＣＴ分期与病理符合３６例，准确率７８．３％。结论：ＣＴ对膀胱壁内浸润程度的区分不够满意，即对癌肿早期分期的准确性受到一定的限制，但对壁外浸润和盆腔侧壁蔓延的估计较准确，并可显示盆腔内肿大的淋巴结。膀胱癌须与慢性膀胱炎、前列腺增生及前列腺癌鉴别。     

HPLC测定丹参益坤口服液中阿魏酸的含量

目的：提高丹参益坤口服液的质量标准。方法：采用HPLC测定丹参益坤口服液中阿魏酸的含量。结果：丹参益坤口服液中阿魏酸的含量在0．0124～0．2477μg线性关系良好,r=0．9999;平均回收率为98．77％,RSD=0．85％。结论：该方法操作易行,稳定可靠,可用于丹参益坤口服液中阿魏酸的含量,以控制该制剂的质量。     

呼吸机撤离指标和撤机方式分析

目的探讨呼吸机通气患者撤机的相关因素及常规撤机指标对撤机的指导意义。方法回顾性分析96例应用机械通气技术的病例,收集各项与撤机相关的因素,并进行统计学分析。结果COPD(慢性阻塞性肺病)患者撤机失败和需要应用撤机技术的比例显著高于外科和其他原因导致的急性呼衰患者,外科术后及其它原因致急性呼吸衰竭患者的血气分析值与拔管时机及呼吸机应用时间长短无明显相关性(P>0.05),而COPD患者撤机后PaCO2潴留与其机械通气时间延长密切相关(P<0.05)。结论目前应用的客观撤机指标对撤机指导意义有限,临床实践中应同时考虑患者全身情况、心理状态及疾病变化等,这对COPD患者尤其重要。     

国内慢性胃炎中医诊疗指南方法学质量与报告质量评价

目的 评价国内慢性胃炎中医诊疗指南方法学质量与报告质量，比较不同慢性胃炎中医诊疗指南异同。方法 以“慢性胃炎”、“慢性浅表性胃炎”、“特殊类型胃炎”、“慢性非萎缩性胃炎”、“慢性萎缩性胃炎”、“指南”等为主题词检索刊载于国内相关数据库发表慢性胃炎中医诊疗指南，以建库至2021年4月15日为检索期限；方法学质量与报告质量评价通过AGREEⅡ与RIGHT准则进行评价。结果 按照纳排标准纳入7部指南，范围和目的评价领域分数61.11%，参与人员领域评价分数44.84%，制订严谨性评价领域分数41.60%，明晰陈述与表达评价领域分数56.15%，应用性评价分数8.21%，编辑独立性分数10.71%；推荐级别B级的指南有5部，推荐级别C级的指南有2部；报告质量中等的指南有1部，报告质量低的指南有6部。结论 国内慢性胃炎中医诊疗指南规范性、严谨性有待加强，中医药指南制定过程中应遵循国际指南规范，突出中医药行业特色，以提高中医药指南质量。     

高效抗凝血杀鼠剂氯鼠酮的性能和应用

要本文报告了抗凝血杀鼠剂氯鼠酮的生物活性和灭鼠性能,观察了实验室和现场大面积推广应用的灭鼠效果。试验结果表明,该药对生物无致癌,畸变和突变反映,对皮肤和粘膜无明显的刺激性,使用安全。现场使用50ppm毒饵,饱和投饵7天,检查校正灭鼠率为95.22～96.5％。3年多来,通过全国几个省市大面积灭鼠效果考核,结果证明,该药对鼠类毒力强,使用浓度低,适口性好,杀灭鼠种广谱,灭鼠效果好,成本较低,有推广使用价值。     

Investigation Into the Impact of Diagnostic Ultrasound with Microbubbles on the Capillary Permeability of Rat Hepatomas

Ultrasound-targeted microbubble destruction (UTMD) takes advantage of transiently increased capillary permeability to enhance the release of tumor-specific drugs from blood vessels into sonicated tumor tissues. However, the application of focused ultrasound is limited because of the lack of an appropriate image-monitoring system. In this study, hepatoma-bearing Sprague-Dawley rats were insonicated with low-frequency diagnostic ultrasound and injected with Evans Blue (EB) dye and microbubbles through their tail veins to test changes in capillary permeability. We studied how the mechanical index, sonication duration and the injected microbubble (MB) concentration affect the hepatoma vascular permeability by quantitatively evaluating the EB delivery efficiency. Confocal laser scanning microscopy was used to observe the deposition of red fluorescence–dyed EB in tumor tissues. In addition, P-selectin, a type of biochemical marker that reflects vascular endothelial cell activation, was identified using an immunoblotting analysis. The experimental results reveal that EB delivery efficiency in tumor tissues was greater in groups with the diagnostic ultrasound–mediated UTMD (8.40 ± 0.71 %ID/g) than in groups without UTMD (1.73 ± 0.19 %ID/g) and EB delivery efficiency could be affected by MI, sonication duration and MB dose. The immunoblotting analysis indicates that diagnostic ultrasound–induced UTMD results in the vascular endothelial cell activation to increase capillary permeability, justifying the high quantity of EB deposited in tumor tissues.     

全身麻醉下局部肿胀液注射联合手术切除术治疗体表神经纤维瘤患者的护理

目的探讨全身麻醉下局部肿胀液注射联合手术切除术治疗神经纤维瘤病的有效护理措施。方法回顾性分析2009年9月至2011年5月在哈尔滨医科大学附属第四医院治疗的9例神经纤维瘤病患者的临床资料,总结其护理方法。结果 9例患者术中出血量少,术野清晰,术后无术区血肿等并发症发生,切口均一期愈合,随访3~12个月,肿瘤均未复发,患者自觉外观及肢体运动功能较术前明显改善。结论全身麻醉下局部肿胀液注射联合手术切除术治疗能够提高神经纤维瘤患者治疗效果,减少并发症的发生率。