摘要:目的: 探讨产前超声检查对胎儿前脑无裂畸形的诊断及鉴别价值。 方法 :对我院产前超声筛查中发现的17例胎儿前脑无裂畸形的超声声像图及引产后的尸检资料进行回顾性对照分析。 结果 :产前超声诊断的17例前脑无裂畸形全部经引产后尸检证实,颅脑异常的声像图表现为单一脑室、丘脑融合及脑镰、胼胝体等中线结构缺如,大多数病例均伴有不同程度的颜面部畸形。 结论 :产前超声对前脑无裂畸形具有重要的诊断价值,该病特有的颅脑声像图特征及大多伴有颜面部畸形的特点有助于诊断及鉴别诊断。Abstract: Objective: To explore the diagnostic and differential diagnostic value of prenatal ultrasound in fetal holoprosencephaly. Methods : The sonograms and autopsy data of 17 cases of fetal holoprosencephaly found in 21568 pregnant women by prenatal ultrasound were analyzed retrospectively. Results : Seventeen cases of fetal holoprosencephaly diagnosed by prenatal ultrasound and autopsy were confirmed. Characteristic ultrasound findings in holoprosencephaly included a single primitive ventricle, fused thalami, absence of midline structures such as the falx cerebri and corpus callosum, and facial abnormalities. Conclusion : Prenatal ultrasound has important value in the diagnosis of fetal holoprosencephaly. The characteristic ultrasound findings of the intracranial and facial abnormalities are helpful for the diagnosis and differential diagnosis of holoprosencephaly.
目的 研究汶川地震后精神伤害对院前急救的影响。 方法 对2010年10月1日－2012年10月31日院前急救患者的地震后家庭成员状况、精神伤害情况及病情程度进行回顾性病例对照分析。共有446例患者纳入研究，男278例，女188例；年龄（41.4 ± 2.8）岁。依据家庭成员遇难状况分3组，A组（家庭成员在地震中遇难）25例，B组（家庭成员在地震中受伤，无遇难情况）127例，C组（地震家庭成员完好）314例。 结果 各组患者最常见的精神伤害状况是焦虑（A组96.0%，B组71.7%，C组40.8%）、过度警惕（A组92.0%，B组70.9%，C组50.0%），差异有统计学意义（P＜0.001）。A组患者要求到上级医院继续治疗率较高（A组56.0%，B组39.4%，C组8.9%），组间差异有统计学意义（P＜0.001）。 结论 地震给人们的精神创伤较重，至今仍然普遍存在，并对患者的就医活动产生影响。提示在北川县院前急救工作中需要考虑患者的精神伤害情况。
近年来,胃癌研究发展迅速,许多先进技术和治疗理念逐渐引入外科领域并为大家接受,以手术为主,辅以化疗、生物靶向治疗的综合治疗观念已经建立,成为主导趋势,现就这方面的问题予以讨论,并与同道商榷.……
Objective To find out what risk factors are related to hypertension in China, and whether there are differences in studies from different years. Methods We retrieved all of the hypertension-related case-control studies which were published in CNKI and PubMed since 1990 and used meta-analysis to calculate the pooled OR and 95%CI. Then all the studies were divided into two groups according to whether they were published before 2000 or after, and results of different group were compared. Results Fourteen studies were included in which the relationship was assessed between hypertension and risk factors such as drinking, smoking, being overweight, and other relevant risk factors. The results of meta-analysis showed that hypertension had a relationship with being overweight, family history of hypertension, and high salt intake. The pooled OR and 95%CI were 3.26 (2.87, 3.70), 4.79 (2.81, 8.14), and 2.33 (1.55, 3.51), respectively. And the same results were obtained in subgroups analysis. The effect of smoking, irritable personality, and literacy between case group and control group showed no significant difference. Their pooled OR values (95%CI) of smoking, irritable personality, and literacy were 1.20 (0.84, 1.72), 2.73 (0.76, 9.82), and 1.22 (0.51, 2.95), respectively, and the same results were obtained in subgroups analysis. Although the effect of drinking between case group and control group showed a difference, its OR value (95%CI) was 1.61 (1.06, 2.45), and the subgroup analysis showed drinking was not related to hypertension. Conclusion Being overweighed, family history of hypertension, and high salt intake have relationship with hypertension, and these conclusions do not differ depending on the time of the studies conducted.
Objective To summarize progress on diagnosis and treatment of advanced gastrointestinal stromal tumor (GIST). Method Through the retrieval of relevant literatures, the advances in the diagnosis and treatment of advanced GIST in recent years were reviewed. Results The diagnosis of advanced GIST mainly depends on imaging examination such as CT, MRI and endoscopy or endoscopic ultrasound. The diagnosis can be confirmed by needle biopsy for advanced GIST patients considering preoperative imatinib treatment. At present, the imatinib is the first-line therapy for patients with advanced GIST, followed by sunitinib and other novel targeted drugs. A multidisciplinary treatment strategy that included targeted therapeutic agents, combining with surgical resection, radiofrequency ablation and embolism chemotherapy have brought dramatic clinical benefit for advanced GIST. Conclusions GIST is easy to metastasis, clinicians should ensure early diagnosis and early treatment. In course of imatinib treatment, an individualized therapeutic regimen should be applied to treat advanced GIST based on specific situation of patients.
【摘要】 目的 探讨超声检查对阴道斜隔综合征的诊断价值，分析超声图像特点，提高诊断率，为临床选用最佳的手术方式提供依据。 方法 回顾性分析2008年1月-2010年6月经手术确诊为阴道斜隔综合征的15例患者的临床资料及超声检查结果，总结阴道斜隔综合征的声像图特点。 结果 15例经临床确诊为阴道斜隔综合征的患者，超声诊断14例，均表现为双子宫、双宫颈、阴道或宫颈积液/血，9例左肾缺如，5例右肾缺如。误诊1例，为单子宫伴一侧附件巨大囊肿。 结论 超声具有诊断准确、简便、无创、重复性好、价格实惠等优点，对于临床诊断生殖系统畸形具有十分重要的意义，应列为首选检查方式。【Abstract】 Objective To investigate the diagnostic value of ultrasonography in examining oblique vaginal septum syndrome, analyze the characteristics of ultrasound image to improve the ultrasound diagnosis rate, in order to provide guidance for clinical surgeries. Methods We retrospectively analyzed the clinical data and ultrasound examination results of 15 patients diagnosed to have oblique vaginal septum syndrome in our hospital, and summarized their ultrasonographic characteristics. Results Among the 15 patients, 14 were diagnosed to have the disease by ultrasound examination. The ultrasound image showed a double uterus, double cervix, and vaginal or cervical fluid or blood for all the patients among whom 9 had absent left kidney, and 5 had absent right kidney. One patient was misdiagnosed to have single uterus with giant cysts on one side. Conclusions Ultrasound diagnosis is simple, noninvasive, reproducible, affordable and accurate in diagnosing. It is very useful in clinical diagnosis of reproductive system abnormalities and should be listed as the preferred way of examinations.
Objective To investigate the impacts of cytokines （interleukin-4，IL-4；tumor necrosis factor-α，TNF-α） and medications of bronchial asthma （dexamethasone，aminophylline，salbutamol） on the activity of histamine N-methyltransferase（HMT） in tracheal epithelial cells.Methods BEAS-2B bronchial epithelial cells were cultured and treated with different concentration of TNF-α, IL-4, dexamethasone, salbutamol and aminophylline respectively. The activity of HMT in BEAS-2B cells was determined by high performance liquid chromatography.Results The activity of HMT in tracheal epithelial cells was (50±7) pmol?min-1?mg pro-1.TNF-α and IL-4 lowered the activity of HMT significantly at the concentration equal to or higher than 1 ng/mL and 5 ng/mL respectively，and reached the maximum inhibitory effect at the level of 10 ng/mL.Dexamethasone and aminophylline could ameliorate distinctly the inhibitory effect of TNF-α on the activity of HMT, while salbutamol had no significant inhibitory effect.Conclusions TNF-α and IL-4 exert the lowering effect on the activity of HMT，which would be one important cause of airway hyperreactivity.Glucocorticoids and theophyllines are administered to treat asthma partly due to its relieving mechanism of TNF-α negative effects on HMT.
Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression. Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined. Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect. Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.